Dr. Michael Bywater recently honored Michelle Munson, who was the 30,000th patient encounter at his practice and presented her with a gift certificate to the Vigneto Cafe in the Highland hamlet.

“We just felt the perfect woman won because she’s a really great lady,” he said. Bywater said this milestone caused him to reflect on spending the first half of his career in California and the second half in New York; he hopes to continue serving the community for another 10 years.

Munson said she and her children have been patients of Dr Bywater for many years.

“He has always been very patient and listens carefully to all of your needs and has taken really good care of all of my kids,” she said. “He’s just a really kind-hearted man and that comes across in the way he doctors. I lost my husband five years ago and he has always had his door open to me. He is an excellent physician, an amazing person and a real gem in our community.”

Bywater said, “as a rural provider I try to bring a lot of services to my practice like glaucoma care, providing special hard contact lenses for people who have suffered eye injuries that glasses don’t help and may delay the need for cornea transplants.”

Bywater expects that soon there will be virtual reality testing for peripheral vision.

“Some diseases, such as glaucoma, don’t restrict the ability to read the letters on the chart, but instead reduces the peripheral vision slowly, so slowly that the patient doesn’t even realize it. To be able to test that is important and we’re on the verge of some new technologies that will make that test easier for patients,” he said.

Bywater said eye transplants have not been successful because, “between the eye and the brain there are 120 million nerves, so we are very far away from being able to re-establish those connections.”

Bywater said today, however, there are options for patients undergoing cataract surgery.

“It is really incredible because after the cataract comes out, you can actually have a lens put into your eye that gives distant and close vision.” He said unlike bi-focal lenses that assign the upper and lower parts to focus on near and far, the new implanted lenses have a dozen concentric rings with one ring for near and the next ring for far and so on.

“It is easy for the brain to get used to having vision for distance and for up close, almost like we had when we were young,” he said. “Whatever is important to you, the brain will focus on. If you’re driving your brain will focus on the distance vision and if you’re looking at your cell phone your brain will focus on the up-close vision. One ring does not impact another ring.”

Bywater also offers urgent care services for people with eye injuries or infections and has a room dedicated for theses emergencies.

“We see these people on a walk-in basis. We established this service during Covid and from March 2020 to August 2020 I’d say we kept 60 people out of the emergency room with things we could handle very easily and efficiently,” he said.
Bywater explained why he loves seeing three year olds.

“Vision takes about six years to fully develop and the only way we can catch certain eye conditions, like ‘lazy eye,’ is to catch it before age six. This condition is when an eye does not see well in spite of glasses because there are not enough nerve connections between the eye and the brain due to the lack of development. When one eye is developing faster than the other the brain will choose to use the vision from the better eye and disregard the slower developing eye.” He pointed out that once the critical age of six passes the eye is not able to make any more connections; there are no second chances.”

Bywater said there are different therapies available, such as patching the good eye for a certain amount of time to force the brain to use the weaker eye.

“If the connections are made the eyes tend to become more equalized and prevents the lazy eye from developing,” he said.

Bywater also offers help with Myopia Management, pointing out that young people today are becoming more near-sighted at an earlier age than their parents.

“We used to blame it on reading books too much and then reading our phones and screens too much, but we actually now know that it’s due to not enough time playing outdoors as a young person,” he said. “The research says two hours a day outdoors is healthy for the eyes.”

Bywater noted that the United Nation’s World Health Organization and the American Association of Pediatrics have made this issue a priority, starting with educating parents.

“I love seeing kids because there is so much that I can do to make their eyes healthier for the rest of their lives,” he said.