Cohen Laser and Vision Center

Allergic Conjunctivitis

admin — Thu, 10 May 2012 17:34:45 +0000

Yes, ’tis the season of itchy, red, tearing and swollen eyes; sometimes associated with itchy nose and sneezing. Allergy season is here. Ocular allergies are caused chiefly by pollen or animal dander that travel into the tear film. Seasonal and pet allergies can also affect the eyes. Seasonal conjunctivitis is caused by different allergens, depending on the month of year and geographic location. April-May allergies are usually caused by trees, June-July by grasses and August-September allergies by ragweed.

Perennial conjunctivitis can occur all year long and is usually caused by animal dander and dust mites. The incidence of allergic conjunctivitis has been increasing over the last 40 years. About 40% of the general population is affected by allergic conjunctivitis.

TREATMENTS OF ALLERGIC CONJUNCTIVITIS

There are both non-medical and medical treatments for allergic conjunctivitis. Non-medical therapy includes avoidance of the allergen, cold compresses, frequent lubrication with artificial tears, use of daily disposable soft contact lenses and air conditioning. Medical treatments fall into 4 basic categories: anti-histamines, mast-cell stabilizers, non-steroidal anti-inflammatory and corticosteroids.

ANTI-HISTAMINES work by inhibiting the chemical histamine release from the mast cell, which causes itching and swelling of the eyes. Common examples of this are: Naphcon-A, Opcon-A , Visine-A and emadine. The anti-histamine is often combined with a vasoconstrictor to “get the red out”. These drugs are available without a prescription.

MAST -CELL STABILIZERS prevent the release of the inflammatory substances from the mast cell, which is activated during the allergic response. These drugs work best before exposure to the allergen and not as well after exposure. Examples include: cromolyn, Alamast, Alocril and Alomide. These medications are by prescription only in the U.S.

COMBINATION ANTI-HISTAMINE/MAST CELL STABILIZER drugs combine the rapid onset of action and itch relief of anti-histamines with the preventive action of mast cell stabilizers. They can be used acutely at the time of exposure as well as provide prolonged relief. These medications are by prescription only and include: epinastine, ketotifen, Lastacaft, Optivar, Pataday, Patanol, Zaditor, Bepreve and Elestat.

NON-STEROIDAL ANTI-INFLAMMATORY drugs have limited effectiveness in treating allergic conjunctivitis as they only work on a small aspect of the “late-phase” of the allergic response. Acular is the only drug approved for this condition, but other drugs in this category are Voltaren, Bromday and Nevanac.

CORTICOSTEROIDS have the fastest onset of action as well as the broadest coverage. These drops work for both the “early” and “late”phases of the allergic response. They are excellent at reducing redness, itching and swelling. However, potential side effects include increased susceptibility to infection, cataracts and increase in intraocular pressure. For this reason, they must be prescribed and monitored by an eye physician. Common examples include Alrex, Lotemax, Pred Forte and FML.

This article is for information purposes only and does not substitute for an exam by your eye care physician.
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Fish Diet and the Aging Brain

admin — Tue, 28 Feb 2012 21:08:09 +0000

Scientists at the UCLA Easton Center for Alzheimer’s Disease in Los Angeles, California conducted a study of 1,575 people with an average age of 67. The study, led by Dr. Zaldy Tan, measured the level of omega -3 fatty acids in red blood cells over three months. The study subjects also underwent an MRI of the brain and the researchers measured brain volume.
The researchers the ranked the level of omega -3 fatty acids in the participants’ blood. People who scored the the bottom 25% in omega-3 fatty acid levels had lower brain volumes compared with those with higher levels. These same people also scored lower on neuropsychological tests designed to test memory, abstract reasoning and function. Conversely, those people with higher levels of omega-3 fatty acids had larger brains and scored higher on the cognitive tests.
However, it is not clear how much fish or other omega-3 supplements are needed to reach a certain blood level of omega-3 or what that blood level should be. Some doctors are recommending that patients consume fish at least 3 times per week or take fish oil supplements to get enough omega-3 fatty acids to obtain the desired health benefits. Further research is needed to answer these questions. Please consult with your physician to determine if this diet is right for you.

Aspirin use and Age Related Macular Degeneration.

admin — Sat, 28 Jan 2012 23:28:48 +0000

Age Related Macular Degeneration is a progressive disease of the macula, the eye’s central part of vision, which usually occurs in elderly people and can result in blindness if untreated. In this European Eye Study conducted at the Queen’s University in the United Kingdom, almost 4700 participants over 65 years of age were divided into 4 groups, ranging from those who never take aspirin to those who take aspirin every day. About 1/3 of the participants who developed wet macular degeneration were daily aspirin consumers compared to 16% without macular degeneration who took daily aspirin. The authors concluded that frequent aspirin use was associated with early and late macular degeneration and the frequency increased with increasing aspirin consumption.
Before one stops aspirin use, consider the small size of the study and that each patient must be considered individually and discuss their specific condition with their medical doctor. Is their a high risk of cardiovascular disease? then frequent aspirin use may be beneficial. Is their a high risk of macular degeneration with a strong family history in an elderly patient? then warning against aspirin may be appropriate. A thorough review of each patient’s medical history is necesssary before any recommendations can be made. Please discuss your situation with your medical doctor and ophthalmologist.

Amniotic Membrane Transplants and Eye Surgery

admin — Tue, 03 Jan 2012 16:30:37 +0000

Amniotic Membrane Transplants are the newest wave in ocular surgery. Cryopreserved amniotic membrane is used to restore ocular tissue with minimal scarring and inflammation. The donor tissue is screened for HIV, Hepatitis, Syphilis, West Nile virus and is sterile and contains no micro-organisms. This tissue is used for patients who have pterygium, chemical and thermal burns, persistent epithelial defects, recurrent corneal erosions, and other corneal problems. I have used amniotic membranes in surgery and found it to speed would healing, decrease post surgical pain and prevent scarring. Hopefully the reader will never need this, but it is available for severely damaged eyes as well as for cosmetic improvement.This procedure is FDA approved in the United States.
On a lighter note, I would like to wish everyone a Happy New Year and Best Wishes for 2012.
I also would like to thank my staff for all their hard work this past year.

Xeomin, A new Botox

admin — Sun, 18 Dec 2011 19:07:36 +0000

Xeomin (incobotulinum Toxin A) is the newest of the Botox like drugs to become FDA approved. Xeomin is manufactured by Merz pharmaceuticals and is the third botulinum toxin available in the US to treat cervical dystonia, blepharospasm, and glabeller lines. It joins Botox (onabotulinum toxin A, Allergan) and Dysport (abobotulinum toxin A, Medicis). These neurotoxins also have many “off-label” uses including migraine treatment, forehead lines, “crows feet” as well as for decreasing sweating. Xeomin is marketed as a “purer” botulinum toxin and seems to have a faster onset of action than Botox. It is also supplied similarly to Botox, available in both 50 and 100 unit vials. Time will tell whether it will be able to penetrate the strong Botox name and market.

Laser Cataract Surgery

admin — Fri, 02 Dec 2011 20:39:20 +0000

There is alot of discussion about the hot topic of “laser cataract surgery”. Firstly, cataract surgery is currently performed with an ultrasonic unit called “phacoemulsification:. With this technique, which is the standard around the world, sound waves break up the cataract into little pieces that can be aspirated from the eye. After the cataract, or “cloudy lens” , is removed, an intraocular lens is inserted in the eye so the patient can see. Lately, there is new technology which uses a femtosecond laser to perform parts of the cataract surgery. This laser is used to make the initial incision into the cornea. Next the laser is used to perform the opening of the lens capsule, or outer cover, of the lens. Finally the laser is used to make cuts into the lens so the parts can be easily removed from the eye. The only laser FDA approved for cataract surgery in the US is LenSx made by Alcon. At the present time, most ophthalmologists do not feel that this technology is worth the cost, which is not covered by insurance. Time will tell if this technology will become the new “standard” for cataract surgery

Cohen Laser and Vision Center

admin — Sat, 19 Nov 2011 21:27:41 +0000

The Cohen Laser and Vision Center is a state of the art Lasik center located in Boca Raton, Florida since 1991. Dr. G. Richard Cohen is a fellowship trained cornea specialist who performs LASIK,PRK, Intralase, cataract surgery, INTACS, cornea transplants as well as BOTOX. RESTYLANE, JUVEDERM and RADIESSE. The purpose of this blog is to educate and inform readers interested in news and the latest developments in laser vision correction, cataract surgery, keratoconus treatment as well as cosmetic injections. Occasionally, there may also be personal blogs about Dr. Cohen and his family.

Cohen Laser and Vision Center Blog

admin — Sat, 19 Nov 2011 00:59:05 +0000

Hello World, this is my first blog. I would like to tell you about a new treatment for keratoconus. It is called INTACS. INTACS are FDA approved to treat keratoconus and prevent its progression. The INTACS surgery is performed in a physicians office and takes approximately 15-20 minutes. Afterwards, antibiotic eye drops are used and the patient usually notices an improvement in vision in a few days. Contact lenses and glasses may now be more easily worn.