Skip to main content
Home »


You’re Never Too Old to Try Contacts!

Are you one of those people who tried contacts in the past, but had no luck? Perhaps you found them dry and uncomfortable, or your allergies made them impossible to wear?  Maybe you were unable to see as clearly compared to your glasses, or you never needed glasses but now you’re struggling to see up close?

If you’ve answered “yes” to any of these questions, it’s time for you to try contacts again!

Advances in Contact Lenses

Over the last decade, contact lens technology has continued to make significant improvements. Do not let your age, prescription, or any previous experiences keep you from giving them another try.

The most common reason for discontinuing contact lenses is due to discomfort, especially at the end of the day. Other common reasons are poor distance vision, or the inability to see both near and far for those over 40 years of age. With the latest contact lens technology, almost all end-of-day discomfort can be eliminated as can the difficulty achieving acceptable vision at all distances.

Early generation soft lenses were thick and known to become dry by the end of the day. Soft lenses today are much thinner, lighter, and more comfortable than the contacts 10 years, 5 years, and even 1-2 years ago.

Wearing contact lenses over a period of days or even weeks causes them to absorb natural oils, mucus, and proteins from our tear film. When these substances accumulate, they can cause contact lenses to dry out faster, resulting in irritation. Today there are many different materials such as silicone hydrogels, water gradient lenses, and other innovations that are designed to reduce drying and enhance the overall comfort.

Disposable Contacts

Are you still having issues with weekly or monthly contacts? Try switching to daily disposable soft contacts! Daily disposables are worn for just one day and then thrown away. Using new, fresh lenses each day avoids the potential problem of debris build-up, which is often the cause of discomfort and blurred vision. In fact, daily disposable lenses may help relieve dry eyes for some users.

Commonly, many people do not close their eyelids completely while blinking, exposing their eyes to air which leads to dehydration. When fitted correctly with the appropriate material, contacts can help seal in moisture to help avoid this issue. The new water gradient design lines both sides of the contact lenses with a thin film of water that keeps the eye moist. The comfort is truly remarkable allowing our doctors to use this lens type for not only vision correction, but for the potential treatment of dry eye as well.

What if I need glasses to see up close while wearing contacts?

Adults over the age of 40 typically have three options when it comes to wearing contact lenses for clear vision. One option is to wear contact lenses for distance vision and then use reading glasses in addition to contact lenses to achieve an acceptable near vision. Second, multifocal contact lenses are designed to allow you to see at both near and far distances and if needed can include an astigmatism correction. Monovision, on the other hand, is the third option which uses a fitting technique fitting one eye with a lens for optimal close-up vision, while the other eye is fitted with a lens for optimal distance vision.

More Information

Need help deciding which option is best for you, or want to schedule a fitting appointment? Give our Donelson EyeCare team a call today at 615-889-0147!

Eye Allergies, Or…?

Hey, allergy season. Welcome back to the time of year when everyone blames almost every distress on allergies! Let us help set the record straight though, since certain symptoms are easily assumed as a seasonal allergic reaction when they can actually be a result of something worth looking into further.

Eye Allergies

But okay, we’ll give eye allergies a little bit of attention since they can be the reason for red, itchy, swollen, sensitive, burning, and overall irritated eyes. First and foremost, don’t forget, it’s not just the pollen. There are several things you can be allergic to from trees to animals to new perfumes, even new contact lenses, believe it or not.

The reason behind the reactions you experience is the release of histamines. Histamines are a chemical that causes all the swelling, tears, et cetera, in an attempt to release allergens and help defend your eyes.

While antihistamine pills and eye drops help calm allergic reactions, it’s suggested that over-the-counters aren’t used for more than a couple of days. Ask us about prescribed eye drops that can be used on a more fluid schedule and can healthily harmonize with any existing eye issues such as glaucoma.

Now that we’ve covered eye allergies, let’s talk about other possible culprits.

Eye Allergies or Eye Infections?

girl with irritated dry red eye or allergy female

The reactions might seem as similar as identical twins in the beginning. But the causes are completely unrelated. Eye allergies are caused by allergens and eye infections are caused by substances like bacteria, parasites, and viruses. If they are not appropriately addressed, symptoms can mutate from a mild itch to more intense pain, light sensitivity and thick, slimy discharge.

Another important thing to know about infections vs allergies: infections can spread to others and allergies cannot. Proper hygiene and following ODs guidance are crucial to healing your own eyes and protecting the eyes of others.

Eye Allergies or Dry Eye?

One oddity of dry eye syndrome is that it can lead to watery eyes. This reflex tearing helps to confuse dry eye syndrome and eye allergies. There are so many varied factors that can lead to dry eye. Factors that can develop at any time. One way to help differentiate the two is maintaining awareness of other symptoms that are more prone to dry eye, such as:

  • Heavy eyelids
  • Blurry vision
  • Eye pain that feels different from allergic irritation

Eye Allergies or Adverse Medicinal Reactions?

Some medications can cause severe eye problems, but the puzzling part is they often don’t kick in until after years of use. This is one of the several reasons why it is important to discuss all side effects with your doctors and to share your use of all medications with your trusted optometrist.

Medications that can lead to eye issues fall in every arena. The most common negative results are dry eye, light sensitivity, and in more serious cases, optic nerve damage and loss of visual acuity. If these reactions begin to take place during the months that are often considered “allergy season”, it may be easy to relate them with allergy responses.

Eye allergies usually don’t come on their own. They’re often accompanied by sneezing, a scratchy throat, and a stuffy nose. The best way to confirm the cause? A checkup! Request an appointment on our website with details of what eye irritations you’re looking to calm. Our team at Donelson EyeCare is here to help!

When the Whites of Your Eyes Just… Aren’t Quite White

White eyes have just about the same cosmetic priority as white teeth or unblemished skin. In fact, several surveys reveal that about 30% of people initially notice eyes when they first meet someone. While you can be a generally healthy human with stained teeth and imperfect skin, your eyes can reveal a lot about you… including your health.

First, allow us to introduce you to the sclera. The sclera is simply the medical term for “the white of the eye”. And it comes with high importance.

The sclera is four coats of protection that wrap around most of the eyeball, from the front of the beautiful colored part of the eye- the iris, to the back with sensitive optic nerves. This eye armor is no more than one millimeter thick, which amounts to the thickness of about 10 sheets of paper, layered on top of one another!

The layers of protective armor that give your eye its white color and the sclera its overall strength include randomly patterned collagen fibers and tissues called the episclera, the stroma, the lamina fusca, and the endothelium.

Typically, the entire sclera, not just one layer, changes color or accumulates spots.

Here are 4 hues to keep a lookout for along with a few reasons why:

  1. Yellow: A yellow tone brings along with it a couple of main suspicions, jaundice and “surfer’s eye”.A buildup of red blood cells that are normally filtered out by the liver can have several different causes but can trigger jaundice which often includes a yellowing of the eyes and skin. Surfer’s eye should really be given the nickname of “Outdoor A Lot Eye” as it is a sign of untreated UV damage from the sun combined with high winds or areas filled with dust.
  2. Blue: A tint of blue/gray might not be easy to detect by looking in a mirror, and often these tints are unavoidable because of long-term use of important medications.Tints of blue are still important to observe with help from your OD to consider or dismiss certain health conditions like genetic bone disease or iron deficiency.
  3. Red: Chances are we’ve all experienced eyes with a shade of red, whether it was thanks to allergies or exhaustion or any other typical culprit.
    However, it is still important to schedule an appointment as soon as possible since a red eye can also signal an infection or a broken blood vessel, especially if accompanied by discharge, pain, or blurred vision.
  4. Closeup of an eye of a black manBrown: Brown spots are on both ends of the spectrum. They range from completely harmless to life-threatening. High levels of melanin, the natural skin pigment which makes skin, hair, and the iris of your eyes a darker color can curate spots outside of the iris and within the sclera which are nothing to worry about.
    However, if a dark spot that resembles a freckle that changes over time develops during or after your 30’s, we suggest you make an appointment. These more serious brown spots are not at all melanin-related and can become cancerous if left untreated.

So, when the whites of your eyes just… aren’t quite white, give us a call at 615-889-0147! Keep note of what is accompanying your sclera color change and alert us about anything such as…

    • Blurred vision
    • Discharge
    • Pain
    • Light sensitivity
    • Swelling or bulging

…and our team at Donelson EyeCare will handle the process to lead your eyes—and your entire self—back to health.

Diabetic Eye Disease Awareness Month

November is Diabetic Eye Disease Awareness Month. Approximately 34.2 million Americans have been diagnosed with diabetes, while around 88 million currently have prediabetes, the condition that occurs just before diabetes. Because this disease affects so many people, I thought I’d take a moment to discuss the ways that it can affect a person’s vision.

What is Diabetes?

Before we discuss the eye conditions that can happen as a result of diabetes, let’s look at the disease itself. Diabetes occurs when there’s too much sugar (glucose) in the blood over time and not enough insulin (the hormone that helps cells process sugar) being made to handle these glucose levels. There are three types of diabetes, type 1, type 2, and gestational.

Type 1 diabetes is hereditary and happens as a result of the body not being able to make insulin on its own. Type 2 diabetes is largely preventable and is caused by high glucose levels and a person’s body no longer making enough insulin. Once there’s not enough insulin to handle the amount of sugar in the blood, glucose levels are hard to control. While type 1 and type 2 diabetes are incurable, gestational diabetes is usually a temporary condition that affects some women during pregnancy.

What is Diabetic Eye Disease?

While diabetic eye disease may sound like one condition, it’s actually a group of conditions that those living with diabetes are particularly susceptible to. All of these can negatively impact a person’s ability to see clearly and can potentially cause blindness. Eye conditions that affect those with diabetes include the following:

  • Diabetic retinopathy- Your retina is the portion of your eye that detects light and sends signals through your optic nerve back to your brain. High blood sugar levels can cause the blood vessels to the retina to leak, damaging the eye over time.
  • Diabetic macular edema- This condition is caused by fluid build-up on and around the retina that causes swelling and blurred vision.
  • Cataracts- Cataracts can happen to anyone, but diabetics are more at risk due to the increased sugar in their blood.
  • Glaucoma- Like cataracts, glaucoma can affect many people, but having diabetes doubles your risk for this condition.


As I said before, diabetes causes an increase of sugar in the bloodstream. This causes damage to blood vessels, which in turn can cause a number of other health problems including diabetic eye disease. Controlling diabetes with medication and diet is the first step to preventing diabetic eye disease.

It’s also extremely important that those living with diabetes or at risk for diabetes have a comprehensive, dilated eye exam at least once a year. While there are very few obvious warning signs of diabetic eye disease, a trained eye care professional can spot and help treat problems before they become more serious.

If you are one of the many people currently living with diabetes, find an eye doctor who will work closely with you to prevent these conditions and keep your eyes healthy for life!

Pre-school Vision

Preschoolers use their vision to guide all their learning experiences. From ages 2 to 5, a child will be fine-tuning the visual abilities gained during infancy and developing new ones.

Stacking building blocks, rolling a ball back and forth, coloring, drawing, using scissors, or assembling toys all improve important visual skills. Preschoolers depend on their vision to learn tasks that will prepare them for school. They are developing the eye-hand-body coordination, fine motor skills and visual perception necessary to learn to read and write.

This is also the time when parents need to be alert for the presence of vision problems such as crossed eyes or lazy eye. Crossed eyes or strabismus involve one or both eyes turning inward or outward. Amblyopia, commonly known as lazy eye, is a lack of clear vision in one eye, which can’t be fully corrected with eyeglasses. In addition, parents should watch their child for an indication of any delays in development. Difficulty recognizing colors, shapes, letters, and numbers can occur if there is a vision problem.

Steps taken during these years to help ensure their vision is developing normally can provide a child with a good head start for school.


School-Age Vision

A child needs many abilities to succeed in school. Good vision is key.It has been estimated that as much as 80% of the learning a child does occur through his or her eyes. Reading, writing, smartboard work, and using computers are among the visual tasks students perform daily. A child’s eyes are constantly in use in the classroom and at play. When his or her vision is not functioning properly, education and participation in sports can suffer.As children progress in school, they face more demands on their visual abilities. The size of print in schoolbooks becomes smaller and the amount of time spent reading and studying increases. When certain visual skills have not developed, or are poorly developed, learning is difficult and stressful, and children will typically:

  • Avoid reading and other near visual work as much as possible.
  • Attempt to do the work anyway, but with a lowered level of comprehension or efficiency.
  • Experience discomfort, fatigue, and a short attention span.
  • Some children with learning difficulties exhibit behaviors of hyperactivity and distractibility. These children are often labeled as having “Attention Deficit
  • Hyperactivity Disorder” (ADHD). However, undetected and untreated vision problems can elicit some of the very same symptoms commonly attributed to ADHD.

Because vision may change frequently during the school years, regular eye and vision care are important. The most common vision problem is nearsightedness or myopia. However, some children have other forms of refractive error like farsightedness and astigmatism. In addition, the existence of eye focusing, eye tracking, and eye coordination problems may affect school and sports performance. Eyeglasses or contact lenses may provide the needed correction for many vision problems. However, a program of vision therapy may also be needed to enhance vision skills.


Vision is more than just the ability to see clearly or having 20/20 eyesight. It is also the ability to understand and respond to what is seen. Basic visual skills include the ability to focus the eyes, use both eyes together as a team, and move them effectively.Other visual perceptual skills include:


– the ability to tell the difference between letters like “b” and “d”


– “picture” in our mind what is happening in a story we are reading


– be able to remember and recall details of what we read

Every child needs to have the following vision skills for effective reading and learning:

  • Visual acuity — the ability to see clearly in the distance for viewing the chalkboard, at an intermediate distance for the computer, and up close for reading a book.
  • Eye Focusing — the ability to quickly and accurately maintain clear vision as the distance from objects change, such as when looking from the smartboard to paper on the desk and back.
  • Eye-tracking — the ability to keep the eyes on target when looking from one object to another, moving the eyes along a printed page, or following a moving object like a thrown ball.
  • Eye teaming — the ability to coordinate and use both eyes together when moving the eyes along a printed page, and to be able to judge distances and see depth.
  • Eye-hand coordination — the ability to use visual information to monitor and direct the hands when drawing a picture or trying to hit a ball.
  • Visual perception — the ability to organize images on a printed page into letters, words, and ideas and to understand and remember what is read.

If any of these visual skills are lacking or not functioning properly, a child will have to work harder. This can lead to headaches, fatigue, and other eyestrain problems.

When is a Vision Exam Needed?

Your child should receive an eye examination at least once every two years-more frequently if specific problems or risk factors exist, or if recommended by your eye doctor. Unfortunately, parents and educators often incorrectly assume that if a child passes a school screening, then there is no vision problem. However, many school vision screenings only test for distance visual acuity. A child who can see 20/20 can still have a vision problem. In reality, the vision skills needed for successful reading and learning are much more complex.

Let’s Discuss Donuts

Today we want to talk about glaucoma, so naturally we’re going to talk about donuts!

Now, we know what you’re asking: What does glaucoma have to do with donuts? An excellent question. No, it’s not because donuts are amazing and should be discussed (they of course are, and they should).  The answer lies in the key to glaucoma diagnosis and treatment, which is to protect the optic nerve, and your optic nerve resembles a, you guessed it, glazed donut. With a donut you have the edible part (arguably the best part) and the hole in the middle. Now while the optic nerves in our eyes don’t actually have a hole, they do have a central depression called the “cup”. During every one of our eye exams we measure the healthy optic nerve (edible part of the donut) and estimate the size of the central cup (hole).

Central cupping can vary due to genetics, refractive error (eyeglass prescription), race, and a few other factors. 33% of the average American’s optic nerve is represented by the cup, meaning the average donut hole is a third the size of the donut.  In general, smaller is better, larger is worse.

What is most important is to measure and monitor the size of the cupping (donut hole) over time. If the donut hole is growing and the edible part of the donut is becoming thinner, it is very likely that the patient may be developing glaucoma.

Glaucoma is truly defined as vision loss characterized by loss of healthy optic nerve tissue over time.  We monitor that with an OCT for structure and visual field for function.  There are a number of evidence-based medicine tests which help us monitor patients who are suspicious for developing glaucoma in the hope that we can prevent, or catch, an early transformation from “suspect” to true glaucoma.

So, now that we’ve taught you a thing or two about glaucoma (and simultaneously made you hungry), ask yourself: What size is MY donut? That’s the question we hope comes to mind the next time you drive by a Krispy Kreme, Dunkin, Donelson, or Cool Springs Eyecare!

If you have any questions about glaucoma or want to schedule an appointment to get your donut checked, call Donelson EyeCare today!

Diabetes – Complications with Sugar

Diabetes and eye health are tied together more closely than you may realize! Let us shed some light on this relationship so you know how it can affect you and those close to you. Diabetes is becoming more and more prevalent in the area, as (9%) of Tennesseans are reported to have diabetes. In some areas of the country, that number exceeds (12%). It is an epidemic that is a truly a growing concern in America and other countries.

We can debate the causes (poor diet, lack of exercise, increased high fructose corn syrup, etc.). The reality remains that we must diagnose, treat, and protect patients from diabetic problems. How does this relate to vision health? The answer lies in a disorder known as diabetic eye disease.

There is both good and bad news when it comes to diabetic eye disease. The good news is most diabetic eye problems do not cause pain. None of us like pain. However, when you have a disorder that is asymptomatic (showing zero to few symptoms) it is especially dangerous. It is dangerous because patients do not report any specific problems or symptoms, even blurred vision in many cases. This leads to a number of patients with diabetic eye disease receiving treatment after the disorder has developed. That’s the bad news.

Let’s talk facts.

Diabetes is the number one cause of new cases of blindness among the working population in the United States, and this has been true for many years. The number one cause for loss of vision and diabetes is due to a fluid buildup in the central part of the retina called the macula. This fluid buildup disrupts vision in mild to moderate levels but is often not as perceived by the patients. For that reason, we use high-quality equipment, doctor knowledge, and advanced technology to evaluate the patient’s retina and macula.

(80%) of vision loss and diabetes is caused by this fluid buildup. The best way to imagine this is noting how you see when you are under water in a swimming pool. It is not as clear as when you are above the water level. Ultimately, that type of blurry, foggy, watery vision is what we’re trying to prevent by diagnosing diabetic eye macular edema (fluid). In some cases, the fluid buildup creates a signal to the brain that it needs to send more blood vessels and oxygen to the retina. While this seems like a good idea, ultimately these new blood vessels are very brittle and breakable. They also have an elasticity to them, so they stick to other parts of the inner eye. These new blood vessels (called neovascularization) can lead to severe loss of vision due to large hemorrhages or retinal detachment. Each of these can be devastating complications that, if left untreated, can lead to blindness. Even when treated, many people do not return to their normal pre-event vision level and therefore suffer from vision decreases.

In general, diabetes can affect many areas of the eye from the cornea (dry eyes) and lens (cataracts) to the optic nerves (glaucoma). Despite these other affected areas, diabetes is especially known for its vascular complications due to leakage and new blood vessel formations at the macula or on the retina.

The best way to prevent diabetic complications are:

  1. Make sure you are seeing your general physicianand understand any risk factors you might have for developing diabetes.
  2. Discuss with your physician the right diet – typically low sugar or carbohydrate to minimize the development of diabetes over time.
  3. Have your eyes checked annually – even if youdon’t have any symptoms of changes in vision.

Our mission is to protect, correct, and enhance eye health and vision. Diabetes poses a significant threat to our patients and those in the United States due to complications on the retina. Your annual eye health and vision exam is a high value, low hassle way to provide you with peace of mind and protect your vision for life.

Fall Allergies: Cause, Effect, and Solution

Seasons changing are often something to look forward to. Especially when the chill of winter is conquered by the warmth of spring, and the swelter of summer is subdued by the cool crisp of autumn. One of the downsides of changing seasons, however, is the allergens that come along with them. So, let’s talk the causes, effects, and solutions of seasonal allergies and how they can upset your eyes. The focus of this talk? Fall.


happy couple and bonfire PMDJ3X6 640x427

Let’s kick this conversation off with a quick background of your eyes and why they can get the brunt of allergy effects. An article from WebMD gives a good explanation, stating that the layer of skin covering the front of your eyes is “…the same type of skin that lines the inside of your nose. Because these two areas are so similar, the same things can trigger allergic reactions in both places.” Typical eye allergies that affect your eyelids, the layers of skin that cover the front and the inside of eyes, are referred to as allergic conjunctivitis by your Doctor of Optometry (OD).

One of the most common allergy triggers that can bother both your nose and your eyes is ragweed pollen. Ragweed grows across the US and its pollen releases during the fall months, with its highest pollen counts in mid-September. While ragweed does not grow in every single state, it can travel in the wind for hundreds of miles!

Two other common triggers in autumn are mold and dust mites. The leaves that pile up outside your home as they fall gracefully from the trees provide a nice, damp breeding environment for mold. Dust mites are invited to frolic around in homes, schools, and other commonplace indoor locations once heat gets turned on in the fall.

You’d probably never guess how much two things that are vastly loved can play a big hand in eye allergies – body fragrances and bonfires. Have you ever noticed that being around a friend or coworker in the spring and summer is perfectly fine but come fall, you’re constantly sneezing and rubbing your eyes around them? This could be because the perfume or cologne they brand themselves with during the cooler months contains an allergen that irritates your eyes. While bonfires are a fun way to gather under the stars around the warmth of an outdoor fire, wildfire smoke can irritate your sinuses and trigger your eye allergies as well.


The American Optometric Association shares that, “ocular allergies are the abnormal response of sensitive eyes to contact with allergens and other irritating substances.” and notes that eye allergies are, “one of the most common ocular surface diseases in primary eye care.”

When allergens come into contact with eyes’ mast cells, an important part of all immune systems, release histamines and other chemicals that can cause your eyes to become inflamed, red, swollen, itchy and watery in an attempt to fight off the allergen. These responses can also cause your eyes to become sensitive to light.

While we should thank the attempt, the response can be extremely frustrating! So, let’s move on to solutions.


Some solutions are very simple but can still be quite hard to secure. For example, taking a hands-off approach. It’s difficult not to touch your eyes throughout the day, especially when they’re itchy, but rubbing your eyes can only make things worse.

A few other short term simple solutions include avoiding eye makeup, applying a cold compress to your eyes, and wearing sunglasses while outdoors to act as a shield against allergens.

You might also want to consider purchasing a dehumidifier and an air filter, switching your bedding from cotton to naturally hypoallergenic silk which also serves as an inhospitable environment for dust mites, and swapping your contacts with glasses when your eyes are suffering.

While over the counter eyedrops can also be very helpful and soothing, consider scheduling an appointment with one of Cool Springs EyeCare’s practice ODs for a comprehensive eye exam to confirm there are no other causes for the symptoms you are experiencing and to construct a customized plan for you during the allergy seasons!

Can My Eye Really Fall Out?

It was big Olympic news. A long distance swimmer was accidentally struck in the eye by a competitor’s arm or elbow during a swim competition. He immediately “went blind” and thought “his eye had been knocked out.” Bad news for this Olympian-he had sustained blunt trauma to the globe and orbit. Good news for this guy-there is almost no physical way his eye could fall out. I have heard post cataract surgery patients swear that their past doctor took their eye out, removed the cataract and then put the eye back in. Good news for them…they had a cataract removed from inside the eye, replaced by an implant, yet did not have their entire eye removed.

This begs the question. If I am hit in the eye, can my eye really fall out? The answer is theoretically, yes, but practically, no!

The eyeball (globe) is connected in the socket very firmly by many muscles, connective tissue, tendons and the optic nerve. Each of these structures are so tightly connected to the globe that to disengage the eyeball would mean catastrophic trauma that crushes the face, head, skull and more often than not would result in devastating injury or death for the patient. Trauma does occur to the eye, and we treat this all the time in our offices. It can result from racquetballs, fists, motor vehicle accidents, chair and table legs or any number of other possible causes. Fortunately, the soft globe (eyeball) is well designed and protected by the bony orbit surrounding it. Ever get a black eye? The bruising and swelling around the eye is evidence that the protective bones surrounding the eye socket took most of the blow.

In some cases the eyeball itself receives a blunt concussive blow and this coup/contra coup force can cause damage inside the eye. When this occurs, we look for lacerations, torn or dislodged structures, blood inside the eye (hyphema) or retinal problems (swelling, hemorrhage or detachment.) We can even see dislodged or damaged eye muscles, stretched optic nerves and any number of other visually threatening sequelae.

We are here to treat whatever traumatic insult affects your eye, whether abrasions, inflammation, hemorrhage, glaucoma, lens or retinal problems. We have a doctor on call 24/7/365 for those and other reasons.

If you sustain a blow to the eye, it is best to let your eye doctor evaluate, diagnose and advise you of the best treatment to preserve or improve your comfort and vision. Yet be assured, even if it feels like someone knocked your eye out, it will still be inside your head…and you do not have to worry about it falling out!

Dr. Keg


Please call the office if no online appointments are available. Thank you! 615-889-0147