Published: 12 August 2020

What Is Intraoperative Aberrometry? Yes, that is a mouthful, but the concept isn’t quite as hard as the name. An Intraoperative Aberrometer is an instrument we can use in the operating room to help us determine the correct power of the implant we put in your eye during cataract surgery. Cataract surgery is the removal of the cloudy natural lens of your eye and the insertion of a new artificial lens inside your eye called an intraocular lens (IOL). The cloudy cataract that we are removing has focusing power (think of a lens in a camera) and when that lens is removed, we need to insert an artificial lens in its place to replace that focusing power. The amount of focusing power the new IOL needs has to match the shape and curvature of your eye. To determine what power of lens we select to put in your eye, we need to measure the shape and curvature of your eye prior to surgery. Once we get those measurements, we can plug those numbers into several different formulas to try and get the most accurate prediction of what power lens you need. Overall, those measurements and formulas are very good at accurately predicting what power lens you should have. There are, however, several eye types where those measurements and formulas are less accurate at predicting the proper power of the replacement lens. Long Eyes: People who are very nearsighted usually have eyes that are much longer than average. This adds some difficulty with the accuracy of both the measurements and the formulas. There are special formulas for long eyes but even those are less accurate than formulas for normal length eyes. Short Eyes: People who are significantly farsighted tend to have shorter-than-normal eyes. Basically, the same issues hold true for them as the ones for longer eyes noted above. Eyes with previous refractive surgery (LASIK, PRK, RK): These surgeries all change the normal shape of the cornea. This makes the formulas we use on eyes that have not had previous surgery not work as well when the normal shape of the cornea has been altered. This is where intraoperative aberrometry comes in. The machine takes the measurements that we do before surgery and then remeasures the eye while you are on the operating room table after the cataract is removed and before the new implant is placed inside the eye. It then presents the surgeon with the power of the implant that the aberrometer thinks is the correct one. Unfortunately, the power that the aberrometer isn’t always exactly right, but with the combination of the pre-surgery measurements and the intra-surgery measurements the overall accuracy is significantly enhanced. The intraoperative aberrometry is also very helpful in choosing the power of specialty lenses like multi-focal and toric lenses. We would encourage you to consider adding intraoperative aberrometry to your cataract surgery procedure if you have either a long or short eye (usually manifested as a high prescription in your glasses) or if you have had any previous refractive surgery.

Published: 05 August 2020

What do Amblyopia, Strabismus, and Convergence Insufficiency all have in common? These are all serious and relatively common eye conditions that children can have. Did you know that 80% of learning comes through vision? The proverb that states ”A picture is worth a thousand words” is true! If a child has a hard time seeing, it stand to reason that she will have a hard time learning. Let’s explore Amblyopia, or “lazy eye”. It affects 3-5% of the population, enough that the federal government funded children’s yearly eye exams into the Accountable Care Act or ObamaCare health initiative. Amblyopia occurs when the anatomical structure of the eye is normal but the “brain-eye connection” is malfunctioning. In other words, it is like plugging your computer into the outlet but the power cord is faulty. Amblyopia need to be caught early in life--in fact if it is not caught and treated early (before age 8) it can lead to permanent vision impairment. Correction with glasses or contacts and patching the good eye are ways it is treated. Most eye doctors agree that the first exam should take place in the first year of life. Early detection is a key. Strabismus is a condition that causes an eye to turn in (esotropia), out (exotropia), or vertically. It can be treated with glasses or contacts, and surgery, if needed. Vision therapy or strategic eye exercises prescribed by a doctor can also improve this condition. When we read, our brain tells our eyes to turn in to a comfortable reading posture. In Convergence Insufficiency, the brain tells the eyes to turn in, but they instead turn out, causing tremendous strain on that child’s eye for reading. Another tell tale sign of this condition is the inability to cross your eyes when a target approaches. The practitioner will see instead, that one of the eyes kicks out as the near target approaches. This condition can be treated with reading glasses or contacts, and eye exercises that teach the muscles of the eye to align properly during reading. Vision therapy is the treatment of choice for Convergence Insufficiency. It is important to understand the pediatric eye and all the treatments that can be implemented to augment the learning process. Preventative care in the form of early eye examinations can mean the difference between learning normall or struggling badly. Remember, a young child can’t tell you if he hasa vision impairment. For the success of the child, be proactive by scheduling an early vision exam.