Happy Holidays from Dr. Andrew Neukirch and Carillon Vision Care!

It is difficult to believe that I will be celebrating my 4th anniversary with Carillon Vision Care this next month. The time has gone by so quickly. I would like to genuinely thank everyone for continuing to help our practice grow.

I am excited as I have even more plans going forward into 2015. We are presently evaluating more designer frame lines, waiting for some new exciting medical technologies to gain FDA approval, and we are considering transitioning in another full-time doctor allowing extended doctor hours to serve you better.

The following is an excerpt form our Holiday Newsletter that went out to our patients this month:

Dear Patients,

I wanted to start this letter, first and foremost, by congratulating our very own Dr. Agrest who recently received a “50 Year Membership Award” in front of hundreds of our professional colleagues at the Illinois Optometric Association’s annual meeting in Springfield. As you know, Dr. Agrest opened Carillon Vision Care’s doors over 56 years ago with the mission of providing the highest quality eye care to his patients, and he is so deserving of this recognition!

I am also pleased to announce two new, friendly faces that you may see around Carillon. Vanessa is a full-time, licensed Optician with more than 10 years experience. She has a uniquely talented eye for finding patients the perfect frames! I would also like to welcome Dr. Vince Brandys, a licensed Optometrist and Glenview local. In addition to his full-time faculty position at the Illinois College of Optometry in Chicago, Dr. Brandys is now available to see patients on Fridays and and some Saturdays at Carillon.

Lincoln shows off the new touchscreen

The office also boasts new medical equipment, including a cutting edge Topcon Automated Phoropter (you know, the instrument where the doctor asks, “What’s better: 1 or 2?”), which enables faster and more accurate glasses prescriptions than ever before, and a new, 27-inch, touch-panel computer screen in the optical. The touch-screen allows our opticians the ability to display various color and size options for prospective eyewear, which we may not have in house at the time. It also gives patients with a new prescription the opportunity to “test out” their computer vision while wearing their new specs.

Last but not least, I am so grateful for the opportunity to care for you and your families, and I sincerely appreciate all of the new referrals (of family, friends, and co-workers) that we received from current Carillon patients throughout the year. I, along with the Carillon staff, wish you and yours a wonderful holiday season and a happy start to 2015!

Sincerely,

Dr. Andrew Neukirch

What exactly are Cataracts?

Cataracts are one of the most common eye diseases, affecting up to 17% of Americans each year. This number increases to over 91% after the age of 85*. Cataracts form in the lens of the eye, which is a clear structure made of water and protein, located directly behind the pupil (the black circle in the middle of the iris). Light or images are directed past the normally transparent lens to reach the retina and finally into our brains for interpretation. However, as we age, the shape of the lens gradually becomes thicker and less flexible. This process causes the proteins to deform and clump together, resulting in a cloudy/hazy lens. It resembles a dirty camera lens, and as you can imagine, the result is similar - a blurry image!

What causes Cataracts?

It is known that ultraviolet (UV) light contributes to the formation of cataracts. The lens has protective function in the eye, blocking UV light from reaching the much more sensitive retina. But over time, this absorbed UV light damages the lens itself.  Also, certain common prescription medications may accelerate cataract formation, as does trauma to the eye. It may take years or even decades for the onset of pharmaceutically-induced or trauma related cataract formation.

What can I do to protect myself from developing cataracts?

The easiest step is to wear UV protection, like sunglasses. However, be mindful that not all sunglasses are created equal; in fact, many are not designed to block UV light at all, be sure to look for UV-blocking certification. Furthermore, many of the contact lenses eye doctors prescribe possess UV blocking properties, and our doctors typically opt for these contact lenses as their first choice. Prescription eyeglass lenses can have a UV blocking coating added to them as well. Last, but not least, do not forget the UV protection for your little ones, as the absorption during developmental years compounds and can have consequences later in life!

I know that I have Cataracts. Do I need surgery?

The first step is to see your primary eye care provider, who will determine if it is truly time for cataract surgery. During this visit, he or she can also discuss the possible risks of surgery (although uncommon), as well as the benefits.

What are the Benefits of Cataract Surgery?

First and foremost, clear vision! The surgical implant technologies used today have continued to advance. In some cases, patients may not require full-time spectacle or contact lens correction for distance vision after the procedure. Advanced multifocal implants like ReSTOR, TECHNIS, and Crystalens may provide post-operative vision requiring no spectacle correction at all!

Who do I see for Cataract surgery?

The doctors at Carillon Vision Care do not perform cataract surgery. However, we are directly affiliated with several Ophthalmologists that are Cataract surgery specialists possessing the newest surgical equipment and best reputations in the North Shore.  We often refer patients to Drs. Tamara Wyse (Northbrook) and Randy Epstein (Highland Park) as well as a handful of other trusted surgeons. As a Carillon patient, our doctors will arrange a consultation appointment for you with a surgeon that best fits your needs. We also co-manage patients with these doctors after your surgery has been completed.

If you or a loved one are interested in discussing cataract surgery, please schedule a visit or let us know when you are in the office!

References: 

*Sperduto RD, Seigel D. "Senile lens and senile macular changes in a population-based sample". Am J Ophthalmology #90: 86–91

What is new at Carillon Vision Care? Fall 2014

I wanted to take a minute and summarize all of the new, exciting things that we are up to at Carillon Vision Care.

Dr. Jerome Agrest

Dr. Agrest was awarded the “50 Year Illinois Optometric Association Membership Award” this past weekend at our state convention and gave a great speech to over 300 of our fellow optometrists.

Our newest full-time employee, Vanessa, is a welcome addition to our optical staff. Vanessa possesses more than 10 years of experience as a licensed Optician, and she has a talented eye for finding our patients the perfect frames. The increase in staff has also allowed us to expand the optical’s hours; our opticians are now available during extended full business hours Monday through Saturday.

Dr. Vince Brandys

We are also pleased to welcome Dr. Vince Brandys, a well-respected, licensed Optometrist that has joined our practice on a part-time basis. Dr Brandys is available to see patients on Fridays and/or Saturdays. His professional biography was featured in last month’s blog entry.

Our optical now boasts a 27-inch, touch-panel computer screen, which has already been a big hit with patients! The screen allows our opticians the ability to display various color and size options for prospective eyewear, which we may not have in house at the time. It also gives patients with a new eyeglass prescription the opportunity to “test out” their computer vision while wearing their new specs.

New 27" Touchscreen! Lincoln (the office dog) approves

The optical is now lit with 100% LED light bulbs, which closely resembles the aesthetic of natural sunlight (and is earth-friendly too!).

Last but not least, we have ordered the new Topcon CV-5000s Automated Phoropter (you know, the instrument where the doctor asks, “What’s better: 1 or 2?”). The Automated Phoropter is a 100% computer-controlled device that is driven by the doctor and enables faster and more accurate glasses prescriptions. It also allows the doctor to demonstrate the difference between new and old glasses prescriptions at the touch of a button! This instrument will be installed in early October.

Topcon Automated Phorpter System

Be sure to watch for next month’s blog where we will share Dr. Brandys’ letter to our patients. It will also be featured in our upcoming Fall newsletter. Check out all of our full newsletters found in the links on the right side of this page.

Announcing our new Associate Optometrist: Dr. Vince Brandys

While serving as a Society President of the Illinois Optometric Association, I had the pleasure of getting to know and befriending my fellow colleague Dr. Vince Brandys. Dr. Brandys has lived in Glenview and has become a very active member of the community for the past few years. He inquired if he could work in our practice a few days per week while still maintaining his position at the Illinois College of Optometry. I believe this is a perfect fit as Dr. Brandys possesses a similar forward-thinking “style” of practicing Optometry and he will be a great new addition to the Carillon Vision Care team. He is currently accepting new patients and starts this Friday. His brief biography follows:

Vince Brandys, O.D.

Dr. Vince Brandys is a well-respected optometric author, lecturer, and a trustee of the Illinois Optometric Association. He is the full-time Senior Director for Governmental and External Affairs for the Illinois Eye Institute.

Dr. Brandys achieved his Doctorate in Optometry in 1990 from the Illinois College of Optometry after receiving a Bachelor’s degree in Biological Sciences from DePaul University.  Dr. Brandys believes that primary health care should encompass the eyes, and his goal is to provide education and the highest level of care to each patient he sees.  

Dr. Brandys moved to Glenview in 2012 and resides with his family in Valley Lo. Outside of the office, he enjoys golfing and spending time with his wife, Leeann, as well as their five adult kids, two dogs, and two cats. We were pleased to have him join Carillon Vision Care as a part-time associate in 2014.

Recognition as a 2014 Optometric Business Innovator

I am proud to share that I was named as a 2014 Optometric Business Innovator by the industry publications Review of Optometric Business and Vision Monday. This month's blog is an excerpt from that article and interview. The full article may be found here.

“I strive to maintain a friendly and comfortable practice for both my customers and my staff, one that also remains innovative and up-to-date with the advances in the profession.” -A. Neukirch

Andrew J. Neukirch, OD, knows about business efficiency-and getting up to speed in a hurry. Neukirch, who purchased his 56-year-old practice in 2011, said there was an immediate to update the office's technology. "When I bought the practice, the retiring doctor and staff members had systems in place that certainly worked well, but technology was not utilized to a significant extent," he said. "Within the first year, we implemented EHR, purchased a SD-OCT, added 50-inch displays in the exam lanes for patient education and displaying test results, and implemented online appointment scheduling with Demandforce."

Complementing the practice's new and improved technology was participation in the IDOC optometric alliance. "I took the first two years researching all of the major optometry groups before discovering that IDOC was the best match for my practice," Neukirch said. "At this early point in my career, IDOC has allowed be to network with experienced and successful practitioners who openly share ideas and strategies that have proven useful to integrate."

With such an emphasis on technology and business efficiency, it's no surprise the practice prides itself on its accessibility online. "Out practice's online presence is unmatched in the area, and over 50 percent of our new patients find us on the internet. Prior to 2011, our online presence was a simple website. I now have a blog that has over 500 views per month, active Facebook and Google+ pages, an interactive online 'walkthrough' tour of the office, and the practice shows up number one on all search engines in the area," said Neukirch. "Through our marketing efforts, most new patients have already read about our office before walking in the door, and we tend to attract high quality, compliant, health conscious patients who are not looking for an optometrist who simply 'takes their vision plan.'"

–The Editors of VM and 

Review of Optometric Business: 

Marge Axelrad, Deirdre Carroll, Mary Kane, 

Andrew Karp, Roger Mummert, John Sailer, 

Margery Weinstein, Catherine Wolinski

Be on the Lookout! Soft Contact Lens Update 2014

Don’t blink or you just might miss them…

As the technology and lens materials continue to improve, new soft contact lenses enter the market on a regular basis. It becomes a challenge for patients, and eye care providers alike, to stay ahead of the curve, so I would like to take this opportunity to discuss some of the newest lenses and contact solutions that are available at Carillon Vision Care.   

 

Dailies Total 1 (Alcon):  Patients that experience discomfort or dryness with 2-week or monthly replacement lenses typically fare better in daily disposable contacts, especially this one. Dailies Total 1 lenses have the latest generation “silicone hydrogel” core, which promotes oxygenation and breathability through the lens. This design also reduces the risk of contact-lens-related eye infections to nearly zero.  The lens has an outer layer that approaches 100% water contact, making it one of the more hydrating lenses on the market. Although you will spend a little more, the comfort of Dailies Total 1 is arguably worth every penny for certain patients.

Dailies Progressive Contact Lenses (Alcon):  Dailies Progressive lenses are the first daily, multifocal contact on the market. They may be worn full-time, but also serve as a great option for patients seeking multifocal contacts for “special occasions” or simply a day of golf. Either way, Dailies Progressive lenses afford the same benefits and convenience of any daily lens. The lens’ optical system is identical to the Optix Multifocal lens, also manufactured by Alcon, which many practitioners have been fitting for years. As a result, this lens tends to be an easy transition for patients and providers alike.

Purevision 2 Multifocal (Bausch & Lomb): This monthly-replacement, progressive lens is designed to enhance all three zones of vision: near, intermediate, and distance. However, it is uniquely effective in the intermediate zone, which is typically utilized with laptop, computer, and cell phone use. The fitting process is simplified for this lens, versus many other multifocal lenses on the market, and may require less follow-up care for a new wearer.

Peroxiclear Solution (Bausch & Lomb): The best way to clean conventional, soft contact lenses, albeit requiring a few extra steps, are hydrogen peroxide based systems. The most prominent brand has been Alcon's Clear Care system for many years. The latest product in this market segment, Peroxiclear, was recently launched and shows much promise. Peroxiclear possesses a reduced concentration of active chemicals, yet is more effective and cleans faster than the alternatives. Patients also reported less discomfort with lens insertion and wear after using Peoxiclear solution. My office was an early launch site for the Chicago area, and I have received extremely positive feedback from patients.  This product is now also available for purchase over the counter at local drug stores.

Keep an eye out for these lenses, which will be available in the near future:

Air Optix Colors (Alcon): This is the first new, major colored lens to be released in 10 years! They are the first colored contact lenses to offer the advantages of a silicone hydrogel design. These lenses recently received FDA approval and are available the week of this publication.

MyDay 1 Day Contact Lenses (CooperVision): *Not yet available in the USA. This will be the first one-day, silicone hydrogel lens from CooperVision. This lens has been very successful in Europe, where it launched in September 2013. I have been informed that the company expects its American debut around Fall 2014.

A Soft Contact Lens for Keratoconus

What is Keratoconus?

Keratoconus is a disease where the front part of the eye, the cornea, begins to transition from its normal, round shape into a thinner, cone-like structure. The cone distorts a patient’s vision in a way that traditional glasses and contact lenses cannot correct. Keratoconus typically presents in teenagers to young adults and may continue to progress over 10-20 years. While there is no cure, early studies suggest that “collagen cross-linking” surgery may successfully slow disease progression. A handful of corneal specialists in the Chicago area currently perform this “yet-to-be FDA approved” procedure; please contact me if you would like more information.

So, if glasses and regular contacts do not help, what are my other options?

Traditional ComfortKone RGP

Traditionally, once a cone started to interfere with vision, we would need to design a custom Rigid Gas Permeable (RGP) contact lens. This lens would essentially wrap perfectly around the cone and re-create a smooth, spherical surface at the front of the eye. There are a number of designs and RGP materials available. In most cases, I find that patients can tolerate the ComfortKone lens from Metro Optics. Although the materials are constantly improving and becoming more “breathable,” these lenses are physically rigid, and as a result, many patients experience considerable discomfort that worsens throughout the day. Another solution is to “piggyback” the RGP lens on top of a soft contact lens, or to wear hybrid lenses, which combine both soft and RGP lenses together. However, these methods can be costly, uncomfortable, and prone to significant complications.

Fortunately, a new, custom-designed, soft contact lens is available for patients with Keratoconus called Kerasoft IC. Kerasoft IC is ideal for patients that are unable to tolerate conventional soft contacts or experience discomfort with rigid gas permeable contacts. I am proud to be one of the few optometrists in the North Shore licensed to prescribe these lenses.

Can you tell me more about Kerasoft IC contacts?

The Kerasoft lens is the first (and only) soft lens that is custom-designed to fit nearly any cone or irregular cornea. The contact is a highly breathable, disposable lens that lasts approximately 3 months. The cleaning regimen is simple and only requires BioTrue contact lens multipurpose solution, an over-the-counter product.

How does the fitting process work?

The initial fit typically takes between 30 minutes to an hour. The doctor will use multiple lenses from a diagnostic fitting set, which is only available to certified practitioners, and a subsequent refraction will also be performed. Other imaging parameters, like corneal topography, will be taken into account to help create the optimal lens. The finalized contacts arrive within a week, and once the perfect fit is confirmed, the patient may order an additional one year (4 pack) supply. Given the nature of Keratoconus, gradual changes in corneal shape may require future adjustments to lens fit and prescription.

What is the cost?

The costs of an initial Kerasoft IC fitting and annual supplies are comparable to older, custom RGP lenses. In a patient diagnosed with Keratoconus, many medical insurance and VSP vision plans will cover the majority of the cost associated with these custom lenses. However, please contact your health insurance and/or vision plan to ensure eligibility and coverage.

How do I see if Kerasoft IC lenses are right for me?

If you have Keratoconus, simply ask your eye doctor if they are a certified provider, or use the “doctor locator” feature on the Kerasoft IC website.

“Don't sit too close to the TV. It is bad for your eyes"

The time we spend with digital devices in our daily lives has increased dramatically over the past decade. Computers, tablet PCs, smartphones, and television have become an integral part of most peoples’ routines. More than 34% of people in the United States spend 4 to 6 hours a day with digital devices and 14% spend between 10 and 12 hours a day*. iPad apps even exist for infants, which are designed to enhance their development of certain motor and visual skills.

There has historically been a concern that doing "near work" might increase the chances of needing glasses later in life (although this has not yet been scientifically proven). Yet, perhaps of greater concern are the small amounts of light radiation that these newer electronic screens emit and the potential damage that could result to the eye.

Blue Light

Doctors, and most of the general public, have understood for years that Ultraviolet, or UV, light causes damage to the skin and eyes. What most people do not realize is that some blue light, also known as high energy visible light, is very close in wavelength to UV light. Similarly, large amounts of blue light may also cause damage, eyestrain, and fatigue to the eyes. Recent research from the Schepens Eye Research Institute suggests that higher levels of blue light may increase the risk of developing macular degeneration**. Blue light itself is present in natural daylight and helps us to stay awake, but as the quality of LCD and LED screens improve, they are emitting more and more blue light.

So, what can be done?

I do not foresee us giving up our laptops or smartphones anytime soon. If anything, our lives will likely become more dependent upon these devices. Many ophthalmic lens manufacturers have recognized the risks, and a variety of lens coatings are already on the market. My office offers choices from Hoya, including their Recharge coating, which has both blue light filtering and anti-reflective properties.

Ideally, electronics manufacturers could also develop the technology to add these blue light-blocking coatings to the device screens themselves, thus reducing emittance of the damaging light rays in the first place. I have had discussions with contact lens manufacturers about adding coatings to contact lenses and have been told that this is an area of ongoing research. I currently prescribe contact lenses with UV protection whenever possible.

Please feel free to contact me, or inquire with your eye care professional, for more information on these protective technologies.

*2012 VisionWatch Findings: A survey among 10,000 adults across America about their use of digital media and symptoms of vision stress, conducted by The Vision Council

**http://www.schepens.harvard.edu/restory/francois-delori-phd/research-story.html

What is Orthokeratology, or Ortho-K?

What is Ortho-K?

How Ortho-K Lenses Gently Mold

Orthokeratology is a treatment where a nearsighted, or myopic, patient places custom designed lenses in their eyes just before going to sleep. These special lenses gently mold the front surface of the cornea (the clear part of the eye that conventional contacts rest on) to correct the patient’s vision. The lenses are removed upon wakening, and contacts/glasses are then no longer needed during the daytime!

Is this surgery?

No. This is a gentle molding of the cornea.

Is Ortho-K reversible?

100% reversible upon discontinuation of the treatment

Is the treatment safe?

Absolutely, under the care of a certified Orthokeratologist. Dr. Neukirch is a member of the Orthokeratology Academy of America (OAA) and will only use materials and designs that are FDA approved. The only manufacturer to receive FDA approval is Paragon CRT, thus these are the only lenses he prescribes. Dr. Neukirch is happy to speak with your doctor or pediatrician should they have any questions.

Is this a new procedure?

Not entirely. Ortho-K has been around since the 1960’s. Ortho-K has historically been very popular in Asian countries, where myopia was much more prevalent. Recent advancements in computerized instrumentation and lens design has yielded dramatically improved results.

Ortho-K may help!

Can Ortho-K keep your eyes from getting worse?

Myopia typically progresses until a patient reaches 20 to 25 years of age. If Ortho-K is initiated before that time, peer-reviewed clinical research indicates that the treatment may slow this progression; sources are found at the end of this article.

Why am I only hearing about this now?

Multiple reasons: 1.) The first and only FDA approved treatment was Paragon CRT in 2011. 2.) Myopia has become much more prevalent in the United States within the past twenty years. 3.) The clinical research which confirms the link between Ortho-K and delayed progression of myopia has only been published in the last couple of years (sources below).

Has anyone at Carillon undergone Ortho-K?

Yes. Our staff member, Anna (previously -2.00 in both eyes), started her treatment this past December, and has been glasses-free ever since. Please feel free to ask her about her personal experience!

Small, gentle custom molds are made for every eye

Am I a candidate?

The best candidates for Ortho-K are myopic children and teenagers, whose eyes are still changing. However, adults (like Anna) can make great candidates, too. Unfortunately, certain prescriptions and corneal shapes may exclude patients from utilizing this treatment.

Okay, I am interested! What’s my next step?

Simply inquire at your next exam, or call our office. Our doctors can review your chart to see if Ortho-K is a possibility for you or your children. Ortho-K consultations are completely free of charge, if the patient has received a comprehensive eye exam at our office within the past year.

Where can I find more information?

In addition to the journal articles below, Paragon CRT has a great patient website at www.CRTvision.com. We also have pamphlets available at the Carillon front desk. Please feel free to email Dr. Neukirch directly at carillonvisioncare@gmail.com with any questions.

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

Sources:

Myopia control in children through refractive therapy gas permeable contact lenses: is it for real? Koffler BH, Sears JJ. American Journal of Ophthalmology. December 2013.

Myopia Control with Orthokeratology Contact Lenses in Spain: Refractive and Biometric Changes. Jacinto Santodomingo-Rubido, César Villa-Collar, Bernard Gilmartin and Ramón Gutiérrez-Ortega. Investigative Ophthalmology and Visual Science. July 2012.

Retardation of Myopia in Orthokeratology (ROMIO) Study: A 2-Year Randomized Clinical

Trial. Pauline Cho and Sin-Wan Cheung. Investigative Ophthalmology and Visual Science. October 2012.