Category Archives: Ophthalmology

LASIK (flap) versus Surface PRK (no flap)

By | Calgary, Dry eye, Epi-lasik, Epilasik, Intra-LASIK, Laser Eye Surgery, Laser vision correction, LASIK, Ophthalmologist, Ophthalmology, Opthamologist, Photorefractive, PRK, Refractive Surgery, Surgeon, VISX | No Comments

STAR S4According to some reports over 28 million laser vision correction surgeries have been performed worldwide since the excimer laser was developed in the 1980s.  Both PRK surface laser and LASIK surgeries use the excimer laser to reshape the corneal surface.  The main difference between the two types of laser vision correction methods is the creation of a corneal flap with LASIK and treatment on the surface of the cornea after removing the thin layer of epithelial cells with PRK.  eyelabeled

 

Advances in both the excimer laser and in flap creation technology have resulted in a variety of names for laser vision correction surgeries.  Flap surgeries include LASIK and IntraLase and no flap treatments include PRK, LASEK, and Epi-LASIK.  With LASIK a small oscillating blade in a device called a microkeratome is used to cut the LASIK flap.  With IntraLase the femtosecond laser is used to create a corneal flap.  Originally called “flap and zap”, with LASIK and Intralase the flap is lifted and the excimer laser reshaping is done on the underlying corneal tissue.  With no flap treatments the excimer laser energy is applied directly to the surface of the cornea.

PRK surface laser vision correction gained in popularity from it’s introduction in the 1980s over the next decade.  LASIK was introduced in the 1990’s  and became the most popular laser vision correction by the early 2000’s due to faster recovery.  Within the past several years there has been a shift back towards surface treatments due to the improvements in post operative management and in excimer laser technology.  It has also been determined that for some people PRK surface treatments may be a better choice.  The reasons that PRK may be recommended include:

1. Risk of flap shift or trauma with job or sports activities.

2. Thin corneas that may be a risk for ectasia (unstable cornea with progressive thinning) with LASIK flap.

3. Very steep or very flat corneal curvatures that may increase LASIK flap complication risk.

4. Previous injury or eye or eyelid surgeries that may raise the risk of LASIK flap complications.

5. Moderate dry eye might be worsened by the deeper disruption of corneal nerves with LASIK flaps.

Both LASIK and PRK have be demonstrated to produce equally good results over 6 months or more.  In the short term of days to weeks LASIK patients will recover vision more quickly.  So taking a short term perspective it makes sense that people may choose a LASIK flap laser vision correction method.

Taking a long term approach there are advantages to forgeting the LASIK flap and choosing a no flap PRK surface treatment.  Advantages of a no flap PRK approach include:

1. no LASIK flap = no flap complictions such as incomplete flaps, buttonholed flaps, partial flaps

2. no LASIK flap eliminates the risk for flap dislocation in the future

3. no LASIK flap means there can not be complications like epithelial ingrowth, diffuse lamellar keratitis, interface debris, flap wrinkles,  or other LASIK flap related complications.

4. Less risk of a weak and unstable cornea called corneal ectasia due to the LASIK flap disrupting the cornea more deeply than surface PRK.

5. Possibly less risk of severe dry eye with surface PRK.

To make the choice that is right for you, first find out if you qualify for laser vision correction and then learn the pros and cons of the treatments available to you.  If you have questions about laser vision correction or wish to book a complimentary evaluation with Dr. Anderson Penno, contact Western Laser Eye Associates.

 

Vision & Vitamins: Can supplements prevent nearsightedness?

By | Cataracts, Diabetes, Laser Eye Surgery, Laser vision correction, Ophthalmologist, Ophthalmology, Opthamologist, Optometry, science, Vision & Vitamins | No Comments

Nearsightedness (also called myopia) affects from 20% to 50% of North Americans and up to >80% of some populations in Asian countries.  The need for nearsighted correction with glasses or contacts can run in families and is more likely to be present if both parents are myopic.  The natural course of nearsightedness is that it can start in childhood or young adulthood and continue to progress up to age 20 or in higher corrections into the 30’s.

There are some conditions that may be associated with nearsightedness so regular eye examinations are recommended even if the prescription has stopped changing.  Nearsighted people and parents of nearsighted children are of course interested in finding ways to slow or prevent the progression of myopia.  There has been conflicting scientific evidence to support the relationship between reading and near work and higher myopia, however there was no proven association between nearsightedness and computer work.  There has also been some evidence to suggest that more time spent in natural light (outdoors) can help to reduce the increase in prescription over time.

There have been a number of studies to try and find a link between nutrition and nearsightedness and to this date there has not been anything proven to prevent natural progression of myopia in children and adults.

It is important for anyone affected by nearsightedness to have regular eye examinations with and optometrist or ophthalmologist even if the prescription isn’t changing.  Sudden shifts in the degree of nearsightedness can indicate conditions like diabetes or cataracts if changes are happening at an older age.

Correcting nearsightedness is usually involves using glasses or contact lenses.  Laser vision correction can be considered after the prescription has stabilized for at least 2 years.

If you have questions about laser vision correction or wish to book a complimentary evaluation with Dr. Anderson Penno, contact Western Laser Eye Associates.

Western Laser Eye Associates Welcomes Dr. Deepak Khosla, Ophthalmology Associate

By | Blepharitis, Calgary, Cataracts, Dr. Khosla, Dry eye, Eye health, glaucoma, Laser Eye Surgery, Laser vision correction, macular degeneration, Ophthalmologist, Ophthalmology, Opthamologist, Optometry, Photorefractive, PRK, Refractive Surgery, Uncategorized, VISX | One Comment

Western Laser Eye Associates is excited to welcome Dr. Deepak Khosla as the newest member of our eye care team.  Dr. Khosla has a special interest in medical retina and general ophthalmology.  He speaks a number of languages including Hindi, Punjabi, Urdu, and Tamil and has a number of years of experience in ophthalmology.  Urgent eye care problems and new patients are welcome.

Dr. Khosla is a general ophthalmologist which differs from an optometrist in the training and scope of practice.  Ophthalmologists are “Eye MD”s with a medical degree and training in all systems in the human body.  An optometrist has specialized training in eye health and also may have more experience and training in the optics of prescribing glasses and contact lenses.  Western Laser Eye associates has a diverse team including 2 optometrists who specialize in eye health including dry eye, glasses and contact lens prescriptions, and eye muscle testing.  Dr. Khosla joins Dr. Anderson Penno as a second ophthalmologist and together they cover a wide array of eye health problems including screening for diabetic patients and treatment of many common eye diseases such as glaucoma and macular degeneration.  Dr. Khosla and Dr. Anderson Penno also care for urgent conditions including foreign body, eye infections, styes, and retinal tears.

Dr. Khosla offers Saturday appointments for select appointments.  To inquire about an eye health exam call 403.247.1477 or ask your medical doctor to fax a referral to 403.247.9774.

If you have questions about laser vision correction or wish to book a complimentary evaluation with Dr. Anderson Penno, contact Western Laser Eye Associates.

Vision & Vitamins: Ginkgo Biloba, Glaucoma, and Macular Degeneration

By | Epi-lasik, Epilasik, Eye health, FDA, Food for thought, Ginkgo Biloba, glaucoma, Health Canada, Laser Eye Surgery, Laser vision correction, macular degeneration, Mayo Clinic, Ophthalmologist, Ophthalmology, Opthamologist, Optometry, Pubmed, Refractive Surgery, science, Uncategorized, Vision & Vitamins | No Comments

Vitamins and natural herbs have become more and more popular for alternative treatment as additional treatments for medical conditions.  Ginkgo Biloba has been used for centuries as a traditional treatment which may help blood flow to the brain and aid in treatment of dementia or Alzheimer’s disease.  It might help treat leg pain that results from blood vessel disease, and there is some suggestion that ginkgo biloba might also help PMS symptoms, depression, multiple sclerosis, and ADHD.  Ginkgo Biloba is extracted from the leaves of the Ginkgo Biloba tree.  As far as vision and eye health are concerned, it is possible that Gingko Biloba might be helpful to eye health but as with many natural products the scientific studies show some favorable and some unfavorable results.

There are some scientific studies that have been reported in the peer reviewed literature which is a data base of articles that have been reviewed by scientists with expertise in the particular field of study before the article is allowed to be published.  Peer review helps to make sure that studies are done in a way that will provide strong statistical evidence for or against a specific area of study.  The most powerful studies are randomized and double-blinded which means the researcher and the subject who is taking the supplement do not know if it is the actual supplement or a placebo being taken.  The “placebo” effect has been well studied and up to 30% of people taking a fake pill who are told it will have beneficial effects will report that it helps whether or not there is any measurable effects.  By double-blinding and using large and randomized numbers of subjects the results will show with more confidence that a particular supplement is helpful or not for a specific condition.  Because there are a lot of different conditions that are being studied, so far there are only a few published peer reviewed scientific studies that have been done to find out if Ginkgo Biloba is good for your eyes.

According to the Mayo Clinic there is some scientific evidence suggesting that Ginkgo Biloba may be helpful in preventing worsening in age related macular degeneration which can lead to central vision loss, but there is little evidence to suggest it might be helpful for treatment of glaucoma.  In the peer reviewed literature there are a few studies including this 2012 study by Cybulska-Heinrich, Mozafferieh and Flammer that suggests supplementation with Ginkgo Biloba might be helpful in addition to traditional medical treatment in cases that are not responding as well as needed to these traditional treatments.  They suggest that antioxidant effects along with a variety of other effects on blood flow might be responsible for the beneficial effects of supplementation with Ginkgo Biloba.  The American Academy of Ophthalmology reported there was a single small randomized trial that showed promise for using Gingko Biloba to slow macular degeneration.

A commonly reported dose of Ginkgo Biloba is a standardized extract, standardized to 24% flavone glycosides and 6% terpene lactones starting at 40 milligrams of that extract three times daily, but there does not seem to be enough evidence in the scientific studies to prove the most effective doses for a specific condition.  Risks and side effects of Ginkgo Biloba supplements include headaches and dizziness, bleeding, and other side effects.  If you are on a blood thinner or aspirin, or are on other medications you should talk to your pharmacist and/or doctor to make sure that there won’t be dangerous interactions.  There is also some question about the quality of the products in some cases and as with all supplements it is important to be sure you are getting a high quality product.  In Canada a DIN or NPH number can be found on products that have been reviewed by Health Canada.  In the US the FDA does not require approval of supplements before the product is marketed but does collect information on adverse events.  The other thing to consider is the cost of a product like Ginkgo Biloba versus the proof that it will be helpful for your health.

Whether you already had LASIK, Intralasik, EpiLasik, PRK, wear glasses or contacts, reading glasses or no glasses at all you should be sure to get regular checks with your eye care specialist (optometrist or ophthalmologist) in order to optimize your vision for the rest of your life.  If you have questions about laser vision correction or wish to book a complimentary evaluation with Dr. Anderson Penno, contact Western Laser Eye Associates.

 

 

Exercise & Eye Health

By | LASIK, Ophthalmologist, Ophthalmology, PRK, Refractive Surgery | No Comments

A long term study of thousands of adults shows that regular exercise lowers risk of vision loss over 20 years.  The Beaver Dam Eye Study started in 1987 and continued to follow approximately 5,000 adults over 20 years.  Vision loss was reported in 5.4% of the population overall.

People who were physically active had a 58% lower risk of vision loss according to this study.  Heart healthy practices like exercise, not smoking, healthy weight, and regular check-ups to monitor blood pressure have been shown to reduce the risk of eye diseases like macular degeneration and glaucoma.

Whether you are considering laser vision correction like LASIK or PRK or not, a heart healthy lifestyle including exercise can keep help to keep your vision safe.  Regular eye health checks with your optometrist or ophthalmologist are also very important to find and treat eye conditions.  For many eye problems early treatment is important in preventing serious vision loss and can often be found before you have symptoms.

If you have questions about laser vision correction or wish to book a complimentary evaluation with Dr. Anderson Penno, contact Western Laser Eye Associates.

Changing Demographics of Women in Ophthalmology: Calgary LASIK Surgeons

By | LASIK, Ophthalmologist, Ophthalmology | No Comments

Ophthalmology Times reported in the March 1, 2008 edition that women physicians are at an all time high. This trend is predicted to increase in the future. In 2004 the American Medical Association (AMA) reported that 25% of practicing physicians were women. They predict that by 2010 thirty percent of practicing physicians will be women.

This trend is even more apparent in certain subspecialities such as ophthalmology and obstetrics. The American Academy of Ophthalmology (AAO) reported in 1994 that women accounted for 25% of trainees in ophthalmology. By 2004 that number climbed to 34% of the members in training. The prediction is that by 2025 the number of men and women on medical school faculties will be equal.

While high volume women LASIK surgeons remain a minority in Alberta, this is likely to change in the next several years as more women complete ophthalmology residencies and refractive surgery fellowships. While women remain a minority in executive positions and academic medicine, this is predicted to change as well in the coming years.