Tuesday, December 27, 2011

What is CME Cystoid Macular Edema?

CME, or cystoid macular edema, is a painless disorder of the central retina or macula. When CME is present, multiple cyst-like areas of fluid appear in the macula and cause swelling of the retina, or edema. The exact causes of CME are unknown, but it does accompany a variety of diseases such as retinal vein occlusion, uveitis, age related macular degeneration, or diabetes. CME has also been linked to eye injury and can be a side effect of medication. CME most commonly occurs after cataract surgery. If a patient gets CME in one eye, there is up to a 50% that it will affect the second eye.

Symptoms of CME included blurred or decreased central vision; however, most patients recover their vision with treatment. The treatment for CME varies depending on what appears to have caused it. Retinal inflammation can be treated with anti-inflammatory medications that include steroid eye drops, pills, or local injections. Diuretics can help reduce the swelling in some cases. If the vitreous is believed to be the source of the issue, then surgery to remove the vitreous, called a vitrectomy, may be required. CME can bring on glaucoma; if this happens, the glaucoma must be treated with medications to reduce pressure.


Thursday, December 22, 2011

Billing for Eye Refractions

An eye refraction is one of the most basic components of most eye exams, yet from a billing standpoint, can be one of the most controversial. An eye refraction is the process of making a clinical decision for prescribing a prescription lens. A manifest refraction is an undilated test; that is, it is done without dilating drops, and allows the crystalline lens of the eye to accommodate. This allows the eye to be examined in its natural state. A manifest refraction is a very subjective test; that is, it's based on the patient’s answer of what looks best to them. A cycloplegic refraction uses cycloplegic drugs to paralyze the ciliary muscles of the eye. This temporarily stops the patient’s ability to accommodate and allows for a more precise refraction. Many cycloplegic drops also dilate the pupil, making it easier for the physician to see the back of the eye and diagnose any retinal issues.

From an insurance standpoint, eye refractions are considered part of a routine eye exam. Because refractions are normally used to determine refractive errors such as myopia, hyperopia, and astigmatism, and therefore prescribe glasses or contact lenses, many insurance companies, particularly Medicare and Medicaid, do not pay for them. It's important to convey that to patients when they are having their eye exam. Refractions are a necessary part of a routine eye exam and must be paid for out of pocket.

If you have any questions regarding your current glasses or contact lens prescription, please contact Eyecare Medical Group at 1-888-374-2020.


Tuesday, December 20, 2011

Contact Lenses in Maine

Contact lenses are lenses placed on the cornea generally for the purpose of vision correction. They are used as an alternative to glasses for millions of people. It is estimated that 125 million people worldwide are contact lens users.


Contact lenses generally correct refractive errors, such as myopia, hyperopia, or astigmatism. They are also used therapeutically to treat such diseases as keratoconus, and have been used for cosmetic purposes as well, to change the color or appearance of the eye. Contact lenses vary in many different ways, including the material that they are made up of. There are hard, gas permeable and soft contact lenses. The majority of people who wear contact lenses wear soft lenses because they are immediately comfortable, as opposed to gas permeable lenses, which require some getting used to. Soft contact lenses also have more oxygen permeability and are easier to wear.

Contact lenses are broken down into two categories- daily wear lenses and extended wear lenses. Daily wear lenses are he most popular type of contact lens and are made to be worn during waking hours and taken out before an individual goes to bed at night. Extended wear contact lenses can be kept in over night and worn for periods of up to 30 days but patients who use extended wear lenses tend to have a higher incidence of corneal infections and ulcers.

Contact lens replacement is determined by the manufacturer of the lens. There are daily contact lenses that are thrown away each day and a new lens is inserted the next day. Typically, soft contact lenses last between 2 and 4 weeks, although hard lenses could be worn up to 10 years, and gas permeable lenses are durable to be worn for several years.

If you are in need of contact lenses, please contact Eyecare Medical Group at 1-888-374-2020.


Thursday, December 15, 2011

The Importance of Corneal Topography

Corneal topography is a vital diagnostic tool in any ophthalmology practice. Since the majority of the refractive power of the eye is in the cornea, topography can be critical in determining the quality of a patient’s vision.


Corneal topography maps the curvature of the cornea by using a special camera that photographs a pattern of concentric lighted rings onto the corneal surface. Several maps are produced that carry different information. The images are analyzed to produce a detailed map of the cornea and are useful in showing areas that are irregular or steeper or flatter than others. It can help diagnose diseases such as keratoconus. Corneal topography is also important in picking intraocular lenses for cataract surgery, and for planning refractive surgeries such as LASIK, as well as assessing their outcomes.

Corneal topography is an essential element of a LASIK screening. If you are interested in having LASIK surgery, please call Eyecare Medical Group at 1-888-374-2020 to set up a free screening.


Tuesday, December 13, 2011

What is Uveitis Inflammation?

Uveitis is the inflammation of the uvea. The eye is made up of three different layers of tissue- the innermost layer is the retina, the middle layer is the uvea, and the outermost layer is the sclera. The uvea contains the veins and arteries that carry blood flow to the eye. Because it nourishes many important parts of the eye, including the retina, inflammation of the uvea, or uveitis, can damage your sight.

Symptoms of uveitis include light sensitivity, pain, redness of the eye, and blurring of vision. Uveitis can come on suddenly either with redness and pain or with a painless blurring of vision.

Uveitis can be caused by many different things. Viral infections, such as herpes, can cause uveitis, as well as fungi such as histoplasmosis or parasites such as toxoplasmosis. Disease in other parts of the body, like arthritis or bacteria such as syphilis are also causes of uveitis. Uveitis can even occur as a result of an eye injury.

Uveitis is a serious condition that can scar the eye and should be treated immediately. Eye drops can help inflammation and pain caused by uveitis. Uveitis can exacerbate existing eye conditions such as glaucoma, cataracts, or neovascularization, so it is important to seek treatment if you believe you have uveitis.


Friday, December 9, 2011

Blepharitis: What is it?

Blepharitis is a common condition of the eyelids and eyelash follicles. It is caused by a buildup of normal bacteria found on the skin and is characterized by redness of the eyelid, flaking of the skin on the eyelids, or crusting on the eyelids. Blepharitis is not serious, although it can be the cause of other eye issues such as styes and chalazia.

Diagnosing blepharitis is fairly easy and generally done through a routine eye examine. Eye doctors use a slit lamp to look at the eyelids and lashes to identify any problems. Treatment of blepharitis is fairly simple. Proper cleansing of eyelids and margins is important, and baby shampoo is often recommended as a cleanser. Warm compresses are a common treatment to help soften build up debris on the eyelids and lashes. In some cases, an antibiotic solution is prescribed to help clear up blepharitis.


Tuesday, December 6, 2011

Meet Sonja Laiho!

Sonja has been in ophthalmology for 21 years. She currently works for Dr. Bruce Cassidy and has been with EMG for about a year and a half. She previously worked for EMG in 2003-2004 before moving to California.

Sonja started in ophthalmology 21 years ago as a certified scrub tech. During the past 21 years, all but 5 were spent in ophthalmology. She took a 5 year break and worked for Youth Alternatives at a group home for at risk and homeless youth. She’s currently a COA, or certified ophthalmic assistant. Sonja has worked for several physicians in her tenure in ophthalmology, and has worked in Maine, Vermont, and California as an ophthalmic assistant. She worked for Dr. Jack Singer in Randolph, Vermont, who was one of the doctors that was part of the FDA clinical trials for the Crystalens. Sonja even got to meet Dr. Stuart Cumming, the inventor of the Crystalens, when she worked for Dr. Singer.

Sonja has been very active with Project Guatemala, a medical mission to give the gift of sight to the Indigenous and Mayan people of Guatemala. Sonja has participated in the mission all but 2 years since she started going to Guatemala in 1998.

We’re happy to have Sonja and all of her ophthalmic experience back at EMG!


Thursday, December 1, 2011

What is Glaucoma?

Glaucoma is a disease of the optic nerve, the part of the eye that carries the images that we see to the brain. This damage is often caused by increased pressure to the eye, otherwise known as intraocular pressure (IOP). Pressure in the eye increases when aqueous humor, the clear liquid inside the eye, becomes blocked and excess fluid cannot flow out of the eye. This fluid pushes against the optic nerve, causing damage.

There are four major types of glaucoma, as the disease can manifest itself in different ways. Symptoms include blurred vision, severe eye pain, headache, halos around lights, and nausea and vomiting. Glaucoma is one of the leading causes of vision loss in the United States, but is easily detectable through a routine eye exam with an optometrist or ophthalmologist. There are risk factors, such as age, ancestry, and other systemic health problems that put individuals at a higher risk for the disease.

Damage caused by glaucoma is not reversible; however, there are steps that can be taken to prevent further damage to the optic nerve. Eye drops to lower IOP are common for those who suffer from glaucoma. There are also several different surgeries that can be done to create new drainage within the eye and help control eye pressure. “Medications to treat glaucoma must be taken exactly as prescribed, and patients must make sure they continue to be seen for follow up exams,” says Dr. Samuel Solish, Glaucoma and Cataract Surgeon at Eyecare Medical Group.

If you have a family history of glaucoma, or are at an increased risk for the disease due to other factors, now is the time to call for a glaucoma screening.