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Levine | Ophthalmology Blogs

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href="/web/20130904180241/http://www.healio.com/"> Healio</a> <span>&#8250;</span> <a href="/web/20130904180241/http://www.healio.com/ophthalmology"> Ophthalmology</a> <span>&#8250;</span> <a href="/web/20130904180241/http://www.healio.com/ophthalmology/blogs"> Blogs</a> </p> <!-- /breadcrumbs --> <!-- blog-content --> <div class="blog-content"> <!-- blogs content tabs --> <div class="blog-tab-group"> <ul class="blog-tabs"> <li> <a href="/web/20130904180241/http://www.healio.com/ophthalmology/blogs/devgan">Devgan</a> </li> <li> <a href="/web/20130904180241/http://www.healio.com/ophthalmology/blogs/dugel">Dugel</a> </li> <li> <a href="/web/20130904180241/http://www.healio.com/ophthalmology/blogs/hovanesian">Hovanesian</a> </li> <li> <a class="current" href="/web/20130904180241/http://www.healio.com/ophthalmology/blogs/levine">Levine</a> </li> <li> <a href="/web/20130904180241/http://www.healio.com/ophthalmology/blogs/mahdavi">Mahdavi</a> </li> <li> <a href="/web/20130904180241/http://www.healio.com/ophthalmology/blogs/narang">Narang</a> </li> <li> <a href="/web/20130904180241/http://www.healio.com/ophthalmology/blogs/pinto">Pinto</a> </li> <li> <a href="/web/20130904180241/http://www.healio.com/ophthalmology/blogs/white">White</a> </li> <li> <a href="/web/20130904180241/http://www.healio.com/ophthalmology/blogs/wohl">Wohl</a> </li> </ul> <!-- tab "panes" --> <div class="blog-panes"> <div class="eviblog-header"> <a id="layout_0_maincontent_0_blogcontent_0_HyperlinkBlog" href="/web/20130904180241/http://www.healio.com/ophthalmology/blogs/levine">Levine</a> </div> <div> <!-- blog bio --> <ul class="blog-bio"> <li class="img"> <img src="/web/20130904180241im_/http://www.healio.com/~/media/Images/Blog Authors/Ophthalmology/levine.jpg" alt="Mark R. Levine, MD" width="70" height="90"/></li> <li> Mark R. Levine, MD, focuses his blog on how oculoplastic surgery can be beneficial to the comprehensive ophthalmologist to diversify his or her practice and to create an interest in this dynamic subspecialty.</li> </ul> <!-- /blog bio --> <div class="blog-post"> <p class="meta-info"> Wednesday, July 17, 2013 </p> <h2> <a id="layout_0_maincontent_0_blogcontent_0_phblogmain_0_ListView1_lnkBlogPostTitle_0" class="postTitle" href="https://web.archive.org/web/20130904180241/http://www.healio.com/ophthalmology/blogs/levine/hemorrhoid-ointment-used-as-anti-aging-cream-can-dilate-the-pupil-presenting-a-diagnostic-dilemma">Hemorrhoid ointment used as anti-aging cream can dilate the pupil, presenting a diagnostic dilemma </a> </h2> <p class="meta-info"> Mark R. Levine, MD </p> <div class="blog-intro"> <p>The business of facial rejuvenation is bigger than ever with promises of reducing the appearance of fine lines and wrinkles. Because these nonprescription wrinkle creams are not classified as a drug, they are not required to undergo scientific scrutiny to prove their effectiveness.</p> <p>How creams work to reduce fine lines and wrinkles varies. Some work on top of the skin by hydrating and exfoliating, while others work under the skin as a collagen-stimulating cream. Many of these creams have antioxidants such as vitamin A, C and E and beta carotene. These neutralize free radicals that breakdown skin and cause wrinkles. Other antioxidants are tea and grapeseed extract.</p> </div> <div class="readmore"> <a id="layout_0_maincontent_0_blogcontent_0_phblogmain_0_ListView1_BlogPostLink_0" href="https://web.archive.org/web/20130904180241/http://www.healio.com/ophthalmology/blogs/levine/hemorrhoid-ointment-used-as-anti-aging-cream-can-dilate-the-pupil-presenting-a-diagnostic-dilemma">Read more...</a> </div> </div> <div class="blog-post"> <p class="meta-info"> Friday, June 7, 2013 </p> <h2> <a id="layout_0_maincontent_0_blogcontent_0_phblogmain_0_ListView1_lnkBlogPostTitle_1" class="postTitle" href="https://web.archive.org/web/20130904180241/http://www.healio.com/ophthalmology/blogs/levine/bb-gun-injuries-are-not-to-be-considered-lightly">BB gun injuries are not to be considered lightly</a> </h2> <p class="meta-info"> Mark R. Levine, MD </p> <div class="blog-intro"> <p>With summer upon us and more people than ever obtaining weapons for protection and enjoyment (target practice), it is worthwhile to summarize the danger of BB and pellet guns.</p> <p>The term &ldquo;ballistics&rdquo; refers to the science of the travel of an object in flight. In the case of a gunshot wound or BB and pellet guns, the energy expended is kinetic energy, or energy due to a motion of bullet penetrating tissue and/or bone. The kinetic energy of a moving object is the function of its mass and its velocity so that KE=1/2 mv<sup>2</sup>.</p> </div> <div class="readmore"> <a id="layout_0_maincontent_0_blogcontent_0_phblogmain_0_ListView1_BlogPostLink_1" href="https://web.archive.org/web/20130904180241/http://www.healio.com/ophthalmology/blogs/levine/bb-gun-injuries-are-not-to-be-considered-lightly">Read more...</a> </div> </div> <div class="blog-post"> <p class="meta-info"> Thursday, May 9, 2013 </p> <h2> <a id="layout_0_maincontent_0_blogcontent_0_phblogmain_0_ListView1_lnkBlogPostTitle_2" class="postTitle" href="https://web.archive.org/web/20130904180241/http://www.healio.com/ophthalmology/blogs/levine/misdiagnosis-of-ptosis-secondary-to-myasthenia-gravis-can-make-you-look-bad">Misdiagnosis of ptosis secondary to myasthenia gravis can make you look bad</a> </h2> <p class="meta-info"> Mark R. Levine, MD </p> <div class="blog-intro"> <p>Acquired ptosis can be divided into neurogenic, myogenic, traumatic, mechanical and aponeurotic. The mechanism for myasthenia gravis consists of antibodies to acetylcholine receptors at the nicotinic neuromuscular end terminus of the neuromuscular junction. These antibodies block acetylcholine interaction with its receptors on the neuromuscular end plate, leading to weakness. The most common complaints from patients include diplopia and ptosis, frequently at the end of the day. With that said, it can be much more subtle and problematic. Let me give you some examples.</p> </div> <div class="readmore"> <a id="layout_0_maincontent_0_blogcontent_0_phblogmain_0_ListView1_BlogPostLink_2" href="https://web.archive.org/web/20130904180241/http://www.healio.com/ophthalmology/blogs/levine/misdiagnosis-of-ptosis-secondary-to-myasthenia-gravis-can-make-you-look-bad">Read more...</a> </div> </div> <div class="blog-post"> <p class="meta-info"> Tuesday, March 19, 2013 </p> <h2> <a id="layout_0_maincontent_0_blogcontent_0_phblogmain_0_ListView1_lnkBlogPostTitle_3" class="postTitle" href="https://web.archive.org/web/20130904180241/http://www.healio.com/ophthalmology/blogs/levine/unilateral-conjunctivitis-not-always-related-to-lacrimal-duct-obstruction">Unilateral conjunctivitis not always related to lacrimal duct obstruction</a> </h2> <p class="meta-info"> Mark R. Levine, MD </p> <div class="blog-intro"> <p>It has always been the teaching that recurrent unilateral conjunctivitis must be evaluated for partial or complete nasal lacrimal duct obstruction. This may be congenital or acquired. In the adult population, women are more commonly involved than men, with an average age range of 50 to 70 years. This may be caused by a narrower nasal lacrimal duct system than in men or postmenopausal hormonal changes on the mucosa. The diagnosis is made by observing discharge or epiphora, pressing on the lacrimal sac fossa to see if the lacrimal sac is enlarged or painful. If discharge on pressure emanates from either punctum, the diagnosis is made of nasal lacrimal duct obstruction, with the blockage distal to the lacrimal sac. Otherwise, it is necessary to gently irrigate the lacrimal system, looking for reflux from the lower system to the upper system, with little to no irrigant going down the nasal lacrimal duct. A DCR is highly successful in resolving the problem. </p> </div> <div class="readmore"> <a id="layout_0_maincontent_0_blogcontent_0_phblogmain_0_ListView1_BlogPostLink_3" href="https://web.archive.org/web/20130904180241/http://www.healio.com/ophthalmology/blogs/levine/unilateral-conjunctivitis-not-always-related-to-lacrimal-duct-obstruction">Read more...</a> </div> </div> <div class="blog-post"> <p class="meta-info"> Monday, January 28, 2013 </p> <h2> <a id="layout_0_maincontent_0_blogcontent_0_phblogmain_0_ListView1_lnkBlogPostTitle_4" class="postTitle" href="https://web.archive.org/web/20130904180241/http://www.healio.com/ophthalmology/blogs/levine/sarcoidosis-diagnosis-and-treatment">Sarcoidosis diagnosis and treatment</a> </h2> <p class="meta-info"> Mark R. Levine, MD </p> <div class="blog-intro"> <p>I have always been interested in sarcoidosis in the way it presents and its diagnostic dilemma, so I would like to pose three test questions and follow up with a discussion to build upon the questions. </p> </div> <div class="readmore"> <a id="layout_0_maincontent_0_blogcontent_0_phblogmain_0_ListView1_BlogPostLink_4" href="https://web.archive.org/web/20130904180241/http://www.healio.com/ophthalmology/blogs/levine/sarcoidosis-diagnosis-and-treatment">Read more...</a> </div> </div> <div class="blog-post"> <p class="meta-info"> Monday, December 17, 2012 </p> <h2> <a id="layout_0_maincontent_0_blogcontent_0_phblogmain_0_ListView1_lnkBlogPostTitle_5" class="postTitle" href="https://web.archive.org/web/20130904180241/http://www.healio.com/ophthalmology/blogs/levine/rethinking-blowout-orbital-fractures">Rethinking blowout orbital fractures</a> </h2> <p class="meta-info"> Mark R. Levine, MD </p> <div class="blog-intro"> <p>It is always a pleasure to attend our national meeting and have the opportunity to see old friends and reassess one's educational experience. The subspecialty day is most valuable, as it discusses controversial topics and allows the physician to be challenged from his or her past experience with what is the new thinking on the subject. The interactive response is very interesting, especially when the speaker presents his or her thoughts about the best way to manage a problem, and surprisingly almost half the audience disagrees and is not planning on incorporating it into their practice.&nbsp; </p> </div> <div class="readmore"> <a id="layout_0_maincontent_0_blogcontent_0_phblogmain_0_ListView1_BlogPostLink_5" href="https://web.archive.org/web/20130904180241/http://www.healio.com/ophthalmology/blogs/levine/rethinking-blowout-orbital-fractures">Read more...</a> </div> </div> <div class="blog-post"> <p class="meta-info"> Thursday, November 1, 2012 </p> <h2> <a id="layout_0_maincontent_0_blogcontent_0_phblogmain_0_ListView1_lnkBlogPostTitle_6" class="postTitle" href="https://web.archive.org/web/20130904180241/http://www.healio.com/ophthalmology/blogs/levine/recognition-and-treatment-of-subconjunctival-fat-prolapse">Recognition and treatment of subconjunctival fat prolapse</a> </h2> <p class="meta-info"> Mark R. Levine, MD </p> <div class="blog-intro"> <p style="text-align: justify;">Interestingly, I have been referred patients with subconjunctival fat prolapse with the referring physician somewhat unsure of what the entity is and what the treatment options are. </p> Subconjunctival fat prolapse is commonly seen in older people resulting from a defect in posterior Tenon&rsquo;s capsule allowing fat to prolapse anteriorly. </div> <div class="readmore"> <a id="layout_0_maincontent_0_blogcontent_0_phblogmain_0_ListView1_BlogPostLink_6" href="https://web.archive.org/web/20130904180241/http://www.healio.com/ophthalmology/blogs/levine/recognition-and-treatment-of-subconjunctival-fat-prolapse">Read more...</a> </div> </div> <div class="blog-post"> <p class="meta-info"> Friday, September 28, 2012 </p> <h2> <a id="layout_0_maincontent_0_blogcontent_0_phblogmain_0_ListView1_lnkBlogPostTitle_7" class="postTitle" href="https://web.archive.org/web/20130904180241/http://www.healio.com/ophthalmology/blogs/levine/chalazion-management-aggressive-treatment-is-better">Chalazion management: Aggressive treatment is better</a> </h2> <p class="meta-info"> Mark R. Levine, MD </p> <div class="blog-intro"> <p>Too often in practice, patients with a chalazion come back to the ophthalmologist multiple times after treatment with warm compresses, massage, topical antibiotics, systemic antibiotics (tetracycline) and steroid injections (triamcinolone acetate 2 mg). Attempts at incision and drainage may be suboptimal, leading to a frustrated patient after three or four visits.</p> </div> <div class="readmore"> <a id="layout_0_maincontent_0_blogcontent_0_phblogmain_0_ListView1_BlogPostLink_7" href="https://web.archive.org/web/20130904180241/http://www.healio.com/ophthalmology/blogs/levine/chalazion-management-aggressive-treatment-is-better">Read more...</a> </div> </div> <div class="blog-post"> <p class="meta-info"> Thursday, September 6, 2012 </p> <h2> <a id="layout_0_maincontent_0_blogcontent_0_phblogmain_0_ListView1_lnkBlogPostTitle_8" class="postTitle" href="https://web.archive.org/web/20130904180241/http://www.healio.com/ophthalmology/blogs/levine/outcomes-for-mucous-membrane-pemphigoid-depend-on-early-diagnosis-aggressive-therapy">Outcomes for mucous membrane pemphigoid depend on early diagnosis, aggressive therapy</a> </h2> <p class="meta-info"> Mark R. Levine, MD </p> <div class="blog-intro"> <p style="text-align: justify;">The first papers I was a co-author on were in collaboration with dermatology regarding blistering diseases of the conjunctiva and mucus membranes. This became known as cicatricial pemphigoid as opposed to benign mucus membrane pemphigoid, which is far from a benign disease. At the time, biopsy specimens were transported to the lab with dry ice, which was soon replaced with Michel&rsquo;s fixative (a great friend). Below is an overview of a disease process that is important to recognize and treat.</p> </div> <div class="readmore"> <a id="layout_0_maincontent_0_blogcontent_0_phblogmain_0_ListView1_BlogPostLink_8" href="https://web.archive.org/web/20130904180241/http://www.healio.com/ophthalmology/blogs/levine/outcomes-for-mucous-membrane-pemphigoid-depend-on-early-diagnosis-aggressive-therapy">Read more...</a> </div> </div> <div class="blog-post"> <p class="meta-info"> Wednesday, July 11, 2012 </p> <h2> <a id="layout_0_maincontent_0_blogcontent_0_phblogmain_0_ListView1_lnkBlogPostTitle_9" class="postTitle" href="https://web.archive.org/web/20130904180241/http://www.healio.com/ophthalmology/blogs/levine/trichiasis-a-pain-in-the-eye">Trichiasis: A pain in the eye</a> </h2> <p class="meta-info"> Mark R. Levine, MD </p> <div class="blog-intro"> <p style="text-align: justify;">Trichiasis refers to abnormal lash growth with the lashes directed posteriorly toward the globe. Unlike entropion, the eyelid is at a normal position.</p> <p style="text-align: justify;">The pathogenesis of trichiasis involves the creation of micro-cicatrices in the area of the eyelash follicles with lash distortion and misdirection. The process may cause keratinization of the lid margin mucosa, which causes ocular surface problems. The ultimate results of trichiasis lead to pain, corneal scarring and decreased vision.</p> </div> <div class="readmore"> <a id="layout_0_maincontent_0_blogcontent_0_phblogmain_0_ListView1_BlogPostLink_9" href="https://web.archive.org/web/20130904180241/http://www.healio.com/ophthalmology/blogs/levine/trichiasis-a-pain-in-the-eye">Read more...</a> </div> </div> <!-- pagination --> <div id="layout_0_maincontent_0_blogcontent_0_phblogmain_0_pagination_divPagination" class="pagination"> <ul> <li> <a class="current page" href="/web/20130904180241/http://www.healio.com/ophthalmology/blogs/levine?Filter=&amp;startItem=0"> 1 </a> </li> <li> <a class="page" href="/web/20130904180241/http://www.healio.com/ophthalmology/blogs/levine?Filter=&amp;startItem=10"> 2 </a> </li> </ul> </div> <!-- /pagination --> <div class="eviblog-footer"> Powered by EviBlog</div> </div> </div> </div> </div> </div> <!-- /main-content --> <!-- sidebar --> <!-- googleoff: index --> <div id="sidebar"> <!-- googleoff: 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style="display:none;"><li><a href="https://web.archive.org/web/20130904180241/http://www.healio.com/ophthalmology/blogs/levine/sarcoidosis-diagnosis-and-treatment">Sarcoidosis diagnosis and treatment</a></li></ul></li><li><a onclick="ToggleVisibility(&quot;entries-20133&quot;)" class="month">March (1)</a><ul id="entries-20133" class="entries" style="display:none;"><li><a href="https://web.archive.org/web/20130904180241/http://www.healio.com/ophthalmology/blogs/levine/unilateral-conjunctivitis-not-always-related-to-lacrimal-duct-obstruction">Unilateral conjunctivitis not always related to lacrimal duct obstruction</a></li></ul></li><li><a onclick="ToggleVisibility(&quot;entries-20135&quot;)" class="month">May (1)</a><ul id="entries-20135" class="entries" style="display:none;"><li><a href="https://web.archive.org/web/20130904180241/http://www.healio.com/ophthalmology/blogs/levine/misdiagnosis-of-ptosis-secondary-to-myasthenia-gravis-can-make-you-look-bad">Misdiagnosis of ptosis secondary 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id="month-2012" class="month"><li><a onclick="ToggleVisibility(&quot;entries-20122&quot;)" class="month">February (2)</a><ul id="entries-20122" class="entries" style="display:none;"><li><a href="https://web.archive.org/web/20130904180241/http://www.healio.com/ophthalmology/blogs/levine/treatment-of-dry-eyes">Treatment of dry eyes</a></li><li><a href="https://web.archive.org/web/20130904180241/http://www.healio.com/ophthalmology/blogs/levine/dont-give-up-on-epiphora">Don't give up on epiphora</a></li></ul></li><li><a onclick="ToggleVisibility(&quot;entries-20123&quot;)" class="month">March (1)</a><ul id="entries-20123" class="entries" style="display:none;"><li><a href="https://web.archive.org/web/20130904180241/http://www.healio.com/ophthalmology/blogs/levine/involutional-ectropion-for-the-comprehensive-ophthalmologist">Involutional ectropion for the comprehensive ophthalmologist</a></li></ul></li><li><a onclick="ToggleVisibility(&quot;entries-20125&quot;)" class="month">May (1)</a><ul id="entries-20125" class="entries" style="display:none;"><li><a href="https://web.archive.org/web/20130904180241/http://www.healio.com/ophthalmology/blogs/levine/enucleation-vs-evisceration">Enucleation vs. evisceration</a></li></ul></li><li><a onclick="ToggleVisibility(&quot;entries-20126&quot;)" class="month">June (1)</a><ul id="entries-20126" class="entries" style="display:none;"><li><a href="https://web.archive.org/web/20130904180241/http://www.healio.com/ophthalmology/blogs/levine/types-of-implants-and-practical-choices-in-enucleation-and-evisceration-surgery">Types of implants and practical choices in enucleation and evisceration surgery</a></li></ul></li><li><a onclick="ToggleVisibility(&quot;entries-20127&quot;)" class="month">July (1)</a><ul id="entries-20127" class="entries" style="display:none;"><li><a href="https://web.archive.org/web/20130904180241/http://www.healio.com/ophthalmology/blogs/levine/trichiasis-a-pain-in-the-eye">Trichiasis: A pain in the eye</a></li></ul></li><li><a onclick="ToggleVisibility(&quot;entries-20129&quot;)" class="month">September (2)</a><ul id="entries-20129" class="entries" style="display:none;"><li><a href="https://web.archive.org/web/20130904180241/http://www.healio.com/ophthalmology/blogs/levine/chalazion-management-aggressive-treatment-is-better">Chalazion management: Aggressive treatment is better</a></li><li><a href="https://web.archive.org/web/20130904180241/http://www.healio.com/ophthalmology/blogs/levine/outcomes-for-mucous-membrane-pemphigoid-depend-on-early-diagnosis-aggressive-therapy">Outcomes for mucous membrane pemphigoid depend on early diagnosis, aggressive therapy</a></li></ul></li><li><a onclick="ToggleVisibility(&quot;entries-201211&quot;)" class="month">November (1)</a><ul id="entries-201211" class="entries" style="display:none;"><li><a href="https://web.archive.org/web/20130904180241/http://www.healio.com/ophthalmology/blogs/levine/recognition-and-treatment-of-subconjunctival-fat-prolapse">Recognition and treatment of subconjunctival fat prolapse</a></li></ul></li><li><a onclick="ToggleVisibility(&quot;entries-201212&quot;)" class="month">December (1)</a><ul id="entries-201212" class="entries" style="display:none;"><li><a href="https://web.archive.org/web/20130904180241/http://www.healio.com/ophthalmology/blogs/levine/rethinking-blowout-orbital-fractures">Rethinking blowout orbital fractures</a></li></ul></li></ul><li><a onclick="ToggleVisibility(&quot;month-2011&quot;)" class="year">2011</a></li><ul id="month-2011" class="month"><li><a onclick="ToggleVisibility(&quot;entries-201112&quot;)" class="month">December (2)</a><ul id="entries-201112" class="entries" style="display:none;"><li><a 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