Berks Eye Physicians & Surgeons

Ready to get cataract surgery in Wyomissing? Our cataract surgeons perform state-of-the-art cataract surgery, giving our patients excellent vision and a fast recovery. Through the amazing advancements in cataract surgery, patients who experience dull or blurred vision before surgery are able to see sharper, brighter images following surgery. And with today´s technology many can do so without dependence on glasses. Cataract Surgery Wyomissing PA There have been many technological advancements in cataract surgery over the last 30 years. The days are past where cataract surgery requires a long hospital stay with weeks of bandaged eyes while you recover. Nearly 3 million cataract surgeries are performed annually in the United States, making it one of the most common surgical procedures. This effective and low risk surgery has wonderful life enhancing benefits for patients. What is done now at our surgery center is a simple out-patient procedure that usually takes several minutes and enables you to get back in the routine of normal activities within a day. Keep reading the other Cataract tabs on this website to improve your understanding of Cataracts, the Cataract Surgery Procedure, and Lens Implant Options. If you feel that you may have cataracts or if you have been diagnosed and wish to have a second opinion, please call our office today to make an appointment with one of our board-certified physicians and cataract surgeons: 610-372-0712. About Cataracts A cataract is a clouding of the natural crystalline lens of the eye. Vision with cataracts can be compared to looking through a piece of wax paper or a foggy window. Cataract development is usually a very gradual process of normal aging, but can occasionally occur rapidly. Many people are unaware that they have cataracts because the changes in their vision are so gradual. Common Cataract Symptoms: Painless blurring of vision Hazy, cloudy vision Sensitivity to light and glare Double vision in one eye Poor night vision Fading or yellowing of colors Frequent changes in glasses or contact lens prescription Steps to Solving Cataract Issues 1. Your cataract evaluation – First you must schedule a cataract evaluation. Our Berks County, Pennsylvania cataract surgeons can diagnose your cataract to determine the severity. Our surgeons will determine if it is time to remove the cataract. 2. How do you want to SEE after cataract surgery? If the doctors have determined that you have a cataract, the only way to solve the problem will be through cataract surgery. Do not be alarmed at this point. If any person lives long enough they will eventually develop cataracts. You will need to have a consultation with our cataract surgeons to determine how you want to see after surgery. Until recently, you could only gain vision at one distance. Now you have the option of advanced technology lens implants that can help you see at near, far and intermediate distances. These intraocular lenses are known as Advanced Technology Lens implants. Please see the Cataract Lens Implant Options page of this website for more details regarding IOLs typically offered by your Berks Eye Surgeon. 3. Schedule your surgery. Cataract surgery has evolved tremendously over the last 25-30 years. Healing times have been drastically reduced and patients go home the same day as the surgery. Please read below to get a better understanding of cataract surgery. Cataract Surgery Treatment Cataract surgery is safe and effective, with a 98% success rate. It gives people the ability to see clearly again, through a simple procedure that lasts minutes. In addition to the summary below, you can be assured your Berks Eye surgeon and the support medical staff will educate you on all steps in the process! The Cataract Surgery Process During cataract surgery, the natural lens of your eye is removed and replaced with a clear artificial lens called an intraocular lens implant. The surgical process involves a small incision, microsurgical, phacoemulsification technique. This means that the cataract surgery is performed using the smallest possible incision, and removal of the lens material is accomplished using an ultrasonic needle. Once the eye has been properly dilated, the eye is then prepared with a cleaning solution. Topical anesthetic is then administered to the surface of the eye. Next, under a microscope an incision of 3 millimeters or less in length is then created at the junction of the cornea (the clear structure on the front of the eye) and the sclera (the white part of the eye). Another dose of anesthetic is then administered inside the eye through this incision. The front part of the lens envelope, known as the lens capsule, is carefully opened so that the lens material can be removed. This is accomplished using a needle-like ultrasonic device, which pulverizes the hardened and yellowed lens proteins known as the cataract.

As a referral center for the evaluation and treatment of glaucoma, Berks Eye Physicians & Surgeons in Berks County, Pennsylvania brings to you the most advanced, proven methods of glaucoma diagnosis as well as comprehensive treatment options. Dr. Tellez and Dr. Michael C. Izzo are fellowship-trained glaucoma specialists and surgeons. All of our physicians provide glaucoma patients with individualized care plans and personalized one-on-one attention. Whether the care plan calls for medication, surgery or simply monitoring exams, your doctor will focus on you as a person and offer the best treatment choices tailored to your individual needs. Our goal is to protect your vision and quality of life and to care for you in the warm and pleasant environment that distinguishes Berks Eye Physicians & Surgeons. What Is Glaucoma? Glaucoma is a group of eye disorders that share the common feature of optic nerve damage. This damage is usually, but not always, caused by elevated fluid pressure within the eye. When pressure inside the eye increases, the optic nerve loses nerve fibers and blind spots can develop, resulting in loss of peripheral or even central vision. The higher the pressure, the greater the chance of damage to the optic nerve. Glaucoma is a leading cause of irreversible visual impairment and blindness in the United States and worldwide. What Is The Optic Nerve? Glaucoma Treatment Wyomissing PAThe optic nerve is the “cable” that exits from the back of the eye and carries the images we see to the brain. It is made up of millions of nerve fibers that start in the retina and end up in the visual processing centers of the back of the brain (the occipital cortex). A healthy optic nerve is necessary for good vision. When the fibers of the optic nerve are damaged in glaucoma, loss of the side vision can develop, which can progress to blindness. Who Is at Risk for Glaucoma? As with many other diseases, certain individuals may be more at risk of developing glaucoma than others. During your glaucoma evaluation, your ophthalmologist will collect a good deal of information to help determine your glaucoma risk factor profile. Below are some of the major risk factors for glaucoma. A family history of glaucoma (especially first-degree relatives) African or Hispanic (especially Mexican) ancestry Anyone over age 60 or African descent over age 40 High myopia (nearsightedness) Past injuries to the eyes High blood pressure Elevated intraocular pressure Central corneal thickness less than 0.5 mm What Causes Glaucoma? Aqueous humor is a clear, watery fluid inside the eye that nourishes the cornea, iris, lens, and maintains intraocular pressure (IOP). This liquid is not part of the tears on the outer surface of the eye. You can think of the flow of aqueous fluid as a sink with the faucet turned on all the time. If the “drainpipe” gets clogged, water collects in the sink and the pressure builds up. If the drainage area of the eye (drainage angle) is blocked or does not work properly, the fluid pressure inside the eye may increase, which can damage the optic nerve. The result of this pressure increase as it pushes against the nerve is constricting (or loss of) the side vision.

Understanding the Retina The retina plays a very important role in our vision. The retina is the innermost nerve layer that lines the back of the eye. Many ophthalmologists compare this to the film of a camera. The retina is responsible for processing the images projected onto it and then the optic nerve transmits this to the brain. Damage to your retina can cause blindness. The retina is susceptible to many types of diseases that we will detail in the web pages of this section What is a Retina Specialist? A retina specialist is a medical doctor trained as an ophthalmologist, who has received additional fellowship training in diseases and surgery of the vitreous and retina. Much of the treatment work done by our retina specialist, Guri Bronner, M.D., involves macular degeneration, diabetic eye disease, retinal detachments, uveitis, and flashes or floaters. We use the latest technology and Imaging here at Berks Eye Physicians & Surgeons in Berks County, PA. What are the Common Problems Associated with the Retina? Common Retinal Issues Reading, PA Macular Degeneration Diabetic Retinopathy Flashes & Floaters Lattice Degeneration Retinal Tear/ Detachment PVD (Posterior Vitreous Detachment) Retinal Vein Occlusion Macular Pucker Macular Hole

The cornea is the clear front surface of the eye. It lies directly in front of the iris and pupil, and it allows light to enter the eye. It also serves to protect the eye from the environment and helps filter out some of the sun’s most damaging ultraviolet (UV) rays. In order to function properly and provide the best vision, the cornea must remain healthy and clear. When the cornea is damaged either by injury, disease or due to hereditary conditions, it may become swollen or scarred. These scars may cause the cornea to scatter or distort light, resulting in reduced vision, sometimes to the point of blindness. If the cornea becomes cloudy or distorted, the only way to restore sight may be a corneal transplant. Common Corneal Issues Corneal Abrasion Also known as a scratched cornea, an abrasion can be very painful and if untreated can lead to an infection. There are multiple treatments that can immediately eliminate the pain as well as decrease the risk of infection Dry Eyes There are many causes of dry eyes, but they all eventually affect the cornea. The cornea has a significant number of nerve endings so when it dries out people may feel irritation, burning, tearing and grittiness. Chalazion (Stye) A chalazion is a blocked oil gland in the eyelids. It can cause eyelid swelling with pain and blurry vision. Often it can be treated with warm compresses, but a small percent need to be surgically drained. Corneal Ulcer A corneal ulcer is a serious condition in which the cornea tissue starts to melt. Most commonly caused by bacterial infections, an ulcer is an urgent condition that is sight threatening and causes redness, pain, sensitivity to light, and decreased vision. Corneal Dystrophy A dystrophy is a genetic disease that causes weakening or degeneration of tissue. These come in many forms in the cornea. Most can be monitored but as they progress will often require a corneal transplant. Epithelial Basement Membrane Disease Often described as “wrinkles” in the cornea, epithelial basement membrane disease is a degeneration of the cornea that worsens with age. It causes many of the same symptoms of dry eye disease. It can also cause severe pain upon wakening. Removal of these “wrinkles” will eliminate the symptoms. Keratoconus This is a thinning and deformation of the cornea that occurs during a patient’s teenage years. It can slowly progress over time leading to vision loss that cannot be corrected with glasses. Special contact lenses are used to correct the vision instead. In severe cases a corneal transplant is necessary to replace the deformed cornea. Corneal Transplant Advances There are two types of corneal transplantation: full thickness and partial thickness. With a full thickness transplant, the complete disease cornea is removed and new cornea is sutured in place. 20 years ago, this was the only method for corneal transplantation. With recent advancements though, these are only used with most severe corneal disease. Nowadays most patients undergo a partial thickness corneal transplant. The benefit of this surgery is increased safety and quicker visual recovery. The most modern form of this surgery is called a Descemet’s Membrane Endothelial Keratoplasty (DMEK). This provides the best chance for good vision, but is difficult to perform so only a small percentage of corneal specialists can do this surgery. Luckily, Dr. Pierson has expertise in this surgery providing patients the highest level of care.

Looking for dry eye treatment in Wyomissing? Dry eye related discomfort is an increasingly common complaint of patients. A recent online poll revealed that nearly half of American over 18 regularly experience dry eye symptoms. Dry eyes affect nearly twice as many women as men. There are roughly 30 million people in the United States and over 300 million worldwide with dry eye. Dry Eye Symptoms The symptoms of dry eye are varied. The list below is not all inclusive, however patients that suffer from dry eye usually experience a number of the following symptoms: Blurry Vision Redness Burning Itching Light sensitivity Excessive Tearing/watery eyes Tired eyes/eye fatigue Stringy mucous in and around the eyes Foreign body sensation Contact lens discomfort Scratchy, feeling of sand or grit in eye What Causes Dry Eye Syndrome? Dry eye syndrome is caused by a chronic lack of sufficient lubrication and moisture on the surface of the eye. Depending on its cause and severity, it may not be completely curable. In most cases, dry eyes can be managed successfully, usually resulting in noticeably greater eye comfort, fewer dry eye symptoms, and often sharper vision. Tears on the surface of the eye are essential to keep your eyes healthy, comfortable and seeing well. A normal tear film consists of three important components: An outer oily (lipid) component produced by meibomian glands in the eyelids A middle watery (aqueous) component produced by lacrimal glands located behind the outer aspect of the upper eyelids An inner mucous-like (mucin) component is produced by goblet cells in the conjunctiva A problem with any of these sources of tear film components can result in tear instability and dry eyes, and there are different categories of dry eyes, depending on which component is affected. If the meibomian glands don’t produce or secrete enough oil, the tear film may evaporate too quickly — a condition called “evaporative dry eye.” The meibomian glands are located along the margin of the eyelids near the base of the eyelashes. These openings can get clogged and as a result the oil that is critical to keeping the tear film from evaporating too quickly cannot do its job. The underlying condition — called Meibomian gland dysfunction or MGD is the root cause of 86% of the cases of dry eye. MGD is a progressive disease that can worsen over time if left untreated. If the obstructed Meibomian glands remain untreated, this can lead to permanent shortening and eventually loss of the glands. Once gland loss has set in it is unlikely to be reversible, so finding and treating MGD early is best. In addition to evaporative dry eye, MGD is also associated with an eyelid problem called blepharitis. In other cases of dry eye syndrome, the primary cause may be a failure of the lacrimal glands to produce enough watery fluid to keep the eyes adequately moistened. This condition is called “aqueous deficiency dry eye.” Some oral medications can also cause ocular dryness, and hormonal changes can also contribute to insufficient and poor quality tears. The specific type of dry eye often will determine the type of treatment your Berks Eye Physicians and Surgeons doctor recommends to give you relief from your dry eye symptoms. Testing for Dry Eye Syndrome Knowing what is causing your Dry Eye will help your Berks Eye doctor determine the best treatment option. Your doctor may perform some or all of the following testing. Osmolarity Testing Takes a sample of your tears to assess quality. It provide a quick and simple method for determining tear osmolarity (saltiness of your tears) using nanoliter (nL) volumes of tear fluid collected directly from the eyelid to aid in the diagnosis of dry eye disease Inflammadry Testing Detects MMP-9, an inflammatory marker that is consistently elevated in the tears of patients with dry eye disease. Using direct sampling microfiltration technology, InflammaDry® accurately identifies elevated levels of MMP-9 protein in tear fluid samples taken from the inside lining of the lower eyelid, the palpebral conjunctiva. Lipiview Testing Berks Eye has the latest technology to view and evaluate the structure of the meibomian glands. We use the LipiView® II Ocular Surface Interferometer with DMI to capture detailed images of the meibomian glands and tear film lipid layer. Tear Film Evaluation Berks County PA Meibomian Gland Evaluation Your Berks Eye doctor may manually or with the help of a Meibomian Gland Evaluator assess whether your glands are excreting any oil. Treatment Options for Dry Eye Syndrome Your Berks Eye doctor may recommend one or a combination of several of these dry eye treatment options:

As we age, upper eyelids droop, skin loosens and there is often puffiness and heaviness of the lids. Upper eyelid surgery has become a popular procedure, because it gives the eyes a renewed and refreshed appearance. When sagging upper eyelid skin interferes with field of vision, people often hold their forehead and brow muscles higher to compensate for impaired vision. The procedure is often considered medically necessary, in such cases it is covered by insurance. The goal of upper blepharoplasty, also known as an eyelid lift, is to remove this excess skin on the eyelids removing obstruction and improving vision. We encourage you to schedule a consultation at Berks Eye Physicians & Surgeons to determine if eyelid surgery is right for you! How Upper Blepharoplasty Works Every year, thousands of men and women choose upper eyelid blepharoplasty to improve their vision and their appearance. Drooping upper eyelids can impair vision and add years to one’s face. Blepharoplasty corrects these problems and also removes puffiness that give the appearance of being worn and tired. Successful facial plastic surgery will involve a good rapport between a patient and the surgeon. Trust, based on realistic expectations and exacting medical expertise develops in the consulting stages before surgery. Your surgeon can answer specific questions about your specific needs. Blepharoplasty removes the excess fat, muscle, and skin from the upper eyelids. The results can be a rejuvenated appearance, with a younger, firmer eye area. People with circulatory, ophthalmological, or serious medical conditions must rely on the diagnostic skills of their own surgeon to determine whether blepharoplasty is an option to consider. During the pre-surgical consultation, you will be examined or asked to answer questions concerning vision, tear production, use of lenses, and your desires for surgery. Your surgeon will explain what you can expect from upper eyelid blepharoplasty. Blepharoplasty Recovery Plan Immediately after the surgery has been completed, antibiotic ointment will be applied. You will be advised to apply ice frequently for two days after surgery. A certain degree of swelling and bruising is normal. Cold compresses, as well as head elevation when lying down, will enhance healing. For a week and a half following blepharoplasty, you will clean the eye area (the eyes may feel sticky, dry, and itchy). Eye-drops may be recommended. Permanent stitches will be removed one week after surgery. Self-absorbing stitches will dissolve on their own. If you are considering Eyelid Surgery in the Eastern Pennsylvania area, call us today at 610.372.0712.

Blepharitis is an inflammation of the eyelids causing red, irritated, itchy eyelids and the formation of dandruff-like scales on eyelashes. It is a common eye disorder caused by either bacterial or a skin condition such as dandruff of the scalp or acne rosacea. It affects people of all ages. Although uncomfortable, blepharitis is not contagious and generally does not cause any permanent damage to eyesight. If you think you may have Blepharitis, please contact our office to make an appointment with one of our board-certified physicians. Please do not attempt to treat the problem without consulting a physician first. Types of Blepharitis Classifications Anterior Blepharitis occurs at the outside front edge of the eyelid where the eyelashes are attached. Posterior Blepharitis affects the inner edge of the eyelid that comes in contact with the eyeball. Individuals with blepharitis may experience a gritty or burning sensation in their eyes, excessive tearing, itching, red and swollen eyelids, dry eyes, or crusting of the eyelids. For some people, blepharitis causes only minor irritation and itching. However, it can lead to more severe signs and symptoms such as blurring of vision, missing or misdirected eyelashes, and inflammation of the cornea. In many cases, good eyelid hygiene and a regular cleaning routine can control blepharitis. This includes frequent scalp and face washing, using warm compresses to soak the eyelids, and doing eyelid scrubs. In cases where a bacterial infection is the cause, various antibiotics and other medications may be prescribed along with eyelid hygiene. Berks Eye sells lid scrubs on our office for your convenience. Simply stop in and ask at check in or you may ask one of our technicians at your next visit. What Causes Blepharitis? Blepharitis can appear as greasy flakes or scales around the base of the eyelashes. Anterior blepharitis is commonly caused by bacteria or dandruff of the scalp and eyebrows. It may also occur due to a combination of factors, or less commonly may be the result of allergies. Posterior blepharitis can be caused by irregular oil production by the glands of the eyelids which creates a favorable environment for bacterial growth. It can also develop as a result of other skin conditions such as acne rosacea and scalp dandruff. How is Blepharitis Treated? Treatment depends on the type of blepharitis. The key to treating most types of blepharitis is keeping the lids clean and free of crusts. Limiting or stopping the use of eye makeup when treating blepharitis is often recommended, as its use will make lid hygiene more difficult. Warm compresses can be applied to loosen the crusts, followed by gentle scrubbing of the eyes with a mixture of water and baby shampoo or an over-the-counter lid cleansing product. In cases involving bacterial infection, an antibiotic may also be prescribed. If the glands in the eyelids are blocked, the eyelids may need to be massaged to clean out oil accumulated in the eyelid glands. Artificial tear solutions or lubricating ointments may be prescribed in some cases. Use of an anti-dandruff shampoo on the scalp can help. If you wear contact lenses, you may have to temporarily discontinue wearing them during treatment. Some cases of blepharitis may require more complex treatment plans. Blepharitis seldom disappears completely. Even with successful treatment, relapses may occur.

Berks Eye Physicians & Surgeons offers emergency treatment when you have an eye issue that requires urgent care. It is important that you see an Optometrist or Ophthalmologist when suffering from an eye injury since a lack of medical attention can cause serious, long-term damage. Whether you have suffered a physical injury or chemical splash, or have noticed sudden, significant changes to your eyesight, please call Berks Eye ASAP by dialing (610) 372-0712 to have your eye issue evaluated by Pennsylvania’s best team of eye doctors. Our doctors will assess your situation quickly and recommend next steps whether that means seeing one of our doctors or proceeding to the emergency room. Symptoms of an Eye Emergency The following symptoms may indicate that you are in need of immediate medical attention by a Berks Eye doctor: Eye Emergency in Wyomissing Chemical contact with eye Sudden loss of vision Black curtain/cobwebs Onset of light flashes Corneal abrasions (scratches on the eye’s surface) Sensation of a foreign object/particle in the eye Painful eye Eyes burning or stinging Sensitivity to light Discharge and crusting Double vision Swelling or drooping eyelids Straight lines look wavy Pupils of unequal size Bulging eyes Eyes not moving together Are Eye Emergencies Covered by Insurance? Eye Emergency in Wyomissing Eye care that is performed to treat an eye emergency is typically covered by medical/health insurance policies and is not covered by vision insurance. Our friendly staff can help advise you of your coverage and file claims with your medical insurance for you. Although eye accidents can happen to anyone, you may be able to prevent a future ocular emergency by visiting your Berks Eye Ophthalmologist or Optometrist regularly. A comprehensive eye exam allows our doctors to assess your eyes and keep tabs on any changes to your eyes or sight. Often, our doctors notice symptoms that precede a future eye emergency, and actions can be taken to prevent or minimize this emergency. Unfortunately, not all conditions have symptoms that are detectable with a comprehensive eye exam. If you notice something wrong with your vision or if you have sustained an injury to your eye that requires immediate attention, please contact Berks Eye at (610) 372-0712.

Comprehensive eye examinations are very important not only to determine if you need correction to see well, but also to maintain the health of your eye. While some eye diseases have obvious symptoms such as red eyes, light sensitivity, or flashing lights, many serious, vision-threatening problems have no warning signs. Glaucoma, for example, will present no symptoms until actual vision loss occurs. Proper eye care and evaluations can help prevent vision loss. Comprehensive eye exams can also detect diabetes, hypertension, retinal holes or tears, and other important treatable medical conditions. A comprehensive eye examination at Berks Eye Physicians & Surgeons involves a series of tests designed to evaluate your vision and check for eye diseases. Each test is necessary and allows your doctor to evaluate a different aspect of your vision. Common Eye Tests We Perform External Eye Exam Your doctor will check your eyes using a light to ensure the exterior parts of your eyes are functioning correctly. In an external eye exam, your eye doctor checks: Your pupils to see if they respond normally, position and movement of your eyes, eyelids and lashes, your cornea and iris for clarity. Eye Muscle Test This test examines your eye muscles to ensure they’re functioning properly. Your eye doctor looks at your eyes as they move in six specific directions. Your doctor will ask you to sit still and look forward, using your eyes to follow an object, such as a pen. The eye muscle test is designed to detect any weaknesses or uncontrolled movements in the muscles that move your eyes up and down and side to side. Visual Acuity Test This test measures how sharply or clearly you can see something at a distance. Your doctor will ask you to identify different letters of the alphabet off a chart positioned usually 20 feet away. The lines of type get smaller as you move down the chart. You cover one eye and read aloud, then cover the other eye and read aloud. Your doctor monitors how well you can identify the letters. Your visual acuity is expressed in a fraction – such as 20/20 vision. The top number refers to your distance from the eye chart, usually 20 feet. The bottom number indicates the distance at which a person with normal eyesight could correctly read the line you read. For example, 20/20 vision means that you can see objects clearly from 20 feet away that a person with normal vision could see clearly from 20 feet away. Refraction Assessment Refraction refers to how light waves are bent as they pass through your cornea and lens. A refraction assessment helps your doctor determine a corrective lens prescription that will give you the sharpest vision. Your doctor will have you look through a phoropter, a devise that holds many lenses, and determine which combination of lenses may give you the sharpest vision. Visual Field Test Your doctor my request you have a visual field test along with your comprehensive examination. This test is used to determine whether you have difficulty seeing in any areas of your peripheral vision – the areas on the side of your visual field. Slit Lamp Examination A slit lamp allows your doctor to see the structures at the front of your eye using a microscope with an intense line of light to illuminate your eye. The slit lamp allows us to examine the cornea, iris, lens and anterior chamber of your eye. Retinal Examination A retinal examination examines the back of your eye, including your retina, optic disc, choroid and blood vessels. We may use special eye drops to dilate your pupils, opening them wider so that we can see the back part of your eye. The effects of these drops will not wear off for several hours. Your vision will be blurry, and you’ll have trouble focusing your eyes. Depending on your job, you might not be able to return to work immediately after your exam. Your eyes will also be very sensitive to the light so we recommend using sunglasses. Tonometry Tonometry measures your intraocular pressure – the pressure inside your eyes. This test in conjunction with other more specific tests such as an OCT, a visual field and a detailed retinal exam will help us determine your risk for the development or progression of glaucoma. Preparing for Your Eye Examination at Berks Eye Physicians & Surgeons Before going to your appointment, please gather information to help answer questions the eye care professional may ask, including: Symptoms of current eye problems (flashes of light, difficulty seeing at night, temporary double vision, loss of vision, etc.) Eye injuries or eye surgeries (approximate dates, where treated) Family history of eye problems (glaucoma, macular degeneration, cataracts, etc.) Any questions about your vision concerning glasses, contacts, laser surgery, etc. A list of all prescriptions and over-the-counter drugs currently being used