Eye Conditions

GLAUCOMA

Glaucoma is a disease of the optic nerve –the part of the eye that carries the images we see to the brain. The optic nerve is made up of many nerve fibers, like an electric cable containing numerous wires. When damage to the optic nerve fibers occurs, blind spots develop. These blind spots usually go undetected until the optic nerve is significantly damaged. If the entire nerve is destroyed, blindness results.

Early detection and treatment by your ophthalmologist (Eye M.D.) are the keys to preventing optic nerve damage and blindness from glaucoma. Glaucoma is a leading cause of blindness in the United States, especially for older people. But loss of sight from glaucoma can often be prevented with early treatment.

Laser Surgery

Laser surgery treatments may be recommended for different types of glaucoma. In open-angle glaucoma, the drain itself is treated. The laser is used to modify the drain (laser trabeculoplasty) to help control eye pressure. In narrow-angle glaucoma, the laser creates a hole in the iris (laser peripheral iridotomy) to improve the flow of aqueous fluid to the drain.

Surgery in the Operating Room

When surgery in the operating room is needed to treat glaucoma, your ophthalmologist uses fine, microsurgical instruments to create a new drainage channel for the aqueous fluid to leave the eye. Surgery is recommended if your ophthalmologist feels it is necessary to prevent further damage to the optic nerve. As with laser surgery, surgery in the operating room is typically an outpatient procedure.

What is your part in treatment?

Treatment for glaucoma requires teamwork between you and your doctor. Your ophthalmologist can prescribe treatment for glaucoma, but only you can make sure that you follow your doctor’s instructions and take your eye drops. Once you are taking medications for glaucoma, your ophthalmologist will want to see you more frequently. Typically, you can expect to visit your ophthalmologist every three to four months. This will vary depending on your treatment needs.

AGE-RELATED MACULAR DEGENERATION (AMD)

What You Should Know About AMD

Macular degeneration is an eye condition in which the macula, a sensitive area in the retina responsible for central and detailed vision, is damaged, often causing loss of central vision.

Prevention

• Regular eye exams by your Eye M.D. Your Eye M.D. is specialty-trained to detect many vision-threatening conditions even before you develop symptoms. The earlier problems are detected, the better the chance of preventing vision loss.
• Protection from UV-A and UV-B rays. Some studies have suggested that prolonged or frequent exposure to UV-A and UV-B rays may be a factor in macular degeneration and other eye conditions, so always wear sunglasses that block 99 to 100 percent of UV rays when outdoors.
• Proper nutrition. High levels of zinc and antioxidants can play a role in slowing the progression of macular degeneration. A healthy diet can’t hurt and can prevent many other health problems.

Treatment

• "Dry" form - The Age-Related Eye Disease Study (AREDS) found that a specific combination of vitamins (zinc, copper, vitamin A, vitamin C, and vitamin E) was helpful in slowing the progression of AMD in advanced cases.
• "Wet" form-Laser surgery, photodynamic therapy, and intravitreal injections may help in addition to low vision rehabilitation.
• Photodynamic therapy (PDT) involves the injection of the FDA-approved drug, VisudyneTM) into the bloodstream, followed by a brief laser treatment. The laser "activates" the drug, which helps destroy abnormal blood vessels in the eye that damage the macula. Several treatments may be necessary for it to be effective.
• Intravitreal injections of steroids (Kenalog, Triescence) and anti-VEGF (Avastin, Lucentis) may help the abnormal blood vessels that form in the macula with wet AMD to regress to preserve vision.

Unproven Treatments

Be wary of any treatment that promises to restore vision, cure, or prevent macular degeneration. There are many so-called "miracle cures" advertised (often in magazines or on the Internet) that have not been adequately tested for safety or efficacy. These treatments may be expensive and are generally not covered by insurance. If you are considering trying a new or untested treatment, make sure you talk to your Eye M.D. to ensure that it is safe and won't interfere with timely and effective treatment of other eye problems.

Current Research

There is a great deal of research and several major scientific studies being conducted to find the causes of AMD and to develop effect treatment for all types of AMD. Visit the National Eye Institute website for additional information: www.nei.nih.gov

Blepharoplasty for Droopy Eyelids

Blepharoplasty is surgical for droopy eyelids. Excess tissue such as skin and fat are removed or repositioned, and surrounding muscles and tendons may be reinforced. It can be both a functional and cosmetic surgery.

Upper Eyelid Blepharoplasty

In upper eyelid surgery cases, an incision is made externally in the upper eyelid crease to remove surplus eyelid skin and fat. The incision is then closed with fine sutures. Since the incisions are made in the eyelids’ natural contours, they are hardly visible and most often fade with time. There may be a slight amount of bruising and swelling following surgery, but this is usually gone within seven to ten days. Patients can usually resume work within three to four days after the procedure.

Presbyopia

Presbyopia is a health condition where the eye progressively has diminished ability to focus on near objects with age. Presbyopia's exact mechanisms are not known with certainty. The research most strongly supports a loss of elasticity of the eye's crystalline lens, although changes in the lens's curvature from continual growth and loss of power of the ciliary muscles (the muscles that bend and straighten the lens) have also been considered d as causes.

Similar to grey hair and wrinkles, presbyopia is a symptom caused by aging. The first symptoms (described below) are usually first noticed between the ages of 40-50. The ability to focus on near objects declines throughout life, from an accommodation of about 20 dioptres (ability to focus at 50 mm away) in a child, to 10 dioptres at 25 (100 mm), and levels off at 0.5 to 1 dioptre at age 60 (ability to focus down to 1-2 meters only).

Our physicians are highly trained in the diagnosis and treatment of presbyopia. Call for an appointment at the first indication that your near vision seems to be changing. Early detection will help you determine the best plan for your vision.

FLASHES AND FLOATERS

What is a floater?

Floaters are specks, strands, or clouds floating in your vision. These are actually clumps of tissue and cells floating in the vitreous, the gel-like fluid that fills your eye. The vitreous gel shrinks over time and can separate from the back of the eye, the retina, resulting in a posterior vitreous detachment. This is a common cause of floaters.

What are flashes?

Flashes are described as flashing lights or stars or lightning streaks. They are commonly caused by the vitreous gel rubbing or pulling on the retina, the sheet of nerves that receives images in the eye.

Flashes and floaters may be a sign of a retinal tear, retinal hole, or retinal detachment. These are serious conditions that can lead to vision loss. You should see your ophthalmologist as soon as possible if you see new floaters, sudden flashes of light, or have loss of side vision.

GENERAL EYE CARE

Loss of vision can be prevented

Regular medical eye exams may help prevent unnecessary vision loss. Recommended intervals for eye exams in patients with healthy eyes are:

Age 20-29:

Individuals of African descent or with a family history of glaucoma should have an eye examination every three to five years. Others should have an eye exam at least once during this period.

Age 30-39:

Individuals of African descent or with a family history of glaucoma should have an eye examination every two to four years. Others should have an eye exam at least twice during this period.

Age 40-64:

At least every two to four years.

Age 65 or older:

At least every one to two years.