Eye Care Services

Supporting Your Eye Health

Marshall Ophthalmology offers comprehensive eye exams to discover early signs of disease or changes in your vision. For children and adults, eye exams are one of the most important things you can do to keep your eyes healthy and functioning. 

The American Academy of Ophthalmology recommends that all adults receive a baseline eye exam at age 40. Identifying the signs of eye disease early gives your doctor the best chance to help preserve your vision.

Some people shouldn’t wait until they are 40 to have a comprehensive eye exam. If you have an eye disease or risk factors for developing one, you should get a comprehensive exam earlier.  

Risk factors for eye disease:

• Diabetes
• High blood pressure
• Family history of eye disease

If you are 60 or older,  yearly exams are recommended to screen for age-related eye diseases such as cataracts, age-related macular degeneration and glaucoma.

Talk to your eye care professional to decide when a comprehensive eye exam is right for you. 

Healthy eyes for every age

Marshall Ophthalmology offers a comprehensive approach to vision health by offering both adult and pediatric eye exams along with extensive treatment options. 

When to have your vision tested

Children 3 years and younger

For children 3 years and younger, pediatricians look for the most common eye problems including lazy eye, crossed eyes or misaligned eyes. If your pediatrician has any concerns, your child will likely be referred to an eye specialist for a more thorough examination. Your child could undergo a more comprehensive eye exam between the ages of 3 and 5.

School-age children and adolescents

It's a good idea to have your child's eyes examined before first grade. If your child has no symptoms and no family history of vision problems, have his or her vision rechecked every one to two years upon the advice of your eye doctor.

Adults

If you have no vision problems and no family history of eye disease, please follow the general examination guidelines below. As always, check with your eye doctor for his or her recommendation. 

• Every five to 10 years in your 20s and 30s
• Every two to four years from 40 to 54
• Every one to three years from 55 to 64
• Every one to two years after age 65

Have your eyes checked more often if you:

• Wear glasses or contact lenses
• Have a family history of eye disease or loss of vision
• Have a chronic disease that puts you at greater risk of eye disease, such as diabetes
• Take medications that may cause eye side effects

While ophthalmologists specialize in the diagnosis and treatment of medical eye conditions, we are well equipped to care for healthy eyes, too. We have the tools to measure you for glasses and contact lenses.

Are you at risk for Diabetic Retinopathy? 

If you have diabetes, the answer is yes, you could be at risk for diabetic retinopathy, a disease which damages the retina causing vision impairment.

Uncontrolled blood sugar that is too high for too long blocks off the small blood vessels that keep the retina healthy. The eye responds by trying to grow new blood vessels, however these new vessels don't develop well and instead, leak fluid into your retina resulting in compromised vision. 

Over time, scar tissue builds up, putting pressure on your retina. This extra pressure can cause your retina to detach or lead to other issues such as glaucoma that may result in blindness. 

Risk factors for diabetic retinopathy

Your risk of developing diabetic retinopathy depends on several factors including: 

• How long you've been diabetic
• How often your blood glucose fluctuates
• How well your sugars are controlled

Dr. Martin can discuss your individual risk factors and develop a screening protocol that will help prevent the development of the disease or control it if you've already been diagnosed. 

Symptoms of diabetic retinopathy

Often, diabetic retinopathy does not cause major disturbances in vision until it has progressed. You may notice:  

• The loss of central vision when you read or drive
• The inability to see colors
• Blurry vision 
• Holes or black spots

Screening for Diabetic Retinopathy

During a comprehensive eye exam, Dr. Martin will dilate your eyes and examine changes in the blood vessels of they eye. She will also study the retina to see if it is swollen or detached. 

Treatment of Diabetic Retinopathy

If you've been diagnosed with diabetic retinopathy, there are several treatment options available including laser, injection, and surgery. Dr. Martin will discuss which options might be right for you.

What is Glaucoma? 

Glaucoma is often a genetic disease that causes damage to the optic nerve. A build up of pressure in the eye called intraocular pressure (IOP), damages the optic nerve which transmits images to your brain. If left untreated, the damage worsens and can cause permanent vision loss within a few years.

There are two types of glaucoma: open-angled glaucoma and angle-closure glaucoma. 

Open-angled glaucoma. This is the most common type of glaucoma in which the drainage system in your eye (trabecular meshwork) does not allow fluid to drain appropriately. 

Angle-closure glaucoma. In this type of glaucoma, the drain space between the iris and cornea becomes too narrow causing a build up of fluid in the eye. 

Risk factors for glaucoma

• Over 40 years old
• Are of African American, Russian, Irish, Japanese, Hispanic, Inuit, or Scandanavian descent 
• Have a family history of glaucoma
• Have diabetes
• Take certain steroid medications 
• Have had trauma to the eye
• Have poor vision

How is Glaucoma Diagnosed? 

During a comprehensive eye exam, your ophthalmologist will put drops in your eyes to dilate your pupils allowing her to observe your optic nerve. Photographs may be taken to help track the progression of the disease over time. Tonometry, or eye pressure test, allows Dr. Martin to check the pressure of your eye. And finally a visual field test may be conducted to determine if you have any peripheral vision loss.

Glaucoma exams, quick and painless. Most people with glaucoma have no symptoms and no pain, therefore regular, comprehensive eye exams are critical to the identification, and treatment of the disease. 

What treatment options are available for Glaucoma? 

There are a variety of modalities available to address and slow the progression of glaucoma. Eye drops, laser surgery, traditional surgery, pills or a combination of these options may be used to prevent or slow the loss of vision related to glaucoma. Dr. Martin can discuss which method is best for the your condition and lifestyle.

Understanding Cataracts

A cataract is a clouding of the normally clear lens of your eye. When this occurs, things tend to look foggy or blurry. 

Eyeglasses or contact lenses are used to correct slight refractive errors caused by early cataracts. More advanced cataracts often require surgery to sharpen vision. 

Risk factors for cataracts

• Aging
• Trauma
• Certian medications such as steroids
• Systemic diseases such as diabetes
• Prolonged exposure to ultraviolet light 

Cataract Surgery

If blurred/foggy vision begins to impact your quality of life, affect your ability to drive, or see clearly at night, cataract surgery may necessary. Cataract surgery has an extremely high success rate and is currently the only effective cataract treatment. Dr. Martin can help determine if cataract surgery is right for you. 

Modern cataract surgery is a quick, relatively painless procedure that often provides immediate vision correction. Benefits include: 

• Outpatient procedure that takes less than 20 minutes.
• No general anesthesia. Anesthetic eye drops are used to numb the eye and intravenous medications may be used to sedate you to ensure that you feel no pain and are relaxed during the procedure.
• Microscopic incision that usually heals without stitches.
• Intraocular lens implantation that often eliminates the need to wear glasses for distance and/or near.

What is Macular Degeneration? 

Age-related Macular Degeneration (AMD) occurs in people over the age of 60 and is the leading cause of permanent vision loss.

As we age, the light sensing nerve tissue of the eye or macula, is vulnerable to deterioration. This break down of the macula can cause blind spots, dim vision and blind spots.

There are two different kinds of macular degeneration - dry and wet form.

Dry form

Dry form macular degeneration often presents as yellow deposits in the macula. While a few of these deposits may not change vision, people often notice a dimming in their eyesight as the deposits grow in size and number over time.

In the later stages of the disease, the light-sensitive layer of cells begins to thin which causes blind spots in central vision. In the most advanced cases of macular degeneration, patients lose central vision. Certain vitamin supplements have been shown to decrease your risk of progression to severe vision loss if you have developed significant dry macular degeneration.

Wet form

The wet form macular degeneration involves an abnormal growth of blood vessels from the choroid underneath the macula. These blood vessels leak fluid and blood into the retina distorting vision, causing blind spots and loss of central vision. Over time, the retina scars leading to permanent loss of central vision. Recently, injectable medications have been developed to treat wet macular degeneration restoring vision to patients.

Who is at risk for developing macular degeneration? 

There are several risk factors involved in the development of macular degeneration. You may be more likely to develop the disease if you are: 

• over the age of 60
• have a familly history of macular degeneration
• smoke
• have high blood pressure
• have high cholesterol
• are obese
• are light skinned and female
• have light eye color. 

Blepharoplasty 

As we age, our skin gradually loses elasticity. The loss of elasticity combined with the constant pull of gravity, eventually leads to drooping and sagging skin on and under our eyes. In some instances, drooping upper eyelids can interfere with eyesight.

Dr. Martin performs blepharoplasty to improve eyesight by removing the excess skin from the upper eyelids.

Small incisions are made along the lash lines allowing the surgeon to remove the excess fat and skin. Tiny stitches are then used to close the incisions and will be removed in five to ten days. Swelling and bruising are common, but most people make a full recovery from the surgery within a week a few weeks.

It is important to note that blepharoplasty does not remove wrinkles, eliminate dark circles, crow's feet or other facial wrinkles.

Other Eyelid Surgeries

Dr. Martin is experienced in the treatment of other problems that can also occur as a result of age including entropion (in-turning of the eyelid) and ectropion (out-turning of the eyelid). She is also trained in the diagnosis and treatment of lesions on the eyelid and around the eye, both benign and malignant. If you notice any eyelid problems, schedule your appointment for further evaluation and discussion of your treatment options.

What is Dry Eye Syndrome?

Millions of people suffer from Dry Eye Syndrome, a condition that results from a deficiency in the oily lipid layer of the eye's tear film. Without this layer, eyes can dry out more quickly leading to dry eye symptoms.

You may suffer from dry eye syndrome if you have any of the following issues: 

• Irritated eyes
• Burning eyes
• Red eyes
• Tired eyes after working on a computer, phone or reading
• Watering
• Fluctuating blurred vision

How is Dry Eye Syndrome treated? 

The first line of therapy is artificial tears, gels, gel inserts, and ointments. They offer temporary relief and provide an important replacement for naturally produced tears in patients with aqueous tear deficiency. Avoid artificial tears with preservatives if you need to apply them more than four times a day.

Another option is to plug the small circular openings at the inner corners of the eyelids where tears drain from the eye into the nose. Punctal plugs can be inserted as a reversible measure or punctal cautery can be performed to permanently close the drainage holes. These procedures help keep the limited volume of tears on the eye for a longer period of time.

Cyclosporine is a prescription drug available to treat dry eye. It increases basic tear production and reduces eye inflammation. It may take up to three to six months for the medication to work.

Xiidra is another prescription drug FDA approved to treat the signs and symptoms of dry eye. Xiidra has been shown to have beneficial effects in just two weeks.

In some patients with dry eye, supplements or dietary sources of omega-3 fatty acids may improve symptoms. The use and dosage should be discussed with your primary medical doctor.

Other things patients can do include: avoiding dry conditions, when possible; wearing glasses or sunglasses that fit close to the face (wrap around shades) or that have side shields to help slow tear evaporation; using a humidifier to add moisture to the air; and allowing eyes to rest and using lubricating products when performing activities that require the use of the eyes for extended periods of time.

Come in today to see which options are right for you. For more information about dry eye, check out Shannon's Dry Eye blog post.

What to do when you have an eye emergency

The eye is a delicate organ which can be easily damaged leading to vision impairment or even vision loss. Marshall Ophthalmology is medically equipped to evaluate and handle most eye-related emergencies. However, in some cases it may be necessary to head to the Emergency Room at your nearest hospital.

Dr. Martin can help determine if you should come to the office or go to the hospital. Please call us at 269-781-4018. 

Eye emergencies include:

• Cuts
• Scratches
• Foreign body in the eye
• Burns
• Exposure to chemicals
• Injury to the eye  
• Certain eye infections
• Medical conditions such as blood clots or glaucoma

At Marshall Ophthalmology, we know managing your health care can be overwhelming—CareHarmony Care Coordination Service is designed to make managing your health a whole lot easier!

Marshall Ophthalmology is proud to announce its partnership with CareHarmony, a Chronic Care Management services provider focused on empowering patients to better manage their chronic conditions. The Medicare-sponsored care coordination program is designed to give patients greater support and access to care between office visits, even while at home.  

Chronic Care Management extends patient care outside the four walls of a physician’s practice to ensure an added layer of support for chronic conditions such as arthritis, diabetes, depression, or high blood pressure. Eligible patients can benefit by receiving monthly telephone assistance from CareHarmony’s dedicated Care Coordinators, who are specially trained to tailor treatment to each patient’s individual needs, including: 

• Assistance with scheduling appointments, lab tests or other tests 
• Explaining how and when to take medications 
• Coordinating home health or medical equipment needs 
• Connecting patients with health education resources, services and programs 
• Identifying available community resources 
• Coordinating follow-up care after leaving the hospital 
• Accessing other support services to help promote health and wellness 

In addition, patients enrolled in the program are granted access to a 24/7/365 Care Coordinator Line to help answer any questions and provide additional assistance, as needed.

This service is covered by Medicare and is subject to your annual deductible and coinsurance (usually 20%). If you have a secondary or supplemental insurance plan, your coinsurance may be covered. It is best to review exactly what your insurance plan covers.  

A CareHarmony Care Coordinator from Marshall Ophthalmology will be calling you soon to explain the service and answer questions. You can enroll in this service or decline it at that time. If you have questions or would like to enroll now, please call (269) 248-7850 to speak with a Care Coordinator.  

Getting you the right support to coordinate your care and achieve your healthcare goals is important to us. Please consider taking advantage of this unique service so we can work with you to help improve your health.   

CCM FAQ  

What is Chronic Care Management? Chronic Care Management is a care coordination program designed by Medicare to help patients better manage their chronic conditions. It was designed to give you greater support and access to care between office visits, even while at home. 

What is a chronic condition? A chronic condition is an ongoing, long-lasting health condition, which will require continual management and treatment. Left untreated, a chronic condition can hinder independence and negatively impact health. A few examples of chronic conditions include asthma, diabetes, arthritis, hypertension, depression, glaucoma, and heart disease.  

What is care coordination? Care Coordination is the deliberate organization of patient care activities and sharing information among all of the participants concerned with a patient's care to achieve safer and more effective care. Care Coordination services (like those that are part of Medicare’s Chronic Care Management program) provide extra layers of support and care between doctor visits to eligible patients who have two or more chronic conditions. 

Who is eligible? To be eligible for the Chronic Care Management program you must be a Medicare beneficiary and have multiple (two or more) chronic conditions expected to last at least 12 months, or until end of life. If you are unsure if your conditions qualify contact your primary care provider and they will be able to assist you further. 

Do I have to be a Medicare member? Yes. At this point the program is only being offered to Medicare patients.  

Why does my doctor want this for me? Managing and coordinating care can be especially difficult if you suffer from multiple chronic conditions. You may be seeing different types of doctors or taking several medications. For every medication you take, it’s important to know how it reacts with other medications. For every doctor you see, there are test results or health information that needs to be shared. When your care is coordinated properly, your doctors get the information they need when they need it.  

But what if I feel fine? One of the great benefits of Chronic Care Management is not only to help you achieve good health, but also to maintain it. That’s why the program also focuses on things like helping you keep on top of preventive care and helping you locate specialists, valuable healthcare resources, and community services.  

What does this program cost? The majority of Medicare patients have secondary insurance, which often covers Chronic Care Management (CCM) program copays. In instances where this isn't the case, CCM may be subject to a modest copay (usually 20%), as well as your deductible. It is best to review exactly what your insurance plan covers. 

Is my information private and secure? Yes. The same rules that protect your medical information in your doctor’s practice apply here as well. Your information is and will always be secure using the latest Certified Information Technology and following all HIPAA guidelines. 

Why should I enroll? Chronic Care Management extends your care outside of the four walls of your physician's practice to help you maintain the best possible health. You will be matched with a dedicated care coordinator and have access to help 24/7. A treatment plan (care pathway) will be created to plan for your ongoing care and better address all your health-related issues. Your care coordinator will be there for you helping you navigate the healthcare system, including scheduling appointments, assisting with refills, and answering lingering questions. Your care coordinator acts as an extension of your doctor and helps your doctor monitor and adjust your care accordingly.  

How do I enroll? Give us a call at 269-248-7850 to learn more about how you can benefit from this program and to gain answers to any questions you may have.  

How do I opt-out of the program? With Chronic Care Management, there is no long-term commitment. You may opt-out any time by notifying us via phone at 269-248-7850 and will be unenrolled at the end of the current month.