Transcript: Eye Health, Macular Degeneration, Blind Waltzer | Dec 07, 2000

(music plays)

The opening sequence shows a wooden table with a small lit candle.
Fast clips show different sets of hands performing activities on the table such as pulling petals from a daisy, drawing a big red heart, tuning a violin, flipping through the pages of a book, cooking, and pouring a glass of red wine.
In animation, the title appears inside the shape of a house: “More to life.”

Maureen Taylor sits in a studio with a yellow wall displaying the “More to life” logo in the background.

Maureen is in her late thirties, with wavy red hair. She’s wearing a striped gray blazer over a red silk blouse.

Maureen says WELCOME TO
MICHLT I'M MAUREEN TAYLOR.
ONE OF THE MOST COMMON
HEALTH CONCERNS IN CANADA IS
VISION.
ONE IN TEN PEOPLE OVER 65
AND ONE IN FOUR OVER 80 HAVE
A PERMANENT VISUAL
IMPAIRMENT OR BLINDNESS AND
WHILE SOME PEOPLE ARE ABLE
TO THROW AWAY THE EYE
GLASSES THANKS TO LASER
SURGERY, OPHTHALMOLOGISTS
ALSO HAVE BEEN PERFECTING
TREATMENTS FOR CATARACTS,
GLAUCOMA AND MACULAR
DEGENERATION.
TODAY WE'RE TALKING ABOUT
EYE HEALTH.
LATER ON IN THE PROGRAMME
WE'LL TAKE YOUR QUESTIONS
FOR OPHTHALMOLOGIST
DOCTOR RAYMOND STAIN.
BUT FIRST WE THOUGHT WE'D
REBROADCAST A STORY THAT
AIRED LAST SEASON ON “YOUR
HEALTH” ABOUT AN AMAZING NEW
TREATMENT TO TREAT MACULAR
DEGENERATION.

A clip plays.

Maureen says RUTH GIBSON HAD NEVER
HEARD OF AGE-RELATED MACULAR
DEGENERATION BEFORE SHE WENT
TO HER OPHTHALMOLOGIST FOR
HER REGULAR TWO-YEAR
CHECK-UP.

Ruth reads on a couch petting a dog. She is in her late forties with short brown hair. She’s wearing a blue long-sleeved shirt.

Ruth says HE SAID HE'D NOTICED
SOMETHING DIFFERENT AND HE
WANTED ME TO GO DOWN AND SEE
THIS DOCTOR DOWN AT
SAINT MIKE'S.
AND I'D NEVER HEARD THE WORD
MACULAR DEGENERATION BEFORE.
AND WHILE I WAS IN THE
WAITING ROOM -- BECAUSE
YOU'RE WAITING THERE FOR
ABOUT TWO HOURS, AND A YOUNG
WOMAN CAME IN.

A caption appears on screen. It reads “Ruth Gibson.”

Ruth continues AND SHE WAS PROBABLY EARLY
30s, AND SHE WAS GIVEN A
FORM TO FILL OUT.
AND WHILE SHE WAS FILLING
OUT THE FORM, LIKE SHE HAS
IT LIKE TWO INCHES FROM HER
FOIS, AND SHE'S SORT OF
TWISTING HER HEAD AROUND TO
READ IT.
THEN SHE SAT DOWN AND I
STARTED TALKING TO HER AND
SHE WAS TELLING ME THIS
STORY ABOUT HOW SHE'D SEEN
DOCTORS IN SUDBURY AND NORTH
BAY, AND THEY COULDN'T DO
ANYTHING FOR HER EYESIGHT.
AND SHE SAID THIS DOCTOR'S
MY LAST RESORT.
AND I SAID “OH!
GEE, THAT'S TERRIBLE, WHAT
DO YOU HAVE?”
AND SHE SAID “OH, I HAVE
MACULAR DEGENERATION.”
AND I THOUGHT OH, THAT'S
AWFUL!
AND THEN THAT'S WHEN -- AND
THEN I WENT IN AND I FIGURED
FOR SURE IT WAS JUST
GLAUCOMA, NO PROBLEM, I
DIDN'T GET INTO A SWEAT
ABOUT IT AND HE SAID OH, I
CONFIRM Dr. GOLDBERG'S
DIAGNOSIS, YOU DO HAVE
MACULAR DEGENERATION.
AND I THOUGHT WHAT?!
BECAUSE ALL I COULD THINK OF
WAS THE WOMAN OUT THERE AND
I THOUGHT OH MY GOD!
I'M GOING BLIND!

A zoom in shot homes in on Ruth’s left eye and then becomes blurry.

Maureen says AGE-RELATED MACULAR
DEGENERATION IS A
MISUNDERSTOOD CONDITION.

Ruth says I DIDN'T KNOW IF I WAS
GOING BLOND IN FOUR MONTHS
OR, YOU KNOW, TEN YEARS.
I DIDN'T KNOW ANYTHING.

Maureen says THE HUMAN EYE IS
LIKE A CAMERA, DESIGNED TO
GATHER AND FOCUS LIGHT.
THE RETINA AT THE BACK OF
THE EYE ABSORBS LIGHT AND
SENDS IMAGES TO THE BRAIN.
A PART OF THE RETINA KNOWN
AS THE MACULA DISTINGUISHES
FINE DETAIL AND COLOURS.
AS WE AGE, THE RETINA THINS
AND YELLOW SPOTS, OR LESIONS
CAN FORM IN THE OUTER LAYER.
THESE LESIONS ARE AN EARLY
INDICATION OF WHAT'S
REFERRED TO AS THE DRY FORM
OF AGE-RELATED MACULAR
DEGENERATION.

An animation shows the process described.

Maureen continues IN TEN TO 15 percent OF PEOPLE,
HOWEVER, THE DRY FORM
DEVELOPS INTO WET MACULAR
DEGENERATION AND THAT'S MORE
SERIOUS.

Fast clips show people’s eyes.

Maureen continues IT STARTS WITH THE GROWTH OF
ABNORMAL BLOOD VESSELS.
THEY LEAK FLUID, AND SCAR
THE TISSUE ACROSS THE MACULA,
CAUSING DISTORTION AND
BLURRED CENTRAL VISION.
WITH THE WET FORM OF AMD,
VISION MIGHT LOOK SOMETHING
LIKE THIS.

A camera records cars driving on a road and a large gray spot appears in the middle of the screen.

Maureen continues FOR NOW, RUTH'S SYMPTOMS ARE
ALMOST UNNOTICEABLE TO HER.
SHE HAS THE DRY FORM OF AMD.
BUT THAT CAN CHANGE
DRAMATICALLY AT ANY POINT IF
THE BLOOD VESSELS LEAK.

Ruth says I WOULD NEVER EVEN KNOW,
EVEN TO THIS DAY, IF HE
HADN'T DIAGNOSED IT YOU KNOW,
THE DOCTOR HADN'T.DIAGNOSED
IT I WOULD NEVER HAVE KNOWN
IT.
THERE'S NO DIFFERENCE TO MY
EYESIGHT, I DON'T THINK MY
DISTANCE VISION IS ANY WORSE
THAN IF I HAD IT OR DIDN'T
HAVE IT.
IT'S JUST THESE STRAIGHT
LINES.

Maureen says RUTH WAS TOLD TO CHECK
HER VISION EVERYDAY AGAINST
A GRID.

Ruth says IT LOOKS LIKE A DRUNK HAS
TRIED TO DRAW A STRAIGHT
LINE.
THAT'S WHAT IT LOOKS LIKE
AND IT'S SORT OF GOING ALL
OVER THE PLACE.
AND ONE EYE IS WORSE THAN
THE OTHER.
BOTH EYES HAVE IT BUT ONE
EYE IS WORSE THAN THE OTHER
ONE.

Maureen says DOCTOR PATRICIA HARVEY IS AN
OPHTHALMOLOGIST AT THE
WESTERN DIVISION OF TORONTO
HOSPITAL.
HER SPECIALTY IS THE RETINA.

Patricia Harvey sits in her office. She is in her mid-forties with curly dark hair. She’s wearing a black zip sweater over a blue T-shirt.

Patricia says PEOPLE WHO HAVE GOT
MACULAR DEGENERATION WILL
GRADUALLY LOSE THEIR VISION
OVER TIME.

The caption changes to “Doctor Patricia Harvey. Ophthalmologist.”

Patricia continues AT SOME POINT, WHEN THEIR
DRY MACULAR DEGENERATION
CONVERTS TO WET MACULAR
DEGENERATION, THAT CAN BE A
SUDDEN OCCURRENCE BECAUSE
THEY GET A BREAK IN THE
RETINAL PIGMENT EPITHELIUM
AND NEW VESSELS START TO
GROW.

Maureen says UNTIL RECENTLY, THERE WAS
NOTHING DOCTORS COULD DO TO
STOP THE LOSS OF CENTRAL
VISION.
NOW THERE IS.

An old man sits in the office with a needle on his arm.

Patricia says DON'T MOVE YOUR HAND NOW,
DOCTOR WALSH BECAUSE THE DIE IS
STARTING TO RUN IN.

Maureen says PHOTO DYNAMIC THERAPY
INVOLVES INJECTING A DRUG
CALLED VISUDINE INTO THE
BLOODSTREAM.
THE DRUG ACCUMULATED IN THE
ABNORMAL VESSELS IN THE EYE.

Patricia says WE'RE STARTING THE
INFUSION NOW AND THIS WILL
TAKE TEN MINUTES, OKAY?

The old man says NO PROBLEM.

Maureen says BUT THE DRUG DOESN'T WORK
UNTIL A LASER LIGHT IS
DIRECTED AT THE EYE.
THIS ACTIVATES THE DRUG AND
STOPS THE ABNORMAL VESSELS
FROM LEAKING.

Patricia says YOU'LL HEAR IT BEEP FIVE
TIMES.
DON'T MOVE, DOCTOR WALSH, WHEN
YOU HEAR IT BEEP, OKAY?
AND THEN YOU'LL HEAR A LONG
BEEP AND THEN WE'RE READY TO
START.
THEN NO MOVING.
THERE YOU GO.
(BEEPING)
HERE WE GO.
DON'T MOVE.

The old man approaches the keratometer and Patricia directs the red laser into his eye.

Maureen says THIS TREATMENT ONLY STOPS
THE PROGRESSIVE LOSS OF
SIGHT.
IT CAN'T REVERSE WHAT'S
ALREADY BEEN LOST.
SO TIMES IS ESSENTIAL.

Patricia says THEY CAN HOPE TO HAVE AT
LEAST AS GOOD VISION AS THEY
HAVE WHEN THEY START SO,
THAT EARLY DIAGNOSIS AND
TREATMENT WOULD BE IMPORTANT,
BECAUSE IF THEY GET THEIR
BLOOD VESSELS TREATED WHEN
THEY HAVE GOOD VISION, WE
COULD STABILIZE THEIR VISION
THERE.

Back in the office, Patricia says OKAY, ALL DONE.
DON'T MOVE BACK, JUST FOR A
SEC.
OKAY.
I'M JUST GOING TO TAKE YOUR
LENS OFF.

Maureen says THE VISUDINE REACTS TO
ULTRAVIOLET LIGHT SO THE
PATIENT IS ASKED TO AVOID
BRIGHT LIGHT, ESPECIALLY
SUNLIGHT FOR THE NEXT 24 TO
48 HOURS.
OTHER THAN THAT DOCTOR HARVEY
SAYS IT'S A VERY SAFE
PROCEDURE.

Patricia says IT DOESN'T REQUIRE THAT
THEY HAVE AN ANAESTHETIC.
IT ISN'T REQUIRING WE DO
ANYTHING SORT OF -- NOTHING
INVASIVE INTO THEIR EYE.
THE MOST INVASIVE THING IS
GIVING THEM A NEEDLE IN
THEIR HAND.
THE SAFETY FACTORS, THE RISK
FACTORS REALLY REVOLVED
AROUND THE NEEDLE IN THE
HAND.
AND THE DYE, BECAUSE THE DIE
IS A PHOTO DYNAMIC DYE THAT
MEANS THAT LIGHT INTERACTS
WITH THE DYE, THAT IS THE
OTHER ISSUE, THAT WHEN YOU
GIVE PATIENTS THIS DYE TO DO
THE TREATMENT, THEY NEED TO
STAY OUT OF BRIGHT LIGHT, SO
THAT THEY DON'T GET A
SUNBURN.
SO THOSE ARE THE KINDS OF
SAFETY ISSUES THAT WE'RE
TALKING ABOUT.
CERTAINLY ON A -- YOU KNOW,
ON A SCALE OF RISK FACTORS
FOR SURGERY, VERY MINIMAL
RISK.

Maureen says FOR THE MILLIONS
OF BABY BOOMERS AT RISK FOR
MACULAR DEGENERATION, THIS
THERAPY IS GOOD NEWS.
IF THE DIAGNOSIS IS WET
A.M.D., THERE'S A GOOD
CHANCE THE PROGNOSIS WON'T
BE BLINDNESS.

A clip in slow motion shows people walking in the street.

The clip ends.

At the studio, Maureen says WEATHER YOU
SUFFER FROM MACULAR
DEGENERATION OR WANT MORE
INFORMATION ABOUT EYE LASER
SURGERY, OUR GUEST THIS
AFTERNOON WILL BE ABLE TO
HELP.
DOCTOR RAYMOND STEIN IS A
SPECIALIST IN CATARACTS, EYE
REPLACEMENT SURGERY AND THE
HEAVILY DEBATED EYE LASER
SURGERY.

Raymond is in his mid-forties, with a moustache and curly brown hair. He’s wearing a blue suit, a light blue shirt and a patterned brown tie.

A caption appears on screen showing two phone numbers.

Maureen continues OUR NUMBER
IN TORONTO FOR YOUR QUESTIONS IS 416,
484, 27-27.
LONG-DISTANCE CALL US TOLL FREE
AT 1-888-411-1234 OR YOU CAN
E-MAIL YOUR QUESTION FOR DOCTOR
STEIN AT MORETOLIFE
@TVO.ORG.
FIRST OF ALL,
CAN YOU TELL US, THAT PIECE
AIRED LAST SEASON ON “YOUR
HEALTH” SO I'M WONDERING
WHAT IS THE STATUS TO TREAT
MACULAR DEGENERATION NOW?

Raymond says PHOTO DYNAMIC THERAPY IS
EXCITING TECHNOLOGY.

A caption reads “Doctor Raymond Stein. Ophthalmologist.”

Raymond continues IT'S UNDER GONE ALL CLINICAL
TRIALS IN THE UNITED STATES
AND CANADA AND THE RESULTS
LOOK VERY PROMISING FOR THE
SMALL PERCENTAGE OF PATIENTS
WITH THE WET FORM OF MACULAR
DEGENERATION.
IT'S AVAILABLE NOW IN MAJOR
TEACHING CENTRES ACROSS
CANADA AND THE UNITED
STATES.

Maureen says I TAKE IT IT'S
NOT COVERED BY OHIP THOUGH.

Raymond says
CURRENTLY IT'S NOT COVERED
BY OHIP.
THE DYE IS VERY EXPENSIVE.
PATIENTS OFTEN REQUIRE
MULTIPLE VISITS AND
TREATMENTS BUT OHIP IS
CURRENTLY LOOKING AT THIS
AND HOPEFULLY ONE DAY WILL
PAY FOR THIS.

Maureen says MOVING ON, YOU
DO EYE SURGERY AT THE
BOCKNER CLINIC IN TORONTO.
WE'VE HEARD ABOUT THE
STUDIES DONE ABOUT NIGHT
VISION, DO YOU WANT TO
ADDRESS ALL OF THOSE ISSUES?

Raymond says YES.
UNFORTUNATELY LASER EYE
SURGERY HAS GOTTEN A BAD
WRAP IN THE MEDIA IN THE
LAST FEW MONTHS HOWEVER THE
FROM IN LASER SURGERY IS
STILL VERY SIGNIFICANT, AND
ONE OF THE TRUE FACTORS THAT
TELLS THE WHOLE STORY IS THE
NUMBER OF EYE DOCTORS THAT
ARE CURRENTLY UNDERGOING THE
PROCEED TOUR.

Maureen says THEMSELVES.

Raymond says
THEMSELVES.
AT THE BOCKNER WE'RE DOING
AT LEAST ONE EYE DOCTOR
EVERY WEEK THAT COMES FROM
ACROSS CANADA OR THE UNITED
STATES.
THE STUDY THAT WAS PRESENTED
IN BOSTON BY A Dr. JORY FROM
ENGLAND SHOWED A HIGH
PERCENTAGE OF PATIENTS HAD
NIGHT VISION PROBLEMS.
HOWEVER THERE WERE A NUMBER
OF PROBLEMS WITH THE STUDY.
ONE, OLD LASER TECHNOLOGY
WAS USED.
EQUIPMENT THAT WAS NEVER
APROVED IN CANADA OR THE
UNITED STATES.
IN ADDITION, THE PATIENTS
THAT WERE CHOSEN FOR THIS
STUDY WOULD BE CONSIDERED
UNACCEPTABLE BY TODAY'S
STANDARDS IN TERMS OF THE
EXTREME DEGREES OF NEAR
SIGHTEDNESS.
BUT WITH PROPER LASER
TECHNOLOGY, WITH PROPER
PATIENT COUNSELLING AND
SELECTION AND FOLLOW-UP, THE
INCIDENTS OF NIGHT VISION
PROBLEMS, IS EXTREMELY RARE.

Maureen says BUT IT'S
SOMETHING PATIENTS DO HAVE
TO BE TOLD ABOUT IN THE
CONSULTATION, I GUESS.

Raymond says
ABSOLUTELY.
THIS IS SURGERY, IT'S NOT
LIKE BUYING A TV OR
REFRIGERATOR THAT YOU CAN
TAKE BACK, AND PATIENTS
SHOULD BE COUNSELLED ABOUT
ALL THE RISKS AS WELL AS THE
BENEFITS.

Maureen says OKAY, YOU'VE
BROUGHT ALONG A COMPUTER
PROGRAMME THAT SHOWS US EYE
LASER SURGERY.
DO YOU WANT TO TELL US ABOUT
THAT?
GIVE US A LITTLE DEMO HERE?

Raymond says SURE,
I'LL BE HAPPY TO GO THROUGH
JUST A LITTLE BIT OF
BACKGROUND INFORMATION.

Raymond runs a presentation on a laptop computer.

Raymond continues THIS IS A HUMAN HAIR THAT'S
BEEN ETCHED BY THE EXEMER
LASER AND YOU CAN NOTE THE
EXQUISITE DETAIL OF THE
ETCHING WITH THIS LASER.
THIS IS JUST A SCHEMATIC
SHOWING THE EYE.

An animated eye cut in half appears.

Raymond continues YOU CAN SEE THAT THE
VERY FRONT PART OF THE EYE
IS THE CALIFORNIA, AND
THAT'S WHAT WE OPERATE ON
AND WE CHANGE THE SHAPE OF
THE CALIFORNIA.
WE EITHER FLATTEN THE
CALIFORNIA IN THE CASE OF
MYOPIA OR WE STEEPEN THE
CORNEA IN THE CASE OF
PATIENTS THAT ARE
SHORT-SIGHTED.

Maureen says SO THIS TREATS
BOTH CONDITIONS, MYOPIA OR
FAR SIGHTEDNESS?

Raymond says AND IN
ADDITION WE'VE BEEN ABLE TO
TREAT ASTIGMATISM OVER THE
PAST TEN YEARS IN CANADA.

Maureen says OKAY.
CONTINUE, SORRY.

Raymond says THIS IS A PICTURE OF AN
EXEMER LASER.

The caption changes to “Laser Vision Correction.”

Raymond continues TEN YEARS AGO THERE WERE
ONLY A COUPLE MANUFACTURER,
TODAY THERE ARE OVER 20 AND
THESE COMPANIES ARE
COMPETING FOR ADVANCES IN
TECHNOLOGY IN THIS MARKET.
THIS IS A PATIENT THAT IS
LYING BENEATH THE LASER.
THERE ARE NO NEEDLES
INVOLVED, ONLY DROPS, AND A
LITTLE SPECK LUM THAT HOLDS
THE LIDS APART SO THE
PATIENT CAN'T SQUEEZE.
THIS WAS THE PROCEDURE THAT
WAS VERY POPULAR FOR A
NUMBER OF YEARS, AND THE
PATIENTS DID EXTREMELY WELL.
IT'S KNOWN AS P.R.K., OR
PHOTO REFRACTIVE KARATECTOMY,
AND UNLIKE THE PROCEDURE OF
LACEK, EVERYTHING IS DONE ON
THE SURFACE OF THE EYE, AND
YOU SAW HERE A LITTLE BRUSH
THAT WAS USED TO REMOVE A
VERY THIN LAYER OF CELLS
CALLED THE EPITHELEU ANDMD A
RETICULE IS PLACED OVER THE
EYE, THE PUPIL AND A SMALL
AMOUNT OF TISSUE IS REMOVED,
USUALLY LESS THAN THE
THICKNESS OF A HAIR AND THEN
THE PATIENTS WERE TREATED
WITH A CONTACT LENS AND
THEIR VISION RETURNED, BUT
IT TOOK A NUMBER OF DAYS
BEFORE THE PATIENTS WERE
VERY FUNCTIONAL.

Maureen says BUT THEY GOT TO
GET RID OF THE CONTACT LENS,
RIGHT?

Raymond says THE
CONTACT WAS REMOVED AFTER
ABOUT FIVE DAYS.

Maureen says OKAY.
OKAY, SO THAT'S PRK.

Raymond says AND THIS SHOWS THE EXEMER
LASER RESHAPING THE
CALIFORNIA AND EACH PULLS OF
THE LASER REMOVES A PRE SAYS
AMOUNT OF TISSUE, AND OVER
ALL, LESS THAN 50 MICRONS OR
A HUMAN HAIR IS REMOVED FROM
THE SURFACE OF THE EYE AND
THIS DIME GRAMATICALLY SHOWS
HOW WE TREAT NEAR
SIGHTEDNESS.

An animation of the procedure appears.

Raymond continues THE PROCEDURES HAVE ADVANCED
TO A TECHNIQUE CALLED LACEK.
THIS IS A PROCEED DUR IN
WHICH THE STRUMT CALLED THE
MICRO KAROTOME IS USED TO
LIFT A VERY THIN FLAP OF
CORNEAL TISSUE AND THEN THE
LASER IS USED IN THE BED TO
RESHAPE THE CORNEA.

The caption changes to “Lifting the Hinged Corneal Flap.”

Maureen says SO WHAT ARE WE
SAYING HERE?
THEY'RE LIFTING THE CORNEAL
FLAP --

Raymond says WHAT
YOU'RE SEEING HERE IS THAT
THIS EYE HAS ALREADY BEEN
CUT WITH A MICRO KAROTONE.
THE PATIENT DOESN'T FEEL
ANYTHING, OCCASIONALLY JUST
A LITTLE BIT OF PRESSURE AND
HERE WE ARE, LIFTING THIS
VERY THIN FLAP OF CORNEAL
TISSUE SHOE AND THEN THE
LASER IS USED IN THE BED.

The caption changes to “Drying the Stromal Bed.”

Raymond continues HERE THE FLAP OF TISSUE HAS
BEEN LIFTED, AND WE'RE JUST
DRYING THE SURFACE HERE,
BECAUSE WE WANT TO MAKE SURE
THAT WE'RE NOT JUST
VAPORIZING FLUID ON THE
SURFACE BUT ACTUALLY
RESHAPING THE CORNEA.

The caption changes to “Laser Ablation.”

Raymond continues AND THE PROCEDURE IS
RELATIVELY QUICK, AND HEAR
WE PLACE A SMALL RETICULE
THAT HELPS FOR ALIGNMENT AND
FOCUSING OVER THE PUPIL TO
RESHAPE THE CORNEA.
WE'LL THEN REPOSITION THE
FLAP --

Maureen says BECAUSE YOU NEED
THAT FLAP.
YOU HAVE TO PUT IT BACK,
RIGHT?

Raymond continues YOU NEED THE FLAP FOR
COMPORT AND QUALITY OF
VISION ISSUES.
WE'RE PUTTING A LITTLE BIT
OF FLUID UNDERNEATH THE
FLAP.
THE FLAP IS REPOSITIONED AND
THERE'S A DRAMATIC
IMPROVEMENT IN VISION, EVEN
AT THIS STAGE.

A clip shows the actual procedure on an eye.

Maureen says SO THE FLAP,
YOU'VE CUT AROUND IT FOLDED
IT BACK, THEN YOU PUT IT
BACK ON.
DOES IT JUST RECONNECT TO
THE REST OF THE ISSUE ON ITS
OWN?

Raymond says IT
ADHERES VERY QUICKLY.
USUALLY WITHIN ONE TO TWO
MINUTES.

Maureen says REALLY?

Raymond says AND
THIS WAS THE GREAT ADVANCE
IN LASER VISION CORRECTION
OVER P.R.K..
WITH P.R.K. WE HAD TO WAIT
UNTIL THOSE CELLS REGREW ON
THE SURFACE OF THE EYE,
WHICH TOOK A NUMBER OF DAYS.
BUT WITH LACEK, ONCE WE
REPOSITION THE FLAP THERE'S
A DRAMATIC IMPROVEMENT IN
VISION AND USUALLY WITHIN
THREE TO FOUR HOURS,
PATIENTS CAN WATCH TV AND
READ.

Maureen says NOW MY SISTER
HAD IT DONE AND I KNOW SHE
WASN'T SUPPOSED TO RUB HER
EYES FOR A WHILE BECAUSE OF
THIS FLAP THING, IS THAT
CORRECT?

Raymond says IT'S VERY IMPORTANT
FOR PATIENTS NOT TO RUB
THEIR EYES, TO LET THE FLAP
SETTLE DOWN BUT USUALLY
WITHIN A WEEK OR TWO, IF ONE
WERE TO RUB THE EYE IT WOULD
BE VERY DIFFICULT TO
DISLODGE THE FLAP.

Maureen says OKAY.
WHAT IS WALKING AROUND IN
THE WORLD WHO'S HAD THIS
SURGERY THE LONGEST?
DO YOU KNOW WHAT I'M SAYING?
HOW OLD IS THIS SURGERY?

Raymond says IN
TERMS OF P.R.K., IT'S ABOUT
13 YEARS.
THERE WAS A MODIFIED
PROCEDURE OF LACEK THAT HAS
BEEN AROUND FOR ALMOST 30
YEARS.
IN FACT IT WASN'T A LASER
THAT WAS USED BY THIS MICRO
KARATOME WHICH WAS THEN USED
TO REMOVE A LITTLE BIT OF
TISSUE, BUT THAT FLAP WAS
REPOSITIONED.
SO WE HAVE DATA OUT THAT'S
ALMOST 30 YEARS OLD.

Maureen says AND WHAT WAS TO
THESE PEOPLE AS THEIR EYES
AGE?
FOR EXAMPLE I DON'T NEED
GLASSES FOR VISION BUT SOME
TAI I MAY NEED THEM TO READ.
WHAT'S GOING TO HAPPEN TO
PEOPLE WHO HAVE HAD THIS
SURGERY?

Raymond says
EVERYBODY THAT HAS VERY GOOD
DISTANCE VISION, WHETHER
IT'S NATURALLY OR FOLLOWING
LASER VISION CORRECTION,
BETWEEN ABOUT 42 AND 47
YEARS OF AGE WILL NEED
READING GLASSES, AND
ALTHOUGH WE'RE WORKING ON
NEW TECHNOLOGIES TO TRY TO
TREAT THAT THERE'S NOTHING
AVAILABLE TODAY FOR THAT.
SO PATIENTS THAT HAVE HAD
THE PROCEDURE DONE WHEN THEY
GET TO BE IN THEIR 40s WILL
NEED READING GLASSES.

Maureen says OKAY AND WHAT
ABOUT THINGS LIKE CONTACT
PRACTICE OR GLAUCOMA.
WHAT IF THAT WERE TO HAPPEN
IN A PERSON WHO'S HAD THE
PROCEDURE DONE.

Raymond says IN
TERMS OF CONTACT RAKTS IT'S
A NORMAL AGING CHANGE.
IF YOU LIVE LONG ENOUGH
YOU'RE GOING TO GET THEM BUT
HAVING HAD LASER SURGERY
DOES NOT INTERFERE IN ANY
WAY WITH REMOVAL OF THE
CATARACT WHICH IS INSIDE THE
EYE.
AND IN THE SAME WAY WITH
LAUK COMA.
THERE CAN BE A FEW LITTLE
TRICKS THAT OPHTHALMOLOGISTS
AND OPTOMETRISTS KNOW IN
TERMS OF CHECKING THE
PRESSURE AFTER A PATIENT HAS
HAD A LASER VISION
CORRECTION BUT IT DOESN'T
INTERFERE WITH ANY THE
TREATMENT.

Maureen says ALL RIGHT, WE'RE
TALKING ABOUT EYES TODAY
WITH OPHTHALMOLOGIST
Dr. RAYMOND STEIN.
IF YOU HAVE QUESTIONS, HIS
SPECIALTY IS ESPECIALLY THE
CATARACT AND EYE LASER
SURGERY, OBVIOUSLY.
VALERIE IS IN TORONTO.
HI VALERIE.

Valerie says HI.
MY QUESTION IS ABOUT CONTACT
PRACTICE.
MY MOTHER HAD A CONTACT RAKT
AND FOR MANY YEARS IT DIDN'T
WORK.
SHE WENT TO MANY PLACES AND
THEY WEREN'T ABLE TO TELL
WHAT WAS WRONG AND IN THE
END SHE HAD TO DO WITH THE
CONTACT RAKT, REPLACE IT AND
GET A CORNEAL TRANSPLANT AND
SHE WENT TO SOME TOP PLACES
AND I'M WONDERING WHERE THEY
COULDN'T TELL RIGHT AWAY.

Raymond says THERE
ARE A NUMBER OF
COMPLICATIONS THAT CAN OCCUR
AFTER CATARACT SURGERY, BUT
WITH TODAY'S NEWEST
TECHNIQUE, THE COMPLICATIONS
ARE UNCOMMON.
IT SOUNDS LIKE YOUR MOTHER
HAD A CONDITION OF THE
CORNEA IN WHICH IT BECAME
SWOL BEN FOLLOWING CATARACT
SURGERY.
USUALLY THAT'S PRETTY
STRAIGHT FORWARD IN TERMS OF
DIAGNOSIS AND THAT CAN BE A
COMBINATION OF PATIENTS
FOLLOWING CATARACT SURGERY
THAT HAVE SOMEWHAT
COMPROMISED CORNEAS AND NEED
TRANSPLANT BUT FAIRLY
UNCOMMON.

Maureen says AND YOU DON'T
THINK IT WOULD HAPPEN WITH
THE NEW TYPES OF SURGERY
DONE TODAY?

Raymond says IT CAN
HAPPEN IN ANY OPERATION BUT
USUALLY WITH PROPER
SCREENING PRIOR TO THE
SURGERY IN WHICH WE CAN
DETECT IF THE CORNEA IS
SLIGHTLY THICKER THAN NORMAL
THE RISKS ARE SLIGHTLY
INCREASED.

Maureen says YOU'VE GOT
CATARACT SURGERY ON YOUR
LAPTOP, TOO, DON'T YOU?

Raymond says WE
HAVE JUST A FEW PICTURES
OF -- WE HAVE LOTS ON THE
MACULA BUT NOT THE
CATARACTS.
I'LL DESCRIBE A FEW THINGS
TODAY.
TEN YEARS AGO THE TECHNIQUE
WAS TO MAKE A VERY LARGE
INCISION, TO GIVE A NEEDLE
BEHIND THE EYE, TO NUMB THE
EYE, IS AFTER THE CATARACT
WAS REMOVED, AN IMPLANT WAS
PUT IN, FREQUENTLY IN FRONT
THE IRIS AND MULTIPLE SUIT
TURNS WERE REQUIRED.
BUT TODAY A VERY TINY
INCISION IS MADE, LESS THAN
THREE MILLIMETRES AND IT CAN
BE DONE UNDER TOPICAL
ANAESTHESIA, THE PROCEDURE
USUALLY TAKES LESS THAN HALF
AN HOUR, FREQUENTLY 10 OR 15
MINUTES, AND THE COMPANIES
HAVE DESIGNED VERY UNIQUE
IMPPLANTS THAT CAN BE FOLDED
AND GO THROUGH A TINY
OPENING AND THEN OPEN UP IN
THE EYE AND THERE'S A
DRAMATIC IMPROVEMENT,
USUALLY WITHIN A HALF HOUR
TODAY.

Maureen says WHY DO WE GET
CATARACTS?

Raymond says
THEY'RE A NORMAL AGING
CHANGE.
NO ONE KNOWS FOR SURE BUT
THE THINKING IS THAT U.V.
LIGHT CAN BE ONE OF THE RISK
FACTORS FOR ACQUIRING A
CATARACT.
SO CERTAINLY IF WE GO OUT
AND IT'S A VERY SUNNY DAY,
IT'S WORTH WHILE TO WEAR
SUNGLASSES.

Maureen says AND HOW WOULD
YOU KNOW IF YOU HAVE HEM?

Raymond says IT'S A
NORMAL CHANGE THAT HAPPENS
OVERTIME.
SMALL CHANGES CAN OCCUR IN
WHICH A PATIENT MAY NOT BE
AWARE OF IT, BUT THEIR CHINATION
EYE DOCTOR WILL BE ABLE TO
DETECT IT.
BUT ONCE THE VISION IS
INTERFERED WITH, IT'S PRETTY
STRAIGHT FORWARD, PERSON HAS
TROUBLE COPING WITH DALE
DAILY ACTIVITIES OF LIVE,
TROUBLE AT NIGHT TIME AND
THAT'S OFTEN ONE OF THE
FIRST CHIT CAL SYMPTOMS OF
CATARACT, WITH GLARE OR
HALOS AT NIGHT.

Maureen says I SEE.
LET'S GO TO JERRY IN
HOPE.
HI.

Jerry says HI.
I HAVE A QUESTION ABOUT
FUKES DYSTROPHY.
IF A LASER CAN WORK ON IT OR
DO THEY HAVE TO DO THE
CORNEAL TRANSPLANT.

Raymond says IT'S A
KVE THE CORNEA WHERE THE
BACK LAYER OF CELLS ARE
ABNORMAL AND THIS
ABNORMALITY CAN LEAD TO
CORNEAL SWELLING.
WHEN THE CORNEA IS SWOLLEN
LASER SURGEVY NOT HELPFUL
BECAUSE WHAT'S NECESSARY IS
TO REPLACE THE CORNEA AND
MOST IMPORTANTLY TO REPLACE
THOSE BACK SES WITH HEALTHY
CELLS SO LASER SURGERY
WOULDN'T BE HELPFUL,
UNFORTUNATELY.

Maureen says SO YOU NEED A
CORNEA TRANSPLANT IN THAT
CASE?

Raymond says PATIENTS WOULD NEED A
CORNEAL TRANSPLANT.

Maureen says WE SHOULD PUT A
LITTLE PLUG FOR PEOPLE TO
SIGN THEIR DONOR CARDS.

Raymond says CORNEAL TRANSPLANTS ARE A
COMMON OPERATION TODAY
WORLDWIDE AND CERTAINLY IN
TORONTO.
WE'VE GOT A VERY
SOPHISTICATED EYE BANK THAT
DISTRIBUTES CORNEAS AROUND
THE PROVINCE AND THE COUNTRY
TO SURGEONS THAT DO
TRANSPLANTS AND THAT'S ONE
OF MY SPECIALTIES.

Maureen says IS THERE A
SHORTAGE OF CORNEAS THE WAY
THERE'S A SHORTAGE OF HEARTS
AND LIVERS AND KIDNEYS?

Raymond says THERE IS A SHORTAGE.
MANY PATIENTS WAIT MONTHS TO
YEARS FOR A CORNEAL
TRANSPLANT TODAY.

Maureen asks HOW LONG DOES
THE TRANSPLANT LAST?

Raymond replies IT CAN
LAST FOR YEARS.
MANY OF THE PATIENTS
UNDERGOING TRANSPLANTATION
ARE IN THEIR 60s OR 70s BUT
THERE ARE A VARIETY OF
CONDITIONS THAT AFFECT
INFANTS AND TEENAGERS, AND
WE KNOW THAT TRANSPLANTS
HAVE BEEN DONE FOR 50 YEARS
AND WITH A HEALTHY
CALIFORNIA TO -- CORNEA TO
START WITH PATIENTS
FREQUENTLY DIE BEFORE THEIR
CORNEA FAILS.

Maureen says IS THAT RIGHT.
KEON, NEXT IN SCARBOROUGH.

Keon says HOW ARE YOU?

Maureen says GOOD, THANGSZ.

Keon says I'M 33 YEARS OLD,
WHEN I WAS 14 I HAD A
DETACHED RETS IN A AND WENT
TO St. MIKE'S AND HAD THE
LASER.
NOW I DON'T SEE OUT OF THE
EYE AT ALL, IT'S KIND OF
COME AND GONE.
I HAD NEVER REGAINED ANY
VISION.
I'M WONDERING IF THEY HAVE
ANY TYPE OF EYE REPLACEMENT,
AND I'M WONDERING, ALSO, IF
FOR THE GOOD EYE, IF IT'S
WORTH THE RISK IN DOING ANY
TYPE OF LASER SURGERY FOR
JUST BETTER VISION?
I MEAN I WEAR GLASSES FOR
THE LEFT EYE AS IT IS.

Raymond says WE CAN
REPLACE MANY PAFRT THE EYE,
CORNEA, LENS, BUT
UNFORTUNATELY WE CAN'T
REPLACE THE RHETT NACHLT
RETINAL DETACHMENT SERGEARY
ARE USUALLY VERY SUCCESSFUL,
BUT COMPLICATIONS CAN OCCUR,
AND CASES CAN BE DIFFICULT,
PROBABLY IN YOUR PLACE AND
THE RETINA HAS BEEN DAMAGED
AND UNFORTUNATELY THERE'S
NOTHING THAT CAN BE DONE AT
THIS TIME.
THERE'S CERTAINLY RESEARCH
GOING ON TO TRY TO CREATE AN
ARTIFICIAL RETINA, BUT THIS
IS REALLY IN THE PRELIMINARY
STAGES.

Maureen says CAN YOU TELL US
A BIT MORE ABOUT KEON'S
CONDITION?

Raymond says A
RETINAL ATTACHMENT IS
ESSENTIALLY WHAT THE NAME
SUGGESTS, DETACHMENT OF THE
RETINA.
THE RETINA IS LIKE THE FILM
OF THE CAMERA.
AND IF A PATIENT DEVELOPS A
TEAR OR HOLE IN THE RETINA,
THEN FLUID CAN GET
UNDERNEATH THE TEAR AND HOLE
AND LIFT UP THE RETINA, AND
IT USUALLY WON'T REPAIR BY
ITSELF, UNLIKE MANY
CONDITIONS, AND PATIENTS
REQUIRE DRAINAGE OF THE
FLUID AND REPOSITIONING OF
THE RETINA.
IF THE RETINA HAD BEEN
DETACHED FOR ANY SIGNIFICANT
LENGTH OF TIME, THEN
DEGENERATION OCCURS TO THESE
CELLS IN THE RETINA,
SO-CALLED PHOTO RECEPTORS,
THAT PERCEIVE LIGHT, AND
SENDS THE IMAGE TO THE BRAIN.

Maureen says SO THE PHOTO
DYNAMIC THERAPY WE SAW
EARLIER THAT WOULDN'T HELP
THIS CONDITION EITHER.

Raymond says NO,
NO.

Maureen says THANK YOU FOR
YOUR CALL.

Maureen turns to look at a computer screen and says JUNE WOULD LIKE TO KNOW IF
LASER SURGERY CAN BE DONE ON
PEOPLE WITH GLAUCOMA.
I HAVE PRESSURE READINGS OF
20 OR SO FOR THE PAST TEN
YEARS.

Raymond says IT CAN
BE DONE ON PATIENTS WITH
GLAUCOMA.
THE QUESTION IS HOW ADVANCED
IS THE GLAUCOMA.
THERE ARE SOME SMALL RISKS
WITH LASER SURGERY WITH
INCREASE IN PRESSURE IN THE
EYE BUT GENERALLY IF THERE
ISN'T ANY SIGNIFICANT
DISEASE LASER SURGERY CAN
WORK VERY WELL.

Maureen says DO PRESSURE
READINGS OF 20 SOUND --

Raymond says THAT'S
A RELATIVELY NORMAL PRESSURE
BUT SHE NEEDS A GOOD EYE
EXAMINATION TO MAKE SURE
THAT THAT PRESSURE IS
SATISFY FOR HER.
FOR MOST PEOPLE THAT WOULD
BE FINE.

Maureen says IN THE MACULAR
DEGENERATION PIECE WE SAW
WHAT PEOPLE WITH WET MACULAR
DEGENERATION SEE, IT GETS
SORT OF FUZZY IN THE MIDDLE.
IT'S MY UNDERSTANDING WITH
GLAUCOMA IT'S THE PERIPHERAL
VISION THAT GETS FUZZ
DISPLEE?

Raymond says THAT'S
RIGHT.
USUALLY WITH INCREASED
PRESSURE THAT'S NOT DETECTED
OR TREATED.
PATIENTS LOSE THEIR
PERIPHERAL VISION SCOMPIRS
IN VERY ADVANCED STAGES THEY
CAN LOSE THEIR CENTRAL
VISION BUT HOPEFULLY THAT'S
PICKED UP IN TIME.

Maureen says GILBERT IS IN
BRAMPTON.
HELLO.

Gilbert says GOOD AFTERNOON.

Maureen says HI.

Gilbert says MY QUESTION'S
REGARDING TRANSPORT SCOMPAN
WHAT I USED TO UNDERSTAND,
I'M NOT SURE IF IT'S TILL IS
A FACT, BUT IF YOU HAD LASER
SURGERY, YOUR PILOT'S
LICENSE WOULD BE SUSPENDED
OR REVOKED FOR A PERIOD OF
TIME.
IS THAT STILL CORRECT?

Raymond says LASER
SURGERY FOR NON-COMMERCIAL
PILOTS IS AN APPROVED
PROCEDURE, BUT IT'S REALLY
UP TO THE AIRLINES TO
APPROVE IT.
IN THE UNITED STATES THE
U.S. MILITARY AND THE AIR
FORCE HAVE APPROVED IT FOR
PATIENTS THAT HAVE HAD LASER
SURGERY.
SO IT'S REALLY UP TO THE
AIRLINE INDUSTRY TO MAKE A
DECISION.

Maureen says AND WHAT IS THE
DECISION RIGHT NOW FOR AIR
CANADA, SAY?

Raymond says FOR
MOST PILOTS THEY DON'T ALLOW
LASER SURGERY, BUT ALL THE
INFORMATION IS OUT THERE,
WITH CLINICAL STUDIES DONE
ON PILOTS, SHOWING SATISFY
NIGHT VISION, AND I WOULD
SUSPECT THAT THEY WILL
PROBABLY CHANGE THEIR
POLICY.

Maureen says IS THAT RIGHT?
OKAY.
IT JUST NEEDS TO BE OUT
THERE A LITTLE LONGER.
AND DO YOU GET THAT FROM
PATIENTS?
ARE THEY JUST A LITTLE
WORRIED THAT IT'S JUST
LITTLE TOO NEW?
EVEN THOUGH YOU'VE TALKED
ABOUT FORMS OF IT BEING
AROUND FOR 30 YEARS, IT'S
REALLY ONLY RECEIVED
ATTENTION IN THE LAST COUPLE
OF YEARS.

Raymond says I
DON'T THINK SO IN THE EARLY
DAYS IT WAS THE RISK TAKERS.
WE TOLD THEM THAT THE
PROCEDURE HAD BEEN AROUND
JUST FOR A FEW YEARS AND
THESE WERE THE THINGS THAT
WERE KNOWN BUT THERE WERE
MANY UNKNOWNS AND PATIENTS
BY AND LARGE, A SMALL
PERCENTAGE HAD IT DONE.
BUT TODAY WE'RE GETTING VERY
CONSERVATIVE PEOPLE THAT
MANY, PHYSICIANS AND EYE
DOCTORS THAT READ ALL THE
AVAILABLE LITERATURE AND
FEEL COMFORTABLE.
MANY OF THE PATIENTS
WOULDN'T GO TO CASINO RAMA,
BUT THEY CERTAINLY COME
HERE.

Maureen says NOW IT SEEMS TO
ME THE DEBATE IS MOVING
TOWARD THE COST OF THE
SURGERY.
SO I'M READING THAT YOU CAN
BRING A FRIEND ALONG AND
BOTH OF YOU GET DONE FOR, I
THINK IT'S 2000 DOLLARS.
AND YET SOME INSTITUTE,
YOURS IS ONE, STILL CHARGING
5,000 DOLLARS FOR THE TWO EYES.
WHAT'S GOING ON THERE WITH
PRICE?

Raymond says WELL, THERE ARE A LOT OF
CORPORATE CENTRES THAT ARE
STRUGGLING FINANCIALLY AND
IT'S A DIFFICULT MARKET OUT
THERE.
IT'S VERY IMPORTANT THAT THE
CONSUMER KNOW THAT THIS IS
REAL SURGERY.
AND THE DECISION ONE MAKES
SHOULD BE SIMILAR TO
RECOMMENDING BY PASS SURGERY
OR NEUROSURGERY FOR
THEMSELVES OR A RELATIVE.
YOU WANT TO KNOW HOW LONG
HAS THE CLINIC BEEN IN
OPERATION AND WHAT ARE THE
QUALIFICATIONS OF THE DOCTOR,
AND WHAT IS THE SUCCESS
RATE.
AND SO IT'S VERY IMPORTANT
FOR THE CONSUMER TO SHOP
AROUND AND MAKE SURE THEY'RE
VERY COMFORTABLE WITH THE
DOCTOR.
BUT YOU WANT TO MAKE SURE
THAT THE TECHNOLOGY IS UP TO
DATE.

Maureen says CAN YOU ASK -- I
GUESS YOU CAN ASK A LOT OF
QUESTIONS OF THE DOCTOR.
ASK IF THERE ARE ANY
LAWSUITS AGAINST THE
INSTITUTE AND THINGS LIKE
THAT?

Raymond says YOU
CAN CERTAINLY ASK THOSE
QUESTION, BUT ASKING OTHER
CONSUMERS YOU KNOW THAT HAVE
HAD THE PROCEDURE DONE THAT
HAVE BEEN HAPPY WITH IT, ASK
THEIR FAMILY DOCTOR, ASK
OTHER OPHTHALMOLOGISTS OR
OPTOMETRIST, THEY REALLY
NEED TO DO THEIR HOME WORK
TO TRY TO FIND THE BEST SPOT
AND THE BEST SURGEON FOR
THEIR EYES.

Maureen says ALL RIGHT, WE'RE
TALKING ABOUT EYE HEALTH
THIS AFTERNOON WITH
DOCTOR RAYMOND STEIN.
IF YOU HAVE A QUESTION ABOUT
YOUR EYES GIVE US A CALL.
LET'S GO TO LEAH
IN RICHMOND HILL.
WELCOME, LEAH.

Leah says YES, THANK YOU
VERY MUCH.
I WOULD LIKE TO KNOW -- I
HAD SIX YEARS AGO CATARACT
SURGERY, AND I WOULD LIKE TO
KNOW, I COULD BETTER MY
VISION.
COULD I HAVE SOMETHING ELSE
DONE TO GET BETTER VISION?

Raymond says THAT'S
A GOOD QUESTION.
WE HAVE TO UNDERSTAND THE
CAUSE OF THE DECREASED
VISION.
IF IT'S SIMPLY PRESCRIPTION,
IF YOU HAPPEN TO BE A LITTLE
NEAR SIGHTED OR FAR SIGHTED
AND THE EYE IS HEALTHY
OTHERWISE, THEN PATIENTS
LIKE YOURSELF COULD HAVE
LASER VISION CORRECTION.
A VERY COMMON PROBLEM THAT
CAN OCCUR A NUMBER OF MONTHS
OR YEARS DOWN THE ROAD AFTER
CATARACT SURGEVY A SMALL
MEMBRANE DEVELOPS BEHIND THE
IMPLANT.
IF THAT OCCUR, THE TREATMENT
IS A DIFFERENT TYPE OF LASER
IN WHICH WE CAN VAPORIZE
THAT MEMBRANE AND RESTORE
VISION.
SO YOU REALLY NEED TO GO
BACK TO YOUR DOCTOR AND MAKE
SURE THAT IT'S SIMPLY A
PRESCRIPTION ISSUE, AND IF
THAT'S THE CASE, YOU
PROBABLY ARE A CANDIDATE.

Maureen says OKAY.
I HAVE A QUESTION ABOUT
CATARACTS HERE ON THE
INTERNET AS WELL FROM BETTY
ANNE IN MIDLAND.
Maureen reads “MY MOTHER WHO IS NOW 90
YEARS OLD HAS HAD CATARACT
SURGERY ON BOTH EYES AND HAD
IMPLANTS PUT IN.
FOR THE LAST THREE OR FOUR
YEARS SHE'S BEEN SUFFERING
FROM DOUBLE VISION AND NO
ONE SEEMS TO BE ABLE TO GIVE
US AN EXPLANATION AS TO WHY
IT HAPPENED OR WHAT CAUSED
IT.”
DISMUN.

Raymond says DOUBLE
VISION CAN OCCUR FOR A
NUMBER OF DIFFERENT REASONS.
IT COULD BE RELATED TO WHAT
I DESCRIBED BEFORE, AN
OLPACIFICATION BEHIND THE
IMPLANT.
IF IT OCCURS JUST IN ONE EYE,
THEN THAT SUGGESTS IT'S
PROBABLY A PROBLEM WITH THE
IMPLANT.
MAYBE IT'S NOT EXACTLY IN
THE RIGHT SPOT, BUT IF IT'S
OCCURRING WITH BOTH EYES
OPEN, THIS SUGGESTS A YOU'RE
IN LOGIC PROBLEM.
THE EYE AND THE SUR ROUNDING
AREA ARE VERY COMPLEX
STRUCTURES.
THERE ARE MANY NERVES THAT
GO TO THE EYE MUSCLE, AND IF
ONE HAS A WEAKNESS OF ONE OF
THOSE MUSCLES OR NERVES,
THEN THAT CAN CREATE A
PROBLEM WITH DOUBLE VISION.
SO IF IT'S OCCURRING WITH
BOTH EYES OPEN, SHE SHOULD
SEE AN OPHTHALMOLOGIST THAT
SPECIALIZES IN THE NERVOUS
SYSTEM.

Maureen says OKAY.
SO SOMETHING CAN BE DONE
PERHAPS FOR HER.

Raymond says
POSSIBLY.

Maureen says OKAY.
BERRY IS IN SUDBURY.
HI BERRY.

Berry says HI.
I WAS JUST WONDERING HOW
CANNABIS HELPS PEOPLE WITH
GLAUCOMA WITH THE EYES?

Maureen says OH, YEAH, HOW
DOES THAT WORK?

Raymond says IT'S A
GOOD QUESTION.
WE USE LOTS OF DIFFERENT
MEDICATIONS TO LOWER INTEROK
LAR PRESSURE AND IT'S HIGH
PRESSURE AT FAULT WITH
GLAUCOMA AND WE HAVE LEARNED
ANECDOTALLY THAT IF PATIENTS
ARE USING CANNABIS, THEN
THIS LOWERS THE PRESSURE IN
THE EYE.
WE DON'T KNOW THE EXACT NECK
NICHL, BUT THERE'S A
STRUCTURE IN THE EYE THAT
MAKES FLUID, AND IT'S
HYPOTHESIZED THAT THE
MEDICATION ACTS ON THIS
STRUCTURE OF THE CILLARY
BODY TO DECREASE FLUID
PRODUCTION.

Maureen says DO YOU BUY IT?

Raymond says IT
SEEMS TO WORK.

Maureen laughs and says ARE THERE OTHER
THINGS THAT WORK AS WELL
THAT DON'T DELIVER SORT OF
CARCINOGENS TO YOUR LUNGS?

Raymond says THERE
ARE MANY NEW DRUGS THAT ARE
ON THE MARKET THAT ARE USED
JUST TOPCALLY AND HAVE VERY
FEW SYSTEMIC EFFECTS.

Maureen says OKAY SO, THAT'S
THAT ANSWER SO WHAT SHOULD
WE -- THIS PRESSURE THAT WE
TALK ABOUT, WILL YOU FEEL AS
IF THERE'S PRESSURE IN YOUR
EYES AS YOU'RE JUST
DISCOVERING THAT YOU HAVE
GLAUCOMA?

Raymond says THERE ARE TWO FORMS OF
GLAUCOMA.
ONE FORM WHICH IS LESS
COMMON AND OCCURS IN ABOUT
5 percent OF CASES IS A MARKED
INCREASE IN PRESSURE WHICH
PATIENTS CAN FEEL, THEY'RE
VERY UNCOMFORTABLE, IT
USUALLY HAPPENS IN ONE EYE
AT A TIME, THE EYE'S VERY
RED, THE PRESSURE IS OFTEN
SO HIGH THAT THEY FEEL
NAUSEOUS AND MAY BE VOMITING
BUT THAT'S THE RARE FORM.
THE MORE TYPICAL FORM WHICH
OCCURS 95 percent OF THE TIME IS
JUST PICKED UP IN A DOCTOR'S
OFFICE BY AN ELEVATION IN
PRESSURE OR CHANGES AT THE
BACK OF THE EYE THAT SUGGEST
THAT THE PRESSURE MAY BE
FLUCTUATING AND OCCASIONALLY
HIGH.

Maureen says HOW DO YOU SEE
THAT?
WITH YOUR LITTLE LIGHT?

Raymond says YEAH,
THERE'S AN INSTRUMENT CALLED
AN OPTHALMOSCOPE THAT ALLOWS
US TO LOOK AT THE PUPIL,
THROUGH THE PUPIL AT THE
BACK OF THE EYE LOOKING
DIRECTLY AT THE NERVE AND WE
KNOW IN GLAUCOMA DAMAGE
OCCURS TO THE NERVE, WHICH
THE EYE CARE PRACTITIONER
CAN VISUALIZE.

Maureen says BUT WHEN MY
FAMILY DOCTOR LOOKS IN MY
EYE WITH THAT LITTLE LIGHT
WHAT'S SHE LOOKING FOR?

Raymond says SHE'S
PROBABLY LOOKING FOR THE --
TO MAKE SURE THERE ISN'T A
CATARACT, IF THERE'S ANY
OPACITY OF THE MEDIA.
THEY WON'T BE ABLE TO LACK
INTO THE BACK OF THE EH.
WON'T BE ABLE TO VISUALIZE
WELL, AND ALSO THEY'LL LOOK
AT THE NERVE TO MAKE SURE
THAT'S HEALTHY AND MOST
PRACTITIONERS ARE SKILLED AT
THE LOOKING AT THE NERVE AND
THE MACULA AS WE LEARNED
ABOUT EARLIER ON IN THE
PROGRAMME.

Maureen says OKAY.
ALL RIGHT LEONARD IS IN
MISSISSAUGA.
HELLO, LEONARD.

Leonard says HI MY QUESTION
FOR THE DOCTOR IS I GOT A
HIT IN MY EYE AT AGE 17, AND
I GO TO QUITE A FEW EYE
SPECIALISTS AND THEY SAY I
HAVE A SCAR AT THE BACK OF
MY EYE.
I WAS WONDERING IF THIS
LASER TREATMENT CAN HELP
BECAUSE I DON'T SEE SO WELL
THROUGH MY LEFT EYE.
I SORT OF GLIMPSE OUT THE
SIDES.

Maureen says WHAT DID YOU GET
HIT WITH?

Leonard says I THINK IT WAS A
PEN OR PENCIL OR SOMETHING
LIKE IT.

Raymond says YEAH,
THE LASER SURGERY WE USE
TODAY FOR REFRIKTIVE
PURPOSES WE OPERATE ON THE
CORNEA AND YOUR PROBLEM IS
AT THE VERY BACK OF THE EYE.
THE TECHNIQUE OF PHOTO
DYNAMIC THERAPY IS FOR
MACULAR DEGENERATION, WHEN
PATIENTS HAVE ABNORMAL BLOOD
VESSELS TO PREVENT LEAKAGE
AND STAR FORMATION.
YOU HAVE A SCAR AT THE BACK
OF THE EYE.
THERE ARE SOME NEW SURGICAL
TECHNIQUES THAT ARE BEING
UTILIZED IN TORONTO AND ON
ONTARIO FOR PATIENTS WITH
MACULAR SCARS BY GOING IN --
THE SURGEON WILL GO IN, LIFT
THE RETINA UP, CREATE A
RETINAL DETACHMENT AND MOVE
A HEALTH YER PARTS OF THE
RETINA TO THE CENTRAL AREA
OF THE EYE.
THIS IS RELATIVELY
INVESTIGATAL SURGERY BUT
HOLDS SOME PROMISE FOR
PATIENTS LIKE YOURSELF.

Maureen says OKAY.
WHAT IS THE EYE DISEASE OR
PROBLEM RELATED TO DIABETES?
IS IT GLAUCOMA THAT YOU HAVE
TO WORRY ABOUT?

Raymond says MOST
OF THE TIME THE DIABETIC
THAT IS NOT WELL CONTROLLED,
OR HAS BEEN A DIABETIC FOR
MANY YEARS CAN DEVELOP
PROBLEMS MORE APT ON THE
RETINA WHERE THEY GET WAU
WHAT'S CALLED A RETINAPATHY,
MULTIPLE HEMORRHAGES OR
PROTEIN DEPOSITS, LIPID
DEPOSITS IN THE RHETT NACHLT
SO PATIENTS WITH DIP BEAT
TIS NEED TO SEE THEIR EYE
CARE PRACTITIONER ON A
REGULAR BASES AND I IF THESE
CHANGES ARE NOTED THERE IS
LASER TREATMENT.
IT'S NOT PHOTO DYNAMIC
THERAPY BUT OTHER FORMS OF
LASER THAT CAN BE HELPFUL IN
PRESERVING VISION.

Maureen says COULD WE
ACTUALLY HELP STAVE OFF
BLINDNESS IN THESE PEOPLE
WHOSE DIABETES IS NOT WELL
MANAGED?

Raymond says
ABSOLUTELY.
YEARS AGO BEFORE LASER
SURGERY WAS USED, MANY OF
THE DIABETIC PATIENTS WOULD
GO TOTALLY BLIND FROM
RETINAL DETACHMENT AND OTHER
PROBLEMS.
TODAY THE PROGNOSIS IS VERY
GOOD FOR THE DIABETIC.

Maureen says GOOD TO HEAR.
OKAY, ANNE IS NEXT IN
LONDON.
HI ANNE.

Anne says HI.
CAN YOU HEAR ME OKAY?

Maureen says YES I CAN.

Anne says OKAY.
I WAS JUST WONDERING ABOUT
FAR SIGHTEDNESS IS THERE ANY
RECOMMENDATION FOR THERAPY
FOR THAT PROBLEM?
AND ALSO I SEEM TO HAVE
DEVELOPED A BLUE RING AROUND
THE EYE.
MY EYES ARE BROWN BUT IT
SEEMS TO HAVE SHADES OF BLUE
COMING AROUND THE EYE.

Raymond says OKAY.
IN TERMS OF FAR SIGHTEDNESS,
YOU HAVE TO DISTINGUISH WHAT
WE CALL HYPEROPIA WHICH IS
ESSENTIALLY THE OPPOSITE OF
NEAR SIGHTEDNESS, WHICH
AFFECTS ABOUT 40 percent OF THE
POPULATION, AND THEY HAVE
TROUBLE BOTH WITH THEIR
DISTANCE VISION AND THEIR
READING VISION, AND WE'VE
BEEN ABLE TO TREAT THIS WITH
LASER SURGERY TODAY.
BUT SOME PEOPLE REFER TO THE
NORMAL AGING CHANGE WHICH A
MEDICAL TERM IS PRESBIOPIA
IS INABILITY IT SEE UP CLOSE
EVEN THOUGH THE DISTANCE
VISION IS FINE AND FOR THAT
WE DON'T HAVE ANY GRAIMT
TREATMENT TODAY.

Maureen says WHICH WOULD YOU BE,
ANNE?

Anne says I CAN'T SEE VERY
WELL -- MY DISTANCE IS OKAY,
BUT IT'S READING NOW, AND IT
SEEMS TO BE DETERIORATING.

Maureen says SO THIS IS JUST
THE NATURAL PART OF AGING.

Raymond says AND WE
DON'T HAVE ANYTHING.
WILL IS ONE OPTION FOR
PATIENTS, IT'S CALLED MONO
VISION, WHERE WE CAN DO
LASER SURGERY VISION ON ONE
EYE LIKE YOURSELF TO GIVE
YOU READING VISION AND THE
OTHER EYE IS USED FOR
DISTANCE VISION.
IT'S NOT FOR EVERYBODY, BUT
WE FIND THAT PEOPLE THAT ARE
FREQUENTLY IN MEETINGS AND
LOOKING ACROSS A TABLE AND
LOOKING AT NOTES, THIS IS A
NICE OPTION.

Maureen says NOW AS PEOPLE
GET OLDER AND NEED GLASSES
FOR READING WOULD THEY EVER
CHOOSE TO USE CONTACTS FOR
THAT PURPOSE OR IS THAT TOO
CUMBERSOME BECAUSE YOU'D BE
WEARING THEM ALL DAY WHEN
YOU REALLY ONLY NEED SOME
SOME OF THE TIME.

Raymond says THERE
IS THAT OPTION AND THERE ARE
BY FOCALLED CONTACT LENSES
THAT PATIENTS CAN WEAR, AND
THERE IS THE OPTION, SIMILAR
TO MONO VISION WITH LASER
SURGERY, SIMPLY WEARING A
CONTACT LENS IN ONE EYE TO
GIVE PATIENTS CLOSE VISION.

Maureen says DO YOU THINK
EVENTUALLY WE'LL SEE THINGS
LIKE CONTACT LENSES AND EYE
GLASSES GO THE WAY OF THE
DINOSAUR AS MORE AND MORE
PEOPLE GET THE LASER
SURGERY?

Raymond says I
THINK THAT THAT'S A
POSSIBLE.
I THINK THERE'LL ALWAYS BE
SOME SMALL RISKS TO SURGERY,
AND FOR PATIENTS THAT HAVE A
MILD PRESCRIPTION, THEY WILL
PROBABLY SIMPLY JUST OPT FOR
GLASSES OR CONTACT LENSES.
BUT FOR PATIENTS THAT ARE
GREATLY VISUALLY DISABLED,
WITH HIGHER CORRECTIONS, I
THINK WE WON'T SEE THOSE
PATIENTS IN THE FUTURE.

Maureen says CAN YOU DO THIS
SURGERY, THE LASER SURGERY
ON CHILDREN?
OR DO YOU DO IT ON CHILDREN?

Raymond says WE TEND NOT TO DO IT ON
CHILDREN BECAUSE THE EYE IS
STILL CHANGING.
THE FRONT OF THE EYE IS
CHANGING, THE LENGTH OF THE
EYE IS CHANGING, AND THAT
TRANSLATES INTO THE PRE
DESCRIPTION CHANGING.
AND SO WE PREFER TO OPERATE
ON PATIENTS WHOSE
PRESCRIPTIONS ARE STABLE.
AND GENERALLY THEY'RE OVER
20 YEARS OF AGE.
I'VE CERTAINLY DONE SURGERY
ON YOUNGER PARENTS, 18 OR 19,
BUT IT'S BEEN FOR
PROFESSIONAL REASONS OR
OCCUPATIONAL REASONS TO JOIN
THE POLICE FORCE, TO BECOME
A FIREFIGHTER, OR PATIENTS
THAT CAN'T WEAR CONTACTS
THAT ARE VERY ACTIVE IN
SPORTS, LIKE HOCKEY.

Maureen says OKAY, ALL RIGHT.
I HAVE AN E-MAIL FROM FAY.
She reads “I WAS DIAGNOSED WITH
KARITOCONIS ABOUT FOUR YEARS
AGO.
I NOW WEAR PIGGIE BACK
LENSES AND I'VE USED ALL
KINDS OF COMFORT DROPS BUT I
STILL HAVE UNCOMFORTABLE
EYES ALL THE TIME ARE.
THERE ANY NEW TREATMENTS OUT
THERE OTHER THAN EYE
TRANSPLANTS.”
WHAT DOES SHE HAVE?

Raymond says IT'S A CONDITION OF THE
CORNEA WHERE THE CORNEA IS
ABNORMAL IN CH IN SHAPE.
MOST SHAPES ARE SIMILAR TO
LIKE EITHER A FOOTBALL OR A
BASEBALL BUT IN THIS DISEASE
IT'S LIKE A FOOTBALL THAT'S
BEEN LEFT OUT IN THE RAIN,
AND THE ONLY WAY OF GETTING
GOOD VISION IS TO TRY TO FIT
A HARD CONTACT LENS.
IT SOUNDS LIKE THIS HAS BEEN
A DIFFICULT FIT AND IN
ADDITION TO A HARD LENS, A
SOFT LENS IS USED AND THIS
IS A PIGGIE BACK TECHNIQUE
OF A SOFT AND A COMBINATION
OF A HARD.
THERE'S NO OTHER TREATMENT
IN TERMS OF RESTORING THE
VISION OTHER THAN A CORNEAL
TRANSPLANT HOWEVER IT SOUNDS
LIKE HER PROBLEM IS MORE OF
COMFORT AND DRYNESS AND
THERE ARE SOME NEW
TREATMENTS OUT THERE FOR DRY
EYES.
IN FACT I CAN SHOW YOU ONE
ON MY COMPUTER.

Maureen asks DO THEY ALL
INVOLVE DROPS?

Raymond replies DROPS ARE THE MOST COMMON
FORM OF TREATMENT BUT HERE
YOU SEE A LITTLE PLUG THAT
HAS BEEN INSERTED INTO THE
LOWER LID.

A picture shows an eye surgery.

Raymond continues TEARS ARE MADE BY A NUMBER
OF DIFFERENT GLANDS ON THE
SUR FACE-OFFS THE EYE.
THE TEARS THEN FLOW ACROSS
THE EYE AND THEY DRAIN OUT.
AND IF WE CAN PUT A STOPPER
IN THAT DRAINAGE CHANNEL IT
ENHANCES THE AMOUNT OF TEARS
TO THE EYE.
SO THIS IS CERTAINLY AN
OPTION AND WE'VE FOUND THIS
TECHNIQUE TO BE VERY HELPFUL
IN PATIENTS THAT ARE WEARING
CONTACT LENSES THAT HAVE
SOME DRYNESS OF THEIR EYES.

Maureen says IS THAT ONE
COVERED BY OHIP?
I SHOULD ASK THIS FROM TIME
TO TIME.

Raymond says THIS
ONE, IN TERMS OF THE
OPHTHALMOLOGIST'S OR
OPTOMETRIST'S FEE IT IS.
PATIENTS GENERALLY HAVE TO
BUY THESE LITTLE PLUGS AND
THEY'RE ABOUT 50 DOLLARS EACH.

Maureen says YOU ONLY PUT
THEM IN ONCE?

Raymond says I'VE HAD PATIENTS THAT
HAVE HAD THE SAME PLUGS IN
FOR EIGHT TO TEN YEARS.
OCCASIONALLY THEY CAN FALL
OUT, BUT THE SUCCESS RATE'S
VERY HIGH.

Maureen says OKAY.
TRACY IS IN BOLTER I THINK.
HI.

Tracy says HI, GOOD
AFTERNOON.
I'M 39 YEARS OLD AND WHEN I
WAS 29 YEARS OLD I WAS
DIAGNOSED WITH CATARACTS IN
BOTH MY EYES.
THEY TOLD ME BECAUSE OF MY
AGE THAT I SHOULD HOLD OFF
HAVING ANY OPERATIONS DONE
BECAUSE THEY ONLY HAD A LIFE
EXPECTANCY ON THE FOLDING
LENS OF ABOUT 40 YEARS, AND
THE STRAIGHT LENS THEY SAID
THEY HAD ABOUT 50 YEARS.
IS THIS INFORMATION STILL UP
TO DATE?
AND I'M WONDERING IF BECAUSE
OF MY AGE, SHOULD I NOW BE
HAVING THIS OPERATION?

Raymond says IT
DEPENDS ON HOW EFFECTED YOU
ARE FROM THE CATARACTS.
IF IT'S A MILD DEGREE, AND
YOU'RE FUNCTIONING WELL AND
ABLE TO DRIVE, THEN
GENERALLY WE DON'T RECOMMEND
THE CATARACT SURGERY IN
PATIENTS THAT ARE RELATIVELY
YOUNG FOR ONE MAIN REASON,
AND IT'S NOT BECAUSE OF THE
IMPLANTS.
THE IMPLANTS, WE'VE GOT A
GOOD TRACK RECORD ON THEIR
USE.
IT'S THAT WHEN WE TAKE THE
CATARACT OUT AND WE PUT A
LENS IN, IT WILL ONLY FOCUS
GENERALLY FOR DISTANCE,
ALTHOUGH WE CAN MAKE IT
FOCUS JUST FOR NEAR, BUT
IT'LL MEAN THIS YOU'LL NEED
READING GLASSES IF THE LENS
WE PUT IN IS FOCUSED FOR
DISTANCE VISION.
FOR PATIENTS THAT ARE
ALREADY INTO READING GLASS,
IT'S NOT A BIG DEAL, BECAUSE
WE CAN RESTORE THEIR
DISTANCE VISION AND THEY CAN
HAVE A SIMPLE PAIR OF
READING GLASSES.
BUT IF YOUR VISION IS
COMPROMISED AND YOU'RE
STRUGGLING WITH YOUR
ACTIVITIES OF DAILY LIVING,
THEN CATARACT SURGERY HAS
GREAT POTENTIAL OF HELPING
YOU.

Maureen says TRACY, WOULD YOU SAY
THAT DESCRIBES YOU?

Tracy says YES, I CAN'T DRIVE AT
NIGHT TIME ANY LONGER, I CAN
ONLY DRIVE IN THE DAYTIME.
BUT IS IT TRUE THAT YOU CAN
ONLY HAVE THE OPERATION ONE
TIME?
YOU CAN ONLY HAVE THE LENS
REMOVED AND PUT IN ONCE?

Raymond says
THEORETICALLY, YOU COULD
HAVE THE LENS REMOVED BUT
THERE'S CERTAIN RISKS TO
THAT AND IT'S VERY UNCOMMON
TO NEED TO HAVE THE LENS
REMOVED AFTER SURGERY.

Maureen says SO YOU WOULDN'T
NEED THIS DONE TWICE.

Raymond says NO.
99.9 percent OF PATIENTS ONE
CATARACT OPERATION IS ENOUGH
FOR THE PERSON'S LIFE.

Maureen says SO SHE CAN'T
DRIVE AT NIGHT --

Raymond says IT'S EFFECTING HER
ACTIVITIES OF DAILY LIVING.

Maureen says SO GO FOR IT.

Raymond continues I
WOULD GO FOR IT.
BUT CERTAINLY TO GET A GOOD
EXAMPLE AND TO MAKE SURE
THERE ISN'T ANYTHING ELSE
GOING ON IN THE EYE THAT
WOULD MAKE HER NOT A
SUITABLE CANDIDATE.

Maureen says OKAY.
ALL RIGHT, GOOD LUCK.
THANK YOU, TRACY.
Maureen reads CAROL SAYS “I WAS RECENTLY
DIAGNOSED WITH AN ACTIVE
CASE OF OK LAR HISTO.”
AFTER 21 YEARS SINCE I LOST
CENTRAL VISION IN THE LEFT
EYE.
A NEW DIAGNOSIS IS IN RIGHT
EYE WITH VISION 20 OVER 2000.
I WAS OFFERED THE PHOTO
DYNAMIC TREATMENT BUT THE
COST IS TOO OVERWHELMING.
IS THERE ANYTHING I CAN DO
TO ASSIST IT PUT PRESSURE ON
OHIP TO COVER THIS PROCEDURE
RATHER THAN LOSING MY ENTIRE
CENTRAL VISION?

Raymond says WELL I
THINK YOU'VE DONE IT.
THANKS FOR SENDING THE
E-MAIL IN AND HOPEFULLY OHIP
WILL HEAR YOUR CONCERNS
TONIGHT.

Maureen says PROBABLY WRITING
TO YOUR O.P.P. -- MPP OR
PREMIER --

Raymond says YES, ANY POLITICAL ACTION
YOU COULD TAKE THAT WOULD
GREATLY HELP YOU.

Maureen says I'M SNEAKING
THIS QUESTION IN, BUT DO YOU
GUYS REALLY WANT IT COVERED
BY OHIP?
THEY MAY NOT PAY YOU THE FEE
YOU'RE CHARGING NOW.

Raymond says WELL
YOU HAVE TO UNDERSTAND THAT
MOST OF THE FEE, PROBABLY
90 percent OF THE FEE DOESN'T GO TO
THE EYE SURGEON BUT ACTUALLY
GOES TO THE COMPANY FOR THE
COST OF THE DYE.

Maureen says AH.

Raymond says SO THE
FEE IS EXPENSIVE ESSENTIALLY
FOR ONE REASON, AND THAT'S
THE COST OF THE DYE FOR THE
PROCEDURE.

Maureen says BUT THEN THOSE
PEOPLE WHO ARE ONLY CHARGING
THE 2000 DOLLARS, THEY MUST BE
MAKING NOTHING FOR THE EYE
DOCTOR THEN, BECAUSE THEY
HAVE THE SAME DYE COSTS TO
THE COMPANY AS YOU WOULD.

Raymond says
ABSOLUTELY.

Maureen says OH, WORKING FOR
FREE.
MARIANNE IS NEXT.
HI MARIANNE.

Marianne says HI.

Maureen says HELLO.

Marianne says HI.
I'VE HAD MACULAR
DEGENERATION IN MY RIGHT EYE
FOR TWO YEARS, OF THE DRY
TYPE.
I'M 68.
MY QUESTION IS HOW WOULD I
KNOW IF THE DRY TYPE TURNS
TO THE WET TYPE, AS I
PRESUME THAT THIS PHOTO
DYNAMIC SURGERY IS ONLY DONE
ON THE WET TYPE, SO WHAT ARE
THE SIGNS AND SYMPTOMS OF
THE CHANGE FROM DRY TO WET?

Raymond says THAT'S
A VERY GOOD QUESTION.
PROBABLY THE MOST VALUABLE
THING YOU CAN DO IS TO
OBTAIN AN AMSTER GRID.
YOU SAW ON THE LITTLE VIDEO
AT THE START OF THE
PROGRAMME A GRID OF LINES
AND TO LOOK AT THIS GRID ON
A REGULAR BASIS.
EVERYDAY.
AND IF YOU SEE A CHANGE IN
THE GRID -- NOT JUST A BLACK
AREA THAT YOU HADN'T NOTICED
BEFORE BUT THE LINES START
TO LOOK WAIVEY, THEN THAT
SUGGESTINGS ACTIVITY,
SOMETHING ELSE GOING ON, AND
IT MAY BE SOME NEW BLOOZ
VESSEL FORMATION WITH
LEAKAGE INTO THE AREA AND
YOU NEED TO SEE YOUR EYE
CARE PROFESSIONAL ON AN
URGENT BASIS.

Maureen says I SUPPOSE ONCE
YOU HAVE A CONDITION LIKE
THAT YOU'RE SEEING AN
OPHTHALMOLOGIST WHAT, MORE
THAN ONCE A YEAR?

Raymond says
TYPICALLY JUST ABOUT ONCE A
YEAR.
IT COULD BE AN OPTOMETRIST
AS WELL, BOTH EYE CARE
PROFESSIONALS.
BUT BECAUSE YOU'RE ONLY SEEN
ON A LIMITED NUMBER OF
VISITS, YOU KNOW, EVERY YEAR,
YOU REALLY NEED TO MONITOR
THIS YOURSELF.
IF YOU HAVE IT.

Maureen says THAT'S ALWAYS
CONFUSED ME.
WHAT DO YOU SEE AN
OPTOMETRIST ABOUT AND WHAT
DO YOU SEE AN
OPHTHALMOLOGIST ABOUT?

Raymond says
OPHTHALMOLOGISTS ARE TRAINED
IN MEDICAL EYE DISEASES.
THEY GO TO MEDICAL SCHOOL
AND THEN GO ON AND
SPECIALIZE IN THE EYE.
AND MANY OPHTHALMOLOGIST
ALSO GO ON AND SPECIALIZE IN
ONE PART OF THE EYE.
AND THERE'S A REAL SHORTAGE
OF OPHTHALMOLOGISTS IN THE
PROVINCE.
THE OPTOMETRIST IS SKILLED
IN A NUMBER OF THINGS, BUT
MOST IMPORTANTLY IS
REFRACTIONS.
AND SO IF YOU, IF YOU'RE
BEING FOLLOWED BY AN
OPTOMETRIST, THEY WILL BE
ABLE TO DETECT IF THERE'S
BEEN A CHANGE IN YOUR VISION,
ESPECIALLY A DECREASE IN
YOUR VISION, AND MAKE THE
APPROPRIATE REFERRAL.

Maureen says OKAY.
GOOD ENOUGH.
THANKS MARIANNE FOR YOUR
QUESTION.
DAVE IS IN BARRIE.
HIGH DAVE.

Dave says HELLO.

Maureen says HI.
GO AHEAD.

Dave says MY QUESTION TO
DOCTOR STEIN IS I'M DIAGNOSED
WITH CATARACT ACONISIS.
I JUST GOT INTO YOUR
PROGRAMME, SO I'M WONDERING
IF LASER WOULD BE APPLICABLE
FOR ME.

Raymond says WE
DISCUSS EARLIER IN THE
PROGRAMME THIS DISEASE
CAUSES A FAIR.
A IRREGULARITY TO THE
TO THE CORNEA.
IF IN THE EARLY STAGES OF
THE DISEASE YOU CAN FUNCTION
VERY WELL WITH EITHER A SOFT
CONTACT LENS OR GLASSES,
THEN LASER SURGERY, NOT
LACEK, BUT PRK CAN WORK
QUITE NICELY, ALTHOUGH
THERE'S A HIGHER CHANCE OF
NEEDING A SECOND TREATMENT.
BUT IF THE CORNEA IS
MARKEDLY IRREGULAR, THEN
WITH THE CURRENT TECHNOLOGY,
WE CAN'T TREAT PATIENTS WITH
LASER VISION CORRECTION.
AND SO YOUR BEST OPTION IS A
CONTACT LENS.

Maureen says SO SOMEBODY'S
GOT TO LOOK AT HIS CORNEA
AND THEN THEY'LL KNOW
WHETHER HE'S A CANDIDATE FOR
THE P.R.K. OR NOT.

Raymond says
EXACTLY.

Maureen says ALL RIGHT,
THANKS A LOT.
GOOD LUCK.
She reads DOUGLAS LIVES NEAR
PETERBOROUGH.
HE'S 48 YEARS OLD AND HAD
HIS LEFT EYE REMOVED SIX
YEARS AGO.
IT HAD A MEMBRANE WITH A
CATARACT COVERING IT AND IT
HAD TURNED TO BONE IN THE
MIDDLE OF IT, CALCIUM.
MY RIGHT EYE HAS BEEN ACTING
FUNNY FOR TWO YEARS AND NO
ONE CAN FIND ANYTHING WRONG.
IT GOES BLURRY AND IT FEELS
LIKE THERE'S SOMETHING IN IT
LIKE AN EYELASH BUT THERE
NEVER IS.
LATELY IT SEEMS TO BE
GETTING LIGHT SENSITIVE AND
I GET A LITTLE PAIN AT THE
LEFT SIDE OF THE RIGHT
EYEBROW.
CAN YOU RECOMMEND ANYTHING?

Raymond says THE
SYMPTOMS ARE SUGGESTIVE OF A
PROBLEM TO THE FRONT OF THE
EYE, THE IRRITATION, AND MAY
SIMPLY BE A DRY EYE PICTURE.
IT'S A VERY COMMON CONDITION
LIKE MACULAR DEGENERATION
AND GLAUCOMA AND IN FACT IF
YOU LIVE LONG ENOUGH, MOST
PATIENTS DEVELOP DRYNESS OF
THEIR EYE.
AND SO THE USE OF
LUBRICATING DROPS OR THE
LITTLE PLUGS WE SHOWED
EARLIER CAN WORK WELL.

Maureen says OK. DANNY'S IN
NEWMARKET.

Danny says HI, THIS IS
DANNY.
I HAVE BEEN DIAGNOSED WITH A
CELLOPHANE DEGENERATION TWO
YEARS AGO AND I'M LOOKING AT
A STRAIGHT LINE WHICH
BECOMES CROOKED, AND
RECENTLY I NOTICED THAT MY
RIGHT EYE, AND THE LEFT
EYE'S IMAGES ARE NOT THE
SAME, AND I WONDER IF THIS
IS MY IMAGINATION OR IS IT
REAL?
AS I LOOK AT IT WHEN I'M
DRIVING, LEFT EYE ON THE
OUTSIDE MIRROR AND THE RIGHT
EYE THROUGH THE REAR MORE
ROAR, THEY ARE NOT THE SAME.

Maureen says NOT THE SAME.

Raymond says YOU
DESCRIBE A CONDITION CALLED
CELLOPHANING OF THE RETINA
AND THAT'S A MEMBRANE THAT
COVERS THE SURFACE OF THE
RETINA AND CAN CAUSE SOME
WRINKLING OF THE RETINA AND:
TORTED VISION.
IF THE VISION IS MILDLY
EFFECTED, THEN MOST SURGEONS
WOULD NOT OPT FOR ANY
SURGICAL INTERVENTION
BECAUSE THERE ARE SMALL
RISKS ASSOCIATED WITH IT BUT
IF THE VISION IS
SIGNIFICANTLY AFFECTED, A
SPECIALIST IN THE RETINA CAN
ACTUALLY GO IN AND REMOVE
THAT LITTLE MEMBRANE AND THE
CHANCE OF RESTORING VISION
ARE VERY GOOD.

Maureen says WHAT ARE THE
COMPLICATIONS THAT COULD
HAPPEN?

Raymond says
THERE'S A SMALL RISK OF
BLEEDING IN THE EYE AT THE
TIME OF SURGERY OR A REAL
NAL TEAR OR DETACHMENT.
BUT IN GOOD HANDS, THOSE
COMPLICATIONS ARE FAIRLY
UNCOMMON.

Maureen says OKAY.
GOOD LUCK WITH THAT AND
THANK YOU VERY MUCH FOR
TALKING TO US ABOUT ALL OF
THIS TODAY.

Raymond says THANK
YOU VERY MUCH FOR HAVING ME.

Maureen says OUR GUEST TODAY
HAS BEEN OPHTHALMOLOGIST
DOCTOR RAYMOND STEIN.
FOR MORE INFORMATION ABOUT
HIS EYE LASER SURGERY
SERVICES, GIVE THEM A CALL
AT:

A slate pops up that reads “Bochner Eye Institute. (416) 960-2020. General Eye Care: www.eyesite.ca.”

Maureen continues WHATEVER NOTIONS
YOU MAY HAVE ABOUT WHAT IT'S
LIKE TO BE BLIND, DOROTHY
MADGETT McCOLLOUGH DEFINES
THEM.
72 YEAR OLD DOROTHY, SHE'S ACTIVE, WORKS A DOZEN
HOURS A WEEK, RUNS HER OWN
BUSINESS -- OH, AND ANOTHER
THING.
SHE'S A BALLROOM DANCER.

A clip plays.

(tango music plays)

Dorothy dances tango. She has short curly brown hair and wears a long red dress.

Dorothy says I STARTED DANCING 15 OR
16 YEARS AGO, AND I'M
DANCING TWO OR THREE TIMES A
WEEK.
I'VE BEEN ALL OVER THE
CONTINENT.

The caption changes to “Dorothy Madgett McCullogh .”

Dorothy continues I'VE BEEN ALL ACROSS THE
SOUTHERN STATES AND
COLLECTING DANCING AWARDS,
AND I EXPECT NEVER TO STOP.

Maureen says DOROTHY HASN'T BEEN ABLE
TO SEE ANYTHING FOR ABOUT
TEN YEARS.
SHE HAS RETINITIS PIGMENTOSA,
INCURABLE AND STARTED WHEN
SHE WAS A TEENAGER.

Dorothy says BALLROOM DANCING IS AN
ABSOLUTE MAGIC SOLUTION FOR
ME.
I THINK IT'S BEEN PERFECT
FOR BALANCE AND BALANCE HAS
BEEN QUITE IMPORTANT,
WALKING WITH A WHITE CANE.

Maureen says DOROTHY'S TAKEN
EVERYTHING IN STRIDE BECAUSE
SHE LIVES WHAT SHE'S BEEN
TEACHING FOR 50 YEARS.
RELAXATION.

Dorothy walks down the street using a cane. Now, she stands in a classroom.

Dorothy says WELL, I WANT TO WELCOME
YOU ALL ABOARD.
AND TELL YOU THAT WE'RE
GOING TO HAVE SOME
INSTRUCTIONS ON RELAXING
LATER ON ON THE BEDS IN THE
RELAXATION ROOM, BUT IN THE
MEANTIME, WHAT I WANT TO DO
IS FOCUS ON FOR A FEW
MOMENTS ON UNDERSTANDING.
UNDERSTANDING WHY WE GET
TENSE.

Maureen says DOROTHY IS A
PHYSIOTHERAPIST.
SHE OPENED HER CLINIC BEFORE
MOST PEOPLE KNEW WHAT STRESS
WAS ABOUT.

Pointing to a poster, Dorothy says SO THIS IS WHAT WE WANT
IS TO ESTABLISH THE BRIDGES
AND THE BARRIERS.
THE BARRIERS THAT KEEP US
FROM THE PERSON WE'RE BORN
TO BE.
BORN UNIQUE.
BORN TO WIN, BORN TO LOVE.
BORN TO BE JOYFUL.
BUT HOW MANY OF US GOT THAT
MESSAGE, THAT WE WERE PUT ON
THIS PLANET EARTH TO BE
JOYFUL?
(LAUGHING)
NOW, YOU'RE LAUGHING AT ME
AND I'M LAUGHING AT NOTHING
AND THAT'S WHAT YOU WANT TO
DO.
JUST PRACTICE LAUGHING AS
YOU MOVE AROUND YOUR
APARTMENT OR HOUSE OR
WHATEVER.

The students lie on the floor.

Maureen says STRESS STARTS IN THE MINDS
AND ENDS UP HURTING THE BODY,
SO DOROTHY TREATS BOTH.
SHE'S HELPED THOUSANDS OF
PEOPLE LIKE KIM HEYWARD.
KIM NEEDED HELP WITH PANIC
ATTACKS AND ANGER
MANAGEMENT.

Kim is in her thirties with short light brown hair. She’s wearing a blue sweater over a dark T-shirt.

Kim says SHE'S TAUGHT ME HOW TO
CONTROL MY ANGER, MY
FEELINGS AND HOW I REACT TO
OTHER PEOPLE, AND IN MY
EVERYDAY LIFE, I FIND THAT
SHE HAS REALLY HELPED ME
LEARN THOUSAND COPE WITH
EVERYDAY STRESS.

The caption changes to “Kim Hayward.”

Kim continues SHE IS SUCH A MOTIVATION TO
ANYBODY, AND TO STILL BE
HERE AT HER AGE, AND MAKING
OTHER PEOPLE FEEL GOOD, JUST
MAKES YOU FEEL GOOD, JUST
KNOWING THAT AND BEING ABLE
TO TALK TO HER, JUST MAKES
YOU FEEL WONDERFUL.

Dorothy gives a massage to Kim.

Dorothy says I'D FEEL GROUNDED IN
REALITY, IN THE PERSON I AM
BORN TO BE, AND MY
RELATIONSHIPS ALLOW OTHERS
TO BE THE SAME.
I THINK IT'S HAVING FUN, AND
FOR AS MUCH AS POSSIBLE,
DOING SOMETHING THAT IS
MEANINGFUL.

The clip ends.

At the studio, Maureen says AND IF YOU'RE IN
NEED OF SOME OF DOROTHY'S
KIND OF RELAXATION THERAPY
GIVE HER OFFICE A CALL,
THEY'RE IN TORONTO.

The slate changes to “Dorothy Madgett Relaxation Clinic: (416) 340-7070.”

Maureen concludes AND
THANKS FOR JOINING US
ON THIS EDITION OF
MORE TO LIFE.
I’M MAUREEN TAYLOR,
WE’RE HERE ON TVO
MONDAY TRHOUGH
FRIDAY, 1:00 TO 2:00.

A closing slate reads “The advice given in the preceding program is of a general nature only. Viewers should consult their own medical professional for medical advice specific to their circumstances.”

Watch: Eye Health, Macular Degeneration, Blind Waltzer