What is Monovision?

What is Monovision?

Monovision is a method of optimizing both distance and near vision.  It is a method that we often use during Lasik, contact lens fittings and during cataract surgery.  We use the dominant eye for distance activities and the non dominant eye for near activities.  The goal of monovision is to optimize both distance and near vision.

Why Do You Need Monovision?What is monovision? | Eye Surgery Institute

Presbyopia is term that refers to difficulty focusing up close with age.  We all develop presbyopia as we age and it usually starts around age 40.  Presbyopia gradually becomes worse as we age.  It can be frustrating to no longer be able to see up close objects such as your cell phone, computer, a menu or a book or magazine.

If you are frustrated by the onset of presbyopia, Dr. Stanley Grandon, Dr. Cindy Wang and I can discuss your options with you.  We will perform a complete eye examination and provide you with the options that best meet your needs.

What Are My Monovision Options?

If you are interested in Lasik eye surgery, we can perform a laser correction and allow your dominant eye to see well for distance activities and your near activities.  Dr. Stanley Grandon, Dr. Cindy Wang and I can also perform a contact lens fitting with monovision

We often aim the near eye for more intermediate vision activities rather that very fine print.  This makes  it easier for you to adjust to the difference between the two eyes.  You will likely still need reading glasses for fine print.

What If I Need Cataract Surgery?

A cataract is a clouding of the natural lens in your eye.  We may recommend cataract surgery if your are experiencing blurry vision from a cataract and it is interfering with your day to day activities.  At the time of cataract surgery, Dr. Stanley Grandon and I will chose an implant power to place inside your eye.   We will discuss with you what options best meets your needs.  We can provide the option of monovision at the time of cataract surgery.

Alaina Kronenberg, M.D.
Cataract Specialist
Comprehensive Ophthalmologist
Dearborn, Michigan 48126


Do I have Glaucoma?

What is Glaucoma?

Glaucoma is a serious eye disease where damage to the optic nerve causes vision loss that is not reversible.  It often happens when fluid builds up in your eye and may be related to eye pressure .  This extra fluid can damage your optic nerve and cause loss of vision.  You will often not notice vision loss from the earlier or even moderate stages.  There is usually no pain or other symptoms associated.

Glaucoma is one of the leading causes of preventable blindness.  The vision loss can often be prevented with early diagnosis and treatment.  There are often no symptoms in the earlier stages.  The vision loss is usually first in the periphery.  Later more advanced stages of glaucoma can cause total blindness.

Risk factors for this blinding disease include family history, age and race.

How is it Diagnosed?Do I Have Glaucoma?

Glaucoma is diagnosed with a comprehensive eye examination.  Dr. Stanley Grandon, Dr. Cindy Wang and I may suspect glaucoma if your intraocular pressure is elevated and/or if your optic nerve looks as though it may have damage.  Up to half of patients with glaucoma do not have an elevated intraocular pressure when examined.  If we have a high enough suspicion, extra tests such as a peripheral vision test (a visual field), a picture of the optic nerve and checking the thickness of your cornea (pachymetry) may be recommended.  Depending on the level of suspicion, we may decide to observe you or choose to initiate treatment.

What Happens if I Have Glaucoma?

Although this eye disease is not curable, it is often treatable by various methods.  Dr. Stanley Grandon, Dr. Cindy Wang and I often initially start treatment with eyedrops.  There are several eye drops available that work in different ways.  We will often start you on a once daily drop.  Sometimes, other drops are added as well.   We will monitor your intraocular pressure, optic nerve and visual field tests to ensure your disease is not progressing.  As of today, there are no dietary supplements that have shown to be effective for glaucoma.

Laser treatments are another method of treatment.  Laser is often performed in the office and can lower intraocular pressure.  Laser does not cure glaucoma.

If we are unable to manage your disease with drops and /or laser surgery in the operating room may be required .  If necessary, there are various types of surgical procedures.  No matter what treatment is iniated, it is important to maintain regular examinations to ensure it continues to be under control.

Alaina Kronenberg, M.D.
Cataract Specialist
Comprehensive Ophthalmologist
Dearborn, Michigan 48126


How Does LASIK surgery work?

What is LASIK?

How does LASIK surgery work?  LASIK stands for Laser Assisted In Situ Keratomileulis.  It is an eye surgery using the VISX laser to reshape the cornea.  The purpose of the eye surgery is to change the surface of the cornea allowing it to refocus light onto the retina so you can see clearly.  You may consider LASIK if you would like to be less dependent on glasses.

Can I Have Lasik?How does Lasik surgery work?

LASIK can treat certain amounts of nearsightedness (myopia), farsightedness (hyperopia) and astigmatism.  There is often a misconception that LASIK cannot treat astigmatism.  Dr. Stanley Grandon and I can perform a comprehensive LASIK evaluation to determine if you are a candidate for LASIK.  We need to make sure your eyes are healthy enough to have the surgery and that your glasses prescription is in the ranges that LASIK can be safely performed.  If you already require reading glasses, we can discuss options with you as well.

How Does Lasik Surgery Work?

The cornea is extremely powerful in focusing light.  It is responsible for 2/3 of the focusing power of the eye. Therefore reshaping the surface has tremendous effects on focusing without the need for glasses.

The laser removes microscopic amounts of tissue on the cornea so that the cornea focuses light onto the retina.  If you are nearsighted (myopic) the cornea will need to be made flatter.  If you are farsighted (hyperopic), the cornea will need to be made steeper, and if you have astigmatism the cornea will need to be made less irregular.

Lasik is a pain free outpatient procedure.  Dr. Stanley Grandon and I will focus the laser onto your eye and perform the procedure in about 5 minutes.  After the procedure, your eye will likely feel scratchy and the vision may be blurry for a few days.  You will need someone to drive you home and then you will be seen in our office the next day.

If you would like to schedule a LASIK evaluation, please call :3135828856

Alaina Kronenberg, M.D.
Cataract Specialist
Comprehensive Ophthalmologist
Dearborn, Michigan 48126


Red, Itchy Eyes From Eye Allergies

Itchy, Red Eyes

If your eyes are itchy and red it can be quite uncomfortable and cause difficulty with your vision.  You may have trouble wearing your contact lenses also.  You may also have other symptoms such as burning, watery eyes and swollen eyelids.  Your symptoms may be from eye allergies, also called allergic conjunctivitis.  Many eye problems such as infections can have similar symptoms so it is important me to perform an examination to assess for other conditions.

Eye Allergies
Itchy Red Eyes Due to Eye Allergies

If you have allergic conjunctivitis you may have other symptoms such as sneezing, sniffling, nasal congestion and a runny nose.  Your eye symptoms will often be in both eyes if they are due to eye allergies.   Fortunately, allergic conjunctivitis usually causes no threat to your eyesight.  It may cause temporary blurriness, though.

Triggers

It is important to try to avoid the triggers that cause your symptoms.  Your allergies may be seasonal or perennial.  If your allergies are seasonal, you may be allergic to pollen, grass or trees.  Perennial allergies can be due to dust, mold and pet dander.

Home Remedies for Allergies

If you have seasonal allergies, it is important to try to not be outdoors during peak allergen times.  It can be helpful to wear eyeglasses or sunglasses and to keep your windows closed when you drive.  If you are allergic to dust mites, washing your sheets frequently can be helpful.  Not rubbing your eyes can be helpful also.

Cool compresses and chilled artificial tears can be soothing if your eyes are bothersome.  Over the counter allergy drops such as ketotifen can be very helpful also.  There are oral over the counter allergy pills that can help.  It is important to choose an oral medication that will not be sedating if during the daytime hours.

How Can We Help You?

Red eyes can be caused by many conditions.  Allergies are just one possibility.  Dr. Stanley Grandon, Dr. Cindy Wang and I can perform a comprehensive eye exam to determine the exact cause of your symptoms.  There are many prescription eye drops available for eye allergies.  Allergy drops are more effective if taken regularly during your allergy season.  For more severe symptoms, if due to allergies sometimes a short course of steroid eye drops can relieve your symptoms faster.

Alaina Kronenberg, M.D.
Cataract Specialist
Comprehensive Ophthalmologist
Dearborn, Michigan 48126


Blurry Vision After Cataract Surgery

Secondary Cataract Causes Blurry Vision

Most patients decide to have cataract surgery because their vision is blurry.  The purpose of your cataract surgery is to correct your blurry vision.  Sometimes, months or years after cataract surgery the vision can become blurry again.  We call this a secondary cataract.

You may worry that the cataract grew back.  This is not the case.  Once the cataract (the cloudy lens in the eye) is removed, it cannot grow back.

When the cataract is removed, an intraocular lens implant is placed into the capsular bag that the cataract previously sat inside.  Up to 50% of the time after cataract surgery, the back of the capsule can become cloudy after cataract surgery.  Some people call this a secondary cataract.  This can occur months or even years after cataract surgery.  A secondary cataract is extremely common.

Symptoms of Secondary Cataractsecondary cataract causes blurry vision

You may notice increased in blurry vision or an increase in glare and mistiness of the vision.   You may notice halos around lights.  It is important for your comprehensive ophthalmologist to perform a comprehensive eye examination to determine the cause of your blurry vision.

Symptoms of a secondary cataract are very similar to the symptoms of having a cataract.

If I feel the blurry vision is due to opacification of the capsule (in layman’s terms a secondary cataract), I will discuss the risks, benefits and alternatives of the the treatment plan.

Yag Laser Capsulotomy

A Yag Laser Capsulotomy is a relatively simple procedure typically performed in my office.  The laser procedure is painless and only takes a minute or two.  No anesthesia is required and you can drive yourself home.

I will give you drops to dilate the pupil and numb the eye.  After, I will place a lens on the surface of the eye.  I will use a laser to make an opening in the capsule.   The purpose of the procedure is to improve your vision.

After a Yag Laser Capsulotomy

Your vision may be blurry for an hour or so after the procedure because of ointment used in the eye during the procedure.  I will give you a drop to use for approximately 5 days.  I will check you in my office 2-3 weeks after your procedure.

Alaina Kronenberg, M.D.
Cataract Specialist
Comprehensive Ophthalmologist
Dearborn, Michigan 48126


When Do I Adopt New Technology?

Changes in Intraocular Implants

As a comprehensive ophthalmologist, my primary surgery is cataract surgery.  The methods and technology used for cataract surgery are constantly evolving.  For example, in the past, patients had to wear very thick eyeglasses after cataract surgery.  This is no longer necessary since intraocular implants became available.  When I completed my residency training, almost all intraocular implants were monofocal.  This means they only correct vision for one distance.  If the intraocular implant is corrected for distance, the patient still needs glasses for computer and reading.  Over the years, much new technology has been developed.

New TechnologyCataract Surgery | Intraocular Implants

It is important that I stay educated on new technology that is developed.  I focus on technology that is relevant to my practice.  I educate myself by reading peer reviewed journal articles, articles regarding experiences of other doctors, and attending local and national conferences.  I also discuss with colleagues their experiences.

I use the information I learn to gather my own opinion on the value of the new technology.  It is important that I feel it is safe for my patients and that it will offer an improved outcome.  I often wait a few months after the technology is approved by the FDA to learn from the real world experience of other ophthalmologists.

Initially when I implement a new technology, I may try in in a very select group of patients.  I evaluate the results before proceeding with a larger group of patients.

Cataract Surgery Intraocular Implants

When I first trained in cataract surgery, monofocal intraocular implants were primarily used.  Most patients still required glasses after their cataract surgery due to either astigmatism and/or near vision needs.

Many patients have astigmatism and benefit from a toric intraocular implant.  I discuss the option of this implant with all patients who have corneal astigmatism.  It reduces the dependence on glasses after cataract surgery.

Multifocal implants can help correct vision both at distance and for near activities.  These intraocular implants can work well for patients who wish to be less dependant on glasses for both distance and near.  I am cautious about recommending these intraocular implants due to the potential for decreased contrast sensitivity and difficulty with night driving.

The Symfony implant corrects vision provides more of a continuous vision by using an extended range of focus technology.  This lens will be a good option for patients who have a desire to be less dependent on glasses for all activities.  It does not run the same risk of halos and glare.

Staying Educated

It is important that I continue to learn and evolve the technology that I utilize.  This will provide my patients with the best outcomes possible.

Alaina Kronenberg, M.D.
Cataract Specialist
Comprehensive Ophthalmologist
Dearborn, Michigan 48126


What is Astigmatism?

What is Astigmatism?

Astigmatism is a very common cause of blurry vision.  The eye is shaped more like an egg or football rather than an orange.  Either the cornea or the lens of the eye is not round if you have astigmatism.  Instead it is oblong.

It is often hereditary and you are often born with it.  Most people have astigmatism in their glasses prescription.  The amount and direction can change over time.  If you have astigmatism, objects can look elongated either vertically or horizontally.

Children and AstigmatismWhat is Astigmatism?

It is important that astigmatism is diagnosed in children at an early age.  Children may not complain of blurry vision.  If your child has a lot of astigmatism that goes undiagnosed, the visual system may not develop properly.  This can lead to a condition called amblyopia (lazy eye).  If your child does not pass a screening evaluation at either their pediatrician or school, it is important that they have a comprehensive eye examination to determine the reason.

Undiagnosed astigmatism can cause blurry vision and possibly difficulty seeing at school.  Refractive error is not affected if you child sits too close to the TV or reads in low light.

What Causes Astigmatism ?

Astigmatism can be caused by either the shape of the cornea or the lens.  The cornea is the windshield of the eye and the lens focuses light inside the eye.  If either structure is shaped more oblong, you may have astigmatism.

How Do I Treat Astigmatism?

You will want to have your astigmatism treated to provide the best possible vision.  It can be treated with glasses and / or contact lenses.  There are many contact lens options available.

It can also be treated with Lasik or Epi Lasek eye surgery.  Dr. Stanley Grandon and I can perform a thorough eye examination to determine if you are a candidate.

If you have astigmatism and require cataract surgery, we can evaluate you for a special implant to correct the astigmatism.  This implant is called a toric implant and can greatly reduce your dependency on glasses after cataract surgery.

Alaina Kronenberg, M.D.
Cataract Specialist
Comprehensive Ophthalmologist
Dearborn, Michigan 48126


Lasik and Dry Eyes

What is Lasik

Lasek has fewer complications of dry eye than Lasik.

Lasik (laser-assisted in situ keratomileusis) is an eye surgery that reshapes the cornea in order to reduce or eliminate the need for glasses.  Epi Lasek is meant to achieve the same outcome as Lasik.  There is no stromal corneal flap with Epi Lasek which eliminates some potential complications.   Both Lasik and Epi Lasek can provide excellent refractive outcomes.Lasik | Epi Lasek | Dry eyes| Alaina Kronenberg MD

Lasik and Dry Eyes

Dry eyes is the most common complication from refractive eye surgery.  Dry eyes can be due to either inadequate tear production or excessive evaporation of the tears.  There can be inflammation of the ocular surface.

It often occurs in the immediate post operative period and it is usually transient and often resolves during the first year after the surgery.  It is important for your ophthalmologist to perform a detailed comprehensive eye examination prior to your surgery to diagnose dry eyes or risk factors for dry eyes.

Dry Eyes

Symptoms of dry eyes can include burning, stinging, a foreign body sensation, fluctuating or blurry vision and a gritty sensation in the eyes.  Dry eyes can range from mild to severe.  Dr. Stanley Grandon, Dr, Cindy Wang and I will treat your dry eyes with a combination of over the counter and prescription medications depending on the severity of the condition.

Lasik and Dry Eye

When traditional Lasik is performed, a flap is cut in the cornea.  This causes some of the corneal nerves to also be cut.  This can cause the sensation of the cornea to be reduced.  You may not sense the need for more lubrication and therefore less tears are made by the glands around the eyes.

Dry eyes after refractive surgery can not only affect the comfort of the eye but also the quality of the vision.  If you suffer from dry eyes after your surgery, it is important that we treat it promptly.

Epi Lasek

When Dr. Stanley Grandon and I perform Epi Lasek, no stromal corneal flap is cut.  Therefore the corneal nerves are not disrupted.  This may decrease the chances you will develop dry eyes after your surgery.  You may be a better candidate for Epi Lasek if you suffer from dry eyes before your surgery.

Alaina Kronenberg, M.D.
Cataract Specialist
Comprehensive Ophthalmologist
Dearborn, Michigan 48126


Eye Pain

 

Eye Pain Can Be an Emergency

What are the causes of eye pain?  Is it an emergency?  Sometimes it is hard for you to know if you should seek urgent attention.  You should seek urgent attention if you have had recent eye surgery or trauma to the eye.  There are many causes of eye pain.  Many eye diseases such as cataracts, most types of glaucoma and macular degeneration do not have pain.  I will discuss some of the more common causes of eye pain.

Corneal AbrasionEye Pain

A scratch on the cornea can be very painful.  The cornea is one of the most sensitive tissues on the body.  It may feel as if there is a foreign body in the eye.  Your vision may or may not be blurry depending on where the abrasion is.  If you think you have a corneal abrasion it is important to have an examination.  Sometimes, Dr. Stanley Grandon, Dr. Cindy Wang and I can control the pain with a bandage contact lens on the eye.  You will also be prescribed an antibiotic drop.  Call us at the Eye Surgery Institute for evaluation.

Foreign body

A foreign body in the eye can be very uncomfortable.  Sometimes a foreign body can be underneath the upper lid or the lower lid and may be difficult to see.  It may also be embedded in the cornea.  If you think you have a foreign body make an appointment for an urgent eye evaluation.  We offer same day appointments for eye pain.

Eyelid pain

Pain and swelling of the eyelid can often be caused by a stye (or hordeolum).  You may feel tenderness and swelling of a portion of the eyelid.  This is often treated with heat and either eye drops or ointment.

Conjunctivitis (Pink Eye)

Conjunctivitis may cause irritation, redness and discharge in either one or both eyes.  This may be either bacterial or viral.  An eye examination can determine what treatment is required.

Iritis

Iritis is when you have inflammation inside the eye.  You will often feel a sore type pain and feel light sensitive.  Iritis can be difficult to diagnose unless your doctor performs a slit lamp examination.  It is treated with steroid eye drops that need to be tapered once you are feeling better.  Iritis can sometimes be associated with other conditions inside your body so we may decide to order more tests such as blood work and a chest x ray.

If you are suffering from eye pain, call us at the Eye Surgery Institute for an urgent appointment.  We offer same day appointments for any urgent eye conditions.

Alaina Kronenberg, M.D.
Cataract Specialist
Comprehensive Ophthalmologist
Dearborn, Michigan 48126


Floaters

What is a Floater?

 Floaters  are when you see a small clump or cloud moving around in your vision.  You may notice them more when looking at a white background.

Floaters become more common as we age.  They form when the jelly that fills the back of our eye liquefies with age.  Portions of the vitreous often clump together and you notice a floater moving around in the vision.

A floater may present in different shapes and sizes.  For example, you may notice a circle, a line or strand, a clump or a cobweb shape.

Why do we get Floaters?Floaters and Flashes | Eye Surgery Institute | Alaina Kronenberg MD

As we age, the vitreous jelly that fills the back of our eye liquefies.  As the jelly liquefies and shrinks, you may notice new floaters.  The vitreous jelly often pulls away from the back of our eye as we age causing a posterior vitreous detachment (PVD).

Why do we get Flashes?

Flashes are when you see lightning streaks or stars in your vision.  We often see flashes when the vitreous jelly is trying to pull away from the retina.  Traction can occur and this can give the sensation of flashes of light in your vision.  Flashes related to your retina usually last a only a few seconds.  Flashes lasting several minutes can be caused by other problems such as a migraine.

Why Do I Need To Have an Urgent Eye Examination?

New floaters and flashes can possibly be a symptoms of a retinal tear or a retinal detachment.  This can be vision threatening.   As the vitreous gel liquefies and shrinks it pulls away from the retina.

It is possible that your new floaters or flashes could signal a serious ocular problem.  There is no way to tell if you have a retinal tear or retinal detachment without an examination.  It is important to have an urgent dilated eye examination to check for a retinal problem.  It is also important to call if you notice a curtain or window shade in your vision.

Alaina Kronenberg, M.D.
Cataract Specialist
Comprehensive Ophthalmologist
Dearborn, Michigan 48126