Category: What’s New

The Light Adjustable Lens (LAL)

Cataracts are an eye condition that affect a large number of people across the world. Generally, cataracts occur later in life, but they can impact a small number of young people as well. The only way to correct vision is through surgery, but it can be difficult to predict how the eye will heal after surgery. Now, through the Light Adjustable Lens (LAL), the surgical lens implant can be adjusted post-surgery in order to help patients maximize their vision without the need for glasses or contacts.

“I am excited to be the first practice along the Gulf Coast to offer this as an option to our patients,” Dr. Drew Salisbury said. “It is the only intraocular lens (IOL) option that is adjustable after it has already been implanted into the eye, making your vision totally customizable. It is also highly advantageous in patients who have undergone previous refractive surgery such as LASIK, PRK or RK.”

The Light Adjustable Lens (LAL):

The LAL is made of a special photo-sensitive material that allows the lens to be adjusted in response to UV light. After the cataract surgery, the LAL works just like a traditional or fixed IOL until your eye heals. Then, a vision exam will be performed by your doctor. With those results, the LAL can be adjusted with a light treatment in order to eliminate any remaining prescription. It can also be adjusted to improve your reading vision depending on your lifestyle preferences.

“Light Treatments,” which involve using UV light to adjust the LAL, last around 90 seconds. Usually, between two and four treatments are needed, each separated by at least 3 days, resulting in a vision goal that you and your eye doctor reach together based on your current prescription and vision exam results. You get to “test drive” your vision and can change it depending on your preferences. Once you are happy with your customized vision, then the IOL is “locked in” so that it will not change in the future.

What are cataracts?

A cataract occurs when the eye’s natural lens becomes thickened, less transparent and rigid. Over time, cataracts can cause vision to worsen and may eventually cause blindness. Cataracts are one of the leading causes of vision impairment, and the only way to correct them is through cataract surgery.

How does cataract surgery work?

At your cataract consultation visit, your eye doctor will take pictures of your eye which measures the size and shape of your eye. This helps them to determine the best type of lens implant for your vision. The surgery itself takes about 10-20 minutes to perform under light sedation. Topical anesthetic eye drops will be administered to numb the eye. Afterward, your vision should improve over the course of a few days and the recovery is typically painless.

There are two main types of cataract surgery: traditional and refractive. Traditional cataract surgery involves removing the natural cataract lens and replacing it with a standard intraocular lens implant (IOL). This will result in clearer vision, but patients who elect to have a traditional IOL will still require prescription bifocal glasses to see their best. The other type of cataract surgery is refractive cataract surgery. This results in clearer vision without the need for corrective glasses or contacts.

Refractive cataract surgery produces fantastic results but sometimes these results are unpredictable, especially for patients who have previously undergone refractive eye surgeries such as LASIK, PRK or RK. In these patients, it is much more difficult to accurately predict how your vision will end up after the surgery. Once a traditional IOL has been placed in the eye, it is fixed and cannot be adjusted. The Light Adjustable Lens (LAL) is a new advancement in cataract surgery technology that allows your eye doctor to adjust your lens after the surgery with simple, painless light treatments to maximize your vision needs and reduce your dependence on glasses. A study of 600 subjects has shown that cataract surgery patients with the LAL are 2X more likely to achieve 20/20 vision without glasses.

Salisbury Vision:

At Salisbury Vision, you can trust Dr. Drew Salisbury to treat you like family. He is a cornea and refractive specialist who performs cataract surgery, LASIK, PRK, ICL, corneal transplants including PKP, DSAEK, DMEK, and DALK, and minimally invasive glaucoma surgery. He also performs iLink cross-linking procedure, which is currently the only FDA-approved treatment for progressive keratoconus.

So, if you want to see the bright future ahead of you, schedule an appointment today!

Have you been considering LASIK but are unsure whether it’s worth it for you? Are you wondering what the practical benefits of this surgery are? Well, don’t just listen to us tell you about all the benefits you can experience post-LASIK, learn what Sally, a real LASIK patient, said about what the surgery has done for her.

Sally had her LASIK surgery on November 22, 2022. Since then, she has been able to live her life to the fullest. Here are some of the main activities Sally said she was able to do better after LASIK.

Traveling:

Before LASIK, Sally struggled with getting the most out of her vacations. She wanted to put her mind at ease, but found herself constantly stressing about making sure she had backup pairs of prescription contacts and glasses.

“I had terrible vision. I think my contact prescription was -8,-8.5, so it was not great,” Sally said. “I struggled with a lot, mainly just not feeling comfortable traveling without having a lot of contact backups.”

Now, after her surgery, Sally has been able to let herself relax while traveling without having to think twice about her vision.

“I traveled recently and I didn’t have to worry about taking three extra pairs of spare contacts, my glasses, anything like that,” she said. “It’s just really comfortable.”

Driving:

Another aspect of daily life that Sally struggled with pre-LASIK was driving. She always had to ensure that she had her glasses or contacts with her because without them she wouldn’t be safe behind the wheel.

“…making sure I always had my glasses on me because I didn’t want to get stuck somewhere and I couldn’t see,” she said. “Because it really wasn’t even safe for me to get in the car and attempt to drive.”

After LASIK, Sally can now set her worries aside and be a safe driver with her 20/20 vision.

“I can wake up in the morning, drive, really go about [my] daily life without having to rely on some type of vision aid. And that’s huge for me.”

Sleeping:

Another activity that has improved for Sally after her surgery is sleep. She found that being able to fall asleep without worrying about whether she left her contacts in or where she had to put her glasses was a huge stress reliever.

“One thing is sleep. I can fall asleep without taking my glasses off, taking my contacts out,” she said. “I know that sounds kinda silly to people who don’t wear glasses but it is really a big deal.”

Peripheral vision:

Sally also found the surgery immensely helpful in improving her peripheral vision.

“When you have bad vision, like I did, when you wear your glasses…your peripheral vision is terrible!” she said. “So even when you had your glasses on, you could see in front of you but don’t think about looking side to side or up or down because you weren’t gonna get the same results.”

Underwater vision

Sally is looking forward to swimming now that her contacts aren’t a concern. She’s also looking forward to other underwater activities such as tubing now that her underwater vision isn’t limited by her prescription.

“I haven’t swam yet but I’m really excited to have that experience in the summer where I’m not worried about getting splashed with water or dunked or anything like that and my contacts coming out,” she said. “The biggest thing is tubing. I went tubing last summer and really hadn’t thought about it before but the whole time the water was spraying you. I [was] like ‘please don’t let my contacts come out, please don’t let my contacts come out’ [so] you shut your eyes, and you’re kind of missing some of the experience.”

Next steps:

If you’re thinking that LASIK sounds right for you, look into a qualified ophthalmologist in your local area. Dr. Drew Salisbury, at Salisbury Vision, has years of experience performing LASIK and helping his patients enjoy life with clear vision. He offers multiple affordability options for financing the procedure, so that YOU can keep your world in focus.

Reach out today to book a consultation. Call 251-341-3413

Cataracts can significantly impair your quality of life. From blurry or reduced vision to blindness, cataracts have the potential to be a major issue over time. In the United States, over 24 million people aged 40+ years are impacted by cataracts. In their advanced stages, cataracts can be particularly difficult to live with if you haven’t had corrective surgery.

Research has found that people who get corrective surgery for their cataracts are happier and more productive after the surgery. Of the over 1300 United States adults who took the survey, 75% said that they gained a greater appreciation for and satisfaction with their lives. 50% said they didn’t realize how much of an impact cataracts had on their lives, and that they’d recommend the surgery to others with cataracts because their lives improved so dramatically.

If you or a loved one have cataracts, read on to learn about some of the surgical options you have for treatment to ensure the future continues to look bright!

Cataracts Symptoms:

A cataract refers to the clouding of the eye’s natural lens; becoming thickened, less transparent, and more rigid. Cataracts worsen over time and can cause blindness if no curative measures are taken. It is most common in people over the age of 60. Symptoms include:

• Blurry vision
• Faded or washed out colors
• Limited night or low light vision
• Glare and halos
• Light sensitivity
• Double vision
• Decreased reading vision

Those with minor symptoms may be able to temporarily delay surgery by optimizing their glasses or contacts. But those with severe symptoms should consider pursuing surgical solutions.

Cataract Surgery:

A popular option available for correcting cataracts is refractive cataract surgery. This procedure is similar to traditional cataract surgery, but the key difference is that refractive cataract surgery uses advanced laser and lens technology to both get rid of cataracts and also remove your prescription and dependence on glasses or contacts. The surgery can correct nearsightedness, farsightedness, and astigmatism.

The natural cataract lens is removed from the eye and replaced with an intraocular lens implant. This artificial lens can reduce or entirely remove your need for prescription glasses or contacts. Multifocal IOLs are the most technologically advanced option for an intraocular lens implant, and are most effective in providing clear long distance, intermediate, and reading vision without the need for glasses or contacts afterwards. Most patients who elect to have this type of lens implanted do not have to depend on readers or “cheaters” for their near vision.

LensX Laser Cataract Surgery is a “bladeless” surgery by using a femtosecond laser to create incisions for the procedure. The use of this laser improves the precision and reproducibility of the incisions made during cataract surgery and ultimately improves visual outcomes in patients who elect to use this technology during their cataract surgery.

Next Steps:

Don’t ignore these symptoms once they start because cataracts worsen with time. Talk to your ophthalmologist about getting a full evaluation and when you are ready for cataract surgery, ask them which option is best for you. Remember that cataract surgery can allow you to be more productive and have a greater appreciation for life, so consider having this life-changing procedure when you start experiencing the visual symptoms of cataracts.

If you are suffering from impaired vision due to cataracts, reach out to Dr. Salisbury today.

Do you suffer from astigmatism? Wish you didn’t have to wear glasses or contacts? LASIK may be the option for you in order to drastically reduce or remove your dependency on prescription lenses.

What is Astigmatism?

Astigmatism is an imperfection in the curvature of the cornea or natural lens inside the eye. “Regular” astigmatism is very common and a lot of people do not even realize that they have this. Lower amounts of astigmatism may be visually insignificant but higher amounts will cause permanently blurred vision that can require glasses or contacts to see clearly. It can accompany a variety of other refractive errors, such as myopia (nearsightedness) and hyperopia (farsightedness). Other eye diseases or traumatic injuries to the eye can create scarring on the cornea which will create “irregular” astigmatism and is much more difficult to treat (often requiring surgery or specialized contact lenses)

Types of Astigmatism:

• Corneal Astigmatism: An imperfect spherical shape of the cornea that people are typically born with and progress with age
• Lenticular Astigmatism: An imperfect spherical shape of the natural lens that will change as people develop cataracts. This could combine with Corneal Astigmatism for a more pronounced effect.
• Irregular Astigmatism: Typically caused by an injury or infection to the eye that leads to scarring

Treatment Options for Astigmatism:

Most people who have visually significant astigmatism can be corrected with glasses or toric contact lenses. Irregular astigmatism often has to be treated with specialized contacts or surgical procedures such as a cornea transplant. For patients with visually significant astigmatism that can be corrected with glasses or toric contact lenses, there are surgical procedures that can cure their astigmatism so that they no longer have to wear corrective lenses. Some of these options are listed below.

• LASIK
• PRK
• Visian Toric ICL
• Refractive Lens Exchange
• Refractive Cataract Surgery

LASIK, or Laser-assisted in situ Keratomileusis, is a vision-correction procedure designed to correct myopia, hyperopia, and astigmatism. A superficial flap is created on the cornea which is lifted and the cornea is reshaped by an excimer laser. Then, the flap is repositioned to its original place for minimal scarring once it heals. All in all, the procedure takes around ten minutes to perform. Recovery from LASIK is generally quick and easy. Both eyes are treated on the same day, and functional return of vision typically only takes a few hours. No stitches or eye patches are required, and eye drops are used for one week following the procedure. Approximately 99% of patients are able to return to normal activities by the following morning.

Another option is PRK, or Photo-Refractive Keratectomy, which uses a similar procedure to reshape the cornea. This procedure is valuable for patients with corneas that are “too thin” for LASIK.

Some patients have too much prescription to safely be corrected with LASIK or PRK. A potential option for these patients is ICL, an implantable collamer lens, which can be surgically implanted into the eye to correct both nearsightedness and astigmatism.

Patients who are starting to become presbyopic in their 40s and 50s and have to rely on reading glasses or progressive/bifocal glasses and contact lenses make great candidates for the Refractive Lens Exchange procedure. This can correct myopia, hyperopia, astigmatism, and presbyopia so that patients no longer have to wear corrective lenses or reading glasses.

Lastly, patients who have developed cataracts but have had to wear corrective glasses or contact lenses for astigmatism can have their vision corrected with Refractive Cataract Surgery. This procedure uses a toric lens implant or the LensX laser system to correct astigmatism and any refractive error as well as the cataract that has developed. This gives patients clear vision with out the need for glasses or contacts afterwards.

Next Steps:

The first step to take if you’re considering LASIK or another surgical procedure to remove your reliance on prescription lenses is to speak with your ophthalmologist about your options. A quick way to check your eligibility for LASIK is with this short, five question quiz. If you’re concerned about financing this surgery, check out these affordability options.

For more information or to schedule a consultation, please visit please contact Dr. Salisbury today at https://salisbury-vision.com/contact/.

January is Glaucoma Awareness Month. Ever wondered what the symptoms could be if left untreated? Or what treatment options are available to you? Here’s everything you need to know about glaucoma.

Types of Glaucoma:

• Primary Open Angle Glaucoma (POAG) – POAG is the most common type of glaucoma in which the eye’s aqueous fluid cannot easily flow through the drainage system. As a result, eye pressure can increase, causing damage to the optic nerve and potentially leading to blind spots in the vision.
• Narrow Angle Glaucoma – Also known as angle-closure glaucoma, this type of glaucoma is caused when the drainage system of the eye suddenly closes off. Eye pressure can rapidly increase leading to permanent vision loss, so treatment is necessary as soon as possible. There are also preventative treatments that should be considered if you are at risk.
• Normal-Tension Glaucoma – This type of glaucoma is similar to open angle glaucoma except the eye does not have elevated Intraocular pressure. This type of glaucoma can be more difficult to treat and leads to optic nerve damage and visual field loss. The cause is currently unknown, although it is hypothesized that it may be due to poor blood flow to the optic nerve.
• Pigmentary Glaucoma – This is a rare form of glaucoma caused by pigment deposits that are released from the iris into the aqueous system that end of clogging the drainage system inside the eye. This reduces the rate of aqueous fluid outflow from the eye and leads to elevated intraocular pressure and subsequent vision loss.
• Secondary Glaucoma – Pressure in the eye is increased due to secondary causes such as an infection, tumor or sudden enlargement of the lens.
• Congenital Glaucoma – This is a rare condition that children can be born with and usually leads to poor vision and cataract formation.

Causes of Glaucoma:

• Genetics – Glaucoma often runs in families and various genes have been linked to the different types of primary glaucoma.
• Eye injury/disease – Eye injuries have been linked to a higher risk of glaucoma. Retinal detachment, infections and eye tumors are other examples of ocular pathology that can increase your risk of glaucoma.
• Steroids – Long-term eye drop steroids can elevate the Intraocular pressure, making you more susceptible to developing glaucoma.

Glaucoma Symptoms: The most common type of glaucoma (primary open angle glaucoma) is asymptomatic so the only way to detect this is to be screened with a regular and thorough eye exam. Other types of glaucoma such as narrow angle glaucoma can present with the following symptoms.

• Severe eye and head pain
• Hazy or blurred vision
• Nausea along with severe eye pain
• Appearance of rainbow-colored circles or halos around bright lights
• Sudden loss of vision

Treatment for Glaucoma:

There is currently no cure for glaucoma, but there are a variety of treatment options to slow down the progression of this ocular disease. Talk to your eye doctor about what is best for you.

• Eye drops – Most glaucoma treatments begin with medicated eye drops used to decrease eye pressure by decreasing the amount of aqueous fluid produced by the eye or by improving how efficiently the aqueous fluid drains from your eye. Some types of eye drops commonly used to treat glaucoma include prostaglandins, beta-blockers, alpha-adrenergic agonists and miotic or cholinergic agents. Each type comes with its own set of associated risks, so be sure to communicate with your doctor about which is best for you.
• Oral medications – These are commonly used if eye drops fail to control your eye pressure and are typically used as short-term treatments.
• Laser therapy – If you have open-angle or pigmentary glaucoma, your eye doctor may use a laser to help open the drainage system in your eye which helps to lower the intraocular pressure.
• MIGS (Minimally Invasive Glaucoma Surgery) – This is often done at the time of cataract surgery and involves the implantation of micro drainage devices that help lower the intraocular pressure. This is a great option for someone who has glaucoma and is undergoing cataract surgery because they are typically very low risk-procedures that can help improve your eye pressure and limit the number of long-term eye drops you have to use.
• Surgery – Glaucoma surgery is reserved for patients who are unable to control their eye pressures with the above options. The various glaucoma surgery techniques typically work by creating a new drainage pathway for the eye (trabeculectomy) or by inserting a tube into the eye to divert the aqueous fluid outside of the anterior chamber. These surgeries are very successful at lowering the Intraocular pressure but have a higher risk of complication compared to the other more conservative treatments for glaucoma. That is why these surgeries are normally only performed as a last resort for patients who cannot get control of their glaucoma.

For more information or to schedule a consultation, please visit please contact Dr. Salisbury today at https://salisbury-vision.com/contact/.

Driving at night can be hazardous when you have pre-existing conditions that impair your vision. In the winter, it is particularly important to seek treatment for vision problems since shorter days mean leaving work after dark coupled with icy roads which can lead to danger for drivers. Here’s why you should consider speaking with your eye doctor about potential solutions and surgical options to improve your vision that can make you a safer driver at nighttime.

Driving dangers:

Simply put, our pupils dilate in the dark which can lead to a myriad of vision issues while driving at nighttime. Dilated pupils enhance myopia (nearsightedness) and astigmatism which can make it difficult to see road hazards such as road signs, pedestrians, and animals. Also, oncoming headlight glare can become burdensome in patients who have developed cataracts or for someone who does not have an accurate prescription in their glasses or contacts. This can make it difficult and scary to drive at nighttime especially in areas that are poorly lit.

Types of vision impairment:

• Myopia (nearsightedness): Results in overall decreased vision at nighttime as well as difficulty identifying and avoiding hazards. You run a high risk of causing injury to yourself and others who share the road with you if you’re driving with this condition, particularly during the night.
• Astigmatism (abnormal curvature of eye): Results in streaky or blurred lights, which can negatively impact how you see car headlights and street lights. You will likely experience increased glare, halos, or streaks, which can cause you to squint.
• Presbyopia (farsightedness): Results in an inability to see your dashboard/GPS, which can prevent you from being able to safely monitor your speed, see the directions on the GPS or even ensure your headlights are on and working properly.
• Nyctalopia (night blindness): Can be caused by cataracts, glaucoma, vitamin deficiencies, and genetically inherited eye diseases. It heavily limits the capabilities of someone to see at nighttime and patients with this diagnosis should completely avoid driving at night.

Solutions:

The first step to improve vision in low light conditions is to have an up-to-date eye exam with your ophthalmologist or optometrist. For most people, making sure you have an accurate prescription and updating your glasses and contacts can significantly improve vision at night. Your eye doctor will also screen you for more serious conditions such as cataracts, glaucoma, and other vision-threatening eye diseases.

There are a wide variety of procedures available to correct the above vision issues that can make you a safer driver at nighttime. Laser vision correction such as Laser-assisted in situ Keratomileusis (LASIK) or Photo-Refractive Keratectomy (PRK) can correct myopia and astigmatism. These are long-term, safe, and effective procedures that can fully correct your vision so that you can see clearly at night without the need for glasses and contacts. It is fairly easy to determine if one of these procedures is right for you. If you are not eligible for laser vision correction surgery or are interested in different options, there are alternatives available to you.

A safe and effective alternative to laser vision correction is the Implantable Collamer Lens (ICL) surgery. This procedure treats nearsightedness and astigmatism, and essentially involves surgically implanting a permanent contact lens into the eye. This can achieve vision results that are equal to LASIK without having to permanently alter the structure of the eye. This is a great option for patients who have been told that they are not LASIK candidates or have too high of a prescription to safely undergo LASIK.

Refractive Lens Exchange (RLE) is a good choice for anyone over the age of 45 with nearsightedness, farsightedness, or astigmatism and minimal cataract formation who require reading glasses to see up close. This procedure can restore a full range of vision in patients so that they no longer need glasses to see far away or up close. An added plus to this surgery is that it lasts for a lifetime and those who undergo it will never form a cataract.

Finally, Refractive Cataract Surgery is a potential choice for anyone suffering from glare, halos, and decreased vision at night time due to cataracts. This procedure is similar to traditional cataract surgery but comes with the added bonus of simultaneously correcting nearsightedness, farsightedness, or astigmatism by correcting all of your prescription at the time of cataract surgery.

For more information or to schedule a consultation, please visit please contact Dr. Salisbury today at https://salisbury-vision.com/contact/.

Keratoconus is a corneal disease that is characterized by corneal thinning and steepening that leads to an abnormally shaped corneal surface. This is a poorly understood condition but can lead to an increase in myopia (nearsightedness) and astigmatism if there is progression. The exact cause is unknown, but there is a genetic link since around 1/10 of people who have keratoconus have a parent with the same condition. There are also recent studies that show eye rubbing can trigger or worsen symptoms in someone with underlying keratoconus. It can appear between the ages of 10 and 25, usually progressing slowly until the age of 40.

Eye rubbing’s effects on keratoconus:

Studies have shown that there appears to be a link between eye rubbing and keratoconus. The repetitive mechanical trauma from eye rubbing can weaken the cornea, increasing the progression of keratoconus.  An individual with a long habit of rubbing their eyes can develop keratoconus in the rubbed eye, both eyes equally or in both eyes unevenly. There is a high association between people with allergies and keratoconus which can be explained by the fact that many people with chronic allergies rub their eyes. Eye rubbing causes keratocyte thinning to varying severities, depending on the intensity and time spent rubbing.

What can I do to be screened for and prevent keratoconus?

The most important step if you suspect you may be at risk for keratoconus is to have regular eye exams. Risk factors for developing keratoconus include positive family history, chronic allergies, eye rubbing, and Down Syndrome. Symptoms of keratoconus include blurry vision with or without glasses/contacts, increasing myopia (nearsightedness), and increasing astigmatism. Scheduling appointments with your eye doctor and informing them of any of the above risk factors or symptoms will allow them to properly screen you for this condition.

Try to avoid rubbing your eyes as much as possible. If you feel intense itchiness or dryness in your eyes which causes you to rub them, try artificial tear drops, allergy eye drops, or oral allergy medications and talk to your doctor about potential solutions for your symptoms. Stay aware of changes to your vision, especially if it begins to progressively decline, and update your doctor of any new changes or symptoms.

Treatment options for keratoconus:

Slowing disease progression and providing optimal vision correction are the primary goals of treatment for keratoconus. Nearsightedness and astigmatism are generally treated with glasses and specialized contacts in the early stages, but as eyesight continues to worsen, other options need to be considered.

One popular treatment option for the early/moderate stages of keratoconus is Corneal Cross-Linking surgery. During the procedure, your eye doctor uses a combination of Riboflovan eye drops and ultraviolet (UV) light to strengthen the cornea by creating extra bonds that act as support beams between the collagen fibers throughout the cornea. This process can prevent the progression of keratoconus, but not reverse any existing damage to the vision that has already been done, so it is important that your eye doctor screens you for this disease in order to diagnose it at an early stage.

If left untreated, keratoconus can eventually deteriorate the vision to a point where glasses and contacts are unable to provide adequate vision. At this point, the only option left to restore vision is Cornea Surgery. Penetrating keratoplasty (PKP) is a corneal transplant procedure that requires the removal of the entire diseased central cornea and replacing it with a new one by suturing a donor cornea in place. The healing time lasts from months to years and patients must use steroid eye drops indefinitely to prevent rejection.

As a whole, it is integral that keratoconus is detected and treated as early as possible in order to prevent having to undergo such an invasive procedure as a cornea transplant. Eye rubbing can trigger and cause the progression of this condition. There is a range of treatment options for the disease, so ask your eye doctor about them today!

For more information, please contact Dr. Salisbury at https://salisbury-vision.com/contact/.