Articles

Lots of people deal with chronic eye and vision problems — including the rich and famous.

For instance, John Goodman took time off from his busy film career a few years ago to have his cataracts removed. Though he had just turned 60, his vision had deteriorated enough to make daily life a challenge.

Goodman chose to have his natural eye lenses replaced with an advanced intraocular lens (IOL). The Indiana Eye Clinic has a number of options on advanced lens for cataract patients.

It’s a common fallacy that cataracts only affects senior citizens. In fact, we frequently see patients in their 50s or even 40s with cataracts!

This article has a list of other well-known people dealing with chronic issues that impact their vision. What’s interesting is that many of these conditions were not even known about until the celebrity chose to share the news themselves. It just goes to show that people can live healthy, happy and productive lives while dealing with eye issues.

Did you know that Mila Kunis was blind in one eye for many years? Her large, dark eyes are undoubtedly her most famous feature. She suffered from iritis, in inflammation of the eye. She eventually underwent surgery to correct the problem, and now has normal vision. This also involved replacing her natural lens with an artificial lens.

Other celebs with eye problems:

  • Bono of U2 has glaucoma. This possibly explains his ever-present sunglasses.
  • Judi Dench has age-related macular degeneration.
  • Missy Elliott sought therapy and treatment for Graves’ Disease, which can cause eyes to bulge or protrude.
  • Brittany Howard of the band Alabama Shakes had multiple eye conditions from early childhood, including  retinoblastoma, or cancer of the eye, that left her partially blind in one eye.

It just goes to show that wealth or fame doesn’t prevent anyone from having vision problems. Many of these can be prevented or addressed more effectively the earlier they’re detected. If you’re experiencing issues with your eyesight, seek help from a qualified ophthalmic physician right away.

 

Now that the warm weather is finally here, you can look your best with a little help from the Indiana Eye Clinic!

On April 18 at our Greenwood clinic and on April 20 at your Plainfield clinic, we’ll be hosting Botox Night. Attendees can obtain botox injections at a greatly reduced price. It takes just 10 minutes and is virtually painless.

Dr. Carissa M. Barina is a board-certified ophthalmic surgeon who has more than a decade of experience specializing in Botox® to temporarily soften lines around your eyes, or anywhere else on your face. Results can last for months!

Botox is a safe and effective way to diminish the appearance of facial wrinkles using tiny injections. It is the only treatment of its kind that is approved by the federal Food & Drug Administration (FDA).

Click here for more information and to register!

Nathan Gehlhausen
Ambulatory Surgery Center Director

After seven years in the workforce as a sales representative for different organizations, Nathan Gehlhausen decided to go back to school. Coming from a family of physicians, including his own father, Nathan knew he wanted to work in healthcare. It was a burgeoning field with lots of opportunity to help people, something about which he’s passionate.

“I grew up in and around healthcare. It was just a field I felt comfortable and knowledgeable in,” he said. “It will always be a necessity and in demand.”

After earning his bachelor’s degree in business administration from Marian College (now University), he obtained a master’s degree in healthcare administration from Indiana University. He then worked for a local healthcare network with their resident programs and medical research before joining Indiana Eye Clinic as Director of its Ambulatory Surgery Center in May of 2015.

“We have extremely knowledgeable and experienced owners and surgeons and a dedicated staff. We have a lot of highly satisfied patients, which is very rewarding,” Nathan said. “What I do in a nutshell is to make sure the patients have a great experience, the surgeons have a great day, and we maintain a financially viable future for the surgery center.”

Nathan oversees the daily operations of the surgery center which includes planning, organizing, and directing all activities of the facility according to its policies, procedures, philosophy, and objectives. He also ensures the facility meets all related local, state, federal, and accrediting-body rules and regulations.

In his spare time, Nathan enjoys playing sports and exploring the outdoors, especially with his family and 9-year-old son. He participates in soccer, softball, rock climbing, tennis, racquetball, basketball – “I’ll do pretty much anything that is competitive,” he says. Nathan also coaches his son’s soccer team, enjoys live music, cooking, and traveling.

Indiana Eye Clinic’s Ambulatory Surgery Center (ASC) was one of the first of its kind to be licensed in the state of Indiana. They have become more popular with the passage of years, in no small part because they can keep costs down — for both patients and doctors — while maintaining the same outcomes as a hospital surgery center.

Recently the Indianapolis Star ran an article on which local hospitals have the cheapest prices for various procedures, including surgical eye procedures. You can read the entire article by clicking here.

In its survey of cataract surgery with lens replacement, the state average to have this procedure at a hospital is $8,582. One area hospital came in below this figure, but four other hospitals were quite a bit above that average. One hospital charged nearly $11,000!

Compared to this, the cost to have cataract surgery at an ASC is much lower.

Here at the Indiana Eye Clinic, you can have the same procedure done for as little as $3,550, which includes physician and facility fee charges.

As you can see, there are ways to cut your medical bills, and ambulatory surgery centers are one vehicle to do just that.

Did you know that your body makes more than one type of tear?

It’s true! We tend to think of tears as being a single type of liquid, like blood or urine. But in fact, the body produces several distinct kinds of tears that depend on our body’s physical or emotional response to situations and stimuli, according to an article on the website of the American Academy of Ophthalmology.

For instance, what we consider “normal” tears — the kind that lubricates, nourishes and protects your cornea — are known as basal tears.

Reflex tears are formed when your needs need to wash away harmful irritants. Emotional tears are produced when you are happy or sad, or some other emotional state, and actually contain hormones and proteins not present in other types of tears.

You may also not have known that tears have different layers. Or that the average human produces 15 to 30 gallons of tears every year!

Click here to read the entire article.

By Michael L. Hopen, M.D.
Ophthalmologist, Indiana Eye Clinic

October is National Seafood Month, and the Indianapolis coalition of the Seafood Nutrition Partnership is urging Hoosiers to incorporate more fish into their diet.

You may already know that fish and other seafood are a huge tool for better heart health. Cardiovascular disease is the leading cause of death in the U.S., and as a nation we spend $273 billion per year treating it.

Seafood is one of the healthiest proteins you can eat, high in Omega-3 fatty acids that help make up that “good cholesterol” you’ve probably heard your family physician talk about.

As an eye surgeon, I decided to join the SNP coalition myself as a way to let people know that seafood has another benefit of which they may not be aware: helping you see better. Eating seafood contributes greatly to the health of the eye, and can help stave off diseases that can rob you of your vision.

I have long recommended to my patients that they increase the amount of seafood in their diet. Omega-3’s are beneficial for various aspects of the eye, especially maintaining the health of the surface of the eye. Many vision problems can occur when the eye is not properly lubricated or the outer layer is weakened.

Seafood can be especially beneficial to the eyesight in young children and infants, as it is proven to contribute to vision development and nerve growth in the retina. Malnutrition can also increase susceptibility to eye conditions like cataracts and age-related macular degeneration (AMD).

In its Dietary Guidelines, the U.S. Department of Agriculture recommends we eat at least two servings of seafood a week. But only about 20 percent of Americans actually do. Hoosiers on average consume even less.

The health benefits of a diet high in seafood are clinically proven. Eating just eight ounces per week reduces the risk of dying from heart disease by at least 36%. Adults with blood levels high in the fatty acids found in fish on average live 2.2 years longer.

A lot of people don’t eat seafood because it wasn’t served much in their household growing up. They feel they don’t know how to cook it properly, or worry about the cost.

You can visit the SNP website at seafoodnutrition.org for recipes and coupons to assist in adding more seafood to your diet. Or go to seafoodindy.org for a list of local events this month. You can even sign up for their newsletter to receive regular updates and encouragement via email.

Any kind of seafood is good for you, whether you buy it fresh, frozen or even canned. Though try to avoid deep frying if you can – all that batter and oil is high in fat and bad cholesterol!

Make an effort this month to try some new seafood dishes. Experiment, find things you like and add them to your regular meal rotation. Together, we can enjoy longer, healthier lives – and better eyesight — if we just pick fish more often at meal time.

The Stories That Matter

By Dr. Charles O. McCormick III

Recently I was delighted to attend the Greenwood Mayor’s Breakfast at the invitation of the local Crossroads Council of the Boy Scouts of America. Mayor Mark Myers was the keynote speaker in a gathering of professionals, business people and volunteers to advocate for Scouting’s value in character building, achievement, outdoors survival and citizenship.

Several of my old friends also attended, and we were all honored by student Scouts in presenting flags, the Pledge of Allegiance and the mayor’s address. We heard a lot of stories that matter. I wanted to share this perspective by F. Duke Haddad, a development officer with the Salvation Army and longtime advocate for the Boy Scouts.

I wanted to share Haddad’s insights, as I think you will find they apply in every walk of life!

Years ago, I was a Boy Scout in Charleston, W.Va., for a relatively short period of time. I enjoyed the experience but was faced with the dilemma of either continuing in scouting of playing Little League baseball. I must say that baseball won the day, but the positive memory of my scouting experience has stayed with me through the years.

Fast forward to my recent experience at a Boy Scouts of America breakfast fundraiser hosted by the mayor of Greenwood, Ind. A wonderful associate who invited me also kindly introduced me to a large number of his friends and associates at our table. I knew what was expected at the breakfast and brought a check to the proceedings. My joy in attending was validated when I immediately saw a number of young boys in Boy Scout uniforms welcome me.

While sitting in my seat getting ready to listen to the program, I had a flashback. I had attended a function in Michigan several years earlier for Eagle Scouts – individuals who achieve the highest rank attainable in scouting. The crowd and the continued impact scouting had on these individuals amazed me. Many former Eagle Scouts at this function were lawyers, doctors and executive in their chosen fields. A physician friend had invited me to this activity. I knew scouting provided a very positive influence on the young men’s growth and development, which continued throughout their lives.

The Boy Scouts of America is one of the nation’s largest and most prominent values-based youth development organizations. This organization – founded Feb. 8, 1910 by Chicago publisher William Boyce – provides programs for young people that build character and train them in the responsibilities of participating in citizenship plus develops personal fitness. Today, scouting is located in 190 of the world’s 195 independent countries. Total membership in this organization is more than 3.5 million.

What affected me at the Boy Scout breakfast in Greenwood was the pitch for funding support. An Eagle Scout told, in story form, that he was influenced in scouting through making friends, learning skills, camping, cooking food, having outside adventures and seeking leadership opportunities. A former scout leader, who continues to be engaged in scouting after 63 years, followed by telling stories of how scouting influenced him and scores of boys through the years. It was very inspiring. He noted that many of the scouts he influenced through the years had no father figures, were low income and without hope before their scouting experiences. Scouting changed their lives for the better.

We were gently asked to give at our table. The mayor of Greenwood noted that scouting provided discipline, honor and respect. These are all values that I aspire to in my life. He told us stories of how local scouts have given much to society and are the leaders of tomorrow. He emphasized that giving today was for the future of society tomorrow. He had me at hello as his remarks touched me and everyone at our breakfast table. The breakfast generated $18,275, a record for the event. It was grassroots fundraising at its finest.

This event proved that storytelling and providing living current examples of how funds are used stimulates joyful giving. One of the best ways to generate funds is through this vehicle plus utilizing an array of testimonials to reinforce the case for support. Your goal in the solicitation process is to show passion and emotion. Use facts wisely and you will have joyful givers. Going to that fundraising breakfast validated my choice in going into the nonprofit profession so many years ago. I can still remember with pride marching and representing the Boy Scouts in a West Virginia parade. Stories that make you think and remember do matter and provide the forum for the fundraising process to be transformational instead of transactional in nature.

(Reprinted with permission.)

By David F. Box, M.D.

In a previous article I discussed Age-related Macular Degeneration (AMD) in which we discussed the signs and symptoms of this disease, as well as the various forms of AMD. Now let’s talk about the various treatment options currently available for AMD.

The information for this article was primarily obtained from the American Academy of Ophthalmology website. (www.aao.org, Treatment of Macular Degeneration, Boyd and Janigian, MD). Please refer to this website for additional information.

To briefly review, macular degeneration is usually classified into two major categories. Wet macular degeneration involves leakage of fluids and blood into the central portion of the retina. The leakage causes vision nerves to fail and scar tissue to develop in the macula of the eye.

The macula of the eye is the location of the highest density of vision nerves. Damage in this area causes decreased central vision and distortion of vision. In severe cases, patients may lose their ability to read clearly, recognize faces or drive a car. Patients will still retain peripheral vision that can be useful for some visual tasks requiring less visual acuity.

Dry macular degeneration involves a gradual failure in the macular nerves as well, but there is no bleeding or leakage of vessels. Usually the scar tissue damage occurs at a slower rate in dry macular degeneration than in wet macular degeneration. However, the visual damage can be equally severe in both forms of the disease.

The exact causes of these diseases is unknown, but research has identified certain risk factors that may contribute to AMD. Yearly eye exams for patients over 60 years old performed by a trained Ophthalmologist may also help to identify patients who are more at risk for AMD. All of our doctors at the Indiana Eye Clinic are thoroughly trained in the diagnosis and management of macular degeneration.

Even though both forms of AMD can cause decreased central vision, research has shown that they are not the same disease. They must be treated differently, even though they are closely related.

It is not unusual to see a patient with dry AMD develop wet AMD in one or both eyes. Sometimes patients with wet AMD will change to the dry form of the disease, although this is a much less likely occurrence.

Research has shown that there are some treatments that seem to help both forms of the disease, whereas other treatments must be individualized to the specific type of AMD. To date, treatments for the dry form of macular degeneration have been more elusive to discover.

Treatment options for the wet form of macular degeneration are more plentiful, but considerable research still remains to be done to obtain better results. Even though there are fewer treatment options available for dry AMD, it is still generally considered to be a milder form of the disease.

Dry macular degeneration usually progresses at a much slower rate. In many patients the visual decrease may not be as severe as can be seen in wet macular degeneration. In wet macular degeneration, the leakage of fluid from abnormal blood vessels in the macula can cause a much more rapid decrease in vision and formation of permanent scar tissue.

The Age-Related Eye Disease Study 2 (AREDS2) showed that people at high risk for developing wet macular degeneration who took a dietary supplement of 500 mg vitamin C, 400 IU vitamin E, 10 mg Lutein, 2mg Zeaxanthin, 80 mg Zinc and 2mg Copper lowered their risk of progression to advanced stages of wet macular degeneration by at least 25 percent.

The supplements did not appear to provide a benefit for people with minimal macular degeneration or people without evidence of the disease during the course of the study. These vitamins are recommended in specific daily amounts in addition to a healthy balanced diet.

Other studies have shown that eating dark leafy greens, and yellow, orange and other colorful fruits and vegetables rich in lutein and zeaxanthin, may reduce your risk of developing macular degeneration.

Several studies show that smoking increases the risk of developing macular degeneration, so smoking cessation is highly recommended.

It is important to remember that vitamin supplements are not a cure for macular degeneration. They will not give you back vision that you may have already lost from the disease. These supplements do play a key role in helping some patients at high risk for developing advanced (wet) macular degeneration to maintain their vision or slow down the progression of the disease.

A common way to treat wet macular degeneration targets a chemical in your body that causes abnormal blood vessels to grow under the retina. The chemical is called vascular endothelial growth factor, or VEGF. Several new anti-VEGF drugs have been developed for wet AMD. Blocking VEGF reduces the growth of abnormal blood vessels, slows their leakage, helps to slow vision loss and in some cases improves vision.

Your ophthalmologist administers the anti-VEGF drug (such as Avastin, Eylea, or Lucentis) directly into your eye after applying anesthetic drops in an outpatient procedure. A patient may receive multiple anti-VEGF injections over the course of many months. Repeat anti-VEGF treatments are often needed for continued benefit.

It is important to remember that only about 10 percent of all macular degeneration cases are of the wet form. Dry AMD is much more common. At the present time only 25 percent of the wet macular degeneration cases can be successfully treated. Considerable research is currently underway to try to improve these statistics.

Patients who have untreatable forms of macular degeneration will not become blind. They will still retain their peripheral or side vision. Patients with low-vision may be helped by visual rehabilitation, devices and services. People with low-vision can often learn new strategies and techniques to help them accomplish daily activities and live independently despite loss of central vision.

Flashers and Floaters

By Dr. Carissa M. Barina, Ophthalmologist

The majority of us will experience an occasional speck, spot or hair-like structure floating in our field of vision. When they come from inside the eye, they are termed floaters.

Most frequently it is a nuisance and of little or no concern, but sometimes it is a harbinger for a sight-threatening condition such as a retinal detachment. How do you know which is which? This can be difficult to discern.

There is a clear gel-like substance that fills the eye called vitreous. It is the consistency of gelatin when we are born. Over time, small clumps of cells or connective tissue can form in the vitreous. When the light passes through the eye hits them a shadow is cast on the retina, or sensing part of the eye, causing a spot in the vision.

These floaters can appear in many forms and configurations — dark spots, indistinct hair-like structures and circles being the most common. Often they move or float through the field of vision with eye movement. Typically, they are not serious and the brain slowly learns to ignore them through a process called neuroadaptation.

In some cases, a larger floater develops when the vitreous gel separates from the back wall of the eye, called posterior vitreous separation. This typically occurs as we age and the vitreous gel starts to liquefy. The gel can then shift or move in the eye and separate from its posterior attachment on the optic nerve. This leaves a much larger and often denser condensation in the gel, in turn, causing a more prominent floater.

It often is associated with flashes or streaks of light in the peripheral vision called photopsias, as the vitreous gel may also tug on its anterior attachment to the retina, irritating it.

Rarely, this tugging can cause a retinal hole — a tear that allows fluid to pass under the retina causing it to detach. The detached retina is separated from its underlying blood supply, which is sight threatening and often requires urgent treatment.

Typically, symptoms of a retinal detachment are more intense like a shower of floaters and flashes. But not always so. Therefore, is imperative to have an eye exam as soon as possible after of the onset of symptoms.

Other causes of floaters are bleeding in the eye from trauma or diabetic retinopathy. Or less commonly, inflammation in the eye.

Regardless of the etiology or cause of the floaters, they do not go away. They may become less noticeable, but brighter lighting conditions or use of backlighting such as a computer or handheld device may make them more apparent.

In rare instances when the floaters are large, sheet-like, and interfere with the overall clarity of the vision, surgical removal may be indicated.

If you are concerned about floaters or flashers impeding your vision, call the Indiana Eye Clinic today to schedule an exam. Or click here to request an appointment online!

By David F. Box, M.D.

Shingles is a common disease caused by the chickenpox virus. In the past, primary chickenpox typically occurred during the childhood years. The chickenpox vaccine was developed in 1995 and has been routinely administered to children in developed countries for many years. So, it is currently rare for a healthy child to develop chickenpox after receiving the vaccine. However, as the immunity to chickenpox declines over time, individuals grow susceptible to a secondary infection, which we call shingles. Most commonly, the infection manifests itself as a painful rash occurring on one side of the trunk of the body. The second most common location is on one side of the face and scalp.

If the rash occurs in that second location, it can attack the eye directly, causing permanent visual damage and chronic eye pain. In many cases, the risk of this can be decreased by prompt treatment. At the Indiana Eye Clinic, all of our doctors are thoroughly trained in the emergency management of shingles involving the eye structures. We work closely with your primary care physician to optimize your treatment and minimize the risks of chronic complications.

Prior to the development of the chickenpox vaccine, the lifetime risk of developing shingles was between 10-20 percent in individuals who had suffered from chickenpox earlier in life. Most experts believe that the immunity to chickenpox resulting from the childhood vaccine is not as long-lasting as the immunity from an actual case of chickenpox. Therefore, the incidence of shingles is expected to increase in the future among individuals who were born after the early ’90s. In addition, it is expected that shingles in this group of patients may occur at a younger average age than their predecessors. Not all experts agree on this subject but the shingles vaccine is expected to be recommended for these individuals by the time they reach the age of 50.

If you were born before 1990, you still are faced with a 10-20 percent risk of contracting shingles. Usually the disease would appear after age 60 in your group. Ophthalmologists commonly see patients over age 60 who are suffering from shingles occurring on the face and scalp. In most patients, the disease is self-limiting and resolves without long-term complications in 2-3 weeks. Unfortunately there is a small group of shingles patients who suffer long-term complications of this disease.

The best option for this disease is prevention. The shingles vaccine (Zostavax) has been shown to greatly decrease the risk of shingles. The vaccine is approved by the Food and Drug Administration for adults 50 and older. It is currently recommended for adults 60 and older with normal immune systems and no known allergies to the components of the vaccine.