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Visian ICL, or “implantable Collamer lens” is an alternative procedure for patients who may not be ideal candidates for Lasik or other alternative corrective eye surgery. Visian ICL is typically used for patients who do not want to remove portions of their cornea, have thin corneas, or that have excessively high levels of nearsightedness (myopia).

This procedure makes a small incision and then implants a personalized prescription lens over the cornea to allow for corrected vision. If your vision then changes due to aging or other natural processes, the lens can be replaced by another lens with an updated prescription.

Who is a Good Candidate for ICL?

Typically, patients that would benefit from ICL are between the ages of 21-45. This age represents a slight increase from the base age of 18 for Lasik. This procedure is also not well suited for geriatric or elderly individuals. Patients may also have mild or severe myopia, and they have a prescription that has been relatively unchanged. While the age requirements are more stringent for ICL than Lasik, there are other less stringent qualifications. This means that even if you aren’t an ideal candidate for Lasik, ICL could be a good option for you.

Performing the Operation

ICL is considered an outpatient operation and only takes about 30 minutes to complete. This means that you will be in and out of your chosen facility on the same day. Patients are given some numbing drops for their eyes and individuals that are more hesitant or uncomfortable may also be given a sedative. 

The surgeon will make several micro-incisions in the eye to insert and place the lens. When the lens has been inserted, it will be unfolded, and the edges of the lens will be placed behind the iris. After this is completed, the operation is considered complete. Your physician may give you some eye drops for postoperative care and then send you home. There may be a follow-up appointment scheduled 24 hours later.

Post-Operation

After your operation, you will be required to have somebody else drive you home. Anytime that you have an operation that may impair your vision or ability to operate a vehicle, you should plan to have somebody else drive you home. Surgery results are typically noticeable 24 hours after the operation.

Recovery time is minimal, and some patients experience mild discomfort or a gritty feeling in their eyes. Your doctor may require you to stay out of the swimming pool and avoid activities that make you heavily perspire because when sweat gets into your eyes, it may aggravate the micro incisions and cause additional discomfort.

While there are some potential complications both during and after the operation, they are typically minimal. The chances of impairing your vision or causing long-term damage are very low with this operation, however, you should make sure to talk about potential side effects with your physician. If you experience any abnormality, you should seek medical attention immediately.
 

LASIK (laser-assisted in situ keratomileusis), is the most popular refractive surgical procedure. In this procedure, a laser is used to permanently change the shape of the cornea (the clear covering on the front of the eye) to correct common vision problems such as nearsightedness, farsightedness, astigmatism, and presbyopia. This improves vision and reduces a person's need for glasses or contact lenses.

LASIK uses an excimer laser (an ultraviolet laser) to remove a thin layer of corneal tissue, giving the cornea a new shape, so that light rays are focused clearly on the retina. In the case of a nearsighted person, the goal of LASIK is to flatten the too-steep cornea; with farsighted people, a steeper cornea is desired. LASIK can also correct astigmatism by smoothing an irregular cornea into a more normal shape.

LASIK is an outpatient surgical procedure with no need to stay at the surgery center overnight as it will take 10 to 15 minutes to perform for each eye. The procedure is done while the patient is awake, but the patient may request mild sedation. The only anesthetic used is eye drops that numb the surface of the eye. LASIK can be done on one or both eyes during the same session.

How to Prepare for LASIK Eye Surgery?

Before LASIK eye surgery, the eye surgeon will evaluate the patient’s medical history and perform a full eye examination, including measuring corneal thickness, refraction, corneal mapping, eye pressure, and pupil dilation. Afterward, the surgeon will discuss what to expect during and after the procedure.

On the day of the surgery, eat a light meal before going to the doctor and take all prescribed medications, if any. Do not wear eye makeup, creams, perfumes or lotions on the day before and the day of surgery, or have any bulky hair accessories that will interfere with positioning head under the laser.

Contact lenses shouldn't be worn for at least three days prior to the evaluation. In the case of, rigid gas permeable contact lenses, they should not be worn for at least three weeks before. Patients should arrange for a ride home from the place of surgery, as their vision might be blurry.
 

Eyelid rejuvenation surgery is a medical procedure that is designed to reduce the appearance of bagginess from the lower eyelids and sagging from the upper eyelids. This operation is often used for cosmetic surgery to reduce the appearance of aging.

This surgery can also be considered when the eyelids are interfering with a patient’s ability to see. Sometimes a sagging upper eyelid can partially obscure the eyeball, interfere with a person’s ability to look in certain directions or interfere with their peripheral vision.

Why Do My Eyelids Sag?

As our skin ages, it often loses its elasticity. This doesn’t allow the skin to rebound back to its original shape and we see the appearance of wrinkles and bulges that aren’t due to weight gain. While these wrinkles can occur all over the body, they typically first appear in the face and eyes. Any additional skin on or near the eyelids can cause the eyelid to sag or droop over the eyelashes and into the frame of vision.

The eyelids also contain some fat to protect and cushion the eyeball. The fat is held in place by a thin membrane. As we age, the membrane can weaken and will no longer keep the fat in place. This fat can create bulges in the upper and lower eyelids.

What Can I Do About Eyelid Sag or Bulging?

There are several non-surgical treatments on the market to help treat sagging skin or reduce the appearance of wrinkles, but it is important to use additional caution when applying any product near the eyes. Always make sure that the product is designed to be used in the predetermined area. If you have questions about a specific product, you should contact your health care provider.

Many individuals find that non-surgical options don’t have enough or any effect on their eyelids. In these instances, they can consider working with a licensed medical professional to weigh their options. Eyelid rejuvenation (blepharoplasty) is also commonly called an eye lift.

There are several different methods for achieving your desired results. Typically, an incision is made into the eyelid, and then the excess skin or fat cells are removed by laser or scalpel. Additionally, your surgeon may suggest that you also get laser resurfacing done in combination with your surgery.

What to Expect

Eyelid surgery can be done in a local office or a surgery center. If you are completing the operation in an office environment, you can probably expect that you will be treated with a local anesthetic and an oral sedative. If you are in a surgery center, it’s likely that you will receive an intravenous anesthetic. The surgery takes about two hours to complete if you are getting all four eyelids done (upper and lower lids). When you are getting all four eyelids corrected, the surgeon will likely opt to work on both upper eyelids first and then move to the lower eyelids. While the upper eyelids will have three to six stitches, the lower eyelids may not have any. The stitches should remain in place for three to six days.
 

Millions of patients are diagnosed with diseases and conditions of the eye every year. Some of which may not display symptoms until there is irreversible damage to the patient’s vision. The outcome of eye disease can range from temporary discomfort to total loss of vision, which is why all eye problems and diseases should be taken seriously and regular eye check-ups are absolutely essential.

What Are The Causes of Eye Disease?

The main causes of eye problems can be divided into five groups:

• Inflammation of the eye and surrounding structures caused by a bacterial, viral, parasitic or fungal infection.

• Injuries to the eye and surrounding structures, either as a result of trauma or an object in the eye.

• Genetically inherited eye diseases, many of which may only manifest later in life and affect the structures and the functioning of the eye which therefore can impair visual abilities. In some cases, however, children are born with these conditions.

• Diseases or conditions, such as migraine or diabetes, which can affect other organs of the body, such as the eyes.

• External causes, such as allergies or eye strain due to over-use, or as a side effect of medication.

What Are The Symptoms of Eye Disease?

The three symptoms indicative of eye disease are changes in vision, changes in the appearance of the eye, or an abnormal sensation or pain in the eye.

Changes in vision can include the following symptoms:

• Nearsightedness is caused by an elongation of the eyeball over time, making it difficult to clearly see objects far away.

• Farsightedness is caused by the shortening of the eyeball, making it difficult to see objects that are close-by clearly.

• Blurry or hazy vision, or loss of specific areas of vision, which can affect one or both eyes and is the most common vision symptom. Any sudden changes in vision should be a cause of concern.

• Double vision means a single clear image appears to repeat itself. This could be accompanied by other symptoms like headaches, nausea, a droopy eyelid, and misalignment of the eyes.

• Floaters are specks or strands that seem to float across the field of vision. These are shadows cast by cells inside the clear fluid that fills the eye. These are usually harmless, but should be checked out as they could point to something serious such as retinal detachment.

Eye disease that is caused by diabetes is currently the number one cause of blindness and vision loss. Due to the increased risk in diabetic patients, doctors recommend that people over 30 with diabetes get an annual dilated eye exam. Diabetic patients under 30 should get this exam five years after they have been diagnosed.

Diabetic retinopathy is a condition that is caused by damage to the retina. Patients that have diabetes may also have experienced extended periods of time where their blood sugar was elevated. The high levels of blood sugar damage the retina’s walls which leave them susceptible to leaking. When fluid accumulates in the retina or macula, it causes vision loss.

To make these matters worse, if prolonged high blood sugar levels are seen again, the retina will be oxygen-depleted. This causes the abnormal growth of new blood vessels. This condition is called neovascularization. This blood vessel type is weak and prone to leaking. As these blood vessels leak, they introduce blood into the eye. Excessive bleeding into the eye can cause blindness.

Treatment

While a healthy diet and exercise can be beneficial to your optical health, diabetic retinopathy is a condition that is caused by damage to the retinal wall. While this damage can sometimes be corrected, simple diet changes won’t reverse the effects.

It is essential to catch the condition in the earlier stages to reduce the effects. This can also help patients understand the importance of monitoring their blood sugar so that repeat events can be limited. Treatment options are even more successful when diabetic retinopathy is caught early. These options include vitrectomy, scatter photocoagulation and focal photocoagulation.

During both scatter, and focal photocoagulation the doctor will use lasers to help alleviate the condition. The lasers make small burns on the retina aimed at the blood vessels. These burns will help to seal the blood vessels to prevent more leakage and stop them from growing larger.

When using scatter photocoagulation, hundreds of small burns are made in a specific pattern during two additional appointments. Scatter coagulation should be used on patients who do not have advanced diabetic retinopathy.

Focal photocoagulation specifically targets the leaking blood vessels that are in the macula. Unfortunately, this procedure is not aimed to correct the blurry vision associated with diabetic retinopathy, but it does stop it from progressing further. Once the retina has detached, neither form of photocoagulation can be used.

Vitrectomy is a surgery that helps to remove scar tissue and/or the fluid that is clouded with blood that has been leaked into the eye. This operation is the most successful when performed before the disease has progressed too far. When the operation only targets removing the fluid, success rates are very high for the procedure. When the procedure also aims to reattach the retina, the failure rate is around 50%.
 

Premium IOLs or intraocular lenses are lenses that are placed in the eye during cataract surgery. The lens placement is designed to restore the natural lens shape. These lenses can also be placed as a vision correction device called refractive lens exchange. Premium IOLs offer advanced features beyond the single vision IOL’s that are also offered. These features include aspheric, toric, accommodating, and multifocal IOL’s.

Understanding Premium IOL Types

Aspheric Lenses

These lenses closely match the natural curve of the eye. Typical lenses were uniformly curved making it easier to manufacture, but at the same time increasing the chance of causing imperfections in vision. Aspheric lenses help to reduce imperfections and improve clarity, especially at nighttime.

Toric IOLs

These lenses are specifically designed to help correct nearsightedness, farsightedness, and astigmatism.

Accommodating IOLs

Accommodating IOL’s can tilt slightly forward when you look at objects that are close to the eye. This helps to improve visibility when you are performing actions like reading a book. While they are not necessarily as sharp as bifocals, patients have a reduced need to use reading glasses while still maintaining excellent distance vision.

Multifocal IOLs

If you require a bifocal or trifocal lens in your glasses, this may be a likely choice for you. Different portions of the lens allow for better vision at different ranges. However, there are some overall sacrifices with vision clarity at a distance.

Understanding PRK: Is It Right for You?

PRK or photoreactive kerectomy is a surgical procedure that was the precursor for the surgery known as Lasik. The biggest difference between the two procedures is how the first portion of the operation is conducted. Additional variability between the two procedures includes recovery, risk factors, and the patient’s overall needs. Understanding these differences can help you decide if PRK is an appropriate solution for your vision issues.

How it Works

PRK utilizes a laser to correct farsightedness (hyperopia), nearsightedness (myopia), and astigmatism. During a PRK operation, a laser is used to remove the exterior epithelial cells from the cornea. This procedure uses an excimer laser to remove the cells which are then discarded. A contact “bandage” is placed over the eye, and the cells can heal over the course of a few days. Your doctor will then remove the contact lens when the eye has healed enough to be exposed.

While the results are like that of Lasik, PRK does take some additional healing time. This is due to the time that must be allowed for the epithelial cells to heal and regrow on the eye. Additionally, Lasik patients generally experience less discomfort and faster results. PRK results can take a few weeks to fully materialize.

This isn’t to say that PRK doesn’t have its own benefits too. This procedure is well-suited for patients that have had previous eye surgeries and may have thin corneas. Because PRK does not make an incision into the cornea and only removes the epithelial cells, it leaves more of the stromal tissues which underly the epithelial tissue. PRK does not run the risk of “flap” issues that can arise from Lasik, and the risk of removing too much of the cornea is reduced. However, if you are considering PRK, you should consult with your medical professional to identify the right procedure for your specific case.

Before the Surgery

When you meet with your eye specialist to discuss your options, there are several factors that they will consider. Your potential surgeon should conduct a thorough eye exam during which they will measure your eye moistness, pupil size, corneal thickness, and corneal curvature. Your doctor should also review your medical and family history to identify any possible concerns about your suitability. Make sure that you bring a list of your medications and previous operations. Finally, you may be required to stop wearing contact lenses for a period before the operation. This can allow your cornea to return to its natural shape before the operation.

If you’ve been diagnosed with glaucoma, you’re probably already familiar with the typical options in glaucoma treatment – eye drops, laser treatment or traditional surgery. While these are certainly effective, especially when glaucoma is diagnosed early, researchers have been working hard to offer new glaucoma treatments. Their goal is not only to improve outcomes but also reduce the treatment’s side effects and frequency of use.

What is the Goal of Glaucoma Treatment?

Before we dive into the new options, it’s important to understand the goal of any glaucoma treatment. At present, glaucoma is not curable. However, treatment can significantly slow the progression of the disease. Glaucoma damages your eye's optic nerve. Extra fluid builds up in the front part of your eye (cornea), which increases the pressure in your eye. Reducing this pressure is the primary objective of any glaucoma treatment. This is often referred to as intraocular pressure or IOP.

What are the Limitations of Standard Glaucoma Treatments?

Eye drops for glaucoma treatment seem like an easy option but there are several challenges that can reduce its effectiveness. It can be difficult to get all the medicine in the eye, especially for older adults with less of a steady hand. In addition, since it must be applied daily, individuals may forget. Since the drops have no perceivable benefit because early stages of glaucoma have no symptoms, patients might make it a lower priority which is understandable since it may also have unpleasant side effects like burning, red eyes.

Beyond eye drops, laser surgery is a less invasive option. The laser opens clogged tubes and drains fluid. It can take a few weeks to see the full results. If laser surgery or drugs don’t relieve your eye pressure, you may need a more traditional operation. You would have to go into the hospital and will need a few weeks to heal and recover. Although usually effective, glaucoma surgery can make you more likely to get cataracts later on. It can also cause eye pain or redness, infection, inflammation, or bleeding in your eye.

What are Recent Advances in Glaucoma Treatment?

Alternatives or Improvements to Eye Drops

The Glaucoma Research Foundation reported several new developments on the horizon. These technologies focus on reducing patient error in applying eye drops which would make the medication more effective and improve the quality of life for the patient. Here are some of the products underway:

• A polymer, like a contact lens, would contain the drug; it would sit under the eyelid and release the medication over several months

• Microneedles would inject medication into a specific spot to be most effective

• Implantable extended-release devices using engineered highly precise microparticles and nanoparticles

• Polymer-based intraocular delivery technologies that would allow customizable sustained release

• Drops that allow the medication to get into the eye more easily

• Tear duct plugs that release medication

In addition, people with glaucoma who take more than one eye drop per day are beginning to see those medications available as a single, combined eye drop. New products include Cosopt (timolol and dorzolamide), Combigan (timolol and brimonidine) and Simbrinza (brinzolamide and brimonidine).
 

Vision therapy is a specialized form of treatment that aims to improve visual function and performance. It involves a series of eye exercises, activities, and visual training techniques designed to address a wide range of vision-related issues. Unlike traditional eye care, which often focuses on correcting refractive errors with glasses or contact lenses, vision therapy takes a holistic approach to addressing the underlying causes of visual problems.

By targeting the root causes of these issues, vision therapy can help individuals achieve better visual function, improve their overall well-being, and enhance their ability to perform daily tasks with greater ease and efficiency.

Amblyopia

Amblyopia, commonly known as "lazy eye," is a common vision condition that affects approximately 2-3% of the population. It occurs when one eye develops reduced visual acuity due to the brain's inability to properly process information from that eye.

In many cases, amblyopia develops during childhood, often due to factors such as refractive errors, strabismus (misaligned eyes), or visual deprivation. If left untreated, amblyopia can lead to permanent vision loss in the affected eye, as the brain increasingly favors the stronger eye and the weaker eye's visual processing abilities deteriorate.

Vision therapy is a highly effective treatment for amblyopia, as it aims to retrain the brain to properly utilize the weaker eye. Through a series of specialized exercises and activities, vision therapy can strengthen the neural pathways between the brain and the affected eye, improving visual acuity and binocular vision.

The key to successful treatment lies in the brain's remarkable ability to adapt and change, known as neuroplasticity. By engaging in targeted vision therapy, individuals with amblyopia can stimulate this neuroplasticity, allowing the brain to reorganize and improve its processing of visual information from the weaker eye.

Strabismus

Strabismus, also known as crossed eyes or misaligned eyes, is a condition where the eyes do not properly align with each other. This can cause one eye to turn inward, outward, upward, or downward, resulting in a lack of binocular vision and depth perception.

Strabismus can have a significant impact on an individual's visual function, self-esteem, and overall quality of life. Left untreated, it can lead to the development of amblyopia (lazy eye) and other vision-related problems.

Vision therapy is a highly effective treatment for strabismus, as it focuses on retraining the brain and the eye muscles to work together in a coordinated manner. Through a series of specialized exercises and activities, vision therapy can help individuals with strabismus improve their eye alignment, binocular vision, and depth perception.

Binocular Vision Disorders

Binocular vision disorders are a group of conditions that affect the way the eyes work together as a team. These disorders can result in a range of visual problems, including difficulty with depth perception, eye strain, headaches, and difficulties with reading and other visual tasks.

Some common binocular vision disorders that can be effectively treated with vision therapy include:

• Convergence Insufficiency: This condition is characterized by the inability of the eyes to properly converge, or come together, when focusing on a close object. This can lead to eye strain, headaches, and difficulties with reading and other near-work activities.

• Accommodative Dysfunction: Accommodative dysfunction is a problem with the eye's ability to focus, or "accommodate," on near objects. This can cause blurred vision, eye strain, and difficulties with reading and other close-up tasks.

• Vergence Dysfunction: Vergence dysfunction refers to a problem with the eye's ability to work together to maintain proper alignment and focus. This can lead to double vision, eye strain, and difficulties with depth perception.

Through vision therapy, individuals with binocular vision disorders can retrain their visual system to work more efficiently and effectively. The goal of vision therapy is to improve the coordination and synchronization of the eyes, ultimately leading to better visual performance and reduced visual symptoms.

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.