Specialized Vision Correction Options

Specialized Vision Correction Options

The vast majority of people who need vision correction have come by their vision problems naturally. Some people just need to have their Myopia, Hyperopia, Astigmatism or Presbyopia corrected by traditional glasses and contacts. However, some people will find that those traditional methods, just don't give them the clear and comfortable vision they deserve. Often times, those people will have irregular vision conditions which require more specialized correction. The technical terms for those common yet previously uncorrectable conditions are Coma, Trefoil, Quadrafoil, Spherical Aberration and other "High Order Aberrations". Utilizing new technology and advanced contact lens fitting techniques, we can finally provide our patients an optimal customized prescription giving them the best possible vision.
​
Refractive surgery patients who are seeking to enhance there vision without additional surgery, are now in luck! If you have had RK, ALK, PRK, LASIK or other elective surgeries and would like to achieve better vision, we can help. For many years, people who have had their vision damaged by refractive surgery have had to simply "make do" with their remaining vision. Utilizing many of the same techniques and technologies that help us correct the vision of other patients, these patients who aren't experiencing "contact lens and glasses free vision" can now have their eyesight restored...and all with out the risk of surgery!

If you would like to learn more about your vision and your vision correction options, please contact our office at
(262) 752-2020 or by email at  office@warreneyecarecenter.com   We are always accepting new and challenging patients. Unlike many other practices we enjoy working with patients who are having problems!

Customized Contact Lenses

Customized contact​

No two fingerprints are identical and the same is true for your eyes, especially the cornea (the clear tissue that a contact lens sits upon). Each cornea has its own distinct shape and texture, just like a fingerprint. So it makes sense that a contact lens should mirror the cornea.

We design and fit Wave Contact Lenses which are custom designed from your corneal “fingerprint”. Wave’s special video camera and software digitally maps your cornea with thousands of numbers. We then use the map data and Wave’s special design software to create a custom lens that follows almost every tiny shape on your cornea. (Look at the astigmatism to the right.) In the width of a hair, there may be as many as 10 distinct curves on the back of the lens. With so many curves, Wave lenses offer unrivaled comfort and sharper optics. Many unsuccessful contact lens wearers are successful Wave lens users.

As a Wave trained doctor Dr. Warren is skilled and Certified to use Wave Contact Lens Design Software for contact lens patients requiring correction of near or distance vision, astigmatism, combined reading and distance vision, keratoconus and post surgical corrections.

Doctor Warren also uses Wave Software to create custom Orthokeratology lenses, a non-surgical vision correction procedure.

Wave’s Custom Designed Lenses differ greatly from plain “mass produced” lenses. Dr. Warren will specify the lens diameter and thickness for comfort and adjust the position of the optics for best visual performance. In all there are 26 different adjustments, offering infinite design possibilities.
​
Wave Designs are available in:

• Single Vision: For distance vision until your mid forties when bifocals are usually necessary for up close activities like reading.
• Bifocal: Simultaneous distance and near vision without reading glasses. Your doctor adjusts the Wave design to match your pupil for maximum near and far vision performance.
• Astigmatism: Wave designs a custom lens that duplicates your astigmatism’s (football) shape. The fit is unsurpassed. Other lenses offer a “get as close as we can” approach.
• Keratoconus & Post Refractive: Most challenging and most in need of Wave’s custom “match the cornea” design philosophy.
• Orthokeratology: A non-surgical, temporary vision correction procedure that allows most “Ortho K” users to go all day without lenses or glasses. Custom lenses gently reshape the cornea while you sleep. Ask your doctor about Wave’ designed Orthokeratology lenses.
• Why wear ‘off the shelf’ contact lenses? Your eyes deserve better.

WHY IS WAVE BETTER?

Wave lenses know exactly how the central and peripheral cornea are shaped. The fit follows the shape leading to a better, more comfortable lens.

Typical lenses do not follow the exact shape of the cornea, especially out in the periphery (round insert). A poor peripheral fit can result in blink discomfort.

Irregular Astigmatism

irregular astigmatism

Regular Astigmatism is a normal and very frequent visual problem that is easily and accurately corrected with eye glasses or conventional contact lenses.

Irregular Astigmatism is not normal and is not correctable with traditional means such as eye glasses and contact lenses. Patients with Irregular Astigmatism will often see double images/ghost images as well as frequently complaining of a “starburst” effect or general distortion of images.

Irregular astigmatism can result from conditions such as Keratoconus or other naturally occurring corneal degenerations. Corneal injuries can also cause irregular astigmatism. One of the most common causes of Irregular Astigmatism is refractive surgery. If the treatment zone is not perfectly centered, Irregular Astigmatism can occur. A poorly centered or unevenly applied Rk treatment zone or incision pattern can also create Irregular Astigmatism.
​
Custom RGP lenses are usually the best vision correction option for patients who suffer from any type of irregular astigmatism. Over the last 10+ years, we have been helping patients see their best by correcting their vision corrections such as irregular astigmatism so don’t despair, there’s hope!

Night Vision Correction

Night vision correction

Because of changes in the pupil size, the way that light moves through the eye is different in low, medium and high light level settings. For some patients this change in optical correction is quite small, but for others it can be significant, to the point that they see and perform better in low light settings with a specific correction.
​
This correction can be eye glasses, standard contact lenses with a different prescription power or ideally WaveTouch lenses which will have varied powers in different areas of the lens to provide the most accurate prescription in any lighting situation.

We measure our patients vision in different light conditions with the 3D Wave Aberrometer. This device measures the corneal curvature as well as the optical power across the entire pupil. This data is used for both eye glass and contact lens prescribing and can result in considerably better vision in all settings.

The image below shows how one of our patient’s optical power (and the correction needed to correct the vision properly) changes from 3mm (blue box) zone to the 5mm (red box) optical zones. The nearsighted correction changes from -6.75 to -7.75 and the astigmatism power changes from -1.00 to -1.50. This patient’s eye glass Rx had to be “blended” for routine use and she was fit with WaveTouch lenses for her best all around vision in all conditions.

Corneal Refractive Therapy

What is CRT?

Corneal Refractive Therapy (CRT for short) uses specially designed vision retainers to
gently and gradually reshape the front surface of the eye (the cornea) to eliminate or reduce nearsightedness (myopia) or astigmatism. The principle is similar to the use of a dental retainer used by an orthodontist to realign crooked teeth. The vision retainers are similar to contact lenses and are only worn at night while sleeping. They are then removed upon awakening to provide clear vision without using glasses or contact lenses! The retainers are comfortable and very easy to care for.

Before CRT

After CRT

​WHY NOT JUST WEAR EYEGLASSES OR CONTACT LENSES?

The main purpose of CRT is to be free from both contact lenses and eyeglasses during waking hours. While this is ideal for sports enthusiasts or those who work in dusty or dirty environments, for others CRT offers the appeal of being free from corrective lenses during the day. CRT also offers relief from the problems sometimes associated with full time contact lens wear like drying and things getting on or under the lenses.

​DOES CRT HAVE ANY ADVANTAGES OVER LASER SURGERY?

There are several. CRT is less than half the cost of Excimer Laser Surgery. It does not involve any post-operative pain. Also, the hazy post-operative vision that can be associated with laser surgery does not occur with VST. Both eyes can easily be done at the same time with CRT. Also, prescription changes are easy to deal with using VST. There are no strong steroid or antibiotic drugs needed with CRT as there are during the post-operative period for laser surgery. Lastly, and perhaps most importantly, CRT is reversible. Laser surgery is not.

​IS EVERYONE SUITABLE FOR CRT AND CAN ANY DOCTOR PERFORM IT?

The answer to both questions is no. It does not work on every patient and needs to be performed in a very exact and meticulous manner. Dr. Warren has received special training and has the necessary diagnostic equipment, computer software and expertise to perform CRT.

​The procedure works best on mild to moderate amounts of nearsightedness or astigmatism. More severe cases can have their vision improved, but will still need some vision correction. The procedure also does not work well on certain shaped corneas. Also, there are several unmeasurable factors for each patient - most notably the cornea’s rigidity. Thus the speed of CRT varies with each patient. Generally, but not always, less nearsighted patients respond faster than more nearsighted ones. There are no age barriers for CRT. It is safe for children and adults and is an excellent alternative for children who are just first becoming nearsighted as CRT will prevent any further nearsightedness from occurring! Also, while success rates are very high, success cannot be guaranteed due to factors like the inability to wear the vision retainer for physiological reasons or other systemic health problems that may reduce wearing time.

I’M INTERESTED IN CRT, WHAT DO I DO NEXT?

Call the office at (262) 752-2020 to schedule a complimentary CRT Consultation with Dr. Warren. If you decide to proceed with CRT, your initial retainers may be ordered that day!

​WHAT DOES THE CRT PROCEDURE INVOLVE?

 A comprehensive eye health examination is performed first. Then, a corneal topographer
is used to obtain a very precise computerized “map” of the cornea’s shape. This information is placed into the CRT computer software and a customized retainer is designed. If at that time it is determined that you are a good candidate for CRT, your own vision retainers will be ordered. It takes about one week for the retainers to be made and delivered. When you pick up your retainers, you will be instructed on how to use and care for them. The maintenance is very easy and involves only one bottle of solution. If the retainers fit properly, you will wear them that first night. Your vision should be clear with the retainers on. You will be seen in the office the next morning. You should come to the office wearing your vision retainers. We will remove them for you. Of course, should you experience any problems while at home with your retainers, simply remove them. Most of the visual changes occur rapidly over the first few days. As the cornea changes shape and vision improves, we will refit and reorder successive vision retainers (if needed). During this interim period we will supply you with (no-charge) contact lenses to be worn during the day. These are usually only needed for the first few days. The majority of patients achieve excellent vision in only a few days. Even after you are seeing well, we will continue to see you a while longer to ensure your cornea is adapting to the retainers.
 
 Most patients are done with their follow up care in two months although some may take more or less time. When the treatment is completed, the last retainer used will be worn on a nightly basis. Some patients are able to use the retainers every other night.

Optical Aberrometry

Optical aberrometry

​Utilizing the latest in technology we are able to detect and quantify your patients’ vision in ways that were not possible even two years ago. The Topcon KR1-W measures a person’s vision in several different ways. It determines a person’s prescription in three different zones (pupil sizes), Measures the corneal surface shape, Provides two different pupil size measurements and also provides the eye’s “optical finger print”.

We use the three prescriptions to determine what lens power(s) to use in different light conditions. Patients who have a large degree of difference between the central and peripheral prescriptions will benefit greatly from WaveTouch lenses or two different Rx’s in their glasses or contact lenses. We may also “blend” the prescriptions to provide the best all around vision in a single prescription.

We have been able to measure the corneal surface contour for many years, we can now analyze that data alongside the rest of the eyes visual characteristics to better put that information to use for the patient’s benefit.

The pupil size measurements allow us to analyze the impact of different light levels and pupil sizes on our patients and many times explains our patient’s symptoms, which then allows us to come up with a plan to improve their visual function.
​
Finally, the “Optical Finger Print” tells us the eyes focusing power at any point inside the pupil. You would be surprised how many patients have patterns of irregular power in many different areas of their visual system. Knowing how they are distributed helps us predict how well our patients will see with different types of vision correction, spectacles, soft lenses, RGP lenses or custom WaveTouch soft lenses, or even surgery.