Wednesday, October 20, 2010

Researchers Using Lasers To Correct Presbyopia

Lasik has been the most discussed process for vision correction - and it certainly does wonders for the near sighted individual. Many middle-aged folks have not had many good options so far. Researchers are constantly improving on techniques to help this demographic.
In one technique, researchers used lasers to re-engineer the eyeball, either by cutting slits, into which tiny lenses can be inserted, or by altering the shape of its outer layer. Leading this field is Technolas Perfect Vision of Germany born out of a joint venture between Bausch & Lomb's Refractive Surgery unit and 20/10 Perfect Vision.
They have patented a process called INTRACOR a technique that provides flapless intrastromal correction using the TECHNOLAS® Femtosecond Workstation, to achieve reshaping of the cornea.

INTRACOR presbyopia procedure is based on a gentle, localized change in corneal curvature. The epithelium and Bowman’s membrane both remain fully intact.

Presbyopia correction with INTRACOR® lasts approximately 20 seconds. During the procedure, gas bubbles form in the cornea, and the patient's vision is blurred for 2 to 3 hours. When the bubbles dissolve, the cornea clears and the distance visual acuity returns. After that, the patient can immediately notice the change in near visual acuity. On the first day after sugery, most patients experience a gain in near visual acuity.
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Tuesday, October 19, 2010


My primary computer is a Macbook Pro and I have been a Mac fan for a lot longer. My office has many iMac's and my staff have come to love its stability and ease of use too.
At home, I have been dabbling in the operating system Ubuntu for a few years now.
I came upon a recent article in Lifehacker about turning your Ubuntu system into a Mac look alike.
The instructions were very simple: Just type four lines in a Terminal window, hitting Enter after each one:

Here is my desktop

Awesome, No?

FDA approval for Ista Pharma’s Bromday eye drop

Cataract in Human EyeWikipedia
Food and Drug Administration
has approved Ista Pharmaceutical's drug Bromday (bromfenac ophthalmic solution) as a once-daily eye drop to treat inflammation and reduce pain in patients following cataract extraction. Shares of Ista Pharmaceuticals Inc. rallied on Monday after this announcement.
Ista already sells Xibrom [bromfenac ophthalmic], a twice-daily eye drop for postoperative inflammation and the reduction of ocular pain in patients who have undergone cataract surgery.
The company reported Xibrom net sales of $81.1 million in 2009. Once Bromday is established with ophthalmologists in the U.S., the company will discontinue Xibrom (bromfenac ophthalmic solution). Xibrom was the first twice-daily NSAID approved for the treatment of this specific problem. It is the revenue leader and one of the fastest growing products in the $335 million U.S. ocular inflammation market. Xibrom revenues in the first half of 2010 were $41 million. The company expects 2010 revenues for Xibrom and Bromday combined of $95–105 million.
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Inhalants For Sexual Pleasure May Cause Eye Damage

In the Vital Signs column in the New York Times, Roni Caryn Robin reports, "Users call them poppers: a class of chemicals called alkyl nitrites that can be inhaled for a quick high, or to enhance sexual pleasure." Now doctors in France are warning that they can also cause eye damage and impaired vision.

In a letter to The New England Journal of Medicine, the author Catherine Vignal-Clermont, M.D.

Fondation Ophtalmologique Adolphe de Rothschild, Paris, France describe four cases over three months in which patients' vision was affected after they used poppers at parties. Exactly how poppers can affect vision is unknown, but it is likely due to a flood of an alkyl nitrite named isopropyl nitrite, which releases nitric oxide.

Consumers and eye care providers should be aware of the possible retinal toxicity of poppers, especially if there is vision loss in both eyes, the researchers conclude.

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Tuesday, October 12, 2010

Is Health Care Recesion Proof?

Americans are abandoning their prescriptions at pharmacies rather than pay higher prices for them, according to a recent analysis of 80 million pharmacy claims conducted by Wolters Kluwer Pharma Solutions. This was reported in the Wall Street Journal.

Wen I started my practice as a 'cold start' 2 years ago (smack bang at the start of this downhill trend!) many friends and relatives assured me that health care is pretty much recession proof. The new data shows that many folks are making some very tough decisions.

The data showed that this phenomenon increased by 55% during the second quarter of 2010, compared to 2006 statistics. Conventional wisdom has indicated that prescription medicines were not susceptible to economic downturns since sick people must take medication in order recover. This new evidence, however, suggests that people are deciding whether to pick up prescriptions based on price.

The average co-pays for brand-name drugs such as cholesterol fighter Lipitor rose to $28 a prescription this year, an 87% jump from 2000, according to the Kaiser Family Foundation. Some co-pays can be as high as $100!

The article quotes Anne Peters, director of the University of Southern California's Clinical Diabetes Program. She notes that patients lost control of their blood-sugar levels after either abandoning Lantus insulin prescriptions or spacing out its use because of the expense, she said.

In response, Dr. Peters is prescribing a less-expensive insulin sold at Wal-Mart Stores Inc. A 10ml vial of Lantus costs $111.88 on, while Wal-Mart charges $24.88 for the same size vial of Humulin ReliOn insulin.

Now, this also brings into question the role Walmart plays in the healthcare field. A very common gripe of private practices like mine is the dispensing of contact lenses at Walmart. The big box retail is able to sell Acuvue2 at a price that is practically unmatched by anyone else. Frequently I prescribe an alternative based on examination findings. Yet, the patient calls back to request I write for Acuvue2 as it is far less expensive! I suppose this is another story for another day!

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Americans Undergoing Treatment For Retinal Conditions Doubled Over 10 Years.

The number of older Americans getting help for fading eyesight almost tripled by 2007 from a decade earlier as the nation aged," according to a study published in the October issue of the Archives of Ophthalmology.

Medicare recipients in 2007 received 812,413 injections into the eye with drugs like Roche’s Lucentis for macular degeneration or Avastin, up from fewer than 5,000 a year from 1997 to 2001, a study in the Archives of Ophthalmology found. Use of rival drugs, laser treatments and photodynamic therapy, such as QLT Inc.’s Visudyne, plunged, according to Dr Ramulu and colleagues from Johns Hopkins University’s Wilmer Eye Institute.

Approximately 1.5 percent of those older than 40, have age-related macular degeneration, according to the National Eye Institute. The number is expected to reach 3 million by 2020 as the population ages, the agency says.

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Thursday, October 07, 2010

Blind People Use Visual Cortex To Heighten Senses Of Touch, Hearing.

A fMRI scan showing regions of activation in o...Image via Wikipedia

Blind people use the visual part of their brain to heighten their senses of touch and hearing, according to a study published in the Oct. 6 issue of the journal Neuron.

In the study, researchers used functional MRI to observe brain activity in 12 people who were blind from birth and 12 sighted people as they performed a set of tasks involving hearing and feeling. The investigators found that the visual cortex in the blind takes on these functions and processes sound and tactile information, which it doesn't do in the sighted.

"The neural cells and fibers are still there and still functioning, processing spatial attributes of stimuli, driven not by sight but by hearing and touch", the study's lead author Josef P. Rauschecker, a professor in the department of physiology and biophysics at Georgetown University Medical Center, explained.

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