Our office provides comprehensive eye care for the entire family. We strive to give each of our patients the best possible care using the latest technology and equipment. Because our office utilizes the professions of both ophthalmology and optometry we can cover the spectrum of vision care. Our services include routine vision care, refractive surgery including LASIK, PRK and CK, cataract surgery and glaucoma treatment. We fit all types of contact lenses including bifocal contacts lenses, lenses for astigmatism and dry eye. We also fit patients with keratoconus as well as patients who have had corneal surgery. We are certified to fit night time vision contact lenses also known as Paragon CRT. We also have Goose Creek Optical next door for your eyewear needs.

our doctors

Warren Tripp, M.D.
Dr. Tripp received his undergraduate degree from Columbia Union College and his Doctor of Medicine degree from Loma Linda University. He then completed his residency in ophthalmology at Loma Linda in 1983. Dr. Tripp has been practicing in Boulder County since this time. His specialty is in eye surgery, including but not limited to: laser vision correction (LASIK and PRK), cataract surgery, eyelid surgery and glaucoma treatment. He has been performing LASIK surgery since 1997 and is a chief surgeon at InSight LASIK in Lafayette. Dr. Tripp is certified by the American Board of Ophthalmology and is a member of the American Academy of Ophthalmology. He lives in Louisville with his wife Tami, he has a son, Matt, and a daughter, Ashlee.

Doug Kennedy, O.D.
Dr. Kennedy graduated from the University of Colorado with a degree in biology. He then attended Pacific University College of Optometry in Forest Grove, Oregon and graduated with distinction in 1995. He is certified in the co-management of laser refractive surgery including LASIK and PRK. Dr. Kennedy specializes in contact lens fitting including contact lenses for astigmatism, bifocal contact lenses, keratoconic lenses and dry eye patients. He also provides general eye care and diagnosis and treatment of eye disease. He is a member in good standing of the Colorado and American Optometric Associations.

Edwin Jeung, O.D.
Dr. Jeung received his optometric degree from the University of California, Berkeley in 1977 and is board certified in the diagnosis and treatment of eye disease. He has been an established eye practitioner in the Boulder and Louisville areas since 1982. He offers general optometric care to both children and adults, vision training and industrial laser exams. He also fits specialty contact lenses such as astigmatic, bifocal and keratoconic lenses. Dr. Jeung has been active in Louisville Jaycees, Chamber of Commerce Director, the Louisville Planning Commission and the Louisville Fire department as a fire medic.

Technology

We pride ourselves on bringing our patients the most up to date technology available for routine eye care and diagnosing eye disease.

Optomap
We offer the Optomap digital retinal evaluation for examining the inside of the eye.  This scanning laser retinal camera provides us with a 200 degree view of the inside of the eye without dilation.  This scanning laser ophthalmoscope is very helpful for detecting and following retinal disease.  It also provides us a view of the retina for routine eye exams which may allow the patient to avoid dilation.  As always, your eye doctor will ultimately decide if dilation is necessary.  Please visit www.optos.com for more information.

Pentacam
A prerequisite to performing safe and precise laser refractive surgery is the ability to accurately measure the shape, thickness and contour of the cornea prior to surgery. We are one of the first practices in Colorado to offer this technology. The Oculus Pentacam can measure these components of the cornea using technology superior to other imaging devices on the market.

One of the most critical measurements to evaluate prior to LASIK is corneal thickness. This can be measured using a handheld pachymeter but this only measures one point on the cornea. The Pentacam measures 25,000 points to evaluate the true overall thickness of the cornea. This will give us much more detail and allow us to determine if LASIK is a safe option for our patients.

In the past, instruments allowed us to only measure the contour of the front surface of the cornea. With the Pentacam, the front and back surface of the cornea can be measured with great accuracy. Some patients may have a normal front corneal surface but if the back surface is irregular this allows us to inform the patient they are not a good LASIK candidate.

The Pentacam is also useful for cataract patients. The cataracts can be imaged and analyzed for future reference to monitor changes in lens opacity. The Pentacam is also very useful in helping the surgeon determine the most accurate lens power to implant in the eye during cataract surgery.

HRT (Heidelberg Retina Tomograph)
Glaucoma is one of the leading causes of blindness throughout the world. It is a disease that involves optic nerve damage from high intraocular pressure. Treatment usually involves eye drops or eye surgery. The Heidelberg Retina Tomograph or HRT is an instrument used in glaucoma detection and management. The optic nerve must be analyzed for glaucoma to be diagnosed. The HRT combines a laser scanning camera and specialized software which evaluates the optic nerve in great detail. The HRT provides measurements of the shape of the optic nerve to determine if glaucoma is present. The most valuable way to use the HRT is to measure change over time. The test is non-invasive and usually does not require dilation.

IOL Master
Cataract surgery involves removing the eye's natural lens which has become cloudy and replacing it with a lens implant. Calculating the lens implant power precisely can reduce nearsightedness, farsightedness and astigmatism. To achieve the best results, we use the state of the art IOL Master which uses wave front technology to measure the length of the eye. Obtaining the most accurate measurement of the length of the eyeball is critical to reaching the desired refractive outcome. This is used along with the traditional ultrasound measuring devices and Pentacam to achieve the highest accuracy possible.

cataract surgery

Dr Tripp has performed more than 5,000 cataract surgeries and would like to provide you with some information regarding current techniques of cataract surgery

A cataract is a clouding of the natural lens inside the eye, which can interfere with vision. Most commonly causing blurry vision but also glare. When the degree of blurriness is bothering a patient's visual needs, removal of the cataract is needed to improve vision. A lens implant is placed in the eye to replace the natural lens.

Cataract surgery has advanced tremendously over the last decade. It is done now through a 3-mm. incision that self-seals tighter than sutured wounds. Anesthesia is usually done with numbing eye drops and no injections around the eye are needed in the majority of cases. IV sedation is also provided and an anesthesiologist performs this. This reduces complications and allows for a very comfortable surgery for the patient. The cataract is removed by a process called phacoemulsification. This instrument uses ultrasound to break up the cataract and then sucks out the material through the small incision. Dr. Tripp was first trained in phacoemulsification in 1983. A lens implant is then placed into the eye to replace the focusing power of the removed natural lens (the cataract). This implant folds like a burrito to enable it to enter the eye through the small incision, then is unfolded within the eye and positioned behind the iris as a permanent part of the eye. There is very little discomfort associated with cataract surgery and there is vision as soon as surgery is finished, although the best post surgery vision can take up to three weeks to be achieved. The surgery lasts about 30 minutes but patients are generally at the surgery center for about three hours. New glasses are prescribed after three weeks.

Calculating the lens implant power precisely can reduce nearsightedness, farsightedness and astigmatism. There are lens implants available that are designed to reduce astigmatism. These lens implants are inserted in the eye at the time of cataract surgery and are effective for treating moderate amounts of astigmatism. Higher amounts of astigmatism can be better dealt with intraoperatively or postoperatively with small corneal incisions or with LASIK after healing from the cataract surgery is complete. To achieve the best results, we are one of the few practices in the state of Colorado that have the state of the art IOL Master which uses wave front technology to measure the length of the eye. Obtaining the most accurate measurement of the length of the eyeball is critical to reaching the desired refractive outcome. This is used along with the traditional ultrasound measuring devices to have the highest accuracy possible.

If you have cataracts, Dr. Tripp would be happy to discuss whether your eyes are ready for cataract surgery as well as all of the details of surgery with you. Please call our office for an appointment.

Lasik

Imagine being able to wake up and see the clock, play sports, drive a car or go to a movie without glasses or contacts. This new freedom is possible with Laser Vision Correction. Laser Vision Correction is the most technologically advanced method in the world for correcting your vision. It has been performed since 1987 and has been shown to produce very predictable, stable results. The excimer laser uses a cool beam of light to gently reshape the front surface of the eye, the cornea. The laser is so accurate that it can remove 39 millionths of an inch of tissue in 12 billionths of a second without damaging surrounding cells.

Who is a candidate?
Good candidates include people who wear corrective lenses for nearsightedness, farsightedness and astigmatism. You must be 18 years of age and have had no change in prescription in 12-18 months. People with certain eye diseases such as glaucoma, cataracts or corneal problems would not be candidates. Some general medical conditions may also prevent you from having laser vision correction. A general eye exam is the best way to determine whether or not you are a candidate.

The Procedure
LASIK (laser assisted in-situ keratomileusis) is a painless outpatient procedure which takes about ten minutes per eye to perform. Only topical anesthetic eye drops are used, no injection or general anesthesia is given. Usually both eyes are treated the same visit. An instrument called a microkeratome is used to lift a thin layer of the cornea called the flap which is temporarily folded back. The laser then reshapes the cornea in less than 60 seconds. The flap is then replaced and self heals. Most people see well immediately but some fluctuation and fuzziness are normal. Some people report a mild discomfort for the first day. Eye drops are used for one week and clear shields are worn at night for one week.

PRK (photorefactive keratectomy) uses the same laser but the treatment is performed on the very front surface of the cornea and no flap is created. This requires gently removing the surface epithelium. The epithelial layer will regenerate within three days with the aid of a contact lens placed on the eye after surgery. Drops are used for three months after the procedure and the best vision may not be noticed for up to 1-3 months. While still a very effective procedure, PRK is not as widely performed as LASIK due to the increased healing time.

Expectations
The goal of laser vision correction is to reduce the dependence on glasses or contacts. Most people achieve 20/20 vision or within 1-2 lines of 20/20 on the eye chart and can pass a driving test. It is important to understand that the goal is not 20/20 vision but functional vision. A small percentage of people may require a thin pair of glasses for night driving. Patients over 40 can expect to need reading glasses after LASIK because it does not correct a condition called presbyopia. Some people may require a touch up procedure after three months to fine tune the initial surgery to get the best result. The risk of a serious complication is less than one percent and no cases of blindness have been reported after one million procedures worldwide. At our office we strive to give you the best vision possible in the safest manner.

What to Bring to your eye exam

It is helpful to bring the following to your exam:

• Your medical insurance card and/or vision coverage information. We accept many insurance plans and will be happy to bill your insurance company for you. However, it is difficult to know each patient's plan and coverage, so knowledge of your vision and medical benefits is helpful. Remember that medical visits for eye disease will be billed to medical insurance, not your vision plan.
• Your current glasses or over the counter reading glasses and, if available, a previous glasses prescription.
• If you wear contact lenses please bring the packaging or a previous prescription with you. You may wear your lenses to your eye exam.
• You may download the patient information and medical history forms and have them filled out prior to your arrival to save time at our office.
  
  
  • DOWNLOAD FORMS HERE

Contact Lenses

Contact lenses can be a great alternative to glasses for full time wear or occasional use for sports or social events. The availability has grown to be able to fit people with astigmatism, people who need bifocals, dry eye patients and people with corneal problems. At our office we have the latest lens technology for astigmatism, high oxygen gas permeable lenses and bifocal contact lenses.

Soft Lenses
Most soft contact lenses worn today are disposable. These lenses are replaced on a regular basis; every day, 2 weeks or 1 month depending on the brand and on your needs. Generally a supply of disposable lenses is purchased at one time. The trends in the contact lens industry are moving toward a more disposable market due to ocular health advantages and ease of care. Daily disposable lenses are one of the healthiest ways to wear soft contact lenses.

Almost all types of soft lenses have the capability of correcting astigmatism with what is called a toric lens. These are available in most powers. Many people are told they cannot wear soft lenses due to astigmatism. This is not the case; however, some people are better candidates than others.

Gas Permeable Lenses (GP)
Oxygen permeable lenses or GP's are made from different plastics than soft lenses. They are smaller and fit the cornea differently. GP's generally provide sharper vision than soft lenses. These lenses are very healthy for the eye and are the best way in most cases to correct astigmatism. They are best worn on a regular basis and one pair of lenses may last one to three years making them very economical. They are not disposable but can be polished in our office regularly if build up or scratches occur. These lenses are used to fit irregular corneas and patents with keratoconus. They can also be used on patients who have had corneal surgery.

Bifocal Contact Lenses
If you have “over 40” eyes and are tired of wearing reading glasses, bifocal contact lenses may help you reduce your need for readers. Bifocal lenses are available in both soft and GP materials. These are a great alternative to wearing glasses. If you are a current Gas Permeable wearer, a bifocal can be designed for you in this type of lens. The vision is very natural and it is very easy to adapt to these lenses.

If you wear soft lenses or have never worn contacts then a soft lens bifocal may be a good option for you. These are available in many different brands and disposable modalities.

What is CRT?
Corneal Refractive Therapy or CRT is nighttime vision correction that gives you freedom from glasses and contact lenses all day without refractive surgery. CRT utilizes a specially designed therapeutic contact lens to gently reshape the cornea while you sleep. The lenses are removed when you awake and you are able to go throughout the day without correction. This is a temporary process. If you stop wearing the lenses, your vision will return to its original state within 72 hours.

How long will the process take?
Most patients will notice great changes in their vision within just 1-2 days but it may take 7-14 days to achieve optimum visual results. During this transitional period we will provide temporary soft lenses for daytime use if needed. Because you are able to see with your Paragon CRT lenses on, you may decide to put on the lenses during the day for a short time during this transitional period.

Who can wear CRT?
Paragon CRT is currently designed for individuals with low to moderate nearsightedness (up to -6.00 diopters) with or without astigmatism (up to -1.75 diopters). The great thing about CRT is that there are no age restrictions. Even children can benefit from this treatment and not have to deal with lenses during the day. We usually will start fitting children into regular contact lenses around age 10 at the earliest and the same would be true for CRT. Children or teens who are active in sports, tend to forget or lose glasses or just won't wear glasses are great candidates for CRT.

There are many people who have trouble with discomfort or dryness from wearing contact lenses during the day. Some people may not be ready for LASIK surgery or are not candidates for LASIK. CRT is a great option for these patients.

Is CRT safe?
There is a small risk involved in wearing any contact lens. These may include increased risk of infection if not taken care of properly, corneal irritation and corneal swelling. In the FDA clinical study of CRT there were no serious adverse reactions.

How long do the lenses last?
It is recommended that the lenses be replaced about once a year. The lenses are a very high oxygen permeable lens and have a very precise design. Replacing the lenses regularly will ensure the best vision possible.

Please feel free to visit www.paragoncrt.com for more information. Or call our office for a consultation to see if you are a candidate for Paragon CRT.