September, 2012
NEXT MEETING
Tuesday, September 11
St. Louis Marriott West
660 Maryville Centre Drive
6:00 p.m. Light buffet
Hosted by Paragon Vision Services
RSVP by Thursday, September 6
7:00 p.m. Business Meeting
7:30 p.m. “Contact Lens Myopia Control”
Jeffrey Walline, O.D., Ph.D.
One hour C.E.
CORNEAL REFRACTIVE THERAPY
Dr. Walline will discuss all forms of myopia control, including eye drops, bifocal spectacles, under-correction, and gas permeable contact lenses. These forms of myopia control will be compared to corneal reshaping and soft bifocal contact lenses in order to put the potential of contact lenses for myopia control into perspective. A discussion of the theory of contact lens myopiacontrol will better enable eye care practitioners to optimally prescribe for myopia control. Iinformation about fitting kids with contact lenses will enhance eye care practitioners’ ability to fit young children with contact lenses.
A graduate of the California, Berkely School of Optometry, Dr. Walline received his Master’s degree in Physiological Optics and a PhD. Degree in Vision Science from the Ohio State University College of Optometry where he is now an instructor in the Bionocular Vision and Pediatrics and Contact Lens Services . this promises to be an interesting and informative presentation.
Reservations by September 6, please.
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MISSOURI OPTOMETRIC ASSOCIATION
2012 ANNUAL CONVENTION
October 11-14
“More Than Meets the Eye”
Chateau on the Lake – Branson, Missouri
Visit moeyecare.org
For details and registration on line
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NEW SLOS MEMBERS
Drs. Barbara Balabas and Nathan Dieckow
St. Louis Optometric Society
Officers: 2011-2012
President
Paul A. Whitten, O.D.
314 839-2400
President-Elect
Jason Riley, O.D.
573 468-4032
Vice President
Scott Tomasino, O.D.
636 272-1444
Secretary
Kimberly Layfield, O.D.
314 739-9293
Treasurer
Erin Niehoff, O.D.
636 528-2020
Sgt. At Arms
Joseph Castellano, O.D.
314 863-0000
Immediate Past President
Karen Rosen, O.D.
314 843-2020
MOA Trustees
Tom Cullinane, O.D.
314 579-0909
Robert G. Goerss, O.D.
636 272-1444
Executive Director
Barbara Nahlik
Phone: 314 725-2020
FAX 314 961-1041
e-mail:
FROM THE AUGUST 14 SLOS MEETING…
Dr. Tom Hobbs, optometrist from Warrensburg, MO, presented the continuing education for the August SLOS meeting. The topic was “Eyes on Fabry.”
Fabry Disease is a silently progressive, increasingly debilitating, often life-threatening genetic disorder. It affects both males and females of all ethnicities and ages, and is a metabolic disorder that is part of the larger family of lysosomal storage disorders. Progressive cellular substrate accumulation begins before birth and leads to debilitating symptoms and life-threatening complications. It can be challenging to identify, but is easy to diagnose.
In Fabry Disease, a deficiency of the lysosomal enzyme alpha-galactosidase A (α-GAL) leads to
Dr. Tom Hobbs discussed Fabry Disease
progressive substrate accumulation of globotriaosylceramide (GL-3). Over time, the build-up can cause irreversible organ damage and death. The multisystemic signs and symptoms begin to show in childhood and adolescence. This can eventually lead to renal failure, heart disease, and stroke.
Fabry Disease is an X-linked (dominant) disease as the α-GAL gene is located on the X chromosome. Therefore, males with the defective gene are always affected and females with the defective gene are affected to varying degrees, possibly due to skewed X inactivation. Also, affected fathers will pass the gene to all daughters, but no sons. Affected mothers have a 50% risk of passing the defective gene to both sons and daughters.
As GL-3 accumulates, signs and symptoms may begin in childhood. These include episodic pain crises, neuropathic pain, hypohidrosis/anhidrosis, corneal and lenticular opacities, recurrent fever, heat and cold intolerance, psychosocial manifestations, and gastrointestinal distress. During adolescence, proteinuria, angiokeratomas, and fatigue may also begin to develop. Finally in adulthood, more life-threatening manifestations can arise including renal insufficiency, neurological complications, cerebrovascular disease, cardiac dysfunction, and hearing loss/tinnitus. Continued on next page
Fabry Disease
As mentioned before, the ocular manifestations include corneal and lenticular opacities. The cornea develops whorl-like rays that are only visible by slit-lamp and usually do not affect vision. These signs are a very useful diagnostic indicator and are found almost universally in males and approximately 70% of females.
Early recognition of the disease is important. Even though the disease usually presents in childhood, it often goes unrecognized until adulthood when underlying pathology is advanced. Patients may see a range of specialists before the disease is recognized and delayed diagnosis may be due to under-recognition of early signs and symptoms. One problem is that the symptoms of Fabry disease are similar to those of other more common disorders. The most common misdiagnoses may include rheumatoid or juvenile arthritis, rheumatic fever, erythromelagia, neurosis, “growing pains”, Raynaud’s syndrome, multiple sclerosis, and petechiae.
Fabry disease management consists of supportive therapy, regular ongoing follow-up and disease specific intervention. Enzyme replacement therapy is one intervention that helps to slow the progression of the disease.
Diagnosing a single Fabry patient is also important because it also means a Fabry family is being identified. The earlier the diagnosis is made the greater chance of preventing irreversible organ damage.
Dr. Hobb’s presentation was co-sponsored by Fabry Support and Information Group (www.fabry.org) and SLOS.
Resources and support: www.fabry.org, www.fabrycommunity.com, www.fabryregistry.com, www.genetests.org.
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Fabry patients, Jack Johnson of FSIG and
Amanda Luchento with Tanya Downing of Gensyme
THANKS FOR THE UM-SL COLLEGE OF OPTOMETRY MOBILE EYECARE UNIT THAT PROVIDED THE SLIT LAMPS FOR FABRY PATIENT OBSERVATION
Members lined up to observe the patients
Observing the Fabry patient
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CALENDAR
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Sept. 5 Vision Summer Seminar
Mason Bias, M.D.
2 hrs. C.E.
Sept. 11 SLOS Meeting
Jeffrey Walline, O.D., Ph.D.
“Contact Lens Myopia Control”
Hosted by Paragon Vision Services
Oct. 9 SLOS Meeting
Dr. Larry Alexander
Oct. 11-14 MOA Convention
Chateau on the Lake, Branson, MO
Nov. 13 SLOS Meeting
Pepose Vision Institute
Dec. 11 Holiday Party
Hosted by Midland Optical
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SLOS COMMITTEES FOR 2012-2013
Contact Lenses: Dan Friederich
Jordan Jones
Co-Management: Drew Biondo
New Technology: Christy Hayes
Jamie Gold
Membership: Barb Aalbers
Kim Folwarski
Marissa O’Brien
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Drs. Jamie Gold, Jessica Carson & Jordan Jones
VISIT THE SLOS WEBSITE
www.stlouisoptometricsociety.org
FABRY SUPPORT & INFORMATION GROUP
The FSIG mission is to provide the Fabry community and the general public with information, advocacy, education and compassionate support to improve the quality of life and the quality of care for Fabry patients and family members.
FSIG strives to raise awareness of Fabry disease and it’s symptoms within and for the Fabry patient, family members, caregivers, medical and therapeutic com-munities as well as the general public. Increased knowledge and awareness of this rare hereditary genetic condition. FSIG is a 501(c)(3) nonprofit organization. Visit: www.fabry-org
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OPTOMETRIST WANTED – private Practice setting
in Lincoln & Pike Counties. Full or Part Time.
Dr, Denise Harvey, Office: 573-324-3131 or
Cell: 573 470-1615