What is a Dilated Eye Exam?

Normal adult pupils contracts to 2~4mm in diameter in response to bright light and dilates to 4~8mm in the dark. In addition, the pupils constrict to increase depth of field to focus on near objects, aka accommodation.

During a comprehensive eye exam, eyedrops are used to pharmacologically enlarge the pupil sizes. This painless procedure allows for a wider and clearer view of the structures inside the back of the eyes. The dilated pupils are temporarily relaxed and cannot respond to light stimulus nor accommodate. This results in visual discomforts, most notably blurred vision, trouble focusing on close objects, and heightened sensitivity to light. This effect cannot be medically reversed and usually relieves in 3 to 8 hours.

The Importance of a Dilated Eye Exam

Eye doctors often compare the pupil to the aperture on a camera or a door to explain dilated eye exams.

• Undilated Pupil: This is like looking through a tiny peephole into a dark room. The amount of light entering and the range of view are both limited. Therefore, it’s difficult to see the details of the whole room.
• Dilated Pupil: This is like a door wide open. It allows the doctor to see the entire room, including any potential issues or problems that might be hidden.

Pupil dilation helps eye doctors see inside the eye, including the retina, optic nerve, macula, and blood vessels. This allows for early detection of eye diseases like glaucoma, macular degeneration, diabetic retinopathy, and hypertensive retinopathy among others. There are also over 250 that have ocular and visual manifestations. These changes often precede or occur concurrently with various systemic conditions, which may be subjectively symptomatic or asymptomatic.

Key Point Comparisons:

The AO Bottom Line

At �鶹����, we pride ourselves as trusted medical professionals and guardians for the well-being of our patients. While we understand the arguments presented in the article, we prioritize our patients’ eye health above all else. While rare, we can’t ignore the possibility of overlooked issues in young, healthy adults. Visit our clinic for comprehensive health assessment today.

If you found this information helpful, please share with your friends and family.

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The article titled “” highlights a global topic of dry eyes.

Understanding Dry Eye Disease

Dry eye disease, or DED, can manifest in various ways, from mild discomfort to significant visual impairment. While many believe that they do NOT have dry eyes because they have watery eyes, it’s important to note that DED isn’t just about quantity, but quality of tears that matters. It is “not due to a lack of tears but is instead a ‘multifactorial condition characterized by a persistently unstable tear film and/or deficient tear film’.”

DED can be asymptomatic or present as various levels of discomfort and/or visual impairment. For example, constant blinking and temporary improvement of vision upon blinking, ocular sensitivity to dry, cold, or windy conditions. These are just a few regular events that occur with dry eyes. Additionally, there are structural changes such as variable amounts of ocular surface epithelial changes, inflammation, and neurosensory abnormalities. These findings commonly associated with dry eyes can be confirmed only during exam and testing.

“Dr. Pflugfelder said that evidence reveals DED to be a heterogeneous disease consisting of aqueous-sufficient and aqueous-deficient types, with tear instability common to both.”

• Aqueous-sufficient DED: A result of meibomian gland dysfunction, leading to poor tear quality.
• Aqueous-deficient DED: Often associated with conditions like Sjogren’s syndrome, which can reduce tear production.

Read our own article to learn more about Dry Eyes, their symptoms, and treatment options we provide.

Prioritize Your Eye Health

Don’t let dry eye symptoms interfere with your daily life. If you experience dry eyes symptoms, schedule a comprehensive eye exam. Our experienced eye care professionals can diagnose the underlying cause of your dry eye on your regular or comprehensive exam. We will develop a personalized treatment plan to restore your eye health and comfort.

Schedule a comprehensive eye exam today to determine the underlying cause of your dry eye and explore effective treatment options. Early intervention can help prevent complications and improve your eye health.

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The Trusted Choice: What Is a Castle Connolly Top Doctor?

Castle Connolly is a respected organization that identifies exceptional physicians across the U.S. Their rigorous selection process looks beyond basic qualifications. Top Doctors earn nomination by their peers for demonstrating:

• Exceptional Clinical Skills: This includes board certification, extensive experience, and mastery of the latest medical advancements.
• Compassionate Bedside Manner: These doctors excel in communication, empathy, and building patient trust.
• Patient-Centered Care: They focus on understanding individual needs to create personalized treatment plans.

This elite group represents only the top 7% of all U.S. practicing physicians.

Experience You Can Trust: Dr. Albert Joseph Rudick

Dr. Rudick has consistently earned the Castle Connolly Top Doctor designation since 2001. This longstanding recognition highlights his leadership in ophthalmology and his dedication to superior patient outcomes.

Benefits of Choosing a Castle Connolly Top Ophthalmologist

Why does this matter for your care? Top Doctors do not pay for this designation. The peer-review process provides an objective, trusted benchmark.

Choosing a Castle Connolly Top Doctor Ophthalmologist gives you:

1. Focused Partnership: A collaborative relationship with a doctor who prioritizes your individual health journey.
2. Vetted Expertise: Confidence in a doctor validated by other medical professionals.
3. Advanced Care: Access to a physician committed to the latest treatments and technology.

Schedule an Appointment with a Top-Rated NYC Eye Doctor

Experience the difference that comes with a Castle Connolly Top Doctor. Dr. Rudick and his team combine award-winning expertise with genuine care.

Ready for exceptional eye care? We welcome new and existing patients.

Schedule Your Appointment Today

For over two decades, our patients have trusted the expertise marked by the Castle Connolly Top Doctor seal. Join them and see why this recognition matters.

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Neuroprotective Benefits of Omega 3 for Dry Eyes

Pilot study shows ω-3 EFA supplementation is neuroprotective in patients with dry eye disease

A 2017 pilot study published in Ophthalmic & Physiological Optics found that oral omega-3 fatty acid supplementation helped protect corneal nerves in patients with dry eye disease. In fact, the research indicated that participants taking omega 3 supplements showed significant improvement in nerve density and reduced tear osmolarity compared to the placebo group.

Key Findings from the Study:

The study revealed several important benefits:

• Increased Corneal Nerve Density: The omega-3 group had higher corneal total nerve branch density (CTBD).
• Improved Dry Eye Symptoms: Consequently, participants reported better Ocular Surface Disease Index (OSDI) scores.
• Reduced Tear Osmolarity: Lower osmolarity correlates with improved tear film stability.
• Neuroprotective Effect: Ultimately, the supplements appeared to protect the delicate nerves of the cornea.

Understanding the 2017 Pilot Study

On March 21, 2017,  reported that oral, long-chain omega-3 essential fatty acid (EFA) supplementation is neuroprotective for patients with dry eye disease. This finding came from a study published online on March 12 in Ophthalmic & Physiological Optics.

Study Design and Participants

Researchers led by Dr. Holly Rose Chinnery conducted a prospective, comparative study. It involved 12 participants from a larger trial of 60 people with moderate dry eye disease. Four received a placebo, while eight took ω-3 EFA supplements for 90 days.

What the Researchers Discovered

Compared to the placebo group, the omega-3 group showed a greater reduction in Ocular Surface Disease Index score and tear osmolarity. Additionally, they had higher corneal nerve density (CTBD and CNBD). Corneal nerve fiber length also increased in the supplement group. A negative correlation was found between CTBD and tear osmolarity. However, no significant changes occurred in basal epithelial or dendritic cell density.

The authors concluded: “These pilot study findings suggest that ω-3 EFA supplementation imparts neuroprotective effects in the corneal sub-basal plexus that correlate with the extent of tear osmolarity normalization.”

How Omega 3 Supplements Support Eye Health

Omega 3 supplements for dry eyes work through two primary mechanisms:

1. Meibomian Gland Support: They improve the oil layer of tears, reducing evaporation.
2. Corneal Nerve Protection: They may reduce inflammation and support nerve health in the ocular surface.

Consult Your NYC Eye Doctor Before Starting

FBefore starting any new supplement regimen—especially for dry eye—it’s important to consult with a professional. Our NYC eye doctors can determine the right dosage and formulation of omega 3 supplements for your specific needs as part of a comprehensive dry eye management plan.

Discuss Omega 3 Supplements at Your Next Appointment. 

Explore Related Dry Eye Care

to see how we can help.

For comprehensive dry eye management, we recommend a tailored treatment plan.

• Explore our Dry Eye Treatment services to see how we can help.
• Read the full study:  or follow this link:

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New research suggests you may be able to delay reading glasses through brain-training exercises. A New York Times report explores how perceptual learning apps could help presbyopia, the age-related vision condition that affects nearly everyone over 45.

What Is Presbyopia?

Presbyopia is the gradual loss of close-up focusing ability that begins in middle age. By 45, it affects 83% of adults. The eye’s lens hardens, making it difficult to read small print. Traditional solutions include reading glasses, bifocals, or progressive lenses.

The Risks of Untreated Vision Changes

Struggling with presbyopia isn’t just inconvenient—it can be dangerous. Poor near vision contributes to falls and auto accidents. Corrective lenses help but can also impair depth perception and contrast sensitivity.

How Perceptual Learning May Help Delay Reading Glasses

Recent studies explore perceptual learning—training the brain to interpret visual information more efficiently. This approach uses challenging exercises like identifying “Gabor patches” (specific visual patterns) to improve processing speed and clarity.

The Science Behind the Training

The theory is that presbyopia isn’t just an eye problem but also a brain-processing bottleneck. By enhancing neural efficiency, you may compensate for the eye’s physical limitations. Research shows improvements in:

• Visual acuity
• Contrast sensitivity
• Reading speed

What the New York Times Experiment Found

Writer Austin Frakt tested the GlassesOff app for several months. The app reported he could read fonts nearly one-third smaller than before, with vision equivalent to someone 10 years younger. However, the training requires consistent, long-term effort.

Important Considerations

• Not a Guarantee: Results vary—the approach doesn’t work for everyone.
• Commercial Ties: Some study authors have financial connections to the apps.
• Commitment Required: Effective training demands regular sessions over months.
• Professional Guidance: Always consult an eye doctor before starting new vision therapies.

Professional Alternatives to Manage Presbyopia

While apps offer one approach, ophthalmologists provide proven treatments. Schedule a comprehensive exam to explore all options tailored to your eyes.

Schedule a Presbyopia Consultation

• Comprehensive Eye Exams for Adults Over 40
• Cataract Surgery & Advanced Lens Implants
• Prescription Eyeglasses & Progressive Lenses

Should You Try Vision Training Apps?

If you’re motivated and curious, apps like GlassesOff present an interesting alternative to reading glasses. However, they require discipline and aren’t a substitute for professional eye care. For most people, a combination of approaches works best.

Consult Our NYC Ophthalmologists

We can evaluate your specific vision needs and discuss whether perceptual learning or traditional correction is right for you. Don’t struggle with blurry close vision—get expert advice.

Contact Our Practice for Expert Guidance

Austin Frakt
 MARCH 27, 2017

By middle age, the lenses in your eyes harden, becoming less flexible. Your eye muscles increasingly  to focus on this print.

But a new form of training — brain retraining, really — may delay the inevitable age-related loss of close-range visual focus so that you won’t need reading glasses. Various studies say it works, though no treatment of any kind works for everybody.

The increasing difficulty of reading small print that begins in middle age is called , from the Greek words for “old man” and “.” It’s exceedingly common, and despite the Greek etymology, women experience it, too. Every five years, the average adult over 30  on the .

By 45,  affects an estimated  of adults in North America. Over age 50, it’s . It’s why my middle-aged friends are getting fitted for bifocals or graduated lenses. There are holdouts, of course, who view their cellphones and newspapers at arm’s length to make out the words.

The decline in vision is inconvenient, but it’s also dangerous,  and . Bifocals or graduated lenses can help those with presbyopia read, but they  to falls and accidents because they can .

I’m 45. I don’t need to correct my vision for presbyopia yet, but I can tell it’s coming. I can still read the The New York Times print edition with ease, but to read text in somewhat smaller fonts, I have to strain. Any year now, I figured my eye doctor would tell me it was time to talk about bifocals.

Or so I thought.

Then I undertook a monthslong, strenuous regimen designed to train my brain to correct for what my eye muscles no longer can manage.

The approach  in , and perhaps you’ve heard of it. It’s based on perceptual learning, the improvement of visual performance as a result of demanding training on specific images. Some experts have  that it can work, but a number of  that it can improve visual acuity, contrast sensitivity and reading speed.

The training involves looking at images called “” in various conditions. Gabor patches . A great deal of the training involves trying to see Gabor patches placed between closely spaced, distracting flankers. In training, the flanker spacing is varied, the target contrast is turned way down, and the images are flashed on a screen for fractions of a second — to the point that one can barely see the target.

Do this and similar exercises hundreds of times over multiple sessions weekly; continue for months; and, gradually, presbyopia lessens,  of .

 examined functions of the eye itself and found none of these improvements were because of changes in the eye. They’re all in the brain.
Various smartphone apps say they offer this kind of vision-improving training; I used one called , the only one I found that was backed by scientific studies.

Perceptual learning can improve the vision of people who already see quite well and those with other conditions. For example,  tested the approach in 23 young adults, around age 24. Compared with a control group of 20 young adults, the treatment group increased letter recognition speed. Similar training is  in , also called “,” which is the most frequent cause of vision loss in infants and children, . It may also improve vision in those with  ().

It should be acknowledged that some researchers involved in many of these studies have financial ties to GlassesOff. However,  obtained similar results, and several scientists I spoke to, including those without ties to GlassesOff, thought the science behind the app was credible.  trained 16 college-aged adults and 16 older adults (around age 71) with Gabor patch exercises for 1.5 hours per day for seven days. After training, the older adults’ ability to see low-contrast images improved to the level that the college-age ones had before training.

Scientists don’t know exactly how perceptual learning relieves presbyopia, but they have some clues based on how our brain processes visual information.
After first taking in “raw data” of an image through the eye, different sets of neurons in the brain process it as  like edges and colors. Then the brain must coordinate activity across sets of neurons to assemble these features into recognizable objects like chairs, faces, letters or words. Reading at our normal pace, the brain has only about  to do this work until the eyes automatically move onto the next letter or word. Once they do so, we’re taking in more information from whatever the eyes focus on next. If we haven’t yet processed the prior set of information, we can’t understand it.

Visual processing time is challenged and slowed by noisy images, low contrast or closely spaced information (like small fonts). There is a  as it attempts to build and then comprehend the image. Therefore, enhancing and speeding up the ability to process image components — through perceptual learning — improves a wide range of vision functions.

What’s surprising is that this is possible in adult brains. Neuroplasticity — the ability of the brain’s processing functions to change to acquire new skills — is most strongly associated with childhood. It’s still more pronounced in children than adults, but for some skills, , the brain is more malleable than once thought.

The training with GlassesOff is long and challenging. I found it fun initially, perhaps because it was new. But weeks into it, I began to dread the monotonous labor. Yet, after a couple of months, the app reports I can read fonts nearly one-third the size I could when I started and much more rapidly. According to feedback from GlassesOff, my vision after training is equivalent to a man about 10 years younger than my age. If I reach 50 — the age at which  to read — and still don’t need reading glasses, I may conclude that the training has paid off.

As apps go, GlassesOff is not cheap. I paid $24.99 for three months of use — long enough to get me through the initial program. Upon completion, I was invited to pay another $59.99 per year for maintenance training. It’s a nice option, but the hard work and price probably mean that the bifocals market will remain strong.

Link to article: 

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Written by: Gabrielle DeGroot Redford

Why more Americans are going blind each year, and what can be done about it

Every year 50,000 Americans , most from treatable or preventable eye diseases such as diabetic retinopathy and macular degeneration. Yet just half of the 61 million Americans at high risk of losing their eyesight saw an eye doctor in the past 12 months, according to the Centers for Disease Control and Prevention.

That’s partly because  are not covered by Medicare or most private insurance, says Peter J. McDonnell, M.D., director of the -Wilmer Eye Institute at the Johns Hopkins Medical Institutions in Baltimore. Not surprisingly, blindness is among Americans’ most-feared medical conditions, along with Alzheimer’s disease and cancer.

“What’s sadder than working your whole life, getting ready to retire and developing something like macular degeneration, where you lose your central vision?” McDonnell says. “It’s a big issue.”

AARP spoke with McDonnell about what’s fueling the rise in eye diseases, steps we can take to protect our eyesight and new developments in the treatment of blindness.

Q: By 2050, the number of Americans who are blind or visually impaired is expected to double to more than 8 million. What’s behind that trend?
A: The two biggest drivers are the increase in the number of  and the fact that we’re living much longer. Thirty years ago, it was pretty rare for us to see someone who was 80 years old. Now, we routinely see patients over 100. Back then, people would have developed these age-related eye diseases, but they didn’t live long enough.

Q: If you have diabetes, are you destined to get diabetic retinopathy?
A: The better you control your diabetes, the less likely you are to have a problem. And if you do develop the abnormal blood vessels in your retina that are a hallmark of the disease, we can treat them with lasers or medications. Unfortunately, only about 20 to 30 percent of people who have diabetes get regular eye exams, and up to 24,000 Americans go blind each year from diabetic retinopathy.

Q: What else can people do to protect their eyesight as they get older?
A: Eat a well-balanced diet, and don’t smoke. We think that the loss of vision that accompanies some eye disease such as age-related macular degeneration may be related to oxidative damage to the eye. People who eat plenty of green, leafy vegetables and antioxidant-rich fruits and vegetables like blueberries and tomatoes might be better off. Plus, when you’re out in the sun, you want to wear UV-absorbing sunglasses and a hat with a brim. Smoking doubles your risk of macular degeneration and cataracts, so if you smoke, quit.

Q: Dry eyesyndrome seems to be on the rise. Even Jennifer Aniston has been diagnosed with it. What’s going on?
A: Dry eye happens when your eye doesn’t make enough tears, and it’s one of the most common eye problems affecting Americans. A lot of people convince themselves it’s normal to feel scratchiness or irritation in their eyes, or to think that it’s just part of getting older. But it’s not.

Q: What is the treatment?
A: We now have two FDA-approved drugs to treat dry eye: cyclosporine [Restasis] and lifitegrast [Xiidra]. Some people can benefit from corticosteroid eyedrops, but you only want to use those for a short period of time. We can also put a plug in your tear duct to make the tears that you do produce stay in your eye longer.

Q: Can you envision a time when no one in America would become blind?
A: I’m counting on it! We have scientists who are growing retinas from stem cells, and as best as I can tell, it’s just a matter of time before we can implant those in people. We’ve also made progress on an artificial optic nerve, so if you can grow the retina and grow the artificial optic nerve that connects the retina back to the brain, hopefully you’re there.

Q: About 2 million Americans — most of them over age 70 — have age-related macular degeneration [AMD], which affects central vision. What can people do to protect themselves?
A: About 14 years ago, we discovered that 75 percent of your risk for AMD is genetic. Obviously, you can’t control who your parents are, but lifestyle choices such as getting regular exercise and not smoking might be protective. And now there are vitamin and mineral supplements that have been proven to slow down the progression of AMD.

Q: Are there any treatments for AMD?
A: People with advanced macular degeneration develop blood vessels that grow into the macula at the back of the eye, and that leak fluid and bleed, and cause scarring and distortion of the retina. We now have a group of drugs called anti-VEGF that you inject into the eye and that cause those abnormal blood vessels to dry up. In a number of patients, vision even comes back to normal. Unfortunately, it’s only available for the 200,000 people a year who develop the “wet form” of neovascular AMD.

Q: How about those with a less advanced form of the disease?
A: We don’t have a treatment yet, but companies are pouring hundreds of millions of dollars into finding a solution. I’d be surprised if we don’t have a treatment 10 years from now, even five years from now.

Link to article: 

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Recent controversies highlight the significant risks of unproven stem cell eye treatments. This page explains a notable case and underscores why choosing FDA-approved clinical research and qualified specialists is crucial for your vision safety.

The Florida Case: A Warning About Stem Cell Eye Treatment Risks

In 2017, The New England Journal of Medicine reported that three women in Florida suffered permanent vision loss after receiving unproven stem cell injections for macular degeneration at a private clinic. This case exposes critical gaps in patient protection and the dangers of clinics operating outside rigorous clinical trials.

Key Takeaway: Stem cell eye treatment risks are real. Patients paid $5,000 each for a procedure that lacked FDA oversight and scientific validation, leading to blindness.

By 
MARCH 15, 2017

Three women suffered severe, permanent eye damage after  were injected into their eyes, in an unproven treatment at a loosely regulated clinic in Florida, doctors reported in an article published Wednesday in The New England Journal of Medicine.

One, 72, went completely blind from the injections, and the others, 78 and 88, lost much of their eyesight. Before the procedure, all had some visual impairment but could see well enough to drive.

What Went Wrong?

• Procedure: The clinic used liposuction to extract stem cells from the patients’ fat, then injected them into both eyes simultaneously.
• Result: Patients experienced detached retinas and high eye pressure. One woman went completely blind.
• Regulation Gap: The clinic argued that using a patient’s own cells exempted it from FDA drug regulations.

All three women found U.S. Stem Cell because it  on a government website,  — provided by the . Two later told doctors they thought they were participating in government-approved research. But no study ever took place, and the proposed study on the site had no government endorsement. Clinical trials do not need government approval to be listed on the website.

Legitimate research rarely, if ever, charges patients to participate, scientists say, so the fees should have been a red flag. But many people do not know that.

Stem cells, which can develop into many different types of cells, are thought to have tremendous potential to repair or replace tissue damaged by disease, injury or aging. But so far, the F.D.A. has approved only a few stem-cell products to treat certain blood disorders.

Red Flags and How to Protect Yourself

This case reveals several warning signs for patients considering experimental stem cell therapies:

1. Charging for Experimental Treatment: Legitimate clinical research rarely charges participants.
2. Treating Both Eyes at Once: Ethical research treats one eye first to preserve vision if complications occur.
3. Misleading Trial Listings: The clinic listed a “study” on a government website (),��which does not imply endorsement or approval.

Expert Insight from the FDA

In an accompanying article, FDA scientists warned that stem cells from fat “are being used in practice on the basis of minimal clinical evidence of safety or efficacy.”

The F.D.A. website warns “the hope that patients have for cures not yet available may leave them vulnerable to unscrupulous providers of stem-cell treatments that are illegal and potentially harmful.”

The F.D.A. article in The New England Journal of Medicine suggested that adverse events from stem-cell treatments “are probably much more common than is appreciated, because there is no reporting requirement when these therapies are administered outside clinical investigations.”

The Importance of FDA-Approved Research

�³󾱱�����stem cell research for eye diseases holds great promise, progress must happen through controlled, ethical clinical trials. The FDA has approved only a few stem-cell products, primarily for blood disorders—not for intraocular use.

Choosing Safe, Ethical Eye Care

Your vision is irreplaceable. We strongly advise:

• Consulting a board-certified ophthalmologist before considering any experimental treatment.
• Verifying FDA approval status for any procedure or clinical trial.
• Being skeptical of “miracle cures” that bypass established medical channels.

Trustworthy Resources on Stem Cell Research

Read the Original NY Times Report:

FDA Consumer Warning: FDA Warns About Stem Cell Therapies

Schedule a Consultation for Evidence-Based Care

If you or a loved one are exploring treatment options for macular degeneration or other eye conditions, our physicians can provide guidance on safe, effective, and scientifically validated pathways.

Book a Consultation with Our Specialists

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Lazy Eye Surgery Facts

Written by: Mark Simborg
Reviewed by: ,��
Mar. 04, 2017

Lazy eye and strabismus surgery are popular topics that are often misunderstood and can be confused.

, is when an eye has poor vision because it’s not working in coordination with the brain. It can happen in both eyes but usually happens in only one eye. The brain then favors the better-seeing eye. Sometimes this causes the weaker (“lazy”) eye to wander outward, inward, upward or downward. When an eye wanders, that condition is called .

Amblyopia usually develops in early childhood and is the leading cause of vision loss in children. Early vision screening by a pediatrician, family doctor or an ophthalmologist is important in detecting children with amblyopia as young as possible. A number of eye diseases can contribute to the development of amblyopia.

Amblyopia treatment should be started as early as possible because:

• Over time the amblyopic “lazy” eye could become permanently blind;
• Depth perception (3-D vision) could be lost; and
• If the other, better-seeing, eye becomes diseased or injured, the amblyopic “lazy” eye cannot replace the loss in vision.

Amblyopia and strabismus are commonly confused. When most people think of “lazy eye” they are actually thinking of wandering or misaligned eyes, which is strabismus. “Lazy eye” is amblyopia — poor vision in one or both eyes. This poor vision (amblyopia) can lead to eye misalignment (strabismus).

Strabismus is more commonly referred to as crossed eyes, wandering eyes, or drifting eyes. If for some reason one eye of a child has decreased vision, the brain will not use that eye and it becomes lazy from lack of use. That is amblyopia — the eye is lazy from lack of use. If one eye happens to be looking somewhere other than the other eye, that is strabismus.

Lazy eye (amblyopia) . It can only be treated when the patient is a child. The younger it is detected and treated the better. In fact, after age 6 the success rate of treatment goes way down. Glasses and eye patches are the most common treatments for amblyopia, or lazy eye.

“Lazy eye surgery” does not exist. This comes from the fact that strabismus (wandering of one or both eyes) is often confused with the eyes being “lazy.” Lazy eyes with amblyopia just do not see well, it DOES NOT mean they wander or drift.

Strabismus, or eye misalignment, CAN be treated with surgery on the eye muscles. This surgery can be performed on both adults and children. Eye muscle surgery can improve not only the cosmetic appearance of the eyes but also visual function.

When most people ask about “lazy eye surgery,” they are really talking about , or surgery to correct misalignment of the eyes.

If you are considering eye muscle surgery, here are the key facts to know:

• The surgery works by either loosening or tightening the eye muscles. This changes the alignment of the eyes relative to each other.

The are two main types of surgery:

• Recession is when an eye muscle is detached and then reattached further away from the front of the eye to weaken the muscle.
• Resection is when a portion of an eye muscle is removed to make the muscle stronger.

• Approximately 1.2 million eye alignment surgeries are performed each year, making it the third most common eye surgery in the United States.
• Eye muscle surgery has a high success rate and serious complications are extremely rare.
• It is a one-day procedure that usually does not require staying overnight in the hospital.
• Children can return to school after a few days of rest. Most adults can return to work within a week.
• Pain, soreness, redness, and double vision are the most common side effects of eye muscle surgery. These are usually temporary.

Whether you are looking into this “lazy eye surgery” for yourself or your child, a vital first step is to discuss your goals and expectations for the surgery with your .

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​The Bright Future of Vision Care

Written by: 
Oct. 10, 2016

Here’s a little known fact that may surprise you: eight out of 10 people worldwide who live with vision loss could have saved their sight through available treatment or preventive measures.

Vision impairment is a major public health issue all over the globe; preventing and treating vision loss are some of the most cost-effective interventions in healthcare. These are the key messages of  on October 13.

About 285 million people worldwide live with impaired vision. The saying, “it takes a village,” is not an exaggeration when it comes to working toward eliminating blindness. Efforts to combat vision loss happen at many levels, in many places—from the halls of research facilities to the huts of remote eye clinics.

The history and evolution of understanding and restoring vision is the subject of an upcoming documentary slated for broadcast on Public Broadcasting Service (PBS) stations. Called  it reveals the global impact of vision loss, and has people talking about future possibilities for a world free from blindness.

Tools to Help People See the World Around Them

The last few years have seen remarkable technological advances in treating vision loss. For example, “bionic eyes” are now a reality in the form of retinal implant devices. Currently available for people with blinding  (and in testing for people with ), the  is restoring some useful vision for those with virtually none to speak of. The system uses a miniature video camera in eyeglasses to send visual information to a small computerized video processing unit (usually worn on a belt or carried in a pocket). This computer converts the image to electronic signals. Those signals are sent wirelessly to an electronic device implanted on the person’s . This allows the user to see patterns of light that the brain eventually learns to interpret as an image.

Marrying sophisticated technology with portability has given rise to low cost diagnostic tools for use in virtually any setting. Eye doctors now have smartphone-based options
for testing vision in rural areas where traditional office  are impractical or impossible.

Yet not all successful eye health interventions rely on high tech. Even a simple eye chart is a vision-saving device. One of the most important steps in preventing vision loss is having access to basic eye exams and eye care services by trained professionals. When eye problems are found earlier in life, it can mean the difference between having or losing vision later.

Simple Treatments Are Not Reaching People Who Need Them

A recent  juxtaposes today’s advanced vision research with the widespread challenges of providing even the most basic eye care. Having  is a “disease of poverty,” according to the article, causing half of all blindness in the world today.

People in a developed country usually undergo  as soon as their lifestyle is affected. But in developing parts of the world (such as Africa and India), millions of people go blind from this easily treated condition due to the lack of access to eye care.

Eye health advocates agree: ending worldwide blindness is a noble effort that requires not only finding new cures, but effectively delivering them.

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Feb. 02, 2017
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Devastating Mishap Causes Eye Injury

Outgoing, boisterous, and always on the move, Jackson Allen is a 5-year-old with a sunny disposition who loves making people laugh. One afternoon, an unimaginable accident nearly cost Jackson his sight, which could have changed the course of his life forever.

On what should have been a routine walk down the stairs two years ago, Jackson tripped on the bottom step in his home, falling onto a coat rack. A hanger hook in just the wrong position punctured the right corner of his eye severing a muscle and narrowly missing his brain.

Jenna Allen, Jackson’s mother, immediately rushed him to the nearest trauma center. The surgeons there operated quickly, but could not re-attach Jackson’s lateral rectus, one of the six muscles responsible for keeping the eye in line.

“I was numb,” said Jenna. “Completely terrified that Jackson was going to lose his eye.”

Accident Leads to Lazy Eye, Damaged Vision

Months later the family moved to Texas. Jackson’s grandmother knew of pediatric ophthalmologist Jane Edmond, MD, and made the referral for further care and treatment. Upon initial evaluation Jackson’s eye had an unsightly red scar and was crossed inward toward the nose, unable to rotate outward. Jackson’s eye was so red and crossed that the brain no longer depended on it for vision, causing his vision to deteriorate to 20/200 – ten times worse than normal 20/20 vision.

Jackson was diagnosed with amblyopia, more commonly known as . Amblyopia occurs when one eye is out of alignment and two images are sent to the brain, which makes the eye cross. When this happens, the lazy eye “turns off” to avoid double vision, leaving a person to use the most dominant eye to see. He was also diagnosed with esotropia which is a form of  –  in which the eyes are not aligned properly and point in different directions.

“Having only dealt with a few cases like this in practice, I considered Jackson’s accident rare,” said Dr. Edmond. “If the coat hook had gone in differently it could have hit his brain or damaged the eyeball resulting in permanent blindness.”

Jackson’s initial treatment began with two-hour daily patching of the left eye to improve and strengthen the vision in his right eye. Dr. Edmond, like the previous surgeons, could not repair the severed eye muscle so she ended up having to perform a more complicated procedure.

“She saved his vision and fixed his eye so he looks like other kids at school. It makes me so happy.” – Jenna Allen

First, she performed a surgery called a transposition, which used two of Jackson’s six muscles that control the eye to replace the severed muscle. She also removed scar tissue to alleviate some of the redness. Lastly, she weakened the medial rectus – or middle eye muscle – that had tightened due to Jackson’s misalignment.

After Jackson’s eye recovered from this treatment, Dr. Edmond performed a second surgery to center the eye. This time, she also injected Botox into the middle eye muscle to make the eye rotate out instead of in.

Vision Restored Following Surgery

Two years after the accident, Dr. Edmond observed near perfect alignment. Jackson had normal vision in his right eye.

“It was the most epic result I have ever seen from this type of devastating injury,” said Dr. Edmond. “You’d never know the extent of the injury to his eye muscle. He has had a really incredible outcome.”

Jackson will continue to wear a patch for one hour a day until his sixth birthday. Like most kids his age, he gripes on occasion about having to wear the eye patch, but otherwise, doesn’t talk much about the injury.

“Dr. Edmond is wonderful,” said Jenna. “I cannot thank her enough for what she did for my son. “I was so worried about him not being able to see and being made fun of by other kids at school. She saved his vision and fixed his eye so he looks like other kids at school. It makes me so happy.”

If not for the series of procedures he received from Dr. Edmond, life might be very different for Jackson. Now, his future is brighter than ever.

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