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.

Boston Doctor for Fuchs’ Dystrophy

Fuchs’ Dystrophy is a slowly progressive disease of the cornea that is typically bilateral and is slightly more common in women than men. While it is possible to observe Fuchs’ Dystrophy in people in their 30’s and 40’s, it usually does not compromise vision until people are in their 50’s or 60’s. While a precise path of genetic transmission is unclear, a familial predisposition seems to exist among those who are first degree relatives. Early in the course of Fuch's Dystrophy patients typically awaken with blurry vision that gets progressively clearer as the day passes. This phenomenon occurs because the cornea normally swells during sleep. A healthy endothelial pump is necessary in order to restore the cornea to a normal thickness. In Fuchs’ Dystrophy, the endothelium removes fluid from the cornea less efficiently. As the Fuchs’ Dystrophy disease worsens, the vision does not clear. Usually we will attempt to help reduce the corneal swelling each day by prescribing hypertonic eye drops and ointments. However, when these measures fail to provide comfort and clear vision, it may be necessary to have a corneal transplant.

If you or someone you know would like to learn more about Fuchs’ Corneal Dystrophy please schedule an appointment with Massachusetts Corneal Specialist JoAnn C. Chang, M.D. at D’Ambrosio Eye Care by calling us at 800-325-3937. You may also request an appointment at facebook.com/dambrosioeyecare.

Boston Doctors for Bulging Eyes

Eye doctors throughout Boston are quite well aware that when patients speak about having bulging eyes they are using the familiar description of the eye conditions known as Exophthalmos or Proptosis. “While patients might think that it is only a matter of being a bit odd looking, bulging eye conditions can also cause a number of problems, such as not being able to completely close your eyes during sleep or even during normal blinking, which can lead to dry eye symptoms, discomfort and ultimately damage the eye’s surface as a result of scarring. Sometimes eye bulging can restrict or interfere with normal eye movements. We need to be able to properly diagnose the difference between eyes that are simply “prominent” as compared to eyes that actually “bulging”. In instances of true bulging eyes we need to carefully determine the cause so that we can offer an appropriate treatment as necessary. Causes of bulging eyes can include Graves Disease that results in hyperthyroidism and too much thyroid hormone, inflammation of the tissue around the eye and inside the bony orbit of the eye called cellulitis, certain tumors behind, inside or around the eye, hemorrhages behind the eye and injury to the eye. If you or someone you know suffers from bulging eyes please feel free to schedule an examination at D’Ambrosio Eye Care at 800-325-3937. You may also request an appointment at facebook.com/dambrosioeyecare.

Contact Lenses & Swimming in Boston

Wearing contact lenses while swimming may be a problem. Boston Cornea Specialist JoAnn Chang, M.D. of D’Ambrosio Eye Care commented on the need for patients to use caution when considering wearing contact lenses while participating in water related activities, such as swimming. “Some patients-and even some eye care professionals-tend to be a little lax when it comes to directing contact lens wearers to avoid wearing their contact while swimming-or even in the shower-and especially in hot tubs or spas,” said Dr. Chang. “Contact lenses really shouldn’t be worn for swimming, taking showers, in bath tubs or in hot tubs as there is plenty of research and clinical experience that tells us that poses unnecessary safety risks to patients.”

The United States Food and Drug Administration (FDA) has recommended that contact lenses not be exposed to any form of water. Although rare, a sight-threatening eye complication, Acanthamoeba Keratitis, is caused by an organism present in all forms of impure water (i.e., swimming pools, tap water, saunas, wells, and showers). Acanthamoeba, and certain forms of bacteria present in water, can become attached to the contact lenses, possibly resulting in an infection. It would be preferable to insert your contact lenses after showering. If lenses are being worn while showering, it is recommended to keep your eyes firmly closed. If you accidentally wear your contact lenses while in the bathtub or hot tub, care should be taken to avoid water being splashed into the eyes. If your eyes are exposed to water, instill a lubricating drop to help loosen the lens on the eye, remove the lens with clean, dry hands, then clean and disinfect it the lens, or discard it. Never sleep in a lens that has been exposed to water, without first cleaning and disinfecting it. If lenses were removed prior to getting in a hot tub, they must be properly cleaned and disinfected before being re-inserted.

“Contact Lenses are really quite safe to wear if your follow proper care guidelines and instructions. However, if water restrictions such as swimming, bath tubs and showering are part of your daily routine, you do need to keep your lenses out. Many more patients-even very successful contact lens wearers-finds this to be a hassle and are now interested in discussing LASIK as an option,” said Dr. Chang.

If you or someone you know is interested in learning more about LASIK or scheduling a free LASIK Consultation please call D’Ambrosio Eye Care at 800-325-3937. You may also request an appointment at facebook.com/dambrosioeyecare.

Multifocal Contact Lenses in Boston

Boston contact lens wearers may want to know that Multifocal Contact Lenses are a good option for vision correction for patients with Presbyopia. Presbyopia is a condition of the eye which results in the loss of ability to focus on near objects. This happens to most people in their early to mid forties. In the past, reading glasses or bifocals were needed to allow people to read up close. Multifocal contact lenses are now available for people with presbyopia, and they can provide clear vision at all distance ranges.

There are many brands of soft multifocal contact lenses. These lenses achieve good vision at distance and near using different technologies. Some multifocal lenses have an aspheric surface which provides a range of clear vision from far to near but vision may be dependent on a person's pupil size. Other lenses have alternating rings which provide clear vision at distance or near but side effects can include halos or ghosting of images.

Multifocal designs are also available in gas permeable lenses. Gas permeable lenses can use an aspheric or translating design to provide a good range of clear vision. Translating contact lenses have a bifocal segment in the lower half of the lens like a pair of bifocal glasses. While vision is potentially very good with these lenses, stability of the lens and proper interaction with the lower eyelid is important.

Monovision is another way to treat presbyopia with contact lenses. With monovision, a distance contact lens is placed on one eye and near contact lens is placed in the other eye. With both eyes open, a greater range of clear vision is possible. However, depth perception may be affected some patients.

When fit properly, multifocal contact lenses can allow many people to meet their daily visual needs without reading glasses or bifocals. This can be determined at an eye examination with one of the eye doctors at D’Ambrosio Eye Care.

Call 800-325-3937 for more information or to schedule an appointment. You may also request an appointment at facebook.com/dambrosioeyecare.

Help for Boston Corneal Infections

“For a lot of our Boston patients, spring is the time we like to get outdoors and participate in activities where corneal infections can become somewhat of a risk”, commented Boston Corneal Specialist JoAnn Chang, M.D. “I would like to remind patients that normally the cornea is very resistant to infection. However, if the outermost layer of the cornea-called the epithelium-is damaged from even mild accidents like getting a poke in the eye from a branch or a finger, a foreign body such as metal or even from a dirty or damaged contact lens, it is possible for bacteria, viruses or fungi to penetrate the cornea and cause an infection. Situations like these can cause painful inflammation and corneal infections called Keratitis,” remarked Dr. Chang.

Anyone concerned about a corneal infection should become familiar with the signs and symptoms of a Keratitis which may include redness, pain, light sensitivity, watering and even the formation of a white spot indicating the focus of the infection. In some instances this can cause a painful inflammation with a discharge, which if not treated quickly and appropriately, can lead to corneal erosion, corneal ulceration and corneal scarring which can impair vision and may require a corneal transplant. Quick diagnosis and treatment are the best way to avoid the potential for damage and vision loss from a corneal infection.

If you or someone you know is experiencing any of these signs or symptoms-especially if they have had any trauma to their eyes, please call D’Ambrosio Eye Care at 800-325-3937 and request an immediate appointment.

Boston Eye Care Electronic Health Records (EHR)

Boston eye care patients will have the benefits of electronic health records at D’Ambrosio Eye care. Francis A. D'Ambrosio, Jr., M.D., Medical Director, Eye Physician & Surgeon at D'Ambrosio Eye Care, explains “With our Electronic Health Records (EHR) system we are able to access patient records remotely and also can utilize mobile applications.” Dr. D’Ambrosio further explains, “This is a great advancement in technology from the days that would require us to physically go into one of our offices to review a patient chart, or transport them from office to office, for a patient visit. This is of particular advantage when one of our optometrists or specialists is on call. It provides a quicker response to the patient or the emergency room doctor, if that is where the call originated.”

D’Ambrosio Eye Care has four office locations within Central Massachusetts and by utilizing EHR, photos and examination results are available to other doctors within the practice immediately.

“It also has eliminated “missing” paper charts and significantly reduced the amount of paper generated at each location, adding to our desire to be more eco-friendly. EHR allows for a seamless transition for all departments whether it is medical eye care, eye surgery, optical and eyewear or billing,” continued Dr. D’Ambrosio, Jr.

Another benefit is the ability to send a “To Do” to another staff member regarding a patient immediately; this eliminates a time lag between taking a message and getting it to the individual who needs the information. With a team of fifteen doctors on staff, each doctor has certain preferences and requirements and this system allows that customization as well as mobile applications.

To schedule an appointment for an eye examination or have other eye care needs, please contact D’Ambrosio Eye Care at 800-325-3937. You may also visit facebook.com/dambrosioeyecare to request an appointment.

What Is Astigmatism?

"Astigmatism is a common condition which is present in many people. It is caused when there is an irregular shape to either the natural lens inside the eye or the cornea, which is the clear front surface of the eye,” explains Michael Fu, O.D., Massachusetts Optometrist at D’Ambrosio Eye Care.

Dr. Fu continues “the lens and cornea focus light on the Retina, the light-sensitive surface at the back of the eye. In astigmatism, the surface of the lens or cornea may have a different curvature in one direction compared to another. For example, someone with astigmatism usually has a cornea shaped more like a football than a basketball.” As a result, light is not focused to a single point on the back of the eye and this can lead to blurred vision.

Slight amounts of astigmatism usually do not affect vision, but larger amounts can lead to blurred vision, eyestrain, or even headaches. The most common ways of correcting astigmatism are with glasses or contact lenses. However, laser vision correction or lens replacement surgery can also reduce or eliminate astigmatism.

Some cases of astigmatism are caused by damage to the cornea from injury or from medical conditions such as keratoconus. Astigmatism from these causes can result in a type of astigmatism called irregular astigmatism. Eyeglasses usually cannot correct this type of astigmatism but technological advances now allow most types of astigmatism to be corrected with contact lenses or even refractive surgery. An eye exam by an eye care provider with experience in these technologies is needed to provide patients with all the available treatment options.

Should you have any questions or are interested in learning if you may be a candidate for laser vision correction or lens replacement surgery, please contact D’Ambrosio Eye Care at 800-325-3937. You may also request an appointment at facebook.com/dambrosioeyecare.

Eyes, Eyestrain & Boston Computer Use

"Boston computer users might wonder about why their eyes feel the way they do and why they suffer from eyestrain,"commented Francis D'Ambrosio Jr., M.D. There are some important things to know about computer and video display terminal use, your eyes and eyestrain. Staring at your computer screen, smart phone, video game or other digital devices for long periods won’t cause permanent eye damage, but your eyes may feel dry and tired. Although there are no long-term studies at this time, we do not believe there is any reason to be concerned that 3-D movies, TV or video games will damage the eyes or visual system.

Normally, you blink about 18 times a minute, but only blink half that often while using computers and other digital screen devices, whether for work or play. Reading, writing or other intensive “near work” can also cause eyestrain of a similar nature.

It is helpful in avoiding computer related eyestrain if you first position yourself about 24” from the screen you are viewing and with your eye gaze is slightly downward. It also helps to reduce glare from the screen by lighting the area properly and if possible use a screen filter if needed. It may seem silly but post a note that says “Blink!” on the computer as a reminder. Then, use the “20-20-20” rule. Every 20 minutes, shift your eyes to look at an object at least 20 feet away, for at least 20 seconds. It is also helpful to use artificial tears to refresh your eyes when they feel dry. Make sure that you take regular breaks from computer work, and be sure to get enough sleep at night. Now, if you wear contact lenses for the computer screen it’s important that you use and care for them properly in order to avoid eye irritation, swelling, infection and vision problems. Also, give your eyes a break and wear your glasses instead of your contacts sometime. Consider a special eyeglass prescription and lens coating for computer use to help manage eyestrain and fatigue.

If you wish to learn more about computers, vision, eyestrain and your eyes please feel free to call D’Ambrosio Eye Care at 800-325-3937. You may also request an appointment at facebook.com/dambrosioeyecare.

Boston Eye Exams with Indirect Ophthalmoscopy

When considering and eye exam in greater Boston it is helpful to learn about the types of instruments and techniques such as indirect ophthalmoscopy that might be used as part of your visit. During an eye exam, your eye doctor may instill eye drops to dilate your pupils. Dilation is often part of a comprehensive eye examination. It allows the doctor to see inside the back part of the eye. Some of the structures that become easier to see with dilation include the crystalline lens of the eye, the optic nerve and the retina.

The indirect ophthalmoscope is an instrument usually mounted on a headset. It projects a bright light and, when used in conjunction with a hand held lens, gives your eye doctor a stereoscopic view of the central and peripheral retina, as well as the optic nerve. This allows the doctor to look for pathology such as retinal hemorrhages, tumors and edema.

If you notice symptoms in your vision such as flashing lights or floating dots, your doctor will use the indirect ophthalmoscope to rule out peripheral retinal holes or tears. Your doctor may also use a technique called scleral depression which involves using mild pressure on the eyeball with an instrument such as a Q-Tip to better visualize the peripheral retina. This technique enhances the view of subtle pathology in the peripheral retina which could potentially lead to a retinal detachment.

For more information or to schedule an eye examination, contact D’Ambrosio Eye Care at 800-325-3937. You may also request an appointment at facebook.com/dambrosioeyecare.

Boston Eye Health Risk & Smoking

Boston eye care patients should be aware of the eye health risk smoking can have on your eyes-especially in terms of your risk of Cataracts and Age Related Macular Degeneration (AMD). Avoiding smoking, or quitting, is one of the best investments you can make in your long-term eye health. Smoking-even in your teens or twenties when your senior years seem far away-increases your future risks for Cataracts and Age Related Macular Degeneration (AMD). The more a person smokes, the greater the risks. In general, if you quit smoking the risks of these eye diseases decreases to approximately the same level as if you never smoked at all. Keep in mind that smoking also increases your risk of cardiovascular disease which also can affect your eyes. Besides the vascular problems mentioned smoking and even being around smokers and their second hand smoke increase the likelihood of dry eye. Learn more about eye health and smoking at D’Ambrosio Eye Care at 800-325-3937.

You may also request an appointment at facebook.com/dambrosioeyecare.

Boston Healthy Sight Choices

Making healthy sight choices in Boston is worth the effort. In a recent report by the American Foundation for The Blind, losing sight was tied with paralysis as the health condition that would have the most negative impact, considered worse than HIV/AIDS, cancer, stroke and several other serious medical conditions. Today’s eyewear can do more than just correct vision; it helps to optimize vision for everyday activities, and plays an important role in protecting and preserving vision for the future. Patients sometimes do not always know the full importance of eyewear. Eyewear can be viewed as a commodity rather than a health care product or medical device which leaves them as a consumer considering price as their ultimate concern when making eyewear selections. At D’Ambrosio Eye Care we educate patients to the importance of eyewear and that it can restore, maintain and enhance vision to enable the greater understanding of the value of vision care and eyewear. We want patients to take steps to protect vision.

Based on the legal principles of “informed choice” we feel, at D’Ambrosio Eye Care, that all patients should be informed so they can make knowledgeable eyewear purchases. Eyewear safety is an obligation that we take seriously as licensed providers. So if you ever have any questions or concerns regarding your vision or your eyewear choices stop by any of our locations anytime and we will be happy to help you choose your next pair of eyewear.

If you have any questions, or need an eye examination, please call D’Ambrosio Eye Care at 800-325-3927. You may also request an appointment at facebook.com/dambrosioeyecare.

Eye Refractions Billing & Cost

One of the most basic parts of an eye exam is checking the refraction of your eyes or an eye refraction test. This allows us to determine what your best possible vision is at that point in time while wearing a prescription optical lens and gives us the basis for prescribing a prescription optical lens. The most common type of eye refraction is called a Manifest Refraction and is performed without the use of eye drops so that we can examine the eye in a natural state. If you have ever had an eye exam, you are probably familiar with the “which is better, one or two” test-this is a manifest refraction.

Another type of eye refraction is called a cycloplegic refraction which is performed after the instillation of eye drops to temporarily immobilize the ciliary muscle of the eye. This temporarily prevents you from accommodating or “focusing” up close and is used when there is a need for an even more precise measurement of refractive error. In addition, the eye drops will also dilate the pupil so the eye doctor can easily see the back of the eye to examine the retina, optic nerve and blood vessels in order to evaluate their health.

From an insurance standpoint, eye refractions are considered part of a routine eye exam. Because refractions are normally used to determine refractive errors such as myopia, hyperopia, and astigmatism, and therefore prescribe eyeglasses or contact lenses, many insurance companies, particularly Medicare and Medicaid, do not pay for them. It's important to understand that when patients are having their eye exam, refractions are a necessary part of a routine eye exam and must be paid for out of pocket.

If you have questions about the cost of your refraction, or billing questions about refraction, please call D’Ambrosio Eye Care at 800-325-3937 and we will be glad to assist.