Dr. Shalu Pal

  • "If you want quality and wonderful service, please go to Dr. Shalu Pal! The patience, care, and true concern that Dr. Pal has for her clients is wonderful. "

    --Seleena J
  • " I was pleasantly surprised by finding a hidden gem within Dr. Pal's office"

    --Naveed
  • "Finally a doctor who is extremely knowledgeable, patient and explains things clearly. She is a wonderful human being who really takes the time to care for your needs. The office has a wonderful atmosphere and the staff are just as helpful as Dr. Pal. "

    --Mikail
  • "I couldn't ask for a better Optometrist. She is a delight to deal with, very patient, helpful and extremely knowledgeable. She was very good with my kids who can be very fussy at times.. And who could ask for a more beautiful location. Highly Recommend! "

    --Natalie M.
  • "My wife and I, highly recommend Dr. Pal. The staff, the service, the merchandise, are all top notch. They really make you feel welcomed. It has been several years since I have been able to see this well !!! You and your staff are the best !!!! "

    --Steve and Maria L.
  • "We barely go to optometrists so when we do, we should look for the best! I am super pleased I chose Dr. Pal\'s office. They were helpful from beginning to end, from booking on the phone to my actual visit. Dr. Pal was very detailed and went in-depth about my eye health. She is very patient and made me feel calm. The optician helped me pick a great pair of glasses, they were genuinely friendly which is a huge bonus."

    --Ahmad S
  • "I have been going to Dr. Pal for several years now. My most recent visit on June 6, 2016 was the best experience there that I have ever had. Firstly, the women on the desk were friendly and efficient - a very good prelude to my examination. Dr. Pal, herself, was, as usual, very thorough and encouraging in her examination. And she puts you at ease before we get into the eyes examination by discussing other things in life. That helps to ease any stress I may have. And they now have a man in the office who does that difficult examination (name of which I do not know!). He is so patient and encouraging and made the exam not so difficult for me this time. After all that, I saw Dr. Pal again before I left and she told me my eyes were good! Even had the news been not so good, I believe that I would be able to handle it because I truly believe that Dr. Pal and her staff would have taken good care of me. I will always go back to Dr. Pal and members of her team because I truly believe"

    --A. Howlett
  • " I have been to a few appointments at Dr. Pal\'s office over the last year for dry eye issues and every time it has been a very positive experience. The 3 receptionists at the front desk are warm and friendly. They are attentive and provide a very high level of customer service. I appreciate that they call me by name and remembered conversations we had at previous visits. I find Dr. Pal to be an excellent practitioner who is very thorough with her exams, has a lovely personality and takes the time to answer any and all questions that may arise. I am happy with the computer glasses I purchased and value the honest opinions I received from the staff when selecting frames. It was refreshing to have multiple opinions on styles and I felt they truly wanted me to walk out with a frame that was best suited to me. I highly recommend Dr. Pal \'s office! As a health care practitioner myself, I think all health care experiences should be this personilzed and friendly!"

    --A. Mclean
Duane's Syndrome



Duane’s Syndrome

Example of Duane s Syndrome affecting the right eye. The right eye has difficulty turning outwards and the lid aperture narrows. Duane’s syndrome is an unusual eye muscle problem. It is a type of strabismus a term that describes eyes that are not properly aligned or do not move normally. With Duane’s the eyes do not always move together because the affected eye has limited movement in one direction (usually outward). Children with Duane’s syndrome are otherwise healthy and usually have normal vision. The condition is congenital and is nearly always limited to one eye although both eyes are involved in about 20% of cases.

Eye Movement Limitations Duane’s syndrome is classified into three types depending on the direction of the muscle restriction. In the most common type of Duane’s the affected eye has restricted horizontal movement outwards (toward the ear). Let’s say the left eye is affected. There is limited movement when looking left. There is usually normal movement to the right but often the affected eye may retract slightly into the eye orbit and the eyelids partly close. Another feature is that the left eye may suddenly move upward (called “upshoot”) or downward (“downshoot”) when looking to the right.

In the least common type of Duane’s the movement limitation is in the opposite direction. So an affected left eye does not move or has restricted movement when looking to the right (towards the nose). In the third type of Duane’s there is limited movement outwards and inwards.

Eye Alignment In most people with Duane’s there are some directions of gaze in which the eyes are perfectly aligned. If there is good alignment in the straight-ahead position (this is most common) the condition is not very apparent. To look to the side one merely turns his or her head instead of the eyes. This avoids double vision and maintains a more normal appearance.

Those people whose eyes are not aligned when looking straight ahead need to turn their face to avoid double vision in the forward direction. This is called a compensatory face turn. If the necessary amount of face turn is far off-centre the head tends to be held in a position that does not look normal. Fortunately this can often be corrected.

What Causes the Problem? Nerves from the brainstem act like wires carrying an electrical message to the muscles that move the eyes. With Duane’s some of the nerves are connected to the wrong muscles so when the brain directs the eyes to move in a certain direction only one eye receives the right message. The other eye gets improper signals which prevent it from moving normally. Over time some of the muscles of the affected eye become tight adding to the eye movement problems.

Treatment In most cases treatment is unnecessary. If there is an especially noticeable face turn the involved eye muscles can be surgically corrected to allow looking at things straight on without having to turn the head. The surgery however is only to improve the head position; it will not improve the eye’s limited range of motion.

As one gets older the eye movement problem will not change for better or worse. But it’s still important to have routine eye examinations to guard against the development of amblyopia (lazy eye) a condition that can sometimes occur with any type of strabismus.

 
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