SENIOR ADULT HEALTH QUARTERLY:

Holiday Season's Ups and Downs

There is always obvious joy throughout the holiday season. Late fall brings cooler temperatures and an anticipation unlike any other. Fires begin to roar, ovens begin to get a little extra use and folks begin to prepare for celebrations and family togetherness. These are all the obvious “ups” of a holiday season.

Unfortunately, there are several “downs” as well. They might be overlooked, unrecognized or sometimes perhaps even ignored. Depression among those over 45 has skyrocketed. The CDC estimates that 1 in 10 adults show signs of depression, and this number nearly doubles during the holidays.

At Gaston Eye Associates, we are committed to our patient's overall health, well-being and quality of life. According to Better Hearing Institute's Dr. Kochkin, a growing body of research indicates that people with untreated hearing loss may be at an increased risk of depression. When left untreated or unaddressed, hearing loss can lead to isolation and other emotional conditions that can affect both quality of life and mental health.

In addition, Lighthouse International estimates that 7-27% of older adults with vision loss had a degree of depression; that is 2-3x the average. Whether a person with vision loss becomes depressed seems more related to the impact the vision loss has on a person's functioning rather than to the actual severity of the vision loss. One thing that is overheard all too often is, “I certainly do not want to talk about my eyesight or have anyone else talk about it either. It would be very depressing. Maybe I have not reached that stage where I am that desperate” Unfortunately, not getting evaluations and services is all too common; experience and research demonstrate that learning skills to compensate for vision loss can have a positive effect on one's emotional well-being and overall quality of life.

One of the leading causes of preventable blindness in the world is cataracts. It is now estimated by the National Institute of Health, that 20.5 million Americans have cataracts and that number is expected to increase to 30.1 million by the year 2020. As many of you know, a cataract is a clouding of the eye's natural lens. This clouding can be the result of trauma, medications and exposure to ultraviolet rays from the sun.

By removing the eye's natural lens that has clouded over, and by implanting an artificial lens designed and calculated for an exact prescription, the surgeon can restore much of one's vision. With today's technology and with Gaston Eye Associates’ expert surgeons, cataract surgery may be one of the very factors that can help improve mobility, maintain independence and keep the onset of depression out of reach.

Vision loss, hearing loss and depression are well-linked. Talk with your primary care physician and talk with family members. You owe it to yourself to remain healthy and vibrant. Allow those around you to help. Please call today to schedule an appointment and to allow the physicians at Gaston Eye Associates to evaluate your vision. May each and every one of you have a happy and healthy holiday season.

The Drug in your Mug:

By Dr. Joshua Ziebell

Headaches affect 11 to 25 million Americans; chances are you have either had one or know of someone who has. They can run the spectrum from being mild and irritating related to stress, all the way to debilitating and require hospitalization. Again, most of us fall somewhere in the middle.

As eye care providers, we are in a unique position to aid both the headache sufferer and the primary care physician in determining a diagnosis and in offering potential relief and therapy. In recent months and years, we have seen an increase in adults and especially adolescents, who present to the office with complaints of severe headaches. After a thorough examination and after ruling out pathological situations behind these headaches, we are sometimes left scratching our own heads.

In speaking with many patients, most are not aware of a substance they are consuming at rates well above the FDA's recommendations. This substance meets all the requirements for being addictive, including dependence, tolerance and withdrawl. It is this withdrawl that can lead to significant headaches. The substance is caffeine.

You might be thinking, “sure, I have a morning cup-o-joe or two, a diet soda with lunch and maybe some tea in the late afternoon, but nothing excessive.” And that is true. Caffeine is a known stimulant that can indeed cause a morning/afternoon pick-me-up and provide some additional attention while that 3 o'clock slump rolls in; in moderation.

The problem may lie in the newer 'energy drinks'. There have been more than 500 new drinks launched representing a 3.5 billion dollar market, and it continues to grow. The advertisements appeal and are specifically geared toward our youth. These drinks contain significantly higher amounts of caffeine than the current FDA restrictions allow, which is 72mg per 12 fluid ounces (a typical 6-8 oz cup of coffee contains 100mg caffeine for example). The makers of these drinks have found a loop hole in the system by falling under the 1994 Dietary Supplement Health and Education Act; they do this by adding ingredients such as ginseng, sucrose, taurine, L-carnitine, thereby offering the illusion of a healthy alternative for a quick-engery high.

Therefore, we as parents and practitioners need to be aware of the effects of this substance in all age groups. Once we have ruled out pathological causes of all these headaches, we must concentrate on a detailed history. Caffeine intoxication, dependence and withdrawl are all well-known phenomenon and most often times result in significant headaches, depression, fatigue, muscle twitching and overall aches and stiffness. As with nearly everything, moderation is key.

In addition to inventing the bifocal, Benjamin Franklin also noted:

“Who is wise? He that learns from everyone. Who is powerful? He that governs his passions. Who is rich? He that is content. Who is that? Nobody.

And speaking in terms of moderation:

STRESSED spelled backwards is DESSERTS

-Enberg.

Doctor goes on mission rather than vacation

Protect Your Eyes at Home and at Play

Contact: Todd Brown, MD

Gaston Eye Associates

704-704-853-3937

(Gastonia, NC, September 2011) September is Eye Safety month and a great time to be reminded about eye safety. According to recent statistics, in one year over 40,000 people have suffered from sports-related eye injuries and over one million people have injured their eyes at home. These numbers prove that eye safety is not just a work-related issue, especially since 40% of 2.5 million annual eye traumas occur at home. In patients under age 25, trauma is the number one cause of vision loss.

Memories are made while at play at any age. Sadly those memories can turn into nightmares with a serious injury to the eye. According to Todd Brown, MD of Gaston Eye Associates, over 90% of eye injuries are preventable with the proper protective eyewear. Any sport has its dangers and proper equipment is paramount. Such protective eyewear includes goggles, face shields , masks and guards made of unbreakable polycarbonate plastic, in both prescription and non-prescription form. Regular glasses and contacts generally do not afford the same type of protection from flying balls, pucks, fingers, elbows and debris. Parents of children participating in sports should make sure their children have the proper protective devices as most leagues do not require them to participate.

Homes are filled with accidents waiting to happen. Injuries can occur from falls, sharp objects or chemical exposures from ordinary household cleaning products. These injuries can come from foreign bodies, burns, and blunt or penetrating trauma resulting in problems ranging from scraped lids and corneal abrasions to blood in the eye, intense swelling and lacerations. “If not properly managed, these injuries can further lead to infection, cataracts, glaucoma, and retinal detachments,” says Dr. Brown.

Brown and his colleagues at Gaston Eye recommend eye protection for any high risk activities and stress that one should never presume to be immune to such accidents; they do happen and are seen by the physicians at Gaston Eye Associates every day.

Signs of severe injury are vision loss, blood in or around the eye, swelling of tissues or foreign bodies. Such concerns should be evaluated emergently by an eye doctor, as some injuries require surgery and not just medications. First and foremost, protect the injured eye from further injury such as rubbing or putting pressure on the eye, by covering the eye with a shield or protective cover over the eye. Had such protection been available prior to the accident, trauma may have been prevented.

Enjoy yourself at play and at home, but protect those eyes with specifically designed eyewear. See your eye doctor before and after so you’ll see tomorrow with both eyes.

For more information, contact Dr. Todd Brown at Gaston Eye Associates, at 704-853-3937 or visit the website at www.gastoneye.com

Community involvement is important to Dr. Ziebell. He attends Grace Covenant Church, is a member of the Political Action Committee for Piedmont Society and he volunteers as a vision screener for Mooresville Police/Fire/Rescue as well as the Lion’s Club N. Tryon Street location in Charlotte.

Gaston Eye Associates is a complete eye care and surgery center with two locations in Gaston County- 2325 Aberdeen Boulevard, Gastonia and 820 Lower Dallas Road, Dallas. For more information about services provided, please contact the Gastonia office at 704-853-3937 or the Dallas office at 704-922-9808 or visit the Gaston Eye Associates website at www.gastoneye.com

Gaston Eye Associates has achieved accreditation by the Accreditation Association for Ambulatory Health Care (AAAHC/Accreditation Association). Accreditation distinguishes this surgical center from many other outpatient surgical facilities by providing a safe work environment and the highest quality of care to its patients.

Status as an accredited organization means Gaston Eye Associates has met nationally recognized standards for the provision of quality health care, set by the Accreditation Association. Almost 5,000 ambulatory health care organizations across the United States are accredited by AAAHC. Not all ambulatory health care organizations seek accreditation; not all undergoing the on-site survey are granted accreditation.

“We believe our patients deserve the best”, stated Dr. Bob McCullen of Gaston Eye Associates. “When you see our certificate of accreditation, you will know that the AAAHC, an independent, not-for-profit organization, has closely examined our facility and procedures. It means that we as an organization care enough about our patients to strive for the highest care possible”.

Ambulatory health care organizations seeking accreditation by the AAAHC undergo an extensive self-assessment and on-site survey by the Accreditation Association’s expert surveyors-volunteer physicians, nurses, and administrators who are actively involved in ambulatory health care. The survey is consultative and educational, presenting best practices to help and organization improve its care and services.

“Going through the process challenged us to find better ways to serve our patients, and it is a constant reminder that our responsibility is to our patients and the quality of care we provide,” said Dr. McCullen.

AAAHC accreditation is specifically for organizations that provide diagnostic or medical care on an outpatient basis-where an overnight stay would not be required. Among the types of ambulatory health care organizations that can seek AAAHC are ambulatory and office-based surgery centers, single and multi-specialty group practices, college health centers, dental group practices, community health centers, occupational health centers, and managed care organizations.

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Summertime is not school time but pool time! Enjoying your independence as well as that of Uncle Sam on July 4th, Independence Day is what summer is all about. What better way to celebrate than with fireworks? People of all ages gather to watch the spectacular displays. Some even purchase their own fireworks to set off and display, potentially turning celebration into tragedy. Fireworks are dangerous and should be handled with caution or better yet left to the professionals.

The eye is the second most injured part of the body in fireworks accidents. Such injuries range from the mild-burns, abrasions, foreign bodies to the extensive- loss of eyesight, complete blindness, even loss of the eye itself. Due to the unpredictability of firework devices common sense and even protective eye wear should be considered for prevention of such injuries.

The U.S. Consumer Product Safety Commission offers these eye-opening statistics :

• Fireworks were involved in an estimated 9,800 injuries treated in U.S. hospital emergency rooms in 2007
• An estimated 6,300 injuries were treated in hospital emergency rooms during the one-month period surrounding the Fourth of July
• An estimated 1,400 fireworks-related eye injuries were treated in the same one-month period of 2007
• Firecrackers accounted for 1,300 injuries, sparklers (1,000)(which can reach 1800 degrees F) and roman candles (800)
• Males accounted for 70% of fireworks injuries
• Firecrackers caused the greatest number of injuries in children 14 and younger, followed by sparklers and rockets.
• Of the 1,100 estimated sparkler injuries, 200 were to children age 4 and younger.
• 2,600 of the fireworks injuries were to children under age 15.
• Bystanders are more often injured by fireworks than operators themselves
• Contusions, lacerations and foreign bodies were the most common eye injuries
• There were 11 fireworks-related deaths in 2007
  

Therefore enjoy the show, don't become part of it. For more information contact www.preventblindness.org or call 1-800-331-2020 to obtain a Safe Summer Celebrations booklet.

In case of eye injury it is important to know how to respond properly to prevent further damage to the eye. The severity of the injury needs to be assessed before placing anything in the eye, avoid direct pressure and rubbing of the eye, and place a protective shield over the eye if available. Go to your local Emergency Room or call your eye doctor for evaluation.

Prevent Blindness America offers the following quiz for proper procedures:

If one of your children was hit in the eye, would you know what to do?

1. Glass or metal from a bottle rocket strikes a child’s eye.  There is no bleeding, and the pain goes away quickly.
   a. Ignore it. There is nothing wrong.
   b. Apply ointment or rinse out the eye.
   c. Take the child to the emergency room.
   
   
2. After an accident, the child is in terrible pain and wants to rub the eye. What should you do?
   a. Let the child rub the eye.
   b. Do not let the child rub the eye and go immediately to the emergency room.
   c. Give a pain reliever as soon as possible.
   d. Apply ointment right away.
   
   
3. The child’s eye has been hit by an exploding bottle rocket, sparkler or another type of fireworks device. First:
   a. Tape or secure some type of protective patch against the bones around the eye area
        and go immediately to the emergency room.
   b. Apply ointment right away.
   c. Rinse out the eye right away.
   
   
4. What is the best pain reliever to give to the child on the way to the hospital?
   a. Aspirin.
   b. An ibuprofen-based pain reliever.
   c. Do not stop for pain relief medication.
   
   
5. Which of these is the wrong thing to do for a child’s injured eye?
   a. Apply ointment.
   b. Keep the child calm.
   c. Tape a patch against the bones surrounding the eye.
   
   
6. Your child’s friends are going to set off fireworks, and your child wants to play too. You:
   a. Remember that bottle rockets can stray off course or throw shrapnel when they explode.
   b. Keep in mind that about half of all fireworks injuries happen to bystanders.
   c. Insist that the child avoid fireworks and take him or her to a professional fireworks display.
   

ANSWERS:

1. c. Get the child to the emergency room. An impact injury, caused by something slamming into the eye can lead to damage that your child cannot immediately feel and you cannot see. Vision loss, even blindness, could occur within hours or days. Only an eye doctor’s examination of the interior eye can reveal the result of an impact injury.
2. b. Do not let the child rub the eye. Rubbing the eye may increase bleeding or worsen the injury.
3. a. Tape or hold a protective shield against the bones surrounding the eye. Do not apply pressure to the eye itself. Using a foam cup or the bottom of a paper juice carton are just two tips. Protecting the eye from further contact with any item, including the child’s hand, is the goal.
4. c. Don’t stop for medication. Over-the-counter pain relievers will not do much to alleviate pain. Aspirin (which should never be given to children) or ibuprofen can thin the blood, increasing bleeding. Take the child to an emergency room right away; this is more important than stopping for a pain reliever.
5. a. Do NOT apply ointment. Ointment makes the area around the eye slippery and harder for the doctor to examine. Ointment may also not be sterile.
6. a-c. All of the answers are correct.

I was recently asked to give a talk at a local Assisted Living establishment, and assumed that I would be speaking to people that lived there, but instead found myself talking to a group of medical professionals…nurses, therapists, and caregivers. My first slide was a slide of 3 pictures that you see above. Only one of the professionals at the seminar answered correctly. So I thought this would be a great topic to write about to my newspaper friends.

A Cataract is a clouding that occurs to the normally clear human lens usually due to age. The lens is about the size of a medium lima bean and sits just behind the iris which is the colored part of the eye. There are other reasons for cataracts to form such as diabetes, steroid use, and trauma, but most commonly they just occur with age.

Surgery is the only way to fix a cataract. It is performed when the patient can longer perform functions that he/she normally would and interferes with the patient’s quality of life. That point is somewhat different for all people, but there is also a second requirement. That requirement is a medical guideline which must be met as well to qualify for insurance coverage of cataract surgery. Once both guidelines are met, the patient is a candidate for removal of their cataract if they desire better vision.

Modern cataract surgery is quick, painless, and very successful in general. Most patients have fast visual recovery and minimal activity limitations, and those limitations are generally for only one week. There is a 1 in 1000 risk of visual loss with the surgery and this is most commonly due to post-operative infection A plastic implant is placed in the eye during surgery to “put back” the optical power of the human lens that was removed.

The most common outcome is to provide distance vision to the patient as close to glasses-free as possible and they generally wear readers for near tasks afterwards such as reading. Recently there has been some other implants that can give near and far vision to the patients instead of just far. These types of implants have the best chance to eliminate all need for glasses, but there are some drawbacks. These drawbacks include increased glare, decreased contrast, and usually include increased out-of-pocket expense. These implants are NOT for everyone, and you should ask your eye doctor which type of implant might be right for you if you ever need cataract surgery.

Oh yeah….and the correct answer is I was recently asked to give a talk at a local Assisted Living establishment, and assumed that I would be speaking to people that lived there, but instead found myself talking to a group of medical professionals…nurses, therapists, and caregivers. My first slide was a slide of 3 pictures that you see above. Only one of the professionals at the seminar answered correctly. So I thought this would be a great topic to write about to my newspaper friends.

A Cataract is a clouding that occurs to the normally clear human lens usually due to age. The lens is about the size of a medium lima bean and sits just behind the iris which is the colored part of the eye. There are other reasons for cataracts to form such as diabetes, steroid use, and trauma, but most commonly they just occur with age.

Surgery is the only way to fix a cataract. It is performed when the patient can longer perform functions that he/she normally would and interferes with the patient’s quality of life. That point is somewhat different for all people, but there is also a second requirement. That requirement is a medical guideline which must be met as well to qualify for insurance coverage of cataract surgery. Once both guidelines are met, the patient is a candidate for removal of their cataract if they desire better vision.

Modern cataract surgery is quick, painless, and very successful in general. Most patients have fast visual recovery and minimal activity limitations, and those limitations are generally for only one week. There is a 1 in 1000 risk of visual loss with the surgery and this is most commonly due to post-operative infection A plastic implant is placed in the eye during surgery to “put back” the optical power of the human lens that was removed.

The most common outcome is to provide distance vision to the patient as close to glasses-free as possible and they generally wear readers for near tasks afterwards such as reading. Recently there has been some other implants that can give near and far vision to the patients instead of just far. These types of implants have the best chance to eliminate all need for glasses, but there are some drawbacks. These drawbacks include increased glare, decreased contrast, and usually include increased out-of-pocket expense. These implants are NOT for everyone, and you should ask your eye doctor which type of implant might be right for you if you ever need cataract surgery.

Oh yeah….and the correct answer is C.

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Norman Span wrote a song made famous by Harry Belafonte and others entitled “Man Smart, Woman Smarter”. The opening lines are:

Let us put men and women together
See which one is smarter
Some say men, but I say no
The women got the men like a puppet show

Which of your 5 senses are you most afraid of losing? If you are like most people, it's probably your ability to see. Despite this, many people are not conscientious about caring for their eyes and often neglect routine eye exam visits after the age of 40. If you have noticed that you have to hold the newspaper farther away from your eyes than you used to, join the crowd. Starting around age 40 the lens loses flexibility and eventually most people need reading glasses or bifocals to see up close. Age can bring on many changes that affect your eyesight. Some changes are more serious than others. The key is to have regular eye exams so you can spot problems early.

The fact is that the leading causes of visual impairment and blindness in the United States are primarily age related eye diseases. Cataracts, glaucoma, age related macular degeneration, diabetic retinopathy, dry eyes, drooping eyelids are just some of the more common causes of vision loss that are most commonly seen in the aging eye.

As Americans are living longer, healthier and more active lives, maintaining good vision in later years is becoming increasingly important. Since our vision is one of the primary ways that we interact with the world around us, loss of vision can be a significant disability. Inability to see well enough to pass the drivers license eye exam can mean a significant loss of independence and mobility. Vision loss to the point where you cannot read or watch television can have a significant effect on our quality of life in later years and contribute to other problems such as depression.

Growing older does not always mean seeing poorly. Many people have good eyesight well into their 80's and 90's. While older people are at much higher risk for more vision problems and eye diseases than younger people, much of the vision loss these diseases cause can be corrected or prevented with early detection and treatment. Over the age of 40 it is recommended that you have a complete eye exam with a eye care specialist (Ophthalmologist or Optometrist) every 1-2 years. During this exam the eye specialist should put drops in your eyes that widen (dilate) your pupils. This allows the examination of the inner parts of the eye where many eye diseases are detected. Over the age of 65 it is especially important to have yearly eye exams. If you have a history of diabetes or a family history of eye disease then routine eye exams are extremely important.

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Eat right – Mom was right, carrots are good for your eyes, but tomatoes and peppers help out your eye health, too. In fact, there are a delectable array of foods that can protect your eyes from such diseases as macular degeneration. Eating a variety of vegetables, especially leafy green ones, should be an important part of your diet.

Foods to improve your vision health and protect the eyes include:

• Foods rich in lutein and zeaxanthin such as eggs and dark green leafy veggies like kale and spinach.
• Fruits and vegetables containing beta-carotene that are deep orange or yellow like carrots, mangos and peaches.
• Fruits and vegetables high in vitamin C like oranges, strawberries, green peppers and tomatoes.
• Foods rich in vitamin E such as almonds, pecans and sunflower seeds.
• Foods containing zinc like meat, liver, whole grains and milk.

Baseline eye exam
Even if you don’t have any current vision problems, you should still see an eye care professional for a comprehensive eye examine so problems can be diagnosed early and suggestions can be made for improving or preserving vision. Eye diseases, such as glaucoma, cataracts and macular degeneration, or other medical conditions such as diabetes and high blood pressure, can damage vision or eventually cause blindness. And, patients may never experience symptoms until the problem is too severe to treat. Children, especially, should be seen early, starting in as early as infants or at least upon starting pre-school and then yearly. Vision screenings at work, doctor’s office or school only serve as preliminary tests. 25 percent of school-aged children have some sort of vision problem so early detection is crucial.

Eye protection -- An estimated 2.5 million eye injuries occur in the U.S. each year, so it is critical to wear proper eye protection to avoid eye injuries during sports such as hockey and baseball and home projects such as home repairs, gardening, and cleaning. For most repair projects and activities around the home, standard ANSI-approved protective eyewear will be sufficient. Sports eye protection should meet the specific requirements of that sport; these requirements are usually established and certified by the sport's governing body and/or the American Society for Testing and Materials (ASTM).

Know your family history -- Many eye diseases cluster in families, so you should know your family's history of eye disease because you may be at increased risk. Age-related eye diseases, including cataracts, diabetic retinopathy, glaucoma and macular degeneration are expected to dramatically increase--from 28 million today to 43 million by the year 2020.

Early intervention -- Most serious eye conditions, such as glaucoma, macular degeneration, and diabetic retinopathy are more easily and successfully treated if diagnosed and treated early. Left untreated, these diseases can cause serious vision loss and blindness. Early intervention now will prevent vision loss later.

Contact lens care -- Follow your eye doctor's instructions regarding the care and use of contact lenses. Abuse, such as sleeping in contacts that are not approved for overnight wear, using saliva or water as a wetting solution, using expired solutions, and using disposable contact lenses beyond their wearing time can result in corneal ulcers, severe pain and even vision loss.

Be aware of eye fatigue
Are you in front of a computer screen all day long? Then you may be among the 88 percent of Americans who suffer eyestrain from too much staring at the screen. Victims of “Computer Vision Syndrome,” or CVS, suffer from headaches, loss of focus, burning, red, tired eyes, blurred vision and neck and shoulder pain. The key to avoiding CVS is to give your eyes breaks throughout the day. Try to abide by the "20-20-20 Rule”: After 20 consecutive minutes of computer time, look up and focus on anything that is at least 20 feet away for at least 20 seconds. If symptoms persist, it could be a sign of several different conditions, such as dry eyes, uncorrected prescription, presbyopia, or poorly fit glasses. See your eye care professional to determine why you are having these problems and to receive proper treatment.

Know your eye care provider -- When you go to get your eyes checked, there are a variety of eye care providers you might see. Optometrists, ophthalmologists, and opticians all play an important role in providing eye care services to consumers. Optometrists are primary eye care providers who examine, diagnose, treat and manage eye diseases and prescribe glasses and contacts to correct disorders of the visual system. Opthalmologist are medical doctors who are specialty trained in the medical and surgical care of the eye. Opticians do not test vision or write prescriptions but instead are trained to design, verify and fit eyeglasses.

Again, the most important thing you can do for your eyes is to have them checked. This will help identify any problems and, hopefully, treat them so as not to harm your vision. Your eyecare professional can give you advice for how to preserve and protect your vision. Your children, too, need yearly exams to ensure their vision is developing correctly or to identify and treat problems early.

So, mark your calenders for Save Your Vision Month, and remember, yearly exams are your best defense againt future vision problems.

Dr Rey Garrido is an optometric physician at Gastoneye Associates, 2325-A Aberdeen Blvd, Gastonia, NC. He has been providing comprehensive eye care the entire family at Gastoneye for more than 15 years.

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Gaston Eye Associates is pleased to announce that we are Gaston County's first and only Implantable Contact Lens (ICL) provider.

The ICL is available to patients with varying amounts of near-sightedness, including those whose prescriptions were not suitable for the LASIK procedure. Not only does the ICL correct vision, it also allows the patient to experience a refractive surgery without the side effects of dryness, halos and glare, and it is a reversible procedure. If your prescription changes, the lens can be removed and replaced with another lens.

Restore your vision to an earlier time in your life. New technology is now available to lessen your dependency on glasses for distance AND near activities. This is made possible by replacing your own natural lens with either the Crystalens HD implant or the new ReStor implant. Call Gaston Eye today and find out how you can have the vision you did when you were younger!