Galiani Ophthalmology Associates

A cataract is a common condition that causes a progressive clouding of the eye’s natural lens. This painless loss of vision affects millions of people over the age of 65 each year. Cloudiness develops as a result of a buildup of protein in the lens causing a gradual reduction in vision. Patients with cataracts often do not experience any symptoms when the condition first develops. However, upon the progression of the cataract the patient may notice blurred or hazy vision, double vision, poor vision in bright light, difficulty driving especially at night, seeing halos around lights, yellowish vision or altered color vision and the patient will frequently feel the need to change his/her glasses or contact lenses. Cataract If visual impairment begins to interfere with your ability to live life normally; which means difficulty reading, writing, doing computer work, cooking, driving (especially at night), then you may want to consider cataract surgery to restore your vision. Cataract Cataract surgery is the most commonly performed surgical procedure in the US, and can be performed quickly and easily with a success rate of 90 percent and a minimal risk of complications. If left untreated, cataracts will worsen over time and may lead to permanent vision loss or even blindness. It is important to see Dr. Galiani regularly in order to detect cataracts as early as possible and to plan an effective treatment method. ✆For more information about Our Services, or to schedule an appointment, please complete our online form or call 215.345.5144.

What Is Glaucoma? Glaucoma is a disease that damages your eye’s optic nerve. It usually happens when fluid builds up in the front part of your eye. That extra fluid increases the pressure in your eye, damaging the optic nerve. Glaucoma is a leading cause of blindness for people over 60 years old. But blindness from glaucoma can often be prevented with early treatment. Types of glaucoma: Primary open-angle glaucoma This is the most common type of glaucoma. It happens gradually, where the eye does not drain fluid as well as it should (like a clogged drain). As a result, eye pressure builds and starts to damage the optic nerve. This type of glaucoma is painless and causes no vision changes at first. Some people can have optic nerves that are sensitive to normal eye pressure. This means their risk of getting glaucoma is higher than normal. Regular eye exams are important to find early signs of damage to their optic nerve. Angle-closure glaucoma (also called “closed-angle glaucoma” or “narrow-angle glaucoma”) This type happens when someone’s iris is very close to the drainage angle in their eye. The iris can end up blocking the drainage angle. You can think of it like a piece of paper sliding over a sink drain. When the drainage angle gets completely blocked, eye pressure rises very quickly. This is called an acute attack. It is a true eye emergency, and you should call your ophthalmologist right away or you might go blind. Here are the signs of an acute angle-closure glaucoma attack: Your vision is suddenly blurry You have severe eye pain You have a headache You feel sick to your stomach (nausea) You throw up (vomit) You see rainbow-colored rings or halos around lights Many people with angle-closure glaucoma develop it slowly. This is called chronic angle-closure glaucoma. There are no symptoms at first, so they don’t know they have it until the damage is severe or they have an attack. Angle-closure glaucoma can cause blindness if not treated right away. What is angle-closure glaucoma? Treatment The damage caused by glaucoma can’t be reversed. But treatment and regular checkups can help slow or prevent vision loss, especially if you catch the disease in its early stages. Glaucoma is treated by lowering your eye pressure (intraocular pressure). Depending on your situation, your options may include prescription eyedrops, oral medications, laser treatment, surgery or a combination of any of these. Eyedrops Glaucoma treatment often starts with prescription eyedrops. These can help decrease eye pressure by improving how fluid drains from your eye or by decreasing the amount of fluid your eye makes. Depending on how low your eye pressure needs to be, more than one of the eyedrops below may need to be prescribed. Prescription eyedrop medications include: Prostaglandins. These increase the outflow of the fluid in your eye (aqueous humor), thereby reducing your eye pressure. Medicines in this category include latanoprost (Xalatan), travoprost (Travatan Z), tafluprost (Zioptan), bimatoprost (Lumigan) and latanoprostene bunod (Vyzulta).Possible side effects include mild reddening and stinging of the eyes, darkening of the iris, darkening of the pigment of the eyelashes or eyelid skin, and blurred vision. This class of drug is prescribed for once-a-day use. Beta blockers. These reduce the production of fluid in your eye, thereby lowering the pressure in your eye (intraocular pressure). Examples include timolol (Betimol, Istalol, Timoptic) and betaxolol (Betoptic).Possible side effects include difficulty breathing, slowed heart rate, lower blood pressure, impotence and fatigue. This class of drug can be prescribed for once- or twice-daily use depending on your condition. Alpha-adrenergic agonists. These reduce the production of aqueous humor and increase outflow of the fluid in your eye. Examples include apraclonidine (Iopidine) and brimonidine (Alphagan P, Qoliana).Possible side effects include an irregular heart rate, high blood pressure, fatigue, red, itchy or swollen eyes, and dry mouth. This class of drug is usually prescribed for twice-daily use but sometimes can be prescribed for use three times a day. Carbonic anhydrase inhibitors. These medicines reduce the production of fluid in your eye. Examples include dorzolamide (Trusopt) and brinzolamide (Azopt). Possible side effects include a metallic taste, frequent urination, and tingling in the fingers and toes. This class of drug is usually prescribed for twice-daily use but sometimes can be prescribed for use three times a day. Rho kinase inhibitor. This medicine lowers eye pressure by suppressing the rho kinase enzymes responsible for fluid increase. It is available as netarsudil (Rhopressa) and is prescribed for once-a-day use. Possible side effects include eye redness, eye discomfort and deposits forming on the cornea.

What Is An Oculoplastic Surgeon? Oculoplastic surgery (also known as ophthalmic plastic surgery) is a specialized dynamic field of medicine that combines the microsurgery of ophthalmology with the cosmetic principles of plastic surgery. This branch of ophthalmology focuses on plastic and reconstructive surgery of the eyelids, tear ducts, and orbit, along with cosmetic surgery of the eyelids and brows. Oculoplastic surgeons also perform aesthetic rejuvenation procedures on the face with Botox/Dysport, and facial fillers like Restylane, Restylane Lyft, and Restylane Refyne/Defyne. Blepharoplasty and Ptosis: Blepharoplasty and ptosis repair to correct droopy eyelids are among the most commonly performed by an oculoplastic surgeon. Blepharoplasty is a procedure to remove excess sagging skin and muscle from the eyelids to restore a more youthful look and improve peripheral vision. When excess fatty tissue and eyelid bags are trimmed away, the cosmetic benefits of the surgery are more apparent. Ptosis repair is an eyelid lifting procedure to restore the edge of the eyelid (from where the eyelashes emerge) to its normal state above the pupil. Recovery from blepharoplasty and ptosis repair is quick and usually not painful. The procedure is often performed in an ambulatory surgery center on an outpatient basis. Browlift: A brow lift is a procedure to lift the eyebrows back to their normal anatomic site. In men, the normal brows rest at or just above the frontal bone above the eyes. In women, the normal brows are usually higher and rest above the bone. Surgery can be performed to lift the brows if they are sagging below these areas. Sometimes combined with blepharoplasty and/or ptosis repair, brow lifting can also be done at an ambulatory surgery center in an outpatient setting. Stye, Skin Tag, Chalazion and Skin Cancer: Tumors around the eyelids and eye socket (orbit) sometimes appear and need to be treated. Whether a benign condition such as a stye or skin tag or a potentially malignant condition such as skin cancer or metastasis, an oculoplastic surgeon can diagnose and treat the condition after a biopsy is performed. In many cases, the biopsy can be performed in the office. Basal cell carcinoma, squamous cell carcinoma, sebaceous gland carcinoma, and melanoma are some of the more common eyelid skin cancers that can appear with sun damage to the area. Ectropion and Entropion: Ectropion and entropion are conditions that can affect the position of the eyelids. When the eyelid turns out away from the eye, an ectropion is present. This often results in tearing and constant irritation with discharge. When the eyelid turns towards the eye and causes the eyelashes to rub on the surface of the eye, an entropion is present. Outpatient or office surgery is usually necessary to correct this condition. Orbital Decompression: Certain conditions such as Graves disease can cause the pressure in the orbit (eye socket) to rise to dangerous levels as the muscles that move the eye enlarge. The increased pressure can cause the eyes to bulge forward giving the patient a “bug-eyed” appearance. By removing fat and/or bone from the eye socket, the soft tissues of the eye socket can relax back into the now enlarged orbit. Orbital decompression can help to relieve the pressure in the eye socket and allow the eye tissues to revert to a more normal position. Dacryocystorhinostomy: The tear ducts are the normal passageway for tears to drain from the eyes and down the nose and throat. A blockage in these tubes will result in tearing of the eyes, sort of like a sink that is clogged. Surgery can be performed to bypass or open the blockage and restore the normal flow of tears. This procedure is known as a dacryocystorhinostomy or DCR. Tiny plastic tubes are often placed in the new tear drain to allow for proper healing around the surgery site. These tubes usually stay in place for three to six months and can be removed in the office.

Medical Retina The retina is a thin sheet of nerve tissue in the back of the eye where light rays are focused and transmitted to the brain through the optic nerve. The vitreous is a gel-like substance that fills the eye and is connected to the retina, optic nerve and many blood vessels. Problems with the retina and vitreous, including retinal tear and detachment, macular degeneration, diabetic retinopathy, infection and trauma can lead to vision loss and blindness. Early detection and treatment are critical in correcting problems before vision is lost or deterioration occurs. Yearly comprehensive eye exams with dilation are essential in detecting retinal problems, such as Diabetic Retinopathy, Age Related Macular Degeneration, Posterior Vitreous Degeneration (PVD), Retinal holes or tears, Retinal Detachments or Macular Pucker. ✆For more information about Our Services, or to schedule an appointment, please complete our online form or call 215.345.5144.

Patients should see their doctor at least every one to two years for a comprehensive eye exam with dilation. Comprehensive eye exams not only test for the progression of refractive errors but also are a valuable tool for the early detection of eye disease. Common eye conditions such as Myopia (nearsightedness), Hyperopia (farsightedness) or Astigmatism (corneal curvature) can be diagnosed during a comprehensive eye exam. Myopia, Hyperopia, Presbyopia and Astigmatism can be corrected with glasses or contact lenses after the refraction is performed. Eye disorders and diseases can also be detected during a comprehensive eye exam such as Glaucoma, Posterior Vitreous Detachments, Diabetic Retinopathy, Macular Degeneration and Retinal holes, tears or detachments to name a few. Early detection is essential to planning an effective method of treatment. ✆For more information about Our Services, or to schedule an appointment, please complete our online form or call 215.345.5144.

Laser vision correction (ie LASIK and PRK) is a refractive procedure that reshapes the cornea to correct nearsightedness, farsightedness and astigmatism. Using targeted excimer laser beam energy, the procedure reshapes cornea tissue to reduce refractive errors so light rays are focused more precisely on the retina to produce clear, sharp vision. At Galiani Ophthalmology Associates, Dr. Derham employs only the most advanced technology; the same technology used to do her own LASIK. Below are some frequently asked questions about laser vision correction. What is laser vision correction? What is LASIK? What is PRK? Can laser vision correction fix astigmatism? Am I a candidate for LASIK? How can I prepare for my evaluation? I have a good vision for distance tasks (like driving and watching movies) but now I need reading glasses for close work. Can this be fixed with a laser? Are there other options besides laser vision correction to reduce my dependency on contact lenses or glasses? Will I ever need glasses again after the procedure? ✆For more information about Our Services, or to schedule an appointment, please complete our online form or call 215.345.5144.

Thanks to the advances in optical technology, almost everyone is a candidate for contact lens use. This includes patients with astigmatism and also those who prefer bifocal or multifocal lenses. At Galiani Ophthalmology we offer a comprehensive array of contact lenses to suit each individual patient’s needs. We offer daily disposables, extended wear soft lenses to gas permeable contact lenses. ✆For more information about Our Services, or to schedule an appointment, please complete our online form or call 215.345.5144.

At Galiani Ophthalmology our doctors are experienced in providing comprehensive emergency on-call care to ensure that all injuries and traumas are handled thoroughly and efficiently to minimize visual loss. Emergency eye care may be trauma-induced as a result of an accident, scratch or contamination. Other troubling symptoms may include sudden loss of vision, redness, pain, swelling, floaters, flashes or visual impairment. It is essential to seek immediate attention for emergent symptoms to reduce the risk of permanent damage. ✆For more information about Our Services, or to schedule an appointment, please complete our online form or call 215.345.5144.

Dysport / Botox Botox itself is a muscle relaxer made from bacteria. It’s been on the market for over two decades, and has been used to treat neurological disorders that cause muscle weakness. It’s also used for the treatment of migraines and other medical conditions. For wrinkle treatment, Botox is primarily used to treat dynamic wrinkles. These wrinkles occur naturally around the eyes and mouth, as well as in between your eyebrows. They become more pronounced with age. Botox injections relax the muscles near these wrinkles. Not allowing the muscles to move reduces the appearance of dynamic wrinkles. Botox is not used for fine lines caused by collagen breakdown. Your healthcare provider will inject the muscles that contribute to the specific wrinkles you want treated. The injection process itself takes just a few minutes with noticeable results within two weeks. Dermal fillers Dermal fillers also treat wrinkles on the face. They’re primarily used to treat smile lines, though the fillers can also be used to plump up the lips or cheeks. Sometimes, they’re used for hand treatments or to reduce the appearance of scars. Dermal fillers aren’t approved for plumping up other areas of the body, though, such as the breasts. Dermal fillers come in different forms, and like Botox, they’re injectable. Some are temporary and used primarily for soft tissues in the face along the smile lines. What we offer Dysport: Used for the treatment and prevention of fine lines and wrinkles. It is commonly used to treat glabella lines (forehead 11’s) and crows feet. Botox: Used to temporarily reduce the appearance of fine lines and crows feet. It can also be used therapeutically in conditions such as blepharospasm. Restylane: Used to restore volume and smoothness to the skin. It is commonly used to fill the lines between the corner of the nose/ lip (nasolabial folds), along with the corner of the mouth (marionette lines). Restylane Lyft: Used to give a natural looking lift to the cheeks, nose, chin, hands and a variety of other areas. Restylane Refyne: Used to soften laugh lines (nasolabial folds and marionette lines). Great for maintaining natural facial expressions. Restylane Defyne: Used to increase support under the skin to minimize the appearance of wrinkles. Commonly used for the treatment of nasolabial folds. Restylane Kysse: Used to add volume to the lips. It smooths upper lip lines and enhances lip color. Designed specifically for the movement of lips and giving a natural-looking result.