We offer comprehensive eye exams for patients of all ages. Our doctors are trained and experienced to diagnose and treat eye disorders, both medically and surgically.

Our practice offers expertise in:

Screening for common ocular diseases such as macular degeneration and glaucoma is easily performed in the office. Medical conditions such as diabetes and hypertension can be asymptomatic and early diagnosis is important for preserving vision. Taking drugs such as plaquenil and amiodarone can affect your eyes. Annual eye exams are recommended to detect any changes and initiate treatment. Call us at 301-587-1220 to schedule your appointment today!

lensx logoRemoval of cataracts is crucial to prevent severe loss of vision and the debilitating effects that this common condition can cause. Recent innovations in cataract surgery now make it possible for cataracts to be removed with greater precision and accuracy. Cataract surgeons at Silver Spring Eye are some of only a few in the U.S. to offer cataract surgery treatment with the LenSx® femtosecond laser.Traditional cataract surgery involves the use of a surgical blade to perform corneal incisions and anterior capsulotomies of the eye, ultimately making it possible to remove the cataract. The LenSx® femtosecond laser is designed to improve precision and reproducibility during certain challenging and critical steps of cataract surgery that are currently performed manually. Because this technology allows for laser precision during these steps, the LenSx laser may contribute to improved surgical outcomes. The LenSx® femtosecond laser utilizes a beam of laser light to create the necessary incisions for cataract surgery. An advanced computer-guidance system, controlled by one of our experienced cataract surgeons, directs the laser over the eye to provide the most precise and accurate results for each individual patient. This makes it possible for the successful combination of the surgeon's skills with state-of-the-art technology to produce extraordinary results.

Laser Assisted Cataract Surgery with Monofocal Lens

During cataract surgery, a small ultrasonic probe is inserted into the eye which breaks up, or emulsifies, the cloudy lens into tiny pieces and gently aspirates those pieces out of the eye. We perform this minimally invasive, small-incision, no-stitch cataract surgery called phacoemulsification ("phaco") surgery. To make your procedure as painless as possible, anesthesia is a combination of local and/or topical along with IV sedation. With the recent advance of foldable IOLs, artificial lenses can be implanted through the same small incision that is created in the phaco procedure. It is an outpatient surgery and is not only one of the most frequently performed surgical procedures in the United States, but it is also one of the safest and most successful surgical procedures that you can have.

service pic1

Cataract Surgery with a Monofocal Lens

 

Posterior YAG Capsulotomy

Yag capsulotomy is laser surgery you may need sometime after cataract surgery. It helps you see clearly if your vision becomes cloudy again. When you have cataract surgery, your ophthalmologist removes your eye’s cloudy lens. They replace it with a clear, artificial intra-ocular lens (IOL). The IOL is held in place in the eye’s natural lens capsule. Weeks, months or years later, this capsule can become cloudy or wrinkled, causing blurry vision. With posterior capsulotomy, a laser is used to make an opening in the cloudy capsule. This allows light to pass through again for clear vision

Corneal transplantation involves replacing the damaged cornea with a healthy one from a donor (usually provided through an eye bank). We perform both traditional corneal transplant and endothelial transplant or DSAEK, which is a partial transplant of the cornea.

Corneal Transplantation and DSAEK

The human cornea is composed of five layers, the epithelial layer is the most superficial layer and lies on the second layer called Bowman's membrane. The third layer called the stroma is the thickest and makes up about 90% of the total corneal thickness. Descemet's membrane is the fourth layer and provides support for the innermost layer, the corneal endothelium. The endothelial cells pump fluid out of the cornea which is necessary for the cornea to remain clear and thin and provide good vision for the eye. If the pump cells become dysfunctional, damaged, or destroyed, the cornea becomes swollen and cloudy, and this causes blurry vision and pain.Endothelial cells can be lost due to aging, inherited diseases (such as Fuchs dystrophy), trauma, or previous intraocular surgery. If a critical number of endothelial cells are lost the cornea becomes swollen and cloudy. Severe cases require a corneal transplant.

Penetrating Keratoplasty: Traditional transplant

A penetrating keratoplasty (PKP) is a full-thickness corneal transplant, and was first developed over 100 years ago. In this procedure, donor tissue is transplanted to replace a patient's central cornea. A corneal transplant is done for a variety of conditions that lead to poor vision including those that affect all layers of the cornea. Traditional corneal transplant surgery has about a 90% success rate, and the rate of rejection is only about 8%. Rejection episodes can often be controlled with topical anti-inflammatory drops. Occasionally, there are problems with sutures which can come loose, cause infections, or cause astigmatism. The astigmatism after traditional corneal transplant surgery can be significant enough that eyeglasses alone won't give adequate vision. These patients may ultimately require contact lenses or additional surgery to reduce or eliminate the astigmatism. Because the wound is full-thickness and 360 degrees, the corneal transplant wound is not as strong as normal. It is at risk to rupture or break open from mild or incidental trauma, even several years after the surgery. Full visual recovery can take over 12 months.

Endothelial Transplant (DSAEK)

A DSAEK procedure is a partial-thickness corneal transplant that replaces only the endothelial layer. A thin piece of donor tissue containing only the endothelial cell layer is inserted onto the back surface of the patient's cornea. The surgery itself takes less time with an experienced surgeon, involves a smaller surgical incision, requires far fewer stitches, heals faster and more reliably, and the vision returns faster.There are several advantages to the DSAEK operation compared to standard corneal transplant surgery. The smaller wound is more stable and less likely to break open from trauma. Because the wound is smaller and requires far fewer sutures, there is very little postoperative astigmatism which can delay the visual recovery. The maximum return in vision takes only about 3 to 4 months following DSAEK. Only patients with endothelial cell problems are candidates for DSAEK. Patients with corneal scarring or other conditions affecting other layers of the cornea will still require the full-thickness procedure. Since corneal specialists have only been performing DSAEK for a few years, there are limited long-term follow-up studies. There is a risk of the thin button of endothelium becoming displaced within the first few days or weeks after surgery and requiring a return trip to the operating room to reposition it. If the DSAEK operation fails, the operation can be repeated with another button of donor endothelium. If the DSAEK fails, either after one or multiple attempts, a traditional corneal transplant operation (PKP) can be performed without any obvious disadvantages.It is the latest technique that offers a much quicker recovery and visual rehabilitation. Both are outpatient procedures that require local anesthesia. These are the most common type of transplant surgeries and have very high success rates.

During cataract surgery the natural lens of the eye is replaced with an intra-ocular lens (IOL). As glasses and contact lenses correct vision, so too will your IOL. With the development of the latest Specialty Lenses, your surgeon can now reduce or eliminate your need for glasses after surgery. Our doctors will discuss your lens options during your initial surgery consultation.

Toric (Astigmatism Correcting) IOLs

If you have a need before your cataract surgery for a lens that corrects Astigmatism, an IOL lens that corrects for Astigmatism can be used that will correct your astigmatism and give you the best outcome.

 

Multi Focal IOLs/Extended Depth of Focus IOLs

Multifocal and Extended Depth of Field IOL lenses are designed to provide you with the greatest opportunity to have minimal dependence on glasses after surgery. As multifocal eyeglasses correct both distance and near vision, so do Multi-focal IOL’s.

An exciting advance in IOL technology, the Extended Depth of Focus IOL’s are designed to provide high quality distance vision and allow you to continuously focus from distance to near and points in between. These lenses offer the greatest possibility of reduced dependence on eyewear after surgery. For more information about IOL options or to schedule a consultation please contact us at 301-587-1220.

tecnis symfonyIOL

 

 

Dry EyesDry Eye is an extremely common eye problem which can significantly affect your quality of life! Traditionally it used to be a disease of women and old age, but thanks to our new lifestyle we are now seeing it in men and young adults as well! Dry eyes is a multifactorial disease and one approach doesn’t fit all.

Dry eye occurs when the eyes aren't sufficiently moisturized, leading to itching, redness and pain. The eyes may become dry and irritated because the tear ducts don't produce enough tears, or because the tears themselves have a chemical imbalance.Dry eye is not only painful, it can also damage the eye's tissues and impair vision. Fortunately, many treatment options are available.Non-surgical treatments for dry eye include blinking exercises, increasing humidity at home or work, and use of artificial tears or moisturizing ointment. If these methods fail, small punctal plugs may be inserted in the corners of the eyes to limit tear drainage, or the drainage tubes in the eyes may be surgically closed.For more information on dry eye and treatment options, see our informational brochure here: DryEyes.pdf

Some of the Prescription and Non Prescription products that are available for the treatment of Dry Eyes are below. Ask us about which ones are right for you.

thera tears
xiidra
Systane
Restasis
Refresh
 

 

Punctal Plugs are a safe and effective way to manage dry eyes and can be done in a short office visit.

Patient Education

Learn More about Punctal Plugs

To detect glaucoma, our physicians will test your visual acuity, visual field as well as the pressure in your eye. We employ the specialized technology of :

OCT(Optical Coherence Tomography)

OCT test result

or

HRT (Heidelberg Retinal Tomography)

hrt3

which can digitally perceive damage that may indicate the onset of glaucoma, allowing treatment to begin before vision is lost.

In most cases, once diagnosed, glaucoma can be controlled. Treatments to lower pressure in the eye include prescription eye drops and medications, laser therapy, and surgery.

refractive surgeryWe are pleased to offer LASIK and PRK to our patients to eliminate the need for eye glasses. This involves making a thin flap in the surface of the cornea or removing the top layer of the cornea with a blade or alcohol depending on which procedure is deemed most appropriate for you. The excimer laser beam is then used to reshape the cornea's curvature to improve vision. The flap is then closed and covered with a protective contact lens. Your vision is improved within the next few days!

ERG is an eye test used to detect abnormal function of the retina due to inherited or acquired diseases such as retinitis pigmentosa and plaquenil toxicity. During the test, an electrode is placed on the cornea (at the front of the eye) to measure the electrical responses to light of the cells that sense light in the retina at the back of the eye. An ERG can also be useful in determining if retinal surgery or other types of ocular surgery such as cataract extraction might be useful. It is the only test that can detect plaquenil toxicity before significant vision loss has occurred.