Diabetic Retinopathy

For a diabetic, eye care is very important to preserve vision. Diabetes is a condition where the body cannot produce enough insulin, a hormone which helps in digesting sugar, or cannot use it effectively. When the blood sugar level is too high, it can damage the blood vessels in the eyes, a condition known as diabetic retinopathy.

The longer someone has diabetes, the more likely they are to develop retinopathy. The eye’s blood vessels become fragile and start to leak. This gives blurry vision. It also impairs blood flow in the eye tissues and the lack of oxygen causes new blood vessels to develop. These new blood vessels are also fragile, and also leak and can cause scar tissue. The retina may be pulled away from the back of the eye (retinal detachment). Left untreated, it can lead to blindness.

Anyone with diabetes could potentially develop diabetic retinopathy. Patients may not initially notice vision changes, but it can later lead to an extremely dangerous form of the disease and cause blindness.

What Causes Diabetic Retinopathy?

Those with diabetes don't typically develop diabetic retinopathy until they have had diabetes for at least 10 years. A change in blood-sugar levels also increases the risk of diabetic retinopathy. High blood sugar can damage blood vessels in the retina which causes them to leak fluid or bleed. This leads to swelling, formation of deposits in the retina, and impaired vision.

Dr. Carter recommends that anyone diagnosed with diabetes have a dilated eye exam at least once a year.

Prevention

You can significantly reduce the risk of developing diabetic retinopathy by taking proper care of yourself.
• Keep your blood sugar under control
• Maintain a healthy diet
• Exercise regularly
• Monitor your blood pressure
• See a doctor regularly

Treatment

The American Academy of Ophthalmology estimates that 95 percent of those with diabetic retinopathy can avoid vision loss if they are well-monitored and treated early. A laser can be used to seal off leaking blood vessels and destroy new growth. While this treatment has proven successful, Dr. Carter stresses the importance of regular eye exams for any patient with diabetes.

If you are diabetic and have more questions or need to schedule an eye exam, please contact our diabetic eye care office today. We serve the Dallas, Texas area.

IOL Risks

Complications associated with intraocular lenses and implantation surgery occur in less than 5 percent of cases, but some IOL risks do exist. Dr. Carter will examine your eyes and carefully review your medical history to determine if you are a good IOL candidate. If you are eligible, the final decision on whether to have IOL surgery is yours. IOLs can correct the vision problems of cataracts and presbyopia.

Intraocular Lens Risks
The most common IOL risk is minor infection. This is generally caught early and managed effectively with antibiotics. Other complications are possible but not necessarily severe.

• Corneal Edema: Swelling in the cornea affects most IOL patients after surgery. If the cornea was healthy before your surgery, the edema should clear up on its own within a day or two. If it persists for longer, Dr. Carter can provide treatment and medications.
• Increased Intraocular Pressure: A spike in intraocular pressure is fairly common following an IOL procedure. One cause is temporarily retained viscoelastic – a jelly-like substance used to facilitate placement and positioning of the IOL. The thick consistency of viscoelastic can inhibit draining of your eye's aqueous fluid, causing intraocular inflammation. Topical medications clear up the problem in most cases.
• Leakage: Wound leaks can cause serious complications if left without treatment. With leakage, the interior of your eye becomes exposed to infectious agents. If a leak is discovered, a bandage contact lens is placed over the eye and will usually slow the leak to allow natural healing.
• Retinal Detachment: During IOL surgery, a retinal tear can cause ocular fluid to seep behind the retina and lead to retinal detachment. Patients with retinal detachment are most often referred to a retinal specialist.

Please call or email eye surgeon Dr. Carter if you would like a free personal consultation and more information about the IOL procedure.

Risk Factors of Developing Glaucoma

Glaucoma is an eye disease that destroys vision by damaging the optic nerve. If left untreated, it causes blindness. Prevention and early detection are the best measures against glaucoma, and being aware of your risk factors is important.

Risk factors for glaucoma include:
• Previous Injury or Surgery -- Eye injuries can damage the eye leading to difficulty with fluid drainage. Complications from eye surgery can also lead to glaucoma.
• Family History – Your risk of getting glaucoma is increased if someone in your family has the disease, because it may be inherited.
• High Blood Pressure – Some studies show that having high blood pressure increases the risk of glaucoma.
• Diabetes – Some studies show that diabetes is associated with an increased risk of developing glaucoma.
• Hypothyroidism – Hypothyroidism (reduced production of thyroid hormones) has been identified as a possible glaucoma risk factor.
• Obesity – Obesity and metabolic problems have been linked to an increased risk for glaucoma.
• Thin Corneas – Clinical trials have discovered that patients with thinner corneas (the clear structure at the front of the eye) are at a higher risk.
• Refractive Issues – Being nearsighted increases the risk of developing open-angle glaucoma. Being farsighted increases the risk for closed-angle glaucoma.
• Race – Open-angle glaucoma is the leading cause of blindness for people who have Black, Hispanic, Eskimo or Asian backgrounds.
• Age – The American Academy of Ophthalmology reports that the risk of getting glaucoma increases after age 50.

Dr. Carter will take the necessary time to discuss your concerns and answer questions you may have. If you are in the Dallas, Texas area, please contact glaucoma specialist Dr. Carter to set up your free vision consultation.

Optical Services

If you are not ready to have a vision correction procedure at this time, there are extensive optical services available to meet your needs. Purchasing a quality pair of glasses is not always an easy decision. Options for selecting eyewear include:

Thinner/Lighter Lenses
Two options for crafting thinner and lighter lenses are:
• Polycarbonate -- aside from its thinner and lighter qualities, polycarbonate is also the most impact-resistant lens material.
• Hi-index material – may be thinner than polycarbonate material and may also offer better optics for you.

Multifocal Lenses
Individuals requiring bifocal or trifocal lenses must decide whether to have a line or no line visible on the lens. A no-line bifocal gradually increases magnification as one looks down the lens. A lined bifocal provides a clearly marked section of the lower portion of the lens with no gradual increase.

Transitions® Lenses
Transitions® lenses darken in sunlight and lighten indoors. They are available in polycarbonate or hi-index material, with gray or brown tint. Transitions lenses are a great alternative for patients interested in having prescription sunglasses.

Anti-Reflective Coatings
Glass, plastic, polycarbonate and hi-index lenses all benefit from anti-reflective coating. This is a hard coating applied to both sides of a lens to help eliminate reflections, such as those caused by computer monitors or oncoming car headlights.

To learn more about your optical choices, please contact eye surgeon Dr. Carter today for a free personal consultation. Our office is in Dallas, Texas.

Eyelid Surgery

Your eyes are one of the first facial areas to show signs of aging. Bags under the eyes and sagging upper eyelids can be corrected with a cosmetic eyelid surgery called blepharoplasty. A Carter Eye Center surgeon uses this fairly simple cosmetic procedure to refresh the appearance of your face and help you to look years younger.

What is Blepharoplasty?

Cosmetic eyelid surgery dramatically improves the look of tired or drooping eyes. A Carter Eye Center surgeon will surgically remove excess skin and pockets of fat from the upper and lower eyelids. In some cases, patients may combine blepharoplasty with other treatments, such as a browlift to raise drooping eyebrows, or BOTOX® injections to treat crow’s feet and frown lines.

Who is Eligible for Blepharoplasty?

Blepharoplasty may a good option if you are in good physical health and have realistic expectations about the outcome. Many people who choose to have eyelid surgery are over 35, but those who have inherited droopy eyelids can have the procedure at an earlier age. If drooping lids are obstructing your vision, a Carter Eye Center surgeon can use blepharoplasty to remedy that problem.

You may not be eligible for blepharoplasty if you suffer from: high blood pressure, diabetes, insufficient tear production, circulatory disorders or cardiovascular disease.

Risks and Benefits

Blepharoplasty brings the same risks as all other surgeries, of excess bleeding, blood clots and infection. But when performed by an experienced and highly-qualified surgeon like a Carter Eye Center surgeon, who is specifically an eye surgeon, the risk level is extremely low. You can lower it even further by following a Carter Eye Center surgeon’s directions exactly, both before and after your surgery.

The benefits are having a younger and more alert appearance of the eyes and perhaps vision improvement also, if you have very droopy eyelids obscuring part of your visual field. The results of eyelid surgery are typically long-lasting.

The decision to undergo any type of cosmetic surgery should be made only after you have all questions answered and concerns addressed. The doctors at Carter Eye Center will gladly help you make an informed decision.

To learn more about eyelid surgery and to discover whether you would be a good candidate for it, please contact the eye surgeons at Carter Eye Center in Dallas, Texas

Types of Glaucoma

Glaucoma is the name for a group of eye diseases which damage the optic nerve. Most often a glaucomatous eye has increased intraocular pressure (IOP), resulting either from too much fluid being produced in the eye or too little draining out. Below are the most common types of glaucoma.

Open Angle Glaucoma
Open-angle is the most common. The anterior structures of the eye can appear normal, but the optic nerve is gradually being damaged and therefore your vision is slowly disappearing. The damage is often caused by aqueous fluid building up and increasing the IOP. In some cases, the IOP is within normal range but damage is still occurring on the optic nerve. Peripheral vision is affected first, without any noticeable symptoms. Eye drops are typically prescribed to lower the pressure. In some cases, surgery is necessary.

Acute Angle Closure Glaucoma
Only about 10% of glaucoma patients have this type. The space between the iris and cornea becomes more narrow than normal, leaving a smaller canal for the aqueous to pass through. If the flow becomes completely blocked, the IOP will rise sharply and cause sudden vision loss.

Secondary Glaucoma
This form happens as the result of another disease or problem with the eye, such as:
• Eye trauma
• Inflammation
• Previous surgery
• Diabetes
• Certain medications

In these cases, both the glaucoma and the primary problem must be treated.

Congenital Glaucoma
This is a rare type that may occur in infants. In most cases, surgery is required.

Dr. Carter will be happy to discuss your concerns and answer your questions. The first step towards receiving glaucoma treatment is to call or email glaucoma surgeon Dr. Carter to schedule your free consultation. We serve all of Dallas, Texas.

How do I Know if IntraLASIK is Best for me?

The LASIK procedure is the most popular vision correction surgery in the country. But many people decide against it because the hand-held blade used in the procedure can be intimidating. The IntraLase laser technology is calming many peoples’ fears by replacing the blade with a laser. This new level of bladeless precision is a good alternative for many who are not good LASIK candidates.

What is IntraLASIK?
In traditional LASIK surgery, Dr. Carter creates a flap on the cornea using a microkeratome blade and reshapes the cornea to improve your vision. IntraLASIK allows Dr. Carter to use computer technology to program the desired depth and position of the flap prior to your surgery and to create it with a laser. This makes flap creation a safer and more accurate procedure for those who have thinner-than-average corneas.

Is IntraLASIK the Best Choice for You?
To decide if IntraLASIK should be your chosen procedure, Dr. Carter will examine your eyes and answer your questions about IntraLase technology. He will explain the potential complications and benefits offered by IntraLASIK.

Two advantages of IntraLASIK

1. The IntraLase laser makes it possible for patients with thin corneas to undergo the procedure. With traditional LASIK, those with thin corneas are ineligible because the blade is unable to cut corneal flaps thin enough for safety. 
2. The laser follows the cornea’s curvature when creating the flap. This enables a smoother corneal surface for treatment and more gradation on the flap edges, both of which help to guard against astigmatism. 
   

Two drawbacks of IntraLASIK

1. IntraLase is associated with fewer flap complications than LASIK, but surgeons are noticing a postoperative complication of increased sensitivity to light. According to some reports, this complication has occurred in up to 20% of IntraLASIK patients.
   
2. Using the IntraLase system instead of a blade increases overall safety, but it also raises the cost. IntraLASIK can mean an additional $300 per eye over traditional LASIK. 
   

Dr. Carter will take the necessary time to discuss your options and help you make the best choice for you. If you are ready to discuss vision correction options, please contact an IntraLASIK specialist to receive Carter Custom Care™ in the Dallas, Texas area.