Stargardt’s disease is an inherited disorder of the retina. This disease starts to develop visual changes in patients in their childhood or teenage years. The changes are gradual but constant until their vision is decreased approximately to 20/200 or worse uncorrected. This condition is also called Stargardt’s macular dystrophy, juvenile macular degeneration, or fundus flavimaculatus. This disease damages or degenerates the macula, which is in the retina. The macula is the area in the eye that delivers sharp straight-ahead vision.
Patients with Stargardt’s experiences a slow and constant central vision loss, hence, becoming sensitive to bright lights. The retina contains light-sensing cells called photoreceptors. These are called rods and cones. Both rods and cones photoreceptors gradually die due to this disease.
As we mentioned earlier, this disease is inherited in most instances due to a mutation in a gene called ABCA4. The ABCA4 gene created a protein that clears Vitamin A byproducts inside the photoreceptors. Due to the cells not being cleansed, the cells become full of fatty substances and consequently the cell dies. This degeneration starts to happen around the macula which is the reason why patients start losing their central vision.
To diagnose Stragardt’s disease, an eye physician needs to do a thorough and complete eye exam.
The following tests are recommended:
- Slit eye exam. An eye physician will see the fatty deposit in the macular under the microscope if Stargardt’s is present
- Visual field testing to determine the areas and progression of the disease
- Color testing determine if the patient is becoming color blind
- A fundus photo which is a detailed picture of the retina
- An electroretinography (ERG) measures the response of cones and rods to light
- Optical Coherence Tomography (OCT) which is a light wave scanning device of the retina
Unfortunately, there is no treatment for Stargardt’s. Patients are encouraged to wear dark sunglasses, not to smoke, and not to take Vitamin A supplements. Low vision aids are quite sophisticated right now and they can lend a lot of help by magnifying images or providing voice commands. Many Stargardts patients become visually disabled in their 20s which can take a significant emotional toll on the individual and their loved ones. Good medical eye care, counseling, and a supportive circle of friends and family are necessary to best confront this disease. There are multiple studies and research worldwide in the works addressing the degeneration of the macula. We look forward, with anticipation, to a new treatment in the medical field to aid all our patient’s with Stargardt’s and Macular Degeneration.
Happy New Year! May 2021 bring us all health, peace and happiness.
Glaucoma is called “The Thief of Sight” because it occurs so gradually that you may not even be aware that you are experiencing vision loss due to glaucoma. Glaucoma occurs when pressure in the eye becomes higher than normal resulting in increased pressure on the optic nerve, pinching the blood vessels that carry blood to the retina and optic nerve.
While many people schedule a baseline screening every year or so, the BEST way to prevent glaucoma is with a comprehensive eye exam. Some people have a higher risk of developing glaucoma. If you are in any of these categories, please call us for a full eye exam:
- Relatives with glaucoma
- African, Asian, or Hispanic background
- Farsighted or nearsighted vision
- High eye pressure on previous exam
- Have diabetes, migraines, or high blood pressure
- Long term use of steroids
Glaucoma is one of the leading causes of blindness but it does not have to happen to you. Early testing and prevention are extremely important, especially since there is no known cure. For vision already lost due to glaucoma these are three procedures that can help to stop glaucoma in its tracks. If you are diagnosed with glaucoma, we can explain these options thoroughly and choose which is best suited for your condition. The goal of any treatment is to lower your eye pressure to a safe level.
- Prescription eye drops
- Laser glaucoma surgery
- Filtration surgery
Anyone can be at risk from glaucoma; everyone from babies to senior citizens can be at risk. Actually, 1 out of every 10,000 babies is born with glaucoma.
Here is the key: When glaucoma is diagnosed and treated adequately, vision can be preserved rarely ending in blindness, hence, the upmost importance of regular eye exams.
Dry eye disease is more common than you might realize, with over 16 million Americans carrying the diagnosis. Many more patients may suffer from these symptoms without a diagnosis, and it has been suggested that one out of every two American adults may experience symptoms of dry eye. About one-third of all the patients I see have complaints that relate to dryness. These symptoms may include blurry vision, glare or light sensitivity, eye pain or foreign body sensation, itching, redness, burning, and tearing. Some patients may have difficulty wearing contact lenses, or notice eye fatigue after reading of watching television. These symptoms can occur in isolation or in any combination.
Most people think that dry eye is just not having enough tears. For some people this is true, but for most people, they might make enough water for the tears, but the tears do not stay on the eye long enough to coat the surface well. These individuals have tears that evaporate too quickly, or perhaps they have excessive tearing – meaning that the tears that are supposed to coat the eye instead run down the cheek. The reason for this is that there is another important part of a healthy tear film – the oil component – which helps the tears stick to the eye. These oils come from the Meibomian glands, tiny glands along the edge of the eyelids that release beads of oil with the force of each blink. If the Meibomian glands are inflamed from blepharitis or Meibomian Gland Dysfunction (MGD) – inflammation of the eyelids, the oil becomes thick and clogs the glands, preventing healthy oil from being released onto the surface of the eye.
Normal oil from the Meibomian glands is free flowing, like olive oil. Inflammation leads to oil that looks like toothpaste, or butter straight out of the refrigerator. When we treat blepharitis, we focus on warm compresses which help to “melt the butter” and improve the flow of oil out of the glands by using heat to liquefy the oil. This is used at least twice daily to maintain healthy Meibomian glands. At the Rand Eye Institute, we have the ability to use state of the art imaging technology called Lipiview, which can directly produce an image of the glands, so that our doctors and patients can see the health of the oil glands and decide on the appropriate treatment plan.
We are very excited to offer our patients who have MGD an additional therapy that is in addition to the traditional dry eye therapies that can be used at home. Lipiflow thermal pulsation technology is available at the Rand Eye Institute. Lipiflow uses a novel device to heat and massage the blocked glands in a 12-minute procedure as part of the exam in the doctor’s office. The system’s activators, which are single use and sterile, are placed on the eye, after numbing drops have been instilled. The procedure is not painful. Most patients say that it’s not only comfortable, but feels good, just like an extended warm compress in a spa-like environment. There is no downtime, and patients start to feel an improvement in symptoms within 4-6 weeks.
This procedure is perfect for patients who are symptomatic with dry eye disease, with Meibomian gland dysfunction that are doing all the correct treatments daily, but looking for something a little stronger to help with their symptoms. The analogy is that you may be brushing your teeth every day, but still want to go to the dentist for a deep cleaning. Lipiflow can be repeated as needed, and many patients choose to have touch up treatments once a year.
We are thrilled with how happy our patients are with the results of their Lipiflow treatments. Receiving proper treatment for dry eye can be life-changing. Please let us know if you are having dry eye symptoms so that we can select the right treatment plan for your individual needs. Give us a call for a dry eye consultation. Dry Eye relief is just a call away to Rand Eye Institute.
Image Enclosed from J&J.
It’s August and while summer vacation is winding down, students and parents are preparing for another school year. This year, don’t forget to include on your back-to-school checklist an annual eye exam.
It is important to have your child’s eyes tested, because it can lead to greater success in the classroom since much of a child’s learning occurs visually.
Have you noticed any change in your child’s vision? Here are some signs and behaviors you can watch for that may indicate a child is struggling with his or her vision.
Is Your Child Doing Any of the Following?
- Rubs eyes frequently;
- Closes or covers one eye;
- Tilts head or thrusts head forward;
- Has trouble reading or doing other close-up work, or holds objects close to eyes to see;
- Blinks more than usual or seems cranky when doing close-up work; or
- Squints eyes or frowns.
Does Your Child Say Any of the Following?
- “I can’t see very well”
- After doing close-up work, your child says, “I feel dizzy,” or “I have a headache,”
- “Everything looks blurry,” or “I see double.”
It is recommended that your child have an annual eye exam to screen for any abnormal changes in vision or to confirm that all is well. Let’s start the new school year off with an “A” in vision!
Cataracts are one of the leading causes of vision loss in the United States yet can be corrected to restore a person’s eyesight with accurate and precise technology.
What are the signs of cataracts?
A cataract is a clouding of the eye’s natural lens that affects many of us as we age.
- People with cataracts often have blurry or double vision.
- Colors start to appear dull or muted.
- Sunlight seems overly bright or glaring.
- Driving at night becomes difficult due to glare or halos. around traffic lights and signs.
- Your eyeglass prescription changes too often and still is not perfect.
The sooner you address your eye concerns and how they affect your everyday activities, the sooner you can enjoy your new restored vision. A cataract left untreated may lead to blindness.
Adult cataracts develop slowly over time, beginning at around age 55. The American Academy of Ophthalmology reports that by age 75, about 70% of people will have cataracts.
Experience and Expertise to See Your Very Best
Early diagnosis is important for maintaining good eye health. Fortunately, we live in a time when correcting cataracts is easily accessible, and the results you can get from The Rand Eye Institute can be extraordinary. Ask about Rand Eye’s Custom Laser Cataract Surgery with the LenSx® Procedure and the various options available to provide your best corrected vision. Schedule a comprehensive eye exam today.
It’s a known fact that we get our eye color from our parents. But did you know that your eye health can be hereditary, too?
That’s why during Healthy Vision Month, and all year long, you should talk to your family members, including parents, grandparents, aunts and uncles, about THEIR eye health history. You might be surprised to learn that genes are a factor in eye disease, including the leading causes of blindness.
In order to keep your eye health on the straight and narrow, learn if anyone in your family history has been diagnosed with an eye disease. This will help determine if you’re at a higher risk for developing an eye disease yourself.
So while you may have “Your Father’s Eyes”, you may end up with his eye conditions too.
If you think you might be at risk, or if it’s been a while since you’ve had an eye exam, like more than a year or two, you owe it to your future family members to have a comprehensive eye exam. Call or click here to schedule yours.
We’ve cautioned over the years about the hazards of smoking, but in this article for Healthy Vision Month, here are the specifics as to why so many serious vision problems could be lessened or eliminated if we just put down the cigarettes, and that includes cigars and pipes.
Dry Eye is not directly related to smoking, but it’s easy to see how smoking can make your eyes feel scratchy, burn or turn red.
Cataracts are a clouding of the eye’s natural clear lens. Because smoke from cigarettes goes directly into the bloodstream, smokers are more at risk for getting cataracts.
AMD, or age related macular degeneration, is more likely to happen to someone who smokes than to someone who doesn’t. Currently there is NO cure for AMD.
Diabetic retinopathy can occur in smokers who already have diabetes.
Optic nerve problems can lead to blindness, and those who smoke are at increased risk of having optic nerve problems.
Uveitis affects the part of the eye called the uvea. Smoking can lead to uveitis.
Graves’ disease is a disease of the body’s thyroid gland. One symptom is bulging eyes. Smokers who have Graves’ disease run the risk of going blind.
Pregnant women who smoke run the risk of their child getting bacterial meningitis, known to cause vision problems. Premature birth is another symptom, which could result in “retinopathy of prematurity”, which could mean vision loss or blindness.
The simple truth: Quitting smoking can help save your vision, and during Healthy Vision Month, it’s more important than ever to know this information.
This month, you might be seeing lots of tips and suggestions for Healthy Vision Month, but before you take them all in, take yourself in for a comprehensive eye exam.
The American Academy of Ophthalmology recommends a baseline eye exam at age 40. That’s the time when early signs of disease and changes in your vision can start to occur. Do you have a family history of eye problems? Do you have diabetes or high blood pressure? These can factor into your decision to have an eye exam more frequently.
Upon examining your eyes, your ophthalmologist can tell you how often you should undergo an eye exam. As we age, it’s more important to have our eyes checked regularly as our risk for eye disease increases.
If you are or have been at risk, or you are 65 years or older, it’s recommended that you schedule a comprehensive dilated eye exam. This important exam can take up to 90 minutes and should include the following:
- A rundown of your family medical history, whether you wear glasses or contacts and which medication, if any, you take.
- Visual acuity. Reading a standard eye chart at various distances.
- Your pupils and how they respond to light shined in.
- Side vision.
- Eye movement.
- Your eye pressure, which can indicate signs of glaucoma.
- The front part of your eye.
- Your retina and optic nerve.
- And your current vision prescription.
Depending upon the results of your eye exam, your ophthalmologist may conduct further tests using specialized equipment to try and diagnose a disease in its early stages or give you a clean bill of health. Either way, don’t overlook the opportunity to have your eyes checked. Maybe this month is the time.
If you’d like to schedule a baseline eye exam or a comprehensive dilated eye exam, please contact us today!
Fleet Week is here in South Florida and it brings to mind a patient of Rand Eye Institute who today is soaring high. Here’s his story:
It’s not often that a growing boy will turn down the chance to dive into a huge summer picnic basket, but that’s exactly what a young Steven Hollender did. Attending an air show with his grandparents many years ago, he was called away to lunch. “Not now. I want to see the planes”, shouted Steven.
Ever since that day, and even before, Steven’s career has been looking up. From as far back as Steven’s mother Carmelann Hollender can remember, “He always had an interest in planes and spaceships.”
When he graduated from Hunterdon Central Regional High School in Flemington, NJ in 2006, he announced to the family that he wanted to fly and knew just the flight school he planned to attend: Embry-Riddle Aeronautical University in Daytona Beach, FL, where he was awarded a three and a half year scholarship.
He graduated from Embry-Riddle with Dean’s List honors three of his four years. Before he could become a pilot, though, Steven had one obstacle to overcome: His less than perfect vision was preventing him from sitting in the #1 seat. At his grandmother Joan Di Maio’s request, her optometrist, Dr. Steven Koganovsky from Margate, FL made a personal call to Rand Eye Institute’s Medical Director, Dr. William J, Rand. Dr. Koganovsky asked if he would please see Steven, “I want you to treat Steven like he’s your grandson”, Dr. Koganosky told Dr. Rand, and that’s exactly what he did.
Steven came to the Rand Eye Institute on July 7, 2008, where Dr. William J. Rand had the honor of personally performing the Advanced Surface Laser Procedure, or No-Flap LASIK on Steven, which restored his vision to crystal clarity, a requirement to fly for the US Navy. Almost a decade has passed and Steven’s vision keeps his eagle eyes trained on his passion.
While Steven’s future was looking up, today he’s looking down, from the cockpit of an F-18 fighter jet, where he’s a pilot in the U.S. Navy. Steven recently returned from deployment in the South China Sea and is now living back in California.
“Dr. Rand, I just want to thank you for all you have done for me in correcting my eye problems,” said Steven. “If it wasn’t for you and your staff, I would not be a naval aviator.” Steven’s mother Carmelann backs him up, “Without Dr. Rand’s help, it wouldn’t have been possible.”
Now that Steven’s deployment overseas has ended, he’s back at his home base, The Naval Air Station in Lemoore, CA, where every August, thousands of young boys just like Steven once was, put their lunch to the side to be mesmerized at the Wings over Camarillo air show.
Thank you, Steven, for trusting Dr. Rand with your LASEK at Rand Eye Institute. We’re honored to have played a small role in your vision, launching your career as a fighter pilot. We salute YOU!
For more info on the Ft. Lauderdale Fleet Week schedule here.
Healthy Vision Month is all this month, so while it’s top of mind, here are some ways to help keep your vision healthy all year long.
The first one is to pop on a pair of shades that offer 100% UV protection to block UV-A and UV-B rays. Sunglasses help prevent retina damage too and protect the delicate eyelid skin, plus they make you look CSI-Miami cool.
Smoking is a no-no on every list we make. Studies have shown that smokers are more likely to develop AMD than non-smokers. We could write an entire article on the hazards of smoking, but enough said: QUIT NOW.
Proper eye protection is a biggie. Just look over our April blogs for more detailed information on which protection is best for your particular needs, then get them.
Have a family reunion with your family history. Sure, summer’s coming. We love to get together for grillin’ and relaxing, but take time during that opportunity to get to know your family’s medical history to see if you can ward off any genetic eye problems before they occur, then, early intervention with a comprehensive dilated eye-exam can be just what the (eye) doctor ordered.
Eye fatigue, including Computer Vision Syndrome, is a real condition. Consider that more than 70% of the world uses smart phones with that tiny text. Get some relief by reviewing our blog from March here.
And finally, exercising and eating right makes perfect sense for your eyes too. Carrots REALLY do offer vision benefits.