Diabetic Eye Treatment Mililani, HI

Diabetic Eye Disease Needs our Attention

November may be the prime time to begin planning for a joyful holiday season, but it’s also Diabetic Eye Disease Month. Studies indicate that approximately 40 percent of those with Type I or Type II diabetes will at some point develop an eye disease related to their primary health condition. As much as we can, we do our part to reduce our patients’ risks. One of the primary ways to do this is through education.

The Progressive Nature of Diabetic Eye Disease

Having diabetes may mean that your blood sugar is typically higher than it should be. For some, blood sugar varies from the low spectrum to the high; rarely does it lie within normal range. Over time, this causes damage in the delicate blood vessels that sit around the retina at the back of the eye. The good news is that this occurs in stages. The bad news is that there are few, if any, symptoms to let you know that your vision is being threatened. Diabetic eye disease follows the progression of:

  • Mild blood vessel damage. This is called mild non-proliferative retinopathy, and it involves areas of swelling and weakening in the tiny blood vessels in the retina. In this stage, blood and fluid may leak from a few affected blood vessels.
  • Moderate blood vessel damage. This is called moderate non-proliferative retinopathy, and it includes swelling and leakage that is severe enough to decrease the circulation of blood in the eye. The retina relies on good circulation for nutrients. Without it, characteristics of this part of the eye change.
  • Retinal changes that occur in severe non-proliferative retinopathy involve growth factor secretion. This happens because the eye wants more nourishment and needs blood vessels to get it. In this stage of disease, new blood vessel growth occurs in and around the retina.
  • Bleeding and scarring. Advanced retinopathy becomes proliferative, meaning that the newly formed blood vessels lead even more fluid into the back of the eye. Furthermore, proliferative diabetic retinopathy may involve scarring around broken blood vessels. Scars can tug the retina away from surrounding tissue (retinal detachment), causing vision loss.
  • Macular edema. Edema is the medical term for swelling. Macular edema is swelling at the central region of the retina, the area that establishes the central field of vision.

Reducing Risks

Diabetic eye disease is a complication of diabetes that we would never want to overlook. While we must not gloss over the fact that diabetic eye disease can be serious, we can focus on how to protect vision. Patients are encouraged to obtain yearly dilated eye exams in our Mililani office for the earliest detection of changes in the retina. Diabetes management with the help of a trusted medical team is also beneficial.

Schedule a diabetic eye exam with us at 808.625.5577.

Cataract Surgery Honolulu, HI

Is there a Right Time for Cataract Removal?

Cataracts can cause vision to become excessively clouded. Next to glaucoma, cataracts account for many of the cases of vision loss that occur. The difference between cataracts and glaucoma, though, is that the clouded lens can be removed and replaced with an artificial lens to restore sight. To date, no non-surgical treatments have been found useful in the correction of cataracts. This leads many patients to question the right timing for cataract surgery.

Sooner or Later: The Matter of Timing

Just because a cataract has been found does not mean it should be removed immediately. If the lens of the eye is only slightly cloudy and this does not interfere with daily activities, surgical removal may not be indicated – yet.

People with cataracts who do not have coexisting conditions such as glaucoma may be monitored to observe how their cataracts progress. If the changes to the cornea become so great that visual disturbances occur, such as intense glare when driving at night, or cataracts pose a challenge to seeing street signs, the computer screen, or text in a book, surgery should be considered.

While there is no value in removing cataracts promptly after diagnosis, there is also no requirement for a specific degree of severity in order for the lens to be successfully replaced. During the early days of cataract surgery, it was believed that cataracts needed to be relatively advanced before they could be removed. Improvements in the diagnosis and treatment of cataracts have made it easier to address this problem at an earlier stage of development.

As cataracts continue to develop, the covered lens becomes more rigid. This could present a slight challenge for surgery. The advanced cataract may also cause inflammation that increases the overall pressure within the eye. For this reason, patients with both cataracts and glaucoma may be monitored more closely.

When cataracts are present in both eyes, surgical removal may occur in stages. Doctors often prefer to treat each eye individually, several weeks apart.

Patient Input

Ultimately, the choice to have cataracts removed is completely up to the patient who is able to make an informed decision about health care. It is our intent to provide the fullest extent of information to our patients so they can determine the timing of their cataract surgery with confidence.

Learn more about cataract surgery. Call our Mililani office at 808-625-5577.

Eye Exam Mililani, HI

The Kids are Back in School, but Are they Fully Prepared?

Usually, the beginning of a new school year is something to cheer. Many children look forward to all the things school offers, from challenging math problems to the release of energy during sporting activities. The weeks before children return to the classroom are often spent preparing. This can mean seemingly endless days of shopping for school supplies, sports gear, clothes, books, and more. In the controlled chaos, it is easy to overlook the vital necessity of eye exams for students.

Keep Your Student Healthy and Happy with These Tips for Eye Health

See the eye doctor.

Children should see the eye doctor before they begin elementary school. If there are risks for eye conditions or the child needs glasses, future eye exams are needed every year. Without risks or vision problems, eye exams are recommended every two years. This aspect of health care is vital to students because, when textbooks or the chalkboard are blurry, learning cannot happen as it should. Often, children with uncorrected vision problems suffer academically and then lose any excitement they had for education.

Protecting the eyes.

There are three things we need protection from:

  • The highest risk for pink eye occurs during childhood. Viral pink eye is spread quite quickly, and accounts for about 3 million missed school days, according to one study. One of the best ways children can protect themselves from pink eye is by washing their hands frequently throughout the school day. Merely touching an object that was handled by someone with pink eye is enough to contract this uncomfortable infection.
  • Statistics show that approximately 35,000 eye injuries occur during sporting activities each year. Every child who plays a sport should wear appropriate glasses. These might be goggles or clear lenses that provide some degree of protection if a collision with another player or ball were to happen. Some helmets come with or can be fitted with helmet-mounted shields to protect the eyes and face without impeding performance.
  • We have come to realize that sunglasses aren’t just a fashion accessory, they are vital eyewear to protect the structures of the eyes from unnecessary UV damage. Rays of sunshine permeate the eyes and can degrade structure, increasing the risk for future eye disease in adulthood. Children who wear sunglasses significantly reduce their risk.
  •  Digital eye strain can lead to dry eye and chronic headaches if care is not taken to limit the time spent staring at a screen or book. It is easy to close the eyes for a few minutes during those intense study sessions and to turn digital devices off long before bedtime to give the eyes time to rest.

We should point out that we can all benefit from these tips, and that your Mililani eye doctor is here to help you and your family. To schedule a visit with us, call 808-625-5577.

LASIK Eye Surgery Honolulu, HI

LASIK or PRK: Which is Right for You?

Most people have heard of the LASIK eye procedure, a surgery that is currently performed hundreds of thousands of times each year. Because LASIK is so familiar by name, many people who are considering laser vision correction to help them reduce their need for eyeglasses don’t even realize they may have another option. Here, we describe the details of LASIK and PRK refractive surgery, as well as a few questions you may ask yourself as you explore your treatment options.

LASIK eye surgery improves vision by reshaping the corneal tissue beneath the ocular surface. To achieve this, a small flap is made. This flap quickly re-attaches to the eye and is not visible nor noticeable in your vision.

The PRK procedure, or photorefractive keratectomy, is also performed to reshape the cornea so light can have a more direct path to the back of the eye. This procedure reaches the corneal tissue by removing the uppermost layer of the cornea. No flap. The tissue that is removed regenerates over time.

Deciding between LASIK and PRK may be challenging for some people, though most of our patients are most interested in being able to see their computer screen or street signs without their glasses or contact lenses. So how do you choose? You ask questions.

  • What is your vision like? The higher your corrective prescription, the better suited you may be to the PRK procedure. When we say “higher prescription,” we are describing a substantial deficit like -8.00. This is because some studies have suggested that individuals with a more significant deficiency in vision may also have thinner corneal tissue that may not be as supportive of the flap made during LASIK.
  • What is your timeline for recovery? One of the benefits of LASIK is that you can get back to normal activities quickly. Vision is clear within a few hours after this laser procedure. PRK heals more slowly because the corneal tissue has been removed. Approximately 70% improvement is gained within a week. After one month, the eyes are about 90% healed. PRK patients cannot drive for at least one week following surgery.
  • How active do you want to be? Most people who undergo laser vision correction have very little to worry about in terms of eye injury. Individuals who play competitive sports may want to consider their injury risks when choosing their procedure. PRK may take longer to heal fully, but the eyes return to a natural anatomical state after this procedure. With LASIK, the flap that is made re-attaches but is always there and may be more prone to damage.

Discover more about the vision correcting treatments available in our Mililani office. Call 808-625-5577.

LASIK Honolulu, HI

Is LASIK Surgery Right for You?

Many people who wear eyeglasses or contacts eventually become frustrated with the side effects of their necessary aids. Glasses slide down the bridge of the nose and need to be often cleaned. Contact lenses may feel uncomfortable if the eyes become dry. There are several reasons to wonder if corrective eye surgery might be right for you. Since LASIK is one of the most common procedures performed to improve vision, we want to discuss how to know if it may be the direction in which you want to go.

LASIK Has a Good Track Record

One of the primary objectives in treating refractive errors that diminish vision is to significantly reduce a person’s reliance on corrective lenses. LASIK’s track record is proof that reshaping the cornea works. Most patients who undergo this procedure achieve at least 20/25 vision, which enables them to engage in a wide variety of activities without needing vision-assistance. Where many LASIK patients still need glasses is when they drive at night.

The results that are achieved with LASIK are dependent on the extent of the refractive error, the type of refractive error, and extenuating factors such as concurrent eye disease like glaucoma. The greatest success has been achieved with patients affected by mild to moderate nearsightedness. When astigmatism and farsightedness are also in the mix, results are more difficult to predict, though improvement is possible.

How LASIK Works

You may recognize LASIK as laser eye surgery that can significantly improve your quality of life by reducing your need to wear contacts or glasses. Essentially, this is all you need to know. However, we like to discuss how innovative techniques work.

The reason that vision loses optimal clarity is that light does not travel to the back of the eye as it should. When there is a direct path through the eye to the retina, we can observe objects with a high degree of clarity. Changes to the structure of the eye, such as myopia, hyperopia, and astigmatism, alter the path of light through the eye, so it lands somewhere other than the retina. Depending on where rays of light land, objects closer or farther away appear indistinct.

The way that eyeglasses and contacts work is by bending light before it enters the eye. LASIK, on the other hand, reshapes the cornea, so rays that pass through the front of the eye have a straight path toward the retina.

Learn more about LASIK and what it can do for you. Call our office near Honolulu at 808-625-5577.

Eye Conditions Honolulu, HI

Every Part of the Eye Matters

The eyes are complex structures that contain various parts. Each part, from the cornea to the retina to the optic nerve, has a role to play in the creation of sight. The retina sits at the back of the eye waiting for light to pass through the cornea and vitreous fluid. When light lands on the retina, it transforms into an image that is sent to the brain for recognition. This is all very fascinating. More importantly, it is integral to our understanding of how to keep our eyes as healthy and viable as possible. In our Honolulu area office, patients can receive comprehensive diagnostic and treatment services to support ongoing retinal health.

Promoting Ocular Health

Foods and lifestyle habits nourish the eyes just like any other area of the body. Therefore, habits like eating leafy greens and getting sufficient sleep are valuable to eye health. In particular, there are specific nutrients that are beneficial to the retinas. These include Vitamins C and E, Lutein, Zinc, and Zeaxanthin. Beneficial nutrients are found in nuts, fish, and citrus fruits, as well, but may also be obtained by taking a supplement formulated for eye health.

Does diet solve all concerns? No. Genetics also have a significant effect on a person’s risk for eye diseases like age-related macular degeneration and retinopathy. The objective of eating and living well is to offset the genetic risk over which we have no control. By living well, we don’t just mean getting plenty of rest and nutrition. The eyes are particularly vulnerable to a few lifestyle factors. These include:

  • People who smoke have significantly higher risks for all types of eye disease, including retinopathy, cataracts, and macular degeneration. Quitting this habit allows the eyes to heal over time, so risk is reduced.
  • Digital Devices. Research is continually discovering the downside to modern technology. As it relates to eye health, lifestyle factors like computer use present a risk for chronic eye strain that may lead to premature aging of ocular structures like the vitreous fluid that supports the retina.
  • UV exposure. Sunlight, as well as blue light from digital devices, can damage the internal construction of the eyes. Studies suggest that ongoing exposure to UV light increases the risk of age-related macular degeneration.

Retinal conditions may offer a few clues, such as floaters, flashes of light, and gradual loss of peripheral vision. Don’t wait for symptoms to alert you to a problem. Schedule a comprehensive eye exam at 808-625-5577.

Eye Exam Mililani, HI

May is Ultraviolet Awareness Month: Just in Time for Summer!

We don’t seem to get too many cloudy days around here. For the most part, both the locals and the travelers to our lovely island paradise understand that ultraviolet light is the norm. Sunny days are appealing, but they also present a risk of sun damage and skin cancer. To mitigate these risks, we have learned to apply broad-spectrum sunscreen products on the daily. But what about our eyes?

Did you know that ultraviolet light can cause sunburn on the cornea of the eye? If you’ve ever surfed on a sunny day, you may have experienced this first-hand. In addition to the pretty rare occurrence of a corneal sunburn, UV light has also been associated with an increased risk of cataracts as well as cancer around or in the eye. This is precisely why we have something called Ultraviolet Awareness Month, and why your Mililani ophthalmologist encourages annual eye exams.

Is it Really That Easy for Sun Damage to Affect the Eyes?

The eyes are vulnerable to a variety of factors, including exposure to sunlight and other UV light. It may not be that the eyes can’t handle any amount of exposure, but that damaging ultraviolet rays are inflicting their powerful energy on the eyes anytime we’re outdoors. Think of the ordinary times that you go outside without thinking to don a pair of shades. UV related eye damage may occur from details as simple as:

  • Having light-colored eyes.
  • A family history of eye disease such as cataracts or cancer.
  • Having an occupation that requires a lot of outdoor time, especially during the midday hours.
  • Frequently working or playing around water or sand without adequate eye protection.
  • Spending any amount of time outdoors without sufficient sunglasses.

In case you didn’t catch it, we mentioned eye protection and sunglasses as a vital measure to avoid increased risks of potentially serious conditions. What does that mean, though? Is any pair of sunglasses good enough? Not really.

Sunglasses need to offer no less than 99% blockage of UV light. The more skin that is covered around the eyes, the better. Wider frames and frames that wrap around the face are ideal because they protect not only the ocular structure but also the skin on the eyelids and directly around the eyes. Depending on the extensiveness of outdoor time, it may also be worth it to invest in a good pair of polarized sunglasses. Polarized lenses reduce the intensity of glare from sunlight.

In addition to wearing quality sunglasses every day, even on the rare occasion of cloudiness, eye protection may be increased by wearing a hat and by not smoking. Many people are not aware that smoking exacerbates UV damage.

Take a step toward lifelong eye health. Call 808-625-5577 to schedule your routine eye exam.

LASIK Eye Surgery Honolulu, HI

Laser Eye Surgery: What You need to Know about Driving

The prospect of having laser eye surgery can be both intimidating and exciting. There is a lot to look forward to, like being able to read without eyeglasses. On the other hand, patients often express a small amount of concern related to unknown factors like what it will be like to drive after laser eye surgery, or when they will be able to drive after their procedure. Let’s discuss this.

Driving After Surgery

Eye procedures that involve laser technology are gentle and efficient. There is very little down time after laser eye surgery. However, patients are not able to drive immediately after their procedure. If laser eye surgery is in your future, you will need to arrange for a friend or family member to drive you to and from your appointment. It is acceptable to use public transportation if necessary, but you should be accompanied even in this situation.

Legally, driving is not supposed to resume until your ophthalmologist has cleared you to do so. In most cases, a follow-up appointment is scheduled for the day after surgery. Like the day of surgery, you will need transportation to this appointment as well. During the follow-up visit, the progress of healing is observed, and the matter of driving may be discussed. Often, patients can safely get behind the wheel within a few days of their procedure and usually need to wait no longer than a week for full recovery.

After the All-Clear

Being cleared to drive and perform other activities is a good sign of progress. There are still a few things that patients need to keep in mind after laser eye surgery. Although the initial recovery from eye surgery is very short, it may take some time for eyes to fully adjust to their new state. Some patients notice that bright lights now have a glare around them, a side-effect of eye conditions or treatments that may make night-driving something to get used to again. To make this transition easier, you may want to go out at night as a passenger first, then as the driver. Noticeable glares and halos typically decrease quite a bit within a few weeks of surgery, and continually improve over time.

Do you need more information about laser eye surgery? Call our office near Honolulu at 808-625-5577.

Diabetic Eye Treatment Mililani, HI

Diabetic Retinopathy a Precursor to Macular Edema

Individuals with the chronic condition of diabetes have a lot to think about. Due to the nature of unregulated blood sugar and insulin resistance, the body tends to be at risk for some secondary ailments such as gum disease, heart disease, and potentially serious eye diseases.

The most common eye condition that we worry about in certain individuals is diabetic retinopathy. This problem originates in the blood vessels of the retina, the tissue that sits at the back of the eye. The retina is what transmits light that enters the front of the eye into signals that travel to the brain through the optic nerve. The blood vessels in the retina are delicate and prone to leakage or bleeding if damaged by elevated pressure in the eye.

Diabetic retinopathy may occur as non-proliferative or proliferative types.

  • Non-proliferative retinopathy is an early stage condition in which blood vessels have started to become weak and swollen. These areas of swelling within blood vessels may lead fluid onto the retina.
  • Proliferative retinopathy is an advanced condition in which blood vessels are spreading. New blood vessels are more delicate than their predecessors, which means they are more likely to bleed and form scar tissue that can lead to retinal detachment and macular edema.

From the Retina to the Macula

When diabetic retinopathy has been diagnosed, the risk that concerns eye doctors is vision loss related to macular edema or swelling around the retina. The bad news about macular edema is that it can lead to vision impairment. The good news is that, while it can occur at any time due to diabetic retinopathy, macular edema usually develops in later stages of that disease. That means we have an opportunity to prevent permanent damage with early action.

The best way to reduce the risk of macular edema and vision loss is to prevent or treat retinopathy. And to do that, diabetics are encouraged to develop strategies aimed at maintaining health. These include:

  • Eating a healthy diet that keeps blood sugar regulated.
  • Controlling blood pressure.
  • Taking medications as directed by a physician.
  • Maintaining or implementing a good exercise routine. This could be as simple as a daily walk.
  • Avoiding alcohol and tobacco.

If you have been diagnosed with diabetes, we know you have a lot to think about. We are here to support you in the long-term health of your eyes. Call our office near Honolulu at 808-625-5577.

Macular Hole Treatment Honolulu, HI

Diagnosing and Treating the Macular Hole

Our eyes are like small cameras, and not just because they capture images that are stored in the brain. Structurally speaking, the eyes resemble cameras through the presence of a lens at the forefront, into which light flows. After passing through the lens, beams of light are then focused on the retina along the back wall of each eye. To clarify the images formed on the retina, we rely on a conglomerate of nerve cells at the center of the retina. It is this collection of cells that we call the macula.

A Hole Where?

We aren’t surprised by learning of holes in the galaxy. In the eye, though, is a phenomenon we don’t see all that often. Macular holes are possible and can affect daily living if not treated properly. Macular holes are diagnosed and treated by retinal specialists and, fortunately, tend to respond well to appropriate care.

What often incites a macular hole is the breakdown of the layer of nerve cells situated on the retina. This decline in the thickness of these cells is related to the natural aging process. Sometimes, retinal detachment occurs simultaneously to this thinning.

Diagnosing the Macular Hole

Anytime vision changes occur, there is the good reason to seek consultation with your eye doctor. Indications that a macular hole has formed include waves of vision and a sensation of looking through dense fog. Squarely within the central field of vision, a dark spot may be noticed. Additionally, the fine details of objects may look fuzzy or hard to make out when observed in central vision. Typically, these symptoms are only noticed in one eye.

To confirm a diagnosis of macular hole, it is necessary to use a special instrument to closely observe the back of the eye. Diagnosis does not require invasive technique and may involve special imaging that allows us to see the details of the retina and macula.

Treating the Macular Hole

Macular holes to not usually heal on their own. The danger in putting off treatment is that the hole may expand over time, further decreasing vision. To prevent this, surgery may be necessary. The success rate for macular hole surgery is high.

Contact our Mililani office at 808-625-5577 to arrange a visit with Dr. Omphroy.