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A Change in the Season

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I must confess, I have been remiss at updating my post here at the Animal Eye Clinic. Part of this was intentional, as the last post describes the new cataract surgery machine we purchased last year that is working like a charm. Changes in technology are fascinating and very rewarding when we, as veterinarians, find one that applies to our patients and is cost effective in this ever-changing world of health care. Part of my delay was unintentional, as changes of the kids’ school, health of relatives, staffing and life in general often reworks our life and schedule when we least expect it. Many fear change, many embrace it, some seek it and others avoid it at all cost. I personally like change as it keeps things fresh and, to be realistic, change is inevitable so why not roll with it?

How is change evident at the AEC? Well sadly, Christina, one of my technicians for 16 years (WOW!) left for the sunny shores in North Carolina. Clients and colleagues loved her and we miss her wonderful personality and strong work ethic. And although word on the street is that she misses her job and friends here, too, we found her replacement in Sherry and Ryan! These two are doing fabulously learning our philosophy and bringing their own personalities to the job. See their stories in the staff section. I am lucky and blessed to still have Suzanne, Chris and Lisa-Marie (reception, technician and office manager) with me (for 8-17 years respectively!) to train these guys and continue keeping our level of service high. They make this place go and I am honored to have all of them as my staff!

In addition, the landscape in veterinary medicine continues to change. I was the new, young, fresh-out-of-residency guy 17 years ago when I joined Dr. Covitz’s original practice in 1999, but now I am the senior ophthalmologist in the state. With that brings experience and knowledge along with a few gray hairs! But I continue to stay current with the latest information by attending meetings, contributing to our international list serve, reviewing journals for the ACVO and reaching out to those with experience in other areas to make sure we are offering the best we can for your friends. I realize you have a choice and feel that our combination of experience, expertise and a mellow, personable environment make us a good choice for your veterinary eye care.

Feel free to search other posts that include descriptions and photos of different diseases, procedures and presentations that may apply to your pet. Topics include cataract surgery, corneal erosions that don’t heal, surgeries if your pet’s eye has to be removed among others that may be of interest. Feel free to call for an appointment if we can be of service.

Technology Upgrade for Cataract Surgery at the AEC

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Cataract surgery in the dog is a highly successful procedure that many owners have chosen for their four-legged friends to regain or improve vision. Cataracts in general and a brief discussion of the preoperative workup and surgery is presented in a prior post that you can peruse if interested titled Cataracts in the Dog. (You can find this older post if you scroll to the bottom of this page and click on Older Entries.) Removal of an opaque, cataractous lens is an elective procedure that is chosen if we feel we can improve our dog’s quality of life by returning his or her vision. This surgery is rewarding for dog, owner and doctor as it can truly bring the “puppy” back in many dogs whose lifestyle had changed with a loss of sight. Nothing beats watching the joy on our client’s faces as their dog ambles back into their arms and makes eye contact after surgery!

The technical aspects of this surgery have evolved over the years with the goal to improve the ultimate success of the procedure. These improvements involve everything from patient selection and timing, pre- and post-operative medical management, surgical technique, quality and type of lens implants, instrumentation and last but not least the science of the cataract surgery machine itself. Veterinary medicine often trails human medicine when it comes to technical advances primarily due to the financial limitations of the very expensive equipment used for diagnosis and treament of many diseases. Here at the AEC, were are proud to introduce an upgrade to the most recent technology for cataract extraction in the dog in the form of a new cataract surgery machine, the Alcon Infiniti, and this post will focus on this machine.

Our new Alcon Infiniti Vision System

Our new Alcon Infiniti Vision System

Cataract removal is primarily achieved by what is called phacoemulsification. In general, a small, beveled needle is introduced into the eye through a 3mm incision. While concurrently irrigating with fluid and aspirating it out, the needle will vibrate with ultrasound power to break the cataract into small pieces that are ultimately sucked out through the tip. Very cool! As you can imagine, there are numerous factors that are involved to make this work. How fast do you introduce the fluid? How much suction do you need to suck the fluid and lens pieces out while keeping the eye inflated? How much ultrasound power do you safely use to break up the lens without disrupting the other structures? How do you create a handpiece to deliver this energy inside the eye? How do you minimize the heat and inflammation that is generated in the process? Lot’s of smart people have worked on these and many other issues to help create different machines to maximize success while miniimizing risk.

The main feature that makes the Infiniti and its Ozil handpiece better is the development of torsional or elliptical phaco. Standard phaco, used for the last 30-40 years, is in a longitudinal mode. The action of the needle is in an in-and-out motion that “jackhammers” the lens material into small pieces. The torsional movement this system features adds a side-to-side motion that shears the cataract as well. This combination creates two benefits. It reduces the heat that is created during the process which can affect inflammation and incision quality and it keeps the pieces stuck to the tip to allow faster breakdown and removal.

Other advances with the pump system help add a smoother delivery and removal of the fluid while protecting against “surge” of the fluid that disrupts the evenness of the procedure. I could go into this and other parameters in more detail here but the take home point for us and your pet is that the procedure becomes faster, easier and less traumatic with this new technology. The biggest difference between a human and a dog getting cataract surgery is that dogs generate more inflammation than people with similar ocular trauma. And inflammation after surgery is the linchpin of complication. Thus, if we can decrease our inflammation by utilizing the above upgrades we should see better success. Our pets are thus benefiting from these advances and possibly to a greater degree than people in respect to inflammation. We are excited to have this new machine in our clinic and maybe your dog will see the reason why!

Summertime Blues!

Summer is here in New England and hopefully all are out and about doing what they like to do when the weather is warm. If anyone complains of heat and humidity I am going to send them right back to February so they remember what cold feels like! I am a sun and fun lover so you won’t hear me complain…no summertime blues for me!

Blue shows up in veterinary medicine in a handful of different ways. We have blue-eyed dogs and Russian Blue cats, blue merle coloring and Blue Amazon parrots. When the eye is blue, that usually refers to

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ACVO Diplomates Giving Back

I am always in awe of how animals enhance and improve our daily life. Whether it is the friendly greeting every day when I come downstairs in the morning or the benefit of the evening walk that I do even if I am not in the mood, to see that unrestrained, unconditional love regardless of the day or mood is priceless. The warm body on a lap during a cold day, the cat rubbing up on your legs awaiting some attention, the look of earnest when you are feeling down, pets of all types fill a very important niche in

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Those darned corneal erosions that won’t heal!

I frequently get asked “what is the most common problem you see?”. The long answer is “depends!” as different species get different diseases, different breeds get different problems, and some problems are seasonal and others are year round. So the allergic conjunctivitis may be absent in winter but cataracts occur at any time and at any age. But one of the problems that shows up on our doorstep on a regular basis is the non-healing corneal erosion in the dog. Your poor friend may be squinting and pawing for weeks in spite of repeated attempts to heal with various

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Losing an eye; it is not a bad as you think…

I was stunned to see the last posted picture on the front page here had snow all over the building and I was talking about our wonderful warm environment that is present year round. Now the warmth of summer is waning and we are all holding on to those last few days with green trees and sunny skies. A beautiful summer was our just reward after such a harsh winter! And September was equally nice!

Our pets have survived as well, and do through many adverse conditions and illnesses that would knock us for a loop. We can learn a lot

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A Warm Environment in the Cold Weather

Been cold enough for you out there? It sure has been for me. I like winter. I enjoy skiing, sledding with the kids, playing frisbee with my dog Tess after a fresh snow, the Winter Olympics this year. a warm fire, Christmas….but wait! I feel like it has been about 9 degrees all season long. Trust me, this is not a big complaint. I lived in Wisconsin for 7 years so this is nothing. And don’t get me started on snow days at school when it closes if it might snow! Alas, that’s one reason we live here is the

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What is the coolest animal you have seen?

This may be one of the more common cocktail party questions that veterinary ophthalmologists get asked! Not that eyes in any species are not cool, but a little exotic flavor can spice up the conversation. Fortunately for us veterinary ophthalmologists, the anatomy of the eye is very similar from species to species. There are significant changes when going from mammal to bird to fish since the anatomy is altered to maximize performance depending on the environment in which an animal lives, however, the main structures are present in most eyes. Disease states will also be different based on these living

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Put Another Lid on It!

Welcome back from the holidays! Hope everyone had a wonderful season full of family joy and giving. Our family here at the Animal Eye Clinic had no complaints as apparently all were on the “nice” list and the New Year rang in sweetly. And now that we have weathered the latest series of storms, I guess it means back to work for all full time!

We had last started a discussion about lid disease. We see lots of patients here with a variety of lid maladies that affect its position, function and appearance. Some are genetic in origin, many are acquired

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Merry Christmas!

From all of us at the Animal Eye Clinic to all of you, may you have a very Merry Christmas, a Happy Hanukkah and a Happy New Year! May your travels be safe and family be healthy and happy. We all hope and pray that the new year will fill us with peace and prosperity after such a trying 2012 especially here in the Northeast. Many thanks to all who visit us here in Wilton as we try our best in our little niche to help you and your furry friends at home stay comfortable and sighted!

Lisamarie, Katie, Christina,

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