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GOOD SENSES
Spring 2010 A Publication From Charlotte Eye Ear Nose & Throat Associates, P.A. GOODSENSES.COM
GOOD SENSES
Fall 200 9
Implantable
Contact Lenses
An Alternative to LASIK
for Nearsightedness GOODSENSES.COM
A Publication From Charlotte E ye Ear Nose & Throat A ssociates, P.A.
CEENTA Physicians
Head South to Provide
Medical Relief to the
People of Haiti
Transnasal
Esophagoscopy
A New Screening Option for
Reflux Sufferers
CEENTACares
New Program Encourages Employees to
Work Together to Support the Community
Charlotte Eye
Ear Nose & Throat
Associates, P.A.
2 GOOD SENSES SPRING 2010
GOOD SENSES Volume 1 • Issue 2
New Beginnings
SENSES
A Publication From Charlotte Eye Ear Hello, everyone! This time of year brings with it so many new beginnings. The
Nose & Throat Associates, P.A. weather begins to warm up, the flowers start blooming, and nature comes alive
again. If this brings tears to your eyes, it’s either the joy of spring or the famous
Main Office: Charlotte pollen count!
Charlotte at SouthPark
Welcome to the Spring 2010 edition of Good Senses magazine! This issue
6035 Fairview Rd. GOODSENSES.COM
r Nose & Throat A ssociates, P.A. brings us some fascinating stories ranging from doctors who travel the world
Charlotte, NC 28210 practicing medicine to the latest clinical advancements in eye and ENT care.
You’ll read about several CEENTA physicians who contributed greatly to the
(704) 295-3000 relief efforts following the recent earthquake in Haiti. One of our newest physicians, Dr. Shuxin “Max”
Li, discusses the many offerings of our sleep medicine program. Dr. Andrew Antoszyk offers insight
GOODSENSES.COM into our robust research arm, Southeast Clinical Research Associates, while Dr. Scott Jaben talks
about the latest and greatest in implantable contact lenses. Jenn Garrett speaks about her successful
President: Donald Stewart, MD implantable contact-lens surgery and how it has changed her life for the better, and in “Grateful to Be
CEO: Charles A. Hoch Singing,” Kandy Cosper tells how the Voice and Swallowing Center has allowed her to continue with
her lifelong passion of singing.
Editorial Mission: Good Senses, a pub-
I hope that this spring season will bring you as much joy as it does me and that you will find this
lication from Charlotte Eye Ear Nose &
publication to be enjoyable and informative. As always, thank you for being a part of the CEENTA family!
Throat Associates, P.A. (CEENTA), is an
educational and informative resource for Sincerely,
current and potential patients and their
families, as well as physicians and other
health care professionals. This publication
features information relating to news Michael F. Miltich, MD
and trends involving otolaryngology, Chair, Department of Otolaryngology
ophthalmology and other health-related Co-President of Charlotte Eye Ear Nose and Throat Associates, P.A.
topics of interests, as well as information
about CEENTA physicians, facilities and
services. The information contained
in this publication is not intended to Spring 2010 Contents
replace a physician’s professional con-
sultation and assessment. Please consult 4 Grateful to Be Singing: The Voice and Swallowing
your CEENTA physician on matters related Center Offers Healing Services
to your personal health. Kandy Cosper, a lifelong soprano, regains her voice and her passion with CEENTA’s help
At CEENTA, the region’s premier provider 6 Implantable Contact Lenses: An Alternative to
for eye, ear, nose and throat care for adult LASIK for Nearsightedness
and pediatric patients for more than 80 Visian ICL™ surgery provides maintenance-free option for patients interested in improving their
years, you’ll enjoy the convenience and quality of distance vision
reassurance of the latest techniques and
highest quality care.
8 CEENTA Physicians Head South to Provide Medical Relief to
the People of Haiti
Drs. J. Robert Silver, Trevor Goldberg and Kenneth Compton aid the Haitian earthquake victims
Charlotte Eye through El Shaddai Ministries International and the Flying Physicians Association
Ear Nose & Throat
Associates, P.A. 10 Potential New Therapy for Patients Who Suffer Eye Strokes
CEENTA has been chosen as a study site for a Phase 1 clinical trial of a drug that may treat vision
loss resulting from a stroke of the optic nerve
Good Senses is published by
Innovative Publishing Ink. 11 Through a Safe and Proven Eye Procedure Comes
10629 Henning Way, Suite 8 Confidence and Freedom
Louisville, KY 40241 • 502.423.7272 Jennifer Garrett attests to the advantages of implantable contact lenses
Innovative Publishing Ink specializes in creating corpo- 12 New Concept, New Service in Sleep Medicine
rate magazines for businesses. Please direct inquiries CEENTA’s unique approach to sleep studies, partnerships with medical equipment service companies
to Aran Jackson at ajackson@ipipublishing.com. and devotion to patient education benefits patients
14 CEENTA News
The latest news and events from CEENTA
www.ipipublishing.com
SPRING 2010 GOOD SENSES 3
Grateful to be SinGinG
the Voice and Swallowing Center offers Healing Services
by Kandy Cosper
Candles flickered in the hands of my robed friends as they sang the age-old carols, following children
down the aisle toward the chancel, where violins and trumpets played. As the procession passed my pew,
several hands reached out to squeeze my arm, and I met many pairs of eyes that showed sympathy and
compassion as I wiped at my own. “We miss you,” someone mouthed.
or the first time in my life, I would not sing any Christmas The breakthrough came with voice therapy. It started in a group ses-
F carols that year. I would not sing in church, or at the piano, or
even in the car while listening to the radio. In fact, for many
days, I would not speak at all.
sion with clinical voice and swallowing specialist Lori Ellen Sutton. We
learned the physiology of the throat and voice, the importance of breath
support, the need for hydration (“drink 64 ounces of water a day and
avoid caffeine!”), the importance of keeping reflux under control, the
I would not sing at the funeral of my neighbor who, after I had sung at need to keep the throat relaxed, to rest the voice throughout the day and
his wife’s service 10 years earlier, had purchased a silver bracelet to be avoid throat-clearing.
given to me after doing the same for him. He died soon after Christmas.
Hoarsely, I read Scripture passages at his memorial service. It was hard to With the help of Dr. Terri Gerlach, clinical specialist and director of the
open the small package the family passed along and read his handwritten Voice and Swallowing Center, I started with breathing exercises — because
thank-you note for a favor I had not been able to give. without breath support, speaking can strain the vocal cords. Each week,
I was given new worksheets that included stretching, jaw-massaging,
It was then that I decided to follow the advice of my good doctor and yawning and deep breathing. Some exercises were so repetitive and boring
friend, Neil Howell, MD, of Charlotte Eye Ear Nose and Throat Associates that it was hard to make myself do them. I got tired of taking a water bottle
(CEENTA), and begin voice therapy.
Two months earlier, after a brief viral infection,
I had begun to lose my voice. It was so weak
and gravelly that I could barely communicate
with the efficient reception staff members.
Dr. Howell numbed and then scoped my throat
and discovered that one of my vocal cords had
ulcerated. The cords were so inflamed that
they looked like “hamburger meat,” and he
pronounced them the worst he had seen in his
35 years of practicing medicine. He could not be
sure I would ever be able to talk normally again,
much less sing. This would be terrible news for
anyone — but especially for a soprano who had
been singing all of her life.
During the next few months, we tried various
medications and treatments. Dr. Howell and his
dedicated nurse, Susie Puckett, were unfailingly
attentive and compassionate. The ladies at the
administrative desk were friendly and caring.
All of that helped me get through the days of
writing notes to tell my husband how my day
had gone, weeks of not answering the telephone
and months of staying home on Thursday nights
when the Covenant Presbyterian Church choir
was practicing. Whenever I tried to sing, only
ragged breath sounds came out.
4 GOOD SENSES SPRING 2010
everywhere I went (and seeking out the inevitable
bathrooms along the way). I had to limit telephone
conversations to five minutes, making sure to talk
only when sitting up straight. If I broke the rules and
tried to sneak in a singing note, only air sputtered
out. The gagging scopes snaked through the nose
to the throat showed brightly colored images of
swollen places that were slowly getting better.
I progressed to humming and then to actual sounds,
chanting “ma ma pa pa” and “mee mee pee pee”
and “myeeeOOOOoooo” over and over again with
utmost control. We worked on beginning sentences
smoothly without a glottal attack, and I began to
walk around repeating “Meager meals make my
mom moan,” and “Molten magma might migrate
many miles.” Of course, I did these in the privacy
and solitude of my own home.
Finally, after three months, I was actually able
to begin singing individual notes, holding a soft
“oooooo” for as long as I could. We timed each
note to chart improvements from week to week. I
could pretend to have a golf ball on my tongue and
actually glide up the scale on the word “knoll.” In
my final session with Lori Ellen — a singer herself
with a similar experience — I was actually singing
again. When I checked out, the staff members at
the front desk told me how much better I sounded,
how normally I was speaking.
I had not shared the news of my progress with
anyone else, not even my husband. So one Sunday
in July, eight months after I had lost my voice,
when he opened the hymnbook and I began singing,
he turned his face toward me in surprise. “I didn’t
know you could do that!” he whispered. And I think
we both choked up a little. Two months later, I
returned to choir practice.
This might all sound overly dramatic. I’m not even
a professional singer. Losing your voice is not a
tragedy like those losses so many other people
suffer because of illness, accidents and natural
disasters. But singing is part of who I am. It is joy,
praise, fun and fellowship. Being able to sing is a
privilege I will never again take for granted. When I
carried my candle down the aisle this past Christmas
Eve, I was wearing the biggest smile in the church.
Recently, a dear friend died, and I was asked
to sing “Amazing Grace” at her funeral. What
a blessing to be able to honor her in this way!
Afterward, I delivered the bulletin from the
service, along with some cookies and flowers, to
the offices of Dr. Howell and the voice center
staff. I encircled the line that read “Kandy Cosper,
soprano,” and I wrote across the top in big red
letters: “THANK YOU.” GS
SPRING 2010 GOOD SENSES 5
IMPlANTAblE CONTACT lENSES:
An Alternative to lASIK for Nearsightedness
by Scott Jaben, MD, and Karon Weeks Petty, MA
Contact lenses have been
around for more than 100
years, and advancements
have allowed just about ev-
eryone to wear them. As a
matter of fact, more than
125 million people world-
wide wear contact lenses
to improve their vision. Everyone is familiar with Figure 1
this vision correction, but did you know that there
is a contact lens that that can be placed inside The Visian ICL™ is made of collamer, an ad- Dr. Jaben and his staff have developed a protocol
your eye? This implantable contact lens will nev- vanced lens material that is highly biocompatible for screening interested Visian ICL™ patients
er dry out, fall out or get dirty. and contains a small amount of purified collagen. to determine both anatomical and psychological
It also contains an ultraviolet (UV) filter that candidacy. The extensive two-hour evaluation
STAAR® Surgical Company’s Visian Implantable provides protection to the eye against cataracts is complimentary and is performed at the
Contact Lens™ (ICL) helps patients become and some retinal problems. SouthPark office of Charlotte Eye Ear Nose and
independent of glasses and contact lenses for Throat Associates. Once Dr. Jaben determines
distance vision. This surgery does not alter the Charlotte Eye Ear Nose and Throat Associates candidacy, he meets with the patient for a second
structure of the eye or involve tissue removal, like is proud to offer Visian ICL™ to our patients. complimentary discussion session to provide
other refractive procedures. The ICL is placed in The physician performing this surgery is Scott L. further education and answer all questions.
a small chamber in the eye and provides vision Jaben, MD, a board-certified ophthalmologist and
that is sharper, clearer and more vivid than other a qualified Visian ICL™ surgeon. Dr. Jaben has If surgery is planned, then several things are
procedures. It is designed to stay in your eye for been implanting this lens for more than three and scheduled. The patient must discontinue the use
decades without maintenance. a half years. He is also a cataract surgeon who has of contacts for a period of time and complete a
implanted more than 35,000 intraocular implants YAG laser iridotomy (which makes one or two
The Visian ICL™ underwent extensive in his 30-year career. small openings near the edge of the iris, which
international research and development before are critical to the control of eye pressure after
being approved for vision correction. In the U.S. Visian ICL™ patients usually fall into three surgery). They must also repeat some testing
clinical study, more than 99 percent of patients categories: those who are non-candidates for and have another refraction (a clinical test in
were satisfied with their implant and would LASIK, those whose prescription is outside the which the eye care professional determines
recommend the surgery to others. While this range that LASIK can safely treat and those who the refractive error of the eye and which lens
lens was approved for use in the United States in desire vision correction without a permanent powers provide the sharpest, clearest vision).
2005, it has enjoyed success in the international change to their eye structure. Patient selection is This allows Dr. Jaben to calculate the strength
medical community for more than 15 years. very important during the evaluation process, so of each lens that he will implant and place the
Today, more than 40,000 people worldwide
enjoy vision with implantable contact lenses.
Future Innovation of the ICL Lens: Toric and Hyperopic ICL
These Visian lenses correct nearsightedness
ranging from -3 to -16 diopters (a diopter is a The Visian TICL™ (Toric ICL) has a toric optical design, which will correct both spherical and
term used to describe lens power), and, when cylindrical refractive errors. Currently, patients who have a high degree of astigmatism (usu-
coupled with LASIK, it may correct up to -20 ally more than 1 diopter) require a second procedure of LASIK to improve their vision after
diopters. If the patient has an astigmatism their ICL surgery. The toric version of ICL should eliminate the need for a second procedure
(meaning that the eye focuses in two places for many patients with astigmatism. In the coming months, this new lens should receive FDA
instead of one, causing certain objects to appear approval for use in the United States.
blurry), the ICL may not be able to correct all
of it, and a LASIK procedure may be necessary STAAR® Surgical Company has also created a hyperopic model of the Visian ICL™, which
to improve the vision. If LASIK is required has thus far proven remarkably effective in the treatment of high farsightedness. The hyper-
to correct the remaining refractive error or opic ICL model is currently not approved for use in the United States but has been success-
astigmatism, there is an additional charge. fully used worldwide and should be available for use in the future.
6 GOOD SENSES SPRING 2010
after; and glare or halos at night, which affects
5 percent or less of ICL patients.
On the day of surgery, there are a few reasons
why surgery may not be completed. These
include: the pupil does not dilate widely enough
Figure 2 to safely perform the procedure; the lens does not
properly fit — in which case, the initial lens will
order for the correct lenses prior to the Visian be removed, and the surgery will be rescheduled;
ICL™ procedure. or a cataract develops during the procedure.
The Visian ICL™ surgery is performed by Dr. While the Visian ICL™ is meant to be a
Jaben at the SouthPark Surgery Center, which is permanent solution for vision correction, the
located on the third floor of the SouthPark office of lenses can be removed if necessary by an
Charlotte Eye Ear Nose and Throat.The procedure experienced ophthalmologist. There are a few
takes approximately 10 minutes per eye. A light reasons why the lens may need to be removed,
topical or local anesthetic is administered, and including: the patient has a significant vision
a mild sedative may be given to minimize the change, the lens becomes decentered, the space
discomfort in the eye and provide relaxation. between the ICL and the human lens is either too
When the patient is comfortable, the procedure wide or too narrow, other eye diseases develop
begins. One or two small openings are created at naturally or the patient requests removal.
the base of the cornea and are used to position
the lens. A gel-like substance is placed in the eye The Visian ICL™ does not treat presbyopia if
and serves as “cushioning” during the procedure. already present, nor does it prevent presbyopia
It will be removed once the lens is placed.The lens from occurring naturally. Presbyopia is the loss
is then folded and loaded into a small cartridge. A of near vision and happens to every person over
micro-opening is created in the eye (Figure 1), and the age of 40. The exact cause of presbyopia
the lens is inserted into the “posterior chamber,” continues to be debated. The Visian ICL™ can
which is located behind the iris and in front of the be implanted in a monovision fashion, meaning
eye’s natural lens. The lens gently unfolds and one eye is set for distance vision and the other
stays in position without stitches (Figure 2). As eye is set for near vision. This allows patients to
the final step, eye drops are given to help prevent perform near-vision activities without the aid of
infection and inflammation. A clear eye patch is reading glasses. Dr. Jaben requires that patients
placed over the eye for protection and is typically practice this form of vision correction with exter-
removed within 24 hours. nal contact lenses prior to choosing monovision
ICL. Glasses and/or external contact lenses can
After surgery, pressure in the eye can elevate, also be safely worn over the ICL to assist patients
so Dr. Jaben requires patients to see him three with their intermediate and near-vision needs.
hours after surgery and then again the next
day. Patients are back to normal activities, The Visian ICL™ has a proven track record of
including work, within 48 hours. Patients will providing improved quality of distance vision.
see Dr. Jaben during the next few months for This advanced, state-of-the-art vision correction
regular eye exams. procedure is the choice for patients needing
and expecting high quality results. It has been
While this surgery takes only minutes to embraced by the U.S. military because of the
perform in our outpatient surgery center, there reliable distance visual clarity the lens provides,
are some complications that may occur. While and it is a good choice for patients with an
less than 2 percent of surgical cases experience active lifestyle who need little down time during
these complications, the following could surgery and a quick return to daily activities.
affect your vision: infection, bleeding, internal So patients looking for a “WOW” factor should
inflammation (iritis), swelling of the cornea or consider the Visian ICL™ procedure.
retina, detachment of the retina and loss or
decrease in vision. Other complications include Interested in Visian ICL™?
increased intraocular pressure, which can be Do you think that you may benefit from the Visian
lowered with medicines or a release of fluid; ICL™ implant? Please call (704) 295-3777 or
cataract development, which may occur in 1.4 e-mail Karon Petty at kpetty@ceenta.com for
percent of cases either during the procedure or more information about Visian ICL surgery.
GS
SPRING 2010 GOOD SENSES 7
CEENTA Physicians Head South to
Provide Medical Relief to the People of Haiti
Dr. J. Robert Silver Travels to Haiti to Deliver Medical Care to Those Injured by the Earthquake
With scrubs in his carry-on and snacks in his backpack, Dr. J. Robert first time. The emergency room was about the size of three exam rooms
“Bobby” Silver, an ear, nose and throat specialist with CEENTA, headed with beds lying side by side and masses of people everywhere. “It was very
to Haiti with 20 other medical professionals and a journalist on February overwhelming,” says Dr. Silver, “The beds did not have sheets on them.
13, 2010. Their mission? To provide medical care to the people of Haiti Patients would lay down with their bloody wounds and later get up and
that were affected by the earthquake that took place one month earlier, leave, only to have the next patient lay down right on top of the bloodstains.”
on January 12, 2010. Each traveler checked two bags of medical supplies
weighing 50 pounds each as they embarked on a weeklong experience The first couple of days were rewarding to Dr. Silver, although there was a
organized by El Shaddai Ministries International. lack of ENT specific cases. “That was fine with me. I was happy to jump in
and do whatever I could to help the orthopedic guys.” But, he asked himself,
Since the Port-au-Prince airport was closed to commercial flights, Dr. “What am I doing down here with my particular skill set?” Although he
Silver’s team had to fly into Santo Domingo, Dominican Republic. After did feel useful helping any patient who came his way, he wanted to do
arrival, Dr. Silver and his group loaded a bus for their 14-hour drive on something within his specialty.
washed-out dirt roads to Les Cayes, Haiti, which is about three to four
hours southwest of the capital of Port-au-Prince. Dr. Silver’s question was answered the night he met 3-year-old Bernard.
Bernard was an orphan, just relocated from Port-au-Prince. He was severely
Dr. Silver and his team lived and worked on a mission compound that included tongue-tied, leaving him unable to speak. His tongue was basically plastered
an orphanage, which was home to approximately 400 orphans. More than to the floor of his mouth. When the team met Bernard, their supplies were
100 of these children had recently been relocated to Les Cayes from Port- packed up, and it was dusk on the night before they were to depart. With
au-Prince because of the collapse of their orphanage in the earthquake. Bernard lying on a picnic table, Dr. Silver put on a headlight, numbed the
These relocated children were so hungry, they were eating Styrofoam area and began the procedure that would allow this little boy to speak.
and dirt. “You could tell they were traumatized,” Dr. Silver says. After the
earthquake, they had gone almost seven days without food or water. “That was exciting for me. It was kind of a confirmation that there was a
reason for me to be in Haiti, even though I had not had many ENT cases.
In addition to treating the malnourished orphans and their medical Here was this one little child that needed my skill set, so it was good to be
problems, the team also worked in the local hospital, which was able to help him out.”
overwhelmed with patients who had been displaced from other cities
by the earthquake. Sanitation at this hospital was well below what is Living conditions for the medical team were better than expected. They
standard here in the United States, and there were chickens roaming slept in a relatively new guest house and meals consisted of food provided
through the wards. Dr. Silver will never forget walking into the ER for the by a local restaurant. Every morning, the team would eat an egg omelet,
Dr. Silver with some of the orphans on their way Dr. Silver examining Bernard before starting the Dr. Silver and Dan Manion, PA, a cardiothoracic
to school tongue-tie procedure physician’s assistant from Asheville, North Carolina
8 GOOD SENSES SPRING 2010
oatmeal that you drink, a banana and some type of bread. There was no to CEENTA, the SouthPark Surgery Center and the One Day Surgery
lunch – just snacks while working at the hospital. On the way home, they Center at Carolinas Medical Center (CMC) for donations. Knowing that
would stop by the same restaurant and grab a meal that consisted of rice he had a weight limit, he requested supplies that would offer the most
and beans and some kind of meat. Goat meat, chicken or fish was served. efficient use for medical relief and limit overall weight.
According to Dr. Silver, goat meat was pretty tasty!
“The call was responded to with fervor, and I was showered with all sorts
After he returned home, Dr. Silver and a friend were discussing the of medical and surgical supplies,” Dr. Goldberg states. With the money
overwhelming need in Haiti. They compared the situation to trying to raised for him by the various staffs, he was also able to acquire large
empty the ocean with a thimble, taking out one small bit at a time. “I can quantities of Betadine. Betadine is in great demand and is very expensive
just take the patient that is in front of me and do the best I can for them because it helps to control infections in severely traumatized patients.
at that moment,” he said. “Every little bit helps.”
A member of the team had a much larger twin-engine plane that
Overall, it was a wonderful trip for them. Every person they saw was undertook four or five flights into Haiti ferrying supplies from a mission
helped. The team called themselves ”street doctors,” because if they depot in Santiago, Dominican Republic. The member described a great
came across someone on the street who needed attention, they took care relief by the inhabitants upon receiving the supplies.
of it. Due to the team being large, a variety of medical specialties were
represented. As a result, someone had some knowledge on how to treat Dr. Goldberg expresses great gratitude to CEENTA, the SouthPark
almost every patient they saw — ranging from severe orthopedic trauma Surgery Center and the One Day Surgery Center at CMC for helping to
to malnourishment to scabies to tongue-tie. secure the donations that allowed him to supply those with the medical
supplies they needed. GS
As for coming back home, Dr. Silver enjoys the convenience of having
all the medical supplies he needs, electronic medical records (EMR)
and hot showers. Our relatively comfortable lifestyle does not bother
him, but he believes we take it for granted. He says, “We are incredibly
blessed. Just to have a clean cup of water that you can drink without
worrying whether it is safe or not is a gift that many in this world cannot
enjoy. I am very thankful.”
Dr. Silver appreciates all that he learned through this experience and the
feeling that he was able to make a difference. In fact, upon returning, Dr.
Silver shared the trials and triumphs of his trip with one of his partners at
CEENTA, Dr. Kenneth Compton. Since then, Dr. Compton has decided to
join El Shaddai Ministries on their second mission later this spring. As for
Dr. Silver, he looks forward to helping out again in the future. Until then,
he will continue being active in his community while practicing medicine
in our Matthews office.
Dr. Trevor Goldberg Works with His Fellow Flying
Physicians to Deliver Medical Supplies to Haiti
Dr. Trevor Goldberg has a passion for flying, and recently, he got the The entire team before heading to the hospital one morning
chance to join that passion with his goal of providing medical relief to
Haiti. He and the Flying Physicians Association planned an educational
trip almost a year ago to take as many donated medical supplies as
possible down to the Caribbean. The Flying Physicians Association is an
organization supporting physicians with a passion for flying to promote
safety, education, research and human interests for flying.
Although the trip was originally planned as a medical supply mission for
the Dominican Republic, when the earthquake hit Haiti, the team decided
to forge ahead with the trip but to route the medical supplies across the
border into Haiti.
Dr. Goldberg’s view of the hospital Some of the medical supplies ready
upon landing for delivery on Dr. Goldberg’s trip
Each member of the group turned to his or her own practice and hospitals
at which they operate to build up the supplies needed. Dr. Goldberg turned
SPRING 2010 GOOD SENSES 9
Potential New Therapy for
Patients Who Suffer Eye Strokes
by Andrew N. Antoszyk, MD
Imagine awakening one optic nerve, which can further reduce circulation
morning and not being able thus resulting in a stroke of the nerve (figure 2).
to see out of one of your
eyes. Such an event occurs Patients who experience decreased blood flow to
in up to 10,000 Americans their optic nerve (AION) can suffer a severe loss of
per year and is due to a vision that can drop a person’s vision to a level where
stroke of the optic nerve. he or she cannot read or drive with the affected eye.
This event is called ante- The vision loss is also accompanied by a loss of side
rior ischemic optic neuropathy (AION). The optic vision, usually affecting the upper or lower half of Figure 2. Patient with a crowded disc who suffered
nerve is a collection of axons (fibers) that transmit one’s vision. Vision can spontaneously improve up to a “stroke” (AION). The top portion of the nerve is
the electrical signals from the eye to the brain so three lines or more in 42.7 percent of patients but swollen, and the margins (edge of the nerve) are not
that a person can see. A loss of blood circulation can also decline an additional three or more lines visible due to the swelling. The vessels on the top half
to these fibers (axons) is called ischemia, and the in 12.4 percent of affected eyes. A three-line vision of the nerve are dilated, and there is mid bleeding.
axons then die, resulting in vision loss. The vision improvement on the eye chart can mean going
loss that occurs in AION tends to be abrupt in onset from no reading vision to reading vision, whereas
and is frequently noticed upon awakening in up to a three-line loss can cause a loss of reading vision
75 percent of patients. in a an eye that could previously do so. An optic
nerve that has suffered a stroke turns pale in the
The exact cause has yet to be identified, but a area of the damage, due to a loss of conducting
drop of blood pressure during sleep (nocturnal fibers called axons, and is called “optic atrophy”
arterial hypotension) is thought to be the most (figure 3). It is unlikely that the nerve will suffer Figure 3. Patient with a pale optic nerve following
common precipitating factor. Other risk factors a similar event, but the other eye is at risk, and up a stroke. Nerve, instead of being orange-pink, has
that are thought to increase an individual’s risk of to 15 percent to 20 percent of patients may suffer a more pale yellow-white appearance, indicating
developing the disorder include hypertension (high a similar event in their good eye within five years. loss of axons in the top half of the nerve.
There is no good treatment for this disorder. In the first phase of the study, patients have to be
Charlotte Eye Ear Nose & Throat Associates has “legally blind” in the study eye as the result of
been selected as a study site for a Phase I clinical an irreversible condition affecting the posterior
trial to assess the safety and tolerability of QPI- segment of the eye (the back two-thirds of the
1007, a new drug that has been developed by Quark eye). The physician must have a clear view to the
Pharmaceuticals that could potentially be used in back of the eye in order to permit documentation
the management of AION. Details of the study of changes, and visual acuity and visual field in the
are available online at http://clinicaltrials.gov/ct2/ non-study eye have to be equal or better than the
show/NCT01064505?term=QUARK&rank=2. study eye. Patients have to be older than 21 years
Figure 1. Patient with a crowded disc. The optic of age in order to participate.
nerve (disc) is the yellow circle on the left-hand The study is divided into two parts (stratums). In
side of the picture with red blood vessels coming the first stratum, “We are seeking to determine In the second phase of the study, individuals must
out of the center. whether a single intraocular injection of QPI- have a diagnosis of AION made within 14 days
1007 is safe in eyes that have suffered irreversible of planned dosing of the drug, and their vision,
blood pressure), diabetes mellitus and elevated vision loss,” stated Dr. Andrew Antoszyk, the tested on a special eye chart, must be 20/63 to
cholesterol (hypercholesterolemia). Patients principal investigator for the study. Individuals light perception. Patients cannot have any other
with an optic nerve that has a more “crowded” with irreversible vision loss with optic atrophy disorders of the eye that could affect visual
appearance are at higher risk of developing AION will be initially selected and will receive a function. Dr. Antoszyk and his co-investigators, Dr.
(figure 1). A “crowded” optic nerve appearance single injection of the new drug into their eye to Donald Stewart and Dr. Timothy Saunders, are
occurs when the space for the optic nerve to exit determine how well the eye tolerates the medicine enthusiastic to have the opportunity to participate
the back of the eye (scleral canal) is smaller, and, and if there is a dose that cannot be tolerated. In in a study that potentially could have applications
therefore, the axons are more tightly packed. The the second stratum of the study, individuals with for a disorder that is currently not treatable.
blood vessels supplying nutrition to these fibers acute anterior ischemic optic neuropathy (AION)
are also more tightly packed. If a person’s blood that had been identified and diagnosed within 14 Individuals who think they may qualify for this
pressure drops, the circulation to the nerve can be days of the onset of their symptoms will be eligible study should contact Angela Price at Southeast
compromised and this can result in swelling of the to be enrolled for treatment. Clinical Research at (704) 295-3390. GS
10 GOOD SENSES SPRING 2010
Through a Safe and Proven Eye Procedure
Comes Confidence and Freedom
by Jennifer J. Garrett, PhD, Coordinator of Research and Program Development, CERRA – South Carolina, Stewart House at Winthrop University
en-year-olds should not wear contacts.” At least that’s what where I could no longer wear contacts, and knowing how I felt about
“T my mother told the eye doctor more than 20 years ago
when he made that suggestion. Several months prior to
that, glasses had been prescribed for me, but since having
wearing glasses, my doctor referred me to Charlotte Eye Ear Nose and
Throat Associates to see if I was a candidate for LASIK.
“four eyes” was completely unacceptable at that age, the glasses Due to extreme nearsightedness (-8.25 in each eye), a slight astigmatism
came off my face as soon I as left my parents’ sight. Without glasses, and thin corneas, I was not a LASIK candidate. This was very
however, I could not see the board at the front of the room, and my disappointing news, but there was one alternative: implantable contact
teachers were becoming more and more concerned. Eventually, their lenses. I was not familiar with this procedure. In fact, it seemed a bit
concern, as did my parents’, turned into extreme frustration. All I had invasive and dangerous. After having many conversations with Dr. Scott
to do was wear the glasses, and all of my problems would be solved. Jaben and his staff, I was convinced this was the right option for me. I
Of course, it did not happen that way. was hopeful again.
Once my mom agreed to contact lenses, the doctor gave me a week to Dr. Jaben and his staff performed my surgery on May 22, 2008. It was
go home and practice. I had to return to his office to prove that I was easy, pain-free and took about 15 minutes per eye. Three hours after
capable of putting in and taking out the contacts. After I demonstrated the procedure, I was reading 20/30 on the eye chart, and at my
just how responsible a fourth-grader could be, I was instructed to wear one-week post-operative appointment, I was reading 20/20. It was
my new lenses for only four hours per day. That meant I had to take them amazing! I could not believe how quickly my eyes healed. My surgery
out while still in school. Let’s just say that several pairs of contact lenses was done on a Thursday, and I was back to work on Monday. A month
did not make it home from Startown Elementary School. later, I was vacationing in Mexico! For the first time, I was able to
open my eyes underwater.
Fast-forward 15 years later to sore eyes and deteriorating vision. I was
having so many problems with my eyes — scratched corneas, infections It has been nearly two years since I received implantable contact lenses.
and chronic dry eyes — all related to contacts. The amount of money Life without external contact lenses and expensive solutions is wonderful.
spent on doctor visits, drops, antibiotics and ointments was impossible I did not realize how much time I spent putting in and taking out my lenses
for a struggling graduate student. Just a few years ago, my eye doctor in every day. And the best part is no more dry eyes. Before my procedure,
Charlotte, North Carolina, informed me that I was allergic to my contacts! I was using rewetting drops every few hours on a daily basis. No more
I didn’t even know that was possible. I tried nearly every manufactured drops! Another very exciting thing is being able to see the alarm clock
brand of contact lenses, and none were suited for me. It got to the point when I wake up in the mornings. This may sound insignificant, but when
you have lived most of your life not being able to see but a few inches in
front of your face without corrective lenses, this is certainly noteworthy.
I recently had a routine eye exam with Dr. Jaben, and my vision was
20/20 in both eyes. It feels great to be able to say that. I am so
grateful to Dr. Jaben and his staff for encouraging me to make this
life-changing decision. Not only has my vision improved, but I also feel
so much more confident than before, personally and professionally.
When I was wearing contacts, my eyes were constantly red. Friends
and coworkers would often ask me if I was tired, or they would make
a reference about having too much fun the night before. While these
comments were always made light-heartedly, it was embarrassing.
Fortunately, I no longer have to worry about the way my eyes look or
feel. They are always clear, blue and comfortable!
For more information on implantable contact lenses, please see the
accompanying article on page 6 of this edition of Good Senses. GS
SPRING 2010 GOOD SENSES 11
New Concept, New Service
in Sleep Medicine
by Shuxin “Max” Li, MD, PhD
In recent years, sleep Inn and Suites in Huntersville. By moving away continuous physician supervision, relapse is
disorders have come to be from the sterile feel of a hospital exam room to much more likely. To help my own patients to
recognized as significant the comfort of a hotel, the patient’s experience manage their weight in a pragmatic way and
health issues. Their high becomes a relaxed, pleasant one. The patient subsequently help their sleep problem, restore
prevalence and their gets to enjoy a spacious room with a queen-size health and improve overall wellness, I have
propensity for increasing bed, a widescreen TV and a private bathroom. developed a no-cost, long-term, physician-
risks of other diseases The hotels even provide those special touches, supervised weight management program that I
have drawn a great deal of such as a morning paper and a free breakfast. call Walk With My Doctor (WWMD).
attention from the general The idea is that patients feel like they are going
population and health care professionals alike. on a relaxing weekend getaway. However, all The WWMD program mainly involves Walking
Common sleep disorders include obstructive the time, they are being peacefully monitored daily, Weighing yourself weekly, Meditating
sleep apnea, insomnia and restless leg syndrome. by our professional, knowledgeable and caring (to reinforce your commitment) and Diet
However, studies have shown that sleep disorders technologists. It is not uncommon for a patient consultation (no fad diet purchase). I partner
are directly associated with many other to request the same technologist if they need to with my patients in this program, so that I
disorders and diseases, such as hypertension, return for subsequent sleep studies. can monitor their process closely and provide
heart disease, diabetes, depression, weight gain continuous counseling. Studies show that, with
and sexual dysfunction, just to name a few. They Superior Durable Medical a physician’s supervision, patients are much are
also increase the risk for car accidents and cause Equipment (DME) Partnerships more likely to succeed and reach their long-
significant decreases in work performance, CEENTA offers its sleep medicine patients top- term weight loss goals.
negatively affecting the overall quality of life. In level customer service by only working with
order to address various sleep issues, Charlotte the best durable medical equipment service Ongoing Patient Education
Eye Ear Nose and Throat Associates (CEENTA) companies. This means that patients enjoy CEENTA believes strongly in the importance
has started a robust sleep medicine program that excellent customer service. Unlike many DME of ongoing patient education, and this is evi-
offers several unique benefits to the patient. companies, who would mail new equipment or dent through our sleep medicine program too.
require patients to come by their office to pick Many of our physicians give ongoing seminars
Unique Approach to Sleep Studies it up, our partner companies deliver directly to to educate patients on various medical top-
CEENTA takes a unique approach to sleep the patient’s home at the patient’s convenience, ics, and our sleep physicians are no exception.
studies — the studies that allow doctors to even on evenings and weekends. They then Check our Web site for a list of ongoing semi-
run a series of tests on patients while they follow up with patients regularly and come to nars regarding sleep, its effects on your overall
sleep. Traditionally, sleep studies are done in their home to provide all technical services. health and weight loss.
hospitals or other medical settings, but these
environments can add additional stress for Partnership in Weight Loss If you have concerns about your sleep, are
patients who are already concerned about their Extra weight contributes greatly to sleep overweight or have daytime sleepiness and
sleep disorders. For this reason, when CEENTA disorders and is the primary cause of sleep fatigue, we invite you to contact a member of
opened our first sleep center, we took patients’ apnea. Being overweight also causes many our sleep medicine team to help you. Let us
experience in sleep labs into consideration. Our other health problems and affects self-esteem show you how your commitment, involvement
sleep centers are set in comfortable business- and quality of life significantly. Weight loss and dedication, together with our compassionate
grade hotels — The Double Tree in SouthPark, requires great commitment and consistency, yet and professional physicians and staff members,
The Courtyard by Marriott in Gastonia and our most commercial weight-loss programs involve can help you to find a renewed life! GS
recently opened third sleep center at the Country fad diets and no physician supervision. Without
12 GOOD SENSES SPRING 2010
Attorneys
Johnston, Allison & hord, P.A.
ExcEllEncE in hEAlth cArE lAw
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dic & Asc
♦ oiG oPinions And irs rulinGs
♦ PhysiciAn contrActs And comPEnsAtion
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♦ mErGErs And Acquisitions
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♦ iPAs And PhysiciAn nEtworks
♦ PEEr rEViEw mAttErs, includinG litiGAtion
Antitrust issuEs
♦ EmPloymEnt lAw–EnForcEmEnt oF non-comPEtEs
♦ collEctions
For morE inFormAtion,
PlEAsE contAct:
John morricE: 704-998-2232
1065 EAst morEhEAd strEEt,
chArlottE, nc 28204
tEl 704-332-1181
FAx 704-376-1628
SPRING 2010 GOOD SENSES 13
CEENTA News
Announcements New Physicians
CEENTA’s Matthews Office Relocates We are pleased to welcome our newest physicians to Charlotte Eye Ear
The new Matthews office will open its doors on June 29! It will host Nose & Throat Associates!
room for six ENT providers and three eye providers. We are very excited
for this move, as it will allow us to better care for our patients. The office Jason Edward Karo, MD
is to remain near the old location as it is in the same office park. Dr. Jason Edward Karo is a board-certified gen-
eral ophthalmologist specializing in cataract
Monroe Office to Start Offering Audiology Services treatment along with surgical and non-surgical
This summer, the Monroe Office will begin offering audiology services. cosmetic enhancements. He is currently practicing
Hearing aids, hearing aid repair and hearing evaluations will be at our Concord office. Dr. Karo joins us from the
available onsite. U.S. Army, where he served as chief of the eye,
ear, nose and throat department. He completed
New Office Hours at the Concord Office his residency and internship at San Antonio
Starting May 17, 2010, the Concord Office will be open five days a Uniformed Services Health Education Consortium. Dr. Karo attended
week to serve you better! medical school at the University of Virginia and received his under-
graduate degree from the University of Florida.
Ray-bans Available in CEENTA’s Optical Shops
The Belmont, Huntersville, Monroe, SouthPark and Statesville offices Jonathan R. Moss, MD
now sell Ray-Ban sunglasses out of their optical shops! The remaining Dr. Moss joins our otolaryngologists this summer
offices will be selling them in the near future. at our Matthews office. He is trained in all
aspects of head and neck surgery with a
CEENTA Participates in Alive particular expertise in the surgical and non-
After Five at Piedmont Town Center surgical management of sinus and ear disorders
Every Wednesday from May 5 to June 30, CEENTA will be participating in adults and pediatrics. Dr. Moss completed his
in Alive After Five at Piedmont Town Center in the SouthPark area. residency and internship at Vanderbilt University
This event includes live bands and different social activities. We will be Medical Center. He attended medical school at
handing out exciting items to all of our visitors, so stop by and see us the University of North Carolina at Chapel Hill School of Medicine
between 5:30 and 9:30 p.m.! as a distinguished medical scholar and received his undergraduate
degree from North Carolina State University.
2010 Wellness Program Kicks Off
At the beginning of the year, CEENTA employees started another round Robert M. Saltzmann, MD
of our wellness program. You may see some of us wearing pedometers, Dr. Saltzmann will join our ophthalmologists
as we are keeping track of our daily steps. Our wellness program this summer, specializing in glaucoma and
provides us with great incentives such as a decrease in the cost of our comprehensive ophthalmology/cataract surgery.
health plan. The first employee to “walk” to Las Vegas wins a trip to He will be practicing at our Belmont and
that destination! Huntersville offices. Dr. Saltzmann completed
his glaucoma fellowship and ophthalmology
CEENTA’s Cookout to benefit residency at the University of Texas Southwestern
Habitat Humanity of Charlotte Medical Center. He attended medical school at
On June 18, 2010, CEENTA will be hosting a cookout from 11:30 a.m. Northwestern University with Alpha Omega Alpha distinction, where he
to 1:30 p.m. at all of our area locations. Proceeds from this event will also received his undergraduate degree.
benefit Habitat for Humanity of Charlotte. We have been hosting various
fundraisers as well as doing many activities as a company during the past Please keep checking our website for more details as we are very ex-
few months so that we can reach our goal of building a home. Please cited to welcome Drs. Karo, Moss and Saltzmann to CEENTA!
join us on this day as we raise more money for a deserving family!
14 GOOD SENSES SPRING 2010
WAITING FOR THE
ECONOMY TO CHANGE?
While you’re waiting, your competitors
are changing their economy. They’re
Patient Education targeting Charlotte Eye Ear Nose & Throat
Seminars Associates patients who make purchasing
Dr. Shuxin “Max” Li, one of our sleep specialists, will be hosting free decisions in this multi-million-dollar
seminars for our patients about sleep, health, snoring/sleep apnea, industry. And these members actively read
insomnia and weight management. These seminars will be held on this magazine like you’re doing right now.
the first Tuesday of the month every other month. Light refreshments
will be provided. Please visit our Web site, www.goodsenses.com, for
times and locations.
WANT TO INFLUENCE THEIR
BUYING DECISIONS?
HealthWise Then contact Kelly Arvin at 502.423.7272 or
Tune in Sundays at 6 p.m. to HealthWise on WTVI for the fol- karvin@ipipublishing.com immediately!
lowing discussion presented by Charlotte Eye Ear Nose & Throat
Associates doctors:
“The Latest Techniques in Vitreoretinal Care”
Presented by Andrew Antoszyk, MD, and Justin Brown, MD
www.ipipublishing.com
Live airing on Sunday, September 12, 2010, at 6 p.m.
Re-airing on Saturday, September 18, 2010, at 9 a.m. GS
SPRING 2010 GOOD SENSES 15
Charlotte Eye Ear Nose & Throat Associates, P.A.
6035 Fairview Rd.
Charlotte, NC 28210
