A cataract is a clouding of the lens (a clear structure inside the eye). It usually develops as a normal aging process. There are several different types of cataracts depending on which part of the lens is affected. Some of the first symptoms of cataracts include glare and poor night vision (often noticed while driving). As the cataract progresses vision gets worse and reading and driving can become difficult. Treatment involves removing the cataract and placing a clear lens (intraocular lens) in its place. There are many different lens options available depending on your visual needs. The newer technology lenses can even let people see certain zones of vision without glasses after cataract surgery!

If you would like to learn more about cataracts, the American Academy of Ophthalmology also has an excellent webpage for information; just click here: 

Once it has been decided that cataract surgery is the right option for you, you will return for an office visit in which many measurements are taken.  This is to ensure that we choose an implantable lens that will alleviate the problems with your vision.  You will speak with the doctor and the surgery scheduler that day; plan on being in the office for a couple of hours.  The surgery scheduler will also arrange an actual appointment for the surgery.  Nowadays the surgery is done in an outpatient setting, under local anesthesia in the vast majority of cases.  You will need a family member or a friend to give you a ride on the day of surgery.  The entire process on the day of surgery will take about 3 to 4 hours, but only about 20 minutes of that time is the actual operation.  Drs. Greuloch and Jick perform every surgery themselves and will talk to you about what to expect.  Nearly every patient reports that the surgical experience was comfortable and quite simple!  After surgery you will go home and relax with a shield taped over your eye.  There are some lifting restrictions that we will review with you, and you will be taking eye drops to assist the healing of the eye.  There are a few postoperative visits at our office, starting on the first day after surgery.

So how does one know if they have cataracts that need surgery?

If you are having visual problems this may indeed be the case, but of course the doctor may find another cause – the only way to know for sure is to come to our office for a simple evaluation.  Please call us if we can answer any questions or you feel that cataracts may be starting to be a problem for you.

At our Optical Center, every person is taken care of by a team with decades of experience. Our optical dispensary exists to serve our patients; we are not a large mall-style shop trying to rush you in and out the door. Our goal is to give you a high-quality experience and make you look great at the same time. With close to 1000 spectacle and sunglass frames to choose from, we have the perfect pair waiting for you!

Diabetes attacks the small blood vessels of the entire body. When the blood sugar is not well controlled it can damage blood vessels in the back of the eye (the retina). These blood vessels can leak fluid and cause swelling. They can also become too weak to supply the proper amount of oxygen and nutrients to the retina. There are two types of diabetic retinopathy. The most common is nonproliferative diabetic retinopathy. This form ranges from mild to severe and can progress into proliferative diabetic retinopathy. This form involves new blood vessel growth (neovascularization) of the retina. These vessels are extremely weak and grow in irregular patterns. The blood vessels leak and produce scar tissue that has the potential to cause severe vision loss. Excellent blood glucose control has been proven to lower the chance of diabetic retinopathy.

Playing sports with distorted vision can significantly impact your performance. Everyone – from children to adults – should see an optometrist or eye doctor for a comprehensive sports vision exam each season. Visual acuity is as important to sports as training is. Without optimal vision, your ability to return your partner’s ball, hit a homerun, or nail a hole-in-one is severely limited.

Did you know…

that your vision could be negatively affecting your game even if you are seeing clearly? That’s because vision is interconnected to other skills, such as hand-eye coordination. A sports optometrist or eye doctor can help you learn exercises that will maximize the skills you need to deliver your best performance.

Frequently Asked Questions

Do I need to see an eye doctor for a sports vision test?

It is highly recommended that you see an eye health professional who specializes in sports vision if you participate in high-impact or competitive activities. According to the American Optometric Association, thousands of eye injuries occur every year in connection with sports. By visiting a sports optometrist, you can learn ways of protecting your eyes, as well as maximize your visual acuity and coordination.

What should I expect during my sports vision appointment?

You can expect a number of screenings at your exam. Your eye doctor will identify your dominant eye, as well as your visual acuity. You may also test for:

What should I expect after my sports eye exam?

Your eye doctor will make recommendations for treatment, if applicable. This may include vision therapy, eye-hand/foot coordination exercises, or even the use of corrective lenses. You may also be advised to wear sports eyewear to protect your eyes from injury while you are active.

It’s no secret that vision changes as people age. Seniors need to take extra special care of their vision, as there is a host of age-related vision problems and diseases that they are at risk for. As vision patients reach age 60 and beyond, they become at greater risk for developing conditions like macular degeneration, cataracts, glaucoma, and even dry eye. Regular visits to an eye doctor can help identify complications in their earliest stages and also make it possible to treat them sooner. With early treatment, many seniors can reduce their risk for total vision loss and maintain healthy eyes and vision for life.

Did you know…

that seniors are more likely to experience visual impairments when driving – especially at night? Often, seniors suffer the loss of peripheral vision or develop cataracts that distort oncoming headlights and street  lights. For safer driving, the American Optometric Association recommends limiting vehicle usage to daytime hours only, as well as reducing overall speed when driving.

Frequently Asked Questions

I just celebrated my 60th birthday. Should I get a senior eye exam?

Yes. Eye exams are more important than ever during the senior years. You should be getting a comprehensive eye exam at least once per year or more if recommended by your eye doctor. Also, do not hesitate to make an appointment before your next annual appointment if you notice any changes to your vision.

What should I expect at a senior eye exam?

Your senior eye exam will be much like the exams you’ve had for years. It will consist of a number of screenings, including tests for your visual acuity, peripheral field vision, and color distinction. Especially important is the retinal exam, which can help to identify the development of a number of vision and health complications.

Is there anything that I should be doing between exams?

Aside from practicing safe driving habits, it may help to supplement your vision with magnifiers and vision enhancers if you are experiencing difficulty with your eyesight. If your eye doctor has prescribed corrective lenses, be sure to wear them as directed – especially when driving, exercising, or walking. You may also find that using products with large types, such as phones and watches, is helpful for managing day-to-day activities.

A retinal exam – also referred to as an ophthalmoscopy – is an in-office screening used to examine the back of your eye. Checking the retina is important because a simple examination can reveal the presence of a number of underlying conditions, including diabetes, retinal detachment, glaucoma, macular degeneration, and cancer. Early diagnosis of these disorders is important for minimizing the risk of vision loss and other health complications.

Did you know?

It is important that you share information about your health history with your eye doctor prior to your examination. This is especially true if you are visiting a new eye doctor or you have had changes in your health since your last screening. Bring a list of your medications and allergies, and be sure to discuss any recent or chronic illnesses you have had.

Frequently Asked Questions

Should I get a retinal exam?

You should have a retinal exam on a regular basis – preferably every year at your periodic eye check-up. Because retinal exams can reveal so many disorders and diseases, patients of all ages – including school-age children – should have a retinal exam each year.

What should I expect during my retinal exam?

Prior to your exam, your eye doctor will put drops in your eyes to dilate your pupils. He or she will then peer into the back of your eye using a special instrument called an ophthalmoscope. Through this device, your eye doctor will be able to view the blood vessels and tissues that surround the retina.

What happens after my retinal exam is over?

Following your exam, you may experience some vision blurring or sensitivity to light due to your dilated pupil. Side effects are only temporary, however, and you should be able to return to your normal routine soon after leaving the office. If your eye doctor finds anything unusual or abnormal during your retinal exam, you may need additional screenings.

LASIK and PRK are ‘refractive surgeries’ that are designed to lessen a person’s dependence on their glasses or contact lenses.  The vast majority of patients who have undergone this type of surgery consider it a very large improvement in their lifestyle.

The LASIK or PRK procedure can only be performed by ophthalmologists, medical doctors who specialize in surgical treatments of the eye.  Dr. Greuloch performs all of the refractive surgeries at Complete Eye Care Inc.  Here is a general outline of the procedure:

 

    •  A special spring is placed on the eyelids to keep the patient from blinking.  Anesthetic eye drops are then applied to the eye
    • Dr. Greuloch creates a protective flap* to access the inner corneal tissue. During this part of the procedure, your vision dims and becomes blurry for about a minute.  After the flap is created you are able to see the flashing fixation light of the laser and the bright lights used for the LASIK procedure.
  • Next the inner layers of your cornea receive computer-controlled pulses of cool laser light. Although the laser light is invisible, the laser makes a clicking sound as it gently reshapes** the inner corneal layer to improve and in many cases, eliminate your prescription. During this part of the procedure, an eye-tracking device tracks your eye movements to ensure precise correction.

Following the re-shaping of the tissue, the LASIK surgeon carefully repositions and aligns the flap to its original position. Protective shields are placed over your eye to prevent accidental rubbing as the flap heals naturally and securely over the next several hours.

With PRK, the above steps are the same except that there is no flap created.  The thin, frontmost layer (the ‘epithelium’) of the cornea is removed instead.  After the procedure a contact lens is placed over the eye to help the healing process of the epithelium.

*You may have read about a microkeratome, which is a blade that is used to create the flap.  We do not use this anymore, as “Intralase” is now available.  This allows us to use a special laser not only to treat your glasses prescription, but to create the flap.  Dr. Greuloch finds this more accurate, safe, and repeatable.

**Your LASIK or PRK will be done with a Custom treatment whenever possible.  This means that the computer tells the laser to treat your cornea with measurements specifically tailored to your eye, resulting in an even better result!

Want to learn even more about LASIK from the American Academy of Ophthalmology? Click here

Frequently Asked Questions:

1. How do I know if I’m a candidate for LASIK?
A complete eye exam will confirm whether you are nearsighted, farsighted and/or have astigmatism. There must be no ocular health problems present, such as cataracts or untreated glaucoma. Additional measurements are needed, such as the thickness of the cornea and a corneal surface mapping.  Dr. Greuloch can ultimately determine whether the patient is a candidate for LASIK

2. What is involved in LASIK? How long does it take?
The procedure takes 5-7 minutes per eye. It is done under topical anesthetic drops. During IntraLase a laser is used to create a flap and remove a precise amount of corneal tissue. After the laser treatment, the flap is laid back into position and kept in place by natural suction, no sutures. Eye drops are used and plastic shields are placed over the eyes to protect them until the following day. Results are almost immediate, with minimum discomfort during the first 24-hour period.

3. How does the laser work?
The excimer laser uses a cold light beam to sculpt the cornea’s surface to the desired shape, correcting nearsightedness, farsightedness and/or astigmatism.

4. Does it hurt?
The cornea is easily numbed with eye drops during the procedure. Most patients say they have little to no discomfort both during and after LASIK.

5. What about recovery?
Recovery is relatively fast. The first couple of hours after surgery, the eye feels somewhat irritated, with a burning sensation and some tearing. Vision is typically blurry during this time. Most patients nap for a couple of hours to rest the eyes. After several hours, the irritation goes away and the vision begins to clear. The day after surgery, most irritating sensations are completely gone and vision is remarkably clear.  If you are undergoing PRK, the healing time is somewhat longer, and this will be reviewed with you.

6. I hate to have anything in my eye. What if I am really nervous?
A mild sedative is available prior to surgery to encourage relaxation during the procedure.  Dr. Greuloch and the procedure room technicians often talk throughout the procedure to put patients at ease.

7. Are both eyes done at the same time?
Some patients may prefer to have each eye done on different days. In most cases, however, both eyes are done on the same day. This avoids the period of imbalance that occurs if one eye still needs correction while the other one doesn’t.

8. What if I move my eye or blink during the procedure?
You will be lying back in a comfortable bed, staring up into a fixation light. During the procedure, a speculum, or lid separator, is used to hold the eyelid open and to prevent blinking. The surgeon has complete control of the laser at all times and, if the need should arise, can stop the procedure until the patient can focus on the fixation light.

9. Will I need glasses after the surgery?
With any medical procedure, there is not a guarantee of perfect vision. Almost everyone experiences improved vision, however, and most see well enough to pass a drivers’ test without corrective lenses. It is important to know that LASIK does not eliminate the need for reading glasses. Beginning at around the age of 40, a condition called presbyopia usually appears, requiring reading glasses or bifocal correction. The laser cannot correct presbyopia at this time; however, there are some promising treatment options on the horizon.

10. How long will I need to take off work?
Most patients return to work within two days.  We will examine you on the first day after surgery and determine how quickly you may return.

11. Will LASIK interfere with my lifestyle?
Active sports should be postponed for two weeks or until the eye is fully healed, unless protective eyewear is approved by the surgeon. Swimming, hot tubs and saunas should be avoided, as well. After full recovery, normal activity can resume, and the ability to play sports without glasses makes them more enjoyable for many patients.

12. How long will the correction last?
LASIK is a permanent procedure. In some cases, however, an enhancement procedure may be required. Some patients’ eyes may change throughout their lifetime, which can happen with glasses or contact lenses as well.

13. Is it true that it takes six months to improve vision after LASIK?  What about PRK?
Fluctuation can occur, but visual improvement is almost immediate following the procedure. Most patients feel that major fluctuations have stopped after two weeks. At the same time, it may take additional time for all of the swelling in the eye to resolve and fluctuations to cease. Many patients do have healing that, in a minor sense, may continue to improve over six to nine months.  PRK more commonly takes 6 months or somewhat longer to attain maximum vision correction.

14. How safe is the procedure? Are there risks?
The procedure is very safe, and that is why it has been so readily accepted. With any surgical procedures, however, there may be complications. Vision-threatening complications do exist, but they are extremely rare. These include infections (an incidence of 1 in 5,000) and irregular healing processes that can lead to something called “irregular astigmatism” that glasses cannot correct and contact lenses or further surgery may be required to improve. There are also complications, which may lead to temporary blurriness, temporary dependence on glasses or contact lenses or a need for additional surgery. In most cases, the patient can still do well and recover with good vision; however it should be known by the patient that serious problems can occur, albeit rarely.

15. What is the success rate?
Success depends on several factors, the most important being the degree of nearsightedness, farsightedness or astigmatism. Depending on the prescription, the surgeon can help determine the likelihood of reaching 20/40 or greater vision. Approximately 95 percent of eyes treated with LASIK reach 20/40 or better vision with one procedure, which is the requirement for driving legally without correction. If a patient does not achieve his or her goal with one procedure, additional correction often improves their vision to a satisfactory level.

16. I am farsighted. Can LASIK or PRK correct my vision?
In the low and moderate ranges, LASIK can treat farsightedness. For high levels of farsightedness, LASIK does not work as well and other refractive procedures may provide a better level of correction.

17. What about astigmatism?
The laser can treat most levels of astigmatism. The laser does this by removing more tissue in one direction of the eye than another to make it more round.

18. I have dry eyes. Is LASIK or PRK still an option?
Many patients who desire LASIK surgery have dry eyes. They have become intolerant of their contact lenses because the dryness makes them uncomfortable. LASIK occasionally worsens dry eyes, but typically, this is temporary and usually treated with frequent artificial tear lubrication. In special cases of severely dry eyes, special punctal plugs that are placed in the lower eyelid tear ducts can be inserted with a significant improvement in dryness. These are easily removed in the office once the dryness resolves, or they can be left in place permanently.  Additionally, the prescription eye drop called “Restasis” can be beneficial.

19. I need reading glasses. Can LASIK correct my vision?
LASIK only corrects the distance vision. If LASIK is performed such that distance glasses are not needed, and the patient is over 40, it is likely that they will need to put on a pair of glasses to read. The exception to this is when patients opt to have monovision, when one eye is corrected fully for the distance and the other is left nearsighted. Only about 10 to 20 percent of patients opt to have monovision correction, and it is only recommended in patients who have tried it with contact lenses and liked the results, as there is a slight decrease in depth perception with monovision.

20. Will insurance cover LASIK?
Most insurance companies do not cover LASIK. Some special employee programs, however, do cover a certain percentage. Patients should inquire with their insurance representatives to determine benefits and coverage.  Complete Eye Care Inc. offers financing plans to try to make this life-changing procedure as easily attainable for our patients as possible.

Glaucoma is a term used to refer to a group of eye diseases that ultimately cause damage to the optic nerve. Unfortunately, there is no cure for glaucoma; but there are treatments available to help manage the condition and prevent vision loss. People with glaucoma often experience slow and gradual vision loss that is so subtle, it is virtually undetectable until it reaches advanced stages. Glaucoma often presents no other symptoms than vision loss, which is why it is important to visit an eye doctor periodically for comprehensive eye exams. As the disease progresses, it can eye pain and nausea, as well as total vision loss.

Did you know…

that glaucoma is a leading cause of blindness in the United States? It accounts for approximately 10 percent of all cases of total vision loss – some who lose their vision despite seeking treatment. The disease can strike anyone at any time, from birth to old age. More than 2 million Americans are believed to live with glaucoma, of who only 50 percent have received a diagnosis.

Frequently Asked Questions

Should I see an eye doctor about glaucoma testing?

Your eye doctor should perform a routine glaucoma screening at your periodic eye exams. However, you should see your eye doctor if you notice changes in your vision, such as blurring or halos when you look at lights. There are several tests available to test for glaucoma, including intraocular pressure testing and visual field testing. These screenings are painless, but could make it possible to diagnose and treat glaucoma in its earliest stages.

What should I expect during glaucoma treatment?

Treatment for glaucoma depends on the severity of the disease. If your eye doctor diagnoses you with the disease, you may begin with a conservative treatment regimen of medicated eye drops or medications that help reduce pressure in your eye. If these types of treatments are ineffective, your eye doctor may recommend a more aggressive treatment plan that includes a surgery to relieve excess fluids from the eye.

Will I need to follow any special instructions during treatment?

If you are taking medications or eye drops to alleviate pressure in your eyes, it is important that you do so according to your eye doctor’s instructions. If you undergo surgical treatment for glaucoma, you will need to adhere to a strict set of post-operative instructions in the days and weeks after your procedure. For example, you will need to wear an eye patch for the first 24 hours after your procedure, and avoid getting water or other substances in your eyes. You’ll also be told to avoid straining your eyes, refrain from strenuous activity, and wear an eye shield at night during the first several weeks after your procedure. Expect to feel some increased sensitivity in your eye, as well as a ‘scratchy’ sensation.

Eyeglasses are removable lenses used to correct vision impairments. Some, such as reading glasses, can be purchased over the counter at local drug stores. Others, such as those used to treat refractive errors like myopia and hyperopia, are available only by prescription from an optometrist or ophthalmologist. In cities around the world, including, eyeglasses are not only a solution for vision impairments but also fashionable accessories for people of all ages. In most cases, vision patients select a frame – usually made of metal or plastic, and then an eyeglass technician sculpts prescriptive lenses to fit it.

Did you know…

that eye glasses have been used to treat refractive errors for more than 700 years? They were once hand-held but eventually evolved into the wearable lenses we have today. Of the 143 million Americans who wear prescriptive eyewear, more than 90 million of them choose eyeglasses.

Frequently Asked Questions

Do I need to wear eyeglasses?

You may need to wear corrective lenses, such as eyeglasses, if you experience difficulty seeing clearly at a distance, up close, or while reading a book. The only way of knowing the type of glasses you may need is by scheduling an eye examination with your eye doctor.

What should I expect when wearing eyeglasses?

If you need to wear eyeglasses, they will be adjusted and customized to comfortably fit your face at the time of purchase. You’ll need to wear them according to the recommendations of your eye doctor, such as for driving or while reading a book. Keep in mind that it may take some time to adjust to eyeglasses, as some patients experience mild vision distortion during the first few days or hours of initial wear.

Do I need to follow any special instructions while wearing eyeglasses?

You will need to keep your eyeglasses clean in order to reap the maximum benefits from your corrective lenses. If possible, only clean your lenses using a microfiber cloth and eyeglass solution. Using paper towels or other cleaning materials can cause abrasions to the lens.

Eye exams are professional screenings used to evaluate the health of the eye and diagnose vision impairments and disease. Each is comprised of a series of several tests that analyze various functions of the eye, such as color differentiation, distance vision, and peripheral awareness. A comprehensive eye exam can identify vision complications during their earliest stages, providing eye doctors the opportunity to treat them more easily. A comprehensive eye exam will consist of:

  • Visual acuity testing to measure the clarity of your sight
  • Refractive evaluation to diagnose refractive errors
  • Visual field testing to measure your peripheral vision
  • Color vision analysis to identify an inability to distinguish certain colors
  • Examination of the back of your eye, retina, and underlying blood vessels
  • Glaucoma testing to measure intraocular fluid pressure
  • Eye muscle testing to identify weak eye movements
  • Corneal exam to evaluate the health of the cornea, iris, lens and surrounding tissues

Did you know…

that a periodic eye exam can reveal underlying health issues long before other symptoms are present? In addition to identifying vision complications and eye disease, a comprehensive eye examination can also reveal conditions like high blood pressure, diabetes, or even a brain tumor. 

Frequently Asked Questions

I’m healthy and can see clearly. Do I need an eye exam?

Yes. Eye examinations can reveal much more than vision impairments – they can save lives. If you haven’t had an eye exam in the past 12 to 24 months, contact your eye doctor to schedule an appointment.

What should I expect during my eye examination?

Your eye exam will take approximately half an hour and will include a series of tests using advanced optometric machinery. You will also be asked about your medical history and any vision complications you may be experiencing. Eye exams typically do not hurt, but you can expect to look into bright lights or have air blown into your eyes during your visit.

What should I expect following my appointment?

If you are given a clean bill of health with no vision impairments, you can return to your normal activities and plan to visit your eye doctor again in one to two year. If you are found to have refractive errors, you may be given a prescription for corrective lenses. In cases where a disease is present, you may be referred to a vision or medical specialist for further treatment.

Kevin Greuloch, M.D.
Sharon L. Jick, M.D.
Paul D. Luong, O.D.

Office Hours
Monday – Friday
8am-4pm
Select Saturdays (please call ahead)
8am-11am

9890 Clayton Rd., STE 200
St. Louis, MO 63124
Phone: 314.395.9613

www.eyestl.com
info@eyestl.com

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James C. Bobrow, M.D.
Paul D. Luong, O.D.

Office Hours
Monday – Friday
8am-4:30pm

121 Hunter Ave., STE 102
St. Louis, MO 63124
Phone: 314.721.1140

www.eyestl.com
info@eyestl.com

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