Glaucoma Awareness Month

Glaucoma is a group of eye diseases that cause damage to the optic nerve located in the back of the eye.  The optic nerve is connected to the brain and carries visual information to the brain in order for us to see.  Glaucoma can lead to irreversible vision loss if undetected and left untreated.

Glaucoma is referred to as the “silent thief of sight” because there are no symptoms in early stages of the disease and vision loss occurs slowly over time.  There are different types of glaucoma (open-angle, narrow-angle, pigmentary, low-tension, etc) and the best way to detect and prevent vision loss associated with the disease is with an annual comprehensive eye exam.

Risk factors include:

• family history of glaucoma

• steroid use

• high myopia

• history of ocular injury

• age (typically over 60)

• African descent and over the age of 40

• diabetes

There is no cure for glaucoma but several treatments are available to halt the progression of vision loss.  We treat glaucoma by lowering eye pressure.  In early and moderate cases, this is achieved via drops, lasers and implantable drug delivery systems.

Regular exercise and a healthy diet consisting of daily antioxidant intake are crucial for overall ocular health.

Early detection and treatment are necessary to prevent irreversible vision loss and blindness from glaucoma.

At Sorella Optique and Eyecare, Dr. Tinari assesses every patient for glaucoma.  Our eye exams include:

• thorough evaluation of the optic nerves

• slit lamp examination to assess angle depth, pigment of the corneal endothelium and iris transillumination

• intraocular pressure measurement with iCare rebound tonometry or Goldmann applanation tonometry 

• corneal pachymetry (corneal thickness measurement)

• OCT of the optic nerve (RNFL and GCC thickness)

• disc photos

• anterior segment OCT

• virtual reality visual field perimetry 

Have you had your annual comprehensive eye exam?  Vision loss can significantly impact your daily activities and lead to a lower quality of life.  If you haven’t had an eye exam within the past 1-2 years, please schedule one soon.  Regular visits will help preserve your precious sight.

OptiLight IPL for dry eye, ocular rosacea and skin rejuvenation

OptiLight IPL is the first and only FDA-approved in-office light therapy treatment for the management of meibomian gland dysfunction, the leading cause of dry eye. OptiLight IPL is not a laser; rather, it works by scattering specific wavelengths of light onto the skin, triggering a reduction in inflammatory vessels and boosting collagen rejuvenation. It helps to repair and protect the meibomian glands which surround the upper and lower eyelids. The heat generated by the treatment allows for an immediate evacuation of inflamed meibum (oil) and improved quality of meibum, leading to a healthy ocular surface. This treatment is also useful for treating styes, chalazia, and ocular rosacea.

Aesthetic benefits of OptiLight IPL include:

•collagen rejuvenation

•brightening of under eye dark circles caused by hyperpigmentation

•even skin tone by reducing red or brown/age spots

•hydrates the skin and plumps fine lines

Patients typically achieve best results after four rounds of treatments spaced 2-4 weeks apart. Sessions may be repeated once a year to maintain ocular and aesthetic results. Flexible spending or health savings accounts may be used to cover the cost of treatments.

Dr. Tinari is one of the first eye care providers in our area to offer this exciting technology and has seen amazing results in hundreds of patients. Whether you are looking to improve dry eye symptoms, achieve aesthetic results, or both, schedule a dry eye evaluation to find out if you are a candidate.

Experiencing symptoms of dry eye disease? Learn more about this common condition and how we treat and manage it at our dry eye center of excellence

Dry eye is a multifactorial disease that can impact your vision and daily activities. Our tear film consists of aqueous, mucin and oil and any imbalance of these constituents can trigger several uncomfortable symptoms.

The most common symptoms of dry eye include: redness, irritation, increased light sensitivity, blurred vision that comes and goes, tearing, frequent styes or chalazia, and decreased contact lens wear time. Several autoimmune and inflammatory conditions like arthritis, thyroid issues, lupus, and Sjogrens can trigger and worsen dry eye. Many skin conditions like rosacea and eczema can also trigger ocular dryness.

Ocular surface disease is inflammatory in nature and there are two main types of dry eye. Our lacrimal gland functions to produce tears but if it is inflamed then tear production can decrease. This is called aqueous deficiency. Our meibomian glands that surround both upper and lower lids function to pump oil into the tear film when we blink. If the meibomian glands are inflamed, clogged or atrophied, then not enough oil enters the tear film leading to evaporation of the tears. This is evaporative dry eye.

Many patients present with one type of dry eye and others have a combination of both. Dr. Tinari uses several tests to diagnose the type of dry eye that her patients have, enabling her to better treat their symptoms. During a dry eye evaluation, she incorporates Schirmers testing to rule out aqueous deficiency. She uses fluorescein staining and meibography to rule out evaporative dry eye and evaluate for corneal epithelial damage. She also performs corneal epithelial mapping to monitor the change in corneal epithelial cells in her dry eye patients over time.

Several treatments are available to manage this chronic disease. Dr. Tinari was one of the first optometrists in the area to invest in OptiLight IPL, the only FDA approved light therapy for the treatment of MGD/ocular rosacea/evaporative dry eye. She routinely prescribes serum tears for patients with recurrent corneal erosions, corneal epithelial damage, neurotrophic keratitis, and dry eye. Punctal plugs, amniotic membranes, and several prescription/OTC drops are available depending on your type of dry eye. Dr. Tinari also assesses the lid margin for any evidence of inflammation or blepharitis which contributes to dry eye symptoms. She performs in office lid cleaning treatments and recommends specific lid cleansers to maintain results. Nutrition also plays a role in the disease, especially with ocular rosacea. Dr. Tinari can recommend specific nutrients and foods that may help reduce the inflammation associated with dry eye.

Dr. Tinari is currently accepting new appointments. A personalized treatment plan for your condition awaits. Book today! We look forward to helping you.

August: Children’s Eye Health and Safety Month

It’s August which means back to school is right around the corner!  Does your back to school checklist include a visit to your child’s eye care office?  A comprehensive eye examination not only checks visual acuity or the need for glasses; it also rules out several binocular vision disorders that can potentially impact your child’s ability to read and learn.  Dr. Tinari screens every child for refractive errors, amblyopia, strabismus, convergence insufficiency and keratoconus.  Yearly eye exams evaluate overall eye health and are crucial for ruling out any possible vision threatening eye diseases.  So this year, schedule an eye exam for your child before the school year begins to give them a head start to an amazing year of learning!

Benefits of Corneal Epithelial Mapping

The cornea, or outer surface of the eye, has five layers and the health of this delicate tissue is crucial in maintaining good vision and ocular comfort.  Light first hits our tear film and cornea, then travels through the pupil, lens, and vitreous gel.  It then lands on our retina and the optic nerve which sends signals to our brain and an image is formed.  Therefore, if the cornea is unhealthy, the image will be blurred and light sensitivity may worsen.  

There are many conditions that can impact corneal health.  Dry eye can cause the corneal cells to suffer, leading to a breakdown of the epithelium (surface layer) and subsequent blur, irritation and light sensitivity.  Astigmatism is when the cornea is oval shaped rather then round.  When light hits an astigmatic cornea, it bends and scatters creating blur and ghosting around lights.  

Several genetic conditions can cause corneal warpage including epithelial basement membrane dystrophy, Fuch’s dystrophy, pellucid marginal degeneration and keratoconus.  

At Sorella Optique and Eyecare, Dr. Tinari incorporates enhanced corneal epithelial mapping technology in order to diagnose several corneal diseases sooner than traditional corneal topography.  The earlier a diagnoses is made, the sooner treatment can commence to prevent irreversible vision loss. 

Epithelial mapping is essential before and after refractive surgeries to ensure the health of the cornea.  Dr. Tinari recommends a baseline corneal scan for all patients as part of a routine eye exam.

Before and after of corneal inflammation associated with contact lens wear

Vuity: A New Prescription Eye Drop for Presbyopia

Presbyopia typically occurs around the age of 40 and results in blurred vision at near. Over time, the lens inside of the eye hardens and loses its flexibility, leading to blur when looking at objects within arms length.

Symptoms of presbyopia include eyestrain when reading, pulling reading material further away to see it better, and eye fatigue or headaches when performing near tasks. It can take the eyes extra time to clear objects at a distance after focusing on something up close.

Treatments for presbyopia include eyeglasses (progressives, readers, bifocals), multifocal or monovision contacts, surgical multifocal refractive lens exchange or monovision LASIK. There is a new solution for patients who do not want to constantly rely on glasses or contacts and do not want to proceed with surgery.

Vuity is a prescription eye drop that helps improve near vision by temporarily reducing pupil size. This once a day drop typically lasts for eight hours and reduces the dependence on reading glasses. Schedule a visit with our medical optometrist, Dr. Giulia Tinari, to find out if you are a candidate for Vuity.

Two Antioxidants You Should Incorporate Into Your Supplement Regimen and Why

While everyone should consider taking a high quality multivitamin for overall health, most do not include the powerful antioxidants lutein and zeaxanthin. Studies reveal that these antioxidants, which are naturally found in dark leafy vegetables, can help protect the eyes (and skin) from the damaging effects of UV and blue light exposure over time. They work best if taken together.
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Repeated exposure to UV and blue light can cause free radical damage in the eyes, which can lead to vision loss via cataracts and macular degeneration. Sufficient intake of lutein and zeaxanthin has been shown to boost protective pigment levels in the retina, which leads to less absorption of damaging wavelengths of light. Studies also show that the skin benefits by improving skin tone and protecting it from premature aging due to UV damage.
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They naturally occur in the macula but the body does not produce as much over time. There’s no recommended dose at this time, but studies show that people who are more prone to free radical damage (such as smokers, people with poor diets/low intake of fruits and vegetables, and those exposed to excess UV or blue light during the day) need more intake. The goal according to the AREDS2 study is at least 10mg of lutein and 2 mg of zeaxanthin a day. Most Americans are only getting 1-3 mg a day in their diets.
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Lutein and zeaxanthin have a high safety profile. I recommend Eyepromise’s Zeaxanthin and Lutein supplement to all my patients interested in supplementing for their eye health. I also recommend Eyepromise’s Screen Shield Pro for those who spend a significant amount of time on digital devices. This product is amazing because it includes 14 mg of zeaxanthin, 7 mg of lutein and other crucial vitamins like D, C, E, omega-3 and bilberry among others. Visit www.eyepromise.com and enter code 13278 at checkout for savings!

I have 20/20 vision, why should I get my eyes checked?

Of all the senses, would you rank vision as the most important?  Most people schedule an eye exam when they notice a decrease in their vision but these exams do more than just reveal if you need glasses or not.  A thorough eye exam involves measuring your visual acuity and evaluating the health of your eyes.  Many potentially blinding ocular conditions, such as open angle glaucoma, can occur without symptoms.  Glaucoma is an optic nerve disease that can result in permanent vision loss.  A dilated eye exam can also reveal a host of systemic diseases like hypertension, diabetes and even certain cancers.  So if you've never had your eyes checked because you believe you have perfect vision, schedule your annual eye exam today just like you would your annual PCP visit.  Preserving your precious vision is worth it!

A Gift of Sight

Donate Your Old Glasses

Sorella Optique and Eyecare is proud to announce our partnership with VSP and their Give Sight Globally initiative. Millions of people around the world cannot provide for their eyecare needs. By donating your old or unwanted sunglasses, readers, glasses, we are one step closer to helping someone in need. Just drop off your pair(s) to Sorella at 1548 E Lancaster, Paoli, PA and we will process the donation! Thank you for joining us in our goal to giving sight to those in need!

A Morning Routine

☀️ Drinking a glass or two of water in the AM rehydrates the body and helps digestion. Adding lemon or lime provides loads of antioxidants and extra hydration to the body and is best consumed 20-30 minutes before eating.
☀️ Omega-3 supplements can help decrease inflammation, improve brain and cognitive functioning and reduce dry eye symptoms. It’s important to take omega 3 supplements in the triglyceride form in order to ensure absorption by the body. We like PRN’s Eye Omega supplement featured here.
☀️ Most of us are deficient in vitamin D so it’s important to supplement! Vitamin D plays a crucial role in immune system and bone health and get help boost mood. It helps to manage blood sugar levels and regulate hormones. Most of us need at least 1000mg a day or more if you are deficient. Of course, you can boost your vitamin D levels by spending 15-20 minutes outside in between 10am-2pm from May-September...but remember to apply sunscreen afterwards to keep your skin safe! PRN’s Eye Omega contains 1000mg of vitamin per serving.
☀️ Lutein and zeaxanthin are antioxidants that aid in skin and ocular health. You should consider supplementing with these vitamins especially if you have a family history of macular degeneration. They can help improve contrast and decrease light sensitivity. PRN’s Eye Omega contains both antioxidants!
☀️ Everyone needs a good multivitamin for overall health. We like Garden of Life’s multivitamins available for men and women.