Thank you all for the past 2 years!

What a wonderful first 2 years it has been for me at Carillon. It certainly feels like much longer in the best way! Dr. Agrest, the staff, and all of the wonderful patients have made this professional transition of mine as wonderful as possible. There is no doubt that the Glenview area is a wonderful place to live, work, and raise a family.

I would like to send a HUGE thank you out to all of our existing and new patients that have been spreading the word about our practice. Another big thanks is due to those of you that have taken the time to review us online. The staff and I read each and every one of these reviews, and it really makes us feel appreciated. Thank you so much for helping me realize my professional dream and allowing everyone at Carillon to do what we love for a living.

I looked at our record database earlier today. There have been over 700 patients entirely new to our office that I have seen the past two years! That is certainly a lot of new patients for an eye doctor new to the area. Not to mention the thousands of wonderful patients that have already been established at our office that I have gotten to know. The best part is, I cannot think of one patient that I did not thoroughly enjoy getting to know.

2013 looks to be another exciting year. You will certainly be seeing some new staff faces as we continue to grow, and quite possibly the addition of another Doctor. Phyllis and I have our eyes on some new exciting designer eyewear lines, and I am always checking out the latest and greatest diagnostic medical equipment to keep our standard of care second to none.

Going forward, I sincerely will continue to do my best to take the finest care of you and your family’s ocular health and vision needs. I love my profession, and always have my eye on what more we can bring into the office to make your experience and care even better. Again, thank you so much for the past two years.

Happy Holidays to you and yours!

Dr. Andrew J. Neukirch

Dr. Neukirch practices at Carillon Vision Care in Glenview, Illinois.

Recent Advancements in Soft Contact Lenses

The optical options, qualities of lenses, and materials available for disposable contact lenses have never been greater, in more than one sense of the word. But this is very confusing for the everyday consumer, and many times even for eye doctors that do not fit these types of new lens technologies everyday. I will briefly introduce what is new and noteworthy in the industry over the past 5 years. My office fits well over a hundred new teenagers into contacts for the first time each year. But we also get many adults into contacts for the first time - or back into them after years of only glasses.

So many options, what is best?

What is best for a new wearer?

One Day Astigmatism Lenses

Over 99% of all contact lens related eye infections I see are from either improper cleaning/storage or not replacing disposable lenses as prescribed. One day disposable contacts solve BOTH of these issues. I have yet to even see a daily lens patient with a lens related infection at the time of this posting. The prices of these contacts have come down considerably the last few years, and the prescription ranges available have been getting better. There are even now multiple choices of daily lenses for patients with astigmatism. And for the established or previous wearer that has problems with lenses drying out, the one day lenses are superior. The materials in the lenses break down much more quickly than 2-week or 1 month lenses, making them extremely moist and comfortable for up to 24 hours straight.

I need bifocals and/or reading glasses. That means I can't wear contacts, can I?

Biofinity Multifocal Contacts

Many of our patients age 40 and older now find themselves reaching for bifocals or reading glasses and believe they are no longer good candidates for contact lenses.  The advancements in multifocal (or “bifocal”) contact lenses are incredible. The first one day multifocal lens came out a few months ago, PERFECT for the over-40 patient just wanting part-time or “weekend” lenses. For the full time patient, I have been having phenomenal success with the Biofinity Multifocal lens. Doctors are able to adjust both the distance power, near power, and what “type” of optical center is in each lens. Over 85% of my patients that try these lenses end up ordering year supplies.

An example of the optics in a type of Biofinity multifocal

My old lenses were so uncomfortable, has this gotten any better?

Most new generation disposable contacts are made of hydrogel, silicone, or a combination of the two.  These materials have superb breathability and comfort. Each lens has values assigned to it that eye doctors can match to each patient’s specific needs. Besides the prescription number (like “-2.00”), there is a curvature, material, Dk/t (a measure of oxygen breathability), wetting angle, sometimes more. The newer lenses also rely on computer designed aspheric optics, resulting in thinner lenses and better vision at night. When the light is low, your pupils get larger, and light from the periphery interferes. Aspheric optics help compensate for this.

I noticed that newer contacts cost more than what I used to wear. Are the newer lenses really better?

From time to time, I get asked about older, but very inexpensive contacts like Acuvue 2. These types of lens still maintain their FDA approval, as do many other types of outdated medical devices. Many times these are not very breathable lenses and are linked - both by my experience and medical literature - to increased incidents of ocular inflammation, infection, and patient non-compliance. Acuvue 2 has been around since the 1990’s. I simply will not prescribe a lens like this when healthier and safer lenses are available.

So are contacts right for me?

Not everyone is a candidate for all the types or even any of lenses we discussed. Some have conditions that require specialty soft or gas-permeable lenses that I fit every day, but I will save that discussion for another time. But if you are interested in contacts, be sure to ask you eye doctor at your next exam! They will certainly tell you if contacts are right and which ones are best for you or your children.

Dr. Andrew Neukirch is an Optometrist and the CEO of Carillon Vision Care located in Glenview, IL. He may be reached at carillonvisioncare@gmail.com

What to expect from your first eye exam at Carillon Vision Care

 I have come to find that many of my new patients are surprised at the depth and "comprehensiveness"  of their first eye exams at my office. Below, I have outlined a basic guide so prospective new patients know what to expect.

Your visual system and the anatomy of your eyes are more complicated than most people think. Therefore a comprehensive eye examination by a medical eye doctor should not only evaluate the clarity of your vision, but also determine how healthy all of the parts of your eye are. To this end, your examination will consist of several tests and procedures. Please be aware that your exam may take more than an hour, although most of our exams are completed within 45 minutes.

            Bring an updated list of current prescription medications, non-prescription medications, eye drops, and supplements or vitamins. If worn, please bring your last pair of prescription glasses and/or contact lenses, as our doctors will be able to inform you if anything has changed. Knowledge of your family history of any eye diseases is helpful, specifically histories of macular degeneration, glaucoma, or cataracts.

            When you arrive, please check in at the front desk. The office staff will copy any medical and vision insurance cards to keep on file and provide you with the necessary intake forms. These may be printed out online from our website and filled out in advance. We ask that you please arrive 15 minutes early if you plan on filling these out at the office.

            Your exam begins with a complete history of why you are here. All of your visual problems and potential issues are identified. Your medical and family history are reviewed.

            Next, your vision is evaluated with your present corrective lenses if applicable. A refraction will be performed to determine your optimal spectacle and/or contact lens correction (think “what’s clearer, 1 or 2?”). All options and the pros and cons of spectacle lens and contact lens designs and modalities are discussed. If applicable, the difference between your old and new corrective lenses is demonstrated.

The function and health of the eye muscles and eye motility is then examined. Depending on age or findings, depth perception and color vision may be assessed. Peripheral vision is examined, and your pupillary responses are checked.

The pressure inside of the eye, or intraocular pressure, is measured with the newest instrument available that requires no eye drops and does not involve an uncomfortable puff of air.           

Next, the eye physician examines the health of the eyes under a specialized high-magnification microscope known as a slit-lamp. You simply place your chin in the rest and forehead against the bar, and will see many bright lights as each individual structure is examined.

            Digital retinal photography is performed on all new patients age 6 and older. This specialized camera allows our physicians to not dilate most of our patients under the age of 60. Certain findings, health conditions, and complaints require dilation as a standard of care. Our physicians will inform you if this is needed at this time. Dilation will always be performed if requested. Neither the dilation nor digital photography cost the patient anything extra as they do at most other offices, as our doctors believe these are essential components of a completely thorough exam. The dilation or photography allows the physician to view the inside of the eye in its entirety. Your eyes may stay dilated for 3-5 hours during which your vision may be blurry and you will be sensitive to bright light. Disposable dark sunglasses for going outside will be provided. Most patients feel comfortable driving while dilated, but if you are unsure, we request you bring someone to the appointment so they may drive you home.

            Carillon offers a High-Definition 3D OCT, or Optical Coherence Tomography, examination for an additional charge. If this test is medically necessary, medical insurance is billed. The HD OCT is the most advanced ocular imaging instrument available in any Ophthalmology or Optometry practice, and can pick up early warning signs of common ocular diseases years before the diseases develop, allowing our doctors to intervene early or recommend preventative steps. The results are clearly explained to the patient by the doctor.

     
            If necessary, your physician may order additional testing to explore any abnormal or at-risk findings further. Sometimes the testing can be done on the same day, but you may be asked to return another day.

            All of your examination and testing results are entered into our state-of-the-art Electronic Medical Records, or EMR, system. A copy of all the information and findings from an initial mock exam is found on our website for your review. If the physician is watching the health of your eyes at the recommendation of another medical physician, a letter with all pertinent findings will be sent.

            At the conclusion of the exam and testing, the physician will discuss the overall health of the eyes. If you are having any problems with your eyes, the best treatment and management regimen is discussed.

            We thank you for interest in our practice and entrusting our staff and physicians with the care of your eyes and vision. Should you have any questions at all, we encourage you to email or call us at 847-657-8787.

Sincerely,

Dr. Andrew Neukirch and the Optometric Physicians and Staff of Carillon Vision Care

So What Exactly Is Glaucoma?

What a patient would see with moderately advanced glaucoma

Glaucoma is a disease that can cause vision to be permanently lost very slowly over time. The disease starts by enlarging an individual’s “blind spot,” then may progress leading to complete blindness. Glaucoma is sometimes referred to as “the silent thief of sight” because a typical person would have absolutely no symptoms in the early stages of the disease, and would only notice after it was too late and the damage was done.

The disease essentially attacks the optic nerve in the back of the eye. Typically high pressure inside of the eye - the Intra Ocular Pressure, or IOP - causes this damage. The number one risk factor for glaucoma is a family history of the disease, but glaucoma may affect anyone.

As with most diseases of the body, the earlier the findings are caught, the more we are able to do. With modern medicine, it is rare that any new case of early glaucoma caught progresses past the “early” stage.

How Do I Know if I am at Risk or Have Glaucoma?

No drops or air puff to measure pressure!

Annual eye exams. Many eye doctors today are equipped with advanced instruments that allow us to catch the earliest signs of elevated eye pressures and damage to the optic nerve. Carillon Vision Care has multiple instruments to check the pressure, and has the most advanced optic nerve imaging instrument available: the Optical Coherence Tomographer, or OCT.

The OCT technology measures every attribute of an optic nerve in micrometers (one-thousandth of a millimeter!). This allows us to know ABSOLUTELY if any damage is present.

I Am Told I am a “Glaucoma Suspect.” What is That?

A Glaucoma Suspect is a medical diagnosis. This typically means that there is either high eye pressures with no optic nerve damage, or the optic nerve looks suspicious for possible damage. A Glaucoma Suspect may never actually go on to develop the disease, but we watch these patients very carefully. Treatment is initiated only when we are certain that there is early damage.

Okay, I Have Glaucoma. How is it Treated?

OCT Images

A number of ways. The first line of treatment is typically to lower the eye pressure by using prescription eye drops. Usually 1 drop once per day is enough.

Our doctors carefully review all of the new research to make sure we use only the best type of medication for each particular patient. The very first generic glaucoma medication came out a year ago, Latanoprost. All other brand name glaucoma medications are very expensive. All of the 1 year published studies on Latanoprost confirm the medicine is just as effective as the name brand, and our doctors have a number of glaucoma patients responding very well to this new formulation.

Stages of glaucoma

When these drops are not enough to lower the pressure, there are a group of simple laser surgeries that are effective for most patients. These lasers essentially increase the drainage channels inside the eye helping lower the pressure.

The take home message here is preventative care. If you or a loved one does not require corrective lenses and has not been in for an eye exam for a while, the time is now. If you would like more information on Glaucoma, or any other common eye disease, check out www.allaboutvision.com.

Dr. Andrew Neukirch is the CEO of Carillon Vision Care located in Glenview, IL
Sources: Merk Manual “Glaucoma,” Jack Kanski’s “Clinical Ohpthalmology,” and allaboutvision.com

Introducing Electronically Focusing Prescription Eyewear

Electronically Focusing Prescription Eyewear

Life Activated Eyewear

Electronic Glasses come to Chicago

Initially unveiled at the Consumer Electronics Show last year, the new emPower! electronic eyeglasses are now finally available in the greater Chicago area at Carillon Vision Care.  These new glasses essentially allow the wearer to turn the no-line, or progressive, bifocal/trifocal in the glasses on and off by either a touch of the frame or tilt of the head. Allow me to briefly explain how they work:

Glasses look like and indeed ARE designer eyewear

emPower! glasses on their charging station

Each pair of eyeglasses includes a microchip, composite lenses with a thin transparent LCD-layer, miniature rechargeable batteries, and a micro-accelerometer to detect tilt (like a Wii or iPhone). The electronics are all hidden within the surprisingly thin eyeglass frames. Turning the reading portion on and off happens instantaneously, and there are no moving parts or noises. Wearers can operate the glasses in three different modes: manual on, automatic, and manual off. These look like, feel like, and are designer eyeglasses. They are shock resistant, waterproof, and one charge of the battery allows for two to three days of operation.

These emPower! glasses are ideal for those people that suffer from presbyopia, the diminished ability to focus on near objects that affects many starting around the age of 40. Unlike typical corrective lenses, emPower! glasses provide a wider field of view, less distortion, and alleviate common side effects associated with progressive lenses and bifocals used to address presbyopia.

All electronics are hidden within the frame itself

I certainly do not intend to use my blog as an advertisement for selling products, I am personally just really excited about this new technology. I enjoy offering the latest tech in both the care of my patient, and in the optical products we prescribe. My lead optician and I have already fit and ordered a handful of “early adopters” in these glasses the past few weeks, and the very first patient in Chicago to receive these glasses took delivery of them from us just last week!

For more information, check out lifeactivated.com. If you would like to ask our staff a question or see them yourself, please contact our office at 847-657-8787, or send us an email at carillonvisioncare@gmail.com.

Thanks for reading! -Dr. N

Empower Glasses on display at Carillon Vision Care

Dr. Neukirch practices at Carillon Vision Care located in lovely Glenview, Illinois.

So What Exactly IS Macular Degeneration?

Top: Normal Vision Bottom: Macular Degeneration

Macular degeneration is a serious and debilitating disease affecting millions of adults typically over the age of 50. It results in the permanent damage of an area of the retina that is responsible for the center of the visual field, often making it difficult or impossible to read or recognize faces, yet usually leaving enough peripheral vision to allow other activities of daily life. There are two forms: the “dry” form where cellular debris forms in the retina typically slowly causing damage; and the “wet” form where new growing blood vessels essentially cause damage much more quickly.

What are the risk factors for developing Macular Degeneration?

Number one is age. The macula of the eyes simply ages and begins to wear out. Those with a family history or macular degeneration have a 50% chance of developing the disease later in life. Other important factors are high blood pressure, elevated cholesterol, simply being of caucasian descent, exposure to sunlight, and smoking.

OCT Image of Wet Macular Degeneration

What can I do to reduce my risk of developing Macular Degeneration?

Leading a healthy lifestyle is obviously the most important. Eating lots of leafy greens and foods containing lutein and zeaxanthin, two compounds found in the macula, has been clinically proven to slow the progression or development of the disease. Many over-the-counter vitamin supplements are available with these compounds based on the AREDS, or Age Related Eye Disease Study. My doctors recommend this formula for all of our patients that have an early form or show high risk of developing the disease.

Annual eye exams are of importance as this is the only way the condition of the macula may be assessed. I closely monitor the appearance of the macula and may recommend the use of our Zeavision testing unit. This specialized instrument measures the levels of Macular Pigment Optical Density (MPOD) in the back of the eye, essentially giving us another big “piece of the puzzle” in the early detection process.

“An ounce of prevention is worth a pound of cure” — Benjamin Franklin

If you or a loved one have been told there are early warning signs of Macular Degeneration and it has been more than year since the last eye exam, get in to see your eye doctor soon! The earlier we identify the disease, the more we can do. And modern medicine now has some promising treatments, and many new exciting ones presently in FDA trials.

Photo of an affected Retina

So I know someone with Macular Degeneration, what’s the cure?

Unfortunately there is no cure, but there is treatment and management. The dry form is managed with the AREDS supplement and we watch the progression very closely, making sure the wet form does not start to form. If it does, then we work closely with a Retinal Specialist that typically administers injections of medicine into the eyes (believe it or not this is relatively painless) that stops the new blood vessels from growing. Until about 5 years ago, we could only slow down vision loss in “wet” patients. Today, most of these patients actually regain some of their vision!

But remember, even with treatment, vision will never be restored to the way it was before the disease, thus preventative care is always the best course of action! 

(This is an excerpt from our Quarterly Newsletter. Dr. Andrew Neukirch practices at Carillon Vision Care in Glenview, Illinois)

Eyes and Vision in Glenview, First Blog!

Dr. Andrew Neukirch

Carillon Vision Care Optical

Hello Glenview readers! As this is my very first blog, please allow me to introduce myself. My name is Dr. Andrew Neukirch and I have recently joined the community as an Optometrist this past January at Carillon Vision Care. I have been practicing in Bloomington, Indiana the past few years.

I have selected to blog in an attempt to help educate our community on the importance of preventative ocular healthcare, and to help answer any questions patch readers may have. I will begin with a FAQ excerpt from my quarterly newsletter:

Why should I have my eyes examined regularly?

In addition to ensuring proper eyesight, regular eye examinations allow your eye care professional to detect and treat diseases at the earliest possible opportunity. Some diseases do not have symptoms in their early stages. A good example is glaucoma, the most common cause of vision loss. Typically, glaucoma does not cause pain, and you don’t notice a change in your vision at first. By the time your vision is affected, we can only prevent it from getting worse because the vision loss is not reversible. If you have regular eye exams, your eye care doctor can more readily detect potential problems and prescribe proper treatments to prevent vision loss. Don’t determine the need for an eye exam on whether you are seeing relatively well. Even though your vision may be clear, undetected changes can occur from high blood pressure, diabetes, eye tumors and retinal disorders. So, don’t just rely on changes in your vision.

Remember, unlike the rest of your body, the eyes don’t usually hurt when something is wrong.

When should my child have his or her first eye exam?

The American Optometric Association suggests that children should have their first regular eye exam at 6 months. Follow-up exams should be done around age 2 to 3 because this is the age when a child’s visual system undergoes its most rapid development and when vision correction is most effective. For example your child could develop a “lazy eye” or amblyopia, which is a loss or lack of development of vision in one eye, usually resulting from a failure of the visual system to use both eyes together. The lazy eye will not function as well as the other eye. The brain is incapable or refuses to acknowledge the image seen with the lazy eye and the brain learns to ignore one image in favor of the other.Before the ages of 2 to 3, the condition can be treated and the brain will use that eye. After this age, it can still be treated, but not as effectively. The earlier it is diagnosed, the greater chance for complete recovery.

How frequently should children’s eyes be examined after their initial exam?

As with adults, children’s eyes should be examined every year, sometimes more frequently if there is an eye or vision problem or a family history of eye disease. School children use their eyes more frequently than adults to read and perform other school activities, so it’s extremely critical for them to have regular eye exams.

Again, since this is my first blog, I’ll keep it short. I encourage you to ask any questions you may have, or provide me with any eye related topics you would like me to address! Thanks for reading, and I’ll certainly do my my best to keep our community up to date on what is going on in the world of Optometry.

Thanks for reading. -Dr N.

Exam Lane at Carillon Vision Care

(Sources: InfantSEE.org and the American Optometric Assocation)

If you would like more information on Dr. Neukirch, please Google or visit his Facebook Page.