Tips In Choosing The Best Eye Doctor Encino Patients Should Consider

By Imelda Reid

Choosing an eye care expert is an essential health care decision. From eye exams to corneal scratches, to Lasik surgery, there are hosts of reasons that you may be looking for an eye doctor. In any case, you will be trusting the specialist to protect your precious sense of sight as well as help you in maintaining a lifetime of good vision. You will therefore want a doctor whose qualifications match your desires. When searching for an eye doctor Encino people must understand that there are two kinds of eye doctors, ophthalmologists and optometrists.

Ophthalmologists are medical doctors or osteopathic doctors who specialize in eye and vision care. They are trained to carry out eye exams, diagnose as well as treat disease, recommend medications and execute eye surgery. Also, they write prescriptions for contact lenses and eyeglasses. They have gone through medical school, internship, and residency.

Nevertheless, an optometrist has concluded four years of dedicated training subsequent to an undergraduate study. The doctor might give many indispensable eye care services for example eye exams and diagnosis of some eye diseases. An optometrist may partake pre- as well as post-operative care for those who have eye surgery done by ophthalmologists.

You should also note that there is another group, which is the opticians. These however are not experts but are important to the eye care team. Opticians use prescriptions given by an optometrist or an ophthalmologist to fit and offer contact lenses, eyeglasses including other eye wear. A lot of people mistake them to be professionals in eye problems and once they visit them they forget about seeking more help.

In some states, opticians must be licensed and have finished an opticianry training course. However, some states do not make it a must for these care providers to have licensure or formal training. Some countries even allow opticians to fit contact lenses, usually after completing a certification program. However, you can get names of good eye care experts from opticians to obtain the right treatment.

Determining the kind of specialist you need prior to visiting any facility is important. You could be having something serious and if you go to opticians, you will only get eye drops. This will not solve your problem but might end up making things worse for you. Ensure that the person you go to has knowledge about eye issues to be able to get the correct treatment.

Researching the doctor's credentials is important to be sure that you are leaving an important part of your body in the right hands. One should also try to find out which schools the expert went to, where he did his residency, area of expertise and if he is certified by the relevant body. Knowing all these will provide one with peace of mind.

After establishing that the specialist meets your needs, is well qualified for the type of care you require and is highly regarded, check to see if he is located near your office or home. This is essential, as you should not spend a lot of time trying to get quality care.

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Stem Cells in Ophthalmology Update 9 First Patients Treated

As I reported back on June 16th, Advanced Cell Technology had enrolled the first two patients in its Phase I/II clinical trials using retinal pigment epithelial (RPE) cells derived from embryonic stem cells (hESCs) for treating Stargardt’s Macular Dystrophy (SMD) and for the treatment of the dry form of age-related macular degeneration (Dry AMD). The company announced today that these first patients had now successfully received their first dose of the stem cells.

(Editors note: Please also see the addendum attached at the end of this piece.)

Here is the announcement:

ACT Announces First Patients Undergo Embryonic Stem Cell Transplantation Treatment for Stargardt's Disease and Macular Degeneration at UCLA's Jules Stein Eye Institute


MARLBOROUGH, Mass., July 14, 2011 /PRNewswire/ -- Advanced Cell Technology, Inc., today announced the dosing of the first patients in each of its two Phase 1/2 clinical trials for Stargardt's macular dystrophy and dry age-related macular degeneration (dry AMD) using retinal pigment epithelial (RPE) cells derived from human embryonic stem cells (hESCs). The patients were treated Tuesday (July 12) by Steven Schwartz, M.D., Ahmanson Professor of Ophthalmology at the David Geffen School of Medicine at UCLA and retina division chief at UCLA's Jules Stein Eye Institute. Robert Lanza, M.D., chief scientific officer of ACT, attended the procedures. Both patients successfully underwent the outpatient transplantation surgeries and are recovering uneventfully.

Both the Stargardt's trial and the dry AMD trial will enroll 12 patients each, with cohorts of three patients each in an ascending dosage format. Both trials are prospective, open-label studies designed to determine the safety and tolerability of hESC-derived RPE cells following sub-retinal transplantation into patients with Stargardt's and dry AMD at 12 months, the studies' primary endpoint.

"This first treatment milestone is welcomed by scientists, stem cell advocates and patients hoping for cures," said Gary Rabin, interim chairman and chief executive officer of ACT. "The two trials could not have started any smoother, and we are very pleased to announce that the procedures went well. The dosing of the first patients represents an important milestone for ACT and opens the doors to a potentially significant new therapeutic approach to treating the many forms of macular degeneration. We believe that these procedures represent a key step forward in therapeutic stem cell research, and the capacity to treat a variety of devastating diseases."

Dr. Schwartz, the studies' principal investigator, explained, "One patient in each clinical trial, the Stargardt's trial and the dry AMD trial, has undergone surgical transplantation of a relatively small dose (50,000 cells) of fully-differentiated retinal pigment epithelial (RPE) cells derived from human embryonic stem cells. Early indications are that the patients tolerated the surgical procedures well. The primary objective of these Phase 1/2 studies is to assess the safety and tolerability of these stem cell-derived transplants. We will be carefully monitoring our patients over the course of the trials. We are privileged to be collaborating with ACT and honored to be working with these pioneering patients."

Dry AMD, the most common form of macular degeneration, Stargardt's and other forms of atrophy-related macular degeneration are usually untreatable. Safe and effective therapies are greatly needed for the treatment of these common forms of blindness. Disease progression of both Stargardt's and dry AMD includes thinning of the layer of RPE cells in the patient's macula, the central portion of the retina and the anatomic location of central vision. With RPE cell death comes the loss of macular photoreceptors and loss of central vision. Currently both conditions are untreatable and often lead to legal blindness over a multi-year course. ACT's Stargardt's and dry AMD therapies treat these conditions by transplanting RPE cells in the patient's eyes before the RPE population is lost.

"Today -13 years after the discovery of human embryonic stem cells - the great promise of these cells is finally being put to the test," said Dr. Lanza. "The initiation of these two clinical trials marks an important turning point for the field.  While we will continue writing research papers and carrying out more research, it's time to start moving these exciting new stem cell therapies out of the laboratory and into the clinic.  Tens of thousands of people continue to die every day from diseases that could potentially be treated using stem cells. In the meantime, we intend to accelerate our efforts to translate new embryonic stem cell (ES) and induced pluripotent stem (iPS) cell therapies into the clinic. It has taken years of extensive research to get to this point. Our research and preclinical studies have demonstrated the safety and effectiveness of such therapies.  We hope these cells may provide a treatment option not only for degenerative eye diseases, but for a wide spectrum of other debilitating conditions, ranging from diabetes to vascular and autoimmune diseases. Our team remains committed to moving the field of regenerative medicine forward from bench to bedside."


Addendum: Along with the news from the company and UCLA shown in the press release above, the Los Angeles Times covered the story and presented some interesting additional information. I have attached the LA Times writeup as an addendum to this piece.


Stem cell clinical trials to treat eye diseases begin at UCLA

By Daniela Hernandez,
Los Angeles Times/For the Booster Shots blog
July 14, 2011, 2:01 p.m.

After more than 20 years of research, doctors at UCLA's Jules Stein Eye Institute have begun treating the first patients in clinical trials for two progressive eye diseases that cause blindness: dry age-related macular degeration and Stargardt's macular dystrophy.

The patients were given an injection of specialized eye cells that were derived from embryonic stem cells. Dr. Steven Schwartz, who is leading the trial at UCLA, performed both stem cell transplant surgeries Tuesday. The two patients are said to be recovering without complications.

According to Dr. Robert Lanza, chief scientific officer at Advanced Cell Technologies Inc., which developed the cells and is sponsoring the trials, "you could feel the excitement in the air and that history was being made."

Surgery began for the first of two patients, a 77-year old woman with dry macular degeneration, around 9:30 a.m. Tuesday and took about half an hour. In the afternoon, a 27-year old woman with Stardgart's macular dystrophy underwent the same procedure. Both patients are legally blind.

Doctors will monitor these two patients over the coming weeks. Another set of surgeries is scheduled to start in August.

Schwartz explained how these trials will help patients and what they mean for regenerative medicine. His comments were edited for space and clarity.

What are dry age-related macular degeneration and Stargardt's macular dystrophy?

Twenty percent of age-related macular degeneration is wet macular degeneration and it is treatable.  The other 80% of people have an untreatable, progressive visual loss leading to legal blindness called dry, or atrophic, macular degeneration.

The retinal cells, the rods and cones, and the underlying retinal pigment epithelium atrophy. As they atrophy, there is a long period of time when they are compromised and then they're gone.

Stargardt's is a genetic disorder and it strikes earlier in life. Patients start to notice visual changes as early as their teens and as late as their forties. There are a number of known genetic abnormalities in the photoreceptors that are toxic over time.

In this trial, what cells in the eye are you replacing with stem cells?
Advanced Cell Technologies Inc. has been able to take [embryonic] stem cells and differentiate them into highly functional retinal pigment epithelium that do everything they're supposed to do. Our strategy of giving the eye brand-new, ready-to-go retinal pigment epithelium is designed for areas that are compromised, not for the areas that are gone. So we need to catch it early enough for this treatment to work.

Will the patients regain vision?

The patients' central vision is already gone. Not rescuable. So the patients we're enrolling in this trial know they will not be getting their central vision back.

If not to restore vision, what is the goal?
This is a safety trial. It's not designed to improve vision. It may; and if we see a signal, that would be great news and we're hoping we will. It's plausible biologically, but that's not what we're looking for.

What results are you hoping to see?

I hope what happens is that we find this is safe and that we can optimize the dosing, and that allows us to move into eyes that are earlier in disease. That could have a real visual upside.

How long is the surgery?

Under an hour. It's an outpatient procedure done with local anesthesia. It's a surgery that we've done before - not with the injection of these stem cells, but we've accessed the eye before, and that's one of the things that I've had a lot to do with surgically.

What does this trial mean for medicine?

We're super-privileged to be taking this first step. It's the unknown. These patients are doing a service for mankind. It's inspirational.

Ebola Patients in Lagos State Quarantine Centre Neglected

Family members and relatives of the Ebola patients that have been isolated at the Infectious Disease Hospital (IDH), Yaba, have cried out to the Nigerian government to make provision for better health care services for their loved ones.

In a report published by PUNCH, families and associates spoke of the squalor and neglect the admitted patients are undergoing, at a press conference held two days ago in Ikoyi.

Dr. Helen Boyo-Ekwueme, a pathologist, described the utter neglect the quarantined (one a member of her family) are dealing with. “They are just being left on their own. Nobody is counseling them. They are just there as if
they have been forgotten. We should remember that they didn’t ask to contract Ebola and it can happen to anybody," she said.

Dismissing blame placed on the government, she asserted that the press conference was not designed to criticize the government more so than to raise awareness about the conditions. "We are simply giving voice to the voiceless. Those people in isolation at the IDH cannot voice out these concerns," she said. "Let them have basic treatment. It shouldn’t be as if we just stood there and abandon them and watch them die one by one."

A spokesman for the group, medical practioner Dr. Ladi Okuboyejo, furthered these claims, and criticized medical staff who abandoned their duties despite the disaster. “If a health facility doesn’t have light, doesn’t have water and the sanitary system is not working properly then we have got a problem. Now the patients are critically ill and their condition is getting worse by day. People, including some medical personnel, are now running away from them. The disease is beyond our capacity to handle in this country," he urged.

Shocking claims were also made concerning the purchase of medical equipment at the facility. Due to the ongoing strike of the Nigeria Medical association, and lacking aid, an American doctor had been personally footing the bill, a family member alleged. “Where is the $12m the Federal Government said it released to fight Ebola?" the family member challenged.

More so, the lack of experienced medical staff and basic immune boosters make matters far worse at the IDH. “There is a need for more medical personnel that will help look after them. Certain immune booster could also have been easily given to them. We are just concerned family members. But from what we have seen we think more can be done to help them,” another source said.

When contacted by PUNCH, the Lagos State Commissioner for Health, Dr. Jide Idris, was unavailable for comment. SOURCE: PUNCH

How The Tdcs Process Works And Its Many Merits To Patients

By Della Monroe

The transcranial direct stimulation therapy is a process that has been used to treat patients with brain injuries like stroke. This therapy is quite simple and can be carried out at a health unit or even the home of a patient. It involves the stimulation of brain neurons with some electric current which is passed through the head from one point to another point in the opposite direction. Tdcs is a critical process and requires professionalism in its undertaking. It should therefore be carried out by an expert with the experience on how the therapy works.

Transcranial direct current stimulation has been advanced to help with other various problems affecting patients. These include helping increase the attention span of an individual, their understanding of a language, problem solving skills and even reduce memory loss cases. A professional therapist understands which part of brain neurons need to be stimulated at a time in order to achieve each different behavior.

The direct electric current used can be passed through the neurons in two different ways. One is by passing it from a positively charged electrode known as the anode while the other is by passing the current from the negatively charged electrode called a cathode. Each mode of current stimulation achieves a different effect. In most cases, one effect is the opposite of the other if the current is passed in the opposite direction.

Electric current is used to cause an excitement of neurons in the brain. This is done by either increasing their excitement or reducing it. When the current flows from the positively charged electrode towards the negatively charged electrode, the resulting effect is an increase in the excitement of neurons. If the current flows from the negatively charged electrode towards the positive electrode, the resulting effect is a reduction in the excitement of neurons. The different resulting effects lead to different behaviors shown by the patient.

This procedure requires you to have a powered device and electrodes to pass the current through the head of a patient. The power source should be able to supply constant direct current during the exercise. Traditional methods have been using only two electrodes for the process. However, modern therapy has adopted the use of more than two electrodes to achieve higher levels of a certain effect.

The process will generally start by the therapist identifying the areas on the scalp where the electrodes will be placed. The skin on the scalp is then cleaned to ensure that electrodes used create a solid connection with the skin for good passage of current.

The current can be adjusted gradually. It can be decreased or increased gradually depending on how the therapist desires as well as how the patient responds. It should however be constant throughout and not too high as it can be dangerous.

As technology advances, modern transcranial simulation continues to grow. There are new methods of conducting the stimulation to ensure the patient receives maximum effects from the process. This includes using many smaller electrodes to increase the level of a desired effect.

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