OTHER PROCEDURES

MonoVision LASIK

MonoVision LASIK is an alternative option to glasses for people with presbyopia. With MonoVision, one eye is corrected for distance and one for near. Typically in MonoVision, the eye that is corrected for distance is the dominant eye. With this procedure, when you look in the distance, your distance eye is at work. When you are reading, the eye corrected for near is working.

Many patients enjoy this option because it can eliminate the need for reading glasses or bifocals. However, a very small percentage of patients do not adjust well to MonoVision. A trial basis can help determine if MonoVision LASIK is right for you through contacts or glasses.

PRK

PRK (Photo Refractive Keratectomy) was the first procedure performed using the Excimer laser. It corrects vision by reshaping the cornea. In the first step, the epithelium, a thin layer of clear protective skin that covers the cornea, is completely removed. After the Excimer laser reshapes the surface (as in LASIK), the epithelium grows back over the treated area, usually within three to seven days. Functional vision typically returns within the first week.

For those patients who are not candidates for LASIK because of larger pupils or thin corneas, PRK can be an alternative procedure. And, in certain cases, your surgeon may recommend PRK as a better procedure for you than LASIK. PRK has provided many patients with outstanding results. However, even though numbing drops are used during the procedure, PRK patients often encounter moderate discomfort and occasionally experience hazy vision for a time after their procedure and may need to take a few days off from work.

Cataract Removal

Understanding Cataracts
A cataract is a vision problem caused by a clouding of the eye’s lens. The most common type is related to aging. More than half of the American population ages 60 and older have cataracts.

What is the lens?
The lens is the part of the eye that helps focus light on the retina. In a normal eye, light passes through the lens and is focused on the retina. To help produce a clear image, the lens must remain clear.
The lens is made mostly of water and protein. As you age, the protein can clump together and start to cloud small areas of the lens that blocks light from reaching the retina, interfering with vision. This is a cataract.
In its early stages, a cataract may not cause a problem. However, over time the cataract may grow larger, making it harder to see. Because less light reaches the retina, your vision may become dull and blurry.

How do I know if I have a cataract?
* Cloudy or blurred vision
* Nighttime glare from headlights.
* Sensitivity to light
* Difficulty reading fine print
* Faded colors

About Cataract Surgery
More than 2 million people have cataract surgery each year, making it one of the most commonly performed surgeries in the United States. It is an outpatient procedure, which typically takes about 10-15 minutes to complete.

At Progressive EyeCare, cataract removal is performed through a procedure called phacoemulsification. In this procedure, high-energy ultrasound waves are used to gently remove your cataract. In most cases, we use only eye drop anesthesia, allowing our patients the fastest possible recovery. Once the cataract is removed, a permanent, artificial lens is inserted. It is not uncommon for our patients to have the benefit of dramatically improved vision within a few hours of their procedure.

	Step 1 – The first step is to make a small hole in the front of the capsule that holds the natural lens or cataract.
	Step 2 – The next step is to insert the small ultrasonic probe into the eye. The probe breaks up the lens into tiny pieces and removes them.
	Step 3 – A permanent, artificial lens is then folded and inserted into the eye.
	Step 4 – The new lens then unfolds and is positioned permanently into place.

After surgery with traditional monofocal lenses, most people experience very good vision either near or at a distance. In most cases, the monofocal lens provides good distance vision for driving, walking and some everyday activities. However, most people receiving monofocal lenses still require reading glasses or bifocals to have a full range of vision.

Premium Lifestyle Lenses

• Surgical Correction for Astigmatism
• Lens Correction for Astigmatism
• Single Focus Lens Implants
• Multi-Focus Lens Implants
• Accommodating Lens Implants
• Presbyopia-Correcting Implants

Cataract Surgery and Clear Lens Replacement

Are you or someone you know suffering from cataracts? 

You’re not alone.  Cataracts are an inevitable part of the aging process.  Over time, everyone will experience some sort of vision impairment due to cataracts. 

The bad news is that the only permanent correction to cataracts is cataract surgery.  The good news is that cataract surgery is one of the safest and most effective procedures performed in the United States.

What’s even more exciting are all of the advancements that have been made in the field of cataract surgery and clear lens replacement.  Traditionally, these procedures remove the natural lens of the eye and replace it with a single focus, or monofocal, Intra-Ocular Lens (IOL).  This is a clear lens that is put in place of the degenerated natural lens.  While the results are wonderful, these lenses only correct the cataract condition. Often they do not fully fix visual errors such as nearsightedness, farsightedness or astigmatism that were present prior to surgery.  That patient will still have to wear contacts or glasses to see clearly.  

Thanks to recent developments in lens and surgical technology, there are now a number of different options available to patients that could have them seeing clearly at all distances, without the need for glasses or contacts. 

Called Premium Lifestyle Lenses, these advanced IOL technologies could eliminate your need for glasses entirely.  Even reading glasses. 

Advanced surgical options, including Premium Lifestyle Lenses, now make it possible to regain your vision at all distances, and permanently correct astigmatism as well! 

Progressive Eye Care utilizes the latest (and safest) technology to increase your potential of regaining your full range of vision.  Incorporating these advanced surgical options has 85-90% of patients living completely glasses free following their surgery.

Below is a list of advanced surgical vision correction options offered at Progressive Eye Care.  Keep in mind that only a thorough examination with your doctor will determine which lens option is best for you. 

Surgical Correction for Astigmatism

Astigmatism is a condition that exists when the outer part of your eye, called the cornea, is shaped more like a football than a baseball.  This oblong shape causes light rays to bend disproportionately before they hit the lens of the eye, resulting in blurred or ‘double’ vision.  Astigmatism is normally corrected through specifically designed lenses in glasses, and special ‘toric’ contact lenses.

Since astigmatism is a condition of the cornea and not the lens, traditional cataract and lens-replacement surgery does not correct the condition.  A patient suffering from pre-existing astigmatism who had undergone traditional cataract surgery would still have to wear corrective lenses after their procedure. 

However, pre-existing astigmatism can be corrected as part of your cataract surgery.  It is entirely possible that one of these procedures could provide you with clear distance vision, without the need for glasses or contacts. 

There are two methods used at Progressive Eye to correct pre-existing astigmatism during cataract surgery:

1. Limbal Relaxing Incisions (LRI) - For low to moderate levels of astigmatism, your surgeon may choose to perform limbal relaxing incisions, or LRI, during your cataract procedure.  These are very small vertical incisions your surgeon makes in the outermost area of the cornea.  These incisions allow the irregular curved cornea to relax, and form a more spherical, natural shape, thereby centering the light passing through the cornea more directly on the newly implanted lens of the eye. 
   
   
2. Toric Intraocular lenses (IOLs) – These are special lifestyle lenses that are specifically designed to eliminate any pre-existing astigmatism after cataract surgery.  They function in a similar fashion to toric contact lenses, by counterbalancing the skewed light rays that pass through a steepened corneal curve.  Click here for more information about the Toric lens.

For cataract patients who have a larger amount of astigmatism, and in general for people under the age of 50, laser surgery such as LASIK or PRK may be a good option for people seeking to eliminate their astigmatism.  LASIK has been FDA approved to treat very high levels of astigmatism, and is a safe and successful option for patients of most all ages suffering from astigmatism, who are seeking independence from glasses or contacts. 

The most important thing to understand is that you don’t have to live with the effects of astigmatism.  Thanks to recent technological developments, there are now many surgical options that can permanently correct astigmatism for virtually any patient – regardless of age. 
 
Lens Correction for Astigmatism

As mentioned earlier, traditional cataract surgery does not correct astigmatism.  People who receive the standard monofocal lenses either have to have additional surgery, such as LASIK, or wear specialized glasses or contacts to see clearly. 

Now there is a Lifestyle Lens, called a Toric IOL, which is specifically designed to provide you with not only clear distance vision, but also eliminate any pre-existing astigmatism present. 

Toric IOL’s are engineered to counterbalance the irregular curvature of the cornea that causes astigmatism.  The lens collects and refocuses the light rays so your vision appears sharper and less distorted.  These lenses have a very high success rate at eliminating any need for glasses or contacts to correct astigmatism. 

While these lenses do correct astigmatism and will provide the patient with clear vision at a distance, it should be noted that this lens does not correct presbyopia, and most people who choose this lens would still need to wear glasses to see objects up close and for actions such as reading.  

Single Focal Lens Implants

Single focus lens implants, or monofocal IOLs, are the traditional type of lenses used when performing cataract surgery.  These lenses are designed to replace the cloudy natural lens of the eye, and provide clear distance vision. This means you will be able to see objects that are far away clearly. However, you will need glasses for reading and any type of close, detailed work following surgery.

Virtually every cataract patient who receives a single focus lens reports a dramatic improvement to the clarity of his or her vision.  The only downside to these lenses is that since they do not correct for most refractive conditions, patients will still have to wear glasses or contacts for reading or to correct for any pre-existing astigmatism.  Single focus lens implants are considered the ‘standard,’ and when used for cataract surgery, the cost is most often covered by insurance.

Multi-Focal Lens Implants

Recent advances in lens technology now provide many exciting options for cataract patients looking for vision correction at all distances.   One of these new advancements is the development of multi-focus, or multifocal IOLs.    These Premium Lifestyle Lenses are designed to function similar to multifocal glasses, such as bifocals.  The lenses are designed with three specific "zones" for distance vision, intermediate vision, and reading vision, thereby providing clear object viewing at all distances, and potentially eliminating the need for glasses. 

The newest multifocal technology available, offered by Progressive Eye Care, is the Tecnis Multifocal IOL.  This premium lens is unique because its aspheric design not only provides vision correction at all distances, but in most light conditions as well.  So if you have problems such as reading in low light then this may be the best lens option for you. 

Multi-focal IOLs have consistently shown to provide satisfactory vision at all distances, including up close for reading.  Their all-encompassing ability makes them an extremely popular option for patients looking to reduce or even eliminate their need for glasses or contacts.  Click here for more about the Tecnis lens.

Accommodating Lens Implants

The major disadvantage of single focus IOLs is that they are rigid lenses designed solely for clear distance viewing.  They do not ‘accommodate,’ or change their focus, for viewing things up close. 

Accommodating IOL's, such as the Crystalens, are special single-focus lenses designed to ‘flex’ like the natural youthful lens of the eye.  They contain hinges that latch on to the cilliary muscles in the eye, and bend in response to the push/pull of these muscles when we focus on an object up close.  So for example, when we attempt to read our computer screens, the lens position is shifted naturally within the eye, allowing clear focus on the objects or text within the screen.  This action mimics the behavior of the natural lens prior to the onset of presbyopia. 

Accommodating IOLs are a great option for patients looking to reduce their dependence on reading glasses after cataract surgery.  Because of their single-focus design, Accommodating IOLs may also decrease your risk of glare or halos.

Presbyopia-Correcting Lens Implants

Presbyopia is the term used to describe the gradual loss of flexibility within the lens of your eye.  This loss of flexibility makes it harder for a person to focus on near objects such as books and computer screens.  Simply put, presbyopia means you need reading glasses. 

Presbyopia quite literally means "old eyes", and it is an unavoidable part of the aging process.  It usually begins in your mid forties and becomes worse as you age.  At some point, your arms will just become ‘too short,’ and you will need reading glasses. 

The good news is that there now exist many surgical options that could reduce or even eliminate your need for reading glasses.

If you are over the age of 50 and suffering from presbyopia, you could be a candidate for a clear lens replacement (lens replacement for a patient without cataracts) with a presbyopic correcting premium lifestyle lens, such as a multi-focus lens or accommodating lens like the Crystalens.  These lenses are specifically designed to restore your close-focus adjustability, while still retaining clear vision at a distance.  Click here for more about Crystalens.

Best of all, presbyopic patients who undergo clear lens replacement will never develop cataracts! 

Clear lens replacement is just one of several surgical options available for the correction of presbyopia.  For instance, Monovision LASIK could be another alternative.  Factors such as age, health and prescription, all play a part in defining what vision correction option is best suited for you and your expectations, and you should work closely with your surgeon to determine which option is right for you and your unique vision.   

As with any eye care procedure, careful patient consideration is necessary to determine which Lifestyle Lens option a person is best suited for. 

If you or a family member has a cataract that is affecting quality of life there is no need to wait for your vision to get worse.  Please contact us for a free consultation to discuss your vision options.

Blepharoplasty

Blepharoplasty, which is also referred to as ‘eyelid surgery,’ or more commonly ‘eyelid lift,’ is a surgical procedure that improves the appearance of both the upper and lower eyelids. 

More specifically, blepharoplasty is used to treat any sagging, puffy or loose skin of the eyelids that becomes increasingly apparent as we age.  The skin around our eyelids is extremely thin, and therefore more susceptible to the effects of aging.  As this skin relaxes, it can create the appearance of droopy or puffy eyelids, and bags under the eye.  These effects basically make you look worn-out, older, and more tired than you really are.  

Blepharoplasty is used to treat these conditions by removing the excess skin and fat cells on the upper and lower eyelids. The procedure is an extremely effective and minimally invasive way to improve the appearance of most men and women.  Thousands of these eyelid procedures are performed every year, with the recipients enjoying a more vibrant and youthful appearance. 

Good candidates for the procedure are healthy men and women who have equally healthy facial muscles and skin. And of course, the prospective eyelid lift patient should be free of serious eye conditions.

Some of the conditions that could make you ineligible for eyelid surgery include:

-Thyroid disease
-Dry eye syndrome
-Diabetes,
-Heart disease, including high blood pressure
-Glaucoma

That’s why a full consultation and heath examination is necessary if you are considering eyelid surgery.  Your surgeon has to determine if you’re medically capable of receiving the procedure. 

All things considered, the very best candidates are people who have realistic goals for the procedure and the outcome expected.
The procedure

Eyelid surgery is most often performed under local anesthesia, on an outpatient basis.  To perform the procedure, the surgeon will make tiny incisions along the natural creases of your eyelids, so the scars remain invisible after healing.  Dr. Foley will then remove the excess skin and fat cells necessary, and then stitch up the incision with tiny sutures.

The overall process is pretty simple and only takes about an hour.   Afterwards, you’ll be given some pain medication and ointment to place on the eyelid skin.  You might experience some general bruising or swelling - cold compresses and head elevation will help reduce these symptoms.

You should expect any bruising or swelling associated with the procedure to disappear within a couple weeks of the procedure.  The desired results should be apparent 4 to 6 weeks after the procedure, although it isn’t uncommon for some patients to experience even more improvement on a gradual basis for up to a year after the procedure.  

It should be noted that while blepharoplasty is an elective procedure that is most commonly performed for cosmetic reasons, there are some instances where it is medically necessary, such as when the upper eyelid skin sags so much it interferes with a person’s vision.  In these instances, it is most likely that your insurance provider will cover your procedure. 

Your eyes are the main focal point for anyone who engages you.  They are also one of the first areas to show the signs of aging.  Eyelid surgery is a wonderful way to reverse these aging signs, and boost your self confidence.  However, it is important that you do your research and only consider eyelid surgery with complete understanding and realistic expectations. 

If you would like to talk to us more about the benefits of blepharoplasty, we’d be happy to assist you in making an educated decision.  Feel free to contact us with your questions, or to schedule a complimentary Eyelid consultation.

BOTOX^®

The word BOTOX^® immediately conjures up images of spoiled celebrities that seem to never age. But it is in fact an inexpensive, successful, non-surgical alternative to plastic surgery.

While we are all searching for the “fountain of youth” cosmetic surgery is a scary (and expensive) proposition, especially when compared to non-surgical alternatives that can produce similar results. That’s why BOTOX^® has become the primary choice for patients who wish to “turn back the hands of time.”

The next question you may be asking yourself is – BOTOX^® at an eye care clinic?

The fact is that BOTOX^® was originally approved by the FDA in 1989 for the treatment of blepharospasm (eyelid twitching). So the very first people to administer BOTOX^® were in fact ophthalmologists. It has only been in recent years that the FDA approved BOTOX^® for cosmetic use. Now plastic surgeons, dermatologists and many other physicians have access to BOTOX^®, but it was the doctors in vision care that have had the most experience administering BOTOX^® medication to patients.

How Does BOTOX^® Work?

• BOTOX^® is a purified protein used to relax wrinkles caused by the frequent movement of muscles in the face, resulting in a more relaxed, stress-free and youthful look. Its original cosmetic intention, and most often used application, is to treat the furrows between your eyebrows. BOTOX^® can also be used to smooth crow’s feet around the eyes as well as wrinkles across the forehead.

What Results Can I Expect with BOTOX^®?

Unlike surgery, BOTOX^® is fast, simple and minimally invasive, with no downtime or recovery. Most people return to normal activity immediately following treatment. Other than the initial redness and light swelling, you should not experience any other irritations. Within days, your appearance will be fresher and more youthful. You won’t look “like you’ve had work done.” You will still be able to smile, frown, raise your eyebrows…etc. There is no limitation to your natural face movement as one may be lead to believe. One BOTOX® treatment keeps the muscles relaxed for up to 4 months.

Is BOTOX^® Right For Me?

The only physical limitations to BOTOX^® are age. It is not recommended for people under the age of 18 or over the age of 65. Other than that, any man or woman who is concerned with their appearance and the effects of aging is an ideal candidate for BOTOX^® treatment.

What Can I Expect During the BOTOX^® Procedure?

BOTOX^® consists of several tiny injections to the problem area. These injections alleviate the muscle activity responsible for your frown lines, relaxing them so that they are temporarily inactive.

This is a minimally invasive procedure that has no down time and does not require anesthesia. The entire procedure takes approximately 10 minutes with very little discomfort, if any.

Will My Wrinkles Reappear Worse Off Than Before?

Fortunately, the answer is no. While the effects of BOTOX^® do wear off after a period of 4 months, the only result is your muscles returning to their original pre-treatment condition.

Even though the effects are not permanent, most patients are happy maintaining a periodic maintenance plan to keep up with their desired appearance. BOTOX^® has a long and proven track record of success, and is wonderful for patients who want a youthful, more relaxed look.

If you are interested in learning more about the capabilities of BOTOX^®, please feel free to contact us for a complimentary BOTOX^® consultation.