The natural lenses of the eyes are naturally very clear but may become clouded due to time or other factors. This cloudiness cannot be “cleaned” off in any way, so the entire lens must be replaced through surgery if the case is severe. Cataract surgery is quite common and has been perfected over many years since its inception.
The procedure itself consists of the removal of the clouded lens through a small slit in the cornea made by the surgeon. This can be accomplished through one of two ways. The first is through emulsifying the cataract through ultrasonic waves and suctioning the remaining material out. If the lens is so cloudy that it cannot be broken up, the surgeon will remove the stubborn lens nucleus in one piece through the slit before vacuuming the rest of the soft lens out.
In both cases, a new artificial intraocular lens (IOL) is placed in the vacated capsule. These new lenses are generally perfect replacements for the old, allowing the patient to achieve improved vision. In most cases, sutures are not needed, as the surgical wound will heal quickly on its own.
Common issues incurred after surgery include mild discomfort, itchiness and crusting discharge. These annoyances should disappear within a few days. It is highly recommended that you refrain from rubbing your eyes for several weeks. The doctor will prescribe eye drops to facilitate healing which should be complete within two months. The doctor should be contacted immediately if you experience a sudden loss of vision, nausea, swollen eyes, light flashes, floaters or severe pain.
Glaucoma is an eye disease in which pressure inside the eye (intraocular pressure) rises dangerously high, damaging the optic nerve and causing vision loss. In a healthy eye, fluid is produced in the ciliary body, enters the eye, and then drains through tiny passages called the trabecular meshwork. In people with glaucoma, these passages become blocked and intraocular pressure rises.
Some cases of glaucoma can be treated with medications. For others, laser or traditional surgery is required to lower eye pressure. Common surgeries include:
Laser Peripheral Iridotomy (LPI) - For patients with narrow-angle glaucoma. A small hole is made in the iris to increase the angle between the iris and cornea and encourage fluid drainage.
Argon Laser Trabeculoplasty (ALT) and Selective Laser Trabeculoplasty (SLT) - For patients with primary open angle glaucoma (POAG). The trabecular passages are opened to increase fluid drainage. ALT is effective in about 75% of patients, and SLT may be repeated.
Nd: YAG Laser Cyclophotocoagulation (YAG CP) - For patients with severe glaucoma damage who have not been helped with other surgeries. The ciliary body that produces intraocular fluid is destroyed.
Filtering Microsurgery (Trabeculectomy) - For patients who have not been helped with laser surgery or medications. A new drainage passage is created by cutting a small hole in the sclera (the white part of the eye) and creating a collection pouch between the sclera and conjunctiva (the outer covering of the eye).
Tube Shunt Surgery - May be recommended for patients with neovascular glaucoma, failed trabeculectomy, or susceptibility to developing scar tissue. A thin, flexible tube (a shunt) with a silicone pouch is inserted in the eye to facilitate drainage.
Pterygium is a benign growth of the conjunctiva (lining of the white part of the eye) that grows into the cornea, which covers the iris (colored part of the eye). A pterygium usually begins at the nasal side of the eye. It can be different colors, including red, pink, white, yellow, or gray.
Patients with pterygium often first notice the condition because of the appearance of a lesion on their eye or because of dry, itchy irritation, tearing or redness. Pterygium is usually first noticed when it is confined only to the conjunctiva. At this stage it is called a pingueculum. Once it extends to the cornea it is termed a pterygium and can eventually lead to impaired vision.
Although the causes of pterygium are not entirely known, it is believed to be caused mainly by exposure to UV light. Another suspected risk is living in a dry, dusty, windy environment. People who live near the equator or play water sports such as surfing and fishing are thus more likely to develop pterygium. Prolonged exposure to these conditions causes the conjunctiva to thicken and the eye to become red and irritated. Collagen in the eye begins to deteriorate, and the eye weakens.
Studies show that there may also be a genetic predisposition to pterygium, with a higher prevalence in men than in women.
Signs and Symptoms
Symptoms of pterygium include dryness, redness, irritation, inflammation, and tearing. In more severe cases, the pterygium may grow over the pupil and limit vision.
Sunglasses that block UV rays, particularly sunglasses that provide side coverage, are a good means of protection against pterygium. Wearing a hat with a brim to block sunlight is also helpful. In hot, dry climates, artificial tears (eye drops) should be used to help lubricate the eyes.
In most mild cases of pterygium, artificial tears can be used to reduce dryness and irritation.
For patients with severe cases whose vision has been affected, different types of surgery are available. Surgery is the only way to definitively remove a pterygium, but it is not a perfect solution; it requires long-term follow-up, and there is a risk that the pterygium will grow back.
Conjunctival auto-grafting is a safe and effective technique that surgically removes a pterygium. In this procedure, the pterygium is removed along with the tissue covering the sclera (conjunctiva). Tissue is removed from the inside of the patient's upper eyelid and replaces the bare sclera.
Amniotic membrane transplantation is another safe and effective pterygium removal procedure. Tissue is removed from the inner layer of the placenta and used to reconstruct the surface of the eye. This type of graft encourages healing and reduces swelling.
If the pterygium persists after surgery, or to minimize the risk of the pterygium recurring, a radiation treatment called strontium plaque therapy may be recommended. Radioactive strontium produces beta particles that penetrate the cornea and prevent the regrowth of blood vessels that occur as the pterygium returns.
Styes and Chalazions
Styes and chalazions are small fluid-filled cysts that develop along the eyelid as a result of an infection or blocked oil gland. While these bumps do not usually lead to any serious complications, they may cause pain, swelling and tearing of the eye. Larger chalazions may gradually obstruct vision.
A stye appears on the eyelid as a small red bump, while a chalazion is similar but usually larger and not as painful. Styes usually heal within a week, while chalazions can take up to a few months.
Many styes and chalazions go away on their own with no need for treatment other than warm, wet compresses. Dr.Steinberg may prescribe antibiotic eye drops or recommend over-the-counter treatments for those that do not heal on their own. Patients should avoid wearing makeup or contact lenses until after the stye or chalazion has healed.
“HILLA STEİNBERG (MD.PLLC.)
(Board Certified Ophtalmologist . Brıstol UK) 1999
“ AHMET UMAY (MD.PLLC.)
( Board Certified Ophtalmologist . Bristol UK) 2000