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Eyes on Your Vision: Corrective Treatment and Surgical Options

February 27, 2018 12:00 PM with Dr. Paul Phelps

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More than 30 million Americans experience some form of vision impairment, including near and farsightedness, cataracts, glaucoma and retinopathy. Oftentimes, eye exams don’t seem important until the issue impacts daily life, and corrective treatment can seem a little scary. You can find out more about what the symptoms of vision problems are and how they're treated with some expertise from Dr. Paul Phelps, NorthShore Ophthalmologist  with a subspecialty in plastic surgery. He will be taking your questions on vision problems and sharing insight on the ways specialists are treating them.

Dr. Paul Phelps (NorthShore) - 11:46 AM:
I am available whenever someone has a question. Thank you!

Kathryn (Moderator) - 12:00 PM:
Our chat on vision problems and treatment options is now open. You can submit questions at any time during our chat.

  Christine (Chicago, IL) - 12:02 PM:
I have worn contacts and glasses for so long, and I am ready to look into LASIK. I don't know where to start. Any suggestions on what questions I should be asking/talking about at my first appointment and what type of specialist I should look for?
Dr. Paul Phelps (NorthShore)
Hi Christine. We have several excellent specialists at NorthShore who have a track record of performing high-quality LASIK procedures. I would start by making an appointment with one of our Corneal specialists for a consultation. Drs. Macsai, Herz, and Kim all do this procedure at NorthShore. You should ask them how they can correct your near and distance vision. There are many options for corrective surgery for refraction, and the first step is to have an exam to learn more about your eyes and what options may be available to you.

  Julie (Highland Park, IL) - 12:07 PM:
Nearing my 50's and have family history of glaucoma and macular degeneration; are there any supplements or corrective actions that would help prevent/delay onset? Thank you.
Dr. Paul Phelps (NorthShore)
Supplements for eye disease are recommended for patients who have intermediate or severe macular degeneration. Those patients have a reduced risk of developing the progression of their disease with the use of AREDS supplements. There is ongoing research with Omega-3 supplements. There does not seem to be harm in taking them, and they may provide benefits for patients with dry eyes or glaucoma. Diet, exercise and not smoking are the keys to preventative eye health.

  Pat (Highland Park, IL) - 12:10 PM:
If YAG laser surgery (making a hole in the eye) is used on closed-angle glaucoma, does that cure that glaucoma issue?
Dr. Paul Phelps (NorthShore)
The YAG laser can cure an acute angle-closure glaucoma. However; it is important to continue to get eye exams so your doctor can keep track of your optic nerve because you still may have a risk for the development of glaucoma.

  Jennifer (Skokie, IL) - 12:11 PM:
Can you tell me the pros and cons of low dose atropine eye drops? They were recently recommended for my 10 year old son.
Dr. Paul Phelps (NorthShore)
The use of low dose atropine in children is usually a for treatment for amblyopia or progressive myopia. This can be used as a solo treatment or in combination with patching (for amblyopia). The benefit is that low dose atropine can prevent amblyopia (development of lazy eye). It is also often easier to do than patching because children often do not like to have their good eye patched. The drop only takes a moment to put in, unlike keeping the patch on for several hours per week. The atropine makes it so your child is forced to look at things in the distance, similar to when your eyes are dilated, so they will not be able to see up close as well, and will have a reduction in the development of amblyopia and/or myopia.

  Priscilla (Northbrook, IL) - 12:16 PM:
I recently had cataract surgery (both eyes) in November 2017. My night vision is still blurry and I continue to see halos around lights (same as prior to surgery). Will this improve with time? Any suggestions for anything I can do to improve this. Thank you!
Dr. Paul Phelps (NorthShore)
Hi Priscilla. Have you worn glasses since your cataract surgery? Sometimes getting a prescription for glasses to wear at night can be helpful. When your pupils enlarge (in the dark), the outside part of the lens implant is refracting (bending) the light more than normal. Another option is to use an eye drop in the evening which makes your pupil smaller. This could be prescribed by your eye doctor if this is affecting you significantly. Also, making sure your eyes are lubricated well with artificial tears can't hurt. Often patients I see have undiagnosed dry eyes.

  Miles (Vernon Hills, IL) - 12:20 PM:
I often read and watch videos on my iPhone Plus phone, but for the last couple of months, I haven't been able to directly read or watch the screen for a longer period of time because my vision will start to get blurry. My vision is clear when I look at my surroundings, just blurry when looking at the phone. What are some reasons this could be happening? Thank you.
Dr. Paul Phelps (NorthShore)
Hi Miles, does the blurred vision improve when you move the phone further away? You may be developing presbyopia. This generally happens around the age of 40 and progresses with time as one ages. Does the vision get blurry in one or both eyes? Sometimes, patients use one eye to watch their phone and can get "bleaching" of the photoreceptors in one eye. This will usually return to normal after about 10-15 minutes. Hope that helps!

  Marla (Wheeling, IL) - 12:25 PM:
Are the vitamins for eye health worth taking? If so, what are some you think are good?
Dr. Paul Phelps (NorthShore)
The main use of eye vitamins is to prevent the worsening of macular degeneration. I would recommend taking the AREDS vitamins for this purpose only if your eye doctor has evaluated you and lets you know if you are at risk for this condition. In those select patients, it will decrease the progression of macular degeneration in about 20% of patients. These vitamins certainly are not a miracle treatment. Omega-3 supplementation has been shown to have some benefit in patients who have dry eyes. This supplement may be worth it if you are having symptoms. Generally, vitamins are good if you have a deficiency or are already diagnosed with a low grade of the disease (macular degeneration or dry eyes).

  Roxie (Evanston, IL) - 12:30 PM:
I suffer from ocular rosacea; have there been any recent improvements on treatments? (I'm honestly not a fan of taking daily medications and the lid scrub/warm compresses only provide slight relief)
Dr. Paul Phelps (NorthShore)
There are several treatments being developed. The main underlying disease in ocular rosacea is a pro-inflammatory condition. Diet and exercise can help. Also, avoiding pro-inflammatory food and drinks like alcohol, processed food, spicy food and dairy can help. Drinking plenty of water and staying hydrated can help. There are chemical peels (salicylic acid) and moisturizers which may also provide relief. Many new treatments are on the horizon. I find some patients benefit from low-dose doxycyline (50 mg daily). Hope this helps!

  Mary (Skokie, IL) - 12:36 PM:
In the process of being evaluated for ptosis, my mom (healthy/active 85 year old) has been diagnosed with nerve damage in her left eye and vasculitis in her right eye. What type of specialist could treat all of this? What might that treatment include?
Dr. Paul Phelps (NorthShore)
Hi Mary, it depends on where the nerve damage and vasculitis are affecting your mom's eyes. Sometimes it can affect the eye muscles or the retina. Other times, it can be the eye socket itself. The specialists we have at NorthShore include a retina specialist (Dr. Khan), and eye muscle specialist (Dr. Shah), and the orbit, lacrimal and eyelid specialist (myself). Hope this helps!

  Nidhi (Chicago, IL) - 12:39 PM:
My son is 5 years old. Since the age of 9 months, I've observed him tilting his head to focus on a point. I took him to several pediatric ophthalmologists, and they said he definitely needs glasses, but to wait till he's older. He's now had glasses for the last couple of months. I'm afraid one his eyes might be in the beginning stages of lazy eye since that is the less-preferred eye. His latest doctor suggested an eye patch. How effective do you think that would be? What else might be suggested down the line? Is there the potential for lifelong damage?
Dr. Paul Phelps (NorthShore)
It sounds like your son may have amblyopia. Patching has been shown to be very effective in the treatment of amblyopia. Having the right glasses prescription is an important first step. Another option is to have the lens over his "good eye" frosted so he is forced to use the "lazy eye" more. Finally, some doctors recommend atropine (an eye drop) in the good eye to help make that one blurry and allow your son to use his "lazy eye" more. These treatments are important during childhood because the changes can be irreversible in teenage years (and beyond); while "lazy eye" prevention is relatively straightforward when the patient is young like your son.

  Julie (Chicago, IL) - 12:44 PM:
How often should a person who has retinopathy of prematurity see a retinal specialist to make sure their retina is still stable? I was born with a damaged retina due to being 3 months premature over 30 years ago. I was told that once I reach my 30's, there was a 50/50 chance my retina could detach. Is that true of ROP patients?
Dr. Paul Phelps (NorthShore)
Hi Julie, how often you should see a retina specialist is dependent on many factors (your refraction, presence of laser treatment, holes/tears, etc.). I recommend seeing them at least once per year and more often as recommended by the retina specialist. They would be able to determine how high your risk is for retinal detachment at this point. Signs of retinal detachment include flashes of light, new onset of floaters, and decreased vision and/or a curtain of vision loss. Those symptoms require urgent evaluation by an ophthalmologist.

  Demi (Chicago, IL) - 12:47 PM:
Are there exercises one can do to improve vision without corrective glasses or surgery?
Dr. Paul Phelps (NorthShore)
Exercises to improve vision have been described and are popular in many foreign countries. To my knowlege, no evidence-based study has demontrated that eye exercises alone can result in long-lasting improvment in vision. Acupuncture has been shown to have long-lasting improvment in vision under some circumstances. The scientists are still working on this, stay tuned!

  Mary (Lincolnshire, IL) - 12:51 PM:
Is Lasik or any other type of surgery available for farsighted people?
Dr. Paul Phelps (NorthShore)
Yes, there are now several refractive options available for patients with hyperopia. LASIK can be done, but I recommend an evaluation with a cornea specialst to determine if you are a good candidate for this procedure.

  Pat (Highland Park, IL) - 12:55 PM:
Is there any type of safe treatment(s) to correct severe farsightedness (like LASIK for prescription of +8 and above) available now?
Dr. Paul Phelps (NorthShore)
Possibly a clear lensectomy/refractive lens exchange. We do that procedure at NorthShore. One of our cornea specialists (Dr. Macsai, Dr. Herz, or Dr. Kim) could help you with that! Unfortunatly you would not be a candidate for LASIK.

Kathryn (Moderator) - 1:00 PM:
Our chat is now closed. Thank you for your questions. For more information about vision problems and the latest options for treating them, or to schedule an appointment with a specialist like Dr. Phelps, please contact the Department of Ophthalmology.
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