The Benefits of a “Boring” Day

Paul Walton, MD; Blake Williamson, MD, MPH; and Gary Wörtz, MD

Eyetube

Paul Walton, MD, joins Blake Williamson, MD, MPH, and Gary Wörtz, MD, to share concepts to help cataract and refractive surgeons avoid horror stories in the OR. He says the goal should always be to have a “boring” day, emphasizing the importance of communication and understanding with patients. The surgeons also detail their approaches to anesthesia and how to best comfort patients before, during, or after surgery.

Autoimmune Disease and the Eye

Many affected patients will present with ocular signs and symptoms.

Anthony DeWilde, OD, FAAO

Modern Optometry

Autoimmune diseases are a complex set of conditions, in which the immune system mistakenly targets healthy cells instead of foreign cells. This can lead to significant morbidity and mortality. Autoimmune disease is the second highest cause of chronic illness in the United States. All in all, there are more than 80 types of autoimmune diseases.1 Diagnosing autoimmune diseases can be difficult, often due to lack of access to health care, testing options that are expensive and difficult to obtain, lack of specificity with testing modalities, and vague symptoms. From initial symptoms to final diagnosis, the process typically takes an average of 4.5 years and involves up to four doctors.2 ODs are in a unique position to help patients with autoimmune disease, as many of these conditions manifest with ocular signs and symptoms. By understanding the association between autoimmune disease and the eye, we can detect early signs and symptoms, allowing earlier referral and treatment. The number of autoimmune diseases that can affect the eye is vast. As such, this article will focus on the three main conditions that I’ve encountered over the course of my career: myasthenia gravis (MG), thyroid eye disease (TED), and giant cell arteritis (GCA). MYASTHENIA GRAVIS MG is a chronic autoimmune disease where autoantibodies bind to the neuromuscular junction, blocking its ability to receive normal signals from acetylcholine. This manifests as muscle weakness and fatigue.

Healthy Habits for Glaucoma Patients

Moderation and communication are key.

Valentina Lozano, MD

Glaucoma Today

Glaucoma surgeons often field questions from patients regarding health and lifestyle practices. Examples of inquiries include the following: “Are there vitamins or supplements I can take to prevent glaucoma?” “What kind of exercises can I perform?” “Can stress affect my glaucoma?” and “Does marijuana help with glaucoma?” Patients may receive short answers or generalized guidance such as, “Eat healthy, exercise regularly, and try to relax.” Understandably, they may feel uncertain about these vague instructions and unclear on what is best for their eye health. The challenge for glaucoma specialists is that it can be difficult to answer the questions definitively. We practice evidence-based medicine, meaning that any recommendation we make to patients is supported by substantial data. Research on lifestyle and glaucoma, however, is limited. To make the situation more complex, we still do not fully understand glaucoma. It is not just one eye condition but a group of eye conditions that damage the optic nerve. Some patients have increased IOP, whereas others have normal IOP and abnormal blood flow to the optic nerve. Until we understand glaucoma well enough to make conclusive lifestyle recommendations, some general wellness principles can be adopted by patients looking to optimize their health. Nutritionist and wellness expert Nancy Lin, PhD, separates healthy living into five pillars: (1) physical, (2) nutritional, (3) environmental, (4) mental/emotional, and (5) spiritual.