Vision

This newsletter is published by the Cottonwood Eye & Laser Clinic. It is our sincere hope that you will find some valuable and interesting eye care information. If you have any comments or questions regarding your eyes, please don't hesitate to call 801-268-6600, or visit www.cottonwoodeye.com.

THE BEST REASON FOR REGULAR EYE EXAMS IS ....

for the detection of glaucoma. Glaucoma is an eye disease sometimes called "the theif in the night." That's because glaucoma seldom causes any eye pain, discomfort or other symptoms. However, undetected and untreated, glaucoma causes a gradual and non-reversible loss of vision. First the peripheral vision is lost and, in the end, the central vision is also lost. People can and do go blind from untreated glaucoma, but if it is detected early and treated, in almost all cases vision can be preserved. Regular eye exams are essential to detect glaucoma in its early stages.

What exactly is glaucoma? It is an eye condition in which the fluid pressure inside the teye is too high. This eye fluid is call aqueous. The randge of normal pressure for the auqeous is between 10 and 20 mmHg (millimeters of mercury). It can be compared to air pressure in a tire. If the pressure is too high, the tire performs poorly and wears out faster. It is similar for the eye, however, low pressure is seldom a problem or concern.

High pressure can damage the sensitive optic nerve in the back of your eye. Aqueous fluid is continually being produced by the eye and draned by the eye. In other words, there is a constant turn over in the aqueous fluid. Another example to better understand glaucoma, is to compare it to a lake, with water continually running in and running out. If there is too much water running in or not enough water running out, the water level of the lake will rise. In the eye, if too much fluid is produced or not enought drains our (through small channels into tiny blood vessels), then the eye pressure goes up.

Who can get glaucoma? Anybody. It can occur at any age but is very rare under age 30. The older a person is, the greater the chance of developing glaucoma. Over age 60, nearly 2% of the population will have or develop glaucoma. There is also a hereditary factor. If glaucoma runs in your family among blood relatives, there is a high likelihood that you will get it.

How do we diagnose glaucoma? When you have an eye exam, the eye doctor will measure your intra-ocular pressure. Your optic nerve will also be examined to see if it shows any signs of damage from pressure. If glaucoma is suspected, you will be given a "field of vision" or peripheral vision test. Sometimes your eye will need to be checked several times over a period of months before confirming a diagnosis of glaucoma, it is still important to have this checked along with a complete eye exam at least every two years.

How is glaucoma treated? The answer is usually with eye drops. There are many kinds of drops available, but they do not all work for all people. Your doctor will determine which drops are best for you. In general, the drops work by either reducing the production of aqueous fluid, or by increasing the aqueous outflow. Another effective method of treatment is by laser - called laser trabeculoplasty. This is an office procedure which is painless and only takes a few minutes per eye. Although the laser treatment effectively loweres the intra-ocular pressure by improving the aqueous outflow, it does not guarantee that drops will not also be necessary. Rearely, actual surgery is required to control the eye pressure.

How do we follow glaucoma patients? This is done by examining the patient's eyes every four months. The eye pressure is always checked. In addition, three other tests are performed each year, one being performed at each of the three visits per year. These tests are: bisual field (to check peripheral vision and for blind spots), potographs of the optic nerves (to document their appearance), and a scanning laser picture of the optic nerves and retinal nerve fiber layer (to accurately measure and record these areas for future comparison). It is important that glaucoma patients return regularly at four-month intervals for these tests, which indicate how well the treatment if working and whether any changes in therapy need to be made. By following the doctors treatment plan, you can be sure that everything is being done to preserve your vision.

LASIK UPDATE

Lasik surgery for vision correction has been performed by Steven Jackson, M.D. and Alan Jackson, M.D. for about ten years, when it was approved by the FDA. Thousands of our patients have now had this procedure. Lasik has an excellend track record for efficacy and safety. In fact, of all the medical / surgical procedures in any speciality, lasik is near the top for both effectiveness and lack of complications. Lasik can now be used to correct nearsightedness, farsightedness and astigmatism (non-spherical cornea). The prcedure itself is virtually painless. Most patients return to work or ordinary activities in one or two days.

How can I know if lasik would be good for me? Although most patients qualify for lasik, the only way you can learn if you are indeed a good candidate and if lasik is right for you is to have a complete eye examination with particular attention to your refraction (prescription), your pupils, and your cornea (the front surface and structure of your eye). If your refraction is too high or your pupils too large, or your corneas too thin, or abnormal in some other way, lasik may not be appropriate for you. Ther are other vision correction procedures that could be viable alternatives to lasik for some people. Our eye surgeons will only recommend lasik if they fell you will have a very good result and will be satisfied with your post-operative vision. Only with a one-on-one visit with one of our eye physicians can this be determined. It is most important to make sure you have lasik by an experienced surgeon who will take time to answer all your questions and make you feel comfortable with your decision.

Is there anything new with lasik? Yes, and no. For the most part, lasik is performed just about the same today as ten years ago. However, because of expanded laser and computer technology, it is now possible to treat some patients who were not previously good candidates. Also now available is "custom lasik" which is recommended for some patients. In "custom lasik", instead of just treating your refraction (prescription), your own particular eye with its own configuration and shape is specifically treated. This custom treatment is based on a corneal mapping system and a laser vision evaluation system called "wavefront". For some patients this may yeild superior vision to conventional lasik. Doctors at Cottonwood Eye and Laser Clinic can help you decide what would be best for you.

A refraction is that part of the eye exam which determines what power or combination of lenses is required to produce your best vision. The refraction gives your best corrected visual acuity, which is important information in detemining the health of the eye. Simply put, it is your prescription for glasses or contact lenses. Your eye doctor will check or determine your refraction on most office visits. If you vision is correctable to 20/20 in each eye, that is one sign that your eyes are indeed healthy. If not, further examination or testing is performed to explain the reason for the reduced vision. The usual charge for this part of the eye exam is $35.00. Insurance may or may not pay for the refraction. If not, you will be required to pay for this part of the exam. Medicare does not pay for refractions.

Contact Lens Safety Review

• Always wash hands before handling contacts.
• Clean and replace contact lens cases regularly.
• Replace contacts as recommended by eye-care professionals.
• Clean and disinfect contacts as recommended.
• Never use tap water or homemade saline with contact lenses (Improper user of solutions has been linked to potentially sight threatening infections.)
• Use frest multi-purpose solution daily to disinfect lenses.