We don’t have to dilate you…..

Aside

…well, maybe.

A dilated fundus examination (DFE) remains the standard of care for the detection, management and treatment of retinal disease.  Although this can often times be inconvenient, uncomfortable and laborious it still remains as one of the most traditional methods for the examination of the back of the eye.  Things have changed but it took a number of years to get there.  I remember my first encounter with an instrument that claimed to be able to negate the need for a dilation, I was an intern in my final year of optometry school.  I don’t want to date or age myself but that was in 2001 and that instrumentation has improved (17 years later) but it still produces an image like the one below:

This image has always bothered me because it is not how the back of the eye appears.  There is no green whatsoever in the physical examination of the retina.  Even the diagrams/cartoons we study in textbooks and are easily searched on the internet to show no green and those lashes at the bottom could sometimes hide a valuable finding:

Screen Shot 2018-10-07 at 6.57.50 PM

So, the question has always lingered, what is that prior image representing?  Is it a true representation of the retina or simply a shortcut to see more patients by not having to wait to dilate the patients?  While charging patients for an image that may not be truly representative of how the eye appears for the sake of convienence?

I am not here to judge what others do.  I am here to justify why Gee Eye Care has finally now decided to employ the use of ultra wide-field (UWF) imaging and what I have decided to do.  First off, an undilated view of the retina with traditional methods (ie. direct ophthalmoscopy, slit lamp with an auxiliary lens like a superfield or digital wide field lens) usually only yields, at maximum, a field of view of 30-60 degrees.  A dilated view or a traditional image with dilation may yield a view at 100 degrees or more (depending on skill level).  An image very similar to the one below:

Screen Shot 2018-10-07 at 7.00.45 PM

The time has come where we can now produce an image to at least 200 degrees in true color!  I have been waiting on this day since 2001.  Some have questioned why I still dilated eyes at Gee Eye Care.  Truth be told, I was not comfortable with any other technology that would properly be able to replace a dilated view with my own eyes and I was not going to compromise your eye health for a shortcut.  Now I finally can show you why because we didn’t have the technology to show you before and you just had to take my word for it!  I now feel confident in the image I am able to obtain in order to reliably depict the actual retina. It took some time and yes, further investment but I am so excited to present to you the following images taken by me on an undilated patient:

Screen Shot 2018-10-07 at 7.10.27 PM

Starting on October 8th we will be presenting patients with the opportunity to defer dilation and choose this imaging.  However, some patients will be required to be dilated:

  • all new patients
  • children (in order to best determine refractive error changes)
  • certain patients with known or suspected disease that may affect the retina (to name a few):
    • diabetes
    • hypertension
    • acute peripheral retinal degeneration
  • certain patients at Dr. Gee’s discretion

This imaging is available to all, even if dilated, for documentation purposes.  When appropriate, it may be billed to your insurance but the cost will be $30 out of pocket for both eyes.  This option will be presented to you before the examination and you will be given the choice to choose prior to beginning your examination (note, Dr. Gee may need to still dilate your pupils if something is noticed upon obtaining the image).  These images will be reviewed by Dr. Gee and shared with you during the examination.  If you would like them digitally sent to you, please ask and they will be emailed immediately.

Welcome to the new age of eye care.  Dr. Gee and Gee Eye Care has always been proud of being on the forefront of eye care technology and this is no different!

Click here to set up your appointment for the “no puff,” “non-dilated,” “no 1’s or 2’s” eye and health examination!

#SiennaEyeDoc

https://www.mayoclinic.org/tests-procedures/eye-exam/expert-answers/eye-dilation/faq-20057882

https://www.reviewofoptometry.com/article/pointcounterpoint-ultrawidefield-imaging-vs-dilated-funduscopy

Notes:

  • Image #1: reference and link to OptoMap Daytona, taken directly from their website
  • Image #2: diagram taken from Cirrus OCT poster
  • Image #3: photo captured by Dr. Gee
  • Images #4 & #5: photo captured by Dr. Gee on an undilated patient

The office is Closed! Why???

In life there are experiences that can’t be replaced, replicated or overlooked. That being said, the office has been closed a few days the past two weeks as a result of the World Series. I wanted to write an open letter explaining why and apologize for any inconvenience I may have caused.

Imagine a young boy growing up playing baseball, fond memories with his dad playing catch & trying to improve his game. Some memories that many would tell about him throwing a ball before he even remembered and shortly after learning to walk at a young age. Life, career choices took him a different direction but the love of the “game” has always been there. Now grown and making a living that same boy, a young professional, vowed he would purchase season tickets at the first chance he had to afford them, starting with only one in the outfield on a mini-season and then two behind the dugout a few years later—so that that father of his could experience the “game” with him. At one time attending every home game played, all 81.

Privileged to go to Spring Training with his father and mother, this tradition continues to this day, every year in March for 1 week. Privileged to visit every ballpark in all of Major League Baseball—31 (+1 new Yankee Stadium also). Privileged to see a miracle World Series run in 2005 only to be swept by the other team. Privileged to attend two Hall of Fame Induction ceremonies again all with his mother and father. Privileged to be associated with and serve the team he grew up cheering for as a member of the Astros’ Buddies.

That’s me. Your doctor by day but son, and now father, by night. I don’t get too personal about stuff in the public but I felt compelled to make a statement because I’m not just closing the doors for a few days of leisure (frankly it’s a lot of work) but I’m closing for the experience to do this with my mother and father, wife and son. I want my son to have these memories recited to him when he grows up.

This World Series run is emotional and much like the “game” it has its ups and downs. I wish I could have predicted that we would be where we are now (actually not really because it wouldn’t be the same) as to not have to reschedule and inconvenience patients but an opportunity like this doesn’t come around very often. Thank you for understanding and Go Astros!

We will be closed Tuesday, October 31st through Thursday, November 2nd as we travel to Los Angeles and reopen on Friday to regular business hours. You can reach Dr. Gee anytime via email or text.  DrGee@GeeEyeCare.com or 281.778.9912 (feel free to text)

Just for “face value,” not this doctor

I received a pretty interesting email this weekend regarding an online contact lens company that many of you have probably seen pop up on your Facebook feed (according to their email you will soon see them in mainstream media as well) they are called Hubble.  I found it interesting and I thought I would share with you my email (the sender’s name has been blacked out) because I need my patients to know and be aware of what these schemes are all about.  See the email below:

hubble-would-like-to-refer-our-missouri-city-patients-to-your-office

A snippet from the email is shown below.  This is being completely transparent with you and how much these lenses could potentially cost you and how much we could make off selling them.  WE are, however, concentrated on the health of the eyes that have been entrusted to us–not making a buck here.

screen-shot-2017-01-30-at-11-47-47-am

At face value, one might look at this and say, “Wow that’s a cheaper lens,” not me! Immediately, I recognized the material, being that I have been prescribing contact lenses for 15+ years it rang a bell that I decided to dig a little deeper.  Check out the facts below (credit http://www.CooperVision.com):

screen-shot-2017-01-30-at-11-40-51-am

And then a simple Google search of “Vertex Contact Lenses” found:

screen-shot-2017-01-30-at-1-57-14-pm

So, what is the deal here?  I’m not going to sit here and implicate but I am going to state facts.  It was well known and documented by doctors that private label contact lenses exist.  Many lenses are the same and relabeled due to negotiations from corporate buying groups and such.  The best thing to ever happen to contact lenses is UPP which stands for Universal Pricing Policy and most contact lens manufacturers are going toward that.  What UPP has done is bring everything to same price point and protect patients from getting unauthorized, uncertified contact lenses for the sake of saving a few dollars.  On the flip side, some of these online retailers are not obtaining their lenses from the manufacturer and you could be receiving rebranded, inaccurate contact lenses.  Contact lens manufacturers like Alcon are now providing a Gold Seal of Authenticity to assure you are receiving the correct lenses for an authorized source.

If you have questions, please feel free to reach out to us!

#SiennaEyeDoc

 

Highly Recommend Dr. Gee Eye Care! — Dallas F.

Dr. Gee and his staff were extremely warm, inviting, and helpful! I would definitely recommend Dr. Gee for anyone looking for an Eye Doctor! Dr. Gee made me feel comfortable and helped me understand my eyes and the problems I had with my Astigmatism. Kenneth and Lilyan on his staff were extremely helpful and kind! A big THANK YOU to Dr. Gee and his staff! Looking forward to many years with the Dr. Gee Eye Care family!

Jul 10, 2015

Dr. Gee’s willingness to spend time with us and share. Treating and appreciating us like family.

Jul 17, 2015

The entire staff seems to care and they operate at the same level of commitment as Dr. Gee. Awesome!!!

Jul 16, 2015

Excellent care and staffing.

Jul 15, 2015

Dr. Gee took the time to explain everything to me and listen to me. He is an amazing optometrist — Joanna T.

Class Act Doctor & Practice — Paul E.

Dr Gee is a class act. He possesses all the attributes of a great doctor. He combines a friendly easy to talk to demeanor with the highest level of technical competencies. Perhaps his most impressive quality is the true dedication he provides his patients. He demands nothing less from his staff, who are all a true pleasure to deal with. The staff truly complements this fine practice. I challenge anyone to find a better eye care provider.

Jul 6, 2015

Gee Eye Care is Awesome-Sauce — Brionne R.

I moved to another city but traveled back to Gee Eye Care so that Dr. Gee could take care of me. He is very personable and professional. And it ALWAYS smells good in his facility!

Dec 1, 2014