Volume 16| February 2018
The Golden Age of Medicine?
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My father-in-law practiced internal medicine and cardiology in Springfield for about thirty years starting in the 1950s. Some doctors call this period the Golden Age of Medicine before, as they see it, government programs began to get in the middle of the doctor-patient relationship and attempt to “fix things.” What was so different when “dad” saw patients? Doctors were obsessed with practicing quality medicine, and consequently were also obsessed with their reputation, knowing that patients had many choices of physicians to choose from. Also, there was less unnecessary testing in that era than there is today. Doctors could certainly get sued for malpractice, but unnecessary tests costs patients more money, again not a recipe for happy patients. A third reason was medical records which were hand written and nowhere as complicated to maintain as current electronic health records (EHR). Hopefully, EHRs will improve in the future as they do offer many advantages like coordination of care to patients who often see multiple doctors. 

Our goal at Chicopee Eyecare is to offer the highest quality care, using the latest technology, all the while remaining cognizant of how expensive health care costs have become for most people. And like my father in law's generation, we are obsessed with Chicopee Eyecare’s reputation.

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Thank you again for choosing our office. Our goal is to safeguard your eyes and help you achieve a lifetime of clear and comfortable vision.

David C. Momnie, O.D.
Camille Guzek-Latka, O.D .
Julianne M. Rapalus, O.D.   

The (Remote) Doctor Will See You Now
An article in a John Hopkins Medicine newsletter dated November, 2017 describes how Howard County General Hospital in Columbia, Maryland is using telemedicine. If a patient suffered an eye injury, they normally would have been sent by ambulance to John Hopkins Hospital, often by ambulance. Now, the eye surgeon on call performs an assessment from his or her home. Able to receive a history and external image of the eye in real time, the eye surgeon determined that the patient did not need to be transferred in the middle of the night. The program, launched last May by John Hopkins Telemedicine, connects the doctor on call to Howard County emergency room clinicians and patients on weekends and evenings when the hospital does not have a local specialist on call. Most patients can be safely followed up at the county hospital, saving them considerable time and stress and saving the healthcare system the cost of a second emergency department visit.
Good News for Patients With Dry Eyes
Restasis is the brand name for cyclosporine and is an eyedrop that has dramatically improved the lives of thousands of people with severe dry eyes since it was first approved by the FDA in 2002. Restasis is used to increase tear production in patients who have dry eyes from insufficient tear production (as opposed to evaporative dry eye which is treated differently.). While Restasis is often covered by most Medicare and commercial insurance plans, it’s not always covered and copayments can be very high. For private paying patients, the cost can be over $500 a month. However, recent court rulings are paving the way for generic cyclosporine, a move that would result in lower drug prices and make it more accessible to patients.

One of the problems with Restasis is that it takes time to work—sometimes patients don’t feel relief from their burning and gritty dry eyes for several months and some patients never get any benefit from the drops. Restasis has a complicated manufacturing process and there is no guarantee that the generic version will work as effectively as the brand formulation.

We at Chicopee Eyecare are anxiously awaiting the release of generic cyclosporine and think it will benefit the majority of our patients with severe dry eyes.
A Blood Pressure Watch!
Omicron is the most popular home blood pressure manufacturer in the United States.  These automated units allow patients to check their own blood pressure several times a day and make it easier to avoid white coat syndrome, being anxious or nervous in your doctor’s office. The first smartwatch by Omicron was released in early January at a large electronics trade show in. La Vegas, Nevada.

When we ask you about your blood pressure, it’s because high blood pressure can damage the tiny blood vessels in the retina, the back of the eye. This blood pressure watch may help millions of people better monitor their blood pressure throughout the day.
New Treatment for Treating Floaters
The eye is filled with a gel called the vitreous which is 99% water. With age, collagen fibrils form and remain suspended in the liquid and move around. We call these particles floaters. (The medical term is Muscae Volitantes, Latin for “flying flies.”).

Most people with floaters find them an annoyance and until recently, the overwhelming majority of patients would have to simply learn to ignore them. A new procedure is now available, YAG laser vitreolysis. A focused 6 micron laser spot breaks apart the annoying floater into tinier particles that are no longer or barely perceptible to the patient. It’s an outpatient procedure with no recovery time.

Retina specialists in Western Mass are not yet performing the procedure but it’s only a matter of time before this service will be available for people in our area bothered by floaters.

Pictured is the new LightLas YAG laser photodisruptor.
Screen Time Affecting Children's Sleep

A recently released German study suggests that electronic media use by children is reducing their overall sleep quality. The study involved 530 three-year-olds and found a worsening of bedtime resistance, sleep anxiety and daytime sleepiness. Previous studies have found that teenagers and adults were sleeping poorer following evening use of electronic devices and this study shows that sleep can be affected much earlier in life. Reading books is a safer activity but unfortunately many parents never take the time in the evening to read to their children. Pediatricians recommend that children and young adults abstain electronic devices and TV an hour or two before going to bed and instead enjoy a good book.
Valley Eye Radio in Springfield
The January issue of Healthcare News featured an article on Valley Eye Radio (VER). Volunteer readers bring news stories to the blind, visually impaired and those unable to read for themselves due to a disability. VER was started 40 years ago and the need for the program’s services continues to grow as people are living longer and more people suffer from visual impairment. Volunteers, the lifeblood or the organization, often have a personal connection to the mission, a loved one or friend who lost their vision and ability to read independently. Says one volunteer, “my mother was a voracious reader, developed macular degeneration, and it got to the point where she just couldn’t read anymore. I would go over there and read things to her. That’s why this is such a natural fit, especially when you can see the kind of impact such a condition can have on someone…”The radio station is now part of a network of six radio stations throughout Massachusetts operating under the nameTalking Information Center (TIC). What’s read? Not just local newspapers. Everything from obituaries to church outings; from football scores to daily horoscopes. For more information, go to www.Valleyeyeradio.org . For listening times, go to www.TICnetwork.org .
Case Of The Month
Hypertensive Retinopathy

Hypertensive Retinopathy is damage to the retina and its blood vessels due to high blood pressure. Most patients with this condition will have no symptoms but a small percentage may complain of blurred vision. When examining a patient's retina, we might see narrowing of the arteries and “nicking”, where the arteries and veins (technically they are arterioles and venules) abnormally cross. Note the picture to the right—the artery appears to be “pinching” the vein beneath it. In more advanced cases of hypertensive retinopathy, hemorrhages can be seen along with other abnormal changes to the retina. 

If we detect hypertensive retinopathy during our exam of the retina, we will stress with our patient the importance of lowering their high blood pressure to reduce the risk of further damage to the retina along with the risk of cardiovascular disease.
I told this recent patient her feet were going in our next newsletter!
Go, Patriots!
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In Case Of Emergency
Chicopee Eyecare provides
"24/7" coverage for emergency eye care 
for our patients.

We recommend that you do not go to the emergency room for an eye injury or acute eye problem unless it is very serious. Drs. Momnie, Guzek-Latka and Rapalus keep slots open for urgent care visits for new and established patients during normal office hours, and provide around-the clock emergency coverage for our established patients for after-hours and weekends.
Call 592-7777 before calling your PCP or visiting a hospital ER!
Office Hours
We are available when you need us 
Our office and optical department are open during the following hours:
Monday         9:00 am - 5:30 pm
Tuesday        9:00 am - 5:30pm
Wednesday   9:00 am - 5:30pm
Thursday       9:00 am - 6:30pm
Friday           9:00 am - 5:30 pm
Saturday       9:00 am - 12:30 pm

One of our doctors is always available for emergencies on nights, weekends and holidays. Call (413) 592-7777 and our answering service will put you in touch with an on-call optometrist.

"The people in this office are committed to providing you with the highest quality of eye care and to treating you with kindness and respect. "  
If you would like to share any feedback or comments please email us at  info@chicopeeeyecare.com

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Chicopee Eyecare · 113 Center Street · Chicopee, MA 01013 · (413) 592-7777 info@chicopeeeyecare.com
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