Mericos Eye Institute

Scripps Mericos Eye Institute provides advanced diagnosis and treatment for a variety of vision problems, including:

• Nearsightedness
• Farsightedness
• Astigmatism
• Presbyopia
• Cataracts
• Glaucoma
• Macular degeneration
• Diabetic retinopathy

Nearsightedness

Nearsightedness (myopia) normally first occurs in school-age children and generally develops before age 20. Correction may be possible with eyeglasses, contact lenses or refractive laser surgery.

Farsightedness

Farsightedness (hyperopia) occurs when your eyeball is too short or the cornea has too little curvature, causing light entering our eye to not focus correctly. Common signs of farsightedness include difficulty in concentrating and maintaining focus on near objects, eyestrain, fatigue, and/or headaches, aching or burning, irritability or nervousness after sustained concentration.

Correction may be possible with eyeglasses, contact lenses, refractive laser surgery, or a new procedure called conductive keratoplasty (CK).

CK is specifically designed for patients over 40 for the reduction of farsightedness. Unlike
LASIK, which corrects either near or far vision or leaves patients with monocular vision
(one eye sees far, the other near), CK tends to give patients blended vision. CK is a
quick and easy outpatient procedure. It takes about three minutes and most patients can see results right away.

Astigmatism

Astigmatism occurs when the front surface of your eye, called the cornea, is slightly
irregular in shape. This irregular shape prevents light from focusing properly on the back
of the eye, called the retina. As a result, vision may be blurred at all distances. Almost all levels of astigmatism can be corrected with eyeglasses or contact lenses. Refractive laser surgery is also a treatment option for some patients.

Presbyopia

Presbyopia is a vision condition in which the crystalline lens of your eye loses its
flexibility, making it difficult to focus on close objects. Presbyopia may seem to occur
suddenly, but the actual loss of flexibility takes place over a number of years. It usually
becomes noticeable in the early to mid 40s and is a natural part of the aging process of the eye.

Presbyopia is not a disease and cannot be prevented, however, it can be corrected with
reading glasses, bifocals, trifocals or contact lenses. Since the effects of this condition
continue to change, periodic changes in eyewear may be necessary to maintain clear,
comfortable vision. Refractive laser surgery may also be a treatment option for some
patients.

Cataracts

A cataract is a clouding of all or part of the normally clear lens of the eye, which results in blurred or distorted vision. Cataracts most often occur in people age 55 and older, but are occasionally found in younger people. According to the American Academy of Ophthalmology, 60 percent of all adults over age 60 experience poor vision due to cataracts.

A cataract is painless and usually develops slowly over several months or years. Usual
symptoms include reduced night vision, impaired depth perception, dull color perception and frequent eyeglass prescription changes. The cause of cataracts is not known, however, excessive exposure to ultraviolet sunlight, cigarette smoke or use of certain medications may be risk factors.

Cataracts can be corrected with eyeglasses, contact lenses or surgery. Cataract surgery is one of the most frequently performed surgeries in the country and one of the most successful. The cataract is dissolved using an ultrasound probe that breaks apart the lens and sucks it out. An artificial lens is then implanted in the eye. It takes a few months for the eye to heal completely, but patients return to their normal activities a few days later.

Cataract surgery continues to improve with new developments, such as no-stitch surgery, the use of topical anesthesia, new intraocular lens designs and the surgical correction of astigmatism.

Lasers are not used in the surgical removal of cataracts. However, the use of laser surgery may be indicated in the post-operative management of a patient who already has had a cataract extracted. If patients develop clouding of the new lens within two years following cataract surgery, a clear window can be created in the cloudy membrane with YAG laser surgery.

Glaucoma

Glaucoma, a disease characterized by elevated intraocular pressure (pressure within the eye), damages optic nerve fibers and can lead to progressive vision loss. According to the National Eye Institute, 50 million Americans are at risk for going blind from this disease. However, since glaucoma strikes with no obvious signs and symptoms, many people are unaware they have it until they begin losing their vision. Currently, damage from glaucoma cannot be reversed, so early detection is critical. Fortunately, glaucoma can be diagnosed with visual field studies.

Everyone should be concerned about developing this disease. According to the American
Academy of Ophthalmology, you may be at greater risk for glaucoma if you:

• Are over age 50
• Are over age 40 and are African American
• Have a family history of glaucoma
• Have a history of serious eye trauma
• Are taking steroid medication
• Have diabetes
• Are nearsighted (myopic)
• Have high blood pressure

The treatment of glaucoma is aimed primarily at reducing the level of intraocular pressure, since elevated pressure is the major risk factor for glaucoma and optic nerve damage. In most cases, treatment is limited to the use of topical and systemic medications. However, in some instances, surgery is indicated in order to reduce the intraocular pressure.

Macular degeneration

Macular degeneration primarily affects people over age 65, and is the leading cause of blindness in the United States and the world. This disease causes the macula (part of the light-sensitive retina at the back of your eye) to break down and degenerate, resulting in gradual or sudden loss of reading or central vision. It is still unknown what causes this condition.

Macular degeneration can produce a slow or sudden painless loss of vision. Some early signs are straight lines appearing wavy, fuzzy vision or shadowy areas in your central vision.

Along with age, you are at risk for developing this condition if you:

• Are female
• Are Caucasian
• Have a family member with macular degeneration
• Are a smoker
• Have high blood pressure
• Are farsighted
• Are obese

There are two forms of age-related macular degeneration: “wet” and “dry.” Seventy percent of patients have dry AMD, which involves thinning of the macular tissues and disturbances in its pigmentation. Dry AMD has no effective treatment and can cause progressive loss of vision.

Thirty percent of AMD patients have the wet AMD, which can involve bleeding within and
beneath the retina, opaque deposits, and eventually scar tissue. Wet AMD accounts for 90 percent of all cases of legal blindness in macular degeneration patients.

The Mericos Eye Institute offers a breakthrough treatment for patients with wet AMD. Photodynamic therapy or PDT, which combines laser surgery and the use of light-sensitive drugs, has been shown to stabilize or improve vision in up to 60 percent of patients with wet AMD who have leaking blood vessels.

Diabetic retinopathy

Diabetic retinopathy is an eye disease affecting the blood vessels in the retina (the back layer of the eye) of people with diabetes. The small blood vessels in the retina become weak and break down or become blocked. Diabetic retinopathy is a major cause of vision loss and blindness.

The longer a person has diabetes, the greater the risk of retinopathy. However, the disease does not affect only people who have had diabetes for many years. It can appear within the first year or two after the onset of the disease. For some people, retinopathy is one of the first signs that they have diabetes. Diabetic retinopathy may be corrected with laser surgery.