- Contact Lens Care
- Eyeglasses, Sunglasses and Sports Frames
- Medical Exams
- Routine Eye Exams
- Visual Fields
- Corneal Topography
- Optical Coherence Tomography Scanner (OCT)
- GDX Optic Nerve Fiber Analysis
- Retinal Digital Imaging incl. Fluorescine Angiogram
- A-scan and B-scan ultrasound
- IOL Master
Your eye has a clear lens through which light passes, allowing you to see. When the lens loses its transparency, the cloudy tissue that develops is known as a cataract.
Cataracts cause progressive, painless loss of vision. In younger people they can result from an injury, certain medications, or illnesses such as diabetes. Prolonged exposure to ultraviolet light may also play a role in the formation of cataracts. Studies have also shown that people who smoke cigarettes have a higher risk of developing cataracts than non-smokers. Although cataracts usually develop without apparent pain, some indications that a cataract may be forming are as follows:
- Blurred or hazy vision
- Double vision
- Poor vision in bright light
- Seeing halos around lights
- Yellowish tinged vision
- Night vision difficulty
If visual impairment interferes with your ability to read, work, or do the things you enjoy then it is time to consider cataract surgery. Surgery is the only proven means of effectively treating cataracts. Cataract surgery is a relatively painless and is one of the most frequently performed procedures. It has a very high success rate and more than 90 percent of cataract surgery patients regain useful vision.
Our talented and experienced surgeons perform the most common and state of the art technique of cataract surgery. This surgery consists of making a small incision at the edge of the cornea and then using an ultrasonic probe with a hollow tip and a vacuum (called phacoemulsification) to break up and remove the cloudy lens. The lens is then removed from the bag or capsule. Finally, the old cloudy lens is replaced with a new small plastic intraocular lens (IOL) implant. This IOL corrects vision for a single focal point (monofocal).
In addition to the monofocal IOL which is the most widely used in cataract surgery, we also offer the latest refractive IOLs, such as the multifocal IOL, accommodative IOL and toric IOL. The multifocal IOL (ReSTOR) and the accommodative IOL (Crystalens) are both designed to correct vision for distance and near. The toric IOL (AcrySof Toric) corrects for astigmatism. These refractive IOLs are not currently covered by insurance and therefore involve a charge to the patient; however, for many it may be well worth the extra cost.
Occasionally, months and sometimes years after cataract surgery, the bag that holds the IOL in position can become cloudy. This is often called a secondary cataract. If this occurs, a laser treatment called YAG capsulotomy is performed to remove the secondary cataract from the center of the bag and restore clarity.
For clear vision to occur, the cornea in the front of the eye must have the correct shape and power to focus incoming light rays precisely on the retina at the back of the eye. If the cornea is too steep, too flat or irregular in shape, it cannot bend light at the angle needed to focus on the retina. Eyeglasses or contact lenses are often needed to refract the incoming light rays at the angle needed for clear vision.
The LASIK procedure uses both surgery and a laser to modify corneal shape and improve vision. During the procedure, the doctor surgically creates a flap of tissue on the front surface of the cornea. The flap is folded back and a laser is used to reshape the layer of tissue underneath (the middle layer of the cornea). Once this is completed, the flap is repositioned and allowed to heal.
Candidates for LASIK should be at least 21 years old with stable vision and no abnormalities of the cornea or external eye.
The cornea is the clear covering on the front of the eye which bends, or refracts, light rays that focus on the retina in the back of the eye. A certain shape or curvature is required in order for light to focus exactly on the retina, rather than partly in front of it (nearsightedness) or behind it (farsightedness). An improperly curved cornea may be corrected surgically or non-invasively to reduce or eliminate the need for eyeglasses or contact lenses. A thorough eye examination and consultation are necessary before a treatment decision can be made.
Corneal transplantation (keratoplasty) is recommended when curvature is too severe to be treated with other methods, or when extensive damage has occurred due to disease, infection or injury. Some of the more common problems that may require transplantation are:
- Keratoconus
- Corneal Ulceration
- Herpes Simplex Keratopathy
- Pseudophakic Corneal Decompensation
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- Central Corneal scar
- Corneal Dystrophies
- Traumatic injury
- Chemical burn
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Transplantation involves replacing the damaged cornea with a healthy one from a donor (usually through an eye bank). Keratoplasty is a low-risk procedure - it is the most common type of transplant surgery and has the highest success rate.
During the procedure, a circular incision is made in the cornea. A disc of tissue is removed and replaced with healthy tissue; these discs may be thin (lamellar keratoplasty) or the depth of the entire cornea (penetrating keratoplasty, the technique used in almost all corneal transplants). Local or general anesthesia may be used. The entire procedure lasts only 30-90 minutes.
DSAEK (Descemet’s Stripping Automated Endothelial Keratoplasty) is a new technique that can help some patients who previously required a full thickness corneal transplant. Both the conventional corneal transplant technique and DSAEK require the use of a donor cornea, but DSAEK replaces only the diseased posterior section of the patient’s cornea. This procedure, which requires minimal suturing, provides patients with more rapid visual restoration, less discomfort, and a reduced risk of sight-threatening complications.
Glaucoma is one of the leading causes of blindness and visual impairment in the United States. It is a disease which involves damage to the optic nerve usually by increased eye pressure. It often has no symptoms and slowly reduces peripheral vision and can eventually diminish the central vision. A simple painless eye exam can detect the disease. With early detection and treatment glaucoma can usually be controlled and blindness prevented.
Glaucoma can affect anyone from a newborn to the elderly. However, it is more prevalent as we age and thus more common in the elderly population. As many as half of those with glaucoma do not know they have the disease. The following conditions increase the risk of glaucoma:
- A family history of glaucoma
- Age of 45 or older without regular eye exams
- Abnormally high eye pressure
- African descent
- Nearsightedness
- Diabetes
- Previous eye injury
- Regular/long term use of Prednisone or other corticosteroid products
Glaucoma can often be treated with medical therapy. There are several classes of eye drops that lower intraocular pressure. In cases where medical therapy is not sufficient, The Eye Center of Concord offers the following procedures for the treatment of glaucoma:
- Selective Laser Trabeculoplasty (SLT)
- Argon Laser Trabeculoplasty (ALT)
- Yag Laser Iridotomy
- Diode Laser Cyclophotocoagulation
- Trabeculectomy Surgery
The retina is a thin sheet of nerve tissue in the back of the eye, where light rays are focused and images are transmitted to the brain. The center of the retina is called the macula. The macula is responsible for our central vision. The vitreous is a gel-like substance that fills the eye and is attached to the retina in several areas including the macula and optic nerve.
The vitreous can separate from the retina, which is called a posterior vitreous detachment (PVD). Symptoms of a PVD are a new floater or floaters, and/or flashing or flickering lights. A dilated eye examination should be done as soon as possible if these symptoms develop.
The majority of PVD’s have an uncomplicated course. However, in a small percentage of patients, problems with the retina may develop after a PVD, such as a retinal tear, retinal detachment, epiretinal membrane in the macula, or a macular hole. Our highly trained and experienced retinal specialists will utilize the most current laser and surgical techniques to treat these conditions.
Other problems that may require retinal surgery include trauma and severe intraocular infection (endophthalmitis). Retinal surgery can correct problems before vision is lost or prevent further deterioration from occurring.
 If you have been diagnosed with Diabetes, we recommend you have a dilated eye examination annually. Studies have shown that achieving adequate or tight blood sugar control can help delay the progression of damage to end organs, such as the kidneys and the eyes. Therefore it is important to work closely with your primary care physician or endocrinologist to adequately control your blood sugar levels.
Diabetes is a disease which can affect the small blood vessels of the retina. Diabetic retinopathy is another leading cause of blindness in the United States. Diabetic retinopathy has two main classifications- non-proliferative diabetic retinopathy and proliferative diabetic retinopathy.
Non proliferative diabetic retinopathy (NPDR) involves small hemorrhages and leakage from blood vessels in the retina. Often this condition is monitored closely. If clinically significant leakage into the macula develops, the central vision can diminish and our retinal specialists may need to perform focal laser and/or intravitreal injection to help stop the leakage of fluid (macular edema).
Proliferative diabetic retinopathy (PDR) involves the obliteration of small blood vessels in the retina and reduced blood flow. If the eye is not receiving adequate blood flow, signals are released to create more blood vessels. This proliferation of new blood vessels is problematic because the new faulty blood vessels often leak and cause bleeding into the vitreous. Furthermore, the new blood vessels can also grow out into the vitreous and create traction on the retina and possibly cause a retinal detachment. If PDR develops, our retinal specialists may recommend an intravitreal injection and will likely perform Pan Retinal Photocoagulation (PRP) which is laser to the peripheral retina to decrease the blood flow requirements to the retina and stop the proliferation of new blood vessels.
If a vitreous hemorrhage or retinal detachment develops, our retinal specialists may need to do a surgical procedure called a vitrectomy.
Age-related macular degeneration (AMD) is a leading cause of blindness in the United States. It is a disease that correlates with aging and becomes more prevalent after the age of 50. Furthermore, after the age of 50, there is an increased risk of developing macular degeneration during each additional decade of life. It is more common in Caucasians with fair skin and lightly colored eyes. Additional risk factors for macular degeneration include smoking, family history of AMD, high blood pressure and high cholesterol.
The macula is the central area of the thin nerve layer in the back of the eye called the retina. The fovea is the located in the center of the macula. This area is responsible for our sharp central vision and for vivid color vision.
There are two basic types of age-related macular degeneration, dry and wet (exudative).
Dry age-related macular degeneration is the most common type and represents about 90% of all cases of macular degeneration. Dry AMD involves atrophy and pigmentary changes in the macula. Often drusen or yellow-white spots are present and located beneath the retina. Mild cases may be asymptomatic, but if the atrophy affects the fovea it may cause blurred central vision and central blind spots. There is no cure or treatment for dry AMD, although vitamins, antioxidants and zinc may be beneficial in slowing the progression of the disease. Over time, it is possible for the dry form to change to the wet form of the disease. This usually involves a sudden change in vision or central distortion, and should be evaluated as soon as possible.
Wet age-related macular degeneration involves leakage and bleeding in the macula which then can cause contraction and scarring of the macula. Blood vessels break through a layer called Bruch’s membrane and then can leak or bleed. This is termed a choroidal neovascular membrane (CNVM). Wet AMD can cause a relatively sudden and significant loss or distortion of central vision. There are several treatments which may improve vision or prevent further deterioration of vision. Our knowledgeable and experienced retinal specialists provide the latest treatment modalities for wet AMD including laser therapy and intravitreal injections of Anti-VEGF agents, such as Lucentis and Avastin.
Dry eye is a term that describes insufficient moisture of the eyes, either because there is not sufficient tear production and/or the tear film has an improper chemical composition. It often occurs during the natural aging process and is more common in women. It can also result from eyelid or blinking problems, certain medications (such as antihistamines, diuretics and antidepressants), climate (low humidity, wind, dust) injury, and various health problems (some types of arthritis, Sjogren’s syndrome).
Dry eyes can vary from mild to severe. Some of the more common symptoms of dry eyes include burning, redness, tearing, foreign body sensation, blurred vision and light sensitivity.
Treatment for dry eyes depends on severity of the disease and symptoms. Milder cases of dry eyes may respond to the use of artificial tears. More moderate or severe cases of dry eyes may benefit from increasing humidity at work or home, using artificial tears, gels or ointments more frequently. Many cases of moderate to severe dry eye respond favorably to Restasis (Cyclosporine ophthalmic emulsion 0.05%) which is a topical medication that may be beneficial in increasing and normalizing the tear film. Finally, punctal plugs also can be utilized to block drainage of tears in order to keep them on the surface of the eye for a longer period of time.
We have several optometrists and ophthalmologists who are well trained in the diagnosis and treatment of dry eyes.
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