Boston Doctor on Double Vision or Diplopia

Boston eye doctor Francis A. D’Ambrosio Jr., M.D. comments on double vision. “Double vision, which we also refer to as diplopia, generally results from either a misalignment of your eyes or a structural problem with the part or parts of the eye that let light into it”, noted “There are two types of double vision. The first type is called binocular diplopia. The second type is referred to as monocular diplopia.” Monocular diplopia can be differentiated from binocular diplopia by a simple test. If the double vision stops when you cover one eye, then you are suffering from binocular diplopia.  If the double vision persists even with one eye covered, that means you are experiencing monocular diplopia.

There are many different causes for diplopia. The problem can arise from the eyes themselves, the surrounding orbit, or the central nervous system. Causes of double vision include corneal infections or scars, cataract, eye muscle weakness from thyroid problems, nerve damage from diabetes or multiple sclerosis, autoimmune disease such as myasthenia gravis, brain tumors or aneurysms, strokes, head trauma, orbital trauma, direct eye trauma and even migraine headaches.
Double vision can occur by itself with no other symptoms. However, depending on the cause other symptoms may be present with diplopia that can include:

• Droopy Eyelids
• Pain with Eye Movements
• Headache
• Nausea
• Misalignment of one or both eyes causing a "wandering eye" or "cross-eyed" appearance
• Weakness of the other muscles in your body

“Double vision that's new or unexplained requires urgent medical attention. With so many potentially serious causes for diplopia, it's important to discover the reason without delay”, said Dr. D’Ambrosio, Jr. A thorough history and physical examination are critical to localizing a disease process and guiding further tests and studies to identify and treat the cause.

If you or someone you know experiences double vision, it is important to schedule an appointment for an examination. Please feel free to call D’Ambrosio Eye Care at 800-325-3937 to schedule an appointment.  You may also request an appointment at facebook.com/dambrosioeyecare.

Staffed by a team of Ophthalmologists, Optometrists, Opticians, technical and administrative staff who provide eye examinations for adults and children, cataract surgery and intraocular lens implants (IOL), laser eye surgery for vision correction such as LASIK, diagnosis and treatment of cornea disease including cornea transplants, care for diseases of the retina including diabetes and age related macular degeneration and diagnosis and treatment of glaucoma as well as contact lenses, eyeglasses, eyewear  and optical services.

D'Ambrosio Eye Care is a leading eye and LASIK care practice serving the greater Boston and central Massachusetts area including Acton, Athol, Berlin, Bolton, Boylston, Boxborough, Chelmsford, Clinton, Concord, Fitchburg, Gardner, Greenfield, Groton, Harvard, Hudson, Lancaster, Leominster, Lexington, Littleton, Lowell, Lunenburg, Marlborough, Milford, Shelburne Falls, Shirley, Sterling, Stow, Sudbury, Templeton, Westminster, Westborough, Winchendon and Worcester, Massachusetts.

Boston Doctors for Eyelid Lumps & Bumps

Boston Ophthalmologist Francis D’Ambrosio Jr., M.D. commented, “Eyelid lumps, bumps and swelling are common eye problems many of us experience.” The most common cause of acute lid swelling is an infection of the tiny sweat and oil glands emptying into the margin of the eyelids. Patients who experience an infection of an eyelid sweat gland, commonly known as a “stye”, usually exhibits diffuse swelling of the lid with a tiny raised nodule on the lid margin that indicates the actual site of involvement. Inflammation of the meibomian or oil glands in the eyelid will result in what is referred to as an “internal hordeolum” that can also result in diffuse lid swelling. With time an internal hordeolum may result in the formation of a capsule in the tissue of the eye lid. The patient will then have a firm lump that can be felt through the skin surface of the eyelid. This lump, called a “chalazion”, is an eruption of the contents of the meibomian glands into the tissues that results in a granulomatous response with a cystic change. If the initial infection is minimal, a chalazion may develop without any history of a swollen lid. If the lump does not resolve after treatment with warm compresses and possibly antibiotics we may need to remove it with excision or drainage.If you or someone you know experiences eyelid lumps, bumps or swelling please call D’Ambrosio Eye Care at 800-325-3937 so we can help. You may also request an appointment at facebook.com/dambrosioeyecare.

Staffed by a team of Ophthalmologists, Optometrists, Opticians, technical and administrative staff who provide eye examinations for adults and children, treatment of cataracts with cataract surgery and intraocular lens implants (IOL), LASIK Laser Eye Surgery, diagnosis and treatment of cornea disease including cornea transplants, care for diseases of the retina including diabetes and age related macular degeneration and diagnosis and treatment of glaucoma as well as contact lenses, eyeglasses, eyewear and optical services.

D'Ambrosio Eye Care is a leading eye and LASIK care practice serving the greater Boston and central Massachusetts area including Acton, Athol, Berlin, Bolton, Boylston, Boxborough, Chelmsford, Clinton, Concord, Fitchburg, Gardner, Greenfield, Groton, Harvard, Hudson, Lancaster, Leominster, Lexington, Littleton, Lowell, Lunenburg, Marlborough, Milford, Shelburne Falls, Shirley, Sterling, Stow, Sudbury, Templeton, Westminster, Westborough, Winchendon and Worcester, Massachusetts.

Non-Glare or “AR Coating” Eyeglass Lenses

Non-Glare or “AR Coating” Eyeglass Lenses are really a high tech way to get the best performance out of your glasses. The foundation of non-glare lenses is a scratch coat layer that can lengthen the life of your lenses and reduce the amount of surface scratches from daily life or cleaning. The lenses are similar to coating found on microscopes or camera lenses. Even the latest equipment used in our practice has non-glare properties. Did you ever wonder why you felt you saw better during your eye examination than with your new glasses? It may be just as simple as the lenses you purchased did not have non-glare coating.

Non-glare lenses consist of several layers of metal oxides applied to the front and back lens surfaces. Because of the layering effect, non-glare lenses sometimes have a hint of green, blue or purple color, depending on the individual manufacturer’s formula. Each layer is scientifically calculated to block reflected light; they also reduce both internal and external reflection on the lenses themselves, creating a nicer cosmetic appearance. Internal reflections appear as rings that make lenses look thick. Eternal reflections mask your eyes from a clear, complete view when someone is looking at you. So with a non-glare lens, reflections are eliminated and lenses look thinner or non-existent and your eyes are more visible so you can make a better eye contact with others. Not all non-glares are the same and the properties that allow more light to reach the eye or the cleanability vary tremendously.

At D’Ambrosio Eye Care our preferred brand is Crizal Avance with Scotchgard™ Protector. These lenses allow 99% of light to reach the eye, improving contrast sensitivity by 20%. The scratch coat layer is applied to both sides of the lens, where others only apply this layer to the front. There is a “hydrophobic” surface layer that prevents water spots (rain, snow and fog) and makes the lens very easy to clean. The “oleophobic” surface layer repels skin oils, smudges, dust, dirt and fingerprints better than leading competitors. These lenses have superior anti-static technology. After 20,000 cleanings this non-glare lens has 98.2% durability, meaning the benefits of the lens do not lessen over the life of the lens, preserving the premium qualities. Other non-glare lenses breakdown over time. Even the value non-glare package at D’Ambrosio Eye Care is 80.1% durable.

For more information or to schedule an eye examination, stop by one of the optical departments at D’Ambrosio Eye Care or call us at 800-325-3937. You may also request an appointment at facebook.com/dambrosioeyecare.

Staffed by a team of Ophthalmologists, Optometrists, Opticians, technical and administrative staff who provide eye examinations for adults and children, treatment of cataracts with cataract surgery and intraocular lens implants (IOL), LASIK Laser Eye Surgery, diagnosis and treatment of cornea disease including cornea transplants, care for diseases of the retina including diabetes and age related macular degeneration and diagnosis and treatment of glaucoma as well as contact lenses, eyeglasses, eyewear and optical services.

D'Ambrosio Eye Care is a leading eye and LASIK care practice serving the greater Boston and central Massachusetts area including Acton, Athol, Berlin, Bolton, Boylston, Boxborough, Chelmsford, Clinton, Concord, Fitchburg, Gardner, Greenfield, Groton, Harvard, Hudson, Lancaster, Leominster, Lexington, Littleton, Lowell, Lunenburg, Marlborough, Milford, Shelburne Falls, Shirley, Sterling, Stow, Sudbury, Templeton, Westminster, Westborough, Winchendon and Worcester, Massachusetts.


Reference sources: All About Vision, Health Sight Counseling, The Vision Council, Jobson Research and Essilor

Optical Coherence Tomography OCT

Optical Coherence Tomography, or OCT, is one of the most widely used diagnostic tests in medicine. An OCT test is a tissue-imaging technique that has amazing resolution. Older generation technology called time-domain OCT allowed for resolution on the order of 8-10 microns. Newer technology, called spectral-domain OCT, has increased resolution to 5 microns. This is particularly useful for imaging the layers of the retina. It can also measure the optic nerve and the retinal nerve fiber layer thickness, as well as the cornea, the anterior chamber, and the crystalline lens of the eye.

OCT testing has revolutionized the way that eye care providers diagnose retinal conditions. Conditions previously invisible upon examination are easily seen with the OCT. Early macular holes, vitreomacular traction syndrome, and subtle macular edema are all easily diagnosed now with this new technology.

OCT is also used frequently when diagnosing and treating glaucoma patients. The ability to measure any thinning of the retinal nerve fiber layer can help confirm the diagnosis of glaucoma. The repeatability of the OCT also helps monitor for any subtle changes in the status of the glaucoma.

OCT can also be used when imaging the anterior chamber angle, which is where the drain of the eye sits. The anatomy of the anterior chamber angle can influence the risk of developing glaucoma. If it is determined that the angle is narrow by OCT the risk for glaucoma may be greater.

As technology advances and resolution capabilities continue to improve, we may be able to diagnose conditions even earlier than we do now. For more information on OCT testing or to schedule an appointment, contact D'Ambrosio Eye Care at 800-325-3937. You may also request an appointment at facebook.com/dambrosioeyecare.

Eye and LASIK Care Convenient in Massachusetts

“We strive to make eye and LASIK care convenient for patients coming from central and western Massachusetts towns like Athol, Greenfield and Springfield as well as from the greater Boston area and suburbs,” commented Francis D’Ambrosio, Jr., M.D., Medical Director of D’Ambrosio Eye Care. “Our Lancaster location is really very convenient for eye and LASIK patients from Fitchburg and our Gardner office is great for eye and LASIK patients from Greenfield and Athol. To make it really convenient we have evening and Saturday appointments so patients don’t have to take time away from work if they don’t have that flexibility,” noted Dr. D’Ambrosio Jr. “No matter patients need-regular eye health and vision examinations for glasses and contacts, cataract exams, LASIK evaluations, diabetic eye exams, glaucoma care-we are happy to make it easy for them to come and see us from Athol, Greenfield and Springfield or really anywhere in central or western Massachusetts.”

Staffed by a team of Ophthalmologists, Optometrists, Opticians, technical and administrative staff who provide eye examinations for adults and children, cataract surgery and intraocular lens implants (IOL), laser vision correction such as LASIK, diagnosis and treatment of cornea disease including cornea transplants, care for diseases of the retina including diabetes and age related macular degeneration and diagnosis and treatment of glaucoma as well as contact lenses, eyeglasses, eyewear and optical services.

D'Ambrosio Eye Care is a leading eye care practice serving the greater Boston and central Massachusetts area including Acton, Athol, Berlin, Bolton, Boylston, Boxborough, Chelmsford, Clinton, Concord, Fitchburg, Gardner, Greenfield, Groton, Harvard, Hudson, Lancaster, Leominster, Lexington, Littleton, Lowell, Lunenburg, Marlborough, Milford, Shelburne Falls, Shirley, Sterling, Stow, Sudbury, Templeton, Westminster, Westborough, Winchendon and Worcester, Massachusetts-You can reach us to schedule an appointment at 800-325-3937.

Lens Implants for Cataracts in Boston

Boston eye care patients with cataracts will find that choosing a lens implant for cataract surgery is an important decision. “The decision on exactly how to correct your vision after cataract surgery used to be a decision that was the sole responsibility of your cataract surgeon,” said Francis A. D'Ambrosio, Jr., M.D., Massachusetts Ophthalmologist and Medical Director of D'Ambrosio Eye Care. “As more advanced types of lens implant technology became available that could do some extra things for patients, we were able to offer our cataract patients some options for their vision correction,” said Dr. D'Ambrosio, Jr.

“While I had been participating in FDA trials of multifocal lens Implants for cataract surgery some years earlier, beginning around 2005 it became necessary for cataract surgeons to discuss lens implant options with patients so together they could choose the most appropriate lens implant for the lifestyle needs of the patient,” said Dr. D'Ambrosio Jr. “ Only after the cataract evaluation can we make a firm recommendation for each patient because the choice of lens implant really depends on several factors including the patient’s prescription, the overall health of their eyes, whether they have any other health problems such as diabetes and most importantly how they use their eyes throughout their daily routine," he further noted.

A type of lens implant called an aspheric lens implant seems to give the sharpest, most crisp vision-but only corrects distance vision and requires you to wear reading glasses or bifocals after cataract surgery. This might be fine for a truck driver who needs cataract surgery, but might not be the best choice for a sales clerk who uses his or her eyes at many distances all day. A type of lens implant called a toric lens implant is often selected for cataract patients who have correction their eyeglasses. If you have a toric lens implant to correct your vision after cataract surgery, you will still need to correct you near vision to see up close with reading glasses of some sort. For those patients who do a number of things throughout the day that require seeing far away, at arm’s length-say for the computer and also to see up close, if you are a good candidate, we can offer you a multifocal lens implant that corrects near vision and presbyopia and so it will help you see at a range of distances without being totally dependent on eyeglasses.

Choosing a lens implant is a joint effort between you and your eye surgeon. It is not your decision alone. It’s not like buying a pair of shoes or a car where you can ask your friends for a good “brand” or you can read a brochure or see a TV commercial and then you can choose. It requires the careful evaluation and recommendation of skilled and experienced cataract surgeon to help you make the best choice.

D'Ambrosio Eye Care is a leading eye care practice serving the greater Boston and central Massachusetts area including Acton, Athol, Berlin, Bolton, Boylston, Boxborough, Chelmsford, Clinton, Concord, Fitchburg, Gardner, Greenfield, Groton, Harvard, Hudson, Lancaster, Leominster, Lexington, Littleton, Lowell, Lunenburg, Marlborough, Milford, Shelburne Falls, Shirley, Sterling, Stow, Sudbury, Templeton, Westminster, Westborough, Winchendon and Worcester, Massachusetts.

Staffed by a team of Ophthalmologists, Optometrists, Opticians, technical and administrative staff who provide eye examinations for adults and children, treatment of cataracts with cataract surgery and intraocular lens implants (IOL), laser vision correction such as LASIK, diagnosis and treatment of cornea disease including cornea transplants, care for diseases of the retina including diabetes and age related macular degeneration and diagnosis and treatment of glaucoma as well as contact lenses, eyeglasses, eyewear and optical services.

If you or someone you know has cataracts and need help with cataract surgery and lens implants information, please feel free to call D'Ambrosio Eye Care at 800-325-3937. You may also request an appointment at facebook.com/dambrosioeyecare.

Boston Insurance Copays Coinsurance & Deductibles

“Understanding insurance copays, coinsurance and deductibles is getting even more confusing for Boston patients”, commented Massachusetts Ophthalmologist Francis D'Ambrosio Jr., M.D. of D'Ambrosio Eye Care. Due to the ever-increasing cost of healthcare, many patients find themselves with higher copays, coinsurance and/or deductibles. It can be confusing to understand all of these terms but it is a very important part in understanding your medical bills.

A co-payment (or co-pay) is the flat amount the patient pays each time they see their medical provider. Your insurance establishes these fees up front and many insurance companies print this information on your insurance ID card. Coinsurance and co-payments are not the same thing. A co-payment is a set amount that you pay each time you see your medical provider. On the other hand, coinsurance is typically a certain percentage of the provider’s fee that is owed by the patient. For example, some insurance companies pay 80% and the patient is responsible for the remaining 20%. That 20% is the coinsurance that is due from the patient per the insurance company. The amount the patient owes will vary based on the fee for the service.

A deductible is a fixed amount of money that the patient must pay before the insurance company begins making payment. For example, let’s say a patient has an insurance policy with a $100 deductible. If the insurance considers $300 of the services provided as “covered” services, the patient must pay $100 and the insurance will pay the remaining $200. Deductible amounts are typically calculated yearly so that means that beginning January 1st of each new calendar year, you must meet your deductible before your insurance will issue payment. If you have any questions on your billing from D'Ambrosio Eye Care, please contact us at 800-325-3937 and we will be happy to explain in detail any charges for you

Boston Sports Require Eye Protection

“Adults and children in Boston are ready up for all kinds of outdoor sports this time of year-they need to consider the need for proper eye protection,” commented Massachusetts Ophthalmologist Francis D'Ambrosio, Jr. M.D. of D'Ambrosio Eye Care. Protecting your eyes playing sports is an important way to help preserve your eye health and vision sometimes gets overlooked. Tens of thousands of sports and recreation-related eye injuries occur each year. The good news is that 90 percent of serious eye injuries are preventable through use of appropriate protective eyewear. The risk of eye injury can vary depending on the activity. Make sure the level of eye protection you or others in your family use is appropriate for the type of activity. Regular eyeglasses do not offer proper eye protection.

Across all age groups, sports-related eye injuries occur most frequently in baseball, basketball and racquet sports. Further, boxing and full-contact martial arts pose an extremely high risk of serious and even blinding eye injuries and there is really no satisfactory eye protection for boxing, although thumbless gloves may reduce the number of boxing eye injuries. When playing baseball, ice hockey and men’s lacrosse, a helmet with a polycarbonate lightweight shatterproof face mask or wire shield should be worn at all times. In general, hockey face masks be approved by the Hockey Equipment Certification Council or the Canadian Standards Association (CSA). Last protective eyewear with polycarbonate lenses should be worn for sports such as basketball, racquet sports, soccer and field hockey.

If you need additional information, or help regarding how to select the best eyewear to protect you while playing sports, please feel free to phone D'Ambrosio Eye Care at 800-325-3937. You may also request an appointment at facebook.com/dambrosioeyecare.