The Humphrey Field Analyzer - Identifying Peripheral Vision Issues

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Serving patients across the Rockville, Maryland region, Dr. Anthony Roberts performs Lasik surgical procedures and utilizes a personalized approach to eye and vision care. To this end, Dr. Anthony Roberts’ team at Shady Grove Ophthalmology conduct glaucoma exams using advanced technologies such as the Humphrey Field Analyzer (HFA). Eye care providers use HFAs to perform a visual field test that helps detect peripheral and central vision issues, which can manifest as a result of glaucoma, brain tumors, strokes, or neurological deficits. Field of vision testing supplements optic nerve examinations, intraocular pressure measurements, and other procedures involved with glaucoma diagnosis and care, making it an important tool for treating the condition. During a HFA exam, an ophthalmologist asks the patient to focus on a central target directly ahead of them and uses the analyzer to present a point of light. The patient presses a button when the light comes into their peripheral vision. After statistically analyzing the responses and comparing them against the normal baseline, the HFA generates a detailed printout that outlines the patient’s visual field and enables the ophthalmologist to identify peripheral vision blind spots.

Health & Medicine

Serving patients across the Rockville, Maryland region, Dr. Anthony
Roberts performs Lasik surgical procedures and utilizes a personalized
approach to eye and vision care. To this end, Dr. Anthony Roberts’ team
at Shady Grove Ophthalmology conduct glaucoma exams using advanced
technologies such as the Humphrey Field Analyzer (HFA).

Eye care providers use HFAs to perform a visual field test that helps
detect peripheral and central vision issues, which can manifest as a result
of glaucoma, brain tumors, strokes, or neurological deficits. Field of
vision testing supplements optic nerve examinations, intraocular
pressure measurements, and other procedures involved with glaucoma
diagnosis and care, making it an important tool for treating the
condition.

During a HFA exam, an ophthalmologist asks the patient to focus on a
central target directly ahead of them and uses the analyzer to present a
point of light. The patient presses a button when the light comes into
their peripheral vision. After statistically analyzing the responses and
comparing them against the normal baseline, the HFA generates a
detailed printout that outlines the patient’s visual field and enables the
ophthalmologist to identify peripheral vision blind spots.

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Optometry is a health care profession that involves examining the eyes and applicable visual systems for defects or abnormalities as well as the correction of refractive error with glasses or contact lenses and treatment of eye diseases. Definition of optometry and optometrist The World Council of Optometry, World Health Organization and about 75 optometry organisations from over 40 countries have all over the world adopted the following definition, to be used to describe optometry and optometrist. Optometry is a healthcare profession that is autonomous, educated, and regulated (licensed/registered). Optometrists are the primary healthcare practitioners of the eye and visual system who provide comprehensive eye and vision care, which includes refraction and dispensing, detection/diagnosis and management of disease in the eye, and the rehabilitation of conditions of the visual system. Competencies • refractive error, • ocular disease management, • medical therapeutics, • binocular vision, • sports vision, • vision therapy, • contact lenses Laws of optometry Currently, optometrists can… 1. Prescribe Schedule II (hydrocodone products only), III, IV, and V narcotics (including oral antivirals, oral steroids, etc) 2. Order imaging, such as MRIs, CT scans, and x-rays 3. Remove foreign bodies 4. Perform post-operative care after 90 days with referral from a physician 5. Treat glaucoma with topicals and orals 6. Treat anterior uveitis 7. Perform dilation and irrigation 8. Perform scraping, debridement, or removal of corneal epithelium 9. Deliver injections limited to anaphylaxis Optometrists cannot… 1. Perform surgical procedures (Any procedure that involves mechanical or laser means to cut, alter, or infiltrate human tissue is included here. This restriction includes refractive surgery, any laser procedure, or chalazia removal/eyelid or conjunctival cyst lancing procedures, to name a few) (Colorado is one of a few states with verbage to explicitly exclude surgery-most statutes maintain that the license to practice optometry does not include the right to practice medicine) 2. Deliver injectables, except for in the case of anaphylaxis 3. Treat posterior uveitis 4. Prescribe Schedule I or II narcotics Acts of optometry 1. Health Professions Procedural Code The Health Professions Procedural Code shall be deemed to be part of this Act. Definitions  “College” means the College of Optometrists of Ontario; (“Ordre”)  “Health Professions Procedural Code” means the Health Professions Procedural Code set out in Schedule 2 to the Regulated Health Professions Act, 1991; (“Code des professions de la santé”)  “member” means a member of the College; (“membre”)  “profession” means the profession of optometry; (“profession”).

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Dr. Anthony Roberts founded Shady Grove Ophthalmology in 1996 and has since attended to over 81,000 Lasik and other refractive procedures. A career ophthalmologist, one of the primary vision acuity tools Dr. Anthony Roberts uses is the Snellen chart. Various charts exist for the initial eye test at a doctor’s visit, with different visual aids such as patterns, images, and letters to determine visual acuity depending on the patient's age and familiarity with the Latin alphabet. However, most ophthalmologists use the Snellen chart for those adept at reading due to standardization across eye care providers and opticians, ease of use, and a well-defined visual acuity grading determination model. Developed by Dr. Hermann Snellen in the 1860s, the chart contains 11 rows of capital letters. The first line has one large letter, with the successive rows gradually increasing the number of letters but reducing the size. During this evaluation, one must stand 20 feet (six meters) from the chart and attempt to read while closing one eye, without any visual aid. The assessment is over when the line can no longer be discerned. Normal vision falls at 20/20—6/6 for metric system countries—which means the Snellen chart can be read correctly and efficiently, typically up to the eighth line, from 20 feet away without corrective aids. However, this does not imply perfect vision, as 20/15 people have sharper vision and can decipher letters from 20 feet away that the 20/20 group can only see at 15 feet. Conversely, an increase in the second number proportionately implies worsening visual acuity. A 20/40 classification means that a person can correctly read the chart at 40 feet whereas a person with 20/20 vision can see it at 20 feet. In most states, a individual can fall into the legally blind category if your number is 20/200 and above. The Snellen chart is useful in determining the corrective aids required as well as eligibility for some tasks, including driving, the armed forces entry, and factory jobs qualifications.

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Dr. Anthony Roberts is the founder and ophthalmologist-in-chief of Shady Grove Ophthalmology, an established eye care clinic in Rockville, Maryland. Together with his team at Shady Grove, Dr. Anthony Roberts has performed over 81,000 refractive eye surgeries, including cataract extraction and laser in-situ keratomileusis (LASIK). Refractive eye surgery, also known as laser eye surgery, is a procedure for correcting farsightedness, nearsightedness, and astigmatism. This procedure corrects the refractive state of the eye and leads to improved vision. People who had refractive eye surgery should rarely have to use contact lenses or eye glasses. There are several types of refractive eye surgeries, the most common are LASIK and photorefractive keratectomy. Both these surgeries use lasers to reshape the cornea, the clear outer layer at the front of the eye which functions by focusing light for vision. Since the US Food and Drug Administration approved LASIK in 1999, over 18 million Americans have undergone this surgery to treat nearsightedness, farsightedness, and astigmatism. Over 700,000 LASIK surgeries are performed each year. Other types of refractive eye surgery include refractive lens exchange, presbyopic lens exchange, and Limbal Relaxing Incisions.

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An ophthalmologist with more than three decades of experience, Dr. Anthony Roberts is the founder and practicing eye physician at Shady Grove Ophthalmology in Rockville, Maryland. Dr. Anthony Roberts has significant refractive surgical experience with numerous refractive procedures including LASIK, and provides medical and surgical treatment and care for various eye diseases such as glaucoma, corneal disease, and diabetic retinopathy. An eye defect that can result in vision loss or blindness if severe, diabetic retinopathy can affect any diabetic patient whose eye(s) have been significantly compromised by the systemic nature of diabetes. Currently, it is the leading cause of vision loss in people with diabetes. Diabetic retinopathy occurs when blood vessels disrupt the light-sensitive tissue layer called the retina at the back of the eye. While the condition is usually asymptomatic at the early stage, some people may occasionally experience difficulty seeing faraway objects or when reading. Generally, a comprehensive dilated eye examination is recommended for all persons with diabetes at least once each year. Since the condition is often asymptomatic, an eye test can rule out early signs of the disease or lead to earlier treatment when detected to avoid long-standing complications. Tailored and effective treatment for diabetic retinopathy is a retinal laser therapy called photocoagulation, a painless surgical procedure that removes hard exudates that are impairing the retinal layer.

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Certified in wavelength laser surgery, Dr. Anthony Roberts is the founder of Shady Grove Ophthalmology in Rockville, Maryland, a private practice that he opened in 1996. Proficient in the LASIK surgery technique, Dr. Anthony Roberts has extensive experience in performing all types of refractive surgeries. RLE, also called refractive lensectomy or clear lens exchange, is a surgical procedure where a natural lens of the eye is replaced with an artificial intraocular lens (IOL). Similar to how cataract surgery is performed, the procedure differs in that cataract is not the condition being treated. RLE has helped millions of people to correct eye problems (such as farsightedness and presbyopia) without having to wear corrective lenses. Although the surgery sounds very involved, RLE typically takes 15 minutes per eye. Depending on specific patient need, the best IOL option varies and ophthalmologists help patients figure out what's best during consultation. When undergoing RLE, any of the three lenses can be used: Monofocal IOL: The most basic of IOL options, the monofocal lens provides clear vision from a single angle — near, far, or intermediate. Multifocal IOL: A premium, multifocal lens corrects vision across multiple distances at fixed references. Accommodating IOL: The most advanced, accommodating IOL provides normal clear vision across all distances.

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The recipient of an MD from the University of Maryland school of medicine in Baltimore, Dr. Anthony Roberts is an eye physician and the founder of Shady Grove Ophthalmology. Dr. Anthony Roberts has experience performing refractive surgeries like LASIK and surgically treating eye diseases with laser cataract surgery. An eye disease that interferes with visual function, cataract is an abnormal clouding of the lens. Worldwide, this disease is the leading cause of impaired visual activity and blindness. Often, patients with the condition seek treatment to regain proper vision. In the human eye, the lens is positioned behind the iris (the colored part of the eye that surrounds the pupil). Physiologically, the lens focuses light on the retina to produce clear images. Age and certain medical conditions can deteriorate the tissues in the lens, causing them to clump together. As the disease progresses, the clouding becomes denser and occupies more of the lens area. The clouding hinders light from reaching the retina through the affected area of the lens, which results in blurred vision. In some cases, cataract is present right from birth or develops during early childhood due to factors like genetics and intrauterine infection. In most cases, a cataract is corrected with a surgical procedure called cataract surgery. Essentially, this treatment replaces the damaged lens with an artificial lens. Many ophthalmologists (eye doctors) are trained in the procedure and offer the treatment on an outpatient basis.

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Dr. Anthony Roberts is an established Rockville, Maryland ophthalmologist who emphasizes patient-centered LASIK care for serious issues impacting eyesight. One of the procedures Dr. Anthony Roberts has extensive knowledge of is cataract surgery, and he frequently performs laser-assisted cataract surgery. An advantage of this approach is that it involves the use of femtosecond laser technology, thereby enhancing the precision of steps in the procedure that previously required hand-held surgical tools. Laser-assisted cataract surgery starts with a surgical plan being created for corneal incision using optical coherence tomography (OCT), which provides a precise 3-D image of the eye. This enables the femtosecond laser to be used in creating an incision that is of a calibrated length, depth, and location across all planes. The femtosecond laser is also used to precisely remove the thin, clear capsule that surrounds the natural lens of the eye. Only the front portion is removed during the anterior capsulotomy, which leaves the rest of the capsule intact. This is critical, because the remaining capsule is used to keep the artificial lens implant in place. Finally, the laser is used to soften the cataract at the same time that it breaks it up, which reduces the energy required to remove the cataract. This is important in avoiding issues of heat buildup associated with ultrasonic devices traditionally inserted to break up the cataract, which in rare cases can induce astigmatism.

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Based in Rockville, Maryland, Dr. Anthony Roberts provides client-centered ophthalmology care for a broad range of eyesight issues such as glaucoma, corneal disease, dry eyes, and diabetic retinopathy. Offering advanced Lasik procedures, Dr. Anthony Roberts provides extended-depth-of-focus (EDOF) intraocular lens (IOL) options to patients with complex vision challenges. IOLs are typically implanted as part of refractive lens exchange or following cataract extraction, within the surgical treatment of presbyopia. Traditional multifocal IOLs employ diffractive optic lenses and separate light between near, intermediate, and long distances. This means that the user is only able to focus on a single distance at a time, with blur, halo, and glare sometimes occurring due to the multiple focal points. By contrast, EDOF-IOLs provide a single elongated focal point that seamlessly improves depth of focus and range of vision. This emerging technology is ideal for patients who do not want their functional vision compromised as they shift focus across distances.

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