Vision.Service.Community Blog | Colony Eye Care Center, Sugar Land TX

3-D Imaging of the Eye

Posted 270 days ago by Dr. Robert Salchak

Optical Coherence Tomography (OCT) is a method of using light to scan and image tissue in the body. Other types of imaging use sound or radio frequency, and the OCT is able to obtain higher resolution because of its use of light. It’s been mostly used in the detection and treatment of eye conditions by imaging the retina, cornea, and tear film. Recent developments have been used in cardiology applications to help in diagnosing coronary artery disease. Recent grants have been awarded to develop OCT devices that can be applied to imaging areas of the body such as ears, cervical tissue, and skin.

Some of the ocular condition that we can detect with our Cirrus HD-OCT by Zeiss Ophthalmics, are glaucoma, macular degeneration, diabetic retinopathy, and other retinal anomalies. The testing is easy for a patient, and it gives us incredibly detailed images of various parts of the eye. We can also image the tear film on the front of the eye in the detection and management of dry eye disease, along with measuring corneal thickness for screening lasik candidates. OCT testing is usually covered by medical insurance as long as there is a medical condition to report.

Posted in Eye Condition, Optical Coherence Tomography | Tagged diabetic retinopathy, glaucoma, macular degeneration | No Comments

Our practice is growing!

Posted 364 days ago by Dr. Robert Salchak

With much excitement, we want to announce that our practice is growing. We recently acquired the practice of Dr. Stuart Miller, known as Eye Trends Missouri City. He and his team will be merging operations with us while still maintaining the business at their current location in the Kroger shopping center at 6134 Hwy 6. It’s located at the corner of Hwy 6 and University Blvd., and the office phone number is 281-499-2020.

Dr. Davenport and Dr. Salchak will continue to see patients only at their current Sweetwater location in Sugar Land, while Dr. Miller will see patients along with our new associates Dr. Nikki Polnick and Dr. Sang Pham in Missouri City. Dr. Polnick also will continue to see patients at the Sugar Land office several days a week.

**Saturday hours**. The Eye Trends location has Saturday hours from 9 am to 4 pm. With this expanded service, we’ll be able to offer Saturday office hours for emergencies and well visits. The Sugar Land office will continue to be closed on Saturday.

Posted in Business | Tagged Colony Eye Care, Community | No Comments

Generic medications: The good and the bad. (Part 2)

Posted 370 days ago by Dr. Robert Salchak

In an article in the Review of Optometry February 2011 issue, “Generics: Friend of Foe” it states a number of facts about generic medications. It also raises some legitimate questions regarding the effectiveness and safety of their use. In my Part 1 blog posting, I ended by saying that ophthalmic drugs have a more difficult time in ensuring their safety and effectiveness with generics when compared to their branded counterpart. Ophthalmic generics are not required to demonstrate therapeutic equivalence to the branded medication. The FDA requires the active ingredient and concentration must be equal in generic and brand name drugs. Inactive ingredients such as preservatives, pH adjusters, antioxidants, buffers and other inactive ingredients are allowed to vary. This may impact the comfort of the drops and the drug’s effectiveness.

It’s a well known fact that with some ocular medications, particularly steroids, a branded drug will penetrate the front of the eye better than the generic equivalent. There’s also evidence of glaucoma drops that are manufactured abroad not having the same effectiveness in lowering the intraocular pressure as the branded counterpart. This can be a critical component in the outcome of treatment in acute and chronic conditions.

Cost is often a driving force in the decision making process for both the patient and the doctor. A typical generic copay is usually between $5-$15, while differing tier copays for branded drugs may range from $20-$40. If you have to pay out of pocket, there will generally be an even larger spread on the cost difference.

Unless the doctor knows a particular safety profile for a generic and branded drug, we can only try the generic, and follow the patient closely for any adverse side affects or diminished effectiveness of the drug. The generic drug may work as well and cost less, but it may also have more limited ability to treat the problem. I recommend that you weigh your benefits of reduced cost with the potential loss of effectiveness, and talk to your doctor about your treatment options.

Posted in Medications | Tagged Colony Eye Care, generic, glaucoma, Insurance | No Comments

Generic Medications: The good and the bad (Part 1)

Posted 370 days ago by Dr. Robert Salchak

As noted in the February 2011 issue of Review of Optometry, patients are asking more often for generic medications instead of brand named drugs. A question one has to ask: “are generics as safe and effective as their branded counterparts?” Another question that needs to be asked: “are there any potentially negative outcomes through the use of these generics?

The level of use of generic alternatives in the US is one of the highest among developed nations. Not all drugs are equal, and there are pros and cons to using generic equivalents. The U.S. Food and Drug Administration (FDA) estimates that 7 out of 10 prescriptions written in the U.S. are for generic medications. Both Medicare and state Medicaid drug plans substitute generic drugs around 80% of the time if the generic version is available.

Let’s look at how a generic drug becomes available to the public. The generic counterpart of a branded drug becomes available for production when the patent expires, generally after 20 years. The FDA authorizes the production of that medications generic counterpart if bioequivalence can be demonstrated. This means that the active ingredient of the drug has to be released into the blood stream at essentially the same speed and in the same amount as the original drug.

With systemic drugs, a manufacturer can perform bioequivalence studies comparing the absorption, efficacy, and elimination of a systemic generic drug. This can be generally obtained by measuring levels of the drug in the blood stream after taking the drug. The concentration must be between 85% and 125% of that measured for the branded drug. Unfortunately, ophthalmic drugs can’t be compared this way. The only FDA regulation for ophthalmic medications requires the generic must contain the same concentration of active ingredient as the brand name product, as well as the dosage, form and route of administration. There could be potential differences in the amount of drug that gets into the eye when comparing a generic to a branded drug.

Posted in Medications | Tagged Colony Eye Care, FDA, generic, Insurance, Medicaid, Medicare | No Comments

Macular degeneration (AMD) and hearing loss

Posted 398 days ago by Dr. Robert Salchak

As reported in the February 2011 issue of Review of Optometry, a recent study in Turkey has linked the prevalence of age-related macular degeneration (AMD) with the incidence of age related hearing loss. The results of the study concluded that the group with AMD reported a higher percentage of cases with hearing loss, along with a lower median pure tone average. Within the AMD group, the hearing loss was greater with those that have dry AMD when compared to those with the wet AMD.

In the U.S., there are 21 million adults with some kind of visual impairment and about 36 million that have some degree of hearing loss.

Posted in Eye Condition | Tagged ARMD, Hearing Loss, macular degeneration | No Comments

Glaucoma, longer lashes, and baldness

Posted 398 days ago by Dr. Robert Salchak

You might be asking yourself “what do glaucoma, longer lashes, and baldness have in common?” The answer is a drug called bimatoprost. This drug has been used for over 10 years as a very effective eye pressure lowering drug in the treatment of primary open angle glaucoma. The brand name for the drug is Lumigan, manufactured by Allergan. One of the noted side affects is that patients may experience elongation of their eyelashes. In 2008, the FDA approved the drug Latisse (brimatoprost 0.03% ophthalmic solution) for the stimulation and enhancement of eyelash growth. Latisse is wiped onto the outside of the eyelids at the base of the eyelashes causing enhanced lash growth.

As reported in a recent February 2011 Review of Optometry article, bimatoprost is now being studied for baldness. The article states that if approved by the FDA, it will likely be manufactured as a cream for application. Latisse costs around $120 a bottle, and this new form of the drug to be used for baldness may prove to be very costly. Stay tuned for further information as it comes out.

Posted in Eye Disease | Tagged glaucoma | No Comments

Everybody Gets Presbyopia. Aka “My arms are too short.”

Posted 424 days ago by Dr. Robert Salchak

There are not many things in life that an eye doctor can guarantee, but one of them is that all of us will eventually develop presbyopia. This is a condition that is due to the natural “maturing” of the eye, and the result is a loss of focusing on things that are close up. This would include difficulty with reading the newspaper, books, working on a computer, and hobbies such as tying knot on a fishing line. We usually hear from patients that they need either more light or longer arms!

Presbyopia is the loss of near focus due to hardening of the natural lens. Normally, there is tension exerted on the lens by muscles in the eye. This causes the lens to flex, and as a result, changes shape in order to focus your vision on near targets. The front and back curve of the lens will change shape with this flexure, thus adjusting how light is bent onto the back of the eye. As we all “mature”, our lens loses it’s flexibility to focus, and eventually we begin to see the affects on our vision.

The eye has to focus more the closer something comes to your face. This is the reason that in early presbyopia, we tend to want to push things away from us. We actually start losing flexibility in our lens in our twenties, but won’t notice the loss of near vision until our early forties. This can be corrected with reading glasses, multifocal glasses, contacts, and refractive surgery in more advanced cases. The type of correction that is best for you will depend upon a number of variables such as your age, how much near and computer vision you need, and if your eyes are dry.

Presbyopia is a natural progression that eventually hits all of us, and unfortunately, there are no exercises or nutritional supplements that will keep it from occurring. So, join the crowd, and either plan on lengthening your arms or get used to some kind of reading lenses.

Posted in Aging, Glasses | Tagged Presbyopia | No Comments

I’ve had lasik….I don’t need to get my eyes checked.

Posted 424 days ago by Dr. Robert Salchak

If you are one of the millions that have had successful lasik surgery, you may be thinking that since your vision is great, you don’t need to have your eyes checked regularly. We would encourage you to consider changing your line of thought.

We emphasize the fact that there are two parts to a comprehensive eye exam: the vision or optical evaluation, and a health assessment. In the vision part of the exam, we evaluate and measure your current visual acuity and what kind of correction may be needed to make it better. With the health assessment portion of the exam, we’re assessing the health of the eye for the presence of any number of eye diseases. Some of these conditions, such as glaucoma, will cause permanent vision loss when left untreated. There are approximately three million cases of glaucoma in the US, and it’s estimated that there are at least three million more cases that are undiagnosed. We consider it a tragedy that there are patients out there with “good vision” that have conditions that will eventually cause permanent vision loss……they just don’t know it yet.

Both Dr. Davenport and Dr. Salchak have had lasik many years ago, but we still have regular check-ups to ensure that we keep an update on the health of our eyes. Just because you have good vision, it doesn’t mean that you can blow off having regular eye exams. We recommend annual exams, and if that’s not possible, don’t go more than two years…..you owe it to your eyes.

Posted in Refractive Surgery | Tagged Comprehensive Eye Exams, lasik | No Comments

The “Stigma” about Astigmatism

Posted 427 days ago by Dr. Robert Salchak

Many patients have “stigmatism”, but don’t really know what it means. Most people have heard of nearsightedness (myopia) and farsightedness (hyperopia), and generally know what they mean. But when it comes to astigmatism, they are either clueless or misinformed.

The shape of the eye is the general reason why any of us need glasses, contact lenses, or refractive surgery. The curve of the front of the eye (cornea), the lens , and the length of the eye make up how light is bent inside the eye. When light naturally focuses on the back of the eye (retina), the vision is clear. When the light focuses off the retina, there is a need for some kind of correction in the form of glasses, contacts or refractive surgery.

Astigmatism is a type of refractive error that is caused by the light rays being focused at two different points inside the eye. It’s usually caused by the front surface of the eye not being spherical (like a basketball). The cornea may have a vertical curve that is different than the horizontal curve (like a football). This causes the light rays to be bent in varying amounts, thus causing the two varying points of focus. We are able to use advanced devices, called a corneal topographer, to map the shape of the cornea. This is a critical measurement that we have to know if we’re going to fit contact lenses or recommend refractive surgery.

There doesn’t need to be a “stigma” about astigmatism. We’d like to perform a comprehensive eye exam and explain your options for correcting your astigmatism.

Posted in Astigmatism, Refractive Surgery | Tagged Contact Lenses, cornea | No Comments

The Dreaded Pink Eye

Posted 427 days ago by Dr. Robert Salchak

One of the most common reasons for minor emergencies in our office is for the pink eye. Patients can get a pink eye in a number of ways, especially if they are wearing contact lenses. The most common way of developing a pink eye is through touching the eye with a contaminated finger, contact lens, or even makeup applicators. This introduces organisms onto the surface of the eye or eyelids that may cause an infection or inflammation.

The name “pink eye” generally refers to an eye that is red and puffy, and usually has some amount of discharge that may be watery or mucousy. The medical term for a pink eye is conjunctivitis, and it is the infection or inflammation of the top layer of tissue that is over the white part of the eye. The conjunctiva also lines the underside of the eyelids. The vision may be blurred as a result, and the affected eye is usually itchy, burny, stinging, gritty, or dry. In severe cases, the eye may also be very light sensitive.

There are generally three types of pink eye: viral, bacterial, and allergic. They all make the eye look red, but can have different types and amounts of discharge, and varying symptoms. The most common type that we see in our clinic is the viral conjunctivitis. This is usually like having a cold in the eye, and sometimes can be treated with OTC drops and cold compresses. Allergic conjunctivitis is often related to seasonal allergies, and we’re usually trying to treat the symptoms with anti histamines and/or decongestants. There are OTC drops (Alaway and Naphcon A), along with prescription drops that can relieve the itching and swelling. The bacterial conjunctivitis is usually the pink eye that can be most visually damaging, and is usually related to contact lens wearers. This type of pink eye requires antibiotic drops and sometimes ointments for treatment.

Good hygiene can go a long way in helping to prevent pink eye, so wash your hands, and throw away any old makeup.

Posted in Eye Infections | Tagged Pink Eye | No Comments