SERVICES

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.

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.

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.

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, 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.

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.

HAVE SOMETHING IN YOUR EYE THAT CAN’T BE FLUSHED OUT?
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 (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.

IT HAPPENS EVERYDAY, “MY DOG ATE MY GLASSES.
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.

IF YOU FEEL THERE ARE FIREWORKS GOING OFF IN YOUR EYE OR YOU SEE A SHOWER OF BLACK DOTS, YOU MAY HAVE A REAL URGENT PROBLEM.
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.

AGE RELATED MACULAR DEGENERATION.
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 PUTS YOUR VISION AT RISK.
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.

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.

SIGNS OF DIABETES: THE CLUES WE SEE FROM EXAMINING YOUR EYES.
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

COMMON SYMPTOMS OF DIABETES, ACCORDING TO THE AMERICAN DIABETES ASSOCIATION:

• 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.

PREVENTATIVE EYE CARE AND HYPERTENSION.
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.

BLOOD PRESSURE IS VERY IMPORTANT TO THE HEALTH OF YOUR EYES.
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.

EARLY DETECTION OF GLAUCOMA.
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.

TESTING FOR GLAUCOMA
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.

WHAT IS A GLAUCOMA WORKUP?
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.

GLAUCOMA TREATMENT
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.

TREATING CATARACTS.
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 EYES DON’T HAVE TO WIN.
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.

UNCOVER NEUROLOGICAL DISORDERS.
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.

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.

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.

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.

• 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

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.