Nika Priest-Allen, MD
Dr. Priest-Allen is a Board Certified Ophthalmologist who grew up right here in Southwest Florida and graduated from Fort Myers High School! After attending Emory University in Atlanta, Georgia, Dr. Priest-Allen went on to receive her Doctor of Medicine Degree from the prestigious Drexel University College of Medicine in Philadelphia, Pennsylvania.
Subsequently, Dr. Priest-Allen completed her Ophthalmology Residency and trained specifically to become a Cataract Surgeon at the World-Renowned Kresge Eye Institute in Detroit, Michigan.
Dr. Priest-Allen then stayed at Kresge Eye Institute and completed a Glaucoma Fellowship in order to become a Specialized Expert in treating patients with Glaucoma. During Dr. Priest-Allen’s Glaucoma Fellowship, she learned the most advanced treatments and surgical techniques for treating patients with Glaucoma. She also participated in Pioneering Research that has lead to the development of effective, advanced treatment options for Glaucoma patients.
What is glaucoma?
Glaucoma is a disease of the optic nerve – the part of the eye that carries the images we see to the brain. The optic nerve is made up of many nerve fibers, like an electric cable containing numerous wires. When damage to optic nerve fibers occurs, blind spots develop. These blind spots usually go undetected until the optic nerve is significantly damaged. If the entire nerve is destroyed, blindness results.
Early detection and treatment by your doctor at Quigley Eye Specialists is the key to preventing optic nerve damage and blindness from glaucoma.
Glaucoma is a leading cause of blindness in the United States, especially for older people. But loss of sight from glaucoma can often be prevented with early treatment.
What causes glaucoma?
A clear liquid called the aqueous humor circulates inside the front portion of the eye. To maintain a healthy level of pressure within the eye, a small amount of this fluid is produced constantly while an equal amount flows out of the eye through a microscopic drainage system. (This liquid is not part of the tears on the outer surface of the eye).
Because the eye is a closed structure, if the drainage angle is blocked, the excess fluid cannot flow out of the eye. Fluid pressure within the eye increases, pushing against the optic nerve and causing damage.
What are the different types of glaucoma?
Chronic open-angle glaucoma – this is the most common form of glaucoma in the United States. The risk of developing chronic open-angle glaucoma increase with age. The drainage angle of the eye becomes less efficient over time and pressure within the eye gradually increases, which can damage the optic nerve. In some patients, the optic nerve becomes sensitive even to normal eye pressure and is at risk for damage. Treatment is necessary to prevent further vision loss.
Typically, open-angle glaucoma has no symptoms in its early stages and vision remains normal. As the optic nerve becomes more damaged, blank spots begin to appear in your field of vision. You typically won’t notice these blank spots in your day-to-day activities and these spots become progressively larger. If all the optic nerve fibers die, blindness results.
Closed-angle glaucoma – Some eyes are formed with the iris (the colored part of the eye) too close to the drainage angle. In these eyes, which are often small and farsighted, the iris can be sucked into the drainage angle and block it completely. Since the fluid cannot exit the eye, the pressure inside the eye builds rapidly and causes an acute closed-angle glaucoma attack.
- Symptoms may include:
- Blurred vision
- Severe eye pain
- Rainbow-colored halos around lights
- Nausea and vomiting
This is a true eye emergency. If you have any of these symptoms, call your ophthalmologist immediately. Unless this type if glaucoma is treated quickly, blindness can result. Unfortunately, two-third of those with closed-angle glaucoma develop it slowly without any symptoms prior to an attack.
Who is at risk for glaucoma?
Ophthalmologists considers many types of information to determine your risk for developing the disease.
The most important risk factors include:
- Elevated eye pressure
- Family history of glaucoma
- African or Spanish ancestry
- Farsightedness or nearsightedness
- Past eye injuries
- Thinner central corneal thickness
- Systemic health problems including diabetes, migraine headaches and poor circulation
Your doctor at Quigley Eye Specialists will weigh all of these factors before deciding whether you need treatment for glaucoma, or whether you should be monitored closely as a glaucoma suspect. This means your risk of developing glaucoma is higher than normal and you need to have regular examinations to detect the early signs of damage to the optic nerve.
How is glaucoma detected?
Regular eye examinations by your doctor at Quigley Eye Specialists are the best way to detect glaucoma. A glaucoma screening that checks only the pressure of the eye is not sufficient to determine if you have glaucoma. The only sure way to detect glaucoma is to have a complete eye examination.
During your glaucoma evaluation, your Quigley Eye Specialists Physician will:
- Measure your intraocular pressure (tonometry)
- Inspect the drainage angle of your eye (gonioscopy)
- Evaluate whether or not there is any optic nerve damage (ophthalmoscopy)
- Test the peripheral vision of each eye (visual field testing, or perimetry)
Photography of the optic nerve or other computerized imaging may be recommended. Some of these tested may not be necessary for everyone. These tests may need to be repeated on a regular basis to monitor any changes in your condition.
How is glaucoma treated?
As a rule, damage cause by glaucoma cannot be reversed. Eye drops, laser surgery, and surgery in the operating room are used to help prevent further damage. In some cases, oral medications may be prescribed.
With any type of glaucoma, periodic examinations are very important to prevent vision loss. Because glaucoma can progress without your knowledge, adjustments to your treatment may be necessary from time to time.
SLT Laser (Selective Laser Trabeculoplasty)
A recent advance in ophthalmology is the use of the SLT laser as a first line of defense and an alternative to eye drops in treating glaucoma. SLT laser has been clinically proven to treat glaucoma by safely and effectively reducing intraocular pressure in a brief office procedure that is covered by Medicare!
The SLT laser selectively targets and stimulates certain cells while preserving surrounding tissue. This produces a biological effect in an area of the eye called the trabecular meshwork which stimulates the body’s natural mechanisms to enhance fluid outflow and thereby reduce intra-ocular pressure.
Glaucoma can also be controlled with eye drops taken daily. These medications lower eye pressure, either by decreasing the amount of aqueous fluid produced within the eye, or by improving the flow through the drainage angle.
Never change or stop taking your medications without consulting your ophthalmologist. If you are about to run out of your medication, ask your doctor at Quigley Eye Specialists if you should have your prescription refilled.
Glaucoma medications can preserve your vision, but they may also produce side effects. You should call us at Quigley Eye Specialists if you think you might be experiencing side effects.
Some eye drops may cause:
- A stinging or itching sensation
- Red eyes or redness of the skin surrounding the eyes
- Changes in pulse and heartbeat
- Changes in energy level
- Changes in breathing (especially with asthma or emphysema)
- Dry mouth
- Changes in sense of taste
- Blurred vision
- Change in eye color
All medications can have side effects or can interact with other medications. Therefore, it is important that you make a list of the medications you take regularly and share this list with each doctor you see.
Laser surgery in addition to SLT laser
Laser surgery treatments other than the SLT laser may be recommended for different types of glaucoma. In open-angle glaucoma, the drain itself is treated. The laser is used to modify the drain (trabeculoplasty) to help control eye pressure. In closed-angle glaucoma, the laser creates a hole in the iris (iridotomy) to improve the flow of aqueous fluid to drain.
Surgery in the operating room
When surgery in the operating room is needed to treat glaucoma, Dr. Nika Priest-Allen at Quigley Eye Specialists uses fine microsurgical instruments to create a new drainage channel for the aqueous fluid to leave the eye. Also, modern glaucoma surgery can include the implantation of a small drainage device to improve the flow of aqueous fluid. Surgery is recommended if Dr. Priest-Allen feels it is necessary to prevent further damage to the optic nerve and glaucoma surgery is typically an outpatient procedure.
What is your part in treatment?
Treatment for glaucoma requires teamwork between you and your doctor. Your doctor at Quigley Eye Specialists can prescribe treatment for glaucoma but only you can make sure that you follow your doctor’s instructions.
Once you are taking medications for glaucoma, your doctor will want to see you more frequently. Typically, you can expect to visit your optometric physician or ophthalmologist at Quigley Eye Specialists every three to four months, however, this will vary depending on your treatment needs.
In your parents or grandparents day cataract surgery was considered risky, required a lengthy hospital stay and was usually postponed for as long as possible.
Today, at Quigley Eye Specialists, cataract surgery is performed as an outpatient procedure and takes only minutes. After cataract surgery, patients can go home to rest in comfort, and avoid the inconvenience and expense of staying in a hospital.
Over fifty percent of people over the age of 60, and quite a few younger than that, suffer from cataracts. In fact, cataracts are so common, it is said that everyone will develop a cataract if they live long enough.
A cataract is a progressive clouding of the eye’s natural lens that interferes with light passing through to the retina. Sufferers usually describe the condition as being similar to looking through a waterfall, or a piece of wax paper, with a gradual blurring or dimming of vision.
Reading may become more difficult and driving a car can actually become dangerous. Cataract sufferers may also be troubled by a bothersome glare, halos around the lights, or even double vision. And, as the cataract becomes worse, frequent changes in eyeglass prescriptions become progressively less helpful and, of course, more costly.
Currently, there is no medical treatment to reverse or prevent the development of cataracts. Once they form, there is only one way to achieve clear vision again, and that is to physically remove the cataract from inside the eye and replace it with an artificial intraocular lens (IOL).
Advances in Cataract Surgery at Quigley Eye Specialists – SmartLenses®
There have been many advances in cataract surgery techniques and IOL technology in recent years. With over one million cataract surgery procedures performed each year, many patients now experience a quality of vision that is even better than before they developed cataracts.
This is particularly true for our patients who choose Quigley Eye Specialists' SmartLenses®. Our SmartLens® is a special multi-focal IOL technology that may allow you to see at distance, up-close and in-between without the need for eye glasses.
Dr. Priest-Allen will remove your cataract with an advanced technique called phacoemulsification or small-incision cataract surgery. Most people only require topical, "eye-drop" anesthesia. After the eye is completely numbed, Dr. Priest-Allen will make a self-sealing incision of only one eighth of an inch in the sclera (the white part of the eye), or in the clear cornea (just about the area where the cornea meets the sclera).
Next, Dr. Priest-Allen will use a phaco-emulsifier to reduce the cataract into microscopic particles using high-energy sound waves and then she will gently suction them from the eye. To compensate for the removal of the eye’s natural lens, an intraocular lens (IOL) such as one of our SmartLenses® is implanted into the “capsular bag”, the same thin tissue that held your natural lens. Once the new intraocular lens is positioned by Dr. Priest-Allen, the eye remains tightly sealed by the natural outward pressure within your eye.
The combination of Dr. Priest-Allen’s extensive training in cataract surgery and her fellowship training in glaucoma make her uniquely situated to treat glaucoma patients who have developed cataracts.
Correction of your Astigmatism
About one in six people in the US have astigmatism which means that the eye is not perfectly round and therefore, one must wear glasses. However, our Cataract Surgeons at Quigley Eye Specialists are able to correct astigmatism with our special SmartLenses, called toric IOL’s, or through a special surgical technique during cataract surgery. This is good news for our patients with astigmatism because its correction opens up the possibility of being less dependent on glasses for everyday activities.
Benefits of Self-Sealing Procedures and Topical Anesthesia
Topical anesthesia and self-sealing incisions have taken cataract surgery to a new level of comfort for our patiensts and many of them are able to see with clear vision much sooner after the surgery. In most cases, it is now possible to return to daily activities, such as driving and reading, almost immediately. With "eye-drop" anesthesia, there is no need for a painful needle injection which delays vision restoration and could cause temporary swelling and skin discoloration.
The Choice Is Yours
It can take months or years for a cataract to fully develop. How do you know when its time to have a cataract removed? The answer is quite simple. The time to have your cataract removed is when you believe your quality of life would be better if you could see better. Only you can decide when it’s time to open your eyes to a brighter, clearer world. And when it is time, come see Dr. Priest-Allen and her team and let them take great care of you!