Thursday, May 31, 2012

Autofluorescence Imaging in Maine

Autofluorescence Imaging in Maine is a test we at Eyecare Medical Group to evaluate diseases and problems of the Retina. Darrin Landry, the photographer here at Eyecare Medical Group in Portland, ME, wrote this article to help us better understand autofluorescence imaging.

A Retina Specialist has a large arsenal of imaging technology to better evaluate retinal disease, and one of the newer technologies used to monitor the dry type of macular degeneration is autofluorescence imaging.

Dry macular degeneration is typically a progressive degenerative process that affects the central part of the retina, called the macula, which is where fine vision, such as reading, takes place. Currently only the wet form of macular degeneration can be treated, but the progression of atrophy in dry macular degeneration can be followed with autofluorescence imaging.
The retina is imaged utilizing a scanning laser with certain wavelength filters. In a normal eye, a substance called lipofuscin, which exists in cells in a layer of the retina, emits a fluorescent light when exposed to this specific wavelength of light.  In cases of atrophic retinal disease, such as dry macular degeneration, the damaged cells block the emittance of this fluorescent light. The result is a dark area in the macula. This damaged area can be followed, and using computer software, can be quantitatively measured for change.

Autofluorescence imaging is very useful for diagnosis in patients with vision loss, and we are starting to understand that certain inherited disorders have distinctive patterns of change. The ability to monitor and track changes at this cellular level gives us valuable information in the prognosis of some of these retinal diseases.
Normal Image



Damaged cells in the center of the macula

Damaged cells in the center of the macula
Change in damaged cells from first visit (on left) to second visit (on right)
Eyecare Medical Group is a leading ophthalmology practice in Portland, Maine staffed by a team of eye care specialists including eye doctors who are fellowship trained glaucoma specialists, retina specialists, cornea specialists and cataract and lens implant specialists-all board certified Ophthalmologists-as well as Optometrists, Opticians, technical and administrative staff who provide eye examinations for adults and children, cataract surgery and intraocular lens implants, (IOL,   laser vision correction such as LASIK, diagnosis and treatment of cornea disease including cornea transplants, care for diseases of the retina including diabetes and age related macular degeneration and diagnosis and treatment of glaucoma.

Eyecare Medical Group is conveniently located for patients from throughout Maine including Auburn, Augusta, Bangor, Bath, Berwick, Biddeford, Bridgeton, Brunswick, Cape Neddick, Casco Bay, Cumberland Center, Eliot, Freeport, Gardiner, Kennebunk, Kennebunkport, Kittery, Lewiston, Old Orchard Beach, Sanford, Scarborough, South Portland, Springvale, Topsham, Waterville, Westbrook, Winslow, Wiscasset, Yarmouth, Portland, Skowhegan and York Maine.


Tuesday, May 29, 2012

Maine Cataract Surgery & Near Vision

Maine Cataract Surgeon Bruce Cassidy, M.D. commented, “Monovision Cataract Surgery is a technique that is used to help patients increase their range of clear vision after a Cataract operation. The technique of monovision has been used for many years by contact lens wearers as well as patients with presbyopia having Laser Eye Surgery for the Laser Vision Correction of nearsightedness, farsightedness and astigmatism.” The monovision technique is simply adjusting the optical correction in each eye so that the dominant eye is corrected for clear distance vision and the non-dominant eye is corrected for improving near or intermediate range vision. For patients who have been wearing monovision contact lenses successfully or who have had monovision LASIK and are pleased with the vision, taking the step into monovision Cataract Surgery is a natural progression. For others, they must consider the possible benefits as compared to those provided by near vision presbyopia correcting multifocal lens implants as some 30% of monovision patients fail to adapt adequately to the “blended” vision. Researchers reporting in the May 2011 Journal of Refractive Surgery studied the optimal monovision prescription that should be used in order to get the highest levels of patient acceptance and overall visual acuity and depth perception. They concluded that the prescription range of 1.00 D-2.00 D of monovision correction was the maximum range and that the optimal prescription for monovision Cataract Surgery was 1.5 D. While this is useful information, patients should understand that a 1.5 D near correction may very well be insufficient for them to perform their daily tasks comfortably without needing readers or bifocals. The only reliable way for you or someone you know with a Cataract to find out if you are candidates for monovision Cataract Surgery or near vision presbyopia correcting lens implants after Cataract Surgery is to schedule a Cataract and Lens Implant evaluation at Eyecare Medical Group at 888-374-2020 or visit www.eyecaremed.com or www.facebook.com/eyecaremedicalgroup.

Eyecare Medical Group is a leading ophthalmology practice in Portland, Maine staffed by a team of eye care specialists including eye doctors who are fellowship trained glaucoma specialists, retina specialists, cornea specialists and cataract and lens implant specialists-all board certified Ophthalmologists-as well as Optometrists, Opticians, technical and administrative staff who provide eye examinations for adults and children, cataract surgery and intraocular lens implants, (IOL), laser vision correction such as LASIK, diagnosis and treatment of cornea disease including cornea transplants, care for diseases of the retina including diabetes and age related macular degeneration and diagnosis and treatment of glaucoma.

Eyecare Medical Group is conveniently located for patients from throughout Maine including
Auburn, Augusta, Bangor, Bath, Berwick, Biddeford, Bridgeton, Brunswick, Cape Neddick, Casco Bay, Cumberland Center, Eliot, Freeport, Gardiner, Kennebunk, Kennebunkport, Kittery, Lewiston, Old Orchard Beach, Sanford, Scarborough, South Portland, Springvale, Topsham, Waterville, Westbrook, Winslow, Wiscasset, Yarmouth, Portland, Skowhegan and York Maine.


Thursday, May 24, 2012

Eye Allergies for Maine Patients

“Eye allergy problems such as allergic conjunctivitis are extremely common in Maine, especially in the summertime when pollen counts are high” says Jordan Sterrer, M.D. Cataract and Refractive surgeon at Eyecare Medical Group in Portland, Maine. “A thorough medical history is important in determining where the allergies are coming from and what can be done to alleviate those symptoms,” said Dr. Sterrer. The itchy, red and swollen eyes that are characteristic of allergic conjunctivitis can be attributed to many different factors, so in order to treat patients properly, it’s important to find out what triggers their allergies. The April 2012 issue of Ophthalmology Management, “The Top 10 Questions for Ocular Allergy Patients”, discusses how patients can avoid allergy flare ups:
  • Don’t rub your eyes
  • Wash your hands regularly
  • If your allergies are bad in the morning, check your pillows for down or feather pillows and switch them to allergy free pillows
  • During your worst allergy season, remain indoors as much as possible, with filtered air conditioning
  • If your allergies are exclusive to your eyes, use allergy eye drops. Likewise, if limited to your nose and sinuses, use nasal sprays. 
  • Avoid OTC remedies that “get the red out”
  • Chill your drops to provide added comfort and efficacy
  • Use cool compresses to alleviate symptoms
  • Use your allergy eye drops before visiting places that tend to trigger your allergies rather than waiting until after your eyes are red, itchy, and swollen
  • Put your pet out of the house or at least out of your bedroom
  • Know your own sensitivities and avoid contact when possible, especially when pollen counts are high.
It is important for the physician and patient to identify what the causes of the ocular allergies are such as pollens, pets, mold, dust, chemicals, or foods? Once this has been determined, the allergen should be avoided when possible, and medications to treat them should be taken before exposure. It is also important to determine what time of year allergies are at their worst, which will help determine what the cause of the allergies may be, and help patients get ahead of itchy red eyes by starting on eye drops early.

If you suffer from allergic conjunctivitis and are looking from relief from itchy, red, swollen eyes, please call Eyecare Medical Group at 1-888-374-2020 to set up an appointment with one of our physicians.

Eyecare Medical Group is a leading ophthalmology practice in Portland, Maine staffed by a team of eye care specialists including eye doctors who are fellowship trained glaucoma specialists, retina specialists, cornea specialists and cataract and lens implant specialists-all board certified Ophthalmologists-as well as Optometrists, Opticians, technical and administrative staff who provide eye examinations for adults and children, cataract surgery and intraocular lens implants, (IOL), laser vision correction such as LASIK, diagnosis and treatment of cornea disease including cornea transplants, care for diseases of the retina including diabetes and age related macular degeneration and diagnosis and treatment of glaucoma.

Eyecare Medical Group is conveniently located for patients from throughout Maine including Auburn, Augusta, Bangor, Bath, Berwick, Biddeford, Bridgeton, Brunswick, Cape Neddick, Casco Bay, Cumberland Center, Eliot, Freeport, Gardiner, Kennebunk, Kennebunkport, Kittery, Lewiston, Old Orchard Beach, Sanford, Scarborough, South Portland, Springvale, Topsham, Waterville, Westbrook, Winslow, Wiscasset, Yarmouth, Portland, Skowhegan and York Maine.


Tuesday, May 22, 2012

Maine Corneal Specialist on Herpes Eye Infections

Maine Corneal Specialist Ravi Shah, M.D. of Eyecare Medical Group in Portland commented on Herpes Simplex eye infections. “Herpes Simplex eye infections affect many more people each year than one might think. Ocular Herpes or Herpes of the eye is caused by the Herpes Simplex Virus and is the most common causes of corneal blindness in the United States today, “ stated Dr. Shah. “Up to 50% of people who have a single Herpes Simplex viral infection of the eye will experience a flare up or recurrence. The virus can often lead to irreversible scarring of the cornea with a loss of vision and even the need for a corneal transplant.”

Ocular Herpes may start as a painful sore on the eyelid or surface of the eye. If left untreated, it may multiply and begin to destroy epithelial cells and progress deeper into the cornea. If the Ocular Herpes penetrates the deeper layers of the cornea and causes a stromal keratitis it may cause corneal scarring-so prompt diagnosis and treatment of Ocular Herpes is important.

It is estimated that 400,000 people in the United States have had some type of Ocular Herpes, with more than 50,000 initial and recurring cases being diagnosed each year. Of these, it is believed that 25% are the more severe form of Herpes Stromal Keratitis. The recurrence of Herpes Simplex eye infections is significant in that it appears to recur in about 10% of patients with one year, 23% of patients within two years and 63% of patients within 20 years of their initial infection. Sometimes a recurrence can be prompted by sunlight, stress, fevers or an unrelated eye injury. Quick diagnosis and treatment is the key to avoiding corneal scarring, vision loss and the possible need for a corneal transplant.

If you or someone you know is experiencing any signs or symptoms of corneal infection-especially if they have had any trauma to their eyes-please call Eyecare Medical Group at 888-374-2020 and request an immediate appointment.

Eyecare Medical Group is a leading ophthalmology practice in Portland, Maine staffed by a team of eye care specialists including eye doctors who are fellowship trained glaucoma specialists, retina specialists, cornea specialists and cataract and lens implant specialists-all board certified Ophthalmologists-as well as Optometrists, Opticians, technical and administrative staff who provide eye examinations for adults and children, cataract surgery and intraocular lens implants, (IOL), refractive laser eye surgery such as LASIK for vision correction, diagnosis and treatment of cornea disease including cornea transplants, care for diseases of the retina including diabetes and age related macular degeneration and diagnosis and treatment of glaucoma.

Eyecare Medical Group is conveniently located for patients from throughout Maine including Auburn, Augusta, Bangor, Bath, Berwick, Biddeford, Bridgeton, Brunswick, Cape Neddick, Casco Bay, Cumberland Center, Eliot, Freeport, Gardiner, Kennebunk, Kennebunkport, Kittery, Lewiston, Old Orchard Beach, Sanford, Scarborough, South Portland, Springvale, Topsham, Waterville, Westbrook, Winslow, Wiscasset, Yarmouth, Portland, Skowhegan and York Maine.


Sunday, May 20, 2012

Employee Appreciation Week at EMG

Every year, Eyecare Medical Group honors its employees with a weeklong celebration filled with fun games, delicious food, and gifts. Prizes are awarded, gift cards are given out, and career milestones are celebrated at the 5th, 10th, 15th, 20th, and 25th. This year, the following employees were honored:


25 Years
Phil Chin, Ann Kidd & Jean Proctor

20 Years
Sue Blanchard, Deana MacPherson, Nancy Mason & Gretel Taska

15 Years
Sue Bowen & Tammy Desjardin

10 Years
Liz Kennedy

5 Years
Erica Dallaire, Linda Deshaies, Johanna Dresser, Erica Mitchell, Tammy Mulholland & Cheryl Palmer

Thank you for ALL of your hard work and dedication!

Eyecare Medical Group is a leading ophthalmology practice in Portland, Maine staffed by a team of eye care specialists including eye doctors who are fellowship trained glaucoma specialists, retina specialists, cornea specialists and cataract and lens implant specialists-all board certified Ophthalmologists-as well as Optometrists, Opticians, technical and administrative staff who provide eye examinations for adults and children, cataract surgery and intraocular lens implants, (IOL), laser vision correction such as LASIK, diagnosis and treatment of cornea disease including cornea transplants, care for diseases of the retina including diabetes and age related macular degeneration and diagnosis and treatment of glaucoma.

Eyecare Medical Group is conveniently located for patients from throughout Maine including Auburn, Augusta, Bangor, Bath, Berwick, Biddeford, Bridgeton, Brunswick, Cape Neddick, Casco Bay, Cumberland Center, Eliot, Freeport, Gardiner, Kennebunk, Kennebunkport, Kittery, Lewiston, Old Orchard Beach, Sanford, Scarborough, South Portland, Springvale, Topsham, Waterville, Westbrook, Winslow, Wiscasset, Yarmouth, Portland, Skowhegan and York Maine.


Tuesday, May 15, 2012

Maine Doctor on Watery Eyes

“Throughout the year in Maine it is not uncommon to have patients ask about watery eyes or excessive watering of the eyes can even have tears running over their eyelids and down their cheeks,” commented Maine Ophthalmologist Jordan Sterrer, M.D. of Eyecare Medical Group. Watery eyes are the common description for the eye condition called Epiphora. Having enough tears is important for your eye health and vision but having too many tears can be annoying and troubling. Watery eyes or Epiphora can be caused by either or both of two main eye problems. First, watery eyes can occur because you simply produce too many tears. Second, eye watering can occur because the tears you do produce just don’t drain properly. As odd as it may seem, one of the most common causes of producing too many tears is dry eyes. When you have a dry eye your eye can “overreact” and produce too much tear fluid due to the irritation. Then, normally when we blink the eyelids push the tears across the eye’s surface, causing them to collect in the lower inner corner of the eye and draining through a tiny opening called a “puncta” into the nasolacrimal canal and out through your nose. If the puncta are closed or the canal is blocked the tears will simply stay stagnant in the inner corners of your eyes making them seem very watery.

So why do we develop tear drainage problems or excessive tear production problems? There are many causes of watery eye and watering eyes are pretty common in people who have dry eye syndrome, clogged tear ducts from infection of inflammation, conjunctivitis or “pink eye”, exposure to irritation from smog, smoke, excessive dust and chemical vapors as well as foreign bodies, eyelid problems turning in or out and corneal abrasions.

If you or someone you know suffers from watery eyes or is bothered by watering eyes please call Eyecare Medical Group at 888-374-2020 to schedule an appointment for an examination.

Eyecare Medical Group is a leading ophthalmology practice in Portland, Maine staffed by a team of eye care specialists including eye doctors who are fellowship trained glaucoma specialists, retina specialists, cornea specialists and cataract and lens implant specialists-all board certified Ophthalmologists-as well as Optometrists, Opticians, technical and administrative staff who provide eye examinations for adults and children, cataract surgery and intraocular lens implants, (IOL), laser vision correction such as LASIK, diagnosis and treatment of cornea disease including cornea transplants, care for diseases of the retina including diabetes and age related macular degeneration and diagnosis and treatment of glaucoma.

Eyecare Medical Group is conveniently located for patients from throughout Maine including Auburn, Augusta, Bangor, Bath, Berwick, Biddeford, Bridgeton, Brunswick, Cape Neddick, Casco Bay, Cumberland Center, Eliot, Freeport, Gardiner, Kennebunk, Kennebunkport, Kittery, Lewiston, Old Orchard Beach, Sanford, Scarborough, South Portland, Springvale, Topsham, Waterville, Westbrook, Winslow, Wiscasset, Yarmouth, Portland, Skowhegan and York Maine.


Thursday, May 10, 2012

EMG Hosts Optometry Students

Will and Sheridon Gove are optometry students from Pennsylvania College of Optometry at Salus University who both recently passed their boards and are finishing up their clinical rotations before graduation. They recently completed a 12 week rotation here at EMG.

Will and Sheridon both got their undergraduate degrees from the University of Maine. They were married in 2008 and went to optometry school in Pennsylvania together.  Their first rotation was at Groton Navy Base in Connecticut, a hospital site where they were doing basic primary eye care. They came to Eyecare Medical Group for their next 12 week rotation, where they spent time with all of our eye doctors, seeing each of the different subspecialties that we deal with at EMG, including retina, glaucoma, and cornea. They got to go into the OR with our physicians and see surgeries and were involved in working up patients.

Will and Sheridon are currently in Colorado for their last 12 week rotation, which is in contact lenses prescribing, use, and training, before they graduate from Pennsylvania College of Optometry on May 20th and begin working for Maine Optometry in Freeport, where Sheridon’s father, Dr. Littlefield, is a Maine optometrist.

Good luck to you both, Will and Sheridon; we miss having you around!

Eyecare Medical Group is a leading ophthalmology practice in Portland, Maine staffed by a team of eye care specialists including eye doctors who are fellowship trained glaucoma specialists, retina specialists, cornea specialists and cataract and lens implant specialists-all board certified Ophthalmologists-as well as Optometrists, Opticians, technical and administrative staff who provide eye examinations for adults and children, cataract surgery and intraocular lens implants, (IOL), laser vision correction such as LASIK, diagnosis and treatment of cornea disease including cornea transplants, care for diseases of the retina including diabetes and age related macular degeneration and diagnosis and treatment of glaucoma.

Eyecare Medical Group is conveniently located for patients from throughout Maine including
Auburn, Augusta, Bangor, Bath, Berwick, Biddeford, Bridgeton, Brunswick, Cape Neddick, Casco Bay, Cumberland Center, Eliot, Freeport, Gardiner, Kennebunk, Kennebunkport, Kittery, Lewiston, Old Orchard Beach, Sanford, Scarborough, South Portland, Springvale, Topsham, Waterville, Westbrook, Winslow, Wiscasset, Yarmouth, Portland, Skowhegan and York Maine.


Tuesday, May 8, 2012

Maine Cataract Surgery Complications

“We impress on our Maine cataract patients that although cataract surgery complications are really pretty rare everyone who is thinking about having eye surgery should learn about complications of cataract surgery so they know and can be comfortable,” said Maine Cataract Surgeon Jordan Sterrer, M.D. at Eyecare Medical Group in Portland. Certainly there are things that could go wrong. “Basically in the hands of an experienced cataract surgeon using modern cataract surgery techniques we do everything possible to reduce the risk of complications, said Dr. Sterrer. “When you consider the huge benefit that patients receive in not only in terms of vision but also lifestyle, comfort, convenience and safety the risk of complications is really quite low”, stated Dr. Sterrer. For routine cataract surgery in healthy patients the complication rate is well under 5%. This might increase somewhat if you have diabetic eye disease, glaucoma or other types of health or eye problems.

So what kinds of things can go wrong? First there are a handful of things that can happen during or within the first 24-48 hours after a Cataract operation. These include the very unusual things like bleeding inside the eye which is really rare, a little bleeding on the surface of the eye or an inner eye infection which is quite rare. Sometimes, if we need to anesthetize the eye using an injection you may have a little “black and blue” eye or an eyelid bruise. This usually clears up pretty quickly. Sometimes the “capsule” around the crystalline lens that is removed as part of the operation might be broken during the surgery and we might need to do a “vitrectomy” as part of the surgery to get a good result. This too is pretty unusual. More common in very nearsighted patients, some patients who have Cataract Surgery can have a retinal detachment. Occasionally in patients who have had “no stitch” Cataract Surgery the actual incision may leak. If this happens it is sometimes necessary for us to put a stitch in place to tightly close the incision. Then there are a few types of complications that can occur over a longer period of time. Very rarely the intraocular lens implant can move off center or the center of the retina can swell. By far the most common complication is a clouding of the lens capsule that has been left in place to support the lens implant. Fortunately, this complication is pretty easily managed with a quick, painless procedure called a YAG Laser Capsulotomy that restores the vision almost immediately after the procedure.

Although it might sound like there are lots of possible complications of Cataract Surgery, rest assured they are quite unusual. This most common one of capsule opacity is easily treated. If you need cataract surgery it is important to have a little knowledge so you appreciate the degree of skill and experience required of your cataract surgeon to help you get the best result.

Eyecare Medical Group is a leading ophthalmology practice in Portland, Maine staffed by a team of eye care specialists including eye doctors who are fellowship trained glaucoma specialists, retina specialists, cornea specialists and cataract and lens implant specialists-all board certified Ophthalmologists-as well as Optometrists, Opticians, technical and administrative staff who provide eye examinations for adults and children, cataract surgery and intraocular lens implants, (IOL), laser eye surgery including LASIK, diagnosis and treatment of cornea disease including cornea transplants, care for diseases of the retina including diabetes and age related macular degeneration and diagnosis and treatment of glaucoma.

Eyecare Medical Group is conveniently located for patients from throughout Maine including Auburn, Augusta, Bangor, Bath, Berwick, Biddeford, Bridgeton, Brunswick, Cape Neddick, Casco Bay, Cumberland Center, Eliot, Freeport, Gardiner, Kennebunk, Kennebunkport, Kittery, Lewiston, Old Orchard Beach, Sanford, Scarborough, South Portland, Springvale, Topsham, Waterville, Westbrook, Winslow, Wiscasset, Yarmouth, Portland, Skowhegan and York Maine.

If you or someone you know has Cataracts and has questions about Cataract Surgery and Lens Implant complications please feel free to call Eyecare Medical Group at 888-374-2020.


Tuesday, May 1, 2012

Eye Health & Makeup for Maine Patients

Maine patients should be aware that the need to consider the proper use of eye makeup can be important for helping to keep your eyes both healthy and beautiful. There are a number of steps and precautions to think about.

Ø First, throw away eye makeup after three months. Infection causing bacteria grow easily in creamy or liquid eye makeup. If you do develop an eye infection, immediately toss all of your eye makeup.

Ø Second, never share eye makeup, and when sampling makeup in stores use only fresh applicators and samples that have not been contaminated by multiple users. In fact the safest choice is to avoid using store samples at all.

Ø Third, if you tend to be allergic, introduce only one new eye makeup or care product at a time. If there is no reaction, add another new product, and so on. If you notice an allergic reaction, find out what the ingredients are and let your eye doctor know.

Ø Avoid products that contain untested or harmful chemicals. In general, before applying makeup, be sure your face and eyelids are very clean. Always apply makeup outside the lash line, away from the eye, to avoid blocking the oil glands of the upper or lower eyelid. These glands secrete oil that protects the eye’s surface.

Ø If you tend to have dry eyes, avoid metallic/glitter, powder or other makeup that flakes. Flakes can get into the tear film and increase your eyes’ irritation. Glitter eye makeup is a common cause of corneal irritation or infection, especially in contact lens users.

Ø Always remove all eye makeup at night before sleeping, especially mascara that can stick to the lashes. Brush a clean cotton swab along the base of the eyelashes to remove all makeup remnants.

Ø If you use eye makeup remover, avoid getting it in your eyes and thoroughly rinse remover off your eyelids.

If at any time you have eye surgery, do not wear makeup around the eye until your eye surgeon tells you it is safe to do so, and then use only fresh, new makeup.

Eyecare Medical Group is a leading ophthalmology practice in Portland, Maine staffed by a team of eye care specialists including eye doctors who are fellowship trained glaucoma specialists, retina specialists, cornea specialists and cataract and lens implant specialists-all board certified Maine Ophthalmologists-as well as Optometrists, Opticians, technical and administrative staff who provide eye examinations for adults and children, cataract surgery and intraocular lens implants (IOL), laser eye surgery for vision correction such as LASIK, diagnosis and treatment of cornea disease including cornea transplants, care for diseases of the retina including diabetes and age related macular degeneration and diagnosis and treatment of glaucoma.

Eyecare Medical Group is conveniently located for patients from throughout Maine including Auburn, Augusta, Bangor, Bath, Berwick, Biddeford, Bridgeton, Brunswick, Cape Neddick, Casco Bay, Cumberland Center, Eliot, Freeport, Gardiner, Kennebunk, Kennebunkport, Kittery, Lewiston, Old Orchard Beach, Sanford, Scarborough, South Portland, Springvale, Topsham, Waterville, Westbrook, Winslow, Wiscasset, Yarmouth, Portland, Skowhegan and York Maine.