Frequently Asked Questions Regarding Refractive Surgery
Cataracts & Cataract Surgery For more information on these and other ocular disorders please see the following sites:
| Q: How do I know if I am a candidate for refractive surgery? A: If you are farsighted, nearsighted or have astigmatism you may be a candidate for refractive Surgery. Q: Will I still need contact lenses or glasses after refractive surgery? A: In many instances patients do very well without corrective lenses after refractive surgery. However, if you are over forty and currently wear bifocal lenses or a monovision arrangement with contact lenses (one eye in focus for distance and one eye in focus for near), you will still need corrective spectacles for near tasks such as reading and/or computer work. If you are over forty and have always been nearsighted (able to see well up close without glasses), refractive surgery will correct your vision for distance. You will no longer be able to see up close without corrective spectacles but should have good vision at distance without glasses. Q: Are there other options available if I am over forty to correct both my distance and near vision? A: Patients over forty may elect to have a procedure called Refractive Lensectomy. This procedure essentially performs cataract surgery, removing the natural lens of the eye and replacing it with a lens implant. There are a variety of options in choosing a-lens implant. You may choose a lens that corrects for distance only and wear reading glasses for near and computer work. You may also choose to be slightly nearsighted enabling adequate vision for distance and some near work. With this option you most likely would still need spectacles for your very best vision both distance and near. The other choice is the ReStor Multifocal IOLThis lens implant allows the patient good vision at both distance and near, only requiring glasses approximately ten percent of the time for best vision both distance and near. However, patients with astigmatism may not be a candidate for the ReStor Multifocal Lens. Q: I wear contact lenses. How long will I need to leave my lenses out prior to having surgery? A: We recommend leaving soft lenses out for a minimum of seven to ten days and rigid gas permeable contact lenses a minimum of two weeks before your pre-operative evaluation to assure the most accurate measurements prior to proceeding with surgery. Q: Will my health insurance pay for refractive surgery? A: At this time, most health insurance does not cover the cost of refractive surgery. However, in some instances using the Refractive Lensectomy procedure, your insurance may cover a portion of the surgery. The ReStor Multifocal Lens, however, is not covered by health insurance and would require some out of pocket expense on the patient's part.
Cataracts and Cataract Surgery A cataract occurs when the naturally clear lens of the eye becomes cloudy, preventing light from properly focusing on the retina. Cataracts may affect you by causing blurry vision and problems seeing in high glare situations such as driving at night and in bright sunlight. Cataract formation is part of the natural aging process although other factors may contribute to their advancement such as diabetes or use of certain medications. Fortunately, the treatment of cataracts is now easy using modern surgical techniques. Cataract surgery is performed as an outpatient procedure, spending on approximately three hours at the hospital. The procedure itself only takes between fifteen to twenty minutes to perform and is done with little or no discomfort to the patient as a mild IV sedative is given prior to surgery. Dr. Greenhaw uses the most modern surgical technique called phaco-emulsification, a procedure using an instrument to break up the cataract, gently removing it from the eye. Once the cloudy lens is removed, an intraocular lens (IOL) is implanted in the eye to replace the focusing ability giving the patient natural vision without the need for contact lenses or thick spectacles. Until recently, most cataract patients had their vision improved with a monofocal IOL. Although the implant provided good distance vision, patient still required reading glasses to perform near tasks such as reading, sewing or computer work. The ReStor Multifocal IOL is now available, providing a full range of vision, allowing the patient to see well at distance, intermediate and near, decreasing the dependency on reading glasses or bifocals.
Diabetes and the Eye If you are a diabetic, your body does not use and store sugar adequately. High blood sugar can damage blood vessels in the retina. This damage is called diabetic retinopathy. There are two types of diabetic retinopathy. Background diabetic retinopathy and Proliferative diabetic retinopathy. Background diabetic retinopathy (BDR) is the early stages of diabetic retinopathy with tiny retinal vessels breaking and leaking fluid causing the retina to swell or form deposits. These deposits are called exudates. Many people who suffer from diabetes have mild BDR and have no problems with their vision. BDR can cause loss of vision the following ways:
Proliferative diabetic retinopathy (PDR) occurs when abnormal new blood vessels begin to grow on the surface of the retina or optic nerve. This is called neovascularization. The main cause of PDR is severe closure of the retinal vessels, preventing adequate blood flow. The retina responds by growing new blood vessels to attempt to supply the blood to the area where the original vessels closed. Unfortunately the newer vessels do not re-establish normal blood flow as they are often accompanied by scar tissue that can cause wrinkling or retinal detachment. PDR may cause more severe vision loss than BDR as it affects both central and peripheral vision. PDR can cause loss of vision the following ways:
A yearly medical eye examination is the only way to diagnose changes on the inside of your eyes from diabetes. Early detection of diabetic retinopathy is the best protection against loss of vision, but if diagnosed can often be treated before any vision problems develop. More frequent examinations may be necessary once diabetic retinopathy has been diagnosed. Diabetic retinopathy can be treated several different ways. Of course the best treatment is to prevent the development of diabetic retinopathy by strictly controlling blood sugar, reducing the long term risk of vision loss. High blood pressure and kidney may also be present and would need to be treated as well. Treatment of Diabetic Retinopathy may include:
For more information regarding diabetic retinopathy or other ocular conditions, please go to www.greenhaweye.yourmd.com.
Glaucoma Glaucoma is a disease of the eye caused by increased intraocular pressure. Intraocular pressure is the pressure inside of the eye. The inside of the eye is constantly producing a fluid called the aqueous humor. In a normal eye a small amount of this fluid is produced constantly while an equal amount of fluid flows out of the eye through a microscopic drainage system. This fluid produced is not part of the tear production system. Because the eye is a closed structure, if the drainage area for the fluid being produced is blocked the excess fluid is unable to drain from the eye putting pressure on the optic nerve and causing damage. Long-term pressure on the optic nerve may cause loss of vision and eventually blindness if left untreated. A complete dilates eye examination to include measurement of the intraocular pressure is needed to detect glaucoma. If the intraocular pressure is elevated or the optic nerve does not appear normal at the time of your exam, the doctor may wish to obtain additional tests such as corneal pachymetry, gonioscopy and a visual field test to determine if you have glaucoma. There are different types of glaucoma: Primary Open Angle Glaucoma is the most common form of glaucoma with typically no symptoms in its early stages and vision remaining normal. As the optic nerve becomes more damaged vision loss can occur with loss of peripheral vision and/or blank spots in your vision, becoming progressively worse with blindness resulting. Closed Angle Glaucoma is usually caused by the way the eye develops. Some eyes are formed with the iris too close to the drainage structure inside the eye. These eyes are often small and farsighted. In these patients, the iris can be pulled into the drainage system and block it completely. Since the fluid cannot drain from the eye the pressure inside elevates causing an acute angle closure attack. The symptoms of an angle closure attack may include blurred vision, rainbow colored halos around lights and/or severe eye pain including headaches with nausea and vomiting. This is a true eye emergency. If you or someone you know experiences any of these symptoms, call the office immediately. Unless this type of glaucoma is treated quickly blindness can occur. Damage caused by glaucoma is irreversible. Treatment options include eye drops, laser surgery or the possible need for surgery in the operating room to help prevent further damage from the disease. In rare cases oral medications may also be prescribed. With any type of glaucoma periodic examinations are important to prevent loss of vision. Because glaucoma can progress without your knowledge adjustments to your treatment may be necessary from time to time. Please visit www.greenhaweye.yourmd.com should you like additional information about glaucoma or any other ocular diseases.
Macular Degeneration Macular degeneration is a natural aging process of the eye causing a deterioration of the macula, The macula is a small area in the retinal responsible for fine detailed vision such as reading or driving. When the macula does not work properly the central vision is affected causing blurriness, dim central vision or distortion. Macular degeneration does not affect the peripheral vision but the central vision of the eye, never resulting in total blindness. There are two common types of macular degeneration (ARMD): * Atrophic or "dry" macular degeneration is mainly caused by aging and thinning of the macular tissues. Vision loss is usually gradual. * Exudative or "wet" macular degeneration accounts for only about 10% of all ARMD patients. It occurs when abnormal blood vessels form under the retina and leak fluid or blood. Vision loss may be rapid and severe. Macular degeneration causes different symptoms for different patients. Patients may notice vision to be blurred or a dark or empty spot in the vision. They may also notice straight lines such as door facings to be crooked or distorted. Many people are unaware they have macular degeneration until undergoing a medical eye examination. Simply viewing the appearance of the macula or performing specialized testing may reveal an abnormal appearance to the macula. The latest scientific studies show antioxidant vitamins and zinc supplements may reduce the risk of macular degeneration significantly. It is important to remember that vitamin supplements are not a cure for ARMD nor will they restore previously lost from the disease, but may play an important role in helping patients maintain their vision. Speak with your eye doctor to determine if you are at risk for developing ARMD and if vitamin supplements are recommended for you. Certain types of "wet" macular degeneration are treatable with laser surgery or a procedure called photodynamic therapy (POT). These procedures may preserve more sight overall but are not cures to restore normal vision. Despite advanced medical treatment many patients still experience some vision loss from macular degeneration. For more information on macular degeneration or other ocular conditions, please go to www.greenhaweye.yourmd.com. |
