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Tonometer

A tonometer refers to the equipment that is used in tonometry – a test that measures the pressure inside your eyes, also known as intraocular pressure or IOP for short. Tonometry is rarely performed at your average comprehensive eye exam unless you are at high risk of or have been already diagnosed with glaucoma. Fortunately, tonometry can be used to detect changes in eye pressure before they cause any symptoms, enabling prompt action to be taken before your vision is affected.


About Glaucoma

Glaucoma is a common eye condition that occurs when the optic nerve, which connects the eye to the brain, becomes damaged. It’s normally caused by fluid building up in the front part of the eye, which causes the pressure inside the eyes to build. As the pressure increases, the optic nerve becomes increasingly damaged, and this prevents messages from being transmitted between your eyes and brain effectively. As a result, the patient’s vision becomes compromised. Without treatment, the level of vision loss will continue to increase. Unfortunately, any vision that has been lost as a result of glaucoma cannot be restored.
 

Most of the time, glaucoma develops very slowly which means that many people don’t realize that they are affected until some damage to their vision has already occurred. However, occasionally glaucoma can develop quickly, and symptoms do occur.

These can include:

  • Red eyes

  • Intense headaches

  • Tenderness around the eyes

  • Eye pain

  • Seeing rings/halos around lights

  • Blurred vision

  • Nausea and vomiting


If you notice any of these symptoms, it’s important that you make an appointment with your eye doctor right away so that you can be assessed. You are likely to have a tonometry test as part of this assessment.
 

What to expect from tonometry testing

There are various methods of tonometry testing, but many eye doctors use either Goldmann tonometry, which is the conventional technique to measure eye pressure, or electronic tonometry.
 

Goldmann tonometry testing is carried out using the Goldmann applanation tonometer, which is attached to a slit lamp microscope. This requires anesthetic eye drops to be used which numb your eyes, before a small probe is pressed gently against the eye, indenting the cornea. The pressure that the cornea pushes back onto the tonometer is what is measured to give your IOP reading. Electronic tonometry is where a handheld, mobile device is gently and quickly applied to the cornea to check the pressure, providing an accurate reading. Some eye doctors also offer non-contact tonometry which is where a puff of air is used to flatten the cornea, although this is reported to be less accurate than the Goldmann technique.
 

If you would like to find out more about Tonometry testing, please call our office to speak with our dedicated eyecare professionals.


Optos

As technology continues to advance, so does the field of the optometric industry. The development of innovative tools and techniques has allowed for more accurate and comprehensive examinations. One such technology is Optos, a revolutionary system that utilizes ultra-widefield retinal imaging technology to provide optometrists with a detailed view of the entire retina.
 

How Does Optos Work?

 

Optos technology is based on the principle of ultra-widefield retinal imaging, which allows for a wider and more detailed view of the retina compared to traditional imaging techniques. The Optos system consists of a specialized camera that captures high-resolution images of the retina using scanning laser ophthalmoscopy (SLO) and optical coherence tomography (OCT) technologies. SLO provides a wide-field view of the retina, while OCT allows for cross-sectional imaging, providing valuable insights into the various layers of the retina.
 

The Optos camera is designed to capture images through a process called optomap, which captures up to 200 degrees of the retina in a single image. This wide-field view provides optometrists with a comprehensive picture of the retina, enabling them to detect abnormalities that may not be visible with traditional imaging techniques. The optomap image can be instantly viewed and analyzed by your eye doctor, allowing for a more efficient and accurate diagnosis.
 

Common Eye Conditions Detected by Optos

 

Optos technology has the capability to detect a wide range of eye conditions, including but not limited to, diabetic retinopathy, macular degeneration, glaucoma, and retinal tears or detachments. Diabetic retinopathy is a condition that affects individuals with diabetes, causing damage to the blood vessels in the retina. Optos can capture detailed images of the retina, enabling optometrists to detect any signs of diabetic retinopathy and initiate appropriate treatment.
 

Macular degeneration is another common eye condition that can be detected using Optos. This condition affects the macula, the central part of the retina responsible for sharp, central vision. Optos allows for a comprehensive view of the macula, identifying any changes or abnormalities that may indicate the presence of macular degeneration.
 

Glaucoma, a condition characterized by damage to the optic nerve, can also be detected using Optos. The wide-field view provided by Optos allows for a thorough examination of the optic nerve and the surrounding structures, facilitating early detection and intervention.
 

Finally, Optos technology is particularly effective in detecting retinal tears or detachments. These conditions can lead to sudden vision loss and require immediate medical attention. Optos allows for a comprehensive view of the retina, identifying any signs of retinal tears or detachments and initiate prompt treatment.


CLE

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.


Surgical Co-Management

In the realm of eye care, surgical co-management has emerged as a collaborative approach that aims to provide patients with comprehensive and seamless treatment. This concept involves the joint efforts of optometrists and ophthalmologists, each bringing their unique expertise to the table. By working together, these eye care professionals strive to enhance patient outcomes and deliver exceptional care.
 

The Role of Optometrist and Ophthalmologist in Surgical Co-Management

 

Surgical co-management is built upon the unique skill sets and areas of expertise of optometrists and ophthalmologists. By understanding their respective roles, you can appreciate the synergy that this collaborative approach fosters.


Optometrists are primary eye care professionals who specialize in the examination, diagnosis, and non-surgical treatment of vision disorders. Their responsibilities in surgical co-management include:

  • Performing comprehensive eye examinations and evaluations

  • Monitoring and managing pre-existing eye conditions

  • Providing pre-operative and post-operative care

  • Educating patients on surgical procedures and aftercare

  • Collaborating with ophthalmologists to ensure continuity of care
     

Ophthalmologists are medical doctors who specialize in the diagnosis, treatment, and surgical management of eye diseases and disorders. Their role in surgical co-management encompasses:

  • Evaluating patients' candidacy for surgical interventions

  • Performing complex surgical procedures

  • Providing specialized medical and surgical care

  • Collaborating with optometrists to ensure seamless patient care

  • Monitoring and managing post-operative complications

  • By combining the expertise of optometrists and ophthalmologists, surgical co-management ensures that patients receive comprehensive and coordinated care throughout their treatment journey.

How Surgical Co-Management Works

 

Surgical co-management is a well-orchestrated process that involves several key steps. Understanding how it works can help you navigate this collaborative approach with confidence.

  • Initial Evaluation: The process typically begins with an optometrist conducting a comprehensive eye examination. During this evaluation, the optometrist assesses the patient's visual needs, identifies any potential issues, and determines if a surgical intervention is necessary.

  • Referral and Consultation: If surgery is recommended, the optometrist refers the patient to an ophthalmologist for further evaluation and consultation. This step ensures that the patient receives specialized medical advice and a thorough assessment of their suitability for the proposed surgical procedure.

  • Pre-operative Care: The optometrist plays a crucial role in providing pre-operative care, which may include managing any existing eye conditions, ensuring the patient understands the surgical process, and addressing any concerns or questions they may have.

  • Surgical Procedure: The ophthalmologist performs the necessary surgical intervention, leveraging their specialized training and expertise in surgical techniques.

  • Post-operative Care: After the surgery, the patient's care transitions back to the optometrist, who closely monitors the recovery process and provides post-operative care and management. This may involve follow-up appointments, monitoring for any complications, and ensuring the patient adheres to the prescribed treatment plan.

  • Ongoing Collaboration: Throughout the entire process, the optometrist and ophthalmologist maintain open communication and collaborate closely. This ensures that the patient's care is seamless, and any concerns or issues are promptly addressed by the appropriate healthcare professional.


Cataract Surgery Co-Management

Cataracts are a common eye condition that can significantly affect your vision. They occur when the lens of your eye becomes cloudy, causing blurred or distorted vision. This clouding is typically a result of aging, but other factors such as genetics, diabetes, or prolonged exposure to sunlight can also contribute to the development of cataracts.
 

As cataracts progress, you may experience symptoms such as difficulty seeing at night, increased sensitivity to glare, or a decrease in color perception. These changes can make daily activities like reading, driving, or recognizing faces more challenging.
 

Why Cataract Surgery May be Necessary

 

Cataract surgery is often recommended when cataracts start to interfere with your vision and affect your ability to perform daily tasks. The primary goal of cataract surgery is to remove the cloudy lens and replace it with an artificial intraocular lens (IOL).
 

The decision to undergo cataract surgery is a personal one and should be made after consulting with your optometrist. Factors such as the severity of your cataracts, your overall eye health, and your lifestyle requirements will be taken into consideration when determining if surgery is necessary.
 

What is Cataract Surgery Co-Management?

 

Cataract surgery co-management refers to the collaborative approach between an ophthalmologist, who performs the surgery, and an optometrist, who provides pre-operative and post-operative care. This partnership ensures that you receive comprehensive eye care throughout the entire process, from the initial consultation to the final follow-up appointments.
 

Your optometrist plays a crucial role in cataract surgery co-management by conducting a thorough pre-operative evaluation to assess your overall eye health and determine the most suitable IOL for your specific needs. They will also provide guidance and education on the surgical procedure, address any concerns you may have, and help you make informed decisions about your eye care.


Lipiflow

Dry eyes are one of the most common conditions that can affect our eyes and is estimated to affect millions of Americans. As you’ve probably guessed, dry eyes occur when tears fail to provide enough natural lubrication for the eyes to be comfortable and healthy. Exactly what causes dry eyes can vary significantly, from side effects from medications to prolonged computer use. What is clear is that while the condition isn’t sight-threatening, it can make day to day life much harder than it needs to be. Fortunately, there are treatments that can help, and arguably one of the most effective is Lipiflow.

 

What is Lipiflow?

Lipiflow is a new technological solution that addresses the underlying cause of your dry eyes, rather than simply treating the symptoms. It is most effective at helping patients whose dry eyes are caused by meibomian gland dysfunction – a condition characterized by problems with the way that the meibomian glands produce the oil that forms an essential part of our tear film. The meibomian glands can become less productive, or in some cases, even blocked by hardened oil deposits. This prevents the oil from reaching your tear film, making it less effective. Lipiflow targets the meibomian glands, warming them to break down oily blockages and massaging your eyes to make sure that the oil, and then the tear film, is evenly dispersed. This helps to combat the symptoms associated with dry eyes, which can include:

  • Eye fatigue

  • Dry, scratchy and uncomfortable eyes

  • Blurred vision

  • Sensitivity to light

  • Difficulty wearing contact lenses
     

Your eye doctor will be able to advise you if Lipiflow has the potential to be a suitable solution for your dry eyes.
 

What to expect from Lipiflow treatment?

Lipiflow treatment is a simple, painless process that is performed in the comfort of your eye doctor’s office. There is no need for anesthetic. Once you are settled in your chair, your eye doctor will open the sterile, single-use applicators which are placed over your eyes. These are connected to a machine that causes the inner eyelids to heat to approximately 42.5°C to, while simultaneously placing gentle pressure on the outer eyelid surfaces. Lipiflow takes around 12 minutes per eye, during which time you can relax. You can even listen to music if you’d like to. There is no downtime, and patients can return to their usual activities right away. It takes around 3 days for patients to begin to see an improvement in their dry eye symptoms, although they may require further treatment in the future to maintain them. Optimal results are usually achieved around 6 to 8 weeks following your Lipiflow treatment.
 

For more information about Lipiflow, or to schedule a consultation to talk about this treatment for dry eyes, please contact our office.


Optikam

Eye care professionals use Optikam’s technology to capture more than 3 million eyewear measurements every year. The OptikamPad iPad app is a total dispensing solution that enables eye care professionals to successfully assist patients at all stages of the eyewear dispensing process, providing them with a unique and custom patient experience.

 

Optikam Posture Devise (OPD)

You may be surprised to learn that wearing glasses can and likely will affect your posture. Glasses lenses are most accurate when you look directly through their center. This means if your glasses are sitting too low or have slipped down your nose, you may find that you are subconsciously tilting your head back and this can affect your overall posture.

 

Optikam’s OPD measurement device is a cutting-edge tool that obtains eyewear measurements that take into account how the frame will be worn by patients, enabling the fit to be customized to their individual parameters. The ten measurements taken into account when determining each patient’s position of wear include:

  • Monocular pupillary distance

  • Multifocal seg heights

  • Pantoscopic tilt

  • Rear vertex distance

  • Wrap (face form tilt)

  • Near pupillary distance

 

This results in frames that not only look fantastic, but that also fit perfectly, remaining both comfortable and stable on the face without you needing to adopt an unnatural posture. The measurements obtained by the Optikam OPD measurement tool are immediately visible on your eye doctor’s tablet so that they can recommend which alterations to the frames are needed to ensure that the frames fit with precision and gives you the best visual experience.

 

Benefits of OptikamPad and Optikam OPD

Traditionally, the process of a comprehensive eye exam, choosing frames and fitting glasses requires fairly close contact with your eye doctor or other eye care professionals. However, with social distancing being a new process variable, many patients are looking for more virtual options. Fortunately, OptikamPad makes it possible for optical stores to dispense eyeglasses with minimal human contact. This is because the OptikamPad can take measurements from a further distance or even through plexiglass screens. It can even be placed on a stand and the app operated using a Bluetooth mouse, putting even greater distance between your eye care professional and you. 

If you would like to find out more about Optikam OPD and OptikamPad, our knowledgeable team would be delighted to help. Please contact us with any questions or to schedule an appointment.


MiBo Thermoflo

Dry eye is a common condition that affects millions of people worldwide. It occurs when the eyes do not produce enough tears or when the tears evaporate too quickly. This can lead to discomfort, irritation, and even vision problems. If you are suffering from the discomfort of dry eye, MiBo Thermoflo can offer you a revolutionary solution.
 

Understanding the Causes of Dry Eye

 

Dry eye is a condition that occurs when the eyes do not produce enough tears or when the tears evaporate too quickly. There are several factors that can contribute to this condition, including environmental factors, certain medications, and aging. Environmental factors such as dry or windy climates, air conditioning, and excessive screen time can all worsen dry eye symptoms. Additionally, certain medications like antihistamines, decongestants, and diuretics can decrease tear production. Aging is also a common cause of dry eye, as tear production naturally decreases as we get older.
 

Meibomian gland dysfunction (MGD) and blepharitis are two common conditions that can contribute to the development of dry eye. MGD occurs when the meibomian glands, which are responsible for producing the oily layer of tears, become blocked or dysfunctional. This can lead to an inadequate amount of oil in the tears, causing them to evaporate too quickly. Blepharitis is an inflammation of the eyelids that can disrupt the normal functioning of the meibomian glands.


Blephex

Our eyes are extremely delicate, yet they can be subjected to harsh conditions and other environmental factors that affect their health. One of the problems that can affect our eyes is an accumulation of dirt, debris and bacteria on the eyelids. This can cause a range of issues, including stopping tear film from reaching the eyes and being properly dispersed over their surface – which is necessary to keep them healthy and comfortable. Fortunately, a new solution called BlephexÔ can help.

 

What is BlephexÔ?

BlephexÔ is a handheld electro-mechanical device that is applied to the margins of the eyelids with the purpose of cleaning them and improving the effectiveness with which tear film flows onto the surface of the eyes.

 

BlephexÔ has a disposable, surgical-grade sponge tip which rapidly oscillates to create a cleaning action. Before the sponge tip is placed onto the eyes, it is soaked in a gentle exfoliating solution. This solution provides soft abrasion to help remove dead skin cells and debris that could be irritating the eyes and interrupting tear film progression. The BlephexÔ device is manually applied to the eyes and moved gently across the eyelids, with the entire, painless process taking approximately 6 to 8 minutes per eye. A different sponge is used on each eye, ensuring that no bacteria is passed between them. After the procedure, patients are given instructions on how to maintain the cleanliness of their eyelids with daily/nightly eyelid hygiene at home.

 

Most patients experience a significant improvement in tear film production and dispersal, and a reduction in unpleasant symptoms that they may have been experiencing within 48 hours of their treatment. While a single treatment is normally enough to produce excellent results, many patients are advised to have BlephexÔ every 4-6 months.

 

What conditions can BlephexÔ help with?

BlephexÔ can be used to clean the eyelids at any time, and people who suffer from dry eyes or eye allergies may find it is particularly beneficial for helping to reduce the symptoms that they experience. It can also be combined with Lipiflow – another technological solution – to help counteract the effects of dry eyes.
 

Unsurprisingly, BlephexÔ is particularly recommended as a treatment for an eye condition called blepharitis. Blepharitis is characterized by the inflammation of the eyelids, which causes them to become red, swollen and itchy. Although the condition is not usually serious, it can lead to further problems if it isn’t treated.
 

Symptoms of blepharitis include:

  • Sore eyes

  • Itchy eyes

  • A gritty, irritated feeling affecting the eyes

  • Redness

  • Flakes or crustiness around the roots of the eyelashes

  • Eyelids that stick together when you wake up in the morning

 

If you are suffering from the symptoms of blepharitis, dry eyes or eye allergies and feel that you would benefit from BlephexÔ treatment, please contact our team to schedule a consultation appointment.


Visual Field

Visual field testing is an important part of most standard comprehensive eye exams. Also sometimes known as perimetry testing, Visual field testing is a method to measure the entire scope of vision of an individual, including their peripheral/side vision.
 

The importance of visual field testing

Visual field testing is one of the most effective diagnostic treatments in the detection of glaucoma. This is because when patients are affected by glaucoma, it is usually the peripheral vision that is affected by their condition first. However, it can also be used to detect central or peripheral retinal diseases, eyelid conditions such as drooping, optic nerve damage and conditions that affect the visual pathways from the optic nerve to the area of the brain where this information is processed into vision.
 

Visual field testing is also an important part of monitoring for people who are considered to be at risk for vision loss from disease and other problems, including those who have been diagnosed with the following:

  • Multiple sclerosis

  • Hyperthyroidism

  • Pituitary gland disorders

  • Central nervous system problems (such as a tumor that may be pressing on the brain)

  • Stroke

  • Diabetes

  • High blood pressure
     

What to expect from visual field testing

There are a variety of methods that can be used to perform visual field testing, including:
 

Static automated perimetry. This is where a machine is used to quantify how well the patient is able to detect flashing lights of varying size and brightness in different areas of their visual field, while they concentrate on a central point. The patient responds by pushing a button when they see the light.

Kinetic perimetry. This involves points of light that are fixed in size and intensity and are presented along the patient’s peripheral vision, before being gradually moved inwards to determine their field of vision. 

Visual field testing is non-invasive, painless and doesn’t require patients to have their eyes dilated. The results, which are usually presented in a series of charts, are digital and sent directly to your eye doctor for interpretation. Depending on the outcome of your results, you may be recommended for further diagnostic testing which could include blood tests. If you have been diagnosed with glaucoma, you will probably be recommended to have several visual field tests each year, which will help your eye doctor to monitor the progression of your condition and recommend treatments to slow it.

If you would like more information about visual field testing, or if you have concerns about your peripheral vision, please don’t hesitate to schedule an appointment with our experienced and knowledgeable eyecare team today.