When I attended my 40th reunion of my medical school class two weeks ago, I was reminded again in a most powerful and succinct way what it means to be a doctor.
Dr. Dan Foster, a world-renowned endocrinologist and teacher of medicine, gave a brief lecture about the ethics of medicine. In it he said that medical doctors have four duties. First, be competent. Second, cure disease and prevent it whenever possible. Third, treat symptoms when there is no cure. Fourth, comfort always.
We are committed to continually seeking new and better ways to cure and treat disease. The technological revolution in health care has brought the ability to see structures of the eye so clearly that we can detect disease at earlier stages than ever before. High-tech equipment like Ocular Coherence Tomography (OCT) wasn’t available 20 years ago and now I cannot imagine practicing without it. The duty of comfort was paraphrased to me once as: “Doc, they don’t care how much you know until they know how much you care.” And it remains true today.
It was wonderful to be brought to ponder the privileged and special relationship the physician has with his patients. I am so grateful to have the lessons learned as a medical student brought so clearly and forcefully forward into my life again.
Tuesday, May 28, 2013
Monday, May 20, 2013
When Red & Itchy Eyes May Be a Sign of Conjunctivitis
Red and itchy eyes may or may not be a sign of conjunctivitis – sometimes called “pink eye.” Conjunctivitis is an inflammation or infection of the thin tissue that covers the white portion of the eye (the “conjunctiva”) and lining of the eyelids. There are three types of conjunctivitis: viral, bacterial, and allergic.
Viral conjunctivitis is extremely itchy. It is not treated with medication, because it will run a definite and limited course without drugs. Bacterial conjunctivitis, on the other hand, improves with medication and will respond to antibiotics after three to four days. A warm, wet cloth held up to the affected eye for a few minutes may ease discomfort.
Both of these types of conjunctivitis ordinarily cause discharge and both are contagious.
Allergic conjunctivitis is an immune response to a foreign substance in the eye, such as pollen, mold, or dust. Another possible trigger may be contact lens wear, which causes “giant papillary conjunctivitis.” We treat most of these cases by suppressing the immune response with antihistamines or, in more severe cases, topical steroids. We ease discomfort with the use of artificial tears (which lubricate the eye) or the application of a cool, wet cloth. Allergic conjunctivitis is not contagious.
If your eyes are red and itchy, first see your eye doctor to determine whether or not you are contagious. Your doctor will tell you if you need a prescription and when you may return to work or school. Your doctor also will check to see whether your red eyes are a symptom of a more serious eye condition.
Viral conjunctivitis is extremely itchy. It is not treated with medication, because it will run a definite and limited course without drugs. Bacterial conjunctivitis, on the other hand, improves with medication and will respond to antibiotics after three to four days. A warm, wet cloth held up to the affected eye for a few minutes may ease discomfort.
Both of these types of conjunctivitis ordinarily cause discharge and both are contagious.
Allergic conjunctivitis is an immune response to a foreign substance in the eye, such as pollen, mold, or dust. Another possible trigger may be contact lens wear, which causes “giant papillary conjunctivitis.” We treat most of these cases by suppressing the immune response with antihistamines or, in more severe cases, topical steroids. We ease discomfort with the use of artificial tears (which lubricate the eye) or the application of a cool, wet cloth. Allergic conjunctivitis is not contagious.
If your eyes are red and itchy, first see your eye doctor to determine whether or not you are contagious. Your doctor will tell you if you need a prescription and when you may return to work or school. Your doctor also will check to see whether your red eyes are a symptom of a more serious eye condition.
Monday, May 13, 2013
Certain Lens Technology Allows Advantages with Outdoor Activities
This beautiful spring weather has provided many of our patients with extra opportunities to enjoy (and sometimes become frustrated) by their favorite outdoor activities. Current lens technology allows multiple solutions for these challenges.
We find that golf enthusiasts, especially those with decreasing midrange and near vision, need special progressive lenses. Those lenses maximize their peripheral and distance vision while providing clear vision at the tee.
There are multiple spectacle and contact lens designs available that meet these requirements. Some golfers prefer polarized sun lenses, while others find these cause distortion in their peripheral field and prefer traditional tinted lenses in shades of amber and brown. Amber and brown lenses highlight subtle changes in topography on the green, helping the golfer to anticipate the path the ball will follow to the tee.
Monovision, a method of correcting one eye for distance and the other for near with contact lenses, may work well for a concert violinist, but not at all for a tennis or golf player who needs excellent depth perception. Creative flexible solutions are sometimes necessary. Great tools for maximum flexibility are press-on adds or clip-on sunglasses in multiple color tints. Gray for running in bright sunlight, polarized for fishing and flying, rose or red hued for relaxation are a few examples where clip-on options would be helpful in multi-sport situations.
When you meet with your eye doctor, make sure to discuss your favorite activities so they may help you meet your personal goals. Within any sport are individual players with individual needs, and years of treating individuals has taught me the necessity of listening closely and exploring multiple options with each patient. Every patient is different and should be treated as such.
We find that golf enthusiasts, especially those with decreasing midrange and near vision, need special progressive lenses. Those lenses maximize their peripheral and distance vision while providing clear vision at the tee.
There are multiple spectacle and contact lens designs available that meet these requirements. Some golfers prefer polarized sun lenses, while others find these cause distortion in their peripheral field and prefer traditional tinted lenses in shades of amber and brown. Amber and brown lenses highlight subtle changes in topography on the green, helping the golfer to anticipate the path the ball will follow to the tee.
Monovision, a method of correcting one eye for distance and the other for near with contact lenses, may work well for a concert violinist, but not at all for a tennis or golf player who needs excellent depth perception. Creative flexible solutions are sometimes necessary. Great tools for maximum flexibility are press-on adds or clip-on sunglasses in multiple color tints. Gray for running in bright sunlight, polarized for fishing and flying, rose or red hued for relaxation are a few examples where clip-on options would be helpful in multi-sport situations.
When you meet with your eye doctor, make sure to discuss your favorite activities so they may help you meet your personal goals. Within any sport are individual players with individual needs, and years of treating individuals has taught me the necessity of listening closely and exploring multiple options with each patient. Every patient is different and should be treated as such.
Monday, May 6, 2013
What is a “refraction,” and why is it important?
When your eye doctor does an exam, the primary thing he/she is trying to determine is whether or not your eye is healthy. The easiest way to tell is to find out how well you see. In other words, is your vision 20/20?
If your vision is 20/20 with your glasses or without any glasses, great. If your vision is not 20/20, “refraction” is the process of putting lenses in front of your eye to see if lenses can bring your vision to 20/20. If you can see 20/20 with refraction, then you just need glasses. If you still cannot see 20/20 with lenses, something is wrong with the eye, and the doctor must find out what. It could be cataracts, glaucoma, diabetes, macular degeneration or other problems with the cornea, lens or retina. Thus refraction shows your doctor right away that there is a medical problem that could threaten your vision.
It is unfortunate that medical insurance does not pay for this valuable test just because it could be used to provide a prescription for glasses. The refraction is extremely important in determining if there’s a serious medical issue. In fact, refraction is just as basic and just as important in diagnosing eye disease as the electrocardiogram is in diagnosing heart disease.
If your vision is 20/20 with your glasses or without any glasses, great. If your vision is not 20/20, “refraction” is the process of putting lenses in front of your eye to see if lenses can bring your vision to 20/20. If you can see 20/20 with refraction, then you just need glasses. If you still cannot see 20/20 with lenses, something is wrong with the eye, and the doctor must find out what. It could be cataracts, glaucoma, diabetes, macular degeneration or other problems with the cornea, lens or retina. Thus refraction shows your doctor right away that there is a medical problem that could threaten your vision.
It is unfortunate that medical insurance does not pay for this valuable test just because it could be used to provide a prescription for glasses. The refraction is extremely important in determining if there’s a serious medical issue. In fact, refraction is just as basic and just as important in diagnosing eye disease as the electrocardiogram is in diagnosing heart disease.
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