Frequently Asked Questions
Below are some answers to frequently asked questions about the eye care services provided at Miramar.
- Retina-Vitreous Surgery
- Diabetic Retinopathy
- Diabetic Evaluation and Treatment
- LASIK Surgery
- Refractive Surgery
- Glaucoma Surgery
- Cataract Surgery
- Adult Strabismus Surgery
- Cosmetic Eyelid Surgery
- Forehead & Brow Lifts
- BOTOX® Cosmetic
- Comprehensive Adult, Adolescent, and Pediatric Eye Care
- Other Eye Health Topics
The retina is a thin sheet of nerve tissue in the back of the eye where light rays are focused and transmitted to the brain.
The vitreous is a gel-like substance that fills the eye and is connected to the retina, optic nerve and many blood vessels.
Problems with the retina and vitreous -- including retinal tear, retinal detachment, severe intraocular infection (endophthalmitis) and trauma -- can lead to vision loss and even blindness. Surgery can correct problems before vision is lost or prevent further deterioration from occurring.
Diabetic retinopathy is a complication of diabetes that weakens the blood vessels that supply nourishment to the retina (the light-sensitive lining in the back of the eye where vision is focused). When these weak vessels leak, swell or develop thin branches, vision loss occurs. In its advanced stages, the disease can cause blurred or cloudy vision, floaters and blind spots - and, eventually, blindness. This damage is irreversible.
Yes. People with diabetes are most susceptible to developing it, but your risk is reduced if you follow your prescribed diet and medications, exercise regularly, control your blood pressure, and avoid alcohol and cigarettes. Regular eye exams are an integral part of making sure your eyes are healthy.
Although damage caused by diabetic retinopathy cannot be corrected, patients diagnosed with the condition can be treated to slow its progression and prevent further vision loss. Treatment modalities include laser and surgical procedures.
Diabetic Evaluation and Treatment
Yes! Patients with diabetes are at an increased risk of developing eye diseases that can cause vision loss and blindness, such as diabetic retinopathy, cataracts and glaucoma. These and other serious conditions often develop without vision loss or pain, so significant damage may be done to the eyes by the time the patient notices any symptoms. For this reason it is very important for diabetic patients to have their eyes examined once a year. The eye is examined through a dilated pupil, and our ophthalmologists look for signs of developing problems in the eye's structures and blood vessels. Diagnosing and treating eye disease early can prevent vision loss. It is also important to maintain a steady blood-sugar level, take prescribed medications, follow a healthy diet, exercise regularly and avoid smoking.
LASIK stands for laser assisted in-situ keratomileusis. It adjusts the curvature of the cornea to improve the eye's ability to focus light.
During the procedure, a device called a microkeratome creates a flap in the outer layer of the cornea called the epithelium. Patients are given topical anesthesia and a mild sedative so they are awake but calm and cannot feel the instruments. The epithelial flap is lifted and an excimer laser beam adjusts corneal curvature so objects no longer appear blurry. The flap is then closed.
The entire LASIK procedure takes only 15-30 minutes per eye, and patients are often ready to leave the office within an hour or two.
The cornea is the clear covering on the front of the eye which bends, or refracts, light rays that focus on the retina in the back of the eye. A certain shape, or curvature, is required in order for light to focus exactly on the retina rather than in front of it or behind it. Corneal curvature may be surgically corrected using LASIK, LASEK or other refractive procedures to reduce or eliminate the need for eyeglasses or contact lenses. A thorough eye examination and consultation are necessary before a treatment decision can be made.
One of the leading causes of blindness in the United States, glaucoma occurs when the pressure inside the eye rises high enough to damage the optic nerve. It cannot be prevented, and vision lost to it cannot be restored. The high eye pressure associated with glaucoma is caused by blockages in the eye's fluid drains. No one knows yet why the blockages form. People at the greatest risk include those who are over the age of 40, diabetic, near-sighted, African-American, or who have a family history of glaucoma.
Glaucoma often develops over many years without causing pain - so you may not experience vision loss until the disease has progressed. Symptoms are occasionally present and should be taken as warning signs that glaucoma may be developing; these include blurred vision, loss of peripheral vision, halo effects around lights and painful or reddened eyes.
Once diagnosed, glaucoma can be controlled. Treatments to lower pressure in the eye include non-surgical methods such as prescription eye drops and medications, laser therapy, and surgery.
A cataract is a cloudy area in the normally clear lens in the front of the eye. Cataracts are caused by a chemical change of unknown origin in the eye, and cause blurred or distorted vision. People at risk for developing cataracts are over 55 years old, have had eye injuries or disease, have a family history of cataracts, smoke cigarettes or use certain medications.
We will apply topical anesthetic drops to your eye to maintain comfort, as well as deliver mild sedatives through an IV administered by an anesthesiologist (MD).
Although a perfect outcome cannot be promised, cataract surgery is considered to be one of the safest surgeries today.
Most people return to work the day after surgery. Contrary to what most people hear, due to our technique, you may bend and lift the next day after surgery.
Plan to be at the surgery center for about two hours, although the actual surgery takes about 5-10 minutes.
You will have a thorough examination of your eyes at your consultation, and discuss the options that are best for your eyes and your lifestyle.
Although your vision may be blurrier due to swelling immediately following surgery, most people drive the next day after surgery.
We generally recommend waiting a week or so after surgery before applying makeup around your eyes.
We recommend using three different eye drop medications beginning the day before surgery and continuing for 1 month after surgery to achieve best healing results: antibiotic, steroid, and non-steroidal anti-inflammatory.
They cannot be prevented from forming, but early detection through regular eye exams can help maintain the clearest vision possible.
There is no pain associated with the condition, but there are several symptoms that indicate failing vision due to cataracts. These include:
- Blurred/hazy vision
- Spots in front of the eye(s)
- Sensitivity to glare
- A feeling of "film" over the eye(s)
- A temporary improvement in near vision
Vision loss from cataracts can often be corrected with prescription glasses and contact lenses. For people who are significantly affected by cataracts, replacement surgery may be the preferred method of treatment. During cataract replacement (the most common surgical procedure in the country), the lens is removed and replaced with an artificial one called an intraocular lens implant or IOL.
Adult Strabismus Surgery
Strabismus, or crossed eyes, is the term for when a person cannot align both eyes on an object at the same time. Strabismus can be constant or intermittent (i.e. due to stress or illness). The condition may manifest at first as double vision. Eventually, the brain begins to ignore, or suppress, information from the weaker eye. If left untreated, strabismus can lead to visual impairment, loss of binocular vision, and blindness in the weaker eye.
Strabismus affects about 5% of children, and treatment is recommended before the age of six for the most effective results. However, adults can be treated too.
Ophthalmic Plastic & Reconstructive Surgery
Cosmetic Eyelid Surgery
By removing excess fat, skin and muscle from the upper and lower eyelids, blepharoplasty can rejuvenate puffy, sagging or tired-looking eyes, giving a more youthful appearance. The procedure is also done to remove puffy bags under the eyes. It is typically a cosmetic procedure but can also improve vision by lifting droopy eyelids out of the patient's field of vision.
Because blepharoplasty cannot be used to raise the eyebrows or reduce the appearance of wrinkles, crow's feet or dark circles under the eyes, the procedure is often combined with others such as a facelift and BOTOX® treatments.
Incisions are made along the eyelids in inconspicuous places (in the creases of the upper lids, and just below the lashes on the lower lids) to minimize scar visibility. If no skin needs to be removed during surgery, the surgeon will likely perform a transconjunctival blepharoplasty, where the incision is made inside the lower eyelid and there are no visible scars.
Contact lenses may not be worn for two weeks. Glasses may be worn immediately.
Give your eyes a natural, refreshed and more youthful look! In May 2003, renowned plastic surgeon Daniel Ebroon, M.D. joined Miramar. He had been an assistant professor of ophthalmology at Northwestern University for five years, where he taught 25 doctors the very specialized skill of cosmetic eyelid plastic surgery (performed to remove excess skin on the eyelids and to remove puffy "bags" under the eyes). He is one of approximately 400 trained eyelid plastic surgeons in the world. Dr. Ebroon is now a faculty member at the UCLA Medical School and the Jules Stein Eye Institute.
Dr. Ebroon performs plastic surgery to revitalize aging, puffy and tired-looking eyes, and to correct droopy eyelids, under-eye bags and wrinkles around the eyes. He also performs forehead and brow lifts to raise the eyebrows and reduce forehead wrinkles. In addition, he specializes in eyelid cancer, broken bones around the eyes, tearing disorders, thyroid eye disease, and other eyelid disorders.
Forehead & Brow Lifts
Browlifts can revitalize drooping or lined foreheads by tightening skin and muscles above the eyes, smoothing wrinkles and raising the eyebrows, helping you to look less angry, sad or tired.
The procedure is often combined with other operations such as blepharoplasty (eyelid surgery) and facelifts to improve the look of the eyes and other areas of the face.
The main difference lies in the type of incision made. In a traditional browlift the surgeon makes a coronal (headphone-shaped) incision behind the hairline, stretching between the ears and across the top of the forehead. In a minimally invasive endoscopic browlift the surgeon makes three to five short incisions (less than an inch long) behind the hairline. The endoscope -- a slim instrument with a camera on the end -- is placed in one incision so the surgeon can see beneath the skin, while he or she lifts the skin and adjusts muscles through the other incisions.
Many patients return to work or school in 7-10 days or less.
Results will fade after a few months.
BOTOX® can be used every 3-4 months, depending on how the muscles respond.
Comprehensive Adult, Adolescent, and Pediatric Eye Care
Regular eye exams test for the development and progression of refractive errors and help your optometrist provide a proper prescription if eyeglasses or contact lenses are needed. Exams are also an invaluable tool in the early detection of eye disease.
Patients with myopia, or nearsightedness, have steep curvature in one or both corneas; they can focus on nearby objects, but distant objects appear blurry. For hyperopic or farsighted patients, shallow corneal curvature causes nearby objects to appear blurry while objects in the distance are clear. Astigmatism causes objects that are close or at a distance to appear blurry or doubled. Most people have some degree of astigmatism, which often occurs in combination with myopia or hyperopia.
Over 140 million people in the U.S. wear eyeglasses, and over 30 million wear contact lenses. Glasses and contact lenses improve vision by adjusting the way the eyes bend and focus light. Prescriptions are measured for each eye so patients can enjoy optimal vision clarity, usually 20/20. Eyewear may be used for certain activities, such as reading for hyperopic patients and driving or watching television for myopic patients, or may be worn at all times.
Children should have their first eye exam at about age two, although it's never to early to test a child's vision and eye health. Comprehensive eye exams are essential in the diagnosis and treatment of vision problems, injury and disease. Early detection allows for treatment to begin before the child experiences difficulty in school due to poor vision, or before any permanent damage has been done to the eye(s). Exams test visual acuity, eye tracking, and focusing skills, and detect problems such as near- and far-sightedness, amblyopia, crossed eyes, dyslexia, and color blindness.
Other Eye Health Topics
Macular degeneration is the number-one cause of blindness in the United States. It occurs when the macula -- a part of the retina in the back of the eye that ensures that our vision is clear and sharp -- degrades or "degenerates," causing a progressive loss of vision.
Yes. They include:
- A gradual loss of ability to see objects clearly
- A gradual loss of color vision
- Distorted vision
- A dark or empty area appearing in the center of vision
The "dry" form of macular degeneration has no treatment, but the "wet" form may be helped by laser procedures if it is detected early. Certain vitamins and minerals may also aid in slowing or preventing vision loss.
"Dry eye" is the term for when your eyes are insufficiently moisturized, either because they do not produce enough tears or because the tears have an improper chemical composition. It often occurs during the natural aging process, but it can also form as a result of eyelid or blinking problems, certain medications, climate, injury, and various health problems.
- Irritated, scratchy, dry, uncomfortable or red eyes
- A burning sensation or feeling of something foreign in your eyes
- Blurred vision
In addition to being uncomfortable, dry eye can damage eye tissue, scar the cornea and impair vision. Dry eye is not preventable, but it can be controlled before harm is done to your eyes.
Treatment for dry eye can take many forms. Non-surgical methods include blinking exercises, increasing humidity at home or work, and use of artificial tears or moisturizing ointment. If these methods fail, small plugs may be inserted in the corners of the eyes to limit tear drainage, or the drainage tubes in the eyes may be surgically closed.
A retinal vein occlusion occurs when an artery supplying blood to the eye hardens or swells and presses on a nearby vein, making it difficult for blood to leave the eye. The restricted circulation leads to high pressure in the eye, which can in turn cause swelling, bleeding, growth of abnormal blood vessels, and partial or total vision loss.
Vascular occlusions do not cause a change in physical appearance, and they can occur with no pain or noticeable loss of vision. For these reasons, it is important to have routine eye exams and also to check one's own vision by closing one eye at a time.
There is no cure for vascular occlusions, but they can be treated. Emphasis is placed on risk management, treatment of symptoms and prevention of further vision loss. It is critical to control high blood pressure, high cholesterol, diabetes and other health conditions that increase the risk of vascular hardening, narrowing and blood clotting.
Corneal Cross-linking is a minimally invasive, FDA approved, outpatient procedure that combines the use of riboflavin eye drops, Photrexa® solutions, and safe ultra-violet A (UVA) light for the treatment of progressive keratoconus.