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Routine Eye Exams & Refractions

Our full range of vision care services includes examinations of children and adults, contact lens fitting of all types, and co-management of laser and cataract surgery. The visual system is a delicate and complicated part of the human anatomy. All parts of the eye and many parts of the overall body affect your ability to see. In our comprehensive eye health and vision examination, the health of your eyes is evaluated from the cornea to the retina. 
You will find that your eye examination is a pleasant and interesting experience. Based on modern optometric techniques, the examination consists not of a single test but a series of integrated tests. The examination is divided into four sections:
● This series of tests is designed to determine whether your eyes are healthy and free of disease. A careful check will be made for certain diseases that manifest themselves in the eye.● A number of objective tests are taken which allow us to observe and measure your eyes without your active participation. These tests also enable us to examine small children of preschool age.● Next, a number of subjective tests are taken. Here you will be actively participating. We will ask you a number of questions and will expect you to answer them as well as you can.● Additional tests will be performed to assess the muscular balance of your eyes, how well your eyes work as a team, and how well your eyes focus.● At the conclusion of the exam, we will explain the results of the tests and make recommendations for any needed preventative or remedial vision care.

Diabetic Retinopathy Eye Evaluations

Diabetes affects nearly 14 million Americans, and if you have the disease, educating yourself as much as possible is important. More than 8000 diabetic patients in the US become blind every year. It is the leading cause of blindness in patients aged 20-64. It causes high blood sugar levels that can damage blood vessels throughout your body, especially in the nerve layer at the back of the eye, called the retina. Non-proliferative diabetic retinopathy (NPDR), commonly known as background retinopathy, is the early stage of diabetic retinopathy. 
In this stage, tiny blood vessels within the retina leak blood or fluid. Vision is generally affected as a result of diabetic macular edema or swelling in the macula, the central portion of the retina. This swelling is the most common cause of visual loss in diabetes. Symptoms of diabetic retinopathy and its complications may include:
● Blurred, double, or distorted vision or difficulty reading.● Floaters or spots in your vision.● Partial or total loss of vision or a shadow or veil across your field of vision.● Pain, pressure, or constant redness of the eye.
Diagnosis of Diabetic Retinopathy A comprehensive medical eye exam is most important to detect changes inside your eye. Dr. Tschetter can often diagnose and treat serious retinopathy before any vision problems occur. Unfortunately, because losing vision is often a late symptom of advanced PDR, many patients remain undiagnosed. Patients with diabetes must be diligent to obtain proper eye care throughout their lives. The American Diabetic Association (ADA) recommends yearly eye examinations for all diabetic patients.

Evaluation for Age-Related Macular Degeneration

Macular degeneration is a disease caused by damage to the center portion of the retina called the macula. This area is where you process 80% of your vision, and it is where photoreceptors are most dense. The center of the macula is the fovea, and it helps you process fine detail vision, reading vision, and distance vision. In macular degeneration, the macula stops working, as explained below, leaving you with peripheral or side vision. 
Types of Age-Related Macular DegenerationDry macular degeneration, which is the most common type, occurs when yellow deposits called drusen progressively thin out the macula. Progression of dry macular degeneration usually takes a long time and does not always lead to wet macular degeneration. Wet macular degeneration arises from existing dry ARMD. This occurs in 10 to 15% of people with dry ARMD. Abnormal blood vessels grow underneath the retina in the area of the macula. These vessels leak fluid, bleed, and lift up the retina. This can reduce central vision and also distort the vision. There is an increased risk of the other eye developing wet ARMD if one eye has it. 
Symptoms Symptoms of macular degeneration generally involve vision loss. There is no pain. Vision loss tends to occur gradually and often affects each eye at different rates. In the early stages, the condition may be hardly noticeable. One of the first symptoms is distortion. Straight lines will not look straight. A telephone pole may seem slightly bent. Later colors may not seem the same in each eye, and you may see a gray spot similar to the after-effect caused by a flashbulb.
Causes Causes of ARMD are generally unknown. Women are at higher risk than men, and Caucasians are more likely than African Americans to develop ARMD. Smoking, high-fat, and high cholesterol diet are all risk factors. 

Glaucoma Diagnosis & Treatment

Glaucoma is one of the leading causes of blindness in the United States and affects approximately 2% of the population over age 40. Glaucoma usually begins without any symptoms or obvious loss of vision. Glaucoma, sometimes called the “silent thief of sight,” can damage vision without causing any pain or significant symptoms until it is sometimes too late to treat. Early detection is key in preventing loss of sight from glaucoma.
Causes & RisksGlaucoma, by definition, is a disease of the optic nerve, the vital nerve bundle that sends all visual information to your brain. It is usually caused by high eye pressure; however, it can be caused by low or normal eye pressure. Factors that increase a person’s risk include:
● Elevated eye pressure – the higher the eye pressure the higher the risk.● Increasing age – the older you get the higher the risk, thus the importance of eye exams at least every two years after the age of 40.● Race – African Americans have a 8x higher likelihood of developing glaucoma than Caucasians● Family History of Glaucoma – Siblings of glaucoma patients have a 5 fold increase in risk for developing glaucoma.● Diabetes – due to circulation problems.● Myopia (nearsightedness).● Long Term Cortisone Treatment.● Injury/Trauma To The Eye.
Types of Glaucoma Open-angle is the most frequently diagnosed type of glaucoma in the US. This type of glaucoma occurs because too much fluid in the eye is being produced or too little fluid is being drained. Treatment generally involves starting someone on eye drops and or a combination of laser therapy. Acute angle-closure glaucoma is an emergency and needs to be treated immediately.  
This occurs when fluid cannot escape because the drain in the eye is closed. This causes pressure to build up suddenly. Most of the time, this causes a tremendous amount of pain. Angle-closure generally occurs in farsighted eyes and patients between the ages of 45-60. Treatment generally involves eye drops and immediate laser treatment.

School Exams

According to the American Optometric Association (AOA), infants should have their first comprehensive eye exam at six months of age. Children should then receive additional eye exams at three years of age and just before they enter kindergarten or the first grade at about age 5 or 6. For school-aged children, the AOA recommends an eye exam every two years if no vision correction is required. Children who need eyeglasses or contact lenses should be examined annually or according to their eye doctor’s recommendations.
It’s important for parents to make sure their children’s eyes are healthy. Approximately 80 percent of all learning during a child’s first 12 years comes through vision. Good eye health and vision are important to your child’s learning, and vision problems can affect their performance in school. 
Undetected or untreated vision problems can hinder a child’s ability to perform to their full potential in school. In fact, many eye diseases can impair vision or lead to vision loss, which is why it is important for people of all ages to have their eyes checked regularly. Many children with undetected vision problems struggle in the classroom. These symptoms include:
● Trouble finishing written assignments.● Losing their place when reading.● A short attention span when reading or doing close work.● Skipping words when reading.
At least 10 to 15 percent – or 8 to 12 million – children are at risk for vision impairment. Preventing these conditions can be easy and help your student perform their best in academics and sports, so schedule your child’s eye exam today!


Cataract Evaluation

A cataract is a clouding of the lens – the part of the eye that focuses light and produces clear, sharp images – resulting in blurred, fuzzy, or double images. For most people, cataracts are a natural result of aging. Cataracts are the leading cause of visual loss among adults over the age of 55. While the risk of having cataracts increases as you get older, eye injuries, certain medications, and systemic diseases such as diabetes have also been known to cause cataracts.
Other risk factors include excessive smoking or alcohol use and prolonged exposure to ultraviolet (UV) sunlight. Early cataract symptoms may be improved with new eyeglasses, brighter lighting, anti-glare sunglasses, or magnifying lenses. If these measures do not help, surgery is the only effective treatment. If you feel cataracts have limited your ability to enjoy the things you used to love, contact Dr. Tschetter today for a thorough examination. After the examination, we will explain your treatment options and provide an action plan to get you on the road to recovery.

Contact Lens Exams

Contact lenses have come a long way since the first FDA-approved soft lenses were launched in 1971. Contact lenses are now available to suit almost every fashion and vision need. Virtually every kind of contact lens is available in a disposable or frequent-replacement format, making lenses healthier to wear, affordable, and easier to care for. With all the advancements available, a thorough evaluation is needed to match the right lens with your specific need. Dr. Tschetter specializes in contact lens evaluation and fitting. We fit any and all types of lenses:
● Soft disposable contacts (including those for astigmatism and bifocals).● Color contacts.● Gas permeable contacts.● Medically necessary contact lenses for eye diseases or post-surgery.
Our office is adjacent to Big Sky Optical, which provides top-of-the-line optical services and a contact lens dispensary.

Amsler Grid 

Click the button to download this eye exam. The instructions can be found in the PDF. 

Snellen Eye Test

Click the button to download this eye exam. The instructions can be found in the PDF. 


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