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We Love Eyes

Our eye doctors James P. Serino, O.D. & Heidi L. Schefferly, O.D. proudly serve Jackson county & surrounding areas.

Our Jackson eyecare office offers comprehensive eye exams & specializes in diagnosis & treatment of eye diseases & vision conditions using advanced technology & vision correction products.

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To Our Valued Patients,
We are pleased to report that we are back, although not completely back to the way things were before! The safety of our patients and staff is our top priority and we have made some changes to reflect this

These are some things that you may notice are different in our office
• In an effort to limit the number of people in the office we are operating on a reduce schedule. Because of this you may not be offered as many options for appointments as previously. Please understand that we are doing everything we can to accommodate everyone needing to be seen, but it simply isn’t possible to catch up quickly from being closed for 8 weeks.
• In an effort to control the flow and number of people in the office, our doors will remain locked. Please call us when you arrive. We will attempt to gather all information from you over the phone for the check in process and let you know when we are ready for you to enter the office.
• We will allow only one parent or guardian to enter the office with a minor child. All adults will be asked to come alone unless a companion is needed for health reasons.
• For those of you wishing to purchase new eyewear, we will not be permitting you to browse as before. One of our opticians will be happy to select the frames for you to try on……as many as it takes! All of the frames will be disinfected before returning to the display. If you wish to try the frames on without your mask, we will make accommodations for that to happen.
• If you need to have your glasses adjusted we are happy to do that for you. However, we ask that you call us when you arrive. We will let you know when an optician is available.
• We have removed most of our seating in the front office and have left only enough to allow for proper social distancing
• All magazines and publications have been removed from the waiting area
• The drinking fountain will no longer be available.
• All exam rooms and equipment are completely sanitized between patients
• All surfaces in the front office are sanitized hourly and you will notice that we have installed Plexiglas partitions on our front counter to protect you and our staff
• All patients will be required to wear a mask. In addition, our staff will be wearing masks when they are in direct contact with patients.
It is exciting to be back and we look forward to seeing you. However, if you or someone you have been in contact with have been diagnosed with or are experiencing symptoms of COVID-19, we ask that you reschedule your appointment for at least 14 days.
Drs. Serino & Schefferly and the Premier Eyecare Team

There are several different variations of Glaucoma, but in this article we will mainly focus on Primary Open Angle Glaucoma. This means that there is no specific underlying cause for the Glaucoma like inflammation, trauma, or a severe cataract. It also means that the drainage angle where fluid is drained from the inside of the eye into the bloodstream is not narrow or closed.

Closed or Narrow Angle Glaucoma, which will be discussed in another article, is treated differently from Open Angle Glaucoma

In the U.S., Primary Open Angle Glaucoma (POAG) is by far the most common type of Glaucoma we treat.

Glaucoma is a disease where the Optic Nerve in the back of the eye deteriorates over time, and that deterioration has a relationship to the Intraocular Pressure (IOP).  Most - but not all - people diagnosed with Glaucoma have an elevated IOP.  Some people have fairly normal IOP’s but show the characteristic deterioration in the Optic Nerve. Regardless of whether or not the pressure was high initially, our primary treatment is to lower the IOP. We usually are looking to try to get the IOP down by about 25% from the pre-treatment levels.

The two mainstays of initial treatment for POAG in the U.S. are medications or laser treatments. There are other places in the world where Glaucoma is initially treated with surgery. However, while surgery can often lower the pressure to a greater degree than either medications or laser treatments, it comes with a higher rate of complications. Most U.S. eye doctors elect to go with the more conservative approach and utilize either medications - most often in the form of eye drops - or a laser treatment.


There are several different classes of medications used to treat Glaucoma.

The most common class used are the Prostaglandin Analogues or PGA’s.  The PGA’s available in the U.S. are Xalatan (latanaprost), Travatan (travapost), Lumigan (bimatoprost) and Zioptan (tafluprost).

PGA’s are most doctors’ first line of treatment because they generally lower the IOP better than the other classes; they are reasonably well tolerated by most people; and they are dosed just once a day, while most of the other drugs available have to be used multiple times a day.

The other classes of drugs include beta-blockers that are used once or twice a day; carbonic anhydrase inhibitors (CAI’s ), which come in either a drop or pill form and are used either twice or three times a day; alpha agonists that are used either twice or three times a day; and miotics, which are used three or four times a day. All of these other medications are typically used as either second-line or adjunctive treatment when the PGA’s are not successful in keeping the pressure down as single agents.

There are also several combination drops available in the U.S. that combine two of the second-line agents (Cosopt, Combigan, and Symbrinza).


The second option as initial treatment is a laser procedure.

The two most common laser treatments for Open Angle Glaucoma are Argon Laser Trabeculoplasty (ALT) or Selective Laser Trabeculoplasty (SLT).  These treatments try and get an area inside the eye called the Trabecular Meshwork - where fluid is drained from the inside of the eye into the venous system - to drain more efficiently.

These treatments tend to lower the pressure to about the same degree as the PGA’s do with over 80% of patients achieving a significant decrease in their eye pressure that lasts at least a year.  Both laser treatments can be repeated if the pressure begins to rise again in the future but the SLT works slightly better as a repeat procedure compared to the ALT.

Article contributed by Dr. Brian Wnorowski, M.D.