Central Valley Eye Medical Group, Inc.

A cataract is the gradual clouding of the natural crystalline lens within the eye. Cataract surgery is the procedure in which this clouded lens is removed and replaced with a new, clear lens to restore vision. Why Choose Central Valley Eye For Your Cataract Surgery? SURGICAL EXPERTISE At Central Valley Eye, our cataract surgeons were all fellowship trained and are dedicated to bringing their surgical expertise to the Central Valley. They are recognized as leaders within the field and continue to actively teach ocular anatomy and/or cataract surgery to Stanford resident physicians. Together, our surgeons have completed tens of thousands of cataract surgeries and have a trusted reputation in the community. We also have fellowship trained glaucoma specialists who co-treat glaucoma at the time of cataract surgery with micro-invasive glaucoma surgery (MIGS) and traditional filtering surgeries. ADVANCED TECHNOLOGY Our physicians utilize the most advanced technologies for cataract surgery and strive to continually bring the best surgical innovations to our patients in the Central Valley. We are proud to provide our patients with the option of LenSx femto-second laser cataract surgery along with the Verion image-guided system to improve visual clarity, precision, safety, and lens positioning. We also utilize the latest technology in intraoperative wavefront aberrometry testing (ORA) which yields real time data validation in surgery to provide the most accurate custom lens selection. Our physicians also implant toric lenses for astigmatism management and multifocal lenses that provide both near and far vision in one lens. LASER CATARACT SURGERY Femto-second laser cataract surgery is a new technology that replaces traditional blades and other manual steps in cataract surgery with a computer-guided laser system. All incisions, the opening of the bag holding the lens, and the initial lens fragmentation are completed with the laser. This allows for increased safety, precision, and decreased ultrasound energy required to remove your cloudy lens. The laser also allows for special incisions in the cornea, called limbal relaxing incisions, which helps to neutralize and decrease lower levels astigmatism at the time of your cataract surgery. This, in turn, provides improved glasses-free vision and decreased reliance on glasses after surgery. ASTIGMATISM CORRECTION – CLARITY WITHOUT GLASSES Astigmatism is an eye condition that causes your vision to be blurry and distorted when not corrected by glasses or contacts. This is due to the shape of the cornea being closer to an oval rather than a sphere. At the time of cataract surgery, lower levels of astigmatism can be treated with the femto-second laser, while larger levels of astigmatism typically are treated with the toric intraocular lens. MULTIFOCAL – THE NEAR & FAR LENS Multifocal lenses are considered “premium” intraocular lenses as they can decrease astigmatism like a toric lens while providing clear vision for both near and far. These lenses are designed to decrease glasses reliance and provide patients with the most spectacle independence of all the lens options. Although these lenses typically provide clear vision, they do have some trade-offs as they can cause some glare and mild blurriness with distance vision when compared to monofocal lens. These lenses are best in patients who have no other significant ocular conditions and are looking to have the lowest reliance on glasses after surgery. Learn more about “premium” intraocular lenses » More Information On Cataract Surgery What Is Femto-Second Laser Cataract Surgery? Intraocular Lens (IOL) Options What Is ORA Intraoperative Wavefront Aberrometry? What Is The Verion Image Guided System? Can You Treat Glaucoma At The Time Of Cataract Surgery? Can You Treat Astigmatism At The Time Of Cataract Surgery? What To Expect Before Cataract Surgery What To Expect The Day Of Your Cataract Surgery Cataract Surgery Procedure Recovery After Cataract Surgery Can I See Both Near And Far After Cataract Surgery? How Long Will My Results Last After Cataract Surgery?

We know your vision is important to you – and it’s important to us. Central Valley Eye Medical Group provides comprehensive eye examinations for both adults and children. We make sure to schedule ample time for your appointment so you will never feel rushed. Our office provides complete eye care for both adults and children. Our eye examinations will check your eyes inside and out for any potential eye disorders or diseases. Some eye diseases, such as glaucoma and macular degeneration, can result in serious vision loss if not detected and treated early. Often patients with these diseases don’t experience any visual symptoms before vision loss occurs. Your visual skills and abilities are carefully evaluated and appropriate treatment is prescribed, whether it’s medication, lenses, or vision therapy.

Diabetes is a disease that affects blood vessels throughout the body, particularly vessels in the kidneys and eyes. Patients with diabetes are at a higher risk of developing eye conditions as a complication of their disease. Diabetic-related eye problems develop from high blood sugar levels, which can cause damage to blood vessels. When diabetes affects the blood vessels in the eyes, it is called diabetic retinopathy. What is Diabetic Retinopathy? Diabetic retinopathy is a complication of diabetes. The longer a person has diabetes the higher the chance they will develop diabetic retinopathy. Diabetic retinopathy is the most common diabetic eye complication and specifically affects the blood vessels in the retina. The retina, located in the back of the eye, detects visual images and transmits them to the brain. When diabetes damages the retinal blood vessels they weaken, swell and leak. This results in a loss of vision and the ability to detect and transmit images. More than 40% of diabetics in the United States have some form of diabetic retinopathy which is the leading cause of blindness in America adults. As diabetic retinopathy develops new blood vessels grow, these new vessels are your body’s attempt to overcome and replace the vessels that have been damaged by diabetes. However, these new vessels are not normal and may bleed, cause the vision to become hazy, and occasionally result in a complete loss of vision. In addition, abnormal blood vessels on the iris can lead to glaucoma and diabetic retinopathy can also cause the formation of cataracts. Diabetic Retinopathy Symptoms If symptoms do appear they can present as: Blurred or double vision Seeing flashing lights, blank spots or dark floaters Pain or pressure in either or both eyes Problems with peripheral vision Severe vision loss if left untreated Irreversible blindness in advanced stages What Causes Diabetic Eye Disease? Chronic high blood sugar levels caused by diabetes are the cause of diabetic retinopathy. These high levels damage the tiny blood vessels in the retina, which is located on the back of the eye. These blood vessels become blocked. To compensate, the eye grows new blood vessels, but they don’t develop normally and can begin to leak. This distorts the patient’s vision. As the condition progresses, these abnormal blood vessels proliferate on the surface of the retina. This can lead to scarring and cell loss in the retina. Who Is Likely To Get Diabetic Retinopathy? If you have diabetes, you can develop diabetic retinopathy. It generally won’t develop, however, until a person has had diabetes for at least a decade. These factors increase your risk: Longer duration having diabetes Poor control of your blood sugar levels High cholesterol High blood pressure Pregnancy Tobacco use Being African American, Hispanic, or Native American Diabetic Retinopathy Treatment at Central Valley Eye Medical Group The best treatment is early diagnosis. Otherwise, vision damage may already have occurred. Treatment depends on if you have nonproliferative (early stage) or proliferative (advanced) diabetic retinopathy. In early stages, simply managing your blood sugar effectively can slow the progression of diabetic retinopathy. For decades, the main treatment for diabetic retinopathy, particular in the proliferative stage, was scatter laser surgery. Recently, new drugs have been developed and are proving to be effective for stopping the blood vessel development and decreasing fluid buildup of macular edema.These are the treatments used to treat diabetic retinopathy: Anti-VEGF injection therapy — In this treatment, drugs are used to block a protein called vascular endothelial growth factor (VEGF), which stimulates the growth of the abnormal blood vessels. The drugs are injected into the vitreous gel of the eye. These drugs have proven to be effective for reversing abnormal blood vessel development and decreasing fluid in the eye. Brand names are Avastin, Lucentis, and Eylea. Focal laser treatment — In this procedure, laser energy is used to either stop or slow the leakage of blood and fluid in the eye. Also called photocoagulation, laser burns close the leaking vessels. This laser surgery may involve just a few small laser burns or up to hundreds, depending on the patient’s condition. Scatter laser treatment — Also known as pan-retinal photocoagulation, here the areas of the retina away from the macula are treated with 1,000 to 2,000 tiny scattered laser burns. These burns cause new abnormal blood vessels to shrink and scar. Scatter laser surgery works best before new, fragile blood vessels have started to bleed. Vitrectomy — This surgical procedure is used to treat severe bleeding into the vitreous. In the procedure, a tiny incision is made in your eye to remove blood from the vitreous, as well as the scar tissue that is pulling on the retina creating detachment.

The name “dry eye” can be a little confusing since one of the most common symptoms is excessive watering! It makes more sense, though, when you learn that the eye makes two different types of tears. The first type, called lubricating tears, is produced slowly and steadily throughout the day. Lubricating tears contain a precise balance of mucous, water, oil, nutrient proteins, and antibodies that nourish and protect the front surface of the eye. The second type of tear, called a reflex tear, does not have much lubricating value. Reflex tears serve as a kind of emergency response to flood the eye when it is suddenly irritated or injured. Reflex tears might occur when you get something in your eye, when you’re cutting onions, when you’re around smoke, or when you accidentally scratch your eye. The reflex tears gush out in such large quantities that the tear drainage system can’t handle them all and they spill out onto your cheek. Still another cause of reflex tearing is irritation of the eye from lack of lubricating tears. If your eye is not producing enough lubricating tears, you have dry eye.

The diagnosis of glaucoma can often be nuanced and requires meticulous attention to details over time. Given that glaucoma is a progressive condition, there are situations where diagnosis will not be possible until your doctor has had time to follow you over time. Typically in this situation, your doctor will identify you as a “glaucoma suspect” and follow you closely to ensure you are treated if you show any clear signs of glaucoma in the future. Alternatively, there are cases where glaucoma can be clearly identified and needs to be treated more urgently.

Blade-Free LASIK LASIK, an acronym for Laser-Assisted In Situ Keratomileusis, is the most common refractive procedure. Using targeted laser beam energy, Lasik reshapes the cornea so that light rays are focused more precisely on the retina. As a result, patients can now have clear, sharp vision without the need for glasses or contacts. Lasik can correct nearsightedness, farsightedness, and astigmatism. Our doctors perform laser vision correction to give patients a better quality of life. iDesign iDesign is a recent development in the performance of the LASIK procedure, and represents the most advanced laser vision correction technology to date. A wavefront-guided procedure, the iDesign Refractive Studio integrates corneal topography that guides the ophthalmologist through the LASIK procedure using the most accurate measurements of the patient’s eyes. Photo-Refractive Keratectomy (PRK) Photorefractive keratectomy, or PRK, is a type of laser eye surgery that reshapes the cornea. Photorefractive keratectomy was the first procedure to use the Excimer laser and, after Lasik, is the second most common type of refractive surgery. Lasik makes a flap and applies the laser to the inner tissue of the cornea. However, with PRK, the epithelium, or outer skin of the cornea, is removed and a laser is applied to the surface of the cornea. Wavefront Diagnostic Technology Until recently, laser vision correction treated patients based strictly on their optical prescription. In other words, if you were a minus-four nearsighted person, glasses with minus-four lenses would allow you to see the best that you could. If you had laser vision correction, that same prescription would be programmed into the excimer laser and the exact amount of tissue would be removed to make a minus-four into a zero. Therefore, anyone with the same prescription was receiving the same treatment which we call conventional laser vision correction. Aberrated Eye Returning Wavefront What is LASIK? LASIK is an eye surgery that corrects nearsightedness, farsightedness, and astigmatism. These common focusing errors of the eye are all attributed to the shape of the cornea, and LASIK reshapes the cornea. In LASIK, after a protective flap of tissue is created in the outer layer of the cornea, the laser is then used to precisely reshape the cornea under the flap. The reshaped cornea then heals and because the light is refracted more optimally onto the retina, the patient’s vision is vastly improved. At Central Valley Eye Medical Group, we continually incorporate new technology into our laser vision correction options, such as iDesign, blade-free LASIK, and Wavefront diagnostic technology. This helps our patients achieve the highest levels of vision improvement with our laser vision correction surgeries. What is LASIK? LASIK is an eye surgery that corrects nearsightedness, farsightedness, and astigmatism. These common focusing errors of the eye are all attributed to the shape of the cornea, and LASIK reshapes the cornea. In LASIK, after a protective flap of tissue is created in the outer layer of the cornea, the laser is then used to precisely reshape the cornea under the flap. The reshaped cornea then heals and because the light is refracted more optimally onto the retina, the patient’s vision is vastly improved. At Central Valley Eye Medical Group, we continually incorporate new technology into our laser vision correction options, such as iDesign, blade-free LASIK, and Wavefront diagnostic technology. This helps out patients achieve the highest levels of vision improvement with our laser vision correction surgeries. How successful is LASIK surgery? These are amazing procedures that allow patients who have worn glasses their entire lives to see clearly without them. It can be life changing to not wake up and first have to reach for your glasses to read the alarm clock. LASIK is one of the most successful surgeries performed, and its success is documented with thousands of clinical studies measuring visual acuity and patient satisfaction. The latest research reports that 99 percent of patients achieve better than 20/40 vision. More than 90 percent achieve 20/20 vision or better. LASIK has an incredibly high satisfaction rate of 96 percent patient satisfaction. This is the highest rate of any elective surgery. These statistics are found in the Journal of Cataract & Refractive Surgery, but they are available from difference sources. LASIK procedures have been performed for over two decades now in the U.S. They have improved the vision of nearly 20 million people.

Macular degeneration is a disease of the macula, an area of the retina at the back of the eye that is responsible for fine detail vision. It is a common disease that appears in older adults and is the leading cause of vision loss in patients over 50. Vision loss usually occurs gradually and typically affects both eyes at different rates. Even with a loss of central vision, however, color vision and peripheral vision may remain clear.

Neuro-ophthalmology is a subspecialty within the field of ophthalmology that focuses on the diagnosis and management of brain disorders that affect vision. At Central Valley Eye Medical Group, Dr. Kimberly Cockerham is a board-certified ophthalmologist with fellowship training in neuro-ophthalmology. Her scope of practice in neuro-ophthalmology focuses on adults with abnormal optic nerve function or double vision.

Central Valley Eye Medical Group has long been recognized as one of the area’s premiere eye care centers, providing a full spectrum of high-quality medical and surgical eye care services. What many patients don’t know is that we’ve also helped thousands of people achieve the appearance they desire through eyelid and facial cosmetic treatments and surgery. You’ve probably heard a lot of hype about a variety of procedures promising to make you look younger. It’s hard to know what’s real and who to trust. You’re wise to be careful, as all cosmetic procedures are not the same. Aging, the environment and your health can all affect the appearance of your eyelids and skin. Droopy eyelids and wrinkles can add years to your face and may even block your vision. The solution might be closer than you think. We specialize in aging changes of the eyelids, brows and face in addition to: Many skin imperfections including excess skin, acne scarring, age spots, wrinkles and sun damage can be treated with procedures such as BOTOX®, microdermabrasion, blepharoplasty and laser skin resurfacing. She has licensed aestheticians on staff to advise patients on skin care needs and provide topical therapies, such as facials, chemical peels and micro-needling. Pricing Different procedures and levels of treatment require different technologies. The best way to find out exactly what your price will be is to come in for a screening or exam. Some procedures may be covered by insurance. If you have questions about what is covered by your private healthcare insurance, contact your plan provider. If you don’t want to pay for your procedure all at once, you can take advantage of one of our affordable financing options and you can apply for financing online.

Services We Offer Eyelid Malpositions Orbital Reconstruction Post Trauma Orbital Tumor Treatment Upper Eyelid Surgery (Blepharoplasty) What Are the Types of Eyelid Malpositions? There are four common types of eyelid malposition, all of which may attributed to some extent by aging. These include: Ptosis, which involves drooping of the upper eyelid. Eyelid retraction, in which the upper eyelid is too high and the lower eyelid is too low compared to the norm. Ectropion, which involves the outward turn of the lower eyelid. Entropion, which involves the inward turn of the eyelid, usually the lower one. Eyelid malposition is not preventable but can be corrected with appropriate treatment. Can You Live a Normal Life With Graves’ Disease? Graves’ disease is an autoimmune condition that requires consistent follow-up with at least one specialist. The condition does not affect the eyes alone; it can affect the muscles, the heart, and even your behavior due to the impact on the brain. Due to the gravity of the consequences associated with unmanaged Graves’ Disease, it feels appropriate to questions whether you can live a normal life with this condition. The very fact that you need to maintain regular visits with your doctor may not seem “normal.” This depends on comparison. If we look only at living with Graves’, then we can say that, yes, you can live a normal life provided that you receive the consistent care that your condition demands. Today, we have more ways than ever to manage the ocular effects of Graves’ disease. These include medications and surgery as needed to manage symptoms. What's the Goal of Orbital Reconstruction Surgery? Orbital reconstruction surgery is one option for managing some of the effects of Graves’ Disease. It may also be necessary as a treatment for injury. The goal of any orbital reconstruction procedure is to restore the internal and external anatomy around the eye globe. This may involve repositioning or repairing injured or entrapped soft tissues. How Are Orbital Tumors Diagnosed? An orbital tumor is an abnormal growth in the area around the eye. Some are cancerous and some are benign. Examples of different types of orbital tumors include vascular lesions that form from blood vessels, cysts, neurogenic (nerve) tumors, and lymphomas. An orbital tumor may also be a secondary tumor that has metastasized from another area such as the cranium or sinuses. A specialist will carefully examine the eye area to evaluate what may be an orbital tumor. Symptoms and medical history are also reviewed. Additionally, the doctor may order imaging such as CT scan, MRI, or ultrasound to observe the detailed aspects of the orbital area. A biopsy may be performed. However, an experienced specialist may discern the characteristics of a tumor using imaging and their physical examination alone. What is Functional Blepharoplasty? In general, blepharoplasty surgery is performed using the same techniques to achieve cosmetic goals as it is to achieve functional improvements. The primary difference between the two terms is that functional blepharoplasty is performed to address eyelid sagging that is causing some type of functional issue. For example, when there is redundant tissue on the upper eyelids, where functional blepharoplasty is performed, this tissue may fold over in a way that causes friction. This rubbing of the tissue can lead to persistent skin irritation. Another thing that functional blepharoplasty might improve is comfort. Many people who are living with significant upper eyelid hooding instinctively raise their eyebrows to create more comfort. The constant use of the muscles near the eyebrows can result in discomfort or even headaches. The most common reason we see patients for functional blepharoplasty is that their upper eyelids, one or both of them, are drooping down over the eyelashes or over the eye itself. This can cause discomfort and also visual impairment. Through functional blepharoplasty, the upper eyelid is lifted through precise trimming, removing the obstacle to good vision. Does Functional Blepharoplasty Correct Eyelid Ptosis? When a person seeks treatment for drooping eyelids, the term a doctor uses is "ptosis." This word is a general clinical way of describing eyelids that sag. Now, there are two reasons why eyelids might sag, and both may be referred to as ptosis. However, the type of treatment that is needed depends on what is causing the sagging to occur. Cosmetic and functional blepharoplasty work by removing excess eyelid tissue. Sometimes, ptosis originates in the muscle that raises the eyelid.