General Practitioners

• Arthritis
  Symptoms are usually characterized by feelings of burning, stinging and dryness. The white of the eyes is often chronically red or injected. While the vast majority of patients who develop a tear flow problem are otherwise in good health, the condition may sometimes be associated with certain systemic diseases such as rheumatoid arthritis, lupus or other so-called "auto-immune" diseases.
• Primary Care
  If your insurance carrier requires a referral from your primary care physician, please make sure that it has been obtained before the visit and that you bring it with you to the office. As a patient, you will be responsible at the time of visit for all copays and refraction charges. When calling or making an appointment by phone, please have your insurance cards handy.
• High Cholesterol

Ophthalmologists

• Glaucoma
  Glaucoma is a disease which may cause significant visual loss if not diagnosed and treated early. The most common form of this disease is open-angle glaucoma. The eye receives its nourishment from a clear fluid that circulates within, called aqueous humor. This aqueous humor returns to the blood stream through a drainage canal called the trabecular meshwork. When the fluid cannot adequately leave through the mesh, increased pressure within the eye results. The elevated pressure causes damage to the blood vessel system which provides nourishment to the optic nerve. The peripheral, or side vision, slowly fades, and central (straight-ahead) vision is affected late in the course of glaucoma. With advanced glaucomatous nerve damage, a "gun barrel" type of vision results. The lack of pain or awareness of visual change leads us to call glaucoma the "silent thief of vision" and makes regular eye exams mandatory for all adults.
• Ophthalmology
  Prior to returning to Kansas City to join with his father, Dr. Allen Parelman, Dr. Parelman was the director of Residency Training for the Department of Ophthalmology at the Washington University School of Medicine. He maintains his interest in medical education as a member of the volunteer teaching faculty of the Department of Ophthalmology at the University of Kansas Medical School.
• Macular Degeneration
  Macular degeneration describes a wide variety of eye conditions which alter the sharpest and most acute central vision. It can affect people of all age, but is most often a problem that develops in late adulthood. The macula is a small area in the back of the eye consisting of highly concentrated light absorbing nerve cells. (See Diagram at Left.)
• Laser Eye Surgery
  PRK utilizes a computer-guided excimer laser to precisely reshape the corneal surface and move the focal point closer to the retina. Unlike during LASIK, a flap is not made, but a very thin layer of the surface cornea (about the thickness of a hair) is removed. Excimer lasers emit a high energy beam that removes tissue by releasing molecular bonds. Since the process does not produce heat or cause burning, the excimer is considered a "cool" laser. For patients with certain corneal disorders or conditions, PRK is preferable to LASIK.
• Cataracts
  A cataract is a progressive clouding of the eye's natural lens. (For reference, please see the accompanying diagram.) Think of the eye as being just like a camera. If the lens in a camera loses its clarity, a cloudy, indistinct picture results. This is exactly what happens to the eye's natural lens. While cataracts affect people of all ages, the occurrence increases with age. Over 50 percent of people past the age of 70 develop cataracts. Although the majority of cataracts are usually age-related, cataracts can also be due to medications, other eye diseases, surgery or trauma. Some people are born with cataracts. Those who develop cataracts 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 become difficult, particularly in the bright sun and at night. Glare, halos around lights, or even double vision may be experienced. Currently, there is no effective non-surgical treatment to reverse or prevent the development of cataracts. The only way to regain clear vision is the surgical removal of the cataract.
• Cataract Surgery
• Eye Exam
  You may see a charge for a refraction (92015) on your statement and may wonder why this was charged separately from your eye examination or office visit charge.A refraction is a test to determine whether you would benefit from spectacles. Your refractive error may not be great enough for you to require a spectacle prescription, but this cannot be determined without performing the refraction. If you have a medical problem, a refraction may be performed to see how the problem has affected your vision. Many carriers including Medicare do not cover the cost of the refraction and require the physician to separately bill the patient for this service.

Internists

• Internal Medicine
  Dr. Parelman received his medical degree from Duke University School of Medicine. He completed his internship in internal medicine at St. John's Mercy Hospital in St. Louis and his residency training in Ophthalmology at the Washington University Medical Center in St. Louis. His fellowship at the Louisiana State University Eye Center concentrated on corneal transplantation, diseases of the outer eye and refractive surgery. He participated in some of the early research and development of the laser now used for LASIK.

Psychiatrists

• Attention Deficit Hyperactivity Disorder (ADHD)
  While it is widely believed that 80 percent of children’s learning is visual, many Americans are unaware of how many children experience visual problems (Pennsylvania Optometric Association). All children should have annual eye exams, and an easy time to schedule those appointments is at the beginning of the school year. Students labeled “problem learners†are commonly children who have undiagnosed visual problems, including children misdiagnosed as having attention deficit disorder or attention deficit hyperactivity disorder (Pennsylvania Optometric Association). School vision screening s are not adequate replacements for annual eye exams. The American Optometric Association recommends that parents who notice that their child is frequently engaging in the following habits should schedule for their child an appointment with an optometrist: headaches, rubbing of eyes, avoiding up-close work, trouble reading, squinting in front of a screen or television, behavioral problems, performing below his or her potential, turns or tilts head, or struggles with homework (Pennsylvania Optometric Association).

Endocrinologist

• Diabetes Care
• Diabetic Retinopathy
  The primary purpose of evaluating and managing diabetic retinopathy is to prevent, retard, or reverse visual loss, thereby maintaining or improving vision-related quality of life.

Radiologist

• Ultrasound
  All patients undergoing cataract extraction are monitored by anesthesia services. Oftentimes patients find it comforting to have the surgeon talk to them during the brief procedure. The surgeon views the eye through an operating microscope. A very small opening into the eye is made, and a small ultrasound probe called a phacoemulsifier is placed into the eye. (See Diagram at Left.) The cataract is removed and an intraocular lens is inserted to take the place of the natural cataractous lens. (See Diagram at Left.) Each implant has a specific focusing power, and patients are typically much less dependent on spectacles following the procedure, often not needing glasses for driving or reading. With current techniques, sutures are rarely used. A special intraocular lens (toric IOL,) can be used to correct for astigmatism. Some patients are candidates for a multifocal intraocular lens, which can allow the patient to not need glasses after surgery for distance, intermediate or near vision.

Plastic Surgeons

• Eyelid Surgery
  Many people incorrectly think of eyelid surgery as "cosmetic". While some patients undergo surgery to restore their normal appearance, in many cases visual function is the reason for surgery. Most insurance companies cover lid surgery provided certain criteria are met.

Dermatologists

• Lesions
  Diabetic retinopathy is a disorder of the retina that eventually develops to some degree in nearly all patients with long-standing diabetes mellitus. While defects in neurosensory function have been demonstrated in patients with diabetes mellitus prior to the onset of vascular lesions, the earliest visible clinical manifestations of retinopathy include microaneurysms and hemorrhages. Vascular alterations can progress to retinal capillary nonperfusion, resulting in a clinical picture characterized by increased numbers of hemorrhages, venous abnormalities, and intraretinal microvascular abnormalities (IRMA). A later stage includes closure of arterioles and venules and proliferation of new vessels on the disc, retina, iris, and filtration angle. Increased vasopermeability results in retinal thickening (edema) during the course of diabetic retinopathy. Visual loss results mainly from macular edema, macular capillary nonperfusion, vitreous hemorrhage, and distortion or traction detachment of the retina.