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Age under 40: If your eyes are healthy and vision is good, it is recommended that you have a complete exam by your Eye M.D. once in your 20s and twice in your 30s. If you experience a problem, such as an infection, injury, pain or unusual flashes of light, etc., visit your Eye MD for treatment and follow his or her recommendations for follow-up exams.
Age 40-65: Early signs of eye diseases, including cataract, glaucoma, diabetic retinopathy and even age-related macular degeneration can begin in midlife but often do not noticeably affect the vision until years later. It’s important to get a baseline comprehensive eye exam at age 40, even for people who have no symptoms or known risk factors. Your Eye MD will recommend follow-up exams based on your family history and the results of the baseline exam.
Age over 65: By age 65, one in three Americans will have a vision-impairing eye disease. I you are over 65 years old, it is important to have a complete eye exam with your Eye MD every year or two to check for age-related eye diseases such as cataract, age-related macular degeneration, glaucoma, diabetic retinopathy and other eye conditions.
Diabetic patients are the exception to the recommendations listed above as they need to have regular eye exams. We recommend yearly dilated eye exams for diabetics with any sign of diabetic retinopathy.
LASIK is an abbreviation for Laser in Situ Keratomileusis. The term Keratomileusis comes from the Greek word for cornea (kerato) and the word for carve (mileusis). “In situ” means working on the cornea in its normal position. LASIK surgery is done to correct nearsightedness, far sightedness or astigmatism. The surgery is not indicated if the patient has a visually significant cataract, tendency to form scars, or corneal disease. LASIK surgery involves forming a partial thickness corneal flap, then applying Excimer laser to reshape the cornea under the flap, and finally repositioning the flap. The procedure typically takes about 10 minutes per eye. In the past, we used a device with a vibrating blade to make the LASIK flap. Today, we offer All-Laser LASIK, sometimes called “bladeless LASIK.” A femtosecond LASER is used to make the flap with great precision. Then, the Excimer Laser is used to reshape the cornea, providing the laser vision correction.
A cataract is a clouding of the normally clear lens in the eye. Early in the development of age-related cataract, the power of the lens may be increased, causing near-sightedness (myopia – sometimes called “second sight” as the patient can now read again), and the gradual yellowing and opacification of the lens may reduce the perception of blue colors. Cataracts typically progress slowly to cause vision loss, and are potentially blinding if untreated. Trauma or long term use of oral steroids can cause cataracts to develop more rapidly. The condition usually affects both eyes, but most often one eye is affected earlier than the other.
An optometrist receives a Doctor of Optometry (OD) degree and is licensed to practice optometry, not medicine. The practice of optometry traditionally involves examining the eye for the purpose of prescribing and dispensing corrective lenses, and screening vision to detect certain eye abnormalities. In comparison, the scope of an ophthalmologist’s practice is much broader. An ophthalmologist is a medical doctor (MD) who specializes in all aspects of eye care including diagnosis, management, and surgery of ocular diseases and disorders. This is the reason many ophthalmologists refer to themselves as EyeMDs. There are almost twice as many practicing optometrists as Eye MDs.
The difference between the training of an optometrist and that of an Eye MD underscores the difference in the range of practice. An optometrist generally has seven years of post-high school training, consisting of three to four years of college and four years in an optometric college. An Eye MD receives a minimum of 12 years of post-high school education, which typically includes four years of college, four years of medical school, one or more years of general clinical training and three or more years in a hospital-based eye residency program which includes surgical training.
Health care is constantly evolving and becoming more complex, more specialized. Today, optometrists and ophthalmologists work together to provide the best overall care for patients.
Astigmatism is the inability to focus light on the retina due to having different points of focus in different meridians. For example, the image may be clearly focused on the retina in the horizontal (sagittal) plane, but not in the vertical (tangential) plane. Astigmatism causes vision to be blurred and can make objects appear tilted. Generally the asymmetric focusing is due to the cornea’s shape with corneal astigmatism the cornea is not round like a ball but rather it is shaped more like a spoon (i.e., with a different curve one way verses another). Astigmatism can less commonly be caused by an asymmetric shape of the lens in the eye. The astigmatic optics of the human eye can most often be corrected by spectacles, hard contact lenses or contact lenses that have a compensating optic, cylindrical lens (i.e. a lens that has different radii of curvature in different planes called toric lenses), or refractive surgery (LASIK).
Astigmatism can also be corrected at the time of cataract by two methods. With Laser-assisted Cataract Surgery, the laser is used to make partial-thickness cuts in the cornea called Astigmatic Keratotomy Incisions to round out the corneal surface and reduce astigmatism. Alternatively, advanced technology intraocular lenses (IOLs) can have the astigmatism correction incorporated within the implant that is placed in the eye to help focus vision after the cataract is removed (these astigmatism correcting IOLs are called Toric IOLs).