General

You will be light sensitive but if you are legal to drive you may. However, if you think you will be more comfortable please bring a driver.

Your visit will last approximately 45-minutes to 1 ½ hours.

You should wait 1-5 minutes between each drop.

After the second day post operative you may.

Depending on positioning requirements and the limitation of activity.

No more that 10-pounds of lifting and no bending over.

Take the drop once you remember. If it is almost time to take the next dose, skip the one you missed and continue with the schedule.

This is dependent on the prescription needed.

No. Drops are to be instilled during waking hours only.

Medication should be discussed with your medical doctor and the surgical center.

You should bring photo ID, and a driver if you prefer.

We prefer if you have a family member present.

All of our patients are here for different reasons and will be taken accordingly as close to their appointment time as possible. Your eyes must be completely dilated prior to seeing the doctor. We ask that you please be patient for unforeseen emergencies.

AT AAYUSH EYE CLINIC……

A general ophthalmologist is a specialist- a PAN OPHTHALMOLOGIST who performs eye care including refraction and surgery including cataract surgery. A retina specialist or surgeon is highly trained in the diagnosis, management, and treatment of retinal problems such as macular degeneration, diabetic retinopathy, macular holes, macular puckers and retinal detachments. A retina specialist trains for for two additional years in a "fellowship" program to learn the intricacies of retinal surgery.

Fee is expected at the time of service.

A minimum of 6-weeks. You will be given instructions to follow and our ophthalmic technicians will review them with you.

You will go home from surgery with a patch over your eye. Keep it on for a couple of hours.

Retina

ANTI-VEGF

Anti-VEGF treatment is a way to slow vision loss in people with conditions like wet form of AMD (Age related Macular Degeneration), CNVM (Choroidal Neo Vascular Membrane), Severe Diabetic Retinopathy, Macular Edema (swelling), Vascular Blocks, Neovascular Glaucoma (NVG), Vitreous Hemorrhage, etc. These retinal diseases, which were earlier considered incurable, or had very poor results with existing treatments are now being tackled with good results with these anti-VEGF agents.

A certain chemical in your body is critical in causing abnormal blood vessels to grow under the retina. That chemical is called vascular endothelial growth factor, or VEGF. Recently, scientists have developed several new drugs (anti-VEGF) that can block the trouble-causing VEGF. Blocking VEGF reduces the growth of abnormal blood vessels, slows their leakage, and helps to slow vision loss.

The anti-VEGF drug must be injected into your eye with a very fine needle. Your ophthalmologist will clean your eye to prevent infection and will administer an anaesthetic to your eye to reduce pain. Usually, patients receive multiple anti-VEGF injections over the course of many months. As with any medical procedure, there is a small risk of complications following anti-VEGF treatment. Any complications that might occur usually result from the injection itself, which in rare circumstances can injure the eye's lens or retina or lead to an infection. For most people, though, the benefit of the treatment outweighs the small risk of injection injury.

Your ophthalmologist will determine if the treatment is appropriate for you. In some cases, your ophthalmologist may recommend combining anti-VEGF treatment with other therapies. For instance, some patients also receive photodynamic laser therapy. With this treatment, a special drug is injected into the veins in your arm, where it flows to your macula. Your ophthalmologist uses a special laser to activate this drug in order to close abnormal blood vessels in the macula. The treatment that's right for you will depend on the specific condition of your retina. As of now, there are three injections available with us for treatment. These are Lucentis, Avastin and Macugen. These injections are given inside the eye. The procedure is a very small one, but is performed inside the operation theatre to maintain the strict asepsis. The patient is discharged within 10-15 minutes of the procedure, and can resume his/her normal activities immediately.

DEGENERATIVE MYOPIA

(I am very shortsighted (-9.5D) and just heard about "degenerative myopia". I wonder how many high degree myopia people will have "degenerative myopia" ?)

2% of the population has this. You are nearsighted. Any person with a high degree of myopia has a higher risk of retinal detachment. It is not likely that you have this but an ophthalmologist (not an optometrist) should be consulted if you feel you may have it.

How can I tell if I have it or not? I'm 13 and my vision has been getting worse every year for just about the past 7 years. I believe there was one year when my vision actually got better, but I dunno. Last I checked, my vision was -9 and -7 in my right and left eye, and I know it's gotten worse this year. Do I have degenerative myopia?

What you are describing is referred to as "progressive" myopia. Progressive myopia is a genetically inherited condition. The classical presentation of progressive myopia tends to follow this time line -- Most first notice a shift into myopia causing a blurring of distance around second to third grade (7 to 8 years of age). The individual then consistently and continually increases in nearsightedness until about the age 17 to 19 at which time most then become somewhat stable in their degree of nearsightedness for many years until other vision issues such as cataract may cause changes.

Could I? What are the symptoms? How can I tell?

I have -9.00 diopters in my right eye and -7.00 in my left. I'm not even an adult yet and my vision seems to keep getting worse even if I don't use it much.

"Degenerative myopia" is a form of myopia where the retinal health is affected. It is different from juvenile myopia progression, in which teens get increasingly nearsighted. The only way to know if you have degenerative myopia is to have a dilated eye examination and have an eye doctor (optometrist or ophthalmologist) make that diagnosis for you. Your retina either has a degenerated appearance or it does not. There is no way to tell by just the spectacle Rx (whether you are -9.00 or not) or whether you are becoming increasingly nearsighted or not.

I see floaters and such. Do I have degenerative myopia?

Floaters are pretty normal, unfortunately. If your vision is suddenly grey, like you're looking through a curtain, call your ophthalmologist immediately.

What kind of profession is most suitable for people who suffer from high degrees of myopia (nearsightedness) or what kind of work they should perform in order not to hurt their eyes?

Well this optometrist gets to -14.25 in the worst meridian of my worst eye. It's given me some insight (sorry) and empathy with at least my high myope patients.

It's a question better tackled from the other end. High myopes are marginally more prone to retinal detachment, so occupations exposed to vibration or shocks are to be avoided: pneumatic drills, driving heavy machinery... High diver, professional football player.

Some occupations require good vision without glasses or contact lenses... principally branches of the military and the fire service, but heavy goods vehicle driving is also legally barred from high myopes on grounds of a minimum vision without glasses requirement in most countries.

RETINAL DETACHMENT

The retina is the layer of neurosensory tissue that lines the back, inside wall of the eye. If you imagine that your eye is like a camera, then the retina is the film. When rays of light enter the eye and are focused on the retina by the cornea and lens, the retina reacts. The light receptive nerve cells that comprise the retina generate a nerve impulse whenever they are exposed to light. The retina then sends these nerve impulses along the optic nerve to the brain which interprets them as a picture. It's rather like the film in the camera being developed so that pictures can be viewed. However, just like a picture cannot be developed if the camera has defective film, vision is not possible in an eye with a defective retina.

The back cavity of the inner eye is filled with clear jelly called vitreous . When the vitreous jelly undergoes the natural aging process it deteriorates and becomes liquid. As the eyeball moves, small pockets of liquid vitreous can move around as well inside the vitreous cavity. This movement causes the vitreous to pull on the retina, causing flashing (photopsia).

Normally the jelly is only loosely adherent to the retina and easily peels away from the retina during vitreous degeneration (syneresis). This event is called a posterior vitreous detachment (PVD) and again is a normal event occurring in most people sometime between 50 and 70 years of age.

However, occasionally, the vitreous jelly is so adherent to the retina and pulls so hard on it that it creates a tear. If this tear is along a blood vessel of the retina this may cause bleeding into the vitreous (called a vitreous hemorrhage) which could lead to a shower of floaters which cloud the vision. Acute retinal tears with or without flashes and floaters pose a risk because fluid can enter through the tear under the retina and lift the retina off, causing a retinal detachment, much like damp wallpaper peeling from the wall. Since PVDs are usually the initiating event of most retinal detachments, this is why PVDs are such a concern.

Retinal tears may be sealed with lasers or cryotherapy (a freezing treatment), or both, to prevent retinal detachment. These treatments are usually painless and seal the retina to the wall of the eye. Both of these procedures create a scar to seal the retina to the back of the eye. This prevents fluid from traveling through the tear and under the retina, and is thought to be helpful in preventing a retinal detachment.

A retinal tear is considered so serious because the vitreous liquid may leak through the tear, and pool under the retina. Gradually, the build up of liquid separates the retina from the wall of the eye, a condition called a Rhegmatogenous Retinal Detachment ( a retinal detachment associated with a hole or break in the retina). Retinal Detachments are a separation of the retinal tissue from the inside wall of the eye. Similar to wallpaper coming lose from a wall, the retinal tissue may develop folds or come completely away from its proper position along the interior of the eye resulting in loss of vision.

Retinal tears and detachments generally offer the following painless symptoms:

  • New Floaters: The presence of some floaters is common because the vitreous is not completely transparent or uniform in consistency. However, a sudden increase in the number and size of floaters perceived in your vision is a warning sign that a retinal tear could be in progress.
  • Flashes: The sudden appearance of flashes in vision may indicate that the vitreous material is pulling away from or tugging on the retina, which could be the first stage of a retinal tear or detachment.
  • Shadow or curtain over vision: The onset of a growing, dark shadow or the appearance of a curtain being pulled over a portion of the vision in one eye is an indication of a retinal detachment. These symptoms usually occur in the peripheral (side) vision. The growing shadow results from the increasing area of retinal tissue being pulled away from the back wall of the eye and no longer able to react to light.
  • Decreased vision: Another common symptom of a retinal tear or detachment is a sudden decrease in vision.

Many people experience flashes or floaters and these are not necessarily a cause for alarm. However if they are severe and seem to be getting worse, and/or you are losing vision then you should see an ophthalmologist immediately. An eye examination with dilated pupils will allow the determination of the source of your symptoms, as well as a recommendation for the appropriate treatment. Prompt treatment can often minimize the damage to your eye.

  • Retinal Surgery

    The detachment of the retina from the back wall of the eye causes it to be removed from its blood supply and therefore its source of nutrition. An untreated detachment will cause the retina to degenerate and lose its ability to function, permanently in some cases. Retinal surgery though offers hope and the chances of successfully restoring vision are dramatically improved when intervention occurs as soon as possible following the onset of symptoms.

    Very small detachments of the retina can be surrounded by laser treatment, just like retinal tears, to help limit their spread. Large retinal detachments, however, need to be repaired surgically. The two major surgical treatments for retinal detachment are scleral buckling - where a sponge or length of silicon plastic is placed on the outside of the eye and sewn in place (the scleral buckle is very small and not visible after surgery), pushing the sclera toward the tear in the retina - and pneumatic retinopexy, a less severe treatment where the surgeon injects a gas bubble inside the vitreous cavity. The bubble pushes the retina against the wall of the eye, allowing the tear to seal against the eye wall.

  • Vitreous Surgery

    If the retinal detachment is too severe for scleral buckling or pneumatic retinopexy, surgery to reattach the retina may be necessary. Under general anesthesia, the surgeon removes the vitreous entirely, replacing it with air or a fluid compatible with the eye. Over time, the fluid (or air) is absorbed, and replaced with the eye's own fluid. Lack of vitreous does not affect the patient's vision.

    The success of these surgical techniques depends upon several factors including the size and location of the damaged area of the retina, the length of time that elapses between the onset of the tear or detachment and the surgery to repair the damage, and whether or not other complicating factors are present. Many persons who have undergone retinal reattachment surgery regain all of their previous vision, while some regain only functional vision. Even in these latter instances, the treatment is usually effective in preventing further damage to the retina and more vision loss.

    All of these surgical techniques are done microscopically. We want to reassure you that your surgeon does not take your eye out of its socket to operate on it. This is simply impossible.

Retinal detachment may be caused by a number of factors ranging from a physiological weakness of the retina to a positive family history. The risk of spontaneous retinal tears and detachments increase as we grow older. Nearsighted individuals are at an increased risk for retinal tears and detachments. Persons who have had cataract surgery or have experienced a blow to the head or injury to the eye are also at risk for retinal tears or detachments. If you have had a retinal detachment in one eye, you are at increased risk of developing one in the other eye. But there is only about a one in ten chance of this happening. Retinal detachments do not happen as a result of straining your eyes, bending or heavy lifting. Retinal detachments in general are quite uncommon however and only about one person in ten thousand is affected.

If your family has a history of retinal detachment, or your doctor determines that you are at risk, it is important that you be familiar with the signs and symptoms of this condition and that you have regular and complete eye examinations.

Awareness of the symptoms of a PVD is the critical first step in preventing a retinal detachment. If you have new symptoms of a PVD (floaters, flashes, shower of spots) it is important to have a prompt and very thorough examination of the retina and its periphery to search for any retinal tears. If a retinal break can be discovered before a retinal detachment develops it can be treated with the laser to seal the break and prevent a retinal detachment. Fortunately the great majority of PVDs do not cause a retinal tear and not all retinal tears will lead to a detachment. In general, though, if a tear is associated with a symptomatic PVD it is at high risk for leading to a retinal detachment and should be treated.

Opthalmologist or an eye doctor with an interest in Retinal surgery usually treats such patients.

Yes, patients with glasses more than 6 Diopters are called high myopes. High myopes have a higher incidence of retinal detachment. Hence you need to see an eye doctor regularly, at least once a year for dilated retinal examination to look for any predisposing condition for retinal detachment or any early signs of detachment.

The chances of a retinal detachment increases in the other eye after one eye suffers the same. A regular dilated retinal examination in the other eye and timely treatment of any predisposing conditions can help prevent a detachment in the normal fellow eye.

You need to see your eye doctor. It could either be due to a long standing retinal detachment or any complication of the detachment surgery like corneal edema, secondary Glaucoma or choroidal detachment.

No, only those with advanced proliferative diabetic retinopathy have very high chances of detachment. You need to strictly control your blood sugar and visit your eye doctor regularly for a dilated retinal examination.

Cataract

Contrary to popular belief, a cataract is not a "film" over the eye. Rather it is a gradual opacification of the lens that causes the lens to become so clouded that light is either distorted or cannot reach the back of the eye (the retina) Retina: The transmitter located at the back of your eye that sends the images to your brain.

About half of the population has a cataract by age 60, and nearly everyone over 75 has at least one. But in rare cases it is earlier. Also infants can have congenital cataracts. These may be related to the mother having German measles, chickenpox, or another infectious disease during pregnancy, but sometimes they are inherited.

A cataract usually starts very small and practically unnoticeable but grows gradually larger and cloudier. Your doctor is probably waiting until the cataract interferes significantly with your vision and your lifestyle. You need to continue to visit your eye doctor regularly so the cataract's progress is monitored. If your cataract is interfering with your vision to the point where it is unsafe to drive, or doing everyday tasks is difficult, then it's time to discuss surgery with your doctor.

All surgery involves some risk, so yes, it is serious. However, cataract surgery is the most commonly performed type of surgery. Many cataract surgeons have several thousand procedures under their belt. Choosing a surgeon with this much experience will reduce the risk of something going wrong.

A small incision is made into the eye. The surgeon will either remove the lens as is, or use ultrasound (Phacoemulsification), commonly but incorrectly termed "laser" to break it up, and then remove it. The back membrane of the lens (called the posterior capsule) is left in place. Usually, a replacement lens (called an intraocular lens, or IOL) is inserted.

YAG lasers are used in a later procedure to create a clear opening in the lens-containing membrane, if the membrane becomes cloudy in the months following the original cataract removal.

Also, "laser-assisted" cataract surgery does exist in a few centers. The technology is in its developmental stage and has not yet attained the popularity of non-laser cataract surgery techniques currently performed by the vast majority of cataract surgeons.

Nowadays, cataract patients who have intraocular lenses (IOLs) implanted during surgery may need reading glasses for close vision, but that's about it.

In fact, with the newer multifocal and accommodating IOLs, even reading glasses are unnecessary.

It varies from one doctor to the next; it also depends on the procedure that is prescribed and the type of artificial lens (intraocular lens) used as a replacement.

As with any surgery, pain, infection, swelling and bleeding are possible, but very rare patients have serious problems or cataract surgery complications.

Retinal detachment also occurs in a few people. Be on the lookout for excessive pain, vision loss, or nausea, and report these symptoms to your eye surgeon immediately.

Cataracts typically cause no symptoms until they have grown large enough to interfere significantly with the passage of light through the lens. Once symptoms of cataracts develop, they may include:

  • cloudy or blurry vision
  • double vision (diplopia)
  • a sense that colors appear faded
  • seeing halos around lights
  • an increased sensitivity to glare and
  • a distortion of vision that makes objects appear as if you're looking at them through a veil.

Age-related cataracts develop very slowly and painlessly. In fact, you may not even realize that your vision is changing until you find yourself going to the eye doctor seeking a change in your eyeglass or contact lens prescription.

Many things can cause a cataract to form, the most common being the natural aging process. As the lens of your eye ages, it gradually thickens and yellows, eventually becoming so cloudy that you are said to have a "cataract." Other diseases, like diabetes Diabetes: A disease in which the body does not produce enough, or properly use, the hormone insulin, Glaucoma: An eye disease that develops when too much pressure inside the eye damages the optic nerve due to the slow drainage of eye fluid through the eye's trabecular meshwork. Without treatment, Glaucoma can cause permanent blindness within just a few years. Symptoms include halos around lights, tunnel vision and vision loss. Glaucoma is most often treated with medications designed to reduce intraocular pressure. Some of these can increase the chances of developing cataracts. Eye injuries and chronic use of corticosteroids Corticosteroids: A class of steroid hormones used to treat a variety of conditions. Chronic use may lead to the formation of posterior subcapsular cataracts.

In many cases, cataracts are age-related, appearing first when a person is in his or her 40s or 50s, but not affecting vision until after age 60. In other cases, cataracts may be related to eye trauma, long-term diabetes, corticosteroid medications or radiation treatments. In infants, cataracts may be congenital (present since birth), occurring as a result of an infection that happened during pregnancy, especially toxoplasmosis, cytomegalovirus, syphilis, rubella or herpes simplex. In infants and young children, cataracts may also be one symptom of a metabolic disease affecting the body's processing of carbohydrates, amino acids, calcium or copper.

Cataracts are the world's leading cause of blindness, accounting for approximately 42 percent of all cases of blindness in all nations. In the United States, most cataracts are age-related, affecting more than half of all Americans older than 65 to some degree. Although the exact cause of age-related cataracts is still being investigated, some scientists suspect that this disorder is linked to chemical changes affecting a class of eye proteins called alpha-crystallins. Current research suggests that alpha-crystallins act as chemical "chaperones," which prevent the abnormal clumping of other types of proteins into cataracts. Inactivation of alpha-crystallins due to age-related exposure to oxidizing agents or ultraviolet light, or to very high levels of blood sugar (in diabetics), may make it possible for cataracts to form.

Yes, there are several types of cataracts. The different types are defined by which part of the lens they affect. Nuclear cataracts are the most common and usually form as a natural part of the aging process as cells from the lens deposit in the nucleus of the lens. Cortical cataracts Cortical cataracts: A cortical cataract occurs when the transparency of the cortex surrounding the nucleus is compromised. Cortex means "shell." While not as common as nuclear cataracts, cortical cataracts are fairly common and are caused by the natural aging process.

No. Since developing cataracts is a natural part of the aging process, it is highly unlikely that you can prevent their development. There are things you can do to slow down their development, however, such as:

  1. Wear sunglasses. Look for lenses that block UVA and UVB
  2. Eat a diet rich in anti-oxidants

There are multiple types of cataracts, and even within the same type, there are a range of symptoms a person can experience.

Yes. If you live long enough, you will likely develop cataracts.

Yes. Diabetes and Glaucoma both predispose a person to developing cataracts.

Because a cataract affects the part of the eye that is responsible for refracting light, it will sometimes cause a refraction error such as nearsightedness or farsightedness. And rarely, if left to mature, a cataract can eventually become so large that it causes a type of Glaucoma.

No. As the natural lens of the eye ages, it often hardens and is less able to flex and focus light. This hardening is often accompanied by a loss of flexibility in the surrounding muscles. This hardening and loss of flexibility is commonly called presbyopia. Because presbyopia is a function of aging, many people with cataracts also have presbyopia. In recent years, multifocal intraocular lenses have been developed to correct both cataracts and presbyopia simultaneously.

No. However, a person can develop cataracts in both eyes.

Yes. When left untreated, cataracts may eventually cause blindness.

This is a colloquial way of saying that the cataract affects vision enough that the benefits of removing it outweigh the risks of the surgical procedure.

Your doctor can make the diagnosis of cataracts by dilating (widening) your pupil with medication and examining your eye directly using an ophthalmoscope and a slit lamp. You will also have a visual acuity test, a test that uses an eye chart to check the effect of the cataract on your vision.

Cataracts are long-term problems. In most patients, their effect on vision increases with time.

In general, there is currently no way to prevent age-related cataracts; however, people with diabetes may decrease their risk of developing cataracts by tightly controlling their blood sugar levels. To help prevent infection-related congenital cataracts, women should check with their doctors about their need for rubella immunization before becoming pregnant. Women who are already pregnant should see their obstetricians regularly for prenatal care.

Call your doctor whenever you have trouble seeing clearly. If you are older than 40, schedule an eye examination with your doctor every two years, even if you have not noticed any change in your vision.

Prognosis:

Cataract surgery improves the vision of 95 percent of patients who have it. In those patients who have intraocular lens replacements, 90 percent have 20/40 vision or better. In some patients who have had extracapsular surgery, part of the lens capsule eventually becomes cloudy, causing a condition called an after-cataract. This can be corrected with laser surgery, usually as an outpatient.

Cornea

Corneal Grafting

Contrary to popular belief, a cataract is not a "film" over the eye. Rather it is a gradual opacification of the lens that causes the lens to become so clouded that light is either distorted or cannot reach the back of the eye (the retina) Retina: The transmitter located at the back of your eye that sends the images to your brain.

About half of the population has a cataract by age 60, and nearly everyone over 75 has at least one. But in rare cases it is earlier. Also infants can have congenital cataracts. These may be related to the mother having German measles, chickenpox, or another infectious disease during pregnancy, but sometimes they are inherited.

A cataract usually starts very small and practically unnoticeable but grows gradually larger and cloudier. Your doctor is probably waiting until the cataract interferes significantly with your vision and your lifestyle. You need to continue to visit your eye doctor regularly so the cataract's progress is monitored. If your cataract is interfering with your vision to the point where it is unsafe to drive, or doing everyday tasks is difficult, then it's time to discuss surgery with your doctor.

All surgery involves some risk, so yes, it is serious. However, cataract surgery is the most commonly performed type of surgery. Many cataract surgeons have several thousand procedures under their belt. Choosing a surgeon with this much experience will reduce the risk of something going wrong.

A small incision is made into the eye. The surgeon will either remove the lens as is, or use ultrasound (Phacoemulsification), commonly but incorrectly termed "laser" to break it up, and then remove it. The back membrane of the lens (called the posterior capsule) is left in place. Usually, a replacement lens (called an intraocular lens, or IOL) is inserted.

The older trephine (hand held blade system) is still widely used. However, the incisions are weak and consequently sutures remain in situ for at least a year post op. Post operative astigmatism is usually very high requiring hard contact lenses to correct vision.

However, the newer Femto dalk technique uses a precise laser to remove only the abnormal corneal tissue whilst conserving the patient's own endothelial cells (less risk of rejection). Furthermore, with early removal of sutures (due to much stronger wounds after laser) result in earlier visual rehabilitation within 7 months as opposed to the 18 months with the older techniques.

No, your eye colour stays exactly the same. The transplant involves only the transparent clear cornea and not the pigmented iris!

This depends entirely on which technique is used. Medical Aids will generally cover the older method in full and will contribute towards the cost of a procedure done with a Femto laser but don't cover the entire cost. Please contact your medical aid advisor for details in your contract pertaining to transplantation. There is usually no/little cover for the laser utilization in the new technique. You will need to ‘top up' this cost. Costs for transplant differ between the older techniques (cheaper) and the new laser technique (more expensive)

Typically, donor families wish to remain anonymous but the donor Eye bank can be approached to pass on recipient's thoughts if appropriate.

General principles apply: bi- annual ophthalmic checkups, sunglasses when outdoors (polarized), healthy diet and a high index of suspicion of rejection i.e. sudden onset of light sensitivity, redness and changing vision.

Not everyone who has fuchs' dystrophy will need a cornea transplant in their lifetime. However, if you DO, then it's important that you don't wait until your doctor tells you that you have to get one, but that you tell the doctor when it's time. Many doctors are waiting for us to tell them we are ready. Others want to wait until we're almost blind before they do anything about it. If you need to get a transplant, the time to get it is as soon as the fuchs' dystrophy symptoms begin to affect your daily life. In other words, as soon as you find that you have to make any kind of adjustment or change due to the symptoms, then it's time to start thinking seriously about getting a transplant. If you go your whole lifetime and never reach the point where you have to make an adjustment or change because of fuchs' symptoms, then you are one of the lucky ones who never need a transplant! If you need one, what's wrong with waiting? Due to not having blood vessels in the cornea the healing time of a cornea transplant (no matter what kind of cornea transplant you have done) may be 6 months to 1 1/2 years. You need to be able to depend on the other eye to have good enough vision to "carry the load" during the healing time so that you don't lose your independence.

No matter what kind of cornea transplant you get you never get someone's eye. They can't do "eye transplants", only "cornea transplants." Even if you have a traditional full transplant done, you only get a tiny little scrap of tissue (like a tiny piece of skin). Visualize it this way: if you fell and scraped a little skin off your knee, the full transplant is probably smaller than that tiny little bit of skin you just lost from your knee. You don't get "someone else's eye"; what you get is just a tiny little piece of tissue.

If you have a traditional full cornea transplant you will get stitches to hold the cornea firmly in place while it heals. Contrary to what one might think, the stitches used in a full cornea transplant are not felt, nor can the patient see them when using their eyes to view things. There is, right after the surgery, some scratchiness, but it goes away after a few days. They are, for all intent and purpose, invisible and undetectable by the patient. When you have a full cornea transplant you aren't even aware of having any stitches at all. Partial transplants don't use stitches to hold the cornea firmly in place, but an air bubble that's pumped inside the eye instead. The air bubbles create their own problem such as not being secure (therefore causing graft dislocation) as well as increasing the internal eye pressure. There are different kinds of partial transplants. One kind has no stitches (these have more potential damage to the cornea and much more cell loss) and the other uses a couple stitches to close the incision.

No, the stitches don't dissolve. However, those who have stitches in aren't even aware that they are in there, even after many years. Some doctors believe in removing the stitches after the surgery, and others believe in leaving them in as long as they can.

No! No matter if you have a full or a partial transplant, you will NOT be blind, but will be seeing out of that eye the next day when they take the patch off! Some people, after a full transplant, are fortunate enough to be seeing 20/25 or 20/30 the very next day, others may only see 20/400 and be "legally blind" for awhile, but even at the worst you will still be able to see and identify people and objects. There will be a long healing time involved, no matter if it's a full OR a partial transplant. However, during that time you won't lose your ability to see and identify people and objects.

In a full transplant (called "PK" or "traditional transplant") the doctor removes all of the cornea except a tiny outside edge, and sews a complete new donor cornea onto that outside edge. Keep in mind that the cornea is just a tiny, thin bit of TISSUE and not a complete eye. In a partial transplant the doctor only removes one or two layers of the cornea, and replaces only those layers. In a partial transplant, instead of stitches, the cornea is held in via an air bubble that's pumped into the eye. There are various kinds of partial transplants.

Yes. With full transplants the patient can do pretty much everything they want to immediately following the surgery, with lifting and bending restrictions only. With partial transplants most of the doctors require the patients to lie flat on their back, as immobile as possible, for anywhere from 4 hours to 48 hours after the surgery.

Full cornea transplants were the first kind of any kind of transplant ever done. They have been done, with an almost 100% success rate, for over 100 years on literally millions of patients. All of the potential problems have been discovered many decades ago, with solutions found for them, and the long-term results are well-known and successful. Because they remove the entire cornea, the odds of the fuchs' dystrophy returning are slim to none. Over the 100+ years of being done the full cornea transplant has been constantly improved upon, with improvements STILL being made on them. Because of the many decades of improvements on improvements, plus their reliability and stability, these have been known as the "gold standard" of transplants.

First couple of DSEKs were done in 2003. It was only in late 2005 and early 2006 that there were large numbers of these done by more than just a few doctors. The DMEK, the newest of all, just started in 2008, and is so different from the DSAEK/DSEK that data for those are also not equivalent to that for DSAEK. Therefore, if you talk DMEK, any data will be on very few patients, the shortest time of all, and cannot be equated with the DSAEK. In fact, there is no data on DMEK at all yet. All of the partial transplants are still considered "investigational".

Yes, it means a lot! It means that right now things are going well for them! You will find people who had partial transplants done who are very happy with the results and you will find people who had full transplants done who were very happy with them. You'll also find (if you ask enough people) some who had partial transplants done who did NOT get good vision, or didn't get it very quickly; and you'll find the same from people who had full transplants done. The big thing to always remember, though, is that everybody is different and their results may not be yours; and, today's results are no indication of what future vision will be like. In other words, we know the full transplants will, in most cases, last a lifetime and have good vision that whole time, because millions of people have proven that over 100+ years. We have no such proof yet for partial transplants, so we do not know yet. We know the future complications and long-term results of full transplants, we don't for partial ones.

Please also be aware that any comparisons made between full transplants and partial transplants results are not exactly comparing "apples to apples" in that: 1) most drs doing partial transplants are starting with much higher cellcounts in the donor tissue than they do with full transplants. This gives much more room for cell loss in partial transplants than full ones.

If the patient doesn't "push" their doctor for a transplant, many like to wait until you're almost blind before doing full transplants. In contrast, many are doing partial ones earlier.... thus "skewing" the results in comparison, since the better the pre-transplant vision USUALLY the better and faster the post-transplant vision in either full or partial transplants.

After a transplant there will be quite a bit of followup work. You will be needing to see someone who knows what they are looking for afterwards. Even though the local dr you see may have experience doing full transplants, there are problems involved with partial transplants that they not only may not be familiar with, but may not know what to look for. If you are having followup work done by a dr who isn't experienced with partial transplants, you run a risk of the dr not spotting things that are not "normal" for a partial transplant, and possibly losing the transplant. Your safest bet for your future vision is to have a dr who is experienced with the procedure doing both the surgery AND the followups afterwards. In addition, since both full and partial transplants run a risk of rejection or graft failure for the rest of your life, it's important that for the rest of your life you have someone as close as possible to run to whenever something is "different" to check it out. It's better to go to an experienced dr and find out that what is happening is "normal", than to either not go, or have someone inexperienced with the procedure check, and find out later it was important. The sooner problems are detected and fixed the better chance you will have of correcting the problem and saving the cornea. It's generally understood that there is about a 48-hour "window" if a rejection starts. If you can get started turning a rejection around within 48 hours of it starting you have a good chance of saving it.

You have to be aware that blisters leave scarring on the epithelium layer of the cornea, and/or the sclera layer. These layers are not replaced with a partial transplant, but they are with a full one. A second stage laser based procedure will then be needed in addition but this procedure wouldn't leave the cornea as clean and good as it would be if it were an epithelium layer that had never had blisters in the first place. If you have blisters, then you have to decide if you want to have a clean scar-free epithelium with a full transplant, or if you'd rather have a partial one and have the additional procedure to remove as much scar tissue as possible later, with the full understanding that the vision after both procedures are done may not be as good as it would be after a full transplant.

If you have more than one eye problem, such as having fuchs' dystrophy and map-dot, this will also have an effect on the kind of procedure you have done. Having a full transplant not only removes both diseases completely so that you don't have to worry about either reccurring, but it gives you a never-been-scarred epithelium layer to see through.

There are many kinds of DSAEK's (partial transplants). The "no stitch" kind does a 3mm incision through the cornea itself. It's important to note that partial transplants, due to the nature of the surgery itself, lose a massive amount of cells doing the surgery- many, many, many more cells than are lost when doing a full traditional transplant. As we've learned with fuchs' dystrophy, the less cells we have, the worse our vision will be. We lose cells normally as we age. Therefore, the amount of cell loss during surgery is something that is important, especially as we get older and lose even more cells. Dr Mark Terry (the original U.S. creator of partial transplants) promotes a kind of DSAEK that has a 5mm incision through the sclera and uses 1-3 small stitches. This kind (through the sclera with a 5mm incision) not only has much less cell loss during the surgery than the 3mm incision, but it also has much less potential corneal damage during the surgery than the one that cuts through the cornea. It's important to understand that stitches are NOT felt or seen by the person who has them, nor by someone looking at them. When you have stitches, you are not even aware that they are in there.

Astigmatism can happen after either kind of transplant, although it's spoken of often as a major problem after full transplants, and is sometimes used by drs as a reason to have a partial done instead of a full transplant. There are other problems just now being discovered with partial transplants, some of which can never be fixed (unlike astigmatism), such as permanent irrepairable pupil dilation. Both full and partial transplants have the possibility of developing Glaucoma due to use of steroid drops after the surgery. Those same drops also have a risk of creating cataracts after the surgery. They also both have the possibility of rejection or infection. There is some talk of having less of a chance of rejection with a partial than a full transplant. Since partial transplants are so very new MOST of the complications and problems are yet to be discovered with them. Major cell loss is one of the major problems with partial transplants. Keep in mind that we all lose some cells normally with aging. This (along with having still "abnormal" layers remaining) is one of the biggest concerns of drs for the long-term.

All doctors admit that fuchs' dystrophy affects all of the layers of the cornea. Removing only the endothelium and descmet's membrane, and leaving other ones behind that were also affected by the disease, is leaving problems behind in your eye.

Keep in mind that this would involve a second major trauma to the eye, in addition to more costs and starting over with healing time. This is not something to be "taken lightly". It is better to have fewer interventions in the eye. Each trauma and/or surgery you have weakens the eye more.

Astigmatism isn't anything to fear, nor a good reason to select one procedure over another. Many people, even those without any eye disease or transplants, have astigmatism. It isn't uncommon. Also, not everyone who has a full transplant has major astigmatism problems. Most who have astigmatism afterwards can correct the astigmatism with glasses. In fact, that's the major reason people (even without diseased eyes or transplants) wear glasses... astigmatism! There are even fewer who can't correct it either with glasses or contact lenses, and these then can have laser correction (Lasik) done on the transplant eye to correct the problem. However, this is not a major issue in most cases of people who have a full transplant. Also, there have already been numerous cases of astigmatism after partial transplants, so it's not a "given" that you'd avoid it by going that route.

Some people can see well quickly after a partial transplant, and others can't. Many people who have partial transplants get "interface haze" which blurs vision similar to having fuchs' dystrophy vision. Sometimes that "haze" lasts a couple of months and sometimes a year or longer. Other people have other problems show up, such as pupil problems. Both partial and full transplants have some people who can see well quickly, and both have some people who do NOT see well quickly.

Generally speaking how quickly you get good vision afterwards isn't as dependent on the KIND of procedure you have done as it is on the person it's done on, which eye is being done on.

This is something that can't be answered with a "yes" or a "no". No matter what kind of transplant you have done you will still have the DNA in your body, so if you have transplants and then have children, your children still have a 50% chance each of inheriting it from you.

Traditional full transplants have been done so long now that they have had statistical proof for many decades now that the disease won't come back in almost every case. The disease progresses from the center of the cornea outward towards the outside edge. If the patient/dr waits until the disease has gone all the way to that very very tiny outside edge that has to remain for a full transplant (to sew the new one onto), there have been isolated cases where the disease has gone back into the new cornea. Since most don't wait that long, though, the risk of that happening is very very slim. With partial transplants too, there is the hope that the disease won't come back like it doesn't with full ones.

Less stitches, possibly less astigmatism, and sometimes somewhat faster healing time. However, keep in mind that not everyone who has partial transplants expecting fast good vision may not get the good vision as fast as they expect, nor as good as they had hoped for.

We must keep in mind all the pros and cons of all types of procedures and choose the one best suited for us.

Keratoconus

Contrary to popular belief, a cataract is not a "film" over the eye. Rather it is a gradual opacification of the lens that causes the lens to become so clouded that light is either distorted or cannot reach the back of the eye (the retina) Retina: The transmitter located at the back of your eye that sends the images to your brain.

About half of the population has a cataract by age 60, and nearly everyone over 75 has at least one. But in rare cases it is earlier. Also infants can have congenital cataracts. These may be related to the mother having German measles, chickenpox, or another infectious disease during pregnancy, but sometimes they are inherited.

A cataract usually starts very small and practically unnoticeable but grows gradually larger and cloudier. Your doctor is probably waiting until the cataract interferes significantly with your vision and your lifestyle. You need to continue to visit your eye doctor regularly so the cataract's progress is monitored. If your cataract is interfering with your vision to the point where it is unsafe to drive, or doing everyday tasks is difficult, then it's time to discuss surgery with your doctor.

All surgery involves some risk, so yes, it is serious. However, cataract surgery is the most commonly performed type of surgery. Many cataract surgeons have several thousand procedures under their belt. Choosing a surgeon with this much experience will reduce the risk of something going wrong.

A small incision is made into the eye. The surgeon will either remove the lens as is, or use ultrasound (Phacoemulsification), commonly but incorrectly termed "laser" to break it up, and then remove it. The back membrane of the lens (called the posterior capsule) is left in place. Usually, a replacement lens (called an intraocular lens, or IOL) is inserted.

Typically, an eyecare professional will treat early stage Keratoconus with contact lenses or glasses addressing the early vision correction needs of the patient. In later stages, rigid gas permeable contact lenses are often recommended. These lenses are used to improve one's vision and to brace the bulge in the cornea. In advanced cases, where the patient can no longer achieve adequate functional vision with contact lenses, corneal transplant surgery may be necessary.

No, historically very few if any persons suffer from total blindness from Keratoconus alone. But in severe cases, one's vision can be significantly impaired and normal everyday activities may be difficult.

Due to the onset and progression of Keratoconus, the weakened cornea loses; its natural dome-like shape. As a result, the light rays entering the eye are no longer focused properly, impairing one's ability to see images clearly.

Intacs are specially designed inserts, made of medical plastic, which are surgically placed under the surface of the cornea. Due to their unique patented design, Intacs are able to remodel the architecture of the cornea re-establishing a more natural dome-like shape and improving one's vision.

Of those who suffer from Keratoconus, approximately 20% will undergo a corneal transplant. The success rate is high although the grafts only last for about 10 years, therefore a young person may have to undergo several corneal transplants. The recovery time for the patient varies and can take more than a year. Contact lenses or glasses are typically required after surgery to achieve acceptable vision.

A corneal transplant is an invasive surgical procedure, requiring the removal of a section of your cornea and having it replaced with donor tissue. Although successful, it is a delicate procedure with typically a long recovery period.

The Intacs procedure does not require removal of corneal tissue, but rather works on the principle of reshaping your own cornea from within utilizing special designed corneal inserts that provide structure to a weakened cornea. The recovery period is typically short, with visual improvement noticed almost immediately.

In the few cases in which a corneal transplant was performed after an Intacs procedure, there were no complications reported.

Cross-linking is a medical procedure that combines the use of ultra-violet light and riboflavin eye drops.

The last two of years has seen a marked increase in the prominence of corneal collagen cross-linking as a treatment strategy for progressive Keratoconus. This interest has arisen from a body of evidence documenting the biomechanical and cellular changes induced by cross-linking. The findings of this research provide a rationale for its use in Keratoconus to retard the progression of this common disease. A rapidly growing number of clinical reports suggest a consistent stabilizing effect of cross-linking along with a variable improvement in corneal shape and visual function in some patients. As a first-line treatment the greatest aim of cross-linking is to reduce and stop Keratoconus in the early phase of the condition, and to treat the progressive vision loss that occurs which can lead to corneal transplantation.

Riboflavin (vitamin B2) is dripped onto the cornea and then exposed to ultra violet light. The light causes the riboflavin to fluoresce, which leads to the formation of bonds between collagen molecules or simply stated, collagen cross-linking.

In 2008, Raiskup-Wolf et al. described what remains the largest published series comprising 241 eyes followed in Dresden for up to 6 years after crosslinking. This uncontrolled, retrospective study confirmed earlier findings with statistically significant improvements in astigmatism, best-corrected visual acuity (BCVA) and maximum simulated keratometry values (Kmax) at 12 months. Flattening was observed in 54% of eyes with a mean change in Kmax of -1.91 D (P 0.01). The effects of cross-linking were maintained over the duration of follow up with progression of the disease documented in only two patients (which responded to re-treatment). Subsequent published reports from several other centers have described similar results.

The ultraviolet light exposure during a crosslinking procedure is comparable to, or even less than, the exposure of the eye to the ultraviolet light in skylight for a full day outdoors in summer. The riboflavin drops are simply vitamin B2, commonly used in foods such as your breakfast cereal.

The first human eyes were treated in 1998.

Very. There are no cuts in the body of the cornea. It is much safer than a corneal graft which has been very successful in the past, and even than a gas permeable contact lens, and also there is no chance of rejection (some grafts tend to last around 10 -15 years).

The transplant carries risks such as infection, rejection, cataracts, Glaucoma, astigmatism and failure. At 15 years, there is no difference in the survival rate between penetrating corneal transplants performed for Keratoconus and those performed for all other indications. Young Keratoconus patients are likely to need one or more repeated grafts during their lifetime. Crosslinking avoids the removal of any corneal structural tissue (only the surface epithelial cells are removed and these grow back mostly within 2 days).

With today's improved technology, the vast majority of people suffering from Keratoconus and other corneal ectasia may safely undergo cross-linking. However, there are exclusion criteria, so consult your ophthalmologist to determine if you are a candidate.

Not usually but consult your ophthalmologist.

Anesthetic eye drops are applied and the surface cells of the cornea (the epithelium) are gently removed so the riboflavin eye drops can penetrate into the cornea. The riboflavin eye drops are applied and allowed to soak into the cornea. The cornea is then irradiated with ultra-violet light. The amount of time the riboflavin soaks into the eye and the amount of time the cornea is irradiated with ultra-violet light vary significantly depending on the ultra violet light source used by the ophthalmologist. Advances in ultra violet light sources have reduced total procedure time to about half an hour. At the completion of the procedure, a bandage contact lens is inserted and the eye is patched overnight.

Studies are ongoing with riboflavin formulations that may allow the epithelium to remain intact during cross-linking. Check with your ophthalmologist regarding this option.

Often transient and treatable and a part of the healing process: Pain in the first 1-2 days, sensitivity to light for several days, haze within the cornea that may cause blurring for up to a few weeks. There are other, less common, possible complications and side effects that your ophthalmologist can discuss with you.

Cross-linking can be combined with Corneal Rings, Phakic Lens Implants, Refractive Lens Exchange, ARK, PRK and LASEK.

Yes, but during the past 13 years a one-time treatment has been shown generally to be enough to treat progression.

One of the goals of cross-linking is to make the cornea more regular, allowing for soft contact lenses to replace the need for rigid gas permeable lenses. Rigid gas permeable lenses are good for vision in Keratoconus, but without warning can cause central scarring and/or can aggravate the condition. Your ophthalmologist will tell you if soft contact lenses are possible after cross-linking and how soon after treatment you may begin wearing them.

The blurring mentioned earlier may affect some people, especially in the first few days, and could limit work and driving during that time. However, consult your ophthalmologist.

No. There is no change in the appearance of your eyes following cross-linking.

Tens-of-thousands of people have had their corneas cross-linked during the past 13 years. Due to the universal acceptance of the benefits of cross-linking among ophthalmologists, and recent advances in technology, the annual number of cross-linking procedures is expected to increase substantially.

Cross-linking was fully approved for use in the EU in January 2007 and almost all other countries have now approved its general use to treat Keratoconus. Cross-linking began FDA clinical trials in the United States in 2008 and at least one company has completed those trials and is expected to submit its results during 2011.

Technically yes, but the short term blurring due to the current procedure makes this impractical.

No. It has no effect on any future surgery as far has been determined until now.

Lasik

Contrary to popular belief, a cataract is not a "film" over the eye. Rather it is a gradual opacification of the lens that causes the lens to become so clouded that light is either distorted or cannot reach the back of the eye (the retina) Retina: The transmitter located at the back of your eye that sends the images to your brain.

About half of the population has a cataract by age 60, and nearly everyone over 75 has at least one. But in rare cases it is earlier. Also infants can have congenital cataracts. These may be related to the mother having German measles, chickenpox, or another infectious disease during pregnancy, but sometimes they are inherited.

A cataract usually starts very small and practically unnoticeable but grows gradually larger and cloudier. Your doctor is probably waiting until the cataract interferes significantly with your vision and your lifestyle. You need to continue to visit your eye doctor regularly so the cataract's progress is monitored. If your cataract is interfering with your vision to the point where it is unsafe to drive, or doing everyday tasks is difficult, then it's time to discuss surgery with your doctor.

All surgery involves some risk, so yes, it is serious. However, cataract surgery is the most commonly performed type of surgery. Many cataract surgeons have several thousand procedures under their belt. Choosing a surgeon with this much experience will reduce the risk of something going wrong.

A small incision is made into the eye. The surgeon will either remove the lens as is, or use ultrasound (Phacoemulsification), commonly but incorrectly termed "laser" to break it up, and then remove it. The back membrane of the lens (called the posterior capsule) is left in place. Usually, a replacement lens (called an intraocular lens, or IOL) is inserted.

There is a risk of loss of best corrected visual acuity. For most patients, visual acuity will have stabilized in about 3 to 6 months, although full recovery, especially for PRK, may take 4 to 12 months.

If you are over 40 years of age and have laser vision correction to correct both eyes for distance vision, you will likely need reading glasses in order to see objects approximately 3 feet and closer, either now, or sometime in the next several years.

You may experience dryness of the eyes and this dryness may cause severe irritation, discomfort, and blurring of vision for several weeks, or longer, and could rarely be permanent.

The cornea could become weakened from the thinning of laser vision correction, and begin to bulge. This is known as ectasia. There is no way to completely eliminate the risks of ectasia with LASIK, PRK or LASEK. Patients having LASIK are at higher risks for ectasia than patients having PRK or LASEK. The doctor may recommend PRK as a way to lower the risk of ectasia, but there is no guarantee that the condition will not develop. Ectasia can result in vision loss.

You can find approved devices, their approval date, and a synopsis of the approved indications on the FDA-Approved Lasers page.

Confidentiality restrictions prohibit FDA from commenting on the status of a device under regulatory review, but you can try asking the laser company for this information.

FDA does not provide comparisons between refractive lasers. FDA approves the safety and effectiveness of a device independent of any other product. Discuss any concerns you may have with your doctor.

Wavefront adds an automatic measurement of more subtle distortions (called higher order aberrations) than just nearsightedness, farsightedness, and astigmatism corrected by conventional LASIK. However, these "higher order aberrations" account for only a small amount (probably no more than 10%) of the total refractive error of the average person's eye. Conventional LASIK increases higher order aberrations. Although wavefront-guided treatments attempt to eliminate higher order aberrations, results from the clinical studies have shown that the average aberrations still increase, but less than they do after conventional LASIK. In a few studies comparing wavefront-guided LASIK to conventional LASIK, a slightly larger percentage of subjects treated with wavefront LASIK achieved 20/20 vision without glasses or contact lenses compared to subjects treated with conventional LASIK. Patient selection and the experience and competence of the surgeon are still the most important considerations.

The difference between traditional LASIK and " All-Laser LASIK" (also known as "Bladeless LASIK") is the method by which the LASIK flap is created. In "All-Laser LASIK", a laser device called a laser keratome (femtosecond laser), is used to cut a corneal flap for LASIK surgery. This is a newer method to create a corneal flap than the traditional method of using a microkeratome, a mechanical device with a blade. There is no absolute agreement among eye surgeons on the better choice for flap creation. Some of the factors a surgeon considers when choosing a preferred method of flap creation during LASIK are as follows:

  • Quality of vision
  • Rate of complications
  • Pain during and after surgery
  • Precision of flap size and thickness
  • Time to recovery of vision
  • Expense

Discuss with your doctor any questions and concerns you have about how they chose their preferred method of flap creation.

Yes. Information on this website can be used freely by the public. Any use on other websites or in publications should be properly cited.

In traditional LASIK, the surgeon uses a hand-held mechanical device to create the corneal flap. With the IntraLase laser, the surgeon uses rapid laser pulses rather than a blade, allowing the surgeon more control. While the traditional procedure has a very low incidence of complications—less than one—percent the IntraLase FS is so precise that it virtually eliminates complications associated with the flap.

Yes. Many patients prefer to minimize the time off work and reduce the amount of healing time they experience after surgery, so they have both eyes done during the same visit.

No. Your vision may be blurry in the first few hours after the procedure. In addition, you will be given a mild oral sedative prior to surgery and, thus, will need someone to drive you home. Many people are able to drive the next day.

You will be told to avoid strenuous activity or visually demanding tasks for at least 1-2 days after LASIK and 3 days after LASEK/PRK. Make sure to ask about specific activities that are important to you.

No. Certain strenuous activities, contact sports and swimming should be postponed for several weeks.

It is recommended that you avoid using eye make-up for the first week after surgery to reduce the risk of infection.

No. You should avoid getting water in your eyes for about one week after surgery, so be careful when washing your face and hair.

Your vision after surgery either will be perfect, or under- or over- corrected. This can be fixed with a minor procedure called an enhancement or touch-up. This procedure typically is performed approximately three months after the initial surgery if visual improvement has not been attained. These enhancements are only necessary in about 10 percent of all cases.

Refractive surgery is considered an elective procedure and, therefore, usually is not covered by insurance companies. Some plans will cover a portion of the screening examination. However, to be sure, check with your insurance company at the time of your evaluation.

As with all types of surgery, there is a possibility of complications, including those due to drug reactions. Understand that it is impossible to be informed of all potential risks of any surgery, including laser vision corrective procedures. Provide the doctor and the staff with complete and up to date information regarding your medical history and your prescription and over the counter medications you currently take. The most common is either over-correction or under-correction, both of which can be treated. Individual variation is part of any refractive surgical procedure. While everyone hopes for perfect vision, perfection is not always the result. Your expectation should be reduced dependence on glasses and contact lenses, realizing that they may still be needed for some activities. Dry eyes are also common in the early post-operative period.

Sight-threatening complications are very rare. There is always a small risk of infection, scarring, abnormal healing patterns, or cell growth underneath the corneal flap. This may cause partial loss of vision and require further medical or surgical treatment.

Although vision may fluctuate slightly during the first few days and also shift slowly for 6 to 12 months, most of the healing is complete within 3 to 6 months. With nearly a decade of experience with PRK, we know that the procedure is stable, with no evidence of late-onset complications. LASIK has been available for about five years and, from the data collected over this period, also appears stable.

There is a very slight chance that your vision could be worse. Results thus far, however, have shown excellent stability after PRK and LASIK.

Yes. In most cases, PRK and LASIK do not interfere with the use of soft contact lenses. Rigid contact lenses can sometimes be used but the fit may be more difficult. Some patients cannot wear rigid contact lenses after refractive surgery.

By middle age, all people need help reading. If your nearsightedness is permanently eliminated by PRK or LASIK, you may need to start using reading glasses in your forties.

Depending on your specific procedure, eye drops may be needed for anywhere from three days to six months, but not permanently.

You can pay your bill with cash, cheque or credit card .

Glaucoma

Contrary to popular belief, a cataract is not a "film" over the eye. Rather it is a gradual opacification of the lens that causes the lens to become so clouded that light is either distorted or cannot reach the back of the eye (the retina) Retina: The transmitter located at the back of your eye that sends the images to your brain.

About half of the population has a cataract by age 60, and nearly everyone over 75 has at least one. But in rare cases it is earlier. Also infants can have congenital cataracts. These may be related to the mother having German measles, chickenpox, or another infectious disease during pregnancy, but sometimes they are inherited.

A cataract usually starts very small and practically unnoticeable but grows gradually larger and cloudier. Your doctor is probably waiting until the cataract interferes significantly with your vision and your lifestyle. You need to continue to visit your eye doctor regularly so the cataract's progress is monitored. If your cataract is interfering with your vision to the point where it is unsafe to drive, or doing everyday tasks is difficult, then it's time to discuss surgery with your doctor.

All surgery involves some risk, so yes, it is serious. However, cataract surgery is the most commonly performed type of surgery. Many cataract surgeons have several thousand procedures under their belt. Choosing a surgeon with this much experience will reduce the risk of something going wrong.

A small incision is made into the eye. The surgeon will either remove the lens as is, or use ultrasound (Phacoemulsification), commonly but incorrectly termed "laser" to break it up, and then remove it. The back membrane of the lens (called the posterior capsule) is left in place. Usually, a replacement lens (called an intraocular lens, or IOL) is inserted.

The "puff test" that most people are familiar with is a screening test that measures IOP. But the gold standard for measuring eye pressure is applanation tonometry. In this Glaucoma test, an eye drop is used to numb the surface of your eye and a small probe rests gently on your cornea to measure IOP. Also, the corneal thickness needs to be measured as the applanation reading depends on it.

Your doctor may also want to check for optic nerve damage by dilating your eyes and check for vision loss with a visual field test.

Though it's unclear whether Glaucoma can be prevented, you might be able to reduce your risk for the disease by maintaining a healthy lifestyle.

I would advise to avoid smoking and excessive alcohol, eat a healthy diet, keep your weight down, exercise, take nutritional products and be sure to see your eye specialist on a regular basis.

There are usually no symptoms to suggest that you're developing Glaucoma until vision loss occurs, which is why it's so important to have regular eye exams. Your eye doctor can detect and treat high IOP before it progresses to optic nerve damage and vision loss.

In some types of Glaucoma you may have headaches. But by and large NO! Glaucoma is called the "sneak thief of sight because it starts by affecting your side vision in very subtle ways that you cannot detect.

Primary open-angle Glaucoma (POAG), normal-tension, narrow-angle (PACG), closed-angle, congenital, pigmentary and secondary. PACG is more common is Asians and East- Asians.

Vision loss from Glaucoma cannot be reversed. Routine eye exams are essential to discover Glaucoma early and begin Glaucoma treatment before significant vision loss has occurred.

Doctors usually prescribe special Glaucoma eye drops that reduce intraocular pressure. These are used one or several times a day, depending on the medication. If the drops don't work, surgery may be the next step. In some cases, surgery might be the first option for Glaucoma treatment.

Generally, eye drops can be prescribed to help lower the pressure in the eye. These drops must be used daily to have optimal effect, and continued for the rest of your life. It is not uncommon to be prescribed more than one type of drop to be used at the same time.

No. Glaucoma is like high blood pressure in that medication does not cure the disease, but it does treat it, preventing further damage. Fortunately we have many good medications available now that are very effective and have few side effects. . New and exciting medications are also under development now.

Unfortunately, eye drops that control Glaucoma can have such side effects as headaches, effects on the heart, asthma and decreased libido. Moreover, there can be a substantial financial side effect in terms of the cost of these drops if you are required to take more than one type of drop. It is important to let your doctor know about any pre-existing diseases that you have so that your medication can be altered accordingly.

Yes, but it is usually not done unless medications fail. There is also a laser procedure, which is beneficial in ACG.

Not really. While some people tout "natural" benefits of marijuana for treating Glaucoma, the American Academy of Ophthalmology says side effects far outweigh any possible benefit that typically is greatly exaggerated. You're much better off using prescribed medication or treatment that is far more effective than marijuana.

People being treated for Glaucoma typically are not good candidates for LASIK. This is because a suction device is used on the eye during the creation of the corneal flap during LASIK surgery, and this briefly causes a significant increase in IOP.

But you might be a candidate for another type of vision correction surgery, such as PRK, which does not require the use of a suction device.

Research studies, have demonstrated that the measurement of eye pressure not the actual eye pressure itself can be affected by surgery that changes a patient's corneal thickness. The degree of measurement error will depend upon the technology that is used to measure your eye pressure.

Squints

Contrary to popular belief, a cataract is not a "film" over the eye. Rather it is a gradual opacification of the lens that causes the lens to become so clouded that light is either distorted or cannot reach the back of the eye (the retina) Retina: The transmitter located at the back of your eye that sends the images to your brain.

About half of the population has a cataract by age 60, and nearly everyone over 75 has at least one. But in rare cases it is earlier. Also infants can have congenital cataracts. These may be related to the mother having German measles, chickenpox, or another infectious disease during pregnancy, but sometimes they are inherited.

A cataract usually starts very small and practically unnoticeable but grows gradually larger and cloudier. Your doctor is probably waiting until the cataract interferes significantly with your vision and your lifestyle. You need to continue to visit your eye doctor regularly so the cataract's progress is monitored. If your cataract is interfering with your vision to the point where it is unsafe to drive, or doing everyday tasks is difficult, then it's time to discuss surgery with your doctor.

All surgery involves some risk, so yes, it is serious. However, cataract surgery is the most commonly performed type of surgery. Many cataract surgeons have several thousand procedures under their belt. Choosing a surgeon with this much experience will reduce the risk of something going wrong.

The answer depends on the sport. In 1997, over 44,000 eye injuries occurred in sports related activities. A large percentage of these were in young athletes. Protective eyewear may decrease these injuries by 90%.

In sports such as basketball, racquetball, tennis and soccer, goggles should be worn to protect the eyes from the ball or from other players' elbows, knees or feet. If your child wears glasses, you may purchase protective goggles with the prescription already built in.

In low risk sports, such as track and field, street wear frames with polycarbonate or plastic (CR-39) lenses should be adequate. A sports head strap that secures the frames also increases safety by helping to keep the glasses from falling off.

People who are nearsighted, or myopic, have difficulty seeing in the distance without glasses. Children with myopia may squint to see distant objects, or complain of being unable to see the board. Infrequently, they may complain of headaches. Headaches are actually more often a sign of other eye problems.

There is no set age for the onset of myopia. Parents who never needed glasses may have a child who starts to wear them in 1st or 2nd grade. Parents who had glasses in grade school may have a son or daughter who does not need them until later if ever. If children exhibit signs of poor vision, such as squinting, closing one eye or wandering eyes, or if a school screening test has detected a problem, you should arrange an exam with an Eye Doctor.

Amblyopia, also known as "lazy eye" is poor vision due to lack of normal development of sight. It is a very common condition, affecting 2-3 of every 100 people. Normally, children's eyes continue to develop from birth until age 9 or 10.

Amblyopia is caused by conditions that interfere with that normal development. There are three major causes of amblyopia:

  1. Unequal focus. In the healthy eye, equal focusing problems can be corrected with glasses. If there is unequal focus because one eye is more nearsighted, farsighted, or has astigmatism, amblyopia may occur. In these cases, the out of focus or blurry eye "turns off" and becomes amblyopic. The brain ignores that blurry eye, and it develops poor vision. This type of amblyopia is very difficult to detect, because the eyes look normal.
  2. Strabismus or misaligned eyes can cause amblyopia when the brain ignores the crossed eye to avoid seeing double. The straight eye usually retains normal vision. Some children may have a large amount of crossing, which is easy to detect. Others have a very tiny amount, which can be difficult to see at home, but can still cause amblyopia.
  3. Cloudiness of the normally clear parts of the eye can prevent a sharp image from reaching the inside of the eye. One example of this is a cataract, or cloudiness of the lens of the eye. Although far less common in children than in the elderly, cataracts can occur in young children.

Amblyopia is diagnosed by finding a difference in the vision of the two eyes. A vision screening exam will help detect this, though further diagnosis and treatment will need to take place with an ophthalmologist. An Eye Doctor will help determine which of the three causes of amblyopia are occurring in your child. Sometimes, more than one can exist at the same time. During that visit, the entire eye will be carefully examined to check for other causes of poor vision.

Treatment of amblyopia involves using the weak eye. Covering or patching the stronger eye accomplishes this by making the weaker eye work alone. Glasses may also be prescribed to correct the unequal focus, or to attempt to straighten misaligned (strabismic) eyes. Patching often needs to be done while wearing glasses full time in order to completely treat amblyopia. If surgery is required for straightening the misaligned eyes, patching or glasses may continue afterward. Surgery, if necessary, may correct the strabismus, but only patching or using the weak eye can correct amblyopia. All forms of treatment need to be started as soon as possible. Amblyopia in particular can become permanent if not treated at an early age.

While the colloquialism "lazy eye" is frequently used to refer to amblyopia, the term is inaccurate because there is no laziness of the eye involved in the condition. For a variety of reasons the brain fails to make the normal neural connections necessary for sight.

Common causes are a misalignment of the eyes, uncorrected refractive error (short-sightedness, far-sightedness or astigmatism), or an obstruction in the line of vision e.g. a cataract.

Usually only one eye is affected. Detecting the condition in early childhood increases the chance of successful treatment.

You can come to Eye Specialists directly for a full eye health check. You will have a range of tests done by our ophthalmic technician before seeing the ophthalmologist. The pupils of the eyes will be dilated using eye drops for the ophthalmologist to have a look into the eye.

Treatment is individualised and may include glasses, drops, patching, surgery or a combination of these.

Many children have sneezing, eyelid swelling, tearing, itching and a clear discharge in springtime or early fall, indicating seasonal allergies or hay fever. If your child has some or all of these symptoms, your primary care doctor may have you try some simple treatments at home.

Cold compresses can be effective for short-term relief of itching. There are many eye drops that are also effective, but you should check with your primary physician before using any over-the-counter eye drops in children. Prescription eye drops are available to provide relief. Your primary care physician may refer you to an Eye M.D. (ophthalmologist) if your symptoms are particularly troublesome or persistent.

A red eye may also occur with a viral infection (commonly referred to as pink eye). Although it is sometimes difficult to initially determine whether a red eye is due to a virus versus seasonal allergies, a few key features can help. A viral infection is more likely if there is a history of a recent cold or exposure to another person with a red eye. Unlike seasonal allergies, viral infections usually begin in one eye first, and may or may not spread to the other eye. It typically lasts for 8-10 days. Careful hand washing can prevent the spread of this infection to others. Your primary care doctor can help determine if other intervention is necessary.

Finally, red eyes that persist or are accompanied by pain or decreased vision can be a sign of a more serious problem. Your family doctor will direct you to an Ophthalmologist for immediate treatment of more serious "red eye" problems.

What do you do if your child is coming home from school with frequent headaches? Ophthalmologists are frequently asked to examine children with this problem. Fortunately, in most cases, headaches are not a symptom of something serious. Tension headaches, which are common, often occur at the end of the day, and are not associated with other symptoms. Occasionally, the need for glasses is the cause of the headache. An exam with an ophthalmologist can uncover that. Children who have already passed a school screening exam, whose headaches are infrequent or not related to a particular activity, probably do not need an eye exam. You should discuss this with your primary care doctor to be sure. On the other hand, headaches that occur after periods of reading, or in someone who squints frequently or closes one eye to see, may indicate a need for corrective glasses. Finally, headaches accompanied by vomiting, persistent fever or lethargy should be taken seriously. In these cases, contact your primary care physician immediately.

The topic of learning disabilities is a very large one. To briefly answer this question, however, learning disabilities are not due to a problem with the eye or visual system. You may have been told that special exercises, tinted lenses, or other types of visual training will be beneficial to your child. There are no scientifically proven studies that support these costly treatments. Children with learning disabilities should have a multidisciplinary approach, involving the pediatrician and school teacher. These two primary sources will help determine what other specialists might be helpful in working with your child. From the ocular standpoint, your pediatrician can help to determine if a learning disabled child also has one of the common childhood eye problems: near sightedness, lazy eye or strabismus. If this is the case, an Eye Doctor will examine your child, to diagnose those eye problems. The treatment they prescribe will help your child's overall visual acuity, but will not change the underlying learning disorder. Again, for that, your pediatrician and child's teacher are the best sources of information on helping to identify and treat learning disabilities.