It looks like hot lava flowing from a cavernous volcano, rivers of it sweeping through valleys, flames shooting from a central red-hot core.
Actually, though, it's an eye. More specifically, it's the optic nerve leading from the eye to the brain. It's one-and-a-half millimeters of it magnified about a gazillion times on a computer screen at Hood River's Cascade Eye Center.
The detailed image is used to detect miniscule changes in the nerve that indicate the onset of glaucoma, the leading cause of blindness in the United States. Glaucoma occurs when tiny fibers in the optic nerve are destroyed. It often goes undetected in its early stages because there is no pain, and vision loss happens only after the disease has progressed. There's no cure for glaucoma, but it can be treated and controlled to minimize vision loss.
"The big thing with glaucoma is changes that happen over time," said Dr. John Willer, an ophthalmologist at the center. "If we can catch it before the changes happen, we can treat it more successfully." Willer gets the detailed images with a device called a confocal scanning laser opthalmoscope, one of several high tech machines Willer and his partners at Cascade, optometrists Mitch Martin and Chris Barbour, use in their comprehensive eye care practice.
Cascade Eye Center was born out of a merger between an existing clinic and Martin and Barbour's clinic, called Summit View Eyecare. The two optometrists landed in Hood River in 1997 after completing their residencies at Portland's Veteran's Administration Hospital.
"We knew we wanted to stay in Oregon," Barbour said. They literally drove around the state looking for a community where they could establish an eye care clinic -- and raise their families. At the time, Hood River native Sab Akiyama was retiring and looking to sell his 37-year-old optometry practice. The trio met and they clicked, and within a few months Martin and Barbour found themselves in practice in Hood River.
Apprehensive, at first, to be taking over Akiyama's well-established clinic, Martin and Barbour soon found that the community was willing to give the new doctors a try.
"The town was very responsive," Martin said. "We kind of experienced this phenomenon of, `Well, let's try these new kids out.'"
They set out to make their clinic the most comprehensive one around. With the addition of Willer last year (who came on board after a previous ophthalmologist moved away) they've done just that. The clinic offers everything from the latest in glasses frames to laser corrective surgery.
The latter is a new addition to Cascade Eye Center. Beginning this month, a cornea specialist from Oregon Health & Science University Hospital in Portland will come to the clinic once a month to conduct seminars for the public on corrective laser surgery options. He'll schedule another day there to perform laser surgeries.
Other surgeries performed at the clinic include cataracts surgery -- Willer's specialty. Cataracts occurs when the normally clear lens on the eye becomes cloudy; it's a normal part of the aging process, Willer said.
"I tell people a lot of times every day that there are four sure things," he said. "Death, taxes, bifocals and cataracts." Once a leading cause of blindness, cataracts now can be successfully treated through surgery. Willer is able to perform the latest "no-stitch" cataracts surgery on more than 80 percent of his patients. The surgery involves a three millimeter incision and takes about 15 minutes.
"(Patients) go home that day and you wouldn't even know they had surgery," he said.
Another recent addition to Cascade Eye Center is a low vision clinic, headed by Barbour. Funded partly through a grant from the Lions Club, the low vision clinic provides testing and vision aids for people who are vision impaired.
"We provide options for people to help them use their remaining vision more effectively," Barbour said. He works with patients to determine what tasks they'd like to be able to do, then recommends one of dozens of possible aid devices, ranging from specialty magnifiers to closed circuit TV -- what he calls "the Porsche in low vision."
"A lot of people don't realize that you can be legally blind and still read, watch TV and do other things," he said.
Along with treating eye problems, Barbour and his partners try to educate patients on preventing eye disorders.
"Everybody's going to get cataracts," Barbour said, "but you can help reduce the aggressive nature of some diseases." There's recent evidence, for example, that certain anti-oxidants help reduce the incidence of macular degeneration, an age-related vision problem, so Barbour discusses with patients certain nutritional supplements that might help ward off eye problems down the road.
Cascade's doctors rely on their staff of opticians to help with education, as well. Jessie Page, optical manager at the clinic, is particularly concerned with sun damage to eyes.
"We're really trying to educate the public about the importance of sunglasses, and prescription sunglasses," she said.
In the meantime, Barbour and his partners will continue to study eyes, both directly and on computer screens, and use the latest technology to help their patients see clearly.
"Our goal is to provide total eye care under one roof," Barbour said.
Cascade Eye Center is located at 2025 Cascade Ave. Their phone number is 386-2402.
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