In Focus Winter 2014

Magazine Edition Winter 2014

Advanced Technology Lenses: The Future of Cataract Surgery Pg 6

Research Study: Crosslinking & Keratoconus Pg 8

Contact Lenses for Your Children: What You Need to Know Pg 10

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In Focus

IN THIS ISSUE: Doctor Spotlight

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Staff Spotlight

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Advanced Technology Lenses: The Future of Cataract Surgery

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Research Study: Crosslinking & Keratoconus Q&A: Low Vision

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Contact Lenses for Your Children: 10 What You Need to Know Implantable Contact Lenses

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Get to Know a Certified Optician 13 Healthy Eating Choices Made Easy: Smoked Salmon Pizza

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Puzzle Corner

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In Focus

ABOUT

IN FOCUS We hope you enjoy this issue of In Focus magazine, our publication to help keep you informed and upto-date on the many great things happening at Gundersen Health System速.

Gundersen Health System速 consistently offers the latest in vision care for patients of all ages. We offer a large variety of vision services, including LASIK, cataract surgery, treatment for macular degeneration, glaucoma and retinal problems, as well as pediatric eye care, full-service optical shops and more. We have 12 clinics located throughout our region and are committed to providing the best care possible.

Our Providers & Clinic Locations

Black River Falls Eye Clinic, Wisconsin Bruce Lahmayer, O.D. Suzanne Falkenberry, M.D. Decorah Eye Clinic, Iowa Jennifer Gipp, O.D. Kristie Shappell, M.D. Andrew Sassaman, O.D. Hillsboro Eye Clinic, Wisconsin Jeff Clark, O.D. Steven Whitford, M.D. Onalaska Eye Clinic, Wisconsin Sarah Clements, O.D. Filomena Larson, O.D. John Purdue, O.D. Todd Verdon, O.D. Matthew Runde, M.D. Prairie du Chien Eye Clinic, Wisconsin Karina Conlin, O.D. Philip Holzer, O.D. Christopher Born, M.D. Sparta Eye Clinic, Wisconsin Jon Williamson, O.D. Steven Whitford, M.D. Tomah Eye Clinic, Wisconsin David Larsen, O.D. Matthew Runde, M.D. Viroqua Eye Clinic, Wisconsin Andy Nahas, O.D. Kenneth Purdue, O.D. Paul Kuck, M.D.

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Waukon Eye Clinic, Iowa James Rixen, O.D. Gary Lenth, M.D. Andrew Sassaman, O.D. Whitehall Eye Clinic, Wisconsin H. Fred Zwick, O.D. Steve Whitford, M.D. Winona Eye Clinic, Minnesota Sean Thompson, O.D. Bradlee Wolner, O.D. Daniel Lange, M.D. Floating O.D. (Works at all vision clinics and La Crosse) Sarah Clements, O.D. LaCrosse Eye Institute, Wisconsin Elizabeth Ault Brinker, M.D. Christopher Born, M.D. Suzanne Falkenberry, M.D. Paul Kuck, M.D. Daniel Lange, M.D. Gary Lenth, M.D. Matthew Runde, M.D. Kristie Shappell, M.D., D.V.M., M.S. Steve Whitford, M.D. Thomas Edwards, O.D. John Larson, O.D. John Sterling, O.D. Todd Verdon, O.D.

Doctor Spotlight Dr. Daniel Lange

Born in Preston, Minnesota, Dr. Daniel Lange grew up on a farm outside of Harmony. He is the third child of George and Ella Lange. His brother is a retired Pharmacist at the University of Iowa in Iowa City and his sister is an Associate Dean at Tufts University in Boston.

He attended and graduated with honors from Augsburg College in Minneapolis. Dr. Lange graduated with honors from the University of Minnesota Medical School where he is a member of the Alpha Omega Alpha Honor Medical Society. He served his internship at Abbot-Northwestern Hospital in Minneapolis, and completed his residency in Ophthalmology at the University of Minnesota. Dr. Lange attended a Vitreoretinal Fellowship with Dr. Steve Charles in Memphis, Tennessee. He joined Gundersen Lutheran in 1987 bringing many new procedures in vitreoretinal surgery. The Department of Ophthalmology has grown from 6 members to 10 Ophthalmologists in the 26 years since Dr. Lange joined the clinic. Dr. Lange’s practice includes vitreoretinal surgery for diabetic retinopathy, macular holes, retinal detachments, as well as cataract surgery. Over the years he has performed over 22,000 major intraocular surgeries and many laser treatments. He has served as Department Chair for the past five years as well.

Dr. Lange is passionate about keeping up to date with medical technology and finding new ways to give his patients the best care.

Ophthalmology is one of the fastest growing fields in Medicine and requires constant attention to the latest innovations. It has required surgeons to relearn new techniques for surgical care every 5 years or so. One of the most satisfying aspects has been the fact that new procedures and medicines have been able to eliminate many causes of blindness. Our list of untreatable causes of blindness keeps shrinking and our results continue to improve.

With the advancements in vitreoretinal surgery, treatment for macular degeneration, along with improved intraocular implants, his practice is always changing and progressing along with patient education.

His hobbies include hunting with his dogs, Inga and Ellie, fishing, sailing, scuba diving, waterskiing and woodworking. If he is not at work, he is usually on the Mississippi River or tending to his tree farm near Holmen which he started 20 years ago and includes 4,500 white oak, red oak, walnut and spruce.

This year, Dr. Lange and his wife, Judy will celebrate their 38th wedding anniversary by taking their children Andrea and Ashley on a scuba diving trip to Honduras.

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Employee Spotlight Jennifer Thompson

Jennifer joined the Gundersen Health team in 2006, where she started as a phlebotomist. Over the next 8 years Jennifer worked in several areas of the hospital, but transferred to ophthalmology in 2009 where she is currently serving as one of our Ophthalmic Technicians.

She recently participated in a mission trip to Nicaragua where she and her team provided eye care to local individuals in the area.

“The experience was amazing! I had the opportunity of serving a 94-year-old man who still worked daily in the coffee plantation fields. We were able to provide him not only with glasses, but prescription sunglasses. He was so excited! As we left the village that day we saw him walking down the mountain with his new sunglasses on! It was an incredible feeling.”

Jennifer’s hobbies include top water fishing, hunting, playing with her two Brittany Spaniels—Sam and Stella, and volunteering.

Jennifer providing eye care in Nicaragua

The Nicaragua eye care team

VALUES MISSION

We distinguish ourselves through excellence in patient care, education, research and through improved health in the communities we serve.

VISION

We will be a Health System of excellence, nationally recognized for improving the health and well-being of our patients and their communities.

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Integrity Perform with honesty, responsibility and transparency.

Excellence Achieve excellence in all aspects of delivering healthcare.

Respect Treat patients, families, and coworkers with dignity.

Innovation Embrace change and new ideas.

Compassion Provide compassionate care to patients and families.

www.gundersenhealth.org/vision 5

Cataract surgery is one of the true medical miracles of the 20th century. Introduction of new advancements, such as advanced technology lenses, promise to make it one of the true medical miracles of the 21st century as well.

For most individuals, a cataract is not a disease; rather, it is a natural aging change similar to gray hair, wrinkles, decreased hearing and waking up with a stiff back. If we live long enough, all of us will require cataract surgery at some time in our lives, so it’s important that the surgery be as positive an experience for everyone as possible.

If you know someone who had cataract surgery as recently as the 1970’s, you may remember how difficult of an experience it was for them. First, they had to spend a week in the hospital, flat on their backs, with sand bags on either side of their head to keep their head still. They couldn’t even get out of bed to go to the bathroom – they had to use a bedpan! Once they survived their week in the hospital, they were discharged with poor uncorrected vision, depending on thick “cataract” glasses or hard contact lenses to safely move around. Many “successful” cataract surgery patients ended up with vision that was poor enough that they couldn’t drive a car even with glasses or contact lenses.

Advancements over the last 50 years have made the cataract surgery experience much more positive. New technologies have made the cataract procedure safer and, most importantly, have remarkably improved results.

TODAY, CATARACT SURGERY IS ONE OF THE SAFEST AND MOST SUCCESSFUL PROCEDURES PERFORMED IN MEDICINE.

Week-long hospitalizations have been replaced by an outpatient procedure where patients are performing their normal activities within a day or two after surgery. Patients who were dependent upon glasses or contact lenses their whole life frequently have little or no need for glasses after cataract surgery. It is in this way that cataract surgery can be truly life changing.

CATARACT SURGERY AND STANDARD INTRAOCULAR LENSES

With cataracts, the lens of the eye becomes cloudy and can blur vision. During cataract surgery, doctors remove the cloudy lens and replace it with an artificial lens called an intraocular lens, or IOL. Generally made of silicone or acrylic materials, IOLs are inserted through a small incision during cataract surgery. Standard IOLs are monofocal, which means they are only focused for vision at one distance. Most cataract surgery patients will need glasses or contacts to see well at other distances if a standard IOL is selected.

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One of the major medical advancements over the last half-century that is responsible for changing cataract surgery from a difficult experience with mediocre results to a mild experience with such fantastic results is advanced technology lenses.

ADVANCED TECHNOLOGY LENSES

Wearing your glasses after cataract surgery is no longer the only option. At Gundersen Health System Eye Institute, our surgeons are qualified to implant advanced technology lenses, or ATLs for appropriate patients. These lenses are specifically designed to provide good vision at all distances.

Like standard IOLs, advanced technology lenses are implanted during cataract surgery, on an outpatient basis. The procedure lasts less than 20 minutes. Generally, the surgeon will implant an advanced technology lens in one eye first, then monitor the healing and vision of that eye before scheduling the procedure for the second eye.

Gundersen Health System Eye Institute offers several options for advanced technology lenses in order to provide patients with the most appropriate treatment for their visual needs. Personalizing a procedure leads to better results and more visual independence for patients.

Because advanced technology lenses are considered an upgrade from the standard monofocal replacement lenses usually used in cataract procedures, insurance does not cover the cost of the procedure. Gundersen Health System Eye Institute does offer flexible financing plans to help those patients who would like to have advanced technology lenses implanted. We believe that the marriage of cataract surgery with advanced technology lenses gives our patients the best opportunity to become independent of glasses and not only see better than they did when they had their cataracts, but better than they did before they developed cataracts.

Ask our staff about Advanced Technology Lenses and what they can mean for you!

Cataract Surgery: Patient, Kim Foster Family time is important to Kim Foster.

Now after cataract surgery and choosing advanced technology lenses from Gundersen Health System, it’s better than ever.

“Now the time I spend with my grandkids is even better with my new vision. I can’t believe how much clearer I can see. I can see distance, read close up, and read tiny print! I’m really glad I trusted Dr. Suzanne Falkenberry with my eyes!”

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Research Study: Crosslinking & Keratoconus

Keratoconus is a hereditary eye disease in which the cornea, or clear window on the front of your eye, thins and loses its natural shape. This “warping” of the cornea causes a progressive and devastating loss of vision over time.

It often develops in young people and can begin affecting vision in teenage years, but it can also develop at any age. In its early stages it is sometimes difficult to detect, and the patient may achieve good vision with glasses.

However, as the disease progresses, rigid (hard) contact lenses are needed to correct the vision and eventually corneal transplant may be needed to obtain good vision.

Gundersen Health System is participating in a study which may clear the way for an effective treatment. Paul A. Kuck, MD, Ophthalmology, says there has been keen interest in a new treatment— new to the United States—called cornea cross-linking (CXL). Cornea cross-linking involves treating the cornea with riboflavin (vitamin B2) and ultraviolet light.

This treatment causes increased connections, or cross links, between the connective tissue of the cornea, which strengthens it, according to Dr. Kuck.

Gundersen Ophthalmology is currently participating in a nationwide study to test the effectiveness of corneal crosslinking with three different treatments varying the length of exposure to the ultraviolet light. The actual amount of ultraviolet energy delivered to the cornea to activate the treatment is the same for all patients.

“This type of treatment has been extensively studied in Europe and other developed countries. Corneal crosslinking treatments have been available overseas for many years,” says Dr. Kuck. “The purpose of this study is also to 8

In Focus

obtain federal Food and Drug Administration approval in the United States. There are a few doctors in United States who already provide this treatment without FDA approval.”

The studies done overseas have demonstrated that this treatment can halt the progression of keratoconus. The treatment has been shown to be very safe.

“Providing the treatment sooner (when keratoconus first develops) or at a younger age provides better results,” Dr. Kuck says. Gundersen ophthalmologists Dr. Kuck and Dr. Born are the providers offering this innovative treatment to patients.

Corneal cross-linking may also benefit patients with thinning or unstable corneas due to previous refractive surgery.

Corneal cross-linking at Gundersen is available to patients over age 12. Evaluation to see if you are a candidate for corneal cross-linking is free, though the procedure is not and is not covered by insurance.

The multi-center study is sponsored by the AmericanEuropean Congress of Ophthalmic Surgery, which hopes to enroll about 4,000 patients nationally. So far, seven patients have been treated at Gundersen.

Contact Vanessa Grams, clinical research coordinator, Medical Research, at ext. 56782 for more information.

FAQ Low Vision Clinic Loss of vision is a stressful problem. As we age, our self-reliance becomes an increasingly important part of our lives. Loss of vision does not necessarily mean loss of independence. At the Gundersen Health System Low Vision Rehabilitation Clinic, we strive to give you the tools you need to achieve your goals and live the most independent lifestyle possible. Here are the answers to some frequently asked questions regarding the Low Vision Rehabilitation Clinic at Gundersen Health System: What is low vision?

Low vision is a visual impairment not corrected by standard eyeglasses, contact lenses, medication, or surgery that interferes with the ability to perform everyday activities.

What is the Low Vision Rehabilitation Clinic?

The Gundersen Health System Low Vision Rehabilitation Clinic is a specialty clinic within the LaCrosse, WI Eye Department, staffed by an occupational therapist, and designed to help our patients remain independent despite vision loss. Our team carefully listens to each patient and creates a treatment plan that helps the patient achieve their goals despite vision loss.

Do I need an appointment?

Yes. Initial appointments are scheduled for one hour.

Follow up appointments are scheduled based on the goals and needs of the patient.

Do I need a referral?

Yes. You’re your eye care provider or primary care doctor can make the referral.

Why is a referral necessary?

A referral is required for insurance to cover the cost of your appointment.

Are appointments covered by insurance?

Yes. Medicare recently extended their plan to cover low vision rehabilitation services provided by an occupational 9

In Focus

therapist to all beneficiaries. Most private health insurance programs cover occupational therapy services for disabilities, including low vision.

How do I make an appointment?

Tell your primary care provider that you would like to make an appointment with the Gundersen Health Low Vision Rehab Clinic, or you can reach us by telephone at (608) 775-5005 or (800) 362-9567 extension 55005 to begin the referral process.

What can I expect during my appointment?

At the Gundersen Health Low Vision Rehab Clinic your goals are our goals. We assist you in identifying areas of your life that are difficult due to vision loss, like dialing a telephone, reading fine print, or threading a needle.

Once your goals have been identified, we implement a personalized treatment plan to help you achieve those goals to our fullest ability. There are many tools on the market today, both optical and non-optical, that can assist you in activities of daily living and help you live a more independent life, even with vision loss. Additional resources we can assist you with include: home safety, community resources, transportation options, safe mobility, computer adaptations, video magnification, area support groups and audio program resources.

How can I learn more?

Visit our website at www.gundersenhealth.org/vision

Contact Lenses for your children: What You Need To Know

Bruce Nelson, COMT

Contact lenses are a good option for many children with refractive errors. Many children choose to wear contact lenses over glasses to improve their self image and confidence. Contact lenses are also the preferred method of visual correction for sporting activities because they offer enhanced peripheral vision, will not fog up or become soiled with perspiration, and are much easier to wear under a helmet.

Gundersen Health System Eye Institute has fit a large number of children in contact lenses, and three of our doctors specialize in pediatric eye patients. One common question we get from parents is, “What is a good age for my child to start wearing contact lenses?” That age has come down significantly over the last 30 years, thanks mostly to increased ease in contact lens cleaning regimens, in combination to the decrease in the cost of contact lenses themselves.

In the 1980’s, the typical age for a child to get into contact lenses was 15 years old. At that time, contact lenses cost $80 or more apiece, and a single pair of lenses had to last a patient an entire year. Cleaning lenses at that time was a more involved affair, as patients 10

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had to either boil their lenses overnight, or use separate solutions for disinfection, cleaning, enzymatic cleaning, and insertion.

In the 1990’s, the typical age for getting into contact lenses dropped to 12 years old because of two factors.

First, it became cheaper to manufacture contact lenses, so disposable lenses were developed to be worn for only a few weeks or months. Second, multipurpose solutions, such as Renu and Optifree were created, making lens disinfection, cleaning, and storage much simpler.

Over the last 5 years, affordable daily disposable contact lenses have become the lens of choice for many children.

Now, a new pair of lenses is taken out of their sterile packages every morning, worn all day, and then thrown away each night. Because these lenses do not need to be cleaned, and are also inexpensive enough that a torn or lost lens is not a financial burden, the typical age to start wearing contact lenses has decreased even more, usually around age 11.

With all that in mind, when parents ask if it is OK for their child to start wearing contact lenses, we tell them that three people have to agree that it is in the child’s best interest: 1. The child has to want it. If the child isn’t driving this decision, many don’t end up wearing contact lenses successfully.

2. The doctor has to feel that the eyes are healthy enough, and that the prescription is suitable for contact lens wear.

3. The parent has to feel that the child is hygienic, coordinated, and responsible enough to manage the daily routine of contact lens wear.

Caring for your contacts:

Of the contact lens options available today, we find that people are most successful wearing a daily disposable contact lens.

Nothing feels better than a brand new lens which patients enjoy every day. A single use disposable lens eliminates the need for a chemical disinfecting system which avoids the potential for a solution reaction.

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Wash and rinse your hands thoroughly before handling contacts.

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Dry hands with a clean, lint-free towel.

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If you use hair spray, use it before you put in your contacts.

Most of the contact lens related complications we see come from wearing the same lenses too long and/or the care system involved.

Convenience, safety, and good ocular health are all attributes of a daily lens modality.

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Put makeup on before you put your contacts in so you don’t get any on your lenses. Take out contact lenses before you remove makeup for the same reason.

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Different types of contact lenses require special care and certain products. Always use the disinfecting solution, eye drops, and enzymatic cleaners your eye care professional recommended.

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Never use tap water directly on lenses, and never put contact lenses in your mouth to "rinse" them.

Microorganisms can live in even distilled water, causing infection or sight damage.

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Clean each contact by rubbing it gently with your index finger in the palm of your other hand.

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Clean your contact lens case every time you use it with either sterile solution or hot tap water. Let it air dry. Replace the contact lens storage case every three months.

Our contact lens department has a very experienced and dedicated staff. We fit all types of lenses and treat patients of all ages.

Contact lenses can address nearsightedness, farsightedness, astigmatism, and the need for a bifocal. We also fit lenses to address therapeutic indications such as irregular astigmatism, ocular trauma, and keratoconus.

If you are interested in trying contact lenses please schedule an appointment today.

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Implantable Contact Lenses: An Alternative to LASIK For many patients, the hope of being freed of glasses or contacts was interrupted when they were told they were not candidates for LASIK due to extreme nearsightedness, dry eye, thin corneas, or other eye conditions. Now that hope can be restored with Implantable Contact Lenses (ICL’s).

WHAT ARE ICLs? The implantable contact lens is just as it sounds; a contact lens made of collamer, a soft, flexible lens material containing a small amount of collagen, that is skillfully implanted into the eye. ICLs offer unparalleled quality of vision, providing compelling contrast and excellent acuity.

SAFE The implantation of the ICL is an exceptionally safe procedure. In the comfort of an outpatient surgical suite, your ophthalmologist here at Gundersen Health System Eye Institute will insert the ICL through a small, micro incision.

Then the lens unfolds in the eye where it is then positioned between the iris and the natural lens. The procedure is performed in a matter of minutes and patients experience immediate vision improvement!

INVISIBLE Like regular contacts, you won’t be able to see the ICL in your eye. Remarkable quality of vision will be the only reminder that you have had this advanced procedure.

REMOVABLE The ICL does not alter any structures within the eye, and can be removed from the eye by a simple surgical procedure should your vision prescription change after your surgery.

At Gundersen Health System we take pride in offering the latest advancements in eye care with the most current technology and practice standards. We are committed to providing excellent vision as well as excellent patient care.

To schedule a no-obligation consultation please see the scheduling department or call us at (888) 863-2694.

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See the Difference:

Certified Opticians at Gundersen Health Eye Institute Being fitted for glasses or contacts is a big deal. At Gundersen Health System, we get that. Our opticians help customers make important decisions on their eyewear every day and take this process very seriously. Here’s why.

Several states across the U.S. do not require opticians to be certified at their profession, including Wisconsin, Minnesota, and Iowa, but here at Gundersen Health System—we do. We understand that when it comes to your vision, you should be in the best hands possible. Getting new glasses is an exciting experience, but there’s more to the process than just getting the latest fashion frames.

Certified opticians have a more in-depth, technical understanding of eyewear prescriptions than a noncertified counterpart. They receive special training in prism application, lens focal length, and progressive lens selection, as well as frame measurements, and thin-lens technology. Certified opticians undergo extensive internal training sessions throughout the certification process plus hours of self-study before sitting for the exam. The learning doesn’t stop once you pass the test, either. After completion of the exam, certified opticians are required to keep up with current medical technology and practice standards through continuing education credits to maintain certification.

At Gundersen Health System our certified opticians ensure your frame and lens selection process will leave you looking and feeling great! We are committed to providing excellent vision care and certified opticians are just one piece of the puzzle. As always, we hope you find excellence in all of our staff members and most of all, hope you have an amazing experience here at Gundersen Health System.

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Smoked Salmon Pizza

Healthy Eating Choices

Made Easy

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Cooking spray

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2/3 cup fat-free sour cream

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3 tablespoons chopped fresh dill

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2 teaspoons lemon zest

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1 clove garlic, minced

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Pinch of red pepper flakes

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Black pepper

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1 13.8 ounce can refrigerated pizza crust (such as Pillsbury Pizza Crust Classic)

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1 cup thinly sliced red onion

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6 ounces thinly sliced smoked salmon

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1/4 cup peeled and thinly sliced cucumber

1. Coat a pizza pan or cookie sheet with cooking spray. Set aside. Heat oven to 425°F. 2. In a small bowl, thoroughly mix first 6 ingredients (sour cream through pepper). Set aside to let flavors blend.

3. Remove pizza dough from tube.

Knead until smooth, roll into a ball, and spread on a round pizza pan or cookie sheet until 12” round in diameter.

4. Sprinkle onion evenly over top and bake for 12 minutes or until golden brown. Remove from oven and cool.

5. Spread sour cream mixture over pizza crust, top with salmon and cucumbers.

Makes 6 servings.

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Recipe courtesy of the American Optometric Association

Puzzle Corner Across 1. He, to Hadrian 5. Multigenerational tales 10. Historic time periods 14. Persuade with flattery 15. Get ___ on: hurry 16. Pet of the Flintstones 17. Madonna role 19. Catch, slangily 20. “___Eat Cake” 21. Settle snugly 23. Pews’ place 26. Discus great Al 27. Noel Coward play 32. Certain votes 33. “Borat” creator ___ Baron Cohen 34. A heap 38. Advanced math 40. Oscar-winning Jessica 42. Sports org. with a March tourney 43. Coffee time, maybe 45. Seaside towns 47. Babylonian sky god 48. Elvis’s first feature film, or a 1956 #1 hit 51. Hoi ___ 54. River at Chartres 55. Devalues 58. Mr. Nasser 62. Welk word 63. Fast rhythm 66. Scrawny 67. Find in a viewfinder 68. Site of Vance A.F.B. 69. Period in Cong.

70. Winter transport 71. “The Untouchables” protagonist

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Stumped? Find the answers on our Facebook page!

Go to www.Printable-Puzzles.com for hints and solutions!

Down 1 2 3 4 Across 1. Reykjavik’s home: 1. He, to Hadrian 14 Abbr.

5. Multigenerational tales 2. “All You Need is 17 10. Historic time periods ___”: Beatles Persuade with flattery 20 3. 14.

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Puzzle ID: #V730OV

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25. Prison break, e.g.

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27. Sheet of cotton

59. Greedy word

Easy Sudoku Puzzles by KrazyDad, Volume 3, Book 3

Sudoku #1

28. Ancient harp

60. Author Martin or Kingsley

29. "Love ___ the air"

61. Some digital displays, briefly

30. ___ Penh

31. "My sentiments exactly"

64. Rubber stamp accompanier

3 2 8 5 9 1 8 3 9 8 5 3 4 6 9 1 4 9 2 3 2 7 4 1 9 7 4 5 2 8 1 3 6 4 2 35. W. Point, e.g.

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37. Suffix with dino39. Armada ships

41. Accusatory Latin phrase 44. Open wasteland 46. Sturdy fabric 49. Outlooks

50. Straighten up

51. They're taken by H.S. juniors 52. ____ ball (alert)

53. Annual telethon host Jerry 56. Seed jacket

© 2013 KrazyDad.com Soduku puzzle courtesy of www.KrazyDad.com

Fill in the blank squares so that each row, each column and each 3-by-3 block contain all of the digits 1 thru 9.

If you use logic you can solve the puzzle without guesswork.

Need a little help? The hints page shows a logical order to solve the puzzle.

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