In order to protect your eye health, it is important to have a complete eye examination regularly. An eye examination can be performed by either an optometrist or an ophthalmologist and includes a number of tests that measure vision, eye pressure, visual field and the health of different parts of the eye.

Visual Acuity

The visual acuity test measures distance vision. If a patient already wears glasses, the test would be performed while wearing the glasses or contact lenses. The patient covers one eye and reads rows of letters aloud from a chart, known as the Snellen chart, 20 feet away and then switches eyes. The smallest row that can be read is recorded as the vision in that eye.

During the refraction examination, the eye doctor determines the eyeglass prescription. The doctor often uses a phoropter, which is a machine that contains a series of lenses of different prescription powers. While showing the patient a Snellen chart, the doctor shows the patient different lenses in one eye at a time and asks which lens makes the letters on the chart look clearer. The doctor repeats this step until the combination of lenses that give the best possible visual acuity is found.

Eye Health

The visual field exams measure peripheral, or side, vision. During a general eye examination, the doctor will perform a confrontational visual field exam. The patient covers one eye and looks straight ahead while the doctor holds an object to the side; the patient reports when the object cannot be seen anymore. There are also machines such as automated perimeters that can also be used to measure the visual field as well. A slit lamp is a type of microscope that allows the doctor to look closely at the patient's eyes.

The patient sits at the slit lamp and the eye doctor sits at the other side. Using the slit lamp, the doctor can examine the eyelids, conjunctiva and cornea as well as structures inside the eye. The eye doctor can examine the back portion of the eye -- the retina and optic nerve; with direct or indirect ophthalmoscopy or using the slit lamp. Typically the doctor dilates the pupils using eyedrops and looks at the rear of the eye using a hand-held ophthalmoscope, which is direct; a light mounted on the doctor's head with a hand-held lens, which is indirect; or the slit lamp with a magnifying lens.

Eye Pressure

The eye doctor typically measures the pressure inside the eye using one of two methods: non-contact tonometry or applanation tonometry. With non-contact tonometry, a puff of air is blown into the eye to measure the eye pressure. With applanation tonometry, the doctor places a topical anesthetic into the eye and while the patient looks straight ahead, a device called a tonometer is placed against the eye to measure the pressure.

Other Tests

There are additional tests that may be performed during an eye examination. One is the color vision test, which measures color blindness. Doctors can also measure the balance of the eye muscles using the eye muscle test in which the doctor asks the patient to look in different directions. Sometimes, the eye doctor uses a machine to automatically determine the glasses prescription before using the phoropter. There are more specialized tests that the eye doctor may perform depending on the patient.

A cataract is a clouding of the normally clear lens of the eye.

How is the surgery performed?

The surgery is performed under local anesthesia, which is administered in the form of eye drops, very similar to the drops used during your office examinations. Dr. Ko will perform the small incision technique of endolenticular phacoemulsification (cataract surgery). Your original lens will be broken up by the use of an ultrasound and removed by a vacuum. Your original lens will be replaced by an intraoucular lens implant. This procedure requires no sutures (stitches) and results in rapid recovery. After the surgery, the discharging nurse will give you drops which you are to use as instruction in the operated eye. You will be seen the next day in our office for your post operative appointment.

Our procedure

Cataract surgery with intraocular lens implantation done by Dr. Ko and staff at Advanced Medical Eye Care, P.C. is the most modern up to date procedure. We use eyedrops for anesthesia, often with no needle injections around the eye; a sutureless technique (without stitches) and the duration of surgery averages 5-10 minutes. This microsurgery is done by ultrasound and can be occasionally followed up by laser (for an aftercataract).

Patient expectations

Cataract surgery is done in an outpatient setting. The surgery usually takes 5-10 minutes and often you are home the same morning or afternoon. You can often resume full activities including physical exertion such as exercise as there are no restrictions. No eye patch or shield is necessary. Post operative visits are scheduled to your convenience and as required. Eye-drop instillation is emphasized.

Complicated cataract surgery

Most cataracts are straightforward and frequently routine. However, a small percentage of cases especially in our practice are more complex due to certain inherent eye diseases, associated glaucoma, medical diseases, trauma, and unknown etiologies. Occasionally, eyes with previous surgery which has been complicated such as a dislocated intraocular implant or a swollen cornea will require additional and specialized surgery to correct the problem. These often require supplemental techniques and can make the surgery longer, more complex and recovery longer. Our practices specializes in such cases and we can discuss the implications.

During LASIK, a thin layer of tissue is folded back from the surface of the cornea. After the laser reshapes the cornea, the tissue is folded back into place, where it bonds quickly. At Advanced Medical Eye Care, P.C., we use Allegretto Wave Eye-Q Laser. This three-minute procedure requires no needles and no stitches.

LASIK can be used to treat nearsightedness, farsightedness and astigmatism. Healing for most patients is so fast that vision can improve within hours of the procedure, and many patients return to work the next day.

AM I A GOOD CANIDATE

Because your eyes and your vision are as unique to you as your fingerprints and DNA, it’s very difficult for us to know whether vision correction surgery can benefit you without a personal examination. In general, the conditions we’re able to treat include: nearsightedness (myopia), farsightedness (hyperopia) and astigmatism. We like our patients to be at least 21 years of age, have healthy corneas, and to have had stable vision and eyeglasses or contact lens presription over the past year. Here are Some Common Conditions That Prevent People From Seeing Well.

Myopia (Nearsightedness)

Distance vision is impaired when the eye is too long in relation to the curvature of the cornea, and light focuses in front of the retina.

Hyperopia (Farsightedness)

Close vision, and to some extent distance vision, is impaired when the eye is too short in relation to the curvature of cornea, and light focuses behind the retina.

Astigmatism

When the cornea is oval, rather than round, light focuses on more than one point on the retina. Astigmatism impairs both distance and close vision.

Presbyopia

This natural loss of close vision with age is caused by hardening of the natural lens. It may be treated by changing the focus of one eye for reading, a procedure called monovision or blended vision.

These procedures are similar to LASIK, except that a tissue flap is not created. The laser treatment is done on the surface of the eye after removing the outer layer of cells. LASEK and PRK are suitable for people whose corneas are to thin or to curved to be good candidates for standard LASIK. With LASEK and PRK, healing time is slightly longer than with LASIK, and good vision is achieved in four to seven days.

We like our patients to be at least 18 years of age, have healthy corneas, and to have had stable vision over the past year with an unchanging refraction.