Eye Diseases and Surgery: What We Treat

The human eyes are powerful but delicate organs, and require consistent, specified care in order to function at their peak. Aging, genetics, and injury can all contribute to less-than-ideal vision, and it is our goal to prevent and correct common eye conditions with precise diagnoses and sophisticated technology. Read on to learn about the various conditions we treat, and how you and your family can receive the best preventative care possible.

• Cataracts
• Glaucoma
• Macular Degeneration
• Diabetic Retinopathy
• Refractive Lens Exchange – An Alterative to LASIK

Cataracts

Any clouding or loss of clarity of the lens of the eye is called a cataract. The lens of the eye is normally a clear structure, which allows the eye to maintain a crisp focus on images. A cataract is caused by the accumulation of protein on the lens, which in turn causes images to appear blurry. This occurs most in individuals over the age of 50 and may onset slowly or rapidly.

Am I a Candidate for Cataract Surgery?

Cataracts are painless, but can be annoying and inconvenient. They may cause glare, double vision, yellow or dark vision, and a change in the prescription of your corrective lenses. Cataract surgery is an elective procedure, and should be performed at a time that is convenient for you. Most people choose to have surgery when their reduced vision begins to interfere with their lifestyles and daily activities.

The Surgery

There is no medical cure for cataracts; they can only be treated with surgical removal. During surgery, the cloudy lens is removed and a clear, artificial lens is implanted in its place. Dr. Warner has performed thousands of cataract procedures using the advanced technique of small-incision, suture-less cataract surgery. By not using stitches, Dr. Warner allows the patient to have a fast, comfortable recovery with a very low risk of complications.

Another technique Dr. Warner practices is phacoemulsification. During this procedure, a small, ultrasound-powered device is used to gently remove the cataract-ridden lens from the eye. Dr. Warner then replaces the lens with a soft, foldable implant, which allows for smaller incisions and a swift recovery.

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Glaucoma

Glaucoma refers to a group of diseases that damage the optic nerve and cause a reduction or complete loss of vision. In some cases, the pressure within the eye is higher than normal, which causes flawed signals to be sent to the part of the brain responsible for vision. Glaucoma can also occur when intraocular pressure is relatively low, but both instances usually result in vision loss. Since individuals with early glaucoma often have no symptoms, regular dilated eye examinations are needed for its detection.

Am I at Risk for Glaucoma?

Anyone can get glaucoma, although certain groups of people are at a higher risk. Risk factors include age, family history of glaucoma, eye injury, African ancestry, diabetes, and high blood pressure.

Glaucoma Treatment

Intraocular pressure is only one of the factors that can lead to glaucoma; however, pharmaceutical therapy and surgery can both successfully lower intraocular pressure and prevent further vision loss. Glaucoma medications accomplish this by reducing eye fluid production or increasing fluid outflow. Surgery can either involve laser therapy, which stimulates fluid outflow by making several small scars on the eye’s drainage system, or filtering microsurgery, which creates drainage holes that decrease pressure on the eyes.

Glaucoma surgery is aimed at preventing vision loss. Unfortunately, it cannot reverse it. That’s why scheduling regular preventive exams is so important, especially as patients grow older.

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Macular Degeneration

Macular degeneration affects over 10 million Americans and is the leading cause of blindness in adults aged 55 and over. It is an incurable disease caused by the deterioration of the central portion of the retina, called the macula. This part of the eye is responsible for central vision, which is what allows you to see detail and color, enabling you to drive, read, and recognize faces.

Macular degeneration can either occur in “wet” or “dry” form. With wet degeneration, new blood vessels form on an area, such as the macula, where they are not supposed to. Dry degeneration can result from the aging of macular tissue or the formation of pigment on the macula, or both.

Am I at Risk for Macular Degeneration?

Macular degeneration most commonly occurs as a result of the aging process. Smoking and ultraviolet light exposure may make the disease worse. In rare cases, macular degeneration may result from conditions such as injury, infection, or extreme nearsightedness.

Treatment for Macular Degeneration

Macular degeneration can be diagnosed during a routine dilated eye examination, which includes a dilation of the pupils. Unfortunately, there is currently no cure for macular degeneration. There is no treatment method currently in use for the “dry” form of macular degeneration, although extensive research is being conducted to find one. If the disease occurs in the “wet” form, it can be slowed by the use of pharmaceutical drugs that stop the abnormal growth of blood vessels.

Another option is photocoagulation, which involves the use of a laser beam to create tiny burns on the areas of the macula that have abnormal blood vessel growth. This seals off the vessels and prevents them from growing.

Photodynamic therapy (PDT) uses a cold laser and a light-sensitizing drug called verteporfin (Visudyne®) to concentrate in the blood vessels under the macula and close them off. This also prevents the progression of the disease.

Finally, macular translocation surgery can be used to relocate the fovea (the centermost part of the macula) away from blood vessel growth to an area with healthy tissue. This kind of surgery is rarely performed, and is only possible if the blood vessels are located directly below the fovea.

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Diabetic Retinopathy

Diabetes is a disease in which the body cannot store and metabolize sugar properly. If your blood sugar becomes too high, it can damage the blood vessels near the eye’s retina (the nerve layer that converts light into image signals and sends them to your brain). Diabetic retinopathy refers to the changes that these tiny blood vessels undergo. Over time, these changes result in poor vision or even blindness. Diabetic retinopathy is a serious complication of diabetes, as well as the most common, and is the leading cause of blindness in American adults.

You may not notice any change in your vision when you first develop diabetic retinopathy, which is why it is so important for diabetics to receive a complete dilated examination each year. Abnormal blood vessels can grow on the iris (the colored part in the front of your eye), eventually causing glaucoma. In addition, diabetic retinopathy may lead to a retinal detachment, which, if left untreated, can cause blindness.

How Can I Prevent Vision Loss from Diabetic Retinopathy?

There is no guaranteed method of prevention. The longer a person has diabetes, the higher the likelihood they will develop diabetic retinopathy, and about 80 percent of people who have had diabetes for at least 15 years have some damage to the blood vessels in their retinas.

However, taking good care of yourself significantly reduces your risk of diabetic eye disease, as well as many of the other complications associated with diabetes. Remember to:

• Keep your blood sugar under good control
• Maintain a healthy diet
• Exercise regularly

Annual dilated eye exams are the best way to preserve your vision, and the early detection of diabetic eye disease is crucial to preventing vision loss.

How Is Diabetic Retinopathy Treated?

The good news about diabetic retinopathy is that treatment may not be necessary. Even when it is, impaired vision can usually be improved and vision loss prevented. Maintaining control of your diabetes and blood sugar can delay, and possibly prevent, both the development and progression of diabetic retinopathy.

If you are diagnosed with diabetic retinopathy, you may need to have special photos of your retina taken. This series of photos is called fluorescein angiography. When you have fluorescein angiography, a yellow dye is injected into your arm, which then passes through the blood vessels in your retina, making it easier to see the vessels in the photos. Your ophthalmologist can then use the photos to determine if laser surgery is necessary.

Dr. Warner performs photocoagulation, which involves the use of a laser beam to create tiny burns on the areas of the macula that have abnormal blood vessel growth, as well as panretinal photocoagulation, which treats the retina with small scars that cause abnormal new blood vessels to shrink and disappear.

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Refractive Lens Exchange – An Alterative to LASIK

Refractive lens exchange (RLE) is a non-laser procedure that corrects poor vision resulting from nearsightedness, farsightedness, presbyopia (age-related farsightedness), or astigmatism. The process is similar to cataract surgery in that the natural lens of the eye is replaced with an artificial one; the only difference is that the natural lens is not clouded, but is simply replaced in order to improve the eye’s focusing power.

During and After Surgery

Refractive Lens Exchange is an outpatient procedure and usually takes about 15 to 20 minutes total. During the procedure, the natural lens is gently suctioned away, and a silicon or plastic intraocular lens (IOL) is implanted between the cornea and the iris, or directly behind the iris (the colored part of the eye). You will be given eye drops to use one week prior to surgery and should continue using them for three weeks afterwards. Patients usually recover quite quickly and can see within minutes of their treatment. Some patients may experience blurring and light sensitivity for a few weeks, and in some cases patients will notice halos or rings around lights or nighttime glaring.

Am I a Good Candidate for Refractive Lens Exchange?

If you suffer from poor vision caused by nearsightedness, farsightedness, presbyopia or astigmatism, are over the age of 18, and have healthy corneas, you are probably a good candidate for refractive lens exchange (RLE). RLE is also a good alternative for patients who cannot or do not wish to undergo LASIK surgery, such as patients with dry eyes.

To find out if refractive lens exchange is right for you, schedule a consultation with Dr. Warner today.