Olympia Eye Clinic - diabetic eye care, cataracts surgery, glaucoma treatment, macular degeneration, lasik surgery, eye lid surgery, contact lenses, eye exam, prk

Cataract Surgery

Most practices use only one technique to measure a patient's eye length before surgery. Because this measurement is used to calculate the appropriate replacement lens power for the affected eye, it is a critical element of successful surgery. At Olympia Eye Clinic, we can utilize both optical coherence and ultrasound biometry units to ensure the most precise preoperative measurements available.

Similarly, while most practices utilize only one lens design and lens material for the implant, we customize the replacement lens for each patient based on that patient's specific eye anatomy, pathology, and visual requirements. We even customize the bio-compatible material of each lens.

Guided by highly sophisticated computerized mapping of the eye, we can eliminate both nearsightedness and farsightedness during surgery. In fact, when appropriate, our advanced surgical techniques also allow us to treat astigmatism during lens surgery.

We also use sophisticated software programs to analyze our results, refine our techniques and fine-tune our calculations for maximum accuracy. As a result, we can offer our patients some of the most accurate lens power determinations in the world.

We hope you will entrust us with the care of your eyes and appreciate the extra effort we put forth to focus on our patients. Contact us at 360-456-4800 for more information or to schedule an appointment.

Olympia Eye Clinic Ambulatory Surgery Center

Our surgical procedures are performed at our beautiful state-of-the-art surgery center in downtown Olympia

PROCEDURES AVAILABLE - REFRACTIVE LENS EXCHANGE

Refractive Lens Exchange (RLE) is gaining popularity as an affordable surgical option for people over 40 who want to decrease or eliminate their dependence on glasses or contacts.

Designed to give patients back their youthful vision, the Crystalens™ IOL is the only accommodative lens available in the U.S. that is designed to provide a continuous range of vision for distance, intermediate, near and everything in between. The Crystalens™ is designed to move within the eye using the same muscle as your natural lens. This enables the eye to automatically focus to provide distance, intermediate and near vision and reduce your need for glasses or contact lenses.

ReSTOR® IOL Provides a full range of vision decreasing the dependency on reading glasses or bifocals. The revolutionary lens technology, which is designed to allow patients to see at all distances without bifocals or reading glasses. The ReSTOR IOL delivers a high level of glasses-free vision for cataract patients.

ReSTOR® IOL gives cataract patients a clinically proven way of leaving glasses behind, because it is designed with apodized diffractive technology. Apodization is a gradual reduction or blending of the diffractive step heights. The apodized diffractive optic is designed to improve image quality while minimizing visual disturbances. The result is an increased range of quality vision.  The recipient of any refractive lens implant will never develop cataracts because the lens implant replaces the natural lens, which is what eventually develops into a cataract in millions of older Americans.

Suitable for the following eye problems:

• Nearsightedness
• Farsightedness

Who is a good candidate?

The best candidates have mild to moderate nearsightedness (myopia), farsightedness (hyperopia), and/or astigmatism. Refractive Lens Exchange is also suitable for higher prescriptions. You must be over the age of 18, in good shape physically and have healthy corneas.

Screening Consultation

Give Betty Cain a call to set up your complimentary screening consultation, 360-456-4800.

PROCEDURES — CATARACTS

Cataract surgery is very successful in restoring vision. In fact, it is the most frequently performed surgery in the United States, with over 2 million cataract surgeries done each year.  More than nine out of 10 people who have cataract surgery regain very good vision, somewhere between 20/20 and 20/40.

Intraocular Lens: When the clouded lens of the eye is removed during cataract surgery, a replacement for the human lens is needed to restore focus to the eye. This implant is called an intraocular lens implant.

In clear corneal cataract surgery a tiny incision is made into the perimeter of the cornea on the side of the eye which is closest to the ear. This incision provides a small tunnel through which the cataract is removed and the intraocular lens is implanted. It is the architecture of this incision that makes it self sealing, thus requiring no stitches.

Who is a good candidate?
  Think about surgery when your cataracts have progressed enough to seriously impair your vision and affect your daily life. Many people consider poor vision an inevitable fact of aging, but cataract surgery is a simple, relatively painless procedure to regain vision.

Cataracts and Diabetes

It has been known for many years (ref 1) that patients with diabetes develop a worsening of their retinopathy following cataract surgery, leaving many if not most patients with worse vision than they had prior to the cataract surgery.  Recent scientific work (ref 2) has shown that this is true even with newer small-incision cataract surgery.  In response to these studies Dr. Bodoia has developed a special protocol for pre-treatment, surgery and post-operative care for patients with diabetic retinopathy.  This protocol has been scientifically proven to eliminate the worsening of retinopathy in nearly all patients, and Dr. Bodoia has successfully performed over 1000 cataract surgeries with this protocol, restoring vision to many happy patients with diabetes.

EYE PROBLEMS — ASTIGMATISM

Symptoms

Slight or significant blurred vision at any distance, headaches or eyestrain. Can accompany nearsightedness and farsightedness.

Causes

Astigmatism occurs when the cornea is shaped more like an oblong football than a spherical baseball, which is the normal shape. The oblong shape causes light rays to focus on two points in the back of your eye, rather than on just one.

It can rarely be caused by lid swellings such as chalazion, corneal scars, or by keratoconus.

Treatment Available

Astigmatism can be corrected with the following:

• Glasses or contact lenses
• Refractive surgery such as LASIK, LASEK, PRK or LRI

EYE PROBLEMS

CATARACTS

A cataract is any clouding or opaque area in the eye's natural lens, which is normally crystal clear. It is not a tumor or skin-growth over the eye. Most cataracts progress and eventually hamper vision, but merely having a cataract does not necessarily mean you have to do anything about it.

What Causes a Cataract?

Most cataracts develop as part of the aging process, from a change in the chemical composition of the lens. They don't usually become a problem until your 60s or 70s. If we live long enough, everyone will eventually develop cataracts. Several major studies have shown that prolonged exposure to sunlight, especially the ultraviolet-B rays (UV-B), over many years can play a role in hastening the development of a cataract.

Cataracts can also occur at a younger age from any number of causes: an eye injury (even many years earlier), certain eye diseases (such as uveitis), medical conditions (such as diabetes), heredity, birth defect, some medications (such as steroids - even if just used in an inhaler), excessive alcohol consumption, and smoking. They are not caused or made worse by using or "overusing" the eyes.

How Can You Tell if You Have a Cataract?

You may notice a gradual blurring or dimming of vision, sometimes more noticeable at distance, sometimes at near. In the early stages, using a bright reading light may make vision better (but a bright light might also make vision worse). Some people see a "halo" or haze around lights, especially at night, and/or have hazy or double (or multiple) vision, especially noticeable around traffic lights.

In the early stages, a cataract may not disturb your vision or cause any symptoms at all. You might not notice even an advanced or dense cataract if your other eye sees well. (You might only become aware of a problem if you happen to cover the "good" eye.) The symptoms may occur only in dim light or when you face bright oncoming car headlights, making night driving difficult.

Eye pain, headaches, and eye irritation are not symptoms of cataract. Unless a cataract is very dense and white, it will not be visible to the naked eye of a casual observer.

Once a Cataract Begins, How Rapidly Does It Progress?

As a rule, no one knows why some cataracts develop rapidly and others slowly. Generally, the clouding of the lens is a slow, gradual process that takes a long time, sometimes decades. On the other hand, there are some conditions, such as poorly controlled diabetes, in which a cataract can progress rapidly.

Recent studies show that antioxidant vitamin supplements, especially vitamins C and E, may help slow the process or even reduce the risk of developing cataracts. But other so-called "treatments," such as medication or exercise, do not help at all. And once cataracts have formed, they cannot be reversed.

How Are Cataracts Treated?

The only effective treatment is surgical removal of the cloudy lens. Cataract surgery is one of the most effective and safest operations performed today. The high success rate (about 99+%) is due to advances in microscope technique, ultra high-tech phacoemulsification instruments, and a wonderful assortment of intra-ocular lens implants.

Cataracts are NOT treated with lasers. If the cataract is small, surgery may be postponed for a while by changing your glasses prescription. If you have cataracts in both eyes, surgery is never done at the same time. You must wait for the first eye to heal before it is safe to proceed with the second eye surgery (typically at least 4 to 6 weeks).

Who Decides When To Remove a Cataract?

You do! You can postpone surgery until the cataract interferes with your vision so much as to make a difference in your life or livelihood. Since everyone's visual needs differ, this point will differ from one person to another. It is not necessary to wait until the cataract is "ripe" (totally opaque) before having it removed. You will be advised that you are a candidate for the surgery and how much improvement in vision you can expect from a cataract removal that is free of complications. You will then have to decide if the cataract is causing you enough trouble to warrant surgery.

There are certain rare circumstances that require cataract removal regardless of vision: if the lens begins to break down (become "overripe"), if the lens releases chemicals (break-down products) that might damage the eye and contribute to a type of glaucoma, or if the cataract is so dense that it prevents observation or treatment of some other eye problem or disease.

How Is a Cataract Removed?

The surgery can be done in an outpatient surgical suite or in a hospital. A small incision is made in the front of the eye and an instrument is inserted into the eye to remove the cloudy lens. Your eye remains in its normal position. It is never taken out of its socket.

There are several procedures for removing a cataract. With the "intracapsular" method (rarely used today), the lens is taken out in one piece along with the membrane enclosing it (called the capsule). With the "extracapsular" method, the front of the capsule is cut and the cloudy lens is taken out. The newest extracapsular techniques combine small incision surgery with phacoemulsification (FAKE-oh-ee-mull-sih-fuh-KAY-shun). With "phaco," a needle-like instrument that vibrates at high speed is inserted into the cataract to break it up. Then the tiny fragments are gently irrigated and suctioned out, and an IOL is inserted. The eye incision is closed, sometimes with sutures, sometimes without ("no-stitch" technique).

Will You Be Awake During the Operation?

Most people choose to have a local anesthetic, and stay awake (though drowsy). You will probably be given a sedative to calm you, and a local anesthetic, given either as eye drops or by injection under the eye, to numb the nerves for pain. The injection also paralyzes the eye muscles, to help keep the eye still during surgery. The lids may be separately injected with a local anesthetic to keep you from squeezing them during surgery. (The injections sting for only a few seconds.)

Sometimes general anesthesia is recommended: if you are especially frightened and don't wish to stay awake during the procedure; if there is a chance you might not be able to hold still; or if you have severe claustrophobia and cannot tolerate having your face covered during surgery.Children always need to have general anesthesia.

When Can Normal Activity Be Resumed?

You will probably be allowed to be up and around on the day of surgery, and in a short time return to most activities that do not require heavy lifting. In a day or so, it will be safe to use your eyes for reading or watching TV. Depending on the procedure used and the size of the incision, you should be able to resume full, normal activity in a few days, but you may be urged to wait for a month or so if your usual activities are strenuous.

What Will Vision Be Like After Surgery?

Your vision after surgery will depend on many factors, such as your vision before the cataract developed and the eye's overall condition. It also depends on how your eye will be optically corrected (IOL or cataract glasses). The surgery removes the natural lens from your eye. Without correction, your vision would be very poor.

If you have an intraocular lens (IOL) implanted during surgery, normal vision should be restored within a few weeks. An IOL is a permanent replacement for your natural lens. After it has been surgically placed inside your eye, it requires no care. You cannot feel or see it, and others do not notice it. Today, almost all patients having cataract surgery safely choose to have an IOL. Even though vision can be quite clear with an IOL, you may require some correction for reading and probably a correction to fine-tune your distance vision. A multifocal IOL is now available that can eliminate the need for reading glasses, but it has some disadvantages you'll need to consider. If such a lens interests you, learn all you can about it before making a decision.

It may take several weeks before the operated eye is fully healed and vision is stabilized. If you have need for critically sharp vision before then, temporary eyeglasses can be prescribed for you.

If you are not having an IOL - they are not appropriate for everyone - your vision will need to be restored by contact lenses or special cataract glasses. Contacts are better optically but not everyone can wear them or handle them easily. Cataract glasses work well but they are not easy to get used to - they are heavy, and they magnify and distort vision. But once you adapt to them, you'll find the improved vision well worth the effort.

What Complications Are Possible?

Some individuals, even with optical correction, do not obtain clear eyesight after the surgery. Some have pre-existing disease affecting the retina (such as macular degeneration) or optic nerve (such as from advanced glaucoma). Others develop one of the rare complications of cataract surgery. Any eye surgery, no matter how safe, presents some risk of infection, bleeding, glaucoma, corneal problems, chronic intraocular inflammation, or retinal swelling and detachment. Fortunately, these are usually temporary and/or can be treated with medications or surgery. With an IOL, there is a very slight additional risk: displacement of the IOL. It may be pulled off-center during the healing process, but this is rare. Rarely, a second surgical procedure will be needed.

Surgical results can never be guaranteed, but the odds are excellent that everything will be fine, and you will see just as well after the operation as you did before the cataract developed, and perhaps even better.