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West Newton


Cataract Surgery Co-Management

Over 50% of people aged 65 and older have a cataract in one or both eyes. As the cataract progresses, vision deteriorates, leading to a decreased quality of life.

Fortunately, cataract surgery can easily treat this condition. This common surgery has a high success rate, with over 95% of all cataract surgeries free of even mild complications.

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Cataracts are one of the leading causes of vision loss in people aged 65 or older. This condition develops as the eye ages, meaning that by the time we reach 80, more than half of us will have developed a cataract or will have undergone cataract surgery.

Without cataract surgery, millions of people around the world would be unable to see clearly.

What Are Cataracts?

A cataract is a clouding of the lens in your eye which is normally transparent. The lens, located inside the eye, behind the iris and the pupil, focuses light onto the retina at the back of your eye, where it is converted to nerve signals that are passed to the brain, thus enabling you to see.

When your lens becomes cloudy, the images projected onto your retina become blurry and unfocused and therefore the signal to the brain is also unclear.

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What Causes Cataracts?

Cataracts are part of the natural aging process of the eye. While the majority of cases develop in old age, there are instances of congenital cataracts, present at birth. Further, secondary or traumatic cataracts can occur at any age as a result of eye injury, surgery, or disease.

Certain medical, genetic, and behavioral risk factors can also accelerate its development, such as diabetes, a family history of cataracts, smoking and excessive alcohol consumption.

What Are the Symptoms of Cataracts?

Symptoms of a cataract may develop slowly at first, or may not even be noticeable.

The most common symptoms include:

  • Blurred or double vision
  • Trouble seeing at night
  • Sensitivity to glare
  • Colored halos around lights
  • Colors appearing more faded
  • Requiring brighter light for reading

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When To Consider Cataract Surgery?

Cataracts don’t suddenly develop overnight. They generally start off small and only begin to noticeably affect your vision as they grow. You should consider getting cataract surgery once the condition begins to seriously impair your vision and adversely affects your daily life, impacting your ability to:

  • Read
  • Drive
  • Play golf or tennis
  • Watch TV
  • Recognize faces

Surgery should also be considered if it’s preventing the treatment of another eye problem, such as glaucoma. The good news is that cataract surgery successfully restores vision in the vast majority of cases.

Cataract Surgery

Cataract surgery, a relatively quick and painless procedure, is one of the most common surgeries performed in North America.

This surgery involves removing the clouded natural lens and replacing it with a clear, plastic intraocular lens (IOL) that becomes a permanent part of the eye.

IOLs are usually made of plastic and most of them are monofocal lenses or single power lenses to correct for distance vision. As technology advances, specialized IOLs continue to be developed. From multifocal IOLs to IOLs that block UV and blue light radiation, patients have greater options available to them now than ever before.

If you or a loved one has cataracts and would like more information on cataract surgery, please contact Dr. Paul Ives, Dr. Alexa Ives, and Dr. Tessa Ives today.

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Diabetic Retinopathy

Are You Diabetic?

All diabetics are at risk of developing diabetic retinopathy, which generally presents without warning signs or symptoms in its early stages. Fortunately, by having regular dilated eye exams, your eye doctor can diagnose and manage the condition to help you avoid vision loss.

What is Diabetic Retinopathy?

Diabetic retinopathy affects approximately 35% of diabetics worldwide. It occurs when the small blood vessels in the retina swell and leak as a result of high blood sugar levels. The new thin and fragile blood vessels that grow may bleed, causing scar tissue. Eventually, if left untreated, this leads to permanent vision loss, perhaps even blindness.

If you’re diabetic, controlling blood sugar levels and undergoing routine eye exams are crucial to preventing vision loss. Several risk factors associated with diabetic eye problems include:

  • Poor blood sugar control
  • High blood pressure
  • High cholesterol
  • Excess weight/obesity
  • Smoking
  • Pregnancy

Why Are Eye Exams Important?

Since diabetic retinopathy is typically painless and shows no symptoms until its advanced stages, many diabetics are unaware they have it.

It’s possible that as the condition worsens, it will cause:

  • Poor night vision
  • Blurred vision
  • Vision loss
  • An increased number of floaters
  • Colors to appear washed out or faded
  • Blank or dark areas in your field of vision

By getting annual eye evaluations, your eye doctor will be able to detect these signs early enough which can help lower your risk or minimize vision loss.

How Can Diabetic Retinopathy Be Treated?

The treatment options listed below may help improve your vision.

  • Medication
  • Anti-VEGF or steroid injections
  • Laser surgery
  • Vitrectomy

How Can Diabetic Retinopathy Be Prevented?

Below are a few ways you can preserve your vision.

  • Control blood sugar levels
  • Maintain healthy cholesterol levels and blood pressure
  • Keep to a healthy diet and exercise regimen
  • Quit smoking, if applicable

To prevent and manage diabetic retinopathy, a multi-disciplinary approach involving your eye doctor and other medical professionals is needed. Your eye doctor will conduct a comprehensive eye exam to determine whether you have diabetic retinopathy, assess its seriousness, and explore prevention and treatment options.

Contact Ives Eyecare Center to schedule your dilated eye exam today, and learn more about what you can do to protect your vision and general health.

Our practice serves patients from Murrysville, West Newton, Delmont, and Pittsburgh, Pennsylvania and surrounding communities.



Is there a cure for diabetic retinopathy?

Early treatments can slow the progression of the disease and may even restore any lost vision. The more effective long-term strategy is to control the risk factors for diabetic retinopathy. Once retinal scarring occurs, vision loss is usually permanent.

Even though my diabetes is well-controlled, could I still develop diabetic retinopathy?

Yes. Despite maintaining control over blood sugar levels, patients who’ve had type 1 diabetes for over 20 years can still develop diabetic retinopathy. Other factors, such as inflammation and direct changes to the blood vessels, are also believed to cause this eye disease.

Are there different types of diabetic retinopathy?

Yes. There are two major types:

  • Non-Proliferative Diabetic Retinopathy (NPDR) – the early stages
  • Proliferative Diabetic Retinopathy (PDR) – the advanced stages when any new fragile blood vessels appear


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Eye Disease Management Blog

Glaucoma Surgery Co-Management

When is surgery used for glaucoma treatment?

In general, surgery isn’t the first line of treatment for glaucoma. But if other treatments fail, glaucoma surgery may be able to save your vision.

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The goal of glaucoma treatment is to lower your intraocular pressure by helping fluid to drain. When the pressure is elevated, it can push on your optic nerve – leading to vision damage. A variety of medicated eye drops can be prescribed to reduce the pressure levels, but they aren’t effective for everyone, especially when pressure levels are very high and need to be lowered quickly or sometimes medicine causes serious side effects, such as hypertension, which makes it a poor option for glaucoma treatment.

In certain cases, your Ives Eyecare Center eye doctor may recommend glaucoma surgery.

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Types of Glaucoma Surgery

Typically, your eye doctor will perform laser surgery first. These procedures are done on an outpatient basis.

Laser surgeries for glaucoma include:

  • Argon laser trabeculoplasty (ALT): This procedure opens blockages in your eye, allowing fluid to drain properly.
  • Selective laser trabeculoplasty (SLT): when ALT isn’t fully effective, this procedure may be used. SLT works by aiming a precisely targeted low-level laser at only the spots with elevated pressure.
  • Laser peripheral iridotomy (LPI): when the gap between your iris and cornea is smaller than normal, narrow-angle glaucoma may develop. With this kind of glaucoma, fluid and pressure build up in this small area of the eye. Using a laser beam, LPI creates a tiny hole in the iris through which the excess fluid can drain.
  • Cyclophotocoagulation: when all other laser treatments do not relieve the fluid buildup and lower pressure, cyclophotocoagulation may be used. This operation aims a laser beam through the sclera and into the ciliary body, which is the part of the eye that produces intraocular fluid. The laser damages the ciliary body so it makes less eye fluid. Cyclophotocoagulation may be repeated over time to keep pressure levels normal.

Conventional non-laser glaucoma surgery:

If laser surgery doesn’t alleviate eye pressure, you may need a different type of procedure.

  • Trabeculectomy: a small incision will be made in the white part of your eye to remove some of the inner mesh of tissue, helping the excess fluid to drain. Medication to prevent scar tissue may also be administered. Research shows that this procedure lowers eye pressure in 6-8 out of 10 people and may be most effective in people who haven’t had previous eye trauma or surgery (for glaucoma, retina surgery, cataracts, or eye muscle problems).
  • Drainage implant surgery: a tiny tube will be inserted inside your eye to facilitate fluid draining. Many minimally invasive implants are now available.
  • Electrocautery: a heat device, called a Trabectome, is used to make a small incision in the drainage tubes of your eye, which sends heat to the inner mesh of tissue and relieves fluid pressure. Electrocautery is less invasive than trabeculectomy or drainage implants.

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Risks of Glaucoma Surgery

Benefits of Glaucoma Surgery

The primary risk of glaucoma surgery is that it increases your chances of developing cataracts later on. Other possible risks include:

  • Red eyes
  • Eye pain
  • Abnormal eye pressure – too high, or even too low
  • Vision loss
  • Eye infection
  • Inflammation or bleeding in your eye

When other types of glaucoma treatment are ineffective or unsuitable, glaucoma surgery offers an excellent alternative to prevent damage to your optic nerve and vision loss.

Also, if the opening in your eye begins to close up again, glaucoma surgery can be repeated. If you’ve already lost vision due to glaucoma, surgery will not be able to restore it – but it can prevent further damage and save your remaining sight!

For glaucoma diagnosis and management, be sure to visit our eye doctors for regular comprehensive eye exams.

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Age-Related Macular Degeneration (AMD)

An estimated 11 million people in the United States have some form of macular degeneration, also called age-related macular degeneration (AMD), a leading cause of vision loss in people over 60. This number is expected to double to nearly 22 million by 2050.

The risk of suffering with AMD increases from 2% for ages 50-59, to nearly 30% for those over the age of 75.

While there is no cure for macular degeneration, with the advent of injections and lasers, Dr. Paul Ives, Dr. Alexa Ives, and Dr. Tessa Ives can help you manage the condition and may even occasionally restore any loss of sight.

What is Macular Degeneration?

The macula is the central part of the retina. It’s a vitally important part of our eyes as it is responsible for central vision and much of our color vision and ability to see fine details. It allows us to read, recognize faces, drive a car, and so much more.

In fact, the light rays of whatever we are looking at are focused on the macula, be it a photograph of a grand-child, the TV, or your partner’s face.

Macular degeneration is the deterioration of the central part of the retina, the inside back layer of the eye that records the images we see and sends them back to the brain. When the macula is functioning properly, it collects highly detailed images at the center of our vision and sends neural signals through the optic nerve to the brain, which interprets them as sight. When the macula deteriorates, the brain does not receive these clear, bright images, and instead receives blurry or distorted images.

Types of Macular Degeneration

There are two main types of macular degeneration: “dry” and “wet.” Between 85% to 90% of people with macular degeneration have the dry (atrophic) form, but the dry form can eventually lead to the wet (exudative) form.

Another form of macular degeneration is Stargardt disease, which occurs in young people. It is caused by a recessive gene, affecting 1 in 10,000 people.

Wet vs. Dry Macular Degeneration

  • Dry (atropic) macular degeneration – this is caused when drusen (yellow deposits of proteins) accumulate under the retina causing retinal distortion. A few small drusen may not change your vision, but as they grow larger they may start to dim or distort vision, especially while reading. As AMD worsens, the light-sensitive cells in your macula further deteriorate and eventually die. With dry AMD, you may also notice blind spots in the center of your vision.
  • Wet (exudative) macular degenerationthis is when new and very fragile blood vessels are formed. These abnormal blood vessels leak blood and fluid into the retina, causing vision to become distorted so that straight lines appear wavy. As the blood vessels continue to bleed, they form a scar, potentially leading to partial or full loss of central vision.

By getting regular check-ups, your eye doctor can diagnose AMD early on and manage the condition to prevent further vision loss.

Symptoms of Macular Degeneration

In the early stages of AMD, you might not have any noticeable symptoms. By the time significant symptoms manifest, irreversible damage may have already occurred.

Symptoms of macular degeneration may include:

  • Decreased or blurry vision
  • Dark or blind spots in the center of your vision
  • Lines appearing wavy
  • Different color perception

Stages of Macular Degeneration

There are three stages of age-related macular degeneration.

  • Early AMD – Medium-sized drusen deposits and no pigment changes. Most people have no loss of vision at this point
  • Intermediate AMD – Large drusen and/or pigment changes. There may cause mild vision loss, but most people don’t experience any problems with their daily tasks
  • Late AMD – Vision loss has become noticeable

What Eye Exams Can Help Detect AMD?

To check for macular degeneration, your eye doctor will perform a comprehensive eye exam that will include:

  • Dilated Eye Exam – During this exam, eye drops are used to dilate the pupil. This allows the doctor to easily see a magnified view of the macula, drusen or detect abnormal blood vessels.
  • Ophthalmoscopy – For this exam, your doctor will use a hand-held light to detect any damage or changes in the retina and macula.
  • Fluorescein Angiography – This uses a dye injected into the bloodstream and is used to detect any leaking blood vessels in the retina.
  • Optical Coherence Tomography (OCT) – This test allows eye doctors to see a cross section through the retina and examine the layers and blood vessels beneath the surface of the retina. This includes the macula, optic nerve, retina, and choroid. Images are seen in 3D and full colour.
  • Amsler Grid – An Amsler grid is used by a patient at home, and allows you to self-examine your vision to notice the sudden appearance of any blurry or blank spots in your field of vision. Any changes of vision can be reported immediately to your eye doctor. This should not replace your regular yearly eye exam.

Visiting your eye doctor regularly and having a comprehensive eye examination can help detect AMD in its early stages, when treatment is most effective. While there is currently no cure for AMD, treatment may slow the disease and keep you from having severe vision loss and may even be able to restore some loss of sight. Contact Dr. Paul Ives, Dr. Alexa Ives, and Dr. Tessa Ives to find the best treatment plan and to discuss ways to manage your AMD.

Our practice serves patients from Murrysville, West Newton, Delmont, and Pittsburgh, Pennsylvania and surrounding communities.

Request An Appointment
Call 724-733-1918

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