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Routine Eye Care

Our high-tech equipment is designed to gather the correct information no matter how nervous you are and where nothing will hurt. We consider your history in concert with all the testing to come up with a diagnosis. This means how do we answer your vision problems, complaints or lack of them to come up with a plan. We then discuss our plan to take care of your eyes. That might mean no treatment is necessary, preventative vitamins to not lose vision, glasses for distance, near, computer, sports and hobbies. This could also deal with any of the myriad of contact lens options from lenses you wear 1 day to specialty contacts made custom for astigmatism, keratoconus or dry eye. This is where we plan for further visits to specifically address your dry eye, diabetes, macular degeneration, or just good ole preventive habits. You bring, we will solve it.

Why get a comprehensive annual eye exam?

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Also known as a well-vision exam, this is like your routine annual physical, but for your eyes. You may not even have a complaint, but we check everything from A to Z. Why? Because most most things that go wrong with eyes have no pain, no symptoms or awareness. For example, patient’s that have the blinding disease called Glaucoma have elevated eye pressure but have no pain. It’s kind of like getting your blood pressure checked, and we all know high blood pressure causes no pain; it just has to be checked. We recommend a yearly preventative eye health exam. It’s always cheaper to keep you healthy than fix you up when you are sick.

What if I need my vision checked for glasses?

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No problem. During you annual eye exam, we will check to see if you need a new corrective prescription or your old one updated. It just takes a few minutes with out automated and synchronized testing equipment. People worry about making the correct lens choices. You know, “which is better 1 or 2?” Don’t worry, our process will not let you make a mistake.

What if I need my vision checked for contact lenses or LASIK?

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Contact lenses are a wonderful option for those who are not in love with glasses. Your suitability for contact lenses, LASIK and Overnight Corneal Reshaping, will be discussed during your routine eye exam. Nowadays you have lots of options. Fortunately, we stock 1000s of lenses to most likely fit you in lenses the same day.

Medical Eye Care

Face it. No one ever plans to get sick.

Often times, our medical conditions involve the health of our eyes.

In fact, many medical conditions first disclose themselves when we examine the interior and exterior of the eye. Think of all the medical shows you’ve seen. There is always someone shining a flashlight at the patient’s eyes or looking at the eye movements or looking inside the eye with an ophthalmoscope. We know the eye is the window to the soul but it is also the window to the rest of the body.

Urgent Eye Care

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If your eye is lacerated, bleeding or has fish hook in it, call 911 or report to the nearest emergency department.

Brill Eye Center can easily and expeditiously handle the most common urgent eyecare problems you may be experiencing. The eye is one cubic inch of the body that the emergency room generally does not like to deal with because they do not have the specialized knowledge and technology to examine closely. They will usually refer you back to an eye doctor. How do we know? We get referrals every day from urgent care clinics and emergency rooms.

Double Vision

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Double vision, also known as diplopia, could be a sign of a brain tumor, stroke or aneurysm. You should see your internist if you have acute onset double vision or go to the emergency room.

Red Eye Treatment

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Fortunately, we can see your eye magnified 40x at the microscope. We also know how to distinguish between allergy, bacterial infections, viral infections, foreign bodies or a dry eye induced red eye.

We can prescribe medicine for you to get at the pharmacy or we may even have a sample.

Abrasions, Pain & Foreign Body Removal

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Most of the time, people know that they were using tools without safety glasses and got something in their eye. Other times, you may not be the welder but you were just standing next to them and got a flash burn.

Sometimes the cause of your pain is not obvious. It may be due to a mascara brush injury, your baby scratching your cornea, or trying to get a contact lens out of your eye you actually lost hours ago.

Whatever the cause, we can make a quick and accurate diagnosis and relieve your pain almost instantly.

Styes or Bumps

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Styes (hordeolas) or bumps (chalazia) can appear quickly and get your attention. This usually means you have a blocked oil gland in your eyelid that needs attention before it gets worse. Special heating, cleansing and medication can resolve styes and bumps if you seek professional attention early enough. This problem can be confused with a life threatening problem called cellulitis, which may require hospitalization.

Broke or Lost Glasses

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While everyone should have a backup pair of glasses and sunglasses, many people like to live dangerously. Don’t worry, we have our optical laboratory on site and often can give you one-hour serve on new glasses replacements. There is no reason to go to the mall, we can do it all in a jiffy.

Flashing lights & floaters

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Most of the time, people that see spots are experiencing what is known as floaters. These can be an innocent representation of debris floating in the vitreous humor. A thorough retinal examination will reveal if you need to have retinal surgery or your floaters are just an innocent variety.

Clue #1: Do you just have one spot that moves in the same direction you move your eyes while looking up at the sky? It’s probably innocent.

Clue #2: Do you see a veil or curtain coming down and your vision is decreased? You are probably having a retinal detachment. Don’t delay, we can get you into a retinal surgeon right away.

Chronic Care

Medical conditions that don’t go away anytime soon are said to be chronic and progressive

The hallmark of a chronic and progressive condition is one that needs to be followed carefully over time. The conditions can get better and worse, or as we say “exacerbate and remit.” Surely, you’ve heard about how an individual’s cancer can go into remission or get worse.

Often, chronic conditions are associated with an inflammatory process, not an infection. These conditions start off being asymptomatic and very few signs may be evident of the illness. Luckily, these conditions are generally noticed during your routine eye exams and physicals. Think about having high blood pressure. It doesn’t hurt, it just has to be measured because there is no pain, symptoms or awareness. It’s chronic, progressive and has to be managed by healthcare providers.

Macular Degeneration

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One of the leading causes of central vision blindness is caused by age-related macular degeneration. The macula is the sensory part of the eye that everyone aims with. If you are looking straight ahead, you are aiming with your macula.

The loss of vision of vision is gradual, but noticeable and can be detected on a routine eye exam by an eye doctor. The cause is generally the effects of ultraviolet light over our whole life as well as smoking and an insufficient diet of dark leafy green vegetables.

A specialized macular pigment optical density test called Quantifeye measures your likelihood of developing macular degeneration over time. Fortunately, it’s never too late to improve your macular function with very specific nutritional supplements that Dr. Brill will recommend.

Diabetes / Hypertension

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If you have been diagnosed with Diabetes or Pre-Diabetes, your vision may be at risk. That’s the bad news. The good news is that our comprehensive eye examination with Optomap panoramic retinal imaging or pupil dilation can be critical to determining if diabetes is affecting your vision. Diabetes is considered to be of epidemic proportion in the U.S. Even before doing the necessary glucose level laboratory tests, diabetes can be detected by an eye examination.

Even before doing the necessary glucose level laboratory tests, diabetes can be detected by an eye examination.

The appearance of blood leaking in the eye, called hemorrhages or microaneurysms heralds the suspicion for diabetes. This is called diabetic retinopathy.

An early type of human lens opacity, called a posterior subcapsular cataract, often is indicative of the metabolic changes seen in diabetes.

Variable changes in glasses prescription on a day-to-day basis may mean that the diabetes is present.
Glaucoma, a condition in which the eye pressure is too high causing a loss of central and peripheral vision.
Macular edema—swelling of the central portion of the retina, leading to decreased vision


  • Polyuria—Frequent urination
  • Polydipsia–Feeling very thirsty
  • Polyphagia–Feeling very hungry very often
  • Extreme fatigue
  • Blurry vision that varies
  • Cuts/bruises that are slow to heal
  • Losing weight–even though you eating a lot (type 1)
  • Tingling, pain, or numbness in the limbs called parasthesias (type 2)

We send a report to your primary care provider and diabetologist every time that you are in for an examination. It is important that we work together as a team to preserve your vision.

Brill Eye Center is all about prevention. We take a preventative approach to vision loss and check for all diseases during our comprehensive examination, including hypertension. We are often the first to suggest that you may have a systemic problem by the findings we see in the eye examination, and can be the first to help get your health and your vision back on track.

Your eyes need to receive the proper blood flow to maintain healthy vision. If you have ever heard someone say they “had a stroke” in their eye, it meant that there was a lack of blood flow to the important optic nerve and retina. The small blood vessels were blocked and allowed the retina or optic nerve to die off.

This lack of blood flow to the retina is called retinopathy. Hypertensive retinopathy and diabetic retinopathy are common. Managing blood pressure levels is key to treating hypertensive retinopathy. When the retina swells from lack of oxygen, vision may be distorted or lost. If the nerve is deprived of oxygen for any length of time, blindness can ensue because the nourishment to the optic nerve does not exist. Without nourishment, the optic nerve will die quickly. This event is referred to as an artery or vein occlusion.

This is comparable to a stroke of the brain where a blocked artery does not allow blood to flow to a specific part of the brain. The eye is considered to be an extension of the brain. The key point is: Manage your blood pressure. It can save your life and vision.


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One of the forms of Glaucoma a condition during which the eye pressure is elevated, eventually causing a loss of central and peripheral vision. More than 3 million people in the United States are affected by glaucoma. While there is no “cure” for this condition, you can protect your eyes from serious vision loss with early-detection examinations and proper treatment.

Checking intraocular presseure is easy. Brill Eye Center employs the most accurate pressure measuring device made called an Ocular Response Analyzer. It checks the eye pressure adjusted for corneal thickness, and the ability of the eye to withstand pressure changes called corneal hysteresas.

We also have the other major testing devices called the I-Care tonometer and a Swiss instrument called the Goldmann tonometer in case we need to double or triple check your pressures.

A comprehensive glaucoma workup includes measuring the extent of your visual field with the Zeiss Humphrey Visual Field Analyzer 3. This is the newest device made for this purpose. The 2nd test involves using a 3D scan of your retina and optic nerve with an instrument called an Optical Coherence Tomographer (OCT). Next a test for corneal thickness is done which is called Pachymetry to determine if the pressure is high due to the cornea being to thick or low because it’s too thin. An assessment of the drainage system of the aqeuous humor is an important test called Gonioscopy. The actual diagnosis of Glaucoma is based on these tests as well as a risk-factor analysis of your personal and family medical history, pharmaceutical use, environmental factors like smoking, migraines and sleep apnea.

While the diagnosis of Glaucoma an be tricky, the treatment usually involves a special pressure lowering eye drop that is used at bedtime. Interestingly, the major side effect of this drug is making your eyelashes longer, darker and thicker. Not bad!

Surgery can be done to lower eye pressure if a patient fails on 4 categories of Glaucoma drops.


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Cataracts cloud the lens of the eye that directly affects vision. This condition is most commonly found among older people, and the risk for cataracts tends to increase with age. A cataract is detected through a comprehensive eye exam, and symptoms can be improved with new glasses, better lighting, or surgery. The moment it affects your everyday activities, is the moment you will want to have the cataract removed

Dry Eye

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Many people who notice symptoms of dry eye experience a scratchy feeling, making it seem like something is in their eye. Other symptoms may involve burning, tearing in excess followed by dryness, pain, redness and blurred vision. If your eyes consistently have the red, itchy feeling of unchecked allergies, but nothing seems to be helping — you may be suffering from dry eye. At Brill Eye Center, we to take a comprehensive 5-step approach that treats your symptoms and gives you relief that lasts.

Neurological Disorders

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Eye exams serve a greater purpose beyond simply “checking your vision.” Neurological disorders, like Multiple sclerosis (MS), have ocular components and can be uncovered during a comprehensive eye examination.

We only use state of the art technology when it comes to caring for our patients.

Objective measurements not requiring a child to respond while they watch a cartoon

A process called, retinoscopy, is performed with a medical flashlight by the doctor to determine myopia, hyperopia or astigmatism. This requires significant skill, patience, and the ability for a child to stay still momentarily while watching a cartoon.

Checking eye pressure for glaucoma

Checking the intraocular pressure of the eye is called Tonometry. A disease called Glaucoma can be detected if the pressure is elevated. Various instruments can measure eye pressure. Brill Eye Center uses the Ocular Response Analyzer, which currently is the most gentle and most accurate instrument on the market.

Assessment of ocular motility

To assess a patient’s ocular motility, a fixation device (which could be letters on a tongue depressor), is moved from left to right in up gaze, straight ahead, and in down gaze. Any unsmooth, jerky, or incomplete movements could mean that a muscle is potentially paralyzed or physically restricted.

Panoramic retinal photography to detect peripheral retinal diseases

The Daytona Optomap Panoramic Widefield retinal photograph has made examination of the inside of the eyes straight forward. Analysis can reveal and detect terrible conditions like cancer as well as minor defects in the eye. In fact, the technology was invented by a Scottish engineer Doug Anderson. His 5-year-old went blind from a retinal detachment. As such, he developed technology that would save the eyesight and lives of thousands of patients a year.

Curvature of the eye and topography of the corneal surface

The very front of the eye is a clear transparent structure that has no blood vessels. The shape of the eye most often determines what or if a child needs a spectacle or contact lens correction. The presence of astigmatism (curvature difference on the front of the eye) and other anomalies like keratoconus (the cornea being shaped like a cone and offering distorted or poor vision) is measured with an Auto-Keratometer, or an instrument call a corneal topographer is make a topographical map of the cornea.

Auto-refraction to help determine what is necessary for a prescription

An auto-refractor is a high-tech instrument used to approximate what the refractive error is in an objective manner (without the need for patient responses) as closely as possible. The quality of these autorefractors over the years has improved greatly. It acts as a starting point to determine the prescription for glasses, which is completed with the patient’s subjective responses.

Analysis of eyelid and eyelash anomalies and cornea health

Face it, children don’t often have the best hygiene. They play in the dirt, then rub their eyes, etc. They get colds and their noses get sniffly, and viruses and bacteria contaminate the eyes and eyelids. Analysis of the infection allows doctors to prescribe the correct medicine or other remedies. Rather than guessing about why a child has a corneal infection or abrasion, Dr. Brill makes a definitive diagnosis. The diagnosis drives the treatment program instead of a shotgun approach performed by non-eye doctors. Antibiotics should be used very judiciously to avoid over prescribing and the development of resistant bugs.

Dry Eye Therapy

Don’t live in discomfort any longer. If you have itchy, red, tired, and irritated eyes – don’t just assume it’s allergies. Chances are, you could be experiencing dry eye. Dry eye doesn’t get the last word. Find the right treatment and the right solution to give you the comfort and lasting relief you’re looking for.

Dry eye is a disease.

For that reason, we call it Ocular Surface Disease. 30% of all people have this disease. Sometimes, dry eye can feel like a mild nuisance, but in other cases, it can cause serious damage to the eye,
even blindness.

While there is no magical “cure” for Dry Eye, it’s important to get it treated and managed before the effects worsen and permanently harm the eye. Left untreated, dry eye can worsen over time because it’s a chronic and progressive condition—like arthritis.


  • Dry sensation
  • Itchy
  • Excess tearing
  • Redness
  • Scratchy, gritty feeling
  • Light sensitivity
  • Blurry vision

Dry is very common, but complex.

It’s not what you think it is. Most people think dry eye means their eyes don’t have enough water. But that’s only true 14% of the time. 86% of the time the problem has to do with a lack of the meibomian oily layer of tears.

Don’t wait. Schedule an exam.

Dry eye is “a multifactorial disease of the ocular surface characterized by a loss of homeostasis of the tear film, and accompanied by ocular symptoms, in which tear film instability and hyperosmolarity, ocular surface inflammation and damage, and neurosensory abnormalities play etiological roles.” In other words, it’s a condition where the tears are inadequate or unstable, leading to inflammation, pain and loss of tear gland structures.

Brill Dry Eye Experience

Root Cause of Dry Eye Disease

Meibomian Gland Dysfunction (MGD) is the source of dry eye conditions for 86% of the time. The other 14% of the time dry eye is due to a lack of the aqueous water layer.

Proper Blinking Is Very Important

When you blink fully the glands squeeze out a small amount of oil onto the eyelid margins. The act of blinking spreads the oil to cover the watery layer and protect it from evaporation.

What Goes Wrong

When these glands become blocked due to improper blinking or atrophy of the meibomian glands, production of the necessary oil to protect the watery layer of the tear film gets compromised. This causes the watery layer to evaporate and leave the corneal surface exposed and inflamed. This process is known as meibomian gland dysfunction, or MGD.

  • Fill out our test to determine if you have Dry Eye
  • You will fill out the Standard Patient Evaluation of Eye Dryness Survey (SPEED).
  • If your score is greater than 6, you have dry eyes, also called Meibomian Gland Dysfunction or MGD for short.
  • We will collect a detailed medical history, including medications that make your eyes dry.

Schedule a dry eye evaluation. Tests will be done to look at the following:

  • Blink pattern
  • Lipid layer thickness
  • Number of oil glands yielding clear oil
  • Lipid Layer thickness and amount of glands yielding clear oil
  • Meibography infrared photography of the oil glands to detect atrophy
  • Evaluation of eyelid inflammation, styes, and chalazia
  • Dye testing for irritation of cornea and conjunctiva
  • Eyelid closure and eyelid seal evaluation
  • Tear Osmolarity. The saltier your tears, the more evaporation you have
  • Staining of the eye with fluorescein and lissamine green for inflammation
  • Tear production with zone quick phenol red thread testing for adequate moisture
  • Screening for ocular allergies, viruses, bacteria, and mite infestation of the eyelids
  • Discuss treatment modalities depending on the diagnosis
  • BlephEx exfoliative eyelid deep cleansing procedure
  • LipiFlow thermal pulsation procedure
  • Anti-inflammatory steroid eye drops
  • Restasis or Xiidra
  • Lubrication eye drops
  • Bandage contact lenses
  • Amniotic membrane use for enhanced healing
  • Eyelid closure and eyelid seal evaluation
  • Scleral contact lenses for corneal surface protection and better vision
  • Discuss what to do to make sure the MGD heals and does not progress further
  • Specific Omega-3 supplements for dry eyes
  • Blink instructions
  • Eyelid cleansing procedures
  • Lubrication eye drops
  • Bandage contact lensesv
  • Ongoing professional care and monitoring
  • Refit into contact lenses that are better for dry eyes
  • Follow-up visits to recheck comfort level and ocular healing
  • Health of meibomian glands
  • Oil flow from oil glands
  • Stability of tears
  • Status of blepharitis
  • Corneal health
  • Vision stability
  • Environmental factors
  • Medications
  • Contact lens wearability
  • Tear Osmolarity
  • Eye redness decrease
  • Symptoms relief
  • Overall eye appearance

Find a Solution to Eye Discomfort

The clinical science behind MGD as the primary cause of dry eye, as well as its treatment, is supported by over 25 years of scientific research.

When it comes to treating dry eye, over the counter eye drops are known to provide some temporary relief by adding fluid to your eye. However, they won’t give you the long-lasting relief you’re looking for. Think of them as a bandage for your symptoms – they may offer temporary relief, but also mask the main problem that needs to be solved.

At Brill Eye Center, we avoid the palliative approach, like “use drops more often.” We like to take a comprehensive approach that treats your symptoms and gives you relief that lasts.

Dry Eye Exposed: Part 1

Dry Eye Exposed: Part 1

Dry Eye Exposed: Part 2

Why I Traveled 3,500 Miles To Receive Dry Eye Treatment From Dr. Brill



If your eyes are frequently uncomfortable, it’s time to make a diagnosis of what is wrong. You need to see an eye care professional who can make a diagnosis of what the main problem is. The diagnosis will drive the recommendations for treatment.


Treating symptoms is only a temporary solution. Dry eye is a chronic and progressive disease so it’s important to not just put a bandage on the problem. Here’s a few ideas: Stop smoking, wear sunglasses outside, avoid air directly blowing on you from fans, start a good omega-3 like Easy Tears brand, and make sure you are not a lazy blinker when using your digital displays. Let your eye doctor determine the root cause of your dry eye so you can find more permanent relief.


Many patients don’t know it, but they sleep with their eyelids partially open. If you wake up with pain, scratchiness, the sensation that there is something in your eye, or mucous discharge, it could be caused by Nocturnal Lagophthalmos or a poor sealing of the eyelids. Because the eyelid does not close completely, it allows the tears in your eyes to dry out, making them feel uncomfortable. It’s tricky to diagnose because you can’t watch yourself as you are sleeping to see if your lids are partially open. We can perform tests to see if this is the cause of your irritation.


Over-the-counter eye drops may help alleviate symptoms by temporarily lubricating eyes, but for ongoing conditions, proper diagnosis and treatment provides relief of dry eyes by treating the root cause rather than just the symptoms. These drops usually are designed to supplement the watery layer of the tears, but this is the issue only 14% of the time. If you use these lubricating drops but the problem recurs in a few minutes, you will need a better answer.


It is certainly possible that your eyes are irritated and itchy due to allergens, however, it is important to take note of how long these symptoms last, since they are also a key indicator of dry eye. If the discomfort persists after allergy season comes and goes, it could be a sign of a more serious problem, such as dry eye. Good antihistamine and mast cell stabilizer drops are on the market. Look for Bepreve, Lastacaft, and Pazeo Rx drops as the best ones. Dry eye and allergies can also coexist. Antihistamine medications will also dry the eye out, so beware, the fix may be more complex than you think.


As always with any medical problem, the ways to treat it vary. For most eye care professionals, dry eye patients may represent a nuisance. Their vision fluctuates with glasses and creates contact lens intolerance. Brill Eye Center has the latest proven diagnostic and treatment tools to address the diagnosed condition. We have a passion for dry eye resolution and love to share the information to address your problems. We prefer to use your time wisely and scientifically treat the root cause of your dry eye instead of trying to just mask the problem with merely palliative treatments. If you go to the emergency room with a broken leg, it is better to cast your leg than just mask the pain with drugs and not solve the root cause.

Pediatric Care

Infant & Children’s Eye Exams
The first professional exam should be at age 10-12 months to avoid the development of a “lazy eye,” also known as amblyopia. Very few people are born with perfect vision today. While it would be nice to be called “eagle eye” your whole life, most people will end up with some form of optical correction to see better at some time in their life. Often, people will not be aware that they do not see well until they have a professional examination, or at least, a school or drivers license screening.

The things you never knew you never knew. We offer those.

Most parents don’t know that a child’s eyes should be checked by an eye doctor at about 10-12 months. “Yes, but the pediatrician checks them with a ‘thiga-ma-jigy’ and I thought that was enough,” you say. Dr. Brill spent an intensive year in a pediatric ophthalmology practice, which included disease detection, exams under anesthesia, and infant contact lens fitting for medical conditions, as well as well-vision eye exams.

  • Tests For Steroacuity and Depth Perception
  • Test for Color Vision
  • Tests for Binocularity
  • Tests for Amblyopia and Strabismus

How Children’s Eye Care Differs.
Kids are not just small adults

Kids do not say, “Mom, please bring me to Dr. Brill so I can see what to do about why I see 20/80 in my right eye and 20/30 out of my left.” They have to have regular routine exams like their regular well-baby checkups.”

Development of binocular skills takes time and refractive error can change rapidly.

Brain development is coordinated with visual development. If there is any interruption in the development due to sickness or hereditary defects, the visual system will be disrupted.”

Amblyopia can be prevented.

Amblyopia is the condition where one eye does not develop properly, causing a difference in visual capability. Sometimes it is due to a significant disparity in optical correction and sometimes accompanied by a turned eye.”

Glasses aren’t your only option.

When it comes to alternatives for correcting children’s eyes for seeing blurry, you have choices. Of course, glasses are a first line of correction and offer ease and safety when the proper materials are used. Consider contact lenses as a viable alternative for myopia prevention.

We participate in InfantSEE.
We provide comprehensive eye exams for babies between 6 and 12 months of age at no cost to you. By partaking in this program we can help to ensure that eye and vision care become an essential part of infant wellness care.

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