The full assessment, including a dilated eye exam will be conducted to determine the presence of any pathology such as:

Corneal disease

Uveitis - inflammation of the eye

Ocular trauma

Glaucoma

Cataracts

Macular disease

Retinal disease

A comprehensive glaucoma evaluation includes:

Applanation Tonometry - standard means of checking eye pressure

Pachymetry - to determine corneal thickness

Gonioscopy - to assess the outflow pathway

Clinical assessment of the optic nerve

Optic nerve imaging

Visual field - if glaucoma is present, test will determine extent of peripheral visual loss

Detailed discussion of glaucoma and a customized treatment strategy will be discussed with the patient including medications, laser or surgery

We offer out-patient laser treatment performed in a state-of-the-art laser suite with excellent nursing staff support. These procedures include:

Selective Laser Trabeculoplasty - This procedure helps lower eye pressure by enhancing the outflow of fluid. Based upon a recent clinical trial study, It can serve as a first-line therapy in lowering eye pressure by up to 30% before consideration is given to prescribing daily glaucoma medications.

Laser Iridotomy - if you are experiencing eye pain or seeing rainbow colors around lights, or nausea, associated with a closed drain determined with gonioscopy, the procedure helps to relieve acute angle-closure by opening up the drain to facilitate outflow.

Cyclophotocoagulation - those with a blind painful eye or diagnosed with end-stage glaucoma with poorly controlled eye pressure despite medical therapy, or are poor surgical candidates, this non-invasive procedure will help lower eye pressure, alleviate pain and bring about comfort restoring quality of life.

Based upon the severity of the glaucoma, Dr. Shareef will work with you to customize a surgical treatment plan that will include stand-alone micro-invasive glaucoma surgery (MIGS), interventional canaloplasty, or glaucoma surgery combined with cataract surgery. In cases of advanced disease, traditional glaucoma surgeries will also be considered. Procedures include:

Kahook Dual Blade Goniotomy

iTrack Canaloplasty

Hydrus microstent implantation

Glaucoma drainage device implantation

Trabeculectomy with anti-metabolite

Stand-alone cataract surgery due to the presence of a mature lens causing angle closure

Goniosynechialysis

Dr. Shareef will conduct a comprehensive dilated eye exam to determine if there is clouding of the natural crystalline lens you are born with, called a cataract, to determine if it is impacting your quality of life. Symptoms of a clinically significant cataract include presence of blurring of vision despite corrective eyeglass prescription, difficulty with reading in dim light or with night driving due to halos from on-coming headlights, and glare.

A part of preparing for cataract surgery includes ruling out other causes of decreased vision such as glaucoma and retinal disease including diabetic retinopathy and macular disease. This information will ensure the best possible surgical and visual outcome. Should other ocular diseases be determined to be present, they will be addressed prior to scheduling cataract surgery.

Dr. Shareef and his staff will provide you with a personalized surgery package and educational videos that will explain all of your options including traditional vs. laser-assisted cataract surgery, astigmatism correction, and selection of a standard vs. premium intraocular lens implant.

Traditional Cataract Surgery

Your insurance will cover the cost associated with performing a standard cataract surgery under topical anesthesia including placement of a monofocal intraocular lens implant. Post surgically, you can expect to wear corrective eyewear either for near or for distance, based upon your desired target refraction.

Laser-Assisted Cataract surgery

If you have astigmatism and desire to eliminate it or opt for a premium lens implant with the goal to make you eyeglass independent, laser technology will be utilized. Not only will the laser enable the surgeon to make precise cuts in the cornea to correct astigmatism but also ensure proper centration of the premium lens implant. Additionally, the laser will be used to soften the cataract by making cuts with appropriate depth to minimize the amount of energy needed to extract the cataract during surgery. Note that insurance does not provide coverage for either the laser portion of the surgery or the placement of a premium intraocular lens implant. Payment options are available.

Yag Capsulotomy - following cataract surgery, the capsular bag in which the intraocular lens implant is placed, can sometimes become opacified making your vision blurry. The opacified posterior capsule can be lasered to restore clarity and vision.

Dr. Shareef will perform an unbiased comprehensive eye exam by evaluating each patient without initially reviewing any prior clinic notes or tests to make an independent determination of your ocular health. He will counsel each patient based upon the findings regarding treatment options if warranted.

For patients who have sustained either blunt or penetrating ocular injury in the past, Dr. Shareef will make a determination if there are any sequelae from such injury including the presence of glaucoma, cataracts, cyclodialysis clefts or iris trauma. If intervention is warranted, Dr. Shareef will counsel you regarding treatment options including glaucoma and cataract surgery and surgical repair of the iris.