Our clinic make it a policy to ensure that all staff members are up-to-date on the latest technology and techniques to make your visit as comfortable and effective as possible. As optometric technology changes, it is even more important to select an eye doctor who has all the right optometry qualifications and follows the latest developments in eye care.
Utilizing cutting edge technology, Dr. Leung is diagnosing and managing, with greater precision, diseases like Glaucoma, Macular Degeneration, Cataracts, and Diabetic Retinopathy. Earlier and more precise diagnosis means earlier treatment and better outcomes. Dr. Leung is taking an aggressive approach to diseases that previously had few treatment options. Great advances have been made in the treatment of these diseases.
Unlike a routine eye exam that assesses your visual system and eye health, anyone who was diagnosed with type 1 or type 2 diabetes requires an additional test for their eye exam. Traditionally, everyone had their pupils dilated in order to get a clear picture of the eye, however, with modern advances in technology, many practices are adding a digital retinal exam as well.
When your eye doctor starts the dilated eye exam, he or she will instill dilating drops in each eye, which would enlarge your pupils to give the doctor a better view of certain parts of the back of the eye. The drops can take at most 20 to 30 minutes to take effect, but the effects last well beyond the exam up to several hours.
Enlarging the pupils will allow for more light to enter the eye. When more light can enter the eye, this allows for your eye doctor to have a greater range of visibility within the eye. This provides your eye doctor the ability to use a special magnifying lens to examine the tissues at the back of the eye, including the retina, the macula, and the optic nerve.
For anyone with diabetes, these exams are essential as diabetic retinopathy is a leading cause of blindness. By examining a greater range of the eye’s interior, the diabetic eye exam can detect signs of swelling or leaking of blood vessels in the retina.
While people might relax at the optometrist’s office until the effects start to fade, it’s recommended that you invest in a pair of polarized sunglasses. In some cases, your optometrist may supply you with a free, generally temporary, pair of sunglasses to protect your eyes. While tinted lenses can reduce the amount of light that enters the eyes, during the time your eyesight is extra sensitive, the added protection from polarization is essential.
The concept is very similar in children. Children naturally have larger pupils, so their eyes are extra sensitive to light, and therefore should wear sunglasses with UV protection.
The findings from your diabetic eye exam can give your doctor important information about your overall health, particularly diabetes and high blood pressure. Plus, your optometrist can help you manage your diabetes and prevent the progression of the condition. For example, most diabetics know that nutrition is the key factor in maintaining a normal, healthy lifestyle. Your eye doctor is a great resource to review your diet and can advise you on what foods are recommended and what to avoid.
Cataracts are a common cause of vision loss after age 55. Learn more about recognizing cataract symptoms, protecting your eyes and understanding cataract surgery.
Typically an eye disorder associated with aging (over half of the people in America over age 80 have either had a cataract or cataract surgery), cataracts generally occur later in life as the lens structure within the human eye changes and gets older. In addition to age, other risk factors that lead to cataracts include smoking, UV overexposure and diabetes
During the evaluation of your eye health we will carefully examine your lens for signs of cataract formation. If a cataract is noticed and the clouding is causing visual disruption, the optometrist will refer you to a trusted and respected surgeon for surgery, which is the only known cure for cataracts. Our Eye Care Practice will be there for you providing pre and post cataract surgery care.
Cataract surgery is the removal of the natural lens of the eye (also called “crystalline lens”) that has developed an opacification, which is referred to as a cataract. Metabolic changes of the crystalline lens fibers over the time lead to the development of the cataract and loss of transparency, causing impairment or loss of vision. During cataract surgery, a patient’s cloudy natural lens is removed and replaced with a synthetic lens to restore the transparency of the lens.
Following surgical removal of the natural lens, an artificial intraocular lens implant is inserted (eye surgeons say that the lens is “implanted”). Cataract surgery is generally performed by an ophthalmologist (eye surgeon) in an ambulatory (rather than inpatient) setting, in a surgical center or hospital, using local anesthesia (either topical, peribulbar, or retrobulbar), usually causing little or no discomfort to the patient. Well over 90% of operations are successful in restoring useful vision, with a low complication rate. Outpatient care, high volume, minimally invasive, small incision phacoemulsification with quick post-op recovery has become the standard of care in cataract surgery all over the world.
Diabetes is associated with several eye health issues including cataracts and glaucoma, but the most well known diabetic eye disease is diabetic retinopathy.
Diabetic retinopathy is an eye disease that only affects diabetics. It occurs when the fragile vascular network that supplies the retina – the light sensitive tissue at the back of the eye that helps us see – begins to swell or leak. During the beginning stages of the disease, there may be no noticeable symptoms, so it’s important to have your eyes checked at least once a year, if you have diabetes.
Once symptoms of diabetic retinopathy do develop, they can include: dark or black spots in your visual field, or blurry vision, and it increases over time. This is a result of bleeding at the back of the eye, which prevents a clear image from being transmitted from the retina to the brain.
Whether you have type 1, type 2, or even just gestational diabetes, you are at risk for developing diabetic retinopathy. The longer you have had the disease, the greater the risk. It is essential to keep your blood sugar levels under control to prevent vision loss, and this may require a trip back to your primary care physician.
Treating diabetic retinopathy can include vitrectomy, replacing the inner gel-like substance that supports the eyeball structure, and laser surgery.
Glaucoma is a leading cause of preventable vision loss and blindness in adults in the United States and Canada and the second leading cause of blindness in the World, even more than macular degeneration.
Glaucoma is not a single disease. It is actually a group of eye diseases that cause damage to the optic nerve due to an increase in pressure inside the eye, which is called intraocular pressure (IOP). When detected in the early stages, glaucoma can often be controlled, preventing severe vision loss and blindness. However, symptoms of noticeable vision loss often only occur once the disease has progressed. This is why glaucoma is called “the sneak thief of sight”. Unfortunately, once vision is lost from the disease, it usually can’t be restored.
Treatments include medication or surgery that can regulate the IOP and slow down the progression of the disease to prevent further vision loss. The type of treatment depends on the type and the cause of glaucoma.
Prevention is possible only with early detection and treatment. Since symptoms are often absent, regular eye exams which include a glaucoma screening are essential, particularly for individuals at risk of the disease. While anyone can get glaucoma, the following traits put you at a higher risk:
Signs and Symptoms of glaucoma: Due to a buildup of pressure in the eye, glaucoma causes damage to the optic nerve which is responsible for transmitting visual information from the eye to the brain. How does glaucoma affect your vision?
Types of glaucoma: There are a number of types of glaucoma, some more acute than others. Learn about the common types of glaucoma and the differences between them.
Diagnosis and Treatment of Glaucoma: Early detection and treatment of glaucoma are essential to stopping or slowing the disease progression and saving vision. Treatment can include medicated eye drops, pills, laser procedures and minor surgical procedures depending on the type and stage of glaucoma.
The intraocular pressure caused by glaucoma can slowly damage the optic nerve, causing a gradual loss of vision. Vision loss begins with peripheral (side) vision, resulting in limited tunnel vision. Over time if left untreated, central vision will also be affected which will increase until it eventually causes total blindness. Unfortunately, any vision that is lost from the optic nerve damage cannot be restored.
Typically, glaucoma sets in without any symptoms. At the early onset of the most common type of glaucoma “open angle” glaucoma, vision remains normal and there is no pain or discomfort. This is why the disease is nicknamed the “sneak thief of sight”.
An acute type of glaucoma, called angle-closure glaucoma, can present sudden symptoms such as foggy, blurred vision, halos around lights, eye pain, headache and even nausea. This is a medical emergency and should be assessed immediately as the intraocular pressure can become extremely high and cause permanent damage within hours.
The primary forms of glaucoma are open-angle and narrow-angle, with open-angle being the most common type.
POAG gradually progresses without pain or noticeable vision loss initially affecting peripheral vision. By the time visual symptoms appear, irreparable damage has usually occurred, however, the sooner treatment starts the more vision loss can be prevented. When untreated, vision loss will eventually result in total loss of side vision (or tunnel vision) and eventually total vision loss.
This is another form of open-angle glaucoma in which the intraocular pressure remains within the normal level. The cause of this form of glaucoma is not known, but it is believed to have something to do with insufficient blood flow to the optic nerve, causing damage. Individuals of Japanese descent, women and those with a history of vascular disease or low blood pressure are at higher risk.
Acute angle-closure glaucoma is marked by a sudden increase in eye pressure, which can cause severe pain, blurred vision, halos, nausea, and headaches. The pressure is caused by a blockage in the fluid at the front of the eye which is a medical emergency and should be treated immediately. Without prompt treatment to clear the blockage vision can be permanently lost.
The inherited form of the disease that is present at birth. In these cases, babies are born with a defect that slows the normal drainage of fluid out of the eye; they are usually diagnosed by the time they turn one. There are typically some noticeable symptoms such as excessive tearing, cloudiness or haziness of the eyes, large or protruding eyes or light sensitivity. Surgery is usually performed, with a very high success rate, to restore full vision.
Glaucoma can develop as a complication of eye surgeries, injuries or other medical conditions such as cataracts, tumors, or a condition called uveitis which causes inflammation. Uncontrolled high blood pressure or diabetes can result in another serious form called neovascular glaucoma.
A rare form of glaucoma, this occurs when pigment from the iris sheds and clogs the drainage of fluid from the eye resulting in inflammation and damage to the eye and drainage system.
Treatment of glaucoma is dependant upon the severity and type of glaucoma present.
During a routine comprehensive eye exam to check for glaucoma, your eye doctor will dilate your eye to examine the optic nerve for signs of glaucoma and will also measure the intraocular pressure (IOP) with an instrument called a tonometer.
Tonometry involves numbing the eye with drops and then gently pressing on the surface of the eye to measure the pressure. Since your IOP can fluctuate throughout the day and glaucoma can exist without elevated IOP this is not enough to rule out the disease. If there are signs of the disease, further testing will be performed.
A visual field test is designed to detect any blind spots in your peripheral or side field of vision. You will be asked to place your head in front of a machine while looking ahead and indicate when you see a signal in your peripheral field of view.
Your doctor may also measure the thickness of the cornea with an ultrasonic wave instrument in a test called pachymetry or use imaging techniques such as digital retina scanning or optical coherence tomography (OCT) to create an image of your optic nerve to look for glaucoma damage.
Treatment for glaucoma depends on the type and severity of the disease and can include medication such as eye drops or pills or laser or traditional surgery.
Medication and drops to lower IOP are often the first resort for controlling pressure-related glaucoma. These drops may have some uncomfortable side effects, but compliance with the treatment plan is essential for preserving vision and halting the progression of the disease.
Surgical procedures are designed to control the flow of fluids through the eye by either decreasing the amount of fluid produced or improving the drainage. Your doctor may decide that a combination of surgery and medication will be the most effective in many cases.
It cannot be stressed enough that the most effective treatment for glaucoma happens when the disease is detected and treated early before significant vision loss occurs. Any vision that is lost cannot be restored. This is why the best prevention is awareness by knowing your risks and taking responsibility by having your eyes examined on a regular basis.
Untreated macular degeneration is one of the leading causes of blindness in those over 65 years old.
While researchers have not yet discovered a cure for age-related macular degeneration (AMD), there are treatment options which prevent the disease from progressing to blindness, and in some cases, they can even improve vision. It’s important to have an open discussion with your eye doctor about the risks and limitations of AMD treatments.
There are 2 basic types of AMD, the wet form and the dry form.
AMD is an age related eye disease that runs in families, and is a leading cause of blindness in our aging population. There is no cure for this ocular disease, and AMD related vision loss is cannot usually be recovered. There are treatments, and preventative measures that can be taken, if detected early, so routine eye exams are essential.