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Ocular Diseases


Cataract:

A cataract is a clouding of the lens that sits behind the iris, the colored part of the eye. When we are younger that forty years old it helps us to shift our focus between far and near.

Over time this structure grows larger, thicker and stiffer. It also can become cloudy. When this occurs we call it a cataract.

There are a number of different forms of cataracts based on the appearance and location of cloudiness within the lens. These forms include nuclear cataracts when the haze is in the center of the lens. When it is the outer layers separate we refer to it as a cortical cataract. When the back membrane of the lens becomes cloudy it is referred to as a posterior subcapsular cataract.
 
The treatment for restoring clear vision to a person with cataracts is through cataract surgery. A small incision is made in the front of the eye and the cloudy lens is removed with a device that pulverizes and removes the lens fragments. A new clear lens also referred to as an intraocular lens implant, or IOL, is then implanted to replace to cloudy lens restoring vision.
 
The standard IOL corrects vision for distance leaving with near vision being corrected with reading or bifocal glasses. There are now options for correcting near vision with bifocal intraocular lenses to reduce the need for post-surgical glasses.
 
Dr. Wheatall examines for cataracts as part of every comprehensive eye exam. He will guide you through the process of dealing with cataracts should they be present.


Macular Degeneration:  

The macula is the area in the back of the eye responsible for fine detailed vision. Because the light receptors are tightly packed together in this area it has a special circulation system. Unfortunately, this circulation system can break down as a result of age, poor circulation or genetically inherited anatomical traits.
 
It has been shown that eating certain foods such as fruits and vegetables provides nutrients that keep this area of the eye healthy. Sometimes additional nutritional supplements in the form of ocular vitamins are needed to slow the progression of age related macular degeneration.
 
Sometimes the body tries to grow blood vessels into the macular area. Unfortunately, these vessels are fragile and break easily. This lead to bleeding in the macular area which is referred to as wet macular degeneration. 

The current method of treating wet macular degeneration is with injections of a medicine such as Avastin or Lucentis into the eye. These stop the formation of the leaky, fragile blood vessels in the macula and help many people to preserve useful vision.
Dr. Wheatall carefully assesses your macular health as part of a comprehensive eye exam and helps you to preserve your eye health.


Dry Eye Syndrome:

This is a very common condition where the tear film does not appropriately wet the surface of the eye. The result is eyes that constantly feel scratchy, sandy, irritated and water a lot.
 
It may seem odd that eyes that water or tear a lot are really dry. These tears result from dry spots forming on the eye triggering nerve reflexes to produce a flushing type of tear that doesn’t properly wet the surface of the eye.
 
Dr. Wheatall carefully reviews your health history and examines your eyes to determine the cause of your dry eye condition. He prescribes treatments that may include eyelid compresses, punctual plugs, artificial tears, nutritional supplements and antibiotics. He may also prescribe a medication, Restasis, which helps your body to make a more effective tear film.
Diabetic retinopathy 


Diabetic Eye Disease
 
Diabetes is one of the most common chronic health conditions in the USA. It affects nearly 8% of the population and is a leading cause of blindness.

There are two major types of diabetes, Type 1, or Juvenile Onset, typically is diagnosed in their childhood or young adult years. It is typically controlled by insulin injections. Type 2, or Adult Onset, typically is diagnosed in an adult. It is often treated with oral medication but sometimes insulin.

Both forms of diabetes can cause damage to the eyes. This is why it is necessary to have an eye exam at least once a year if you are a diabetic.  Health insurance companies recognize and provide coverage for all diabetics to have eye health exams to identify and correct diabetic health problems at early stages.

Diabetes causes a variety of eye problems. One of the early indicators of diabetes is a rather rapid change in eyeglass prescription. This is due to the lens in the eye accumulating sugar and changing its refractive properties. This can create some rather large changes in refractive error over a short period of time. Once the blood sugar is regulated the refractive error stabilizes and lenses can then be prescribed.

Another result of the accumulation of sugar in the lens of the eye is the development of cataracts. This generally happens after someone has been a diabetic for a few years. The changes of the chemical and physical properties of the lens change because of the presence of extra sugar. This causes the lens to become cloudy which in turn makes vision blurry. Cataract surgery is needed in order to restore a clear optical pathway in the eye.

A more serious complication of diabetes and the eyes is diabetic retinopathy. Here the circulation in the retina of the eye breaks down. This leads to bleeding and leakage of blood vessels in the fragile nerve tissue that lines the inside of the eye.  If left untreated diabetic retinopathy will lead to blindness.

In an effort to identify diabetic retinopathy Dr. Wheatall dilates all of his patients to exam for evidence of this condition whether or not they know they are diabetic. For it is only through a careful examination of the inside of the eye through a dilated pupil that the early signs or diabetic retinopathy can be found.

Through fundus photography in Dr. Wheatall’s office diabetic retinopathy can be followed carefully for changes that require treatment.

In an effort to help his patients control their diabetes he works with their physicians to keep them informed of eye health status.


Keratoconus and Pellucid Marginal Degeneration:

These are conditions where the front surface of the eye, the cornea, becomes irregular in shape. The cornea can take on a cone shape as the cornea thins and bulges which is where the name originates. There are several types of keratoconus based on the appearance and location on the cornea where the distortion occurs. All of these create distorted vision that is not able to be corrected with glasses.
 
The most common way to improve the vision of someone with any type of keratoconus is through the use of rigid gas permeable lenses or ClearKone hybrid contact lenses. These serve to provide the eye with a new optically correct front surface while bridging over the irregularities of the keratoconic cornea. 
 
Dr. Wheatall offers specialized services of fitting keratoconus correcting lenses. He has a state of the art Medmont E300 topographer, fitting sets of spherical gas permeable lenses, quadrant specific lenses such as the Quadracone, aspheric designs such as the Rose K, large diameter scleral lenses, and ClearKone hybrid lenses. With such a variety of lens designs he is able to help most people with keratoconus and pellucid marginal degeneration to achieve clear comfortable vision.


Dr. Wheatall welcomes the opportunity to provide you with a consultation about treatment options for keratoconus and pellucid marginal degeneration.

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