Eye Care & Surgery Center NJ Bladeless LASIK Laser Cataract Surgeon Blog

Tuesday, June 28, 2011

About Eye Focusing Problems

Myopia is the medical term for near-sightedness, and occurs when light entering the eye focuses in front of the retina instead of directly on it. Individuals with myopia typically see objects that are close well, but have difficulty seeing objects that are far away. It is caused by a cornea that is steeper, or an eye that is longer, than a normal eye. Approximately 30% of people in the United States are near-sighted. Myopia typically starts to appear between ages 8-12, often progresses over childhood, and stabilizes by adulthood.

Hyperopia is the medical term for far-sightedness, and occurs when light entering the eye focuses behind the retina, instead of directly on it. Individuals with hyperopia usually have trouble seeing up close, but may also have difficulty seeing objects far away as well. It is caused by a cornea that is flatter, or an eye that is shorter, than a normal eye. Because young people with mild to moderate hyperopia can often focus their eyes to see clearly, hyperopia is often undetected until later in life, when the eye begins to lose its ability to accommodate.

Astigmatism refers to the shape of the cornea of the eye. A cornea without astigmatism has a spherical shape, like a basketball. A cornea that has astigmatism has a more oval shape, similar to a football. Most astigmatic corneas have two curves – a steeper curve and a flatter curve. This curve causes light to focus on more than one point in the eye, resulting in blurred vision at distance and near. Astigmatism often occurs along with myopia or hyperopia.

Presbyopia is a term that is used to describe an eye in which the natural lens can no longer accommodate. Accommodation is the eye’s way of changing its focusing distance: the lens thickens during accommodation, thereby increasing its focusing power and its ability to see up close. As we age, the lens begins to lose some of its elasticity. This is a gradual process, although to many it appears to occur suddenly (typically around the age of 40). Most people first notice difficulty reading very fine print such as the phone book, a medicine bottle, or the stock market page. They may also have difficulty adjusting their focus from near to far. At first, holding reading material further away helps many patients, but eventually, correction is needed in the form of reading glasses, bifocals or contact lenses. Near-sighted individuals may simply be able to take their glasses off to read.

Options: There are four main options for correcting these refractive errors. These are glasses, contact lenses, refractive surgery or lens implantation. Feel free to discuss any or all of these options with your eye care professional to find out which one may be best for you.

Thank you to Dr. Ivan Jacobs, our guest blogger today, for sharing his insights and knowledge with us.

Thursday, June 23, 2011

Eyelid Spasms–What Causes This?

Are there different types of eyelid spasms?
Yes. The three most common types of eyelid spasms are eyelid twitch (or tic), essential blepharospasm, and hemifacial spasm.

What causes minor eyelid spasms?
The cause of minor eyelid twitching is unknown. A slight spasm of the lower eyelid or even both eyelids is common and of no concern. Minor eyelid twitches require no treatment as they usually resolve spontaneously. Reducing stress, using warm soaks, or correction of any refractive error may help.

What is essential blepharospasm?
Essential blepharospasm is an involuntary condition usually involving both eyes, where the eyelids and, sometimes, the eyebrows close involuntarily. In advanced cases, muscles of the mouth or neck are sometimes involved in these spasms. When these spasms occur, temporary inability to see may result because of the involuntary eyelid closure. These spasms are rare but very troublesome, and often incapacitating.

What causes blepharospasm?
Blepharospasm is caused by abnormal nerve impulses, which produce muscle spasm. It is almost never a psychiatric disease.

How can blepharospasm be treated?
Blepharospasm can be treated with medications, biofeedback, injection of botulinum and surgery. Medications and biofeedback are rarely successful in managing blepharospasm, but may be advised in mild cases or cases not responding to other treatment.

Botulinum injections are now the most commonly recommended treatment for blepharospasm. Injection of botulinum (botulism toxin) in very small quantities into the muscles around the eyes relaxes the spasm. The injection works for several months, but will slowly wear off and usually needs to be repeated.

The treatment is very successful with few side effects. Drooping of the eyelids, double vision or dryness of the eye are possible side effects, but occur rarely and will subside as the injection wears off.

Surgery may also be recommended by your ophthalmologist. The surgeon removes either the nerve causing the spasm or the spastic muscles themselves. The surgical results are generally permanent and any side effects are also usually permanent.

What is hemifacial spasm?
Hemifacial spasm is a condition which involves the eyelid muscles and usually the muscles around the mouth on only one side of the face. Hemifacial spasm is usually caused by an artery pressing on the nerve to the facial muscles, causing the face to twitch. Botulinum injections may be beneficial in relieving the eyelid spasms in patients with hemifacial spasm.

A neurosurgical procedure for hemifacial spasm may relieve the pressure of the artery on the nerve. While it is generally successful, it is a major neurosurgical operation and serious complications are possible.

Thank you to Dr. Milton Kahn, our guest blogger today, for sharing his insights and knowledge with us.

Tuesday, June 21, 2011

About Intraocular Lens Implants (IOL)

Intraocular Lens Implants which are also referred to as Intraocular Lenses or IOLs are tiny artificial lenses that are used to correct vision as part of the Cataract Surgery procedure. IOLs can also be used for certain patients who suffer from presbyopia, a condition in which the crystalline lens of the eye becomes less flexible thus losing its ability to focus on near objects.

Monofocal Lens Implants vs. Multifocal Lens Implants
The traditional lens implants that were used for some 25 years were of a type called Monofocal Lens Implants. As the name implies, Monofocal Lens Implants can only offer patients clear vision at one set distance-usually far away. Today we are able to offer patients vision correction after Cataract Surgery with Multifocal or Accommodating Lens Implants that allow patients to see at a range of distances. This technology allows us to replace the eye’s natural lens with a new, artificial lens that can help restore visual clarity for near, intermediate and distance vision with reduced dependence on eyeglasses and often not requiring them at all.

Astigmatism Correcting Toric Lens Implants
For patients who wore eyeglasses to correct astigmatism before their Cataract Surgery they may still experience blurred and distorted vision after traditional Cataract Surgery because a Monofocal IOL cannot correct astigmatism. To achieve the best quality of distance vision with a traditional IOL may still require glasses, contact lens or further surgery. If freedom from glasses for distance vision is important to you, you now have a better option. “We are now able to implant a special lens implant design called an astigmatism correcting toric lens implant making it possible to reduce or eliminate astigmatism and significantly improve uncorrected distance vision”, said Joel Confino, M.D. “Toric IOLs provide significantly improved distance vision and reduce the need for corrective lenses compared to a traditional Monofocal IOL.”

Aspheric Lens Implants
“Most people do not realize that their eyes have optical distortions-called aberrations-that can cause vision problems”, said Ivan Jacobs, M.D. of Eye Care & Surgery Center.
One type of common aberration is called spherical aberration and is generally associated with vision disturbances including:
• Blurriness
• Halos
• Loss of contrast
• Poor night vision

Today at The Eye Care & Surgery Center we can implant aspheric lens implants that are designed to reduce spherical aberration resulting in increased contrast sensitivity, enhanced clarity and improved image quality especially in dim illumination or low contrast environments such as driving at dusk or on rainy foggy conditions.

Please feel free to contact us with your questions about Cataracts, Cataract Surgery or Lens Implants by calling Eye Care & Surgery Center at 908.789.8999.

Friday, June 17, 2011

Medical Insurance – What to Know?

In today’s world of big insurance companies and small employer groups, understanding your health benefits can be a tough task. I think most of us can agree that deductibles, co-pays and premiums are higher than they have ever been. In order for employers and insurance companies to save money, out of pocket expenses have been passed on to the policy holder.

It is important for patients to understand that their insurance policy is an agreement between the patient and their insurance carrier.

Call them and ask the questions you would like the answers to:

Is the doctor I’m seeing in network?
Do I have any type of deductible?
Do I need a referral for a specialist?
Is this a covered benefit?

These questions can help you avoid unexpected out of pocket expenses. They can also help you utilize your insurance coverage to ensure you get the most from your benefit package. The call should not take too much of your time and it may save you lot of aggravation in the future. Insurance companies have made it easy for patients to find out their coverage. There should be a member services phone number on your insurance card. Ask for the benefit department and they should be able to review your individual policy and give you the answers you are looking for.

From a physician’s office point of view, practices have patients coming in and out all day and see many different insurance cards. They cannot possibly know or be held accountable for every patient’s individual insurance benefits.

A physician’s office will usually submit a claim on your behalf but at the end of the day the patient is the person that will be held accountable for any outstanding balances and non covered services. Make the call, know your insurance and be your own advocate. In the long run you will be glad you did.

Thank you to Judy McCann, Director of Billing at The Eye Care & Surgery Center, our guest blogger today, for sharing her insights and knowledge with us.

Wednesday, June 15, 2011

Chalazia and Styes: Symptoms and Treatment

The term Chalazion comes from a Greek word meaning a small lump. It refers to a swelling in the eyelid caused by inflammation of one of the small oil producing glands (meibomian glands) located in the upper and lower eyelids.

A chalazion is sometimes confused with a stye, which also appears as a lump in the eyelid. A stye is an infection of a lash follicle that forms a red, sore lump near the edge of the eyelid. A chalazion is an inflammatory reaction to trapped oil secretions. It is not caused by bacteria, although the site can become infected by bacteria.
Chalazia tend to occur farther from the edge of the eyelid than styes and tend to "point" toward the inside of the eyelid. Sometimes a chalazion can cause the entire eyelid to swell suddenly, but usually there is a definite tender point. When a chalazion is small and without symptoms, it may disappear on its own. If the chalazion is large, it may cause blurred vision.
Chalazia are treated with any or a combination of the following methods:
1. Warm Compresses and Massage. Warm compresses can be applied in a variety of ways. The simplest way is to hold a clean washcloth, soaked in hot water, against the closed lid. Do this for five to ten minutes, three or four times a day. Repeatedly soak the washcloth in hot water to maintain adequate heat. The majority of chalazia will disappear within a few weeks. An alternative to a moist washcloth, which can get cold too rapidly, is to place a moist paper towel in a zip lock bag, or heat a baked potato, bag of rice, or bag of beans in the microwave oven to heat it, and then wrap a washcloth around the heated object. This is then placed over the affected eyelid after which the chalazion is to be massaged in the direction of the eyelashes.
2. Steroid Injections can be useful after soaks have been tried and a small lump remains.
3. Surgical Incision or Excision of large chalazia, which do not respond to other treatments, can be surgically opened after the early inflammation is reduced.
Chalazia usually respond well to treatment, although some people are prone to recurrences. If a chalazion recurs in the same place, your ophthalmologist may suggest a biopsy to rule out more serious problems.

Thank you to Dr. Chris Thiagarajah, Cosmetic Eye Plastic & Reconstructive Surgeon at The Eye Care & Surgery Center, for sharing his insights and knowledge with us.

Thursday, June 9, 2011

Glaucoma with Cataracts: Can I Treat Both?

Endoscopic Cyclophotocoagulation (ECP) & Cataract Surgery
The treatment of coexisting cataract and glaucoma is a complex issue. For some patients who have this combined problem, cataract extraction combined with ECP is our procedure of choice.

Simultaneous Cataract and ECP Surgery could allow you to improve your vision while reducing, or completely eliminating your dependence on Glaucoma medications. Each of these surgical procedures lasts only a few minutes, using highly refined, minimally invasive, surgical techniques and state of the art instrumentation. ECP is a surgical technique that inhibits the production of aqueous in the eye, typically resulting in a decrease in intraocular pressure and the reduction or elimination of a patient's dependence on glaucoma medications. Simultaneous Cataract & ECP Glaucoma Surgery is also convenient, typically reducing the frequency, number and costs of glaucoma medications for patients, and requiring no more follow-up visits than for cataract surgery alone.

The ECP procedure is performed using a state-of-the art laser microendoscope. Endoscopy, which allows surgeons to view and treat internal structures through a small incision, (as in Arthroscopic knee surgery for example), has revolutionized minimally invasive surgery, affording patients quicker and more comfortable recoveries along with improved and more predictable outcomes. The microendoscope chosen for our facility is a unique instrument. It is about the diameter of a small paper clip, the smallest medical endoscope developed to date.

It utilizes an integrated imaging and laser fiberoptic bundle to allow simultaneous viewing and highly targeted treatment of the surface cells of the ciliary processes. The ciliary processes are a series of organs located below the base of the underside of the iris which exude aqueous fluid into the eye.

During combined cataract and ECP glaucoma surgery the laser microendoscope is introduced through a small incision already made during the cataract procedure. Both surgeries are performed under local anesthesia on an out patient basis.

While there are other surgical options to treat glaucoma, ECP is offered because it provides the following:

• Excellent Safety Record
• Predictable, Improved Outcomes
• Uncomplicated Follow-Up
• Fast Recovery

ECP can also be performed without simultaneous cataract surgery. Pre-emptive to glaucoma filtering surgery, ECP in conjunction with SLT (Selective Laser Trabeculoplasty), may be used in an attempt to better control glaucoma and improve pressure lowering of glaucoma without more invasive and dangerous surgery. However, if the ECP still fails to control the glaucoma, then standard glaucoma surgery may still be performed.

Thank you to Dr. Ivan Jacobs, our guest blogger today, for sharing his insights and knowledge with us.

Tuesday, June 7, 2011

New Jersey Cataract Awareness Month

Eye Care and Surgery Center wishes to announce that Prevent Blindness America has designated June as National Cataract Awareness Month. Cataracts are the leading cause of blindness worldwide. About 20.5 million Americans age 40 and older have cataracts and more than half of all Americans develop cataracts by age 80.

“Many patients do not actually know that a cataract is a clouding of the crystalline lens of the eye preventing light rays from passing through it easily. This results in a clouding and blurring of vision”, said Joel Confino, M.D. a Cornea, LASIK and Cataract Surgeon at Eye Care & Surgery Center. “We want them to understand that cataracts are not a growth or a film over the eye.”

For many patients cataracts start out slowly and have little effect on vision at first. But, as the cataract becomes denser, so does the impact on vision. The most common symptoms that bother patients with cataracts include:

• blurring of vision
• sensitivity to light and glare
• double vision in one eye
• poor night vision
• fading or yellowing of colors
• frequent changes in glasses or contact lens prescriptions.

When cataracts do begin to interfere with daily activities or with patient comfort and safety, they can be treated surgically. Cataract surgery is one of the safest and most frequently performed surgeries in the United States. Today, at The Eye Care & Surgery Center we have a full range of Intraocular Lens Implants (IOL) available that allow us to correct near vision as well as distance vision without requiring bifocals or reading glasses for the vast majority of patients. Please feel free to contact us with your questions about Cataracts, Cataract Surgery or Lens Implants by calling Eye Care & Surgery Center at 908.789.8999.