Your doctor has noted such changes in your eyes and feels that you should be seen by a specialist.

We pride ourselves as being readily available to our patients, since a large portion of our patients are sent to us on an emergency basis. If your condition is an emergency we will see you that day. If you are not being referred as an emergency, we will do our best to give you the next available appointment at a time that is convenient for you.

It is the nature of our practice to see several emergencies each day. This may cause us to run behind schedule from time to time. We appreciate your patience if this occurs.

Upon arriving for your first exam, you will be asked to fill out a short patient information form. Please bring with you your insurance cards, a current list of medications, and a list of any allergies that you may have. Our staff will be happy to make copies of these for your record and to help you if you need any assistance.

You will then be escorted to an examination room. The technician will ask you a few questions concerning your eye problem and will perform a complete review of your health. They will then check your vision and eye pressure and begin dilating your eyes.

Once your eyes are dilated, the doctor will perform a complete eye exam with particular attention to the vitreous and retina. This will involve the use of bright lights which will temporarily blur your vision. When the exam is finished the doctor will provide you with an explanation of the findings and discuss with you any further tests or treatments.

If vitreous and retinal surgery is required, our doctors are well trained and able to provide the newest surgical techniques. They are also actively involved in developing and evaluating new surgical methods, including new techniques for less common retinal problems.

Laser Surgery: We have a laser in each of our offices so that we may provide timely treatments for our patients. Lasers are most commonly used for: Diabetic Retinopathy, Macular Degeneration, Retinal Vascular Diseases, Retinal Tears

Office Surgery: We are capable of performing many operative procedures within each of our offices. Examples include: Repair of some Retinal Detachments, Repair of Retinal Tears, Injections of Medications into the eye.

Out-Patient Surgery: We provide our surgery on an out-patient basis, however, overnight rooms are available if needed.

There are two Kinds of Diabetic Retinopathy:

In diabetic retinopathy the blood vessels of the retina become abnormal and cause the problems that people with diabetes have with their eyesight. Normally, the blood vessels in the retina do not leak. But with diabetes, the retinal blood vessels can develop tiny leaks. These leaks cause fluid or blood to seep into the retina. The retina then becomes wet and swollen (called "thickened" in some scientific studies) and cannot work properly. The form of diabetic retinopathy caused by leakage of the retinal blood vessels is called non-proliferative (or background) diabetic retinopathy.

Another problem with the retinal blood vessels in diabetes is that they can close. The retinal tissue, which depends on those vessels for nutrition, will no longer work properly. The areas of the retina in which the blood vessels have closed then foster the growth of abnormal new blood vessels, called neovascularization, that can be very bad for the eye because neovascularization can cause bleeding and scar tissue that can result in blindness (total loss of vision). The form of diabetic retinopathy caused by closure of the blood vessels and in which neovascularization develops (proliferates) is called proliferative diabetic retinopathy.

Age-Related Macular Degeneration (AMD) is the most common cause of vision loss in people over the age of 50, and it is currently the number one cause of legal blindness in the Western World.

To understand this condition, it is important to understand how the normal eye works. The eye functions essentially like a camera. Light comes in from the front of the eye, is focused by the lens on the retina, and the retina is like the film in the camera. It takes the picture and sends that picture through the optic nerve to the brain. You may have had your lens surgically removed and replaced with an implant if you have had cataract surgery.

The center part of the retina is called the macula. This is the part of the retina that is responsible for the functions of central vision, including reading, driving, watching television, and identifying people’s faces. It is also the part that is affected in the condition we call macular degeneration. Simply put, the disease is a degeneration of the macula.

As you may know, there are 2 types of macular degeneration. In the "dry", or "atrophic" form, there is atrophy and deterioration of the cells in the macula. This is usually accompanied by yellowish deposits under the retina called "drusen". This form of AMD causes gradual visual loss which is usually mild, but may become severe. This is the most common form of AMD, accounting for 85% of all cases. There is NO known effective treatment for this form of the disease.

Only 15% of patients have the "wet" or "exudative" form of AMD but these patients usually have the most severe visual loss. In this form of AMD, abnormal blood vessels grow underneath the retina, which leak and bleed. In 65% of these cases, those vessels are not directly underneath the center of the retina, and they can be treated with a laser. This is still the gold standard of treatment. While the laser treatment leaves a scar and a blind spot, it can prevent further visual loss, and in certain cases, improve the vision.

In 35% of cases of "wet" AMD, the abnormal vessels grow underneath the center of the retina (called the "fovea"). These cases are called "subfoveal", for "underneath the fovea", and conventional laser treatment is of marginal benefit. The treatment leaves a central blind spot, and in many cases makes the vision worse. However, studies have proven that this treatment leaves a smaller blind spot than the patient would have if the disease would run its course untreated. There are several different laser treatment choices when the vessels are directly under the center of the macula. While none have been shown to improve the vision, in some cases the laser treatment may prevent further visual loss.

Most serious retinal problems that require surgery are caused by problems with the vitreous. The vitreous is much like the clear "white" of an egg and it fills the central cavity of the eye. The vitreous is attached to the retina. It is most strongly attached to the retina at the sides of the eye. It is also attached in the back part of the eye to the optic nerve, the macula, and the large retinal blood vessels.

As a person ages, the thick vitreous gel becomes less like a gel and more like a fluid. Small pockets of fluid form within the gel of the vitreous. As the eyeball moves, the liquefied vitreous moves around inside the vitreous cavity. Because of this movement of fluid, the vitreous begins to pull on the retina. With time, the vitreous can pull free and separate from the retina and optic nerve in the back (or posterior) part of the eye. This is called a "posterior vitreous detachment" (PVD).

Why is a retinal tear considered a serious problem? When a tear of the retina occurs, the liquid in the vitreous cavity may pass through the tear and get under the retina. The liquid collects under the retina and lifts it up off the back wall of the eye. Little by little, the liquid from the vitreous passes through the retinal tear and settles under the retina, separating it from the back wall of the eye. This separation of the retina is called a retinal detachment. Vision is lost wherever the retina becomes detached. Because most tears are located in the peripheral (or side of the) retina, the retinal detachment first results in loss of side, or peripheral, vision. A patient may notice a dark shadow, or a veil, coming from one side, above, or below. In most cases, after a retinal detachment starts, the entire retina will eventually detach and all useful vision in that eye will be lost.

Vitrectomy is required for retinal reattachment in a variety of conditions. For example, scar tissue may grow on the vitreous or surface of the retina and pull on the retina and detach it. Occasionally, something is in the vitreous, such as blood, that prevents the passage of light through the eye to the retina. The most common conditions requiring vitrectomy are vitreous hemorrhage with retinal detachment, proliferative vitreoretinopathy, giant retinal tears, diabetic retinopathy with vitreous hemorrhage and / or traction retinal detachment, epiretinal membranes (macular pucker), intraocular infection (endophthalmitis), trauma, and intraocular foreign body.

In a vitrectomy, instruments are passed through the sclera into the vitreous cavity. A variety of instruments can be used to remove the vitreous gel and any scar tissue that may be growing on the surface of the retina. A laser probe can be inserted into the eye so that laser treatment can be done during surgery.

Vitrectomy can be combined with the placement of a scleral buckle. Occasionally, air, gas, or silicone oil is placed in the vitreous cavity. These materials hold the retina in place against the back wall of the eye while the laser scars are taking hold. After this surgery, it may be important for the patient to maintain a certain position of the head, which is often a face-down (prone) position. Eventually, the air or gas is absorbed by the body and replaced by fluid produced by the eye. If silicone oil has been used, it usually must be removed at a later time with another surgical procedure. Vitreous surgery usually lasts one to two hours but, with very severe and difficult problems, may take many hours. Following surgery, the patient may experience some discomfort and a scratchy sensation in the eye, but significant pain is unusual. If it occurs, the surgeon should be told immediately.