A. The lens of the eye should be a transparent structure that causes incoming light to focus on the retina which creates an image that the brain can perceive. Should this lens becomes clouded, images will blur or haze and there may be increased sensitivity to light and glare. A cataract is this clouding of the lens.
A. A cataract or clouding of the lens of the eye, results from a chemical change within the lens. Contributing factors to this change can include aging, heredity, trauma, disease such as glaucoma, and medical conditions such as diabetes.
A. A slit lamp biomicroscope can be used to observe areas in the eye that appear hazy or spotty. Only severe cataracts can be easily seen with the naked eye.
A. Ultimately, treatment involves the surgical removal of the affected lens under a local anesthetic and replacement of the lens with a clear plastic intraocular lens (IOL), a contact lens, or an aphakic spectacle also referred to as “cataract eyeglasses”. Most patients achieve normal vision after surgery.
A. Glaucoma is a potentially blinding disease that sneaks up on patients as it erodes their vision slowly. It is estimated that 2 million Americans are currently affected.
A. The Woolfson Eye Institute uses the latest technologies and techniques for early diagnosis and monitoring of glaucoma. This includes advanced imaging and the latest visual function tests. Our doctors are involved in laboratory and clinical studies to understand and improve therapies. Our surgeons are expert in even the most complicated glaucoma cases including those on patients who had unsuccessful surgeries in the past.
A. The macula is a specialized part of the eye that allows one to see fine details. Macular Degeneration occurs when the macula is damaged and results in blurring or darkness most often in the central region of one’s field of vision. A common form of this disorder is referred to as Age-Related Macular Degeneration (AMD) and is the result of a disease that causes progressive damage to the macula. Macular degeneration affects both close-in and distance vision, and can affect one eye years before the other.
Loosely speaking, there are two forms of AMD. Dry or atrophic AMD is defined by caused by the thinning of the tissues in the macula. Wet or exudative AMD is defined by the growth of abnormal blood vessels under the macula which bleed and cause scarring. Wet AMD typically causes the most severe loss of central vision.
A. Even when it affects both eyes, it typically does not result in total blindness. However, it is the leading cause of legal blindness (far less severe than total blindness) in patients over 55 and affects 30% of those over 70. Fortunately, only a small percentage of patients with AMD experience severe visual loss.
A. Because this disorder affects the perception of fine details through one’s visual system, common ways to detect it include noticing blurring of words on a page, a dark/empty area in one’s central vision, or bends in what should be straight lines.
A. Although the root cause(s) are still unknown. AMD does appear to be linked to aging.
A. Patients consuming diets in leafy green vegetables may have a lower risk of developing AMD, in particular wet AMD. Also, vitamin and mineral supplements may be preventative, but the evidence is limited and should only be undertaken under the supervision of your Woolfson team.
A. Laser therapy can benefit some patients with wet AMD, but only a highly experienced ophthalmologist (and retina specialists) such as those found here at the Woolfson Eye Institute can determine if laser therapy is indicated and apply it effectively and safely. Even if a patient’s disease is untreatable, better vision can be achieved with magnifiers, computerized reading machines, and other aids.
A. Diabetic retinopathy is a potentially blinding complication of diabetes. Patients suffering from this progressive disease have blood vessels in the retina leak (and in some patients new blood vessels form), resulting in a loss of vision more technically referred to as macular edema.
A. Unfortunately, there tend not to be early warning signs for this disease. Diabetic patients should have retinal exams with full dilation on a regular basis. This should occur immediately upon diagnosis of diabetes and then annually thereafter. It is estimated that 14 million Americans with diabetes have this disease, enough to make it the leading cause of blindness in those aged 20 to 64.
A. Two treatments: laser photocoagulation and vitrectomy can be considered with your Woolfson physician. The laser treatment is designed to stop the leaking/bleeding from the vessels and shrink any new vessels that have formed. Statistically, it has been shown to reduce cases of vision loss by 50%. In cases where more severe bleeding has already occurred, the second technique – a vitrectomy – can surgically remove blood and scar tissue from the eye and reattach the retina to restore useful vision.
A. This technique uses intense cold to scar and destroy retinal and potentially choroidal tissue. The doctor carefully positions a metal probe which has a tip that rapidly cools to form water crystals and then rapidly thaws to destroy the target cells, typically under local anesthesia.
A. Retinal cryotherapy is a technique that can be useful on problematic areas of retinal tissue such as the abnormal retinal blood vessels causing Coats’ disease, retinal breaks, retinal bleeding (where laser techniques are not appropriate), and small intraocular tumors.
A. In a nutshell, lasers generate light of a particular wavelength that can be absorbed by tissues. This creates heat which affects the absorbing tissue and the tissues that surround them. Laser surgeries can destroy problematic cells, affect oxygen requirements and delivery for various body structures, change blood flow, and influence fluid flow and delivery.
The most commonly used lasers include the Nd:YAG, argon blue-green, argon green, krypton red, and organic dye laser (can emit yellow, orange, and red wavelengths). Each of these lasers must be carefully chosen to treat patient conditions based on the particular wavelengths of light that they can produce.
A. As with all surgery, there can be some side effects for laser procedures. These can include negatively affecting ones central vision, peripheral vision, or night vision as well as the creation of blind spots referred to as scotomata in the treatment area.
A. This surgical area treats problems primarily related to the eyelids, tear ducts, and the bony socket surrounding the eye. The surgeons in this area are board certified ophthalmologists who have gone on from there to complete highly specialized plastic surgery training. Because of their extensive and specialized training, Woolfson surgeons in this area are uniquely qualified to evaluate and surgically manage all conditions in this area of specialty. Just a few examples include: reconstructive surgery of the eyelids following trauma, repositioning of ocular structures to restore or improve their function as well as appearance such as the correction of protruding or sunken eyes, removal of orbital tumors, removal of eyes that have lost all ability for sight, orbital fractures, socket preparation for artificial eyes, etcetera. Our Ophthalmic plastic surgeons are highly proficient in esthetic surgery on eyelids, the midface and forehead. Because of their background as ophthalmologists, they also have extensive training in laser surgery and can employ these most advanced laser techniques to esthetic cases such as laser skin resurfacing and removal of excess eyelid skin and bags.
Of course, Woolfson Eye Institute boasts surgeons that have passed the American Society of Ophthalmic Plastic and Reconstructive Surgery, Inc.’s rigorous national standards.
A. This surgical procedure inserts small instruments into the eye through the pars plana, the part of the eye between the retina (converts light into a signal our brains can interpret as an image) and the pars plicata (makes intraocular fluid). Because the pars plana has no function in the eye after fetal stages of development, it is well-chosen as a surgical entry point.
These techniques can treat a variety of blinding disorders including: diabetic retinopathy, retinal detachments due to trauma, and macular holes and puckers. The various microsurgical instruments can remove away scar tissue or blood, and even apply laser treatment.
A. Generally, this is an outpatient procedure done under intravenous sedation with additional local anesthesia, but general anesthesia may also be warranted as may a hospital stay. Postoperative pain varies, but is typically well controlled with pain medications. In some cases the surgeon may place an intraocular gas bubble in the eye which will require the patient remain a face-down after surgery under the instructions of his/her surgeon. If your Woolfson surgeon is recommending vitreous surgery, remember that it has saved the sight of many patients precisely because of its ability to manage complex conditions.