For Young and Old Alike

South Tampa clinic welcomes new physicians, expands service.

Florida Eye Specialists & Cataract Institute’s South Tampa clinic recently welcomed two new physicians: Evan N. Dunn, MD, and G.S. “Jack” Guggino, MD.

Photo by Jordan Pysz.

G.S. “Jack” Guggino, MD (left) and Evan N. Dunn, MD

Dr. Dunn is a retina specialist; Dr. Guggino is a pediatric ophthalmologist. Their arrival expands the specialty services accessible to area residents.

Fellowship trained at National Children’s Medical Center in Washington, DC, Dr. Guggino has practiced pediatric ophthalmology in Tampa since 1974. Over the years, he introduced new surgical techniques for treating strabismus, a term used to describe misaligned eyes, and lectured on the subject across the country.

In his practice, Dr. Guggino treats newborns, infants, toddlers, pre-teens and teenagers.

“We recommend that children have their first routine eye exam during the first year of life,” he states. “Many ocular conditions show no signs of being present and can be successfully addressed when diagnosed early. Follow-up eye exams should then take place at two-year intervals.”

Common conditions in childhood and adolescence are myopia (nearsightedness), hyperopia (farsightedness) and astigmatism. These are refractive errors – vision problems caused by the eye’s inability to properly focus light on the retina to form clear images.

“Children who are farsighted can clearly see objects in the distance but have difficulty seeing objects up close,” Dr. Guggino describes. “Those who are nearsighted have the opposite problem; nearby objects are clearly visible, but far away objects are out of focus.

“The vast majority of patients who follow-up as recommended can avoid losing vision from diabetic retinopathy.” – Dr. Dunn

“Astigmatism is an irregular curvature in the lens or cornea. Astigmatism leads to distorted, fuzzy or blurry vision. Nearsightedness, farsightedness and astigmatism can easily be corrected with prescription eyeglasses.”

Dr. Guggino also treats other routine conditions, including infections, blocked tear ducts, styes, chronic tearing and foreign bodies children may get in their eyes while playing outside. Two of the more common disorders he treats are amblyopia and strabismus.

“Amblyopia, also referred to as lazy eye, occurs prior to the age of 9 years when one eye is deprived for any reason of clarity of vision,” Dr. Guggino explains. “This could be due to uneven astigmatism or farsightedness. It can be caused by a deviating eye (strabismus) or a cataract.

“Amblyopia is typically treated by providing the best vision possible in the problem eye and patching the other eye.”

Strabismus is a term used to describe misaligned eyes. The eyes cross toward each other (esotropia) or deviate away from each other (exotropia). Strabismus is treated with glasses or surgery or both.

“Strabismus can occasionally be treated with eyeglasses that force the affected eye to work in concert with its partner. But the condition most often requires eye muscle surgery to align the eyes properly.” – Dr. Guggino

Dr. Guggino understands that children may be frightened when visiting an eye doctor for an examination. To ease their fears, Dr. Guggino and his staff create a calming environment where children can feel secure and unthreatened.

“On the days that I see patients at the South Tampa clinic, the office is transformed into a child-friendly oasis,” the doctor describes. “The environment and the personnel are all dedicated to the needs of children. In the waiting area, there are children’s videos playing and there is a playroom for the children to enjoy.”

Dr. Guggino and his staff are enthusiastic and friendly, and specially trained to make eye exams as easy as possible for the children.
“It is not necessary for children to know how to read for us to determine if they need glasses,” he notes. “We perform an objective exam, which allows us to gather all the information necessary to make a diagnosis.”

Threats to Vision

Children aren’t the only ones getting more attention at the South Tampa clinic. Dr. Dunn treats adults with disorders of the retina, including diabetic retinopathy and macular degeneration, two leading causes of treatable vision loss.

Photo by Jordan Pysz.

Dr. Guggino treats newborns, infants, toddlers, pre-teens and teenagers.

Diabetic retinopathy is the most common cause of vision loss in working-age adults. High blood sugar causes abnormalities in the retinal blood vessels that may slowly decrease the quality of vision or cause sudden vision loss.

“The vast majority of patients who follow-up as recommended can avoid losing vision from diabetic retinopathy,” Dr. Dunn stresses. “We feel very fortunate that advances in technology have allowed us to maintain and improve vision in working-age adults who
suffer with diabetes.”

There are two main types of diabetic retinopathy, nonproliferative and proliferative.

“The nonproliferative type is an early stage of diabetic retinopathy characterized by small outpouchings of normal blood vessels called microaneurysms and tiny areas of bleeding within the retina,” Dr. Dunn explains. “These retinal changes may progress to a much more serious type of diabetic retinopathy that, if left untreated, may cause permanent vision loss.

“We monitor these patients routinely to make sure that if worsening occurs, we can treat it before the patients ever lose vision.”

The most severe form of diabetic retinopathy is proliferative diabetic retinopathy. People have a 50 percent chance of losing their vision if they develop this condition. Fortunately, there have been significant advances in therapy that allow retina specialists to restore vision and prevent vision loss in the majority of these people.

“Some patients may develop leaky blood vessels that decrease vision, a condition called macular edema,” Dr. Dunn informs. “There are a number of well-established and new treatments available to restore vision in patients who develop this condition.”

Age-related macular degeneration (AMD) refers to changes in patients 50 years and older. It comes in a spectrum from very mild changes that cause no visual disturbances (dry form) to more severe changes that can lead to a significant loss of central vision (wet form).

The goal of treatment for dry, intermediate AMD is two-fold: Prevent worsening of existing macular degeneration and detect worsening early should it occur.

“Patients with dry AMD are often asked to use a specific formulation of eye vitamins,” Dr. Dunn reports. “It is critical that these patients check each eye individually once or twice a week to evaluate for new distortion or blurriness in their vision. Either of these changes may indicate that their eye has developed the wet form of AMD. This requires treatment within several days for optimal results.

“Wet AMD is characterized by the formation of undesirable, abnormal new blood vessels. These blood vessels tend to leak and/or bleed, which decreases the quality of vision. Excellent treatment exists for this condition, and most patients who present promptly regain significant vision and are able to maintain good vision during their lifetime.”

Tears and Detachments

Diabetic retinopathy and macular degeneration are medical retinal disorders. Two of the more common disorders requiring an in-office procedure or possibly surgery are retinal tears and retinal detachments.

“We suspect a retinal tear as soon as a patient reports flashing lights or a sudden onset of new floaters, which are common complaints,” Dr. Dunn states. “Flashing lights and floaters can be due to normal changes of the eye, but one of five people who presents with those symptoms will likely have a retinal tear to explain them.”

A retinal tear is an unwanted consequence of a normal, age-related process in which the vitreous gel between the lens and retina liquefies. But that process is complicated by the vitreous inadvertently pulling at the retina. That is how a retinal tear is formed.

A retinal tear should be treated promptly using a laser or freezing procedure. If it is not treated promptly, a tear can turn into a retinal detachment.

“A tear in the retina allows fluid to pass through it,” Dr. Dunn describes. “Then, there is fluid on the undersurface of the proverbial wallpaper. The next thing you know, the wallpaper is falling off of the wall, and that is a retinal detachment.

“Retinal detachments may be repaired in a variety of ways. The most common way is with an outpatient surgery called a vitrectomy, during which the vitreous is removed and replaced with a bubble of gas or air. Over a short time, the bubble smooths out the retina and seals the detachment.”

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