About Midwest Refractive Surgery and Cornea Consulting, P.C.

At Midwest Refractive Surgery and Cornea Consulting, P.C. we offer examination, consultation and treatment for many eye disorders. These include:

Dry Eyes

The eye has a tear film which coats the outer layer of the eye. This tear film is very important for the lubrication and comfort of the eye as well as for the clarity of vision. As we age, this protective tear film diminishes, and leaves the eye more exposed to the drying effects of the air, wind and dust. In many people the dryness is worse in the afternoon and evening.

Dry eye is not caused by a lack of tear production. In fact, during dry eye, the eye can still make so many tears that many patients complain of wet eyes and tearing with this malady. That's because the dryness causes the eye to produce more tears in an effort to replace the tear film. Dry eye is probably the most common problem seen in the eye doctor's office.

Dry eye symptoms include burning, stinging or a gritty sensation which may come and go depending on many factors. Itching, tearing and light sensitivity may also occur. Occasionally long strings of mucus can be stretched from a dry eye.

Blinking is very important for the maintenance of the tear film. When performing such activities as reading or working on a computer, we blink less frequently. This aggravates the symptoms of dry eyes. Sometimes environmental factors can also aggravate dry eye symptoms. Dry weather, either in hot or cold temperatures, robs the eye of needed lubricants. Cigarette smoke, fumes, dust and airborne particles are common irritants. In most patients, this condition is not associated with systemic disease.

Treatment helps in most patients. We cannot cure this condition, so treatment is an ongoing project. Usually artificial tears, available over-the-counter, soothe the eyes and give temporary relief. These artificial tears work for only an hour or two, at best, and must be repeated at frequent intervals. Ointments last longer, but they blur vision and are most effective at night.

Newer techniques to treat dry eye include plugs which block the tear duct. These plugs can be placed in the two tear ducts, top and bottom, in both eyes or in only the lower ducts. Some test plugs are also available which dissolve a few days after insertion. If the dry eye symptoms disappear when the temporary plugs are inserted, then permanent plugs should be considered as a treatment option.

Corneal Abrasion

A corneal abrasion occurs when the outer layer of the cornea, called the epithelium, is torn away. (The cornea is the clear outer coating of the front of the eye.)This can occur by a variety of means such as a finger in the eye, a tree limb, flying glass in an automobile accident, etc. It is one of the most common injuries to the eye.

The corneal has more nerve endings than virtually any other part of the body. Because of these many nerve endings, any damage to the cornea is very painful. Abrasions usually heal in a short time period, sometimes within hours. But while they are healing they can cause excessive tearing, redness, blurred vision and light sensitivity. In many cases, the cornea will heal overnight during sleep. If treatment is needed, it consists of a tight patch to keep the lids from moving and pain relievers as needed for comfort.

An antibiotic may be used following an abrasion because the open area of the epithelium invites infection. Small abrasions heal rapidly. However, if one covers more than one-third of the cornea, it may take an extra day or two for the epithelium to completely recover the front of the cornea.

Typically, an anesthetic is used in the eye doctor's office to ease the pain and to aid in the examination. After the examination, the pain typically returns. But, repeated use of anesthetic can harm the eye and is therefore not used in the treatment of abrasions. It may take several weeks for all the blurriness to resolve. Permanent loss of vision is very rare with superficial abrasions.

DO NOT rub the eyes during the healing phase following an abrasion. New cells require time to re-connect to the non-damaged layers of the cornea. These new cells can be easily rubbed off. If the new cells get removed, the pain returns and repatching is necessary.

Occasionally, long after an abrasion has healed it recurs spontaneously, often upon awakening in the morning. This is called a recurrent erosion and represents an area of the epithelium that is not re-connected well to the deeper parts of the cornea.

The treatment is similar to that for the abrasion. Sometimes the surface of the cornea is treated with a special instrument in order to help form better connections between the corneal layers. Extended use of bedtime ointments or lubricants may also help in preventing recurrent erosions.

Glaucoma

Glaucoma is one of the leading cause of blindness in the United States. It is a disease that typically affects older people, but it can occur at any age. Loss of vision is preventable if the disease is detected early and treatment is started.

The eye has about 1 million tiny nerve fibers which run from the back of the eye to the brain. These nerve fibers allow us to see. Glaucoma is a disease which causes the destruction of these fibers. It was once thought that the loss of these fibers was due to strictly to high pressure in the eye. But now it is known that even patients with normal eye pressure can have glaucoma and loss of these nerve fibers.

In many patients, the disease is not noticed in the early stages, because there is no pain and no noticeable change in vision. Early detection by an eye doctor is the key to the prevention of vision damage from glaucoma. Routine eye examinations are recommended.

Types of Glaucoma

The reason that eye pressure is high in many glaucoma patients is that the drainage system in the eye is not working properly. The fluid in the eye, called aqueous humor, does not flow out of the eye as quickly as it should. The drainage system lies in a part of the eye called the angle, which is between the outer layer and the iris of the eye. This angle can be open or closed.

There are several kinds of glaucoma. The most common form of glaucoma is called chronic open angle glaucoma. The drainage angle is open in these patients, but the eye fluid does not drain as quickly as it should. Closed-angle glaucoma occurs when the drainage angle closes, and almost no eye fluid can escape. During closed-angle glaucoma, eye pressure can get very high and there is pain. Angle closure glaucoma is an emergency and must be treated immediately. If the high pressure is allowed to continue for too long, blindness can result.

Some persons are more likely to have glaucoma. These include persons who are older, have nearsightedness, have a family history of glaucoma, have had past eye injury, have diabetes or have a past history of vascular shock. Also, African-Americans are 6 times more likely to have the disease.

Glaucoma is treated with eye drops that lower the eye pressure. If the pressure does not fall to a low enough level with drops, then surgery may be necessary. Glaucoma surgery opens up the drainage system in the angle so that the eye fluid can flow more freely.

OUR COMPREHENSIVE SERVICES:

• Primary Eye Care including General Eye Exams
• Ambulatory Surgery Center for Comfortable and "Close to Home" Outpatient Eye Surgery
• Diagnosis ans Management of Dry Eyes
• Medical and Surgery Treatment of Corneal Disease including Corneal Transplants
• Diagnosis, Surgery and Treatment of Glaucoma
• Laser Eye Surgery for Glaucoma
• Laser Eye Surgery for the correction of nearsightedness, farsightedness and astigmatism including LASIK, Custom LASIK and PRK performed in the comfort of our office.
• Excimer Laser Therapeutic Surgery for Corneal Disease

REFERRALS

If your insurance or HMO requires a referral to a specialist, you must bring this with you at the time of service. If another doctor has sent you to us, we will provide a written report to that referring doctor.

EMERGENCY CALLS

If you have an emergency after hours, please call the above office phone number. Our answering service will ensure that our on-call doctor contacts you.

FEES, INSURANCE, BILLING

We make every effort to keep our fees reasonable for all patients. We request that payment for office visits be made at the time of service. We accept checks, VISA & MasterCard. We will file all insurance claims for you for office visits, diagnostic services, and surgery. We are participating providers with most local HMOs. Please notify our staff of your insurance coverage when you make an appointment. If a referral is required, please be sure to bring it with you for your visit. All co-pays will be collected at the time of service.