By Joseph T. O’Connor Explorebigsky.com Senior Editor

BOZEMAN – When Katherine Milledge noticed her son Oliver had strabismus, a condition diagnosed when the eyes are misaligned, she took him to an eye doctor who prescribed glasses.

“He said, ‘If this doesn’t work, we’ll just do surgery,’” said Katherine, holding her five-year-old son on her lap in the waiting room of Advanced Eyecare Associates in Bozeman.

The Milledges wanted to explore other options and brought Oliver to Dr. Jody Fink, an optometrist with AECA. Fink is a 36-year-old Helena native with an optometry degree from the College of Optometry in Boston, and has been with AECA for more than five years. She enjoys working with visually challenged children and told the Millidges that surgery might not be necessary.

“I explained the alternative options,” said Fink. “It’s a process. The first step was getting him to wear glasses full time with the proper prescription and vision therapy. I believe we should try alternative approaches before surgery or in correlation with [it].”

For Oliver, Fink put a piece of scotch tape over the glasses lens on his affected eye, near the bridge of his nose. Eyes tend to avoid out-of-focus objects, she says, hoping the therapy will train Oliver’s eye away from the tape, thus avoiding surgery.

Until recently, Fink practiced vision therapy, a form of optical training that uses glasses, patches and eye exercises to strengthen or train eyes. While she continues doing pediatric work, she has limited vision therapy appointments.

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Advanced Eyecare Associates has been providing southwest Montana patients with optometric exams, lenses, frames and referrals for nearly 30 years, and with offices in Bozeman and Belgrade, both constructed in 2008, the company has expanded its patient base.

AECA offers extensive eye exams, diagnoses optically degenerative diseases such as glaucoma and congenital cataracts, and screens for, among other issues, macular degeneration, an age-related condition that causes vision loss in the center of the vision field.

Using the latest technology, the five-doctor practice has optometrists and opticians, as well as business and technical staff, who are able to work with clients and patients from the time they open the door to the time they walk out.

“We’re kind of junk nerds,” said Dr. Cynthia Johnson, part owner of AECA’s Bozeman location, referring to the clinic’s stockpile of high-tech gadgets.

A new Optical Coherence Topography machine shows images that can identify early glaucoma symptoms, and determine macular edema, or swelling, and cornea thickness, for example. If the cornea is too thin, says optometrist and part owner Doug Kimball, the person isn’t a candidate for LASIK, a procedure using lasers to manipulate the cornea.

“During laser surgery, they’re actually removing tissue from your cornea,” Dr. Kimball said. “If the cornea’s too thin, it’s like filling up a balloon with air and having a weak spot on the balloon – it bulges forward and they’ll [need] a corneal transplant.”

AECA’s Optomap Retinal Exam machine is another device that makes for a cutting-edge practice. The ORE takes images of the retina, the back lining of the eye, and is an optimal screening tool for all patients, according to technician Janene Molebash.

“Everyone who comes in has the option for an Optomap,” she said. “In the past, you had to dilate the pupils to get a good view of the retina. This is much easier on the patients. There are some times when it’s more appropriate to dilate, but for routine exams, it’s a great option.”

Kimball agrees. “If we see something with the Optomap, we may dilate the patient, but it’s great for us to take a quick view. It’s not the be-all-end-all, but it provides a baseline that we can review from year to year.”

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For 30 years, AECA occupied offices on South 11th Street in downtown Bozeman, but with limited room for growth in 2008 they sought a better location, finding it on the edge of town. The new building, at 4265 Fallon Street, gave them room to expand, adding needed space for eyeglass displays, parking and a bigger staff.

The team is now comprised of 21 employees, including Drs. Fink and Jennipher Harper – the “young doctors,” as Johnson refers to them – and an array of talented eye care specialists, according to Heidi McLoughlin, a customer from Manhattan, Mont.

AECA is a full-service clinic with a professional staff that looks out for its patients, said McLoughlin, who stopped into the Bozeman location on June 19 in search of new frames for her prescription lenses.

“I’ve been coming here for a few years now,” she said. “They have good doctors and a wide variety of choice.”

These broad options are due, in part, to the size of the location. At 6,000 square feet, AECA’s Bozeman locale has spacious exam rooms and expansive front-of-the-house floor space to display hundreds of sunglass and eyeglass frames manufactured by dozens of companies, including Oakley, Nike, Lindberg, Oliver Peoples and Jimmy Choo.

This is also where the opticians work. Among them is Laura McIlrath, who is helping McLoughlin, and Jordyn Kinna.

Kinna, 21, started at AECA four months ago. As an optician, she determines the type of lens an individual needs, performs adjustments, fits people for frames and repairs broken ones. Kinna’s mother is also an optician in her hometown Havre, but Jordyn moved to AECA for the bigger selection of product and a more competitive salary.

“My favorite part [of being an optician] is the mechanical side of it – fixing things,” Jordyn said, sitting at her large desk covered with frames of all different shapes, colors and sizes. “I love repairs.”

McLoughlin is talking and laughing with McIlrath, having selected the perfect fit. Beyond AECA’s professional diagnoses and broad frame selection, McLoughlin appreciates the group’s candor.

“They’ll honestly tell you if the glasses on your face look good or not,” she said. “They’re a one-stop shop. From walking in the door to walking out, you’re stylish.”