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Comprehensive Eye Care
Dr. Broberg, Dr. Settle, and Dr. McGlathery will perform a comprehensive eye exam for you once a year. It is important for every individual to have a yearly eye exam, because of the silent symptoms of eye disease such as Glaucoma. Our comprehensive exams will include a complete health check from the vision of each eye, the health of the surface of the eye and eyelids,and the health of the retina, optic nerve and macula of the eye. This evaluation includes checking for all eye diseases. Upon the conclusion of your exam, you will recieve a prescription for glasses, if necessary for you to have the best quality of vision.
Cataracts
A cataract is cloudiness in the usually clear lens of the eye. Common cataract symptoms include poor night vision, sensitivity to light, a painless blurring of vision and a fading or yellowing of colors. Cataracts may develop slowly over a period of years and may not be immediately apparent if the cloudiness is not near the center of the lens.
Cataracts are most commonly caused by aging, but may be related to family history, eye injury, eye surgery or some medications and long-term exposure to sunlight.
Surgery is the only method of removing a cataract, though a change of glasses may be sufficient to correct the vision, if the symptoms are mild.
Some commonly asked questions:
What is a Cataract?
The eye is very much like a camera. They both have an internal lens that focuses an image onto film. In the eye, the lens is focused using muscles rather than your hand, and the film consists of a thin film of nerves called the retina. If the lens in the camera were to be smudged or scratched, your pictures would be blurred. Similarly, when the lens in your eye becomes cloudy, you see the world as blurred or not clear. When this happens, we call it a Cataract.
What causes a Cataract? Who gets it?
Everyone eventually gets Cataracts if they live long enough. It is part of aging, much like getting gray hair. Aging is the most common cause of Cataracts. Other causes include medical conditions such as Diabetes and medications such as certain steroids. Some people are born with Cataracts, and some develop a Cataract after trauma.
When is a cataract “ripe”?
Different people have different visual needs. If you are visually limited from performing your daily activities from Cataracts, then you may be a candidate for Cataract surgery. One does not have to wait until the cataract is "ripe."
What happens if a cataract is left alone? Is it dangerous?
Leaving a Cataract in the eye is not dangerous except in rare situations. Cataracts, in general, do not harm the eye. In most cases, surgery can be postponed for as long as the patient desires or not done at all. The only side-effect would be the blurred vision from the Cataract. With time Cataracts do increase in size and hardness, and if the Cataract is very advanced, the surgery can be slightly more difficult to perform. However, even in these situations the result is usually very good.
How is the surgery done?
In the not-so-distant past, cataract surgery involved making a large incision to remove the cloudy lens, and patients were often brought into the hospital overnight or for several days. Now, with the aid of new technologies, the surgery can be performed through a very small incision — less than 1/8th of an inch — and the recovery time is significantly shorter. Through this small opening, a slender instrument can gently break up the cloudy lens using sound waves and remove the pieces by vacuum. This process is called phacoemulsification.
Once the cataract has been removed, a new clear implant lens is folded, inserted through the small incision, and allowed to open up in the same "bag" that used to hold your own lens in place. In some cases, an implant lens may not be implanted, or a different type of lens implant lens may be placed outside of the "bag" if your surgeon feels this is best for your eye. Patients have many options for lens implants such as a monofocal, meaning one point, lens implant, multifocal – meaning more then one –implant, and also a toric implant for astigmatism. The latest technology available allows patients more flexibility when it comes to cataract surgery to have the best quality vision.
The surgery typically takes 15-30 minutes to perform and is done as outpatient surgery. This means that the patient has the surgery and goes home on the same day. It is performed with local anesthesia and thus does not carry the risks of general anesthesia. After the surgery, the patient typically goes to the recovery room and then home.
Can it be done with a laser?
Cataracts are removed with sound waves not laser light. In 20-30% of patients undergoing cataract surgery, a thin film of scar tissue will form behind the implant lens and cause the vision to be blurred. Often patients will feel that their cataract has "grown back." In these cases, an opening can be made in the scar tissue with a laser, and the vision will usually be restored. Some people hearing of this might think that all cataracts can be removed with laser.
Can a cataract recur?
No. Once the cataract has been removed, it will not recur. Sometimes a thin film of scar tissue can form behind the new lens implant, creating blurred vision and the sense that the cataract has recurred. However, this thin film can usually be easily treated with a laser and does not require repeat surgery.
What to expect from Cataract surgery
What is the success rate?
This is one of our most successful surgeries. Approximately 98% of patients experience improvement in their vision. How much improvement is dependent on the initial health of the eye; certain diseases of the retina can limit the final visual result.
Complications
As with any surgery, there are risks associated with cataract surgery, and complications (such as bleeding, infection, corneal decomposition, macular swelling, and retinal detachment) can occur during or after surgery in spite of the best care. It is impossible to predict in which patients these complications will occur. Fortunately, the risk of these complications is quite low.
Recovery time
After surgery, you will be seen in the clinic to ensure that you are healing properly. Typically these visits occur 1 day, 2-3 weeks, and then 1-2 months after surgery. During this time you will also be using eye drops to help the eye to heal. On the morning after surgery, your eye patch will be removed, and you can often begin using the eye. The vision is usually blurred from ointments and from swelling associated with the surgery, but over the following weeks, the vision will usually progressively improve. At one month after surgery, the eye is typically healed and ready for refraction for new glasses.
Physical activity after surgery
Your surgeon will discuss with you any limitations on your physical activities. In general, you can resume most of your normal activities, but will be asked to minimize lifting, bending, and straining for the first 48 hours after surgery. Carrying a purse, light briefcase, or a small bag of groceries is usually fine. You will also be asked to avoid getting water such as a pool or hot tub in the operated eye for 1 to 2 weeks. Although water from the shower or tap is safe for showering and drinking, it still has some bacteria and can cause an infection, so please use caution in your daily showering routine. Lastly, your surgeon may give you a shield to wear over the eye at bedtime; this is to protect you from rubbing or pressing on the eye in your sleep. As for returning to work or driving, this varies from one patient to another. This should be discussed with your doctor.
How long does a lens implant last?
There are no signs to indicate that a lens implant will "wear out." They should last the life of the patient.
Can surgery be done on both eyes at the same time?
No. It is best to perform the surgery on one eye at a time so that you can use one eye while the other is healing.
Preparation for surgery
Once you and your doctor have decided to do cataract surgery, you will need to be measured for a lens implant. This is usually done in the clinic. When the surgery date is set, you will be given a list of pre-operative instructions.
Corneal Transplants
The cornea is the clear part at the front of the eye, covering the pupil and iris. The cornea helps to focus light, and a clear, healthy cornea is essential for good vision. If the cornea is damaged, or becomes swollen or scarred, it may lose its clarity or smoothness, scattering or distorting the light and leading to blurred vision. Ophthalmologists perform over 40,000 cornea transplants - sometimes called keratoplasty - each year in the US - it is the most common and most successful type of surgery done today. Looking through a microscope, the ophthalmologist measures the eye for transplant, carefully removes the injured cornea and sews the new donor cornea into place. Transplant surgery would not be possible without the hundreds of thousands of generous donors and their families who have donated corneal tissue to enable others to see. The physicians also treat numerous corneal diseases including keratonconus, iritis, Fuch’s Dystrophy to name a few.
Glaucoma
Glaucoma is an eye condition, which currently affects 7 to 8 million Americans. There are actually twenty different types of glaucoma, many of which fall under the broad category known as 'open angle'. Open angle glaucoma is a painless, progressive disease that results in irreversible damage to the optic nerve. Individual cells that comprise the optic nerve are responsible for transmission of information from the retina to the brain. In eyes affected by open angle glaucoma, these cells die, resulting in a permanent loss of sight. The destruction of the cells is usually preceded by an increase in eye pressure (intraocular pressure). The cause of the pressure rise is not currently understood. Many research projects are currently underway to answer this very important question.
There are no symptoms in the early stages of open angle glaucoma. The eye does not become red or painful. An eye examination is the only way to detect glaucoma. The doctor measures the 'intraocular pressure', examines the optic nerve and may have the patient perform a visual field test and/or take a mapping of the optic nerve. When a patient is aware of vision loss, as a result of untreated glaucoma, irreversible damage may have already occurred. One form of open angle glaucoma, diagnosed at birth or shortly after, is called 'congenital'. When diagnosed in patients during their teens or early twenties, open angle glaucoma is referred to as juvenile onset. There is also a form, which is often first diagnosed in middle aged and older patients and is known as primary open angle glaucoma. It is currently unknown how much genetic overlap there may be between these three categories, if any.
We are also investigating two syndromes, which place individuals at increased risk for developing glaucoma: pigmentary dispersion syndrome and pseudoexfoliation. Pigmentary dispersion syndrome, which is when the iris (colored portion of the eye), actually loses pigment is usually diagnosed in young adulthood. Pseudoexfoliation is most usually diagnosed in middle aged or older patients. Fortunately, many medicines and surgical treatments are currently widely available to treat open angle glaucoma. The physician will determine which treatment is best for control of the intraocular pressure to preserve your best vision possible. It is important to stress that the earlier treatment is initiated, the less vision loss is likely to occur. If left untreated, glaucoma can lead to total blindness.
* This site DOES NOT provide Medical advice. The content provided is for informational purposes only. It should not be used as a substitute for any professional medical advice and treatment. Any personreviewing the materials presented herein should obtain specific medical advice and answers to specific medical questions by a qualified healthcare professional.
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