Available Services

A comprehensive wellness examination should include more than just a prescription for glasses or contact lenses. It should include evaluation of the central and peripheral vision, binocular (two-eyed) vision, eye muscle function, intraocular pressure, ocular surface anatomy, and retinal and optic nerve anatomy (on the inside of the eye). Additionally, our comprehensive examination includes testing for glaucoma, cataracts, macular degeneration, retinal holes and tears, and the ocular complications associated with common systemic diseases, like high blood pressure, diabetes, and high cholesterol.

The Optomap is an instrument that allows the doctor’s assistant to take a picture of the inside of the eye so that the doctor will be able to look for ocular disease that could lead to vision loss. The image provides a view of the inside of the eye for the doctor, in order that she may screen for glaucoma, macular degeneration, retinal holes and tears, as well as the ocular complications associated with many common systemic diseases, like high blood pressure, diabetes, and high cholesterol.

Our doctors find this technology especially valuable as it allows them to monitor for change in a more accurate manner than was previously available, by looking at old and new retinal images over several years at one time.

For more information on the Optomap retinal exam, please visit their website:

http://www.optos.com/en-us/Patients/

Currently diabetes is the leading cause of blindness among adult persons in the United States. Diabetes affects the vision by damaging the microvascular system (small arteries and veins) in the retina. Increased blood glucose can cause smaller arteries to weaken, form microaneurysms, and leak. This process causes a decrease in the efficiency of the blood movement to all of the areas of the retina, and sometimes the retina will start to grow new blood vessels. The new blood vessels do not typically grow properly and often cause larger problems, like retinal detachments. For this reason, they must be treated immediately with laser to avoid permanent loss of vision.

According to the American Diabetes Association, people with type 1 diabetes should have a comprehensive retinal examination within 5 years of diagnosis, and then every year after. People with type 2 diabetes should have a comprehensive retinal examination immediately after being diagnosed, and every year after. If a patient is diagnosed with damage to the retinas from diabetes, sometimes more frequent examinations are needed in order to allow for earlier detection of sight-threatening changes.

LASIK surgery is a nice alternative to glasses or contact lenses. It is an elective procedure that utilizes a laser to remove microscopic portions of the cornea to reshape its surface for the purpose of correcting near-sightedness, far-sightedness, and/or astigmatism. The procedure is performed quickly and painlessly, and typically, vision correction is noticed immediately.

Not every patient is a good candidate for LASIK surgery, so be sure to consult Dr. Stehlik or Dr. Wild during your examination about your best options for surgical vision correction. Both of our doctors are experienced in providing pre- and post-operative care for patients who have had LASIK surgery, beginning before the surgery takes place and resuming one day after the procedure.

As the eye ages, there are normal and abnormal changes that should be watched for and often treated.

Dry Eye Syndrome is a disease that increases in prevalence with age as our tear production within the lacrimal gland decreases and is a frequent side effect of many common systemic medications. Dry Eye Syndrome can cause problems like discomfort, vision fluctuation, or, in severe cases, corneal scarring and loss of vision.

Cataracts are a clouding of the crystalline lens on the inside of the eye. Initially, the clouding may cause fluctuations in one’s glasses or contact lens prescription, and eventually cataracts will cause a decrease the quality or clarity of vision to a degree that is not correctable with a new glasses prescription. An important part of a yearly examination is diagnosing cataracts when they present and monitoring them until they are ready for treatment.

Glaucoma is a disease that increases in frequency with age. It involves the progressive death of optic nerve fibers, resulting in a loss of peripheral vision over time. Glaucoma is diagnosed through the use of optic nerve evaluation, intraocular pressure measurement, and peripheral vision testing.

Contact lenses are now available for a variety of vision difficulties, including near-sightedness, far-sightedness, astigmatism, presbyopia (age-related near vision changes), and even irregular corneas damaged by trauma or disease.

For first time wearers, our staff is experienced and patient in training patients in contact lens insertion and removal techniques.

Glaucoma is an eye disease that involves a progressive and permanent loss of peripheral vision that corresponds to the damage of nerve fibers at the optic nerve. It is the second leading cause of blindness in the United States.

While there is currently no cure for glaucoma, often vision loss can be halted or slowed through the use of topical medication. When medication fails to stop the progression of the disease, laser treatments or surgery may be employed with a glaucoma surgeon.

The most dangerous component of glaucoma is its ‘silent’ nature. A person who has glaucoma may not be aware of the vision loss until the disease is very advanced and vision loss is extensive and irreparable. A routine annual eye examination is the best way to screen for glaucoma and potentially catch the disease in its earliest stages, often before vision loss has occurred.

Over time, the natural lens on the inside of the eye that functions to focus light on the retina (called the crystalline lens) changes from a crystal-clear structure to become yellow, hazy, and eventually opaque due to cataract formation. Cataracts occur as a result of the normal metabolic changes to the body that are a part of the normal aging process, cumulative damage from ultraviolet light exposure, and sometimes damage from chronic diseases, like diabetes.

Cataracts cause the vision to change gradually over time, initially causing changes in one’s glasses or contact lens prescription and eventually leading to hazy/blurry vision that is not correctable to 20/20 even with the use of glasses or contact lenses. Cataracts will cause progressive vision loss and can cause blindness if they are left untreated.

Cataracts are treatable through surgery that removes the natural crystalline lens and replaces it with a crystal-clear synthetic implant to focus light on the retina. Through recent advances in medical technology, cataract surgeons are now able to create an implant that is specific to the patient’s ocular measurements, thereby simultaneously correcting near-sightedness or far-sightedness and often significantly decreasing the patient’s dependency on glasses.

Advanced implants are also available now to correct for astigmatism and provide multifocal correction for distance and near vision, eliminating the need for glasses altogether in some patients.

Thanks to the advances in intraocular lens implant technology, patients who are not good candidates for LASIK vision correction (whether due to a high glasses prescription, thin or irregular corneas, or age) can now consider a procedure called Clear Lens Extraction or Refractive Lens Exchange. This procedure is basically cataract surgery (performed before there is a visually-significant cataract) for the purpose of correcting the vision to eliminate the need for glasses or contact lenses.

Both Dr. Stehlik and Dr. Wild provide peri-operative care for patients who undergo cataract surgery or Clear Lens Extraction.

Vision disorders have been found to be the most prevalent handicapping condition during childhood, though in one study, only 31% of children between age 6 and 16 were found to have had a comprehensive vision and eye examination within the last year and only 16% of children under the age of 6 had ever been comprehensively examined. The American Optometric Association recommends the first comprehensive examination to be at 6 months of age, followed by an exam at age 3, and then at least every 2 years through age 18. (American Public Health Association. Improving early childhood eyecare. Policy Statement No. 20011. Washington, DC: APHA, 2001.)

Some of the vision problems commonly diagnosed in childhood involve blur at distance, blur when reading, eye turns, lazy eyes, and poor coordination of eye muscles. In certain cases, the treatment is as simple as observation or prescribing a pair of glasses, but in other cases, immediate intervention is needed to prevent permanent vision loss related to a condition called Amblyopia.

Additionally, evaluating a child’s ocular health is important to rule out degenerative congenital diseases and monitor for proper development.

We know that you can’t plan for everything, and when an emergency occurs, sometimes you need to be seen the same day. Emergency visits can be scheduled for minor problems (like a contact lens stuck in the eye or a case of suspected “pink eye”) or more severe acute care, like an abrasion, laceration, or ulcer. If your symptoms include pain in, on, or around the eye, mucous production from the eye, or sudden substantial changes in your vision, please call our office for an emergency visit. We also always have a doctor on-call for true emergencies that present after hours or over the weekend.

Macular degeneration is a retinal disease that causes progressive central vision loss in adults, typically over the age of 50. It remains the leading cause of vision loss in older adults.

Vision loss with Macular Degeneration can be rapid in progression or very slow. A person who has advanced Macular Degeneration will often be able to see only with peripheral vision.

Macular Degeneration has 2 forms: Dry (the milder and more common form) and Wet (the more severe and quickly progressing form that requires more extensive treatment)

Risk factors for the disease include:

1. Age – persons over 50 are more at risk, though your risk increases as you get older
2. Smoking – studies show that smoking tobacco will increase a person’s risk for macular degeneration two-fold
3. Family History – because there is a hereditary component to the disease, persons who have a diagnosed family member are at a greater risk for the disease themselves
4. Race – Caucasian persons are at highest risk for the disease among other races

Early detection and consistent monitoring of Macular degeneration is crucial to minimize vision loss. In the advanced stages of the disease, your doctor may recommend other types of therapy in the form of injections or laser treatment. Macular Degeneration can be diagnosed during your routine eye examination, through retinal evaluation.