LookingBehindtheLens

MelanieBabich

EnglishIIIHonors
Mrs.Kopp
February26,2015

Babich1

MelanieBabich
Mrs.Kopp
EnglishIIIHonors
26February2015
LookingBehindtheLens
Manypeopleallovertheworldstrugglewithvisionlossoreyediseases.Tosolvethese,
ophthalmologistsandoptometristsprovidecare.Thoughbothbranchesofmedicinefocusonthe
humaneye,ophthalmologistscompleteprocedurestocureeyecomplicationswhileoptometrists
donotoperateanysurgicalprocedures.Ophthalmologistshavethequalificationsfromproviding
glassestooperatingatechnicalsurgeryonapatient.Intheupcomingyears,improved
technologyanddifferentbusinessstandardswillchangetheworldofmedicinedramatically
includingeyecare.Inthefieldofmedicineophthalmologyprovidescare,alongwiththe
preventionofeyediseaseswhichallowspeoplesvisiontoincreasewhichcanmakeacrucial
impactononeslife.
Ophthalmology,abranchofmedicinefocusedonthestudyoftheeyessuchasstructure
anddiseasesprovidescareinmanywaystothepublic.Ophthalmologistsmayprescribedrugs,
performsurgeriestoimproveorcorrecteyedisordersandoreyeinfections.Thisprofession
whichrequiresadoctorofmedicine(M.D.)degree.Focuseddisordersconsistofcataractsand
glaucoma,whileasmallamountoftimeandattentionconcentratesonpreventingblindnessor
tendingtotheblindpatients.Theeyecomprehendinglowlevelsoflightknownasrefraction
leadstovisiondisability(Ophthalmology1).Opthamologistcanalsoprescribepersonalized
glassesandcontactsforpatients.Theseglassesorcontactscanresolverefraction.Thefieldof

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ophthalmologycontainssuchawidevarietyofoptionsthatresultsinanintriguingcareerwith
manyopportunities.
Everycareerfaceschallengeswithrewardsalongtheway.Inthemedicalfieldthe
challengeslaymorestressandpressureonthephysicianinvolvingthemakingofcrucial
decisions.Inoptometrysomemaysaythatapatientwithsuddenblurryvisionmakesthedoctor
faceanimmenseclinicalchallenge.Thedoctorsresponsibilitynarrowsdowntothe
determinationofdiagnosingthepatientsblurintheeyefromrefractiveoramedicalcause
(Mills).Alongwiththesechallengesrewardingfeelingsexist,whichkeepsdoctorsinthefield
ofophthalmologycontinuingresearchmotivated.Byprovidingsomethingusefullikeclearsight
totheyoungandneedysatisfiesdoctorsinthisfield(Mills).Everyonemayfindadifferent
motiveenteringthemedicalfield,buttheresultendsupmakingapositivechangeinsomeone's
lifeonewayoranother.
Problemscanleadtosurgicaltreatments,glasses/refraction,andorthopticsinwhichan
ophthalmologistresolves.Eyemuscleexercisesandcaringfortheblindalsotakepartinthe
responsibilityofanophthalmologist.Basicandcomplicateddiseasesoccur,althoughcommon
diseasesinclude:cataracts,glaucoma,diabeticretinopathyandretinaldetachment.Cataracts
resultinalossoftheclearnessofthelenswithintheeye,possiblycausedfrominjury,infection
orageing.Glaucomadevelopswithhighpressureinsideoftheeyeandtheopticnervebecomes
damaged.Diabeticretinopathyoccurswhenbloodcellsandserumescapefrombloodvessels
whicheventuallyleadstodamageoftheretina.Retinaldetachmentoccurswhentheretina
separatesfromthechoroidandthebaseoftheeye,alsoknownasthesclera.Themostcommon

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occurrenceofeyesightlossinchildrenappearsasamblyopiaorlazyeyeasareactiontotrauma
oftheeye.
Currentlyagrowthfactorbeta(TGFbeta)hasapossibilitytoattachtheretinaagainto
regainsight,thisactsasaretinalgluefortheeyetoreform(Ophthalmology6thedition1).
Thisgrowthfactorbetaalongwithothertechnologicaladvanceswillchangethelivesofmanyto
onceagainrestorevisiontoitspreviousstate.
Glaucomacausespressureontheopticnerveinthebackoftheeyewhichleadto
negativeeffects.Thiscrucialopticnervesendssignalstothebrainforsighttoprocessand
comprehend.NationalEyeInstitute(NEI),underthesupervisionoftheNationalInstituteof
Health(NIH)worktogethertowardsthecureandpreventionofdiseasessuchasglaucoma
(KeepVisioninYourFuture10B).Increasingawarenessforthepublicwithmore
informationaboutglaucomawillinformpeopleaboutthebasicsofglaucoma.
Thoughoverfourmillionpeopleaffected,aboutonlyhalfofthepopulationrealizethat
theyhaveglaucoma.Althoughsomesymptomsmayshowbriefly,aneyedoctorshould
administeradilatedeyeexamtofullydiagnose.TheNEIrecommendspeopletohavea
completeddilatedeyeexamtoensurethatnoglaucomaexists.Risksforglaucomadramatically
raisesatmidlifeagemeaningthisrecommendedexamcompletedatage40benefitsthepublic
(Mahoney).Withafamilyhistoryorapatientovertheageof60theriskincreases(Keep
VisioninYourFuture10B).Withmanypeopleaffectedbyglaucomaophthalmologistcan
informtheirpatientsmoreabouttheireyehealthtopreventit.
Agingresultsinmanydifferenteffectsonthebodyincludingtheeyeschangingin
variousways.Dryeye,floaters,flashes,orhavingtroublereadingallreflecttheeyesaging

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alongwiththerestofthebody.Dryeye,aresultofhormonalchangesaffectsmostlywomen
overtheageof40(Mahoney).About52%ofwomeninAmericaadmitdealingwithdryeye
symptomsdaily.Thisconsistoftheeyenotproducingenoughorthecorrecttypeoftears
resultinginaitchingorburningsensation.Topreventdryeyeartificialtears,gelsandointments
fulfillthenaturalbalanceofmoisturewithintheeye.Byslippingsmallsiliconplugsinto
drainageholesforthetearductsinthecornersoftheeyelids,thetearsstayontheeyeslonger
causingmoremoisturetoremain.
Floatersandflasheswithintheeyemayappearnormalbutsuddendifferencescanshow
thestartofatearontheretinaleadingtoalossofvision.Aspeopleagethecleargelsubstance
shrinks,lettingofftinyamountsofunwantedcellsanddebris.Thedriftingsubstancesintheeye
castsshadowsmakingfloatingthingsappearinthepathofvision.Asthegelshrinksmoreitcan
causestressontheretina,creatingflashesthatcanlastforweeksormonths(Mahoney).A
possibilityforurgentcareorseeingadoctorimmediatelyhelpswithfloatersorflashes,resolving
ordiagnosingthisquicklyhelpsthepatients.Laserprocedurescansealthetearoftheretina
whichmaysolvethedilemma(Mahoney).Floatersandflashersmaynothavewaystoprevent
them,thoughthesolutionsofsurgeryorproceduressolvethecomplicationsifneeded.
Presbyopiaalsoknownasoldmaneyesoccursintheageofearly40swhenreading
fromnormaldistancesbecomesdifficultandeventuallyimpossible.Thelensoftheeyebegins
tobecomestiff,resultinginthelensnotfocusingnormally.Prescriptionlenseshelpwith
presbyopia,thoughwhentheydonotfunctionanymore,theindividualshouldgototheeye
doctor(Mahoney).Unfortunatelypresbyopiacontinuestoincreasewithagingandlingerswith
someoneastheygrowolder.

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Cataracts,growthsonthecorneaandmelanomaresultfromtheoverexposureofsunlight.
FordhamUniversitydiscoveredthatsunglasseslowertheriskofalltheseandprotectthehuman
eye(SmarterShades47).Populationnegativelyaffectedbycataracts,growthonthecornea
andmelanomabecauseofthesunlight,decreaseswhenanophthalmologistprovidesinformation
priortosunexposure.
Hatsorsunglassesprotecteyesfromharmfulsunlightandpreventsprobableeye
complications.HighexposuretosunlightmayresultinEyediseasessuchascataracts,macular
degeneration,photokeratitisandpterygium(Chua41).Cataractsbeginswithacloudylensinthe
eye,whicheventuallyleadstoblindnesswhensevere.Themacularregionontheretina
deterioratescausingimpairedvisionforpeopleabovetheageof55,knownasmacular
degeneration.PhotokeratitisresultsfromtheexcessiveexposureofUVB,creatingareversible
sunburnonthecornea.Pterygiumresultsinagrowthofpinkishtissuesthatspreadsoveraclear
corneaandblocksvisionorcancausetemporaryblindnessthatcanlastabout12days.Sun
exposureonthebeachorsnowwithoutprotectioncausespterygium(Chua41).Sunglasseswill
decreasethepossibilityofcataracts,maculardegeneration,photokeratitis,alongwithothereye
imperfections.
Wellprotectingsunglasseslikelargewraparoundsshouldcontainlensthatblock
wavelengthsbelow400nanometers,sunglassesmayhavethisinformationavailableonthetagor
asalespersoncanprovidethis(SmarterShades47).Anopthamologistpreventseyediseasesby
providinghelpfulinformationtotheirpatientregardingthepossibilityanddangersofsun
damage.

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Manythingspreventpeoplefromexperiencingeyeissuesincludinghealthyfoodsand
vitamins.Anadjustmentinsomeone'sdietcanaffecttheirriskofcataracts,sucha
sintegrating
a
supplementofvegetablesandfruitstoonesdietwhichcandecreasesomeonespossibility.
Agerelatedmaculardegenerationaffectspeopleovertheageof50,inwhichthemacular
regionontheretinadisappears(YvonneSamples64).Forsomeonediagnosedwithagerelated
maculardegeneration(AMD)theircentralvisionwillappeardisoriented.Thissectionofthe
reinastimulatescentralvision,coloranddetailcausingblindspotsanddisorientinglines
(Mahoney).SomeonewithAMDcouldstillpossiblyseeonthesidesbutnotdirectlyinthe
middle(YvonneSamples64).Womenlivelongerthanmen,puttingwomenatahigherriskof
havingAMD(Mahoney).TodecreasetheintensityofAMD,takingsupplementalvitamins
providelackingnutrients.AccordingtoAbdhishR.Bhavsar,MD,aresearching
ophthalmologist,exercisingregularly,watchingyourcholesterolandbloodpressure,andeating
ahealthydiet,includingplentyofleafygreens,fruits,andnuts,canallhelp(Mahoney).
AformofvitaminAdetachesfromitsproteinwhichactivatesavisualmessagetothe
brain.Thisprocessofthedetachmentreferredtoasbleaching,processesvitaminAwhichthen
rejoinswiththerhodopsinandrestorestheeyesabilitytoabsorblight(YvonneSamples64).
VitaminA,necessaryforhealthyeyestakesalargepartintheprocessofbleachingtogive
energythenprocessesoftheeyerespondingtolight(YvonneSamples64).Includingbleaching,
thereductionrateofcataracts,andAMDallrequireahealthydietinhighfruitsandvegetablesto
fulfillthenutritionneeded(YvonneSamples64).Byeatinghealthyapositiveimpactwill
reflectthroughthehealthofoneseyes.

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Otherthaneatinghealthy,otherwayssuchasexercisingandsleepingalsoprevent
unhealthyeyes.Eyescountoncirculationandoxygen,byexercisingregularlyhighamountsof
circulationprovidetheneededoxygen.Avoidingsmokeneartheeyesorstayingawayfrom
environmentalallergenswillpreventirritatedeyes(Mahoney).Withirritatedeyessomesleepor
closingthemforawhilewillhelpmakethedustandallergensdisappear.Eyescontinuously
soakedintearswhenclosed,helpwashawayirritantswhilegivingthemarest.Regulareye
examsrecommendedbyadoctorspreservehealthyeyes(Mahoney).
Fruitsandvegetablesprovideneedednutrientsfortheeyesalongwithvitaminsin
someonesdailydiet.Thesesupplementsdecreaseandpreventmanypossibleeyediseasesthat
mayoccur.DietarycarotenoidsprovidevitaminAthroughantioxidantstoourbodiesthat
decreasetheriskofcataracts(YvonneSamples64).Dietarycarotenoidsincludesomefoods
suchasredcoloredfruitsandvegetables,andavarietyofgreenleafyvegetablesthatcontain
vitaminA(YvonneSamples64).Healthyfoodandnutrientsalsoslowdowntheprocessof
maculardegeneration.Someallowthehumanretinatolocatefreeradicalsandtheseimportant
scavengersdestroytheunneededagitatorsintheeye.Freeradicalscontainoneormore
unpairedelectrons,whichresultsinanunstablemoleculeandnegativelyaffectsthebloodstream
(YvonneSamples64).
VitaminBandfolicacidprotectandstrengthentheretina.Peoplewhoateoilyfish,like
salmon,aboutonceaweekhada50%lowerofriskofAMDcomparedtoothers.Night
blindnessdevelopsfromaninabilitytorecreaterhodopsinbecauseofalongtermvitaminA
deficiency(YvonneSamples64).Patientswithnightblindnessdonothavetheabilitytoadjust
fromdarktodaylightorvisaversa.VitaminAdeficiencycanalsoleadtoadryandlongterm

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injuredcornea,knownasxerophthalmia(YvonneSamples64).Themostpreventabletypeof
blindnessreferredtoasxerophthalmia,unfortunatelyindevelopingcountriesthisaffectsabout
10millionchildren.Inthesedevelopingcountries500,000ofthechildrengoblindduetothe
lackofsufficientamountsvitaminA(YvonneSamples64).SincevitaminAcomesfrom
mostlyfreshfruitsandvegetableseatingahealthydietbecomescrucialtothenutritionrequired
forhealthyeyes.
AccordingtoJAMAOphthalmologythestudiesindicatethatindividualsshowmore
positivefeedbackoneyetestsatthedoctorsratherthanintheirownhomes.Eyeexamstaken
withintheofficecanrevealanunrealisticviewofhowpatientsactuallyseeonaregularbasis
(HomeVisionNotAsSharpAsInDoctor'sOffice).Morebrightlightwithinthedoctors
officeincreasesvision,whereasathomedimlightdecreasestheabilityofsharpvision(Home
VisionNotAsSharpAsInDoctor'sOffice).Alsowithlessbackgroundanddistractions
someonesvisionfocusincreases.Lowlightathomecanraisetheriskofaninjury,tolowerrisk
peopleshouldboostlightlevelsinthehomeenvironmentmostlywhendoingtasksthatrequire
sharpvision(HomeVisionNotAsSharpAsInDoctor'sOffice).Overallsightaccuracy
decreasesatthehouseholdbecauseofthelocationandmanyvariables.
Themedicalprofessionrequiresmanyyearsofeducationthatguidesyoungadultsinto
becomingsuccessfuldoctors.Specificrequiredundergraduatecoursessuchas:microbiology,
chemistry,zoology,biology,publichealthandmathematicsguidefuturedoctorsthathavea
focusonophthalmology(Mills).Someoftheseclassesofferedwithinhighschoolgiveabasic
understandingofwhattheeducationalfutureholdsforanoptometristorophthalmologist.

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Throughouttheeducationalpathmoreemphasisonbusinessandpracticemanagementcourses
preparessomeonelookingtoowntheirownpractice(Mills).Overtheyearsofalongprocess,
professionaladvancementprogressesfromgraduatingmedicalschooltoresidencyaffiliatedwith
ahospita.Finallythedecisionmakingofowningaprivatepracticeorworkingunderanother
medicalfacility.Postgraduateeducationwithinthenextfewyearswillincreaseinvolumeand
intensity(Mills).Allofthisdiligentworkandmedicalexperienceadvisesyoungadultsin
becomingwelleducationoptometristorophthalmologist.
Potentialgrowthofpopulationdemandandtechnologyimprovingimpactsacareerina
tremendousway.StudiesshowthattheamountofeyecarepractitionerscansupporttheUS
populationforatleastthenexttwentyyears.Withthisinformation,populationgrowthandthe
increaseofnewgraduatescomplimenteachotherinnumber.Opportunitycontinuestogrow
withservicetheelderlyalsoknownastheagingofAmerica(Mills).Withthisnewamountof
olderpeopleinneedofmoreassistanceitallowsanewareaoffocuscurrentlywitheyedoctors.
Nationalaveragesalaryapproximatelylaysaround140,000dollarsayear,thoughlong
termgoalshaveunlimitedpotential.AccordingtolocaloptometristDr.Mills,Inoptometry
salaryismorealignedtothebusinessefficiencythantotheknowledgeofthemedicineandthe
abilitytodeliverpropercare(Mills).Theamountofmoneychangesbasedonhowefficienta
privatepracticecanreach,ratherthanhowmuchthedoctorknows.Inconclusionmostlywith
privatepracticestheworkefficiencyhasanequalamountofvalueasthedoctorapplyingtheir
knowledge.
TheHealthInsurancePortabilityandAccountabilityAct(HIPAA)of1996followedby
theHealthInformationTechnologyforClinicalHealthAct(HITECH)of2009includehealth

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careprivacyconcerns(PRNewswire).Thiswastooriginallyassistthedevelopmentofhealth
informationsystemwithstandardsandrequirementsfortechnologicaltransmissionwithmedical
information.TheyimprovetheperformanceofMedicare,Medicaidandtheoverallhealthcare
systembyplacingrequirementsonbusinesses.Theseregulationsaffectprivacyofthepatient,
securityoverallandtransactionsbetweenpeopleandmedicaloffices.TheU.S.Departmentof
HealthandHumanServices(HHS)createdtheprivacyruleforHIPAAtoenforce(PR
Newswire).Thisprivacyruleensurestheconfidentialityofapatient'sinformationforsafety
purposes.DespitethefactthatHIPAA,HITECHandotherregulatinglawshelpinmanyways,
theyalsotakeupdoctorsvaluabletime.Thesecompaniesdonotincreasepaymenttothedoctors
orhospitalswhichcreatesachallengeforthedoctortoprovidequalityservicewhilelosingtime
whenfollowingthesestrictregulations.
Themedicalprofessionhaschangeddramaticallyoverthepastfiveyearsandcontinues
toadvance.Inophthalmologyoverthelastcoupleyearsasignificantincreaseintheregulations
constrictbusinesses.ThefederalHealthInsurancePortabilityandAccountabilityAct(HIPAA)
andElectronicMedicalRecord(EMR)continuetoplacemorerestrictionsinthemedical
business(Mills).Bothhospitalsandprivatepracticesacquiremandatoryregulations,though
theserulesrapidlychangeinophthalmology,requiringmoretimetoperformstateandfederal
regulatoryrequirementsresultsinlosttimeandmoney.Withthistimeusedfillingout
paperwork,thestandardofqualitypatientcarestillholdshighstandards(Mills).Although
HIPAAandEMRusetheirpowertokeepmedicalfacilitiessafe,thevaluechangesdramatically
ondoctorswhoownprivatepracticesduetotheincreaseofthephysiciansandassistivestaff
demandedtime.

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Asanophthalmologist,responsibilitiesspreadoutfromprescribingeyewearto
performingdelicatesurgeries,preventingorsolvingeyediseasestoallagesalongwithinforming
thepubliconhealthyeyecarecreatesawellroundedophthalmologist.Improvedtechnologyand
differentbusinessstandardschangesthewayeyecarecontributestothepublicandwillcontinue
todoso.Ophthalmologymakesanimmenseimpactonhowoneviewstheworldwithclear
healthyvision.

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