Glaucoma Care and Treatment
Glaucoma is a disease of the eye where the pressure in the eye is high enough to cause damage to the optic nerve and therefore result in loss of vision. Glaucoma robs you first of your peripheral vision and saves the central vision until the very end. By the time a patient is symptomatic, the glaucoma has done 99% of its damage. Therefore, it is important to have regular eye examinations to rule out the presence of glaucoma as there is no way for the patient themselves to diagnose it. The good news is that glaucoma can be managed if detected early. With treatment, most people with glaucoma do not lose their vision. Glaucoma is treated both medically, the use of eye drops or pills, and surgically, the use of laser surgery and filtering surgery. Our doctors will recommend an individual treatment plan that’s best for you.
Diabetic Eye Care and Treatment
The best way to ensure a lifetime of good vision is through regular, comprehensive eye examinations. If you are a diabetic, it is critical that you have a comprehensive eye examination every year. An eye condition known as diabetic retinopathy is one of the most common complications associated with diabetes and is the leading cause of blindness among working-age Americans.
How does Diabetes affect my vision?
The damage caused by diabetes occurs in the thin layer of nerve tissues that lines the back of the eye called the retina. The retina is nourished by many blood vessels. Over time, damage to these blood vessels affects the health of the retina. Continued damage leads to diabetic retinopathy.
What are the risk factors for developing Diabetic Retinopathy?
The risk of diabetic retinopathy is related to many factors particularly the duration of diabetes and level of diabetes control. Other factors may aggravate the risk and severity of diabetic retinopathy. Control of these medical issues is the first-line treatment to prevent diabetic retinopathy. Medical issues and risk factors include:
- uncontrolled blood pressure
- elevated cholesterol and triglycerides
- kidney disease
- anemia
- smoking
- pregnancy
How can I prevent vision loss from Diabetes?
Diabetes control & good health are the best prevention of vision loss. It has been shown that people with retinopathy had reduced vision loss by lowering their blood pressure into normal range and controlling cholesterol and triglycerides.
Your Primary Care Doctor may follow your diabetes control with a blood test called a hemoglobin A1c (Hb A1c). This test gives a good estimate of how your blood sugar has been over the previous three months. Studies have shown that a 10% decrease in the HbA1c produced a 23% to 46% reduction in developing the vision threatening diabetic retinopathy.
Regular vision exams with your Eye Group Associates doctor are critical in your on-going health and vision care.
To learn more, or ask questions about your risk of vision loss from Diabetes, talk with your doctor at your next visit. If you are not a patient, contact us for your next Diabetic exam and learn how The Eye Group Associates is dedicated to helping you maintain your best eye health.
Cataract Evaluation and Treatment Options
If you think that you may have cataracts, our appointment desk will schedule you for a complete dilated eye examination. As there can be many causes for vision loss besides cataracts, your examination will be quite thorough.
- The examination will start with a discussion of your symptoms. Cataracts can cause a variety of problems, such as difficulty reading fine print, difficulty seeing road signs while driving, or trouble with viewing the television. Cataract patients often give up driving at night because of glare symptoms. Hobbies such as handwork and crocheting can become difficult. Nowadays cataract surgery is indicated when you can no longer see well enough to participate in the activities you enjoy.
- Measurement of your vision and careful refraction, measurement for glasses will be done. Even if you have cataracts, your vision may be improved adequately just by updating your glasses. It is often possible to put off cataract surgery for years by periodically changing glasses prescription. Eventually, however, a cataract can progress to the point where new glasses will no longer provide adequate clarity of vision. At this point generally cataract surgery is considered.
- Next, your pupils will be dilated so that your eyes can be examined inside and out. A cataract is a clouding of your natural lens. The lens is located behind the iris (colored part of your eye). With your pupil dilated the lens can be seen in its entirety. Your doctor will judge the degree of clouding of the lens and whether it would help to replace it with an intraocular lens implant.
- All other parts of the eye are closely examined as well. Diseases of the cornea (the clear window in front of the eye), retina, and optic nerve can also cause blurred vision. In particular, detection of diseases such as macular degeneration and glaucoma are critical before considering cataract surgery. A professional can often predict whether or not in a given patient cataract surgery will lead to a significant improvement in visual acuity.
- Finally, a cataract evaluation will include a discussion of treatment options. Of course, there is always the option of doing nothing. Cataract surgery is almost always elective and the timing of surgery is generally up to the patient. Other medical problems may need to be attended to first. A risk-to-benefit analysis will help in the decision of whether to proceed with cataract surgery. Fortunately, modern cataract surgery has a success rate in excess of 95%.
Once the decision to proceed with cataract surgery is made, there will be a discussion of which intraocular lens implant will best fit your needs. Remember that a cataract is a clouding of the natural lens and surgery involves removing it. A new lens implant is then placed in the eye in a position behind the iris where the cataract was located. These intraocular lens implants come in all different powers and styles. New developments in lens technology allow correction of astigmatism and presbyopia (need for reading glasses) as well as nearsightedness and farsightedness. Lessening or eliminating your need for glasses simultaneously with cataract surgery is now an exciting new option for you to consider.
Dry Eye Care and Treatment
Tears help your eyes to stay moist, healthy and comfortable. Dry Eye, or Dry Eye Syndrome, is an eye condition that affects the quantity and quality of tears, causing your eyes to feel dry and irritated. Studies have shown that roughly 3 million women over the age of 50 suffer from dry eye, but it can affect men and women of any age. Often confused with allergies, dry eye frequently goes undiagnosed and can lead to long-term complications if untreated. Dry eye may also be a sign of other health or eye issues.
Unfortunately, there is no cure for dry eye, but there are a variety of treatments that can help soothe its symptoms: Appropriate artificial tear use, punctal occlusion, diagnosis and management of lid margin disease, prescription medications targeting inflammation. Often the answer to dry eye treatment is multi-fold and at The Eye Group Associates, we have a special interest in helping this medical eye condition. If you think you have dry eyes or have been using treatment with limited benefit, let us help.
Macular Degeneration
In some individuals, tiny dot-like deposits (known as drusen) slowly accumulate beneath the macula. While these deposits usually do not cause visual loss directly, they indicate that the patient is at risk for developing further problems with the macula. Usually, these deposits would not be apparent before the age of 50.
Visual problems in macular degeneration take two basic forms. The first, milder problem occurs as the cells of the macula slowly lose sensitivity and may become less numerous. This may result in fluctuating vision—the sight is clearer on some days than others—and slowly (typically over months to years) vision may worsen. This is referred to as the “dry” form of macular degeneration.
The second type of problem occurs more suddenly and may cause a more serious drop in vision. Tiny clusters of abnormal blood vessels may begin to grow beneath the macula. These vessels “leak” and blood or watery fluid may accumulate beneath the macula. This can result in irreversible damage to the macula, resulting in loss of the central detail vision. The presence of leaks is often referred to as the “wet” form of macular degeneration.
Why does macular degeneration occur? What can be done to prevent macular degeneration?
While the most important risk factor for macular degeneration is age, it is not yet understood why macular degeneration occurs in some seniors and not in others.
There may be some inherited factors that predispose individuals to have this condition, and research to identify the genes which are associated with macular degeneration is ongoing. The development of drusen, and the slow loss of retina cells that sometimes occurs, is not preventable by any means yet identified. However if the genetic basis of macular degeneration was identified, it might be possible to correct the defect before macular degeneration can begin. Many researchers are working on this question, but it remains a difficult problem.
If a person has macular degeneration, it appears that keeping the entire body healthy—control of blood pressure, control of cholesterol, good nutrition, and avoiding cigarettes—helps to reduce the risk of developing visual loss. The Age-Related Eye Disease Study (AREDS) was a major study sponsored by the National Eye Institute (NEI). In the study, scientists looked at the effects of zinc and antioxidants (vitamin C, vitamin E & beta carotene i.e. provitamin-A), on patients with cataracts and age-related macular degeneration (AMD). Patients with intermediate to advanced AMD, as determined by the doctor, who were taking the anti-oxidant and zinc combination had a demonstrable decrease in the incidence of developing wet AMD.
While most patients in the study experienced no serious side effects from the doses of zinc and antioxidants used, a few taking zinc alone had urinary tract problems that required hospitalization. Some patients taking large doses of antioxidants experienced some yellowing of the skin. The long-term effects of taking large doses of these supplements are still unknown. Previous studies have shown that individuals who smoke and take beta-carotene are at an even greater risk of developing lung cancer, and therefore current and recent smokers should not take beta-carotene.
If you have intermediate (or advanced macular degeneration in one eye only), talk to your physician about taking nutritional supplements. Your doctor can help you determine if they may be beneficial-and safe-for you, and what types and doses of supplements to take. The doses used in the study were: Vitamin C 500 mg, Vitamin E 400 IU, Beta-carotene 15 mg, Zinc 80 mg, as zinc oxide, Copper 2 mg, as cupric oxide (copper should be taken with zinc, because high-dose zinc is associated with copper deficiency).
The effect of other antioxidants such as Lutein, Zeaxanthin, and Omega-3 fatty acids is not yet known. They are currently being evaluated in a large-scale national study, and results should be known in the near future.
An additional factor that may aggravate macular degeneration is unprotected exposure to the sun’s UV rays. While this is not yet proven, most patients find some form of sunglass use (with UV filtration) makes seeing more comfortable and in some cases, certain tints can enhance contrast sensitivity.
How is macular degeneration treated?
There is no cure for dry AMD, but vitamin supplementation, as described above, may slow down the progression of the disease. Please check with your doctor to see whether vitamins would be appropriate for your eyes.
“Wet” macular degeneration
Significant advances in treating “Wet” macular degeneration have been the development of a new class of drugs. The drugs are based on the discovery that a group of proteins in the body, one of which is called vascular endothelial growth factor (VEGF), play a significant role in the formation of the abnormal blood vessels that damage the retina in wet macular degeneration.
In addition, other treatments including laser and newer therapies may be available for “wet” AMD, but whether or not you are a candidate for treatment depends on:
- type & location of the leak
- progression over time
- affect on your vision & macula
Some of the newest treatments finally offer the hope of restoring some lost vision, if treatment is started in the early stages. In most cases vision can at least be stabilized. Feel free to talk with your doctor about treatment options for your AMD.
Low Vision Treatment
Low vision is a general term that refers to a permanent functional vision loss that cannot be corrected by medication, surgery, or glasses. Low vision patients may experience a wide array of diseases, defects in their field of vision, and varying degrees of vision loss. This decreased visual acuity or visual field results in an impaired ability to perform work, leisure, or daily living activities. It is already known that low vision in adults does impair quality of life, and one study demonstrates that children with visual impairment had significantly lower quality of life scores than an age-matched comparison group using the Low Vision Quality of Life Questionnaire. This research reinforces the need for low vision services for children. Please see the study: 1.Chadha RK, Subramanian A. The effect of visual impairment on quality of life of children aged 3-16 years. Br J Ophthalmol. May 2011;95(5):642-5.
A low vision examination should detail the kinds and the quality of visual deficits afflicting patients and how they are adapting to their vision loss. This may include a chief complaint, as well as social, functional, and ocular health history.
Equipment in low-vision therapy is as follows:
- Near aids – Readers, microscopes, handheld magnifiers, stand magnifiers
- Closed-circuit television
- Computer programs
- Distance aids – Telescopes, sunglasses
- Aids for daily living and eccentric viewing – Adaptive equipment, eccentric viewing training, contrast
At The Eye Group, we carry a full line of top quality Low Vision Therapy devices. If you or a loved one might benefit from an evaluation, please contact us and make time to see us, there is help available and our low vision specialist just might be able to make a difference for you.
Contact Lenses
Our doctors provide complete contact lens services for both rigid and soft contact lenses. They select from a wide variety of lens materials to find contacts that will give you clear vision and optimum comfort for your eyes.
It’s important to remember that there are literally thousands of makes and models of contact lenses – rigid versus soft, disposable or extended wear, plus variations in material, oxygen transmission, thickness and lens shape. A combination that’s safe and comfortable for one patient may not work for another. That’s why it’s crucial for those considering contact lenses to have an experienced doctor customize their initial fitting and for experienced lens-wearers to have routine contact lens evaluations to ensure that their contact lens wearing experience is a healthy one. We offer the ability to order contacts lenses online and our prices are more than competitive. Please visit us at Eyegroupdispensary.com to order contacts, check our prices, and see our rebates!
Latisse — Grow Longer or Lengthen Your Eye Lashes
Latisse solution is the only prescription treatment used to grow eyelashes, making them longer, thicker and darker. Only Latisse has been approved by the FDA as a prescription treatment to grow eyelashes and has been studied in clinical trials to demonstrate its safety and effectiveness.
Results are gradual, with full results in 16 weeks. People who use Latisse can typically expect their lashes to double in fullness. Latisse is by prescription only, but we can discuss if you are a candidate during your next complete eye exam!
