What We Offer
We provide primary eye care for the entire family – from treating and managing eye disease, helping children with vision related learning disabilities, fitting all types of contact lenses, co-managing post-op LASIK and cataract patients, to offering the latest in eyewear design and technology – these are the things that the doctors and staff of Advanced Eye Care are committed to providing to our patients. Request an Appointment today so we can help treat your eye care needs.
An eye exam involves a series of tests designed to evaluate your vision and check for eye diseases. Your doctor may use a variety of instruments, aim bright lights directly at your eyes, and request that you look through a seemingly endless array of lenses. Each test during an eye exam evaluates a different aspect of your vision. A comprehensive eye exam is one of the best ways to protect your vision because it can detect eye problems at their earliest stage – when they’re most treatable. Regular eye exams give your Optometrist a chance to help you correct or adapt to vision changes and provide you with tips on caring for your eyes.
What to Expect from Your DoctorIf you’re seeing a new eye doctor or if you’re having your first eye exam, expect questions about your vision history. Your answers to these questions help your eye doctor understand your risk of eye disease and vision problems. Be prepared to give specific information, including:
- Are you having any eye problems now?
- Have you had any eye problems in the past?
- Were you born prematurely?
- Do you wear glasses or contacts now? If so, are you satisfied with them?
- What health problems have you had in recent years?
- Are you taking any medications?
- Do you have any allergies to medications, food or other substances?
- Has anyone in your family had eye problems, such as cataracts, macular degeneration, or glaucoma?
- Has anyone in your family had diabetes, high blood pressure, heart disease or any other health problems that can affect the whole body?
What to Expect from the Examination
- First, you will be asked about your medical history and any vision problems you might be experiencing.
- Next, your doctor measures your visual acuity, assesses your need for glasses and examines your eyes for signs of disease.
- Finally, your eye doctor checks your eyes using a light to ensure the interior and exterior parts of your eyes are healthy.
ResultsAt the end of your eye exam, your doctor will provide you with a detailed assessment of your vision, along with any risks you should be aware of and preventive measures you can take to protect your eyesight. Normal results from an eye exam include:
- 20/20 vision
- Good tracking or eye movement skills
- Good peripheral vision
- Normal-appearing structures of the eye upon examination
- No evidence of cataract, glaucoma, or retinal (macular) degeneration
Neurological TestingA series of tests will be performed to determine how the nervous system (brain) works with the eyes. Tracking of the eyes into six different directions, peripheral vision, and pupil function are all part of a simple set of tests done during an eye exam. These tests help your Optometrist determine how well your eyes communicate with the brain. It can help check for a number of serious conditions such as brain tumor, aneurysm, concussion, and stroke.
Visual Acuity TestThis test measures how clearly you can see from a distance and while reading. Your doctor will ask you to identify different letters of the alphabet printed on a chart (Snellen chart) positioned usually 20 feet away. The lines of type get smaller as you move down the chart. You cover one eye and read aloud, then cover the other eye and read aloud.
Refraction AssessmentRefraction refers to how light waves are bent as they pass through your cornea and lens. A refraction assessment helps your doctor determine a corrective lens prescription that will give you the sharpest vision. Your doctor may start with a computerized refractor to measure your eyes and estimate the prescription you need to correct a refractive error. Or he or she may use a technique called retinoscopy. In this procedure, the doctor shines a light into your eye and measures the refractive error by evaluating the movement of the light reflected by your retina.
Your eye doctor fine-tunes this refraction assessment by having you look through a Phoroptor, a mask-like device that contains wheels of different lenses, to judge which combination gives you the sharpest vision. By repeating this step several times, your doctor finds the lenses that give you the greatest possible acuity.
Slit-lamp ExaminationA slit lamp is a microscope that enlarges and illuminates the front of your eye with an intense line of light. Your doctor uses this light to examine the cornea, iris, lens and anterior chamber of your eye.
When examining your cornea, your doctor may use eye drops containing fluorescein (flooh-RES-ene) dye. The orange dye spreads across your eyes to help your eye doctor detect tiny cuts, scrapes, tears, foreign objects or infections on your cornea. Your eyes’ tears eventually wash the dye away.
Retinal ExaminationA retinal examination — sometimes called ophthalmoscopy or fundoscopy — examines the back of your eye, including your retina, optic disk and the underlying layer of blood vessels that nourish the retina. The retinal examination takes only a few minutes, but if you’re given eyedrops to dilate the pupils, their effects may not wear off for several hours. Your vision will likely be blurry, and you may have trouble focusing your eyes. If you’re particularly sensitive to light, you may need to wear dark glasses (or sunglasses) for a short time. You may not be able to drive, so make sure you have another way back to work or home. Depending on your job, you might not be able to work until the effects of the eyedrops wear off.
TonometryThe most common type of tonometry is the dreaded “air puff" test. This is a test that measures the pressure inside your eyes and is a screening test for glaucoma. It does not require the use of any eye drops in the eye, however, it can be startling to you — especially for first-timers. If you prefer, there are other methods for acquiring this measurement. Applanation tonometry is a less-startling method of measuring eye pressure, but does require a short-acting numbing drop in each eye. You can always request applanation tonometry, if you do not like the “air puff".
Besides these basic evaluations, you may need more specialized tests, depending on your age, medical history, family history, or if any of the tests above are abnormal.
Medical Eye Services
Our physicians treat a range of eye diseases and problems to keep your eyesight as healthy as possible.
What is Diabetes?Diabetes Mellitus is a chronic disorder characterized by lack of insulin secretion and/or increased cellular resistance to insulin in the body. Diabetes can result in complications involving the eyes, kidneys, cardiovascular system, and nervous system.
The Two Types of Diabetes
Type 1Also known as insulin dependent diabetes, accounts for 10% of all patients with diabetes in the United States. This type of diabetes results in the destruction of the islet cells in the pancreas, which is responsible for insulin production. This type of diabetes can occur at any age, but typically is more common in those under 30 years old. Symptoms of Type 1 Diabetes include: excessive hunger, excessive thirst, excessive urination, unexplained weight loss, dry mouth, leg cramps or pains, delayed healing of skin wounds, and recurrent infections of the skin, genitalia, or urinary tract.
Type 2Also known as non-insulin dependent diabetes, accounts for 90% of all diabetics in the US. Type 2 Diabetes is characterized by a resistance of body tissues to the action of insulin. It typically occurs in adults over the age of 40, but is also on the rise in children in the past few years. Most Type 2 diabetics have no symptoms, and therefore, frequently go undiagnosed for years. Risk factors for this type of diabetes include, cardiovascular disease, smoking, sedentary lifestyle, and obesity.
Diabetic Eye Disease – Diabetic RetinopathyDiabetic Eye Disease is an end-organ response to a generalized medical condition. Diabetic Retinopathy is the most serious sight-threatening complication of diabetes, although, diabetes has been shown to cause an increased risk of cataracts, glaucoma, and refractive error changes (near-sightedness). Diabetic Retinopathy is characterized by blood vessel changes, swelling, leakage and/or hemorrhaging within the retina. Diabetes is the leading cause of blindness in working age Americans today. At least 50,000 Americans are legally blind from this condition. Although Diabetic Retinopathy is not preventable or curable, many cases of blindness may be avoided due to advances in the management of Diabetic Retinopathy. Early diagnosis and long-term, consistent follow up evaluations are essential for effective treatment, and can significantly lower the risk of blindness.
Recommended Eye ExaminationsAll newly diagnosed diabetics should have a comprehensive, dilated eye examination immediately. In the absence of any diabetic eye disease, annual eye examinations are recommended. Depending on the level of retinopathy, you may need to be seen by your eye doctor more frequently, in order to monitor for progression of the disease.
- Problems with normal blinking
- Certain medications like antihistamines, oral contraceptives and antidepressants
- Environmental factors like a dry climate and exposure to wind
- General health problems like arthritis or Sjogren’s syndrome
- Chemical or thermal burns to the eye
- Redness of the eyes
- Irritated, scratchy, dry or uncomfortable eyes
- A burning sensation of the eyes
- A feeling of a foreign body in the eye
- Blurred vision
- Excessive watering as the eyes try to comfort an overly dry eye
- Eyes that seem to have lost the normal clear glassy luster
If you are experiencing the symptoms of dry eye, your optometrist can perform “dry eye" tests using diagnostic instruments to give a highly magnified view and special dyes to evaluate the quality, amount and distribution of tears. Your optometrist will also need to know about your every day activities, your general health, medications you are taking and about environmental factors that may be causing your symptoms.
Unfortunately, dry eye cannot be cured, but your eye’s sensitivity can be lessened and treatment prescribed so that your eyes remain healthy and your vision is not affected. There are several over the counter and prescription medications available to help treat dry eyes. Other dry eye treatments are:
- Changing environmental factors like avoiding wind and dust and increasing the level of humidity
- Frequent blinking to spread tears over the eye, especially when using a steady focus for an extended period
- Using artificial tear solutions
- Using moisturizing ointment, especially at bedtime
- Hot compresses or a heated mask (ask our doctors about the new Tranquileyes mask) to help tear gland function
- Taking a daily Omega-3 vitamin supplement (fish oil, and/or flax seed oil)
- Insertion of small plugs in the corner of the eyes to slow drainage and loss of tears
- In rare cases, surgery may be recommended
As a general rule, a red, irritated eye that does not get better should be seen by a doctor within a couple of days. A contact lens should NOT be worn on a red, irritated eye. New eye drops, both prescription and non-prescription, are constantly being developed. They are giving us improved medical options as we treat our patients’ eye infections.
As we age, there is shrinkage of the overall volume of the vitreous. With this comes a contraction of the fibrous elements away from the retina. This is called a POSTERIOR VITREOUS DETACHMENT. The resulting traction on the retina is responsible for the characteristic “flashes" which often accompany PVD’s. The “floaters" are typically fibrous clumps within the vitreous. However, in some cases, they are actually from some fragments of retina which may have been dragged into the vitreous cavity by this separation.
It is important that all eyes with recent onset of flashes and floaters be examined carefully by an eye doctor. Most of the time, nothing unusual is found and simple reassurance is all that is needed. The flashes eventually go away, and the floaters diminish and become less bothersome with time; however, in some eyes with a posterior vitreous separation, a tear in the retina may occur. If left untreated, these tears may lead to a retinal detachment. A retinal detachment is a very serious sight threatening condition requiring a major surgical procedure to repair. Even in the best of hands, the results can be very unpredictable.
If retinal tears are found, treatment is much easier and more effective. They can be sealed off to prevent a retinal detachment. This is done either by “spot welding" several circles of burns around the tear with a laser, or by sealing it with a freezing unit. Both accomplish the same purpose with good results and low complications rates. The procedure is done on an outpatient basis under local anesthetic.
When flashes and floaters appear, it is important to examine the eye within a few days of their onset. Changes can occur rapidly, and time can be of the essence if a retinal detachment is present. If all is normal in the first occurrence, one cannot assume that subsequent occurrences will be harmless also. Each event should be carefully examined and treated if necessary.
Glaucoma treatments have drastically changed over the past decade. In the past, we had only a limited selection of eye drops to control pressure within the eye. Some of these medications caused unpleasant side effects, like headaches and blurred vision.
Today, we have a much wider range of choices. The specific glaucoma medicine you receive depends upon any pre-existing health problems, your lifestyle, and glaucoma history. If the eye drops do not adequately control the glaucoma, surgery can be done. Here, openings through the drainage system of the eye are artificially produced, often with a laser. This allows for healthier fluid circulation and a reduction in eye pressure. It’s good to know these treatments are available should you develop glaucoma, but early diagnosis is really the key to a lifetime of healthy vision.
In its earliest stages, keratoconus causes slight blurring and distortion of vision and increased sensitivity to glare and light. These symptoms usually first appear in the late teens and early twenties, and it has been estimated that the incidence of keratoconus is 1 in 2000. It is found in all parts of the United States and the rest of the world. It has no known significant geographic, cultural or social pattern. Keratoconus may progress for 10-20 years and then slow in its progression. Each eye may be affected differently.
Eyeglasses or soft contact lenses may be used to correct the mild nearsightedness and astigmatism that is caused in the early stages of keratoconus. As the disorder progresses and the cornea continues to thin and change shape, rigid gas permeable contact lenses can be prescribed to correct vision more adequately. The contact lenses must be carefully fitted, and frequent checkups and lens changes may be needed to achieve and maintain good vision.
In severe cases, a corneal transplant may be needed due to scarring, extreme thinning or contact lens intolerance. This is a surgical procedure that replaces the keratoconus cornea with healthy donor tissue.
For more information about keratoconus, visit the National Keratoconus Foundation’s website.
Age-related Macular Degeneration is the leading cause of legal blindness in people older than 55 years in the United States, affecting more than 1.75 million individuals. Unfortunately, due to the rapid aging of the U.S. population, this number is expected to increase to almost 3 million by 2020. Smoking, obesity, and family history are among the leading causes of this debilitating disease process.
There are two types of Macular Degeneration, dry and wet. The most common type of Macular Degeneration is the dry form. In this form, progression tends to be slower, causing gradual vision loss over time. However, the dry form can convert to wet ARMD at any time when fluid starts to accumulate underneath the macula. Regular examinations by a doctor experienced with Macular Degeneration and monitoring your eyes daily with the use of an Amsler Grid, are vital. Vitamin therapy (an AREDS approved formula) can be effective in slowing down the advancement of this disease. Medical treatment, in the form of intraocular injections (injections directly into the eye), has been shown to greatly improve long-term vision related to wet ARMD.
We believe in utilizing the latest developments in optical technology to best care for your eyes and your vision.
OCT (ocular coherence tomography) is one of the most innovative new technologies on the market. It allows your optometrist to view your optic nerve (the nerve which transmits what you see to your brain) and the layers of the retina (the back internal covering of the eye essential for acute vision) in cross-section. It helps to diagnose glaucoma, swelling or hemorrhaging in the back of the eye, macular degeneration and many other retinal eye problems.
Retinal Imaging is digital photography of the back surface of the eye that allows your optometrist to diagnose, treat, and follow glaucoma, macular degeneration, diabetes, large freckles that can potentially be cancerous, blood vessel changes due to high blood pressure, and many other diseases. It allows us to monitor these diseases with year to year comparisons accurately for stability or progression. These findings can be critical to our patients’ overall health.
Topographical mapping of the cornea is a very valuable tool used in both the diagnosis of corneal disorders and the fitting of the contact lenses. A very quick and non-invasive test, disks of light are reflected off the eye and then digitally imaged and evaluated, providing us with detailed information about surface irregularities and curvatures. This technology can turn a previously poor candidate for contact lenses into a happy, successful contact lens wearer.
Visual Field is an instrument which gives your optometrist critical information in diagnosing certain blindness-causing diseases. It allows us to treat and follow progression of diseases like glaucoma and optic neuritis (associated with multiple sclerosis). It also helps us diagnose certain types of tumors, strokes, aneurysms, and other neurological and vascular diseases.
The latest research on Glaucoma has uncovered an aspect of the eye’s anatomy that has been found to be a very prominent risk-factor for glaucoma, corneal thickness. This very quick test accurately measures the corneal thickness, which gives us another piece of the puzzle when deciding to begin treatment on borderline cases.
A variety of types of contact lenses are available to suit all of our patients. We will work with you to determine the best fit contacts for your unique needs.
Most daily wear soft contact lenses are now disposable and can be thrown away after a short period of use. Being able to have a fresh pair of soft contact lenses means less chance of infection, less cleaning, and more comfort, especially for people whose eyes naturally produce more protein which clouds contact lenses.
Current technology now allows for some extended wear contact lenses to be worn for an entire month! These new contact lens materials are considered “super-permeable" and allow much more oxygen to get to the eye. This greatly minimizes the health risks that arise from low oxygen.
These lenses are available in a wide range of powers, and they cost about the same as regular daily wear lenses.
Astigmatism is a very common problem. It results from the cornea having a slightly irregular shape. This causes images to blur at 2 different locations in the eye. A standard contact lens cannot correct both points of blur. A special toric contact lens can correct this visual problem. The fitting for a toric lens requires an exact measurement of the astigmatism, and a proper selection of contact lens size, material, and power. Changes in the fit of the lens are sometimes necessary. However, there are more options than ever in soft contact lens technology to enable most people with astigmatism to wear contact lenses.
Because of the unusual curvature of the cornea from these conditions, standard soft contact lenses frequently do not adequately correct vision. Thus, more creative methods of vision correction have arisen. Special contacts to the rescue! Special designs in contact lenses can restore a smooth optical surface to the eye, creating crisper vision than can be achieved with glasses. While these contact lens fits can be more challenging, we are armed with the newest technologies to help us achieve the desired results. With these advancements in contact lenses, we now have the ability to fit even the most challenging eyes with contacts!
Some visual conditions cannot be treated adequately with just glasses, contact lenses and/or patching, and are best resolved through a program of Vision Therapy. Learn more about how Vision Therapy can help your vision.
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