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REFRACTION EXPLAINED By Dr. Mark German, Optometrist at Lakeshore Eye Care Professionals with offices in Mequon & Saukville, Wisconsin

By editor
October 27, 2014

What is “Refraction" and why is this service often not covered by Medicare or some private insurance companies?  If you are confused about this topic, you are not alone.  Refraction is the part of the eye exam where you look through a machine called a phoropter at the eye chart.  We than flip different lenses in place and ask, "Which view is clearer, number one or number two?"

Why is Refraction necessary?  Many think that refraction is only necessary if you want to purchase new glasses.  While we do need the refraction information to write a glasses prescription, this is not the main reason our doctors want this portion of the exam completed.

Refraction is a key part of a comprehensive eye examination and should be done at each and every complete eye exam. Without this testing, our doctors cannot determine your best possible vision. Many patients think their vision is just fine but then a change is noted during the exam. Without doing the refraction, we have no way of knowing if the change is simply due to an outdated glasses prescription or if something more serious has occurred like progression of cataracts or macular degeneration.

Dr. Mark E. GermanWhy does Medicare generally not cover refraction? Medicare and many private insurance companies do not cover aspects of your medical care that they deem as “routine.”  While this aspect of your eye exam is routine, that does not mean it is not vital in allowing our doctors to optimize your vision.

Still confused? Ask any member of our staff at your next appointment.

Dr. Mark German is an optometrist specializing in general eye care and hart-to-fit contact lens patients. He accepts patients of all ages into his practice and most insurance plans. For more eye care information, call 262-241-1919 or visit www.LakeShoreVision.com.


WHAT IS A SECONDARY CATARACT? By Dr. Martha Jay, Ophthalmologist at Lakeshore Eye Care in Mequon & Saukville, Wisconsin

By editor
October 21, 2014

A common question from patients is, “Do cataracts come back?” The answer is yes and no. Once you have cataract surgery, you do not have to go back to the operating room at a later date to repeat the procedure. What can happen is that you may develop a secondary cataract. This is a clouding behind the implant and is easily treated with a quick laser procedure.

The lens in the eye is shaped like a tiny pillow, rounded on the edges and flattened on the front and back. It is covered with a thin membrane, measuring less than 5 microns thick. At the time of cataract surgery, we carefully remove a circular area from the front of this membrane and gently vacuum out your cloudy lens. We then use this remaining membrane, known as “the bag,” to support the plastic intraocular lens which allows you to see clearly after surgery.

In about 10% of cases, this membrane becomes cloudy over time and we call it a secondary cataract.  It usually takes 3-5 years for this to happen and the symptoms are very similar to those noticed prior to the original surgery: blurred distance vision, glare and halos around lights.

Dr. Martha F. Jay

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

As previously mentioned, the treatment is a quick laser. You wear street clothes and put your chin on something that looks just like what we use in the office during your eye exam. Afterwards there are no activity restrictions and the potential risk for complications is minimal. So if you start to notice that your vision has become blurred several years after cataract surgery, come in and we will determine if this is your problem.  If so, you are just a quick laser away from resuming your clear vision.

Dr. Martha Jay is a board certified ophthalmologist specializing in medical and surgical eye care including small incision cataract surgery and blade-free LASIK vision correction.

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


HALLOWEEN HOLIDAY HAZARDS By Dr. Josephine-Liezl Cueto, Ophthalmologist at Lakeshore Eye Care Professionals in Mequon & Saukville, Wisconsin

By editor
October 16, 2014

Halloween is such a great time of the year…the beautiful fall colors, the crispness in the air, the endless supply of candy and of course the cute children in Halloween costumes.  However, Halloween festivities can cause an increased risk for potential eye hazards. Therefore, it is important to be aware of these risks before planning your celebrations.

A popular costume trend is the decorative contact lens. Because people can buy them over the counter or on the internet, it is believed that contact lens fitting or proper care is not necessary. This is WRONG.  Unfortunately, these “one size fits all” novelty contacts are not professionally fitted and could cause pain, infections, scratches or even permanent corneal scarring and vision loss.  It is important to realize that these costume products are being sold illegally and are not FDA-approved. By federal law ALL contact lenses are considered a medical device, only to be distributed by a licensed eye care professional after determining the proper fit and prescription.

Other Halloween activities can also lead to eye injuries.  Unfortunately, what may seem like a harmless traditional game, like apple bobbing, could lead to scratches on the surface of the eye and infections from dirty water.  Lanterns and glow sticks can also cause dangerous but avoidable accidents. Hitting the edge of a lantern may lead to a corneal abrasion or the chemicals within a broken glow stick could damage the eye.  Last of all, be sure your children’s costumes do not obstruct their side vision because they need to be on the lookout for cars coming when out trick or treating.

This holiday just take a little bit of extra care while having fun!  Happy Halloween from all of us at Lakeshore Eye Care!

Dr. Josephine-Liezl P. Cueto

Dr. Josephine-Liezl Cueto

Dr. Josephine-Liezl Cueto is a board certified ophthalmologist specializing in medical and surgical eye care including cataract surgery, glaucoma treatment and much more.

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


IT'S A BOY! By Dr. Josephine-Liezl Cueto, Ophthalmologist at Lakeshore Eye Care Professionals in Mequon & Saukville, Wisconsin

By editor
October 7, 2014

My new baby son Benjamin arrived two weeks ago Saturday!  Already a self-starter, he decided to come several weeks ahead of schedule.  He is very sorry to have inconvenienced those patients who had their appointments delayed or switched to Dr. Jay or Dr. German.  He just wanted to get out and meet his big sister Isabella! He knew the nice patients at Lakeshore Eye Care would understand.

I am taking a little time off for this big adjustment but look forward to coming back to Lakeshore Eye Care in early January. In the mean time, you are in good hands with my colleagues Dr. Martha Jay and Dr. Mark German. They have added extra hours to accommodate my patients and for emergency eye problems.

Dr. Josephine-Liezl P. Cueto

Dr. Josephine-Liezl Cueto

For routine eye care, it is not too soon to call for your appointment with me in January or later.  I'll be getting right back to treating medical and surgical eye problems such as cataracts, glaucoma, diabetic eye disease, dry eyes, macular degeneration and much more.

Being a parent is a very special privilege.  I would like to thank you, my patients, and my colleagues at Lakeshore Eye Care for providing me with the time to adjust to this monumental life change.  See you in January!

Dr. Cueto is a board certified ophthalmologist specializing in medical and surgical eye care. For more eye care information call 262-241-1919 or visit www.LakeShoreVision.com.


WHAT HAPPENS WHEN YOU COMBINE CHICKENS, LASIK AND FLEX PLANS? By Dr. Martha Jay, Ophthalmologist at Lakeshore Eye Care with offices in Mequon & Saukville, Wisconsin

By editor
September 30, 2014

Each fall these three factors combine, motivating those “chickens” to arrange LASIK for the coming year. They have wanted LASIK for years but were frankly a little afraid of the procedure. They then did their research and calmed down when they realized that our blade-free LASIK is extremely safe, making it almost impossible to have a complication during this pain-free procedure.

Those “chickens” also insist on a well respected, experienced local doctor they can trust. They know that I was the first doctor in the Milwaukee area to perform laser refractive surgery and thus have consistently offered the safest and most precise technology available. That includes the exclusive use of blade-free LASIK since 2005.

When you combine the “LASIK for Chickens” concept with the annual Flex Plan enrollment period, you have a perfect mix.  Whether the goal is to spend down your 2014 funds or you are planning for 2015, be sure to include LASIK in your calculations.

Don’t despair if a Flex Plan is not available to you, you can still take advantage of our other finance options. We offer interest-free financing through CareCredit and accept most major credit cards.  LASIK is a sure investment in your future and over time represents a considerable savings over the expenses associated with contact lenses.

Dr. Martha F. Jay

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

Motivated now? Then call today to arrange your complimentary LASIK screening exam before your Flex Plan enrollment period expires. See you soon!

Dr. Martha Jay is a Board Certified Ophthalmologist specializing in medical and surgical eye care.  For more eye care information, call 262-241-1919 or visit www.LakeShoreVision.com.


HOW TO AVOID TROUBLE WITH CONTACTS By Dr. Mark German, Optometrist at Lakeshore Eye Care Professionals in Mequon & Saukville, Wisconsin

By editor
September 18, 2014

Contact lenses are a great alternative to glasses for sports and everyday wear. You can avoid fogged up glasses, expand your peripheral or side vision, wear off-the-rack sunglasses or non-prescription sports goggles, and avoid the annoying “slide down the nose” syndrome.  Contacts, however, do take a bit more care than just throwing on a pair of glasses each morning.

Staying out of trouble with contacts starts with being sure you have an accurate fit and prescription by having a complete eye exam every one to two years. If your eyes hurt, become red or your vision changes suddenly then an emergent appointment is indicated as something more serious may be occurring.

As for daily care, start by making sure that your lens case is very clean. Wash it out daily and let it air dry in a clean place. Change the solutions every day. Be sure you are not just using saline to clean your contacts.  You need a product that disinfects as well as cleans the contacts to prevent eye infections.  In addition, discard the contacts according to the schedule advised by your eye doctor. Finally, NEVER sleep in your contacts as this greatly increases your risk of developing a severe infection called a corneal ulcer.

Dr. Mark E. GermanIf your goal is to wake up with clear vision in the morning and avoid taking the time to properly care for your contacts, then you might want to consider seeing my colleague Dr. Martha Jay about LASIK vision correction. As for avoiding problems such as infections and injuries, you may be surprised to learn that we see far more problems in contact lens patients than in those who have had LASIK.

Dr. Mark German is an Optometrist at Lakeshore Eye Care Professionals with offices in Mequon & Saukville, Wisconsin. He specializes in first time contact lens fits and those with challenges such as astigmatism or exploring bifocal contact lens options. For more eye care information, visit www.LakeShoreVision.com or call 262-241-1919.


PUPILS ARE REVEALING By Dr. Josephine-Liezl Cueto, Ophthalmologist at Lakeshore Eye Care Professionals in Mequon & Saukville, Wisconsin

By editor
September 11, 2014

The pupil is the opening in the center of the iris which is colored part of the eye. Light passes through the pupil to reach the retina in the back of the eye. Pupils become larger in the dark (dilate) and smaller in bright light (constrict).  When you come in for a complete eye examination, we pay close attention to your pupils. The reason is that they tell us a lot about how your eyes and even your brain are functioning.

The nerves that control you pupils travel a long way.  They start in the eye detecting brightness, go back into the brain, down to the spinal cord, back over your lungs and again back into eye to control the small muscles in the iris. Any problem in the eye or anywhere along that pathway (such as a tumor, stroke or head trauma) can affect how your pupils function.  How do we check your pupils?  We take a small light and swing it from one eye to the other.  We then record the size, shape and how quickly each pupil responds to light.

Dr. Josephine-Liezl P. Cueto

Dr. Josephine-Liezl Cueto

Up to 20% of people have pupils that are not the same size so this is generally not of concern.  However, a new change in your pupils is different story especially if it is associated with of the following: a recent head injury, blurred vision in one eye or a new drooping eyelid. If any of these situations apply, you should come in right away for a thorough eye examination.

The evaluation of the pupils is just one of the many components of a complete eye examination which is a thorough medical evaluation of your eyes and how your brain processes visual information. See you soon!

Dr. Josephine-Liezl Cueto is a board certified ophthalmologist specializing in medical and surgical eye care such as cataract surgery, glaucoma treatment, macular degeneration, dry eyes and much more.

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

 


CATARACTS & MACULAR DEGENERATION By Dr. Martha Jay, Ophthalomologist at Lakeshore Eye Care Professionals with offices in Mequon & Saukville, Wisconsin

By editor
September 2, 2014

Many people have both cataracts and macular degeneration as both conditions are more common later in life. Cataracts are caused by a clouding of the lens in the front of the eye and are treated with surgery. Macular degeneration is an aging change in the back of the eye.  There are two types of macular degeneration: “dry” and “wet.”  The dry type is less severe and may just be noticed during a routine eye examination. The more severe wet type usually causes blurred or distorted central vision. Sometimes the wet type is treated with injections into the eye on a regular basis.

If your vision is impaired by macular degeneration and you also have cataracts, you may wonder if having cataract surgery would be of any benefit.  A recent study in the medical journal “Ophthalmology” looked at this very question.  The study followed 800 patients and came to the conclusion that cataract surgery did improve vision in patients with all levels of macular degeneration.  Expectations should be guarded, however, about how much improvement could be expected.  The retinal is like the film of a camera, so if it is damaged by macular degeneration you cannot expect to get a perfect picture even with a perfectly clear lens.

Dr. Martha F. Jay

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

Every situation is different so the decision to proceed with cataract surgery is one that you make with the assistance of your eye physician.  While cataract surgery is a relatively quick and easy procedure, you want have reasonable expectations. We can thoroughly discuss your options and explain what visual improvement you could expect with cataract surgery the time of your next complete eye examination.

Dr. Martha Jay is a board certified ophthalmologist specializing in medical and surgical eye care including cataract surgery and macular degeneration care. For more eye care information, call 262-241-1919 or visit www.LakeShoreVision.com.


CHOLESTEROL AND DIABETIC EYE CARE By Dr. Josephine-Liezl Cueto, Ophthalmologist at Lakeshore Eye Care Professionals with offices in Mequon & Saukville, Wisconsin

By editor
August 17, 2014

If you have diabetes, you probably concentrate on your blood sugars with testing during the day and the 90 day test at your doctor’s office called “hemoglobin A1c” but other aspects of your blood samples are important as well, including cholesterol levels.

A recent study, reported in the medical journal "Investigative Ophthalmology,"  took advantage of the advanced technology of optical coherence tomography (OCT) scans which allow us to visualize the layers of the back of the eye in the retina. This device is helpful for evaluating diabetic eye disease, among other uses.  Almost 100 patients were included. Blood samples were drawn to measure cholesterol  and hemoglobin A1c levels.  OCT scans were obtained of the central retina.

The results showed that those with poorly managed cholesterol were more likely to have thickened retinas, an early sign of diabetic eye disease.  Diabetes is a condition that can affect small blood vessels especially in the eyes, heart and kidneys. The result in the eyes is that the vessels become leaky, causing swelling and eventual blurred vision. Sometimes these problems are treated with lasers or injection into the eye but prevention is the key.

Dr. Josephine-Liezl P. Cueto

Dr. Josephine-Liezl Cueto

The bottom line is that diabetes is not just about blood sugars, cholesterol levels are also very important. If you or a family member has diabetes, remember that a thorough eye examination with dilating drops is suggested at least yearly. Call today if you have been putting off this very important aspect of your diabetic care. At Lakeshore Eye Care, we always send a report to the primary care physician of all our diabetic patients so they can be kept up-to-date on whether the diabetes has affected the eyes.

Dr. Josephine-Liezl Cueto is a Board Certified Ophthalmologist specializing in medical and surgical eye care including cataract surgery, diabetic eye care, glaucoma treatment and much more. For more eye care information, call 262-241-1919 or visit www.LakeShoreVision.com.


WHY VISUAL FIELD TESTING IS IMPORTANT By Dr. Martha Jay, Ophthalmologist at Lakeshore Eye Care Professionals with offices in Mequon & Saukville, Wisconsin

By editor
August 11, 2014

If you have glaucoma or are at risk for glaucoma, we have probably suggested that you return for a visual field test at least yearly. That is a test where you look into a large bowl-like machine and hit a clicker when you see small lights in your side vision. We generally have the technicians do the testing and then one of our doctors sends you a report about the results in the mail. At the same time we take a picture of your optic nerve in the back of the eye, called an OCT test.

While we don’t get many complaints about the OCT, some patients balk at the idea of the visual field test. Recent comments have been: “I’ve had glaucoma for years, why do I need this test?” Or, “I just had one last year, why do I need to repeat it?”

Dr. Martha F. Jay

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

Why is this test so important? Glaucoma is evaluated by monitoring several things: your eye pressure, the appearance of the optic nerve in the back of the eye AND your side vision. The idea of the visual field is to detect very small changes in side vision BEFORE you become aware of them so we can appropriately start or alter your glaucoma treatment. You can lose up to 40% of your side vision without it becoming obvious to you.

Should we notice small changes on the visual field, glaucoma is easily treated with eye drops. Laser or surgical treatments are also available if drops alone are not adequate.  No one should lose vision from glaucoma today with appropriate monitoring.       Now that you know how important this test is, you won’t be tempted to put it off.  As an extra bonus, we are now using an even quicker version of this test lasting only 2-4 minutes per eye, this is HALF the time it took before! Help us help you preserve your vision.

Dr. Martha Jay is a board certified ophthalmologist specializing in medical and surgical eye care. She welcomes patients of all ages into her practice and accepts most insurance plans, including Medical Assignment. For more eye care information, call 262-241-1919 or visit www.LakeShoreVision.com


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