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All posts by Marianas Eye Institute

Saipan Eye Clinic Combats Cataract Blindness in Africa

​Saipan Eye Clinic Combats Cataract Blindness in Africa

​Dr. David Khorram, Marianas Eye Institute’s co-founder, travelled on behalf of the Saipan eye clinic to Ghana, in Africa, to provide needed cataract surgery.  Dr. Khorram was accompanied by his 16 year-old son, Arman, who also participated as a volunteer in the project.  The duo were Global Impact Fellows with the non-profit organization, Unite for Sight, based out of New Haven, Connecticut.  Global Impact Fellows undergo extensive training on providing care in rural and under-served areas.  “The training was a refresher of sorts for me,” said Dr. Khorram, who has significant experience as a volunteer eye surgeon is such settings.  “However, it was all new for Arman, and it prepared him well for the time we spent in the villages in Ghana.”

​Large Scale Village Cataract Screening

​On the ground in Ghana, the Khorram’s were joined by three other volunteers, all university students, who had come to spend some weeks in Ghana as part of the Unite for Sight team.  The team members, accompanied by staff from the Crystal Eye Clinic in Accra, the capital of Ghana, traveled each day to outlying villages and conducted large scale community screening campaigns to identify those with vision problems.  In addition, the team members, including those from the Saipan eye clinic, gathered statistics to be used in research to improve care in the region.  They saw up to 200 patients per day.  “The screenings were done in partnership with local village organizations who announced days ahead of time that we were arriving,” Khorram explained.  “Because of the absence of hospitals and health centers, we used local schools or community centers to perform the exams.  The university volunteers and Arman checked vision, while those of us with medical training, conducted the formal eye exams.”

​Cataract Surgery in Ghana Different than Saipan​

​On some days while the team members were in the outlying villages, Dr. Khorram joined local ophthalmologists from the Crystal Eye Clinic to help clear the backlog of cataract surgery.  “There are a limited number of ophthalmologists in the country,” said Khorram.  “Not enough to serve the population.  So volunteer ophthalmologists are needed to perform cataract surgery.”  Dr. Khorram explained that while cataract surgery is the most common eye surgery performed on Saipan, the surgery is a much different technique than the one used in Ghana.  “At Marianas Eye Institute, we use the most advanced techniques for cataract surgery, which requires expensive high-tech equipment.  In most places in the world, this equipment is too expensive, so we use a technique that has been especially developed for these settings,” the Saipan eye clinic surgeon explained.

Cataract and Diabetes

​Cataract is the world’s leading cause of reversible blindness, affecting some 20 million people globally.  Cataracts are also the leading cause of vision loss in Saipan.  The World Health Organization has identified cataracts as a priority eye disease.  It is also a priority at Marianas Eye Institute.  Cataracts is a clouding of the natural lens inside the eye, which causes blurred vision.  It occurs most commonly with aging, and with diabetes.  “Because Marianas Eye Institute is the major center for treatment of diabetic eye disease on Saipan, we also treat a lot of cataracts.  Cataract surgery, with today’s modern technique of phacoemulsification, can be performed in under 20 minutes, and the same day, the patient can see again,” explained Russ Quinn, the Saipan eye clinic’s CEO.  Dr. Dennis WIlliams, a renown ophthalmologist who is listed in Best Eye Doctors in America, performs the high-tech cataract surgery on Saipan, while Dr. Khorram now spends most of his professional time as an international volunteer eye surgeon.

Marianas Eye Patients Contribute

“​The trip to Ghana was a truly memorable experience,” said Dr. Khorram.  “Like Saipan, the people were kind and appreciative, and full of laughter.  Arman and I felt right at home there,” he said.  Marianas Eye Institute continues to support efforts to combat blindness and suffering.  “While our priority for eye care will always be Saipan, Tinian, and Rota, we feel a responsibility to help those beyond the shores of the Mariana Islands,” said Quinn.  “It’s great to participate in these projects, and all everyone who is a patient at Marianas Eye Institute, helps make our support to the global fight against blindness possible, so we thank you all, ” he said.

Marianas Eye Institute is know as a regional leader in eye care, providing total eye care for the family, including express glasses, contact lenses, medical eye care, surgery and laser.  Marianas Eye Institute is staffed by Dr. Dennis Williams, who has been listed in “America’s Top Ophthalmologists,” and Dr. Mark Robertson, a magna cum laude graduate, along with eight other highly talented and nationally certified eye care technicians, opticians, and contact lens technicians.  Located on Beach Road in Garapan, across 13 Fishermen Monument, the Saipan eye clinic is open Monday through Saturday and accepts new patients as well as walk-ins.  Anyone interested in supporting the Saipan eye clinic’s global outreach program can call 235-9090.

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Saipan Eye Clinic Shines

Saipan Eye Clinic Shines with New Technology

Marianas Eye Institute, your Saipan eye clinic, in its ongoing commitment to bringing cutting edge technologies and the highest quality eye care to the region, has purchased the “best in class” Visucam 524 retinal camera made by the renown optics and engineering company Zeiss. The Visucam 524 allows for the highest quality of care in diabetes, glaucoma, and macular degeneration.

The Visucam 524 takes photos of the inner layers of the eye – the retina – which are affected by a broad range of diseases. “For years we have been the only clinic in the CNMI performing fluorescein angiograpy – a test that can record blood flow through the delicate blood vessels of the eye, which is particularly important in diabetic patients,” said Russ Quinn, the Saipan eye clinic’s CEO. “The Visucam 524 adds the additional capability of detecting early stages of macular degeneration and other retinal diseases though something called ‘auto fluorescence’, which is an important non-invasive tool in detecting and following diseased retina” he explained.

The Zeiss camera boasts a 24 mega-pixel sensor which produces brilliant detail-rich images to effectively aid in detecting and monitoring a broad range of retinal diseases. Training for the new camera was provided by Zeiss representative, Joanna Givens who traveled the Saipan eye clinic. She was impressed with the skill of the clinic staff, and commented that “the eye care technicians all took beautiful photos. They are well trained at getting just the right angles.”

Marianas Eye Institute’s Certified Ophthalmic Assistant, Thelma Tenorio, commented, “These images are amazing. You can really see so much more detail with this new camera. This will definitely help the doctors detect any problems early on.”

The Visucam 524 retinal camera sets a new standard with its ultra-high resolution images and superior clarity, which ensure that difficult to detect diseases can be identified by the doctors at Marianas Eye Institute. The camera comes with sophisticated software for processing and viewing the images. One of the most practical elements of the software is a feature that allows the doctors at this Saipan eye clinic to view the full images as an overview, and also to magnify portions in order to see the smallest details.

“Many years ago, Retinal Physician Magazine recognized Marianas Eye Institute as ‘one of the best-equipped eye clinics in the Asia-Pacific region’”, said Quinn. “We are committed to maintaining that standard so our patients know that they have access to the best in the region. This camera ensures that all the people of the CNMI, but particularly those with diabetes, glaucoma, and macular degeneration, will benefit from advances in the field.”

 

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Smartphone Blindness

A recent report of two women who temporarily lost sight in one eye after reading their smartphones while lying in bed shouldn’t cause alarm, experts say. But the incidents do point to the importance of using digital devices smartly to avoid eye strain.

The women lost vision for up to 20 minutes in one eye after reading their phones in the dark while lying in bed with the other eye covered by a pillow, researchers wrote in The New England Journal of Medicine.

Dr. Gordon Plant of Moorfield’s Eye Hospital in London told the Associated Press that the eye reading the phone was adapted to the light, while the covered eye was adapted to the dark. When the women put their phone down, they couldn’t see with their reading eye. “It’s taking many minutes to catch up to the other eye that’s adapted to the dark,” Plant said. People should look at their phones with both eyes, he advised.

The researchers called the condition “transient smartphone blindness.” They said that it is likely to become more common, because phone manufacturers are making brighter screens for easier reading.

Dr. Rahul Khurana, a spokesman for the American Academy of Ophthalmology, told Today he doesn’t consider this a serious problem. He noted it is not an official medical condition, and needs more study.

But there are steps you should take to protect your eyes when reading your phone. Staring at your phone can make your eyes feel dry and tired. You may develop fatigue, blurry vision or eye strain. That’s because people blink much less when using digital screen devices such as smartphones and computers.

When using a smartphone, computer or other digital device:

  • Use the “20-20-20” rule to avoid eye strain: Take a break every 20 minutes. Shift your eyes toward an object that’s at least 20 feet away. Look at the object for at least 20 seconds.
  • When your eyes feel dry, refresh them with artificial tears.
  • To make it easier for your eyes to see, adjust the lighting in your room so your screen is not much brighter than the surrounding light. Also try increasing the contrast on your screen.

(From the American Academy of Ophthalmology)

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Google DeepMind and Eye Disease Research

Google DeepMind is the promising Artificial Intelligence (AI) division of Google, and it’s first medical project is to help identify eye disease — specifically diabetic retinopathy and macular degeneration.  Diabetic retinopathy is the leading cause of blindness in Saipan and the CNMI.  Google is partnering with the world’s largest eye hospital, Moorfields, in the UK, in this pilot study.  You’ll recognize in this video, many of the same advanced technologies that we have at our Saipan eye clinic.  At Marianas Eye Institute, we track new developments as part of our efforts to continue to bring you the very best in eye care.

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The Sun, UV Radiation, and Your Eyes

With the intensity of the sun increasing during the summer months, we advise all our Saipan eye clinic patients to take extra protection.  We’re happy to share this article from the American Academy of Ophthalmology:

 

Eye specialists caution us that too much exposure to UV light raises the risks of eye diseases, including cataract, growths on the eye, and cancer. Strong exposure to snow reflection can also quickly cause painful damage called snow blindness.

Growths on the eye, such as pterygium, can show up in our teens or twenties, especially in surfers, skiers, fishermen, farmers, or anyone who spends long hours under the mid-day sun or in the UV-intense conditions found near rivers, oceans, and mountains.

Diseases like cataract and eye cancers can take many years to develop, but each time we’re out in the sun without protection we could be adding damage that adds to our risks for these serious disorders. Babies and kids need to wear hats and sunglasses for this very reason. People of all ages should take precautions whenever they are outdoors.

Follow these tips to protect your eyes from the sun all year long:

  • Sun damage to eyes can occur anytime during the year, not just in the summertime, so be sure to wear UV-blocking sunglasses and broad-brimmed hats whenever you’re outside.
  • Don’t be fooled by clouds: the sun’s rays can pass through haze and thin clouds.
  • Never look directly at the sun. Looking directly at the sun at any time, including during aneclipse, can lead to solar retinopathy, which is damage to the eye’s retina from solar radiation.
  • Don’t forget the kids and older family members: everyone is at risk, including children and senior citizens. Protect their eyes with hats and sunglasses.
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Prevent Fireworks Eye Injuries

With the Liberation Day festivities on Saipan and the Fourth of July just around the corner, it’s important to know how to keep your family’s eyes safe.  Nearly every year, our Saipan eye doctors are called to the hospital to deal with eye injuries from fireworks.  Be safe!

Fireworks safety tips

The American Academy of Ophthalmology advises that the best way to avoid a potentially blinding fireworks injury is by attending a professional public fireworks show rather than purchasing fireworks for home use.

For those who attend professional fireworks displays and/or live in communities surrounding the shows:

  • Respect safety barriers at fireworks shows and view fireworks from at least 500 feet away.
  • Do not touch unexploded fireworks; instead, immediately contact local fire or police departments to help.

For those who decide to purchase consumer fireworks because they live in states where they are legal, the Academy recommends the following safety tips to prevent eye injuries:

  • Never let young children play with fireworks of any type, even sparklers.
  • People who handle fireworks should always wear protective eyewear that meets the parameters set by the American National Standards Institute and ensure that all bystanders are also wearing eye protection.
  • Leave the lighting of professional-grade fireworks to trained pyrotechnicians.

What to do for a fireworks eye injury

If an eye injury from fireworks occurs, remember:

  • Seek medical attention immediately.
  • Do not rub your eyes.
  • Do not rinse your eyes.
  • Do not apply pressure.
  • Do not remove any objects that are stuck in the eye.
  • Do not apply ointments or take any blood-thinning pain medications such as aspirin or ibuprofen.
(From the American Academy of Ophthalmology)
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Smart Contact Lens for Glaucoma

When a patient gets glaucoma, it can be difficult to know whether the disease will progress slowly or advance quickly, taking vision with it. A smart “electronic” contact lens could help solve this problem.

A new study appearing in the journal Ophthalmology this April shows that electronic signals from a such smart contact lens can be used to predict which glaucoma patients may have a faster advancing version of the disease.

“This could be very useful if you want to know whether a new medication is working for a patient,” said study author C. Gustavo De Moraes, M.D., MPH, an associate professor of ophthalmology at Columbia University Medical Center.  “You can see how their eye is reacting to the therapy in a much more meaningful way.”

(Although the technology is not readily available, our Saipan eye clinic continues to monitor new developments with the lens.)

Why eye pressure matters in glaucoma

Glaucoma is a leading cause of blindness in the United States and affects nearly 3 million people. Pressure inside the eye, or intraocular pressure (IOP), is the only known controllable risk factor for glaucoma.

Patients with glaucoma should get their eye pressure measured at an ophthalmologists office regularly.  But what happens to their eye pressure in between visits or at night remains somewhat of a mystery, one that could help unravel more about this vision-stealing disease. To help record eye pressure over time, scientists created a smart contact lens that can indirectly measure intraocular pressure continuously.

How it works

A sensor in the lens detects when the curvature changes. As eye pressure fluctuates throughout the day and night, the curve of the lens changes, generating an electrical signal sent to a wireless device that records the signals. Similar to how an electrocardiogram shows a heartbeat, the profile of signals from the smart lens indirectly shows eye pressure changes over time.

Researchers at Columbia tested the Sensimed Triggerfish® lenses on 40 patients between ages 40 and 89 undergoing treatment for open-angle glaucoma, the most common form of the disease. Over two years, scientists performed at least eight standard visual field tests on these patients. Half were classified as having slow disease progression while the other 20 had fast disease progression.

Then patients wore the smart contact lens for 24 hours, including overnight as they slept. Investigators found that patients with steeper spikes recorded overnight and a greater number of peaks in their signal profile overall tended to have faster glaucoma progression.

Using this tool, ophthalmologists may one day be able to more accurately gauge whether a patient’s glaucoma will progress quickly by looking at a readout from the smart lens.

(Adapted from the American Academy of Ophthalmology)

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Cure for Age Related Macular Degeneration?

A new clinical trial is underway to find a cure for one of the most devastating causes of blindness, Age-Related Macular Degeneration (or “AMD”).  Scientists are implanting cells behind the retina in an attempt to regenerate the layer of cells that is damaged by AMD.  If successful, the treatment could lead to cure for millions of people.  Our Saipan eye clinic will be watching these and other new developments, to bring you the best in eye care.  Read about this new frontier in AMD treatment here.

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Zika Virus and the Eye

Although Zika virus has not been identified in Saipan, it may be only a matter of time.  We do have the mosquito, and recent reports have shown the virus in the western Pacific.  Recently, a study in Brazil showed that 10 of 29 infants who had been infected with Zika virus showed signs of severe eye damage.  In this day and age of international travel, infections in one part of the world can quickly and quietly be introduced into new areas.  The doctors at Marianas Eye Institute continue to be alert to the possibility of Zika virus entering the CNMI.

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Marianas Eye Institute Makes News for Discovery of Eye Disease Gene

We’re pleased to have news of our discovery published in the Marianas Variety.  Here is the full story below.

 

Local Eye Clinic Discovers Gene for Saipan Eye Disease

The doctors at Marianas Eye Institute, in collaboration with U.S. researches, have discovered a new gene that is the cause of an eye disease that affects families on Saipan.

 

The results of their research was recently published in the scientific journal, Molecular Vision. The article by the team that made the discovery is titled, “Novel TMEM98 mutations in pedigrees with autosomal dominant nanophthalmos.”

 

Dr. David Khorram, the co-founder and prior ophthalmologist at Marianas Eye Institute, initiated the research over 20 years ago, when he noticed an eye disease affecting members of the same Saipan families. “It made sense that there would be a genetic basis for the disease because so many people in the family were affected,” explained Dr. Khorram, “So, with the permission of the family members, we collected blood samples and sent them to the premier genetic eye research center in the U.S.”

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