Advanced Technology

Mapcat SF

The Mapcat SF is a new device that measures the level of macular pigment at the back of the eye (also called Macular Pigment Optical Density or MPOD).

Macular pigment (a yellow-colored protective layer found in the central part of the retina) is responsible for protecting the macula against damage caused by waste products that build up in the eye, and against the damaging effects of short wavelength light (‘high energy visible’ or blue light). The Mapcat SF test can be performed as part of the cataract surgery pre-operative assessment. After surgery, MPOD can be monitored over time as part of the patient’s post-operative care.

Stephenson Eye Associates is proud to introduce the Mapcat SF into our diagnostic portfolio. Invented by Professor Richard Bone at Florida International University, the Mapcat SF is the first device to use a ‘single fixation’ measurement technique (making it much easier for the patient to perform than other tests), and the ability to measure the density of the patient’s lens as well as the density of the macular pigment.

With the Mapcat SF, it is possible to accurately measure the Macular Pigment Optical Density (MPOD) before cataract surgery, and compare this baseline measurement at follow up to monitor the MPOD after surgery. If it is low, rebuilding and maintaining the macular pigment serves to protect the eye from the inside (in the same way that wearing sunglasses protects from the outside).

In addition to being a modifiable risk factor for Age-related Macular Degeneration, and a biomarker for several other diseases (including cognitive diseases such as Alzheimer’s), the macular pigment also plays an important role in vision performance. Because of the way it is focused as it passes through the eye, shorter wavelength light (blue light) can decrease contrast, and increase halos and glare (for instance when driving at night). Macular pigment filters blue light, which can reduce these negative effects.

Increasing macular pigment levels has been proven to reduce the risk of disease progression, and also to increase vision performance (contrast sensitivity, glare disability, photostress recovery). We are delighted to be able to offer this additional service to our patients here at Stephenson Eye Associates.

Apeture CTC - Automated Anterior Capsulotomies

Watch a lecture Dr. Stephenson presented about Automated Anterior Capsulotomies

 


Corneal Topography

Watch Dr. Stephenson's lecture on corneal topography technology.

 


Expanding Small Pupils - APX 200

Dee Stephenson MD, explains the use of the APX 200 Pupil Expanding Device to assist in the mechanical dilation of small pupils.  Click here to see the video to learn more about this advanced technology.


Ora System™ Technology

ORA System™Technology is a sophisticated device used to provide real time measurements of the patient’s eye–during cataract surgery, not possible with today’s conventional instruments. At any point, the surgeon can easily take a measurement, which is then analyzed by ORA System™Technology to provide specific information used to optimize decision-making in correcting the vision of that eye. Prior to the ORA System™, surgeons were unable to assess the quality of vision during the procedure, and would often have to wait until weeks after the surgery to determine the accuracy of the surgical results.

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LENSAR with Streamline

The addition of the Streamline technology reduces procedure time as well as improves on the already high level of laser precision. Another extremely exciting feature of the state of the art Streamline laser technology is that during the same laser procedure we can now take care of your cataract and also set the laser to automatically correct your astigmatism.

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iLux - Dry Eye Treatment

iLux is a handheld device that treats meibomian gland dysfunction (MGD), the main cause of dry eye disease.

Do you suffer from any of the following:

  • Your eyes feel dry, gritty, itchy or burning.
  • You feel like you have something in your eye.
  • Your eyes water excessively (especially in windy or dry environments).
  • You are unable to wear contact lenses for extended periods of time.
  • Your vision fluctuates (for instance when driving at night).
  • You take eye drops for glaucoma or other diseases.

 

If the answer to any of these questions is yes, you may have dry eye disease. Your eyes produce tears, which nourish, protect, and hydrate the cornea. The tear film is made up of three layers – an inner mucous layer (which keeps the tear stuck to the front of the eye), a middle aqueous layer (a mixture of water, proteins and salts) and an outer lipid layer (made of meibum, an oily liquid that prevents the aqueous from evaporating too quickly). In the majority of cases of dry eye disease, the oil glands in the upper and lower eyelids (called Meibomian glands) do not produce sufficient meibum, and the tear film becomes unstable as a result. This is called Meibomian Gland Dysfunction, or MGD. Inflammation and damage to the cornea and globe of the eye can occur. As MGD progresses, the cornea can become significantly damaged, which may eventually affect vision quality.

Reduction in meibum production can be caused by several things. These include increasing age, hormonal changes (especially in women), a lack of good quality Omega-3 essential fatty acids and other nutrients in the diet, spending long periods in dry environmental conditions (like an air-conditioned office or car, or being underneath overhead fans).

Meibum is expressed from the Meibomian glands in the eyelids each time you blink. Any activity that reduces the frequency or completeness of blinking is thought to contribute to MGD. Unfortunately, use of digital devices like smartphones, tablets, and computer screens, results in a reduction in the number of blinks per minute. Extended periods of digital device use are thought to increase the likelihood of MGD, as the Meibomian glands are expressed less effectively than needed, and the meibum begins to stagnate in the Meibomian glands. Whatever the initial cause of MGD, once it starts, it can quickly become chronic and progress quickly. If the Meibomian glands remain blocked for a significant length of time, they can atrophy (waste away) and may eventually disappear completely. At this stage, dry eye symptoms can become severe and permanent, and significant damage can occur to the front of the eye.

Diagnosing MGD and dry eye disease is especially important for patients who are about to have cataract or refractive surgery. As part of the pre-operative assessment process, highly accurate measurements of the eye are taken to provide the right data to calculate the power of the artificial lens to be implanted or the amount of refractive correction needed. If the tear film is unstable, and/or the cornea is damaged by dry eye disease, these measurements can be significantly affected. Because of this, diagnosing and treating MGD and dry eye disease is crucial for the accurate measurement of the patient’s eyes before surgery.

MGD is diagnosed in several ways. Self-reported symptoms are often the first indication that MGD and dry eye disease are affecting a patient, and these symptoms can give a good first impression as to how severe the condition is. At Stephenson Eye Associates, we utilize the TearLab osmolarity test. Osmolarity is a measurement of the amount of ‘saltiness’ in your tears, and an increased osmolarity level, or an uneven measurement between the two eyes, is an indication of dry eye disease.

Dr. Stephenson will also examine the Meibomian glands in your eyelids, by squeezing gently on the lid at the slit lamp microscope and examining the quality and quantity of meibum that is able to be expressed. Normal healthy meibum is thin and clear, like olive oil. Patients with MGD have meibum that may be cloudy and milky, or more solid and paste-like (like butter from the fridge). In advanced cases, the meibum may be completely solid and unable to be expressed at all, or the gland orifices may be completely blocked or capped, preventing the meibum from being expressed.

The most effective way to express the meibum from the glands is to heat the lid tissue to a therapeutic temperature of around 108 o f, which warms and melts the solid meibum, and then apply gentle pressure to squeeze the meibum and unblock the gland orifices. Stephenson Eye Associates are one of the first practices in the country to provide MGD treatment with iLux. iLux treats Meibomian Gland Dysfunction by the application of light- based heat and compression under direct visualization.

The iLux system applies a proprietary light-based heat source to warm the bulk tissue of the lid to the appropriate temperature and melt the meibum. Sensors in the sterile disposable iLux Smart Tip monitor the eyelid temperature and control the light intensity to keep the lid within the therapeutic range.

After heating the eyelid and meibum for an appropriate length of time, gentle pressure is applied to clear the blocked gland orifices. During treatment, the amount of pressure applied to the lid is under the control of the operator, and a magnifying lens in the iLux device allows a view of the meibomian gland orifices, and the amount and quality of meibum expressed. This view allows the operator to determine the effectiveness of the treatment while it is being provided.

Treatment with iLux is quick and effective, with most patients being treated in less than 10 minutes. Following your iLux treatment, Dr. Stephenson will recommend steps you can take at home to help keep the Meibomian glands producing oil and maintain the outcome of your iLux procedure. These steps may include things like eyelid hygiene products (lid scrub), artificial tears, Omega-3 supplements, warm compresses and other methods. By regularly performing these home-care steps, your Meibomian glands will be encouraged to produce more of the clear healthy meibum your tear film needs to be stable and provide protection to your eyes. Depending on the severity of your MGD and dry eye disease, you may need additional iLux treatments in order to keep the gland orifices open and the meibum healthy. If you’re experiencing any of the symptoms discussed above, contact Stephenson Eye Associates to find out more about treatment with iLux.