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Dr. Rick
Dr. Rick, Board Certified MD
Category: Eye
Satisfied Customers: 10784
Experience:  Ophthalmology since 1994 with Retina sub-specialty interest
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Looking an eye physician who has competent

Customer Question

Looking for only an eye physician who has competent experience/knowledge in macula edema and eye injections such as lucentis
Submitted: 1 year ago.
Category: Eye
Customer: replied 1 year ago.
Only wish DR DAN B to be answering this......
Customer: replied 1 year ago.
Situation..........my senior mother has received lucentis and avantis (sp?) injections to treat macula edema.
She received 5 injections in 2010 and then another 3 in 2012 by one physician. When she was seen by another doctor in the same clinic, he stated there was no more leakage. Now my mother has moved
altogether to another city and new clinic altogether.
Regardless of the frequency of injections and whether this condition has been halted, she experienced
a corneal scratch upon the placement of one needle as she moved as she had acute pain when the needle was placed. The doctor at the time used what looked like a vertical qtip into the eye socket to numb the eye even further.....they thought she had an oversensitive eye.1. What is this procedure called to numb the eye more?
2. Is it more local anaesthetic? Is it the technique that is more effective - the vertical qtip?
3. What is the cause - more nerves in the eye?
4. The old clinic only sent a report, but not the actual historical eye imaging - is this not needed
to see a baseline of where my mother is at vs now?She is already fearful as she is scared of getting pricked with the needle again.
Too many interns also have lack of experience and bedside manner
Expert:  Dr. Rick replied 1 year ago.
Hi. I am Dr. Rick.
I am a retina specialist and deal with wet macular degeneration on a daily basis and do well over two hundred intraocular injections, including lucentis, every month.
I would be happy to assist you today if you would like.
Let me know.
Customer: replied 1 year ago.
okay we will see the quality of your answer
Expert:  Dr. Rick replied 1 year ago.
Let's hope I can meet your standards ;)
Let me go over your questions in order:
1. You can numb the eye more with a subconjunctival injection of lidocaine. This is called local anesthesia.
2. I use the qtip soaked in lidocaine jelly all the time. It works well in about 98% of patients.
3. It is hard to say why your mom jumped. Perhaps she was nervous, things were not well explained to her, she was sitting in an uncomfortable position etc. It would not be due to more nerves in her eye than usual.
4. No. The old OCT and/or fluorescein angiograms themselves are not necessary to continue treatment. This is because every decision to give -- or not to give -- an injection is based on what the eye looks like on exam that day in the office....not what it was like in the past.
5. The needle is very, very small. I would bet that her fear, and not the actual pain of the injection, is the issue here....
Given what you have posted it is very important that your mother be treated by an ophthalmologist who has an excellent bedside manor and whom she can trust.
Do not let her fears keep her from seeing an ophthalmologist for follow up. Wet macular degeneration, left untreated -- or delayed getting treated -- can cause permanent loss of central vision and legal blindness.
Does this make sense to you?
Don't forget to mash the positive feedback button for me...the one labeled "excellent" is the most fun to push by far ;)
It's safe for you to press the positive feedback button now if you so desire. And, never fear, even after you press that button I don't go up in a puff of smoke -- I'll still be right here to continue helping you, but, as I do work for tips, I want to make sure you are happy before rating me.
Dr. Rick MD FACS
Customer: replied 1 year ago.
1. What is this called technically - the vertical qtip application?
2. What is it numbing exactly - components of the eyeball, eyelid?
3. I heard them historically stating they applied an extra "unit" of ananesthetic?
4. Is macular edema not different from wet macular degeneration?
5. How difficult is it to diagnose......one physican over 2 years did 8 shots and then all of a sudden another doctor states
no more leakage after another 2 years - seems not accurate?
Customer: replied 1 year ago.
Hello???
Customer: replied 1 year ago.
Can someone answer the followup questions.............thankyou
Customer: replied 1 year ago.
Moderator please close question off