“I was having problems seeing at night,” admits active
theatre-guild member Nancy Stroop. “As a performer of Guild on the Go, which is
a troupe that performs all over Vero Beach and its outlying areas, I do a lot
of driving. While driving at night, I was beginning to see halos around the
lights of oncoming cars, which made seeing difficult.
“I like to go
places and do things,” notes Nancy, who is also very active with the Vero Beach
Museum, “and I didn’t want to be tied down worrying about whether or not I
could see to drive. Because I was aware that my symptoms could be a sign of
cataracts, I knew I needed to schedule an appointment with an ophthalmologist.”
Nancy scheduled an appointment with William J. Mallon, MD,
a board-certified ophthalmologist and fellowship-trained ophthalmic plastic and
reconstructive surgeon at the Center for Advanced Eye Care in Vero Beach.
“I have several friends who are patients of Dr. Mallon’s
and I’ve heard nothing but good things about him,” she reflects, “so when I
realized I needed to have my cataracts taken care of, there was no question
that he was the doctor I wanted, so that’s what I did.”
Nancy confides that, along with cataracts, she also had
astigmatism [see sidebar].
“Additionally, I was very,
very
nearsighted,” she says. “I have worn glasses since I was a
little
kiddo
. My vision was so poor
that if I would have tried to go anywhere or do anything without my glasses, it
probably would have been a disaster.”
Consequently, Nancy was pleased to learn that with today’s
improved technology, cataract surgery has now moved into the refractive realm.
The tiny intraocular lens implant that replaces the clouded natural lens is
manufactured with a power that is individualized for each patient. Cataract
surgery may, in fact, reduce or eliminate the need for eyeglasses after
surgery.
“After a few exams by his professional staff members, Dr.
Mallon came in and thoroughly explained everything to me,” remembers Nancy. “I
really appreciated the fact that he did not rush through anything. He answered
all of my questions. He gave me in-depth information. He spent the time and
attention with me that you usually don’t receive from the medical field in
today’s world.”
“We really spend a lot of time with our cataract patients
discussing their needs and their post-cataract goals,” says Dr. Mallon. “There
are many options to choose from, and my goal is to educate our patients so that
they can make their own best choices.”
Myriad of options
Along with deciding when their eyesight has deteriorated
to the point that they want their cataracts removed, patients also need to
choose what type of eyesight they want following surgery.
Patients can have both eyes corrected for distance vision,
in which case they will require glasses for near vision, or they may choose to
have their eyes corrected for close-up vision, in which case they will require
glasses for distance. Some patients may also choose monovision, a technique
where the dominant eye is focused for distance vision and the nondominant eye
is focused for near-to-intermediate vision. Monovison can help patients be as
independent from glasses as possible.
But that is only the beginning.
“Several types of lens implants are available today,”
educates Dr. Mallon. “Along with the monofocal lens, there are multifocal
lenses such as the
ReZoom
and
ReSTOR
lenses, which provide more than
one focal distance.
“These lenses are similar to a bifocal,” notes Dr. Mallon.
“The ReZoom lens seems to deliver better vision in the distance and
intermediate range, whereas the ReSTOR performs better in the near and distance
range but is not as strong in the intermediate zone. ReSTOR might be a better
choice for a patient who is an avid reader or does a lot of close-up work such
as threading needles or painting in miniature.
“The down sides to ReSTOR and ReZoom lenses are that they
can give some patients glare at night, and each patient must go through a
period of adaptation where the brain really learns how to use these new tools.
Not everyone learns them at the same rate, which can vary from a few days up to
several months.”
Then there is the
crystalens
accommodating intraocular lens (IOL), which is a hinged implant designed to
allow the optic, or the part of the lens that you see through, to move back and
forth as you constantly change focus on images around you. It uses the natural
focusing ability of the eye and provides a single focal point throughout a
continuous range of vision from far to near. The lens is actually designed to
move inside the eye, so it simulates more of a natural type of vision. The
quality of the distance, intermediate, and near vision will depend somewhat on
the individual patient.
“These are good lenses for active patients for whom
distance is their most important visual zone, but they want good intermediate
vision as well,” observes Dr. Mallon. “The crystalens is good for night driving
and for patients who do not mind wearing reading glasses to help them with
their near vision.”
For patients with an astigmatism who want monovision or
single-vision lenses, a new
toric
IOL
can correct both vision and astigmatism simultaneously without having to make
extra incisions on the eye.
“Additionally, we offer three different versions of what
is called an
aspheric
IOL,” informs
Dr. Mallon. “These single focus lenses have been shown to provide patients with
improved contrast sensitivity, which results in superior night vision and
reduced aberrations in the eye. However, these lenses are not well suited for
every patient.”
Excellent results
Nancy chose the TECNIS Lens, which is the only lens with
FDA-approved claims for improved functional vision and night-driving simulator
performance.
“Dr. Mallon also corrected my astigmatism at the same time
as my cataract surgery,” says Nancy. “He did my left eye first, and when the surgery
was over, I looked up and thought,
Oh my
heavens, I can actually see all the way across the room.
“It was like a miracle to me because I don’t ever remember
being able to do that. It was just wonderful.
“Two weeks later he did my right eye, and now I am
absolutely amazed at my vision. It is so great not to have to worry about
seeing at night.
“It has made a huge difference. Colors are brighter and
everything is so much clearer. Now I can even go on stage and don’t have to
worry about falling off it if I don’t have my glasses on.”
Nancy laughs. “I can actually see where I’m going.
“To me, it’s miraculous.”
What is astigmatism?
A condition where the cornea (or significantly less often,
the lens) is irregularly shaped, affecting light as it enters the eye causing
blurry vision, is known as astigmatism.
“Rather than having a symmetrical, circular cornea,
patients with astigmatism have a slightly oblong cornea shaped more like a
football,” describes Dr. Mallon. “It is steeper at one angle than another.
Because light rays entering the eye are bent unequally, there is a distortion
of the image on the retina resulting in two focal points. Uncorrected
astigmatism causes ghosting or double images.
“During cataract surgery there is an additional procedure
we can perform that corrects existing astigmatism. The surgery, known as
limbal-relaxing incision, is almost comparable to letting out the seams in a
dress. Using precisely measured limbal-relaxing incisions, we relax the steep
angle in the cornea, providing our patients with reduced or eliminated
astigmatism.”
Dr. Mallon offers his patients various treatment options
for astigmatism, including limbal-relaxing incisions, Lasik, PRK, Alcon Toric
IOLs, and combinations thereof.