November is Diabetes Awareness Month

Did you know that diabetic retinopathy is the current leading cause of blindness in adults in the U.S.? The condition is serious, but the fortunate news for patients is that with proper screening, a majority of devastating vision loss is preventable. We encourage patients with diabetes to make regular annual visits to an eye care professional a priority, particularly as they age. Spending an hour or less at your doctor’s office once a year could mean the difference between potentially losing all vision and effective treatment that prevents such a loss.

What is diabetic retinopathy?

Diabetic retinopathy is a condition that occurs in the retina that generally results from chronically elevated blood glucose levels. Glycosylation of these blood vessels can lead to breakdown of blood vessel walls, leakage and swelling and ultimately decreased vision. In addition, unstable new blood vessels can form that can break and bleed, which can also lead to decreased vision.

Diabetic retinopathy, although the leading cause of blindness in patients under the age of 55 in the US, is largely preventable with proper screening and treatment.

On top FA/FP moderate NPDR, bottom FA/FP severe PDR with NVD, NVE, and ischemia. (Fluorescein Angiogram/Fundus Photo).

How is diabetic retinopathy diagnosed?

Up to 60% of diabetic patients are not properly screened for diabetic retinopathy. Proper screening can consist of yearly visits to an eye care professional or, more recently, telemedicine screening visits in a primary care setting. Through local telemedicine partnerships, Austin Retina is pleased to have seen up to 80% compliance rates, ultimately saving the sight of thousands.

Once any diabetic retinopathy is detected on initial screening, other testing modalities such as optical coherence tomography (OCT) and fluorescein angiogram imaging are employed. OCT is an excellent tool used to detect subtle changes in macular thickness, which often occurs in early diabetic maculopathy. Optos fluorescein angiogram wide-angle imaging is critical in analyzing the peripheral retina for ischemia and neovascularization, both of which can be easily missed by direct examination or routine photography.

OCT (optical coherence tomography) – Image of a patient with diabetic retinopathy.

How is diabetic retinopathy treated?

The two critical variables for control of diabetic retinopathy are blood pressure and blood glucose.

Controlling blood glucose (hemoglobin A1C less than 7%) limits the destruction that can occur from glycosylation of small blood vessels in the retina. In most cases, this can be achieved through diet and exercise. Controlling blood pressure decreases the amount of leakage and swelling that can occur from these already damaged blood vessels.

The newest treatments for diabetic retinopathy involve the use of medications that can be effective not only in stabilizing the condition but also in restoring vision. These medications are injected into the eye through an office-based procedure called an intravitreal injection. This relatively painless injection through the white part of the eye is performed after the eye is thoroughly anesthetized with topical eye drops. Additionally, medications such as Eylea, Lucentis, and Avastin have the potential to improve vision by reducing the amount of macular edema caused by diabetic retinopathy.

Do you have questions? Please contact Austin Retina directly so we can assist. You can request an appointment online here or call our office at 800-252-8259 during normal business hours.

Three Commonly Misdiagnosed Retinal Conditions

It can be difficult for doctors and patients alike to understand why a medical misdiagnosis has taken place. However, there are many reasons why an incorrect diagnosis could occur. One reason is that there are countless medical conditions that can closely mirror one another – even to such a degree that a trained and experienced medical professional with advanced diagnostic equipment could choose one condition over the correct issue.

One of the ways the medical industry (including the field of retina care) works to reduce instances of misdiagnoses is to better educate the community, particularly in cases where the condition is well known for being misdiagnosed. At Austin Retina Associates, we want to ensure that our doctors are armed with all available knowledge for patient care and that patients can feel confident in the decisions their doctors are making.

Three Commonly Misdiagnosed Retinal Conditions

Macular Hole

Often, patients who are referred to our practice by another doctor have been told that they have a macular hole, but what they actually have is a lamellar macular hole. The reason the two conditions are confused is that a macular hole is simply a more severe version of a lamellar macular hole. To further illustrate:

  • A macular hole extends through all of the retina layers; a lamellar macular hole does not.
  • A macular hole requires surgical treatment; a lamellar macular hole usually isn’t treated with surgery unless the patient’s vision worsens.

Retinoschisis

Sometimes, patients who were told that they have a retinal detachment actually have a condition called peripheral retinoschisis. The reason why the two conditions can be confused is that both feature an elevated retina. However, peripheral retinoschisis has a very thin appearing retina, a particular shape, and sometimes have white dots in its bed which distinguish it from a retinal detachment. The distinction is important since a retinal detachment is sight-threatening and treated with surgery while a peripheral retinoschisis is not sight-threatening and is observed.

Central Retinal Vein Occlusion

The presence of scattered blot hemorrhages in all four quadrants can be seen in both central retinal vein occlusion (CRVO) and diabetic retinopathy. Both conditions can also cause visually significant macular edema. The difference between the two conditions ultimately lies in a CRVO diagnosis usually includes venous tortuosity and disc edema. We understand that what makes one retina condition different from another can be found in minute details. Many conditions are quite similar in nature, making a medical misdiagnosis both possible and unfortunately common. The ultimate goal is to never put a patient in a position where they lack confidence in their referring doctor or undergo unnecessary treatment. This is why our practice enjoys so many patient referrals and second opinion requests in order to help ensure the best possible patient care. If you have questions about any of the above conditions or would like to schedule a consultation, please contact our practice today.

Why Should I Participate in a Clinical Trial?

At Austin Retina Associates, we understand that there are a number of misconceptions patients may have about what it means to participate in a clinical trial. These misconceptions are unsurprising, as clinical trials, particularly modern ones, are not part of our normal, everyday conversations.

We hope that the information below will help describe the reality of being in a clinical trial and the many potential benefits of the process. Of course, if you have questions or are interested in a specific clinical trial with our practice, please contact our staff today.

What is a clinical trial? And are they safe?

Clinical trials are scientific medical research initiatives into the appropriateness, effectiveness and safety of new treatments in humans. The goal of a clinical trial, whether for a vision-related issue or other health problem, is to improve patient care and advance medical knowledge. And yes, they are safe as long as they are conducted by reputable, experienced organizations, such as Austin Retina Associates.

Why do clinical trials exist?

Clinical trials present an opportunity for patients to try medications and treatments that might not otherwise be available because the scientific community is not yet fully confident in their success (e.g. not yet FDA approved), but believe that the highest possible quality of data can be achieved while ensuring patient safety. This means that, at the completion of the trial, those involved will have possibly found successful treatment and such treatment can move forward toward use for the general population.

Here are some core benefits to clinical trial participation at Austin Retina:

  • Participants will (potentially) have access to the newest and most advanced drug(s) ahead of FDA approval.
  • The “worst case scenario” for participation is that a patient would receive standard care.
  • Participants enjoy “extra” care as being involved in a trial includes additional blood testing or imagining – all of which are carefully monitored by the trial’s clinical team.
  • There is no cost to the patient – ever. Patients might even receive a stipend.
  • Patients are connected with a main coordinator throughout the trial for every visit over the course of 6/12/24 months – A true VIP experience.
  • A trial is an opportunity to receive potential treatment when no other remedy is currently available.

Who is a good candidate for a clinical trial?

The answer to this is very dependent on the type of clinical trial being offered and the symptoms and condition a patient is experiencing. For example, a patient may have condition “X” but not display any symptoms relating to a specific clinical trial, so they would not be a good fit for that trial. Of course, your doctor is the best resource for advice regarding clinical trials that are applicable to your individual situation.

We recommend that you connect with your doctor in order to determine whether there is a trial you can participate in. Your doctor will only recommend a trial if he or she believes it will be of significant benefit to your health – having someone enter into a clinical trial is not taken lightly or without real consideration.

How do I find out whether I can participate in a clinical trial?

As noted, your doctor is the one to talk to about participating in a clinical trial. At Austin Retina, we frequently enroll patients in open clinical trials when possible. Sometimes, a clinical trial can reach capacity and we are unable to continue enrollment. You can learn more about trials that are currently open for enrollment here. You can also contact our office to ask about clinical trial participation today.

Fun in the Sun: 5 Summertime Eye Health Tips

Woman wearing sunglasses and a hat

Long days and plenty of outdoor activities equal more time spent in the sun—particularly in Texas. While the dog days of summer may mean fall is not far away, it’s important to be mindful of your eyes’ unique needs long after Labor Day. Here are five easy tips to keep your eyes safe all summer long—and all year round.

Don’t Forget the Shades

Just like your skin, your eyes require special care when it comes to UV exposure, so don’t forgo the sunglasses—even on a cloudy day. According to the American Academy of Ophthalmology (AAO), “studies show that exposure to bright sunlight may increase the risk of developing cataracts and growths on the eye, including cancer.” Long-term exposure to sunlight can also increase the risk for certain conditions within the eye, such as solar retinopathy or choroidal melanoma. In addition, eyes can become “sunburned” which causes a painful condition known as photokeratitis.

To protect your eyes from sun exposure, be sure to wear sunglasses that provide 100% protection against both UV-A and UV-B rays, even when you think you don’t need them. A broad-brimmed hat can also help keep harmful sunlight away from your face and eyes.

Take the Contacts Out

Planning to hit the pool? If you wear contacts, swimming can pose a serious threat to your eyes without proper protection.

Like sponges, contact lenses absorb water—as well as any chemicals or bacteria that may be present, introducing germs to the eyes that can lead to discomfort, irritation, and potentially vision-threatening infections. In fact, according to the American Optometric Association (AOA), “serious eye infections can lead to blindness and affect up to one out of every 500 contact lens users per year.”

To keep your eyes safe, the U.S. Food and Drug Administration recommends keeping contacts away from all types of water, including swimming pools, lakes, and even your own shower. If you must wear contacts in the water, consider no-leak swimming goggles—or better yet, invest in a prescription pair instead.

Play It Safe

Of course, swimming isn’t the only summer activity that requires eye protection. Whether you are finally getting around to those home improvement projects, playing sports, or just mowing the lawn, keeping your eyes safe should always be top of mind.

ANSI-approved protective eyewear is appropriate for most household projects. To prevent eye injuries on the court or in the field, check out the AAO’s recommendations for your sport.

Keep Them Refreshed

If you suffer from chronic dry eye, you know how uncomfortable the summer months can be. In addition to the heat outside and air conditioning inside, sweating, squinting, and even wearing sunscreen can irritate your eyes and make dry eye worse.

Keep your eyes comfortable by using artificial tears, wearing wraparound sunglasses outside that can block wind and dry air, and avoiding direct contact with fans or air conditioners.

Get a Checkup

Lastly, summer is the perfect time to get your kids’ eyes checked (and yours, too) before they return to school. Myopia (also known as nearsightedness) as a result of digital eye strain is on the rise, especially in children. According to the AOA, one in four parents have a child with myopia, making it one of the most increasingly prevalent vision issues in the U.S. Fortunately, these issues can be caught and managed with early intervention, like an annual eye exam.

Have questions about your eye health or need to schedule an appointment? We’re here to help! Contact us anytime at 800-252-8259 or [email protected]

Keep Your Eyes Safe This Fourth of July

Fireworks are a summertime staple, especially during the weeks before and after the Fourth of July, but the results of a homemade display can be harmful – and even potentially blinding. The U.S. Consumer Product Safety Commission’s most recent fireworks injury report found that 14% of all fireworks injuries resulted in eye trauma. In addition, fireworks were responsible for eight deaths and nearly 13,000 total injuries in 2017. 

According to the American Academy of Ophthalmology (AAO), “fireworks can rupture the globe of the eye, cause chemical and thermal burns, corneal abrasions, and retinal detachment—all of which can cause permanent eye damage and vision loss.”

Don’t let your holiday celebration turn into a trip to the emergency room. Here is a short firework safety video you can watch with the kids, and five tips to keep everyone’s eyes safe this Independence Day:

  • Stand back: Be sure to light all fireworks in a clear, open area and watch from a safe distance—about 500 feet away for professional displays and 35–50 feet away when using fireworks at home. Protective eyewear is a must for both the person igniting the fireworks and the audience.
  • Keep clear: Avoid leaning over the top of or looking into any fireworks and never light a firework while holding it. Keep your body as far from the product as possible and once lit, move to a safe distance as quickly as possible.
  • Beware of duds: If a firework fails to explode, don’t assume it’s safe to handle. Never inspect or attempt to relight any firework that fails to ignite. Have water ready to soak duds and used fireworks before discarding.
  • Watch your kids: Even seemingly kid-friendly fireworks like sparklers can result in significant eye trauma as they burn at more than 2,000 degrees Fahrenheit (hot enough to melt some metals!). It is best to discourage children from playing with fireworks of any kind and supervise them at all times.
  • Leave it to the pros: Of course, the best tip of all is to refrain from using fireworks altogether and take in a professional display instead. 

Fireworks-related eye injuries are medical emergencies that require immediate attention. If you need emergency eye care, do not do any of the following before seeking treatment as they may make the injury worse:

  •  Rub or rinse your eyes
  • Apply pressure to the injury
  • Remove any objects that are stuck in the eye
  • Apply any ointments or take any pain medications

 If you need urgent care for an eye injury, head to the nearest emergency room or call 911. 

What Can You Do About Floaters and Flashes in the Eye?

Flashes and floaters in the eye happen for many reasons, the most common being. Both flashes and floaters are generally harmless and do not require medical treatment. However, they may sometimes signal a retinal tear or detachment, which are conditions that can lead to vision loss if left untreated.

“Although very common, sudden onset of flashes and floaters should prompt a thorough peripheral retinal eye exam to be certain there is not a retinal tear or early retinal detachment,” explains Dr. Jose Martinez. “Both can be treated effectively but left untreated can lead to more serious sight-threatening problems.”

If you experience any of the following key warning signs of retinal tears or detachment, call your doctor right away:

  • A new onset of floaters and flashes of light in the eye
  • Gradual shading of vision from one side (like a curtain being drawn)
  • Rapid decline in sharp, central vision

What are eye floaters?

Eye floaters are spots in your vision that occur because the jelly-like substance (vitreous) inside your eyes becomes more liquid. As a result, microscopic fibers clump together and cast tiny shadows on your retina.

What are eye flashes?

Flashes are common after an eye injury. Many people report having ‘flashing lights’ or ‘lightening streaks’ appear in their visual field. This happens when the vitreous gel inside your eye rubs or pulls on the retina. Flashes of light can persist for several weeks or months following an eye injury.

What can you do about flashes and floaters in the eye?

The easiest way to get rid of flashes and floaters in the eye, at least temporarily, is to move your eyes up and down (this is more effective than moving your eyes side to side). This movement shifts the fluid around in your eye and moves them out of your field of vision.

If your condition is more serious and your vision is impaired, your doctor may recommend surgery or laser treatments including:

  • Vitrectomy
    Vitrectomy is a surgery to remove some or all of the vitreous gel from the eye. Your physician will then replace this jelly-like substance with a synthetic substitute to help your eye maintain its shape.
  • Vitreolysis
    While less common, floaters can be broken apart using a laser treatment. During this procedure, a laser is aimed at the floaters and breaks them apart so they are no longer noticeable.

For expert uveitis treatment in Austin, Texas, call Austin Retina Associates at 800-252-8259 to schedule an initial consultation.

7 Best Foods for Healthy Eyes

Many people can enjoy an active life well into their golden years without ever experiencing vision loss. However, with age comes a higher risk of developing age-related eye diseases and conditions like: Age-related macular degeneration, cataract, diabetic eye disease, glaucoma, low vision and dry eye. While eye problems and eye diseases become more prevalent with age, many can be prevented.

7 best foods for healthy eyes

If you’d like to preserve and protect your eye health and vision as you age, try some of these delicious selections:

  1. Dark leafy greens
    Dark leafy greens like spinach and other foods rich in vitamin C, like sweet potatoes, kale, carrots, turnips, butternut squash and mustard greens may be helpful for slowing the progression of cataracts.
  2. Citrus fruits and berries
    Citrus fruits and other fruits rich in vitamin C like cantaloupe, strawberries, kiwi, mango, papaya may be helpful for maintaining connective retinal tissues that diabetic eye disease damages.
  3. Nuts and seeds
    Almonds, hazelnuts and peanuts, as well as other foods rich in vitamin E like avocados, spinach, broccoli, wheat germ and sunflower seeds, may help improve vision. In fact, when used in combination with vitamin B and DHA, vitamin E has shown to improve visual fields and retinal sensitivity in people with glaucoma.
  4. Fish
    Fish, particularly omega-3 rich fish oil, is known for reversing dry eye (including dry eye caused by prolonged or regular computer use). You’ll get the most beneficial levels of omega-3s when you try some of these tasty options: Tuna, salmon, trout, mackerel and sardines.
  5. Whole grains
    Whole grain foods like brown rice, oatmeal, whole wheat bread, pasta or crackers are high in vitamin E. This powerful antioxidant vitamin may help reduce your risk for age-related macular degeneration.
  6. Legumes
    Kidney beans, black-eyed peas and lentils are good sources of bioflavonoids and zinc, which can help protect the retina and lower the risk for developing macular degeneration and cataracts.

If you would like more information about protecting your eye health or are in need of skilled retinal surgery in Austin, call Austin Retina Associates at 800-252-8259 to schedule an initial consultation.

Common Symptoms of a Detached Retina

Are you noticing more “floaters,” or cobweb-like specks in your field of vision? Are you seeing flashes of light? These are a few symptoms of a retinal detachment, and it is a medical emergency. If not promptly treated, retinal detachment can cause permanent vision loss. If you’re having any symptoms of a retinal detachment, see an eye care professional immediately.

“Early detection of symptoms and seeking care promptly is of great benefit to the patient,” said Dr. Peter A. Nixon.

The retina is a key factor in your normal, healthy vision. This light-sensitive layer of tissue lines the inside of your eye and transmits visual messages through the optic nerve to your brain. When the retina detaches, it is pulled or lifted from its normal position.

Symptoms of a detached retina

You may be surprised to learn that retinal detachment is painless. However, warning signs almost always occur before detachment occurs or as it is progressing. These critical signs include:

  • Multiple floaters (tiny specks that seem to drift through your field of vision) suddenly appearing
  • Seeing flashes of light in one or both eyes (photopsia)
  • Experiencing blurred vision
  • Noticing a gradual reduction inside (peripheral) vision
  • Seeing a curtain-like shadow over your visual field

“Flashes and floaters can indicate a retinal tear or retinal detachment. The only way to establish the diagnosis is to be examined by your eye doctor,” explains Dr. Nixon. “Early detection of symptoms and prompt evaluation are very important in preventing loss of vision.”

Are you at risk for retinal detachment?

Although retinal detachment can happen at any age, it is more common in Caucasian men over age 40. You have a greater risk for retinal detachment if you:

  • Have had a retinal detachment in the other eye
  • Have a family history of the condition
  • Are extremely nearsighted
  • Have undergone cataract surgery
  • Have other eye diseases or disorders, such as degenerative myopia, retinoschisis, uveitis or lattice degeneration
  • Have had an eye injury

Central Texas’ most trusted care for detached retina and other eye conditions

If you or a loved one are experiencing any of the symptoms of retinal detachment, immediate treatment is vital to saving your vision. If you live in Central Texas, Austin Retina Associates has three locations to serve you: Austin, South Austin and Round Rock.

Should you need retinal surgery in Austin, Texas, rest assured, our board-certified physicians, licensed ophthalmologist and fellowship-trained retinal specialist are ready and able to help. In addition to providing advanced, accurate diagnostics, our experienced and caring physicians are skilled in the latest, minimally-invasive, outpatient surgical techniques. Let our team of experts help you manage diseases of the retina, vitreous and macula so you enjoy the best possible eye health and vision.

For more information or to schedule an appointment, call 800-252-8259 or use our easy online form.

 

Diabetic Eye Disease Awareness Month

November is Diabetic Eye Disease Awareness Month, which helps raise awareness of diabetes and its negative effects on the eyes. Diabetes is the leading cause of new cases of blindness among adults, though anyone with diabetic eye disease is at risk for vision loss and blindness. The retina specialists at Austin Retina Associates encourage anyone suffering from diabetes to seek immediate treatment for any vision problems to avoid vision loss or blindness.

The importance of regular vision exams

Anyone with diabetes should get regular vision screenings to help protect his or her eyesight. While a routine exam cannot diagnose diabetic eye disease, it can help identify issues while they are still treatable. If your doctor notices any unusual changes in your vision, he may recommend a comprehensive dilated eye exam with an ophthalmologist or optometrist.

Common types of diabetic eye disease

People with diabetes are more likely to develop cataracts and glaucoma than those without diabetes, however, the primary vision problems caused by diabetes are:

  • Diabetic retinopathy
    Retinopathy is a general term that means the retina of the eye is damaged. Over time, diabetes can damage the blood vessels in the retina, causing them to leak blood and other fluids. The build-up of excess blood and fluid causes the retinal tissue to swell, which leads to clouded vision. While diabetic retinopathy cannot be cured, treatment options are available to help preserve vision and reduce the risk of vision loss.
  • Diabetic macular edema
    If left untreated, diabetic retinopathy can lead to diabetic macular edema (DME). DME is an accumulation of fluid in the macula, the functional center of the retina that controls our most detailed vision abilities. Treatment options are available to help stop and sometimes reverse vision loss.

How to avoid diabetic retinopathy and DME

If you are diabetic, Diabetic Eye Disease Awareness month is the perfect time start actively protecting your vision. Here are a few easy steps to help you get started:

  • Maintain good blood pressure and cholesterol through healthy diet and exercise.
  • Receive a comprehensive dilated eye exam at least once a year (or more often as directed by your doctor).
  • If you are pregnant and have been diagnosed with gestational diabetes, it is important to pay close attention to your blood glucose levels. Try eating a low sugar, low carb and high fiber diet.

For expert diabetic eye disease treatment in Austin, call Austin Retina Associates at 800-252-8259 to schedule an initial consultation.

What Is a Diabetic Eye Exam?

Diabetes is a disease that impairs the body’s ability to produce the insulin hormone and leads to elevated levels of glucose (sugar) in the blood. Chronically elevated blood sugar levels can increase your risk for an array of eye problems including blurry vision, cataracts, glaucoma and diabetic retinopathy.

Often, diabetes damages the small blood vessels in your retina, or the back of the eye. This condition is called diabetic retinopathy, the most common cause of vision loss among people with diabetes. Diabetic retinopathy develops when blood vessels in the eye are exposed to high blood glucose levels for a prolonged period of time. This weakens the walls of the blood vessels in the eyes. The longer a person has had diabetes and the greater his/her exposure to high blood glucose, the higher his/her risk of having this condition.

“Diabetic eye disease, when caught in time, is no longer a blinding condition. Nowadays, with early detection and prompt treatment, we can prevent vision loss and in some cases, are able to reverse some of the diabetic changes in the retina. But what we like to do, at Austin Retina, is help educate our patients on what diabetes is and how it affects their vision,” explains Dr. Robert W. Wong. “By working together with the primary care physician, endocrinologist and the patient themselves, we find strategies to improve blood sugar and blood pressure control. These two risk factors, among others, are things our patients have the ability to control. And with guidance, our goal is to keep them seeing well and living healthier lives.”

If you have been diagnosed with diabetes, it is important to get regular eye exams, so your doctor can detect problems like diabetic retinopathy early, preserve your eye health and protect your vision.

What is a diabetic eye exam?

Anyone with diabetes is encouraged to get regular eye exams. This allows your ophthalmologist to look for changes in the blood vessels of the retina that may indicate diabetic retinopathy. Here is what you can expect during a diabetic eye exam:

  • Your ophthalmologist will ask you about your medical and vision history.
  • Next, you will read an eye chart.
  • The doctor will then examine the retina in the back or your eye using an instrument called an ophthalmoscope.
  • Often, your doctor will administer drops to dilate your pupils and use a special light called a slit lamp to view the retina.
  • A test called fluorescein angiography may be used to reveal changes in the structure and function of the retinal blood vessels. For this test, your doctor will inject a fluorescent yellow dye into one of your veins and photograph your retina as the dye outlines the blood vessels.
  • During a diabetic eye exam, your doctor will also check your eyes for cataracts and glaucoma.

If you’ve been diagnosed with diabetic retinopathy, the experienced eye care specialists at Austin Retina Associates can help. We are skilled in the treatment of diabetic retinopathy in Austin. Call at 800-252-8259 to schedule an initial consultation.