Eye Care Services Provided in Southeast Idaho
At Idaho Eye and Laser Centers we are proud to offer our clients the additional following services:
Glaucoma Diagnosis and Treatment
Glaucoma, one of the leading causes of blindness, is estimated to affect 1 of every 50 adults. Although glaucoma can occur at any age, the risk of developing the disease increases dramatically after the age of 35. Glaucoma is also more likely to develop in those who are severely nearsighted, those with a family history of the condition, diabetics, and African Americans. Because the symptoms of early glaucoma are so slight, the disease often goes unnoticed until permanent vision loss has occurred. However, with early diagnosis and careful treatment, visual damage from glaucoma can be prevented.
Glaucoma is a disease which damages the optic nerve. When light enters the eye, an image is focused onto the retina, the delicate nerve layer lining the inside back wall of the eye. The retina then transforms the light images into electrical impulses which are carried to the brain by the optic nerve. Damage to the optic nerve and retina causes blind spots in the field of vision. If the entire nerve is destroyed, blindness will occur.
Glaucoma is usually caused by an increase in the fluid pressure in the eye. The front part of the eye contains a clear, nourishing fluid called the aqueous which constantly circulates through the eye. Normally, this fluid leaves the eye through a drainage system and returns to the blood stream.
Glaucoma occurs from an overproduction of fluid or when the drainage system becomes blocked, causing fluid pressure to increase. The high pressure causes damage to the optic nerve, resulting in permanent vision loss. The exact reason the fluid system in the eye stops functioning properly is not completely understood. Much research is being done in this area to further our understanding of glaucoma.
With early detection and treatment, glaucoma can almost always be controlled and vision preserved. However, glaucoma cannot be cured, and once vision has been lost it cannot be restored. A combination of eye drops, medication, laser treatment, and conventional surgery is used to treat glaucoma. Treatment is concentrated on lowering the pressure inside the eye to prevent damage to the optic nerve.
Prevention is the best medicine – vision loss from glaucoma is permanent but can be prevented with early detection and treatment – regular eye examinations are important.
Macular Degeneration Diagnosis and Treatment
Age-related macular degeneration (AMD) is a chronic condition that causes central vision loss. It affects millions of Americans. In fact, it is a leading cause of blindness in people 60 and older. The older you are, the greater your chance of being affected. That’s why it’s important to learn the symptoms of AMD now, so if you ever notice anything wrong, you can see an ophthalmologist right away. Early detection is key to avoiding vision loss.
LEARN THE SYMPTOMS SO YOU KNOW WHAT TO LOOK FOR
AMD symptoms include blurriness, wavy lines, or a blind spot.
You may also notice visual distortions such as:
- Straight lines or faces appearing wavy
- Doorways seeming crooked
- Objects appearing smaller or farther away
If you notice any of these symptoms, you should see an ophthalmologist as soon as possible. If you are diagnosed with wet AMD, it is important to see a Retina Specialist for the most appropriate care.
AMD occurs when the macula—the central portion of the retina that is important for reading and color vision—becomes damaged. AMD is a single disease, but it can take 2 different forms: dry and wet.
Wet AMD is the more serious form, with more than 200,000 people in the United States diagnosed every year. Without treatment, patients can lose their central vision over time, leaving only peripheral, or side, vision. The symptoms can occur suddenly or gradually over time.
Early detection and treatment can help you avoid severe vision loss.
How is Wet AMD treated?
Wet AMD can be treated with laser surgery and injections into the eye. None of these treatments is a cure for wet AMD. The disease and loss of vision may progress despite treatment.
- Laser surgery.This procedure uses a laser to destroy the fragile, leaky blood vessels. A high energy beam of light is aimed directly onto the new blood vessels and destroys them, preventing further loss of vision. However, laser treatment may also destroy some surrounding healthy tissue and some vision. Only a small percentage of people with wet AMD can be treated with laser surgery. Laser surgery is more effective if the leaky blood vessels have developed away from the fovea, the central part of the macula. (See illustration at the beginning of this document.) Laser surgery is performed in a doctor’s office or eye clinic.The risk of new blood vessels developing after laser treatment is high. Repeated treatments may be necessary. In some cases, vision loss may progress despite repeated treatments.
- Injections. Wet AMD can now be treated with new drugs that are injected into the eye (anti-VEGF therapy). Abnormally high levels of a specific growth factor occur in eyes with wet AMD and promote the growth of abnormal new blood vessels. This drug treatment blocks the effects of the growth factor.You will need multiple injections that may be given as often as monthly. The eye is numbed before each injection. After the injection, you will remain in the doctor’s office for a while and your eye will be monitored. This drug treatment can help slow down vision loss from AMD and in some cases improve sight. The two most common injections treatments used by the Idaho Eye Center are Avastin and Lucentis.
Treating the wet form of macular degeneration with Avastin provides hope for the more than 10million Americans suffering from the incurable eye disease, according to the American Macular Degeneration Foundation. Known for its cancer-fighting abilities, Avastin retards the growth of abnormal blood vessels in the rear portion of the eye.
How Avastin Treats Macular Degeneration
Inhibiting the growth of blood vessels in the retina is the main purpose of Avastin, according to the American Macular Degeneration Foundation. Leaking blood vessels in the retina cause vision loss, or blurred spots, for wet macular degeneration patients. Administering Avastin through an IV drip works to reduce the growth of these cells. Given as an off-label drug, Avastin had not been FDA-approved for the treatment of macular degeneration. Used primarily for the treatment of cancer, Avastin has not been tested for ophthalmic uses.
When to Use Avastin for Macular Degeneration
Used within the first six to 12 months of onset, patients with macular degeneration may see a slowing in the process of the eye disease. Avastin is not a cure, simply a treatment, to slow the growth of blood cells. Avastin is a name brand formula of bevacizumab manufactured by Cerner Multum, Inc.
Improvement of vision within a week is the top selling point for patients investigating Avastin for ocular treatment. Dr. Rosenfeld also noted restoration of the ocular cells after treatments of Avastin, making the treatment desirable.
Warnings Regarding Avastin
Starting Avastin as a treatment of macular degeneration should be carefully considered. Wait at least four weeks, or until the incision is completely healed, from any type of surgery before beginning this regime. Known to cause increased bleeding and infection, Avastin may delay post-operative healing.
Labeled as pregnancy category C by the FDA, Avastin has not been determined safe for pregnant or lactating mothers. It is unclear if the drug can be passed to newborns through breast milk.
On rare occasions, Avastin has been known to cause neurological disorders that affect the brain. Common side effects include feeling light-headed, faint or dizzy. Used primarily with cancer patients, Avastin has been documented to cause an increased risk of heart attacks and strokes.
About LUCENTIS®(ranibizumab injection)
LUCENTIS is an FDA-approved treatment for wet age-related macular degeneration (AMD). LUCENTIS is an injection given into the eye. Before you get your LUCENTIS injection, your eye will be prepped—or cleaned thoroughly—to help you avoid eye infections. Then your retina specialist will numb your eye to limit any discomfort you might feel. Many people who get injections for wet AMD feel some pressure on their eye. Most of the time this pressure is all you will feel. After your retina specialist gives you the injection, the pressure should go away.
Who is LUCENTIS for?
LUCENTIS®(ranibizumab injection)is a prescription medicine for the treatment of patients with wet age-related macular degeneration (AMD).
What important safety information should I know about LUCENTIS?
Like any prescription medication, LUCENTIS is not for everyone. You should not use LUCENTIS if you have an infection in or around the eye.
Like other injections given into the eye, serious eye infection (endophthalmitis) and detached retina have occurred with LUCENTIS. Increases in eye pressure have been seen within 1 hour of an injection. Your eye doctor should monitor your eye pressure and eye health during the week after the injection.
If your eye becomes red, sensitive to light, painful, or has a change in vision, you should seek immediate care from your eye doctor.
Although uncommon, conditions associated with eye- and non-eye-related blood clots (arterial thromboembolic events) may occur.
Serious side effects related to the injection procedure were rare. These included serious eye infection, detached retina, and cataract. Other uncommon serious side effects included inflammation inside the eye and increased eye pressure.
The most common eye-related side effects were red eye, eye pain, small specks in vision, the feeling that something is in your eye, and increased tears. The most common non-eye-related side effects were nose and throat infection, headache, and respiratory and urinary tract infections.
LUCENTIS is for prescription use only. Individual results with LUCENTIS may vary.
How is Dry AMD treated?
Once dry AMD reaches the advanced stage, no form of treatment can prevent vision loss. However, treatment can delay and possibly prevent intermediate AMD from progressing to the advanced stage, in which vision loss occurs.
The National Eye Institute’s Age-Related Eye Disease Study (AREDS) found that taking a specific high-dose formulation of antioxidants and zinc significantly reduces the risk of advanced AMD and its associated vision loss. Slowing AMD’s progression from the intermediate stage to the advanced stage will save the vision of many people.
If retinal pathology is detected, a procedure called Fluorescein Angiography (FA) may be performed. A dye, which quickly travels to the eye, is injected into the patient’s arm. High Resolution Digital Photographs of the blood vessels in the retina are then taken to determine the extent of damage.
Ophthalmic Plastic and Reconstructive Surgery
Problems affecting the eyelids, the tear system, the orbit, and adjacent face can arise as a result of birth defects, aging changes, tumors, trauma, or generalized disease such as thyroid disease. Depending on the reason for your problem, surgery may be described as either cosmetic or reconstructive.
The most common procedures performed by ophthalmic plastic surgeons are eyelid deformities (entropion, ectropion), baggy eyelids (dermatochalasis),scars, trauma, eyelid cancer (malignancy), droopy eyelids (ptosis), loss of an eye (anophthalmos), thyroid disease, birth defects (congenital), and tear duct problems.
These procedures are available and routinely performed at the Idaho Eye Center.
Diabetic retinopathy is the leading cause of blindness among adults in the United States. Approximately 25% of current diabetics have some form of the disease. The risk of developing diabetic retinopathy increases with the age of the diabetic person and the duration of the disease. It is estimated that 90% of diabetics may experience some form of diabetic retinopathy over the course of their life. However, only a small percentage of those developing diabetic retinopathy have serious vision problems, and even a smaller percentage become blind.
Diabetic eye disease may include:
- Diabetic retinopathy—damage to the blood vessels in the retina.
- Cataract—clouding of the eye’s lens. Cataracts develop at an earlier age in people with diabetes.
- Glaucoma—increase in fluid pressure inside the eye that leads to optic nerve damage and loss of vision. A person with diabetes is nearly twice as likely to get glaucoma as other adults.
Diabetic retinopathy is a complication of diabetes mellitus which causes abnormalities in the tiny blood vessels nourishing the retina. These vessels weaken, leak fluid and blood, and fail to provide nutrients necessary for good health in the retina. Left untreated, diabetic retinopathy can result in severe visual loss, including blindness.
Though vision may gradually become blurred, significant loss of sight does not usually occur with background retinopathy. Since the patient does not experience pain or external symptoms such as bloodshot eyes or discharge, changes in the retina can go unnoticed unless detected by an eye examination.
A comprehensive eye examination is the best protection against the progression of diabetic retinopathy. The Idaho Eye Center can diagnose and treat diabetic retinopathy.
Retinal Tears and Detachments
The Idaho Eye Center also offers diagnosis and treatment of many other types of retinal disorders including retinal tears and retinal detachments. However, in some cases, the Idaho Eye Center may refer patients to other specialists in the region for a particular retinal disorder.
A retinal detachment is a serious eye problem which effects one if every 10,000 people. Retinal detachment occurs when the retina becomes separated from the back wall of the eye. When the retina becomes detached, its blood supply is reduced and its ability to process light rays is impaired. If total detachment occurs, the retina becomes useless, as it can no longer transmit information to the brain, and the eye becomes blind.
What Causes Retinal Detachment/Tears
As part of the normal aging process, the clear fluid which fills the inner cavity of the eye begins to shrink and pull away from the retina. Most of the shrinking causes no damage to the eye. However, sometimes the vitreous remains attached to the retina and then the shrinking of the vitreous causes the retina to tear.
Left untreated, retinal tears can lead to retinal detachments. Once a retinal tear is present, fluid from the vitreous may seep through the tear into the space between the retina and the wall of the eye. The fluid causes the retina to separate from the back of the eye or detach. The part of the retina which becomes detached will not function properly, resulting in vision loss.
What are the Symptoms of Retinal Detachments/Tears
Retinal tears may develop without any noticeable symptoms. In other cases, the vitreous gel pulling away from the retina may cause the patient to see flashes of light. Floaters, whish appear as black spots or lines in the field of vision, may result from bleeding of torn retinal vessels or the formation of small clumps of vitreous matter.
Once retinal detachment occurs, the patient may notice a wavy or watery quality in their vision. If detachment occurs in the peripheral retina, a curtain or shadow may appear across the field of vision. If the area of detachment is in the macula, central vision will be distorted and reduced. The patient will be unable to read or see in fine detail. Occasionally, detachment occurs suddenly and is accompanied by a total loss of vision.
Many retinal tears can be treated with lasers or with a freezing probe (cryopexy) and can be done on an outpatient basis in an ambulatory surgery center like the Idaho Eye Surgicenter. Once a retina becomes detached, it must be repaired surgically, usually in a hospital setting.
Prevention is the Best Medicine
Retinal tears and detachments are serious problems which require immediate treatment. Persons who are severely nearsighted or have a family history of retinal detachment should have regular eye examinations to detect any changes in the vitreous or retina. Persons who have suffered a serious eye injury should also be examined for retinal damage. With early diagnosis, retinal tears can be treated before retinal detachment and loss of vision occurs.
If you are experiencing the symptoms of a retinal tear or detachment or another vision problem, you should contact an eye physician immediately.
Floaters and Flashes
Sometimes people see small spots or specks moving in their field of vision or experience flashes of light. These occurrences are called floaters and flashes. Although annoying, floaters and flashed are generally of little importance. However, in some cases, floaters and flashes may be the symptoms of a more serious eye problem, such as a retinal detachment.
What is a floater?
A floater is a small clump of gel that forms in the vitreous, the clear jelly-like fluid which fills the cavity inside the eye. Floaters may be seen as dots, lines, cobwebs, or spiders and are most often noticed when reading, looking at a blank wall or gazing at clear sky.
Although floaters appear to be in front of the eye, they are actually floating in the fluid inside the eye. Sometimes floaters do not interfere with vision at all. However when a floater enters the line of vision, light is blocked and a shadow is cast on the retina.
What are flashes?
Flashes appear as flashing lights or lightning streaks in the field of vision, although no light is actually flashing. Flashes are most often noticed at night or in a dark room.
Flashes are caused by the vitreous gel tugging on the retina. If the gel actually separates from the retina, flashes of light may appear periodically for several weeks. Flashes which appear along with a large number of new floaters or with a loss of part of the field of vision may indicate retinal detachment, requiring an immediate eye exam.
Prevention is the best medicine
Although floaters and flashes are usually not considered serious vision problems, one should have a complete eye examination to determine their importance. In most cases, treatment is not necessary. However, early detection and treatment of serious problems, such as retinal tears, can prevent permanent vision loss.
If you are experiencing floaters, flashes or other vision problems, you should obtain a complete eye examination.
Corneal transplantation, also known as corneal grafting, is a surgical procedure where a damaged or diseased cornea is replaced by donated corneal tissue (the graft) in its entirety (penetrating keratoplasty) or in part (lamellar keratoplasty). The graft has been removed from a recently deceased individual with no known diseases or other factors that may affect the viability of the donated tissue or the health of the recipient. The cornea is the transparent front part of the eye that covers the iris, pupil and anterior chamber.
Corneal transplants are performed at the Idaho Eye Center on a routine basis. The Idaho Eye Center specializes in corneal disorders and trauma.
Corneal Collagen Cross-Linking
Keratoconus is a non-inflammatory eye condition in which the typically round dome-shaped cornea progressively thins and weakens, causing the development of a cone-like bulge and optical irregularity of the cornea. This causes ‘static’ in your vision and can result in significant visual loss and may lead to corneal transplant in severe cases.
Corneal cross-linking is a minimally invasive outpatient procedure that combines the use of ultra-violet (UV) light and riboflavin (vitamin B2) eye drops. Photrexa® Viscous (riboflavin 5’-phosphate in 20% dextran ophthalmic solution), Photrexa® (riboflavin 5’-phosphate ophthalmic solution) and the KXL® system are the first and only therapeutic products for corneal cross-linking which have been FDA approved to treat progressive keratoconus. Cross-Linking has the potential to stop the progression of keratoconus.
- Creates new corneal collagen cross-links
- Results in a shortening and thickening of the collagen fibrils
- Leads to the stiffening of the cornea
Chronic Dry Eye occurs most often when the meibomian glands on the eyelids become inflamed or clogged and is referred to meibomian gland dysfunction, or MGD. Meibomian glands serve to produce the lipid that stabilizes the tear film and prevents it from immediately evaporating. When the lipid layer is not present, tears can evaporate too quickly. MGD affects 86% of all those with Dry Eye! Dry eye can also develop when the eyelids do not close properly or when the lacrimal glands of the eye fail to produce enough lubricating tears.
This system combines visual imaging to diagnose a patient’s dry eye syndrome with a treatment which applies painless heat and compression to unclog the meibomian glands.
LipiView is the digital imaging component that allows us to measure the lipid layer of your tear film.
LipiView only takes a few minutes to evaluate your eyes. You will simply look into a camera and blink normally. A special light, camera, and computer program do everything else. Then we will be able to determine the best therapy.
Surface lighting originates from multiple light sources to minimize reflection. Changes to the light intensity across the surface of the illuminator compensate for the lid thickness variations between patients.
If you are diagnosed with dry eye syndrome secondary to meibomian gland dysfunction, you can then undergo a 12-minute LipiFlow treatment. This uses a single-use eyepiece to relieve blockage of all the meibomian glands, both upper and lower. The treatment sensation has been compared to an eyelid twitch or gentle pulsation.
After a treatment, the glands become unclogged and in 2 to 6 weeks you should see a noticeable difference in your dry eye symptoms. This is because the natural production of lipids needed for your tear film resumes functioning normally.
Free Screenings for Cataracts and LASIK
Every Friday at the Idaho Eye Centers in Idaho Falls and Pocatello
Between 8:00 AM and 2:00 PM
(no appointment necessary)
Call us today for more information or to schedule any services. 208-524-2025