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In the realm of eye care, surgical co-management has emerged as a collaborative approach that aims to provide patients with comprehensive and seamless treatment. This concept involves the joint efforts of optometrists and ophthalmologists, each bringing their unique expertise to the table. By working together, these eye care professionals strive to enhance patient outcomes and deliver exceptional care.
 

The Role of Optometrist and Ophthalmologist in Surgical Co-Management

Surgical co-management is built upon the unique skill sets and areas of expertise of optometrists and ophthalmologists. By understanding their respective roles, you can appreciate the synergy that this collaborative approach fosters.

Optometrists are primary eye care professionals who specialize in the examination, diagnosis, and non-surgical treatment of vision disorders. Their responsibilities in surgical co-management include:

• Performing comprehensive eye examinations and evaluations

• Monitoring and managing pre-existing eye conditions

• Providing pre-operative and post-operative care

• Educating patients on surgical procedures and aftercare

• Collaborating with ophthalmologists to ensure continuity of care
   

Ophthalmologists are medical doctors who specialize in the diagnosis, treatment, and surgical management of eye diseases and disorders. Their role in surgical co-management encompasses:

• Evaluating patients' candidacy for surgical interventions

• Performing complex surgical procedures

• Providing specialized medical and surgical care

• Collaborating with optometrists to ensure seamless patient care

• Monitoring and managing post-operative complications

• By combining the expertise of optometrists and ophthalmologists, surgical co-management ensures that patients receive comprehensive and coordinated care throughout their treatment journey.

How Surgical Co-Management Works

Surgical co-management is a well-orchestrated process that involves several key steps. Understanding how it works can help you navigate this collaborative approach with confidence.

• Initial Evaluation: The process typically begins with an optometrist conducting a comprehensive eye examination. During this evaluation, the optometrist assesses the patient's visual needs, identifies any potential issues, and determines if a surgical intervention is necessary.

• Referral and Consultation: If surgery is recommended, the optometrist refers the patient to an ophthalmologist for further evaluation and consultation. This step ensures that the patient receives specialized medical advice and a thorough assessment of their suitability for the proposed surgical procedure.

• Pre-operative Care: The optometrist plays a crucial role in providing pre-operative care, which may include managing any existing eye conditions, ensuring the patient understands the surgical process, and addressing any concerns or questions they may have.

• Surgical Procedure: The ophthalmologist performs the necessary surgical intervention, leveraging their specialized training and expertise in surgical techniques.

• Post-operative Care: After the surgery, the patient's care transitions back to the optometrist, who closely monitors the recovery process and provides post-operative care and management. This may involve follow-up appointments, monitoring for any complications, and ensuring the patient adheres to the prescribed treatment plan.

• Ongoing Collaboration: Throughout the entire process, the optometrist and ophthalmologist maintain open communication and collaborate closely. This ensures that the patient's care is seamless, and any concerns or issues are promptly addressed by the appropriate healthcare professional.

Strabismus is a relatively common condition, affecting about 2-4% of the population worldwide. It is one of the most frequent eye disorders seen in children, though it can also develop in adults due to conditions like stroke or trauma. In the United States alone, it is estimated that around 12 million people are affected by strabismus, with varying degrees of severity. Early diagnosis and treatment are essential, as untreated strabismus in children can significantly impair visual development.

What is Strabismus?

Strabismus, commonly referred to as crossed eyes, is a condition in which the eyes do not properly align with each other when looking at an object. One eye may turn in, out, up, or down, while the other eye focuses correctly. This misalignment can be constant or intermittent and may affect one or both eyes. Strabismus occurs when the muscles controlling eye movement do not work together correctly, leading to difficulty in focusing both eyes on a single point. This condition can lead to visual issues such as double vision and, in some cases, can result in amblyopia (lazy eye) if left untreated.

How Does Strabismus Develop?

Strabismus develops when there is a disruption in the coordination of the muscles that control eye movement, leading to a misalignment of the eyes. This disruption can result from various causes, including genetic factors, neuromuscular conditions, or problems with the nerves that transmit signals to the eye muscles. In some cases, it may be present at birth, while in others, it can develop later in childhood or adulthood due to conditions such as cerebral palsy, Down syndrome, or even trauma to the eye or brain.

Signs and Symptoms of Strabismus

The primary symptom of strabismus is the visible misalignment of the eyes. However, there are other signs and symptoms that may indicate the presence of this condition:

• Blurred or double vision

• Headaches or eye strain

• Difficulty with depth perception and spatial awareness

• Reduced visual acuity in one eye

• Frequent eye rubbing or squinting

• Tilting or turning the head to compensate for the misalignment

What is amniotic membrane treatment?

Prokera and CAM360 from BioTissue are FDA-approved cryopreservered amniotic membrane tissue used to treat various corneal conditions, to help with anti-inflammation, anti-scarring, and promote healing on the front surface of the eye. The amniotic membrane is provided by a tissue bank that undergoes rigorous quality testing and regulated by the FDA. 

What can it be used to treat?

• dry eyes and ocular irritation

• keratitis

• corneal scarring

• chemical burns

• post-surgical recovery (LASIK or cataract)

• corneal injuries, ulcers, and recurrent corneal erosions
   

What are the key benefits?

These treatments work by reducing inflammation and minimizing scarring, helping to restore your cornea to its normal, healthy state with its regenerative abilities.

• reduces inflammation

• improved eye health

• regenerates corneal nerves

• faster recovery from infection and surgery
   

What does treatment entail?

Prokera is a cryopreserved amniotic membrane supported by a soft ring worn under taped lids for 1-3 days. It must be removed by your doctor. CAM360 is a similar ringless version that dissolves on its own in roughly 48 hours. Your doctor will discuss which option is best for you during your visit.

Astigmatism is a common refractive error that occurs when the cornea or lens of the eye is not perfectly spherical. Instead of having a uniform, rounded shape, the cornea or lens has a slightly more curved or irregular shape, resembling more of an oval or football-like appearance.

This irregular shape causes light to bend or refract unevenly as it enters the eye, leading to blurred or distorted vision. Astigmatism is often present from birth, but it can also develop later in life due to various factors, such as eye injuries, certain medical conditions, or the natural aging process.

Common Symptoms of Astigmatism

If you have astigmatism, you may experience a range of symptoms that can impact your daily life. Some of the most common symptoms of astigmatism include:
 

• Blurred or distorted vision, especially at a distance or when reading

• Difficulty seeing clearly at night or in low-light conditions

• Frequent headaches or eye strain

• Sensitivity to glare or bright lights

• Double vision or the appearance of halos around lights
   

These symptoms can vary in severity and may become more pronounced over time, especially if the astigmatism is left uncorrected.

Corneal refractive therapy, also known as CRT, is a simple, painless treatment for refractive eye errors like myopia and has two core benefits. First, it can be used to help patients see clearly during the day without using glasses or contact lenses, giving them the freedom and flexibility that they need to live life to the fullest. Second, CRT has been shown to help slow the progression of myopia, keeping prescriptions under control and potentially reducing the likelihood of patients developing serious eye health problems associated with high myopia in the future. 

Here’s everything that you need to know about corneal refractive therapy and what it means for you. 

Understanding refractive eye problems

Refractive eye problems like nearsightedness, farsightedness and astigmatism are extremely common, with nearsightedness – also known as myopia – being the most common of all. Patients with myopia can see nearby objects clearly, but those further away become progressively more blurred. Refractive eye errors occur when the shape of the clear dome covering the front part of the eye, called the cornea, impair the light-bending and focusing process in your eyes. This leads to the light ending up in the wrong place inside the eye, and the message that is sent to our brain from our eyes is muddled, causing blurred vision. 
 

What is corneal refractive therapy?

Corneal refractive therapy was initially developed as a treatment to correct and slow the progression of nearsightedness. However, it has also been found to be effective at controlling other refractive errors, including farsightedness, astigmatism and an age-related refractive condition called presbyopia.

CRT is a non-invasive, painless and straightforward method of correcting patient vision so that they don’t need to wear contacts or glasses, and they don’t need laser vision correction surgery to see clearly. CRT uses special contact lenses that are worn overnight and apply light pressure to the cornea in order to reshape it so that light is refracted correctly, and the image sent from the eyes to the brain is clear. The cornea is able to retain this new shape even after the contact lenses are removed the next morning, meaning that you can continue to see clearly for several hours. The more consistently you wear your CRT lenses overnight, the longer your eyes will learn to retain their new shape and eventually, patients can enjoy up to 48 hours of clear vision without using prescription lenses. However, the effects aren’t permanent so if you stop wearing the lenses, your vision will gradually return back to normal over the course of a few days. 

Slowing the progression of myopia with corneal refractive therapy

Another key benefit of CRT is that it can actually help to slow the progression of myopia. Most people who are nearsighted find that their eyesight gets progressively worse as they get older. This deterioration may not be rapid, but it can end in patients requiring high prescriptions. Studies have found that patients who have high myopia are more likely to develop serious eye problems in the future, including glaucoma, macular degeneration, cataracts and a detached retina. Regular use of your corneal refractive therapy lenses could help keep your prescription stable and lower your risk of developing these problems. 

Am I a candidate for corneal refractive therapy?

You may be a candidate for corneal refractive therapy if you:

• Have a myopia prescription within specific parameters

• Have a prescription for hyperopia, presbyopia or astigmatism within specific parameters

• Have stable vision, which means that your prescription hasn’t changed during the last two years

• Are not a suitable candidate for laser vision correction

• Have a job that makes it impractical or unsafe to wear glasses or contact lenses

• Enjoy hobbies that make it impractical or unsafe to wear glasses or contact lenses

• Have healthy eyes and are generally in good health

For more information, please contact our friendly and knowledgeable team today.  

Visual field testing is an important part of most standard comprehensive eye exams. Also sometimes known as perimetry testing, Visual field testing is a method to measure the entire scope of vision of an individual, including their peripheral/side vision.
 

The importance of visual field testing

Visual field testing is one of the most effective diagnostic treatments in the detection of glaucoma. This is because when patients are affected by glaucoma, it is usually the peripheral vision that is affected by their condition first. However, it can also be used to detect central or peripheral retinal diseases, eyelid conditions such as drooping, optic nerve damage and conditions that affect the visual pathways from the optic nerve to the area of the brain where this information is processed into vision.
 

Visual field testing is also an important part of monitoring for people who are considered to be at risk for vision loss from disease and other problems, including those who have been diagnosed with the following:

• Multiple sclerosis

• Hyperthyroidism

• Pituitary gland disorders

• Central nervous system problems (such as a tumor that may be pressing on the brain)

• Stroke

• Diabetes

• High blood pressure
   

What to expect from visual field testing

There are a variety of methods that can be used to perform visual field testing, including:
 

Static automated perimetry. This is where a machine is used to quantify how well the patient is able to detect flashing lights of varying size and brightness in different areas of their visual field, while they concentrate on a central point. The patient responds by pushing a button when they see the light.

Kinetic perimetry. This involves points of light that are fixed in size and intensity and are presented along the patient’s peripheral vision, before being gradually moved inwards to determine their field of vision. 

Visual field testing is non-invasive, painless and doesn’t require patients to have their eyes dilated. The results, which are usually presented in a series of charts, are digital and sent directly to your eye doctor for interpretation. Depending on the outcome of your results, you may be recommended for further diagnostic testing which could include blood tests. If you have been diagnosed with glaucoma, you will probably be recommended to have several visual field tests each year, which will help your eye doctor to monitor the progression of your condition and recommend treatments to slow it.

If you would like more information about visual field testing, or if you have concerns about your peripheral vision, please don’t hesitate to schedule an appointment with our experienced and knowledgeable eyecare team today.

Clear Lens Extraction (CLE) is a surgical procedure that involves the removal of the natural lens of the eye and replacing it with an artificial lens implant, also known as an intraocular lens (IOL). CLE is primarily performed to correct refractive errors, such as nearsightedness, farsightedness, and astigmatism.
 

Understanding CLE and How It Works

Clear Lens Extraction is similar to cataract surgery, where the natural lens is removed and replaced with an IOL. However, in CLE, the lens is clear and not clouded as in the case of cataracts. The procedure begins with the administration of local anesthesia to numb the eye and ensure a painless experience for the patient.
 

Once the eye is numb, a small incision is made on the cornea, which is the clear front surface of the eye. Through this incision, your eye surgeon accesses the lens and carefully removes it. The artificial IOL is then inserted into the empty lens capsule. The IOL is specifically chosen to correct the patient's refractive error, providing them with improved vision.
 

After the IOL is implanted, the incision is closed with tiny sutures or self-sealing techniques. Following the surgery, patients are usually prescribed antibiotic and anti-inflammatory eye drops to prevent infection and reduce inflammation.
 

Factors to Consider Before Undergoing Clear Lens Extraction

Before deciding to undergo Clear Lens Extraction, there are several factors that need to be considered. Firstly, it is crucial to have a thorough eye examination to determine if you are a suitable candidate for the procedure. Your optometrist will evaluate your overall eye health and discuss your expectations and goals for vision correction.
 

Age is another important factor to consider. CLE is typically recommended for individuals over the age of 40 who have developed presbyopia, a condition that affects near vision. It is also important to have stable vision, as any changes in prescription can affect the accuracy of the IOL power calculation.
 

Additionally, it is essential to understand the potential risks and complications associated with the procedure. While CLE is generally safe, there is a small risk of infection, bleeding, and retinal detachment. Your optometrist will discuss these risks with you and address any concerns you may have.

Optomap is an innovative new technology that gives eye doctors the ability to perform ultra-wide retinal imaging that is far superior to what can currently be achieved using conventional retinal imaging options. In contrast to conventional retinal imaging, Optomap captures at least 50% more of the retina in a single capture, and with Optomap’s multi-capture function, up to 97% of the retina can be viewed. This gives eye care professionals greater opportunity to monitor the health and condition of patient vision.
 

Why is Optomap important?

Optomap is another great preventative eyecare technology tool. By allowing your eye doctor to have a comprehensive view of your retina, they will be able to detect any developing eye diseases early on, before they have a detrimental impact on your vision and day to day life. Not only can Optomap detect eye conditions such as retinal holes, retinal detachment, macular degeneration and diabetic retinopathy, but it can also be used to identify some general health conditions such as cardiovascular disease, stroke and cancer.
 

What to expect from Optomap scanning

Optomap is a fast, painless and non-invasive procedure that is suitable for patients of all ages, even children and pregnant women. Many patients require their eyes to be dilated ahead of the scan and will be given eyedrops which will widen their pupils and make it easier for the camera to see the structures inside the eye. Pupil dilation is painless, but patients may feel more sensitive to light both during their Optomap scan and afterwards for up to 24 hours. You may also have slightly blurred vision for a few hours. Once your eyes are dilated, you’ll be sat down and asked to look into a small device that will take the pictures of your retina. A short flash of light will let you know that the image has been taken, and the entire imaging is over in just a few seconds. The results will be sent digitally to your eye doctor who will then evaluate them. The results will also be stored on your personal optical record for future information.  
 

If you would like more information about what is involved in Optomap, or to schedule an appointment for this effective screening technology, please contact our eyecare team.

We all want to look our best and in the last decade, we have seen a significant increase in the number of people seeking cosmetic services in order to enhance their appearance. With our eyes being our most distinguishing feature, we want to make the most of them. Thankfully there is now a range of cosmetic services that can help to rejuvenate our eyes and the area around them to keep them fresh, young and wrinkle-free. 

Let’s take a look at some of the services on offer.
 

Pigment removal

The brown pigment spots that appear on the face are often referred to as age spots and are a result of sun exposure. With age, the repeated exposure to UV rays causes melanin, a compound that is responsible for pigmentation and protecting the skin begins to clump together to form an area of hyperpigmentation. Whilst they aren’t any cause for concern, many people feel that they look unsightly. Luckily, there are a number of different treatments that you can get to remove them including topical creams, laser therapy, and chemical peels.

If you are suffering from darker pigmentation then we strongly recommend that you make an appointment with a qualified dermatologist who will recommend the best course of treatment for you, based on your specific needs.
 

If you are one of the thousands of people considering LASIK laser eye surgery, then you will probably be gathering as much information as possible about the treatment. By this point, you are probably aware of the benefits that LASIK offers, such as a reduced or eliminated need for glasses or contact lenses and greater convenience in your day to day life. However, for many patients, despite the advantages of LASIK, the thought of surgery on their eyes is still a cause of anxiety and fear. One of the best ways to alleviate this concern is to find out more about what the procedure entails.
 

Your consultation

Before you can be approved for any form of laser vision correction, including LASIK, you will need to attend a consultation appointment with your surgeon. During the consultation, he will perform an examination of your eyes and use your medical and ocular history to determine if you are a good candidate for the procedure. He will also speak to you about the expected outcome from your surgery, making you aware that while LASIK will dramatically improve your eyesight, there is no guarantee that you will not need to wear glasses in some situations, such as while driving in the dark. 
 

How LASIK Works

LASIK uses a cool, ultraviolet beam of light to reshape the patient’s cornea. Doing so will more accurately focus the light that enters the eye on to the retina, thus improving the patient’s vision. The way in which the cornea needs to be reshaped will depend on the visual needs of the patient. For example, a patient who is far-sighted will need their cornea reshaping to be steeper to experience better eyesight. Alternatively, a patient who is near-sighted will require their cornea to be flattened in order to improve their vision. LASIK can also smooth an irregular cornea into a more standard shape, meaning that the procedure can also be used to correct astigmatism.
 

The LASIK procedure

The LASIK procedure is very fast and straightforward. Although you will probably be in the surgical suite for around half an hour, the actual process only takes a couple of minutes per eye. The rest of the time will be spent preparing and ensuring that you are comfortable. Anesthetic eye drops are given to patients before their procedure so that the entire process is pain-free. If you are particularly anxious, it may also be possible for you to be slightly sedated – this should be discussed with your doctor at your consultation appointment.

Once you are in position, we will use a femtosecond laser to cut a thin, circular flap into the outer cornea. This can then be pulled back to reveal the underlying corneal tissue, known as the stroma so that it can be reshaped using the laser. The exact path that the laser needs to take, known as the topography, will have been pre-programmed ahead of the procedure and can be followed with complete precision and accuracy.

Once the reshaping is complete, the flap is replaced back over the eye and the surgery is complete. There is no need for sutures or bandages as the cornea will start to heal immediately and without any medical intervention.