Cataract Surgery
We perform a minimally invasive, no-stitch cataract surgery called phacoemulsification ("phaco") surgery. First, the eye is numbed with anesthesia. Then a tiny incision is made in the eye to make room for a small ultrasonic probe. This probe breaks up, or emulsifies, the cloudy lens into tiny pieces.
After the cloudy lens has been removed, a new artificial lens is implanted in the eye. With the recent advance of foldable IOLs (intraocular lenses), artificial lenses can be implanted through the same small incision from the phaco procedure.
Refractive Lens Implants
Using methods similar to those in cataract surgery, refractive lenses are implanted in front of (phakic intraocular) or in place of (clear lens replacement, or CLR) the eye's natural lens. Both procedures use local anesthesia and take approximately 15-30 minutes.
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Phakic Intraocular lenses are implanted in front of the patient's natural lens either in the anterior chamber (in front of the iris) or the posterior chamber (between the iris and natural lens). The new lens helps the patient focus better, leaving the natural lens in place allowing the patient to "accommodate," or shift focus between distant and nearby objects. The procedure is reversible.
Clear Lens Replacement (CLR) is usually recommended to patients over 45 who wear bifocals, since it replaces the natural lens with an artificial one that cannot "accommodate" (shift focus between distant and nearby objects). Three options are available to correct for this loss:
- Bifocal or multifocal glasses or contact lenses.
- Multifocal lens implants – sort of "bifocals for the brain," multifocal lenses have several built-in correction levels which the brain chooses from for the clearest view of any given object.
- Monovision – the eyes are adjusted so that one focuses on distant objects and the other on nearby objects.
Glaucoma
Glaucoma is a leading cause of blindness in the U.S. It occurs when the pressure inside the eye rises, damaging the optic nerve and causing vision loss. The condition often develops over many years without causing pain or other noticeable symptoms – so you may not experience vision loss until the disease has progressed.
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Symptoms that you could be developing glaucoma include blurred vision, loss of peripheral vision, halo effects around lights, and painful or reddened eyes. People at high risk include those who are over the age of 40, diabetic, near-sighted, African-American, or who have a family history of glaucoma.
To detect glaucoma, your physician will test your visual acuity and visual field as well as the pressure in your eye. Regular eye exams help to monitor the changes in your eyesight and to determine whether you may develop glaucoma.
Once diagnosed, glaucoma can be controlled. Treatments to lower pressure in the eye include non-surgical methods such as prescription eye drops and medications, laser therapy, and surgery.
Glaucoma Surgery
Some cases of glaucoma can be treated with medications. For others, laser or traditional surgery is required to lower eye pressure. Common surgeries include:
- Laser Peripheral Iridotomy (LPI) – For patients with narrow-angle glaucoma. A small hole is made in the iris to increase the angle between the iris and cornea and encourage fluid drainage.
- Argon Laser Trabeculoplasty (ALT) and Selective Laser Trabeculoplasty (SLT) – For patients with primary open angle glaucoma (POAG). The trabecular passages are opened to increase fluid drainage. ALT is effective in about 75% of patients, and SLT may be repeated.
- Nd:YAG Laser Cyclophotocoagulation (YAG CP) – For patients with severe glaucoma damage who have not been helped with other surgeries. The ciliary body that produces intraocular fluid is destroyed.
- Filtering Microsurgery (Trabeculectomy) – For patients who have not been helped with laser surgery or medications. A new drainage passage is created by cutting a small hole in the sclera (the white part of the eye) and creating a collection pouch between the sclera and conjunctiva (the outer covering of the eye).
- Tube Shunt Surgery – May be recommended for patients with neovascular glaucoma, failed trabeculectomy, or susceptibility to developing scar tissue. A thin, flexible tube (a shunt) with a silicone pouch is inserted in the eye to facilitate drainage.
BOTOX® Cosmetic
BOTOX® Cosmetic is commonly used to reduce or eliminate the appearance of facial wrinkles. It is injected under the skin into areas surrounding the eyes, forehead and mouth to smooth crow's feet, frown and worry lines, and lines on the neck. Made from a purified protein, BOTOX® injections block nerve impulses, weakening muscles to relax wrinkles and give the face a rejuvenated look. BOTOX® may also be useful for migraine headaches, excessive sweating, and eye and neck muscle spasms.
- To read more about BOTOX®, click here.
Photorejuvenation
The natural consequences of aging on our skin include sun damage, freckles, age spots, acne scarring, enlarged pores, and redness caused by broken capillaries and rosacea. Photorejuvenation reduces these signs of aging using non-invasive, painless pulses of light. Treatments can also improve the appearance of birthmarks and uneven pigmentation and stimulate the production of collagen. There is no recovery time and low risk of complications. Multiple sessions of about 20 minutes each are performed every few weeks until the desired result has been achieved.
Contact Lenses
Over 30 million Americans wear contact lenses, according to the American Optometric Association. Unlike glasses, contact lenses move with your eyes so you can enjoy a larger field of vision with fewer distortions. You also don't have to deal with frames hovering in your peripheral vision or external lenses that fog up on cold days or get wet in the rain.
There are many different kinds of contacts, including rigid and flexible, extended wear, disposable and planned replacement lenses. Some can be made as bifocals or in different colors. After a thorough eye exam and consultation with an experienced physician, patients who qualify for contact lenses can discuss which type is right for them. All contact lenses require special care and cleaning. You'll need to make regular follow-up visits to ensure your eyes remain healthy.
Routine Eye Examination
Regular, routine eye examinations are one's best assurance for maintaining good eye health and good vision throughout life. During this eye examination, all the structures of the eye are checked for health and function, and eye problems may be detected and treated before they become significant. The main parts of the eye examination include:
- Vision testing – acuity, color vision, depth perception.
- Refraction – measurement of any lenses needed to optimize the vision.
- Eye pressure – to check for glaucoma.
- Slit lamp examination – special illuminated microscopic examination of the front surface, lens, and pupil space of the eye.
- Funduscopic examination – special illuminated instrument to visualize the inside of the eye (fundus), includes the optic nerve, retina, macula, and vitreous fluid.
- Motility – check on coordination of eye movements.
Other tests often used for specific indications include:
- Visual field.
- Pachymetry (corneal thickness).
- Ultrasound imaging.
- Eye photography.
- Corneal topography.
- Dry eye testing.
Some parts of the eye examination require dilation of the pupil with drops to allow a better view inside the eye. Certified ophthalmic assistants may do some of the testing, however, Dr. Spector sees every patient and makes all treatment decisions with the patient.
The suggested guidelines for the frequency of these eye examinations are as follows:
Ages 0-2: Eye screening at regular pediatric visits by pediatrician.
- Ages 3-5 Eye screening every one to two years at regular primary doctor visits.
- Ages 6-19: At least one examination by an Eye M.D., and as needed.
- Ages 20-29: Same as above.
- Ages 30-39: Two eye examinations during these years.
- Ages 40-65: Eye examination every two to four years.
- Ages 65 and over: Eye examination every one to two years.
These are the minimal, suggested frequencies for routine eye examinations. Dr. Spector may recommend more frequent eye checkups if any eye conditions are present which would require closer follow-up and monitoring.
Out patient eye surgery eliminates costly hospital stays, and allows you to recuperate in the comfort of your home, with the company of your family and friends. The same high quality care is available, but without the risk of hospital acquired infections, sometimes connected with external hospital stay. The vast majority of Ophthalmic Surgery can be done with safety and efficiency at the Presidential SurgiCenter.
The Presidential SurgiCenter is dedicated to providing you with the most comfortable, competent car available in this area. Every consideration has been taken to create a pleasant comfortable and friendly atmosphere for you. We know that surgery is not something you are involved with often, so we encourage you to ask question to set your mind at ease. Our friendly staff is completely trained to help you understand what out patient surgery is all about.
Blepharoplasty (Eyelid Surgery)
Blepharoplasty can rejuvenate puffy, sagging or tired-looking eyes by removing excess fat, skin and muscle from the upper and lower eyelids. It may be performed for cosmetic reasons or to improve sight by lifting droopy eyelids out of the patient's field of vision. The procedure is usually performed in an office with local anesthesia in as little as 45 minutes. Blepharoplasty can be combined with a facelift or BOTOX® treatments to raise the eyebrows or reduce the appearance of wrinkles, crow's feet or dark circles under the eyes.
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Ptosis (Drooping of the Upper Eyelid)
Ptosis may occur for several reasons such as: disease, injury, birth defect, previous eye surgery and age. In most cases, it is caused by either a weakness of the levator muscle (muscle that raises the lid), or a problem with the nerve that sends messages to the muscle.
