Eye Care Services

A standard eye exam is a series of tests performed by one of our ophthalmologists. It is one of the best ways to protect your vision because it can detect eye problems at their earliest stage and when they are most treatable. Regular eye exams give your Ophthalmologist at Albany Eye Associates a chance to help you correct or adapt to vision changes. We can give you expert tips on ways to reduce eyestrain and how to care for your eyes.

Even if you think your eyes are healthy, you'll still need an eye exam at least once every couple of years. You should know what to expect during an eye exam, who to see for a thorough exam and how to prepare. Eye exams can make sure your eyes are healthy now and help you understand your risk of eye disease in the future.

There are several factors that will determine how frequently you need an eye exam, including your age, health and risk of developing eye problems.

Infants, toddlers and preschoolers should have their vision checked each time they visit their pediatrician. It may be difficult to perform in-depth vision tests on this age group, so for children under 3, your pediatrician will likely look for the most common eye problems like lazy eye and crossed eyes. Depending on your child's ability to cooperate, his or her first more comprehensive eye exam should be done between the ages of 3 and 5. You should talk with your pediatrician about when an eye exam is appropriate for your child.

You should have your child's vision checked before he or she enters first grade. Depending on family history of vision or eye problems or any vision complaints your child may have, your child should be seen at least every one to two years.

Adults who don't wear glasses or contacts lenses, have no symptoms of eye trouble, don't have a family history of eye disease and don't have a chronic disease, such as diabetes, that puts you at risk of eye disease, should have an eye exam every couple of years.

If you do wear contacts, you'll need to have your eyes checked at least yearly. If you notice any problems with your vision, schedule an appointment with one of our Ophthalmologists. Blurred vision, for example, may suggest you need a prescription change. A sudden increase in the number of floaters, dark spots darting through your vision, could suggest vision-threatening changes to your retina.

If you have certain other health problems or a family history of eye disease, you may need more frequent eye examinations. Check with your doctor to determine how often you need an eye exam if you have any of the following risk factors:

• A personal or family history of eye disease.
• A previous eye injury.
• A disease the affects the whole body, such as diabetes, high blood pressure, heart disease, rheumatoid arthritis or acquired immunodeficiency syndrome (AIDS).

Routine Eye Care for Kids

Vision problems in children are uncommon but when they do occur, they often go undetected. Young children may not realize or be able to communicate that their vision is impaired, and even older children may not notice if the vision in only one eye is affected. Every parent wants their child to have perfect vision, so how often should children have eye examinations to make sure their eyes are healthy?

Every newborn undergoes a brief eye examination shortly after birth, mainly to ensure that no birth defects of the eye are present. This is usually performed by a pediatrician, family physician, nurse practitioner, or a physician’s assistant. A similar examination should take place between six and twelve months of age, usually during a well-child check-up with a pediatrician or family physician. A primary goal of this second examination is to ensure that light can enter the eye unobstructed, so that vision will develop normally. This is evaluated by shining a light into the eye and observing a red or orange glow, called a red reflecx, in the pupil of the eye – similar to the red eye often seen in photographs taken using a flash. Any problems that prevent light from entering the eye – such as extreme far-sightedness, crossed eyes (strabismus), or even a cataract – can prevent normal vision development. This results in a condition called amblyopia, or lazy eye. Many conditions, if left undetected, can cause amblyopia, which can be treated if it is identified during the critical vision development period that lasts until children are about 8 years old.

Once a child reaches age 2 ½ to 3 ½, and certainly by the age of 5, a vision screening should take place to make sure that vision is developing normally. Children in this age group are preparing to enter pre-school or kindergarten, and this examination is a good check for school readiness. This examination can be done during a well-child visit to the pediatrician or family physician, but should include some measurement of the child’s vision. Most children this age cannot read the letters on the eye chart, but special vision-testing charts – including some with easy-to-recognize pictures – are available for children this age. Because vision is vulnerable to amblyopiain this age group, a formal examination by an eye care specialist should take place if the pediatrician is unable to perform testing, or if the test results are in any way abnormal. Some children in this age group have high degrees of near-sightedness or far-sightedness, and need glasses to help their vision develop normally.

If they are passing all screening exams and no problems are noted by parents, we still recommend that all children have a baseline eye examination by an ophthalmologist once before age 5 years. Thereafter, most children will undergo one or more vision screenings in elementary school, providing additional opportunities to identify vision problems.

If a child fails any screening exam or problems are noted, by parents, physicians, or school personnel, an immediate eye exam is recommended. Otherwise, normal children need routine eye exams every 3-5 years.

Diabetes is the leading cause of preventable vision loss in the United States.  Modern techniques of diagnosis and treatment would allow the majority of patients to avoid this serious complication.

This is why if you have diabetes or take medication to lower blood sugar you, need to have regular diabetic eye examinations. 

Diabetic eye exams are very similar to comprehensive eye exams but specific attention is paid to the eye structures that may be damaged by diabetes.  You exam will consist of medical and eye history, visual acuity (measure how sharp you vision is), eye pressure check, and eye health evaluation that includes a dilated exam.  A dilated exam means your pupils will be dilated with eye drops.  This allows the doctor to examine the back part of your eye: the optic nerve, macula and retina for problems.  Your doctor will tell you results of the exam right away and will arrange for any further treatment if needed.

During cataract surgery, your surgeon will remove the natural lens of the eye that has become a cataract and will implant a new clear intraocular lens (IOL). A standard monofocal lenses allow clear focus in only one plane, usually at distance.  Patients who have surgery with a monofocal implant will see better at one range of vision, usually distance however will need glasses to see close up or to correct astigmatism.

If you need cataract surgery you may choose not only to improve clarity of vision, but also to reduce or virtually eliminate the need for glasses.  Modern Premium Lens Implants may allow you to drive, play golf, use a smart phone, and read a newspaper with less dependence on glasses. 

When considering advance technology lenses it is important to educate yourself about the advantages and disadvantages of such lenses and discuss your expectations and concerns with your surgeon.

Multifocal IOL

Multifocal IOLs have a patented design of rings of different powers that allow your eye to focus light on the retina for clear vision at near, far and intermediate distances. PanOptix, ReSTOR or Technis multifocal lenses are commonly used.

Toric IOL

Many cataract patients also have an astigmatism and require glasses for most of their everyday activities. During cataract surgery, patients with an astigmatism can choose to receive a Toric intraocular lens implant to achieve sharper distance vision. This lens design has a built-in astigmatism correction that allows the surgeon to reduce postoperative astigmatism.

PanOptix, Vivity, Eyhance or Technis Symphony intraocular lenses may be considered by patients that have astigmatism and would also like to be able to see well at distance and up close.

Insurance may cover the cost of a standard monofocal lens implant but they do not cover the cost of premium IOL.  You can use health care savings account or flexible spending plan to cover this cost.  Alternatively, you may choose to apply for CareCredit.

Albany Eye Associates is an Accredited Dry Eye Center. Our doctors are effective in recognizing and treating this common eye condition.  Technologies such as TearLab, Lipiscan and Lipiflow are available on site.  Please read our Dry Eye section to learn more about this ailment.

Diabetic Retinopathy

It is estimated that more than 20 million people in the United States are affected by diabetes and that almost one third are not aware of their disease. It is important to recognize that diabetes is the leading cause of vision loss in individuals 20-74 years of age and that modern techniques of diagnosis and treatment would allow a majority to avoid this serious complication.

Unfortunately, the diabetic eye problem often goes undiagnosed and untreated, in large part due to the fact that when the problem can be most effectively diagnosed and treated, it is without symptoms and only becomes apparent when vision is affected. Early detection is most important as treatment is most beneficial in preserving vision rather than in an effort to recover vision already lost.

The risk of developing diabetic eye complications of the retina (diabetic retinopathy) is influenced by a number of factors. The better the blood glucose control, the less chance of diabetic retinopathy appearing or progressing. Maintaining a blood pressure no higher than 130/80 reduces the risk by 1/3. Control of blood lipid (cholesterol) levels significantly lowers eye complications. While current treatment methods are highly effective, and newer treatments are being evaluated and appear to be promising, the most important element in protecting vision is regular examination at intervals based on the presence and degree of diabetic change in the eye.

Glaucoma causes irreversible damage to the optic nerve and may result in blindness.  Many forms of glaucoma exist and each approach may be different depending on type of glaucoma. While there is no recognized cure for glaucoma, available treatments can manage the disease.  This is usually done by lowering pressure in the eye. Laser or eye drops are common initial treatments and most patients with glaucoma can be controlled with eye drops alone. If intraocular pressure cannot be managed with a laser or eye drops, surgery may be recommended.

Laser treatment of glaucoma

Laser Peripheral Iridotomy (LPI) – Is usually an initial treatment for patients with narrow-angle glaucoma. A small opening is made in the iris to increase the angle between the iris and cornea and encourage fluid drainage.

Selective Laser Trabeculoplasty (SLT) – Can be used in patients with primary open angle glaucoma (POAG), normal tension glaucoma . The trabecular passages are treated to increase fluid drainage.

Minimally invasive glaucoma surgery (MIGS)

Traditional glaucoma surgery such as trabeculectomy, ExPRESS shunts, external tube-shunts like the Ahmed and Baerveldt styles — are major surgeries. While they are very often effective at lowering eye pressure and preventing progression of glaucoma, they have a long list of potential complications. The MIGS group of operations have been developed in recent years to reduce some of the complications of most standard glaucoma surgeries.

iStent surgery - A tiny stent that is inserted in the eye during cataract surgery and improves fluid drainage.  This procedure has over 85% success rate and a low risk of complications.

Endoscopic cytophotocoagulation (ECP) - During this procedure, an ophthalmologist uses a laser on the ciliary tissue to decrease the production of fluid within the eye. Studies have shown that the ECP procedure has significant success rate with a relatively low complication risk.

If you are a patient with glaucoma or would like to be examined for glaucoma, call Albany Eye Associates 518-434-1042 to schedule an appointment.

Our doctors may recommend eyelid surgery for a variety of reasons such as chalazion, lid cysts, or skin cancer. Other common eyelid procedures are blepharoplasty (for a droopy eyelid) and ectropion/entropion repair for eyelid malpositions.

Blepharoplasty is a type of surgery that repairs droopy eyelids and may involve removing excess skin, muscle and fat. As a person age, eyelid skin stretch, and the muscles supporting them weaken. As a result, a person may devep droopy upper lids. Severely sagging skin around the eyes can reduce side vision (peripheral vision), especially the upper and outer parts of your field of vision. Blepharoplasty can reduce or eliminate these vision problems.

Other procedures such as ptosis repair (tightening the muscle that opens the eye) or brow lift may be done at the same time if needed.

Age-Related Macular Degeneration (AMD)

AMD is a common cause of vision loss in people over 60. It rarely causes total blindness but can make normal activities difficult to perform.

What is AMD? It is the deterioration of a tiny part of the retina called the macula. AMD can be "dry" and "wet." Dry AMD is more common and less severe. In wet AMD, blood vessels under the macula leak and cause it to become uneven. Vision becomes distorted and blurred.

How is AMD detected? You'll probably be asked to look at an Amsler Grid with its pattern of straight lines (although they may appear wavy to someone with AMD) and to have a test where special dyes are injected into an arm vein. Photographs are taken as the dye travels in blood vessels under the retina. This helps the doctor detect and treat leaky vessels. The doctor also looks for yellow material in the retina, called drusen, which can be an early sign of AMD.

Is there treatment for Macular Degeneration? Definitely, especially for wet macular degeneration. The goal is to stop the formation and leakage of new blood vessels. Newer and better laser, surgical and drug treatments are constantly being developed.

What if I’ve already lost vision to AMD? In certain cases, some vision can be restored and in other situations, further loss of vision can be reduced.

Retinal Detachment

The retina normally lies flat against the back, inside wall of the eye. A detached retina must be reattached to prevent loss of vision.

What causes retinal detachment? The most common cause of retinal detachment is normal retraction of the vitreous gel (the gel-like substance filling the eye) as we age. Rarely, this can tear the retina, which will allow fluid to creep beneath it. The fluid causes retina to separate from the back wall. A tear in the retina does not necessarily lead to retinal detachment.

Who is most likely to get a retinal detachment? You are most vulnerable if you are older than 50, nearsighted, have a family history of retinal detachment, or have had an eye injury.

What are the symptoms? Most people report seeing flashes of light and floaters. Another common symptom is the appearance of what is often described as a dark curtain floating across the visual field.

How is a detached retina repaired? A retinal detachment is treated surgically, in an out-patient facility or hospital. The two most common methods of treatment are scleral buckling and vitrectomy. Another technique is called pneumatic retinopexy. It uses a gas bubble in the eye to hold the treated tear in place. All three surgical procedures use cryotherapy (freezing) or laser to seal the retinal tear.

Neuro-ophthalmology is a subspecialty of ophthalmology that deals with the visual pathways from the eye to the visual cortex of the brain. The optic nerves carry the message of vision from the eye to the occipital cortex of the brain as an electrical current. This pathway, if damaged, results in visual loss. Many processes can affect this visual pathway.

If the reason for the visual loss cannot be explained with a routine eye exam, it is often the job of the neuro-ophthalmologist to determine if there is a problem with the nerves of the visual pathway or within the brain.

Neuro-ophthalmologists also diagnose and treat diseases that affect the nerves that control the eye muscles, eyelids and pupil.

Conditions

Common conditions treated by neuro-ophthalmologists include:

• Blepharospasm
• Double vision
• Eye movement disorders
• Vision-related migraines
• Myasthenia gravis
• Multiple sclerosis
• Optic neuritis (inflammation of the optic nerves)
• Papilledema (swollen optic nerves due to increased intracranial pressure)
• Pseudotumor cerebri
• Pupil abnormalities
• Thyroid eye disease
• Visual system tumors

Evaluation and Diagnosis

Evaluation includes a detailed history and physical examination. From this initial examination, the neuro-ophthalmologist is often able to formulate a list of possible diagnoses and may order additional testing aimed at identifying a specific disease process or abnormality. Tests commonly ordered include:

• Cerebral angiography
• Electrophysiologic testing of the retina or optic nerve
• Laboratory blood studies
• Neuro-imaging (MRI or CT Scan)
• Ocular coherence tomography (OCT) and fundus photography
• Visual field testing

The Albany Eye Associates Optical Shop was established in the late 1990's to offer our valued patients a full range of services to accommodate any lifestyle and budget. Education is a very important part of the eyewear and lens selection. Our licensed optician, Barbie Hinds, is very knowledgeable in all aspects of frame and lens choices, including all the latest in breakthrough technology. This is extremely beneficial when you are choosing eyewear to meet your specific visual needs.

See more on the Optical Shop.

HydroEye

HydroEye is a patented nutritional formulation that works from the inside out to provide continuous dry eye relief. HydroEye, the focus of new dry eye research, delivers a proprietary blend of omega fatty acids (GLA, EPA and DHA), antioxidants and other key nutrients that work together to support a healthy tear film and dampen inflammation.

HydroEye features a proprietary blend of omega fatty acids and nutrient cofactors that help reduce inflammation, an underlying cause of dry eye, and support all three layers of the tear film. It is much more powerful than flaxseed oil or fish oil alone, and HydroEye includes omega-3 EPA and DHA from highly pure USP®-verified fish oil and also provides the unique omega fatty acid, GLA, from black currant seed oil that cannot be easily obtained from the diet. GLA has been found to play a key role in dampening dry eye symptoms in seven clinical studies. GLA is not found in flaxseed or fish oil.

HydroEye has been found to raise levels of lactoferrin, a protective protein found in tears.

HydroEye offers uninterrupted dry eye relief with continued use; results typically experienced within 30-60 days.

HydroEye has been clinically tested and found to improve dry eye symptoms, keep inflammation at bay and maintain corneal smoothness in a double-blind, placebo-controlled, multi-center trial, recently published in the peer-reviewed journal, Cornea. The study examined HydroEye's effect on dry eye symptoms, markers of inflammation, and corneal smoothness - a key factor for healthy vision and eye comfort.

HydroEye is not available in drug stores but may be purchased at our office or on-line. You should see your Ophthalmologist before starting HydroEye. To learn more about Dry Eye Treatment and HydroEye contact Albany Eye Associates at 518-434-1042 to schedule an appointment with one of our Board Certified Doctors.