Exposure keratopathy occurs when the eyelids fail to properly close and lubricate the cornea due to underlying conditions that limit eyelid closure. This leads to drying and damage of the corneal epithelium. Causes of exposure keratopathy include 7th cranial nerve palsy, lid abnormalities such as lagophthalmos or ectropion, and orbital diseases causing proptosis. Treatment focuses on adequate lubrication and ensuring eyelid closure through temporary or permanent measures such as lid taping, tarsorrhaphy, or ptosis surgery. Prevention involves assessing corneal protective mechanisms and warning patients of risks.
This document discusses techniques for measuring corneal thickness, known as pachymetry. It begins by introducing pachymetry and its importance in assessing corneal health and thickness. It then describes 12 techniques for measuring corneal thickness, including the gold standard of ultrasonic pachymetry. The document provides details on the principles, advantages, and disadvantages of each technique. It concludes by discussing the clinical utility of pachymetry in procedures like LASIK and for conditions like glaucoma and keratoconus.
This document discusses various refractive surgery procedures used to correct refractive errors of the eye, including incisional keratotomy techniques, lamellar procedures, laser ablation procedures, corneal implants, and lens-based procedures. It provides details on common procedures like radial keratotomy, LASIK, PRK, and LASEK. It covers patient evaluation, surgical techniques, potential complications, and advantages of different approaches. Wavefront-guided customized excimer laser surgery is also introduced to correct higher-order aberrations in addition to spherical and cylindrical errors.
Types of intraocular lenses include foldable acrylic and silicone lenses. IOLs are either single piece or multipiece, and have different optic designs like aspheric, toric, or multifocal to correct vision. IOLs are implanted either in the capsular bag or ciliary sulcus, and are made of materials like acrylic, silicone, or hydrogels. Newer accommodating IOL designs aim to restore accommodation.
This document discusses cryotherapy, a technique that uses extreme cold to destroy abnormal tissue. It provides a brief history of cryotherapy dating back to 1899 when liquefied gases were first used for medical purposes. The document then focuses on the use of cryotherapy in ophthalmology, describing the cellular effects and techniques used. Applications for various ocular pathologies are discussed such as trichiasis, basal cell carcinoma, and retinal tears/detachments. Complications are also addressed.
Presbyopia is a natural part of the aging process where the eye's ability to focus on nearby objects decreases, requiring reading material to be held farther away. It results from a loss of accommodative amplitude and facility. Symptoms include blurred near vision, headaches, and fatigue when doing close work. Presbyopia is diagnosed through visual acuity and refraction tests and treated with reading glasses or contact lenses, and in some cases refractive surgery like monovision LASIK or lens replacement.
Keratoplasty involves replacing diseased cornea with donor tissue. The main types are penetrating keratoplasty (PK), which replaces the full corneal thickness, and lamellar keratoplasty, which replaces only diseased layers. PK indications include scarring, infections, dystrophies and injuries. It has risks of rejection, infection, and high astigmatism. Newer techniques like deep anterior lamellar keratoplasty (DALK) and Descemet's membrane endothelial keratoplasty (DMEK) replace only diseased layers, reducing risks. Careful donor screening, surgical technique and postoperative management including steroids can reduce complications of keratoplasty.
Exposure keratopathy occurs when the eyelids fail to properly close and lubricate the cornea due to underlying conditions that limit eyelid closure. This leads to drying and damage of the corneal epithelium. Causes of exposure keratopathy include 7th cranial nerve palsy, lid abnormalities such as lagophthalmos or ectropion, and orbital diseases causing proptosis. Treatment focuses on adequate lubrication and ensuring eyelid closure through temporary or permanent measures such as lid taping, tarsorrhaphy, or ptosis surgery. Prevention involves assessing corneal protective mechanisms and warning patients of risks.
This document discusses techniques for measuring corneal thickness, known as pachymetry. It begins by introducing pachymetry and its importance in assessing corneal health and thickness. It then describes 12 techniques for measuring corneal thickness, including the gold standard of ultrasonic pachymetry. The document provides details on the principles, advantages, and disadvantages of each technique. It concludes by discussing the clinical utility of pachymetry in procedures like LASIK and for conditions like glaucoma and keratoconus.
This document discusses various refractive surgery procedures used to correct refractive errors of the eye, including incisional keratotomy techniques, lamellar procedures, laser ablation procedures, corneal implants, and lens-based procedures. It provides details on common procedures like radial keratotomy, LASIK, PRK, and LASEK. It covers patient evaluation, surgical techniques, potential complications, and advantages of different approaches. Wavefront-guided customized excimer laser surgery is also introduced to correct higher-order aberrations in addition to spherical and cylindrical errors.
Types of intraocular lenses include foldable acrylic and silicone lenses. IOLs are either single piece or multipiece, and have different optic designs like aspheric, toric, or multifocal to correct vision. IOLs are implanted either in the capsular bag or ciliary sulcus, and are made of materials like acrylic, silicone, or hydrogels. Newer accommodating IOL designs aim to restore accommodation.
This document discusses cryotherapy, a technique that uses extreme cold to destroy abnormal tissue. It provides a brief history of cryotherapy dating back to 1899 when liquefied gases were first used for medical purposes. The document then focuses on the use of cryotherapy in ophthalmology, describing the cellular effects and techniques used. Applications for various ocular pathologies are discussed such as trichiasis, basal cell carcinoma, and retinal tears/detachments. Complications are also addressed.
Presbyopia is a natural part of the aging process where the eye's ability to focus on nearby objects decreases, requiring reading material to be held farther away. It results from a loss of accommodative amplitude and facility. Symptoms include blurred near vision, headaches, and fatigue when doing close work. Presbyopia is diagnosed through visual acuity and refraction tests and treated with reading glasses or contact lenses, and in some cases refractive surgery like monovision LASIK or lens replacement.
Keratoplasty involves replacing diseased cornea with donor tissue. The main types are penetrating keratoplasty (PK), which replaces the full corneal thickness, and lamellar keratoplasty, which replaces only diseased layers. PK indications include scarring, infections, dystrophies and injuries. It has risks of rejection, infection, and high astigmatism. Newer techniques like deep anterior lamellar keratoplasty (DALK) and Descemet's membrane endothelial keratoplasty (DMEK) replace only diseased layers, reducing risks. Careful donor screening, surgical technique and postoperative management including steroids can reduce complications of keratoplasty.
This document discusses ectropion and entropion of the eyelids. It describes the anatomy of the eyelids and various types and causes of ectropion and entropion. Signs, symptoms, evaluation, and treatment options are provided for different types including congenital, involutional, cicatricial, and paralytic ectropion as well as entropion. Surgical procedures for correcting ectropion and entropion such as horizontal lid shortening, medial canthal tendon plication, and tarsal fracture are explained.
Surgical management of glaucoma includes various laser surgeries, filtering surgeries like trabeculectomy, and other procedures. Laser surgeries like argon laser trabeculoplasty and selective laser trabeculoplasty use laser energy to increase drainage by altering the trabecular meshwork. Trabeculectomy involves creating a small hole in the eye to allow drainage of fluid into a filtering bleb under the conjunctiva. Other options include non-penetrating surgeries, artificial drainage implants, and cyclo destructive procedures to ablate the ciliary body. The goal of all these surgeries is to lower intraocular pressure and slow glaucoma progression.
Femtosecond lasers can be used to assist with cataract surgery by performing three key steps: creating a precise capsulotomy, fragmenting the lens, and making incisions. The laser uses ultrashort pulses to precisely cut tissue with minimal collateral damage. During femtosecond laser-assisted cataract surgery (FLACS), the laser performs several pre-operative steps, then the surgeon completes phacoemulsification and lens implantation manually. Potential advantages include more reproducible incisions and capsulotomies, decreased ultrasound energy, and reduced stress on zonules, but the procedure takes more time and has a higher cost than conventional cataract surgery.
Angle recession glaucoma is a type of secondary glaucoma that can develop years after blunt ocular trauma causes tearing of the ciliary body and recession of the iris root. It is often underdiagnosed due to delayed onset and forgotten injury history. Management involves topical glaucoma medications, with filtering surgeries used if medication fails to control pressure. Early diagnosis and aggressive treatment are important to prevent glaucoma-related vision loss from this condition.
Cataract surgery has advanced significantly with improvements like phacoemulsification that uses ultrasound to break up the cataract. This technique allows for a smaller incision and faster recovery compared to previous extracapsular cataract extraction surgery. Newer intraocular lenses and technology have also improved vision outcomes and the ability to reduce dependence on glasses after surgery. Cataract surgery is now a very common and highly successful operation.
Ectropion
It is an outward turning of the eyelid margin . This more frequently affects the lower eyelid.Upper eyelid ectropion is uncommon.Classified in 5 types
1)Congenital 2) Involutional 3) Paralytic 4) Cicatricial 5) Mechanical
Involutional ectropion is more common.Congenital ectropion is very rare.
Symptoms Epiphora :- excessive tearing.Excessive dryness.
Foreign body sensation Irritation.Burning.Redness.Chronic conjunctivitis KeratinizationCorneal exposure
Grading
Lid margin is out rolled and depending on out rolling ectropion can be classified as under:
Grade I –only punctum is everted
Grade II –lid margin is everted and palpebral conjunctiva is visible
Grade III –fornix is also visible
Etiological factors
Horizontal lid laxity:-can be demonstrated by pulling the central part of the lid 8 mm or more from the globe, with a failure to snap back to its normal position on release without the patient first blinking.
Medial canthal tendon laxity
demonstrated by pulling the lower lid laterally and observing the position of the inferior punctum If the lid is normal the punctum should not be displaced more than 1–2 mm
Lateral canthal tendon laxity
characterized by a rounded appearance of the lateral canthus and the ability to pull the lower lid medially more than 2 mm.
>Normally, the displacement should only be 0-2 mm.
Treatment
1 medical therapy
2 surgical therapy
This document provides an overview of vitrectomy, including a brief history, the key steps in a simple vitrectomy procedure, and descriptions of the equipment used. It discusses trocars and cannulas, sclerotomies, illumination sources, viewing systems, vitreous cutters, and vitreous removal. Advantages of smaller gauge vitrectomy instruments are also summarized.
1) Trabeculectomy is a glaucoma surgery that creates an opening in the eye to drain fluid from the anterior chamber and reduce intraocular pressure.
2) It involves making a partial thickness scleral flap, removing a block of tissue underneath, and suturing the flap loosely to allow fluid drainage.
3) Antifibrotic agents like mitomycin C or 5-fluorouracil are often applied to reduce scarring and improve surgical success rates.
This document discusses pediatric refraction and various techniques used for refracting children. Pediatric refraction is different from adult refraction due to active accommodation in children. Cycloplegic refraction is preferable to paralyze accommodation. Different techniques are used based on the age of the child, including near retinoscopy, dynamic retinoscopy, and book retinoscopy. Cycloplegics help obtain an accurate refraction by paralyzing accommodation.
This document discusses fluorescein angiography (FA), a technique used to examine the circulation of the retina and choroid. FA involves injecting a fluorescent dye called sodium fluorescein and then taking photographs of the retina as the dye circulates through the eye. The dye is absorbed by the blood vessels and any leaks or blockages are visible. Precautions are taken and potential side effects explained to the patient. The sequence of FA images provides information about blood flow and any pathological conditions.
This document discusses accommodative esotropia, a condition where excessive accommodation effort causes the eyes to turn inward. It is most often caused by uncorrected hyperopia. If left untreated in a visually immature child, it can lead to loss of binocular vision and amblyopia. Treatment involves full refractive correction through glasses to relax accommodation and restore binocular vision. The timing between onset and treatment determines the visual outcome.
Dr. Karan Bhatia provides an overview of keratoplasty (corneal transplantation). There are different types including penetrating keratoplasty (replacing the full thickness of the diseased cornea), partial thickness lamellar keratoplasty, and rotational keratoplasty. Penetrating keratoplasty has been the standard procedure but carries risks. The history and techniques of penetrating keratoplasty are described in detail including pre-operative evaluation, donor cornea excision, recipient cornea trephination, suturing, and post-operative management. Potential complications are also reviewed. Lamellar keratoplasty is introduced as an alternative to penetrating keratoplasty to reduce risks
This document discusses suture material properties and classifications. It describes the ideal properties of suture material and notes that no single suture has all ideal properties. Suture materials are classified as absorbable or non-absorbable, monofilament or multifilament. Both natural and synthetic absorbable and non-absorbable suture materials are described in detail, including their tensile strengths, degradation times, and tissue reactions. Surgical needle shapes, sizes, and ideal properties are also discussed.
A surgical procedure featuring a partial thickness scleral flap that creates a fistula between AC and subconjunctival space for filtration of aqueous and creation of conjunctival bleb in an effort to lower IOP
This document discusses esotropia, which is an inward turning of one or both eyes. It defines esotropia and describes the different types including accommodative esotropia, congenital esotropia, and microtropia. It outlines the causes, characteristics, diagnosis, and management of each type of esotropia. Some key points covered include the role of accommodation and refractive error in accommodative esotropia, the importance of early treatment for congenital esotropia to prevent amblyopia, and the use of occlusion therapy, refractive correction, surgery, and botulinum toxin injection in the management of esotropia.
- Aphakia is the absence of the crystalline lens from the eye. It can be congenital or caused by surgery or trauma.
- In aphakia, the eye becomes highly hyperopic, the anterior focal point moves forward, and the retinal image is magnified. This decreases visual acuity and field of view.
- Aphakia is treated with spectacles, contact lenses, or intraocular lenses. Spectacles cause issues like increased image size, ring scotomas, and reduced field of view. Contact lenses and IOLs provide better image quality but have risks of complications.
This document discusses biometry, which involves measuring the eye to determine the ideal intraocular lens power for cataract surgery. It notes that biometry errors are the second most common cause of claims in cataract malpractice cases. It describes various techniques for measuring the corneal curvature and axial length of the eye, including manual and automated keratometry, ultrasound A-scan, and optical biometers. It also discusses considerations for biometry in special cases and different intraocular lens calculation formulas.
Presbyopia is the loss of accommodation ability that occurs with aging. It results from a loss of elasticity in the lens and ciliary muscles. By age 40-45, most people experience difficulty seeing objects close up. Symptoms include problems with near vision that are worse in low light. It is diagnosed by reduced amplitude of accommodation. Treatment involves using reading glasses, bifocals, or progressive lenses to add the needed optical power for near vision. Multifocal contact lenses and refractive surgery can also help treat presbyopia.
The cover test is used to qualitatively measure strabismus. It involves covering each eye separately while having the patient fixate on a target. This allows the examiner to observe any movement in the uncovered eye, indicating the presence or absence of a manifest deviation. There are three main types of cover tests: direct cover test to detect manifest squint, cover-uncover test to detect heterophoria, and alternate cover test to differentiate between unilateral and alternating squint and determine if the deviation is concomitant or paralytic. The results of the cover test help diagnose the type of strabismus present.
Cataracts are clouding of the lens inside the eye that degrade vision over time and are caused by aging and other factors like diabetes, smoking, and UV exposure. There are different types of cataracts but they can usually be removed through a simple outpatient surgery called phacoemulsification where the clouded lens is broken up and removed and replaced with an artificial lens. While cataract surgery is very safe and effective, there are rare risks of complications like infection, swelling, or the need for secondary procedures if the artificial lens does not function properly.
Cataracts are clouding of the lens inside the eye that degrade vision over time and are caused by aging, sun exposure, diabetes, corticosteroid use, and genetics. They are typically treated with phacoemulsification surgery which uses ultrasound to break up and remove the cloudy lens and replace it with an artificial lens. While very safe and effective, cataract surgery complications are rare but can include infection, swelling, or the artificial lens not functioning properly.
This document discusses ectropion and entropion of the eyelids. It describes the anatomy of the eyelids and various types and causes of ectropion and entropion. Signs, symptoms, evaluation, and treatment options are provided for different types including congenital, involutional, cicatricial, and paralytic ectropion as well as entropion. Surgical procedures for correcting ectropion and entropion such as horizontal lid shortening, medial canthal tendon plication, and tarsal fracture are explained.
Surgical management of glaucoma includes various laser surgeries, filtering surgeries like trabeculectomy, and other procedures. Laser surgeries like argon laser trabeculoplasty and selective laser trabeculoplasty use laser energy to increase drainage by altering the trabecular meshwork. Trabeculectomy involves creating a small hole in the eye to allow drainage of fluid into a filtering bleb under the conjunctiva. Other options include non-penetrating surgeries, artificial drainage implants, and cyclo destructive procedures to ablate the ciliary body. The goal of all these surgeries is to lower intraocular pressure and slow glaucoma progression.
Femtosecond lasers can be used to assist with cataract surgery by performing three key steps: creating a precise capsulotomy, fragmenting the lens, and making incisions. The laser uses ultrashort pulses to precisely cut tissue with minimal collateral damage. During femtosecond laser-assisted cataract surgery (FLACS), the laser performs several pre-operative steps, then the surgeon completes phacoemulsification and lens implantation manually. Potential advantages include more reproducible incisions and capsulotomies, decreased ultrasound energy, and reduced stress on zonules, but the procedure takes more time and has a higher cost than conventional cataract surgery.
Angle recession glaucoma is a type of secondary glaucoma that can develop years after blunt ocular trauma causes tearing of the ciliary body and recession of the iris root. It is often underdiagnosed due to delayed onset and forgotten injury history. Management involves topical glaucoma medications, with filtering surgeries used if medication fails to control pressure. Early diagnosis and aggressive treatment are important to prevent glaucoma-related vision loss from this condition.
Cataract surgery has advanced significantly with improvements like phacoemulsification that uses ultrasound to break up the cataract. This technique allows for a smaller incision and faster recovery compared to previous extracapsular cataract extraction surgery. Newer intraocular lenses and technology have also improved vision outcomes and the ability to reduce dependence on glasses after surgery. Cataract surgery is now a very common and highly successful operation.
Ectropion
It is an outward turning of the eyelid margin . This more frequently affects the lower eyelid.Upper eyelid ectropion is uncommon.Classified in 5 types
1)Congenital 2) Involutional 3) Paralytic 4) Cicatricial 5) Mechanical
Involutional ectropion is more common.Congenital ectropion is very rare.
Symptoms Epiphora :- excessive tearing.Excessive dryness.
Foreign body sensation Irritation.Burning.Redness.Chronic conjunctivitis KeratinizationCorneal exposure
Grading
Lid margin is out rolled and depending on out rolling ectropion can be classified as under:
Grade I –only punctum is everted
Grade II –lid margin is everted and palpebral conjunctiva is visible
Grade III –fornix is also visible
Etiological factors
Horizontal lid laxity:-can be demonstrated by pulling the central part of the lid 8 mm or more from the globe, with a failure to snap back to its normal position on release without the patient first blinking.
Medial canthal tendon laxity
demonstrated by pulling the lower lid laterally and observing the position of the inferior punctum If the lid is normal the punctum should not be displaced more than 1–2 mm
Lateral canthal tendon laxity
characterized by a rounded appearance of the lateral canthus and the ability to pull the lower lid medially more than 2 mm.
>Normally, the displacement should only be 0-2 mm.
Treatment
1 medical therapy
2 surgical therapy
This document provides an overview of vitrectomy, including a brief history, the key steps in a simple vitrectomy procedure, and descriptions of the equipment used. It discusses trocars and cannulas, sclerotomies, illumination sources, viewing systems, vitreous cutters, and vitreous removal. Advantages of smaller gauge vitrectomy instruments are also summarized.
1) Trabeculectomy is a glaucoma surgery that creates an opening in the eye to drain fluid from the anterior chamber and reduce intraocular pressure.
2) It involves making a partial thickness scleral flap, removing a block of tissue underneath, and suturing the flap loosely to allow fluid drainage.
3) Antifibrotic agents like mitomycin C or 5-fluorouracil are often applied to reduce scarring and improve surgical success rates.
This document discusses pediatric refraction and various techniques used for refracting children. Pediatric refraction is different from adult refraction due to active accommodation in children. Cycloplegic refraction is preferable to paralyze accommodation. Different techniques are used based on the age of the child, including near retinoscopy, dynamic retinoscopy, and book retinoscopy. Cycloplegics help obtain an accurate refraction by paralyzing accommodation.
This document discusses fluorescein angiography (FA), a technique used to examine the circulation of the retina and choroid. FA involves injecting a fluorescent dye called sodium fluorescein and then taking photographs of the retina as the dye circulates through the eye. The dye is absorbed by the blood vessels and any leaks or blockages are visible. Precautions are taken and potential side effects explained to the patient. The sequence of FA images provides information about blood flow and any pathological conditions.
This document discusses accommodative esotropia, a condition where excessive accommodation effort causes the eyes to turn inward. It is most often caused by uncorrected hyperopia. If left untreated in a visually immature child, it can lead to loss of binocular vision and amblyopia. Treatment involves full refractive correction through glasses to relax accommodation and restore binocular vision. The timing between onset and treatment determines the visual outcome.
Dr. Karan Bhatia provides an overview of keratoplasty (corneal transplantation). There are different types including penetrating keratoplasty (replacing the full thickness of the diseased cornea), partial thickness lamellar keratoplasty, and rotational keratoplasty. Penetrating keratoplasty has been the standard procedure but carries risks. The history and techniques of penetrating keratoplasty are described in detail including pre-operative evaluation, donor cornea excision, recipient cornea trephination, suturing, and post-operative management. Potential complications are also reviewed. Lamellar keratoplasty is introduced as an alternative to penetrating keratoplasty to reduce risks
This document discusses suture material properties and classifications. It describes the ideal properties of suture material and notes that no single suture has all ideal properties. Suture materials are classified as absorbable or non-absorbable, monofilament or multifilament. Both natural and synthetic absorbable and non-absorbable suture materials are described in detail, including their tensile strengths, degradation times, and tissue reactions. Surgical needle shapes, sizes, and ideal properties are also discussed.
A surgical procedure featuring a partial thickness scleral flap that creates a fistula between AC and subconjunctival space for filtration of aqueous and creation of conjunctival bleb in an effort to lower IOP
This document discusses esotropia, which is an inward turning of one or both eyes. It defines esotropia and describes the different types including accommodative esotropia, congenital esotropia, and microtropia. It outlines the causes, characteristics, diagnosis, and management of each type of esotropia. Some key points covered include the role of accommodation and refractive error in accommodative esotropia, the importance of early treatment for congenital esotropia to prevent amblyopia, and the use of occlusion therapy, refractive correction, surgery, and botulinum toxin injection in the management of esotropia.
- Aphakia is the absence of the crystalline lens from the eye. It can be congenital or caused by surgery or trauma.
- In aphakia, the eye becomes highly hyperopic, the anterior focal point moves forward, and the retinal image is magnified. This decreases visual acuity and field of view.
- Aphakia is treated with spectacles, contact lenses, or intraocular lenses. Spectacles cause issues like increased image size, ring scotomas, and reduced field of view. Contact lenses and IOLs provide better image quality but have risks of complications.
This document discusses biometry, which involves measuring the eye to determine the ideal intraocular lens power for cataract surgery. It notes that biometry errors are the second most common cause of claims in cataract malpractice cases. It describes various techniques for measuring the corneal curvature and axial length of the eye, including manual and automated keratometry, ultrasound A-scan, and optical biometers. It also discusses considerations for biometry in special cases and different intraocular lens calculation formulas.
Presbyopia is the loss of accommodation ability that occurs with aging. It results from a loss of elasticity in the lens and ciliary muscles. By age 40-45, most people experience difficulty seeing objects close up. Symptoms include problems with near vision that are worse in low light. It is diagnosed by reduced amplitude of accommodation. Treatment involves using reading glasses, bifocals, or progressive lenses to add the needed optical power for near vision. Multifocal contact lenses and refractive surgery can also help treat presbyopia.
The cover test is used to qualitatively measure strabismus. It involves covering each eye separately while having the patient fixate on a target. This allows the examiner to observe any movement in the uncovered eye, indicating the presence or absence of a manifest deviation. There are three main types of cover tests: direct cover test to detect manifest squint, cover-uncover test to detect heterophoria, and alternate cover test to differentiate between unilateral and alternating squint and determine if the deviation is concomitant or paralytic. The results of the cover test help diagnose the type of strabismus present.
Cataracts are clouding of the lens inside the eye that degrade vision over time and are caused by aging and other factors like diabetes, smoking, and UV exposure. There are different types of cataracts but they can usually be removed through a simple outpatient surgery called phacoemulsification where the clouded lens is broken up and removed and replaced with an artificial lens. While cataract surgery is very safe and effective, there are rare risks of complications like infection, swelling, or the need for secondary procedures if the artificial lens does not function properly.
Cataracts are clouding of the lens inside the eye that degrade vision over time and are caused by aging, sun exposure, diabetes, corticosteroid use, and genetics. They are typically treated with phacoemulsification surgery which uses ultrasound to break up and remove the cloudy lens and replace it with an artificial lens. While very safe and effective, cataract surgery complications are rare but can include infection, swelling, or the artificial lens not functioning properly.
A cornea transplant (keratoplasty) is a surgical procedure that involves replacing part of your cornea with corneal tissue from a donor. Your cornea is a transparent, dome-shaped surface of your eye. It is where light enters your eye and is a large part of your eye's ability to see clearly.
A cataract is a clouding of the lens in the eye that leads to decreased vision. It is the leading cause of blindness worldwide and the most common eye surgery performed, with over 1 million cataract operations annually in the United States. Cataracts usually form due to aging but can be acquired due to diseases like diabetes, injuries, or medications. Surgical removal of the clouded lens and replacement with an artificial lens is currently the only effective treatment for restoring vision impaired by cataracts.
Cataract is an opacity in the lens or its capsule that can be developmental or acquired. It is the third leading cause of preventable blindness worldwide. Risk factors include age, heredity, UV exposure, smoking, and diabetes. Symptoms include decreased and blurred vision. Cataracts are classified based on location and appearance. Diagnosis involves visual acuity tests and slit lamp examination. Treatment is usually surgical removal of the cataract followed by intraocular lens implantation. The surgery involves making incisions and using ultrasound or lasers to break up the cataract before removing it. Post-operative care includes antibiotic and steroid eye drops with follow up exams to ensure proper healing.
This document provides information about keratoplasty, also known as corneal transplantation. It begins by describing the cornea and its functions. Conditions that can necessitate a corneal transplant are then outlined, such as scarring, distortions or haziness. The donor cornea procurement process is explained, noting corneas are obtained from eye banks. The surgery is described as replacing the diseased cornea with a healthy donor cornea using fine sutures. Possible short-term complications are infection, wound separation or rejection, which can usually be treated. The recovery process and gradual vision improvement is summarized.
Extracapsular cataract surgery involves removing the clouded lens and surrounding capsule from the eye. The most common method is phacoemulsification, which uses ultrasound to break up the lens for removal through a small incision. After removal of the cataract, an intraocular lens implant is typically placed. Surgery is usually quick and has a high success rate in improving vision, but risks include infection, swelling, bleeding or complications that may require further treatment.
Cataract Surgery Recovery Timeline: Navigating the Road to Clear Vision. Cataract surgery is a common and safe procedure, but understanding the recovery process can be overwhelming. Our blog is here to guide you through the recovery timeline, from pre-surgery preparation to post-surgery care. We'll cover the most common symptoms, tips for a speedy recovery and help you to set realistic expectations. Join us as we navigate the road to clear vision and regain your confidence.
CATARACTS NEW of the human eye and its management.okumuatanas1
A corneal ulcer is an open sore on the cornea caused by a break in the corneal epithelium that allows bacteria or other pathogens to enter. Common causes include bacterial or viral infections, especially in contact lens wearers, or due to eye injuries or dry eyes. Symptoms include eye redness, pain, blurred vision, and photophobia. Diagnosis involves fluorescein dye staining and tissue biopsy. Treatment consists of antibiotic, antifungal or antiviral eye drops depending on the cause, along with pain medications and eye patching. Complications can include vision loss if left untreated.
A cataract is a cloudy area in the lens of the eye that can cause blurred or dim vision. It is the leading cause of blindness worldwide and a common cause of vision impairment in the United States. Cataracts develop due to aging, sun exposure, smoking, poor nutrition, eye trauma, certain diseases, and some medications. Diagnosis involves an eye exam using a slit lamp microscope. Treatment is typically cataract surgery to remove the cloudy lens and replace it with an artificial intraocular lens. The decision for surgery depends on the degree of vision impairment and its impact on quality of life. Modern cataract surgery is a low risk outpatient procedure with rapid recovery of clear vision.
Retinal detachment occurs when the retina separates from the back of the eye. It is a medical emergency that can cause permanent vision loss if not repaired. The retina is made up of layers and receives images that the brain interprets as vision. Retinal detachment can be rhegmatogenous, tractional, or exudative and risks include nearsightedness, eye surgery or injury. Diagnosis involves eye exams and ultrasound. Treatment may involve laser, cryotherapy, scleral buckle surgery, pneumatic retinopexy or vitrectomy to seal retinal breaks and reattach the retina. Nursing care focuses on medication administration, activity safety, and education on signs of recurrence and postoperative care.
Cataract is a clouding of the normally clear lens of the eye which can lead to vision loss. It is very common in older people. The document discusses what cataracts are, types of cataracts, causes, symptoms, risk factors, diagnosis, treatment which is usually surgery to remove the clouded lens and replace it with an artificial lens, complications, prevention and why cataracts are so prevalent in India. It also includes a case study of a 70 year old widow who underwent cataract surgery.
This document provides information about cataracts and their management. It discusses what a cataract is, risk factors for cataract formation such as aging, associated ocular conditions, nutritional and physical factors, and systemic diseases. It describes the clinical manifestations of cataracts and the diagnostic evaluation including various visual acuity tests and examinations. Treatment options discussed include medical management using glasses or surgery. The two main surgical procedures mentioned are extracapsular cataract extraction and phacoemulsification. Postoperative care and potential complications are also outlined. Finally, it provides conclusions and references several research articles on prevalence and risk factors of cataracts.
This document discusses cataracts and presbyopia, as well as treatment options performed by Dr. Helga Fuenfhausen Pizio. A cataract is a clouding of the eye's lens that causes vision problems and is common in older adults. Symptoms include blurry or faded vision. Surgery is the only treatment and involves removing the clouded lens and replacing it with an artificial lens. For presbyopia, which causes near vision issues, multifocal lenses can provide both near and distance vision after cataract surgery without glasses. Dr. Pizio performs cataract surgery using small incisions and ultrasound and was the first in Nevada to implant a new multifocal lens.
This document discusses various options for treating presbyopia, including glasses, contact lenses, and surgical interventions. It provides details on:
- The prevalence of presbyopia and its impact.
- Accommodation anatomy and theories of how it works.
- Treatment options like monovision, LASIK, conductive keratoplasty, corneal inlays, and scleral/lens surgery.
- Presbyopia-correcting intraocular lenses, including multifocal and accommodating lens designs.
- Factors to consider for patients like expectations, alternatives, and selection criteria.
As we get older, the lens inside the eye gradually becomes misty or cloudy. When the vision becomes hazy, the condition is known as cataract. Cataract still continues to be the leading cause of treatable blindness. This condition can be treated by surgery which can also be done when you have other eye diseases like diabetic retinopathy or glaucoma.
Secondary cataract, also known as after-cataract, is an opacification of the posterior capsule of the lens that may develop months or years after cataract extraction surgery. It occurs when epithelial cells proliferate behind the new lens capsule, preventing light from reaching the retina and causing vision loss. Up to 20% of patients who undergo cataract extraction may develop secondary cataract, especially younger patients. Symptoms include decreased visual acuity and blurry vision. The standard treatment is Nd:YAG laser capsulotomy to cut an opening in the opaque capsule and restore vision, though there are small risks like increased eye pressure or retinal detachment.
Types of Cataract Surgery: Cutting-Edge Techniques for Clear Vision. Are you or a loved one facing cataract surgery? Stay informed with our blog, where we break down the latest and most advanced cataract surgery options available. From traditional methods to cutting-edge techniques, we'll help you understand the benefits and risks of each option and make an informed decision for your eye health. Don't let cataracts cloud your vision any longer. Join us as we explore the different types of cataract surgery available to regain your clear vision. Find out which is right for you, and get back to seeing clearly again!
- A cataract is a clouding of the lens in the eye that can cause vision loss. It is often related to aging but may be caused by other factors like smoking.
- Symptoms include decreased vision, glare from lights, and frequent changes to prescriptions. Cataract surgery is usually done to replace the cloudy lens with an artificial lens implant.
- There are different types of intraocular lenses that provide varying levels of vision correction and independence from glasses after surgery. Conventional lenses correct one distance while newer lenses aim to provide multifocal vision.
This document provides information about cataracts, including:
1. A cataract is a clouding of the lens in the eye, which can develop due to aging, metabolic disorders, trauma, or heredity.
2. Cataracts are classified based on morphology, age of onset, maturity, and etiology. The main types include nuclear, cortical, posterior subcapsular, and congenital cataracts.
3. Surgical removal of the clouded lens and replacement with an intraocular lens is the primary treatment for cataracts. Post-operative care involves monitoring for complications and administering eye drops.
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2. What is a cataract?
A cataract is a clouding of the eye's lens,
which is normally clear.
3. Causes of cataracts
• ADVANCED AGE
• Ultraviolet radiation from sunlight and other sources
• Diabetes
• Hypertension
• Obesity
• Smoking
• Prolonged use of corticosteroid medications
• Previous eye injury or inflammation
• Previous eye surgery
• Significant alcohol consumption
• High myopia
• Family history
4. Cataract symptoms
• Hazy, cloudy vision
• Glare
• Seeing double (when you see two
images instead of one)
• Having trouble seeing well at night,
or needing more light when reading
• Seeing bright colors as faded or
yellow instead
7. Prevalence
• Nearly 25.7 million Americans over age
40 have cataracts. The number is
projected to increase to 45.6 million by
2050.
http://forecasting.preventblindness.org/
• Cataract surgery is the most common
elective surgery among Medicare
beneficiaries in the United States.
http://www.ncbi.nlm.nih.gov/pubmed/22978
526?dopt=Abstract
8. Benefits
Multiple studies have demonstrated its
association with improved quality of life,
reduced risk of falling and fewer car crashes.
• http://www.ncbi.nlm.nih.gov/pubmed/22851116
• http://www.ncbi.nlm.nih.gov/pubmed/22273356
• One study found that those who had cataract
surgery had a 40 % lower long-term mortality
risk than those who did not.
http://www.aaojournal.org/article/S0161-
64201300143-7/fulltext
9. How is a Cataract Detected?
• Visual Acuity Test: Determines how well
you can see at various distances.
• Dilated eye exam where drops are
placed in the eyes to dilate or widen the
pupils.
This will allow for evaluation of the
cataracts, optic nerve, and retina.
11. Are you Ready to have Cataract Surgery?
• Are your cataracts impacting your daily or
occupational activities?
• Are your cataracts affecting your ability to
drive safely at night?
• Are your cataracts interfering with the outdoor
activities you enjoy?
• Can you manage your cataracts in other
ways?
12. What Happens if you DON’T
have cataract surgery?
• Your vision will gradually get worse over time.
• Cataracts never stay the same
• Cataracts never get better
• Cataract surgery is not an emergency
• Cataracts that become very dense can
become:
Harder to remove
Associated with an increased risk of complications
13. About Surgery
• Same day procedure
• Done under sterile conditions
• Topical anesthetic +/-IV sedation
• Can be done with or without assistance of
laser
• Typically takes 15-20 minutes
• Cataract is broken up into pieces, and
removed
• Intraocular lens is inserted
• Incision is sealed, typically without stitches
16. Traditional Cataract Surgery
• Incision is created with a small blade
• The sac which holds the cataract is
opened up manually with handheld
instruments.
• Phacoemulsification (ultrasound power)
is used to break the lens up into pieces.
• Those pieces are then removed using
ultrasound power.
• An artificial lens is placed into the eye
17. Laser assisted cataract surgery
• In laser cataract surgery, a femtosecond laser
replaces or assists use of a hand-held
surgical tool for the following steps in cataract
surgery:
The corneal incision
The anterior capsulotomy (opening the sac which
holds the cataract)
Cataract fragmentation
• Removal of cataract pieces must still be done
using traditional ultrasound
• Implant must still be placed in the traditional
manner
18. Laser assisted cataract surgery
• Pros:
Can cut down on the amount of phaco
energy used to remove the cataract since
the laser has already broken the lens into
pieces.
Precision of placing incisions exactly as
planned pre-operatively
This can also be used to correct
astigmatism
19. Laser assisted cataract surgery
• Cons:
Not covered by insurance
Longer procedure time
Not everyone is a candidate
Laser can produce gas bubbles
within the sac that holds the
cataract. In rare cases, these can
rupture the sac.
20. Intraocular lenses (IOLs)
• An intraocular lens is a tiny,
artificial lens for the eye. It
replaces the eye’s natural lens
that is removed during cataract
surgery.
• IOLs come in different powers,
just like glasses or contact
lenses.
21. IOLs
• Monofocal: It has one focusing distance
It is set to focus on distance OR close up
OR intermediate range
Pros:
• covered by insurance
• Most commonly selected IOL
• Unlikely to get halos aftewards
Cons:
• Must wear glasses for the other distances
23. IOL-monovision
• Monovision is where two different
monofocal IOLs are used in order to
minimize the need for glasses.
The dominant eye is used to correct the
distance vision.
The non-dominant eye is used to correct
the reading vision.
This is frequently done with contact lenses
24. IOL-monovision
• Pros:
Can minimize the need for glasses
Usually covered by insurance unless
astigmatism needs to be corrected.
• Cons:
Lack of binocular vision
There are truly three different distances
(far, intermediate, near), but only two eyes!
25. IOLs
• Multifocal: Provides both distance and
near focus at the same time. Designed
so that the brain learns to select the
correct focus automatically.
• Pros: 75-80% of people who get these lenses
do not need to use glasses for anything
• Cons:
– Not covered by insurance
– Often associated with halos around lights at night.
– Not everyone is a candidate for this type of lens
28. IOLs
• Accommodative lens:
Lens that moves inside of the eye to allow
focusing at different distances
• Pros: May allow for some degree of
independence from glasses.
• Cons:
– Not covered by insurance
– Sometimes, with time and scarring, the movement of
the lens becomes limited, and it no longer functions
as intended
30. IOLs
• Toric IOL (for astigmatism reduction):
Astigmatism is a refractive error caused by
an uneven curve in your cornea or lens.
• Astigmatism may be corrected by glasses or
contacts.
• It may be corrected by an astigmatism
correcting lens:
– Pros: Typically well tolerated.
– Cons:
» Not covered by insurance
» May move out of position in the early post
operative period and require re-positioning.
33. IOLs
• Symfony:
Lens option that corrects distance and
intermediate vision, but still mandates the
need for reading glasses.
Pros:
• Less likely to induce halos than multifocal IOL
• Can also correct astigmatism
Cons:
• Not covered by insurance
• May also induce halos
35. Which IOL is right for YOU?
• This will involve discussion with your
ophthalmologist. It depends largely on:
Your pre-existing ocular/medical conditions
The measurements of your eye
Your feelings about glasses
Financial considerations
36. What things may limit your visual recovery?
• Pre-existing medical conditions
Diabetes that has already caused damage
to the retina
Hypertension that has already caused
damage to the retina
37. What things may limit your visual recovery?
• Pre-existing ocular conditions
Macular degeneration
Glaucoma
Other diseases or conditions which affect
the optic nerve and/or retinal health
39. Risks of Surgery
• Risks include:
• Infection:
Rate in the US is 6 or 7 out of 10,000 people
Can be devastating, and can result in loss of
vision and even loss of the eye itself.
How we try to prevent it:
• Topical antibiotic drops before surgery, morning or
surgery, during surgery, and after surgery
• Cleansing of the eye prior to surgery
• Sterile operative technique, and careful post operative
handling
40. Risks of Surgery
• Bleeding inside of the eye (<1%)
• Swelling of the retina (1-5%)
• Risk of need for additional surgery:
Retinal detachment (<1%)
Retained pieces of cataract inside of the
eye (<1%)
Wound leak (<1%)
41. Risks of Surgery
• Chronic inflammation (<1%)
• Development of glaucoma (<1%)
• Prescription error may not be
completely corrected with intraocular
lens.
There is a higher likelihood of this in very
near-sighted or very far sighted individuals
42. Restrictions after Surgery
• No swimming for 2 weeks
• No eye makeup or powder makeup for
at least 1 week.
• No heavy lifting, bending, or straining
for 2 weeks.
• Remain in an area where you have
access to quality medical care for at
least a month after surgery
43. Drops
• You will need to use drops before and
after cataract surgery. These will
include:
Antibiotic drops
Anti-inflammatory drops
Steroid eye drops
45. Recovery
• The amount of time it takes for vision to
recover varies from one person to the next,
typically next day to a few days
• This also depends on how dense the cataract
is, and how much swelling resulted from
surgery
• Downtime from work is usually around 2
days, unless job is very demanding physically
46. A Few Thoughts
• Cataracts can never return. Ever.
• This is not considered a painful
procedure
Most people take nothing for pain
afterwards
Sometimes patients take Tylenol or Advil.
• You will not see the cataract surgery
happening to your eye. At most you will
see colors, lights and shadows.
47. Down the Road
• The intraocular lenses will last forever. It
would take major trauma to
dislocate/damage the lens
• Sometimes, people develop scar tissue
behind the lens, and complain of foggy
vision
This is called “after cataract” or “secondary
cataract”
This can be corrected with a laser
procedure in the office