I read with great interest a CNN article titled, “Prince William reveals how his poor eyesight helped with nerves when public speaking.”

The article mentions that when HRH Prince William felt uneasy, he would simply not wear his contact lenses.  This causes blurred vision such that he would then be unable to see the body language expressions of his audience.

Infact, Prince William describes a condition known as uncorrected refractive error (URE). Uncorrected refractive error is a leading cause of blindness throughout the world.  On World Sight Day 2006, the WHO estimated that 153 million worldwide suffered from blindness or visual impairment due to uncorrected refractive errors.(NIH article)

Lou et. al IOVS article (2016) states, “Uncorrected refractive error (URE), which affects a large proportion of the world population, is the major cause of vision impairment and the secondary cause of blindness. The Global Burden of Disease (GBD) Study 2010 estimated that in 2010, 101.2 million cases of moderate and severe visual impairment (MSVI), and 6.8 million cases of blindness were due to URE. Uncorrected refractive error may reduce educational opportunities, productivity, and overall quality of life.”

Other leading causes of blindness include age-related macular degeneration (AMD), diabetic retinopathy, glaucoma and cataracts.  These diseases account for most cases of adult blindness and low vision among people in developed countries. Because these eye diseases cause no pain and often have no early symptoms, they do not automatically prompt people to seek medical care. 

A thorough eye exam can also detect other health conditions, such as stroke, cardiovascular disease, diabetes, high blood pressure, autoimmune diseases, sexually transmitted diseases and some cancers. 

So a pair of eyeglasses — or in the case of HRH Prince William, contact lenses — can actually help with self confidence, overall vision and quality of life.

I spent many weeks in March & April — as my practice was shut down, surgeries cancelled, and stock market in free fall — in deep prayer for the well-being and recovery of one my best friends from childhood.

I had described Navin in my own wedding speech as, “a person whose spirituality and counsel have guided me for over two decades.”

The collective prayers of family and friends worldwide were answered when he improved, was released from the hospital, and spent the last many weeks in home rehab.

I hope you’ll take a few minutes to read his compelling experience.

Navin Girishankar’s “My COVID Story” can be found on LinkedIn here.

Regional Eye Associates has implemented COVID-19 safety protocols in our two-ophthalmologist practice. This includes standardized pre-screening protocols, expedited check-in & check-out, waiting room changes, required masks for all patients & staff, PPE, cleaning and extra safety innovations.  

Patients are screened prior to a visit for COVID-19 symptoms using CDC guidelines. On arrival, the patient calls the front desk at 856-795-8787 or rings the doorbell. The patient checks-in at a new check-in desk near the front door.  An ophthalmic technician performs a patient work-up. Patients, family members, and staff wear masks.  If a patient is able to walk by themselves, then family members are asked to wait in their cars during a patient visit.

The technician enters the chart visit information — including chief complaint, medical history, medications and compliance, visual acuity and testing — into our EMR (electronic medical record).

The ophthalmologist reviews the chart, speaks with the patient, and performs the examination.  Talking is limited when the ophthalmologist and patient are within six feet.  

The ophthalmologist will then discuss the treatment plan with the patient and family members. The plan may include continuing current medications, adding or changing medications, scheduling follow-up studies, consultations, and/or procedures. Medication prescriptions are sent electronically to the pharmacy. The patient receives a secure email via our patient portal at the end of the day or next morning. As well, our staff mails the patient a visit summary, co-pay receipt, and follow-up appointment date.

To schedule a consultation with Dr. Miano & Goel, contact Regional Eye Associates using the online form here or send a secure message via our patient portal.

If you have a sudden loss of vision, trauma, chemical injury or other injury, you should call 911 and go to the nearest emergency room.

The American Academy of Ophthalmology has an excellent coronavirus guide for eye patients here.

Due to the COVID-19 pandemic, ophthalmologists nationwide transitioned from performing usual services to a limited schedule of urgent and emergent patient visits only. As ophthalmologists continue our mission of protecting sight, telemedicine quickly became a useful method to evaluate patients for many ophthalmic conditions and without a slit-lamp evaluation.

I also recently started performing visual acuity and intraocular pressure (IOP) measurements in the parking lot. This service has proven especially helpful for my patients who are under treatment for glaucoma or are glaucoma suspects. Both telemedicine and parking lot patient evaluations will continue as clinical practices expand patient hours on a regional basis.

Patients are screened prior to a visit for COVID 19 symptoms using CDC guidelines. On arrival, the patient calls the front desk. My ophthalmic technician performs a patient work-up in the parking lot. The patient stays in the car. The patient, family members, and staff wear masks.  My tech returns inside and enters the chart visit information — including chief complaint, medical history, medications and compliance — into our EMR (electronic medical record). 

I review the chart and meet my patient at their car. Patients who are mobile are asked to stand next to their car (better ergonomics).  Elderly patients or patients with mobility issues stay seated. Best corrected visual acuity using a portable eye chart is recorded.  For patients who have retina issues or macular degeneration risk factors, Amsler Grid evaluation is performed. In addition, I place an anesthetic drop into each eye and perform IOP measurement with a portable tonopen. I examine both eyes.

I discuss the patient plan with the patient and family members. The plan may include continuing current medications, adding or changing medications, scheduling follow-up studies or procedures. I return inside to complete the patient chart and send medications electronically to the pharmacy. The patient receives a secure email via our patient portal at the end of the day or next morning. As well, my staff mails the patient their visit summary, co-pay receipt, and follow-up appointment date.

Four eye diseases — age-related macular degeneration (AMD), diabetic retinopathy, glaucoma and cataracts — account for most cases of adult blindness and low vision among people in developed countries. Because these eye diseases cause no pain and often have no early symptoms, they do not automatically prompt people to seek medical care.

Glaucoma in particular is a “silent disease.” Patients who have glaucoma are often taking ophthalmic medications to lower their eye pressure. As the COVID-19 social distancing guidelines continue, a parking lot visual acuity and intraocular pressure evaluation offers a convenient opportunity to monitor a patient’s ophthalmic status, optimize medication management, promote compliance and overall eye health.

To schedule a consultation with Dr. Goel, contact Regional Eye Associates using the online form here or send a secure message via our patient portal.

If you have a sudden loss of vision, trauma, chemical injury or other injury, you should call 911 and go to the nearest emergency room.

The American Academy of Ophthalmology has an excellent coronavirus guide for eye patients here.

One of my COVID goals was to create a monthly patient newsletter. The American Academy of Ophthalmology offers wonderful resources to help educate the public in monthly campaigns.

Delighted to promote May as Healthy Vision Month! Regional Eye Associates shares 5 steps to lower your risk of eye disease. Check out our inaugural monthly newsletter below or here!

5 Steps to Lower Your Risk of Eye Disease

By age 65, one in three Americans will have a vision-impairing eye disease. Many sight-threatening conditions can be treated if detected early enough.  In many cases, early treatment interventions can limit or eliminate the damage to your eyesight. During the month of May, Regional Eye Associates joins the American Academy of Ophthalmology to share valuable information on eye health and vision.

Four eye diseases — age-related macular degeneration (AMD), diabetic retinopathy, glaucoma and cataracts — account for most cases of adult blindness and low vision among people in developed countries. Because these eye diseases cause no pain and often have no early symptoms, they do not automatically prompt people to seek medical care. But a thorough checkup by an ophthalmologist — a physician who specializes in medical and surgical eye care — can detect them in their earliest stages. Early treatment is vital because it can slow or halt disease progression or, in the case of cataracts, restore normal vision.  

A thorough eye exam can also detect other health conditions, such as stroke, cardiovascular disease, diabetes, high blood pressure, autoimmune diseases, sexually transmitted diseases and some cancers. It’s not uncommon for a trip to the ophthalmologist to actually save a life. The Academy’s global community of 33,000 physicians urges you to follow these five simple steps to take control of your eye health today:

1. Get a comprehensive medical eye exam at age 40. Early signs of disease or changes in vision may begin at this age. An exam by an ophthalmologist is an opportunity to carefully examine the eye for diseases and conditions that may have no symptoms in the early stages. 

2. Know your family history. Certain eye diseases can be inherited. If you have a close relative with macular degeneration, you have a 50 percent chance of developing this condition. A family history of glaucoma increases your glaucoma risk by four to nine times. Talk to family members about their eye conditions. It can help you and your ophthalmologist evaluate your risk.

3. Eat healthy foods. A diet low in fat and rich in fruits, vegetables, and whole grains, benefits the entire body, including the eyes. Eye-healthy food choices include citrus fruits, vegetable oils, nuts, whole grains, dark green leafy vegetables and cold water fish.

4. Stop smoking. Smoking increases the risk for eye diseases such as cataract and age-related macular degeneration. Smoking also raises the risk for cardiovascular diseases which can indirectly influence your eye health. Tobacco smoke, including second-hand smoke, also worsens dry eye.

5. Wear sunglasses. Exposure to ultraviolet UV light raises the risk of eye diseases, including cataract, fleshy growths on the eye and cancer. Always wear a hat and sunglasses with 100 percent UV protection while outdoors.An ophthalmic examination helps to evaluate the overall health of the eyes and relationship to systemic diseases. 

Both Dr. Miano and Dr. Goel are board-certified comprehensive ophthalmologists. Visit our practice website to schedule an office visit or telemedicine consultation. 

To learn more ways to keep your eyes healthy, visit the American Academy of Ophthalmology’s EyeSmart® website.

I was honored to be a guest on the cutting edge podcast Wall Street to Main Street. Emily Advani & Reuben Advani have created a great venue to explore business, the economy and the stock market. We discuss COVID-19, telemedicine & my passion for protecting sight. Please check out the podcast and send me feedback!

Wall Street to Main Street: Episode 12 – COVID-19: TeleHealth, TeleMed and the Practice of Medicine