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What is an Optometrist?


 

Optometrists are healthcare professionals that are doctors of Optometry, the profession of examining the eye for defects and faults of refraction. These doctors are state licensed in order to provide eye care service. Optometrists provide services to consumers that include vision and eye health examinations, vision disorders, prescribing glasses and contact lenses. An Optometrist can also prescribe vision therapy and medicines for the eye and perform certain surgical procedures.

Optometrists examine internal and external structures of the eye. These examinations are thorough and help in the diagnosis of eye diseases like Glaucoma, retinal disorders and cataracts. Doctors of Optometry also help with vision conditions like nearsightedness, farsightedness, Presbyopia and Astigmatism.

Optometrists are well educated and have completed pre-professional undergraduate education in a college or university and four years of schooling at a college of Optometry. Upon successful completion they will receive a Doctor of Optometry, or OD degree.

 


How Optometrists Were Selected


Consumers’ Research Council of America has compiled a list of the top 10% of all Optometrists throughout the United States. The method used assesses a point value for criteria that we deemed valuable in determining top Optometrists.

The criteria that was used is as follows:

Experience:  Each year the Optometrist has been in practice
Training: Education and Continuing Education
Professional Associations:       Member of Optometrist Associations

Simply put, Optometrists that have accumulated a certain amount of points qualified for the list. This does not mean that Optometrists that did not accumulate enough points are not good healthcare professionals, they merely did not qualify 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 on 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 value system.

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 the more years in practice is better than less years in practice; more education is better than less education, etc.

The Top Optometrist list that we have compiled is current as of a certain date and other Optometrists may have qualified since that date. Nonetheless, we feel that our list of Top Optometrists is a good starting point for you to find a qualified Optometrist.

No fees, donations, sponsorships or advertising are accepted from any individuals, professionals, corporations or associations. This policy is strictly adhered to insure an unbiased selection.

 


Finding an Optometrist


Choosing an Optometrist is an important decision. Thus, our goal is to assist you in making that decision.

First of all, when selecting an Optometrist, you may want to begin your search in several different ways:

  Ask a 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.

  Ask family, friends, neighbors and/or co-workers.

  Contact your local Chamber of Commerce or Better Business Bureau for reputable Optometrists.

Contact your state's local Optometrist associations, as many of them have referral services.

 


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 sclera, choroid and the retina.

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 holds the pigmentation. This coloration usually consists of shades of brown, blue or green. The muscular action of the iris regulates how much light should enter the eye, which is done by the muscle dilating and contracting the iris. The pupil is the round opening in the center of the iris. 

The outer layer, or sclera, is the visible white part of the eye.  The conjunctiva covers the visible portion of the sclera. The center is the cornea which is basically the window of the eye.

See the detailed list below for more information.

 


Parts of the Eye



Conjunctiva

The conjunctiva is a mucus membrane that covers the exposed forward section of the sclera

Cornea

The translucent membrane that forms the outside coating of the eye.

Iris

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 pupil.

Lens

The lens is the clear membrane which makes up the outer coating of the eye.

Macula

The macula is located in the center of the retina. Incoming rays of light are focused by the macula.

Pupil

The pupil is the dark round hole in the center of the iris

Retina

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 for the brain to interpret.

Sclera

The Sclera is the white part of the eye and covers over 80% of the exterior of the eye.

 


The Eye Examination


 

A standard eye exam lasts about thirty minutes. It includes examining the outside and inside of the eye. The Optometrist will ask a series of questions which include the reason for your visit, whether or not you wear corrective lenses, are you susceptible to headaches, and if there is a history of eye problems in your family. Once these are answered satisfactorily, an Ophthalmoscope is used to view the inside of the eye by shining a light through the pupil. This helps the Optometrist to detect any underlying medical problems. In addition, if you’re over forty, your Optometrist will recommend a Glaucoma test to check the pressure of your eyes.

To measure your vision, your Optometrist will do a series of tests. You will be asked to look through many different lenses to see which one provides the most clarity. Tests will be administered for close distances as well as far distances. With the results, your doctor can determine which vision correction options would be best to suit your particular needs.

 


Vision Correction


Glasses

Just about everyone will need glasses at some point in their lives. Glasses are not only a corrective device, but also a fashion item. Nowadays, 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 material: glass and plastic. Glass has excellent optical properties and resists scratches quite well. However, glass is also very heavy and the potential for breakage is very high. 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. This helps the lenses last much longer. These attributes make plastic lenses the most popular of the two.

Along with which type of material to choose from, there are different kinds of lenses to choose from as well. To help you better 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 to 50 years old. It’s not unusual for the inability to focus both near and far to begin happening 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 and, 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.

Photo chromatic 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. These lenses are available in grey or brown tints.

Frames are also an important factor to consider when purchasing glasses. If your prescription is strong, 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 usually because of the light weight and because the chances for fogging up is much less.

Last but not least, make sure the fit is right when purchasing glasses. It can be annoying and uncomfortable when glasses rest against your cheeks. A qualified Optometrist will make sure you leave the office with properly fitted glasses.

Contact Lenses

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 more comfortable and safer. 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 the glass lenses, the plastic lenses allow oxygen to pass through to the eyes making them 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 worry of cleaning and disinfecting disposable lenses as you do with other contact lenses. This makes them very popular. Color contacts have also become very popular. 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:

Feeling 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 than 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 the eye
Require a prescription from an eyecare 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 technological advances proceed, contact lenses continue to become safer and more comfortable.

Lasik Surgery

Lasik, or "LAser in SItu Keratomileusis", 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 Excimer 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 of the group, it does not necessarily mean that the physician performing your surgery has done all 20,000 procedures. Therefore, find out how many surgeries the doctor performing your surgery has actually done; we suggest a minimum of 300. We also suggest asking your family physician or friends for any recommendations when searching for the right surgeon.

Also, feel free to ask your physician questions. Most eyecare professionals won’t mind. 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.


Eye Diseases and Problems


Everyone should have an eye checkup every two years in order to detect any eye disease before it can get to serious and cause permanent damage. Many eye diseases do not have obvious symptoms, and therefore can go undetected, sometimes causing permanent damage to the eye. Your Optometrist may recommend that you have an eye exam every year if you are at higher risk for eye disease.


Glaucoma:

Glaucoma prevents optic information from getting from the retina to the brain. Nerve cells that relay visual 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 to 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 and can run in families. If you are in either of these higher risk groups, it is advisable to be checked more frequently.


Cataracts:

The lenses in your eyes are clear. Cataracts are a condition where the lenses become cloudy, a milky white color. This cloudiness restricts light from entering into the eye and results in poor vision. The cloudier the cataracts become the worse the vision becomes.

Cataracts are cause 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. Often this surgery is done on an out patient basis. This type of surgery is performed by an ophthalmologist, a medical doctor that specializes in eye surgery. Your Optometrist can recommend a ophthalmologist if needed.

See the complete article below.


Macular Degeneration

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 affects older people sixty five years of age or older. It is recommended to get eye exams yearly after the age of fifty. Optometrists will usually send you to an ophthalmologist to confirm his diagnosis. There is little you can do to prevent macular degeneration and it is difficult to treat. Some treatments can be effective when this eye diseases is caught in the early stages.

Nearsightedness (myopia)

Myopia is when 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 strong. 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 correction of myopia.


Farsightedness (hyperopia)

Hyperopia is when objects that are far 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 to get headaches when trying to read. There are many options for hyperopia vision correction.

Astigmatism

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, but contact lenses are the most effective treatment available.

See the complete article below.

 


Nutrition & Your Eyes


Research has found that certain vitamins can be very beneficial to your eyesight. These vitamins include vitamin A, C and E. The leading cause of blindness in the developing countries is a deficiency in vitamin A. In Sub-Saharan Africa, over 3 million children under the age of five years suffer blindness due to the lack of vitamin A. In addition, two thirds of children who do not meet their requirement of vitamin A die from increased vulnerability to infection.

Research and various studies have shown that high levels of vitamin C can reduce the risk of cataracts. Cataracts are caused by a buildup of protein and which results in cloudy vision. Studies have shown with positive data that Vitamin C may also prevent and alleviate Glaucoma. Studies also show that Vitamin C will reduce pressure in the eyes of Glaucoma patients.

Vitamin E has similar effects to those of vitamin C; When used in conjunction, however, the results are even better. Studies on Vitamin E and eyes have shown that the regular use of multivitamins or a Vitamin E supplement may decrease the risk of cataract formation. Studies also indicate that people with a low intake of Vitamin E have a higher rate of cataract formations in their eyes.

It is very important that you get these vitamins through a proper diet and/or supplements because your body cannot make them on it's own. If you smoke or drink it is even that much more important to take nutritional supplements. Smoking stops the body from absorbing vitamins, and drinking alcohol depletes what vitamins you already have.

The following foods contain the vitamins that your eyes need:

Cod liver oil, liver, carrots, sweet potato and kale are filled with vitamin A.
Peppers, kale, broccoli, strawberries and oranges are packed with vitamin C.
Nuts are the best way to get all of your vitamin E needs.

Making sure that you get the vitamins that you need for your eyes will keep your eyes in healthy condition. Not getting the proper amount of these vitamins will increase the risk of diseases like Glaucoma, Cataracts and Macular Degeneration.


What 20/20 Really Means


Many people are under the impression that if you have 20/20 vision that your eyesight is perfect. This is not always the case. 20/20 is the measurement of how clearly you see at a specified distance. If your eye test reports are 20/20, it means that you can see an object clearly at 20 feet which should normally be seen at 20 feet. However, if you have 20/60 vision, it means that you have to stand 20 feet away to see what should normally been seen at sixty feet away.

The test fails to confirm other very important visual aspects. You could have what is known as "perfect" vision and have other visual problems, deficiencies or abnormalities, such as eye focusing, eye coordination, eye movement, visual perceptual skills and color vision.

 


Vision Over 40


During middle age, usually around the 40's, many begin to experience blurred vision. It starts to affect them when doing tasks that require them to focus eyes at close range such as reading, sewing and working at the computer. Unfortunately, there is no way of getting around it. It happens to everyone-- even to people who have never had visual problems before. Blurred vision occurs gradually; people find that they continually need to hold books, magazines and other reading materials at arm's length to read them properly.

This condition is called Presbyopia and is normal as people age. Presbyopia is caused by a gradual loss of flexibility in the lens inside your eyes. This occurs when the proteins in the lens change, thus making the lens less flexible over the years. Another factor is the changes that take place in the muscle fibers surrounding the lens. With less flexibility, it makes it harder for the eye to focus up close.

There are a few treatments for Presbyopia, including reading glasses, contacts, and surgery. Reading glasses are good for people who spend much of their time reading materials close-up. Another type of glasses allow people to see off in the distance. The most popular type of glasses are glasses with bifocals. These allow people able to see near and far without having to switch between two pairs of glasses. Many people are interested in surgery but this procedure is still "in the works" as a viable option. We will update you on any surgical updates as new information is released.


Eye Safety Tips


It is very important to protect your eyes. They are the windows to your brain—protect them. Here are some safety tips for protecting your eyes.

Walk, don't run, with sharp objects such as scissors, pens, pencils and rulers.
Avoid guns, bow-and-arrows, slingshots and firecrackers.
Use good lighting to avoid tiring your eyes when reading, writing or cruising the Internet.
Wear proper eye protection when you are doing hazardous hobbies, chores or mixing chemicals.
Wear proper eye protection when you are playing sports such as racquetball and baseball.
Wear sunglasses that block both ultraviolet-A and ultraviolet-B radiation from the sun.
Never look directly at the sun.
Point chemical sprays away from your face before spraying.

Astigmatism Facts


Astigmatism is a vision condition that occurs when the front surface of the eye, the cornea, is slightly irregular in shape. This irregular shape prevents light from focusing properly on the back of the eye, the retina. As a result, vision may be blurred at all distances.

People with severe astigmatism will usually have blurred or distorted vision, while those with mild astigmatism may experience headaches, eyestrain, fatigue or blurred vision at certain distances. It may accompany nearsightedness or farsightedness.

Most people have some degree of astigmatism. A comprehensive optometric examination will include testing to diagnose astigmatism and determine the degree. Almost all levels of astigmatism can be optically corrected with properly prescribed and fitted eyeglasses and/or contact lenses.

Astigmatism occurs when the cornea is shaped like an oblong football, rather than a spherical ball, which is the normal shape. In most cases, the oblong or oval shape causes light rays to focus on two points in the back of your eye, rather than on just one. This is because an astigmatic cornea has a steeper curve and a flatter one.

Usually astigmatism is hereditary: Many people are born with an oblong cornea, resulting in vision problems that may get worse over time. But astigmatism may also result from an eye injury that has caused scarring on the cornea, from certain types of eye surgery, or from disease.

Treatments

Astigmatism can be corrected with glasses, contact lenses, or surgery.

Eyeglasses

Eyeglass lenses are shaped to counteract the shape of the cornea that's causing blurred vision. Eyeglasses work well when the patient looks straight ahead, but depending on the specific correction, the glasses can make the floor appear to tilt.  Patients with significant astigmatism usually adjust to their first pair of glasses within a week or so.

Contact lenses

Specially designed contact lenses can also correct astigmatism. All contact lenses rotate when a person blinks. The lenses used for astigmatism—called toric lenses—are designed to return to the same position each time the wearer blinks. So, toric contact lenses compensate for any abnormal curvature in the cornea.

Laser eye surgery

In this technique, the surgeon uses a laser to reshape the cornea so it can focus light rays better. It's the only treatment that directly fixes the underlying problem causing astigmatism.

In laser surgery—commonly known as LASIK—a sterile mechanical devise creates a delicate flap in your cornea that is thinner than a grape skin. Numbing eye drops prevent the patient from feeling pain. The surgeon lifts and sweeps back the flap with a tiny instrument. The central portion of the deeper corneal layers is exposed for laser treatment. Next, you will hear clicking noises as a laser precisely removes tiny amounts of your inner cornea.  The doctor then sweeps the flap back to its original position. Finally, the doctor administers anti-inflammatory and antibiotic eye drops. 

This surgery is costly: It can cost $700-$3,000 per eye, depending on the doctor. Because cheaper eyeglasses can also fix the problem, LASIK is rarely covered by health insurance.


All About Cataracts


Cataracts are clouding of the lens portion of the eye. The prevalence of cataracts increases dramatically with age. It occurs in the following ways:

The lens is an elliptical structure that sits behind the pupil and is normally transparent. The function of the lens is to focus light rays into images on the retina—the photosensitive tissue at the back of the eye.

In young people, the lens is elastic and changes shape easily; this allows the eyes to focus clearly on both near and distant objects.

As people reach their mid-forties, the chemistry of the proteins in the lens change, causing them to harden and lose elasticity. This causes a number of vision problems.

The proteins in the lens may also clump together, forming cloudy, opaque areas called cataracts. They usually develop slowly over several years, although in some cases loss of vision progresses rapidly.

Depending on how dense the protein clumps are and where they are located, cataracts can block the passage of light through the lens and interfere with the formation of images on the retina, causing vision to become cloudy.

Cataracts have several known causes. Although older age is the primary risk factor for cataracts, experts are still not certain about the exact biologic mechanisms that tie cataracts to aging.

Oxidation

Research has been focusing on particles called oxygen-free radicals as a major factor in the development of cataracts. Oxygen-free radicals—also called oxidants—are unstable molecules produced by natural chemical processes in the body. Because oxidants are missing an electron, they tend to bind with other molecules in the body. Toxins, smoking, ultraviolet radiation, infections, and many other factors can create reactions that produce excessive amounts of these radicals. In such cases, overproduction can set off a chemical chain reaction that damages any type of cell in the body. Cataract formation is one of many of their destructive changes.

Smoking

Cataracts are one of the many negative effects caused by smoking. Studies have implicated smoking in the development of cataracts. The major damaging effects of cigarette smoke appear to be development of oxygen-free radicals (oxidants), the chemical byproducts in the body that can damage cells, including those in the eye.

Genetics

Hereditary factors are often involved in the development of cataracts in children. They also may play a role in some adult cataract cases. The exact hereditary predispositions have yet to be established.


Cataracts are detected through a comprehensive eye exam that includes:

Visual acuity test: This eye chart test measures how well you see at various distances.
Dilated eye exam: Drops are placed in your eyes to widen, or dilate, the pupils. An eye care professional uses a special magnifying lens to examine your retina and optic nerve for signs of damage and other eye problems. After the exam, your close-up vision may remain blurred for several hours.
Tonometry: An instrument measures the pressure inside the eye. Numbing drops may be applied to your eye for this test.

Surgery

Cataract surgery saves millions of Americans from blindness. In the past, cataract surgery was not performed until the cataract had become well developed. Newer techniques have made it safer and even more efficient to operate in earlier stages.

Although surgery is the only remedy for cataracts, it is almost never an emergency. Most cataracts cause no problem other than reducing a person's ability to see, so there is no harm in delaying surgery. Early cataracts may be managed with the following measures:

Stronger eyeglasses or contact lenses.
Use of a magnifying glass during reading.
Strong lighting.
Medication that dilates the pupil. This may help some people with cataracts, although glare might be a problem with this treatment.

All cataract procedures involve removal of the cataract-affected lens and replacing it with an artificial lens.

 

Extracapsular Extraction

This is a rather old technique in which a 12mm incision is performed in the eye to extract the lens as a whole. The lens capsule is left in place to hold an intraocular lens. Multiple sutures, or tiny stitches, are required to seal the eye after surgery. These sutures must be carefully tightened to prevent astigmatism.

 

Phacoemulsification

Phacoemulsification was developed in the search for a way to extract cataracts through a smaller incision. It has become the preferred technique for cataract extraction. An ultrasound or laser probe is used to break the lens apart without harming the capsule. These fragments are then removed from the eye. A foldable intraocular lens (IOL) is then introduced through a 3mm incision. Once inside the eye, the lens unfolds to take position inside the capsule. No sutures—fine threads used surgically to close a wound—are needed, as the incision is self-sealing. Over 90% of people achieve a vision rating better than 20/30 after Phacoemulsification.

 


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