Ophthalmology Services

Eye exams are important whether or not you are experiencing problems. Many issues can go unnoticed and escalate over time. Click here for 

more information on our eye exams.

Diabetic eye disease is an umbrella term for a variety of eye conditions that can affect individuals that are either prediabetic or have type one or type two diabetes. These conditions, such as diabetic retinopathy, diabetic macular edema, or glaucoma, can cause significant damage to the structures in the back of the eye leading to vision loss.

More information to follow.

Dry eyes is a condition that can be caused by a number of reasons including, but not limited to: 1) poor quality tears; 2) not producing enough tears / tears that evaporate away too quickly; 3) improper drainage of the tears; 4) or poor position of the eyelids. Certain medications and allergies may also contribute to dry eye symptoms. While dry eye symptoms, including itchy, watering, and gritty feeling eyes may seem relatively benign, dry eye can drastically affect your vision. Individuals may also notice that things aren’t as clear as they used to be, or are clear only for a few moments after a few blinks. Since there are many causes for dry eyes, is important to talk to your eye doctor about your dry eyes or dry eye symptoms.

In our dry eye accredited office, we utilize a variety of tests to assess tear functionality and quality, which include, but are not limited to: 1) visualizing your tearfilm with a microscope; 2) analyzing the osmolarity (i.e. tear film quality) of your tears using next generation microfluidic analyses with the tearlab tear osmolarity system; 3) Visualizing the meibomian glands which secrete oil to prevent your tears from evaporating away with the Meibox infrared Meibomian Gland imaging system . These quantitative data and specialty imaging systems, in conjunction with our comprehensive eye exam, allows our physicians to determine the course of treatment best tailored for you. If you are experiencing dry eye, call us today to schedule an appointment.

LASIK

We are proud to announce that Dr. Lemanski is the first and currently only independent physician in the Capital Region certified to use a bladeless laser system for superior surgical outcomes. For more information on LASIK surgery, please click here or call us today!

PRK

Photorefractive Keratectomy (PRK), like LASIK, is a type of refractive surgery for the correction of myopia (nearsightedness), hyperopia (farsightedness) and astigmatism. Like LASIK, the procedure is bladeless but utilizes only one laser to treat your glasses prescription. No corneal flap is made. As such, PRK may be a better option over LASIK for a patient with thin corneas, past corneal issues (e.g. scars), dry eyes, or individuals who participate in contact sports. However, because no flap is made, recovery time is longer and patients will need to wear a bandage contact lens for one week.

ICL

Not all patients are candidates for laser vision correction (LASIK and PRK). If the corneas are too thin, if the refractive error is too high to safely preform an ablative procedure, if the patient has very large pupils or very dry eye, or if the patient has a systemic disease that interferes with corneal healing, an implantable contact lens can be a way that a patient can achieve a glasses and contact lens independent lifestyle. The implantable collamer lens (ICL), or, implantable contact lens, as it has come to be known, is an intraocular lens that is implanted inside the eye, behind the iris and in front of the natural crystalline lens.  For patients with high refractive errors, ICL can provide higher quality vision compared to laser ablative procedures, and does not make the cornea thinner. The ICL is FDA approved for nearsighted patients with -3.00 to -20.00 D of refractive error, from ages 21-45 years old. The ICL is not for everyone, but your ophthalmologist can tell you if you are a candidate. Ask your doctor if the implantable collamer lens is right for you.

An astigmatism correcting ICL is not yet available in the USA. For patients who require astigmatism correction, there is the option to perform a laser ablative procedure in addition to the ICL.

Your Options

At your consultation, Dr. Cheng and Dr. Lemanski will do a full eye exam and discuss your options with you so that you can make the best decision for your eyes. Whether it is 1 day after, 6 weeks after or 6 years after, your LASIK doctor will be the one to provide you with ophthalmic care.

Schedule a complimentary consultation to see if either LASIK, PRK  or ICLs are the right surgery for your situation.

Cataracts are a condition when the natural clear lens in the eye begins to physically change into a cloudy lens. In the early stages of cataracts, this clouding of the natural lens scatters light that enters the eye resulting in glare, especially at nighttime while driving. Patients may also notice frequent changes in the prescription of their glasses and colors may appear faded. As the condition progresses, cataracts grow in size and increase in hardness, resulting in impaired vision that is generally not correctable with glasses. In some instances, the cataracts may grow so large that they push on the drainage structures of the eye, putting patients at an increased risk for Glaucoma.

In cataract surgery, the large cloudy lens is removed by hand with a small handheld device and is replaced with an artificial lens that restores light to the back of the eye. There are many different types of artificial lenses and surgical procedures that can be used depending on what the patient is looking to get from their cataract surgery and what the patient is a surgical candidate for (determined at your pre-operative evaluation).

Please visit our cataract surgery page for more information on the procedures we offer to combat cataracts and call us to schedule an appointment today!

Many patients suffer from drooping upper lids and puffy bags under their eyes. Whether its inherited or caused by aging, these extra areas of skin can interfere with your vision, preventing you from seeing things as well as you could, in addition to making you looking older and more tired. Additionally you may be surprised to learn that a brow lift may be the better solution as opposed to an eyelid surgery.

Should you be interested in a lid lift or a brow lift, ask your doctor at your next eye exam. Our doctors will examine you to determine the cause of your drooping lids and then come up with the best treatment plan for you. Your surgeon will also help you decide whether a brow lift, a lid lift, or a combination of both is the right solution for you.

Please call our office for more information or to schedule an appointment.

Cosmetics: Pelleve Skin Tightening, Botox / Xeomin Injections, Juvederm, and Alphaeon Teoxane

Not only should you see your best but you should look and feel your best. At our office, we have a wide variety of cosmetic treatment options to consider to meet your needs and your budget.

Pelleve Skin Tightening

The Pelleve device delivers precise, radiofrequency energy to the skin in order to diminish the appearance of fine lines and wrinkles. This energy gently heats the lower levels of the skin, stimulating collagen growth. Because your own collagen is stimulated, the result is a more natural look. Pelleve is a great option on its own, or as a compliment to Botox and/or fillers.

Pelleve treatments are usually done over the course of three sessions. Patients typically notice improvement in skin tone within a few weeks. In most cases, treatments last for 7-10 months, allowing you to enjoy more time doing the things you like versus receiving continuous treatments. Pelleve on its own will not resolve very deep wrinkles. In these instances, a combination of Pelleve plus a filler or a Botox / Xeromin supplement is recommended.

As the Capital Region’s only physicians with a Pelleve skin tightening system, we are proud to have Dr. Cheng and Dr. Lemanski offer this unique technology to our patients.

Botox / Xeomin Injections

For patients that have a significant degree of wrinkles, Botox or Xeomin injections may be a good option. In addition to being used for patients with blepharospam, Botox and Xeomin injections are used for to decrease the appearance of moderate to severe lines between the eyebrows and on the face. These medications work by blocking nerve activity in specific facial muscles, causing a temporary reduction in muscle activity. Results typically last three months and, with small and precisely delivered doses, a natural look is achieved.

Juvederm

This area under construction.

Alphaeon

This is a line of products developed by physicians that compliment the medical treatments that are offered. It is also an option for those who do not wish to have injections or procedures, or for those who wish to do a little more at home to compliment their in office treatments.

Please call our office for more information or to schedule an appointment.

While most have come to known Botox and Xeomin for its use in cosmetics, both compounds are FDA approved for individuals with Blephrospasm, also known as uncontrollable blinking. For these individuals, the use of Botox and / or Xeomin reduces or eliminates debilitating lid spasms and restores the quality of life that one should expect from their vision. As Blepharospasms are a medical problem, the treatment is covered by your medical insurance. If you or someone you know suffer from lid spasms, ask your doctor about Botox or Xeomin.

Glaucoma is a progressive condition that causes damage to your eye’s optic nerve, leading to vision loss. The optic nerve transfers visual information from your eye to your brain. However, pressure in the eye, known as intraocular pressure, can rise to a point that it damages this nerve. Without any intervention, damage to the nerve can become greater as time progress, leading to vision loss and eventual blindness. There are many different types of glaucoma; some are inherited, some are characterized by higher eye pressure, and other by “normal” pressure. Some glaucoma’s occur quickly while others occur slowly.

To understand how a patient’s glaucoma may progress, our practice uses a combination of the results of your routine eye exam, highly advanced automated perimetry analysis, ultra widefield retinal photography, and computerized imaging devices. Jointly, these data can be statistically analyzed and can be used to detect and treat glaucoma, far in advance of vision loss. Regardless of the type of glaucoma, the general mainstay of glaucoma treatment involves lowering the pressure inside of the eye.

Eye drops, pills by mouth, laser procedures, stents, traditional glaucoma surgeries or a combination of these methods can be used to accomplish these goals. If your family member has been diagnosed with glaucoma you may be watched more closely by doctors for the same condition. If detected early, and managed appropriately, people with glaucoma may retain good functional vision for the duration of their lives. If you have been diagnosed with glaucoma, contact us today to discuss treatments and surgical options aimed at preserving your vision.

Keratoconus occurs when the cornea thins and cannot hold its round shape and bulges outward like a cone. This causes decreased vision and can sometimes even be painful. Keratoconus is frequently hereditary and symptoms can begin in teenage years and progress until about age 40. In less severe forms of keratoconus, eyeglasses, or soft or hard contact lenses may improve vision. If the disease progresses these options may no longer provide adequate vision correction. Because there are a few other corneal conditions that are similar to keratoconus, we utilize gold standard imaging devices that allow your doctor to precisely image and examine your cornea to aid in the diagnosis of keratoconus and other ectatic disorders of the cornea. We offer in house glasses and contact lens fitting, hybrid and scleral contact lenses. Click here for more information!

For patient whose vision has stabilized, corneal inlays (Intacs) may be an option. For patients whose disease progresses to the point where they have pain or they have lost usable vision, we offer cornea transplant surgery and corneal crosslinking.

Cornea transplant is a procedure that replaces the cornea with tissue from a donor. Options include both penetrating keratoplasty (PKP), where all five layers of the cornea are replaced, and deep anterior lamellar keratoplasty (DALK), where the top four layers are replaced and the patients own endothelial cell layer is left in place.

Corneal crosslinking, approved by the FDA in April of 2016, is an in office procedure that utilizes ultraviolet light and a riboflavin based eye drop to strengthen the thinning cornea in attempt to stop the progression of keratoconus and ultimately avoid corneal transplant surgery. It is thought that corneal crosslinking crosslinks the collagen fibers that make up the cornea. In FDA trials, crosslinking halted the progression of keratoconus and allowed patients to continue having good vision with their glasses and contact lenses. In select cases, some patients even had regression of their keratoconus to a small degree.

Corneal crosslinking has been available outside the United States for 10 years. Since its implementation significantly fewer corneal transplants have been preformed. In the Netherlands, for example, there were 25% fewer corneal transplants performed in this population of patients in a 3 year period following the introduction of crosslinking (1).

Dr. Lemanski and Dr. Cheng are proud to offer Epithelial-Off Corneal Crosslinking to their patients at the Capital Region’s only designated Center of Excellence, one of three in the North East. Epithelial-Off Corneal Crosslinking is currently the only FDA approved corneal crosslinking treatment available in the US.

Please call our office for more information or to schedule an appointment.

A corneal transplant is a surgical procedure in which part or all of the cornea is replaced with tissue from a donor. View our corneal transplant page for mor information or give us a call today.