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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

Measuring Eye Pressure (IOP)

As part of your comprehensive eye exam, we check the pressure of your eye, the Intraocular Pressure (IOP).  This test, called tonometry, is one way to see if you are at risk for glaucoma. Regular screenings are a simple way to monitor your eye health.  Early detection is essential in the treatment of glaucoma, since many times there are no symptoms with increased pressure, unless it is sudden.

UNDERSTANDING EYE PRESSURE:

Increased pressure (IOP)

Inside the eye, there is a cycle of fluid production and fluid drainage.  This fluid, in the front part of your eye, is called the the aqueous humor.  The aqueous humor nourishes your eye and helps it to keep its shape.  If this cycle is out of balance, and more fluid is produced than is able to drain effectively, IOP increases.  Over time, this Increased eye pressure may cause damage to the optic nerve.  A general guideline for normal eye pressure is between 10 and 21 mm/hg.

HOW WE MEASURE EYE PRESSURE:

Measuring IOPIn our office, we measure eye pressure by instilling a drop that numbs your eye.  Using a blue light, we then use an applanation tonometer that gently touches the surface of your eye. This painless test is a very effective way of measuring your pressure.  It is helpful for the patient to relax and breathe normally while we perform this test.

Although there are many other ways of measuring eye pressure, many people are familiar with the “puff of air test”.   This test, called non-contact tonometry, uses a rapid air pulse to flatten the cornea. Your pressure is measured by detecting the force of the air against your eye.  Although we don’t use this process, often when we ask patients them to “put your chin in the chin rest and forehead against the band” they worry we are going to puff air at them. They don’t seem to like it! 

We can’t emphasize enough the importance of comprehensive eye exams. It is especially important to have an eye exam if you have a family history of eye disease, diabetes or high blood pressure. The best way to protect your vision is to come in for an exam, where Dr. Moran will evaluate your risk for disease and advise you of the optimal schedule of visits to protect your eye health.

Schedule your exam today, by calling our office at 610-628-2022, or by filling out the form on the website.

Surfer’s Eye

There is an eye condition called “Surfer’s Eye”.  Can you guess how it got its name?

surfing large

 

It’s not about the water…but If you thought it had to do with too much sun exposure, you would be right!

Long-term exposure to UV rays from the sun, as well as wind and dust, may result in growths on the surface of the eye.  Surfers are particularly vulnerable, since they spend their time in the sun without sunglasses or other eye protection.

The technical term for growths on the eye caused by sun exposure are called Pinguecula and Pterygium.  The condition appears on the eye’s conjuctiva (the clear covering over the white part of the eye.

pinguecula surfers eyePinguecula is a yellowish, raised growth on the conjunctiva. It’s usually on the side of the eye near your nose, but can happen on the other side too. A pinguecula is an abnormality formed by protein deposits, calcium or fat. It’s like a callus on your finger or toe.

 

Pterygium surfers eye

Pterygium (Surfer’s Eye) is a growth of fleshy tissue (has blood vessels). It usually has a triangular shape.  It can remain small or grow large enough to cover part of the cornea.  When it grows into the cornea, it can interfere with your vision.

Symptoms

The symptoms of pinguecula and pterygium can range from mild to severe. They include:

  • redness and swelling of the conjunctiva
  • a yellow spot or bump that builds on the white of your eye
  • dryness, itching and burning in the eye.
  • sensation of something in the eye

    Treatment

  • The best treatment is prevention…keep your eyes lubricated with artificial tears and wear sunglasses with UV protection.
  • If you have the condition, lubricating eye drops will help to reduce discomfort.
  • Your doctor can prescribe steroid eye drops which may reduce inflammation, redness and swelling in the eye.
  • Surgical Removal:  If eye drops alone don’t alleviate the symptoms, or if the growth is large enough to interfere with your vision, the growth can be removed surgically.

Protect your eyes, protect your vision.  If you have any questions about caring for your sight, email, call or text our office.  We are here to help!

 

 

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? Visual Field

The visual field test checks the range  of your peripheral vision by measuring the ability to see pinpoints of light that flash inside the testing globe.   The device measures the area that you can see up/down/left/right while the patient focuses straight ahead.

What is the visual field test used for?Humphrey Visual Field
  • Glaucoma Screening & Evaluation:  Loss of peripheral vision is often an early sign of glaucoma.  We repeat this test once a year so the doctor can evaluate treatment plans and the progression of the disease.
  • Lid Drooping (Ptosis):  If your eyelids have started to droop, the visual field can see if you have any loss of vision due to the drooping lid.
  • Effects of Medication:  We can also test for effects of medications, such as plaquenil, which can affect the central retina.
  • Optic Nerve Conditions: The visual field can help evaluate your vision affected by stroke, optic neuropathy, tumors and injury.
What is a normal visual field? 

The definition of a visual field is the space or range in which objects are visible to eyes that are fixed in place, focused on an object.

The normal human visual field extends to approximately:

  • Inward: 60 degrees nasally
  • Outward: 100 degrees temporally
  • Up: 60 degrees above
  • Down: 75 degrees below
Taking the test:

The testing device is a large globe or bowl, with pinpoints of light that flash on and off during the test. Patients press a button each time they see a light flash inside the globe. The lights flash in varying patterns and different levels of brightness.  It’s kind of like a video game!

During the test, the patient is asked to focus on an amber light directly in front of them, so that we can accurately measure the range of vision all around.  We test one eye at a time, so the eye that is not being tested is covered with an eye patch.  The test takes about 5-8 minutes per eye. Testing time can vary from patient to patient.

If you have questions about any of the tests that we do, please ask us in person, text or send us an email!  We are happy to explain how we use each device to better care for your vision.  

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.