Frequently Asked Questions

Informative Facts Concerning Our Services

Below is a list of some frequently asked questions, but please feel free to call our office if you need additional information at (631) 231-4455. We are always pleased to assist you.

What is a cataract and how can it be treated?
A cataract is a cloudy area in the eye's lens that can cause vision problems. Most cataracts are caused by aging. In fact, more than half of all Americans, age 65 and older, have a cataract. In the early stages, stronger lighting or new glasses may lessen vision problems caused by cataracts. At a certain point surgery alone will be needed to improve vision. Cataract surgery, today, is safe and very effective. Dr. Passarelli utilizes the latest techniques using ultrasound fragmentation (phacoemulsification) to remove cataracts. Dr. Passarelli is currently trained in laser cataract surgery but this procedure has not yet been approved by the FDA. In Dr. Passarelli's hands, over 98% of patients have an improvement in vision following cataract surgery.

What is glaucoma and how can it be treated?
Glaucoma is a disease which can lead to damage of the optic nerve of the eye which can result in blindness. Open-angle glaucoma, the most common type of glaucoma, affects about 3 million Americans. At first there are no symptoms, but over the years it can steal your sight. With early treatment, you can often protect your eyes against serious vision loss and blindness.

Although glaucoma can never be cured, you can be treated in order to control the disease. This makes early diagnosis and treatment important to protect your sight. Eye drops are the first line of treatment in most cases, with the objective to lower the intraocular pressure to a safe level. This may require one or several different drops to achieve adequate lowering of the pressure within the eye. If medical therapy fails, laser surgery can then be tried to lower the eye pressure. Conventional surgery, which creates a new opening for fluid to leave the eye, can be performed as a last resort.

Remember that the treatment for glaucoma may not restore lost sight - peripheral vision loss from glaucoma is irreversible, but early detection and treatment is the key to preserving your sight. This is why Dr. Passarelli routinely measures the intraocular pressure in your eyes.

Why do I need to be concerned about diabetic retinopathy?
Diabetic retinopathy is a potentially blinding complication of diabetes that damages the retina. Half of the 15 million Americans with diabetes suffer from diabetic retinopathy. At first, there are no symptoms. But the longer you have diabetes, and the worse your blood sugar control, the greater the risk of you developing more severe diabetic retinopathy. Timely laser treatment is the key to preventing vision loss from diabetes, but the real key is screening all diabetics for retinopathy when their diagnosis is made. Diabetics requires annual visits to the ophthalmologist and follow-up visits are determined at each visit. Dr. Passarelli, a board certified ophthalmologist, is also the ophthalmologist for the North Broward Diabetes Center, and is uniquely qualified to manage diabetic retinopathy.

What is macular degeneration and can it be treated?
Age-related macular degeneration (AMD) is a disease that affects your central vision. It is a common cause of vision loss among people over the age of 60. Because only the center of the vision is affected, one does not become totally blind. However, AMD can impair the ability to read, drive or perform other daily activities that require fine, central vision.

There are two forms of AMD: Dry and Wet.

Dry AMD affects about 90% of those with the disease. It's cause is unknown. Slowly, the light sensitive cells in the center of the retina (macula) degenerate. With less of the macula working, the central vision diminishes over a period of years. Dry AMD usually affects both eyes, but at different rates. There is no treatment for Dry AMD.
Wet AMD accounts for only 10% of AMD cases but causes 90% of the blindness associated with AMD. It is caused by the growth of new blood vessels under the macula which can then leak fluid or blood under the macula. This blood or fluid can cause rapid damage to the retina with loss of central vision in a short period of time.

Treatment of AMD includes laser surgery for selected wet cases. Unfortunately, there is not treatment at present for Dry AMD. However, Dr. Passarelli will instruct you on how to use various grids and charts to help you monitor the eye for damage that could be caused by the wet form of AMD.

What is dry eye and how can it be treated
Some people do not produce enough tears to keep the eye lubricated in normal situations. These people will complain of burning, stinging, scratchiness, mucous discharge, excessive tearing, eye irritation and difficulty wearing contact lenses. Dry eye syndrome is often associated with menopause, arthritis and affects women more often than men. Dry eyes can also be caused by decreased tear secretion secondary to the use of many medications.
The main form of treatment for dry eyes is tear supplements, in the form of drops, gel or ointment. Conserving tears, by blocking their drainage from the eye, is a second step in the management of dry eyes. Dr. Passarelli will gladly supply you with samples of tear supplements and literature regarding dry eye treatment.

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What is oculoplastic surgery?
Oculoplastic surgery is a subspecialty in the field of ophthalmology that deals with cosmetic and reconstructive surgery of the eyelids, lacrimal (tear duct) and orbit, the bony cavity around the eye.
To be an oculoplastic surgeon, one must complete an approved residency in ophthalmology, become board certified, complete a formal fellowship in oculoplastic surgery, take a written and oral exam and submit a thesis of original work to the American Society of Ophthalmic Plastic and Reconstructive Surgery. Dr. Passarelli has reached this professional pinnacle and is eminently qualified to manage disorders that affect the eyelid, tear duct and orbit.

Problems in this area include:

Eyelid malposition - droopy lids, lids that turn in or out
Eyelid tumors - either benign or malignant
Cosmetic eyelid problems - excess skin on upper lids, bags on lower lids
Tear Duct - trauma to the tear outflow apparatus or blockages in the tear duct
Orbit - problems with the bony housing of the eye, including fracture, thyroid eye disease or tumors.

What is blepharoplasty?
The eyelids protect one's eyes in addition to enhancing one's appearance. Over time, your upper or lower eyelids may become droopy or baggy as the eyelid tissue stretches, muscles weaken and fat pockets bulge and become more prominent around the eyes. This most often occurs with aging but can occur in younger patients as well. Aesthetically, such conditions may detract from the overall attractiveness of one's eyes and cause a "tired" or older appearance. When severe, these conditions may also cause functional problems, such as impaired field of vision or difficulty wearing glasses.

Before

Eyelid surgery to correct and improve the appearance of the eyelids is called blepharoplasty.

Blepharoplasty is performed on an out-patient basis using local anesthesia with IV sedation. In upper eyelid surgery, excess skin, muscle and fat are removed in a meticulous fashion. In lower lid surgery, sometimes only the bulging fat tissue is removed, or the skin and muscle may also need to be removed. Incisions are made in such a way as to hide them in the natural folds in the eyelids. Lower lid surgery is frequently done from the internal surface of the lids, the so-called "stitch less" blepharoplasty. Eyebrows that are too low can also be corrected by the oculoplastic surgeon.

After

Is eyelid surgery covered by insurance?
Some insurance plans will cover upper eyelid surgery if they can be convinced that there is a functional impairment caused by the droopy upper eyelid skin.

These impairments include:

Restricted upper field of vision
Symptoms of eyelid irritation attributed to the redundant eyelid skin
Eyelid skin laying on the eyelashes
Each insurer is different, and their response will vary patient to patient. Lower eyelid surgery is virtually never covered by insurance.

What are the latest treatment options for "crow's feet"?
Crow's feet, or wrinkles on the skin around the eyelids, can be successfully treated. Current techniques include chemical peels and laser treatment. Microdermabrasion is a newer but ineffective treatment for crow's feet. Chemical peels are unreliable and are not used by Dr. Passarelli any more for wrinkle treatment. The best treatment, in Dr. Passarelli's opinion is the CO2 laser or the Erbium - YAG laser to rid the face of wrinkles caused by aging or sun damage. The treatment is done in the office, using state of the art laser technology and is always completed in one session. Which laser is used depends on the skin type and the degree of wrinkling. Both the CO2 and Erbium - YAG lasers work to resurface the damaged skin and stimulate a tighter framework under the skin - the end result is fewer wrinkles and a better looking you!

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What is laser surgery for wrinkles?
The laser used for wrinkle removal is a highly sophisticated instrument which allows the physician to control the exfoliation process, by safely removing thin layers of skin.

Where can the laser be used?
The laser can be used for fine lines and wrinkles around the eyes and mouth. The deep laugh lines around mouth and the frown lines around the eyes can be softened. Even acne and some surgical scars can become softer.

What is the recovery time?
The laser procedure can take as little as ten minutes and patients can go home immediately after treatment. Some swelling may occur but the procedure is virtually painless. Treated areas require care to avoid crusting, and healing is nearly complete after one week. Initially there may be some redness which fades in a few weeks and can easily be camouflaged with makeup.

How do I care for my treated skin?
Dr. Passarelli will prescribe creams and skin treatments to keep the skin from drying. Sun protection is mandatory to avoid skin discoloration and further wrinkle formation.

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Can I have laser surgery to get rid of my glasses?
The answer really depends upon your particular vision problem.
Nearsightedness occurs when light is focused in front of the retina
Farsightedness arises when the light rays are focused behind the retina
Astigmatism is the result of having a cornea shaped like a football rather than a soccer ball, causing light to be focused on the multiple locations in the eye.
The excimer laser is a revolutionary new tool that can correct nearsightedness, farsightedness and astigmatism by reshaping the cornea.

What is LASIK and how does it work?
LASIK is an acronym that stands for Laser in-situ Keratomileusis, which means to shape the cornea, using a laser. Using an instrument called a microkeratome, a thin flap of corneal tissue is folded back. The excimer laser is then used to precisely remove a predetermined amount of tissue from the inner cornea to correct the nearsightedness, astigmatism, or farsightedness. The corneal flap is then repositioned without stitches, and the eye is then operated on.

Does LASIK hurt?
No. Because the cornea is treated with numbing drops, patients experience little if any discomfort during or after the procedure.

How long does it take for the vision to improve?
While results vary from patient to patient, most patients have markedly improved vision in one to three days. Full visual results are usually realized in one to four weeks.

Can I get 20/20 vision with LASIK?
While Dr. Passarelli guarantees you that he will do his very best to get you to 20/20, no one can guarantee that you will have perfect vision or that you will never need distance or reading glasses again. But virtually everyone experiences improved vision, and most people see well enough to pass a driver's test without glasses.

Are there any risks with LASIK?
Every surgical procedure, including LASIK, has some potential risk. Risks include over-correction, under-correction, corneal scarring and even loss of vision. Dr. Passarelli will gladly review all the risks and benefits of LASIK with you, and your visit is never over until all your questions have been answered.

Is LASIK covered under my healthy insurance plan?
LASIK is a refractive surgery and is considered "cosmetic" by most insurance carriers. It is not covered by health insurance.

How can I find out more about LASIK?
Please call Dr. Passarelli's office for a complimentary refractive surgery consultation. At that time, you will receive literature and a video about LASIK, and Dr. Passarelli will determine if you are a candidate for LASIK.

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FAQs

Frequently Asked Questions

Informative Facts Concerning Our Services

General Ophthalmology

About Oculoplastic Surgery

Laser Skin Resurfacing

Refractive Surgery