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The Other Side of the Exam Chair

It was my turn to be on the other side of the exam chair.

I was sitting at home on a Sunday afternoon, when I first saw sparks of light out of the corner of my right eye.  At first, they occurred a few times an hour.  By Sunday night, they were happening a few times a minute.  They moved in curved arcs along my peripheral vision.

Since I happen to know people trained in eye care, I sent a text to the office staff to tell them what was happening.

They asked me all of the right questions:

  • Did you sustain an injury to the eye? No
  • Was there a curtain falling across my vision? – No
  • Did you see a sudden shower of floaters? – No
  • Any loss of vision? – No
  • Any pain? – No

Dr. Moran asked me, “What would you tell a patient who called with these symptoms?”  I answered, “We would tell them to call us if it gets worse, or they can answer YES to any of the above questions. We would then schedule them for a dilated exam the next day.” 

I understood everything that I was told.  It was a “classic textbook” issue.  I have spoken to patients who were experiencing the same symptoms, and explained that they should come in for an exam, but not to worry. Flashes can be a common occurrence.

But…I must admit that it felt different being the patient. Even though I understood what was happening,  I felt better after checking in with Dr. Moran and the rest of the team.

By the next morning, the symptoms had stopped. I had a very thorough dilated eye exam, and everything was normal. I knew that the sparks of lights were caused by the vitreous tugging on the retina, which is common.  It is seen more often in older adults.  I am 58, so I fit that profile.  I knew that the issue was most likely age-related.

When you are having an issue with your eyes, don’t delay, contact our office.   

We will ask you the key questions that mean the difference between an emergency, or something that can wait until you can come into the office for an exam.

You can feel confident that you are in good hands with Dr. Moran and the staff at Moran Eye Associates.  We take your concerns seriously, because we know what it is like to be on the other side of the exam chair.

P.S.  Almost two months later all is well.  I am very aware of the importance of  follow up exams, and will make sure to see my ophthalmologist regularly!  Bobbi

Drops or reading glasses?

Woman reading paper

Most everyone has heard of nearsightedness and farsightedness, but, presbyopia isn’t quite as familiar to most people.

Remember nearsighted is when you can’t see in the distance. And, farsighted is when you can’t see up close. Both of these problems are due to the incorrect length of your eye so the image doesn’t land in the correct spot on your retina.

Presbyopia starts when you are about 40 years old.  It is when you have difficulty seeing up close.  What makes it different than farsightedness is the reason for the problem. Presbyopia is because the lens of your eye can no longer focus enough to place the images on the correct spot  of your retina.

Presbyopia develops because of the process of aging. Think of it as farsightedness brought on by aging. The root of the word “presbyopia” actually means “old eyes” in Greek. Everyone gets presbyopia. You can circumvent the need for glasses to focus up close, if you’re nearsighted.  Taking off your glasses “resets” your eyes to near and you don’t need to focus.

Refractive surgery such as LASIK effectively corrects nearsightedness and farsightedness by reshaping the cornea.  It does not treat the lens, and in turn doesn’t correct presbyopia. LASIK surgery can help presbyopia vision by leaving a small amount of nearsightedness, similar to the trick of a nearsighted person taking off their glasses to read.

Eye drops instead of reading glasses?

Recently two kinds of eye drops are being tested to enter the market to help presbyopia. If these drops pass clinical trials patients may be reaching for drops instead of reading glasses. As with any type of treatment or medication there are pluses and minuses.  Not needing glasses to read is the obvious plus.

The first type of drop being tested is called a miotic drop. It makes the size of the pupil smaller creating a “pinhole effect.” This effect limits the out-of-focus light entering the eye, making both near and far things clearer. Headaches, limited night vision and a decrease in contrast have been reported as side effects. The drops take effect  30 minutes after administration and last four to seven hours.

The second type of drop softens the lens of the eye. As the lens becomes more flexible, as it was in the younger eye, it becomes easier to focus up close again. The drop won’t return the lens back to its peak at eighteen years of age, but it will turn the clock back ten years. The drops must be taken over a period of days or weeks to achieve results.

We’ll keep you posted

Neither of these drops are available to the general public at this time. Neither drop appear to be the “magic bullet”  in treating presbyopia. Your eye doctor will likely need to determine which, if  any, is correct for you.

Read more about LASIK & Presbyopia  

 

 

 

What is an Astigmatism?

Do you have an astigmatism?

The word might sound scary, but an astigmatism is nothing to be afraid of!  It is a common vision condition which most commonly occurs when the cornea (the clear front cover of the eye) is irregularly shaped.

If you have an astigmatism, the curve of your cornea is shaped more like a football, instead of round like a basketball.  This irregular curvature causes vision to be blurry, because your eye cannot focus light to a single sharp point on the retina.  Instead, light hits the retina in multiple places, so images are blurred.

You may have been born with astigmatism.  You could have inherited it from your parents.   It can decrease or increase over time. Astigmatism often occurs along with with nearsightedness, or farsightedness.

How is astigmatism measured?

Astigmatism refraction

Testing for astigmatism may may include:

  • Visual acuity-When you read letters on a distance chart, you are measuring your visual acuity. The result is given in two numbers, like 20/40.  The first number is the number of feet from the eye chart. The bottom number shows the smallest size line you can read.  If you have 20/40 vision, you would have to be within 20 feet of the chart to see what someone with normal vision could see at 40 feet.
  • Topography– This device measures the topography of the surface of the cornea.  As you might guess, this measurement is important for a good fit for contact lenses.
  • Refraction– You might know this as the “Better 1 or Better 2 test”.  While you look through an instrument called a phoropter, we rotate through a series of lenses.  Based on your answers, the power is then refined to determine the lenses for the clearest vision. This power can be determined with machines but patient input remains integral in determining vision needs.

How is Astigmatism Corrected?

A comprehensive eye exam will measure the correction or power needed for your vision, which may include a prescription to correct your astigmatism.  Eyeglasses or contact lenses will help you to focus and to see more clearly.

  • Eyeglasses. Astigmatism can be treated with a pair of prescription eyeglasses.  The lens will have a prescription that compensates for the astigmatism. This prescription provides additional power in specific parts of the lens.  The correction power lies along a specific axis.
  • Contact lenses.  Contact lenses may provide clearer vision and a wider field of view.  A special toric soft contact lens offers astigmatism correction for many patients. This contact lens is weighted so that it maintains the correct axis when worn. Another contact lens option is a rigid gas-permeable (RGP or “hard”) contact lenses to help reshape the cornea decreasing the astigmatism.
  • Laser and other refractive surgery procedures. LASIK or PRK surgery can correct astigmatism by reshaping the cornea.  With LASIK using Custom-Vue Wavescan, your  treatment is tailored to your eyes.  Dr. Moran has great success treating patients with astigmatism.

Let us help you achieve your best vision.  Schedule an appointment to correct your vision.  Click here for more information on LASIK

Expert Education – OCT Lecture

 

Continuing Education Lecture – Dr. Moran Presents

Dr. Moran recently gave a presentation to local optometrists at our office in Fountain Hill.  This lecture was part of a professional continuing education program approved by the Pennsylvania State Board of Optometry. The doctors that attended earned two continuing education credits, and learned valuable diagnostic skills.

OCT lecture certificate

The topic was History and Mechanism of Retinal Coherence Tomography (OCT).  The OCT is a device that scans the retina using light waves.

Dr. Moran illustrated each of the retina’s distinctive layers, which are seen clearly on the test. The scan allows the doctor to check on the health of the eye, measuring and tracking changes to the retina.  This information is important to  diagnose retinal disease such as macular degeneration.  In addition to retinal scans, the OCT is also used to take pictures of the optic nerve, which helps to monitor glaucoma.

Since the lecture was done at our office, the doctors were able to get hands-on experience with our OCT equipment. During the lecture, Dr. Moran presented case studies, which offered the doctors a chance to make their own diagnoses based on the scans and some basic patient information – gender, date of birth, date.

Case Study

In one such case study, the date of the scan was an important diagnostic clue!  Remember the solar eclipse on August 21, 2017?  And do you remember the warnings not to look directly at the eclipse without special lenses.  The scan was taken on August 22nd, the day after the eclipse.  As The test showed that he had retinal damage because he looked directly at the eclipse…he didn’t listen to the warningsLecture shows eclipse damage

In addition to the presentation,  everyone who attended the lecture was treated to a homemade dinner featuring Beth’s turkey barbeque, with all the fixings.  We celebrated the season of thanksgiving with pumpkin and apple pies!  Education is always easier on a full stomach!

UP NEXT

In 2020, Dr. Moran will be taking this presentation on the road.  He will be giving a similar seminar on interpretation of OCT tests at an upcoming ophthalmology conference.  Education has always been an important part of his professional life, and is a vital part of our practice.  Whether it is educating doctors, staff or patients, Dr. Moran provides excellent instruction!

Along with his medical practice, Dr. Moran is also a Clinical Associate Professor in the Department of Surgery at the Philadelphia College of Osteopathic Medicine (PCOM).  He graduated from PCOM in 1986. In 2017, he earned a Masters Degree in Healthcare Informatics from Drexel University.

Want to know more about your vision and the health of your eyes?  We are happy to take the time to help you understand, just ask!

 

What does this Test Do? Pinhole Test

Why do I see better when I look through the pinhole?

When we check your vision, we test each eye individually using an occluder.

The occluder is a simple device that covers one eye at a time.  If your vision isn’t clear, we move the pinholes into place and have you look at the eye chart again. If your vision improves with the pinholes, it means that your vision may be corrected with glasses or contacts.

The pinhole is a simple way to focus light.  When you look through this tiny hole, light enters through the center of the lens of the eye only. If you can read the 20/20 line when looking through the pinholes, you should be able to see 20/20 with the correct prescription.  Click to learn more about 20/20 vision

Ever wonder why squinting helps you to see better?  It’s the same principle as looking through the pinholes.  By squinting, you reduce the focusing area, which makes things appear sharper.

If your vision does not improve when you look through the pinhole, there may be other factors that affect your vision.  The other issues that could be affecting your vision may include cataracts or problems with your retina.  Lack of vision improvement with this simple test can be the first step in diagnosing, and correcting your vision problems.

 

 

 

 

 

Your Pharmacist – A Great Resource

Pharmacist and prescription medications

Talk to your pharmacist…you’ll be glad you did!

Have you spoken to your pharmacist lately?  We know that prescription medications can be expensive. Your pharmacist can help you manage your medications, and may be able to help you find savings on your prescriptions.

Make friends with your pharmacist.

Your pharmacist is an essential part of your healthcare team.  They may be aware of resources that can save you money, all you have to do is ask!  Ask if you can speak with your pharmacist, they are happy to take a few minutes to review your medications.  Most pharmacies have a private place for patient consultations.

Discount PROGRAMS.

Your pharmacist might be aware of discount programs that can save you money.  They have a complete list of your medications, so they can can review the list with you.  Talk to the pharmacy staff to see if there are any discount plans or strategies that might help you save some money.

ASK YOUR DOCTOR.

Ask your doctor if you there is a generic version of the medication.  Generics are less expensive, and have the same active ingredients as the brand-name medications.

We want you to stay on track with the medications that are prescribed for you.  The first step toward that goal is making sure that you get the medications that you need to stay healthy.

We know that an informed patient makes the best healthcare decisions, so make sure ask questions!  You can benefit from relationships with every member of your healthcare team.