The Mt Hood Vision Center incorporates eye health care into all of our evaluations. Our examinations view the health of the inside and outside of the eye and relate it to other health issues that you may have.
Our care includes services for eye conditions related to diabetes, glaucoma, macular degeration, cataracts, eye infections, eye allergies, dry and trauma.
We communicate with your primary care doctor when necessary and we regularly refer for care to other specialties when it is in your best interest.
For more information about specific eye health conditions, refer to the topics below.
Diabetes and Your Eyes: Over 16 million Americans have diabetes. Diabetic Eye Disease is the leading cause of new cases of legal blindness among working-age people in the United States. Diabetic Eye Disease often has no early warning signs. Diabetics should have a comprehensive dilated vision examination once each year or more.(For More Info)
Glaucoma: Glaucoma is a disease in which there is progressive damage to the optic nerve. This is usually related to increased pressure inside the eye that limits the blood supply to the nerve. There is often a family history of glaucoma and you will have a higher risk of glaucoma if you have high blood pressure, diabetes or if you have afro-american heritage.(For More Info)
Age Related Macular Degeneration: Age Related Macular Degeneration is the leading cause of central vision loss and blindness for people over 65 in the United States. At first, it is only visible as subtle changes in the tissue of the back of the eye. The slowly progressive process may gradually distort your central vision until details are hard to see or lost. People with heart problems, hypertension, diabetes or a family history of macular degeneration will have a higher risk for macular degeneration.(For More Info)
Cataracts: Cataracts form when the clear tissue of the lens in the eye starts to cloud and scatter light. It may be the result of aging, injury, excessive ultraviolet light or a side effect of a disease like Diabetes. It is most common for people over 60 but it may occur at any age.(For More Info)
In general, there are two forms of diabetes. Type 1, previously called juvenile-onset or insulin dependent diabetes is characterized by a deficiency of insulin. Type 2, previously called adult-onset or non-insulin dependent is characterized by an inability to properly use insulin. Ninety percent of patients with diabetes have type 2 diabetes and it is becoming much more common at younger ages.
Diabetic damage can be detected when you have a complete eye evaluation that includes the dilation of the pupils for improved viewing of the retina and other internal structures of the eye.
Once diabetic retinopathy has progressed to the point where the vision starts to blur, it is often difficult to prevent vision loss even with aggressive treatment. If diabetic retinopathy is diagnosed early before any visual symptoms have occurred, the success rate of preventing vision loss with treatment is much greater. Annual examinations are recommended for controlled diabetics, we may determine that more frequent evaluations are necessary.
Preventing vision loss for diabetics requires a conscientious effort by the patient to change their eating habits and life style. Routine monitoring of blood sugar levels on a daily and quarterly basis will significantly improve your chances of avoiding unwanted visual changes. Preventing diabetic changes also requires appropriate medical management by your Medical Doctor and regular follow-up by your Optometric Physician.
If you suspect that you may be at risk due to family history, borderline test results, excess weight or a history of gestational Diabetes, start living like you are diabetic and change your diet and lifestyle. Your actions now can delay or stop the development of diabetes and other major health problems. Even if your Medical Doctor confirms that you do not currently have diabetes, heed the warnings and start to change your habits. With diabetes, prevention and treatment require the same lifestyle and dietary changes.
Type II Diabetes is a disease that is primarily caused by a breakdown of your ability to utilize insulin due to a diet that is high is refined carbohydrates (sugar, refined flour, pasta, pastries, sugared soft drinks, sweetened juices, and prepared foods.) Type I diabetes is a due to a lack of insulin caused by destruction of part of the pancreas and will require more intense management including insulin.
A diet that is designed to reduce your risk of developing type 2 diabetes will encourage an increase in fresh fruits and vegetables. You should eat often in small amounts and eliminate white sugar, white flour and refined foods. Stop all soft drinks, and reduce pastas, sweet rolls, and most processed foods. Most people on this diet will feel better, loose weight, have more energy and live longer. Do it for your grand children!
The retina is the light sensitive structure that lines the back of our eyes. When light hits the retina, a signal is sent to the brain. Our brain interprets these signals, allowing us to see. Any damage to the retina impairs our ability to see. The retina is nourished by many blood vessels which are effected by diabetes.
In early stages of diabetic eye damage, we will often see small discrete spots of red blood vessel leakage inside the eye that do not interfere with your vision. We may also find rapid changes in the power of your glasses, a decrease in near focus ability and the early onset of cataracts.
When the leakage effects the central area of vision it can cause swelling which is called Diabetic Macular Edema. This swelling damages the central detail vision and can cause serious loss of vision.
Diabetes can also cause new blood vessels to grow. This is called Proliferative Diabetic Retinopathy. These new blood vessels are very fragile and can break, causing bleeding within the eye resulting in mild to severe vision loss.
Try to keep your blood sugar levels below 180 even after eating. The day to day tests gives you a good idea of how to modify your diet and control your blood sugar.
Know your A1C test results. This test evaluates how stable your blood sugar has been on the average for the last 3 months and should be below 7.0. The lower this number goes, the less likely you will be to have diabetes and related complications.
Any sudden or significant changes in vision should be investigated immediately including blur, central loss, double vision, floaters, flashers and spots.
Take advantage of one of the Diabetic education programs available in the area. Repeat the course every few years to see what is new and what you have forgotten. Ask your Medical Doctor for a referral.
Don't pretend that you are immune to the damage caused by Diabetes. See your Medical Doctor as you are instructed.
Yearly vision examinations are important for early identification of changes. Make sure we have the opportunity to dilate and carefully examine your eyes at least once each year.
Exercise and diet are critical for the control of blood sugar. In many cases, exercise and diet can replace or reduce the need for medications.
If you smoke, STOP! Smoking also causes progressive damage to your blood vessels. This adds significantly to the risk of loss or blindness.
Dont wait until you have signs of leaky vessels to start taking good care of your self. By then it may be too late.
The optic nerve carries information from the eye to the brain where images are formed. When exposed to high eye pressure for prolonged periods of time, the optic nerve begins to loose nerve fibers. Side (peripheral) vision is lost first. This early visual loss is rarely noticed by the patient. If changes continue, irreversible damage to the optic nerve will eventually cause loss of central vision and blindness.
The common kinds of glaucoma have no early symptoms. By the time the patient starts to be aware of the loss of vision, the damage is usually severe and irreversible. People cannot normally "feel" an elevated pressure inside their eyes unless the pressure is very high or has risen suddenly. A sudden onset of intermittent pain, blurred vision or seeing halos around lights may indicate a glaucoma crisis and should be evaluated promptly. The goal of glaucoma treatment is to preserve the patients vision and prevent further loss. Nerve damage caused by glaucoma CANNOT be restored.
Glaucoma cannot be "cured", so treatment is usually life-long. Multiple medications are often required and these medications may need to be adjusted over the course of several visits until the most effective combination is found. Surgical options do exist for reducing the pressure in the eyes. Even after the pressure is controlled, visits to the office may be necessary several times a year to make sure that the pressure remains controlled.
Glaucoma that cannot be controlled with medications may respond to laser therapy. This can be performed on an outpatient basis in the clinic. Patients who do not respond to medications or laser surgery may require glaucoma surgery which is usually done on an outpatient basis. These procedures either seek to create an artificial drainage pathway for the aqueous fluid to leave the eye or attempt to decrease the amount of aqueous fluid produced inside the eye.
Glaucoma medications should not be stopped without consulting your doctor (unless severe illness or allergy occurs). If the medications are forgotten, used incorrectly or taken less often than prescribed, progressive glaucoma damage is more likely to occur. The medications should be used even on the day of an office visit, so that the treating physician can accurately assess how well the medication is working. It is also important to bring all of one's medications to every visit to help the physician determine if each medication is being taken correctly.
Glaucoma drops contain medication that can affect other parts of the body. Closing the eye for several minutes after the drops are put in the eyes will decrease the amount of medicine that goes into the bloodstream via the nose, thus decreasing bodily side effects. Like all medications, these drops should never be shared with anyone else.
The slow, early form is called Dry Macular Degeneration. Small yellowish deposits start to appear in the area around the central sensitive part of the retina. These deposits will gradually separate the macula from its blood supply. Dry macular degeneration may cause minor to moderate distortion of the central part of vision. 90% of all people with macular degeneration will not advance beyond this stage.
Wet Macular Degeneration will occur if the blood supply to the macula is sufficiently disrupted and your body starts to grow new blood vessels in an attempt to support the Macula. These new vessels (neo-vascularization) are generally fragile and will often leak, break or bleed, causing significant, and often sudden, central vision loss. When new vessels are noted in the back of the eye, referral will be made to a retinal specialist for advanced procedures.
Recent major studies have confirmed that what you eat will effect the development and progression of Macular Degeneration. The biggest study reviewed the effects of supplementation with Vitamin C, Vitamin E, Beta Carotene, and Zinc. The result showed a significant decrease in the rate of vision loss for the people taking the supplement. Other studies have indicated significant improvement in vision and protection of the macula from a diet that is high in lutein. Lutein is an anti-oxidant that is present in green leafy vegetables and will be deposited in the back of the eye if your diet is adequate.
Supplementation with the vitamins that were included in the studies plus others that are supportive of blood vessel health is an important part of preventive care related to macular degeneration. It is best if your supplements are from whole food sources and are not chemically mass produced.
Added omega 3 oils from fish, fish oil, flax and flax oil is important for vascular health and is probably a beneficial addition to most diets for people with macular degeneration.
A diet that is high in fresh fruits and vegetables and low in refined carbohydrates and processed foods has been proven to reduce the risk of heart attacks and stroke. A diet lacking in fresh fruits and vegetables will make degenerative changes of the blood vessel more likely, including macular degeneration.
Smoking is another known factor that increases the risk of vascular diseases including macular degeneration. The toxins and poisons from smoking cause a consistent challenge to the ability of the tissue to regenerate itself. Smoking will also reduce the diameter of your blood vessels, which increases the resistance to blood flow and makes it easier for plaque to clog the arteries.
We recommend a significant increase in fresh fruits and vegetables combined with a decrease in refined carbohydrates and fried fats. Increased exercise and decreased smoking are major factors in the health of the Macula and the rest of your blood vessels. We often suggest nutritional supplementation to improve the vitamin, mineral and anti-oxidant levels of the body. We have recommendations for your dietary and life style changes but there is no proven best combination or product.
Early cataract changes may have no symptoms. Early symptoms will include increased glare, mild decrease in visual acuity and night vision problems. Patients will often come in expecting a minor change in their glasses and find that their problem is a small amount of cataract formation. Frequent changes in eyeglass prescription are common as cataracts develop.
As cataracts advance, vision will become more seriously distorted, filmy or foggy. Colors often seem faded or yellowish and eye strain often increases. Surgery becomes an option when the degree of blur or discomfort starts to interfere with the comfort and safety of your daily activities.
Treatment for Cataracts requires surgery to replace the aging lens with a special plastic lens that is inserted in the eye. The actual surgery will take less than 15 minutes. After the eye and the tissue around the eye is fully numbed, the surgeon makes a very small opening at the edge of the cornea to allow special instruments to reach inside. The surgeon will then use an ultrasonic probe to gently break up and suction out the cloudy lens material. This is replaced with a small and flexible plastic lens that is gently inserted inside of the eye. Healing is usually fast and the results are readily apparent within 1 to 7 days of the surgery. For most people, the results are dramatic and make a big difference with reading and distance vision.
Mt Hood Vision Center will monitor your visual health up to the time that we determine that you are ready for surgery. We will then help you to choose a surgeon. In most cases, you may choose to have us co-manage your care after the surgery and schedule your follow-up appointments in our office. In some cases, your insurance company and PCP will be responsible for choosing your surgeon and will dictate your follow-up services.
After surgery, you will be able to get new glasses. Medicare and most insurance programs will pay most of the costs for your first eye glass prescription after surgery. The surgery may make glasses unnecessary for distance activities.
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