General Ophthalmology
Comprehensive Eye Examination
Comprehensive eye examinations should be a regular part of every person's healthcare routine. They are an important tool in eye health by detecting and preventing eye diseases and evaluating the overall health of the patient. Some diseases, such as glaucoma, develop gradually without symptoms of pain or visual loss, so patients may not notice that anything is wrong until significant and irreversible damage has been done. Early detection of eye diseases allows for a choice of treatment options and a reduced risk of permanent damage.
Our practice tests vision and provides prescriptions for eyeglasses and contact lenses when necessary. We use state-of-the-art equipment and techniques to evaluate and maintain your overall eye health.
A regular eye examination encompasses comprehensive testing for the early detection of a range of problems including:
- Cataracts
- Glaucoma
- Dry eye
- Macular degeneration
- Diabetic retinopathy
- Corneal disease
If any eye health issues are detected, an individualized treatment program will be designed to address the condition or prevent it from progressing.
Dry Eye
Dry eye is a common condition that occurs when the eyes are insufficiently lubricated leading to burning, redness and pain from dry spots on the surface of the eye. The eyes may become dry and irritated due to decreased production of tears or a chemical imbalance in the tears.
Patients with this condition often experience irritating symptoms which may result in more serious damage to the eyes if the condition is left untreated. Dr. Greco can diagnose dry eye after thorough evaluation of your eyes and your general medical health. Treatment options include lubricating eye drops, anti-inflammatory drops, or plugs in the tear ducts (punctal plugs).
Conjunctivitis
Conjunctivitis is an infection, or inflammation of the conjunctiva, the membrane that lines the eyelid and covers the white part of the eyeball. The inflammation affects the blood vessels of the eye and gives the eye a pink or red appearance.
Conjunctivitis can be caused by either a bacterial or viral infection, an allergic reaction, chemical exposure, or contact lens-related conjunctivitis. This condition can be contagious so the diagnosis and proper treatment is important. Most common symptoms of conjunctivitis include:
- Redness
- Itchiness
- A discharge that may become crusty overnight
- Excessive tearing
- A feeling of grittiness in the eye
Treatment for conjunctivitis depends upon the type of conjunctivitis. Treatment for bacterial conjunctivitis usually includes a prescription for antibiotic eye drops or ointment. Most cases of viral conjunctivitis will eventually resolve over time. If the source of the viral conjunctivitis is the herpes simplex virus, the doctor will most likely prescribe anti-viral medication. Allergic conjunctivitis can be treated with topical antihistamines. Chemical conjunctivitis requires immediate irrigation on site with tap water or eyewash if available. The patient needs to go directly to the emergency department for further irrigation and will require close ophthalmic care afterwards. Contact lens-related conjunctivitis is treated with antibiotic or anti inflammatory eye drops depending upon the cause of the conjunctivitis.
Flashes and Floaters
While flashes and floaters are common in people with healthy eyes, they can be symptoms of more serious problems such as retinal tears and retinal detachments. Flashes and floaters are caused by a posterior vitreous detachment, a condition, which occurs when the vitreous gel pulls away from the retina. Patients who have floaters complain of seeing dots, lines, circles, cob webs, and or clouds moving in their field of vision. Floaters are tiny clumps of cells or material inside the vitreous which cast a shadow on the retina which causes the appearance of the floater.
Symptoms of flashes are usually caused by tugging on the retina by the vitreous gel but may also be the result of a retinal tear or detachment. Flashes which appear more like jagged lines or heat waves that are not caused by a vitreous detachment are usually caused by a spasm of blood vessels in the brain, called a migraine. If a headache follows the flashes, it is called a migraine headache. If there is no headache, it is called an ophthalmic migraine. Patients who have flashes and floaters should contact their ophthalmologist immediately.
Diabetic Retinopathy
Diabetic Retinopathy develops when elevated blood sugar levels cause changes in blood vessels in the eye. This damage to blood vessels can result in leakage of fluid into the retina, loss of blood supply to the retina, growth of abnormal new vessels in the retina, and bleeding of these new vessels causing hemorrhages in the eye. Severe diabetic retinopathy can result in glaucoma or retinal detachments and total loss of vision if left untreated.
Diabetic patients need to work closely with their medical doctors to maintain their blood sugar levels in an adequate range. Yearly dilated retinal examinations by an ophthalmologist are necessary to screen for diabetic retinopathy. Treatment for diabetic retinopathy can include laser surgery to blood vessels causing leakage of fluid in the retina and extensive laser to the peripheral retina to inhibit the growth of abnormal new vessels in the retina. Medications called anti-VEGF are very effective in slowing or halting the progression of severe diabetic retinopathy caused by the growth of abnormal blood vessels.
Age-Related Macular Degeneration
Age-Related Macular Degeneration (ARMD) is a deterioration of the eyes’ macula which is the part of the retina responsible for crisp, detailed central vision. It is the most common cause of functional blindness in the United States more often affecting Caucasian patients. People with macular degeneration, even in the worst cases, do not go completely blind since the peripheral retina continues to function providing some less-detailed vision.
There are two types of macular degeneration, dry or atrophic macular degeneration, and wet or exudative macular degeneration. Dry macular degeneration is the most common variety affecting almost 30 percent of people over the age of 75 and causing symptoms such as blurred distance vision or reading vision, hazy vision and loss of vivid color perception. A small percentage of people with dry macular degeneration progress to wet macular degeneration which causes more severe damage to the macula resulting in loss of central vision, distorted vision or blank spots in the vision.
Since macular degeneration is significantly more prevalent in the elderly population, people over the age of 65 should undergo dilated eye examination by an ophthalmologist annually for evaluation of the macula. If macular degeneration is detected, specialized testing can be performed to evaluate the degree of damage of the macula. Treatment in mild to intermediate dry age- related macular degeneration is usually antioxidant vitamins based upon the AREDS 2 formulations and the use of polarized sunglasses. Wet age- related macular degeneration can be treated with Anti –VEGF medication and laser surgery.
