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READING AFTER CATARACT SURGERY By Dr. Josephine-Liezl Cueto, Ophthalmologist at Lakeshore Eye Care Professionals with offices in Mequon & Saukville, Wisconsin

April 21st, 2014

So your friend had cataract surgery and now she rarely wears glasses. She does, however, pull out reading glasses for small print. Why does she now need glasses for reading but not for distance?

The reason is that during cataract surgery, we not only remove your natural cloudy lens but we replace it with a clear plastic implant. These implants are especially selected for you to generally improve your distance vision. This is wonderful for those who have needed glasses to see far-away since childhood. But if you don’t need glasses for distance, you will need them for reading.

Dr. Josephine-Liezl P. Cueto

Dr. Josephine-Liezl Cueto

However, there is an option to avoid the hassles of reading glasses after cataract surgery. We offer special bifocal-like implants that let you see far-away, close-up and intermediate distances after your cataract surgery without glasses. This more closely mimics the vision you had when you were younger and provides relative freedom from glasses. These ReSTOR implants do cost a bit more but if you and glasses don’t get along, they are worth considering.

Not everyone is a candidate for the bifocal implants. For example if you have macular degeneration or considerable astigmatism they are not a good option for you. When you come in for your comprehensive eye examination and we determine that your cataracts are ready for surgery, all the potential lens options will be explained thoroughly.

See you soon!

Dr. Josephine-Liezl Cueto is a comprehensive ophthalmologist (Eye Physician and Surgeon) specializing medical and surgical eye care including cataract surgery, dry eye treatment, macular degeneration management, glaucoma treatment and much more.

For more eye care information, visit www.LakeShoreVision.com or call 262-241-1919.

Posted in Cataracts: Symptoms and Treatment, Dr. Josephine-Liezl Cueto's Blogs, Medical and Surgical Eye Care, Our Doctor's Blogs | No Comments »

ALCOHOL AND YOUR EYES By Dr. Josephine-Liezl Cueto, Ophthalmologist at Lakeshore Eye Care Professionals with offices in Mequon & Saukville, Wisconsin

March 31st, 2014

Moderate drinking has little effect on your vision. However, heavy drinking is another matter. We mentioned last week about the possibility of vitamin A deficiency in alcoholics which actually mimics malnutrition seen in third world countries. The result can be a painless loss of vision in both eyes called optic neuropathy. Color perception and vision clarity can be permanently affected.

Short term vision problems from a bit too much alcohol include blurred vision, double vision, problems with depth perception, decreased peripheral vision, dry eyes, red eyes, migraine headaches and brightness sensitivity. Most of these changes in vision are due to poor coordination of the eyes. There are 6 eye muscles controlling the positioning of each eye, and a considerable portion of your brain stem is involved with keeping the two eyes yoked. Even if they are offset by just a little bit, double vision results. Nystagmus or a jerking back and forth of the eyes is another eye muscle problem used by authorities to judge intoxication.

What about when you are “under the limit”? A recent study in Australia measured the visual functioning of volunteers who were still able to legally drive and found that they had decreased contrast sensitivity. This means that they were less able to detect a pattern as it stood out from the background, a key visual factor in seeing a pedestrian along the side of the road. They also experienced light sensitivity because their pupils did not appropriately constrict with bright lights used to mimic oncoming headlights.

Dr. Josephine-Liezl P. Cueto

Dr. Josephine-Liezl Cueto

In order to maintain healthy vision, use alcohol only in moderation and walk to the pub or bring along a designated driver!

Dr. Josephine-Liezl Cueto is an Ophthalmologist (Eye Physician & Surgeon) practicing at Lakeshore Eye Care Professionals with Drs. Martha Jay and Mark German. She welcomes patients of all ages to her practice and accepts most insurance plans.

To learn more about eye care, call 262-241-1919 or visit www.LakeShoreVision.com.

Posted in Dr. Josephine-Liezl Cueto's Blogs, General Eye Care, Medical and Surgical Eye Care, Our Doctor's Blogs | No Comments »

MYTH BUSTER: CARROTS HELP YOUR VISION By Dr. Mark German, Optometrist at Lakeshore Eye Care Professionals with offices in Mequon & Saukville, Wisconsin

March 24th, 2014

Sorry if you heard this from your mother, but eating more carrots will probably not have much of an effect on your night vision. Carrots, broccoli, sweet potatoes, pumpkin and leafy green vegetables all contain beta-carotene which is a carotenoid. That means that they contain a pro-vitamin that is converted to vitamin A in the body but on an as-needed basis. So if you already have a balanced diet, the excessive consumption of carrots won’t have much effect on your vitamin A levels.

Another source of vitamin A is from liver, cod-liver oil, fish oil and butter. They contain retinoids which, when consumed in excess, directly increase your vitamin A levels. So as is the advice on most dietary factors, balance is the key.

Vitamin A deficiency is rare in the US but, in keeping with our last column about worldwide eye care, is seen with malnutrition in developing countries. Especially susceptible are pregnant women and small children. In fact, 1/3 of all children under 5 worldwide have a vitamin A deficiency. The result can be night vision problems and poor resistance to infection. One place where we do see vitamin A deficiency in the US is with alcohol abuse. Alcoholics tend to have a poor diet and the retinoids they do consume are broken down faster.

Dr. Mark E. German They bottom line is eat your vegetables, don’t smoke or quit if you do, and wear sunglasses on a regular basis. These are your best strategies for maintaining good vision. Also important is regular eye care. That means a complete, dilated eye exam at least every two years or more frequently if you have diabetes, macular degeneration or glaucoma.

Dr. Mark German is an Optometrist at Lakeshore Eye Care Professionals practicing with Dr. Martha Jay and Dr. Josephine-Liezl Cueto. He welcomes patients of all ages into his practice and accepts most insurance plans.

For more eye care information, call 262-241-1919 or visit www.LakeShoreVision.com

Posted in Dr. Mark German's Blogs, General Eye Care, Medical and Surgical Eye Care, Our Doctor's Blogs | No Comments »

EYE PROBLEMS AROUND THE WORLD By Dr. Martha Jay, Ophthalmologist at Lakeshore Eye Care Professionals with offices in Mequon & Saukville, Wisconsin

March 17th, 2014

The World Health Organization (WHO) recently released a fact sheet about visual impairment worldwide. Not surprisingly, of the 285 million people with some type of visual impairment worldwide, 90% are in developing countries.

However, 80% of all vision problems can be prevented or cured. Remarkably, lack of appropriate glasses accounts for 43% of those with vision problems alone. Another 33% struggle with visual impairment stemming from cataracts and could benefit from access to surgery.

What are the WHO and other organizations doing about these problems? One success story concerns onchocerciasis related blindness. This parasite is carried by black flies which breed near rivers earning the moniker “river blindness”. Treatment programs in Sub-Saharan Africa and South America have considerably reduced this condition by providing anti-parasitic medication twice yearly to those in susceptible areas. Untreated, this condition causes intense itching and inflammation of the eyelids along with severe glaucoma.

Another success story is with Trachoma. This eyelid infection is caused by Chlamydia from flies or contact with others who are infected. If left untreated, the result is severe scarring of the eyelids and damage to the cornea causing blindness. A single dose of Azithromycin antibiotic is effective for this condition and is part of many worldwide health projects.

Dr. Martha F. Jay

Martha F. Jay, Ph.D., M.D.

Other projects include children’s clinics to provide glasses and surgical access for underserved populations in remote locations. All these worthwhile endeavors still have a way to go before the good vision we all take for granted is more widely available.

Dr. Martha Jay is a board certified Ophthalmologist (Eye Physician & Surgeon) practicing at Lakeshore Eye Care Professionals with offices in Mequon and Saukville, Wisconsin.

For more eye care information, call 262-241-1919 or visit www.LakeShoreVision.com.


Posted in Dr. Martha Jay's Blogs, General Eye Care, Medical and Surgical Eye Care, Our Doctor's Blogs | No Comments »

DOES YOUR BLOOD PRESSURE AFFECT YOUR EYE PRESSURE? By josephine-Liezl Cueto, Ophthalmologist at Lakeshore Eye Care Professionals with offices in Mequon & Saukville, Wisconsin

March 10th, 2014

As far as your health is concerned, the two times you hear about “pressure” is with blood pressure and eye pressure. An abnormally high blood pressure could lead to heart disease or stokes. An abnormally high eye pressure could lead to vision loss from glaucoma. A logical question is whether or not the two are directly related.

It turns out that the two are related. A 2005 article in the British Journal of Ophthalmology reported on the Beaver Dam study. This is a Wisconsin based long term study following thousands of people in Beaver Dam, Wisconsin. The study looked at diastolic (the low number) blood pressure and systolic (the higher number) blood pressure and compared it to the patient’s eye pressure. The results found that for every 10 mm Hg increase in diastolic blood pressure, there was a corresponding 0.6 mm Hg increase in eye pressure. The effects of systolic blood pressure on eye pressure were less. For every 10 mm Hg increase in systolic blood pressure, there was a 0.3 mm Hg increase in eye pressure.

Is this important? First and foremost you concern should be maintaining a healthy blood pressure. This is something for you and your primary care provider to determine. As for eye pressure, you would have to have a very significant elevation in blood pressure to cause significant vision damage from glaucoma but it could certainly happen.

Dr. Josephine-Liezl P. Cueto

Dr. Josephine-Liezl Cueto

This is just another reason to keep on top of your general health care as it can affect your eye pressure too. Other potential eye problems from uncontrolled blood pressure include small strokes behind the eye and broken or blocked blood vessels in the eye. Take care of yourself and make your eyes happy too!

Dr. Josephine-Liezl Cueto is an Eye Physician and Surgeon (Ophthalmologist) practicing with Dr. Martha Jay and Dr. Mark German at Lakeshore Eye Care Professionals with offices in Mequon and Saukville, Wisconsin. She welcomes patients of all ages to her practice and accepts most insurance plans.

For more eye care information, call 262-241-1919 or visit www.LakeShoreVision.com.

Posted in Dr. Josephine-Liezl Cueto's Blogs, General Eye Care, Medical and Surgical Eye Care, Our Doctor's Blogs | No Comments »

MARIJUANA FOR GLAUCOMA? By Dr. Mark German, Optometrist at Lakeshore Eye Care Professionals in Mequon & Saukville, Wisconsin

March 4th, 2014

With 20 states allowing some form of medical marijuana usage and the recent legalization of marijuana in both Colorado and Washington, we are getting more questions about marijuana as a possible treatment for glaucoma. Glaucoma is an eye condition where the eye pressure is too high. This can cause damage to the optic nerve in the back of the eye and possible vision loss. It is generally treated with eye drops but sometimes laser treatment or surgery is required.

Most people have heard that marijuana can lower eye pressure. There are several problems to using this as a treatment for glaucoma, however. Firstly, the positive effects of marijuana on eye pressure only last a short time. This means that the patient would have to smoke cannabis every 3 hours, that’s 8 times a day! Secondly, the mood-altering effects of marijuana use on mental functioning make tasks such as driving and operating machinery hazardous. Also of concern are the hundreds of other components in marijuana cigarettes that could damage the lungs and the unknown effects of chronic usage on the brain.

So why not just use the active ingredient of marijuana called tetra-hydrocannabinol (THC) instead of smoking marijuana? While this method would eliminate the harmful effects of smoking on the lungs, those benefits are curbed by the other systemic side effects such as loss of judgment and drowsiness.

Dr. Mark E. GermanWith that, we recommend sticking with conventional glaucoma treatments such as drops, lasers or surgery! If you have glaucoma, be sure to take your drops as directed and have frequent follow-up examinations to be sure that this potentially sight threatening condition is being adequately managed.

Dr. Mark German is an Optometrist practicing at Lakeshore Eye Care Professionals with Dr. Martha Jay and Dr. Josephine-Liezl Cueto. He welcomes patients of all ages into his practice and accepts most insurance plans, including Medicare Assignment.

For more eye care information, call 262-241-1919 or visit www.LakeShoreVision.com.

Posted in Dr. Mark German's Blogs, Glaucoma: Diagnosis and Treatment, Medical and Surgical Eye Care, Our Doctor's Blogs | No Comments »

DRY EYES AND COMPUTER USE By Dr Martha Jay at Lakeshore Eye Care Professionals with offices in Mequon & Saukville, Wisconsin

February 24th, 2014

Due to the miserable winter, this has been a bad year for those with dry eyes. Symptoms of dry eyes vary but generally include feeling like there is something in your eyes, blurred reading vision or eye fatigue. This is caused by your tear film not adequately coating the surface of the eye. In winter the dry air both inside and outside causes your tear film to evaporate faster, thus leading to more symptoms. Generally these symptoms worsen with reading and computer use, during the winter months and at the end of the day.

While it has been long known that computer use contributes to dry eyes, a recent study showed that the effects are far more universal than previously thought. The study evaluated the effects of computer use on dry eye symptoms and found that over 75% of female and about 60% of male office workers who use computers have dry eye symptoms! The test sample was of office workers in Japan and included a questionnaire of symptoms along with a thorough eye examination.

The association between dry eyes and computer usage is thought to be due to decreased blink rate. We all tend to stare when using computers. A good way to be more comfortable while using computers is to try to blink more, occasionally refocus farther away and to use tear supplements.

Dr. Martha F. Jay

Martha F. Jay, Ph.D., M.D.

If those strategies are not effective, you may need other treatments such as prescription drops (Restasis) or punctual plugs which keep the tears that you have in your eyes last longer. Those options and more can be explained at the time of your complete eye examination. Meanwhile, realize that your eyes will be more comfortable once the humidity increases in a few months.

Dr. Martha Jay is a board certified ophthalmologist (Eye Physician and Surgeon) specializing in medical and surgical eye cares such as blade-free LASIK and small incision cataract surgery. She practices with Dr. Mark German and Dr. Josephine-Liezl Cueto at Lakeshore Eye Care Professionals.

For more eye care information, call 262-241-1919 or visit www.LakeShoreVision.com.

Posted in Dr. Martha Jay's Blogs, Dry Eye Syndrome, Medical and Surgical Eye Care, Our Doctor's Blogs | No Comments »

AREDS2 FOR MACULAR DEGENERATION By Dr. Mark German, Optometrist at Lakeshore Eye Care Professionals in Mequon & Saukville, Wisconsin

February 24th, 2014

The two types of macular degeneration are the “dry” and the “wet”. With the dry type, we see pigment changes in the back of your eye but your vision may be unaffected initially. The wet type is more serious. This is where blood vessels have broken through the back of the eye causing distorted central vision. If this happens, you may be referred to a retina specialist for treatments such as injections in the eye.

Macular degeneration patients are asked to view an Amsler grid at least monthly and return promptly if any distortions are noted. In order to decrease the chances of converting to the wet type, they are to include leafy green vegetables in their diet, not to smoke, to wear sunglasses outside and to take vitamin supplements called AREDS.

AREDS contain a high dosage of beta-carotene which converts to vitamin A in the body. This substance is an antioxidant that helps with macular degeneration and also for some cancers and heart disease. There is a problem, however, in that this substance can increase the chances of lung cancer in current or former smokers and may cause stomach upset in many people.

Dr. Mark E. German A recent study indicated that taking out the beta-carotene and substituting lutein and zeaxanthin was just as effective without the potential side effects. This new formula is called “AREDS2” and is available from PreserVision in stores or Viteyes on line for home delivery. So next time you need supplements for macular degeneration, all our doctors are recommending that you switch to the AREDS2 and take 2 gel tablets per day. This makes life simpler because you no longer have to take extra lutein tablets. Still confused? Give us a call.

Dr. Mark German is an optometrist practicing at Lakeshore Eye Care Professionals with Dr. Martha Jay and Dr. Josephine-Liezl Cueto. He accepts patients of all ages into his practice and most insurance plans. For more information, call 262-241-1919 or visit www.LakeShoreVision.com.

Posted in Dr. Mark German's Blogs, General Eye Care, Medical and Surgical Eye Care, Our Doctor's Blogs | No Comments »

CAN’T SWALLOW THOSE PILLS? TRY A SMOOTHIE! By Dr. Martha Jay at Lakeshore Eye Care Professionals with offices in Mequon and Saukville, Wisconsin

February 10th, 2014

We don’t prescribe many pills in ophthalmology but do recommend supplements for macular degeneration. The problem comes when people have trouble swallowing them or other pills. I can’t say this is my idea because it came from a patient: toss the supplements into the blender when you make a “smoothie’. You get the health benefits of fresh fruits and vegetables along with your medications!

What else can you put in your smoothie? We suggest plenty of leafy green vegetables for our patients with macular degeneration so you can add some fresh spinach in too. Be careful if you have a history of kidney stones but everything is good in moderation. No fresh fruit because it’s winter? No problem, just get frozen berries or other fruits and use them all year round. Unlike with juices, you get the benefit of fiber along with the nutrients.

All you need is some type of blender then use your creativity by adding any combination of fruits, vegetables, yogurt, almond milk, some whey for protein or nuts and then those pesky pills that are hard to swallow. The supplements for macular degeneration are red but so are strawberries – they literally get lost in the mix.

Dr. Martha F. Jay

Martha F. Jay, Ph.D., M.D.

Besides the supplements, we recommend that macular degeneration patients look at their grid monthly with each eye independently through reading glasses, return promptly if any changes are noted, not smoke and do wear sunglasses outside. We have recently changed our supplement suggestion from AREDS to AREDS2, more on that topic next week.

Dr. Martha Jay is a board certified Ophthalmologist who specializes in medical and surgical eye care including small incision cataract surgery and blade-free iLASIK. She practices with Dr. Josephine-Liezl Cueto and Dr. Mark German at Lakeshore Eye Care Professionals with offices in Mequon and Saukville, Wisconsin.

For more eye care information, visit www.LakeShoreVision.com or call 262-241-1919.

Posted in Dr. Martha Jay's Blogs, General Eye Care, Medical and Surgical Eye Care, Our Doctor's Blogs | No Comments »

IS LATTISE FOR YOU? By Dr. Josephine-Liezl Cueto, Ophthalmologist at Lakeshore Eye Care Professionals with offices in Mequon & Saukville, Wisconsin

January 27th, 2014

For those individuals who were not blessed with long, full eyelashes- current beauty trends can be very tempting. Every few weeks, I have a patient ask me, “Can I try that new product Latisse that I hear about on television?” While this product may give you your desired beautiful eyelashes, there are some considerations and side effects that are important to be aware of.

Latisse (bimatoprost ophthalmic solution) was approved by The US Food and Drug administration to help lengthen, thicken and darken eyelashes. Surprisingly it is the same active ingredient as a glaucoma medication, Lumigan. Those patients who were using Lumigan to treat their glaucoma found a side effect: longer eyelashes! As a result, Latisse was created for cosmetic purposes.

Although this medication is very effective, it does come along with other possible side effects: redness of the eye, darkening of the skin of the eyelids (which reverses after discontinuation) and darkening of the iris (the colored portion of the eye) which usually is permanent. Latisse should not be used by anyone under the age of 18 years old, pregnant women or women who are breastfeeding.

If you have any desire to start this medication, it is always important to consult your eye doctor first to see if this is a good fit for you. This is especially true if you have a history of ocular infections, glaucoma, macular edema or eye inflammation. Remember, we are always here to answer any questions you may have about the health and care of your eyes!

Dr. Josephine-Liezl P. Cueto

Dr. Josephine-Liezl Cueto

Dr. Josephine-Liezl Cueto practices with Drs. Martha Jay and Mark German at Lakeshore Eye Care Professionals with offices in Mequon and Saukville, Wisconsin. She specializes in medical and surgical eye care including cataract surgery, dry eye treatment, glaucoma care, macular degeneration and much more.

For more eye care information, call 262-241-1919 or visit www.LakeShoreVision.com

Posted in Dr. Josephine-Liezl Cueto's Blogs, General Eye Care, Medical and Surgical Eye Care, Our Doctor's Blogs | No Comments »