Brianna Fleischmann – Independent Project

Brianna Fleischmann – Independent Project

Class of 2017

Introduction to Topic

In the field of optometry, many things can go wrong. Eyes being one of the most heavily relied on parts of the body, people are very particular about the quality of their vision. With new technology and many new treatment options for common diseases and problems within the eye, the field of optometry is rapidly expanding. I chose to shadow Dr. Reed at Seidenberg and Protzko Eye Associates for these reasons. Throughout this experience, I was able to be exposed to ways to maintain proper eye health, as well as ways to properly identify and treat diseases of the eye.

Project Description

I completed 75 hours of shadowing under Dr. Reed at Seidenberg and Protzko Eye Associates over the past 9 months. I shadowed at both the Bel Air office, as well as occasionally at the Havre de Grace office. Throughout this opportunity, I was enlightened as to how many people experience impaired vision every day due to a variety of factors, and the lack of treatment opportunities. Patients continue to be inconvenienced by the usage of contact lenses due to common environmental stimuli that everyone is exposed to. Through witnessing common recurring issues being presented in the office such as conjunctivitis, allergen-induced irritation, and sunlight sensitivity, I have developed a contact lens that not only helps treat these issues but allows the patient to promote proper eye care and health. This contact lens uses the technology of sustained drug release, daily disposable contact lenses, and the transition lens technology to target frequently arising symptoms. By delivering a prescribed amount of a drug throughout the day and adapting the lenses’ tint to allow for light filtration to occur, proper eye health is better able to be maintained in patients with impaired vision as well as maximize comfort in the lenses.

Experience Description

Throughout the time at Seidenberg and Protzko Eye Associates, I have learned many things and acquired knowledge so much new knowledge about the eye and the common problems associated with it. I enjoyed my time in this office very much, and would gladly go back. It has sparked an interest of mine in optometry, and have allowed me to experience what a typical day as an optometrist would be like. Through this experience, I have learned that I definitely would like to pursue patient care, but not necessarily optometry. I felt that the typical days were extremely redundant. Even though everyone was extremely kind, I do not see myself striving to have a career within this field. I saw many patients and heard many stories about things I would not be able to handle on my own, and was thankful I was not the person responsible for the care of it.

For example, on July 26th, I was shadowing Dr. Reed at the Havre de Grace office. He said that the last time he was on-call for this emergency office, a man came in with a fish hook looped through his eye. The man had previously been to the hospital; however, the hospital was unsure of whether the fish hook had penetrated the actual eye. When the man arrived at the office, it was determined the hook had only penetrated the top and bottom eyelids through examination by pulling gently at the corners of the eyelid to observe the behavior of the hook. The only procedure that had to be done was the careful removal of the hook. Using the help of the paramedics and residents also on the call, the fish hook was removed and the eyelid was stitched. There were no permanent effects of the incident, and the eyelids would heal themselves. Using the help of the paramedics, the hook was removed and stitched. With this patient, I was able to acquire the knowledge of the eye structure and the glands that surround them. I was able to understand how the treatment of damaged glands works, as well as learn how the patient could help to heal them.

Another example of a case I would not have wanted to deal with on my own was on December 28th at the Bel Air Office.  This patient was a middle-aged man who had previously been seen for a stye on his upper eyelid but was so large it had to be confirmed by the eye doctors. Compared to the previous visit, there had not been much change in the cyst, despite the patient’s best efforts to follow the doctor’s instructions. He had been putting a warm compress on the infection site several times a day , as well as applying the cream he bought over-the-counter at CVS.  It had appeared that none of the treatments had had any effect. Dr. Reed explained to the man that this sometimes happens and that only 90% of styes will disappear solely with the treatments he had been using. The next step in the treatment of this sty was to attempt to extract the pussy core from the center to allow for the raised part of the eyelid to diminish. Using two cotton swabs and a small pair of scissors/tweezers, Dr. Reed attempted to squeeze the cyst like a pimple. He was able to remove the jelly-like puss sitting on top and around the core, however, the hardened core would not come out. The options for further treatment of this stubborn sty included an internal surgical procedure, which would open up his eye and remove the core. Through this patient, I was able to gain more knowledge on styes and how commonly they occur. I learned more about the causes as well as the types of stys that can appear on the eyelid.

Although it was interesting to see these procedures completed, I was very thankful I was not the person responsible for the treatment of these issues. Considering I am very easily disgusted, I have ruled out the field of optometry for my future.

Innovation Description

Due to my experiences at Seidenberg and Protzko Eye Associates, I have developed a solution to problems many contact lens users have to deal with both periodically and every day. I have combined the newly developed transition lenses (Nusca, 2009) with the also newly developed sustained release technology lenses  (Bloom, 2013). The goal of these contact lenses is to provide maximum comfort for contact lens users, as well as promote eye health through proper dosage of medications. The two types developed will deliver allergy medication to the eyes throughout the day, and the other form will deliver a medication for conjunctivitis.

Throughout my shadowing experience, I visited with many patients who were unsatisfied with their contact lens usage. One of the most notable patients that I saw was a 14-year-old girl who presented on July 13th. This young girl obviously was experiencing extreme irritation due to her contacts. Since she was new to glasses and very young her main concern was with her appearance. She did not even own a pair of glasses; solely contact lenses. This obvious irritation from the contacts had left this girl susceptible to infection, and it was recommended that she stop wearing the lenses for a few weeks.

This patient got me brainstorming how I could help patients deal with the irritation caused by everyday exposures, such as contact lenses. Throughout my other days at Seidenberg and Protzko Eye Associates, I noticed the most common types of patients presented with minor infections and inflammations. I decided to adapt my innovation to allow for the treatment of the minor infections, conjunctivitis, and allergen-induced irritation. Since so many people suffer from seasonal allergies (“Allergies Can Mean Misery for Contact Lens Wearers”) as well as wear contacts, it would be frustrating to have to compromise vision for comfort, or vice-versa. Also, many patients presented with minor infections and conjunctivitis (Conjunctivitis, n.d.). When patients present with conjunctivitis, they are unable to wear their contacts until the infection is gone to allow the infection to heal and prevent the irritation of the corneas. Since this if such a contagious eye irritant, it would again be frustrating to have to wear glasses instead of contacts for this infection to heal.

The concept of the sustained release technology would be beneficial to patients because it would allow for more constant exposure to medication without causing a reaction to the medication. It would prevent patients from overusing their prescriptions frequently which could induce irritation. I researched the sustained release technology for 2 hours, along with all of the scientific trials occurring with this technology currently.

Each of these two lenses would contain different types of medication. Commonly, in order to treat irritation induced by allergens in the eye, a drug called Olopatadine is used. (Evaluation of Comfort Using Olopatadine 0.1% O…, n.d.). In the lens developed to treat conjunctivitis, a drug called Lotemax  (“List of Conjunctivitis Medications (26 Compared)”). will be used. These drugs are beneficial to be used because they cause little irritation, have been shown to not react or calcify with contact lenses, and cause minimal side effects. I researched the types of drugs that would be the most effective, and the studies associated with these drugs for 2 hours.

One of the most frequent complaints about contact lenses in the office was the lack of comfort. Numerous times throughout my shadowing experience, patients would complain that their contacts didn’t seem to be fitting correctly, were “swarming”, or failed to stay in the eye throughout the day. In order to help patients with these issues, Dr. Reed would suggest trying daily disposable contact lenses (How to Use Daily Contact Lenses, n.d.). I decided that this would be beneficial to my innovation to promote the healthy usage of the contacts and to ensure patients are receiving the required amount of medication. If an extended-use lens was used, it would be harder to control how much of the medication is released during overnight periods and is not being administered to the eye.

The daily disposable sustained release contact lenses would be the most effective in giving the proper and recommended amount of medication to the eye throughout the day. It would be required to visit the optometrist in order to receive these special lenses, as an overuse of these medications can cause irritation.

One other patient that stood out to me throughout my shadowing experience was a man in his 70’s that was looking for a pair of prescription sunglasses. Frustrated by his lack of ability to find sunglasses that he felt he could see effectively from and were safe to use, he wanted a pair or prescription lenses to make it safer for him to be in the sun, and to prevent the freckle on his retina from getting worse. He did not enjoy the way the transition lenses appeared on the glasses and enjoyed to be a great deal. He felt that sunglasses were the best option to maintain his eye care and his appearance.

This got me thinking that it would be nice if this man could go without glasses entirely, and could manage his vision with contact lenses.  While it is a hassle to carry around two pairs of glasses as this man was about to do, it would be much easier for the man to carry no glasses at all. By having contact lenses that “transition” like the lenses in Transition glasses, this man would be able to maintain his eye health, and not worry about carrying around multiple pairs of glasses.

Transition contact lenses are currently being developed. I researched this topic for 3 hours, and the recent developments and studies with the production of this product. Made out of synthetic material similar to regular contact lenses, The transition contact lenses are made with a polymer laced with a network of nano-sized tunnels that can be filled with dyes. These dyes will adapt to light entering, and become darker in an attempt to filter the light entering through the cornea (Nusca, 2009). To demonstrate this concept, I have created a 3D model to show example tints of the lenses. As the contact is exposed to more and more light, the lens will progressively get darker, and filter the amount of light in the eye. The design took me about 3 hours to complete with accuracy to a contact lens shape and can be found here.

Overall, I have combined all of these aspects into a single, highly advanced contact lens. With easily identifiable packaging for the doctor. The packaging presents a sample of a company logo on the package, as well as the contents of the box. The colorful paper makes it easy to see and minimizes the chance of mistakenly giving a patient the incorrect form of a lens. The sample packaging took 2 hours to complete and can be found here. I have created a contact lens with the abilities to deliver medication throughout the day, as well as adjust to the amount of light entering the eye, this contact lens is designed to promote eye health, and keep patients comfortable with their contact usage. I have acquired contacts and dried them out for a life-size model to gain an understanding of size. It took me about 4 hours to get contacts, dry them out, and clearly mark them with colors to show how the contacts will be identifiable to the user. The green and pink ring around the contacts is used by the patient to see that the contact lens has not been tampered with, and contains the medication. The rings will be placed on the lenses using a saline-based dye that will mimic food coloring, yet will dissolve within minutes when placed on the eye. The mucous, water, and oils of the tear film will dilute the dye until it is gone.

Treating allergies and conjunctivitis are the main focuses due to the commonality of these inflammations within the eye, and the tinting capability is designed to accommodate patients’ convenience. It is the overall goal of optometry to make life with impaired vision easier on patients, and these contact lenses address a number of frequent complaints from patients regarding their contact lenses.

+ Project Topic

Introduction to Topic

In the field of optometry, many things can go wrong. Eyes being one of the most heavily relied on parts of the body, people are very particular about the quality of their vision. With new technology and many new treatment options for common diseases and problems within the eye, the field of optometry is rapidly expanding. I chose to shadow Dr. Reed at Seidenberg and Protzko Eye Associates for these reasons. Throughout this experience, I was able to be exposed to ways to maintain proper eye health, as well as ways to properly identify and treat diseases of the eye.

+ Project Overview

Project Description

I completed 75 hours of shadowing under Dr. Reed at Seidenberg and Protzko Eye Associates over the past 9 months. I shadowed at both the Bel Air office, as well as occasionally at the Havre de Grace office. Throughout this opportunity, I was enlightened as to how many people experience impaired vision every day due to a variety of factors, and the lack of treatment opportunities. Patients continue to be inconvenienced by the usage of contact lenses due to common environmental stimuli that everyone is exposed to. Through witnessing common recurring issues being presented in the office such as conjunctivitis, allergen-induced irritation, and sunlight sensitivity, I have developed a contact lens that not only helps treat these issues but allows the patient to promote proper eye care and health. This contact lens uses the technology of sustained drug release, daily disposable contact lenses, and the transition lens technology to target frequently arising symptoms. By delivering a prescribed amount of a drug throughout the day and adapting the lenses’ tint to allow for light filtration to occur, proper eye health is better able to be maintained in patients with impaired vision as well as maximize comfort in the lenses.

+ Experience

Experience Description

Throughout the time at Seidenberg and Protzko Eye Associates, I have learned many things and acquired knowledge so much new knowledge about the eye and the common problems associated with it. I enjoyed my time in this office very much, and would gladly go back. It has sparked an interest of mine in optometry, and have allowed me to experience what a typical day as an optometrist would be like. Through this experience, I have learned that I definitely would like to pursue patient care, but not necessarily optometry. I felt that the typical days were extremely redundant. Even though everyone was extremely kind, I do not see myself striving to have a career within this field. I saw many patients and heard many stories about things I would not be able to handle on my own, and was thankful I was not the person responsible for the care of it.

For example, on July 26th, I was shadowing Dr. Reed at the Havre de Grace office. He said that the last time he was on-call for this emergency office, a man came in with a fish hook looped through his eye. The man had previously been to the hospital; however, the hospital was unsure of whether the fish hook had penetrated the actual eye. When the man arrived at the office, it was determined the hook had only penetrated the top and bottom eyelids through examination by pulling gently at the corners of the eyelid to observe the behavior of the hook. The only procedure that had to be done was the careful removal of the hook. Using the help of the paramedics and residents also on the call, the fish hook was removed and the eyelid was stitched. There were no permanent effects of the incident, and the eyelids would heal themselves. Using the help of the paramedics, the hook was removed and stitched. With this patient, I was able to acquire the knowledge of the eye structure and the glands that surround them. I was able to understand how the treatment of damaged glands works, as well as learn how the patient could help to heal them.

Another example of a case I would not have wanted to deal with on my own was on December 28th at the Bel Air Office.  This patient was a middle-aged man who had previously been seen for a stye on his upper eyelid but was so large it had to be confirmed by the eye doctors. Compared to the previous visit, there had not been much change in the cyst, despite the patient’s best efforts to follow the doctor’s instructions. He had been putting a warm compress on the infection site several times a day , as well as applying the cream he bought over-the-counter at CVS.  It had appeared that none of the treatments had had any effect. Dr. Reed explained to the man that this sometimes happens and that only 90% of styes will disappear solely with the treatments he had been using. The next step in the treatment of this sty was to attempt to extract the pussy core from the center to allow for the raised part of the eyelid to diminish. Using two cotton swabs and a small pair of scissors/tweezers, Dr. Reed attempted to squeeze the cyst like a pimple. He was able to remove the jelly-like puss sitting on top and around the core, however, the hardened core would not come out. The options for further treatment of this stubborn sty included an internal surgical procedure, which would open up his eye and remove the core. Through this patient, I was able to gain more knowledge on styes and how commonly they occur. I learned more about the causes as well as the types of stys that can appear on the eyelid.

Although it was interesting to see these procedures completed, I was very thankful I was not the person responsible for the treatment of these issues. Considering I am very easily disgusted, I have ruled out the field of optometry for my future.

+ Innovation

Innovation Description

Due to my experiences at Seidenberg and Protzko Eye Associates, I have developed a solution to problems many contact lens users have to deal with both periodically and every day. I have combined the newly developed transition lenses (Nusca, 2009) with the also newly developed sustained release technology lenses  (Bloom, 2013). The goal of these contact lenses is to provide maximum comfort for contact lens users, as well as promote eye health through proper dosage of medications. The two types developed will deliver allergy medication to the eyes throughout the day, and the other form will deliver a medication for conjunctivitis.

Throughout my shadowing experience, I visited with many patients who were unsatisfied with their contact lens usage. One of the most notable patients that I saw was a 14-year-old girl who presented on July 13th. This young girl obviously was experiencing extreme irritation due to her contacts. Since she was new to glasses and very young her main concern was with her appearance. She did not even own a pair of glasses; solely contact lenses. This obvious irritation from the contacts had left this girl susceptible to infection, and it was recommended that she stop wearing the lenses for a few weeks.

This patient got me brainstorming how I could help patients deal with the irritation caused by everyday exposures, such as contact lenses. Throughout my other days at Seidenberg and Protzko Eye Associates, I noticed the most common types of patients presented with minor infections and inflammations. I decided to adapt my innovation to allow for the treatment of the minor infections, conjunctivitis, and allergen-induced irritation. Since so many people suffer from seasonal allergies (“Allergies Can Mean Misery for Contact Lens Wearers”) as well as wear contacts, it would be frustrating to have to compromise vision for comfort, or vice-versa. Also, many patients presented with minor infections and conjunctivitis (Conjunctivitis, n.d.). When patients present with conjunctivitis, they are unable to wear their contacts until the infection is gone to allow the infection to heal and prevent the irritation of the corneas. Since this if such a contagious eye irritant, it would again be frustrating to have to wear glasses instead of contacts for this infection to heal.

The concept of the sustained release technology would be beneficial to patients because it would allow for more constant exposure to medication without causing a reaction to the medication. It would prevent patients from overusing their prescriptions frequently which could induce irritation. I researched the sustained release technology for 2 hours, along with all of the scientific trials occurring with this technology currently.

Each of these two lenses would contain different types of medication. Commonly, in order to treat irritation induced by allergens in the eye, a drug called Olopatadine is used. (Evaluation of Comfort Using Olopatadine 0.1% O…, n.d.). In the lens developed to treat conjunctivitis, a drug called Lotemax  (“List of Conjunctivitis Medications (26 Compared)”). will be used. These drugs are beneficial to be used because they cause little irritation, have been shown to not react or calcify with contact lenses, and cause minimal side effects. I researched the types of drugs that would be the most effective, and the studies associated with these drugs for 2 hours.

One of the most frequent complaints about contact lenses in the office was the lack of comfort. Numerous times throughout my shadowing experience, patients would complain that their contacts didn’t seem to be fitting correctly, were “swarming”, or failed to stay in the eye throughout the day. In order to help patients with these issues, Dr. Reed would suggest trying daily disposable contact lenses (How to Use Daily Contact Lenses, n.d.). I decided that this would be beneficial to my innovation to promote the healthy usage of the contacts and to ensure patients are receiving the required amount of medication. If an extended-use lens was used, it would be harder to control how much of the medication is released during overnight periods and is not being administered to the eye.

The daily disposable sustained release contact lenses would be the most effective in giving the proper and recommended amount of medication to the eye throughout the day. It would be required to visit the optometrist in order to receive these special lenses, as an overuse of these medications can cause irritation.

One other patient that stood out to me throughout my shadowing experience was a man in his 70’s that was looking for a pair of prescription sunglasses. Frustrated by his lack of ability to find sunglasses that he felt he could see effectively from and were safe to use, he wanted a pair or prescription lenses to make it safer for him to be in the sun, and to prevent the freckle on his retina from getting worse. He did not enjoy the way the transition lenses appeared on the glasses and enjoyed to be a great deal. He felt that sunglasses were the best option to maintain his eye care and his appearance.

This got me thinking that it would be nice if this man could go without glasses entirely, and could manage his vision with contact lenses.  While it is a hassle to carry around two pairs of glasses as this man was about to do, it would be much easier for the man to carry no glasses at all. By having contact lenses that “transition” like the lenses in Transition glasses, this man would be able to maintain his eye health, and not worry about carrying around multiple pairs of glasses.

Transition contact lenses are currently being developed. I researched this topic for 3 hours, and the recent developments and studies with the production of this product. Made out of synthetic material similar to regular contact lenses, The transition contact lenses are made with a polymer laced with a network of nano-sized tunnels that can be filled with dyes. These dyes will adapt to light entering, and become darker in an attempt to filter the light entering through the cornea (Nusca, 2009). To demonstrate this concept, I have created a 3D model to show example tints of the lenses. As the contact is exposed to more and more light, the lens will progressively get darker, and filter the amount of light in the eye. The design took me about 3 hours to complete with accuracy to a contact lens shape and can be found here.

Overall, I have combined all of these aspects into a single, highly advanced contact lens. With easily identifiable packaging for the doctor. The packaging presents a sample of a company logo on the package, as well as the contents of the box. The colorful paper makes it easy to see and minimizes the chance of mistakenly giving a patient the incorrect form of a lens. The sample packaging took 2 hours to complete and can be found here. I have created a contact lens with the abilities to deliver medication throughout the day, as well as adjust to the amount of light entering the eye, this contact lens is designed to promote eye health, and keep patients comfortable with their contact usage. I have acquired contacts and dried them out for a life-size model to gain an understanding of size. It took me about 4 hours to get contacts, dry them out, and clearly mark them with colors to show how the contacts will be identifiable to the user. The green and pink ring around the contacts is used by the patient to see that the contact lens has not been tampered with, and contains the medication. The rings will be placed on the lenses using a saline-based dye that will mimic food coloring, yet will dissolve within minutes when placed on the eye. The mucous, water, and oils of the tear film will dilute the dye until it is gone.

Treating allergies and conjunctivitis are the main focuses due to the commonality of these inflammations within the eye, and the tinting capability is designed to accommodate patients’ convenience. It is the overall goal of optometry to make life with impaired vision easier on patients, and these contact lenses address a number of frequent complaints from patients regarding their contact lenses.

By | 2017-05-12T03:03:34+00:00 May 12th, 2017|Biomed Capstone Project 2017|0 Comments

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