Custom LASIK, Laser Vision Correction
(also read FDA on LASIK)
Visian ICL (Implantable Collamer Lens) by STAAR Surgical
Crystalens® by eyeonics™
AcrySof® ReSTOR® intraocular lens (IOL)
Cataract Treatment (also read "Cataract")
Correction of Refractive Errors
Mixed Esotropia and Treatment
Strabismus Repair
Pseudostrabismus
Correcting Vision with Glasses and Contacts
Dilation of the Pupils
also please read - ADDITIONAL RESOURCES and VIDEOS
DILATION OF THE PUPILS
The most common procedure performed to diagnose vision problems is dilation of the pupils. To "dilate the pupils" means to make the pupils bigger. The pupils are the little black dots in the center of the front of the eyes. The pupils act as windows to the eyes regulating the amount of incoming light.
Why Dilate the Pupils? - Dilating the pupils permits us to do two things: (1) Better see the structures inside the eye such as the lens, vitreous, optic nerve and retina, and to (2) Perform a refraction.
What is a Refraction? A refraction determines whether and how much the eyes are hyperopic (farsighted) or myopic (nearsighted) with or without astigmatism. Astigmatism is present when the eye is shaped more like a football rather than like a basketball. Glasses are prescribed based on the refraction.
Why Dilate to Refract? Children under the age of ten will most likely require dilation of the pupils in order to obtain an accurate refraction. Under ordinary circumstances the refraction changes from moment to moment as you look around the room due to the lens of the eye making automatic focus adjustments much like an autofocus camera. These instantaneous adjustments of the lens cover up the true refraction. We therefore need to relax the lens in order to perform a stable refraction. Dilation drops not only dilate the pupils, but also temporarily relax the lens.
How Do You Dilate the Pupils? We use standard dilating eye drops once, twice or three times depending upon how well certain eyes dilate. The drops take effect after 30-45 minutes.
Why is Vision Blurred By Dilation? The focusing ability of the lens is what allows us to see objects at near. The dilation drops relax the focusing ability of the lens. Therefore, after dilation near vision becomes blurred but distance vision is minimally affected. However, if you are hyperopic (farsighted) the lens also normally focuses at distance. Therefore, after dilation in patients who are hyperopic (farsighted), near AND distance vision may be blurred. Your current glasses should help in either case.
What are the Side Effects? The eyes may be sensitive, however, sunlight will not harm them. Complimentary sunglasses are available at check-out. Although we are unable to recommend driving a motor vehicle, or operating heavy machinery while the eyes are dilated, many patients do drive home reporting minimal effect on driving vision. Use your best judgment.
How Long Will My Eyes Stay Dilated? Adults may expect gradual return of normal vision over 4-8 hours. Children will likely require a day (or rarely two or three) for complete return of normal vision and pupil size. Some eyes are just more sensitive to the eye drops and remain dilated for several days. Don't worry, the effect of the dilation drops will wear off completely without any harm to the eyes. Occasionally, the dilation drops in children can cause slight facial redness, fever, thirst, or sleepiness. These symptoms should go away in a matter of hours.
Reasons to Call the Office - Please call the office if you experience eye pain, severe headache with nausea (symptoms of acute glaucoma) or any other concern about an adverse reaction to the eye drops.
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CORRECTING VISION with GLASSES & CONTACTS
Glasses and contact lenses correct refractive errors by adding or
subtracting focusing power to your cornea and lens. The power needed to focus
images directly on your retina is measured in diopters. This measurement is also
known as your eyeglass prescription.
If you have myopia, your cornea and lens have too much focusing power, bending light rays to meet at a
point in front of the retina. Glasses and contacts compensate for this condition
by subtracting power from the eye's natural focus and allowing light rays to
focus further back on the retina. If you have myopia, your prescription will be
negative, for example, -4.25 diopters.
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Myopia
correction |
If you have hyperopia,
glasses and contacts add focusing power, causing light rays to bend more as they
enter the eye. This process moves the focal point back to the retina, allowing
for clear vision. If you have hyperopia, your prescription will be positive, for
example, +4.25 diopters.
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Hyperopia
correction |
If you have astigmatism,
the shape of the glass lens compensates for the uneven corneal curve and focuses
the light rays to a single point on the retina.
Copyright © July 2004 American Academy of Ophthalmology®
STRABISMUS REPAIR
What To Expect:
Outpatient procedure under
general anesthesia, half an hour or less, straightens eyes, reduces or eliminates double vision, mild discomfort postoperatively, red eye(s) for 1 month.
Preprocedure:
Complete physical by primary care provider, re-examination by Dr. Davidson for final pre-operative measurements for surgical plan.
Postprocedure:
No eye patch, eyedrops three times daily for one week, moderate pain relievers for one or two days, return to work in two to three days, double vision for 2-4 wks.
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CUSTOM LASER VISION CORRECTION - CUSTOM LASIK
Custom LASIK surgery, also known as wavefront LASIK, uses 3-dimensional measurements of how your eye processes images to guide the laser in reshaping the front part of the eye. With a wavefront measurement system, some extremely precise, individualized vision correction outcomes may be achieved that would be impossible with traditional LASIK surgery, contact lenses or eyeglasses. Custom LASIK might be the best choice if you have difficult-to-correct or unusual vision defects.
With custom LASIK, your eye’s ability to focus light rays is measured from front to back, and a 3-D map is created that demonstrates irregularities in the way your eye processes images. Information contained in a map guides the laser in customizing the treatment to reshape your eye’s corneal surface so that these irregularities can be corrected.
Standard prescriptions for glasses, contacts, or conventional LASIK procedures can correct ordinary vision defects such as myopia, hyperopia, and astigmatism. But other irregularities associated with the eye’s optical system can now be addressed thanks to the advent of wavefront and related technology used in Custom LASIK.
Wavefront technology is groundbreaking because it has the potential to improve not only how much you can see, but also how well you can see, in terms of contrast sensitivity and fine detail. This translates into a reduced risk of visual disturbances, such as glare, halos, and difficulty with night vision.
How much you see depends upon vision defects known as lower-order aberrations associated with common refractive errors including myopia, hyperopia, and astigmatism, which traditional LASIK can treat. How well you can see can depend upon the type and number of visual disturbances known as higher-order aberrations, which can include irregularities other than common refractive errors. These higher-order aberrations can create problems such as decreased contrast sensitivity, reduced night vision, glare, shadows, and halos. Unlike traditional LASIK, Custom LASIK treats both lower- and higher-order aberrations.
Custom LASIK’s advantage lies in the area of quality of vision:
- Greater chance of achieving better than 20/20 vision
- Reduced chance of losing visual quality or contrast sensitivity
- Reduced chance of night-vision disturbances and glare
The surgeon will begin by using the wavescan device to transmit a safe beam of light into your eye. The light is then reflected back off the retina, out through the pupil and into the device, where the reflected wave of light is received and arranged into a unique pattern that captures your eye’s lower- and higher-order aberrations.
All of these visual irregularities are then displayed as a 3-D map. This information is then electronically transferred to the laser and computer-matched to the eye’s position, enabling the surgeon to customize the LASIK procedure to your unique visual requirements.
Like conventional LASIK, Custom LASIK won’t cure all vision-related problems, so it is important to discuss its applications with your eye doctor or surgeon to determine if you are a good candidate.
CATARACT TREATMENT
A cataract may not need to be treated if your vision is only slightly blurry. Simply changing your eyeglass prescription may help to improve your vision for a while. There are no medications, eyedrops, exercises or glasses that will cause cataracts to disappear once they have formed. Surgery is the only way to remove a cataract. When you are no longer able to see well enough to do the things you like to do, cataract surgery should be considered. In cataract surgery, the cloudy lens is removed from the eye through a surgical incision. In most cases, the natural lens is replaced with a permanent intraocular lens (IOL) implant.
Cataract surgery is a major eye operation and must be done with the child asleep under general anesthesia. It can be performed at any age. The lens is removed using delicate surgical instruments (not a laser) through a small incision near the outer corner of the eye.
Usually the child feels little or no pain, and goes home a few hours after surgery. The eye needs to be examined in the office within one day, and several more times during the next few weeks. Eye drops are given several times per day during the early weeks after surgery to prevent infection and to promote healing.
MIXED ESOTROPIA
Mixed esotropia is a condition where the eye(s) turn inward. Straightening of the eyes requires a mix of both glasses and surgery. Accommodative (also called refractive) esotropia is corrected 100% by glasses and surgery is not performed. Nonaccommodative esotropia requires only surgery and glasses play no role in treatment.
PSEUDOSTRABISMUS
Pseudostrabismus is a condition where the eyes are normal although they look crossed and is more common in individuals with "almond-shaped eyes" of Asian or Hispanic decent. The skin folds covering the inner corners of the eyes block the white part of the eye especially in side gaze. This creates an optical illusion where the eyes appear to turn in. You can convince yourself that the eyes are truly straight by looking at a photo and noting that the camera flash is in the center of each eye. Pseudostrabismus does not affect vision or visual development and may be outgrown eventually.
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