Eye Surgeon, PC

Overview Amblyopia, commonly known as lazy eye, is an eye condition that results in reduced vision in one eye. When this condition occurs, the unaffected eye usually becomes stronger and suppresses the amblyopic eye, causing a permanent reduction of vision. This condition usually develops in children before the age of six, and can significantly affect central vision if left untreated. Learn More To learn more about Amblyopia, please call 212.753.6464 today to schedule a consultation.

Blepharitis Explained Blepharitis Treatment in NYCBlepharitis is an inflammation of the eyelids. It is seen commonly in both children and adults. Common causes are bacteria normally found on the skin, fungal, viral or parasitic organisms. In addition, systemic disorders and skin conditions such as eczema, psoriasis, seborrhea, and rosacea are also common causes. The lid contains skin, lashes and meibomian glands. The meibomian glands empty at the lid margin. They secrete oil that is part of the normal tear film. These glands are commonly involved in blepharitis, and as a result, dry eye symptoms are common. Other common symptoms are crusting along the lid margins, red and irritated lid margins, itchy eyelids, eyes that sting and blurred vision. Additionally, both styes and chalazia may occur. Treatment often includes warm compresses, lid hygiene, and antibiotic drops or ointment. Learn More To learn more about Blepharitis, please call 212.753.6464 today to schedule a consultation.

Introduction A cataract is a clouding of the natural lens in your eye and affects millions of people each year, including more than half of all Americans over the age of 65. There are many causes of cataracts including genetics, nutrition, life style, medications and the normal aging process. Cataracts cause a progressive, painless loss of vision. When a cataract forms, the normally clear lens gradually becomes cloudy, making it progressively more difficult to see. This is a change in the substance of the lens and is not a film or membrane. A cataract can cause many different vision problems. Glare, especially at night, can make driving very difficult. Making out street signs or even a person’s face can become difficult. It typically seems that your glasses are dirty but you just can’t get them clean. Fortunately, we have a very effective treatment for cataracts. Treatment If visual impairment begins to interfere with your ability to read, work or do the things you enjoy, you may want to consider cataract surgery to restore your vision. Cataract surgery is the most commonly performed surgical procedure in the US, and can be performed quickly and easily with a success rate of over 90 percent and a minimal risk of complications. Advanced Cataract Surgery Cataract surgery is the most commonly performed procedure in the US, replacing the cloudy natural lens of the eye with a clear artificial lens called an intraocular lens (IOL). Cataracts affect millions of people each year, including more than half of all Americans over the age of 65, and cause a progressive, painless loss of vision. Cataract Lens Options There are a wide range of replacement lenses available to cataract patients, each offering different advantages for your post-surgery vision. The most effective lens depends on each patient’s individual preferences and goals for their vision. The latest lenses help eliminate the need for glasses or contacts after cataract surgery, providing convenient, effective results for your specific vision conditions.

What Causes a Chalazion? Chalazion on the top of a mans eye-lid under a red filterA chalazion occurs when a meibomian gland become clogged and the oils back up in the gland. This causes the vessel walls to distend and leak oil into the subcutaneous tissue, causing an intense inflammation. The lids can become very inflamed and tender. How is a Chalazion Treated? Doctor Cole’s initial treatment is to use warm compresses for 5 minutes at least four times a day. Those that do not resolve can be easily treated with an injection of medication or removed with a minor surgical procedure. Learn More To learn more about Chalazion Treatment, please call 212.753.6464 today to schedule a consultation.

Overview The outer most layer of the eye is called the conjunctiva. When this becomes inflamed and irritated it is called conjunctivitis. Causes can include allergies, getting material such as soap in the eye, viral and bacterial infections. One or both eyes can be affected. The most frequent cause is a viral infection which is commonly called “pink eye” because the conjunctival blood vessels dilate and give the conjunctiva a pink hue. Treatment depends on the cause. Learn More To learn more about Conjunctivitis, please call 212.753.6464 today to schedule a consultation.

Overview Patients with diabetes are at a higher risk for developing eye conditions because a high blood sugar level can damage blood vessels in the eye. Over 40 percent of patients diagnosed with diabetes develop some form of eye disease as a result. These conditions can cause blood or fluid to leak from the retina or new blood vessels to grow on the surface of the retina which can lead to significant damages to your vision and overall quality of life. It is important for patients with diabetes to have dilated eye exams once a year to detect any signs of diabetic eye disease as soon as possible. Diabetic Retinopathy Diabetes has the potential to cause devastating damage to the eye. Diabetic retinopathy is a leading cause of blindness in adults. High blood sugar levels can lead to leaky blood vessels in the retina, ischemia of the retina and vision loss. Learn More To learn more about Diabetic Eye Conditions, please call 212.753.6464 today to schedule a consultation.

Overview Diabetes has the potential to cause devastating damage to the eye. Diabetic retinopathy is a leading cause of blindness in adults. High blood sugar levels can lead to leaky blood vessels in the retina, ischemia of the retina and vision loss. Good blood sugar control and regular eye exams are essential for anyone with diabetes. A variety of treatments are available for diabetic retinopathy and include both laser and surgery. Proliferative Diabetic Retinopathy Proliferative diabetic retinopathy is the most advanced stage of diabetic retinopathy, and is classified by the growth of new blood vessels on the retina. These blood vessels are abnormal and fragile, and are susceptible to leaking blood and fluid onto the retina, which can cause severe vision loss and even blindness. If blood leaks on top of the retina, patients may begin to notice floaters in their vision, which are actually specks of blood floating above the retina. While floaters can sometimes clear up on their own, it is important to see your doctor as soon as you notice them as they can lead to severe vision loss.

Overview This is a common problem caused by a reduction in the quality and/or quantity of the tear film. It occurs more commonly as a person ages, in women more often than men, those with lid closer problems and those with autoimmune disorders such as rheumatoid arthritis, Sjogren’s syndrome, lupus, ocular cicatricial pemphigoid and Steven-Johnson syndrome. It can also be seen following refractive surgery. Treatment includes artificial tears, medications and punctal occlusion. Learn More To learn more about Dry Eyes, please call 212.753.6464 today to schedule a consultation.

Overview Flashes and floaters are symptoms of the eye that commonly occur as a result of age-related changes to the vitreous gel. When we are born, the vitreous is firmly attached to the retina and is a thick, firm substance without much movement. But as we age, the vitreous becomes thinner and more watery, and tissue debris that was once secure in the firm gel can now move around inside the eye, casting shadows on the retina. Although flashes and floaters are common, especially as we age, it is important to see your doctor if you experience them, as they may indicate a retinal tear or hole. Your doctor can distinguish between harmless flashes and floaters, and those that may require treatment for an underlying condition. Learn More To learn more about Flashes and Floaters, please call 212.753.6464 today to schedule a consultation.

Introduction Primary open angle glaucoma is a progressive optic neuropathy of unknown etiology and is one of the leading causes of severe vision loss. Glaucoma causes optic nerve damage, which in turn leads to the progressive loss of vision. There are several types of glaucoma but two common types are Open-angle glaucoma and Narrow-angle or Closed-angle glaucoma. Open-angle Glaucoma This is the most common type of glaucoma. This is typically associated with high eye pressures. There are no symptoms during the early stages of this disease. It can, however be identified during a glaucoma examination. Tests performed include pachymetry, OCT and visual field testing. Angle-closure Glaucoma This is a much less common type of glaucoma yet causes a disproportionate amount of vision loss. In this type of glaucoma, the angle, the area between your iris and cornea, closes. This is a problem because this is the area where the fluid produced in your eye drains. Symptoms include the sudden onset of severe eye pain and rainbow colored halos around point sources of light. Emergency treatment is necessary and is often performed with a laser. Treatments for Glaucoma Once glaucoma has been diagnosed, treatment should begin as soon as possible to help minimize the risk of permanent vision loss. There is no cure for glaucoma, so treatment focuses on relieving symptoms and preventing further damage from occurring. Most cases of glaucoma can be treated with eye drops, laser surgery or microsurgery. Eye drops are used to reduce eye pressure through a variety of mechanisms, but can lead to redness, stinging, irritation or blurry vision. Patients should tell their doctor about any allergies they have to minimize the risk of side effects. Laser surgery for glaucoma is designed to either increase the outflow of fluid from the eye using laser trabeculoplasty or iridotomy or reduce fluid production using cyclophotocoagulation. Microsurgery involves a surgical procedure called a trabeculectomy, which creates a new channel to drain fluid from the eye and reduce the eye pressure. Surgery is often performed after medication and laser procedures have failed. Preventing Glaucoma While there is no way to prevent glaucoma from developing, regular screenings and early detection are the best forms of protection against the harmful damage that the disease can cause. Learn More To learn more about Glaucoma, please call 212.753.6464 today to schedule a consultation.

Overview Keratitis is inflammation of the cornea. There are several causes of keratitis, including contact lens over wear, allergies, dry eye syndrome, eye lid disorders, viral, bacterial and fungal infections. Keratitis can cause severe pain and blurring of vision. The eyes are often injected and sensitive to light. It is important to see a doctor for a complete eye exam at the first sign of symptoms. Treatment depends on the cause of the problem. This can vary from supportive care such as artificial tears to potent antibiotic and antiviral therapy. If left untreated, keratitis can lead to serious complications and can permanently affect vision. The treatment plan is based on each patient’s individual condition. Learn More To learn more about Keratitis, please call 212.753.6464 today to schedule a consultation.

Overview Keratoconus is a progressive eye disease in which the normally round cornea thins and begins to bulge into a cone-like shape. The cornea is the clear, central part of the surface of the eye, which is responsible for most of the eyes focusing power. In patients with keratoconus, the cone-shaped cornea deflects light and causes distorted vision. Keratoconus often begins to develop between the teen years and the early 20s, although it can develop at any age. Changes in the shape of the cornea occur gradually, usually over several years. Patients with keratoconus often experience blurred and distorted vision, nearsightedness, and sensitivity to light. Early stages of keratconus can be treated with eyeglasses or soft contact lenses. For progressive keratoconus, rigid gas-permeable contact lenses can be used and for certain individuals collagen cross-linking may be an option. If keratoconus becomes severe enough, corneal transplant surgery can be performed to correct the condition. Learn More To learn more about Keratoconus, please call 212.753.6464 today to schedule a consultation.

Introduction Macular degeneration, also known as age-related macular degeneration (AMD) is a common condition in older adults and the leading cause of vision loss and blindness in people over the age of 65. Macular degeneration affects the macula, the part of the retina responsible for the crisp, detailed vision needed for reading or driving. As this area breaks down, central vision becomes hazy and parts of vision can be missing. Types Macular degeneration can be classified as either wet (neovascular) or dry (non-neovascular). In dry macular degeneration, the more common of the two, cellular waste products called drusen accumulate, resulting in a loss of normal retinal cells. In wet macular degeneration, abnormal vessel growth leads to leakage of fluid and bleeding that results in a loss of normal retinal cells. About 10% of patients will develop wet AMD, although it accounts for 90% of the vision loss caused by all types of AMD. Symptoms Patients with macular degeneration may notice gradual changes to their vision, fuzzy or distorted vision or perceive straight lines as wavy. Amsler grid testing can help identify changes in central vision. Regular eye exams are important so macular degeneration can be detected early and permanent visual side effects can be minimized. Risk Factors and Treatment for Macular Degeneration Risk factors include advancing age, smoking, and a family history of macular degeneration. Although there is no cure, for macular degeneration there are several treatment options. These include vitamins, lasers and medications. Learn More To learn more about Macular Degeneration, please call 212.753.6464 today to schedule a consultation.

Overview A pterygium is the growth of abnormal conjunctival cells that grow onto the cornea. They are typically caused by sun and wind exposure and are most often seen in those who grew up in sunny, dry climates. They are most often treated with artificial tears and sunglasses, however if they grow onto the central cornea they can be removed with a minor surgery.

Overview The condition occurs most commonly in children, although adults may suffer from it as well. Strabismus may be congenital or acquired and may manifest at first as double vision. If left untreated, it can lead to visual impairment, loss of binocular vision, and blindness in the weaker eye. For children, early treatment is best, preferably before the age of six. Learn More To learn more about Strabismus, please call 212.753.6464 today to schedule a consultation.

What Is Cataract Surgery? Cataract surgery is the most commonly performed procedure in the US, replacing the cloudy natural lens of the eye with a clear artificial lens called an intraocular lens (IOL). Cataracts affect millions of people each year, including more than half of all Americans over the age of 65, and cause a progressive, painless loss of vision, as well as: Blurred/hazy vision Spots in front of the eye(s) Sensitivity to glare A feeling of “film” over the eye(s) A temporary improvement in near vision The Cataract Surgery Procedure Explained We perform a minimally invasive, small-incision, no-stitch cataract surgery called phacoemulsification (“phaco”) surgery. During this procedure, a tiny incision is made in the eye to make room for a small ultrasonic probe. This probe breaks up, or emulsifies, the cloudy lens into tiny pieces. The pieces are then suctioned out through the probe. Once the cloudy lens has been removed, the artificial IOL is implanted in the eye. Advanced foldable IOLs can be inserted through the same small incision from which the original lens was removed. Because of its small size and design, the surgical incision typically self-seals and can heal on its own. As a result, only topical (eye drop) anesthesia is required and there is no need for injections or stitching in the eye at all. Cataract surgery usually takes only a few minutes to perform and is painless for most patients. The small incision used significantly reduces recovery times while improving safety and reducing the risk of bleeding, scarring, irritation, and distortion. After the procedure, a shield will be placed over the eye and you will be asked to go home and rest. You will return home the very same day but will need someone to drive you home. Typically your vision will be improved on the first post-operative day, however, there is some variability with this based on how your eye heals. For the next few days, you may experience itching, mild discomfort, fluid discharge and sensitivity to light and touch. Your doctor will prescribe eye drops to help the healing process and to reduce the risk of infection. By four weeks after cataract surgery, your eye will be healed enough to resume all your usual activities and get a prescription for glasses if needed. There are several different IOLs available to help each patient achieve the best possible results from his/her cataract surgery. Accommodative/Multifocal IOLs allow for full vision correction at near, intermediate and far distances, completely eliminating the need for eyeglasses or contact lenses in most patients. Toric IOLs can also correct astigmatism. YAG Capsulotomy During cataract surgery, the clouded lens in the eye is removed from the lens capsule and replaced with a clear, artificial lens called an IOL. Weeks, months or years after the surgery, some patients experience a loss of vision. This is attributable to a hazy posterior capsule. The posterior capsule is located behind the artificial lens that was implanted during cataract surgery. It is sometimes called an after-cataract or secondary membrane. If an examination confirms that this is the case, and if the clouded capsule prevents the patient from doing what he or she wants or needs to do, then a YAG capsulotomy may be recommended. This simple procedure uses a YAG laser to open a window in the posterior capsule and restore clear vision. YAG capsulotomy is a painless outpatient procedure that takes less than 15 minutes. Vision improvement is quick, and the patient can resume normal activities immediately.

Overview A chalazion occurs when a meibomian gland become clogged and the oils back up in the gland. This causes the vessel walls to distend and leak oil into the subcutaneous tissue, causing an intense inflammation. The lids can become very inflamed and tender. Initial treatment is to use warm compresses for 5 minutes at least four times a day. Those that do not resolve can be easily treated with an injection of medication or removed with a minor surgical procedure. Learn More To learn more about Chalazion Treatment, please call 212.753.6464 today to schedule a consultation.

Corneal Surgery Corneal surgery, or keratoplasty, is recommended when extensive damage has occurred due to disease, infection or injury. When Is Corneal Transplantation Required? The cornea is the clear covering on the front of the eye which bends, or refracts, light rays that focus on the retina in the back of the eye. The cornea must be clear and have a certain shape or curvature in order for the light to focus properly on the retina. Common problems that require transplantation are: Corneal Ulceration Herpes Simplex Keratopathy Pseudophakic Corneal Decompensation Keratoconus Corneal Dystrophies Eye infections Traumatic injury Ocular surface diseases Chemical burn How Is Corneal Surgery Performed? Corneal surgery involves replacing the entire thickness of the damaged cornea with a healthy one from a donor (usually through an eye bank). The new cornea is stitched into place, and stitches are usually removed over the course of a year, although some may be left permanently. It may take this long for vision to be restored to satisfactory levels as well, requiring many patients to wear glasses or contact lenses after undergoing corneal surgery. Corneal Transplantation (DSAEK) In patients with specific types of corneal disease, technological advances have allowed the development of a new procedure called Descemet’s stripping and automated endothelial keratoplasty, or DSAEK for short. This procedure replaces only the innermost layers of the cornea, including the endothelial layer. This allows the procedure to be performed through a much smaller incision with shorter recovery times and fewer risks than a traditional corneal transplant. DSAEK is commonly performed on patients with Fuchs’ Dystrophy, an inherited eye disease that causes the cells of the endothelium to deteriorate, resulting in distorted vision and corneal swelling. As this condition progresses, vision will continue to worsen as damaged cells cannot grow back. The DSAEK Procedure During the DSAEK procedure, your surgeon will remove the damaged endothelial tissue. The donor tissue is then folded and implanted in the eye. Your doctor will prescribe antibiotic and steroid eye drops to be used as the eye heals. You will need to return to your doctor the next day for a follow-up appointment as well. Vision Improvement After Corneal Transplantation Most patients notice improvements to their vision significantly faster than with the traditional corneal surgery procedure, which may take 12 months before effective results are achieved. Other existing eye conditions may slow or hinder the improvement of vision after the DSAEK procedure. Is DSAEK Safe? While the DSAEK procedure is considered safe for most patients with cornea damage, there are certain risks involved with any type of surgical procedure, including infection, bleeding and more. Although rare, there is a risk of transplant rejection, which may result in redness, sensitivity to light and blurred vision. If you are experiencing these or any other symptoms after DSAEK, you should contact your doctor to prevent any damage from occurring. Learn More To learn more about Corneal Surgery in NYC, please call 212.753.6464 today to schedule a consultation.

Trabeculectomy This type of surgery creates a fistula or drainage channel to move fluid from the anterior chamber of the eye to the subconjunctival space. Successful surgery can lead to long term pressure control, with or without medication, although there is a risk of either temporary or permanent vision loss. Glaucoma Valve Surgery Some patients are not candidates for trabeculectomy, such as patients with neovascular glaucoma, failed trabeculectomy, or susceptibility to developing scar tissue. An alternative is glaucoma valve surgery. This procedure implants an artificial valve or outflow channel in the eye. Successful surgery can lead to long term pressure control, with or without medication, although there is a risk of either temporary or permanent vision loss. Selective Laser Trabeculoplasty (SLT) Selective Laser Trabeculoplasty or SLT is a laser treatment for open angle glaucoma. It is designed to improve the outflow of fluid from the eye and thereby lower eye pressure. Laser Peripheral Iridectomy (LPI) Laser Peripheral Iridectomy or LPI is a laser procedure used to treat narrow-angle or angle-closure glaucoma. Your Doctor creates a small opening in the peripheral iris to allow fluid to flow from the area where it is produced, behind the iris, directly to the angle of the eye where it drains. Learn More About Glaucoma Surgery To learn more about Glaucoma Surgery in New York City, please call 212.753.6464 today to schedule a consultation.

Overview A minor surgical procedure can remove a pterygium from the cornea, however, there is a risk the pterygium will grow back. There are several techniques for removing pterygia. Conjunctival Auto-grafting Conjunctival auto-grafting is a safe and effective technique that surgically removes a pterygium. In this procedure, the pterygium is removed down to bare sclera. Normal conjunctiva from another area of the eye is removed and placed on the area of bare sclera created by the pterygium excision. Amniotic Membrane Transplantation Amniotic membrane transplantation is another safe and effective pterygium removal procedure. In this procedure, instead of using the patient’s own normal conjunctiva, amniotic membrane is used. This type of graft encourages healing and reduces swelling. Learn More To learn more about Pterygium Excision, please call 212.753.6464 today to schedule a consultation.

Overview Punctal plugs can relieve dry eye symptoms when drops or ointments fail. Punctal plugs are placed in the opening of the tear ducts (called “puncta”) in the eyelids to block tear drainage and keep the eyes moist. Implantation should reduce the need for artificial tear drops and increase the patient’s overall comfort. Punctal plugs come in a few different shapes and sizes, and may be placed in the lower or upper eyelid or both eyelids. The most common plugs are umbrella-shaped and made of silicone. Implantation takes only a few seconds in the doctor’s office.

Introduction Photorefractive Keratectomy (PRK) / Advanced Surface Ablation (ASA) PRK/ASA is a laser procedure that effectively corrects nearsightedness, farsightedness and astigmatism without the use of the blade used in the traditional LASIK procedure. Candidates Candidates for PRK/ASA This procedure is ideal for patients who: Are over the age of 18 Have a stable eye prescription Have no major health issues Seek to improve nearsightedness, farsightedness or astigmatism Benefits Benefits of PRK/ASA This procedure offers patients many benefits over LASIK, including an elimination of flap complications and reduced risk of dry eye after surgery. The Procedure The PRK/ASA Procedure PRK/ASA takes about 30 minutes to perform and is done on an outpatient basis using only anesthetic eye drops. During the procedure, your surgeon will first remove the surface layer of the eye (epithelium). Once the epithelium is removed, the cornea is then carefully reshaped with a laser to correct vision. The advanced laser used during this procedure customizes vision correction for each individual patient to ensure successful results. A bandage contact lens is then placed over the eye to promote proper healing. Recovery Recovery from PRK/ASA After the PRK/ASA procedure, patients will be able to go home, although someone will need to drive you home. The bandage contact lens will be worn for 5-7 days. Eye drops will be prescribed to prevent infection and keep the eyes moisturized. In most cases, patients can return to work the next day, although strenuous exercise should be avoided for at least a week. Patients will notice an improvement in vision within the first few days after surgery, with full results gradually developing over the course of six months. Results PRK/ASA Results Some patients may still require glasses or contact lenses after treatment. It is important to note that PRK/ASA does not correct presbyopia, the natural change in the eyes that occurs after the age of 40, so older patients will still need reading glasses after surgery. Learn More To learn more about Refractive Surgery, please call 212.753.6464 today to schedule a consultation.