Forty Fort Eye Associates and Home Eye Care are located at 1600 Wyoming Avenue (Route 11) at the corner of Arlington Road in Forty Fort, Pennsylvania, 18704. The office is located 3 miles from Wilkes-Barre, PA, in Luzerne County, and in Wyoming Valley. The office phone number is (570) 288-1218, the fax number is (570) 287-2673, and the office e-mail address is jasonffea@epix.net. Dr. Joseph Smith and Dr. Jason Smith have been providing personalized quality, family eyecare to the residents of Northeastern Pennsylvania since Dr. Joseph Smith founded this practice in 1950. Dr. Joseph Smith is one of the leading research optometrists in the contact lens industry. He has lectured extensively and has written numerous articles on his many patented processes for manufacturing and finishing gas permeable contact lenses. He is a graduate of the Pennsylvania College of Optometry in Philadelphia, and has served as a visiting faculty member at this optometric institution. He attended the University of Pennsylvania, and the University of Maryland and taught engineering and mathematics while in the U.S. Army. He founded OMNI-LENS CORPORATION which manufactures and distributes gas permeable contact lenses nationwide with offices and laboratory facilities located in Forty Fort. He is a member of the American Academy of Optometry, the American, Pennsylvania, and Northeastern Pennsylvania Optometric Associations, and the Society for Inventors and Scientists of America. He has served as an adjunct faculty member at the Pennsylvania College of Optometry, has taught at Allied Medical Center, is past-president of the Plymouth Kiwanis Club, and served 2 terms as president of the Torch Club of Wilkes-Barre. He has been featured on many local and national news and television programs including PM magazine and CNBC featuring the latest research and advances in rigid gas permeable lens technology. He holds patents for gas permeable finishing processes in the United states and in Canada. In 2008, Dr. Smith was awarded a 58 year membership plaque by the Northeastern Pennsylvania Optometric Association.
Dr. Jason Smith is a graduate of the New England College of Optometry in Boston, MA, the University of South Florida in Tampa, FL, the University of Florida in Gainesville, FL, King's College in Wilkes-Barre, PA, and Wyoming Seminary College Preparatory School in Kingston, PA. He is the founder of HOME EYE CARE which provides optometric care to homebound and nursing home patients. The latest portable equipment is used to provide complete eye examinations which include evaluations for glaucoma, macular degeneration, and retinal and diabetic eye diseases. Hand-held trial lenses are used in order to check an eyeglass prescription and eyeglasses can be provided when necessary. Dr. Smith is currently the staff optometrist at many nursing homes in Luzerne and Lackawanna Counties. These nursing homes include Birchwood in Nanticoke, Manor Care in Kingston, Golden Living in Wilkes-Barre, Summit in Wilkes-Barre, Tiffany Manor in Edwardsville, Kingston Commons in Kingston, Nanticoke Villa in Nanticoke, Riverview Ridge in Wilkes-Barre, Riverstreet Manor in Wilkes-Barre, and ACS Christian Manor in Pittston. In 1995, he was featured on the front page of the Times Leader Newspaper about doctors making house calls. In 2000, he was again featured in the Citizen's Voice newspaper in an article about Home Eye Care. He is very interested in current health issues, health problems, and health education. His dedication to continuing medical and health education is evidenced by the fact that Dr. Smith completed his 4th academic degree at King's College in 1999 with a Master of Science Degree in Health Care Administration. He is the 1st optometrist to complete this graduate program at King's College. In 1998, Dr. Smith was awarded a graduate certificate of achievement in recognition of completing the requirements for Executive Leadership in Health Care Administration at King's College. In 1999, he was appointed as an adjunct faculty member at King's College and teaches courses in Long-term Care Administration and Community Health.
Dr. Smith is treating many eye conditions as a result of a new optometric therapeutic drug law that went into effect in 1997. Conditions such as corneal abrasions, keratitis, allergic, bacterial, and viral conjunctivitis, blepharitis, dry eyes, and ocular inflammation may be treated by optometrists in Pennsylvania. In this highly regarded contact lens practice, he is currently doing research with patients who have a corneal degenerative disease process called keratoconus. His results are to be published in the journal "Contact Lens Spectrum" by the fall of 2009.
Dr. Smith is a candidate for the American Academy of Optometry which is the profession's foremost research and academic organization. He is a member of the American, Pennsylvania, and Northeastern Pennsylvania Optometric Associations, the American College of Health Care Executives, the American Public Health Association, the National Academy of Opticianry, the National Society to Prevent Blindness, and the American Foundation for Vision Awareness. In 2008, Dr. Smith was awarded a 15 year membership plaque by the Northeastern Pennsylvania Optometric Association. In 2006, Dr. Smith was asked to serve on a task force for the Luzerne County Health Department in order to evaluate health and vision problems affecting the residents of the county.
Ms. Marie Kolesa provides all types of opticianry, business, and professional support that provide a unique and pleasant environment that will continue to provide quality eyecare and medical care to the residents of Northeastern Pennsylvania into the 21st century.
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The ability to see is dependent upon the actions of several structures in and around the eyeball. The graphic below lists many of the essential components of the eye's optical system.
When you look at an object, light rays are reflected from the object to the cornea, which is where the miracle of sight begins. The light rays are bent or refracted and focused by the cornea, the lens, and the vitreous. The job of the lens is to make sure that the rays of light come to a sharp focus on the retina. The resulting image on the retina is upside-down. At the retina, the light rays are converted to electrical impulses which are then transmitted to the optic nerve. These impulses are transmitted through the optic nerve to the brain where the image is translated and perceived in an upright position.
Think of the eye as a camera. A camera needs a lens and film to produce an image. In the same way the eye needs a lens(the cornea, the lens, and the vitreous) to refract or to focus rays of light. If any one of these components do not function correctly, the result is a poor picture. The retina represents the film in our camera. It captures the image and sends the information to the brain to be developed. The macula is the highly sensitive area that is responsible for focusing our vision. It is the part of the retina most often used to see.
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Amblyopia is a term used to describe an uncorrectable loss of vision in an eye that appears to be normal. It is commonly referred to as a "lazy eye" and can occur for a variety of reasons. A child's visual system is usually fully developed by the ages of 9-11. Until that age, children readily adapt to visual problems by suppressing or blocking out a blurry image. If it is found early enough, amblyopia can often be corrected and vision can be preserved. However, after the age of 11, it is difficult if not impossible to train the brain to use the eye normally. The treatment for amblyopia depends upon the underlying problem. In some cases, the stronger eye can be temporarily patched so that the child is forced to use the weaker eye. Patching therapy can also require the good eye to be patched to help balance the vision in both eyes. Sometimes special eyeglasses with prisms or muscle surgery may be needed. Some causes of amblyopia include strabismus, crossed eyes, esotropia, exotropia, congenital cataracts, a cloudy cornea, droopy eyelids, ptosis, unequal vision, uncorrected astigmatism, and hyperopia(farsightedness). Amblyopia may occur in various degrees depending on the severity of the underlying problem. Some patients experience just a partial loss of vision, while others have a more significant loss of vision. Patients with amblyopia lack binocular vision, depth perception, or stereopsis. This involves an inability to blend the images of both eyes together. Stereopsis is what allows us to appreciate depth. Without stereopsis, the ability to judge distance is impaired.
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Astigmatism is a condition of refraction where light rays coming from a single point are not focused at one point but instead are focused as two images. When astigmatism is corrected in eyeglasses or contact lenses, the lens surface resembles a football(toric shaped). If one does not have astigmatism, then the lenses would resemble the shape of a baseball(round shaped). Astigmatism may be caused by the shape of the cornea and the shape of the lens. Most astigmatic corneas have 2 curves; a steeper curve and a flatter curve. This causes light to focus on more than one point in the eye causing blurred or distorted vision in the distance, at reading distances, or both. It can occur in combination with farsightedness or with nearsightedness.
Below is an anatomical representation as to how light focuses in a normal eye and when astigmatism is present.
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Blepharitis is a common inflammatory condition that affects the eyelids. It usually causes irritation of the eyelid margins, burning, tearing, itching, or crusting around the eyelids upon awakening. Inflammation of the white of the eye related to conjunctivitis, superficial inflammation of the cornea called keratitis, and styes are often associated with blepharitis. Treatment is usually scrubbing the eyelid margins with a mild shampoo like Johnson's baby shampoo twice a day using a warm washcloth. Warm compresses can be applied to the eyelids for 15 minutes 4 times a day. If there is an associated dry eye syndrome, preservative-free artificial tears can be used as often as 4-8 times a day. If the condition is moderately severe, erythromycin or bacitracin ointment can be used 3 times a day and at bedtime. Eyelid cleansing and the use of warm compresses can be reduced as the condition improves. Like dandruff, there is no cure for blepharitis but it can be controlled.
The picture below shows an eyelid margin with scaling of the eyelashes, pus, redness, and edema.
A branch retinal vein occlusion can have symptoms of a blind spot in the visual field or a loss of vision usually occuring in one eye. Superficial hemorrhages can develop in a sector of the retina along a retinal vein as shown by the blue arrows. Sometimes central vein occlusions occur when the circulation of the central retinal vein becomes obstructed by an adjacent blood vessel. This can also cause the vein to hemorrhage. Swelling and retinal ischemia (a lack of oxygen) are secondary complications. Treatment can involve the use ot retinal laser photocoagulation if there is edema in the macula of 3-6 months duration or if vision is less than 20/40. Treatment of any underlying medical problems is also necessary.
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A basal cell carcinoma is a type of cancer that occurs most commonly on the face or on the neck. It is commonly seen on or near the eyelid margins as seen in this photograph. The tumor cells are thought to originate from the basal, or innermost layer of the skin. Two types of basal cell carcinoma are seen; a nodular type which has a firm mass with telangiectasia(dilated blood vessels) over the tumor margins. Sometimes the center of the lesion is ulcerated. The other type is a morpheaform type which has appears as a firm, flat subcutaneous lesion with indistinct borders. Basal cell carcinoma is the most common skin cancer in the United States. For every 100,00 citizens, 100 cases are reported every year. Fair-skinned people over age 50 are most commonly affected and it is rare among those people with darker skin complexions. The incidence increases significantly with sun exposure. Those people who work outdoors or who live in sunny climates such as Hawaii, Arizona, Texas, and Florida are at a higher risk. In Queensland, Australia, over half of the Caucasian population has had at least one incidence of basal cell carcinoma by age 75. The Australian national government is currently funding an ongoing campaign to warn and to protect its' citizens concerning the damage that the sun can do. The ultraviolet radiation in sunlight is thought to be the cause in most cases. People with dark complexions have more melanin and more pigmentation in their skin which absorbs higher amounts of the damaging ultraviolet rays. Since fair-skinned people have less melanin, they are not able to withstand the effects of ultraviolet exposure. Over 90% of basal cell carcinomas occur on the face, often at the side of the eye or on the nose. However, the tumor can appear virtually anywhere on the body. It starts as a small, flat nodule and grows slowly, eventually breaking down at the center to form a shallow ulcer with raised edges. Left untreated, the growth gradually invades the surrounding tissue. Fortunately, basal cell carcinomas almost never metastasize(spread to other parts of the body). Diagnosis is made by microscopic examination of the tumor cells by a laboratory. Individuals at risk should avoid overexposure to strong sunlight. Protective clothing, brimmed hats and sunscreen should be used. Basal cell carcinoma can be destroyed with radiation therapy or removed surgically. Surgery offers the best chance for a complete cure however, new tumors may develop if adequate preventive measures are not taken.
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A branch retinal artery occlusion(BRAO) occurs when an artery branching from the central retinal artery becomes blocked. This blockage is usually caused by an embolus(blood clot) in the blood stream. The occlusion decreases the blood supply to the area of the retina nourished by the affected artery. The classic symptoms of BRAO include a dudden, painless loss of vision in one eye. In the photograph below, the affected area of the retina is the pale, whitish-yellow area marked by the blue arrows. The surrounding reddish-orange area remains as healthy retinal tissue. Patients may have a history of a transient visual loss referred to as amaurosis fugax.
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The term cataract refers to the clouding of the normally transparent crystalline lens of the eye. The lens is located behind the pupil and focuses light onto the retina in the back of the eye so that we can see clearly.The word cataract comes from the Greek word for waterfall. It was thought that a cataract was formed by opaque material flowing, like a waterfall into the eye. Cataracts are actually formed as a result of aging, injury, ultraviolet light, drugs, systemic and ocular disease. People with cataracts and blurred vision often find that their everyday activities like driving, reading, watching TV, and even walking become increasingly difficult. To improve their quality of life, sometimes a new eyeglass prescription may help. But ultimately in order to improve the quality of life, cataract surgery can restore the ability to perform these activities. As the lens becomes increasingly opaque, light rays entering the eye are prevented from focusing onto the retina, the light sensitive tissue lining the back of the eye. Symptoms of cataracts include blurred vision, sensitivity to light, glare, and a dimming of colors and of vision.
The pictures below show cataract development.
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A central retinal vein occlusion(CRVO) occurs when the circulation of the central retinal vein becomes obstructed by an adjacent blood vessel. This causes the vein to hemorrhage into the layers of the retina. As seen in the picture below, hemorrhages are seen on the retina. Other signs that can be seen include cotton wool spots. These are white, fluffy lesions with feathered edges also seen in the photograph below. Cotton wool spots lie in the nerve fiber layer of the retina and represent a micro-infarct, impplying an ischemic microvascular disease. Other signs of CRVO include optic disc edema, retinal edema, and neovascularization of the optic disc. CRVO may occur due to hypertension, glaucoma, vasculitis, abnormal platelet function, thyroid disease, or polycythemia. CRVO causes a marked decrease in vision and requires immediate attention.
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A chalazion is an eyelid lump which can cause swelling, pain, and tenderness. It is caused by the blockage of an oil-producing gland and can occur on the outside or the inside of the upper or lower eyelid. The picture below shows a chalazion on the lower eyelid. Treatment for chalazia include warm compresses for 15-20 minutes 4 times a day. Light eyelid massage over the nodule can tend to loosen the pyogenic granules that accumulate within the nodule. Chalazia usually do not cause pain because this is not an infectious process compared to the appearance of a stye which is usually painful. A topical antibiotic ointment such as bacitracin or erythromycin ointment used twice a day over the nodule is sometimes helpful. Steroid injections consisting of triamcinolone 40 mg/ml is sometimes injected into and around the chalazion, although steroid injections can lead to permanent depigmentation of the skin around the injection site. If the chalazion does not disappear after 3-4 weeks of appropriate medical therapy, the patient can choose to have this removed. Surgical incision and drainage of the lipid globule material and multinucleated giant cells will resolve the chalazion.
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A choroidal nevus is a flat, benign, pigmented area in the choroid which is a layer behind the retina. In the photograph below, it appears as the darker brown area. Nevi are similar to freckles on your skin and do not typically change or grow. Retinal photographs are usually taken to monitor any changes over time.
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Viral conjunctivitis is often associated with an upper respiratory tract infection, flu, colds, rhinovirus, or sore throats. The virus can be very contagious and easily spread with human contact. Disinfecting surfaces such as doorknobs abd counter tops, avoiding touching the nose or face, not sharing washcloths or towels, and frequent handwashing can reduce the spread of any infection. Like the common cold, there is no cure for viral conjunctivitis. Visual symptoms can be relieved by using cool compresses around the eyes or by using artificial tears. In certain cases, topical steroid drops will help to reduce the inflammation and will increase comfort. Most viral conjunctivitis resolves within 3 weeks or less.
Allergic conjunctivitis causes symptoms such as watery, itchy eyes which may include swollen eyelids. Symptoms are usually seasonal and can be at their worst during the hayfever season in the spring or early summer. Cool compresses and artificial tears may help relieve some discomfort in mild cases. In more severe cases, non-steroidal anti-inflammatory drops and ocular antihistamines can be used.
Bacterial conjunctivitis is characterized by swollen conjunctiva, redness, tearing, irritation, and a discharge that often causes the eyelids to stick together. This may only affect one eye but can spread to both eyes. The most common bacteria causing this type of conjunctivitis are staphylococcus and streptococcus. Antibiotic drops or antibiotic ointments are prescribed and this can sometimes be used in conjunction with a steroid-antibiotic combination drug.
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Corneal dystrophies are a rare group of slowly progreassive, usually bilateral, degenerative disorders which usually appear in the second ot third decades of life. Some corneal dystrophies are hereditary and can be classified according to their anatomical site within the cornea. Meesman's dystrophy is an autosomal dominant hereditary condition in which cysts are present between the epithelial cells. The dystrophy of Reis and Bucklers is an autosomal dominant condition characterized by the fragmentation of the collagen of Bowman's layer and a recurrent corneal erosion. Other dystrophies include Granular, where milky, white spots occur in the superficial stroma. Lattice dystrophy gives the cornea a ground glass appearance due to surface irregularity and lesions occuring within the stroma. Macular dystrophy presents as greyish-whites spots that are found in the stroma which tend to be superficial centrally and deep peripherally. In Fuch's dystrophy, the basic lesions lie within the gutatta of the corneal endothelium. This condition is inherited as an autosomal dominant trait and tends to affect women moreso than men. The gutatta are more numerous in the central cornea and spread peripherally as the condition advances. Patients with Fuch's dystrophy have a deficiency in their endothelial cells. If these cells are lost or damaged, they do not regenerate. The endothelial cells that remain tend to "spread out" to fill the existing empty spaces created by the loss of endothelial cells. This results in a less efficient pumping system that can lead to corneal swelling and a loss of vision. This swelling may be more noticeable in the morning and may clear up to some degree as the day progresses. Sodium chloride or salt solution drops or ointment can be prescribed to reduce the swelling. If these dystrophies progress to the point that vision is severely compromised, corneal transplant surgery may be necessary to restore lost vision.
The picture below is a magnified photograph of the cornea. The "edema" that is seen under bright light is caused by Fuch's corneal endothelial dystrophy and is seen as this "mottled" appearance.
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