How the Eye Works
 
 
In order for the eye to see clear images, the cornea (the clear portion on the front of the eye) and the lens must bend or curve light rays so they can focus on the retina (the lining on the back portion of the eye). The retina is responsible for changing these light rays into signals that are then sent to the brain and accepted as an image. A person with normal eyes will be able to see clear images because the cornea and lens are correctly focusing images on the retina. A person with refractive error sees blurry or hazy images because the cornea and lens are unable to focus light rays on the retina. This can be attributed to an improperly shaped eye  
 
In a "normal eye, light from a distant object is focused precisely on the retina, making the object appear clear and distinct
(myopia, hyperopia, and astigmatism); a loss of lens accomm-odation (presbyopia); or a clouding of the lens of the eye (cataracts).Fortunately, there are a variety of new and exciting treatments for myopia, presbyopia, hyperopia, and astigmatism at Atlantic Eye. These treatments are designed to either reshape the eye to correct refractive error or replace the natural lens of the eye to improve accommodation. Contact Atlantic Eye to learn more about our vision correction alternatives.
 
 
Myopia (Nearsightedness)
 
Myopia is a common type of refractive error that results when the eye is too long or the cornea is too steeply curved relative to its distance to the retina. Patients with myopia are able to see near objects clearly but have difficulty seeing objects at a distance. Distant objects appear blurry because light from a far away object focuses in front of the retina rather than directly on the retina. Myopia can be easily diagnosed with a simple eye exam at one of our Atlantic Eye Laser Vision Correction Centers  
 
With myopia, light from a distant object focuses in front of the retina, making the object appear blurred
 
How is Myopia Treated?
 
Myopia can be treated with laser vision correction or general ophthalmology services, including glasses and contact lenses. At Atlantic Eye, laser vision correction LASIK surgery is the most popular choice for patients with myopia who would like to reduce or eliminate their dependence on glasses or contact lenses. During laser vision correction surgery, the eye surgeon uses an excimer laser to "flatten" the cornea, thereby reducing curvature. This allows light from distant objects to focus directly on the retina, sending clear and precise images to the brain.
 
   
         
The thin protective corneal flap is created   The cool light from the excimer laser is applied usually for about 60 seconds or less   Myopia is corrected by making the central cornea flatter, thereby refocusing the light on the retina as in a "normal" eye
 
ASA-PRK, or Advanced Surface Ablation, is another treatment offered at Atlantic Eye for patients with myopia. Visit our FAQs page to find out which type of refractive surgery is appropriate for your needs
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Hyperopia (Farsightedness)
 
Hyperopia is a refractive error that occurs when the eye is too short or the cornea is too flat. Hyperopia causes difficulty seeing objects close up, and in severe cases, can also make it difficult to see objects clearly at a distance. Vision from a short distance appears blurry for hyperopic patients because light focuses behind the retina rather than directly on the retina. The doctors at Atlantic Eye can easily diagnose hyperopia with a standard eye exam.  
 
With hyperopia, light focuses behind the retina, making near objects appear more blurred than distant objects
 
How is Hyperopia Treated?
 
To correct hyperopia, it is necessary to alter the way light focuses on the retina. This can be achieved with glasses, contact lenses, LASIK, or ASA-PRK. Laser vision correction with LASIK is the procedure of choice for many patients with hyperopia. During LASIK surgery, the cornea is reshaped with an excimer laser, essentially "steepened," to allow light to focus directly on the retina rather than behind it. This improves the eye’s ability to focus on near objects, including print from a magazine or book.
 
   
         
The thin protective corneal flap is created   The cool light from the excimer laser is applied usually for about 60 seconds or less   Hyperopia is corrected by making the central cornea steeper, thereby refocusing the light on the retina as in a "normal" eye
 
Visit our general LASIK and ASA page for an in-depth look at how laser vision correction can be used to treat hyperopia.
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Astigmatism
 
Astigmatism is a type of refractive error that can be linked to an irregularly shaped cornea. Patients with astigmatism have blurred vision at all distances. While a normal eye is shaped like a sphere, the eye of someone with astigmatism is shaped like a football. This causes light rays to focus more in one direction than the other, meaning only partial focus can be achieved at any time. Astigmatism may sometimes occur alongside myopia or hyperopia. It is important to schedule an exam with an eye surgeon at Atlantic Eye each year to track the progression of astigmatism and determine the proper course of treatment.  
 
With Astigmatism, light focuses in two distinct places in the back of the eye, distorting both distance and near vision
 
How is Astigmatism Treated?
 
Astigmatism can be treated with corrective eyewear or laser vision correction. At Atlantic Eye, Dr. Ply offers laser vision correction for the simultaneous correction of astigmatism, hyperopia, and myopia. During the surgery, the cornea is made into a more spherical shape with an excimer laser. We use advanced laser vision correction technology to treat patients with astigmatism. With the newest generation of VISX® excimer lasers, our surgeons are able to correct astigmatism, hyperopia, and myopia during a single procedure. If you are considering refractive surgery, contact Atlantic Eye to schedule a vision correction consultation with one of our premier eye surgeons.
 
   
         
The thin protective corneal flap is created   The cool light from the excimer laser is applied usually for about 60 seconds or less   Astigmatism is corrected by making the cormea "more spherical" at the same time as the myopia is being treated
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Presbyopia
 
Presbyopia is a common condition that generally affects men and women over the age of 40. Patients with presbyopia suffer from poor near vision and have a difficult time focusing for reading and other close up activities. The change in vision associated with presbyopia is due to the fact that over time, the lens of the eye loses its ability to "accommodate," or change focus. Presbyopia tends to be progressive, but it is not a disease, it is simply a natural part of the aging process. Presbyopia is sometimes confused with hyperopia (farsightedness), but the two conditions are completely distinct from one another. Patients with hyperopia share much of the same difficulty with near vision, but this is due to an irregularly shaped eye, while change of vision from presbyopia is caused by an inflexible, or "unaccommodating" lens. If you are unsure whether your loss of near vision is being caused by presbyopia or hyperopia, contact Atlantic Eye to schedule a vision correction consultation and comprehensive eye exam.
 
What is Presbyopia ?
 
When your eyes were young, your natural lens was both transparent and flexible. Because of this, your vision was most likely stable until you reached your forties. Around that time, you may have noticed that you had to hold a many or a book farther and farther away to read it. Many people end up wearing a pair of reading glasses or bifocals to compensate for this aging of the eye. This condition is called "presbyopia" and eventually affects everyone, including those who are nearsighted, farsighted, have cataracts, or had perfect vision most of their life.
 
How is Presbyopia Treated?
 
Presbyopia can be treated with glasses, contact lenses or surgical correction. Surgical correction of presbyopia can be achieved with monovision LASIK or intraocular lens implants. A consultation with one of our surgeons will help you decide on the most appropriate option for your particular situation.

Monovision refers to the process of correcting one eye for distance vision and one eye for near vision. This allows patients to see up close with one eye and at a distance with the other eye, producing what is known as "monocular vision." Our surgeons can achieve monovision via laser vision correction, lens implants, or contact lenses.

Lens implants are designed to replace natural lenses clouded by cataracts; however, they also have the added benefit of correcting near and distance vision for patients with presbyopia. Lens implants like Crystalens®, ReZOOM™, and ReSTOR® are flexible and can change shape, or focus light at multiple focal points to allow good distant and close vision without corrective lenses. This produces a much higher quality of vision for presbyopia patients.

Contact Atlanic Eye to find out more about presbyopia vision correction.
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Cataracts
 
How Cataracts Develop
A cataract is a clouding of the natural lens inside your eye. This lens, located behind the iris (or colored part of your eye) works just like the lens of a camera - focusing light images on the retina, which sends the images to your brain.
 
The human lens, made mostly of protein and water, can become clouded - so clouded it keeps light and images from reaching the retina. Eye injury, certain diseases, or even some medications can cause the clouding. But, in over 90% of cases, clouding is caused by the aging process. A cataract is not a "film" over the eye, and neither diet nor lasers will make it go away. The best way to treat a cataract is to remove the old, clouded lens and provide a replacement. A cataract can be the reason sharp images become blurred, bright colors become dull, or seeing at night is more difficult. It may also be why the reading glasses or bifocals that used to help you read, or do other simple tasks, no longer seem to help. Unfortunately, cataracts can't be prevented, but removing the cataract and replacing it with an artificial lens can restore your vision and in many ways, significantly improve your quality of life. The time to have your cataracts removed is when the quality of your vision begins to put limits on your activities and enjoyment of life.  
 
Cataract extenraction
 
 
Crystalens™
 
Crystalens™ is a new replacement lens (IOL) that works naturally with muscles in the eye to retain the eye's ability to "accommodate" -- to shift focus between nearby and distant objects. With older IOLs, patients lose this ability and require corrective eyewear to see clearly at near and intermediate distances.

Unlike rigid lenses, the flexible silicone Crystalens features innovative hinges that allow it to move with the eye's muscles and accommodate seamlessly, thereby reducing or eliminating the need for vision correction. The Crystalens is implanted using the same, nearly risk-free cataract surgery techniques as with other IOLs.		  
 
Crystalens™
 
 
Age-related Macular Degeneration
 
When we think of eye conditions that affect our vision, many of us have heard about glaucoma or cataracts. Very few people, however, are familiar with age-related macular degeneration (AMD) - a leading cause of vision loss in people over age 60. Because scientists have not yet found a cure for the disease, it is important that you learn as much as possible about AMD and how to protect your eyesight.  
 
AMD Vision
What is AMD and how does it affect my vision?
 
AMD is a serious disease that may result in loss of central vision. The exact cause is not known. It occurs when there is damage to the macula, the part of the eye that allows you to see fine detail. AMD does not affect peripheral, or side vision. Although people rarely go totally blind from the disease, AMD can make it difficult to read, write, drive or perform other normal daily tasks. There are two kinds of AMD: "dry" and "wet". Dry AMD affects about 90 percent of patients with AMD. It usually develops slowly, so people may not notice any change in their vision right away. Both eyes may or not be affected. A common early sign of dry AMD is the formation of yellow deposits, called drusen, under the macula.
Dry AMD can sometimes turn into wet AMD. Wet AMD affect only 10 percent of AMD patients, but it is responsible for 90 percent of all severe vision loss from the disease. Wet AMD occurs when abnormal blood vessels develop and leak blood and fluid under the macula, causing damage that leads to rapid loss of central vision. Treatment options include Avastin, Lucentis, and Macugen which are aimed at stopping abnormal blood vessel growth.
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Dry Eye
 
Some people do not produce enough tears to keep the eye healthy and comfortable. This is known as dry eye. Tears are produced by two different methods. One method produces tears at a slow, steady rate and is responsible for normal eye lubrication. The other method produces large quantities of tears in response to eye irritation or emotions. Tears that lubricate are constantly produced by a healthy eye. Excessive tears occur when the eye is irritated by a foreign body, dryness and when a person cries.  
Dry eye
 
What are the symptoms of dry eye?
 
The usual symptoms include:
 
  • Stinging or burning eyes
  • Scratchiness
  • Stringy mucus in or around the eyes
  • Excessive eye irritation from smoke or wind
  • Excess tearing
  • Difficulty wearing contact lenses
Excess tearing from "dry eye" sounds illogical, but if the tears responsible for maintenance lubrication do not keep the eye wet enough, the eye becomes irritated. When the eye is irritated, the lacrimal gland produces a large volume of tears that overwhelm the tear drainage system. These excess tears then overflow from your eye.
 
Non-surgical treatments for dry eye include prescription eye drops such as RESTASIS® which can treat chronic dry eye caused by low tear production. Made by Allergan, RESTASIS® drops increase tear production so the eyes are better moisturized and less painful. If this method fails, small punctal 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.
 
Diabetic Retinopathy
 
If you have diabetes mellitus, your body does not use and store sugar properly. High blood-sugar levels can damage blood vessels in the retina, the nerve layer at the back of the eye that senses light and helps to send images to the brain. The damage to retinal vessels is referred to as diabetic retinopathy.  
Diabetic Retinopathy
 
Types of Diabetic Retinopathy
 
There are two types of diabetic retinopathy: nonproliferative diabetic retinopathy (NPDR) and proliferate diabetic retinopathy (PDR). NPDR, commonly known as background retinopathy, is an early stage of diabetic reinopahty. In this stage, tiny blood vessels within the retina leak blood or fluid. The leaking fluid causes the retina to swell or to form deposits called exudates. Many people with diabetes have mild NPDR, which usually does not affect their vision. When vision is affected is the result of macular edema and/or macular ischemia. PDR is present when abnormal new vessels (neovascularization) begin growing on the surface or the retina or optic nerve. The main cause of PDR is widespread closure of retinal blood vessels, preventing adequate blood flow. The retina responds by growing new blood vessels in an attempt to supply blood to the area where the original vessels closed. Unfortunately, the new, abnormal blood vessels do not re-supply the retina with normal blood flow. The new vessels are often accompanied by scare tissue that may cause wrinkling or detachment of the retina.
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Glaucoma
 
Glaucoma is a leading cause of blindness in the U.S. It occurs when the pressure inside the eye rises, damaging the optic nerve and causing vision loss. The condition often develops over many years without causing pain or other noticeable symptoms - so you may not experience vision loss until the disease has progressed.  
Rental Nerve Fibers
Sometimes symptoms do occur. They may include:
  • Blurred vision
  • Loss of peripheral vision
  • Halo effects around lights
  • Painful or reddened eyes
People at high risk include those who are over the age of 40, diabetic, near-sighted, African-American, or who have a family history of glaucoma. To detect glaucoma, your physician will test your visual acuity and visual field as well as the pressure in your eye. Regular eye exams help to monitor the changes in your eyesight and to determine whether you may develop glaucoma. 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.
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Detached Retina / Torn Retina - Flashes and Floaters
 
What is the retina?
The retina is a nerve layer at the back of your eye that senses light and sends images to your brain. An eye is like a camera. The lens in the front of the eye focuses light onto the retina. You can think of the retina as the film that lines the back of a camera.
 
What is a retinal detachment?    
A retinal detachment occurs when the retina is pulled away from its normal position. The retina does not work when it is detached. Vision is blurred, just as a photographic image would be blurry if the film were lose inside the camera.

A retinal detachment is a very serious problem that almost always causes blindness unless it is treated.		  
Retinal detachment
What causes retinal detachment?
A clear gel called vitreous (vit-ree-us) fills the middle of the eye. As we get older, the vitreous may pull away from its attachment to the retina at the back of the eye. Usually the vitreous separates from the retina without causing problems. But sometimes the vitreous pulls hard enough to tear the retina in one or more places. Fluid may pass through the retinal tear, lifting the retina off the back of the eye, much as wallpaper can peel off a wall. Signs of retinal tear or detachment include flashes and floaters, a group or web of floaters, wavy or watery vision, a sense that there is a veil or curtain obstructing vision, or a sudden drop in vision quality. If you experience any of these symptoms, call your doctor immediately. Early treatment is essential to preserve your vision.
 

The following conditions increase the chance of having a retinal detachment:

 
  • nearsightedness;
  • previous cataract surgery;
  • glaucoma;
  • severe injury;
  • previous retinal detachment in your other eye;
  • family history of retinal detachment;
  • weak areas in your retina that can be seen by your ophthalmologist (Eye M.D.);
 
What treatment is needed?
 
RETINAL TEARS
Most retinal tears need to be treated with laser surgery or cryotherapy (freezing), which seals the retina to the back wall of the eye. These treatments cause little or no discomfort and may be performed in your ophthalmologist's office. Treatment usually prevents retinal detachment.
 
RETINAL DETACHMENTS
Almost all patients with retinal detachments require surgery to return the retina to its proper position.
 
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Oculoplastics
 
There are a number of eye conditions that pose cosmetic concerns and also affect vision. Oculoplastics is a broad term referring to any cosmetic or reconstructive treatment of the eyelids, eyebrows, tear ducts, or orbit (bony area) of the eyes. With ocular plastic surgery, our eye surgeons can treat a variety of vision problems caused by everything from droopy eyelids to orbital fractures, skin cancers of the eye, and facial spasms. Our goal is to not only restore vision, but also repair the function and appearance of the eyes.
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Common Oculoplastics Treatments
 
At Atlantic Eye, we customize each oculoplastic surgery procedure to meet the needs of our patients. We routinely perform eye lift, or blepharoplasty surgery, to repair drooping eyelids that are obstructing vision, and our surgeons are trained in the latest reconstructive surgery techniques for the correction of eye abnormalities. We also offer cosmetic blepharoplasty of the upper and lower eyelids to provide your face with a more youthful appearance.
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