Cataracts are a gradual and progressive clouding of the natural lens of the eye leading to blurred vision. Patients with cataracts note difficulty focusing, blurred vision for both reading and distance, and often experience glare symptoms. When daily activities are impaired because of these visual difficulties, cataract surgery is often advisable.


    Cataract surgery improves vision by replacing the clouded lens (cataract) with intraocular lens (IOL). Various lens implants can be employed to restore vision. Traditional lens implants restore vision to one distance, either distance or near. Patients will typically have an ongoing need for glasses for some activities. Those desiring more freedom from spectacles may opt for a “premium lens implant”. Such implants are not covered by Medicare or commercial insurance plans and cost will vary depending on which IOL technology is used. Your ophthalmologist will discuss the options available to you to optimize the results to fit your needs and lifestyle.


    The cornea is the clear, domed-shaped front surface of the eye. When its damaged from eye disease or an eye injury, it can become swollen or scarred and blur or distort vision. When this happens, and glasses or corrective lenses can’t restore vision, a cornea transplant may be necessary to replace the damaged tissue with grafted corneal tissue from a donor. A corneal transplant can restore vision, reduce pain and swelling, and improve the appearance of damaged or diseased eye tissue.

    There are two main types of cornea transplant surgeries: the traditional cornea transplant (known as penetrating keratoplasty, or PK) and back layer cornea transplant surgery (endothelial keratoplasty, or EK).

    With traditional corneal transplant surgery, a circular section of tissue is removed from the surface of the cornea. Donor tissue is then inserted and sutured into place, and a plastic shield is placed over the eye to protect it while the cornea heals.

    Endothelial keratoplasty is a newer procedure the selectively replaces only the innermost (back) later or the cornea and leaves the overlying tissue intact. The surgeon makes a tiny incision and places a thin disc of donor tissue containing a healthy endothelial cell layer on the back surface of your cornea. An air bubble is used to position the new endothelial layer into place. The smaller incision provides greater stability to the eye compared to a full thickness transplant.

    EK has several advantages over the more traditional PK procedure, including: faster recovery, less operating time, minimal removal of corneal tissue (and therefore less impact on the structural integrity of the eye and less susceptibility to injury), fewer sutures, and a reduced risk of astigmatism after surgery. However, traditional full-thickness PK is still the most appropriate option when the majority of your cornea is diseased or scarred.

    In each case, recovery can take a year or more following the procedure, and because the new corneal tissue won’t exactly match the natural curve of the existing tissue.


    It’s a fact of life that your eyesight changes as you get older. Sometimes vision can change significantly but this doesn’t have to compromise your lifestyle. To maintain healthy vision as you age, it is important to care for your eyes.

    Cokingtin Eye Center services include the diagnosis and treatment of eye diseases such as glaucoma, macular degeneration, cornea and external eye diseases, along with routine preventative eye care and specialty contact lens fittings.


    Glaucoma refers to a group of eye disorders that produce increased pressure called ocular hypertension within the eye caused by a backup of fluid in the eye. Over time, it causes damage to the optic nerve.

    Through early detection, diagnosis and treatment, you and your doctor can help to preserve your vision. There are various diagnostic tools which aid in determining whether or not you have glaucoma — even before you have any symptoms. Most treatments for glaucoma are designed to lower and/or control intraocular pressure (IOP), which can damage the optic nerve that transmits visual information to the brain.

    Glaucoma eye drops often are the first choice over glaucoma surgery and can be very effective at controlling IOP to prevent eye damage. If untreated or uncontrolled, glaucoma first causes peripheral vision loss and eventually can lead to blindness. Glaucoma is the second-leading cause of blindness in the U.S. (behind macular degeneration), and the second-leading cause of blindness worldwide (behind cataracts).


    Age-related macular degeneration, often called AMD or ARMD, is the leading cause of vision loss and blindness among Americans who are age 65 and older. AMD is degeneration of the macula, which is the part of the retina responsible for the sharp, central vision needed to read or drive. Because the macula primarily is affected in AMD, central vision loss may occur. Macular degeneration is diagnosed as either dry (non-neovascular) or wet (neovascular). Neovascular refers to growth of new blood vessels in an area, such as the macula, where they are not supposed to be.

    The dry form is more common than the wet form, with about 85 to 90 percent of AMD patients diagnosed with dry AMD. The wet form of the disease usually leads to more serious vision loss.


    Blepharoplasty is a surgical procedure that may be done to correct ptosis (sagging eyelids), remove fatty bulges around the eyes, and eliminate hanging skin from the eyelids. The procedure may be medically necessary when the sagging is blocking the field of vision. At times, it may be a cosmetic procedure.

    The results of eyelid surgery will appear gradually as swelling and bruising subside to reveal a smooth, better-defined eyelid and surrounding region, and a rejuvenated appearance. While there is usually little pain involved in this surgery, there can be swelling and bruising. Most patients will be comfortable appearing in public in 10 to 14 days, however, it takes a few months to fully heal.

    The results of your blepharoplasty will be permanent although you will continue to age naturally. Ongoing sun protection will help to maintain your results.