At the Switch Eye Center, a wide variety of surgical procedures are available to patients. Dr. Switch diagnoses and treats a wide range of diseases of the eye.
As an educational tool, Dr. Switch has developed a list of common eye conditions. Click on the links below to learn basic information about a given condition.
Information on this web site is not intended to replace or augment a consultation with an eye care professional. The Switch Eye Center disclaims any and all liability for injury or other damages that could result from use of the information obtained from this site.
Nd:YAG Laser Capsulotomy (Removal of capsular hazing after cataract surgery)
A cold laser called a Nd:YAG (yttrium-aluminum-garnet) laser is utilized in the office to polish the haze of the posterior capsule. This haze is often referred to as a secondary cataract.
This haze is a thin film that develops along the back portion of the membrane that holds the newly implanted lens in place after cataract surgery.
Often, the symptom that will alert a patient to presence of this secondary cataract is a decrease in vision months to years after cataract surgery. The surgical procedure is a minor outpatient procedure that takes only a few minutes.
1. First, your eye will then be dilated with eye drops.
2. Next, you eye will be number with drops.
3. A small laser, which is attached to a lamp that Dr. Switch uses to evaluate your eye, will be brought up to your chair.
4. Dr. Switch will focus the laser on the hazed portion of the secondary cataract. The laser is applied while you are sitting in the chair and is painless.
5. You will be sent home with an anti-inflammatory drop to use for four days.
6. There is no risk of infection or burn with this cold laser. Typically, patients notice some small “floaters“ in their vision for the next 2-3 days.
7. Dr. Switch will have you come back in one week to reevaluate the eye.
8. Once the secondary cataract is removed, it does not come back.
Peripheral Laser Iridotomy (PI)
This treatment is recommended for patients who have been identified as having anatomically narrow or closed angles (drainage ducts) in the eye, which places them at risk of a closed angle glaucoma attack. It is also used for patients who have elevated pressures, which are not well controlled with eye drops.
A Peripheral Iridotomy is a small opening that is created in the iris (the colored part of the eye) that allows excess fluid to drain without resistance and prevents a buildup of pressure. The hole is usually made in the superior portion of the iris where it is hidden under the eyelid. This hole is made using a cold laser, which is applied while the patient is sitting in the exam chair.
As the eye creates fluid (aqueous), the fluid flows around the lens and into the front chamber of the eye in front of the pupil. This fluid is then drained at the base of the iris. In some individuals, this flow of fluid can be blocked off before it reaches the drain. As the pressure builds in the eye, patients are at risk of serious complications and damage to the structures of the eye. The small hole in the iris (PI) allows the fluid to bypass this area of blockage and drain normally, thus preventing an acute glaucoma attack.
Dr. Switch preforms this office procedure for patients who have been identified being at risk for this condition. The procedure is outlined below.
1. Dr. Switch will instill a drop, which constricts the pupil.
2. A numbing eye drop will be placed in the eye, although the procedure is virtually painless, this drop decreases the urge to blink more often during the procedure.
3. A special contact lens will be placed on the eye causing a temporary blurring.
4. The procedure typically takes less than one minute. During the procedure, Dr. Switch will be focusing a small light in your eye. You will here several “beeps” from the laser as it is applied.
5. After the procedure, Dr. Switch will have you wait 15 minutes and then recheck your eye pressure.
6. You will be sent home on an anti-inflammatory eye drop to use for four days.
After surgery, you may be light sensitive for the next 4-6 hours. There are no restrictions after this procedure. Typically, the procedure only needs to be done once. In some patients, this small hole can close up, which requires a second procedure. Patients with closed angle glaucoma in one eye have a 50% chance of developing it in their other eye. For this reason, Dr. Switch may recommend having this procedure in both eyes.
SLT (Selective Laser Trabeculoplasty)
Selective laser trabeculoplasty (SLT) is a surgical procedure that is used for multiple types of glaucoma. The goal of this procedure is to decrease the overall pressure of the eye by increasing the drainage of the fluid in the eye (aqueous humor). Often times, patients are able to reduce or stop their glaucoma drops after this procedure.
This procedure is recommended when control of pressure cannot be maintained with drop alone and before more invasive surgery is considered.
The Selective Laser Trabeculoplasty uses low energy light to selectively remove the pigmented cells that block the drainage system, known as the trabecular meshwork, while avoiding damage to other structures. This opens up the drain and allows the fluid to flow out of the eye more efficiently. The eye will continue to make more fluid, but the rate it is drained from the eye will be increased so that that pressure no longer builds as it does in untreated glaucoma.
Dr. Switch preforms this painless office procedure for patients who have been The procedure is outlined below.
1. While seated in the exam room chair, the eye is numbed with an eye drop.
2. A specialized contact lens is placed on the eye. This lens allows Dr. Switch to focus the laser light. The contact lens also prevents blinking.
3. During the procedure, you will here a beeping sound as Dr. Switch applies the laser to the remove the cells that are clogging up the draining meshwork.
4. After the procedure, you will remain at the office for at least 15 minutes to have the eye pressure rechecked.
5. Once the eye pressure is checked, you will be able to leave without any restrictions.
There will be several follow up appointments to ensure the eye pressure decreases after this procedure.
It is important to understand that this procedure does not improve eyesight. The goal of this procedure is to preserve vision from loss due to damage from elevated eye pressure.
Dry eye is a common problem that is often the result of decreased production the tears that lubricate the surface of the eye. Initial treatment consists of supplementing these tears with artificial tear eye drops. When this fails to relieve the patient’s symptoms, it is often helpful to reduce the ability of the tears to drain from the eye. By keeping the tears from draining from the eye, they remain coating the surface of the eye.
There are two drainage holes in the eyelids. One in the upper lid and one in the lower lid corner near the nose. These holes known as punctum drain into the nose and the back of the throat.
Punctal occlusion is the procedure in which the lower punctum (drainage hole) is plugged with a small silicone plug. The procedure is relatively straightforward. Dr. Switch uses an eye drop to numb the lower lid. A small plastic inserter is used to place a silicone plug directly at the opening of the punctum. The inserter is removed and the plug remains. The entire procedure takes only a few minutes and takes place while the patient is sitting in the exam chair in the office.
Patients often feel results immediately. In rare cases, the plug may cause irritation, in which case Dr. Switch will simply remove the plug in the office.
A Chalazion is the medical term for a swollen and infected eyelid oil duct. These often cause swelling and pain in the upper or lower lid. Small chalazions may be treated using warm compresses and treatment similar to that of Blepharitis. Larger Chalazions may need to be drained. If recommended, Dr. Switch will discuss the risks and benefits of surgically treating the Stye. This in-office procedure takes approximately five minutes. The following outlines the basic steps of the procedure.
1. After the eyelid is anesthetized with a small injection of lidocaine.
2. A small clamp to evert the lid and to control bleeding is placed on the eyelid.
3. The eyelid is flipped.
4. A small incision is placed at the top of the infected gland, on the inside of the eyelid.
5. The contents of the gland are expressed and the gland is cauterized.
6. The clamp is removed.
7. A pressure patched will be held on the eye for several minutes.
8. An antibiotic ointment is applied to the eye and the patient is able to leave without any restrictions.