Keep Glaucoma, Cataracts In Check
Dr. William Wong
Ophthalmologist at Eye Surgery Center of Hawaii and Hawaii Vision Clinic
Where did you receive your schooling/training?
I did my undergraduate studies at Santa Clara University and medical school at Jefferson Medical College in Philadelphia. Ophthalmology residency training was with the U.S. Army in San Antonio, Texas.
How long have you been in practice?
What is your area of expertise?
As a comprehensive ophthalmologist, my main focus is cataracts and refractive surgery. We now have the Catalys laser, which is not only a technological advancement in routine cataract surgery, but at Eye Surgery Center we are exploring new uses of the laser for non-routine cataract patients. We are finding new ways to treat patients with advanced eye disease, prior surgery, trauma, genetic eye conditions, concurrent eye problems that need cataract surgery, and make it less risky, with fewer complications and better outcomes. We can now confidently treat certain conditions that were previously rather precarious. I also treat eye conditions like glaucoma and diabetic eye disease. I do LASIK and an implantable contact lens. There are only two doctors here on Oahu who do that. For folks who want to correct their vision but are not LASIK candidates, they may qualify for the implantable contact lens.
Are eye diseases most commonly age related?
Many eye conditions are age related. Conditions like diabetes and high blood pressure also affect your eyes. As people get older they need more eye care to monitor vision and possible glaucoma. Vision starts to change and people come in more often in their 40s. At around 60 to 70, cataracts start forming. If you have glaucoma, which is increased eye pressure, we start treating that as early as possible. It’s one of those painless, slowly progressive conditions that people don’t realize is happening until it’s too late. It makes good sense to have your eyes checked at least once a year when you hit 40.
How does glaucoma damage the eye?
The eyeball is round and full of fluid with pressure, that’s how it maintains its shape. If the pressure is too high, the nerve and retina inside the eye will get damaged. It’s usually a painless condition that slowly steals vision away, usually starting out in the periphery, and it slowly constricts your field of vision until all that’s left is maybe a little bit in the middle. That’s when people start noticing, “I’m not driving very well. I can’t see things,” and by then it’s too late because you can’t get the vision back.
What treatment do you offer for glaucoma?
Because the pressure is high, we need to lower the pressure. Usually eye drops are the easiest way to do that in the beginning. If people have a problem with eye drops, or the drops stop working, I use lasers or the new iStent minimally invasive glaucoma implant at the same time as cataract surgery.
Does Hawaii’s constant sunshine damage people’s eyes faster?
There is a strong correlation between ultraviolet light exposure and cataract formation in people who are in tropical areas. They tend to get cataracts faster, earlier and more advanced. It does make the surgery a little bit harder if you wait too long and the cataract gets too hard. Then the procedure can be a little trickier.
What does it take to remove a cataract?
Like a camera, your eye has a lens, and the retina which is the film. When light comes in, the lens will focus it on the film to have a good picture. With a cataract, the lens gets cloudy and dark. The only way to improve the vision is to take that out. Without any shots or stitches, I enter the eye, remove the cloudy lens, and insert a lens implant back into its natural position. We can choose the type of implant according to how you want your vision to be. In the past, it was a vision restoration process, but now it has evolved to a vision improvement process, where we can reduce the need for glasses, correct astigmatism, and instead of wearing bifocals, you can have a multifocal lens in your eye.
What eye issues do diabetics face?
Especially in Hawaii where there’s a very high incidence of uncontrolled diabetes, it is a challenge to preserve people’s vision. When your blood sugar level is uncontrolled, over time you will develop hemorrhages in the eye, and abnormal blood vessels that can progress to swelling and eventually severe bleeding where the whole eye will fill with blood. Eventually retinal detachments and other problems with the retina make it a vision salvage procedure, and a lot of people end up going blind because of that. It’s important to control your sugars because at a certain point the damage in the eye is not reversible. It’s the same with your fingers, toes, kidneys – if you don’t control your sugars and take care of your body, you lose them. People end up on dialysis and have amputations.
Anything you’d like to add?
ESCH was started by a group of independent ophthalmologists with the common goal of creating a pleasant environment for people to have eye surgery without having to feel threatened or nervous. We offer a superior experience to a hospital. We have better equipment, pleasant staff, lower costs and less time involved to have a surgery done. For cataract surgery in a hospital, someone can spend four to five hours to get one eye done and they may end up, even with insurance, having to pay $300 or $400 as co-payment. Comparatively, at ESCH they are here for about two hours and their co-payment is usually about half that price.
We are a specialty center, so we have the latest and most-advanced equipment. We’re on par with some of the major academic centers on the West Coast, like Stanford and UCLA. In fact, we might be more advanced. Our secondary goal was to create a place where other eye doctors can operate. We offer open access for them to come and utilize the center, because the equipment is better and with our specifically trained staff there’s less chance of mistakes. Doctors tend to like it and patients appreciate it.