Autofluorescence Imaging in Maine

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Autofluorescence Imaging in Maine is a test we at Eyecare Medical Group to evaluate diseases and problems of the Retina. Darrin Landry, the photographer here at Eyecare Medical Group in Portland, ME, wrote this article to help us better understand autofluorescence imaging.
A Retina Specialist has a large arsenal of imaging technology to better evaluate retinal disease, and one of the newer technologies used to monitor the dry type of macular degeneration is autofluorescence imaging.
Dry macular degeneration is typically a progressive degenerative process that affects the central part of the retina, called the macula, which is where fine vision, such as reading, takes place. Currently only the wet form of macular degeneration can be treated, but the progression of atrophy in dry macular degeneration can be followed with autofluorescence imaging.
The retina is imaged utilizing a scanning laser with certain wavelength filters. In a normal eye, a substance called lipofuscin, which exists in cells in a layer of the retina, emits a fluorescent light when exposed to this specific wavelength of light.  In cases of atrophic retinal disease, such as dry macular degeneration, the damaged cells block the emittance of this fluorescent light. The result is a dark area in the macula. This damaged area can be followed, and using computer software, can be quantitatively measured for change.

Autofluorescence imaging is very useful for diagnosis in patients with vision loss, and we are starting to understand that certain inherited disorders have distinctive patterns of change. The ability to monitor and track changes at this cellular level gives us valuable information in the prognosis of some of these retinal diseases.

Normal Image

Damaged cells in the center of the macula

Damaged cells in the center of the macula

Change in damaged cells from first visit (on left) to second visit (on right)

Eyecare Medical Group is a leading ophthalmology practice in Portland, Maine staffed by a team of eye care specialists including eye doctors who are fellowship trained glaucoma specialists, retina specialists, cornea specialists and cataract and lens implant specialists-all board certified Ophthalmologists-as well as Optometrists, Opticians, technical and administrative staff who provide eye examinations for adults and children, cataract surgery and intraocular lens implants, (IOL,   laser vision correction such as LASIK, diagnosis and treatment of cornea disease including cornea transplants, care for diseases of the retina including diabetes and age related macular degeneration and diagnosis and treatment of glaucoma.

Eyecare Medical Group is conveniently located for patients from throughout Maine including Auburn, Augusta, Bangor, Bath, Berwick, Biddeford, Bridgeton, Brunswick, Cape Neddick, Casco Bay, Cumberland Center, Eliot, Freeport, Gardiner, Kennebunk, Kennebunkport, Kittery, Lewiston, Old Orchard Beach, Sanford, Scarborough, South Portland, Springvale, Topsham, Waterville, Westbrook, Winslow, Wiscasset, Yarmouth, Portland, Skowhegan and York Maine.

Maine Corneal Specialist & Shingles Eye Infections

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Maine Corneal Specialist Ravi Shah, M.D. of Eyecare Medical Group in Portland commented on Shingles Eye Infections. “Herpes Zoster Shingles eye infection or Keratitis is actually caused by the same virus that causes chicken pox, called Varicella-Zoster virus,” commented Dr. Shah. “It is entirely possible that after having chicken pox as a child, the virus remains in the nerve cells of your body in an inactive state and due to a number of possible reasons, the virus can reactivate later in life and travel through the nerves in your body causing a painful blistering rash,” he further explained. “We become concerned if the Varicella-Zoster virus travels to your head or neck because it can affect the eye and thus cause a corneal infection or Keratitis.”

It is critical to have Herpes Zoster Keratitis diagnosed quickly as the infection can penetrate deeply into the cornea and it can cause scarring and vision loss. The Herpes Zoster “Shingles” eye infection can also result in a loss of corneal sensation, which can be permanent and very undesirable. It may be necessary to prescribe both oral medications and eye drops to try and resolve the infection and prevent serious damage from occurring.

It is possible for anyone who has been exposed to the chicken pox Varicella-Zoster virus to get shingles. However, it seems to mostly affect those of advanced age and those with weakened or suppressed immune systems. Further, corneal problems from shingles may occur many months after the facial shingles appear to have resolved so it is important to schedule regular follow up appointments for eye examinations as instructed by your doctor.

If you or someone you know has had Shingles or Chicken Pox and is experiencing any type of eye problem please call Eyecare Medical Group at 888-374-2020 and request an immediate appointment or visit Eyecare Medical Group or facebook.com/eyecaremedicalgroup.

Eyecare Medical Group is a leading ophthalmology practice in Portland, Maine staffed by a team of eye care specialists including eye doctors who are fellowship trained glaucoma specialists, retina specialists, cornea specialists and cataract and lens implant specialists-all board certified Ophthalmologists-as well as Optometrists, Opticians, technical and administrative staff who provide eye examinations for adults and children, cataract surgery and intraocular lens implants, (IOL), laser vision correction such as LASIK, diagnosis and treatment of cornea disease including cornea transplants, care for diseases of the retina including diabetic retinopathy and age related macular degeneration and diagnosis and treatment of glaucoma.

Eyecare Medical Group is conveniently located for patients from throughout Maine including Auburn, Augusta, Bangor, Bath, Berwick, Biddeford, Bridgeton, Brunswick, Cape Neddick, Casco Bay, Cumberland Center, Eliot, Freeport, Gardiner, Kennebunk, Kennebunkport, Kittery, Lewiston, Old Orchard Beach, Sanford, Scarborough, South Portland, Springvale, Topsham, Waterville, Westbrook, Winslow, Wiscasset, Yarmouth, Portland, Skowhegan and York Maine.

Maine Lyme Disease & Your Eyes

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Maine Ophthalmologist Jordan Sterrer, M.D. commented on the effects of Lyme Disease and your eye. “Lyme Disease affects all the systems of the body-including the eyes-and can be devastating to an individual if not treated properly and in a timely manner,” says Dr. Sterrer, M.D. of Eyecare Medical Group in Portland, Maine. “We are all familiar with the common symptoms of Lyme Disease, but few people are aware of the eye and ocular manifestations that the disease can have.” Lyme disease is a bacterium transmitted by a tick bite and is most commonly characterized by a bull’s-eye rash that develops after contact. The tick much be attached to the skin for at least 24 hours for the infection to develop. Left untreated, the clinical manifestations of Lyme Disease occur in 3 stages. Early infection, stage 1, is the localized bull’s-eye skin rash. Few other symptoms accompany this stage; however, ocular manifestations such as conjunctivitis and photophobia, or light sensitivity, can be present. Stage 2 is the early infection stage and where the severe ocular effects of the disease can begin, although these symptoms can take several weeks to months to appear. These include double vision, or diplopia, optic neuritis, blurred vision, Bell’s palsy, and uveitis. Stage 3 is the late persistent infection stage. Symptoms during this stage are more severe and eye conditions such as episcleritis, keratitis, iritis, panuveitis, exudative retinal detachment and branch retinal artery occlusion can be present.

Treating the ocular effects of LD requires treating the disease itself as well as the effects on the eye. Early treatment with antibiotics is the best way to prevent issues later. However, if the disease isn’t discovered until it’s already in the later stages, any symptoms that arise as a result will also need to be treated. Lyme Disease is most often treated with antibiotics but the stage of the disease will depend on whether or not it is treated with oral or IV medications, and what type of antibiotics will be used, as well as how long the treatment course will be. Any ocular issues that occur as a result of LD will need to be treated as they would if the disease was not present. Patients and ophthalmologists should be aware that treatment may take much longer than if LD was not present.

"Because of the mild winter and spring we’ve had here in Maine, ticks are predicted to be exceptionally bad this year. It is important to take all the proper precautions to prevent exposure to Lyme Disease. The best way to do this is to wear long pants and insect repellent, and to avoid areas where ticks are present when at all possible. If you are in heavily wooded areas or areas with tall grass or lots of shrubs, it is important to thoroughly check yourself for ticks. Showering as soon as possible after being outside also limits your chances of getting a tick bite,” noted Dr. Sterrer.

If you have questions or concerns about Lyme Disease and your eyes please schedule an appointment at Eyecare Medical Group at 888-374-2020 or visit http://www.eyecaremed.com/ or facebook.com/eyecaremedicalgroup.

Eyecare Medical Group is a leading ophthalmology practice in Portland, Maine staffed by a team of eye care specialists including eye doctors who are fellowship trained glaucoma specialists, retina specialists, cornea specialists and cataract and lens implant specialists-all board certified Ophthalmologists-as well as Optometrists, Opticians, technical and administrative staff who provide eye examinations for adults and children, diagnosis and treatment of cataracts, cataract surgery and intraocular lens implants, (IOL), laser vision correction such as LASIK, diagnosis and treatment of cornea disease including cornea transplants, care for diseases of the retina including diabetic retinopathy and age related macular degeneration and diagnosis and treatment of glaucoma.

Eyecare Medical Group is conveniently located for patients from throughout Maine including Auburn, Augusta, Bangor, Bath, Berwick, Biddeford, Bridgeton, Brunswick, Cape Neddick, Casco Bay, Cumberland Center, Eliot, Freeport, Gardiner, Kennebunk, Kennebunkport, Kittery, Lewiston, Old Orchard Beach, Sanford, Scarborough, South Portland, Springvale, Topsham, Waterville, Westbrook, Winslow, Wiscasset, Yarmouth, Portland, Skowhegan and York Maine.

Maine Cataract Surgery & Lens Implant Cost

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Maine Cataract Surgeon BruceCassidy, M.D. of Eyecare Medical Group in Portland commented on the cost ofCataract Surgery and Lens Implants. “The cost of Cataract Surgery and Lensimplants can get a little confusing. Almost all insurances and Medicare coverthe bulk of the cost of Cataract Surgery and basic Lens Implants. HOWEVER,deductibles, co-pays and the extent to which certain services are or are notcovered can affect the actual amount you might need to pay out of pocket,”noted Dr. Cassidy. “Our administrative staff and billing personnel are quiteexpert at helping our patients navigate through any confusion.”

Some things to know about the costof Cataract Surgery and Lens Implants: Preoperative Testing and ConsultationWith the exception of co-pays anddeductibles specific to your insurance plan the eye examination, consultationand measurements necessary for Cataract Surgery and basic Intraocular Lens(IOL) implantation are covered services. If there are specialized tests thatmight be required such as more precise types of testing for multifocal lensimplants or toric lens implants, you may need to pay for these tests out ofpocket as your insurance and Medicare may only cover the basic testing. If thisis the case these extra tests may range in cost up to a few or several hundreddollars depending on the scope of the necessary testing.Surgery Center Facility FeeThe surgery center facility fee isgenerally covered by insurances and Medicare although there may be a smallco-pay or deductible with certain plans. This fee will cover the use of thefacility including the operating room, the nursing staff, the instrumentationand equipment and all related operating room supplies. Depending on the typesof anesthesia used it is possible that there will be an additional fee-mostlycovered by your insurance or Medicare-for the administration of anesthesia andthe staff.
Cataract Surgeon’s FeeThe Cataract Surgeon’s fee isgenerally covered by insurances and Medicare although there may be a smallco-pay or deductible with certain plans.Lens Implant FeeThe cost of a basic Monofocal lensimplant is generally covered by insurances and Medicare within the facilityfee. However, should you and your Cataract Surgeon elect to use an astigmatismcorrecting toric lens implant or multifocal lens implant there will be an outof pocket fee as most insurances and Medicare do not cover these more advancedtypes of Lens Implants.If you or someone you know hasquestions about the cost of Cataract Surgery and Lens Implant please feel freeto call Eyecare Medical Group at 888-374-2020, visit Eyecare Medical Group or facebook.com/eyecaremedicalgroup.Eyecare Medical Group is aleading ophthalmology practice in Portland, Maine staffed by a team of eye carespecialists including eye doctors who are fellowship trained glaucoma specialists, retina specialists, cornea specialists and cataract and lens implant specialists-all board certified Maine Ophthalmologists-as wellas Optometrists, Opticians, technical and administrative staff who provide eyeexaminations for adults and children, cataract surgery and intraocular lensimplants, (IOL), laser vision correction such as LASIK, diagnosis and treatmentof cornea disease including cornea transplants, care for diseases of the retinaincluding diabetes and age related macular degeneration and diagnosis andtreatment of glaucoma.Eyecare Medical Group is conveniently located for patients fromthroughout Maine including Auburn, Augusta, Bangor, Bath, Berwick, Biddeford, Bridgeton,Brunswick, Cape Neddick, Casco Bay, Cumberland Center, Eliot, Freeport,Gardiner, Kennebunk, Kennebunkport, Kittery, Lewiston, Old Orchard Beach,Sanford, Scarborough, South Portland, Springvale, Topsham, Waterville,Westbrook, Winslow, Wiscasset, Yarmouth, Portland, Skowhegan and York Maine.

Meet Jim Fickett, COA!

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Jim Fickett has been working at Eyecare Medical Group for the past 11years. He works for Dr. Robert Daly and has since he started at EMG. Jim lovesworking with Dr. Daly and his staff, “Dr. Dalymakes it easy for me to work for him. He advocates for me, I have no problemstalking to him, and he’s a wonderful teacher”. Jim feels fortunate to work in the area that he does here at EMG.  “Because Dr. Daly is a generalophthalmologist, I have a lot of experience with different things, like plastics,cataracts,cornea,and glaucoma.There is very little about the eye that I’m not at least familiar enough withso I can help patients out a little, or direct them to where they need to be”says Jim. 
When asked what his favorite part of his job is, Jim says “I love toscrub in the OR and then see the patient the next day, when they are withoutglasses and their vision is great”.  Hesays that the OR is the place where he feels like he’s helping the doctor themost, and that he’s most hands on with fixing the patient.  His favorite type of surgery to assist withis complex cataracts.  “With a regularroutine cataract, I’m basically just handing Dr. Daly instruments.  But with a complex cataract surgery, I haveto think more and anticipate what Dr. Daly is going to need. At that point,we’re a team.”
In 2003, Jim had LASIK with Dr. ElizabethSerrage.  “LASIKchanged my life forever. It’s the best thing I’ve ever done for myself- or EMGhas ever done for me” said Jim.  BeforeLASIK, Jim was very myopic and had been a long time contact lens wearer. LASIKhas also helped Jim with his favorite hobby- softball. In his personal time,Jim plays in 3 softball leagues, and he’s on a roster for a 4th.  He’s played softball all over New England andin several national tournaments.  
Thanks for all of your hard work, Jim!!!
Eyecare Medical Group is aleading ophthalmology practice in Portland, Maine staffed by a team of eye carespecialists including eye doctors who are fellowship trained glaucomaspecialists, retina specialists, cornea specialists and cataract and lensimplant specialists-all board certified Ophthalmologists-as well asOptometrists, Opticians, technical and administrative staff who provide eyeexaminations for adults and children, cataract surgery and intraocular lensimplants, (IOL), laser vision correction such as LASIK, diagnosis and treatmentof cornea disease including cornea transplants, care for diseases of the retinaincluding diabetes and age related macular degeneration and diagnosis andtreatment of glaucoma.
Eyecare Medical Group is conveniently located for patients fromthroughout Maine including Auburn, Augusta, Bangor, Bath, Berwick, Biddeford, Bridgeton,Brunswick, Cape Neddick, Casco Bay, Cumberland Center, Eliot, Freeport,Gardiner, Kennebunk, Kennebunkport, Kittery, Lewiston, Old Orchard Beach,Sanford, Scarborough, South Portland, Springvale, Topsham, Waterville,Westbrook, Winslow, Wiscasset, Yarmouth, Portland, Skowhegan and York Maine.

Knee Pain Causes

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Knee pain or hip pain after crouching or squatting is common in those with tight lower back, hip and knee muscles. Most of us who sit all day long have tight muscles in the lower back and lower limbs. So when we perform crouching or squatting movements whether done in a prolonged fashion or repetitively.

These days, knee pain has become a common complaint among many people. Every person suffers from knee pain sometime or the other. While it is easy to cure knee pain, you need to know the actual cause behind your knee pain before you go on to cure it. For example, knee pain can occur because of a variety of reasons.

Common Causes of Knee Pain:

· Ligament Injuries. Torn ligaments are caused by a hard stop or twist of the knee that typically occurs when participating in athletic activities.

· Dislocation of the Kneecap. This is another common injury that causes a lot of knee pain. If the kneecap (patella) moves out of place, a doctor may have to snap it back in place. Ouch!

· Tendon Ruptures. Certain tendons (quadriceps and patellar) can rupture partially or completely. Many joggers experience knee pain caused by tendon ruptures.

You should also consider alternative treatments as your knee pain therapy. In 1997, a National Institutes of Health consensus panel determined that acupuncture can actually help treat many types of knee pain, including the pain caused from knee osteoarthritis.

Sharp knee pain causes are often hard to pinpoint because of the inconsistency of the pain. It may come and go, or it may be present with some activities, but not others. Actually, this seeming inconsistency may hold the key to identifying the problem, so it is important to keep track of when you experience your pain issues, and what activities you were doing at the time.

Symptoms:

1.) Locking (where you cannot straighten or bend your knee)
2.) Popping or snapping sensation in the knee
3.) Giving way (feeling as if your knee is giving way when you walk)
4.) Inability to put weight on the knee

REMEDIES FOR KNEE INJURY

Any knee injury should not be ignored as else it might lead to knee surgery. So right from the onset opt for proper remedies to heal knee injury and prevent knee surgery.

Even if you do not have any knee injuries it is a good idea to give proper rest to your knee and avoid extreme activities that may initiate knee pain. Be cautious when working out as the wrong kind of work out or an excessive work out might lead to knee pain.

Consequently, conventional treatments used for traumatic pain (such as ice therapy and rest) may not give you chronic pain relief in the long run. They are useful but do not always "cut it". It is always wise to have your chronic knee pain evaluated by a physician to help determine the cause.

Other methods of treating knee pain include physiotherapy, bracing, use of medication (pain killers, corticosteroid, hyaluronic acid etc.) and surgery. These treatment methods should be implemented after consulting with a physician.

Meniscal injuries are also a form of knee pain. If the knee cap is rotated while bearing a lot of weight, the menisci can be damaged or injured. This usually happens in sports and can be the cause of considerable pain. A large tear in the mensci can leave it hanging on by a thread of cartilage.

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Sciatica Treatment

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Sciatica is one of the most difficult conditions for medical practitioners, even those experienced in treating back pain and sciatica patients, to identify and treat. Sciatica often presents itself as a tingling and/or numbness, not unlike the feeling one may experience with a pulled hamstring muscle, the biceps femoris at the back of the leg. The sensation may be dull, almost an ache, with periods of tingling and/or numbness occurring during certain activities.

Many causes of sciatica exist. Instances of trauma to the sciatica nerve have been reported from accidents injuring the pelvic region, diseases such as diabetes damaging the sciatica nerve, osteoarthritis induced bone spurs narrowing the spinal canal and tumors placing pressure on the nerve. More commonly, however, the cause of sciatica can be found in a herniated lumbar disc.

When a person has to deal with sciatica for quite some time the best thing to learn about are all the different causes of sciatica. In fact, many people are rather surprised when they find out some of the different things that cause sciatica. Even though it depends on what type of professional you speak with about sciatica, there are really many different ways to get sciatica.

Treatment of sciatica is usually associated with treating a bulging disc. The first line of treatment is usually an attempt to reduce inflammation to reduce pressure on the nerve by means of oral medications. For more powerful anti-inflammatory effects, spinal injections with steroids like cortisone may be used.

This exercise program is primarily geared to stretch and strengthen the muscles of the lower back and the legs, reducing back pain and sciatica. The following are stretches that will assist in pain reduction and relief by removing much of the stress from the lower back, pelvis (hips) and lower extremities.

Natural remedies are growing in acceptance and are usually gentler and safer to use and focuses on other mean to achieve pain relief and help with a healthier back. While drugs are appropriate for immediate pain relief, reduction of inflammation and relaxation of muscles, it may be better to avoid them on an ongoing basis and to look for a holistic approach to treating the problem.

Sciatica Symptom:

In the previous two articles in this series we've discussed some of the reasons why we experience sciatic nerve pain or sciatica. In this article I would like to jump back just a bit and discuss the symptoms associated with sciatica, explain just why we experience this type of pain, and some of the other basic issues often faced when we experience it.

You cannot begin to consider cures for sciatica without first understanding exactly what sciatica is. That said, allow me to reiterate that cures for sciatica exist and are available, accessible, and effective as you will see in this article and on the next page.

Sciatica Treatment

Chiropractors, through the use of manually induced spinal adjustments, can often help the symptoms of sciatica. The adjustments, usually quick and painless, can align the spine and reduce the pressure on the sciatic nerve. A sciatica treatment usually begins with some type of heat therapy to loosen up the muscles surrounding the affected area.

Sciatica Causes

Many different sciatica causes exist. Sciatica, a symptom of a diagnosed condition, can stem from a number of ailments. Though sciatica leg pain is the most common complaint, not all individuals will experience it. For example, in piriformis syndrome, discomfort and pain are most often felt in the buttocks and hip area.

Sciatica exercise can greatly enhance a sciatica sufferer's quality of life, easing pain and creating a stronger, more limber body. Many health practitioners agree that the key to preventing repeat episodes of sciatica is practicing sciatica exercise on a daily basis.

Some typical symptoms which you should consider when trying to decide whether you may be suffering from piriformis syndrome are pain in the buttock, the discomfort in the back of the leg described before, and a painful muscle spasm or tenderness in the buttock evident when pressure is applied to it.

Releasing muscle tension is simple enough if you know how to stretch, what to stretch and when to stretch... the 3 essential ingredients for any stretching routine. Building muscle strength also is simple. You don't need to spend hours in a gym, all you need to know is how to stimulate the nerve and blood supply to your muscles which gives them the strength they need to support your joints. Exercise just means you can lift more heavy objects.

The sciatic nerve is the largest nerve in the body. Its nerve roots run from the lumbar spinal cord located at the lower back extending through the buttocks, hips and lower limb. When this nerve becomes inflamed or irritated it produces pain that resembles like a leg cramp.

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