Comprehensive Ophthalmology
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What is a Cataract?
The lens inside the eye sits behind the pupil and focuses light entering the eye onto the retina in the back of the eye.
A normal lens is crystal clear, but with aging may become cloudy and discolored. A lens that is no longer clear is called a "cataract." (In the picture to the right, the lens is cloudy and yellow, representing a cataract).
What causes a Cataract?
Most cataracts are the result of normal aging changes within the eye. Some cataracts may be the result of previous trauma to the eye or previous eye surgery. Long-term use of steroid medication can also lead to cataracts.
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What are the symptoms of a Cataract?
-blurring of vision
-distortion or ghost images
-increasing glare, especially in bright
sunlight or while driving at night
-fading or yellowing of colors
How are Cataracts treated?
If you have an early cataract, a change in glasses may help for awhile. If your vision becomes blurry enough to interfere with daily activities cataract surgery may be an option.
What is Cataract surgery?
Cataract surgery is performed when your vision is causing difficulties with everyday activities- reading, driving, seeing TV, handiwork, golf. Cataract surgery involves removing the lens of the eye. This is performed with an ultrasound instrument which breaks up the cloudy lens into small fragments which are then suctioned out of the eye. An intraocular lens is then implanted to replace the natural lens. Modern cataract surgery is performed as an outpatient procedure with minimal restrictions during the healing period.
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photos courtesy of National Eye Institute, NIH
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What is Glaucoma?
Glaucoma is a potentially blinding disease which involves damage to the optic nerve (see diagram). The optic nerve is responsible for sending visual information from the retina to the brain. A damaged optic nerve cannot repair itself and blind spots in the vision are the result.
What causes Glaucoma?
Although the precise mechanism of glaucoma is not known, most types of glaucoma involve an increased pressure within the eye. The normal eye pressure is controlled by fluid inside the eye. Uncontrolled high eye pressure leads to optic nerve damage, causing vision loss.
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How is Glaucoma diagnosed?
At first there are generally no symptoms from glaucoma. Glaucoma is diagnosed during a complete eye exam. Glaucoma can be successfully controlled, so early detection is crucial.
How is Glaucoma treated?
Most patients with glaucoma can be successfully managed with medicated eye drops. These drops do not cure glaucoma, but prevent vision loss from optic nerve damage. Some patients not successfully treated with eye drops may require laser treatment or eye surgery to control their glaucoma.
photos courtesy of National Eye Institute, NIH
Diabetic retinopathy is the leading cause of visual disability among working-age people.
What is diabetic retinopathy?
Diabetes can cause abnormalities in the blood vessels of the retina (the thin layer covering the back inside wall of the eye). Diabetic retinopathy develops when the retinal blood vessels weaken and leak. Leaking blood causes small hemorrhages within the retina. Leaking fluid causes swelling of the retina ("macular edema"). This swelling can cause blurred vision. These changes are called "non-proliferative diabetic retinopathy."
In more advanced disease, the retinal blood vessels can become obstructed, decreasing the amount of oxygen reaching the retina. Areas of the retina not receiving enough oxygen cause the growth and proliferation of new blood vessels, a process termed "neovascularization." (see photo to right) These new blood vessels are abnormal and can cause bleeding and formation of scar tissue within the eye. These changes are termed "proliferative diabetic retinopathy."
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How is diabetic retinopathy treated?
In early forms of non-proliferative diabetic retinopathy, often no treatment is required. If macular edema (swelling of the retina) causes blurring or distortion of vision, laser treatment can be applied to the retina to reduce the edema.
Proliferative diabetic retinopathy can lead to serious bleeding in the eye. A second problem is the growth of scar tissue, which can lead to retinal detachment. These more serious problems are typically treated through intraocular surgery.
How can diabetic retinopathy be prevented?
-maintain normal weight and good diet
-control blood sugar levels as instructed
by your internist or endocrinologist
-maintain good blood pressure
-stop smoking
-PATIENTS WITH DIABETES SHOULD HAVE
AN ANNUAL DILATED EYE EXAM, EVEN IF
THEY ARE NOT EXPERIENCING ANY
PROBLEMS.
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photos courtesy of National Eye Institute, NIH