Eye and Vision Related Disorders in a Primary Care Setting
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He routinely screens patients for the presence of cataracts and educates patients on treatment options. Any opacity in the crystalline lens of the eye can be categorized as a cataract. However, when and if surgical intervention as a treatment modality to be employed should be approached as a subjective entity. Rarely is a cataract a threat to one's ocular health in the Western World. Therefore, visual function and quality of life must be weighed from the patient's point of view before surgery is performed. Currently there is no other empirically proven means for cataract treatment other than surgery. He is familiar with diagnosis, surgical approaches to correction of cataracts and post-operative management of the cataract (aphakic or pseudo-phakic) patient.
Expert is very familiar with the Bjerrum Screen in the context of testing visual function. This is a basic means to asses a patient's monocular (right / left eye) visual function in terms of visual field from the center of vision out to 30 degrees from the center utilizing a simple black cloth screen or tapestry whereby the screen is divided in 5 degree increments in terms of Field of View when a patient is situated approximately one meter from the center of the screen. The test provides basic information about the existence/non-existence of pathology affecting gross vision. The pathology may lie anywhere between the front of the patient's eye (cornea) to visual processing centers. Therefore, the test is not diagnostic of what is causing any vision loss, rather that there simply is a gross loss of vision. The test is basic, slightly better than the "counting fingers" test though not as reproducible as a more standard and qualitative Humphrey Visual Field Test which is computerized.
He has diagnosed and managed patients affected by the eyelid disorder called Blepharospasm. The majority of expert's patients with this disorder would fall under the category of essential blepharospasm as an isolated entity. Patients may present with this as a self-limiting condition and therefore not need additional medical treatment. However, all potential etiologies should be ruled out including ocular surface disorders, disorders of the brain stem / basal ganglia, dystonias, Meige's Syndrome and pharmacologically induced blepharospasms such as those observed with various oral medications used to treat Parkinson's Disease. One should not confuse this disorder with the milder lid muscle disorder, lid myokymia (a slight twitch-like sensation in either the upper of lower lid of an eye NOT resulting in the involuntary closure of the eyelids).
He has extensive education in the field of optics as described by the unit of the reciprocal of focal length, the Diopter. A single diopter (stigmatic) lens will focus light approaching from infinity at exactly one meter from the secondary principal point of the lens or lens system. Expert has taken coursework in Physiological Optics, Visual Optics and Geometric Optics in the context of his education culminating in a Doctorate in Optometry.
In reference to disease, the undesired state or pathological condition affecting an organ, process or collection of organs, he is most experienced in those diseases and syndromes affecting the human eye and the visual system in general. General human systemic disease processes can and often do affect the ocular tissues, and therefore do constitute a basic foundation of his knowledge base; however recognition of these disease processes and how they manifest in terms of affecting the human eye and visual system are his main area of interest and expertise.
He has a good general knowledge base of pharmaceutical agents (drugs) in a systemic application. However, his expertise is in ocular pharmacology. Expert has 10 years clinical experience in the proper use and affects of ocular drugs, typically consisting of topically applied medications. These medication classes generally include antibiotic, anti-inflammatory, anti-viral, allergy, glaucoma and anti-VegF (typically utilized in advanced macular degeneration).
He prescribing habits for oral medications are limited to those conditions directly affecting the eye and related structures.
He served as an industry consultant for an ophthalmic medication manufacturer in the context of professional product communication and marketing.He is an on-going consultant for various ophthalmic products in on-line forum (Epocrates).
