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INSURANCE

 

Most medical plans are accepted including UnitedHealth, Aetna, BlueCross/Shield, Humana, Superior Vision, Vision Service Provider, Spectera, Medicare & Medicaid. Dr. Goetz is one of the few M.D.'s who accepts VSP and Superior Vision in the Houston area.

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SOME COMMON EYE CONDITIONS WE TREAT

GLAUCOMA

Glaucoma is a group of eye disorders that lead to progressive damage to the optic nerve. People with glaucoma can lose nerve tissue, resulting in vision loss.

The optic nerve is a bundle of about 1 million individual nerve fibers that transmits the visual signals from the eye to the brain. In the most common form of glaucoma, primary open-angle glaucoma, the fluid pressure inside the eye increases. This increase in pressure may cause progressive damage to the optic nerve and loss of nerve fibers. Vision loss may result. Advanced glaucoma may even cause blindness.

Not everyone with high eye pressure will develop glaucoma, and some people with normal eye pressure will develop glaucoma. When the pressure inside a person's eye is too high for a particular optic nerve, whatever that pressure measurement may be, glaucoma will develop.

Glaucoma is the second-leading cause of blindness in the U.S. It most often occurs in people over age 40, although an infant (congenital) form of glaucoma exists. People with a family history of glaucoma, African Americans over the age of 40 and Hispanics over the age of 60 have an increased risk of developing glaucoma. Other risk factors include thinner corneas, chronic eye inflammation and taking medications that increase the pressure in the eyes.

glaucoma

DRY EYE

Dry eye is a condition in which a person doesn't have enough quality tears to lubricate and nourish the eye. Tears are necessary for maintaining the health of the front surface of the eye and for providing clear vision. Dry eye is a common and often chronic problem, particularly in older adults.

With each blink of the eyelids, tears spread across the front surface of the eye, known as the cornea. Tears provide lubrication, reduce the risk of eye infection, wash away foreign matter in the eye, and keep the surface of the eyes smooth and clear. Excess tears in the eyes flow into small drainage ducts in the inner corners of the eyelids, which drain into the back of the nose. Dry eyes can occur when tear production and drainage is not in balance.

People with dry eyes either do not produce enough tears or their tears are of a poor quality:Layers of tears

  • Inadequate amount of tears. Tears are produced by several glands in and around the eyelids. Tear production tends to diminish with age, with various medical conditions or as a side effect of certain medicines. Environmental conditions, such as wind and dry climates, can also decrease tear volume due to increased tear evaporation. When the normal amount of tear production decreases or tears evaporate too quickly from the eyes, symptoms of dry eye can develop.

  • Poor quality of tears. Tears are made up of three layers: oil, water and mucus. Each component protects and nourishes the front surface of the eye. A smooth oil layer helps prevent evaporation of the water layer, while the mucin layer spreads the tears evenly over the surface of the eye. If the tears evaporate too quickly or do not spread evenly over the cornea due to deficiencies with any of the three tear layers, dry eye symptoms can develop.
CATARACTS

A cataract is a cloudy or opaque area in the normally clear lens of the eye. Depending upon its size and location, it can interfere with normal vision. Most cataracts develop in people over age 55, but they occasionally occur in infants and young children. Usually cataracts develop in both eyes, but one may be worse than the other.

The lens is located inside the eye behind the iris, the colored part of the eye. Normally, the lens focuses light on the retina, which sends the image through the optic nerve to the brain.

However, if the lens is clouded by a cataract, light is scattered so the lens can no longer focus it properly, causing vision problems. The lens is made of mostly proteins and water. Clouding of the lens occurs due to changes in the proteins and lens fibers.

Cataracts generally form very slowly. Signs and symptoms of a cataract may include:

  • Blurred or hazy vision
  • Reduced intensity of colors
  • Increased sensitivity to glare from lights, particularly when driving at night
  • Increased difficulty seeing at night
  • Change in the eye's refractive error

There is no treatment to prevent or slow cataract progression. In age-related cataracts, changes in vision can be very gradual. Some people may not initially recognize the visual changes. However, as cataracts worsen, vision symptoms increase.

Cataract

PTERYGIUM

Pterygium (Surfer's Eye) most often refers to a benign growth on the outer lining of the eye. A  It is associated with and thought to be caused by ultraviolet-light exposure, low humidity, and dust.

Symptoms of pterygium include persistent redness from smoke, inflammation, foreign body sensation, tearing, dry and itchy eyes. In advanced cases the pterygium can affect vision as it invades the cornea with the potential of obscuring the optical center of the cornea and inducing astigmatism and corneal scarring.

Pterygium image

MACULAR DEGENERATION

Age-related macular degeneration (AMD) is a common eye condition seen in people over 50 years of age. It causes distortion or loss of central vision – the part of your vision you need for activities like reading and driving. Risk factors for AMD include increasing age, smoking and a family history.

There are two types of AMD with one called ‘dry’ and the other ‘wet’. Dry AMD is the most common (about 80-90%) and is caused by ‘wear and tear’ changes at the macula. Dry AMD develops very slowly leading to a gradual change in vision. ‘Wet’ AMD occurs more rapidly and is caused by abnormal blood vessels growing at the macula.

There is currently no treatment available to restore vision lost as a result of dry AMD. However, nutritional supplementation, dietary and lifestyle modifications and careful monitoring with an Amsler Grid may help to prevent vision loss. There are several options available to treat vision loss from wet AMD but it is important to seek help quickly for treatment to be effective.

Macular Degeneration Diagram

KERATOCONUS

Keratoconus is a vision disorder that occurs when the normally round cornea (the front part of the eye) becomes thin and irregular (cone) shaped. This abnormal shape prevents the light entering the eye from being focused correctly on the retina and causes distortion of vision.

In its earliest stages, keratoconus causes slight blurring and distortion of vision and increased sensitivity to glare and light. These symptoms usually appear in the late teens or late 20s. Keratoconus may progress for 10-20 years and then slow in its progression. Each eye may be affected differently. As keratoconus progresses, the cornea bulges more and vision may become more distorted. In a small number of cases, the cornea will swell and cause a sudden and significant decrease in vision. The swelling occurs when the strain of the cornea's protruding cone-like shape causes a tiny crack to develop. The swelling may last for weeks or months as the crack heals and is gradually replaced by scar tissue. If this sudden swelling does occur, your doctor can prescribe eyedrops for temporary relief, but there are no medicines that can prevent the disorder from progressing.

Eyeglasses or soft contact lenses may be used to correct the mild nearsightedness and astigmatism that is caused by the early stages for keratoconus. As the disorder progresses and cornea continues to thin and change shape, rigid gas permeable contact lenses can be prescribed to correct vision adequately. In most cases, this is adequate. The contact lenses must be carefully fitted, and frequent checkups and lens changes may be needed to achieve and maintain good vision.