NOMS North Central Eye

Cataract Surgery: What is a Cataract?

The lens is a clear part of the eye that helps to focus light, or an image,on the retina. The retina is the light-sensitive tissue at the back of the eye. In a normal eye, light passes through the transparent lens to the retina. Once it reaches the retina, light is changed into nerve signals that are sent to the brain. The lens must be clear for the retina to receive a sharp image. If the lens is cloudy from a cataract, the image you see will be blurred.

How is a Cataract treated?

The symptoms of early cataract may be improved with new eyeglasses, brighter lighting, anti-glare sunglasses, or magnifying lenses. If these measures do not help, surgery is the only effective treatment.

Surgery involves removing the cloudy lens and replacing it with an artificial lens. North Central Eye Associates are experts at no-stitch cataract surgery and helping you determine which type of lens replacement implant is right for you. Premium lens implants such as the CRYSTALENS or RESTOR lens can help you achieve complete independence from glasses, in many cases, after modern cataract surgery.

A cataract needs to be removed only when vision loss interferes with your everyday activities, such as driving, reading, or watching TV. You and our surgeons will make this decision together. Once you understand the benefits and risks of surgery, you can make an informed decision about whether cataract surgery is right for you. Cataract surgery is a covered medical expense under Medicare and private insurance plans.

What can I do to protect my vision?

Wearing sunglasses and a hat with a brim to block ultraviolet sunlight may help to delay cataract. If you smoke, stop. Researchers also believe good nutrition can help reduce the risk of age-related cataract. They recommend eating green leafy vegetables, fruit, and other foods with antioxidants.

If you are age 60 or older, you should have a comprehensive dilated eye exam at least once every two years. In addition to cataract, our surgeons will check for signs of age-related macular degeneration, glaucoma,and other vision disorders. Early treatment
for many eye diseases may save your vision.

Glaucoma Surgery: What is glaucoma?

Glaucoma is a group of diseases that can damage the eye's optic nerve and result in vision loss and blindness. Glaucoma occurs when the normal fluid pressure inside the eyes slowly rises. However, with early treatment, you can often protect your eyes against serious vision loss.

What is the optic nerve?

The optic nerve is a bundle of more than 1 million nerve fibers. It connects the retina to the brain. (See diagram below.) The retina is the light-sensitive tissue at the back of the eye. A healthy optic nerve is necessary for good vision, glaucoma damages the optic nerve.

What are some other forms of glaucoma?

Open-angle glaucoma is the most common form. Some people have other types of the disease. Low-tension or normal-tension glaucoma; optic nerve damage and narrowed side vision occur in people with normal eye pressure, lowering eye pressure through medicines slows the disease. Angle-closure glaucoma; the fluid at the front of the eye cannot reach the angle and leave the eye. The angle gets blocked by part of the iris. People with this type of glaucoma have a sudden increase in eye pressure. Symptoms include severe pain and nausea, as well as redness of the eye and blurred vision. If you have these symptoms, you need to seek treatment immediately. This is a medical emergency. Neovascular glaucoma; a severe form linked to diabetes.

What are the symptoms of glaucoma?

At first, there are no symptoms. Left untreated, glaucoma can cause blindness.

How is glaucoma detected?

Glaucoma is detected through a comprehensive eye exam that includes: Visual acuity testing; the eye chart test measures how well you see at various distances. A tonometer measures pressure inside the eye to detect glaucoma. Visual field test measures your side (peripheral) vision. It helps your doctor tell if you have lost side vision, a sign of glaucoma. Dilated eye exam; drops are placed in your eyes to widen, or dilate, the pupils. Your doctor uses a special magnifying lens to examine your retina and optic nerve for signs of damage and other eye problems. Pachymetry; a numbing drop is applied to your eye. Your doctor uses an ultrasonic wave instrument to measure the thickness of your cornea. Optical Coherence Tomography( OCT ); this is a scanning laser we use at North Central Eye to give us a zoom image of your optic nerve. With this image we can better detect and monitor glaucoma.

Can glaucoma be treated?

Yes. Immediate treatment for early stage, open-angle glaucoma can delay progression of the disease. Glaucoma treatments include medicines, laser trabeculoplasty, conventional surgery, or a combination of any of these. While these treatments may save remaining vision, they do not improve sight already lost from glaucoma. That's why early diagnosis is very important.

SLT laser treatment is the latest improvement for office treatment of glaucoma. North Central Eye is proud to partner with FTMC to provide this cutting-edge therapy to our patients.

What is age-related macular degeneration?

Age-related macular degeneration (AMD) is a disease associated with aging that gradually destroys sharp, central vision. Central vision is needed for seeing objects clearly and for common daily tasks such as reading and driving. AMD affects the macula, the part of the eye that allows you to see fine detail. AMD causes no pain.

In some cases, AMD advances so slowly that people notice little change in their vision. In others, the disease progresses faster and may lead to a loss of vision in both eyes. AMD is a leading cause of vision loss in Americans 60 years of age and older. AMD occurs in two forms: wet and dry.

Where is the macula?

The macula is located in the center of the retina, the light-sensitive tissue at the back of the eye. The retina instantly converts light, or an image, into electrical impulses. The retina then sends these impulses, or nerve signals, to the brain.

What is wet AMD?

Wet AMD occurs when abnormal blood vessels behind the retina start to grow under the macula. These new blood vessels tend to be very fragile and often leak blood and fluid. The blood and fluid raise the macula from its normal place at the back of the eye. Damage to the macula occurs rapidly. With wet AMD, loss of central vision can occur quickly.

What is dry AMD?

Dry AMD occurs when the light-sensitive cells in the macula slowly break down, gradually blurring central vision in the affected eye. As dry AMD gets worse, you may see a blurred spot in the center of your vision. Overtime, as less of the macula functions, central vision is gradually lost in the affected eye. The most common symptom of dry AMD is slightly blurred vision. You may have difficulty recognizing faces. You may need more light for reading and other tasks. Dry AMD generally affects both eyes, but vision can be lost in one eye while the other eye seems unaffected.

How is wet AMD treated?

Wet AMD can be treated with laser surgery, photodynamic therapy, and injections into the eye. None of these treatments is a cure for wet AMD. The disease and loss of vision may progress despite treatment. Laser surgery- This procedure uses a laser to destroy the fragile, leaky blood vessels. Wet AMD can now be treated with new drugs that are injected into the eye (anti-VEGF therapy). Abnormally high levels of a specific growth factor occur in eyes with wet AMD and promote the growth of abnormal new blood vessels. This drug treatment blocks the effects of the growth factor. You will need multiple injections that may be given as often as monthly.

How is dry AMD treated?

Age-Related Eye Disease Study found that taking a specific high-dose formulation of antioxidants and zinc significantly reduces the risk of advanced AMD and its associated vision loss. Slowing AMD's progression from the intermediate stage to the advanced stage will save the vision of many people.

What is diabetic eye disease?

Diabetic eye disease refers to a group of eye problems that people with diabetes may face as a complication of diabetes. All can cause severe vision loss or even blindness.

Diabetic eye disease may include: Diabetic retinopathy damage to the blood vessels in the retina.

Cataract clouding of the eye's lens. Cataracts develop at an earlier age in people with diabetes.

Glaucoma increase in fluid pressure inside the eye that leads to optic nerve damage and loss of vision. A person with diabetes is nearly twice as likely to get glaucoma as other adults.

What is diabetic retinopathy?

Diabetic retinopathy is the most common diabetic eye disease and a leading cause of blindness in American adults. It is caused by changes in the blood vessels of the retina. All people with diabetes--both type 1 and type 2--are at risk. That's why everyone with diabetes should get a comprehensive dilated eye exam at least once a year. The longer someone has diabetes, the more likely he or she will get diabetic retinopathy. Between 40 to 45 percent of Americans diagnosed with diabetes have some stage of diabetic retinopathy. That is why finding diabetic retinopathy early is the best way to prevent vision loss.

Treatment of diabetic retinopathy:

When patients reach the stage treatment is required, North Central Eye has teamed with FTMC to provide state-of-the-art office-based laser treatment to dramatically decrease the risk of progression. Our laser surgeons will perform laser delivery to the retina with the expectation of vision improvement or stabilization. Diabetic retinopathy can now be treated with new drugs that are injected into the eye (anti-VEGF therapy). Abnormally high levels of a specific growth factor occur in eyes with diabetes and promote the growth of abnormal new blood vessels. This drug treatment blocks the effects of the growth factor.

Oculoplastic Surgery Our eyes say so much about us. They reveal what we think and they express what we feel. But sometimes, because of heredity or the aging process, our eyes do not convey the full range of human thoughts and emotions. "Tired" eyelids or droopy eyebrows can make a person look constantly sad and worn out. An injury to the eyelid or orbit or certain health conditions, such as Graves' disease may cause an abnormal appearance as well as damage to the function of the eye. In addition to aesthetic concerns, heavy eyelids and eyebrows can obstruct vision, creating an unnecessary limitation. Any number of eye conditions can be corrected through oculoplastic surgery (cosmetic plastic surgery) in which the appearance of the eye can be improved to produce a younger, brighter, less tired look. Cosmetic eye surgery at North Central Eye consists of plastic surgery of the upper eyelids, lower eyelids and eyebrows.

During your initial consultation, our surgeon will advise you as to whether or not you are a candidate for cosmetic eye surgery. Complications are rare but your physician will discuss these with you in detail, as well as your expectations. Cosmetic eye surgery is performed in a outpatient operating room. Before the procedure begins, you will receive local anesthesia administered by a physician so that you are comfortable and do not feel any pain during surgery. Following surgery, you will be prescribed medication to reduce any pain. A regular follow-up examination will be scheduled. Following surgery, most patients are able to return to work within days.

Blepharoplasty (also known as cosmetic eyelid surgery or eyelift) is one of the most commonly performed procedures in plastic surgery. The eyes are usually the first place to show signs of aging. With time the upper eyelids can develop folds of loose skin or become droopy. This usually gives the false impression of a tired look. This can also make it very difficult to wear eye makeup. Lower eyelid fat can prolapse and develop loose skin, which can give a tired and sad look to the face. In addition, the skin of the eyelid is very thin and quite prone to developing many fine wrinkles.

WHAT CAN BLEPHAROPLASTY (COSMETIC EYELID SURGERY) ACHIEVE?

The eyes will appear more rested and vibrant after cosmetic eyelid surgery. Most often the results are so natural that friends and coworkers will comment on how great you look, without realizing that surgery was performed. The incision for blepharoplasty is hidden in natural creases of the eyelid, and it heals extremely well.

WHAT DO YOU MEAN BY CUSTOMIZED BLEPHAROPLASTY?

Many plastic surgeons perform the blepharoplasty procedure in the same manner for all patients. This is like visiting a hairstylist who can who can only cut your hair in one way. The Art of Blepharoplasty needs to be refined and customized for each patient individually. This is why North Central Eye customizes the treatment plan for each patient individually to achieve a youthful harmonious outcome.

I AM INTERESTED! HOW SHOULD I PROCEED?

If you are considering this procedure we encourage you to schedule a private consultation. During this visit we will listen to your concerns and, after a comprehensive evaluation, will discuss the best management for you. If you are a suitable candidate you will be informed of all potential risks of the procedure. Depending on your gender, ethnicity, and age, a customized procedure will be tailored for you.

RECONSTRUCTIVE SURGERY

Aging, disease processes, injuries, sun and smoke can all lead to destructive changes of the eyelid. These vital structures may no longer be capable of supporting and comforting the eyes as they are designed to do. Our surgeons at North Central Eye have extensive training at Reconstructive procedures to restore patients to a better lifestyle with fewer symptoms. Below are the most common reconstructive procedures we perform.

Ptosis (pronounced toe-sis), is the medical term for drooping of the upper eyelid. The droopy eyelid can be mild to severe. People who have ptosis may complain that people tell them they look tired or lazy. Because of a constant effort to raise the eyelids it is not uncommon to also complain of fatigue and tension headaches.

WHAT ARE THE COMMON CAUSES OF PTOSIS (DROOPY EYELIDS)?

The most common reason for ptosis is acquired ptosis, which develops as we age. This is due to disinsertion of the tendon that holds the eyelid up in a normal anatomic position. Another cause is congenital ptosis , which happens when a child is born with droopy eyelids. This is rather an urgent medical condition for the child and surgery may be needed to prevent permanent loss of vision in the affected eye. Other rare causes of ptosis include myogenic ptosis from conditions such as Myasthenia gravis, neurogenic ptosis, due to third nerve palsy and mechanical ptosis from tumors or trauma.

Eyelid Malposition Eyelids can be malpositioned for a variety of reasons. It could be congenital, meaning the person was born with it, or it could be secondary to aging, trauma, burn or tumors. A malpositioned eyelid not only aesthetically looks unappealing, but more importantly, it can cause severe irritation, burning, tearing and in some instances compromise vision. Here are a few reasons for eyelid malposition.

Ectropion is an outward turning of the eyelid. This condition is most often associated with aging however it could also be caused by facial nerve paralysis (Bell's palsy) or scarring of the skin around the eyes from previous injury or burn. Most patients with ectropion complain of constant tearing and a burning sensation. Depending on the cause, the surgical correction varies. If the ectropion is secondary to aging, the lateral aspect of the lower eyelid is tightened and thus repositioned. If the ectropion is secondary to scarring, skin graft from the upper eyelids or behind the ear will be harvested to correct the defect.

Entropian is an inward turning of the eyelid, typically involving the lower lid. It is usually caused by a loose lower lid, however it can also be caused by scarring from trauma or inflammation from certain ocular diseases. Because of this inward turning the patient complains of constant irritation, tearing and a burning sensation. Depending on the cause, either a lower lid tightening procedure, or the release of scar tissue and = placement of a mucus membrane graft will be needed.

Involuntary Eyelid Blinking Blepharospasm (pronounced "bla-for-o-spaz-m") is the name for a condition in which the eye blinks excessively and involuntarily. It usually occurs in persons in their 50's or 60's, and to women more commonly than men. While its cause is not yet known, it is believed that blepharospasm is caused when there is a miscommunication among the signals between the brain and the eye muscle. The patient may also experience spasms of the face and neck muscles as well. Some people may have an episode of blepharospasm while for others, it becomes a chronic condition.

It is important to have blepharospasm evaluated by trained ophthalmologist because it may be a symptom and not a condition unto itself. Sometimes, blepharospasm maybe the result of dry eye, eye infection, corneal disease, acute glaucoma or several other types of ocular conditions. Stress, fatigue, bright lights, and situations where one may need to stare ahead (watching television or driving) may exacerbate blepharospasm. However, a variety of relaxation techniques may decrease symptoms temporarily. Treatment for blepharospasm include medications, local injection of botulinum toxin (also known as "botox" injections which are used for cosmetic purposes) and surgery. As with treatment for any kind of condition, it is important to discuss with your physician the treatment that works best for you.

Strabismus is a common inherited visual condition that occurs when the eyes do not properly align. This leaves one or both eyes turning outward, inward, upward, or downward. In America, this can be found in 4% of children, but it also can occur later in life.

In children, prolonged untreated esotropia (when the eye turns in) or exotropia (when the eye turns out) can permanently affect vision. Adults who develop strabismus later in life often complain of double vision.

Often times, strabismus can be treated with patching or with glasses. If these do not help, muscle surgery may be required.

Having your children checked for prescription error (glasses) and eye alignment is an important preventive measure to take during their developing years. If there is a strong family history of strabismus, "lazy eye", or if you have family members with thick glasses, your child should be checked before age 3.

OPTICAL SHOP

We are a full service optical boutique staffed by two licensed Opticians with over 20 years experience each. We will provide you with all your optical needs from general everyday, sport, industrial, sunglasses, children’s, or computer use. We have a fabulous selection of high-quality frames on display ranging from budget to the latest designer fashion. Some of the designer lines we carry are Liz Claiborne, Kenneth Cole, BCBG, MaxAzria, Columbia, Chesterfield and Carrera. Our licensed Opticians will help you choose the perfect glasses, from “Hey look at me!” to something a little more on the subtle side. Our frame selection is constantly changing with new and exciting styles. We use some of the most current premium lenses from industry leaders like Varilux, Transitions, Drivewear, and Crizal. We can make lenses to fit your existing frame using our remote tracer. Technology that means you can continue to wear your glasses while new lenses are being made.