Category Archives: Education

Corneal Topography

Corneal Topography
Corneal Topography

We now have the most advanced corneal mapping technology. Computerized corneal topography is a three dimensional imaging process used to map the surface power of the cornea. The data points gathered are then digitized and analyzed by sophisticated computer software. The result is a detailed map of the corneal curvature much like a topographical map of land.

With this information the doctor is able to design soft and gas permeable contact lenses with curvature changes every 10 microns creating the ultimate custom lens. This results in a more comfortable contact lens and better vision.

In addition, data gathered from topography can be used in the diagnosis and management of corneal disease and curvature abnormalities.

Also, this instrument is essential for determining if a patient is a candidate for refractive surgery, in addition to managing their pre-operative and post-operative care.

Visual Field Testing

Heights EyeCare is dedicated to ocular disease diagnosis and management. The Humphrey Field Analyzer with its advanced software enables the doctors to diagnose diseases resulting in field loss. This visual field testing will be another valuable tool to aid us in intervening as early as possible with a treatment to prevent further vision loss as a result of glaucoma.

The Humphrey Field Analyzer II is the recognized standard of care for early diagnosis, treatment and management of diseases resulting in visual field loss, including glaucoma.

New Corneal Measurement Technology

We now have the most advanced corneal mapping technology. Computerized corneal topography is a three dimensional imaging process used to map the surface power of the cornea. The data points gathered are then digitized and analyzed by sophisticated computer software. The result is a detailed map of the corneal curvature much like a topographical map of land.

With this information the doctor is able to design soft and gas permeable contact lenses with curvature changes every 10 microns creating the ultimate custom lens. This results in a more comfortable contact lens and better vision. In addition, data gathered from topography can be used in the diagnosis and management of corneal disease and curvature abnormalities.

Also, this instrument is essential for determining if a patient is a candidate for refractive surgery, in addition to managing their pre-operative and post-operative care.

 

Marco TRS 5100 Refracting System

visual testing rt5100

The TRS (Total Refracting System) by Marco allows the doctor to measure your glasses prescription more accurately. Compared to the traditional “which is better one or two?”, it is faster and a more patient friendly method of performing eye exams. With a press of a single button, an old prescription can be compared to a new one. This is also helpful as we design prescriptions for computer work.

 

I-Care Tonometer

visual testing icareUsing no drops, no dyes, and no puff of air, we have added new technology that helps us screen for glaucoma. Using rebound technology, the I-Care is accurate and comfortable, and gives the doctor valuable information.

 

Cirrus-HD OCT

visual testing cirrus

As part of our commitment to provide the latest technology to our patients, we have added the Cirrus-HD OCT by Zeiss Meditec. The OCT (Optical Coherence Tomography) captures a high resolution image of the retina. We are able to see the individual cell layers that make up the retina. This is helpful in diagnosing, monitoring, and treating patients with glaucoma, diabetes, and age-related macula disease.

With new progression analysis software, we are able to compare images from one visit to the next, to determine if there have been statistically significant changes. This allows for earlier diagnosis of retinal diseases and better management over time.

Optomap Digital Retinal Imaging

An Optomap Digital Retinal Imaging
An Optomap Image of the Retina

The Optomap retinal imaging exam takes a high resolution, 200 degree wide, color digital image of the retina, which can be immediately evaluated by our doctors. The Optomap is a scanning laser ophthalmoscope that allows the doctors to view different layers of the retina. Images can be enlarged and are stored on the hard drive, which allows the doctors to monitor and measure any retinal changes from visit to visit. Keep in mind:

  • More than 1.1 million Americans are legally blind. An additional 50,000 people lose their sight each year, yet nearly 1/2 of all blindness can be prevented.
  • Blindness is the #1 complication of diabetic patients. Diabetic retinopathy is the leading cause of new cases of blindness.
  • People over the age of 65 have a 30% chance of developing age-related macular degeneration, which gradually destroys sharp, central vision.

The Optomap retinal exam is revolutionizing how eye exams are performed. There is no pupil dilation, no eye drops, no blurred vision, or sensitivity to light. The Optomap is a simple, quick and comfortable way to maintain optimum eye health. The doctors at Heights Eyecare recommend all of their patients have this exam. Don’t you and your family deserve the best eyecare available?

LASIK Refractive Surgery Management

How does LASIK work?

LASIK is the acronym for “laser assisted in situ keratomileusis.” LASIK is a surgical procedure that uses a cool laser to reshape the front of the eye in order to improve vision. The surgical procedure is capable of correcting a wide range of nearsightedness (myopia), farsightedness (hyperopia) and astigmatism.

In this procedure, a very thin cap of corneal tissue is created. The cap is folded back from the surface of the eye. The computerized laser gently sculpts the cornea, permanently altering the shape of the cornea to correct the curvature. The cap is returned to its original position and adheres quickly back on the eye without needing any stitches.

Am I good candidate?

Good candidates have a strong desire to be less dependent on corrective lenses and are willing to accept the risks of surgery. You need to be 18 or older, have healthy eyes and your vision needs to be stable before surgery.

Not everyone is an ideal candidate for refractive surgery. Eligibility depends on your current vision prescription, the curvature and thickness of your cornea as well as a number of other factors that our doctors evaluate during the course of your pre-operative examination. With major advances in technology, many people are now good LASIK candidates that previously did not qualify. Our doctors are well trained in this area and will make recommendations based upon your eyes and vision requirements.

Why choose us?

Every day you hear and see the marketing hype for LASIK advertised on television, radio and print ads. How can you possibly sort through all the media information in order to make the best decision for your eyes?

Refractive surgery is not a single event but a process that begins with a careful preoperative evaluation and ends with regular postoperative care. In fact, the pre- and postoperative exams are as important as the surgery for maximizing the likelihood of a successful outcome.

At Heights EyeCare, our doctors and staff take the time to conduct a thorough preoperative exam, including all of the necessary advanced tests needed to determine if you are a good candidate for surgery. If you are a candidate for LASIK, we discuss all the variables that go into making the final decisions:

  • Which surgeon is best suited for your needs
  • Which laser is best for your eye
  • Review the different guarantees offered by the laser centers and the diagnostic equipment available.

We will help you make a decision based specifically on your eyes so that your LASIK outcome is the best it can be.

Pre Op/Post Op

Before surgery

Your pre-operative examination will involve a complete medical and eye history and a comprehensive eye examination. Your vision will be checked for stability, your eyes will be tested for glaucoma and a microscopic evaluation of the interior of your eyes is done. Tests will measure the thickness of your cornea, pupil size, a corneal topography (mapping) will be done and your current refractive prescription will be determined.

If you wear contact lenses, you will need to discontinue wearing them for a while before the procedure. Your doctor will give you the necessary guidelines.

During surgery

During the surgery, anesthetic eye drops are applied to numb the eye. The surgeon applies a suction ring designed to control the eye so you do not have to worry about holding your eye steady. A special instrument is used to create and raise a flap of tissue to prepare the cornea for treatment.

The computer-controlled laser sculpts the cornea’s curvature by removing small amounts of tissue to reshape the cornea to precise measurements. The surgeon then places the flap back into its original position and observes the eye for three to five minutes to ensure flap adhesion. Because the tissue bonds quickly, healing is rapid and no stitches are required. The whole procedure takes about 15 to 30 minutes for two eyes.

After surgery

You will need to make arrangements to be driven home from surgery and you should plan to relax the remainder of the day. You may experience some discomfort and you will be given a prescription for pain medication that you can take, if you need. You will also have eye drops to use. Some patients experience light sensitivity and sunglasses will help make you more comfortable. Most patients can return to work within one to two days.

Your post op visits are usually scheduled at 1 day, 1 week, 1 month, 3 months, and 6 months. Your visits consist of monitoring the healing process and evaluating your vision correction and overall health of your eyes.

Wavefront™

The Next Generation in Laser Eye Surgery – Custom LASIK

Your eyes and vision are unique – as personal as your fingerprint or your DNA.

Until now, the diagnostic measurements taken prior to laser vision correction have involved primarily the cornea – the clear portion of the eye covering your iris and pupil. The Custom LASIK Wavefront™ technology is an important advance in eye care because it analyzes your entire visual system from cornea to retina – from the front to the back of your eye, even including the tear film that covers your cornea.

This diagnostic information, used in conjunction with other tests such as a standard eye chart reading and corneal topography, allows your eye doctor first of all to determine whether you are a good candidate for laser vision correction and to personalize your treatment for the best possible result.

Wavefront™ technology creates a three-dimensional (3-D) corneal map. The information contained in the map guides the laser in customizing the treatment to your individual visual irregularities, beyond myopia, hyperopia and astigmatism. Prior to the advent of Wavefront™ technology, two people with the same prescription would receive the same glasses, contacts or LASIK procedure.

Potential Benefit

Wavefront™ technology is groundbreaking because it has the potential to improve not only how much you can see – the visual acuity measured by the standard 20/20 eye chart, but also how well you can see, in terms of contrast sensitivity and fine detail. This translates into a reduced risk of post-LASIK complications, such as glare, halos and difficulty with night vision.

Custom LASIK’s advantage lies in the area of quality of vision:

Greater chance of achieving 20/20 vision Greater chance of achieving better than 20/20 vision Reduced chance of losing best-corrected vision Reduced chance of losing visual quality or contrast sensitivity Reduced chance of night-vision disturbances and glare

Potential also exists for custom LASIK to treat those people who have lost best-corrected vision from any prior refractive surgery: LASIK, PRK or RK procedures, etc.

Eyes Over 40

As people get older, usually around their mid to late 40s, a condition called presbyopia can set in. Presbyopia is the inability to focus on objects near the eye. One usually notices that it is harder to read or use the computer. Bifocals or reading glasses are a way to remedy this condition.

eyes over 40

Presbyopia is a natural consequence of the aging process. There is no cure, though researchers are constantly looking for one. Even if a person has never had vision problems before, he or she can still develop presbyopia. While symptoms can present suddenly, presbyopia usually occurs over a long period of time. Symptoms include having to hold things at arm’s length to see them clearly, eye strain, fatigue and headaches from near work.

Fortunately, the doctors at Heights EyeCare carry a number of products designed to eliminate the difficulties associated with presbyopia. To combat presbyopia in your own life, stop in and ask the Doctor about:

Computer Glasses – To reduce eye strain and fatigue, we carry specialized computer lenses. These lenses are perfect for computer users who spend a majority of their day working on a computer. And since three out of four computer users will suffer from Computer Vision Syndrome, computer lenses are a great way to keep your eyesight healthy.

Reading Glasses – One of the first areas of your life where presbyopia becomes prominent is in your ability to read. The doctors at Heights Eyecare carry a broad line of reading glasses to help you read without holding the page at arms length. There are a variety of styles available, with sleek designs that allow you to carry them anywhere.

No-Line Bifocals – For many presbyopes, bifocal lenses are a necessity. But it can be difficult to adjust to the harsh line that is found in bifocal lenses. Fortunately, there are no-line lenses which are also called progressive lenses. No more lines! Just a gradual change in focusing power which allows you to comfortably focus on any distance. Just like bifocals, distant objects are viewed through the top portion of the lenses, and near objects are viewed through the bottom portion of the lenses.

Bifocal Contacts – If you need bifocals but can’t stand wearing glasses, we have just the thing for you: bifocal contact lenses. Now you can have all of the benefits of bifocal lenses in the convenience of contact lenses. Talk with your doctor about bifocal contacts today.

Monovision Correction – For some of our emerging presybopes we offer another option to glasses, monovision. This is a method of fitting your dominant eye for distance vision and your non-dominant eye for near vision. Contacts are available in disposable, extended wear, and even daily disposable lenses to fit your lifestyle. Most patients require 2-4 weeks to make the adjustment from binocular vision to monovision.

Vision Conditions

Amblyopia
amblyopia
A normal view vs. a blurred view related to Amblyopia

Amblyopia, commonly called lazy eye, occurs when one eye develops differently than the other eye, causing one eye to be weaker than the other. Sometimes a difference in focusing ability causes one eye to be used more often. Other times, the eyes are misaligned, causing one eye to “shut off” to avoid double vision. Regardless of the cause, the result is a weakened, or amblyopic eye.

Symptoms

It’s hard to spot amblyopia. Sometimes a child will noticeably favor one eye over the other. Another possible symptom is the child frequently bumping into things on one side. The best way to tell if your child has lazy eye is through a complete exam around six months and three years. Early diagnosis can prevent amblyopia from leading to more serious problems such as loss of the ability to see three dimensions or functional blindness in the amblyopic eye.

Treatment

Most of the time amblyopia can’t be entirely corrected. The amblyopic eye will always be a bit weaker than the other. However, with treatment, vision in the amblyopic eye can be improved to some extent. Treatment involves encouraging the weak eye to develop. This is done using eye patches, vision therapy, glasses, and usually a combination of the three. The strong eye may be patched to encourage the weak eye to develop. Vision therapy can help to correct improper use of the eyes. If a focusing error is at the root of the problem, then glasses may reduce the error. Most of the time the amblyopic eye will always require glasses.

Astigmatism

Sometimes the cornea is irregularly shaped, causing the eye to focus an object on two different areas of the retina. This is known as astigmatism. For the cornea to bend light correctly, it should be dome-shaped, like a basketball. Astigmatic corneas are shaped more like a football. This causes a distorted view when looking at objects which are close-up and far away.

The cause of astigmatism is unknown. Astigmatism is often associated with myopia or hyperopia, and usually occurs from birth. It may be hereditary, or it may be caused by factors such as pressure on the cornea, incorrect posture, or increased use of the eyes for “near work.”

Mild astigmatism usually doesn’t need to be corrected. Eyeglasses, contact lenses, or refractive surgery can correct moderate to high degrees of astigmatism.

Computer Vision Syndrome

Computer vision syndrome (CVS) affects three out of four computer users. It is a series of symptoms related to extended periods of computer usage. Though it is no cause for panic, measures can be taken to relieve symptoms of CVS.

Symptoms CVS can appear as a variety of symptoms. Headaches, eye strain, neck and back aches, sensitivity to light, blurred vision, double vision, and dry or irritated eyes are all possible problems related to CVS.

Risk Factors Any computer user can develop CVS. Your vision, your computer, and the environment where you use your computer are all factors which can lead to CVS.

Emmetropia

When an eye’s optical power is perfectly matched to its length, the eye is said to be emmetropic. Emmetropia is the medical term for 20/20 vision needing no corrective lenses, contact lenses, or reading glasses. It occurs because the optical power of the eye can perfectly focus an image to the retina, giving them “perfect” vision.

The opposite of emmetropia is ametropia. With ametropia, the focal point of the eye is some distance in front of or behind the retina.

Hyperopia

Hyperopia is more commonly known as farsightedness. As the name suggests, people with farsightedness are able to focus on objects that are further away, but have difficulty focusing on objects which are very close. This is because the eyeball is shorter than normal, which prevents the crystalline lens in the eye from focusing correctly on the retina. About a fourth of the population are afflicted with hyperopia. Hyperopia can lead to chronic glaucoma, a more serious condition, later in life.

Myopia vs. Hyperopia
Myopia vs. Hyperopia

A family history of hyperopia is a risk factor for developing hyperopia. Often babies are born with hyperopia but they can usually outgrow the condition as the eye develops into the correct shape.

Hyperopia can be corrected with eyeglasses or contact lenses. There are also new surgical procedures that can correct hyperopia.

Myopia

Myopia is the medical term for what most people call nearsightedness. It is a condition where you can see objects clearly only when they are closer, but when objects are further away you can’t focus on them. Myopia usually develops in early childhood, though it sometimes develops in early adulthood. In rare cases, myopia can lead to more serious conditions such as retinal detachment.

Myopia is considered a genetic disorder. If your parents are nearsighted, you are at greater risk of also being nearsighted. Another risk factor is ‘near work’ – work involving fine detail or focusing on close objects.

Myopia can be accommodated and sometimes corrected with eyeglasses or contact lenses. Sometimes myopia continues to gradually worsen throughout life, a condition known as myopic creep. Myopia can also be corrected by LASIK surgery.

Presbyopia

As people get older, usually when they hit their mid to late 40s, a condition called presbyopia can set in. Presbyopia is the inability to focus on objects near the eye. One usually notices that it is harder to read or use the computer. Bifocals or reading glasses can help.

Presbyopia is a natural consequence of the aging process. There is no cure, though researchers are constantly looking for one. Even if someone has never had vision problems before, they can still develop presbyopia. It may seem to occur suddenly, but actually occurs over a long period of time. Symptoms include having to hold things at arm’s length to see them clearly, eye strain, fatigue, and headaches from near work.