Patient - Retina Specialist | Eye Diseases | Eye Care

Amy and I got back from Orlando, last week. We attended the American Academy of Ophthalmology annual meeting, the world’s largest gathering of ophthalmologists and those associated with our “industry.” It’s our huge trade show. For us, we got some national exposure for our new company.

Telling a Story

You may remember that we received a nice endorsement from the AAO earlier in the year. The endorsement came in the form of acceptance of our lectures (4) and and invitation to address young doctors about marketing.

In short, we told everyone about what we are doing here at RetinaEyeDoctor.com.

We told the story of how we started, how it has benefited my practice (patients arrive internationally and nationally), how we use the site to educate patients (real and virtual) and it has become a valuable tool in developing relationships with my patients and my “tribe” (those that follow this site…um, that means you!).

Teaching More than SEO and Social Media

While the courses topics ranged from choosing a URL to implementing social media via a blog, we were advocating some very simple points;

1. If You Have No Website, You Don’t Exist: Patients have become empowered by the Internet. Long gone are the days where a patient will blindly take the “referral” of one physician from another. Today, patients want to select their doctors based on their own criteria. The easiest way to search is to use Google, but you (my readers) know this. If a doctor has been recommended, but a website can not be found (or is old and stale), patients will never call to make an appointment.

2. Doctors need Transparency: There are two types of transparency that physicians must display, personal and business. Personal transparency means that a doctor must display some attributes of being human. This personal transparency means that doctors should share a bit about their personal side to which patients (as other humans) can relate. Patients want to relate to their doctors.

As an example, a doctor listing his/her hobbies is much more engaging than listing the elite academic achievements to which noone else can relate (even other doctors).

Every other business in every other industry, except medicine, opens itself to public criticism and evaluation. Movies, books, restaurants all go under review of the public. Doctors must get used to the notion of operating this type of transparent business.

3. Serving the Public Good. The only way a medical practice can use a website as an effective marketing tool is to publish credible health information. While over 80% of the public turns to the Internet first for health related questions, there is a paucity of reliable information (you know this, too!).

If every doctor were to publish/write on their own sites, they would get the rankings they want …and the public would get the answers they need. Best of all, this means that the quality of health information available to the public improves.

What Does This Mean? We got validated. We met so many doctors trying to learn how to engage the Internet, to make their websites useful and to learn how to build relationships. We were appreciated and really became to feel that we are leading a movement…..maybe we are.

Intraocular injections of Avastin usually do NOT hurt. Once in awhile, I have patients or readers of my blog who complain of severe pain following an intraocular injection. Why?

It’s Not the Needle That Hurts

I believe the pain is due to the solution used to clean the eye prior to the injection and not the needle itself.

The solution is called “Betadine” and is commonly used to cleanse the eye prior to intraocular injection. Most retina specialists use this a part of their routine.

In a special few cases, these patients are not feeling pain from the needle, they are actually super-sensitive to the iodine prep. This prep is commonly used to clean the eye prior to the actual injection.

Usual Preparation for Injections

My preparation for the “procedure” is probably slightly different than your own doctor’s.

Upon arrival to the office, my patients have already been using antibiotic drops for the past four days. In theory, this limits the bacteria that builds up around the eye and may reduce the chance of infection from the injection. This has never been proven.

At the office, we dilate the eye and start the numbing procedure. We use a cotton swab dipped in 4% lidocaine (numbing solution) and keep it pressed against the area of injection for about 20-30 minutes. We usually use 2-3 different swabs over the 20 minutes.

How to Keep the Eye Open

Using a spring like device, called a lid speculum, the eyelids are opened. You can not blink.

A drop of Betadine is placed on the eye at the injection site.

While looking “up,” the shot is given using a very short (27 gauge), but very sharp needle. I like to inject at the “6 o’clock” position just beneath the cornea.

After the needle is withdrawn, another drop of iodine solution (Betadine) is placed on the eye. The eye is then rinsed.

Patients Who Have Pain

Patients who experience pain from the intraocular injection describe pain that last overnight. Often, they don’t tell me about the horrible experience until the next visit. This makes me believe that the discomfort is pretty steady for several hours.

To me, this is not injection pain. Others describe the pain as an electric current. Almost always the pain takes 12-18 hours to dissipate. This can not be from a simple needle. (Ever get an injection in the arm?).

How to Avoid Pain from Intraocular Injections

In patients in whom I suspect a “sensitivity” to Betadine, I’ll omit the iodine-based solution at the time of the next injection. Almost always, this is the remedy!

Remember, this is my method of treatment and your own doctor may not agree.

What Does This Mean?

It took me several patients to realize that this was happening. People didn’t complain often, but when they did, the complaints were emphatic. I believed them.

The best part of this discovery is that…you shouldn’t fear the injections due to pain! Too many people write in refusing additional injections due to the pain.

If you have experienced a painful intraocular injection, you might want to suggest this to your doctor. This may be a simple solution to continue treatment to save your vision!