Preventing Sports-Related Injuries in Kids

 Ophthalmology, Pediatric Ophthalmology  No Responses »
Oct 172012
 

I was listening to the radio the other day about the new concussion policy rules that a lot of youth football leagues now have in place.  It started me thinking about the many eye injuries I see as a consequence of sports and trying to increase awareness about these potentially devastating, completely preventable injuries.  I’m a little late – September was Sports Eye Injury Prevention Awareness Month (that doesn’t exactly roll off the tongue, does it?)  But the message is important, even if the name of the month is a bit long.

Below is one of my favorite patients and what happened to him should serve as a cautionary tale for all parents whose children are involved in sports.  This kid was 10 years old, playing baseball and accidentally walked behind the batter.  He was struck in the face with the bat (accidentally) and suffered from numerous fractures of his face, the bones around his eyes and lost vision in the right eye from the trauma.

Dr. Timothy McDevitt was able to repair the fractures in Kaliu’s face and I performed surgery to straighten his eyes.  Here he is post-op.  Click here for his mother’s testimonial about her son’s surgical experience at Honolulu Eye Clinic.


He looks great post-operatively and we were able to make the eye look much more normal. Unfortunately, there was no way to restore his vision in the right eye.  As a mother of 2 young boys, this kind of preventable injury hits close to home.  I always think that an injury like this could have been prevented if all of the children on the baseball field had been required to wear sports goggles (also called recreational spectacles).

One problem I’ve noticed is that often kids (and even their parents) will wear their regular glasses when playing sports.  But, you shouldn’t!   More than 40,000 sports-related eye injuries occur every year.  Blunt trauma, such as a ball hitting the eye cause the majority of these injuries.  Some parents also mistakenly think that the helmets with face shields are enough to project the eyes (like football helmets).  But, this is not true.  Your child’s eyes are still exposed to penetrating sports equipment or fingers! Kids and teens have high rates of sports-related eye injuries because of their wide involvement in athletics in school and their tendency to play aggressively. The types of eye injuries can vary including:

1. Corneal abrasions

2. Bleeding in the eye (hyphema)

3. Fracture of the bones surrounding the eye (orbital fracture)

4.  Retinal detachment, or even rupture of the eye.

 

Depending upon which part of the eye is damaged, permanent vision loss can result and surgery may be required to repair the eye. Wearing eye protection significantly reduces the risk of these injuries by ninety percent!

Recommended Protective Eyewear
Many people mistakenly believe that regular glasses or contacts can protect their eyes. Yet, glasses can break upon impact causing a penetrating injury to the eye and contacts do not protect the eye at all.
The American Society for Testing and Materials (ASTM) has standards for the types of sports goggles to be worn in various sports. All sports goggles should be made from polycarbonate.   Polycarbonate is a high-impact resistant plastic that offers UV protection and can be made in prescription or non-prescription lenses. Regular eyeglasses only have 5 percent of the impact resistance of polycarbonate lenses.  Even though all children’s eye glasses are made from polycarbonate, the frames can still bend and break in the eye, making them unsuitable to wear during sports.

At HEC, we carry Liberty Sport goggles, so I’m most familiar with them, pictured below.

They are a type of protective goggles especially designed to be worn during sports. Fitting most prescriptions, Liberty Sport brand goggles are tested and approved to withstand high impacts. They have very soft padding on the bridge and sides of the frame aimed to protect the bridge of the nose as well as the temples. Their wrap design helps prevent dirt, dust, and even UV rays from damaging the eyeball and the delicate areas surrounding the eye.  Liberty Sport goggles automatically come in the polycarbonate lens material mentioned above and can be ordered clear, or with polarized sunglass lenses, or also with Transitions Lenses (also known as photochromic lenses)–which turn from clear indoors to dark, sunglass-type lens when exposed to UV light outdoors.  They are also designed to fit under sports helmets (baseball, football, etc). And the best part, as mentioned above, is that we can customized them with yours or your child’s glasses prescription in them.  I have some patients that like to wear these as their regular glasses! Of course, they also come in a wide variety of colors and styles.

Whichever type of sports goggles you choose, just make sure that it has polycarbonate lenses and is certified by American Society for Testing and Materials as safety goggles.

 

 

 

 Posted by hawaiimomdoc at 3:02 pm

Mommy Makeovers

 Cosmetic  No Responses »
Sep 132012
 

We had a wonderfully successful cosmetic event a few weeks ago at Honolulu Eye Clinic.   Our theme was ‘Mommy Makeovers” to provide an opportunity to tired, overworked mothers to have some time to themselves.

My good friend, Shandis Ching, helped me create a beautiful tablescape for our guests and gift bags as well.  I love throwing parties, click here to see a post about my son’s third birthday party and I especially enjoy doing signage, paper aspects of a party.  Shandis is brilliantly creative and has lots of wonderful ideas.  We always say we should start a party planning business together.

Shandis tied sand dollars and raffia to white towels for each guest to take home.  

 

 

I packaged turquoise bath salts in little jars and made cute Honolulu Eye Clinic water bottle labels.

And, each guest received their own tote bag, which Shandis hand stamped!

Childcare was provided  and all the kids had a great time back in our pediatric waiting room, painting and drawing and eating!

 

 

 

Guests learned about beauty products like Skinceuticals (recently named to Allure and In Style magazine’s Best Skin Products list)  and were each treated to a complimentary skin analysis.

They also witnessed a live injection demonstration of  Dysport and fillers and enjoyed hand rolled sushi.

 

A big mahalo to David from Medicis for helping sponsor this event and sharing the latest news about Dysport and Restylane. Restylane is terrific for rejuvenation of the eyes.  And, another huge MAHALO to Shandis Ching and to all of the gorgeous moms who came out for this event.

If you missed this event, don’t worry, we’ll have another in a few months.  Keep checking my cosmetic website: www.drrupawong.com or our facebook page.

 Posted by hawaiimomdoc at 9:52 am

Best Doctors Honolulu cover shoot

 Ohana  No Responses »
Jul 172012
 

As some of you may have seen, I was a “cover girl” for a month.  I was thrilled and honored when I (and my husband, Dr. Jeff Wong) made the Best Doctors list last year.  But, I was truly excited when Honolulu magazine asked me to be the doctor featured on the cover.

Jeff and I were featured together on the lead-in to the Best Doctors section inside. 

It’s been a bit bizarre and surreal seeing my face as I go into Whole Foods.  It almost feels like one of those fake magazine covers that you get printed when you go the fair.

The photoshoot was fun, but a lot more work than I had anticipated.  I’m the kind of person who loves getting my hair/make-up done, so that part was enjoyable and reminded me of my wedding day.

 

 

The photographer, Rae Huo, is amazing and we met at her studio downtown.  She kept the atmosphere light and entertaining.  In attendance, was the Art Director, Kristin Lipman, the associate Art Director, Cody Kawamoto, the stylist and my husband.  The shoot took 3 hours!  They fussed and primped me and analyzed every strand of hair, the fold of my white coat, the accessories in my pockets – everything.  Even Jeff got a little powder for his pics.

 

I have a new found respect for models now!  After each shot, the team viewed it immediately after on their computer to see if they liked the lighting, my hair, etc, and then would make changes.

 

 I got a bit punchy by the end.  The pic below doesn’t exactly scream ” best doctor!”

When we were first doing the shots of Jeff and I together, we’re so used to assuming certain stances (like for an engagement photo or prom), that everyone laughed.

 

It was a wonderful honor and a big mahalo to Rae, Cody, Kristin and Christine for their help with the shoot!!

 

 

 

 Posted by hawaiimomdoc at 9:58 am

Pre-school Vision Check

 Ohana  No Responses »
Jun 152012
 

A few weeks ago,  my team of technicians from the Honolulu Eye Clinic, Dr. Jenifer Bossert and I went to an area pre-school to perform a vision screening for about 100 students!  Yes, you read correctly, 100 preschoolers!  The kids were great and really eager to earn their sticker reward for participating in the vision screen (amazing what kids will do for a sticker!).  Most knew their letters and only a few were too shy to participate.  Instead of using old fashioned eye charts, we used an I PAD app which had a vision testing tool allowing us to use letters to test the older kids and symbols and a “tumbling E” for younger kids.

 

Like most vision screenings for children between 3-5 years, we tested each child for strabismus, which is a misalignment of the eyes that affects about 4% of children.  We also evaluated the distance vision or for refractive errors to determine whether they might have a myopia (nearsightedness) or hyperopia (farsightedness).  Finally, we tested the children’s stereo vision, which is the ability to see one image with two eyes.  Many kids like this test because the evaluation is based on the child’s ability to see 3D images with 3D glasses on.

Dr. Rupa Wong checking the alignment of eyes

Stereo Vision Test

It is very important for children to have their vision checked yearly as vision problems can occur at any age, which can hinder developmental performance and cause other problems that include vision loss or even blindness.  Many abnormalities or problems that are detected early are treatable.

Pre-schooler having a distance vision test

Technician Jocelyn performing distance vision test using a new iPad app.

 

 

 

 

 

 

 

 

 

 

We had a wonderful time with the pre-schoolers and would like to thank the teachers for assisting us with the children.  It was a great way to start the day at the pre-school with the enthusiastic children.  Honolulu Eye Clinic staff would like to send a big Mahalo to the staff and teachers at the Pre-school for their assistance during our visit.

 Posted by hawaiimomdoc at 8:36 am

Scleral Contact Lens

 Ophthalmology  No Responses »
May 212012
 

Today, we have a guest post by Dr. Jenifer Bossert, staff optometrist, and  head of the Contact Lens Department at Honolulu Eye Clinic.

 

 

 

Sometimes what is old becomes new again!

It happens in fashion, music, and now, even in eyecare.

After 125 years, Scleral Contact Lenses have reemerged as a treatment for certain eye problems.

In 1888 (!), the first scleral contact lens (SCL) was made out of blown glass!  It was very large, 18-20mm, and didn’t allow the eye to breathe so it wasn’t a very healthy. Over time, contact lenses developed from glass, to hard gas permeable, to the soft contact lenses that 89% of our CL wearers enjoy today.  Due to the availability of super-oxygen permeable materials, SCLs are now used to treat a variety of corneal issues.

SCLs are large.  The average gas permeable (hard) lens is 9.5mm.  The average soft contact lens is 14.0-14.5 mm.  SCLs range from 14-22mm.

Below is a picture of a scleral lens on the left and a regular rigid gas permeable lens on the right. Look at that size difference!

SCLs are custom made lenses designed individually for each eye.  Instead of resting on the super-sensitive cornea, they sit on the white part of the eye called the sclera.  Unlike traditional gas permeable lenses, SCLs don’t move when you blink…so, they are very comfortable.

A unique characteristic of SCLs is that the portion of the lens that vaults over the entire cornea is filled with fluid that acts like a liquid bandage to help extremely dry or diseased corneas.  This fluid reservoir also masks corneal irregularities and/or distortions; often, enabling a significant improvement in vision.

Patients who have been told they can’t wear contact lenses may be able to wear a scleral lens. Who is a candidate for the SCLs?  These lenses may be helpful for eyes than are unable to achieve good correction with glasses due to corneal irregularity, those who are contact lens intolerant, or those with significant dryness issues…such as:

  • Kerataconus patients
  • Patients with Sjogren’s Syndrome
  • Corneal transplant patients
  • Severe dry eye patients

 

So you think you might be a candidate, what next?  In order to begin, we need a current comprehensive eye examination, computerized corneal map, and a scleral contact lens trial fitting.  This is a multi-visit, multi-week process.  There are no SCL manufacturer’s inHawaiiso it’s not unusual for this process to take 8-12 weeks.  And it may take more time to help you master how to apply and remove scleral contacts due to the larger size of the lenses.  In our office, a scleral contact lens training usually takes about 1-2 hours for the first visit and then multiple visits afterwards.

For these reasons, scleral contact lenses cost significantly more than standard contacts; in fact, it is not uncommon for scleral contacts to cost three or four times more.  However, for patients who were previously unable to wear contact lenses at all, these lenses offer a great chance at improved vision.

 Posted by hawaiimomdoc at 9:20 am

Work-Mind-Body Balance

 Ohana  No Responses »
Apr 292012
 

This week’s post was inspired by an amazing event that Hawaii Pacific Health held for female physicians.  It was an evening dedicated to restoring balance in our work, personal and family lives.  As a working mom, I know sometimes I feel completely overwhelmed by all of my responsibilities -work, motherhood, wifehood (is that even a word?).  I want to do it all and I feel guilty when I take a little time for myself.  Anyone else feel the same?  And, for my friends who stay at home –  they’re even in more desperate need for time for themselves.

So, Kapiolani organized this event which had an hour long yoga session, followed by a cooking demonstration by Chef Russell Sui of 3660 On the Rise.  The yoga was nice and relaxing.  Not hot yoga, where you’re getting all sweaty and trying to get in shape.  This was yoga at its purest – good breathing and stretching.  I felt invigorated afterwards.

OK, this shot was staged.  This is me in my backyard, but I forgot to take pics of the yoga session.  Don’t I wish I had the motivation to do yoga by myself in my yard?  I’m doing tree pose, but i look more like a leaning pine than a tall, stately oak.

Then, the the fun stuff — the food! Chef  Russell  Siu is extremely entertaining.  He prefaced the demo with the caveat that he was asked to prepare healthy meals. “So, if you are still hungry afterwards, its not my fault!” he said half-jokingly.  Throughout the demo, he mentioned places in the recipe he might otherwise want to use butter or cheese, but couldn’t because of the “healthy” limitation.  Hmmm…I got the sense he would have far preferred cooking without the healthy limitation.  But it was delicious nonetheless.

Here’s my friend, Dr. Deborah Yang, a dermatologist at Kaiser Permanente, and I eagerly awaiting our first course.

 

And, the Chef himself.

So, on to the meal.  Oops – I ate the soup without taking a pic first (I was very hungry after a one hour yoga session after all!).  But, here’s the recipe.  All recipes are courtesy of 3660 On the Rise.

print recipe

Chicken Soup

With Cilantro, Onion, Tortillas and Grilled Shrimp
Service for 6 people

Ingredients:

  • 12 ounces chicken breast, small dice
  • 1 each onion, small dice
  • 1/4 cup diced tomatoes in juice
  • 48 ounces chicken stock
  • 1 clove garlic, finely chopped
  • 1/2 tsp. oregano
  • pinch of cumin
  • 1 each bay leaf
  • 4 wedges of lime on the side
  • 1 each 8 inch corn tortilla, fine julienne, fried
  • 6 each shrimp, 21-25, peeled and deveined
  • 1 clove garlic, finely chopped
  • 4 Tbsp. oil
  • 1/4 tsp. basil
  • 1/4 tsp. oregano

Directions:

  • Sauté onion with 2 Tbsp. oil in a soup pot until transparent over medium heat. Season chicken with salt and pepper and add to pot and sauté for about 2 minutes.
  • Add garlic, oregano, cumin and bay leaf and sauté another 1 minute.
  • Add diced tomatoes and chicken stock and simmer for about 20 minutes over medium heat.
  • Season with salt and pepper

Shrimp:

  • Marinate shrimp with 2 Tbsp. oil, basil, garlic and oregano for about 1 hour.
  • Season with salt and pepper and grill.

 

I did remember to take a pic of the second course, halfway through (I would be a lousy food blogger, I can’t restrain myself from eating before taking the photograph of the food!).  It was delicious as well, though I don’t like tomatoes.  I was surprised at how sweet the raw corn was in this meal.

And, here’s the recipe for the chicken pasta.

print recipe

Grilled Chicken Over Pasta Shells

With Slivered Onions, Cherry Tomatoes, Cucumbers, Kahuku Corn
Basil Vinaigrette
Service for 4 people

Ingredients:

  • 12 ounces chicken breast
  • 1/2 cup slivered red onions
  • 12 each cherry tomatoes, cut in half
  • 2 each cucumbers, Japanese. Medium diced
  • 1 each kahuku corn, kernels only
  • 1 1/2 cups pasta shell, raw
  • 1/4 cup parmesan cheese, grated

Directions:

  • Marinate chicken breast with 1/2 of the basil vinaigrette for about 2 hours and grill until cooked.
  • Slice and reserve in a warm area.
  • Toss rest of ingredients with the basil vinaigrette with half of the parmesan cheese.
  • Top salad with balance of parmesan cheese and top with the sliced chicken.

Basil Vinaigrette

Ingredients

  • 1/4 cup red wine vinegar
  • 1/4 cup extra virgin olive oil
  • 1/2 cup orange juice
  • 1/4 cup onion, sweet, diced
  • 1 clove garlic
  • 8 leaves basil, fresh
  • 1/2 tsp. orange zest
  • 1/2 tsp. Dijon mustard
  • 1 Tbsp. honey

Directions

  • Blend all the ingredients in a blender until smooth. Season with salt and pepper.
  • For a sweeter sauce add more honey.

 

The next course was a pan seared salmon and was one of my favorites. I think this is easy enough that I could actually make this without a bunch of sous chefs. As you can tell, I enjoyed it and then remembered to take a picture.

 

But, luckily, a few physicians weren’t able to make it to the event, so there were leftovers, which I brought home for Jeff.  Here’s his plate and he just put everything on there at one time, so it has the chicken pasta and the salmon on it.  The recipe is below:

 

print recipe

Pan Seared Salmon

Orange Honey Jus, Parsley Red Potatoes
Service for 4 people

Ingredients:

  • 4 each salmon fillet, skin off (6 ounces)
  • 2 Tbsp. extra virgin olive oil
  • 1 clove garlic, sliced
  • 4 leaves basil, chiffonade
  • 1 Tbsp. black pepper, cracked

Directions:

  • Marinate salmon in a ziplock back with above ingredients for about 1 to 2 hours.

Orange Honey Jus

Ingredients

  • 1 cup orange juice
  • 1 tsp. orange zest
  • 1/2 cup white wine
  • 1 Tbsp. shallots, brunoise
  • 2 Tbsp. honey
  • 5 leaves basil, chopped
  • 1/4 cup butter, unsalted

Directions

  • In a sauce pot over medium heat, add orange juice, orange zest, white wine, shallots, honey and basil.
  • Reduce mixture by 25%.
  • Whisk in butter and season with salt and pepper.
  • Strain through a chinois and keep hot.

 

I mentioned that the salmon was one of my favorites and that’s because the dessert – a vanilla bean panna cotta was my absolute favorite.  Unfortunately, since this was not “healthy”, we were not given the recipe.  I don’t even like pannacotta and I thoroughly enjoyed this one.

 

I love my work – there is nothing I would rather do.  Every day I am rewarded. I love the relationship I am able to have with my patients here in Hawaii and I truly enjoy caring for them.  I love my boys – I am blessed with 2 wonderful, sweet and healthy sons.  But, I’m a firm believer that as a woman, I also need to take more time for myself – whether it’s doing yoga, going out to dinner with my girlfriends, reading, anything that recharges me.  When I’ve had that time, then I know I’m a better physician, mother and wife.  So, thank you Hawaii Pacific Health and all associated hospitals for such a wonderful event!

 Posted by hawaiimomdoc at 8:55 pm  Tagged with: , , ,

Blinking, itching and burning

 Ohana, Pediatric Ophthalmology  No Responses »
Apr 082012
 

We live in Hawaii and allergies are a huge problem here compared to the mainland.  For 8 years, I lived smack in the middle of Manhattan and the pollution and dirt never caused a problem.  But, my first month of living here, the flora and VOG of Hawaii put my allergies on overdrive!  And along with allergies and the symptoms you think of  runny nose, sneezing, coughing, comes ocular allergies.

In children, allergic conjunctivitis can present like this:

 

His eyes are only slightly red, but he has a little cough (which isn’t associated with a cold) and a little sneezing and there’s that non-stop blinking.

First, I should back up – what is the conunctiva?  It’s the mucous membrane of your eye – the white part and the pink part on the inside of your eyelid.

 

6 Signs of Allergic Conjunctivitis:

1.  Itching

2.  Tearing

3.  Redness

4.  Mucous discharge from the eyes

5.  Allergic shiners (look like black eyes underneath the eyes)

Allergic shiners (under the eyes)

6.  Blinking

 

There are many different kinds of allergic conjunctivitis that your eye doctor can diagnose.  This is not the same as “pink eye”.  There is no infection and it’s not contagious.

Types of allergic conjunctivitis:

– Seasonal or year round (perennial) allergic conjunctivitis – some people are specifically allergic to mangoes or only to VOG

– Vernal conjunctivitis – I see this a lot.  Tends to happen in young boys and needs aggressive treatment.  These boys will have really red eyes, light sensitivity and are at risk for losing vision in advance stages of the disease.

– Giant papillary conjunctivitis – that’s for all you contact lens wearers out there.  If you overwear your contacts, you can develop a reaction to the material, making your eyes red and intolerant to wearing contact lenses.

 

I am mainly going to discuss seasonal/perennial allergic conjunctivitis in this post.

So, what causes allergies?  Allergies are mediated by a type of white blood cell, called a mast cell.  It has a special form in the conjunctiva.  And, when it gets activated by the thing you’re allergic to (also called the allergen), it releases chemicals.  These chemicals, such as histamine and prostaglandins, are what cause symptoms of allergies.  They cause blood vessels to become large and leaky, causing redness, swelling and itching.

Here’s the kind of chart that other opthalmologists like to show each other when explaining allergy.  I swiped it from my husband’s presentation he had given on allergy.

 

 

Allergic response

 

So, how do we treat allergic conjunctivitis?

  • Allergen avoidance – this is ideal, but it can be hard in Hawaii.  Can’t exactly avoid VOG, and did you know cockroaches are really allergenic?  Hard to find a place here without cockroaches.  However, I always tell patients to try avoiding touching and rubbing their eyes, which is how a lot of allergens get in the eyes in the first place.
  • Cold compresses (not warm!) – I know patients sometimes get confused, we tell them warm compresses for this, cold for that.  But for allergies, we want cold compresses to make the blood vessels smaller and leak less.
  • Systemic medications – Benadryl, Claritin (anti-histamine), Zyrtec.  These medications are taken orally, and may not be helpful for the eyes at all.  In fact, they can often cause dry eye, making the symptoms of allergic conjunctivitis even worse!
  • Eye drops

 

Let’s talk about eye drops for allergic conjunctivitis.  Many patients will self-treat with over-the-counter drops such as Visine, which constricts the blood vessels and takes away the redness, but does nothing to treat the allergic reaction.  Then there are over-the-counter drops such as Visine-A, Naphcon-A, and Opcon-A which have a weak antihistamine.  They are safe and effective for short term use, but the preservatives in these drops can be harsh and irritating to the eyes.  Also, the effect from these drops lasts only about 2 hours, so patients must overdose themselves in order to get all-day relief.

When I tell patients that they shouldn’t use Visine, they’re always quite surprised.  But, it really isn’t the best drop you can use.

There are also some people who use Similasan Eye Allergy homeopathic drops, however there is no scientific evidence that these drops work.  In general, most eye doctors discourage the use of these over-the-counter eye drops.

Fortunately, we have some much better prescription drops for allergic conjunctivitis.  Pataday, Lastacaft, Bepreve, and Elestat are some of the best drops for allergic conjunctivitis.  They not only block histamine’s nasty effects, but also prevent histamine from being released.  Pataday and Lastacaft only need to be given once a day.  All of these drops are very safe, and can be used long term.

If you have a red eye, you should see your eye doctor – don’t diagnose it yourself.  There are many different causes of red eyes which can be dangerous or vision threatening (like uveitis, corneal ulcers, trauma, angle closure glaucoma, corneal abrasions or foreign bodies).  There are also many different causes of blinking in children (tic, dry eyes, Tourette syndrome, irritation from eyelashes etc). Get it checked out first!
 Posted by hawaiimomdoc at 11:00 pm  Tagged with:

An Update: Lashes and Tear Ducts

 Cosmetic, Pediatric Ophthalmology  No Responses »
Mar 292012
 

Latisse Update

So, after much deliberation, I have decided not to do the Latisse challenge.  The reason is because I’m still nursing and Latisse is not FDA approved to be used in pregnant or nursing mothers.  I knew that beforehand and I’ve never prescribed it to a patient who is pregnant or nursing, but my overzealousness to have nice lashes almost got the better of me.  I figured that the amount of Latisse that is systemically absorbed is quite small.  But, when I sat down and really considered it, I realized it just wasn’t worth the risk.  Though I’m not a patient person, I would rather wait 6 months and know for sure that I am not harming my baby.  The only time I used it was when I posted the video.  So, instead I’ve put one of my staff on Latisse and I’ll be posting pics of her every 2 weeksThis is obviously not a picture of my employee’s lashes, but my son, Nikhil has the best lashes, so I just decided to post a pic of him until I get the staff pics uploaded.

 

Tear Duct Update

On a happy note, Taj’s nasolacrimal duct obstruction has completely resolved.  It’s interesting, it appeared to be worsening one day and then all of a sudden there was no discharge, no tearing.  So, parents out there – continue the massage, it really does work.  I did the Crigler massage much more consistently than the antibiotic ointment or warm compresses.

No more tearing or discharge!

 

 Posted by hawaiimomdoc at 7:32 am  Tagged with: ,

The end is in sight

 Office  No Responses »
Mar 132012
 

Our renovation is almost over – thankfully!  Thanks to all of our patients who have endured the chaos, mess and cramped temporary reception area as we have renovated over the past 2 months.  Our HEC patients are so great – they tolerated sitting on the ground, their charts being misplaced and all sorts of blunders as we tried to cope with seeing patients while renovating.

Of course, the reno was supposed to be done on Feb 1, by the time I returned from maternity leave.  And, of course, that didn’t happen.  Demolition only began on January 23, so there was no way that it was getting done in a week.  We have never renovated anything before and this was certainly a learning experience.  Lots of delays, items that we had to make sure were done properly.  But, we are getting very excited – the new space will certainly now be large enough to accommodate all of our patients.  Below is a sneak peek at the office.  We have started using the reception area even though we are still waiting for the granite to be installed and there’s a laundry list of items that still need to be completed.  The end is in sight!  Anyone out there survived a recent renovation of your home or office?

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Even baby Taj is helping clean the new shelves!

 Posted by hawaiimomdoc at 11:43 pm

Where did you get those lashes? The Latisse Challenge

 Where did you get those lashes? The Latisse Challenge  Cosmetic  No Responses »
Mar 072012
 

Many of you have probably seen the commercials for Latisse.  They originally featured Brooke Shields and now Claire Danes and looks like this:

So, what exactly is Latisse, how does it work and does it actually work?

Latisse is the only FDA approved medication proven to grow lashes longer, thicker and darker.  Quite a statement, right?  Well, how did they come up with Latisse.  Latisse is the brand name for bimatoprost ophthalmic solution 0.03%.  And, what exactly is that?  Well, it’s the same medicine as Lumigan, a glaucoma drop.  And, it’s similar to Xalatan (latanoprost ophthalmic solution) and Travatan (travaprost ophthalmic solution).  All three are known as prostaglandin analogues, and are a specific type of glaucoma medicine.  Each differs slightly and is made by different manufacturers.  Well, we ophthalmologists began prescribing these medicines for glaucoma, we noticed that patients reported that their eyelashes got longer.  For men, this was an unwanted side effect.  But, someone had the bright idea of repackaging Lumigan (which you can still buy for glaucoma) and selling it as Latisse.  Instead of placing the drop in the eye as you would for glaucoma, you place it on the lashes (I’ll get to that later).

So, how does Latisse promote your lashes to grow?  Well, that’s kind of unknown.  If you go to the Latisse website, you’ll find this diagram.  All this tells you is that each hair follicle undergoes a cycle of growth and death.  For some reason, Latisse makes the growth phase of lashes longer, but it isn’t known why.

So, on to the third and final, and most important question.

Does Latisse work?

The FDA clinical trials actually proved that lashes did grow significantly with the use of Latisse, after 16 weeks of use.  Here are the pics from the clinical trial.

But, I think it’s more impressive when you see pics of real people using Latisse.

This is Christina, my receptionist.

And, here’s Kelley, one of our technicians.

 

 

 

 

 

 

This is what she says about Latisse:

” I started using Latisse about a year ago and have definitely noticed an improvement in the length and fullness of my lashes.  I have noticed a slight darkening of the skin on my lash line, but I don’t mind.  It looks like I have on a little eye shadow, or perhaps eyeliner, without the hassle of putting it on!  I am using less mascara and can even go without it now and still have long, lush looking lashes!  I am not the kind of person w ho does anything regularly with my hectic schedule, so it’s difficult for me to remember to use it every day, but I have still gotten excellent results.  People compliment me on their beauty when I’m in stores and I always have the same reply, “Thanks, I use Latisse” 

And, last, another employee – Shawna.  She uses Latisse two to three times a week and these are her lashes.

My mother uses Latisse and she barely uses any cosmetics.  She noticed during my wedding when the make-up artist was putting false eyelashes on her that it made her eyes look the way they did when she was young.  She commented that the loss of eyelashes as you age is so gradual, you don’t notice it at first.  Once she started using Latisse, she saw a dramatic difference within 4 weeks (the label on the box says you’ll see a change in 16 weeks, though most of my patients report seeing an increase in lash growth and thickness even within the first month) and it restored a youthful appearance to her eyes.

Before we discuss how to apply Latisse, I want to briefly review the potential adverse effects of it.  It is a medication, which is why only a doctor can prescribe Latisse.  And, I do recommend purchasing Latisse from your eye doctor so that they can perform an eye exam on you before and during Latisse use.

Side Effects

  • Change iris color – this is what most people really worry about and it actually wasn’t shown to happen in the FDA trial at all.  But, the glaucoma medicine (when you put the drop in your eye instead of on the lashes) can cause hazel eyes to turn darker brown.  Blue eyes remain blue and brown eyes remain brown
  • Skin pigmentation – if you don’t apply Latisse correctly or put it on the lower lashes (not supposed to), then you may get darkening of the skin of the lower lid.  This happened in about 4% of patients
  • Uveitis – this is inflammation of the eye.  This is why I like to do an eye exam on anyone who requests a prescription for Latisse.  Many doctors may not and since there are many non-ophthalmologists prescribing Latisse (internists, OB/Gyn, etc, they wouldn’t know how to check for uveitis anyway), it may get missed.  However, I like to be careful
  • Skin irritation or redness
  • Macular edema – this is swelling of the retina of the eye.  Again, this can only be detected by an ophthalmologist or optometrist

 

How to Apply Latisse

The above is what you’ll find on the Latisse website, but I’ve made a little video to make it easier.  Sorry if I seem a bit serious in here, it’s weird talking to yourself in the bathroom.


So, I’m starting the Latisse challenge.  Yes, I know it’s not like a marathon challenge or anything really important, but still…For years, I’ve wanted to try Latisse.  Honolulu Eye Clinic was one of the first clinics in Hawaii to dispense Latisse, but because I was pregnant with my first son at the time, I was never able to try it (it is contraindicated in pregnant and nursing mothers).  But, I will no longer have lash envy of the other women in my office.  I’m going to start using Latisse and will post weekly pictures on the blog and you can follow along.

I almost forgot, right now we have a

Buy one box of Latisse, get one free

So, if you’ve ever wanted to try Latisse, hurry on over to Honolulu Eye Clinic, while supplies last.  Once we run out of the special, we still offer $25 off each box of Latisse.  Yes, Latisse is expensive – $125/ box full price.  But, unlike lash extensions, these are your own lashes and they never look artificial.  I’ve had many patients tell me that once they reach the length they desire, they are able to taper down to using Latisse a couple times a week instead of daily (again, this is not the FDA recommended use of the product).

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