Providing Superior and Advanced Eye Care
SERVICES
We are proud of our reputation for excellence in eye care. Our commitment is to provide our patients the most thorough, up-to-date, and individualized care possible.
Drs. Jeruss and Zaunbrecher have been trained extensively to diagnose and treat functional vision disorders as well as eye disease. Our dedication to continually develop our knowledge and skills, along with constantly expanding our state-of-the-art equipment allows us to be experts at solving even the most challenging vision and eye health problems.
Here is some of the high-tech equipment we have available for testing your eyes:
NIDEK AUTOMATED REFRACTION / KERATOMETRY (OBJECTIVE MEASUREMENT OF REFRACTIVE ERROR)
ZEISS HUMPHREY HFA3 VISUAL FIELD ANALYZER & HUMPHREY FDT (PERIPHERAL VISION SENSITIVITY TESTS FOR VISUAL PATHWAY LESIONS)
REICHERT NON-CONTACT TONOMETRY (GENTLE AIR PUFF) AND GOLDMANN APPLANATION TONOMETER FOR TESTING EYE PRESSURE (GLAUCOMA)
KERATRON CORNEAL TOPOGRAPHY (FOR SPECIALTY AND CUSTOM CONTACT LENSES)
KONAN CORNEAL ENDOTHELIAL DENSITOMETRY / PACHYMETRY (CORNEAL HEALTH & THICKNESS)
NIDEK STEREO DIGITAL FUNDUS PHOTOGRAPHY (3-D VIEW TO DETECT SMALL CHANGES IN OPTIC NERVE GLAUCOMA PROGRESSION & DISTINGUISH NEVI FROM TUMORS)
NIKON-OPTOS ULTRA-WIDE FIELD DIGITAL RETINAL CAMERA (CAPTURES 200° IMAGES OF THE BACK OF THE EYE WITHOUT PUPIL DILATION TO SEE WHERE YOU CAN’T SEE!)
ZEISS OCT (CAPTURES ULTRA-HIGH-RESOLUTION INTERNAL IMAGES OF OPTIC NERVE AND MACULA TO DETECT EARLY DISEASE & MINUTE CHANGES)
Most adults between the ages of 19 and 40 enjoy healthy eyes and good vision. The most common problems for people in this age group are due to nearwork-related eyestrain and eye injuries.
Some things that can be done to minimize these are:
- Adjust your work chair and computer so that the top of the screen is at or below eye level
- Use proper lighting
- Take rest breaks
- Wear safety eyewear when handling chemicals or using equipment that throws off high-speed fragments
- Wear UV-blocking sunglasses outdoors
If you are asymptomatic, in good health, not taking medications that have ocular side effects, and you have no family history of eye disease, you should get your eyes examined every 2 years. Otherwise, it is recommended to get checked every year.
Vision changes after around age 40, so the recommended interval to have your eyes examined is every 1 year. Decreased near vision is a near universal problem due to the eye’s crystalline lens becoming less elastic with age, resulting in diminished ability to automatically change power to adjust for seeing up close. This is the age when many eye diseases begin to show up, such as cataracts, glaucoma and macular degeneration. Many systemic diseases and medications have ocular effects as well, the most visually devastating of which is diabetes with diabetic retinopathy.
INFANTS' VISION
The visual system undergoes dramatic change when we are children. At birth, infants are only capable of distinguishing light and large shapes. As the nerve pathways begin to pass more and more visual information to the brain and the eyes begin working together, by 2-3 months of age babies can focus on a nearby face and follow moving objects with their eyes. By 5 months, they are developing color and depth perception, and their acuity is almost 20/20. By 9-12 months, babies can judge distances pretty well, and by 2 years their hand-eye coordination should be well developed.
Parents can do many things to help their baby's vision develop properly:
- Use a nightlight in the room
- Change the crib's position
- Alternate right and left sides with each feeding
- Hang a mobile, crib gym or various objects across the crib for the baby to grab, pull and kick.
- Give the baby plenty of time to play and explore on the floor.
- Provide plastic or wooden blocks that can be held in the hands.
- Play patty cake and other games, moving the baby's hands through the motions while saying the words aloud.
- Play hide and seek games with toys or your face to help the baby develop visual memory.
- Encourage crawling and creeping.
- Roll a ball back and forth to help the child track objects with the eyes visually.
- Give the child building blocks and balls of all shapes and sizes to play with to boost fine motor skills and small muscle development.
- Name objects when talking to encourage the baby's word association and vocabulary development skills.
Most babies begin life with healthy eyes, but occasionally problems can occur. Parents need to look for the following signs that may indicate serious trouble:
- Appearance of a white pupil may indicate an eye tumor or cataract.
- Extreme sensitivity to light may indicate high pressure in the eye (glaucoma).
- Constant eye turning may indicate the eye muscles are not working together, which can lead to amblyopia (decreased acuity).
- Red or crusted eyelids may indicate an eye infection.
- Excessive tearing may indicate blocked tear ducts.
All babies should have their first eye exam between the ages of 6 and 12 months. Things that the optometrist will test for include:
- excessive or unequal amounts of nearsightedness, farsightedness, or astigmatism
- eye movement ability
- eye health problems.
These problems are not common, but it is important to identify children who have them at this young age. Vision development and eye health problems are easier to correct if treatment begins early.
PRE-SCHOOL CHILDREN'S VISION
According to the American Public Health Association, about 10% of preschoolers have eye or vision problems. However, children this age generally will not voice complaints about their eyes.
Parents should watch for signs that may indicate a vision problem, including:
- Sitting close to the TV or holding a book too close
- Squinting
- Tilting their head
- Frequently rubbing their eyes
- Short attention span for the child's age
- Turning of an eye in or out
- Sensitivity to light
- Difficulty with eye-hand-body coordination when playing ball or bike riding
- Avoiding coloring activities, puzzles and other detailed activities
It is important to know that a vision screening by a pediatrician or at preschool is not a reliable indicator of a child's possible vision problems. Vision screenings usually test visual acuity only and may miss as many as 60% of children with vision problems! Only a comprehensive optometric examination can determine if:
- the eyes are healthy
- the nerve pathway to the brain is functioning
- the eye muscles are working together properly
- there is a color vision defect
- there is a depth perception problem
By age 3, your child should have a thorough optometric eye examination to make sure his or her vision is developing properly and there is no evidence of eye disease. If needed, an optometrist can prescribe treatment, including eyeglasses and/or vision therapy, to correct a vision development problem.
With today's diagnostic equipment and tests, a child does not have to know the alphabet or how to read to have his or her eyes examined. Here are several tips to make your child's optometric examination a positive experience:
- Make an appointment when the child is rested.
- Talk about the examination in advance and encourage your child's questions.
- Reassure them that there will be no shots!
SCHOOL-AGE CHILDREN'S VISION
We know that that 80% of our learning is visual, therefore good vision and visual function are crucial to school success. A child's eyes are constantly in use in the classroom and at play, so when vision doesn't function properly, school and sports performance suffer.
All parents want to see their children do well in school and most parents do all they can to provide them with the best educational opportunities. But too often one important learning tool may be overlooked - their child's vision.
Because vision may change frequently during the school years, regular eye and vision care is important. The most common vision problem is nearsightedness or myopia. However, some children have other forms of refractive error like farsightedness and astigmatism. In addition, the existence of eye focusing, eye tracking and eye coordination problems may affect school and sports performance.
Myopia has become a worldwide epidemic, caused in large part by the indiscriminate prescribing by eye doctors of single vision correction for children. Research has proven that eyes become longer when they are subjected to "peripheral retinal hyperopic blur", which is caused by single vision lenses. We have had huge success in preventing the progression of myopia by prescribing Ortho-K corneal re-shaping treatment or bifocal contact lenses for children!
Please prepare to be surprised, shocked, and amazed at the latest information available on this topic at the following website:
Myopia Prevention and Control
www.myopiaprevention.org/index.html
As children progress in school, they face increasing demands on their visual abilities. The size of print in schoolbooks becomes smaller and the amount of time spent reading and studying increases significantly. Unfortunately, the visual abilities of some students aren't performing up to the task. When certain visual skills have not developed, or are poorly developed, learning is difficult and stressful, and children will typically:
- Avoid reading and other near visual work as much as possible.
- Attempt to do the work anyway, but with a lowered level of comprehension or efficiency.
- Experience discomfort, fatigue and a short attention span.
Some children with learning difficulties exhibit specific behaviors of hyperactivity and distractibility. These children are often labeled as having "Attention Deficit Hyperactivity Disorder" (ADHD). However, undetected and untreated vision problems can elicit some of the very same signs and symptoms commonly attributed to ADHD. Due to these similarities, some children may be mislabeled as having ADHD when, in fact, they have an undetected vision problem!
Vision is more than just the ability to see clearly or having 20/20 eyesight. It is also the ability to understand and respond to what is seen. Basic visual skills include the ability to focus the eyes, use both eyes together as a team, and move them effectively. Other visual perceptual skills include:
- recognition (the ability to tell the difference between letters like "b" and "d"),
- comprehension (to "picture" in our mind what is happening in a story we are reading), and
- retention (to be able to remember and recall details of what we read).
Every child needs to have the following vision skills for effective reading and learning:
- Visual acuity — the ability to see clearly in the distance for viewing the chalkboard, at an intermediate distance for the computer, and up close for reading a book.
- Eye focusing — the ability to quickly and accurately maintain clear vision as the distance from objects change, such as when looking from the chalkboard to a paper on the desk and back. Eye focusing allows the child to easily maintain clear vision over time like when reading a book or writing a report.
- Eye tracking — the ability to keep the eyes on target when looking from one object to another, moving the eyes along a printed page, or following a moving object like a thrown ball.
- Eye teaming — the ability to coordinate and use both eyes together when moving the eyes along a printed page, and to be able to judge distances and see depth for class work and sports.
- Eye-hand coordination — the ability to use visual information to monitor and direct the hands when drawing a picture or trying to hit a ball.
- Visual perception — the ability to organize images on a printed page into letters, words and ideas and to understand and remember what is read.
If any of these visual skills are lacking or not functioning properly, a child will have to work harder. This can lead to headaches, fatigue and other eyestrain problems. Parents and teachers need to be alert for symptoms that may indicate a child has a vision problem.
A child may not tell you that he or she has a vision problem because they may think the way they see is the way everyone sees. Signs that may indicate a child has vision problem include:
- Frequent eye rubbing or blinking
- Short attention span
- Avoiding reading and other close activities
- Frequent headaches
- Covering one eye
- Tilting the head to one side
- Holding reading materials close to the face
- An eye turning in or out
- Seeing double
- Losing place when reading
- Difficulty remembering what he or she read
Your child should receive an eye examination at least once every year. If the doctor detects a vision problem, he can correct it with eyeglasses, contact lenses, or vision therapy exercises.
(For more detailed info on eye diseases, CLICK HERE)
The following is a list of some of the vision disorders and eye diseases we diagnose and/or treat:
- Myopia, hyperopia, astigmatism, presbyopia, eye muscle imbalances (eyestrain, diplopia)
- Glaucoma
- Cataract/IOL implant surgery pre-op and post-op care
- Macular Degeneration diagnosis
- Diabetic retinopathy diagnosis
- Retinal degeneration, hole, tear, & detachment diagnosis
- Vitreous floaters
- Dry eye / Watery eye
- Bacterial eye infections
- Herpes zoster and simplex infections
- Corneal abrasions & lacerations
- Removal of embedded foreign objects
- Chemical removal of eyelid growths
- Punctal occlusion
- Keratitis
- Conjunctivitis
- Iritis
- Episcleritis
- Styes and chalazia
- Ocular allergies
- Conjunctival abrasions & lacerations
- Eyelash epilation
- Chemical burns
- Stuck contact lens removal
DOING THE IMPOSSIBLE
We are recognized in the Atlanta area for "doing the impossible" with contact lenses. Local doctors and patients know that we take on the most difficult cases and turn them into successful contact lens wearers. We just don’t give up.
CUSTOM ORTHO-K & MYOPIA CONTROL
(Click HERE for more specific detailed info)
Our most well-known specialty is custom Ortho-K corneal re-shaping to prevent myopia progression in children.
SCLERAL LENSES
Have you ever been told that your vision could not be corrected well with soft lenses therefore you would need to wear RGP (rigid gas permeable) lenses?
Did you ever TRY wearing RGP lenses but had to quit because it felt like you were wearing POTATO CHIPS in your eyes???
The reason is that typical RGP lenses are smaller than the cornea and sit between the eyelids. Whenever you blink, the upper eyelid bangs into the top edge of the lens, giving you that uncomfortable scratchy feeling. Even with my 36 years of experience with RGP lenses, with the last 15 of them using custom lens design software, it is often difficult to match the comfort of a soft lens.
UNTIL NOW!
SAY HELLO SCLERAL LENSES!
Scleral RGP lenses have been around awhile, but they only came in limited parameters and were not utilized much. Today we have a dozen companies making different lens designs….AND we even have WAVE custom designed scleral lenses, which bring a whole new level to exceptional vision and comfort!
Every single one of our patients putting on scleral RGPs for the first time has said: “These feel like SOFT lenses!” or “I can barely feel them!”. Yes, we know…
We always recommend scleral lenses for eyes that have been compromised by disease, failed refractive surgeries, and corneal scarring, but patients with healthy eyes can also benefit from the much increased comfort and vision quality that sclerals offer.
INDICATIONS FOR SCLERAL LENSES
- Patients who need the best vision and comfort possible
- Bifocal contact lens wearers who need better lens centration
- Athletes who need vision that is stable while engaged in intense sports activities
- Patients who need lenses that won’t pop off during strenuous activities
- Keratoconus
- Pellucid marginal degeneration
- Corneal scarring from injuries and infections
- Dystrophies of the anterior cornea
- Severe dry eye
- High myopia, high hyperopia, high astigmatism
- Severe ocular surface disease
- Post-corneal transplant
- Failed RK surgery
- Failed LASIK/PRK surgery
- Irregular astigmatism
ASTIGMATISM CONTACT LENSES
Maybe you've heard it before: "Sorry... you have astigmatism...you can't wear contact lenses". Or maybe you tried RGP (rigid gas permeable) lenses but couldn’t tolerate the discomfort so you quit wearing them?
Hmmm...maybe it's time you come to a doctor who specializes in astigmatism! Do you know that there are over 60 different brands of soft toric lenses that correct astigmatism...even extreme amounts of astigmatism? And gas permeable hard lenses can be easily customized for your eyes to make them comfortable!
Astigmatism is merely a visual condition of the eye that is caused by its shape, just like myopia (nearsight) and hyperopia (farsight). Nearsight is caused by an eye that is too long, while farsight is caused by an eye that is too short. Astigmatism is caused by an eye that has two different powers, which splits the focusing of an object into two separate images. The most common form is corneal astigmatism, in which the front of the eye is not perfectly spherical, but warped, with two unequal curvatures. These unequal curvatures result in magnification differences and cause blurry vision, shadows seen around objects, eye muscle spasms, eyestrain, and headaches.
Approximately 84% of the population has astigmatism...it is by far the most common refractive problem, more than nearsight and farsight put together!
Both eyeglasses and contact lenses correct astigmatism, but, contrary to what most doctors still say, contact lenses do a much better job! Astigmatism eyeglasses cause distortion just like those "Fun House" mirrors that make you look tall and skinny or short and fat...there is more magnification in one axis than in the opposite axis. Most of the distortion occurs away from the lens centers, so large eyeglass frames cause more problems than small frames. In addition, when you move, the side vision appears to "swim". Contact lenses do not cause any of these problems because the eyes are always looking through the center of the lenses, where there is no distortion! When you move your eyes, the contacts move too.
Most doctors still tell people that they can't wear contacts if they have astigmatism. The truth is that it is too time consuming for them to fit astigmatism contacts, or they have not kept up with new contact lens technology.
You really do have to try them for yourself. If you already use astigmatism contacts, or you've tried them unsuccessfully in the past, call us to set up an evaluation, we will discuss all your options…and WE…WILL…NOT…QUIT…until we find a lens that works!
BIFOCAL AND PROGRESSIVE MULTIFOCAL LENSES
If you already wear contacts but are having problems with your near vision because you are over 40 years old, then you will be happy to hear about this newest area of contact lens development. Imagine being able to read or work at your computer, without having to strain your eyes or pull out your reading glasses. We now have the contact lenses you've been waiting for!
Bifocal contact lenses have had major improvements over the past few years, and there are now dozens of brands available for people with different vision needs.
People often confuse bifocal contacts with "monovision", where one eye is corrected for far vision, and the other eye is corrected for near vision. Bifocal contacts are designed with a far and near correction in each lens! There are many different designs, but they fall into 3 main categories:
Line bifocals (aka “translating” bifocals): weighted on the bottom, so that they stay in the proper position. When you look straight ahead, you are looking above the line through the far prescription, and when you look down to read, the lens stays put while the eye “translates” downward, and you are looking below the line, through the near prescription.
Concentric bifocals: the center has the far prescription, and the outer portion has the near prescription.
Concentric progressive multifocals: the prescription gradually changes from the center of the lens toward the outer portion. They come in center distance/periphery near or center near/periphery distance designs. These work better for computer users than the other 2 types of bifocal lenses..
No matter how strong or weak your prescription is (and now, even if you have astigmatism too!), there is a bifocal lens that will very likely work for you. We are quite familiar with all of the brands and will be happy to discuss all of your options with you.
SPORTS CONTACTS
Many people wear contact lenses for sports only. They appreciate the improved peripheral vision that eyeglasses do not provide. They also enjoy not having to constantly wipe perspiration off their glasses or look through fogged up lenses.
Typically, a large lens is the best for sports, because it is less likely to move around and cause fluctuating vision. It is also less likely to fall out during strenuous activity or windy conditions. There are a number of contact lens brands made with the sports enthusiast specifically in mind.
For those whose sports activities occur only on weekends or even less frequently, daily disposable "single use" lenses may be the answer, for both convenience and economy.
CONTACT LENSES FOR KERATOCONUS AND OTHER OCULAR SURFACE ABNORMALITIES
Keratoconus is a progressive condition that causes the cornea to become thinner and eventually bulge forward in a cone-like shape. The result is increasingly distorted vision that cannot be corrected with eyeglasses or soft contact lenses.
There are a variety of RGP (rigid gas permeable) lens designs that fit different types of keratoconus, and all of them do an excellent job of providing clear vision by negating or compensating for the distortion of the cornea.
Contact lens options for keratoconus include:
- Small to medium-sized RGP (rigid gas permeable) corneal lenses that fit over the "cone".
- "Piggy-back" lenses: a small to medium sized RGP corneal lens is worn over a soft contact lens to provide better comfort than an RGP lens by itself.
- "Hybrid" lenses, which combine an RGP center with a soft outer skirt, providing the clear vision of an RGP lens with the comfort of a soft lens. Dr J is one of the very first doctors in the US to fit this design: ( SynergEyes™ http://www.synergeyes.com/)
- Large diameter "scleral" hard lenses that are larger than the cornea to provide better health, better centration, better vision, and much better comfort. This modality has become our FIRST CHOICE to correct keratoconus and other ocular surface abnormalities.
DISPOSABLE CONTACT LENSES
Disposable contact lenses have made major strides in material development and manufacturing quality. We now have materials that transmit 6 times more oxygen to the cornea than previous lenses or that maintain their water content throughout the day, providing relief to contact lens wearers who have dry eye problems.
We have lenses for many different wearing schedules. There are 3 month, 1 month, 2 week, 1 week, and daily disposables, each of which can provide good corneal health, comfort, and vision when worn and replaced properly. We have seen superior results with daily disposables, so we have been moving more and more of our patients into them.
Patients often ask: "Which lens is the best?" The answer is that we have lenses that are "the best" for dry eyes, lenses that are "the best" for deposit resistance, lenses that are "the best" for oxygen transmission, lenses that are "the best" for easy handling, etc.
We will fit YOU with "the best lenses for YOU"!
CONTACT LENS OPTIONS IF YOUR RK OR LASIK HAS WORN OFF
Don't worry. We have turned this situation around many times with specially designed contact lenses to enhance the effect of the surgery. They act similarly to the Ortho-K lenses described in the article "Improve Your Vision While You Sleep". These contacts gently re-shape the corneal curvature to the desired prescription, and stabilize the vision to a more satisfactory level.
Other options are:
- RGP corneal lenses
- Piggyback lenses
- Hybrid lenses
- Scleral lenses
Fashion Designer Frames
We are proud of our beautiful collection of designer eyewear. Our licensed super-optician Joanne is constantly updating our frame inventory with the latest styles and colors to give our patients the most appealing look possible. We know that people love to wear glasses when they look great in them. We carry approximately 700 DIFFERENT frames (not 4,000 of the same frame with different colors!) at our office, including such designers as:
- Gucci
- Oakley
- Silhouette
- Kate Spade
- Saint Laurent
- Puma
- ÖGA
- Nautica
- Argyleculture
- Penguin
- Vera Wang
- Adidas
- Rayban
- Light Tech
- Lilly Pulitzer
- 9 West
- Flexon
If you see a frame somewhere else that you love, ask Joanne if she can find it for you.
Eyeglass Lenses
But what good does it do if you LOOK great, but can't SEE well because an inexperienced frame stylist (instead of a licensed trained optician) picked the wrong lens design for your vision needs? We are very proud to provide up-to-date products and the knowledge to match them with YOUR individual needs. Our staff completes continuing education every year in order to be the best at what they do.
There has been an enormous increase in the number of lens materials and designs in the past few years. At Eye To Eye, we have access to all of the companies' products, not just 2 or 3, like you might find at the "fast food" optical stores. What this means is that we can custom design the best lens for your prescription.
We now have thin, thinner, and thinnest lenses that can make your old thick prescription "Coke® bottles" a distant memory.
Our new patternless edger is "state-of-the-art" equipment for grinding your lenses into shape, guaranteeing beautiful workmanship and accurate prescriptions every time.
There are hundreds of progressive (no line) bifocal lenses available today, but we prefer to use the best ones for your individual vision needs, so that you can adjust to them easily without the distortion experienced with most of the commonly used cheaper brands of progressives.
We use the 2 anti-reflective coatings that are considered the best in the industry:
- Zeiss Carat Advantage™
- ROYAL InvigorEyes Retinal Bliss DES AR™, the newest anti-reflective coating that now blocks high energy visible (HEV) blue light as well. HEV blue light and UV light are known to cause cataracts, macular degeneration, photokeratitis, pterygium, and eyelid cancers. This coating is the ultimate protection from the harmful rays of the sun and electronic devices.
Older brands of A/R coatings tended to develop fingerprints and "scratch" or wear off fairly easily. This problem has been dramatically reduced now.
Many people think that they can get a better deal on eyeglasses at the big commercial opticals, but we guarantee that our prices are better when you "compare apples to apples". Come in and see for yourself!
LASIK / PRK (laser refractive eye surgery)
LASIK (Laser-Assisted-In-Situ Keratomileusis) and PRK (PhotoRefractive Keratectomy) are refractive surgical procedures that can dramatically reduce (but not entirely eliminate) the need to wear glasses and contact lenses. Both are highly effective for most low, moderate, and higher prescriptions, and there are now techniques to correct myopia, hyperopia, and astigmatism.
In LASIK, a special bladed device called a microkeratome creates a flap of corneal tissue, which is then folded back to expose the inner layer of the cornea. Then a cool beam of light from an excimer laser is used to reshape the corneal contour to the curvature required to eliminate the refractive error. The flap is then repositioned, and the patient is able to see well almost immediately, with only mild discomfort.
IntraLase (also called "bladeless") LASIK uses a laser instead of a microkeratome to create the corneal flap, resulting in a smoother surface. A big advantage of this procedure is the ability to cut a thinner flap, allowing people with higher prescriptions and thin corneas to have LASIK. Studies have also suggested that the incidence of post-operative dry eye is reduced with this technique.
PRK is performed when the cornea is too thin to cut any flap. The excimer laser is used directly on the outer corneal surface, and, although it is considered to be more accurate at re-contouring the desired shape, it leaves the patient with a large corneal abrasion. A high oxygen silicon-hydrogel extended wear contact lens must then be worn for 4-7 days while the abrasion heals.
"Custom" LASIK and "Custom" PRK utilize a wavefront analyzer to measure the way light travels through your eye. Numerous types of visual imperfections exist. Three of them we know as myopia, hyperopia, and astigmatism, but the others, referred to as higher-order aberrations, cause glare and haloes. Custom LASIK and PRK target these higher-order aberrations as well, resulting in an even better visual outcome.
As mentioned earlier, laser refractive surgery dramatically reduces, but cannot eliminate the need to wear eyeglasses or contact lenses entirely. Our eyes change as we get older, and especially when we get into our 40's and beyond, the need to use reading glasses becomes greater (known as "presbyopia"). A way to reduce this need for reading glasses has been used by contact lens wearers for a long time (called "monovision", where one eye is made to see far away, while the other eye is made to see near by slightly undercorrecting it). This can be done using laser refractive surgery as well, but because gaining this near vision means losing some distance clarity, we recommend that you try monovision with contact lenses for a week and prioritize your vision needs before making a decision.
SCLERAL LENSES
Have you ever been told that your vision could not be corrected well with soft lenses therefore you would need to wear RGP (rigid gas permeable) lenses?
Did you ever TRY wearing RGP lenses but had to quit because it felt like you were wearing POTATO CHIPS in your eyes???
The reason is that typical RGP lenses are smaller than the cornea and sit between the eyelids. Whenever you blink, the upper eyelid bangs into the top edge of the lens, giving you that uncomfortable scratchy feeling. Even with my 36 years of experience with RGP lenses, with the last 15 of them using custom lens design software, it is often difficult to match the comfort of a soft lens.
UNTIL NOW!
SAY HELLO SCLERAL LENSES!
Scleral RGP lenses have been around awhile, but they only came in limited parameters and were not utilized much. Today we have a dozen companies making different lens designs….AND we even have WAVE custom designed scleral lenses, which bring a whole new level to exceptional vision and comfort!
Every single one of our patients putting on scleral RGPs for the first time has said: “These feel like SOFT lenses!” or “I can barely feel them!”. Yes, we know…
We always recommend scleral lenses for eyes that have been compromised by disease, failed refractive surgeries, and corneal scarring, but patients with healthy eyes can also benefit from the much increased comfort and vision quality that sclerals offer.
INDICATIONS FOR SCLERAL LENSES
- Patients who need the best vision and comfort possible
- Bifocal contact lens wearers who need better lens centration
- Athletes who need vision that is stable while engaged in intense sports activities
- Patients who need lenses that won’t pop off during strenuous activities
- Keratoconus
- Pellucid marginal degeneration
- Corneal scarring from injuries and infections
- Dystrophies of the anterior cornea
- Severe dry eye
- High myopia, high hyperopia, high astigmatism
- Severe ocular surface disease
- Post-corneal transplant
- Failed RK surgery
- Failed LASIK/PRK surgery
- Irregular astigmatism
CONTACT LENSES FOR KERATOCONUS AND OTHER OCULAR SURFACE ABNORMALITIES
Keratoconus is a progressive condition that causes the cornea to become thinner and eventually bulge forward in a cone-like shape. The result is increasingly distorted vision that cannot be corrected with eyeglasses or soft contact lenses.
There are a variety of RGP (rigid gas permeable) lens designs that fit different types of keratoconus, and all of them do an excellent job of providing clear vision by negating or compensating for the distortion of the cornea.
Contact lens options for keratoconus include:
- Small to medium-sized RGP (rigid gas permeable) corneal lenses that fit over the "cone".
- "Piggy-back" lenses: a small to medium sized RGP corneal lens is worn over a soft contact lens to provide better comfort than an RGP lens by itself.
- "Hybrid" lenses, which combine an RGP center with a soft outer skirt, providing the clear vision of an RGP lens with the comfort of a soft lens. Dr J is one of the very first doctors in the US to fit this design: ( SynergEyes™ http://www.synergeyes.com/)
- Large diameter "scleral" hard lenses that are larger than the cornea to provide better health, better centration, better vision, and much better comfort. This modality has become our FIRST CHOICE to correct keratoconus and other ocular surface abnormalities.
Dr Jeruss TV Interview