Episódios
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In this episode of Clearly KC, Dr. Melissa Barnett interviews Dr. Jay Mashouf, an experienced optometrist and owner of Scripps Poway Eye Care in San Diego. Dr. Mashouf shares his approach to managing keratoconus (KC), emphasizing the importance of compassionate communication, early diagnosis, and personalized treatment plans, including options like crosslinking and scleral lenses. He also highlights the value of collaborating with specialists to provide comprehensive care.
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Clearly KC host Dr. Melissa Barnett welcomes the Chief Medical Officer at Epion Therapeutics Dr. Michael Belin, and VP Clinical Operations at Epion Therapeutics Tiffany Haynes to discuss advances in keratoconus diagnosis and treatment. Dr. Bellin highlights the importance of early detection and intervention, made possible by modern imaging tools like corneal tomography. The conversation also covers Epion’s Phase 3 clinical trial of EpiSmart, a new epithelium-on crosslinking intended to preserve the cornea’s surface, reduce discomfort, speed up recovery time, and minimize the risk of scar formation and infection. Tiffany explains how patients can join the clinical trial, currently enrolling at 26 sites in the United States.
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Clearly KC host Dr. Melissa Barnett OD welcomes Dr. Fayiz Mahgoub OD the founder of Augmented Vision Labs a company that is utilizing cutting edge technology to help end contact lens dropout due to difficulty with lens application and removal.
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Clearly KC host Dr. Melissa Barnett OD welcomes Dr. Justin Schweitzer OD from Vance Thompson Vision in Sioux Falls, SD to discuss co-management of keratoconus patients. Dr. Schweitzer notes he practices in a tertiary eyecare setting, and local optometrists regularly refer patients for testing, treatment, or surgery. Dr. Schweitzer acts as the conduit between community optometrists and the Vance Thompson Vision surgeons. He reports successful collaboration usually means the patient returns to the referring doctor for post-operative care. He emphasizes the benefit of educating patients about their treatment options and stresses the importance of communication between referring doctors to assure patients are appropriately managed.
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Clearly KC host Dr. Melissa Barnett OD checks in with Dr. Karen DeLoss OD of the Kellogg Eye Center at University of Michigan and reads questions collected from keratoconus patients. Dr. DeLoss offers some brand name solutions that she recommends and cautions that not all solutions work for all lenses. She reveals she quizzes her patients on their lens management techniques and uses these sessions to find out if her patients have developed any bad habits or gaps in understanding. For the patient who says she can’t insert her scleral lens, Dr. DeLoss encourages the patient to keep trying: there will be a great pay-off if the patient perseveres.
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Clearly KC host Dr. Melissa Barnett OD explodes some myths with crosslinking expert Dr. William Trattler MD, of the Center for Excellence in Eye Care in Miami. He shares that patients with extremely thin corneas can be successfully crosslinked if the surgeon makes some adjustments in the treatment protocol. While most crosslinked patients will not need a second procedure, he observed that a repeat treatment can be safely performed if progression is suspected. Another myth debunked is that disease progression stops at age 40. Dr. Trattler reported seeing progression in older patients, often after years of no change, reinforcing the need for annual follow-up exams even after crosslinking or years of stability.
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Clearly KC host Dr. Melissa Barnett OD visits with Mark Morarie, inventor of The LensBase, a useful device that helps patients insert scleral lenses. Mark remembers receiving the keratoconus diagnosis after his near perfect vision declined. His vision improved with scleral lenses, but he struggled with applying his lenses. Over several years, he tinkered with designs to produce an aid for contact lens wearers. Now an FDA registered medical device, The LensBase is portable, clean, stylish, low tech and gentle on the eye. Designed by a keratoconus patient and scleral lens user, anyone who dreads putting lenses in should listen to this episode and visit TheLensBase.com.
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Clearly KC host Dr. Melissa Barnett OD spends some time with Ash Arellanes, digital content creator and enthusiastic KC advocate. Ash shares her journey of vision loss until she finally was diagnosed with keratoconus. She remembers how she experienced relief to finally have an answer along with confusion and loneliness of having a condition she knew nothing about. Ash had an existing online presence for her dog, Demi, and she started using her social media to share stories of life with keratoconus. Through her TikTok account, @demi_the_vlog_dog, Ash educates and entertains her 320,000 followers, including many in the keratoconus community.
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Clearly KC host Dr. Melissa Barnett OD welcomes colleague Dr. Jason Marsack PhD from the University of Houston, where his lab is engaged in correcting higher order aberrations. Dr. Marsack shared his story of a keratoconus diagnosis while a college student and his vow to apply his engineering skills to improving the vision of others. He and Dr. Barnett discuss isolation, empathy and the “KC Personality” which he observes may be the search for answers and frustration with the technology gap that many patients experience. He is encouraged by advances in KC treatments and the dedication of scientists and practitioners to improving the detection and management of these individuals.
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Clearly KC host Dr. Melissa Barnett OD chats with Carl Domke of McKinney, Texas. Carl is the winner of the 2023 World KC Day Photo Contest with a photo collage that celebrates improved vision with contact lenses. The 80-year old photographer shared what it was like to be diagnosed with KC in 1959 and how, as a high school sophomore, he was given contact lenses that ‘changed his life’ and made it possible to continue his education. Carl also shares the story of waiting for donor tissue and his 3-day stay at Wills Eye Hospital where he had a corneal transplant 20 years later.
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Clearly KC host Dr. Melissa Barnett OD meets up with Myeisha Essex of Los Angeles to discuss tips, tricks and hacks to simplify life with keratoconus. Myeisha shares her KC journey from diagnosis during graduate school to her career as an entertainment journalist. Her eye doctor convinced Myeisha to refocus on her vision health, and she left long days under bright studio lights to start Essex Media Group and to work as a meditation and wellness coach. Since she has transitioned to a mindfulness advocate, Myeisha has learned to slow down and pay attention to life’s lessons. In their conversation, Dr. Barnett mentions the Scleral Lens Education Society (www.sclerallens.org) as a resource for finding an expert in fitting scleral contact lenses. Learn more about Myeisha’s activities at www.myeishaessex.com.
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Clearly KC host Dr. Melissa Barnett OD visits with Poppy McCabe, a recent graduate of Falmouth University in England. Poppy was runner-up in the 2023 World KC Day Photo Contest. Her submission shows her at her final art exhibit at school. Investigating symptoms associated with her Ehlers Danlos syndrome, Poppy learned keratoconus was the source of her vision struggles. She used her diagnosis as inspiration for an installation that invites viewers to experience the visual distortions that accompany keratoconus. Through graphic design, Poppy found a way to channel her creativity to raise diseases awareness.
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Clearly KC host Dr. Melissa Barnett OD asks Dr. Ann Ostrovsky MD about managing the care of individuals with Down syndrome who are diagnosed with keratoconus. Dr. Ostrovsky who is chief of ophthalmology at ECU Health in Greenville, North Carolina stresses the importance of avoiding eye rubbing and scheduling regular eye exams to monitor for vision changes. She notes that it can sometimes be difficult to get reliable test results and shares tips to make these patients more comfortable. Dr. Ostrovsky notes the importance of working with parents or caregivers who are vested in optimizing their child’s eye health and partnering with them when considering procedures like crosslinking.
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Clearly KC host Dr. Melissa Barnett OD welcomes Dylan Muyambo of Cape Town, South Africa. For the 2023 World KC Day Photo Contest, Dylan submitted a joyful picture with his students on a field trip. Dylan shares with Dr. Barnett how he struggled with his vision from a young age, was diagnosed with severe keratoconus at age 9, and underwent corneal transplants in both eyes by the time he was 20. Dylan admits because of his poor vision, he relies on attentive listening and believes keratoconus motivated him to a career in education.
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Clearly KC host Dr. Melissa Barnett OD invites Dr. Araba Otoo OD to talk about pubtometry – a word Dr. Otoo uses to describe the intersection of optometry and public health. Ghana-born Otoo is a recent graduate of The Ohio State University College of Optometry; she started Cherish Eyesight & Vision, a nonprofit whose mission is to increase vision health literacy and educate the public about eye conditions. Partnering with NKCF, Otoo and her global team of animators created short entertaining videos about keratoconus as part of the Vision Tales project.
To watch Cherish Eyesight Vision Tales, visit https://www.youtube.com/@cherisheyesightvision1001 or go to https://www.cherisheyesight.org
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Clearly KC host Dr. Melissa Barnett OD sits down with keratoconus guru Dr. Christine Sindt OD, from University of Iowa for a discussion of higher order aberrations (HOA), a common concern of individuals with keratoconus. Dr. Sindt notes doctors have sympathized with their patients who complain of halos or double vision but until recently could do little to fix the problem. While the technology is still in its infancy, Dr. Sindt reports understanding of how to correct for the complicated optics that cause glare and ghosting are better appreciated. Within a few years, she is confident contact lenses will be able to reduce vision issues associated with HOAs.
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Clearly KC host Dr. Melissa Barnett OD is joined by ophthalmologist Dr. Steven Greenstein MD and optometrist Dr. John Gelles OD, partners at the Cornea and Laser Eye Institute in New Jersey. Dr. Gelles shares results of wave front guided scleral lenses, an emerging technology that creates a 3-D model of the cornea to craft individualized contacts. Dr. Greenstein spoke of CTAK (corneal tissue addition keratoplasty) a new surgical procedure that adds biocompatible donor tissue to reshape corneas, improving vision and contact lens comfort.
Drs. Barnett, Gelles and Greenstein recounted their curation of the 2023 Keratoconus Education Initiative, a comprehensive resource for practitioners. To download a copy, visit: https://reviewob.com/2022-keratoconus-education-initiative
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Clearly KC host Dr. Melissa Barnett OD catches up with KC expert Dr. Andy Morgenstern OD who shares that his career in keratoconus was inspired when he first had access to pentacam tomography, a technology that visualizes the back (posterior) of the cornea. He also spoke of a soon-to-be published paper that used tomography to screen Chicagoland students to reveal the prevalence of pediatric KC in the US is much higher than previously predicted.
As co-founder of International Keratoconus Academy for Eye Care Professionals, Dr. Morgenstern shared details of the upcoming IKA symposium for optometrists and ophthalmologists on May 18-19, 2024 in Bethesda, MD. For more information, visit www.gotoper.com/AM-IKA
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Clearly KC host Dr. Melissa Barnett OD celebrates World KC Day with returning patient and health advocate Rachel Dungan. They discuss keratoconus as an invisible disability that others may not perceive or appreciate. Rachel declares that KC makes her move through the world and pick up cues from others differently. The two also assess the importance of not letting KC hold you back, even if it means taking extra steps to achieve your goal. They discuss the importance of trusting yourself and communicating changes in health and vision with your doctor in order to find the right treatment options.
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Clearly KC host Dr. Melissa Barnett OD chats with Sacramento-based cornea surgeon Dr. Sam Lee MD. Dr. Lee has performed corneal crosslinking since the procedure earned FDA approval in 2016. He described the procedure in detail and noted the results are quite good, with only 1-5% of patients needing retreatment and emphasized the importance of crosslinking as soon as there is any evidence of progression. Dr. Lee and Dr. Barnett ended with a comparison of epi-on versus epi-off protocols, and Dr. Lee predicted that the future would bring less invasive and more individualized crosslinking techniques to treat keratoconus.
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