Got glaucoma? The iStent procedure could be right for you.

Dr. Joshua Evans

Dr. Joshua Evans

Written by Dr. Joshua Evans, an ophthalmologist at UK Advanced Eye Care.

Glaucoma is an eye condition that causes damage to the optic nerve, which can result in vision loss or blindness.

Traditionally, glaucoma is treated with medication or surgery. Although surgery can help relieve pressure on the optic nerve, some procedures can cause complications.

More recently, however, newer types of procedures called minimally invasive glaucoma surgery, or MIGS, are being used to treat glaucoma without the potential risk of complications. One such procedure is called the iStent.

The iStent procedure

The iStent is a 1mm titanium tube that is inserted into a patient’s eye using a microscope. It’s approved to treat mild-to-moderate open-angle glaucoma when placed at the time of cataract surgery.

The procedure uses the same incisions as cataract surgery and only adds a few minutes to the procedure. It can result in improved eye-pressure control and the possibility of fewer or even no eye drops.

How it works

The device works by allowing fluid from the front of the eye to bypass the tissues that provide the greatest resistance to fluid flow.

The stent allows this fluid to pass directly into the eye’s drain. No tissue alterations are made outside of the eye, and the entire process takes place internally.

And, if any further glaucoma surgery is necessary, the iStent makes it far simpler and less likely to fail due to previous scarring.

Who’s a candidate for the iStent?

For patients with glaucoma who do not tolerate eye drops well or who find them too difficult to use, the iStent might be a good option.

However, not all glaucomas are the same. Patients who have a history of angle-closure glaucoma, neovascular glaucoma or a condition causing elevated pressure in the episcleral veins (Sturge-Weber syndrome, thyroid eye disease or retrobulbar tumors) are not good candidates for the iStent.

If you or someone you know suffers from glaucoma and is interested in what options are available beyond eye drops, contact the the glaucoma specialists at the UK Advanced Eye Care Center. We’re accepting new patients and can explain options that may be right for you. Schedule an appointment today by calling 859-257-1000.

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UK medical students open new ophthalmology clinic at Salvation Army

Many people neglect their vision, even those with insurance and access to providers, and many others feel intimidated by large healthcare systems. The new ophthalmology clinic at the student-run UK College of Medicine Salvation Army Clinic aims to improve the health of the people seen there and serve as a bridge to other providers who can help those in need.

The opening of the new ophthalmology clinic was “a culmination of people saying we can do this,” according to Dr. Julia Stevens, associate professor of ophthalmology and pediatrics, and liaison to the students working to bring the clinic to life.

When UK Advanced Eye Care began the process of moving their clinic into the new Shriners Hospitals for Children Medical Center, now located on the UK campus on South Limestone, the opportunity to acquire donated equipment and supplies from the old space arose. Medical students Paras Vora and Riley Bylund jumped at the chance to increase volunteer opportunities at the Salvation Army Clinic and help underserved patients receive vision care.

“We had the idea to encourage more volunteer opportunities within the field of ophthalmology, and serendipitously Dr. Stevens had just found out that there would be equipment and supplies available as the Department of Ophthalmology moved to the new Shriners location,” Vora said. In 2017, Vora and Bylund began the process of developing the new clinic space.

Because of the donation of equipment, Vora and Bylund say the amount of funding they needed to secure was minimal. The pair submitted a proposal to the Salvation Army Clinic Board, and with the help of clinic managers Lindsay Westerfield and Akin Erol, the proposal was accepted.

A portion of the space at the Salvation Army Clinic, located on West Main Street in Lexington, was modified to create a hybrid exam room which could function both as a traditional exam room as well as a specialized eye examination space.

While Voras and Bylund have advanced in their studies and begun to focus on research, the current clinic managers are excited about what the new space will mean in terms of serving the community and improving their skills as physicians.

“Starting an ophthalmology clinic is exciting because it provides students a unique opportunity to gain hands-on experience practicing ophthalmology examination techniques under the guidance of caring physicians – all while providing a much-needed service to patients who otherwise would not receive this type of care,” said students Connor Appelman and Marc Kai.

Next steps:

Alexis Johnson

Eye care experts provide lifelong support for blind equestrian

When Alexis Johnson, a 22-year-old avid equestrian and resident of Versailles, Ky., prepares to jump with her horse Joey in competition, she is keenly focused on what lies before her. There are no distractions, no nerves and no fear. Everything around her is in shades of gray, and the only sound she hears is the rhythmic pace of Joey’s hooves as he begins to canter.

As Joey jumps over the fence, Johnson feels like she’s flying – a feeling of pure joy and exhilaration. Her limitations are nonexistent.

It doesn’t matter that she is legally blind.

Twenty-two years ago, Alexis’ mother, Lynn Johnson, was standing outside on a sunny day holding her then 8-month-old daughter. She noticed the pupils of Alexis’ eyes were so large that she thought the sun might burn them. Alexis also squinted her eyes a lot in bright light, displayed repetitive rapid eye movements and had one eye that was turned inward.

Lynn took Alexis to a general ophthalmologist but wasn’t satisfied with the lack of answers. She made an appointment with Dr. Julia Stevens, an opthalamologist at UK Advanced Eye Care, for a second opinion.

After several tests to rule out brain injury, an electroretinogram (ERG) confirmed a diagnosis of congenital achromatopsia, a rare hereditary disease that affects only one in 33,000 people in the U.S.

Not only had Lynn found answers, she found a physician who would provide healthcare and support for Alexis throughout her life.

UK provides support after rare diagnosis

An ERG examines the light-sensitive cells of the eye, the rods and cones, and their connecting cells in the retina. When Alexis was tested 22 years ago, a large contact lens was placed on her eye to measure the light responses in her retinas.

“We were fortunate because UK was one of the few facilities to have an ERG,” Lynn said. “The wires that record the natural responses to light showed that Alexis had no response to light. The line on the screen was flat.”

Dr. Julia Stevens

Dr. Julia Stevens

Stevens explains that achromatopsia is an autosomal recessive disease, meaning two copies of a mutated gene must be present in the affected person.

“Both parents must be carriers, and their child will inherit one recessive gene from the mother and one from the father,” Stevens said. “Individuals with achromatopsia have nonfunctioning cones and rely on rods for their vision. Rods do not function well in daylight, thus people with achromatopsia have extreme sensitivity to light, poor color vision and poor central (reading) vision.”

Today, UK Advanced Eye Care has the most technically sophisticated ERG technology available anywhere, offering significant advantages over the prior system. The new ERG machine provides easier testing with comfortable-fitting electrodes that can sit on the skin or on the surface of the eye, highly sensitive and reproducible signal recording, and a large library of tests that can be used to determine problems in the visual pathway to better understand why patients are experiencing vision loss.

UK Advanced Eye Care recently acquired a new, smaller ERG machine that can easily be taken into the operating room and to other locations throughout the hospital to test for diseases of the retina and optic nerve. The current equipment can be used for ERGs on babies and toddlers without having to use sedation, as the system is handheld and can be easily positioned over the patient’s eye during testing.

A lifetime of comprehensive care

At UK Advanced Eye Care, patients can see multiple subspecialists in one location, allowing their complex eye care to be provided by an integrated team.

Stevens says that in Alexis’ care, for example, she had testing through the retinal service, care for her achromatopsia with appropriate eyeglass prescriptions, diagnostic tests by Stevens and a pediatric ophthalmologist, and assistance from the optometry service and optical shop to provide special tinted contact lenses.

As an infant, Alexis was fitted with red-tinted glasses. The red tint is protective of the eyes and filters out light rays, which makes it easier for her to recognize outlines and objects.

After Alexis experienced some bullying in elementary school because of her bulky red glasses, Lynn had Alexis fitted for red contacts, which she said made a big difference. Red-tinted contacts completely seal the eyes so light cannot enter, and Alexis says they’vr made her “feel normal” for the first time.

‘I will find a way’

Alexis has 20/200 vision and is legally blind. She only sees in shades of gray with limited color perception and no fine vision. Even so, she’s confident that nothing in life is beyond her reach because of achromatopsia.

At age four, Alexis learned to play soccer by the sound of the footsteps around her. In preschool, she zip-lined across an open field. She danced her way from first grade through early high school as she learned ballet, tap, jazz and hula. She played the flute in her high school marching band, attributing dance lessons with helping her get into formation relative to other people. She completed high school and attended Bluegrass Community and Technical College.

Her love of horses started when she was 2 or 3 years old and hasn’t waned. Recently, Alexis participated in the American Quarter Horse Congress, which she refers to as the “Super Bowl of quarter horse shows” because of its enormity and level of professionalism. She says the crowds don’t make her anxious or nervous.

“I don’t care about all the people watching me, I can’t see them anyway,” she said. “It’s just me and the horse in the ring. I go in wanting to do my best with my horse as a partnership. It’s not about the ribbons; it’s about having fun and doing the best I can.

“If there is something I want to do, even if it’s hard, I will find a way because it’s always worth it.”

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Protect your eyes with these 9 tips for everyday sun safety

Dr. Claire Fraser

Written by Dr. Claire Fraser, an ophthalmologist at UK Advanced Eye Care.

Now that the solar eclipse is over, it’s a good idea to review the basics of everyday sun protection for your eyes. Long-term exposure to ultraviolet (UV) radiation in sunlight can lead to damage on the inside and the outside of your eyes.

There is an increased risk of developing cancers of both the eyelids and the eye itself with increased exposure to the sun. Long-term sun exposure can also result in chronic eye irritation and non-cancerous growths. Sun exposure can even cause cataracts. Every time we are out in the sun without eye protection, we may be adding damage that increases our risk. These problems can take years to develop, but it’s never too early to protect your eyes.

Eye protection is important all year. Snow-blindness is a type of painful damage to the front of the eye that can occur when UV rays are reflected from ice and snow.

For these reasons, eye doctors recommend that you wear proper sunglasses and a brimmed hat when you’re in the sun for long periods of time. Here are nine tips for eye protection:

1. Choose the right sunglasses.

Look for sunglasses that offer at least 99 percent UV absorption. Glasses with 100 percent UV absorption are even better. This can also be indicated by a label stating, “UV absorption up to 400 nm.”

2. A darker lens isn’t always the best.

It can make your eyes feel more comfortable in bright light, but it doesn’t mean improved UV protection. A colored lens such as amber, green or gray can still have 100 percent UV absorption.

3. Large-framed lenses offer more protection.

Larger frames and wraparound styles allow fewer UV rays to reach the eye from around the glasses. This means more protection to the eyes and eyelids.

4. You don’t have to spend a lot of money.

There are excellent inexpensive options for sunglasses that offer 100 percent UV protection.

5. All sunglasses must meet impact standards.

These standards are set by the Food and Drug Administration for safety. Plastic lenses are less likely to shatter when hit by an object. For sports, get plastic lenses that offer shatter-protection.

6. Sun damage can happen during all seasons.

Don’t forget to protect your eyes during the winter months, especially when outside in the snow.

7. Tanning beds can cause severe eye damage.

Tanning beds can produce UV radiation levels up to 100 times higher than that from the sun.

8. Never look directly at the sun, even with sunglasses.

Looking directly at the sun at any time can lead to permanent damage to the center of your vision.

9. Protect your children’s eyes, too.

Don’t forget to protect your children’s eyes with hats and sunglasses. Damage from UV radiation adds up over time.

Next steps:

Diagnosing eye cancer early preserves girl’s sight

When Kenley Overton’s parents took their infant daughter in for her four-month wellness checkup, they didn’t know much about retinoblastoma, the rare form of eye cancer that most commonly affects children. But that quickly changed.

Kenley was born Aug. 24, 2010, to Jason and Kendra Overton. When Kenley was a few weeks old, her parents noticed that her right eye would cross frequently. They brought it up to their local pediatrician during a wellness checkup and were told that it wasn’t abnormal for newborns.

However, when the Overtons brought Kenley in for her four-month wellness checkup, her right eye was still crossing. The pediatrician suggested Kenley see an eye doctor as it was likely she would need glasses to fix the issue.

In a whirlwind of appointments, Kenley first saw an optometrist who believed she had a detached retina. She was then referred to Dr. Peter J. Blackburn at UK Advanced Eye Care. After some testing, Blackburn diagnosed Kenley with retinoblastoma – a form of eye cancer that begins in the retina. Thirteen days after her wellness check, Kenley was scheduled for surgery with Blackburn to evaluate the situation and decide on a plan moving forward.

The best-case scenario

Retinoblastoma is a rare disease; only 200 to 300 children are diagnosed with it each year in the U.S. About three out of four children with retinoblastoma have a tumor in only one eye. Overall, more than 90 percent of children with retinoblastoma are cured, but the outlook is not nearly as good if the cancer has spread outside the eye.

Blackburn says that although there are no known avoidable risk factors for retinoblastoma, some gene changes that put a child at high risk for the condition can be passed on from a parent. Children born to a parent with a history of retinoblastoma should be screened for this cancer starting shortly after birth because early detection greatly improves the chance for successful treatment.

When Blackburn came out of surgery, he told the Overton family that Kenley’s cancer was only in her right eye – the best-case scenario.

He was pleasantly surprised because at Kenley’s young age, he had suspected the cancer might have been in both of her eyes. The decision was made to remove Kenley’s right eye that day.

In the years following her surgery, Kenley was regularly monitored to make sure the cancer hadn’t spread to her left eye. As Kenley continued to grow and show no signs of the retinoblastoma in her left eye, Blackburn became more confident that the cancer was limited to Kenley’s right eye.

Compassionate care at UK

Kendra Overton looks back on this difficult time in Kenley’s life and remembers how tough it was on her family. While taking care of Kenley, she and Jason also had to care for their older daughter, Jaylen, who was 4 years old at the time. But through the stress, she remembers Blackburn and the care he provided for Kenley.

“Dr. Blackburn was a very confident in the information he delivered about Kenley and her treatment plan, and he had a wonderful bedside manner,” she said.

She said Blackburn even took the time to pray with her family before Kenley’s surgery.

“At a time when we were falling apart, we really needed that and you don’t normally hear of doctors doing that,” she said.

Kenley is now a thriving 6-year-old. Kendra describes her daughter as naturally funny and someone who never meets a stranger. She just has a love for people, her mother says.

“Everyone who comes in contact with her says she is just so amazing,” Kendra said.

Next steps:

  • Learn more about UK Advanced Eye Care, which provides comprehensive care for patients of all ages  from routine eye exams to treatment for the most complex ophthalmic issues.
  • Earlier this year, UK Advanced Eye Care moved into a new state-of-the-art clinic that will allow us to provide even better care for our patients. Find out more about our new location.
Many people know the dangers that exposure to sunlight can pose to the skin, but did you know it can also severely damage your eyes?

Here comes the sun! Get outside, but be sure to protect your eyes

Written by Shaista Vally, OD, an optometrist at UK Advanced Eye Care.

Dr. Shaista Vally

Dr. Shaista Vally

The weather is warming up, and sunshine, swimming and the great outdoors are on everyone’s mind. While there is a lot of fun to be had in the summer, we must also consider how to adequately protect our eyes and skin, which can be damaged by prolonged exposure to sunlight.

Wear sunglasses with UV protection

Exposure to the sun’s ultraviolet A (UVA) and ultraviolet B (UVB) radiation can cause sunburns and in some cases lead to cancer. UV radiation can also be a catalyst for cataracts, an eye condition marked by blurred vision. The best way to keep your eyes safe in the sun is to wear sunglasses with UV protection that prevent UV rays from entering the eye.

The American National Standards Institute (ANSI) determines the safety of ophthalmic sunglasses and verifies that they can prevent ultraviolet radiation from damaging the eye. Look for the “ANSI” symbol and “UV protection” when purchasing sunglasses. Keep in mind that cheaper shades are more affordable and trendy, but they may not offer you any protection from ultraviolet radiation.

In fact, wearing sunglasses without protection from ultraviolet radiation can actually do more harm than wearing nothing at all. When you wear nothing over your eyes, your tendency is to squint or keep your eyes closed, and the brightness naturally makes your pupils constrict, allowing fewer harmful rays to enter your eye. But your eyes dilate slightly when you wear tinted lenses, which lets more harmful rays enter your eye.

Apply sunscreen around your eyes

Additionally, the eyelid and eyebrow region is especially susceptible to basal cell carcinoma, squamous cell carcinoma and melanoma, which make up 5 to 10 percent of all skin cancers. Because the skin around the eye is very thin and contains very little subcutaneous tissue, it makes it easier for tumors to spread to nearby nasal and orbital cavities. Sunscreen with SPF is a simple way to prevent damage to the skin, but people often overlook applying sunscreen to their eyelids and area around their eyes as it often irritates their skin.

Buying facial lotions formulated for sensitive skin and applying a small amount with your eyes closed can prevent it from burning. Some people find that applying their daily facial cream first and allowing it to dry before applying SPF lotion helps prevent sunscreen irritation.

Get out there and enjoy the sunshine, but don’t forget to apply SPF sunscreen around your eyes and wear some UV-protected sunglasses!

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UK Shriners

UK Pediatric Orthopaedics, UK Advanced Eye Care moving into new Shriners building

The new Shriners Hospitals for Children Medical Center ‒ Lexington building on the UK HealthCare campus, which broke ground in March 2015, will open this spring.

In addition to Shriners, the building will be home to UK Pediatric Orthopaedics and will provide leased space for UK Ophthalmology (now renamed UK Advanced Eye Care).

Current locations of UK Advanced Eye Care along with the UK HealthCare Optical (formerly known as University Optical) will close March 17. They will reopen in the Shriners Building on March 20.

Pediatric orthopaedics patients will be seen in the new Shriners facility beginning April 17, although there will be a period of transition during which patients may be seen at either the current clinic within the Kentucky Clinic building or in the new Shriners space. During this transition, which is expected to last four weeks, parents whose children have a pediatric orthopaedics appointment are encouraged to call 800-444-8314 (toll-free) in advance to confirm where they will be seen.

Inpatient care for pediatric orthopaedics patients will be provided at Kentucky Children’s Hospital.

Members of UK health plans, including the UK-HMO and PPO/EPO options, will see no change in their copay/out-of-pocket charge with this move.

The new Shriners, which will be an outpatient surgical and rehabilitation center, was built on land that Shriners leased from UK. It remains a separate entity that is not owned or managed by UK.

UK Orthopaedic Surgery & Sports Medicine providers serve as the pediatric orthopaedic specialists for Shriners, an arrangement that has been in place since the 1970s.

The proximity of Shriners to Kentucky Children’s Hospital will facilitate collaboration of Shriners’ pediatric orthopaedic expertise and UK HealthCare’s specialty and subspecialty care for children with complex conditions.

Patients and families with appointments in the new facility will park in the UK HealthCare Parking Garage located just across Conn Terrace from Shriners. The building can be accessed via a pedestrian bridge at Level C of the garage.

Next steps:

How often should you have an eye exam?

How often should you have an eye exam?

Dr. Shaista Vally

Dr. Shaista Vally

Written by Shaista Vally, OD, an optometrist at UK Advanced Eye Care.

There is a widely held belief that if you don’t have any vision problems, you don’t need an eye exam. But this isn’t the case. Getting eye exams, especially for children, is necessary for maintaining healthy vision throughout life. So, how often should you see your eye doctor?

It’s recommended that all children between birth and 6 months old have a vision screening. Depending on the findings of the exam, children may need another exam in six months. If there are no abnormal findings, children can be seen every two years until they’re 6 years old. Then, depending on symptoms and exam results, exams can occur every five to 10 years until the age of 40.

It’s imperative for children under the age of 6 to be screened regularly because that is when the brain is developing strong connections to the eyes. If there is a problem with the eyes turning, blurry prescriptions, or with the eyelids or lens inside the eye obstructing vision, it can lead to a visual impairment known as amblyopia, or lazy eye. The good news is amblyopia can be prevented with adequate and frequent care.

Individuals with no systemic health issues, visual complaints or strong family history of medical conditions don’t have to be examined as frequently. However, anyone with diabetes, hypertension, heart disease, vascular disease or neurological disease and those with visual complaints (blurry vision/headaches) should be seen yearly.

There are some symptoms that are urgent and require immediate attention. Please call your local eye care provider right away if you experience new-onset vision loss, flashing lights, new floaters, painful red eyes, extreme sensitivity to light or any distortions in your vision.

Eye exams are important for maintaining healthy vision, and they can detect changes in your overall health, too. So be sure to schedule regular eye appointments for you and your loved ones.

Next steps:

  • Learn more about UK Advanced Eye Care, which provides comprehensive care for patients of all ages with eye and vision conditions.
  • On March 20, UK Advanced Eye Care is moving to a state-of-the-art location in the new Shriners Building on the UK HealthCare campus. Find out more about our new location.
UK Shriners

Watch: UK Advanced Eye Care doctors discuss new state-of-the-art clinic

The experts at UK Advanced Eye Care provide comprehensive care for patients of all ages  from routine eye exams to treatment for the most complex ophthalmic issues.

Later this month, we’re opening a new state-of-the-art clinic, allowing us to provide even better care for our patients. Starting March 20, all UK Advanced Eye Care appointments will be located in the leased space within the new Shriners Medical Center building, just across South Limestone from the UK Albert B. Chandler Hospital.

We sat down with a few of our eye care providers to talk about the beautiful new space and what patients can expect when they visit. Check it out!

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