2 ■ SUMMER 1995 ISSUE
■
SINAI HOSPITAL
High-tech Eye Care is
•
at Sinai
n adult or child who needs
Unlike other lasers, the excimer cuts
"The department has existed since
ordinary or complex eye
without heat and removes tissue with-
1966 and has always been at the fore-
care will find leading-edge
out scarring, making it idea for refrac-
front of technology."
WARNING SIGNS
treatment and high-qual-
tive surgery, says Dr. Spigelman.
Lasers are used at Sinai for glau-
ity results at Sinai. Inno-
The adults with low amounts of my-
coma treatment, retina repair, some
OF RETINA DAMAGE
vative methods of correcting vision are
opia and astigmatism who have had ex-
post-cataract surgery, and three-
part of the total eye care offered at Sinai.
cimer treatment have done extremely
It's vital to see an ophthalmologist
dimensional image scanning of the
Results have changed the lives of pa-
well, reports Dr. Spigelman. A few
optic nerve.
within 24-hours of experiencing:
tients, including a 23-year-old recent
needed retreatment for hazing. Some
Sinai's eye experts also correct vi-
flashes, floaters, shadowed vision or
college graduate. His life-long dream of
still need glasses, generally for reading.
sion using traditional methods.
sudden blurring. Sinai's Ophthalmic
a law enforcement career seemed
That's a boon to others whose jobs re-
Those include glasses, all kinds of con-
Diagnostic Center can pinpoint a
doomed when he failed a mandatory
quire 20/20 vision, athletes, and those
tact lenses, radial keratotomy (RK)
diagnosis and provide
vision test due to nearsightedness.
who just want to see their clock or get
surgery, and cataract surgery.
state-of-the-art treatment.
But he got back on
track when his vision
was corrected by state-
of-the-art laser treat-
ment at Sinai.
That young man
traveled from Ohio to
Sinai, the only site in
Michigan at which the
experimental procedure
was being done. Alan
Spigelman, M.D., and
William Albert, M.D.,
are using the VISX
excimer laser to correct
A normal, healthy retina.
Complications of diabetes can affect the retina.
Eyesight can deteriorate with age. The condition
vision.
This photograph illustrates bleeding inside the eye.
shown in this photograph is macular degeneration.
They use the excimer
laser for "refractive surgery" to reshape
to the bathroom at night, notes Dr.
For the partially sighted, Sinai offers
Glaucoma affects a huge portion of
the eye's contour. In a painless proce-
Spigelman. Other pleased patients in-
low-vision aids and in-depth training
the population but can be very difficult
dure of 30 to 100 seconds, the laser's
clude a photographer who couldn't wear
for patients who use them. Results can
to detect in its early stages. Early de-
highly precise beam of ultraviolet light contacts and whose glasses got in the
be dramatic, especially for children, ex-
tection is key to preventing blindness
vaporizes an extremely thin layer of
way of her camera.
plains Mary Jo Ference, 0.D., who di-
because that's when glaucoma can best
the cornea.
Sinai is one of only 20 sites across the
rects Sinai's Vision Rehabilitation
be treated.
Patients wear a patch over the treat-
U.S. with special Food and Drug Ad-
Institute.
No single test can diagnose glauco-
ed eye for a few days, with minimal dis-
ministration (F.D.A.) approval to use
One six-year-old's school work and
ma. But experts at Sinai's ODC, Drs.
comfort. "Most people say it feels like a
the excimer laser. That's a tribute to
personality soared when she began us-
Cyrlin and Rosenshein, have developed
hair is in their eye for 24 hours,"
the caliber of ophthalmologists at Sinai,
ing aids which improved her vision from
glaucoma multi-testing, a sophisticat-
explains Dr. Spigelman. Vision begins
led by department chairman Hugh
20/200 to 20/30.
ed neurosensory series, to find it as
to improve within a few days. The sec-
Beckman, M.D.
Another pioneering area at Sinai is
early as possible. It is only available at
ond eye usually is treated six months
"We have always been pioneers in
the Ophthalmic Diagnostic Center
Sinai.
later.
the use of lasers," says Dr. Beckman.
(ODC).
continues on page 6
Ulcer Update
xtensive gastroen-
g 6 E terology
research is
underway at Sinai,'
according to Jay Levinson,
M.D., section chief of Gas-
troenterology. The ulcers that
have long been synonymous
with stress and poor eating
habits are now responding to
an innovative form of treat-
ment. Bacteria is a major force
in ulcers, too. Alan Cutler, M.D.,
director of clinical research in
the section of Gastroenterolo-
gy, has been researching lieli-
cobacter pylori, an S-shaped
bacterium that lives in the mu-
cous lining of the stomach near
the surface cells. Irritation to
the stomach caused by the bac-
teria weakens the lining and
makes it more susceptible to
damage by stomach acid, thus
resulting in the formation of ul-
cers.
"The bacteria causing ulcers
is the most common infection in
man," Dr. Cutler explains.
There are two kinds of ulcers
— gastric and duodenal. Gastric
ulcers, sores that form in the
lining of the stomach, can vary
tremendously in size. Duodenal
ulcers, which occur at the be-
ginning of the small intestine,
tend to be smaller than stom-
ach ulcers and also generally
heal more quickly. According
to Dr. Cutler, "Most people who
develop these ulcers produce too
much stomach acid, and it ap-
pears that the Helicobacter py-
lori causes the stomach to
produce the extra acid in addi-
tion to the bacteria's effects of
weakening the stomach wall."
Prior to the discovery of this
bacteria as the ulcer-causing
agent, ulcers would recur as
much as 70% of the time. Since
then, efforts center on effective
pharmaceutical treatment. Dr.
Cutler and his colleagues have
been instrumental in deter-
mining new methods of diag-
nosis and treatment for ulcers.
His research is involved with
methods of diagnosis, including
blood tests for antibodies and
bacteria, and a special breath
test indicating the presence of
the bacteria. Before this dis-
covery, an ulcer meant a bland
diet and careful monitoring to
eliminate sources of stress.
Dr. Cutler states, "Current-
ly, a course of antibiotics for two
weeks is generally sufficient.
While psychological factors can
undoubtedly contribute, the
main focus is on drug therapy."
Correct use of antibiotics has ef-
fectively cured 85 to 90% of all
duodenal ulcers, and 60% of all
gastric ulcers.
sinai
1.
Stomach ulcers can.be
' seen using endoscopy.
The light area to the left
of center is an ulcer.