Summertime means more time spent outdoors, and studies show that exposure to bright sunlight may increase the risk of developing cataracts, age-related macular degeneration (AMD) and growths on the eye, including cancer.*

This June, UNC Eye joins the American Academy of Ophthalmology (AA0) in observing UV (ultraviolet light) Safety Awareness Month. Through its EyeSmart™ campaign, the AAO wants to remind Americans of the importance of protecting their eyes from the sun's harmful rays by wearing proper protection.  We also want to remind you of the importance of protecting eyes from indoor UV light when using tanning beds.

The AAO offers these tips to protect your eyes from the sun:

During UV Safety Month, remember to schedule your eye exam appointment with a UNC Eye MD by calling 919-966-5509.

* Source: American Academy of Ophthalmology

Click here to access the UNC Eye Living with Low Vision Resource Guide

Bob Baillie, founder of MIRA USA, and several members of his staff visited Dr. Amy Fowler and UNC Eye staff at Chapel Hill North recently.  MIRA USA is an Aberdeen, NC-based organization which is the only one in the United States whose mission is to provide guide dogs to children between the ages of 11 and 17.   Mr. Baillie founded MIRA USA in 2008 after losing his sight as a result of complications from coronary bypass surgery.

Bob Baillie (left), Eric St. Pierre (center), and MIRA USA Staff arrive at Chapel Hill North

After appearing on several local Triangle television news outlets to spread the word about the need for young people who are without sight to have the opportunity to have guide dogs and the work of MIRA USA, Mr. Baillie brought about 10 of his most recently completely trained guide dogs to UNC Eye at Chapel Hill North.  He and his team, led by MIRA head trainer Eric St. Pierre, conducted demonstrations on what it's like to be without sight and rely on a guide dog to do everyday things that many people take for granted, such as walk down the sidewalk in a busy shopping center.

Dr. Amy Fowler, First-Year UNC Eye Resident Dr. Drew Hunter, and UNC Eye Fellow Dr. Lyndon Lee, along with several other staff members participated by walking blindfolded with a trained guide dog along the crowded walkway outside the UNC Eye office at Chapel Hill North, under the watchful supervision of the MIRA staff.  All of the participants marveled at the sophisticated level of training the guide dogs received and what a unique experience it was to rely on them for help in navigating their way.

MIRA USA Founder Bob Baillie chats with Dr. Amy Fowler

"Wow! What an experience to just trust this dog," Dr. Fowler said after taking a 100 yard walk down the sidewalk at Chapel Hill North, while blindfolded and led by Fiona, the guide dog that MIRA USA provided for the demonstration.  An additional 8 children were introduced to their guide dogs for the first time in a ceremony in Pinehurst, NC on March 17th.  For more information on MIRA USA, visit www.mirausa.org.

Dr. Amy Fowler and two MIRA USA seeing eye dogs

Dr. Lyndon Lee receives instruction from MIRA USA trainer

Click here to hear Eric St. Pierre talk about his experiences in training seeing eye dogs.

As UNC Eye continues to follow the American Academy of Ophthalmology (AAO) Calendar of Monthly Observances, March is designated as Age-Related Macular Degeneration Awareness & Low Vision Awareness Month.

According to the AAO:

Age-related macular degeneration (AMD) is a deterioration or breakdown of the eye's macula. The macula is a small area in the retina — the light-sensitive tissue lining the back of the eye. The macula is the part of the retina that is responsible for your central vision, allowing you to see fine details clearly.

Click here to learn more about AMD from the American Academy of Opthalmology.

The following UNC Eye MDs specialize in treating AMD:

• Sai H. Chavala, MD
• Odette M. Houghton, MD
• Travis A. Meredith, MD
• J. Niklas Ulrich, MD

To schedule an appointment with any UNC Eye MD, please call 919-966-5509.

The American Academy of Ophthalmology (AAO) recommends an eye disease screening for all adults as they age.

The Academy now recommends that adults with no signs or risk factors for eye disease get a baseline eye disease screening at age 40 — the time when early signs of disease and changes in vision may start to occur.

Based on the results of the initial screening, an ophthalmologist will prescribe the necessary intervals for follow-up exams.

Don't miss out on reading, driving, and watching children and grandchildren grow.  During Healthy Vision Month, remember to schedule your eye exam appointment with a UNC Eye MD by calling 919-966-5509.

Share these important tips from the AAO's www.geteyesmart.org website with your friends and loved ones.

Vision is our most precious sense. Protect your sight by getting regular eye exams with an ophthalmologist.

Media contact: Tom Hughes, (919) 966-6047, tahughes@unch.unc.edu

Thursday, May 9, 2013

CHAPEL HILL, N.C. – A large new study finds that taking omega-3 fatty acid supplements has no effect on slowing the progression of age-related macular degeneration (AMD).

However, for people with low levels of lutein or zeaxanthin in their diets, supplementation with lutein and zeaxanthin may slow the progression of AMD, the study found.

Four researchers in the Department of Ophthalmology in the University of North Carolina School of Medicine contributed to the Age-related Eye Disease Study (AREDS) 2. Results from AREDS 2 were published online May 5 in the Journal of the American Medical Association.

“Many patients ask whether they should be taking lutein and omega-3 fatty acids for their age-related macular degeneration (AMD),” said Odette Houghton, MD, associate professor and one of the UNC researchers. The others were Seema Garg, MD, PhD, Maurice B. Landers III, MD and Travis M. Meredith, MD, chair emeritus of the Department of Ophthalmology.

“The AREDS 2 results indicate that if you have low levels of lutein or zeaxanthin in your diet, or if you take the original AREDS vitamins without beta-carotene, then supplementation with lutein and zeaxanthin may slow the progression of AMD. However, omega-3 fatty acids appear to have no beneficial or harmful effect on AMD,” Houghton said.

The AREDS2 study  suggests that lutein and zeaxanthine are safer alternatives to beta-carotene in those people who have a history of smoking. There was a higher incidence of lung cancer in participants that had a history of smoking and who took AREDS supplements with beta-carotene.

“We have no control over some of the major risk factors for the advancement of AMD, such as age and family history,” Houghton said. “Regular dilated eye exams, avoidance of smoking and taking AREDS2 supplements when indicated are ways we may be able to reduce the risk of blindness from AMD.”

However, the AREDS supplements have only been shown to be effective in people who already have an intermediate stage of AMD. These supplements do not benefit people who have no AMD or mild AMD. A dilated eye exam by an eye care provider is the only way to detect AMD, Houghton said.

The American Academy of Ophthalmology recommends that adults get a baseline eye disease screening at age 40. The necessary interval for follow-up exams can be based on the results of this screening. Everyone age 65 and over should have complete eye exams every one to two years.

UNC Eye Department Chair Donald Budenz, MD, MPH, was one of only ten Johns Hopkins Bloomberg School of Public Health alumni selected to the Alpha Chapter of Delta Omega, the most prestigious society in Public Health.

"Dr. Budenz has been a leader in the fields of glaucoma and public health and it is terrific that he has been chosen to receive this well deserved honor by his peers in the public health community" said Kuldev Singh, MD, MPH, Professor of Ophthalmolgy, Director of the Glaucoma Service at Stanford University and current President of the American Glaucoma Society.

Budenz, who graduated with his MPH from Johns Hopkins in 2004, was nominated and selected for his ongoing contributions to research in ophthalmology, including the medical testing of glaucoma, epidemiology of eye disease in West Africa, and clinical trial leadership.

Since the establishment at Johns Hopkins of the Alpha Chapter, the Society has expanded nationally to 59 local chapters with about 6,000 members, including the Theta Chapter at UNC Chapel Hill's Gillings School of Public Health.

Dr. Budenz and his research group worked for 2-1/2 years in Tema, Ghana, West Africa, where they performed eye examinations with ancillary testing and photography on over 5,600 randomly selected adults age 40 and over. They found the highest prevalence of glaucoma in the world (6.8%) and a startlingly high prevalence of blindness and visual disability in this group.

Glaucoma is the leading cause of irreversible blindness worldwide, but it is preventable if identified early enough. The study will be used to heighten awareness of the glaucoma problem in people of African descent and to direct resources to glaucoma screening and treatment in Africa.

The studies, entitled "Tema Eye Survey" and "Tema Glaucoma Prevalence," were published in the top two clinical ophthalmology journals, Ophthalmology and JAMA Ophthalmology, respectively.

In reference to the Tema Eye Survey, Jeffrey Liebmann, MD, the immediate past president of the American Glaucoma Society said, "Hopefully this study will cause other organizations to focus resources on this difficult problem."

Dr. Budenz recently returned to Chapel Hill from his most recent annual trip to Ghana, where he and his team continued their glaucoma research and performed eye examinations.

Click here to read more about Dr. Ulrich from the UNC Health Care and School of Medicine Newsroom.

The UNC Department of Ophthalmology will celebrate Residents' Research Day on June 15th, 2013 in the UNC Lineberger Building - Joseph S. Pagano Conference Room (450 West Drive; Chapel Hill, NC 27514).  The Annual Research Day presentations will feature 15-minute presentations of research performed by UNC Eye Ophthalmology residents and fellows, along with a Visiting Professor lecture and a Distinguished Alumnus lecture.

For additional information, contact Chris Postlethwait via email or via phone at 919.843.0264.

The Visiting Faculty will be:

• S. Dace McPherson, Jr. Memorial Lecturer: D. Rex Hamilton, MD, MS, FACS of Jules Stein Eye Institute, University of California at Los Angeles, keynote address: "Advanced Corneal Tomography and Biomechanics"
• Distinguished Alumnus Lecturer: Evan H. Black, MD, FACS, UNC Eye Class of 1998

Click here for directions.

Click here to view a printable Schedule of Events.

A UNC Eye researcher is finding ways to reduce vision loss from Diabetic Retinopathy by taking advantage of advances in telemedicine.  The March 2013 edition of Retinal Physician magazine features an article by UNC Eye MD Seema Garg about her research on how the use of telemedicine can help treat Diabetic Retinopathy.

Per the article:

Telemedicine for Diabetic Retinopathy evaluation "establishes a logical partnership between primary care physicians and retina specialists by facilitating the identification of patients who are at high risk of vision loss from diabetes and who may not seek the recommended annual evaluation by an ophthalmologist... This could make a major public health contribution by ultimately reducing barriers to care and preventing vision-threating DR."

Click here to read the article.

To schedule an appointment with Dr. Garg or any of our UNC Eye MD's, please call 919-966-5509.

Click here to view the Program Agenda.

Keynote speakers were:

• S. Dace MacPherson, Jr. Memorial Lecturer: D. Rex Hamilton, MD, MS, FACS
• David E. Eifrig Distinguished Alumnus Lecturer: Evan H. Black, MD, FACS (UNC Eye Class of 1998)

UNC Eye Chairman Donald L. Budenz, MD, MPH said, “Thanks to the hard work of the residents and fellows and our two visiting professors, Drs. Hamilton and Black, I heard from faculty and alumni that this was the best UNC Residents' Day ever.”

Please enjoy the following photos from the Residents' & Fellows' Research Day Lectures and Dinner:

UNC Eye hosted the 2013 Spring Symposium on Saturday, April 13th at the Rizzo Conference Center in Chapel Hill.  Visiting Professors and UNC Faculty presented the latest in the areas of:

• Retina
• Glaucoma
• Cornea
• Neuro-ophthalmology
• Pediatrics
• Plastics

Participants were able to claim 8.5 AMA PRA Category 1 Continuing Medical Education credit(s).

Featured speakers included Visiting Professors:

John G. Clarkson, MD - Keynote Speaker

American Board of Ophthalmology

University of Miami Miller School of Medicine

Bascom Palmer Eye Institute

Eduardo Alfonso, MD

University of Miami Miller School of Medicine

Bascom Palmer Eye Institute

Oscar A. Cruz, MD

St. Louis University School of Medicine

St. Louis University Eye Institute

Steven E. Feldon, MD, MBA

University of Rochester School of Medicine & Dentistry

Flaum Eye Institute

Philip J. Rosenfeld, MD, PhD

University of Miami Miller School of Medicine

Bascom Palmer Eye Institute

M. Bruce Shields, MD

Yale University School of Medicine

Yale Eye Center

Craig M. Greven, MD

Wake Forest University

Wake Forest University Eye Center

Douglas J. Rhee

Associate Professor of Ophthalmology

Harvard Medical School

Symposium participants are invited to provide UNC Eye with feedback on the symposium by clicking here and completing the survey provided.

UNC Eye recently hosted the first-ever Tri-Residency Cataract Course, in which faculty and residents from The University of North Carolina at Chapel Hill, Duke University, and Wake Forest University gathered together for lectures and case discussions about cataract treatments.  Faculty from each institution gave lectures on cataract surgery and then residents had the opportuthnity to practice under supervision in the newly opened NC Eye Bank Surgical Skills Lab at UNC.

UNC Eye Department Chair Donald L. Budenz, MD, MPH said, "The ability to teach microsurgery to residents in a state-of-the-art laboratory is a huge advance in residency training. In addition to weekly training in cataract surgery, we will be holding courses in every subspecialty monthly to teach surgical techniques to treat glaucoma, corneal disease, retinal disease, oculoplastics, and strabismus surgery. This will be excellent preparation for our trainees before they begin operating on real patients."

Dr. Budenz continued, "In addition, we are in the process of organizing weekend training courses in the implantation of newly approved implants for the management of glaucoma. These courses will be open to practicing ophthalmologists who may not have received training in the implantation of devices that were not available when they did their residency training."

First-year resident Bradley King, MD

Residents and Fellows in Surgical Skills Lab

The cross-University participation was greatly appreciated.  UNC Eye Professor Kenneth L. Cohen, MD said, "To me, the exciting part of our first phacoemulsification training course was the educational experience received by ophthalmology residents from not only UNC, but Duke and Wake Forest. As state-of-the art as our facility is, our successful course could not have happened without expert participation by faculty from Duke and Wake Forest, vendors, teaching by our very own third year residents, and support from our department."

Dr. Cohen provides instruction and leadership

UNC Eye Residents were very excited to have this new resource at their disposal.  Chief Resident, Kevin Gertsch said, "The Surgical Skills Lab is an amazing new addition to our residency program. This first-class facility demonstrates the clear focus on education at UNC.  The Surgical Skills Lab allows us to master the skills necessary to become excellent surgeons. Residents can learn and be observed through monitors at individual stations to provide one-on-one instruction.  This training is invaluable for both the residents and their patients enabling residents to become proficient and confident with procedures prior to going to the operating room.  We currently have access to the lab for both large group instruction as well as individual practice time. This allows for a variety of learning opportunities."

Dr. Gertsch continued, "We have weekly lab time to work on surgical procedures of our choice and monthly conferences with faculty members teaching specific procedures in the various subspecialties within ophthalmology.  We have the chance to practice techniques required for corneal transplants, glaucoma procedures, eye muscle surgery, complicated anterior segment procedures and even practice retinal lasers.  The facility has more than enough room and stations for our entire residency program to practice at the same time.  We have enjoyed sharing the facility with our colleagues in Otolaryngology and Neurosurgery as we all benefit from the available technology and training resources.

Our recent tri-residency cataract course was a success for all who attended.  Residents from UNC, Duke, and Wake Forest were able to be instructed by faculty from all three residency programs and then put the new principles learned into action in the wet lab.  Using pig eyes and artificial eyes from the KITARO wet lab system, first year residents practiced the multiple steps of cataract surgery under the supervision of faculty experts and upper-level residents.

Chief Resident Kevin Gertsch, MD, first-year Resident Rob van der Vaart, MD, and second-year Resident Adam Dao, MD instruct fourth-year medical student Ronald Milam

The cataract course for first-year residents reflects the strong tradition at UNC to begin learning surgical skills early in residency training to encourage a more in-depth and comprehensive understanding of the principles of ophthalmic surgery.  We plan to hold similar courses in the future and hope expand to invite upper-level residents from all three NC programs to participate as well.  We also hope that the new lab will be a center for education for other surgeons in the community."

Second-year UNC Eye Resident, Adam Dao, MD was somewhat surprised by his experience during the course, saying, "The UNC Cataract Course was the most educational, efficient, and dare I say it, fun(!) educational activity that I have had since I have been an ophthalmology resident. It was great to get formal instruction and feedback from faculty from a myriad of institutions. It was also nice to meet other residents from other programs and to share (and commiserate about) our experiences in learning cataract surgery. The course was as professional and high caliber as the new North Carolina Eye Bank surgical skills laboratory."

Third-year UNC Eye Resident, Jim Wrzosek found the course extremely valuable, stating, "Overall, being able to first see lectures from experienced faculty on basic phaco techniques followed by an immediate opportunity to practice those techniques under the supervision of the faculty and advanced residents showcased the one of the main strengths of both the training course and the new practice lab.  The availability of top end phaco equipment from AMO and the new cataract simulation equipment from Kitaro also helped make the course valuable for the residents."

For more information on the North Carolina Eye Bank Surgical Skills Lab at UNC, please contact lab manager Matt Pillsbury at matthew_pillsbury@med.unc.edu.

Chief Resident Kevin Gertsch, MD provides instruction

UNC Eye faculty member Seema Garg, MD, PhD recently spoke about the importance of the North Carolina Area Health Education Centers (AHEC) Program in a feature on the University of North Carolina at Chapel Hill main website.

Dr. Garg is a retina specialist who has been flying via AHEC’s Medical Air Operations to a retina clinic in New Bern for the past eight years. She is also pioneering a statewide telemedicine program for diabetic retinopathy evaluation by working with the Mountain, Eastern, Southern Regional and Greensboro AHEC primary care residency programs.

Here are a few highlights of Dr. Garg's conversation:

Why do you do what you do through AHEC?

Garg: AHEC helps me reach the UNC Department of Ophthalmology’s retinal clinic in New Bern, N.C., via AHEC’s Medical Air Operations. In addition, the infrastructure of the AHEC sites across the state facilitates our medical services to patients we wouldn’t normally be able to help, for instance, through telemedicine.

How have you influenced people through AHEC and what influence do you hope to have in the future?

Garg: Diabetes-related retinopathy is the leading cause of blindness in North Carolina, and this promising new collaboration we’re working on with AHEC will greatly benefit patients who may have poor access to sub-specialty eye care geographically and financially.

The North Carolina Area Health Education Centers (AHEC) Program, based at Carolina, sends out hundreds of faculty members to towns across the state to teach, to care for patients and to look for ways to improve how each center serves the local community. Nine regional centers serve all 100 counties in North Carolina.

To read our latest Newsletter, click here.  Topics include:

• Chairman's Corner - Donald Budenz, MD, MPH
• 25 Year Faculty Member
• Meet Our First Resident
• 2012 Spring Symposium
• Intermediate Historical Perspective - David Chesnutt, MD
• New Optical Shop Manager
• Dutton Appointed Spinoza Chair
• 2013 CME Calendar
• Resident & Fellow Update

Since 1990, the donations and commitment of North Carolina Lions and Lions Clubs International have helped UNC Eye improve vision to the visually impaired children, youth, and adults of North Carolina and others whom we serve.

Press "play" on the video below to learn more:

Thanks to our relationship with this generous service organization, Michelle Cabrera, MD and J. Niklas Ulrich, MD are training two visiting ophthalmologists from China to treat Retinopathy of Prematurity (ROP), a disease that renders many children in their homeland blind, with no qualified individuals or means to treat the condition.

UNC Eye is also providing a more comfortable patient experience by using the Electroretinogram (ERG) machine, donated by NC Lions, to evaluate the function of the retina.

Jennifer Williamson (UNC School of Medicine Class of 2013), a medical student and future resident (starting in July 2014) working on a rotation with UNC Eye MD Dr. Sai Chavala, recently had an article published in the The Lancet, one of the most prestigious journals in all of medicine.  Click here to read the article.

Said Sai Chavala and Jennifer Williamson, "We are delighted that The Lancet has chosen to publish these clinical images.  Sturge-Weber syndrome is a disorder that requires multidisciplinary care, and awareness of its ocular complications, including retinal detachments, by multiple specialties is necessary to prevent vision loss.  We hope that these images will help readers make the association between the “port wine” stain of Sturge-Weber syndrome and its ocular manifestations in order to re-emphasize the importance of ocular exams in these patients."

For more information on Sturge-Weber syndrome, please visit the Sturge-Weber foundation website or call 919-966-5509 to schedule an appointment with Dr. Chavala.