FAQ
Yes! There are soft lenses available for astigmatism correction (toric lenses) available up to very high powers. In addition, gas-permeable lenses (often called hard lenses), hybrid lenses, and scleral lenses will also correct astigmatism.
Soft lenses will generally provide the best overall comfort with perhaps a slight vision trade-off compared to glasses, and are available in daily, two week, and monthly disposable. Rigid gas permeable lenses provide superior vision, usually equivalent to glasses, but take a lot more time to get used to as far as comfort. They are available as a pair that lasts up to a year or more. Because of the significant comfort difference, soft lenses are much more popular.
There are basically three: 1) Both eyes corrected for distance, with reading glasses needed over the contacts; 2) Monovision, where we correct one eye for distance and the other for reading; and 3) Bifocal contact lenses. The first option always works if you are willing to use readers. The success rate with monovision is about 75% and is for the patient willing to live with the trade-off of not needing readers versus non-optimal distance and near vision. Bifocal contact lenses have improved tremendously since 2005 or so, with a 65-75% success rate. There are now currently two options in bifocal soft lenses for the patient with astigmatism.
There are enhancers for light eyes and opaques for dark eyes. Currently there are no color options for patients with astigmatism.
Our contact lens prices are very competitive with both online and retail providers of contact lenses. In many cases they are cheaper, since we often can offer rebates they cannot. In addition, we will take care of any problems with defects, power changes, etc. quickly and effortlessly on your part. Still, we are happy if you prefer to price-shop the lenses and will provide you with a written prescription so that you may do so.
True “hard” lenses were made of a plastic called PMMA, which gives the eye very little oxygen. We do not fit those anymore. We do fit rigid gas permeable (RGP) lenses, which are similar in texture and size, and give the eye much more oxygen than the old hard ones.
Quick answer: depends. If you have a significant astigmatism, there are only two options available to try, both in monthly disposable. As another option we could try a rigid lens or the Duette hybrid (which has a rigid center and a soft skirt around it). If there is little or no astigmatism, then we have a 65-75% chance you could wear them. The challenge in fitting them lies in getting the patient happy with BOTH the distance AND the near acuity at the same time. Usually when they fail, there is either too much far or close vision compromise.
Usually around twelve or so. This can vary depending upon the child’s responsibility/maturity level. The main issue is that they will remember to take the lenses out before bedtime. Cleaning the lenses is very simple with modern cleaning systems. If our doctors, in consultation with the parents, feel like the child is ready we can try them a year or two younger than that.
A lot. Currently there are many lenses out there approved for up to one week extended wear, and three approved for up to thirty days without removing.
Infection is the biggest, followed by corneal edema (swelling) and neovascularization. By far, corneal ulcers are most common in people that sleep in their lenses – even if the lens is approved to be slept in, and the patient is compliant with the removal schedule. They are treatable but painful, and usually require 7-10 days out of the lenses. Corneal edema causes blur and discomfort and requires no lens wear for sometimes up to a month or more. Neovascularization (or new blood vessel growth) of the cornea usually requires an adjustment to the wearing schedule when mild, but when severe may mean having to discontinue contact lenses permanently.
The only con is that they are more expensive. Everything else is a pro: they are easy to use because there is nothing to clean, you do not have to purchase a disinfecting system, they will not deposit because each pair is only used one day, and they are the most comfortable contact lenses available. Most manufacturers offer rebates – currently up to $200 – to help offset the patient’s investment.
None are available as of 2022.
The doctor has to make sure your eyes are healthy enough for contact lens wear and that the lenses fit properly. Poor-fitting lenses can cause irritation and infection.
There is new technology available now with the advent of silicone hydrogel lenses. They wet much better than older plastics and give the eye more oxygen. Many patients who had comfort issues in the past with contact lenses have done very well with the new technology.
In almost all cases, yes. We usually start with a trial pair then follow up a week later to be sure you are happy with them before committing to them. In some instances we have to order the lenses, which can take 3-5 business days to arrive.
It varies from person-to-person. Generally as little as 15 minutes up to an hour or so.
Hybrid lenses have a gas-permeable center, with a soft skirt around it. They can be a great option for the patient wanting “rigid lens vision” with very near soft lens comfort. They will correct astigmatism and are also available in bifocal.
Scleral lenses are larger-diameter gas permeable lenses, which are fit to vault over the cornea with the sclera bearing all the weight of the lens. Since nothing touches the cornea, they are usually much more comfortable than rigid gas permeable. Sclerals quite often will give far superior vision compared to spectacles in patients with a history of keratoconus or failing radial keratotomy (RK).
The doctor needs to make sure that your eyes remain healthy and that the lenses continue to fit properly.
Progressive lenses are popular for other reasons than just “hiding the line.” They work like a trifocal, in the sense that as you look straight ahead you have the distance correction, and as you look down the lens, power is progressively added so that there is a point of focus for both mid-range (arm’s length) and close detail work at the very bottom of the lens. Lined bifocals jump quickly from distance to near, once the pupil of the eye crosses the line. The lined bifocal is usually easier to adapt to, and gives a larger field of view up close than the progressive. In addition, there is a bit of distortion in the lower-periphery of no-line bifocals that is not experienced with the lined bifocal. Most patients adapt well to the progressive by learning to keep their eyes in the same position and turning their head turn to scan the environment.
There are two types: Transitions (plastic) and Photogray (glass). The plastic lenses are much more popular since they are lighter in weight. Transitions have been improved to the point that they will get almost as dark as the Photogray, and lighten quickly when you move indoors. We have a sample lens we can use to show you how dark they actually get outdoors. Ultraviolet rays make the lenses darken, which has proven slightly problematic for some patients as of late. Modern auto manufacturers now put a UV protection in their windshields – which means the lenses may not darken much in the car!
Spectacle frames have a one-time replacement warranty for one year on breakage. Lenses with Crizal anti-reflective coating have a two-year two-time replacement warranty for scratches. Please note: very few insurance companies require the use of their own lab’s frame and lenses, which may have a different warranty system.
Either a progressive lens, which will also allow functionality when away from the computer, or a separate pair in single vision set up for the distance between your eyes and the screen (which will only be good for computer use). Crizal anti-reflective coating is highly recommended to help reduce glare. There are specialty progressives with a wider corridor specially made for high-rate computer users – the Essilor Computer Lens being a good example.
Smaller eye size frames are ideal for higher corrections. Also, if you are significantly near-sighted, stay away from rimless and semi-rimless frames – i.e., pick a frame that totally encapsulates each lens. Plastic is ideal because it will help hide the thicker lens edges. In addition, high myopes (whose lenses have thicker edges) should consider a high index plastic for their lenses, which can greatly cut down edge thickness. High hyperopes (whose lenses have thicker centers) will benefit from an aspheric lens which will reduce the magnification of the eyes.
A lot of people can with absolutely no problem. However, if there is a significant difference between the eyes as far as prescription, or a significant astigmatism in either eye, a prescription pair is recommended.
In most cases, yes. Your brain will get used to a nice, sharp image and objects may look more blurred when you are not wearing the glasses due to perceptual adaptation. For far-sighted patients, many times the eyes will be so happy to be relaxed and allowing the glasses to do the work, that they don’t want to “go back to work” when the glasses aren’t on. The exception is milder prescriptions, for part-time wear.
UV protection is paramount. UV rays have been linked to both cataract formation in later life as well as macular degeneration. Polarized lenses give the overall best optical quality because they reduce both transmitted light through the lens and reflected light off bright surfaces (like water, snow, or the chrome of the bumper in front of you in traffic).
The doctor needs to make sure that your eyes remain healthy and that the prescription remains optimal.
Some simple single vision glasses we can have ready same-day or the next, if there is an emergency situation. Most jobs take about a week to complete. We certainly do not promote “glasses in one hour.” We are going to take our time to make sure that your glasses are perfect in every way.
Doctors of Optometry (O.D.s/optometrists) are the independent primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. They prescribe medications, low vision rehabilitation, vision therapy, spectacle lenses, contact lenses, and perform certain surgical procedures, as well as counsel their patients regarding surgical and non-surgical options that meet their visual needs related to their occupations, avocations, and lifestyle. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system. (American Optometric Association)
Yes, and if they are licensed as an Optometric Glaucoma Specialist they can treat glaucoma too. All of our doctors are licensed as an Optometric Glaucoma Specialist.
All are licensed as Therapeutic Optometrists (the treatment of ocular surface disease) and Optometric Glaucoma Specialists.
Near-sighted people (myopes) see more clearly at near without their prescription than they do at distance. Far-sighted people (hyperopes) generally see better at distance than they do at near; more precisely, hyperopes have to focus just to make distance clear, and when they look close up they have a much higher focusing demand than others (since they are already having to work to clear their distance vision).
The most common type is external astigmatism; the cornea (the outermost portion of the anterior eye) is oval-shaped instead of perfectly round – much like a football or an egg. Internal astigmatism, much less common, is when the lens – deeper in the eye – has an oval shape. Astigmatism in general is quite common.
Presbyopia occurs when the human lens starts to lose its elasticity; it becomes much more difficult for it to change shape and focus for us close up. Also, to some degree, the muscle that controls the change in shape of the lens starts to weaken somewhat. This results in the need for a reading correction, either reading glasses (if the patient has no distance problem) or bifocals (if they are already wearing glasses). Onset is almost always in the early to mid-forties.
Near-sightedness definitely tends to run in families. If both parents are near-sighted the odds do go way up that their children will be; however it is difficult to put a number on. We see families all of the time where both parents require a distance correction but all or some of the children may be fine – or vice versa. Alot depends on how the genes combine at conception.
The quick answer is if they are going to change, they are going to change whether you are wearing glasses or not. Correction neither cures the problem (so that you eventually do not need correction) nor keeps it from getting worse. Glasses “correct” in the sense that you see better with them; they do not make the problem go away.
For myopes, onset is usually in the preteen to early teen years, leveling off in the early twenties. For hyperopes, it can vary depending on severity. A life-long hyperope may need reading glasses as early as adolescence, reaching a point in adulthood where they need them full-time. Their distance vision will generally worsen in their forties until leveling off in their mid-fifties.
There is limited evidence that some exercises may delay the need for reading glasses for a young hyperope or emerging presbyope. We believe them to be ineffective for myopes.
This situation can occur frequently. A child is far-sighted and needs reading glasses. Usually far-sightedness occurs because the eye is shorter in length than it needs to be. As the child grows, so does the eye, and they may indeed reach a point they no longer need correction.
Glaucoma is a disease that occurs most commonly as a result of a high pressure inside the eye. The pressure increases usually because the fluid inside the eye cannot drain properly, but can be a result of over-production of fluid. The high pressure compresses the tiny nerve fibers running through the retina, leading to their death and optic nerve damage. The nerve damage causes vision loss. Much less often glaucoma can be present with pressures in the normal range; modern theory is that there is a blood flow problem to the optic nerve, resulting in damage to the nerve itself. This type of glaucoma, commonly called “normotensive glaucoma,” can be much more difficult to treat. Most types of glaucoma, like Primary Open Angle, are slowly progressive without treatment. However, one rare type – Angle Closure – can onset very quickly with skyrocketing pressures and is considered an ocular emergency. Treatment options for all types include eye drops (usually) or surgical procedures to relieve the pressure.
A cataract is a clouding of the eye’s lens. The lens is positioned just past the pupil and behind the iris (the colored part of the eye). This occurs naturally with age, and a lifetime’s exposure to ultraviolet radiation has been linked to their formation. Perhaps obviously, this clouding will cause a decrease in vision. Cataracts can also be caused by trauma to the eye, and some medications (particularly steroids like prednisone and cortisone). Treatment requires surgical removal, and replacing the lens with an implant.
Macular degeneration is a breakdown of tissue and blood vessels near and/or underneath the macula. The macula is located in the center of the retina and is responsible for our central, fine-detail, and color vision. There is strong evidence now that there is a genetic predisposition to the disease; it used to be believed that it was strictly an age-related problem. 90% of macular degeneration is the dry form; 10% of cases are the wet form. Wet macular degeneration causes a devastating loss of central vision, while the dry form may drop central vision to 20/40 or so. One study showed conclusively that antioxidant vitamin therapy (Vitamins A, C, and E) dropped the risk of macular degeneration occurring in the other eye in patients with the disease in the fellow eye by 25%. There is also strong evidence that additional zinc and lutein supplementation is beneficial. We now recommend that patients in their sixties with a strong family history of the disease strongly consider the ocular formulations of these supplements. In addition, more recent studies have linked UV exposure to macular degeneration (wear your sunglasses!). Treatment has advanced tremendously even in the past 10-15 years and can include laser therapy, but usually the use of injections. Surgical treatment is currently only limited to the wet form.
Diabetic retinopathy is a fairly easy diagnosis, so yes, we can look in an eye and be almost certain diabetes is present. However, we cannot look in an eye and be certain it is absent. This is because not all patients with diabetes will have retinopathy. Separately, we can get suspicious about a patient developing the disease based upon certain changes in their prescription – as a patient’s blood sugar elevates, their prescription will shift more near-sighted due to (temporary with treatment) changes in the lens. This suspicion will be raised in a patient who shows a prescription shift atypical for their age. The only way to make the diagnosis definitive is to refer for blood tests.
Retinitis Pigmentosa is a genetic retinal eye disease where vision is lost from “the outside in;” patients lose peripheral vision first and in end stages are only left with a small central area of tunnel vision and eventually complete blindness. The most common early symptom is a huge loss in night vision. Most forms of the disease will cause the deposition of “pigment spicules” in the peripheral retina along with a waxy, dull appearance to the optic nerve head, diagnosed by routine ophthalmoscopy. An ERG (electroretinogram) confirms the diagnosis. High-dose vitamin A therapy can slow the disease, but there is currently no cure. Patients diagnosed should be educated that genetic testing is available for many forms of R.P., to determine if their offspring are carriers of the disease.
Diabetes is a disease of the small blood vessels. The vessel wall can break down, allowing fluid and blood components to leak into the surrounding tissue. The process is most easily viewed by looking into the eye, and if it is occurring there it is called diabetic retinopathy. These changes can cause permanent retinal damage and vision loss. Retinopathy can be treated with injections and laser surgery, but it is critical to catch the problem as early as possible. Hence it is essential for diabetics to have their eyes checked every year – in the early stages the patient may not realize anything is going wrong. As far as the patient’s prescription goes, elevated blood sugar will cause a myopic shift, meaning a sudden worsening of distance vision. This sudden change is nature’s way of warning a diabetic to check their blood sugar!
Many forms of arthritis, adult and juvenile, have been linked to both scleritis (a sometimes painful inflammation of the white of the eye) and uveitis (a painful inflammation of the anterior-internal part of the eye characterized by a red, extremely light-sensitive eye). Both are treated with topical steroid drops.
Risk factors for primary open angle glaucoma, the most common type, include elevated intraocular pressure, age (over 60), ethnicity (five times more common in African Americans than Caucasians), family history of glaucoma, diabetes, hypertension, hypothyroidism, and long-term steroid use. Risk factors for angle closure glaucoma, a severe and sudden-onset type, include a farsighted correction, age, and persons of Asian or Eskimo descent. As for race, it is more common in women among Caucasians.
Yes. We will often see changes where arteries cross veins in the retina. Hemorrhages can occur if an artery compresses a vein to the point it is occluded and ruptures. The same can occur from an occlusive event from a clot or plaque, which are risks throughout the body when talking about uncontrolled hypertension. Patients with hypertension are also at greater risk for glaucoma.
Yes. The eye is the only exposed mucus membrane on the body, and often may be the only area of the body experiencing symptoms (usually itching, burning, and/or watering).
Keratoconus is a corneal condition occurring when a portion of the cornea begins to thin. The pressure inside the eye pushes this thinning area forward, creating a “nipple” which destroys the smooth spherical curvature of the cornea and creates a severe irregular astigmatism. Usually the only corrective option for patients with keratoconus is rigid, hybrid, or scleral contact lenses. In advanced cases the thinning area can begin to scar, and rupture even becomes a possibility. These end-stage cases require a corneal transplant. Corneal cross-linking, a procedure done under the care of a corneal specialist, can often slow progression.
Family history is a risk factor for glaucoma, particularly if a sibling has been diagnosed. There is strong modern evidence that there is a genetic component to macular degeneration, too. Just get your eyes checked! “Risk factor” simply means you are at greater risk than someone without a family history, not that you are doomed to get it. As for cataracts, most genetic types will show up very early in life. The most common, by far, are age-related cataracts. Modern cataract surgery is as close to perfected as a human endeavor can be, usually a 20 minute procedure and the vision is completely restored. Hope you live long enough to worry about cataracts. And when it happens, stop worrying!
There are two prescription drops for dry eye treatment, Restasis and Xiidra. They have proven to be quite effective to relieve symptoms, but it may take 6 weeks or more of therapy before relief occurs, and both may burn a bit with insertion (especially Restasis). Another option is punctal plugs, which are inserted into the tear duct to block the drainage of tears from the eye. The idea is the tears stay in the eye longer and simply evaporate into the atmosphere instead of draining. Consider a humidifier for use while sleeping and keep the ceiling fans off – or wear a sleep mask if you just have to use the fan. There are moisture masks you can purchase for night-time use, too. For several years we thought that fish oil supplementation may be beneficial to relieve symptoms – unfortunately a recent study showed no benefit.
At the least, take your multivitamin. If you are sixty or older with a family history, you should consider the ocular formulation of the antioxidants (Vitamin A, C, and E). One study (AREDS) showed conclusively that antioxidant vitamin therapy dropped the risk of macular degeneration occurring in the other eye in patients with the disease in the fellow eye by 25%. There is also strong evidence that additional zinc and lutein supplementation is beneficial. In addition, recent studies have linked UV exposure to macular degeneration (wear your sunglasses!).
That term simply will not go away; we prefer the word amblyopia. Amblyopia occurs when one eye does not see as well as the other, usually due to either a large difference in correction between the two eyes or due to an eye turn (strabismus), AND there is no disease present.
Yes. The idea is to catch the problem during the critical time that the eyes are learning to “talk to” the brain (birth to age 7 or 8). The brain is ignoring the problem eye, and if this continues amblyopia will result (see question above). The idea is to patch the good eye to force the brain to use the problem one, and do close-up, fine detail exercises.
The odds are very low after age 7 or 8, as far as improving the vision. However, if you are talking about the cosmetic issue of a turning eye, then yes – there are surgical options.
If you are a child younger than eight, we should get you fully-corrected and try patching therapy. If you are older than that, simply said, it’s all about the good eye. You should wear protective eyewear for all sports, and goggles when weed-eating, grinding metal, etc. to protect that good eye. Be sure to have your eyes checked annually to be sure your eyes remain healthy.
Yes. School screenings are VERY effective and can catch a lot of issues, but the children are only screened for a distance vision problem. They could pass that test, yet still need glasses for reading.
Yes. Without enough one-on-one time, it can be difficult to tell if the child really has a problem or if they are just nervous or a bit rushed during a school screening (or sometimes “faking it”). Bring them to an eye doctor and we will figure it out.
Yes, and it happens more than you might think. There are tests we can do to very closely approximate their prescription, without their input. What those tests show should jibe with what they are able (or willing) to read on the eye chart. So for example, if they will only read 20/50 for us, but our tests show the prescription near zero and healthy eyes, we start to get suspicious.
Unless you see something that makes you suspicious there is a problem, a good age for the first routine exam is 5 or 6. We usually specifically recommend the summer before kindergarten or first grade. Our office can handle ages 4 and up; any younger than that and they should see a pediatric specialist.
Reassure them it’s painless, and we will work to do the same thing when they come. It’s always smart to let them sit in with you or a sibling during your exam so they can see what they’re in for! Oh, and feel free to tell them we don’t give shots.
Exposure to UV has been linked to both cataract formation and macular degeneration in later life. It can also cause a growth on the exterior of the eye called a pterygium. Everyone, at every age, should wear sunglasses with UV protection when outdoors as much as possible.
Antioxidants! Vitamins A, C, and E. That would include green leafy vegetables, and yes, carrots. Foods high in zinc and lutein are also beneficial.
Everyone. Did you know that the highest lifetime UV exposure occurs in childhood and adolescence?
First, make sure your eyes do not need correction at the computer. If so, wear the glasses. It also helps to look away from the screen at a distant object for a 5-10 second count every 15-20 minutes. Adjust the monitor’s brightness and contrast to a point it feels most comfortable. If the monitor’s screen will tilt, adjust it to remove any glare from overhead lighting.
Blue blockers involve a clear coating on the spectacle lens that blocks blue wavelengths of light. Two separate studies have shown a significant improvement in eyestrain with computer work and tablet use, and a benefit in keeping the circadian rhythm (sleep cycle) consistent. As to long-term health benefits to the eyes, it’s too soon to say (we are still studying that).
LASIK is an acronym for Laser-Assisted in situ Keratomileusis. But that’s not the answer you are looking for. LASIK is a surgical procedure to correct a distance vision problem. A surgical flap is cut in the cornea, either by keratome or laser, the flap is laid back, and a laser reshapes the cornea to correct that patient’s refractive error. The flap is then laid back into place. Recovery time is minimal and patients immediately notice improved vision – quite often to 20/20. The procedure does not correct the over-40 reading problem (presbyopia), so if the patient is over 40 they will still require correction just for reading.
The procedure has been around for years; it is basically cataract surgery. Surgeons just use a newer type of implant that can correct both far and near vision – an implant that acts like a bifocal. Lens replacement is sometimes a better option than LASIK for patients with high corrections or patients over 40 that do not want to have to use reading glasses. It is a more invasive procedure than LASIK, and significantly more expensive. A patient that undergoes lens replacement will never have to worry about cataracts.
For LASIK, it depends upon mainly corneal thickness. Some patients have thin corneas, and that could make them poor candidates. Extremely nearsighted, far-sighted, or highly astigmatic candidates may not be candidates (their better option would be lens replacement). Patients with a history of dry eye are poor candidates for LASIK, as the procedure may worsen symptoms. Diabetics are also considered poor candidates due to a more unpredictable corneal response. For lens replacement, corneal thickness is a non-issue, and the procedure can correct higher refractive errors than LASIK. If there is astigmatism, sometimes the surgeon will perform a LASIK procedure just for the astigmatism and the rest will be corrected with the implant – but there are now toric implants that also correct astigmatism. Patients over 40 who have LASIK will still need glasses to read, unless they have it set up in monovision (one eye distance, one eye near). Patients who have lens replacement should rarely if ever need readers.
Any sport involving a ball small enough to cause damage to the eye (racquetball is a perfect example), or contact sports where there is risk of getting poked in the eye. We can put a patient’s prescription in sports goggles, too.
Probably contact lenses. There is risk of losing a lens if you rub the eye or get poked in the eye, but glasses tend to fog up with sweating, and may fall off or break. The absolute safest thing for sportswear is prescription sports goggles. They are vented to avoid fogging and also offer eye protection.
We are open Monday-Friday 9:00 am – 6:00 pm, and closed for lunch from 1:00 – 2:00 pm. We are open Saturdays 9:00 am – 1:00 pm, and are closed Sundays.
Ages 4 and up. A child younger than 4 should see a pediatric specialist.
July 2003.
Yes. The doctors can perform most of the exam in limited Spanish, and we have Spanish-speaking staff that can assist them.
Vision Service Plan (VSP), EyeMed, Spectera, CompBenefits (Vision Care Plan), Block Vision, Superior Vision/Davis Vision (Versant), Aetna, Cigna, Safeguard, Blue Cross/Blue Shield, and several others. If your plan is not listed give us a call at 817.453.4682 and we can tell you if we are providers for your plan.
All of our doctors are Medicare providers. None are Medicaid providers.
Yes, unless the patient prefers or is required to pay themselves and self-file for reimbursement.
Some plans have Out-of-Network benefits, and we can help you determine if yours does.
No, in fact it rarely is.
You can call the phone number on your card, or provide us with the name of the carrier and your ID number and we can do it for you.
Usually No, with a few exceptions. There are a few medical plans that cover a routine vision exam, but usually only medical issues like glaucoma diagnosis and management, eye infections, foreign body removal, and the like may be filed on medical.
A floater is a piece of pigment suspended in the gel of the eye, observable in your field of vision, which you cannot look directly at (it “runs away” when you try to). Floaters can be anything from dot-shaped shadows to squiggly lines. It is normal for you to get a few more as you age; it is not normal for a sudden increase in their number. A sudden increase could indicate a retinal tear or detachment, and you should seek care immediately.
This could mean a myriad of things, from a benign ocular migraine to a retinal tear or detachment. The latter are considered ocular emergencies. This symptom accompanied by a sudden increase in floaters and/or a distorted section of vision in one eye likely indicates a retinal detachment. Drop everything you are doing and get to your eye doctor; fast intervention may mean no permanent vision loss!
Seek the care of an eye doctor immediately. This symptom, usually accompanied with light flashes and/or a sudden increase in floaters, may indicate a retinal detachment.
This can be caused by corneal irritation and/or swelling from toxic exposure or contact lens wear complications. This symptom is also usually the primary one in patients suffering from uveitis, which is an inflammation of the internal eye. In both cases the eye is usually at least a little red. In the presence of a quiet, white, and happy eye, the symptom is often associated with a migraine syndrome. Contact your eye doctor.
If you wear contact lenses, take them out. Seek the care of an eye doctor, as infection or inflammation are likely culprits.
Flush copiously with water or saline if available, as fast as you can get to it. It is important to dilute the chemical quickly to decrease the risk of permanent damage. After 5-10 minutes of flushing, get to an eye doctor.
Absolutely – in fact headaches are usually the primary symptom that uncorrected farsighted patients (hyperopes) suffer from.
Keep the head tilted back – never forward as gravity will work to drain the intraocular fluid. Do not put any pressure on the eye. Ideally you would like to gently tape a small cup, like a Dixie cup, over the eye. If the object is protruding from the eye (like a nail), do not attempt to remove it. Go to the nearest emergency room, calling ahead if possible to tell them what has happened and to please alert their on-call ophthalmologist. This is obviously an ocular emergency.
Seek care immediately. If you are diabetic or hypertensive, the likely problem is a (usually temporary) nerve palsy affecting the extraocular muscles, and temporary prism correction in glasses or patching one eye will relieve the symptom. Keep in mind, however, that serious neurological problems can cause this also.
Flashes of light in one eye accompanied usually by a sudden increase in floaters and a slowly enlarging distorted or dark area of the field of vision.
Usually simple blur. Some patients describe the vision as “like looking through a film,” and that colors appear duller and washed-out. Halos and starbursts around lights at night are another symptom.
Open angle glaucoma, the most common type, is painless. The patient is usually symptom-free until the disease is advanced, when they notice portions of their visual field missing. Angle closure glaucoma, which is much rarer, can cause sudden severe pain to the point of nausea and vomiting, with a very red angry eye.
Symptoms range from simple blur to a central blind spot. Patients who have the wet form will note they can try to look at a person’s face but the head will be missing, although they can see their shoulders and the rest of the body, as well as the environment around them. Also, when looking at a grid pattern they may note that lines are wavy or distorted centrally, or even missing completely. There is no pain involved.
Check your blood sugar. This is nature’s way of letting you know it is elevated.
We will test how well you see with and without correction, as well as obtain the optimum prescription for both distance and near vision. We will make sure both eyes work well together, and that all the muscles controlling the eyes work properly. The eyes’ pressure will be checked, pupil reactions assessed, and the doctor will take a very careful look both internally and externally to make sure both eyes are healthy.
They might be. The doctor will discuss this with you if it is needed or recommended. As long as the doctor does not feel it is urgent to dilate them the day of the exam, it can be rescheduled for a different day. We almost never have to dilate just to get the glasses prescription.
Four to six hours. Darker eyes tend to stay dilated longer than light eyes.
Light sensitivity and near blur for 4-6 hours. We give every patient we dilate a free pair of super-stylish paper sunglasses.
Yes, for most people asking this question. You will just want some sunglasses on (and we will give you some paper ones). There are a few patients who have tried it before and it just makes them too nervous. If you are in that latter category, or have never had it done, you may want to bring along another licensed driver. In non-emergency situations, we can always schedule the dilation on a different day than the exam.
Of course. If they are eighteen or older, privacy laws require us to make sure it’s OK with the patient.
Yes. The prescription may fluctuate some during the pregnancy, but it usually stabilizes after the birth of the baby.
Everyone’s favorite machine at the eye doctor’s is called an NCT (Non-Contact Tonometer). It measures the pressure in the eye, and is a glaucoma screening test.
That is an AutoRefractor. It estimates your prescription so that the doctor has a place to start from.
Yes, even if your eyes are healthy, so that we can have a baseline we can always come back and compare to if we see changes. We perform an Optomap on every patient, at no additional charge.
The visual field test maps out for us your entire field of vision, from the center all the way out to the periphery. It is a diagnostic tool for many diseases, including glaucoma, optic nerve problems, retinal disease, and even neurological issues between the back of the eye and the vision center in the brain. Your eye doctor has been trained to look at a problematic field’s appearance and extrapolate where the problem lies. The test itself involves testing each eye separately. The patient pushes a button when they see lights of varying brightness appear. It’s basically a boring video game, but with a purpose.
We use corneal topography to obtain a color-coded mosaic of the entire corneal surface. It is an easy, non-invasive test that helps us determine the “peaks and valleys” in the corneal surface and is quite useful in diagnosing corneal issues like keratoconus and pellucid marginal degeneration. In addition, we use that information for more complicated contact lens fits like some rigid gas permeables and sclerals.
This device can capture a 200-degree image of the retina in less than a second per eye and allows us to be much more thorough on our evaluation of inner-eye health. As an interesting sidenote, the technology was invented by a gentleman whose son had a retinal detachment that went undiagnosed through several different visits to different doctors.
The technology is vital to photo-monitor any abnormalities in the eye – like freckles, atypical-looking vasculature, or deviations from normal in the appearance of the optic nerve or macula. This allows the practitioner to detect subtle changes at the earliest possible stage. Although this tool does not replace dilation in patients requiring that (for example, diabetics), it does allow a vastly improved view of the retina than we doctors can see without dilation.
Most doctor’s offices require an additional fee for this testing, if they even have the technology – we do not. It is a routine part of every eye examination at Mansfield Vision Center.
OCT stands for “Optical Coherence Tomography,” and is a non-invasive imaging test that measures the amount of dim red light that reflects from the inner surface of the eye (or retina). The device gives the doctor a cross-sectional view in microscopic detail of the individual retinal layers, as well as the optic nerve and macula. It is quite useful to us in several ways:
- It can help us determine if a retinal lesion is flat or elevated, and in what layer it originates
- It is extremely accurate in determining retinal nerve fiber layer (NFL) thickness and can compare a patient’s results to both age- and sex-matched norms. Generally, you will see thinning of the NFL in glaucoma. The OCT can analyze a 52-year old Hispanic male, for example, and compare his NFL thickness to what we expect for any healthy 52-year old man of that ethnicity and give the doctor a color-coded analysis
- It assists the doctor with any subtle changes to the optic nerve anatomy
- It can show subtle changes to the macula that are not always apparent with the doctor’s naked eye. Examples would include vitreo-macular traction, where the vitreous gel is causing tension on the macular surface – which could result in a macular hole; it will show new blood vessels growing from beneath the macula and/or disruptions in the outer retinal layer, which could indicate macular degeneration; and it detects macular swelling from fluid accumulating – often including its source
The OCT is mainly used in glaucoma detection and progression analysis, as well as macular disease (primarily macular degeneration). Its greatest characteristic is the newer technology can allow detection of disease at a much earlier stage.
