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Commonly referred to as ‘lazy eye,’ amblyopia is the failure of sharp vision to develop. Typically, good vision develops early in life as the result of normal use of the eyes. If something interferes with this normal use, visual ability decreases. Amblyopia can be caused by crossing of the eyes (strabismus), where the eyes do not work together and one or both of the eyes turns in, out, up, or down. It can also be caused by vision problems such as a high degree nearsightedness farsightedness and astigmatism. If there is a large difference in the prescription, the eyes do not have equal focusing ability. The weaker eye does not develop properly. The eye with the better visual ability does all of the work, allowing the other eye to become lazy or amblyopic. More rarely, amblyopia can be caused by eye disease, such as cataracts.
Treatment of amblyopia involves first treating the condition which caused the amblyopia. Once this is accomplished, the weak eye must be forced to work to develop vision. This may be done by wearing glasses, patching, or using drops.
It is imperative that our patients have annual, comprehensive exams to ensure that their eyes are at optimal health. Each of our state-of-the-art facilities, experienced staff, and extraordinary doctors diagnose and communicate to you, your best course of action. Whether you need glasses, contacts or corrective surgery, you’re in exceptional hands.
During your visit with us, our team thoroughly evaluates your ocular health with glaucoma testing and dilated fundus examination. Your doctor may suggest further testing if there are specific concerns, including retinal imaging or visual field testing.
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A cataract is a clouding of the lens in your eye. Typically, light rays enter the eye and are focused onto the retina on the back of the eye. The lens must be clear to properly focus the light. As it clouds, we call it a cataract. Patients may notice blurring or dulling of their vision. Colors may not seem as bright as they used to be. They may also have difficulty with glare or driving at nighttime. Patients often describe their vision as having a ‘dirty windshield’ in front of their eyes.
When your eye doctor is no longer able to correct your vision with glasses and your vision is interfering with your ability to engage in your normal activities, it may be time for you to have cataract surgery. Cataract surgery is an effective, efficient way to restore vision in most patients. A small incision is made in the eye and the lens is broken into smaller pieces and vacuumed out. Generally, the eye is numbed with drops and a small amount of anesthesia is given through the vein to make the patient comfortable. Patients usually report very little pain or anxiety during their surgery.
When cataract surgery is performed, your natural lens is replaced with a clear, man-made lens. Prescription is put into this lens to try to minimize your need for glasses. The most common target for this is good distance vision. You will still need reading glasses for close up tasks, such as handwork or reading. Other options exist, including aiming for good near vision in both eyes, or blended vision (monovision). In monovision, one eye is targeted for near vision and the other for distance vision. This helps reduce dependence on glasses, although they may be still required for certain tasks.
Sometimes, a patient has a strong desire to eliminate glasses for certain tasks or altogether. In these cases, it may be necessary to place a special intraocular lens (IOL).
The typical IOL that insurance pays for does not address astigmatism. Toric IOLs are a special lens that is designed to address this astigmatism. This lens is a good option for a patient that is looking to minimize their need for glasses for distance or near.
The typical IOL that insurance pays for corrects vision at only one distance. The patient and surgeon typically have to choose a target for where their vision will be clearest. A multifocal IOL allows a patient the ability to see at distance and near. This is an option for patients who want to minimize their need for glasses at all distances. Not all patients are candidates for these lenses. Your surgeon will evaluate your eye health and discuss your options for IOLs at your appointment.
Diabetic retinopathy is a disease that can lead to blurred vision or even blindness. You should have a dilated eye exam yearly once you are diagnosed with diabetes. This way your doctor can detect changes in your eyes before your vision is damaged. It is important to control your sugars, quit smoking, and control high blood pressure to help prevent damage from diabetes.
Early changes in diabetes include weaknesses in the blood vessels in the back of the eyes. Your doctor may see bleeding or leakage of these blood vessels in the back of the eyes. Sometimes this may resultin swelling (edema) in the back of the eye. When this occurs in the sharp center of vision (macula), your doctor may recommend treatment. Treatments for macular edema include injections or lasers to stop the blood vessels from leaking further.
Sometimes new, abnormal blood vessels grow in the back of the eye. These blood vessels are weak and prone to bleeding. This can cause blurred vision and ultimately result in permanent vision loss. Treatment depends on your condition. It can include laser to stop vessel growth, surgery to repair a damaged retina or remove the vitreous if it becomes filled with blood.
The retina is a structure that lines the back of the eye. It is where the image lands that is then transferred to the brain where it is turned into visual images. Sometimes part of the retina tears or detaches from the back of the eye. Vision loss may occur. These can be caused by normal aging, eye injury, or other eye problems. Symptoms of a tear can include floaters (specks or threads in your vision) or flashes (lights, stars, or streaks in your vision). Tears can be sealed so they don’t progress into a detachment. Treatment consists of laser or freezing. Symptoms of a detachment may include signs of a tear or the appearance of a curtain or veil coming down over the vision. Treatment of a detachment typically involves surgery.
Open angle glaucoma is the most common kind of glaucoma. The drainage area in the eye becomes clogged, so not enough fluid drains from the eye. The pressure slowly builds up in the eye, which can cause damage in the optic nerve over time. This may result in loss of side (peripheral) vision. Patients can go completely blind from open angle glaucoma. Often, this type of glaucoma has no symptoms, so it is important to have your pressure periodically checked. Patients have an increased risk of glaucoma as they age. Also at risk include those with African ancestry, family history of glaucoma, previous history of eye injury or surgery, and those with other health problems such as diabetes or high blood pressure.
Narrow angle glaucoma is less common than open angle. The drainage system in the eye suddenly can become completely blocked leading to a rapid build up in pressure. This is called 'angle closure.' A patient may notice blurred vision or haloes around lights. They may also have pain, headaches, nausea, and vomiting. If not treated quickly, blindness may occur rapidly. Sometimes, patients will be treated for narrow angle glaucoma if it is felt that they have risk factors for angle closure.
Blepharitis is a disease of the tear film, which is made up of both a liquid (tear) and lipid (oil) layer that affects the oil portion of the tear film. Blepharitis is primarily a dysfunction of the oil portion of the tear film. Common symptoms patients describe are irritation, redness of the eyelid margin, and styes. Often, symptoms are worse in the morning than later in the day. It can occur simultaneously with other disorders such as acne rosacea or dry eyes. Treatment for blepharitis is usually multi-faceted, including lid hygiene, omega-3 supplements, and warm compresses. In severe cases, antibiotics may also be used.
The cornea is the clear part in the front of the eye. Typically, there are cells in this part of the eye whose job is to continually pump fluid out of the cornea to keep it clear. Sometimes, a patient will not have as many of these cells as a typical person. When these cells dysfunction or are unable to keep up with the fluid, the cornea can become cloudy, resulting in blurred vision. Early symptoms of the disease may include blurred vision that only occurs in the morning and clears throughout the day. Treatment for the disease includes over the counter drops to help pull more fluid from the cornea and corneal transplant surgery to replace the cells that deal with the fluid.
The tear film of the eye is made up of both a liquid (tear) and lipid (oil). Dysfunction in either of these can result in symptoms of dry eyes. Dry eye can be caused by a deficiency of tear production, or dysfunction in the oil portion of the tear film which results in increased evaporation of tears. Symptoms can include redness, irritation, a foreign body sensation, pain, or even tearing. Some patients report blurred vision that gets better with blinking the eyes while they drive, watch television, or read. Severe dry eyes can even lead to scarring of the front surface of the eye and decreased vision. Treatments of dry eye are typically multifaceted and can include over the counter drops, prescription drops, or closure of the tear drains in the eyelids.
A corneal abrasion is a scratch on the clear part of the front of the eye (the cornea). This is an extremely sensitive part of the eye and a scratch here causes a lot of pain, irritation, and blurred vision. Treatment can range depending on the severity of the abrasion. Treatments may include artificial tears, antibiotic drops, or patching of the eye. In some cases, if the abrasion doesn't heal well, additional procedures may be done.
A stye, or chalazion is an enlargement of the oil glands of the eyelid. The oil glands in the eyelid can become blocked which leads to enlargement of the area. These areas are referred to as a stye or chalazia. Sometimes these can be red and inflamed and painful. Other times, they can be a painless enlargement of the area. Some patients will notice a foreign body sensation or crusting at the eyelid margins. Generally, the first line management of this condition is warm compresses and possibly antibiotics. If the area doesn't respond to conservative treatment, the chalazion can be removed in the office with a 5 minute procedure.
Treatment of open angle glaucoma often begins with drops that are used to lower eye pressure. If needed, your doctor may recommend supplemental laser to lower the pressure further. This is a laser which is applied to the drainage system of the eye. It does not damage the structure of the eye and so does not interfere with the success of future surgeries. It is repeatable if its effects eventually wear off and may delay the need for additional medications/surgeries in patients. It is performed in the office and takes less than 5 minutes to complete. Generally, there are no restrictions or extra drops needed after this procedure.
Treatment of narrow angle glaucoma involves making a hole in the iris to allow fluid to move between the front and back parts of the eye. The procedure usually involves a YAG laser, but sometimes a combination of two lasers may be used to create this opening. Laser iridotomy is performed in the office and takes less than 5 minutes to complete. There will generally be a follow up appointment to ensure the treatment was successful.
Nonproliferative Diabetic Retinopathy
Proliferative Diabetic Retinopathy
Fuchs Corneal Dystrophy
Glaucoma (open angle)
Selective Laser Trabeculoplasty (SLT)
Glaucoma (Narrow Angle)
Laser Peripheral Iridotomy
Retinal holes, tears, and detachments
Some people experience flashing jagged lights or ‘heat waves’ that last 10-20 minutes. If this is followed by a headache, it is called a classic migraine. However, sometimes these symptoms can occur in the absence of a headache. These symptoms are thought to be caused by spasming of blood vessels in the head. It is important to see an eye doctor to be examined if your symptoms change or are prolonged, as flashing lights can be symptoms of other eye conditions.
A pinguecula is a small growth on the thin film overlying the white part of your eye. It is not a cancer and is common. It is thought to arise from a combination of UV exposure and dryness. Symptoms can include a gritty sensation, like a piece of sand is in the eye. Rarely, these are problematic enough that they need to be removed.
A pterygium is a triangular, fleshy growth that starts on the film overlying the white part of your eye that eventually extends onto the cornea (the clear part of the eye). They are thought to arise from a combination of exposure to UV rays as well as dirt or foreign body getting into the eye. Sometimes these can become very raised and red and can cause symptoms such as a foreign body sensation or like sand is in the eye. They can also distort the surface of the eye and can cause astigmatism. In some cases, these are removed surgically to relieve the patient’s symptoms.
Strabismus is a condition where the eyes are not aligned properly. One or both eyes can cross in, out, up or down for various reasons. Typically, children do not complain of symptoms with strabismus and it is usually an adult that notices the crossing. In children, strabismus can cause amblyopia where the vision does not develop properly in one or both eyes. In these cases, the child may be treated with glasses, patching, surgery, or a combination of these. In adults, new onset strabismus typically causes double vision. It can be an indication of a stroke, multiple sclerosis, or other problems inside the head. Other times, it can be a small strabismus that has simply worsened over time. In all cases, suspected strabismus should be examined by an eye doctor.