Dr. Pradhan’s Blog

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If you live in the Richmond area, you have seen the carpet of yellow pollen covering all of the cars and sometimes the street as well. The rain helped settle it out of the air and left beautiful yellow swirls in the parking lot one day after work too!

Some tips to help you combat itchy eyes during this time of year and dry eyes that can be made worse with allergies too: 

  1. Wash your hands and face too after coming in from outside. So simple but important to get the allergens off your hands, face and clothes when you come in from outside. 
  2. Do not rub your eyes. So simple but important! Rubbing your eyes or even an allergic rash activates your immune system to bring more immune cells/mast cells and release more histamines which can make the allergic reaction worse. 
  3. Use a triple therapy approach if needed – eye drops, nasal sprays and oral meds. If the allergies are affecting your ability to breathe, you need to see your doctor and maybe get inhaled medications or steroids.  

Allergy wipes: 

  1. Ocusoft Allergy wipes – works great for kids (and adults) who hate eye drops and can just wipe the itch away from the surface of their closed eyelids. 

Over-the-counter allergy eye drops: 

  1. Systane Zaditor (ketotifen 0.035%) – anti-histamine
  2. B&L Alaway (ketotifen 0.035%) – preservative free anti-histamine
  3. Opcon A (naphazoline 0.02675%-pheniramine 0.315%) – decongestant and anti-histamine 
  4. Visine Allergy (naphazoline 0.025%-pheniramine 0.3%) – decongestant and anti-histamine 
  5. Pataday 2x/day, Pataday 1x/day and Pataday Extra Strength – Olopatadine 0.1%, 0.2% and 0.7% (sometimes the stronger dose burns more and doesn’t help more)
  6. Alcaftadine (Lastacaft)

Prescription allergy eye drops: 

  1. Cromolyn 
  2. Elestat/Epinastine
  3. Steroid drops if needed 

Over-the-counter nasal sprays:

  1. Saline Nasal spray
  2. Astelin or Astepro (azelastine)
  3. NasalCrom (cromolyn nasal spray)

Prescription allergy nasal sprays: 

  1. Patanase

Over-the-counter oral allergy medications: (generic of all below also available)

  1. Loratadine (Claritin) – antihistamine
  2. Desloratadine (Clarinex) 
  3. Cetirizine (Zyrtec) – antihistamine
  4. Levocetirizine (Xyzal) – antihistamine
  5. Fexofenadine (Allegra) – antihistamine
  6. Diphenhydramine (Benadryl) 
  7. Chlorpheniramine
  8. Phenylephrine (Sudafed) – decongestant

Remember all of these likely come with a “-D” version like Claritin-D which has pseudoephedrine (a decongestant) which can make your dry eyes worse. 

Prescription oral allergy medications: 

  1. Montelukast (previously known as brand-name Singulair) – black box warning as causing worsening anxiety and sometimes nightmares. 

If you’re looking for just redness relief, Lumify is safer than Visine Red Out for long term use.

Hope this post was helpful!

Happy Spring! 

 

Photo by Skyler Ewing: https://www.pexels.com/photo/fly-sitting-on-bright-flowers-4856399/

Links may be Amazon Affliate links which provide us a small commission with no extra charge to you. Thank you for helping support our small business!



I’m happy to share I’ve invested in the NuVissa Plasma Pen for treatment of the upper eyelids and crow’s feet after many of you have asked me for treatment options without surgery. The NuVissa Plasma Pen uses plasma technology to help collagen building, tighten the upper eyelid skin, and decrease the appearance of fine lines and wrinkles. It can be used anywhere on the face as well. The patients I’ve used it on have loved the effect!

Frequently asked questions: 

1) Procedure time: about 30 minutes of numbing, 10-15 minutes of treatment and then 25 minutes of LED therapy afterwards to help healing.

2) Risks: Risks of scarring and discoloration in darker skin types so not able to be used on anyone darker than me or Fitzpatrick 5-6 skin types are contraindicated. It can be used on Fitzpatrick 1-4 skin types.

3) Recovery time: About 1 week with some facial swelling

4) Number of treatments needed: About 1-2 depending on the droopiness of upper lids and crow’s feet.

5) How long does the effect last: About 1-2 years per the company. I will learn more as I do more of these treatments. Then you can repeat the process.

6) Other options: If your level of eyelid droopiness is greater than what the plasma pen can treat, you will be referred to an Oculoplastics surgeon for surgery on your eyelids (after a VF test as requested by most insurance companies).

7) Is it covered by insurance: The cosmetic application to the eyelids is not covered by insurance. Please call our office to discuss prices. If you are not medically covered to have eyelid surgery, this is a great option.

8) What else can the Plasma Pen do?: I have also used it on the eye itself to tighten loose conjunctiva (conjunctivochalasis) with great results and a similar healing period of 1 week or so. The application on the eye is an insurance-covered procedure and great option for this condition.

9) Treatment of MGD: The NuVissa Plasma Pen also has an electrophoresis tip (different from the skin tightening tip discussed above) which can be used to treat Meibomian Gland dysfunction (MGD) for dry eye disease. My preferred treatment for MGD starts with oral omega-3 supplementation and IPL (Intense Pulse Light) treatment for patients who are candidates (Fitzpatrick skin type 1-4) however this electrophoresis tip now allows me to treat skin types 5-6 for MGD as well and helps patients feel normal for 6-8 weeks. This is also a self-pay procedure.

I’m excited to share this new technology and offer it to our patients! Using it in combination with Xeomin (Botulinum injections) can help give you the youthful appearance you’re seeking and help you see better by lifting your upper lids.

Call to make an appt for consultation for droopy eyelids and the Nuvissa Plasma Pen if it sounds like it can benefit you.


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Happy Valentine’s Day! 2024!

Please allow me to share my side project. My passion for writing and publishing has turned into helping a friend, Ms. Pam Soddu, publish her legacy of love to her children and grandchildren under my Pradhan Publications LLC company.

This book, The Night of Christmas Miracles, was written in verse and beautifully illustrated with images in the likeness of her children and grandchildren and explores the true meaning of Christmas.

You can learn more about the book on her website www.pamsoddu.com.

Buy ebook on Amazon for $7.49: https://amzn.to/43mxKgn

Buy paperback on Amazon for $14.99: https://amzn.to/3TAdTa9

Buy hardcover on Lulu for $24.99: https://www.lulu.com/shop/pam-soddu-and-pam-soddu/the-night-of-christmas-miracles/hardcover/product-2mm92wk.html?page=1&pageSize=4

The book is live and for sale with links on her website. All proceeds from book sales will be donated to charity by Ms. Pam Soddu. Please make sure to leave a 5-star rating and review on Amazon and Lulu if you love the book!

If you’re inspired by the book and would like to have the author come to your local church or school and do a book reading/signing/sale, please contact her through her website contact form. Thank you for allowing me to share.


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Get ready for the Solar Eclipse on April 8th, 2024! There is not another one in North America until August 2044!!

As you may know, we are going to experience a beautiful solar eclipse on Monday, April 8th, 2024 between the hours of 2 pm and 4:30 pm EST.

You can learn more about this wonderful natural event and how much of it we will see here (quite a bit!) in and around Richmond, Virginia on the NASA website.

Keep your kids safe too!

https://science.nasa.gov/eclipses/future-eclipses/eclipse-2024/

Did you know the temperature drops 10 degrees during the solar eclipse? 

Learn more fun facts here: https://science.nasa.gov/eclipses/future-eclipses/eclipse-2024/faq/

We want you to know that you cannot look directly at the solar eclipse as it can damage your eyes (except during the few minutes during totality). We have ordered NASA-approved solar eclipse glasses for you to buy for yourself and your loved ones.

Solar eclipse glasses:

If you’d like to buy your own online, please buy safe ones as recommended by NASA as linked on their website. https://eclipse.aas.org/eye-safety/eyewear-viewers and do not buy ones not approved on other websites.

Here’s my referral link:

1) solar eclipse glasses and commemorative brochure

2) St. Jude’s solar eclipse glasses

3) Regular bulk solar eclipse glasses

We have solar eclipse glasses for sale in the office. Regular ones for $7 each and special St. Jude’s benefit ones with their logo for $10 each and we will donate the difference to St. Jude in April.

 

Did you know there are phases of the solar eclipse and different cool sites you can see during the two phases?

According to the NASA website, there are a few phases.

1) Partial Eclipse

– First contact – when the moon first “touches” the sun

– The sun appears as a crescent

– Shadow bands – remember physics? These are rapidly moving dark and white bands sometimes visible on the sides of buildings

– Bailey’s beads – light rays from the moon edge through valleys of the moon’s horizon

– Diamond ring – when a single bright spot remains at the edge of the moon before totality

2) Totality – moon completely covering the sun (1-4 minutes only!)

– also known as second contact

– no direct sunlight so it is the only time when safe to look at the sun without solar eclipse glasses but don’t look if you are not sure and not in an area where totality will exist (we will not get totality in Virginia, only 83%)

– can see a pink circle around the moon (chromosphere of sun)

– you may see 360-degree sunset

– the temperature may drop up to 10 degrees

3) Partial eclipse again with same events as prior partial eclipse

– Brightening – aka third contact when the moon starts moving off the sun again and you start to see the sun peeking out again

– make sure to get your glasses back on if you’re in an area of totality.

4) Fourth contact – none of the sun is covered by the moon’s shadow and the eclipse is over!

 

Other reminders:

1) Remember your sunscreen and protective clothes

2) you cannot use the solar eclipse glasses over your camera. That requires a specialized solar filter

 

Remember, if you don’t have solar eclipse glasses, you can use the indirect viewing method to look at the effects of the eclipse and it’s pretty easy to make! Check it out on the NASA website.

You can probably get some solar eclipse glasses or guidance on making an indirect viewer tomorrow at your public library! Contact your local resources!

During a solar eclipse in high school (when I didn’t have eclipse glasses), I still got to experience it by being under a tree and seeing all the shadows of the leaves as crescent shadows. It is such a cool memory to this day.

 

Stay safe and keep your eyes and your family’s eyes protected!

Sincerely,

Shilpi Pradhan, MD

EYE DOCTOR MD PC


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I’m super proud mom announcing that my oldest daughter wrote and illustrated a children’s book, called “Tara The Dolphin”. We self-published on Amazon. It was a really fun project for us to do together as well. She also has a book of poems and art from her Covid year in school called “Summer Fun Unmasked”.

We would love your support. Buy the paperback or e-book on Amazon! If you love it, please leave a review. If you have Kindle unlimited, you can read it free on your Kindle device or Kindle app on your tablet. We also have a few copies for sale in the office.

We’re also having an Author Showcase Event at the Twin Hickory Library where you can hear her read the book and buy a book and get it signed. The event is on June 13th, 2022 at 7 pm. Learn more here: https://henricolibrary-va.libcal.com/event/9177759

Thank you for indulging me and letting me share about my daughter, Shreya.



What’s New with Eye Doctor MD PC?

  1. We have lucky to have Dr. Samita Goyal working in our office every Wednesday! She is a Plastic Surgeon who specializes in breast cancer and breast reconstruction. She also does aesthetic medicine and even ear piercings! Call our main number for an appointment: 804-270-3333
  2. We have partnered with the amazing Nutraceuticals company, Nutrafol, for hair loss supplements. Learn more.
  3. Dr. Pradhan did 25 push-ups for each day in February during a Facebook challenge and raised $750 for the American Cancer Society. Like us on Facebook and follow us!

You’re all caught up here! Make sure to call us for your eye exam and keep up with your eye health and screening!



Did you know there is actual science behind IPL helping Dry Eye Disease and it’s been proven many many times?

This review article published last year goes through the various studies that have proven that IPL helps dry eye disease.

Let’s learn some terminology and learn the science behind it.

IPL is Intense Pulse Light Therapy

MGD is Meibomian Gland Dysfunction or Disease

DED is Dry eye disease

DED is caused by either low water layer (aqueous deficiency) or low oil layer (evaporative) or a combination. It is actually much more complex with inflammation as the root cause which worsens both the water and oil layers.

Where does the inflammation come from? It can be autoimmune like in patients with rheumatoid disease or even diabetes. But more commonly it’s actually from the clogged and dysfunctioning oil glands (meibomian glands) in your eyelids. They secrete inflammatory cytokines (chemicals) which make the surface of the eye dysfunction more and it becomes a downward spiral.

How do we break this inflammatory cycle? There are many ways and sometimes all are necessary to help stop dry eye disease and help you get your life, your eye comfort and your vision back to normal.

The basics include using omega-3s by mouth.  Read my omega-3 page to learn more about which ones are the best for your eyes.

IPL is a great modality that has been around for decades in the dermatology world and has been used in the eye world for about 5-6 years. In fact, Dr. Pradhan has been doing IPL for dry eye disease since December of 2017!

What does IPL do?

IPL uses light therapy of a specific wavelength to help stop the blood vessels that are growing abnormally like in ocular rosacea. This causes the leaked inflammatory cytokines to stop being on the ocular surface and helping break the cycle.

IPL helps melt the meibum (the oil) in the dysfunction oil glands and helps reset the functioning of the oil glands. IPL also helps increase the oxygen levels in the oil glands by decreasing the scar tissue that develops around them over time with inflammation.

IPL helps kill demodex, which is a little mite that lives in the lashes of patients and creates inflammation.  Demodex mites also cause inflammation so killing them decreases the inflammation on the ocular surface.

IPL also helps kill other skin bacteria that may be living on the eyelids and skin and causing inflammation to be worse like in patients with rosacea or chronic crusting (blepharitis) of the eyelids.

IPL helps skin rejuvenation by boosting collagen synthesis and this can help the eyelid position to be more natural against the eye and allow better distribution of the tear film.

IPL can potentially help the mucus production on the surface of the eyelid which would help a smoother blink rate and lubrication of the eye as well as can help eye allergy symptoms. It can also help the dry spots/staining of the corneal surface.

Is it approved in all patients?

IPL has been studied in white patients, Korean patients, Chinese patients, Indian patients. All of these patients had improved dry eye disease signs and symptoms.

IPL is not approved for patients of African American origin whose skin color is darker than a Fitzpatrick IV as it can cause skin color changes and/or keloids.

Can it hurt you?

If IPL is done by a trained professional, like Dr. Shilpi Pradhan who has many years of experience, there is little downside to doing the procedure.  Dr. Pradhan makes sure your eyes are fully covered by laser grade metal shields and you are comfortable during your entire procedure.

If IPL is not done by a trained professional with proper protection of your eyes, it can cause retinal damage, inflammation inside your eyes, loss of vision and skin surface burns.

How many treatments do I need?

Many patients improved with even just one treatment but the recommended is a series of 2-4 treatments approximately 3-4 weeks apart.

Call today to schedule an appointment with Dr. Pradhan 804-270-3333

References:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7330664/



Did you know Dr. Pradhan has the powerful Lumenis M22 IPL and the ResurFX laser resurfacing machine?

IPL is useful for many treatment options including meibomian gland dysfunction (MGD) and dry eye disease. It is also useful for age spots, hair removal and rosacea.

ResurFX is useful for skin tightening and scar treatment like the one below. A simple ResurFX treatment really helped this patient be able to shave better on a daily basis.

Imagine if you could get rid of your age spots on your face, your hands or other discolorations that bother you!

Imagine if you could lighten a surgical scar to make your daily life more comfortable!

Call us today and ask for an IPL or ResurFX treatment with Dr. Pradhan! We look forward to helping you.

Read more about our Aesthetic Center and IPL for Dry Eye Disease