Here at Dr. Wieber’s office, Monticello Optical, we specialize in early treatment of eye diseases. Our doctors diagnose and are licensed to treat diseases of the eye. Over 80% of the patients we see are for eye disease. When it comes to medication for infections, inflammations, pain, dry eyes, and allergies, we prescribe them all. For cataracts and other surgeries we have been fortunate for the past 10 years to have Andrea Joplin, M.D., from Eye Surgeons and Physicians present for Wednesday consultations. If surgery is indicated, all pre and post-operative care can be done right here in our office. We will make sure your eyes are taken care of, referring you to a specialist if necessary.
Here are some of the eye diseases we diagnose and treat:
Eye Infections and Eye Inflammation
An infection is an attack on the human body by another organism like bacteria, virus, fungus or parasite. An inflammation is the body’s response to an insult, which could be from an infection, an injury, an allergen or idiopathic (unknown). Of course, the eye, the orbit (structures surrounding the eye) or the optic nerve can have infection, inflammation or both. There are truly hundreds of diseases in this category. They range in severity from self-limited, non-vision threatening to vision threatening (like corneal ulcers) to life threatening (preseptal cellulitis, orbital cellulitis). We have treated them all and here at Monticello Optical located in Monticello, Minnesota we take pride in what we do.
Conjunctivitis is an infection or inflammation of the conjunctiva which is the clear membrane covering the white of the eye and inner lids. Conjunctivitis is probably the most common, but there are many types—bacterial, viral, sterile, irritative, allergic. Most important is proper diagnosis since these all look very similar. Differential diagnosis can be made by experienced clinicians using a Slit Lamp Microscope by carefully considering the presentation of the disease, to order the appropriate medicine. Without use of the Slit Lamp, diagnosis is more difficult. Here at Monticello Optical we always use a Slit Lamp during every exam to ensure proper diagnosis.
Anterior Uveitis, often called “Iritis”, is a more serious condition because it is painful, causes light sensitivity and can result in permanent visual loss if not properly treated quickly. This disease can be confused with Conjunctivitis without the use of a Slit Lamp. The treatment necessary to combat this disease is steroid eye drops to decrease inflammation.
Keratitis is a infection or inflammation of the cornea and is another serious, painful condition. Treatment would be an antibiotic (if the cause is bacterial), an antiviral, and a steroid alone or in combination or lubrication drops.
Glaucoma is when the intraocular pressure (IOP) is too high for the optic nerve to sustain. For some people this might be a pressure of 25, for others 20, for others it might be 15. Glaucoma is a complex, sneaky disease that has no symptoms in the beginning and if left unchecked, will result in permanent vision loss. In addition to just checking the pressure we monitor family history, the appearance of the optic nerve head, changes in the appearance of the optic nerve head, the retinal nerve fiber layer along with additional testing of Threshold Visual Fields, Retinal Photography and Optic Nerve Scans. At Monticello Optical we have treated glaucoma for many years and usually pressure lowering eye drops will protect the optic nerve. However, if the glaucoma is particularly aggressive, we will usually seek the counsel of Thomas Samuelson, M.D., a world famous glaucoma surgeon, who will usually perform glaucoma surgery.
Cataracts are the most common cause of reduced vision in adults, when the natural lens inside the eye becomes cloudy. When the decrease in visual acuity starts to affect a person’s lifestyle, it is usually time to remove the cataract and insert a lens implant. Andrea Joplin, M.D. of Eye Surgeons and Physicians has been performing cataract surgery for our office for over ten years.
Age Related Macular Degeneration
Age-Related Macular Degeneration (AMD) is the leading cause of vision loss for Americans over age 65. Persons at risk can usually be identified during an eye health exam. Latest research confirms that certain vitamins and minerals are helpful in preventing or slowing the progression of macular degeneration. We can counsel you in this area and we will not try to sell you some over-priced vitamins. If AMD has occurred in a patient, we can help with the treatment and differentiation between dry and wet AMD, and refer you to the appropriate retinal specialist when indicated.
Diabetic patients should have an annual, dilated eye exam with retinal photographs. We will then report the results to your primary care practitioner who is managing your diabetes. Of course we have the latest instrumentation to detect and record retinal changes. If there is proliferative retinal disease or need for further evaluation, we will refer you to a retinal specialist for further testing or treatment.
Disease of the Orbit
Disease of the Orbit would include Blepharitis (inflammation of the eyelash follicles), Diseases of the Lacrimal System (Tear production), styes, or the very serious cellulitis. Treatment could be antibiotics (drops or pills), steroid drops, lubrication, punctal plugs or warm compresses.
Dry Eyes is a disease that can cause a lot of discomfort and the causes are more than just lack of tears. Human tears are complex and as every sufferer of dry eyes knows, the solution may take some time to find, but we are patient and can help you find relief using a measured approach.
Foreign Bodies that become lodged in the eye are usually in the cornea. The cornea is the clear membrane covering the pupil and essential to sight. It has the highest concentration of sensory nerve cells in the entire body so a foreign body is sight-threatening and painful. Scarring of the cornea is always a big concern and is sometimes unavoidable, depending upon location, depth, size and material content. We always start with the least invasive procedures (irrigation, magnetism). Next is we use a Slit Lamp to magnify the object and evaluate the best way to try to lift it off with least harm to the cornea, using instruments specifically designed for this purpose. Often a “dimple” is left behind as a depression when the foreign body is removed. To further protect the cornea during the healing process, we usually insert a bandage soft contact lens which the patient wears 24 hours per day. Which also provides great pain relief, lubricating eye drops and antibiotic eye drops are also prescribed to relieve pain. Corneal Abrasions or scratched corneas are also very painful and are treated very much like the Foreign Body removal noted in the above paragraph.
Floaters and Flashes
Floaters and Flashes of Light can often be seen by patients for several reasons. Usually the floaters occur in the Vitreous, which is the clear, jelly-like substance that comprises the bulk of the internal eye. The vitreous is often not perfectly clear and small, less clear (opaque) parts can thus cast a shadow on the retina as the light becomes focused from the front to the back of the eye. This is perceived by the brain as objects which seem to float in mid-air, taking a shapeless form or the form similar to a cobweb. This can also be due to the separation of the vitreous from the retina which could result in the sudden appearance of floaters. If the vitreous actually pulls on the retina, this may activate the sensory retina causing the brain to perceive a flash of light. So the sudden onset of flashes or floaters should be thoroughly checked out with a dilated exam and further by using a Binocular Indirect Ophthalmoscope to view the retina and make sure there is not retinal instability like tears or detachments. If this is detected, you will be referred to a retinal specialist. Here at Monticello Optical we have the skills and technology to do this.