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COVID-19 Update #2!

Due to changes in the CDC recommendations regarding routine eye exams, we have made the difficult decision to reschedule all routine exams for at least the next 2 weeks. We will still see urgent/emergency visits on a case by case basis. Please call the office if you are experiencing any eye pain, injury, redness, sudden vision changes, flashes, floaters, unusual visual disturbances, etc so we can evaluate the next steps for getting you seen. The government has expanded Telehealth coverage for more people so that may be an option also for some conditions. We will have staff on hand for glasses and contact lens pickups for orders placed recently. Please call the office when you arrive so someone can bring your items out to your car. If you lost or broke your glasses or ran out of contacts and do not have a backup pair of glasses, please let us know and we will see what we can do about getting you a temporary replacement ASAP. We apologize for the inconveniences this will cause many people but we have to prioritize the health and safety of our patients, staff, and community at large. If you have any questions please contact us through phone call, text, or email. Thank you.

COVID-19 Update!

Dear Patients,

As you know, the COVID-19 outbreak is currently affecting all of us both near and far and we wanted to give an update on the plan we have made for the office as we all band together to fight this outbreak. All of us at Sugar Land Total Eye Care are completely committed to the health and safety of our patients and staff and will take every necessary precaution needed. We plan on following the recommendations of the CDC and the local/state/federal governments and will update our plan as new guidance is released. We will remain open for patient care as long as possible, but we will close the office if recommended by the authorities.

All patients who are currently experiencing or have experienced flu-like symptoms, shortness of breath, cough, fever, chills, sore throat in the past 2 weeks or had recent travel overseas to areas with significant outbreaks of COVID-19 in the past month will not be allowed to be seen and will be sent to the ER or PCP to screen for COVID-19 first. We will be checking everyone’s temperature with an infrared thermometer as you come in and if you show a fever, we will ask that you leave and reschedule. We hope that you understand that this is for the safety of everyone including other patients and the office staff/doctors.

Due to the current recommendation of no gatherings of more than 10 people and the practice of social distancing, we are taking several steps to implement this in our practice.

  1. We will be limiting the number of people present at the office at any given time to 10. This means that patients should do their best to minimize the number of people they bring with them to their appointment. We will only allow 1 extra individual in the pretest/exam area with each patient. Any others will need to remain in the car.
  2. We will be trying to limit our exams to patients with urgent or emergency vision and medical problems. If you lost/broke your glasses or ran out of contacts and don’t have a backup option, we will happily see you if we can or work out a temporary solution. If you suffer an eye injury or are experiencing sudden changes in vision, flashes, floaters, or missing areas of vision, we will find a way to see you or get you to somewhere who can.
  3. If you feel like your vision is unchanged and are just wanting to make an appointment because of a reminder text or email, we ask that you wait to schedule until the main threat has passed.
  4. We strongly urge any patient in the high-risk demographics group (Age 60+ or very young, immunocompromised patients, etc.) to wait to schedule their non-emergent appointments until after the main threat has passed.
  5. If you are just picking up a glasses or contact lens order, please park outside and call the office and we can bring your items out to you. We can also mail your order to you if needed.
  6. We are implemented a temperature check for everyone who comes inside the office. We also ask that patients use hand sanitizer or go to the restroom and use soap and water to clean their hands when they come into the office and before trying on any frames. We have both available in office for your use.
  7. We have implemented more thorough cleaning and disinfecting procedures for the surfaces that patients may come in contact with including countertops, pens, clipboards, and eyeglass frames among others. Everything touched by patients will be kept separate until cleaned and disinfected.
  8. Payments of co-pays may be done through our text to pay system to minimize credit card handoffs.
  9. We ask that new patients fill out their paperwork before arriving to the office. We will email the forms and you can fill them out at home and email them back or bring them with you to your appointment.

We have always had strict policies for maintaining a clean and safe environment for our patients. We always carefully clean and disinfect all our office equipment between each patient. We have soap, water, hand sanitizer, and Kleenex tissues available for everyone as needed. Good hygiene is of the utmost importance and our doctors and staff will always follow the strictest protocols to keep you safe.

CDC information regarding the Novel Coronavirus COVID-19.

  • There is currently no vaccine to prevent coronavirus disease 2019 (COVID-19).
  • The best way to prevent illness is to avoid being exposed to this virus.
  • The virus is thought to spread mainly from person-to-person.
    • Between people who are in close contact with one another (within about 6 feet).
    • Through respiratory droplets produced when an infected person coughs or sneezes.
  • These droplets can land in the mouths or noses of people who are nearby or possibly be inhaled into the lungs.

The CDC recommends that everyone practice the following:

  • Frequently wash your hands with soap and water for at least 20 seconds or use hand sanitizer with 60% alcohol content or higher.
  • Avoid touching your face especially your eyes, nose, and mouth with unwashed hands. If you accidently touch those areas, immediately wash your hands and disinfect any surfaces you may have touched.
  • Cover your cough with a tissue or your elbow. Wash your hands and discard any tissues used immediately after.
  • Practice Social Distancing. Maintain a minimum of 3 to 6 feet between you and other individuals. Avoid handshakes or other forms of contact. Avoid individuals who are sick or may have been exposed to the virus.
  • Stay at home if you are experiencing any flu or cold like symptoms and seek medical care as directed by the CDC.

 

For more information, please visit the CDC website or the links below.

https://www.cdc.gov/coronavirus/2019-ncov/about/index.html

https://www.cdc.gov/coronavirus/2019-ncov/downloads/2019-ncov-factsheet.pdf

https://www.cdc.gov/coronavirus/2019-ncov/prepare/prevention.html

 

We thank you for your cooperation during this unexpected situation. We hope to resume normal operations as soon as possible and will do our best to keep you updated as more information comes out. Please stay safe out there!

 

 

Thank you,

Jason Idiculla, OD

Somaira Zia, OD

Adv. Surface Ablation

LasikHave you been told LASIK is not right for you?

People involved in contact sports, those with dry eyes and those with thin corneas should know about Advanced Surface Ablation, (ASA). It is a laser vision alternative for the treatment of nearsightedness, farsightedness and astigmatism.

How Advanced Surface Ablation is Different

ASA offers additional safety. In LASIK, a microkeratome (oscillating blade) or Intrase Laser is used to create a corneal flap. This gives the eye surgeon access to the deeper tissue where treatment is done. After the laser work is finished the flap is replaced and typically heals without incident.

In ASA there is no flap. Instead, a small portion of corneal epithelial (surface) cells is gently polished away with a diluted alcohol solution. Laser reshaping is completed in the same way as for LASIK surgery. Since no flap was created, a bandage contact lens is applied to the treated area for protection. It is worn for several weeks while the corneal surface cells regrow.

Pros and Cons of Advanced Surface Ablation

The recovery period for ASA is longer because of the necessary cell regrowth. For some patients it is a bit more uncomfortable than with LASIK. However, ASA avoids all the potential complications of flap creation:

  • Formation of flap wrinkles during healing
  • Infection under the flap
  • A flap that is too deeply cut
  • In incomplete flap which must be redone

Things that must be avoided after LASIK, such as bumping or rubbing your eyes, are not such an issue after ASA. Most importantly, there is less potential for dry eye. That is because cutting a LASIK flap also cuts some nerves connected to the lacrimal (tear-producing) glands. Until they regrow, the glands produce little or no tears. With no flap, ASA protects you from that side effect.

ASA Corrects Common Vision Problems

In nearsightedness, the cornea is too steep. Advanced Surface Ablation flattens it slightly by removing corneal tissue from the corneal center. This enables the cornea to focus light directly on the retina, instead of in front of it.

In farsightedness, the cornea is too flat. ASA steepens it slightly by removing corneal tissue from the cornea’s outside central optic zone. This allows the cornea to focus light directly on the retina, instead of behind it.

In astigmatism, the cornea is oval-shaped like a football. This shape creates two focal points that produce the blurry vision typical of astigmatism. ASA makes the corneal shape more spherical, creating a single focus point directly on the retina. Astigmatism can be treated along with nearsightedness or farsightedness.

Good candidates for Advanced Surface Ablation

Good candidates:

  • Wish to reduce or eliminate dependence on eyeglasses or contacts
  • Are beyond 18 years of age
  • Have enjoyed a stable eye prescription for one year or more
  • Have no chronic health issues affecting their eyes
  • Have wider pupils than average
  • Have thin corneas inappropriate for LASIK
  • Wish to avoid typical LASIK flap complications
  • Wish to minimize dry eye problems following laser vision correction surgery
  • Cannot have LASIK because of glaucoma, other eye pressure problems or corneal dystrophy
  • Do not want a microkeratome used during their laser vision correction

ASA offers an excellent opportunity for many more people to enjoy laser vision correction. However, it is still a surgery and involves some risks, although they are extremely rare:

  • A dry feeling
  • Glare
  • Nighttime halos

MACULAR VISION-HELP!

REDUCE YOUR RISK FROM MACULAR DEGENERATION!

Macular helpFind Out Which Foods and Supplements Will Help.

Age related macular degeneration (AMD) is associated with a slowly progressive deterioration of central vision for which there is no cure. It is the leading cause of irreversible vision loss among the elderly. The condition may lead to severe loss of central acuity, such that the affected may lose ability read, drive a vehicle, or recognize familiar faces. However, as in many disease states, prevention may be possible and every person with AMD or at risk for AMD should understand the basic principles.

There are a number of risk factors for AMD, including genetic inheritance, advancing age, smoking, and high blood pressure. Unfortunately, many people that get AMD or are at risk for the disease don’t have any risk factors that are under their control, except possibly one: nutrition. In this article, we’ll review two landmark studies linking nutrition to AMD and we’ll provide specific nutritional advice to those with AMD as well as those at risk for the disease.

Ophthalmologists and vision scientists at the Massachusetts Eye and Ear Infirmary published the results of a study investigating the relationship between dietary factors and AMD in the Journal of the American Medical Association in November, 1994. This study found that individuals who had the highest consumption of vegetables rich in carotenoids (lutein and zeaxanthin) had a 43% lower risk of developing AMD than those who ate these foods the least. Vegetables rich in carotenoids include dark, leafy green vegetables, especially raw spinach, kale, and collard greens. As stated by the investigators in this study, “in particular, a higher frequency of intake of spinach or collard greens was associated with a substantially lower risk for AMD”. The authors stated, at the conclusion of the study, that “consumption of foods rich in certain carotenoids, in particular dark green, leafy vegetables, may decrease the risk of developing advanced or exudative (“wet”) AMD, the most visually disabling form of macular degeneration among older people”.

A second study investigating nutritional factors and AMD, supported by the National Institutes of Health/National Eye Institute, showed that high levels of antioxidant vitamins and zinc significantly reduced the risk of advanced age-related macular degeneration and its associated vision loss. This study, known as the Age Related Eye Disease Study (AREDS), was truly another landmark study for patients with AMD. The investigators state, “people at high risk of developing advanced stages of AMD, a leading cause of vision loss, lowered their risk by about 25 percent when treated with a high-dose combination of vitamin C, vitamin E, beta-carotene, and zinc”. Interestingly, the participants in the study who had either early AMD or no AMD did not appear to benefit from this antioxidant and zinc regimen.

“This is an exciting discovery because, for people at high risk for developing advanced AMD, these nutrients are the first effective treatment to slow the progression of the disease,” said Paul A. Sieving, M.D., Ph.D., director of the National Eye Institute. “AMD is a leading cause of visual impairment and blindness in American 65 years of age and older. Currently, treatment for advanced AMD is quite limited. These nutrients will delay the progression to advanced AMD in people who are at high risk those with intermediate AMD in one or both eyes, or those with advanced AMD in one eye already”. Dr. Sieving further states that patients with AMD should understand that there isn’t a cure for AMD and that proper nutrition will not restore vision that is already lost. However, the study results also clearly demonstrate that nutrients play a key role in helping to maintain vision in people at high risk for developing advanced AMD.

The nutrients evaluated in the AREDS study contained 500 milligrams of vitamin C, 400 international units of vitamin E, 15 milligrams of beta-carotene, 80 milligrams of zinc as zinc oxide, and two milligrams of copper as cupric oxide. In this study, the NEI was supported by and collaborated with Bausch and Lomb, an ophthalmic products and pharmaceuticals company that provided the nutritional supplements, financial support for laboratory testing, and distribution of the supplements themselves. Today, these supplements can be found in a formulation called Ocuvite Preservision.

What Supplements Should One Take to Prevent AMD Progression?

Given the findings of these studies, most ophthalmologists have begun to recommend that patients with AMD include an abundance of leafy green vegetables in their diet.

Bausch and Lomb, the maker of Ocuvite, produces other supplements specific for patients with macular degeneration, including Ocuvite Extra, and Ocuvite Lutein. These products are found in retail stores and pharmacies everywhere. Macular Protect Complete from Science Based Health, Alcon laboratories ICaps, and other supplements also contain antioxidant vitamins and zinc in dosages supported by the AREDS study group, along with various doses of other vitamins and minerals, which are beyond the scope of this article.

It should be pointed out that supplementation with beta-carotene, a vitamin A precursor, has been shown to increase the risk of lung cancer among smokers. However, whole food based supplementation has not been shown to increase the risk of lung cancer among smokers and, in fact, there is some evidence that whole food based nutrition may decrease the risk of lung cancer in smokers. One study showed that a higher intake of green and yellow vegetables or other food sources of beta-carotene decreased the risk of lung cancer. As such, smokers should exercise caution in consuming any non whole-food based supplement that contains beta-carotene or Vitamin A.

Conclusions:

It is clear from the studies to date that a diet rich in dark, leafy green vegetables will help to decrease an individual’s risk of developing age-related macular degeneration (AMD). It would be wise to include a serving or two of raw spinach, kale, or collard greens in your diet every day to help prevent macular degeneration and/or to help delay progression of the disease once it has begun.

If an intermediate degree of AMD has already developed, or an advanced degree of AMD has developed in one eye, studies clearly indicate that dietary supplementation with vitamins E and C, beta-carotene, zinc and copper, in the doses previously mentioned, will help to delay progression of the disease. These antioxidant vitamins are readily available in a number of over-the-counter products including Ocuvite, ICaps, and many others.

AMD may not be an entirely preventable disease, however, it is certainly prudent for all of us to minimize our risk. How do we do this? Don’t smoke. Be sure your blood pressure is controlled. Consume plenty of dark, leafy green vegetables along with antioxidant vitamins and zinc.

Chris A. Knobbe, M.D.

Assistant Clinical Professor

University of Texas Southwestern Medical Center – Dallas

Risk for Glaucoma

HealthDay News) —

glaucoma riskGlaucoma is a progressive disease of the eye that eventually causes blindness if untreated and is the leading cause of irreversible vision loss.

Glaucoma is a disease that affects three million Americans, half of whom do not know they have it because of its lack of early symptoms. While early glaucoma may not reveal symptoms, the eye is still being damaged by the disease.

Advances in glaucoma treatment are only beneficial when the disease is detected early. By the time people realize they are losing vision, the vision they have already lost is gone forever.

Here are some common risk factors, courtesy of the Glaucoma Foundation:

  • Being black or Hispanic.
  • Being 60 years or older.
  • Having family members with glaucoma.
  • Being Asian makes you more prone to a specific type called angle closure glaucoma.
  • Having a prior eye injury or ocular vascular accident.
  • Being diabetic.
  • Being nearsighted.
  • Having high blood pressure.

Those in higher risk groups should get a dilated eye exam in which drops are placed in the eye to dilate the pupils at yearly. A dilated eye exam allows the doctor to obtain a better view of the eye’s optic nerve to look for early signs of glaucoma.

COME IN FOR YOUR GLAUCOMA EVALUATION-COVERED BY MOST MAJOR MEDICAL INSURANCES!

Cataract Surgery

Cataract surgery

No stitch means the eye heals naturally without the need for any stitches, or any need to perform another procedure on the eye in the future to take out the stitch.

No injection means no need to inject a needle around the eye, so no pain and no risk of causing damage to the optic nerve or retina.

No patch means no uncomfortable patch to wear that obstructs the vision in that eye.

No glasses means with custom cataract surgery utilizing “Premium” lens technology most patients significantly reduce their need for glasses.

The vision can be further refined with LASIK if needed, resulting in most patients being free from the need for glasses 80% of time or more.

Our ophthalmologists are well trained in the field of “Custom Cataract Surgery”. This is the latest advancement available and not all cataract surgeons perform this state of the art procedure.

What is involved in Custom Cataract Surgery?

Custom Cataract surgery utilizes new lens technology that involves replacing the natural lens that you are born with that has now become “cloudy”, what is known as a cataract, with a new state of the art lens that allows the eye to focus on objects at far and near distances while also preserving good depth perception.

If the front of the eye is not naturally round, what is known as astigmatism, we will reshape the eye using laser technology to provide the best visual outcome possible.The entire lens procedure usually takes about 15 minutes to perform as an outpatient surgical procedure.

You will go home about 30 minutes after surgery. Most all activities can be resumed by Day 1, except heavy lifting, bending, or straining.

If the eye also needs to be reshaped with the laser, that will be performed at around 3 months to further refine the vision.

These procedures produce little to know pain with only mild discomfort and light sensitivity the first few days.

**Click here for real patient testimonials ~http://www.acrysofrestor.com/cataract-surgery/restor-testimonials.asp~

How long does it take for my vision improve to “normal”?

The lens procedure is done on one eye at a time usually within 2 weeks of each other. The first eye generally has significant improvement in vision as early as Day 1, but every patient heals at different rates. The best vision is achieved after both eyes have had the procedure since the new lens technology works the best when both eyes are working together. If there is any astigmatism, best vision will not be achieved until the eye is reshaped with the laser to provide final refinement of the visual system.

What is the difference between Custom Cataract Surgery and “regular” cataract surgery?

With “regular” cataract surgery, a standard lens is used that is usually set to focus at distance with both eyes or alternatively, the dominant eye focused for distance and the non-dominant eye focused for near (Monovision).

If the patient chooses to have both eyes set to focus at “distance”, then near vision task such as reading a book, or working at the computer will require bifocals or reading glasses in order to see.

With “Monovision”, since both eyes are set to focus at different distances, some depth perception is sacrificed. “Custom” Cataract Surgery utilizes the state of the art custom lenses that act like a bifocal inside the eye, so the eye can focus at distance with both eyes simultaneously ( thus better depth perception) and near without the need for bifocals or reading glasses in most circumstances.

This provides more independence and freedom from having to wear glasses, at a range of distances.

Am I good candidate for Custom Cataract Surgery?

We will examine your eyes during the initial consultation and perform a thorough ocular examination to determine if custom surgery will work well for your visual needs. Generally, people with chronic eye disease, uncontrolled diabetes, macular degeneration, or other such eye problems are not ideal candidates. Patients with severe dry eye may need to have surgery delayed several weeks while the cornea is being treated, and it returns to its normal “smooth” hydrated state.

In addition, people who drive at night for a living, or whose occupation requires excellent night vision, airplane pilots, and patients who are hypercritical or have unrealistic expectations are generally not good candidates.

What are the risks?

There are risks associated with any surgery and no one can guarantee good vision after surgery. You will experience some glare and halos especially at night that usually disappear by 4-6 months. If there is a concern that the premium, custom lens will not center well in your eye, or there is a complication preventing safe use of this lens at the time of surgery, a standard lens may be implanted instead.

Will insurance pay for Custom Cataract Surgery?

What is the price you put on reading a book? Or a menu? To clearly follow a golf ball as it sails over the fairway?

Your vision connects you to the world and your loved ones in many ways. With Custom Cataract surgery, you don’t have to miss any of it.

Insurance policies vary, but most insurance plans including Medicare will not cover all the cost to upgrade to custom lenses.

They will pay for the standard cost of cataract surgery, i.e. the facility fee, anesthesiology fee, preoperative evaluation and tests, and most of the surgical fee, allowing the patient to pay the additional cost to upgrade their surgery to a custom procedure utilizing premium lens technology.

Clinical Results

The current lens technology most used by our opthalmologist during cataract surgery is the FDA approved AcrySof ReSTOR or Technis lenses. Clinical data demonstrates that the AcrySof ReSTOR and Technis lenses greatly reduces dependence on glasses or bifocals:

  • 80% of patients reported that after lens implant surgery with ReSTOR or Technis lenses, they never needed glasses or contact lenses to see clearly at all distances.
  • 94% reported being able to drive or read the newspaper without glasses or contacts
  • Nearly 94% were so satisfied that they would have the procedure again.

In addition, the quality of vision compared to wearing bifocals and/or trifocals is significantly improved. You’ll have a full range of vision, without having to tilt your head to find that portion of your glasses that allows you to see clearly.

Everyone’s focusing ability is different. Most people will be able to see clearly in the distance, have very good reading vision and good middle vision without glasses, but some people may be more comfortable with additional correction, particularly at night or in dim light or for long periods of computer work.

It is important to remember that implant surgery cannot resolve preexisting visual conditions such as floaters, flashes, or visual field loss that are a result of conditions of the eye and not related to the lens.

While virtually everyone experiences much improved vision after cataract surgery, some people will have better uncorrected vision than others.It may be necessary for some people to wear glasses for distance, intermediate and/or near vision to obtain optimal visual acuity.

It is often necessary to wear glasses for optimal acuity while viewing objects at middle distances such as the computer.

The difference from standard lenses is that most people will not be dependent on these supplemental vision aids to function normally.

Acanthamoeba Alert

upclose eyeRisk Factors

  • Use of tap water in cleaning and disinfecting contact lenses including the lens case.
  • Swimming with contact lenses in the eyes, especially in fresh water lakes and rivers. Acanthamoeba keratitis has also been isolated from virtually all water sourcesfrom pools to hot tubs to showers.
  • Failure to follow lens care instructions (see Lens Care Guide below)/poor compliance.

Lens Care Guide

  • Always wash hands before handling contact lenses.
  • Rub and rinse the surface of the contact lens before storing.
  • Use only sterile products recommended by your optometrist to clean and disinfect your lenses. Saline solution and rewetting drops are not designed to disinfect lenses.
  • Avoid using tap water to wash or store contact lenses.
  • Contact lens solution must be discarded upon opening the case, and fresh solution used each time the lens is placed in the case.
  • Replace lenses using your doctor’s prescribed schedule.
  • Do not sleep in contact lenses unless prescribed by your doctor and never after swimming.
  • Never swap lenses with someone else.
  • Never put contact lenses in your mouth.
  • See your optometrist regularly for contact lens evaluation.
  • If you experience RSVP (redness, secretions, visual blurring or pain), return to your optometrist immediately!

Demodex and Itchy Lids

Eyelid lashesThe Demodex mite is an eight-legged (an arachnid) ectoparasite (living on the surface of the host) that can reside in our hair follicles and oil glands. Of the 65 described Demodex species, only Demodex brevis and Demodex folliculorum are found on humans. Demodex is contracted and spread by either direct contact or dust containing eggs. It is associated with Excema if on the scalp or face.

The typical Demodex life cycle is usually 2 to 3 weeks. A female Demodex mite lays 15 to 20 eggs inside the hair follicle, such as an eyelash, near the sebaceous, oil, glands. The eggs develop into larvae, which eventually become an adult eight-legged mite. The adult male Demodex mite will leave the follicle in search of a mate, while the adult female mite remains in the follicle. The mites are capable of walking approximately 10 mm/h and tend to be more active in the dark.

Patients who suffer from Demodex infestation may complain of eyelid and eyebrow itching (especially in the morning), madarosis, a burning sensation and a foreign body sensation that seems to originate beneath their lids. Demodex blepharitis is observed equally in males and females and is age related. A study by Junemann showed that Demodex is found in 25% of 20-year-olds, 30% of 50-year-olds and 100% in patients older than 90 years.

Patient instructions

Our office will send patients home with specific at-home lid and hair treatment instructions. They should immediately wash sheets and pillow cases in hot water and dry with the “high” dryer setting and discard their pillows. They should not use makeup for at least 1 week and discard all old makeup. Recommend using tea tree soap on their face and consider tea tree hair shampoo as well. Make an appointment for the patient’s spouse to have an evaluation, as they are frequently also infested.

Thanks for this information: http://www.healio.com/optometry

For your interest in seeing the Demodex: https://www.youtube.com/watch?v=KfLIn_X1Xx0

Care with your face soap!

Infected EyeA new study reveals that a person’s choice of soap may play a role in eye infections. This article appeared in EyeWorld, an international news magazine for ophthalmologists by Lisa Samalonis, Correspondent. Using antibacterial/deodorant soap before surgery can reduce the amount of external disease in ocular surgery compared with using non bacterial soap.In addition, patients with recurring eye infections who use deodorant/antibacterial soap daily or at least several times a week can decrease disease significantly.

A recent study he conducted included 427 consecutive patients with significant eye infection com-plaints. Diagnoses included ble- pharitis, meibomianitis, chalazia, and corneal ulcer. Criteria for the study required that patient treatments included topical antibiotic drops, topical antibiotic ointment, oral antibiotics, and hot compresses.

The patients were given a questionnaire on symptoms and personal hygiene. Of the 427 cases, 89% of patients indicated they used non deodorant soaps. Of the 89% that used non antibacterial/non- deodorant soap, 224 cases (52%) said they used Ivory. Other non- deodorants used were Dove (72 cases, 17%), Neutrogena (34 cases, 8%), tap water (30 cases, 7%), cold cream (34 cases, 8%), Canay (15 cases, 4%) and others (23 cases, 5%).

The remaining 11% of patients said they use deodorant/antibacterial soaps, such as Safeguard (13 cases, 3%), Dial (nine cases, 2.1%), Irish Spring (seven cases, 1.6%), Lever 2000 (five cases, 1.2%), Coast (five cases, 1.2%), Zest (four cases, 0.9%), or others (five cases, 1.2%). The study included double- blind cultures from 62 consecutive patients with eye infection complaint, it was fount that 16 patients used deodorant soap and 46 used non deodorant/antibacterial soap. “Results from the double-blind culture showed that Staphylococcus epi-dennis and aureus infections occurred in 52% of the non deodorant/antibacterial soap users, while 30% occurred with the deodorant/antibacterial soap users,’ he said.

The study was performed with patients from the Houston area. According to the study, deodorant soap represents about two-thirds of soap sold in the area. For example, Safeguard represents about 18% of the soap sold in Houston, roughly three times Ivory sales. The Safeguard patients represented 3% of cases treated. Fifty-two percent of the cases treated were Ivory soap users. In this study, deodorant soap was used by 11% of severely infect- ed patients. There was one Safeguard case for every 16 Ivory cases. “Eighty-nine of every 100 bacterial external disease infections will use a non deodorant facial soap.

“Based on the results of this study, doctors should recommend deodorant/antibacterial soap to patients with contact lenses, especially extended wear contact lenses, recurrent chalazia, and Staphylococcus marginal ulcers,” he said.

Most surgeons recommend that deodorant soap be used before and after intraocular and refractive surgery.

Research indicated that the soap does not have to be used every day. “I suggest to patients who are sensitive to antibacterial soaps that they use it in their morning shower or every other morning or every third morning.” “For patients with a long history of recurrent staph ulcers, using Safeguard or Irish Spring every other day seems to break the cycle.” Further study “Although preoperative use of antiseptic/deodorant soaps seems reasonable to reduce the rate of infection, further study is needed to prove this point.

Stark noted that multiple studies have shown that topical antibiotic agents given preoperatively, reduce the amount of lid and conjunctival bacteria. Patient’s normal lid and conjunctival flora are the most potential sources of infection during intraocular surgeries. Various staphylococcal species, which are the most common organisms causing endophthalmitis, predominate in this flora. “Application of 5% povidone iodine solution on the eye at the time of surgical preparation causes a similar decrease in the number of bacterial colonies.

Such prophylactic measures may help reduce the incidence of endophthalmitis, although the evidence is inconclusive,’ he said. Routine use of preoperative antibiotics or antiseptic soaps may lead to alteration of protective nor- mal host flora, development of resistant bacteria, and allergic reactions, he said. “In a large study, up to 95% of eyes had positive culture results for organisms capable of causing severe intraocular infections, yet few of those eyes went on to develop infections,” Stark said.

Dry Eye Help-Punctal Occlusion

Red EyeOne way to alleviate dry eye is to help the eyes to make better and longer use of the small amount of lubricating tears they do produce. This is accomplished by closing off the small funnel-like drain hole found in the inner corner of the upper and lower eyelids. These drain holes, called punctums can be closed with tiny plugs called punctal plugs. The plugs can be placed in the two tear ducts, top and bottom, in both eyes or in only the lower ducts. Punctal plugs can be temporary or permanent. Temporary plugs dissolve a few days after insertion. If your dry eye symptoms disappear when the temporary plugs are inserted, your doctor may consider permanent punctal occlusion.

Punctal occlusion is for those:

  • who have been diagnosed with dry eye
  • whose doctor has determined that punctual occlusion is the appropriate treatment for their condition

What to expect on procedure day:

  • Your treatment will be performed in an examination room. It does not require a surgery center. Once you have been checked in and settled comfortably, drops will be used to numb your eye no injections or needles are used.

Your doctor will pull your eyelid up and ask you to look toward the outside of your head, away from your nose. Using a forceps-like applicator, the plug will be placed into the corner of your eye, then released. An applicator or another tool will then be used to gently push the plug into your natural punctal opening and you’ll be asked to blink. Once the plugs get wet, they will expand to completely fill the opening. The entire procedure takes only a few minutes. Many patients report immediate relief from dry eye symptoms and resume normal activities immediately.Realistic expectations:

  • Serious complications with punctal occlusion are extremely rare, but like any medical procedure, it does have some risks. If you experience side effects, your doctor can remove the plugs. Going to a specialist experienced in punctal occlusion can significantly minimize risks.

If you and your doctor decide that punctal occlusion is an option for you, you will be given additional information about the procedure that will allow you to make an informed decision about whether to proceed.