What is an Ophthalmologist?
|An Ophthalmologist is a physician, an MD (Medical Doctor), or a DO (Doctor of
Osteopathy) who specializes in complete care for the eyes. They are trained in preventative eye care, eye disease treatment, injury
treatment, and medical and surgical procedures of the eye. An Ophthalmologist attends four years of pre-medical college, four years
of medical school, one year of internship and a minimum of three
years of specialized training in refractive and surgical procedures.
Ophthalmologists' specialized education and training qualifies them to detect and treat
vision disorders such as Cataracts, Glaucoma, Trachoma (a bacterial
infection found mostly in developing countries), Conjunctivitis
infections, detached retinas and tear duct obstructions, as well as
Presbyopia and Astigmatism. An
Ophthalmic examination can reveal the presence of high blood pressure, Diabetes, brain tumors
and other neurological disorders.
An Ophthalmologist provides total eye care. Most Ophthalmologists provide complete vision services that encompass contact lenses, glasses, eye
examinations and surgical procedures. The most common refractive surgical procedure done by Ophthalmologists is LASIK Surgery
, a surgical procedure that corrects imperfect vision. This procedure has become very
popular and the immediate results are most impressive. See more on this subject in the Vision
How Ophthalmologists Were Selected
|Consumers’ Research Council of America has compiled a list of top Ophthalmologists
throughout the United States by utilizing a point value system. This method uses a point value for criteria that we deemed valuable in
determining top Ophthalmologists.
The criteria that was used is as follows:
the Ophthalmologist has been in practice
and Continuing Education
||Member of Ophthalmologic
Simply put, Ophthalmologists that have accumulated a certain amount of points
qualified for the list. This does not mean that Ophthalmologists that did not accumulate enough points are not good healthcare professionals, they
merely did not qualify for this list because of the points needed for qualification.
Similar studies have been done with other professions using a survey system. This type of study would ask fellow professionals
who they would recommend. We found this method to be more of a popularity contest. For instance, professionals who work in
a large office have much more of a chance of being mentioned as opposed to a professional who has a small private practice.
In addition, many professionals have a financial arrangement for back-and-forth referrals. For these reasons, we developed the point
Since this is a subjective call, there is no study that is 100% accurate. As with any profession, there will be some degree of variance
in opinion. If you survey 100 patients about their satisfaction with a particular physician, you will undoubtedly hear that some are very satisfied, some moderately
satisfied and some dissatisfied. This is really quite normal.
We feel that a point value system takes out the personal and emotional factor and deals with factual criteria. We have made certain
assumptions. For example, we feel that more years in practice is better than less years in practice; more education is better than less education, etc.
The Top Ophthalmologist list that we have compiled is current as of a certain date and other Ophthalmologists may have qualified since that date.
Nonetheless, we feel that the list of top Ophthalmologists is a good starting point for you to find a qualified Ophthalmologist.
No fees, donations, sponsorships or advertising are accepted from any individuals, professionals,
corporations or associations. This policy is strictly adhered to, insuring an unbiased selection.
Finding an Ophthalmologist
|Choosing an Ophthalmologist is an important decision. Thus, our goal is to assist
you in making that decision.
First of all, when selecting an Ophthalmologist, you may want to begin your search several
family physician. They are in constant contact with all
kinds of health care professionals and will be able to point
you in the right direction.
family, friends, neighbors and/or co-workers.
your local Chamber of Commerce or Better Business Bureau for
your state's local Ophthalmologist associations as many of
them have referral services.
|We recommend that you interview
the Ophthalmologist and ask the following:
||Is your staff friendly and accommodating?
||Do you have two waiting rooms, one for sick people and one for healthy people that
are just in for checkups?
||Do you take walk-in patients, or is it by appointment only?
||What are the procedures if a doctor is needed in the middle of the night or on a weekend?
||Do you have an associate that covers for you when you are not available?
||Do you have more than one office and if so, how is your time divided between offices?
||What kind of continuing education do you utilize?
||Do you accept phone calls during office hours?
||How do you stay current on the latest drugs and prescriptions available, medical
testaments and modern concepts?
||What types of insurance coverage do you accept?
||How do you handle billing? Do you require payment at the time of visit?
||Discuss your family medical history and particular problems you are concerned about.
After you have consulted a few
Ophthalmologists, you should have a good idea which one you felt most comfortable
with and who best answered your questions.
About Your Eyes
The human eye is located on the front part of the human skull and rests in a bony
cavity socket. The eyeball contains three thick layers of tissue: the
The innermost layer of tissue is the Retina.
The retina is a network of nerve cells, nerve fibers,
rods and cones.
The second layer is the Choroid.
The Choroid is made up of pigment and blood vessels
that nourish the tissues. Located near the center are muscles that are
used to change the shape of the lens so it can focus. The Choroid layer
contains the Iris which is where the pigmentation is. Pigmentation is usually
shades of brown, blue or green. The Pupil
is the round opening in the center of the Iris. The muscular action of the Iris regulates how
much light should enter the eye. This is done by the muscle dilating and contracting the Iris.
The outer layer, or Sclera,
is the visible white part of the eye. The center is the
which is basically the window of the eye. The Conjunctiva
covers the visible portion of the Sclera.
Parts of the Eye
conjunctiva is a mucus membrane that covers the exposed forward section of
membrane that forms the outside coating of the eye.
The Iris is the part
of the eye that determines the color of the eye. The iris surrounds the
pupil and is made up of tissues and membranes that control the size of the
The lens is the clear
membrane that makes up the outer coating of the eye.
The macula is located
in the center of the retina. Incoming rays of light are focused by the
The pupil is the dark
round hole in the center of the iris
Light enters the eye
and is focused on the retina by the lens. The retina produces an image or
picture which is sent along the optic nerve to the brain to interpret.
The Sclera is the
white part of the eye and covers over 80% of the exterior of the eye.
The Eye Examination
|An Ophthalmologist subjectively assesses visual acuity, color vision, visual fields and overall ocular health.
Ophthalmologists use the
Snellen Letter Chart, also known as the Standard Eye Chart, to measure the capability of your visual system. The
Ophthalmologist will ask a series of questions which include the reason for your visit, whether or not you wear corrective lenses, if you are
susceptible to headaches, and if there is a history of eye problems in your family.
Various diagnostic equipment used in the exam:
Slit Lamp: A binocular
microscope with a moveable light source used to examine the anterior portion of the eye.
A device that focuses a light source onto the retina permitting the doctor to view
the retina and vitreous.
A Tonometer is a medical device that measures excessive
intraocular pressure. Non-contact Tonometers generate a puff of air that deforms the Cornea.
Intraocular pressure is measured by the time taken to produce a set amount of Corneal flattening when the puff of air is activated.
The Keratometer allows a doctor to examine the curvature and aberration of the cornea. Exact measurement of the
Corneal curvature is essential to properly fit contact lenses and for refractive surgery procedures.
Many Ophthalmology exams are for a specific reason. It is common for Optometrists to refer
patients to an Ophthalmologist when surgical remedies are required, or when an eye problem needing further examination
is detected. Ophthalmologists perform surgical procedures and handle the more complicated eye conditions.
Just about everyone will need glasses at some point in their lives. Glasses are not only a
corrective device, but also a fashion item. Currently there are a variety of styles to fit everyone’s personality. The following
information can help you in choosing which style is best for you.
Lenses are primarily made out of two types of materials,
Glass has excellent optical properties and resists scratches quite well. However, glass is also very
heavy with a high potential for breakage. This could be a concern to anyone who plays sports or who is exposed to possible impacts.
Plastic, on the other hand, is substantially lighter in weight and resists breakage better. Also, many plastic lenses are now available
with a scratch resistant coating, which helps the lenses last much longer. These attributes make plastic lenses the most popular of the two.
Along with which types of materials, there are different kinds of lenses to choose from. To help you choose which type of lens best suits you,
a description of each is found below.
Single vision lenses are the most popular and widely prescribed.
Single vision simply means that the lens has one single power. That power allows people to see clearly at all distances. Most younger people
wear single vision lenses. However, as people age, the need for two power glasses
increases. These dual powered lenses are called Bifocals.
Bifocal lenses are common for people between the ages of 40 and 50 years old. It’s not unusual for the inability to focus both near
and far to occur between these ages. This inability to focus is called Presbyopia.
However, Bifocals assist greatly in this matter. The top portion of the Bifocal lens helps to see distances
as the bottom portion assists in seeing objects closely. It used to be that the separation between lenses was quite obvious, thus
making the lenses very unattractive. Fortunately, as the demand for style and fashion increased, the Bifocal lens became the Progressive lens.
Progressive lenses are aesthetically more attractive and allow for a smoother transaction between the two lens segments.
lenses have a tint that adjusts to the amount of light they are exposed to. This chemical coating gets darker
as the ultra-violet rays absorb into the chemical coating. Photo Chromatic lenses are available in grey or brown tints.
are also an important factor to consider when purchasing glasses. If your prescription is , you may want to choose a
smaller frame with smaller lenses since larger frames will house larger, heavier, thicker lenses. People who are active and participate in sports
usually prefer smaller sized frames. This is generally because of the light weight and less of a chance of the glasses fogging up.
Last but not least, when purchasing glasses, make sure the fit is right. It can be annoying and uncomfortable when glasses rest against your cheeks.
A qualified Ophthalmologist will make sure you leave the office with glasses that fit correctly.
Contact lenses were first developed by Adolf Flick in 1887.
To measure the eye for fitting, a mold of the eye was taken. From the mold, actual glass was used to make the lenses. Not only did this make the
contact lens completely unsafe, they were extremely uncomfortable and, therefore, could only be worn for very short periods of time.
Fortunately, with today’s advanced technology, contact lenses have become much safer and more comfortable. There are now precise
optical eye measuring instruments used for an exact fit. Instead of glass, state of the art plastics are now used. Unlike glass lenses,
the plastic lenses allow oxygen to pass through to the eyes, making the lenses much more comfortable to wear for much longer periods of time. Furthermore, to make things more convenient,
disposable contact lenses are also available. Disposables are easy to use; you just throw them away after using them.
You don’t have the same worry of cleaning and disinfecting disposable lenses as you do with other contact lenses, making them very popular.
Color contacts have also become very fashionable. They give another option to those who wish to change the color of their eyes.
Many people find several advantages to wearing contacts lenses over glasses. These include:
more attractive wearing contacts than wearing glasses
||Better sight can be achieved than with glasses|
||Contacts are lower maintenance than glasses. They don't get spots on them from rain, mud, etc.
||Less worry of losing or breaking them as with glasses|
||No fog-up during sports activities|
||Can correct many typical vision disorders|
However, there are some disadvantages with contact lenses. These include:
||Require cleaning maintenance|
||Possible risk of infection if not cared for properly|
||Require regular office visits and follow-up care|
||Can slip off center of eye|
||Require a prescription from an eye care practitioner|
||Cannot correct all corrective vision problems|
In spite of any disadvantages that contact lenses may have, they continue to be popular;
over 26 million people in America wear them. And as technology advances, contact lenses continue to become safer
and more comfortable.
Lasik means "LAser in SItu Keratomileusis". Lasik is the most common refractive surgery procedure used to correct poor vision.
This procedure is great for people who are tired of wearing glasses or who have a difficult time wearing contact lenses.
Many people who are susceptible to getting eye infections from contact lenses will opt for this surgery.
The actual procedure is fast and virtually painless. First, anesthetic eye drops are put in your eye. After a few moments the eye drops will start
numbing the nerves of the eye. A suction ring is then placed over the center of the cornea. The suction creates pressure in the eye which is
required for the Microkeratome to function properly. The Microkeratome is a highly
sophisticated instrument that is of paramount importance in the Lasik procedure. The instrument has an extremely sharp blade that moves back
and forth at a very high speed. It actually shaves a thin layer of the cornea and folds the cornea back. The part of the cornea that is uncut
acts as a hinge.
At that point the suction ring and the Microkeratome are removed. The next instrument used is the
Laser. This laser uses a cool ultraviolet light beam to precisely remove very minute pieces of tissue from the cornea to
actually reshape it. A properly shaped cornea will focus light into the eye and onto the retina, resulting in clear vision. The last step is folding back
the Cornea into its original position. The eyes heal very quickly and vision will improve immediately.
When opting for this procedure, finding a physician is very important. Even with the highly technical and sophisticated Excimer Laser and Microkeratome, the
physician is still the most important part of the procedure. Therefore, choosing a physician should take a lot of thought and consideration.
Many consumers can be fooled by the clever advertisements they hear on the radio or see on TV. For instance, it is common for vision correction
facilities to advertise that they have performed over 20,000 procedures. Although this may be true, it does not mean that the physician
performing your surgeries has done all 20,000 procedures. Therefore, find out how many surgeries the actual doctor performing your surgery
has done. We suggest that they have done a minimum of 300. We also suggest asking your family physician or friends for any recommendations
when searching for the right Ophthalmologist.
Also, feel free to ask your Ophthalmologist questions. Most eye-care professionals don’t mind if you inquire about their procedures.
Here are a few questions you may consider asking:
||How many procedures have you performed?|
||How long have you been performing the LASIK procedure?|
||What is your complication rate for LASIK treatment?|
||Who will perform my pre-treatment testing?|
||Who will perform my post-treatment follow up?|
|We also suggest asking your family physician or friends for any recommendations.
Latest Advances in LASIK Surgery
|LASIK surgery now has a new has an enhanced version called Wavefront. The Wavefront system
allows the eye surgeon to customize the procedure for each individual eye. This enables the surgeon to be more accurate, thus providing a higher
probability of better vision. Millions of people have had the LASIK procedure, which corrects refractive errors such as nearsightedness, farsightedness and even
These vision problems are created because of the inability to focus light precisely on the retina because of optical defects. This technology
detects imperfections 25 times more accurately than previous methods. The result is an increased success rate for laser eye surgery patients.
The new technology used in Wavefront is adapted from research of the scientists who fixed the Hubble Space Telescope's image distortion
problem. The information and data learned from this was used to perfect LASIK procedures. Basically, a sensor and laser is used; a laser beam is
used and a wave of light is sent through the eye to the retina. The light is then reflected back through the lens and the pupil. At that point
the sensor accurately measures any irregularities at the front of the wave of light as it leaves the eye. As this occurs a 3D map is instantly
constructed of the eye's visual system that shows all of the cornea's imperfections and aberrations. Currently there are three
different Wavefront LASIK systems that have been approved by the FDA. They are as follows:
Alcon's LADARWave Customized Ablation System
VISX Custom Vue System
Bausch & Lomb's Zyoptix
Data and statistical research shows that 90 to 94 percent of patients receiving
Wavefront LASIK had a visual acuity of 20/20 or better as compared to 80 percent of patients who had the conventional LASIK procedure.
We recommend that you consult with a reputable Ophthalmologist and get a thorough examination. The eye surgeon will
discuss with the patient any potential risks as well as the benefits of the procedure.
New Treatments for
|Macular Degeneration is the leading cause of vision loss in people over the age of 55.
This eye disease affects the macula, which is a small part of the retina. This area is responsible for central vision; macular degeneration is essentially the
breakdown or deterioration of the macula.
A new procedure, Macular Translocation, is being performed by the doctors at Duke Eye Center. This procedure moves the macula by placing it in an
area that is away from the damaged area. Patients that benefit from this procedure must have lost vision in both eyes, with no more than six months elapsing
after losing vision in the last one.
Duke is only one of a few centers around the world that is performing this procedure. It is a two step procedure; the first procedure will leave the patient's vision
slightly "tilted". The second will correct the tilted effect.
Laser Presbyopia Reversal (LAPR)
|Presbyopia commonly occurs after the age of forty. The lens becomes more rigid and flexibility
begins to diminish, resulting in more difficulty focusing on nearby objects. Reading and other tasks that require you to focus at close range
become very demanding, as the images appear blurred.
Presbyopia can now be reversed by a new laser procedure called Laser Presbyopia Reversal (LAPR). This procedure takes approximately 30 minutes per
eye and involves eight tiny laser incisions in the sclera, the white of the eye. These incisions allow the lens to expand and focus at different
The first trial was cleared December 2002 by the FDA under an Investigational Device Exemption (IDE). Trials outside the US have indicated almost no
regression after this procedure and more than 80% of patients can read without glasses. Doctors are optimistic that this procedure will be common in years to
come. We will keep you updated as more information and data is released on LAPR.
Eye Diseases and Problems
|Everyone should have an eye checkup every two years in order to detect any eye disease
before it can get too serious and cause permanent damage. Many eye diseases do not have obvious symptoms and therefore can go undetected, causing
permanent damage to the eye. Your Ophthalmologist may recommend that you have an eye exam every year if you are at higher risk for eye disease.
Glaucoma prevents optic visual information from getting from the Retina to the brain.
Nerve cells that relay the information to the brain become damaged . With some forms of Glaucoma, pressure in the eye becomes elevated and
sometimes extremely high. Your eye is filled with fluid and it is always being replaced. When too much fluid is being produced and not draining properly
it creates high pressure in the eye.
People over forty years of age are much more likely to get Glaucoma than younger people. Studies have shown that Glaucoma can be hereditary.
If you are in either of these higher risk groups, it is advisable to be checked more frequently.
See the complete chapter on Glaucoma below.
The lenses in your eyes are clear. Cataracts are a condition where the lenses become a cloudy,
milky white color. This cloudiness restricts light from entering into the eye and results in poor vision. The cloudier the cataracts, the worse the
Cataracts are caused by long term exposure to ultra-violet light and aging. People over sixty-five are higher risk. Cataract surgery is now a
relatively minor procedure, and is often done on an
outpatient basis. This type of surgery is performed by your Ophthalmologist, a medical doctor that specializes in eye surgery.
The Macula is a small part of the Retina which is responsible for central vision. Macular Degeneration
is essentially the breakdown or deterioration of the Macula. This can result in poor vision, but rarely causes blindness. Macular Degeneration generally
affects people sixty-five and older. It is recommended to get eye exams yearly after the age of fifty. There is little you can do to prevent Macular
Degeneration and it is difficult to treat. Some treatments can be effective when this eye disease is caught in the early stages.
Myopia is a condition where objects that are near can be seen clearly, but objects
that are at a distance are blurred. Myopia occurs when the eyeball is too long or the refractive power of the eye’s lens is too . The
image is then focused in front of the Retina rather than upon it. Glasses, contact lenses and Lasik surgery are all options to consider
for the correction of Myopia.
Hyperopia is when objects that are far away can be seen clearly, but objects that are
near are blurred. Hyperopia occurs when the image is focused behind the Retina of the eye rather than on it. It is common for people with
Hyperopia to get headaches when trying to read. There are many options for Hyperopia vision correction.
An Astigmatism is a non-uniform curvature of the cornea. This irregular curvature produces
poor vision because light rays do not all come to a single focal point on the Retina. Some of the rays of light focus in front of the Retina
and others focus behind it.
There are various vision correction options for Astigmatisms, but contact lenses are the most effective treatment available.
and your Eyes
High blood glucose (sugar) and high blood pressure from diabetes can hurt four parts of your eye:
The retina is the lining at the back of the eye. The retina's job is to sense light coming into the eye.
The vitreous is a jelly-like fluid that fills the back of the eye.
The lens is at the front of the eye and it focuses light on the retina.
The optic nerve is the eye’s main nerve to the brain.
Retina damage happens slowly. Your retinas have tiny blood vessels that are easy to damage.
Having high blood glucose and high blood pressure for a long time can damage these arteries, causing them to swell and weaken. Some blood vessels then become
clogged and do not let enough blood through. Loss of vision from these changes might not be immediately apparent; this is why you need to have an eye exam once
a year even if your vision seems fine.
As diabetes retina problems worsen, new blood vessels grow. These arteries are weak and break easily, causing blood to leak into the vitreous of your eye.
The leaking blood keeps light from reaching the retina. You may see floating spots or almost total darkness. Sometimes the blood will clear out by itself, but surgery may
be needed to remove it.
Over the years, the swollen and weak blood vessels can form scar tissue and pull the retina away from the back of the eye. If the retina becomes detached,
people may see floating spots or flashing lights. People afflicted with this condition may feel as if a screen has been pulled over part of what they are
looking at. A detached retina can cause loss of sight or blindness if you don't take care of it right away.
You may not be able to prevent eye damage entirely, but you can certainly do a great deal to reduce your chance of getting it. You can also stop it from
worsening if you already have it. However, to either prevent it or stop it from getting worse, it is best to take action early.
||Keep your blood glucose and blood pressure as close to normal as you can. Have an eye doctor examine your eyes once a year. Have this exam even if your
vision seems normal. Finding eye problems early and getting treatment right away will help prevent more serious problems later on.|
||Ask your eye doctor to check for signs of cataracts and Glaucoma.
||Get proper exercise.|
The usual treatment for damage to your retina is by laser therapy. Laser treatment seals leaking
or new blood vessels. It mainly works by preventing and delaying further damage from occurring.
Surgical treatment, called vitrectomy, may be needed if bleeding from the retina into the eyeball is causing persistent cloudy vision or if scarring has
Keratoconjunctivitis Sicca, or dry eye, is dryness of the conjunctiva and cornea.
Dry eyes may be due to inadequate tear production. With this disorder, the tear gland does not produce enough tears to keep the entire conjunctiva and cornea
covered by a complete layer of tears, which is the most common type found in postmenopausal women.
Dry eyes may also be due to an abnormality of tear composition that results in accelerated evaporation of the tears. Although the tear gland
produces a sufficient amount of tears, the rate of evaporation is too rapid.
See more about Keratoconjunctivitis Sicca below.
Symptoms of dry eyes include irritation, burning, itching, a pulling sensation, pressure behind the eye,
and a feeling like something is in the eye. Symptoms are worsened by activities in which the rate of blinking is reduced. Activities that specifically involve prolonged
use of the eyes, such as reading, working on a computer, driving, or watching television are some of the biggest culprits. Dry eyes are also worse in dusty or smoky
areas and dry environments, such as in airplanes or in shopping malls; on days with low humidity; and in areas where air conditioners, fans, or heaters are being used.
Some drugs can worsen symptoms. Dry eyes may improve during cool, rainy, or foggy weather and in humid places, such as in the shower.
Artificial tears—eye drops that act like real tears—applied every few hours, can generally control the problem.
Avoiding dry, drafty environments and using humidifiers can help also. Minor surgery can be done to block the flow of tears into the nose, so that more tears are available
to bathe the eyes. In people with very dry eyes, the eyelids may be partially sewn together to decrease tear evaporation.
All About Glaucoma
Glaucoma is a disease of the optic nerve—the part of the eye that carries the images we
see—to the brain. The optic nerve is made up of many nerve fibers. It acts like an electric cable, or wiring, that transmits visual information to the brain. When
damage to the optic nerve fibers occurs, blind spots develop. These blind spots usually go undetected until the optic nerve is significantly damaged. If the entire
nerve is destroyed, blindness results. Glaucoma is a leading cause of blindness in the United States, especially for older people. But loss of sight from Glaucoma
can often be prevented with early treatment.
There are different types of Glaucoma:
Chronic open-angle Glaucoma
This is the most common form of Glaucoma. As age increases, so does the chance of developing chronic
open-angle Glaucoma. Drainage of fluids in the eye becomes less efficient over time, and pressure within the eye gradually increases, which can damage the
optic nerve. In some people, the optic nerve becomes sensitive even to normal eye pressure and is at risk for damage. Treatment is necessary to prevent further
vision loss. Typically, open-angle Glaucoma has no symptoms in its early stages and vision remains normal. As the optic nerve becomes more damaged, blank spots
begin to appear in the field of vision. People typically won’t notice these blank spots in your day-to-day activities until the optic nerve is significantly damaged and
these spots become large. If all the optic nerve fibers die, blindness results.
Some eyes are formed with the iris—the colored part of the eye—too close to the drainage angle. In
cases such as these, the eyes are often small and farsighted; the iris can be sucked into the drainage angle and block it completely. Since the fluid cannot exit the eye,
pressure inside the eye builds rapidly and causes an acute closed-angle attack.
Symptoms may include:
||Severe eye pain
||Rainbow-colored halos around lights
Nausea and vomiting