Retinal Detachment

What is Retinal Detachment?

Retinal Detachment is a serious condition where the retina detaches and is moved from its original position. If left without treatment, permanent vision loss will occur.

Symptoms of Retinal Detachment

Symptoms of retinal detachment may include the presence of increased eye floaters, light flashes, watery vision, a veil or curtain blocking your vision, or a sudden dramatic decrease of vision. Patients with these symptoms should contact their eye doctor immediately and be seen for an exam the same day if possible The sooner a retinal detachment is diagnosed, the better the chances of saving vision.

Retinal Detachment Treatment and Prevention

Pneumatic retinopexy is a treatment where a small gas bubble is injected into the eye. The gas bubble pushes the retina back into place. The bubble eventually dissolves and the retina has to be held in place by either cryotherapy, the use of nitrous oxide to freeze the retina in place, or laser to weld the retina back in normal position.In cases where these treatments do not work, another treatment using silicone oil to replace the vitreous gel can be performed. This process has many different results and more information can be found about the NEI supported clinical trials at http://www.nei.nih.gov/neitrials/static/study39.htm.

For more information on retinal detachment visit your eye care doctor or visit http://www.nei.nih.gov for more research. Materials on this page have been researched from the national Eye Institute.

Eye Cataracts

What is a Cataract?

A Cataract is the clouding of the eye's lens. The exact cause of cataracts is still uncertain but cataracts seem to form as we age. Besides age, other factors might include exposure to ultraviolet light, cigarette smoking, alcohol, and eating habits. According to the National Eye Institutes, "By age 80, more than half of all Americans either have a cataract or have had cataract surgery."

Types of eye cataracts

• Age Related Cataracts - occurs when protein clusters up in the lens and causes cloudiness or from the discoloration of the lens from aging
• Secondary cataract - forms after surgery from other eye disease like glaucoma or diabetic retinopathy
• Traumatic cataract - forms after eye injury
• Congenital cataract - present at birth due to birth defects, diseases, or other problems
• Radiation cataract - forms after major exposure to radiation

Symptoms and detection of cataracts

Warning signs of cataracts may include blurry vision or glare from car headlights especially at night. Sunlight or indoor overhead lighting may seem to be seem too bright or cause glare. You may notice that bright colors may appear dulled. Sometime cataracts can cause double vision, and you may actually find that you are frequently changing contact or eyeglasses prescriptions. These symptoms might also be signs of other eye related problems so it is best to get checked by your eye doctor if you are having any of these problems.The eye doctor will place drops in your eyes to dilate your pupils and perform a thorough eye exam and study the crystaline lens of your eye as well as to check the optic nerves and retina for changes that might be contributing to your vision complaints.The eye doctor will also perform a test called tonometry in order to measure the pressure inside your eye as one of the diagnostic tools for glaucoma.

Cataract Eye Surgery

The only effective treatment for cataracts is to have them surgically removed. Modern cataract surgery is one of the most frequently performed surgical procedures in the United States.When performed by an experienced cataract and lens implantation surgeon, it is also one of the most successful surgeries that you can have. Cataract surgery usually requires the replacement of the natural lens with an intraocular lens (IOL). The IOL replaces the natural lens that has been removed because it was cloudy and thus gives you better vision. Today, Ophthalmologists can actually replace the cloudy lens with an advanced technology intraocular lens such as Crystalens or ReSTOR which will correct not only your distance vision but your near and arms length vision as well. They can hardly be distinguished from your natural lens and can give you back the focusing ability you lost in your 40's when you became presbyopic. There are two main types of cataract surgery that are used today. They are called phacoemulsification and extracapsular surgery. In Phacoemulsification or "Phaco" , a tiny incision is made into the cornea and a computer assisted device emits ultrasound waves to breakup the lens. The cloudy natural lens is then removed and replaced with an IOL. In extracapsular surgery, a longer incision is made and the cloudy core of the lens is removed as a whole piece while any left over areas of the lens are sucked up. Complications of cataract surgery are unusual but may include infection, bleeding, pain, swelling, and sometimes even something called an "after-cataract".This is a condition where tissue surrounding the IOL becomes cloudy. Fortunately, an eye surgeon can easily eliminate the "after cataract" by using a laser and without any additional surgery. This procedure, called a YAG Laser Capsulotomy may be required to remove the after-cataract and is extremely effective and relatively quick and simple. In the vast majority of cases cataract surgery and lens implantation is performed in an outpatient setting and you will be able to have your cataract removed and a new lens implanted and be able to go home within a few hours. Most of the time you will be able to resume your normal work and recreational activities within just a few days.

Lowering the risk of cataracts or at least slowing down the formation of cataracts is something you can do as first step to your overall health. It is a good idea to get annual eye exams. Since people with diabetes are more likely to also form cataracts, they should get checkups more frequently. Wearing sunglasses or eyeglasses that block ultraviolet light is a good idea. Some research, although not conclusive, has suggested that smoking and use of some drugs like steroids increases formation of cataracts. Stopping smoking or at least decreasing the amount you smoke could help slow the formation of cataracts. Cataract formation can also be slowed by eating healthy foods. Eating green leafy vegetables and fruits high in Vitamins A, C, and E can slow the growth of cataracts.It is important to learn more about cataracts and their prevention. According to Vision Problems in the U.S., an article by the NEI and Prevent Blindness America, "...the federal government spends more than $3.4 billion each year treating cataract through the Medicare program." As you can see, cataracts are also a huge financial burden for all of us. For more information on cataracts visit your eye care doctor or visit http://www.nei.nih.gov for more research. Materials on this page have been researched from the National Eye Institute.

After Cataract Surgery

Almost immediately after surgery patients are able to see and go about their everyday activities. Your doctor will setup a few appointments to see you the next day after cataract surgery and schedule times after that to check up on your healing process. During this time the patient should be care not to bring upon any pressure to the eye especially during cleansing and little things you may be unaware of such as rubbing your eyes. You should receive eye drops that will help the pressure around your eye, your doctor should let you know how long to use it. Because of the surgery and eye drops you may find that you will have fluid discharge. Some people may experience pain, discomfort or itchy eyes. Your doctor may give you medication to help relive these symptoms.

Macular Degeneration

What is Macular Degeneration?

Age related macular degeneration (AMD) is a disease that affects the macula, a part of the retina that allows you to see straight ahead and in fine detail. AMD is the most common cause of blindness because its main risk factor is age. Other risk factors include people who smoke, people who have bad eating habits and are obese, people of white race, family history of AMD, and women have greater risk of developing AMD.

Forms of Age Related Macular Degeneration, including Drusens

Dry AMD, the most common type, occurs when light-sensitive cells in the macula degrade and central vision begins to slowly fade. Dry AMD has three stages. Early AMD, the first stage, has a presence of drusens, yellow deposits under the retina, but usually no vision loss or problem is detected. In Intermediate AMD, there are many medium sized drusens or large sized drusens present. In this stage, blurry areas may be present and it is more difficult to do regular task. In Advanced Dry AMD, the light-sensitive cells begin to degrade dramatically and a blurred spot may appear in the central of your vision. Atrophy may also be a factor in advanced stages. This spot may appear larger and become darker and it becomes almost impossible to see with clarity and detail. Dry AMD can evolve into Wet AMD.

Wet AMD is more severe and vision loss occurs more rapidly. In wet AMD, small, abnormal blood vessels form. These new blood vessels are very thin and fragile and will begin to break and leak. The blood and fluids eventually causes damage to the macula and causes rapid loss in vision. Although Wet AMD is less common, loss of vision occurs faster so it is essential to get it diagnosed as quickly as possible.

Macular Degeneration - Symptoms and Detection

Symptoms of Dry AMD include the presence of drusens that begin to enlarge. Another symptom is blurry areas in central vision. A symptom of Wet AMD is seeing straight lines as wavy ones.

A visual acuity test can help an eye care professional determine if any central vision is lost. An Amsler grid may also be used to detect AMD. In this test you cover one eye and stare at a black dot that has patterns of straight lines. If these lines appear wavy or are missing then AMD could be present.

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Treatment and Prevention of Macular Degeneration

There is no treatment to restore vision once AMD has reached its advanced stage. However there are methods to prevent the advancement of AMD from immediate stage to advanced stage. Taking a high-dose formulation of antioxidants and zinc slows progression of AMD significantly. According to the research done by the NEI "The specific daily amounts of antioxidants and zinc used by the study researchers were 500 milligrams of vitamin C, 400 International Units of vitamin E, 15 milligrams of beta-carotene (often labeled as equivalent to 25,000 International Units of vitamin A), 80 milligrams of zinc as zinc oxide, and two milligrams of copper as cupric oxide. Copper was added to the AREDS formulation containing zinc to prevent copper deficiency anemia, a condition associated with high levels of zinc intake." This high level of antioxidants is virtually impossible to achieve with daily diets or multi-vitamins.

Wet AMD is treated with laser surgery to destroy the new blood vessels before they cause any more damage. This process can also cause more vision loss as it damages nearby tissue. New blood vessels may for and more treatments may be needed. Another process called Photodynamic Therapy (PDT), which was approved by the FDA in April 2000, uses a special drug that is injected into the body. This drug attaches itself to the new blood vessels in the eye. A special laser is then focused on the eye which activates the drug and destroys the abnormal blood vessels in a painless manor. There maybe some after surgery precautions with this method so it is best to ask your eye care doctor about specific details.

Prevention of AMD includes lowering risk factors and eating healthy diets of antioxidants and zinc. Quit smoking and eating foods with Vitamins A, C and E could help reduce chances of developing AMD. Exercising and keeping healthy are always good preventive methods for all diseases. For more information on nutrition and eye care visit our eye care nutrition pages.

For more information on Age related Macular Degeneration (AMD) visit your eye care doctor or visit http://www.amdalliance.org/ or http://www.nei.nih.gov for more research. Materials on this page have been researched from the national Eye Institute.

Glaucoma

Glaucoma is a disease that damages the eyes' optic nerves. Damage does not become noticeable until significant damage has occurred and if not treated could lead to severe vision loss or even blindness. Glaucoma is usually present with high intraocular pressure, pressure in the eyes, and results in a loss of peripheral vision. Early detection through eye exams will greatly help slowing down the disease.

Forms of Glaucoma

• Normal-tension Glaucoma - occurs when there is optic nerve damage and loss of vision even with intraocular pressure within a normal range
• Angle-closure Glaucoma - Increase in eye intraocular pressure due either to too much fluid being produced in the eye or to fluid not being able to exit the eye due to a blockage of the meshwork inside the eye. This can cause pain, headaches, nausea, red eyes, blurred eyes and vision loss. According to the NEI, "This is a medical emergency. If your doctor is unavailable, go to the nearest hospital or clinic. Without treatment to improve the flow of fluid, the eye can become blind in as few as one or two days."
• Secondary Glaucoma - can form after eye surgeries or from certain medical conditions like diabetes
• Congenital Glaucoma - present at birth due to birth defects that hinders the flow of fluid out of the eye that causes cloudy, white eyes and sensitivity to lights
• Open-Angle glaucoma - the most common type of glaucoma, occurs when fluid drainage from the eye is hindered, causing intraocular pressure to increase above normal, thus damaging optic nerves and eventually leading to vision loss. Usually peripheral (side) vision is damaged first leading to tunnel vision and in time to blindness if not properly treated and monitored

Glaucoma Symptoms and Detection

Warning signs of glaucoma are different for each form. Glaucoma is usually not noticeable until significant damage has been done to the optic nerves. With open-angle glaucoma, the most common form, an increase in intraocular pressure and loss in peripheral vision are key signs. A tonometer is an instrument that measures pressure inside the eye. It can show abnormal pressure that causes damage to optic nerves. A dilated eye exam uses drops to widen the pupils to allow an eye care professional to check optic nerves for changes. A visual field test helps an eye doctor tell if any peripheral vision loss has occurred, which is a sign of glaucoma. A nerve fiber analyzer is an instrument that very precisely examines the nerve fibers of the optic nerve for damage.

Glaucoma Treatment and Prevention

he most conventional treatment for glaucoma is medicine that is taken as a pill or as eye drops. The medicine has one goal and that is to decrease eye pressure. These medications either decrease the amount of fluid produced or help the eye remove fluid easier. Glaucoma medication might interfere with other medication so it is a good idea to consult your doctor and let them know about all of the medications you are taking. There are several different types of glaucoma medication so your doctor may want to try another one if it conflicts with medication you are currently taking or causes unwanted side effects. For most people medicine is enough to control glaucoma. For others, surgery is the better option. Laser trabeculoplasty is another option for decreasing pressure in the eyes. In this option, an Ophthalmologist sends a laser beam into the meshwork where fluid drainage occurs,called the trabecular meshwork. The process increases the drainage area and lowers pressure. With Argon Laser Trabeculoplasty (ALT), the surrounding tissue in the meshwork is damaged and usually requires another session after a few years. Sometimes medication must also still be taken. With Selective Laser Trabeculoplasty (SLT), a specially designed laser emits a low-energy laser light that targets only melanin-containing cells in the trabecular meshwork. The laser is heated only enough to affect the opening of the meshwork and adjacent areas are not damaged. This allows for multiple re-treatments. Endoscopic CycloPhotocoagulation (ECP) is another process to help alleviate eye pressure if medication and laser trabeculoplasty are not effective. Unlike laser trabeculoplasty, ECP uses lasers to target the ciliary body that produce fluid. This causes less fluid to be produced and in effect lowers pressure. Lowering the risk of glaucoma or at least slowing down the progressive damage to optic nerves is the best preventive measure. It is important to get routine check ups because glaucoma is unnoticeable at first. Certain risk factors to watch out for include race, medical disorders, and family medical history. Glaucoma is more common in African Americans and Hispanic patients, especially with increasing age. People with diabetes or who have had eye surgery are also more likely to have glaucoma. A family history of glaucoma increases the risk that you could have glaucoma. If any of these factors relate to you, then you should definitely go for more frequent eye exams.

For more information on glaucoma visit your eye care doctor or visit http://www.glaucoma.com/ or http://www.nei.nih.gov for more research. Materials on this page have been researched from the national Eye Institute.

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