Comprehensive Primary and Specialty Eye Care for All Ages
We diagnose and treat a variety of eye problems. Our more frequently asked-about services are explained below.
Routine vision exams for adults and children
A yearly dilated eye exam is the best way to preserve your vision and the health of your eyes.
Exams for pre-school age children check for correct eye alignment, clarity of vision, and any disorders that may prevent the development of good vision.
Since so much of learning is visual, an annual eye exam for school age children can reveal any visual impediments to scholastic success. Older teens and young adults can be unaware that they have less than optimal vision, and their success in college or at work depends on healthy eyes and great vision.
As we grow older, disorders such as cataracts, glaucoma, and macular degeneration can sneak up on us. A yearly dilated eye exam can uncover problems while they are still treatable. This is especially true for people with medical disorders such as diabetes, hypertension, lupus, and sarcoidosis, or for people taking certain high-risk medications such as ethambutol or hydroxycholorquine (Plaquenil).
References: https://newsinhealth.nih.gov/issue/may2015/feature2 and https://nei.nih.gov/healthyeyes/eyeexam
A clouding of the natural lens inside the eye that causes blurred vision is called a cataract. When reduced vision interferes with activities, or when the cataract begins to harden, swell, or interfere with the examination of the eyes, it is time for cataract surgery.
Modern cataract surgery is very precise and complex. However, we have developed our techniques to make this as much of an uneventful procedure as possible The eye is made comfortable with drops or a local anesthetic, the lens is removed through a one-eighth inch small incision, and a clear artificial lens is implanted inside the eye. After surgery, glasses are prescribed to fine-tune vision, especially for reading.
For patients wanting clearer vision with reduced need for eyeglasses, we offer multifocal and astigmatism correcting lens implants, and blended vision. The multifocal and astigmatism-correcting lens implants place the astigmatism and bifocal reading corrections inside the eye for a range of focus from near to distance. Blended vision gives a range of focus from near to distance by emphasizing one eye for distance, and the other eye for more up close work.
If your cataract is identified as ready for surgery, Dr. Mirate will determine what lens implant is best for your visual needs. We will be sure that you are well informed before we begin the scheduling process.
Diabetic eye disease
Diabetes damages blood vessels throughout the body, but especially in the heart, kidneys, and the eyes. The progression of untreated diabetic eye disease begins with leakage of clear fluid from blood vessels in the back of the eye, causing blurred or distorted vision. Later, whole blood leaks from the vessels, causing permanent blockage of vision. In the most severe cases, bleeding and scarring leads to retinal detachments and loss of the structure of the eye.
The good news is that diabetic eye disease is preventable and treatable.
The best way to preserve vision with diabetes is to keep sugar levels controlled, and to have a yearly dilated eye examination for early detection of disease. When diabetic eye disease is discovered early, treatment with medications or lasers can stop progression of the disease, and prevent loss of vision.
Other eye disorders related to diabetes are swelling of the lens, cataracts, glaucoma, and eye muscle palsy.
Glaucoma is an insidious and usually painless eye disease that can destroy sight long before it is recognized. The optic nerve that carries images from the eye to the brain is susceptible to damage from excess fluid pressure in the eye squeezing against the nerve and its surroundings, and from reductions in nutrition to the nerve due to blood pressure problems and other as yet unidentified causes. In the not too distant past, glaucoma could be detected only after twenty to thirty percent of nerve tissue was irreparably lost, and after there was a measurable decrease in peripheral vision. Treatment consisted of eye drops with many unpleasant side effects, or major surgery. Many patients progressed to severe vision loss because their glaucoma was discovered only after too much damage had already occurred.
Modern detection of glaucoma with optical coherence tomography can reveal early and very subtle loss of optic nerve tissue, long before any change in vision is apparent. Early detection and treatment helps to preserve vision. Newer eye drops with few side effects are available, as is in-office laser treatment with selective laser trabeculoplasty.
One type of glaucoma that is painful is called narrow-angle or angle closure glaucoma, in which the fluid drain in the eye is blocked by the iris, and the eye pressure rises rapidly to very high levels. Unlike the typical slow and painless disease of open angle glaucoma, narrow angle glaucoma can cause sudden recurrent painful attacks, blurred vision, and nausea and vomiting. In fact, this type of glaucoma can be misdiagnosed as migraine, tension headache, flu, and even an acute stomach disorder. The very high eye pressures with narrow or closed angle glaucoma can cause blindness. Treatment is urgent, and consists of drops and oral medications to lower the eye pressure, and then a laser treatment to unblock the fluid drain within the eye.
References: http://www.lumenis.com/Solutions/Ophthalmology/Education/Patients and http://www.glaucoma.org/
The macula is a very small part of the back of the eye that is responsible for seeing fine details. Macular degeneration is the condition in which this small area – literally the size of the head of a pin – becomes irregular and scarred. Small distortions in vision can progress to a significant loss of clarity. Some eyes develop microscopic swelling and hemorrhages at the macula, with further loss of vision. Fortunately, modern advancements in the treatment of macular degeneration can slow or even halt the progression of this debilitating disorder.
A yearly dilated eye exam is the best way to check for macular degeneration. Prevention includes avoiding exposure to tobacco smoke; getting plenty of omega-3 fatty acids, vitamin D, antioxidants and exercise, and maintaining an ideal body weight. Treatment ranges from oral antioxidant pills, to injections of medication in the eye, to laser procedures. Most of the more technical treatments are carried out by referral to a retina subspecialist.
Sagging eyelids, lids that turn in so that the lashes rub the eyeball, folds of eyelid skin hanging down and interfering with vision, and growths on the eyelids are conditions that can be treated with eyelid surgery. Many of these surgeries can be done in our office surgical facility, or at the off-site ambulatory surgery center.
Evaluation begins with a comprehensive dilated eye examination, photographs, and visual field testing when appropriate. If there is a possibility that the condition may be deemed not medically necessary by your insurance, we offer interest-free payment plans through Care Credit. https://www.carecredit.com/
External Eye Disease: Dry, red, itching, burning, painful, irritated, infected, or weeping eyes
There are multiple possible causes for eyes that don’t look or feel right. Allergy, infection, dry eye disease, blockage of the tear drainage system, cancerous and non-cancerous growths, misdirected eyelashes, a small particle stuck on the cornea, a scraped cornea, a corneal ulcer or other infection, and a variety of medical conditions are all possibilities. A comprehensive eye examination is the first step in the process to properly diagnose and treat the condition. Treatment may include non-prescription or prescription eye drops, oral medicines, office procedures, or surgery, depending on the cause. Please note that a red irritated or painful eye needs urgent attention, especially if accompanied by sudden blurred vision. References follow:
Corneal injuries: https://medlineplus.gov/ency/article/001017.htm
Dry eye: https://www.xiidra.com/what-is-dry-eye
Cornea and external eye disease: https://nei.nih.gov/health/cornealdisease/
Tear duct blockage: https://medlineplus.gov/ency/article/001016.htm
Sjogren’s Syndrome: http://www.sjogrens.org/
Eyeglass needs vary by age, activities, occupation, and hobbies. Children should wear glasses with polycarbonate lenses that are more resistant to breakage. Adults with hazardous occupations, hobbies or sports in which objects could strike the eyes at high velocity should wear safety glasses in order to protect the eyes. Reference: https://nei.nih.gov/sports/
Modern technology glasses are notable for free-form digitally surfaced lenses that are 10 times more accurate than ground lenses, and that offer sharper vision across the entire lens.
Crizal is an anti-glare and scratch-resistant technology that is built into the lens, and offers improved contrast and less glare. Reference: http://www.crizalusa.com/
Transitions variable tint lenses change from clear to a darker tint when exposed to sunlight. We recommend protective eyewear for extensive computer use, and prescription sunglasses for bright sunlight and for driving.
Glasses come in all styles, such as elegant, business, fun fashion, and sporty. Our main goal is to first identify what optics and frames will address your vision and fashion concerns, and then to assist you with your purchase of the glasses that you need. We offer interest-free payment plans through Care Credit. https://www.carecredit.com/
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We specialize in dispensing AirOptix contact lenses by Alcon (For more information about AirOptix, see: https://www.airoptix.com/). This particular brand offers a variety of superbly comfortable and stable lenses for people who are nearsighted, farsighted, have astigmatism, use reading glasses, or have dry eyes. However, if you are happy with your current lenses, no matter what brand, we can evaluate your fit and vision. If you bring us a copy of your prescription, we can update your prescription with minimal cost and bother.
We also accept the challenge of hard-to-fit patients, previous contact lens failures, and those who have been told they cannot wear lenses contact.
Our main goal is to first identify what type of contact lenses will address your vision needs, then let you “test drive” a pair of trial lenses for one week. During your follow-up exam, we will make sure that your contacts are the best power and fit and are absolutely right for you, before you order your supply of lenses. In order to help you purchase the contact lenses that are best for your needs, we offer discounts for full year supply purchases, and interest-free payment plans through Care Credit. https://www.carecredit.com/
Questions? Call us!