SERVICES & TREATMENTS
The physicians and staff at MomPremier Eye Institute are well verse in the latest in ophthalmic teachings and are highly trained to treat a wide range of conditions. They are dedicated to helping you make informed decisions about your ocular health. As a vitreo-retinal specialist, Dr. MomPremier may also coordinates your care with primary-care physicians, general ophthalmologists, optometrists and other medical specialists to help manage your eye care.
The retina is the light-sensitive tissue lining the back of our eye. Light rays are focused onto the retina through our cornea, pupil and lens. The retina converts the light rays into impulses that travel through the optic nerve to our brain, where they are interpreted as the images we see.
Symptoms of a retinal tear and a retinal detachment can include the following:
• A sudden increase in size and number of floaters
• A sudden appearance of flashes, which could be the first stage of a retinal tear or detachment
• Having a shadow appear in the periphery (side) of your field of vision
• Seeing a gray curtain moving across your field of vision
• A sudden decrease in your vision
Any of the above symptoms may be indicative of a retinal detachment.
People with the following conditions have an increased risk for retinal detachment:
• Nearsightedness in which the eye is longer than normal
• Previous cataract, glaucoma or other eye surgery
• Severe eye injury
• Previous retinal detachment in the other eye
• Family history of retinal detachment
Weak areas in the retina can be seen by an ophthalmologist during an eye exam.
Retinal tears need to be treated by sealing the retina to the back wall of the eye with laser surgery or cryotherapy. These procedures create scars that helps seal the retina which usually prevents the retina from detaching. These treatments cause little or no discomfort and may be performed in your ophthalmologist’s office.
In the event that the retina is detached, then vitrectomy surgery with or without a scleral buckle may be required. Often times a long lasting gas bubble is placed inside the eye as well to help the retina heal in place.
Glaucoma is a condition in which damage of the optic nerve in a specific pattern. Without treatment, it can lead to permanent, irreversible vision loss. It is often, but not always associated with increased intra-ocular pressure. Glaucoma is the leading cause of blindness among African Americans. While the disease can be managed effectively with medications and/or surgery, there is currently no cure for glaucoma.
Because there are no initial symptoms, glaucoma is sometimes referred to as the silent thief of sight. Sometimes, patients may report eye pains or headaches. The only way to diagnose the condition in its early stages is with ocular examination. Early detection and treatment is vey important in preventing vision loss.
Increased intraocular pressure is a main risk factor for glaucoma. Other risk factors include a family history of glaucoma, African/Latin descent, myopia (nearsightedness), diabetes, age, and certain medications.
Eye drops that lower the intraocular pressure are the mainstay of treatment. The goal of therapy is to prevent optic nerve damage and preserve vision. Laser therapy and/or intraocular surgery are reserved for more advanced cases or those that do not respond to traditional medical therapy.
Cataract formation is the process by which the natural lens inside the eye slowly becomes cloudy over time. Rarely, children may be born with genetic form of cataracts.
You may not notice signs or changes in your vision the moment cataracts first start to develop.
However, some changes you may notice include: blurry vision, double vision, sensitivity to light, having trouble seeing well at night, or when you read, and seeing bright colors as faded or yellow instead, glare.
• Having parents, brothers, sisters, or other family members who have cataracts
• Having certain medical problems, such as diabetes
• Having had an eye injury, eye surgery, or radiation treatments on your upper body
• Having spent a lot of time in the sun, especially without sunglasses that protect your eyes from damaging ultraviolet (UV) rays.
Early cataracts are treated by a change in your eyeglass prescription. However, when changing the eyeglass prescription no longer improves your vision and you are unable to see well enough to do the things you need or want to do, then cataract surgery is indicated.
Age-related macular degeneration (ARMD) is a deterioration of the eye’s macular region. The macula is the part of the retina that is responsible for your central vision, allowing you to see fine details clearly. The macula makes up a small part of the retina, but it is much more sensitive to detail than the rest of the retina.
There are two types of macular degeneration: dry macular degeneration and wet macular degeneration. Most people who have macular degeneration have the dry form. Macular degeneration usually begins when tiny yellow or white pieces of fatty protein called drusen form under the retina. Eventually, the macula may become thinner and stop working properly. The dry type of ARMD may transform to the wet form of ARMD which leads to edema and hemorrhage as well as severe central visual loss.
• Blurry distance and/or reading vision
• Need for increasingly bright light to see up close
• Colors appear less vivid or bright
• Hazy vision
• Difficulty seeing when going from bright light to low light (such as entering a dimly lit room from the bright outdoors)
• Trouble or inability to recognize people’s faces
• Distorted vision — straight lines will appear bent, crooked or irregular
• Dark gray spots or blank spots in your vision
• Loss of central vision
• Size of objects may appear different for each eye
• Family history
• High blood pressure
• Abnormal cholesterol
Scientific study has shown that antioxidant vitamins and zinc may reduce the impact of dry ARMD in some people by slowing its progression toward more advanced stages.
Treating the wet form of macular degeneration may involve the use of anti-VEGF treatment, thermal laser treatment or photodynamic therapy (PDT). Treatment of wet macular degeneration generally reduces the risk of severe vision loss.
Uveitis is inflammation of the uvea, which is made up of the middle linings of the eye. The specific cause of uveitis often remains unknown. In some cases, it can be associated with another disease or infection in the body.
Uveitis may develop suddenly with eye redness with or without pain and blurry vision. Other symptoms of uveitis may include light sensitivity, floaters and headache.
A case of simple “red eye” may in fact be a serious problem such as uveitis. If your eye becomes red or painful, you should be examined and treated by an ophthalmologist.
• Uveitis may be associated with: A virus, such as shingles, mumps or herpes simplex;Systemic inflammatory diseases; A result of injury to the eye; or Rarely, a parasite such as toxoplasmosis.
• Smoking also contributes to the likelihood of developing uveitis.
Uveitis is a serious eye condition that may scar the eye. It needs to be treated as soon as possible. Eye Drops, especially corticosteroids and pupil dilators, can reduce inflammation and pain. For more severe inflammation, oral medication or injections may be necessary. If you smoke, strongly consider stopping.
Floaters are actually tiny clumps of cells or material inside the vitreous, the clear, gel-like fluid that fills the inside of your eye. You can sometimes see them hover within your field of vision while staring at a bland background such as a white wall of paper.
Symptoms of vitreous floaters include seeing small specks or clouds moving in your field of vision, or seeing dots, circles, lines or “cobwebs.” If the vitreous gel shrinks and pulls away from the wall of the eye, the retina can tear. If you notice other symptoms, like the loss of side vision, new floaters or flashes, you should see your ophthalmologist.
• Myopia (Nearsighted)
Other floaters are usually harmless and fade over time or become less bothersome, requiring no treatment. However, laser treatment or surgical removal of floaters are options for the most bothersome floaters.
Eye allergies, called allergic conjunctivitis, are a common condition that occurs when the eyes react to something that irritates them. The eyes produce a substance called histamine in response and as a result, the eyelids and conjunctiva become red, swollen and itchy, with tearing and burning. Unlike bacterial or viral conjunctivitis, allergic conjunctivitis is not spread from person to person.
The most common eye allergy symptoms include:
• Red, swollen or itchy eyes
• Burning or tearing of the eyes
• Sensitivity to light
If accompanied by nasal allergies, you may also experience a stuffy, itchy nose and sneezing, as well as a headache, an itchy or sore throat or coughing.
• Genetic predisposition
• Certain Seasons
The key to treating eye allergies is to avoid or limit contact with the substance causing the problem. If necessary, an allergist can perform a skin or blood test to help identify the specific allergens. Topical eye drops and oral medications are sometimes used to treat ocular allergies.
Dry eye syndrome (DES) is a condition caused by eye dryness due to decreased tear production or increased tear evaporation. It can occur alone or in association with certain systemic diseases.
Patients with dry eye often complain of a foreign body sensation in the eye. Burning and gritty eye irritation often worsens as the day progresses. Other symptoms include itching, stinging, scratchiness, tired eyes, pain, redness, pressure, light sensitivity, or mucous discharge. Excess tearing can also occur secondary to chronic inflammation and irritation.
DES is more common among women, particularly after menopause. Patients who have a condition called Sjögren’s syndrome will usually have dry eye; so will others with similar systemic diseases like lupus, rheumatoid arthritis or thyroid disease. Patients who have had LASIK or other refractive surgery and those who wear contact lenses long term are particularly at risk of dry eye syndrome. Individuals who are sensitive to certain climates (such as windy, dry air) or to environmental factors like cigarette smoke or air conditioning may develop dry eye when they are exposed to these conditions. Because people who work long hours at a computer are less likely to blink often, they are susceptible to drying of the cornea.
A wide variety of approaches are available for treatment including avoidance of exacerbating factors, tear stimulation and supplementation, increasing tear retention, eyelid cleansing, and treatment of ocular inflammation. In some instances, the drainage system of the eyelids may need to be close using a small procedure in the office in order to keep more of the natural tear on the surface of the eye.
Diabetic retinopathy is damage to the retina caused by diabetes. Both type I and type II diabetics patients are at risk for retinopathy. It affects up to 80% of people who have had diabetes for 10 years or more, and if untreated, can eventually lead to blindness.
Diabetic retinopathy often has no warning signs or symptoms. All diabetics must have yearly eye examinations. Abnormal blood vessels can form in the retina, bleeding and leading to blurred or distorted vision. Dr. MomPremier can detect these abnormal blood vessels in the back of the eye before they bleed so they can be treated to prevent visual loss.
All patients with diabetes are at risk for diabetic retinopathy. The longer a person has diabetes, the higher the risk of developing diabetic retinopathy. It is recommended that all pregnant women with diabetes have a dilated eye exam every trimester.
It is best to try to prevent the development of diabetic retinopathy with well-controlled blood sugars. Mild-moderate diabetic retinopathy can be monitored with dilated examination. Laser treatment, intraocular injections and intraocular surgery are reserved for advanced/progressive diabetic retinopathy.
Retinopathy caused by the actions of systemic high blood pressure are called hypertensive retinopathy.
Signs & Symptoms
• Blurred vision
• Constricted and tortuous arterioles
• Retinal hemorrhage
• Hard exudates
• Cotton wool spots
• Retinal edema
• Optic nerve edema
Risk factors for essential hypertension include high salt diet, obesity, tobacco use, alcohol, family history, stress, and ethnic background. The major risk for arteriosclerotic hypertensive retinopathy is the duration of elevated blood pressure.
The treatment for hypertensive retinopathy is to reduce the systemic blood pressure below 140/90 mmHg. This can be accomplished by any of the armamentarium of medical treatments for hypertension. Medical treatment can only treat the acute changes of hypertension from vasospasm and vascular leakage. There is no treatment for arteriosclerotic changes of chronic hypertension.
Blurriness is a visual symptom that makes it difficult to see clearly or sharply.
Blurriness may be associated with:
• Age-Related Macular Degeneration (ARMD)
• Black Eye
• Blocked Tear Duct
• Chalazion (Stye)
• Conjunctivitis (“Pink Eye”)
• Corneal Abrasion
• Corneal Laceration
• Corneal Ulcer
• Detached and Torn Retina
• Diabetic Retinopathy
• Farsightedness (Hyperopia)
• Fuchs’ Dystophy
• Fungal Keratitis
• Herpes Keratitis
• Nearsightedness (Myopia)
• Optic Neuritis
The symptoms and possible related eye conditions/diseases in this section are for general reference only, and do not contain all visual symptoms or all possible related conditions or diseases. If you have any unusual vision symptoms, speak with your ophthalmologist.
Dr. MomPremier recommends that adults with no signs or risk factors for eye disease get a baseline eye disease screening at the age of 40. For individuals at any age with symptoms of or at risk for eye disease, Dr. MomPremier recommends that individual call us to determine how frequently their eye should be examined.
The treatment is dependent on what is causing it. Contact come in for a diagnosis recommendation that is best treatment for you.