Monday, August 4, 2014

Meet Jennifer, she just had LASIK.

Meet Jennifer, she is a patient who just underwent refractive surgery here at COA.  She was willing to share some of her thoughts with us…
"I am so glad I chose to go to Dr. Bryan for my procedure. Everyone there was very helpful and did their best to make me feel as comfortable as possible for the big day. Dr. Bryan talked me through everything as he was doing it, even counting down to the last second of the laser. I was pretty anxious, so that helped put me at ease.
So far, I am beyond satisfied with my results! Among many things, one of the biggest is being able to get up with my 3 month old late at night for his feedings. I am able to see when getting up without hunting down my glasses. This makes the process a lot easier. Being a new mom is challenging enough, but this really helps me cut back on time and stress. As a matter of fact, the same day I had the procedure done, my oldest son wanted to go outside and play soccer. I remember going outside and sitting on the front porch with my baby. I looked around and was amazed at how clear things were! I knew this was the beginning to many good changes from having this done. I look forward to vacations and swimming in the future. I can watch my kids play at the beach without worrying if I will get water or sand in my eyes. I also don't have to worry about packing extra contacts and saline for the trip. These are just a few things to mention. I am so happy I was finally able to get it done! I chose the perfect place with the perfect staff! They met all of my expectations and gave me perfect vision!"

Thanks for sharing your experience, Jennifer!  Nice to know you were enjoying life the very same day of the procedure.  Congrats on your new little one!  He has your eyes J

Thursday, July 17, 2014

Can You See "E" Now? Wearing Contact Lenses After 40.

Once we hit our forties, we all experience the feeling that our arms are not long enough.  Pulling our reading material away, we curse under our breath that type has become smaller and smaller.  What really lies behind this situation is the loss of accommodation.  While we are young our lens has the ability to swell changing our focal point and providing us with clear vision both at distance and near-this is known as accommodation.  Like the rest of our body, the aging process takes its toll on our eyes and our lens begins to lose this ability. 

So we accept that this is natural, but how can we contact lens wearers adapt to this change?  There are a few options:

Option #1: Distance only

You can correct both eyes to see clearly in the distance.  You will remain glasses free while running or enjoying a movie, but this will mean that whatever you hold up close will be blurry.  You will need to join the masses in stockpiling mounds of reading glasses to assist you in your close range tasks.


Option #2: Multifocals

There are a few multifocal contact lenses on the market.  They employ different designs to offer near and far correction in one lens.  This is kind of a hit or miss deal.  Some patients love their multifocals while others never have luck with them at all.  As a general rule, distance vision may not achieve 20/20 at distance or near, but the multifocal aspect may provide the best help with the midrange (computer distance) vision.  Many patients who opt for this are willing to forego having crisp distance vision.


Option #3: Monovision

One eye (generally the dominant eye) is set to correct distance vision while the second eye is set to correct near vision.  In most, the brain will automatically choose which eye to pay attention to.  This can take a while for your brain to adjust to so make sure you give it a fair shot.  Try it for a few days before you become frustrated.


You can wear contacts after 40!
It’s good to know that there are ways to cope with presbyopia (or the loss of accommodation-also known as living past 40).  When you find that fountain of youth, let us know.  In the meantime, we will make sure you can keep on looking for it. 
See you soon!


Thursday, June 26, 2014

Jones Angell and His Laser Sharp Vision.

If you don’t recognize him by sight, you are likely familiar with Jones Angell’s voice. He is the play by play voice for Carolina Athletics. This spring he decided to undergo LASIK vision correction with Dr. Bryan here at COA. Jones filled us in on the issues that convinced him to opt for refractive surgery and allowed us to follow him through the process. Thanks Jones!

“The biggest challenge for me came with my profession.  As a broadcaster, I need to be able to see things well from a great distance and having to wear contacts/glasses sometimes made that a challenge.  I look forward to being able to see the field and court clearly even from far away.”

Jones and Jeannette at the WaveScan

Before undergoing the procedure, Jeannette took WaveScan images (or a 3D analysis) of Jones’s corneas. After that, Tracy went over his post op instructions and answered any remaining questions while checking his blood pressure and prepping him for LASIK.

Tracy preps Jones

Meanwhile Polly and Casey prepped the laser room.

Polly and Casey prep the laser room while Dr. Bryan administers a numbing drop.

Once Jones came into the laser room Dr. Bryan took a look at Jones’s corneas at the slit lamp to make sure his axis was correctly marked for his astigmatic correction.

Dr. Bryan marks the axis for astigmatic correction.

Once everything was set and a time out was done to be sure everyone was on the same page, it was go time. “I was a little nervous at the beginning of the procedure,” said Jones, “but Dr. Bryan and his team did a tremendous job of keeping the atmosphere positive yet professional while also making sure I was informed of the progress of the procedure the entire time.”

Undergoing the procedure.  Jeremiah and Chad, techs from Sightpath assist.

If you are feeling a bit nervous, Dr. Bryan’s Laser Gator can help you get all of your nervous energy out by allowing you to squeeze him tightly.

Holding onto our Laser Gator.

Looking at the clock on the wall.  Right after surgery most patients are stunned to realize they can already see the numbers on the clock.

Now Jones gets to look forward to life independent of glasses or contact lenses. “I would always have problems with my contacts losing focus so having the consistency of my new vision has been tremendous. I have been in glasses the last several months so getting to wear sunglasses again has been great!”

Jones and Dr. Bryan.

For a first person account of what the procedure feels like, check out Laura’s blog post from a few months back.

Jones took the leap, and now he is living without the limitation of glasses or contact lenses.
Call us at 919-945-3937 to schedule your free consultation. Start living your life without limitations.

Friday, June 6, 2014

The Cat(aract) Came Back. What May Cause Blurred Vision After Cataract Surgery and how a Laser Can Help.

The other day a patient was sitting in a chair a year after cataract surgery in both eyes.  She read 20/20 minus a few letters in the right eye and was exclaiming how fantastic her vision was; she never had this kind of vision as a youth.  Then she changed over to check the left eye and she was struck by how blurred the letters appeared when compared with the vision in her right eye.  Her vision tested at around 20/40 in the left.  Troubled she asked the question, “Did my cataract come back?”

The first thing she needed to be clarified on is what a cataract really is.  A cataract is a clouding of the natural lens of the eye.  It can be a congenital condition, effects of certain medications, trauma, or the aging process.  Once a cataract has become significant enough that it affects a person’s daily life or hinders a person from enjoying their hobbies due to poor vision, it is time to consider cataract surgery. 

photo credit:  


Today, cataract surgery is accomplished very quickly with a speedy recovery period and minimal discomfort.  The lens of the eye sits in a thin bag inside the interior of the eye called the capsule.  An incision is made in the cornea either by hand or by laser, the surgeon then opens the capsule, breaks apart the hardened lens and replaces this with a clear artificial lens inside the capsule.  There are a variety of options out there and you should speak with your Ophthalmologist’s office for more insight into these options.   These artificial lenses cannot develop cataracts. 

What then could cause the patient’s blurred vision?  In a small percentage of patients, the cells that are left inside the posterior portion of the capsule begin to multiply causing an opacity that will blur vision.  This condition is sometimes referred to as an “after cataract”.   Luckily, a laser procedure is done to break apart this clouding and restore cleared vision.

Photo credit: OpthoBook
(Image is lens and capsule seen from side view.)

If you thought cataract surgery was fast and painless get ready for the ease of a YAG laser procedure.  A numbing drop is instilled about a half hour prior to the procedure as well as a dilating drop so the laser can enter through the pupil of the eye.  A second numbing drop is administered, the patient places their head in the laser machine and after just a few seconds and a few zaps the cells are obliterated. 

Directly after the procedure intraocular pressure is checked to ensure it has not spiked and the patient is sent home.  Vision generally clears within the next couple of days.

Friday, May 23, 2014

Is My Kid Just Clumsy?

“I thought she was just like me…” said Ethan, “clumsy.”  She was only five and running into corners and the edges of doorways.  Ethan didn’t think much of it because toddlers, by nature, are clumsy beings.  
One afternoon Sarah, Hadley’s mom, was looking through the digital graveyard of family photos to send a few gems to Grandma when she noticed something odd. Every picture of Hadley showed a right eye squint. The lighting conditions were different, the angles changed, there was flash, there was no flash, but there was always that right eye squint.
“It was at her five year old check-up that the nurse was conducting a standard vision exam and discovered Hadley wasn’t recognizing the letters she was being shown.  [The nurse] switched from the alphabet to images and found the same issue.  She recommended we take her to see an eye doctor.  We were very fortunate to find an eye doctor with experience withamblyopia.”
Amblyopia is a condition where one eye is weaker than the other, commonly referred to as a “lazy eye”.  Sometimes this may be caused by a condition known as strabismus.  Strabismus is caused when the eyes are not properly aligned due to muscle problems, issues with the nerves, or the brain.
When a muscle issue occurs that causes the eyes to become misaligned an adult isgenerally aware because he/she has a harder time suppressing one of the eyes and will see two images. Children, on the other hand, are expert adapters. Rather than deal with two images the brain may simply begin ignoring the signal coming from one of the eyes. In Hadley’s case her brain opted to ignore her right eye. The images coming from her right eye continued to blur. If caught too late, the brain may never learn to interpret messages from the amblyopic eye and vision can be lost.
Because Hadley never complained of two images and because there was no physical manifestation of any problem (no crossing of her eyes) the issue went unnoticed until a mother’s intuition and a nurse’s nice catch sent the family to a local Ophthalmologist.
“He diagnosed the problem immediately,” said Ethan, “and put us on the proper therapeutic road.  We started with dilation drops [in the left eye to blur the vision coming from the stronger eye], but found that Hadley was sensitive to the side effects.”  Hadley was switched to the patching method whereby the stronger eye is occluded with a patch forcing the amblyopiceye to work harder.  The upside was that Hadley was able to play “Pirate”.  “We found many helpful resources online, including a website that sells colorful eye-patches and children’s books about her condition,” remarks Ethan.
Today Hadley is eleven and no longer considered amblyopic in her right eye.  She is encouraged to exercise her right eye to maintain good vision.  “It could have been completely different,” says Ethan. “Looking back I realize she had poor stereo vision from the weakness in the right eye. Come to think of it, she never seemed to care much for those 3D movies we took her to. I just thought, not only is she clumsy, like me, but she is just as hard to impress.
Don’t wait if you believe there may be a problem.  Come by if you or your child needs a vision screening.   We care, you’ll see.--COA

Friday, March 7, 2014

Reduce Your Risk of Macular Degeneration

Macular Degeneration (MD) is a term used to describe many conditions which affect central vision. Your central vision is processed by the macula, which is located in the center of your retina. MD occurs when the cells of the macula break down and start to function less effectively, usually as a result of age. This causes loss of vision in the center of the visual field.

While peripheral vision remains, loss of central vision can make it difficult or impossible to do things like read or recognize faces.

Possible ways to reduce your risk of Macular Degeneration:

Don’t Smoke If you smoke, stopping can only help reduce your risk of MD. Many studies suggest that smokers are more likely to suffer from MD and other eye-related problems.

Stay Healthy Maintaining a healthy diet and lifestyle is important for your overall health as well as your eye health.
·         Keep a healthy diet, including plenty of dark, leafy greens and other vegetables.
·         Exercise regularly
·         Maintain a healthy weight
Your body relies on many types of tissues and organs functioning properly, including the retina, to allow for good vision. Staying healthy can help every part of your body, including the macula.

Take Vitamins Ask your doctor if nutritional supplements may be a good idea for your eye health. It can be difficult to obtain all the nutrients you need from diet alone, and there are vitamins available that are specifically designed to help maintain healthy eyes.

Wear Sunglasses While there isn’t necessarily a link between UV exposure and MD, wearing sunglasses helps keep your eyes healthy and can prevent other eye problems. Maintaining healthy eyes is a good starting point for a healthier retina.

Have Regular Eye Exams The best thing you can do to reduce your risk of the vision loss associated with MD is see your ophthalmologist regularly for eye exams. Regular exams can help your doctor detect MD and monitor it so you can receive proper treatment, if appropriate.

Tuesday, February 4, 2014

Color Blindness

Color blindness is a condition that affects the way a person distinguishes two or more colors, most commonly red and green. It is also possible to lack the ability to distinguish any type of color, though this is very rare.


The most common cause of color blindness is a problem in the development of the color-sensing ability in nerve cells of the eye, called cones. Cones are found in the retina, which is the layer of tissue at the back of the eye on which light is focused. 

This problem is most commonly inherited from mutations on the X chromosome. Because of that genetic location, color blindness is more common in men than in women (who have two X chromosomes and a higher likelihood of having at least one that is sufficient to provide normal color vision). 

Other causes include accidents or trauma, side effects from certain types of medication, and damage to the retina.


The Ishihara Color Test is the most common way to diagnosis color deficiencies. It is a series of pictures made up of colored spots with a figure embedded in it as a slightly different color. The figure can be seen with normal color vision, but not with a particular color defect. 

In this picture, the number 74 should be visible to people with normal color vision. Viewers with certain deficiencies may see it as 21, and others with more drastic color blindness may not see any number at all. 


There is no treatment to cure color blindness. People who suffer from color blindness have to learn to adapt to the lack of color vision. However, there are strives toward helping color blind people. Check out these apps designed specifically for people with color deficiencies.