Eye care: Helping you achieve your best vision

Macular degeneration is the leading cause of vision loss among people older than 50. The disorder occurs when the tissue at the back of the eye (retina) begins to break down as you age. You might notice a loss of sight in your central line of vision. This is because the cells in the center (macula) of the retina stop working.

A cataract is a clouding of the eye’s lens. When this happens, light cannot pass to the back of your eye and your vision becomes hazy.

These are conditions that affect the surface of the eye. The most common conditions are dry eye, blepharitis (eyelid irritation), conjunctivitis (pink eye), allergies, corneal infections and dystrophies.

Diabetic retinopathy can cause vision loss and blindness in people with diabetes. Diabetes mellitus causes damage to blood vessels in the retina. This can lead to leakage or bleeding in your retina and eye. Damage may occur without symptoms. Annual examinations are recommended by an eye care professional for all patients with diabetes mellitus.

Dry eye is a common condition and happens when your tears don’t provide enough lubrication for your eyes.

Injuries of the eye, eyelid and eye socket (orbit) can result from sports, accidents or foreign objects in the eye. Pain, swelling and redness are common in eye injuries. Serious injury can result in vision loss.

Eye tumors (ophthalmic or ocular tumors) can be cancerous or noncancerous and develop in your eyes. The most common eye tumors include melanoma, retinoblastoma and metastases (tumors that have spread from the surrounding areas). Eyelid tumors can also be cancerous or noncancerous and may include skin cancers, such as basal cell carcinoma, melanoma or squamous cell carcinoma. Common tumors of the eye socket (orbit) include cysts, lymphoma, metastases, vascular (blood vessel) lesions and neurogenic (nerve) tumors.

Eyelid disorders include:

• Droopy eyelids (eyelid dermatochalasis or ptosis)

• Droopy eyebrows (eyebrow ptosis)

• Entropion (eyelid turning inward)

• Ectropion (eyelid turning outward)

• Skin cancer of the eyelid

• Trichiasis (abnormal eyelashes)

Glaucoma is a group of eye diseases that might rob you of your vision. Its exact cause is unknown. In many cases, it’s believed to occur when pressure builds up in your eye. This damages your optic nerve.

Inherited retinal diseases (IRDs) can cause vision loss or blindness. They are caused by at least one gene that is not working properly. They can affect people of all ages and many have symptoms that get worse over time.

Keratoconus is when your cornea (the clear front surface of your eye) thins and bulges out in a cone shape. This causes blurred vision and light and glare sensitivity.

Low vision is impaired eyesight that cannot be corrected by eyeglasses, contact lenses, medications or surgery. The most common causes of low vision are macular degeneration, glaucoma and diabetic retinopathy.

Neuro-ophthalmic disorders are vision disorders associated with the brain and systemic conditions. They include:

• Vision loss due to brain tumor or stroke

• Optic neuritis due to multiple sclerosis, infection (syphilis, lyme disease, tuberculosis, COVID-19, flu) or other autoimmune diseases

• Vision loss due to poor nutrition (vitamin deficiency), toxicity (e.g., tuberculosis medication) or genetic disease

• Double vision due to misalignment of the eyes

• Droopy eyelids (ptosis)

• Ischemic optic neuropathy — swelling of the optic nerve from blocked blood vessels

• Ocular myasthenia gravis — an autoimmune disorder that causes droopy eyelid and/or double vision

• Pupil asymmetry/abnormalities

• Papilledema — swelling of the optic nerves due to raised brain pressure

• Visual hallucination

• Amblyopia

• Birth defects affecting the eyes

• Cataracts

• Diplopia double vision

• Eye muscle conditions (binocular vision disorders, strabismus)

• Genetic disorders of the eyes

• Glaucoma

• Nearsightedness (myopia)

• Droopy eyelids (ptosis)

• Retinal disorders

• Tear duct conditions

Strabismus occurs when the eyes do not look in the same direction due to weak or misaligned eye muscles. One eye can wander or move independently.

Tearing (eye-watering) can happen when the tear duct is blocked, or when the eyes produce too many tears. Conditions that can cause tearing include:

• Blocked tear drain (nasolacrimal duct obstruction)

• Dry eyes

Thyroid eye disease (TED) is swelling of the eye muscles, eyelids and tissues behind the eye, usually related to abnormalities in thyroid hormone levels. This can cause red, swollen and uncomfortable eyes and can push the eyes forward, resulting in “bulging eyes.”

Uveitis is inflammation of the middle layer of the eye (uvea), usually caused by your immune system fighting an infection. Sometimes your immune system can attack healthy tissue in your eye, too.

Vitreous fluid is the clear gel-like substance that helps your eye keep its shape. The retina is the back part of your eye that receives light. The very center of your retina is the macula, which is where light focuses, giving you sharp vision. Vitreoretinal disorders can affect any of these three areas and include:

• Diabetic retinopathy

• Eye cancer

• Flashes and floaters

• Macular degeneration and holes

• Retinal detachment

• Retinitis pigmentosa

• Retinoblastoma

• Retinopathy of prematurity

• Uveitis

Cataract surgery separates the cataract from the lens capsule. In most cases, the lens is replaced with an intraocular lens implant (IOL).

A corneal transplant (keratoplasty) replaces part of the cornea with corneal tissue from a donor.

• Glasses including single and multifocal

• Contact lenses, including specialty lenses such as hybrid and hand-painted lenses

• Assistive technologies for low vision patients, including:

  • Hand-held, stand and pocket-lighted magnifiers

  • Telescope and microscope glasses

  • Absorptive filters (prescription and non-prescription)

  • Portable and desktop video magnifiers

  • Task lighting

  • Other optical aids

Vision rehabilitation is the process of maximizing visual functional ability, improving quality of life and independence in a person who has visual impairment. A patient's rehabilitation plan can include prescription glasses, contact lenses, magnification devices, electronic devices, assistive technology, therapeutic filters, training on eccentric viewing, non-optical aids and referral for additional services with other professionals.

Eyelid surgery (blepharoplasty) is a type of plastic surgery around the eyes. It improves drooping of your eyelids and the puffy bags that can sometimes appear below your eyes. The surgery involves removing excess fat, muscle and skin. This could help you appear younger and more alert and can also improve your peripheral vision. Learn more

Botox, Juvéderm, Restylane and other facial fillers can also be used for facial rejuvenation. Learn more

When your two eyes do not move together correctly, your binocular vision is affected. Orthoptics use treatments such as eye patches, eye exercises, prisms or glasses to strengthen the muscles that control your eye movements to improve alignment.

Oculoplastic (oculofacial) surgery is plastic surgery to the areas around the eyes: The eyelids, orbit (bones and soft tissues behind the eye) and lacrimal (tear) system. Eyelid surgeries include blepharoplasty, ptosis repair, ectropion repair, entropion repair and eyelid reconstruction following trauma or skin cancer treatment.

Our eye surgeons perform several types of refractive surgery:

• Photorefractive keratectomy (PRK) uses an excimer laser to shave ultra thin layers of tissue from the cornea.

• Laser In Situ Keratomileusis (LASIK) combines the use of a special instrument known as a microkeratome to create a “flap” of corneal tissue. The laser is then used, like PRK, to treat your nearsightedness, farsightedness and/or astigmatism under this flap.

• IntraLASIK uses a computer-guided laser that delivers a near infrared beam of light to create a flap from below the surface of the cornea.

• Custom LASIK uses a wavefront analyzer to guide the treatment of additional imperfections in the optical system of the eye called “higher order optical aberrations.”

An office visit to check vision, screen for eye disease, and/or update eyeglass or contact lens prescriptions.

Scleral lenses are custom-made contact lenses designed to fit your specific eyes. They are for patients with the following conditions:

Corneal irregularities

• Keratoconus

• Pellucid marginal degeneration

• Salzmann’s nodular degeneration

• Corneal dystrophies

• Post-corneal transplant/surgery

• Post-LASIK, post-PRK

• Traumatic scarring

Ocular surface diseases

• Severe dry eye syndrome

• Sjogren’s syndrome

• Systemic autoimmune disorders

• Graft-versus-host disease (GvHD)

• Stevens-Johnson syndrome

• Epidermal ocular disorders

• Neurotrophic keratitis

• Ocular cicatricial pemphigoid

Sharp vision correction for patients with normal corneas

• High astigmatism

• Multifocal for presbyopia

To help diagnose diabetic retinopathy earlier, primary care facilities throughout Wisconsin can participate in our Teleophthalmology program. Patients with diabetes are referred by their primary care provider (PCP) to get their eyes screened during a regular visit, in the same building and without having to make a second trip or appointment. The images are sent to UW Health eye specialists in Madison, who send reports back to the primary care clinic and patients.

Surgeries to repair disorders of the vitreous, retina and macula.