Dr. Pedroza and Dr. Abert are seen hanging out atop the Space Needle on the clearest day of their visit!
Each year, Dr. Brian Abert, O.D., FAAO and Dr. Deanna Pedroza, O.D. do their best to attend the annual American Academy of Optometry meeting. The last time they attended the meeting was in Boston, Massachusetts in 2011. Last year, our docs skipped the Academy meeting in Phoenix, Arizona because they were getting married (pretty good excuse!). This year the Academy meeting was held in Seattle, Washington. The conference was, as usual, fantastic and our doctors learned new techniques, new technologies, and new treatment methodologies for a variety of eye-related issues. Among the classes they took:
Recurrent Corneal Erosion – This disease can occur after an eye is injured (say, scraped by a fingernail, or scratched by a tree branch). The front skin of the cornea (the clear part of the eye) sometimes takes a while to grow back properly, and the same site of that injury can literally reoccur, causing chronic pain. Managing the disease requires persistence and lots of new techniques were shared during this lecture.
Anterior Segment Disease – The ‘anterior segment’ refers to the front part of the eye. This class centered mainly on trauma and reminded our doctors of the importance of wearing safety glasses when doing, well, anything dangerous!
Keratoconus Contact Lens Management – This was a fantastic talk on contact lens treatment techniques for patients with challenging corneal diagnoses such as keratoconus, pellucid marginal degeneration, and post-LASIK / corneal refractive surgery fits. The trend with contact lens fitting these days seems to lean towards scleral lenses (Dr. Abert also took a class on scleral lens fitting techniques) and it is easy to see why: scleral lenses are comfortable, provide great vision, and have even been used to treat dry eyes because they hold continuous moisture against the eye. Unlike just about every other contact lens out there, scleral lenses don’t move at all, but rather suction-cup to the front of the eye, bypassing any corneal irregularities and providing great vision.
The Optic Nerve in Glaucoma – Glaucoma is a surprisingly common and potentially devastating disease of the eyes. It affects patients’ side vision which can be both good and bad: good in that we use our peripheral vision less than our central vision, but bad in that you can have pretty nasty glaucoma and not even know it. The clinical sign that our doctors look for is the appearance of the optic nerve, the nervous disk seen at the back of the eye, usually under the microscope in the exam room. A funny-looking optic nerve with side vision loss and high eye pressure tends to point towards glaucoma.
Managing Highly Elevated Intraocular Pressures – It doesn’t take a big increase in eye pressure to damage the retina and change the appearance of the optic nerve. Most pressures remain fairly low, or just a bit high with glaucoma, but when the pressure gets high, the clock is ticking. Every minute that the eye’s pressure remains elevated is another minute causing potential visual loss. If the eye pressure is extremely high, multiple medications may be needed to bring that pressure down and stabilize the eye. Thankfully, acute increases in eye pressure don’t happen very often and many of the risk factors for acute pressure increase can be identified early- another great reason to have your eyes checks regularly!
Anisocoria – This refers to a size difference between each pupil. There are a variety of things that affect the Third Cranial Nerve (the never that provides the bodily data connection to the pupil). Stroke, diabetes, and trauma can contribute to funny-sized pupils, as can having Horner’s Syndrome or Adies’ tonic pupil.
Systemic Antibiotic Management of Infection and Ocular Disease – People often assume that the only way to treat something eye-related is by using eye drops. Lots of topical eye medications can be administered to the eyes, but there comes a time when eye inflammation and infections needs to be addressed from the inside-out. This lecture was a great review of the many types of medications and tricky populations prescribed for (such as sick patients, children, and older patients).
Off-Label Uses of Common Medications – It was interesting to learn about all the different medications that are actually prescribed off-label. When the FDA approves medications, they are approved for specific ailments/diseases. In reality, clinical practice adapts medications for other uses. Really a class on technicalities, but it was still interesting to learn how the FDA works.
Dry Eye – There is no shortage of dry eyes in Colorado, and our patients can tell you all about that! There is so much more to treating dry eyes than just throwing around artificial tears. Proper nutrition assures that the patient’s tears are of the appropriate quality. Punctal plugs are a great way to manage dry eye for the long-run because they allow the patient’s tears to stay in contact with their eye longer. This is much more reliable than trying to remember to put eye drops in your eyes all day. New therapies include utilizing scleral lenses as a source of constant moisture to the eye.
Controversies in Corneal Infection and Inflammation – The cornea is a challenging tissue to treat, and most of the corneal injuries that our eye doctors see involve foreign bodies in the eye. This is typically treated with antibiotics if there was a resulting abrasion, and the rust deposits (if the offending particle was metallic) needs to be manually removed to assure good healing.
Co-Management in Oculoplastics – We refer patients to an oculoplastics specialist when the architecture of the eye needs to be permanently altered to improve visual function or comfort. A common example of this would be repairing the effects of an eye injury or addressing a congenitally droopy eyelid. The speaker for this lecture worked mostly with young children, and in young children, the concern with a drooping lid is that the lid could impair vision and prevent normal development of that eye’s ability to see.
Our optometrists attend the Academy’s Poster Session.
Management of Cataract Patients – When it comes to vision, every patient really is unique in and of themselves. People have different refractive errors to begin with (nearsightedness, farsightedness, and astigmatism) along with different hobbies, work environments, and habits. In short, everyone uses their eyes differently, and it is important to keep that in mind when identifying how cataracts affect their vision and what to do about it. Some patients do well with modern multi-focal cataract implants (called ‘IOL’s’). Multifocal IOL’s allow good vision at distance and near with the goal of eliminating reading glasses for most activities. Other patients don’t mind having possibly clearer vision in general, but being more dependent on glasses for reading or computer work. This class discussed some lens selection, as well as managing the healing process after cataract surgery.
Poster Session – Dr. Abert and Dr. Pedroza had never been to a posterior session before, but they were really fun, and provided interesting information and a wide variety of subjects. Posters are tacked up on boards, and anyone who wants to walks around and reads about the different presentations. Some are interesting case studies and others are research studies. The posters’ presenters are there to answer questions.
Our optometrists had a blast in Seattle, and they look forward to attending next year’s Academy meeting…in Denver, Colorado!