NEWSLETTER - WINTER 2002
/ SPRING 2003
|Brazil meeting faculty
During the second week in March, my wife Vicky, my assistant Laurie
Brown and I traveled to Brazil to participate in the VII International
meeting for Advances in Ophthalmology, co-sponsored by the Brazilian
Society of Ophthalmology, the Brazilian Society of Cataract and Intraocular
Implants, the Brazilian Society of Refractive Surgery, the Brazilian
Society of Ophthalmic Administrators and the Medical Society of Maringa,
On the first day in Brazil, after landing in Rio de Janiero, we were
greeted by our hosts, Drs. Gilberto and Edna Almodin. That evening,
they took us to a seven hour parade of the winning Samba school floats
in downtown Rio de Janiero. We had front row seats, and we were dazzled
by the spectacular costumes, elaborate floats and the inordinately
The second day we flew to the Pantanal, a seasonal flood plain in
mid-south Brazil close to a town called Bonito. We spent two full
days in this uniquely beautiful, unspoiled place, whose major industry
is cattle ranching. It is also characterized by unusual natural resources.
Among the most striking of the geographical features of the Pantanal
are the enormous caves, filled with large stalactites and stalagmites,
which were quite fascinating to see. They were the result of carbon
hydroxide and water seeping through the soil, into the large open
spaces to form candlelight projections from the ceiling and adjacent
up from the floor. The caves are incredibly large, and require a great
deal of energy and effort with which to climb in and out. In addition,
there are beautiful natural springs that are derived from underwater
aquifers, which bubble up through the sand.
The rivers are fairly cool in the tropical climate, and are fairly
rapid, but they are totally without turbulence. Therefore, there is
no stirring of the sediment, which sits placidly on the bottom of
the water. The resulting clarity enables one to see seventy to one
hundred meters through the river while snorkeling, as well as straight
to the bottom of the river. We were provided with wetsuits, and air
filled sandals, which enabled us to lie on top of the water to snorkel.
We were then carried effortlessly by the current, able to relax and
view the fish and underwater plants.
Following our two days in the Pantanal, we flew to Maringa for two
days of meetings. We were able to demonstrate our clinical research
in new phacoemulsification and intraocular lens technologies and techniques,
and Laurie and I performed live surgery to demonstrate refractive
lens exchange, utilizing new bimanual micro-incision phacoemulsification.
We were also able to observe one of our past fellows, Dr. Leonardo
Akaishi, perform his spectacular and flawless surgical technique.
We take enormous pride in the fact that we had helped in the training
of this young, especially talented and exceptionally goodhearted surgeon.
We were so impressed with the work that he is currently doing in Brazil.
On the last night in Brazil, we were treated to an elaborate banquet,
where I was celebrated as a special and honored guest of the Brazilian
Society of Ophthalmology, which is given once a year to people as
an equivalent to a lifetime achievement award. It was a grand manner
in which to be celebrated, and we were humbled by the praise of my
Brazilian colleagues. The final day was spent in Sao Paulo with friends
from the United States. We went to a fauschwada restaurant for a long
dinner, and then had an exhausting trip home. We are always impressed
with the unique beauty and sweetness of the Brazilian people, and
we look forward to a return trip every year. [ top ]
During his recent journey in March to Brazil to participate in the
VII International Advances in Ophthalmology Symposium, Dr. Fine was
recognized as a Special and Honored Guest of the Brazilian Society
of Ophthalmology, in Maringa, Brazil. Dr. Fine was bestowed this great
honor due to his tremendous contributions to Brazilian ophthalmology.
Dr. Fine has worked with many physicians from Brazil, those who have
come to Oregon on fellowships to our practice, as well as those who
have learned new phaco techniques and technology by attending Dr.
Fine's numerous teaching and lecture seminars held in Brazil during
the past decade. By working extensively with the Brazilian Society
of Ophthalmology, Dr. Fine has educated and trained many Brazilian
ophthalmologists in cutting-edge surgical techniques, helping to bring
sight to many in need. It is a wonderful honor to see Dr. Fine recognized
by an ophthalmic community who has gained so much in the mutual friendship
between our practice and the wonderful country of Brazil.
Dr. Fine was also honored by being invited to deliver the Paton Medal
Lecture during the 18th Annual Cullen Course at the Cullen Eye Institute,
Baylor College of Medicine, in Houston, Texas. The Paton Medal is
awarded in honor of Dr. David Paton, a world-renowned ophthalmologist,
whose contributions to the field have been vast, and who continues
working toward his goal of eradicating curable blindness. Dr. Fine
was delighted by this invitation, and his lecture, "New Perspectives
in Cataract and Refractive Surgery", was received with great
enthusiasm. A high point for Dr. Fine was being able to receive his
Paton Medal from his good friend and colleague, Dr. Douglas Koch of
the Cullen Eye Institute. Dr. Fine enjoyed his time in Houston, and
he will always remember the honor of being asked to participate in
such a prestigious gathering. [ top ]
Problems with tearing can be especially frustrating.
Surprisingly, some tearing is actually due to deficiencies in the
tear film, while other causes of tearing include droopy eyelids or
blocked tear ducts. In our office we carefully evaluate each individual
tearing problem to discern its cause and determine the best treatment
|Mark Packer, M.D
If tearing is accompanied by irritation or burning it often means
that the oily layer of the tear film is deficient. Tiny glands along
the eyelid margin produce a clear oil which coats and protects the
surface of the eyes. These glands can become inflamed or clogged,
so the oil cannot lubricate the eyes. This lack of lubrication causes
a feeling of sand or grit in the eyes. The irritation sends a signal
that produces reflex tearing. When irritation accompanies tearing
the solution is often increased lubrication with artificial tears
or quieting the eyes with anti-inflammatory eye drops.
When tears spill out of the eyes onto the cheek the problem may
be sagging eyelids. The eyelids work like a pump to move the tear
film across the surface of the eyes and down the tear duct into
the nose. If the eyelid pump loses its vigor because of drooping
lids the answer is often to correct the position of the eyelids.
A variety of simple procedures are available to improve the pumping
mechanism of the lids and get the tears where they are supposed
Sometimes the tear duct itself may be blocked further downstream,
causing overflow of tears. People with a history of sinus disease
are more prone to develop a blocked tear duct, although it is often
quite common among babies. Some babies are born without a fully
developed tear duct. In these cases we can almost always open the
duct with a simple procedure and eliminate the tearing. In adults
a blocked tear duct has usually been bypassed by connecting the
open portion of the duct directly into the nose. This procedure
is called DCR (dacryocystorhinostomy). A new advance in DCR is the
use of a laser to make the new opening. Using the laser means we
don't have to make any incision into the skin or use any stitches,
so the recovery time is reduced, and the operation can be completed
in a small fraction of the time it used to take. We have been involved
in the development of new instruments to make possible Endoscopic
Laser DCR, and are very pleased to be able to offer this procedure
to our patients.
If you have a problem with tearing, please come in and see us for
an evaluation. We'll show you why tearing is nothing to cry over.
[ top ]
It sounds fishy but it may be true. Researchers
are now finding that particular fatty acids within our diet may
have a beneficial effect on dry eyes and other diseases. Essential
fatty acids cannot be produced within our bodies and must be obtained
from the foods that we eat. The two most important groups of essential
fatty acids are omega-6 and omega-3 fatty acids.
| Richard S. Hoffman,
The average American consumes an excess of omega-6
by eating milk, ice cream, hamburgers, steaks, and fried food.
Unfortunately, omega-6 fatty acids have a detrimental effect on
our bodies by increasing inflammatory metabolites. In contrast,
omega-3 fatty acids have an anti-inflammatory effect within our
bodies and offset the effects of omega-6. Omega-3 fatty acids
have been shown to be beneficial to our cardiovascular system
by lowering the bad (VLDL) cholesterol and triglycerydes while
simultaneously raising the good (HDL) cholesterol. Omega-3 fatty
acids can be found in flaxseed oil, salmon, sardines, herring,
and mackerel - unfortunately, most Americans do not consume enough
of these foods.
Fish oil supplements are rich in ecosapentanoic acid (EPA) and
flaxseed oil is eventually converted by the body into EPA. EPA
has a strong anti-inflammatory effect in the body and also blocks
the conversion of omega-6 fatty acids into inflammatory molecules
ultimately resulting in an increase in the production of anti-inflammatory
prostaglandins. EPA has been shown to help treat rheumatoid arthritis
and increase our natural tear production. It also has a beneficial
effect in reducing the inflammatory eyelid condition termed blepharitis.
Omega-3 has also been shown to improve the quality of the oil
layer of our tears, resulting in less evaporation of the tear
layer and an improvement in dry eye symptoms.
Flaxseed oil and fish oil supplements are taken orally by mouth
and can be found in most natural food stores. Prolonged omega-3
supplementation can deplete vitamin E levels so it would probably
be prudent to supplement this treatment with a daily vitamin E
capsule. Patients who have had their gallbladders removed should
consult their primary care physician before supplementing their
diet with these fatty acids. [ top ]
Our goal at Drs. Fine, Hoffman & Sims is to provide the
best in ophthalmic patient care possible. One way that we have
strived to provide patient service is to have our world-renowned
staff of physicians and ophthalmic technicians practice at our
satellite office in the beautiful coastal town of Florence, Oregon.
With Dr. Richard Hoffman providing service four times a month,
Dr. Packer providing service two times a month, and Dr. Fine providing
service once a month, the citizens of the Oregon coast are able
to be seen by highly trained physicians in a location that is
convenient and close to home. While the size of our branch office
may sometimes necessitate a longer wait than usual in our home
office, the wait is certainly worth it, considering the quality
of care that we are able to provide on a weekly basis right in
your hometown. We would like to thank all of our loyal patients
for their patience! We feel privileged to be able to serve the
coastal communities on a regular basis, and we hope that you will
call for an appointment at our satellite Florence office if you
are in need of our friendly, professional service without the
long drive to Eugene. [ top ]
vs. Medical Benefits
By Belinda Baldwin, CPC, Office Manager
In the insurance world, understanding your benefits can be very
confusing. What provider can you see? Is there an annual deductible
to meet before your insurance will pay? Will there be a co-pay
or a percentage due at the time of service? Do you need a referral
from your primary care physician in order for your insurance to
In the world of ophthalmology, we add to that confusion by asking
two more questions: Are you using vision benefits or medical
benefits? Is your vision insurance with a different
company than your medical insurance?
Drs. Fine, Hoffman & Sims are physicians and surgeons.
If you have a medical complaint your claim will be considered
medical unlessyou tell us to use your vision benefits.
Why is it to your advantage to know your vision benefits vs.
your medical benefits? There are several reasons:
- Your claim will be filed with the right diagnosis
and the correct insurance company from the start.
- Your vision benefits might have less out of
pocket expense, perhaps no deductible, or just a co-pay at the
time of service. On the other hand, your medical benefits might
have less out of pocket expense, perhaps with only a co-pay
at the time of service. By knowing your benefit package you
can make an informed decision on what is best for you.
- Depending on your vision benefit package, you
may be able to use it once every 12 months or 24 months WITHOUT
a referral from your primary care physician.
There are many options to consider and these options
change with individual benefit packages. We want to help
make this process as easy as possible, but we may not
know your particular benefit package. Help us to help
you! Know your benefits package and let us know if you
are using vision or medical benefits at the time of service.
[ top ]
am writing to let you know how my life has changed since I received
my multifocal lens implants. First, I can see! I can see to thread needles,
read a paper, read small print on documents, or look out my window at
the fir trees and even the cones on them. I can see what kinds of birds
are at the feeder, and read a road map while traveling. Recently, while
trying to find an address, I was the one who saw a street sign first.
I was never able to do that before; street signs were nothing but a
fuzzy blur. Now I can do it without squinting. I just wanted to say
how grateful I am to everyone at Drs. Fine, Hoffman & Sims. You
have truly changed my life, and now I will never have to worry about
cataracts. Thank you. [ top ]
had been wishing I could do something about my vision because I
hated having to wear my trifocal glasses and could tell that my
eyes were getting worse. My eyesight was so poor that, without my
glasses, I could not tell whether or not my grandchildren were smiling
at Grandma, even when I was holding them in my arms. I knew I had
to do something. I had heard the radio commercial for Drs. Fine,
Hoffman & Packer, so I called and made an appointment. I got
to see Dr. Packer who he told me he could help me so that I would
no longer be dependent on glasses. Of course, at that time, he didn't
know that I would be one of his difficult patients, but he never
gave up on me. It took over a year, and multiple surgeries, but
he did it. I'm so thankful for him and his staff. They were always
so positive, and I appreciate all of them so much. I do recommend
Drs. Fine, Hoffman & Sims to my family, friends and anyone
who needs an eye doctor. Thank you so much from the bottom of my
heart. [ top]
Feel free to call or drop in if you'd like to speak to someone in person.
1550 Oak St., Suite 5
Eugene, OR 97401
here for Maps
and Directions to our offices.