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Patient’s Corner

General Questions about eye examination:

1.How much time does an eye examination take?

A comprehensive eye examination takes approximately 60-90 minutes, depending on the various tests the doctors deem necessary.

2.Will my eyes be dilated?

If your eye exam includes an examination of the back of the eye (the retina), you will receive eye drops to dilate your pupils. Dilating drops may blur your vision or make your eyes sensitive to light for a few hours afterward. In children, this symptom may last up to 2-6 hours.

3.Can I drive after my eyes are dilated?

Many patients do drive themselves after having their eyes dilated, but it is important to remember that you will be sensitive to light and your vision may be blurry. You should wear sunglasses after your exam. Your safety is important, so if you do not feel comfortable driving, you should arrange for someone to drive you home.

4.Do I really need a driver for this appointment?

A driver is recommended as your vision may be blurred from dilation. If you haven't had a problem before, you may use your judgment.

5.What should I expect during my eye exam?

The parts of a comprehensive medical eye examination vary depending on the patient's age, date of last exam and other factors. Not every part of the eye exam may be needed or performed during your visit. Some of your tests may be performed by various ophthalmic medical personnel assisting the doctors. Parts of the eye exam will include documenting your medical history, visual acuity testing, external examination (eyelids, tear duct system, areas around the eye), eye muscle examination, visual field examination, slit lamp examination (looking closely at the outer and inner part of the eye with a special microscope), tonometry (measurement of your intraocular pressure) and ophthalmoscopy (using an instrument that shines a bright light into the eye to examine the retina through the pupil).

6.How often should I have an eye exam?

Maintaining regular checkups is important.

  • Children under 18: Annually
  • Age 18-45: Every two years
  • Age 45 and over: Annually

Contact lens wearers once every year regardless of age.

7.About how long will the appointment take?

You should expect to be at your appointment 2-3 hours. Some appointments may take less time but we want you to be prepared.

8.Why do I have to wait so long to see the doctor when I got here on time?

There are several tests which must be done by the technician so that your doctor will have necessary information to evaluate your eyes. You may also be dilated for the appointment, which takes 30 - 45 minutes.

9.Why do you have to check my vision today? You just checked it last week!

Vision can change for many reasons, just as pulse rate and blood pressure can change

10.Why do you need to know my medical history if I am only here about my eyes?

Many medical conditions affect the health of the eyes.

11.What exactly does '20/20 vision' mean?

20/20 vision is a term used to express normal visual acuity (the clarity or sharpness of vision) measured at a distance of 20 feet. If you have 20/20 vision, you can see clearly at 20 feet what should normally be seen at that distance. If you have 20/100 vision, it means that you must be as close as 20 feet to see what a person with normal vision can see at 100 feet.

20/20 does not necessarily mean perfect vision. 20/20 vision only indicates the sharpness or clarity of vision at a distance. There are other important vision skills, including peripheral awareness or side vision, eye coordination, depth perception, focusing ability and color vision that contribute to your overall visual ability.

Some people can see well at a distance, but are unable to bring nearer objects into focus. This condition can be caused by hyperopia (farsightedness) or presbyopia (loss of focusing ability). Others can see items that are close, but cannot see those far away. This condition may be caused by myopia (nearsightedness)

12.I have a question for my doctor, how can I get all of my concerns to him/her?

Yes of course. Please make a list of your concerns prior to your visit. We believe in spending a good amount of time with you to answer all your queries. In case you have forgotten something we are reachable over phone for general questions that you may have. You can also e mail your concerns & queries to us.

Questions pertaining Glasses & Contact Lenses:

1.What is the difference between nearsightedness and farsightedness?

Nearsightedness, or myopia, causes objects in the distance to be blurry while farsightedness, or hyperopia, causes near objects to appear blurred.

2.What is presbyopia?

Presbyopia is the hardening of your eyes’ natural lenses. This makes it harder to see sharp images at all distances. , especially for near.

3.Does having high eye pressure mean I will lose vision?

Not necessarily. But it does indicate that you may be at risk for glaucoma, which may lead your doctor to recommend an appropriate treatment to lower IOP.

4.Should I be sleeping in my contact lenses?

NO. you should never sleep-in your contact lenses unless your practitioner advices you.

5.What’s the difference between soft contact lenses and gas permeable (GP) contact lenses?

Soft contact lenses are made of soft, flexible plastics that allow oxygen to pass through to the cornea, while GP lenses are made of rigid plastics that are more durable and resistant to deposit buildup. While soft lenses are often regarded as more comfortable and easier to care for, GP lenses are able to correct certain vision problems that soft lenses cannot.

6.What is "amblyopia"?

Amblyopia is the inability to see clearly out of an eye that is otherwise sound. It is due to miswiring between the eye and the brain and can lead to permanent reduction of visual acuity unless treated in early childhood

7.What is IOP?

It means the intra oculat pressure. It is measured by a special instrument called the Tonometer. 10-22mm/hg is normal IOP. It may differ from eye conditions.

8.How many days should I be off contact lenses for my eye examination?

A contact lens wearer should off contact lenses for 24- 48 hours.

9.How do I avoid annoying reflections on my eyeglasses?

Anti-reflective coating, also known as AR coating, helps you to see through your eyeglasses more easily, lets others see your eyes better and eliminates the annoying white glare spots in photos taken with a flash.

10.Why do I suddenly need glasses to read?

In most people, our ability to focus up close decreases as we age into our forties and beyond. This can be corrected with prescription or non-prescription reading glasses or bifocals.

11.Can I swim or shower with contact lenses on?

There are two main reasons why you should not swim or shower with your contact lenses – possible loss of the lenses and, most importantly, contamination of the lenses. Underwater, contact lenses may be washed out of your eye, or above water a small wave or splash may take the lens with it. Contact lenses, especially the soft variety, will absorb any chemicals or germs in the water. They will then stay in or on the lens for several hours, irritating the eyes and possibly causing infection.

12.Can children wear contact lenses?

The deciding factor for whether a child should wear contact lenses should be that child’s maturity level. Children of all ages can tolerate contact lenses well, but they must be responsible for the care of the lenses. Parents should make that judgment based on the child’s personal hygiene habits and their ability to perform household chores.

13.What are those small things I see floating all the time?

You may be experiencing "Floaters" which are a result of the normal aging process. However, if you are experiencing a sudden onset of Floaters with Flashes of light, you may be having a Retinal Detachment. This is a medical emergency. Please contact our office immediately.

Questions About Diabetic Retinopathy:

1.Who's at the most risk for diabetic retinopathy?

Fluctuating blood sugar levels increase risk for this disease, as does long-term diabetes. Most people don't develop diabetic retinopathy until they've had diabetes for at least 10 years.

However, adult onset (type 2) diabetics should be evaluated at the time of diagnosis and every year thereafter, whereas juvenile onset (type 1) diabetics should be evaluated five years after diagnosis and every year thereafter, at a minimum.

2.Is there any way to prevent diabetic retinopathy?

Keeping your blood sugar at an even level can help delay the onset of diabetic retinopathy. If you have high blood pressure, keeping that under control is helpful as well.

Even controlled diabetes can lead to diabetic retinopathy, so you should have your eyes examined once a year; that way, your doctor can begin treating any retinal damage as soon as possible.

3.What are the signs and symptoms of diabetic retinopathy?

In the early stages of diabetic retinopathy, you might have no symptoms at all, or you might have blurred vision.

In the later stages, you develop cloudy vision, blind spots or floaters. But never assume that good vision means all is well in the retina! This can be a setup for disaster.

4.What are the different types of diabetic retinopathy?

Diabetic retinopathy is classified as either nonproliferative (background) or proliferative. Nonproliferative retinopathy is the early stage, where small retinal blood vessels break and leak.

In proliferative retinopathy, new blood vessels grow abnormally within the retina. This new growth can cause scarring or a retinal detachment, which can lead to vision loss.

The new blood vessels may also grow or bleed into the vitreous humor, the transparent gel filling the back of the eye in front of the retina.

Proliferative retinopathy is much more serious than the nonproliferative form and can lead to total blindness.

5.How does diabetic retinopathy cause vision loss?

Blood vessels damaged from diabetic retinopathy can cause vision loss in two ways.

Fragile, abnormal blood vessels can develop and leak blood into the center of the eye, blurring vision. This is proliferative retinopathy and is the fourth and most advanced stage of the disease.

Fluid can leak into the center of the macula, the part of the eye where sharp, straight-ahead vision occurs. The fluid makes the macula swell, blurring vision. This condition is called macular edema. It can occur at any stage of diabetic retinopathy, although it is more likely to occur as the disease progresses. About half of the people with proliferative retinopathy also have macular edema.

6.Is diabetic retinopathy curable?

No. Early treatment can slow the progression of diabetic retinopathy, but is not likely to reverse any vision loss.

7.What diabetic retinopathy treatments are currently available?

The best treatment is to keep your diabetes under control; blood pressure control also helps.

Your doctor may decide on laser photocoagulation to cause regression of leaking blood vessels and prevent new blood vessel growth. If blood gets into the vitreous humor, your doctor might want to perform a procedure called a vitrectomy.

Also, there are a number of new diabetic retinopathy treatment options like special intraocular injections that are used to treat Diabetic retinopathy.

8.What are some points to remember about diabetic retinopathy?

  • If you have diabetes, get a comprehensive dilated eye exam at least once a year.
  • Proliferative retinopathy can develop without symptoms. If it gets to this advanced stage, you are at high risk for vision loss or even blindness.
  • Macular edema can develop without symptoms at any of the four stages of diabetic retinopathy.
  • You can develop both proliferative retinopathy and macular edema and still see fine. However, you are at high risk for vision loss.
  • Your eye care professional can tell if you have macular edema or any stage of diabetic retinopathy. Whether or not you have symptoms, early detection and timely treatment can prevent vision loss

FAQ s about Retina:

1.What are the retina and vitreous?

Retina is a tissue that line inside the eye wall and is an extension of the brain.

It is like the film of the camera. This tissue when stimulated by light transmits the information to the brain where it is seen as an image. Vitreous is a ”gel” that fills the eye cavity.

2.What are vitreo-retinal diseases?

A large variety of conditions can affect the vitreous and retina that lie on the back part of the eye that is not readily visible, such as diabetic retinopathy, macular degeneration, retinal detachments or tears, macular holes, retinopathy of prematurity, retinoblastoma, uveitis, eye cancer, flashes and floaters and retinitis pigmentosa.

3.What are retinal detachments and retinal tears?

Retinal tear is a rip in the retinal tissue. If fluid gets behind the retinal tissue, it will detach or separate the retinal tissue from the eye wall. This leads to loss of vision and blindness if left untreated.

4.What are the symptoms of retinal detachments?

Flashes of light, floaters and loss of vision in the form of a dark curtain are symptoms of retinal detachment and tears.

5.What is the treatment for retinal detachments and tears?

Retinal tears without detachment can be treated with laser.

Retinal detachment can be treated with surgery using a band (Scleral buckle) around the eye or vitrectomy. The choice of treatment depends on the severity and type of detachment.

6.What is a macular hole?

Macular hole can cause blurred vision, the loss of central vision can occur due to loss of tissue in this area.

7.How is a macular hole diagnosed?

Macular hole is diagnosed during a complete eye exam, including a dilated retina exam. Optical coherence tomography aids the retina specialist in determining the extent of macular hole.

8.What are the treatment options for a patient with a macular hole?

Currently vitrectomy with gas injection is the treatment of macular hole with 90% success rate. The patient may be asked to maintain a face-down or an upright position to let the gas bubble close the macular hole.

What Are Floaters and Flashes?

Floaters

Floaters are small specks or clouds moving in your field of vision. You may see them more clearly when looking at a plain background, such as a blank wall. Floaters are actually tiny clumps of gel or cells inside the vitreous, the clear jelly-like fluid that fills the inside of your eye. Floaters can have different shapes, such as little dots, circles, lines, clouds, or cobwebs.

Though these objects look like they are in front of your eye, they are actually floating inside of it. What you see are the shadows they cast on the retina, the nerve layer at the back of the eye that senses light and allows you to see.

When people reach middle age, the vitreous gel may start to thicken or shrink, forming clumps or strands inside the eye. Floaters often occur when the vitreous gel pulls away from the back wall of the eye, causing a posterior vitreous detachment. In some cases, the retina can tear as the shrinking vitreous gel pulls away from the wall of the eye. A torn retina is always a serious problem, since it can lead to a retinal detachment.

The appearance of floaters may be alarming, especially if they develop suddenly. You should see an ophthalmologist right away if you suddenly develop new floaters.

Flashes

When the vitreous gel inside your eye rubs or pulls on the retina, you may see what looks like flashing lights or lightening streaks. You may have experienced this sensation if you have ever been hit in the eye and see "stars."

These flashes of light can appear off and on for several weeks or months. As we grow older, it is more common to experience flashes. If you notice the sudden appearance of flashes, you should visit your ophthalmologist immediately because it could mean that the retina has been torn.

You should see your ophthalmologist as soon as possible if:

  • One new, large floater or "showers" of floaters appear suddenly
  • You see sudden flashes of light, especially if these flashes are persistent
  • You notice other symptoms, such as the loss of side vision or if it looks as if a shade or curtain is being drawn over your field of vision

Floaters and flashes become more common as we grow older. While not all floaters and flashes are serious, you should always have a medical eye examination by an ophthalmologist to make sure there has been no damage to your retina.