Other Services

Ophthalmic Surgery

In addition to small incision cataract surgery, Dr. Kassels performs:

• blepharoplasty surgery for dermatochalasis (droopy lids)

• entropion/ectropion (in-turned/ out-turned lids)
• eyelid skin cancer
• pterygium
• trabeculectomy and MIGS for glaucoma
• punctual plugs for dry eye
• a variety of minor procedures
• If your condition requires a sub-specialist Dr. Kassels can arrange a referral as appropriate.

Laser and other services

Laser treatment is available in the office including:

• -YAG Capsulotomy for capsule opacification after cataract surgery (PCO, secondary cataract, after-cataract).
• -Laser Iridectomy (PI)  or SLT (Lumenis Selectra) for glaucoma Argon laser for glaucoma.
• -Argon laser for localized retinal edema or retinal tears with referral to a retinal specialist when necessary or preferred.
• Referral for subspecialty ophthalmology procedures like retinal detachment, corneal transplant, DSEK/DSEAK/DMEK for Fuch's Corneal Dystrophy, LASIK* or PRK* for myopia and astigmatism, Nasolacrimal Duct Obstruction, strabismus, and advanced glaucoma surgery can be arranged.

*Note that cataract surgery routinely corrects nearsightedness or farsightedness AND is covered under your medical insurance. If you are considering vision correction surgery (PRK, LASIK, or EPI-LASIK) and have any degree of cataract, you might do well with standard cataract surgery alone. Save your glasses and medical records from before your refractive surgery (RK, PRK, and LASIK). Changes in your eye after refractive surgery introduce errors in IOL calculations for unavoidable eventual cataract surgery. The more pre-LASIK data we have, the more likely you can remain glasses free when, one day, you need cataract surgery. 

Diagnostic Examinations and Vision Exams

Our doctors perform complete medical eye examinations. We diagnose and manage conditions such as glaucoma, macular degeneration, cataract, amblyopia in children, dry eye and diabetic retinopathy. We provide routine vision care and contact lens evaluations and accept most vision care plans*. We offer work-in appointments for emergencies such as sudden vision loss, new floaters/flashes, red eye, trauma, or other acute problems. We are happy to provide a second opinion on any ocular condition to set you mind at ease. Tennessee River Eye Clinic now has an optical dispensary: TREC SPECS. Compare our products and pricing to other options in Florence, Muscle Shoals, Russellville, Sheffield, or Tuscumbia.

Refraction? Whats a refraction? Why do I need a refraction?

The refraction is the subjective glasses lens measurement ("which is better: 1 or better 2?") used to determine your glasses prescription. We cannot know the results of the refraction without performing the refraction. Performing the refraction does gaurantee that we will find an improvement in your vision with new glasses. Vision plans generally cover the refraction while medical insurance generally does not cover the refraction.  Theefraction is necessary to determine your Best Corrected Visual Acuity(BCVA). Although medical insurers reqiuire documentation of BCVA as part of evaluation of cataract and other medical eye problems, they still dont generally cover the refraction.

* Note that "vision care" plans are for glasses and contact lens exams, and include the refraction.  You will need a medical eye examination if your visoin evaluation reveals any significant problems. Your Vision plan will not cover examinatrion for red eye, infectiuon, pain or vision loss.

Ophthalmologist or Optometrist or Optician?

An Ophthalmologist is a Medical Doctor (MD or DO) who, after college, has completed 4 years of medical school followed by internship and residency in Ophthalmology and Ophthalmic surgery. Sub-specialists have performed an additional 1 to 4 years of sub-specialty fellowship training to further their skills in managing retina, glaucoma, cornea, or other ophthalmological conditions. A lot of things happen inside an eyeball! An Ophthalmologist will limit his/her medical and surgical practice to his/her training, skill level, and the needs of the patient population. Ophthalmologists can perform routine eye care as well.  Eye surgeons are ophthalmologists.

An Optometrist is a Doctor of Optometry who, after college, has completed 4 years of Optometry School. An Optometrist usually performs vision exams, refractions (glasses measurements), contact lens fittings, and disease diagnosis and management consistent with his/her level of training, and follow up after cataract surgery (co-management). Currently in Alabama, optometrists are licensed to manage some eye diseases and prescribe certain medications, but not to perform surgery or laser procedures.

An Optician is a trained professional who fits eyeglasses and, in conjunction with an Ophthalmologist or Optometrist, contact lenses.

Technology

Tennessee River Eye Clinic continually invests in new technology to Disease monitoring devices: We do not “shot gun” every new patient with every test. But, technology is invaluable for monitoring certain conditions and catching vision threatening disease at a treatable stage.Our technology includes:

• Zeiss Atlas 9000 Corneal Wavefront Topographer to quantify the visual effect of keratoconus, pterygium , and corneal nodules.  Corneal Wavefront measures of higher order aberrations important for multi-focal operative planning IOL planning

• Spectralis OCT scanning laser interferometer, by Heidelberg Engineering, for following glaucoma, macular degeneration, and diabetic retinopathy.

• Humphrey Visual Field Analyzer 3 for glaucoma, optic nerve problems, and patients taking Plaquenil/hydroxychloroquine.

• Zeiss IOLMaster 700 with the Barrett Suite of IOL calculation formulae uses laser interference biometry to measure the eye’s focal length to within one one-hundredth of a millimeter for the most predictable outcomes after cataract surgery, measures posterior corneal curvature for more accurate astigmatism measurements, and confirms alignment with foveal OCT.  All of these measurements take place in seconds.
 

Dry Eye Syndrome

When over the counter artificial tears are not enough, we offer:

• Restasis is a low dose immunosuppressant eye drop. With time, aqueous deficiency dry eye patients can produce more of their own natural tears. Restasis may take months to take effect, and will need to be continued indefinitely. But, it can restore your ability to make your own tears. Xiidra is another twice daily anti-inflammatory eye drop which can improve the symptoms of dry eye. Xiidra needs to be taken indefinitely.
• Occasionally "serum tears" will be prescribed for severe dry eye which has failed other treatments.

• Punctal plugs can be inserted in seconds and can last indefinitely. The plug is a small silicone stopper which keeps more of your own tears the eye surface longer.

• Permanent Punctal Occlusion can be performed when punctal plugs help, but do not stay in place.

• Treating the eyelids (meibomitis) can improve “evaporative” dry eye. In office treatments are becoming available for the treatment of evaporative dry eye. Currently, these treatments are not covered by insurance. At this time Tennessee River Eye Clinic does not offer office based meibomitis treatment.