LASIK EYE SURGERY

Overview

LASIK is eye surgery that permanently changes the shape of the cornea (the clear covering on the front of the eye). It is done to improve vision and reduce a person’s need for glasses or contact lenses.

For clear vision, the eye’s cornea and lens must bend (refract) light rays properly. This allows images to be focused on the retina. Otherwise, the images will be blurry.

This blurriness is referred to as a “refractive error.” It is caused by a mismatch between the shape of the cornea (curvature) and the length of the eye.

LASIK EYE SURGERY

LASIK uses an excimer laser (an ultraviolet laser) to remove a thin layer of corneal tissue. This gives the cornea a new shape so that light rays are focused clearly on the retina. LASIK causes the cornea to be thinner.

LASIK is an outpatient surgical procedure. It will take 10 to 15 minutes to perform for each eye.

The only anesthetic used is eye drops that numb the surface of the eye. The procedure is done when you are awake, but you will get medicine to help you relax. LASIK may be done on one or both eyes during the same session.

To do the procedure, a flap of corneal tissue is created. This flap is then peeled back so that the excimer laser can reshape the corneal tissue underneath. A hinge on the flap prevents it from being completely separated from the cornea.

When LASIK was first done, a special automated knife (a microkeratome) was used to cut the flap. Now, a more common and safer method is to use a different type of laser (femtosecond) to create the corneal flap.
The amount of corneal tissue the laser will remove is calculated ahead of time.

The surgeon will calculate this based on several factors including:

• Your glasses or contact lens prescription

• A wavefront test, which measures how light travels through your eye

• The shape of your cornea surface

Once the reshaping is done, the surgeon replaces and secures the flap. No stitches are needed. The cornea will naturally hold the flap in place.

LASER PHOTOCOAGULATION - eye

LASER PHOTOCOAGULATION - eye

Overview

Laser photocoagulation is eye surgery using a laser to shrink or destroy abnormal structures in the retina, or to intentionally cause scarring.

Your doctor will perform this surgery at an outpatient or office setting.

Photocoagulation takes place by using the laser to create a microscopic burn in the target tissue.

The laser spots are usually applied in 1 of 3 patterns.

Before the procedure, you will be given eye drops to dilate your pupils. Rarely, you will get a shot of a local anesthetic. The shot may be uncomfortable.

You will be awake and pain-free during the procedure.

• You will be seated with your chin in a chin rest. A special lens will be placed on your eye. The lens contains mirrors that help the doctor aim the laser. You will be instructed to look straight ahead or at a target light with your other eye.

• The doctor will aim the laser at the area of the retina needing treatment. With each pulse of the laser, you will see a flash of light.

Depending on the condition being treated, there may be only a few pulses, or as many as 500.

CATARACT REMOVAL

Overview

Cataract removal is surgery to remove a clouded lens (cataract) from the eye. Cataracts are removed to help you see better.

The procedure almost always includes placing an artificial lens (IOL) in the eye.

Cataract surgery is an outpatient procedure. This means you likely do not have to stay overnight at a hospital.

The surgery is performed by an ophthalmologist. This is a medical doctor who specializes in eye diseases and eye surgery.

CATARACT REMOVAL

Adults are usually awake for the procedure. Numbing medicine (local anesthesia) is given using eyedrops or a shot. This blocks pain. You will also get medicine to help you relax. Children usually receive general anesthesia. This is medicine that puts them into a deep sleep so that they are unable to feel pain.

The doctor uses a special microscope to view the eye. A small cut (incision) is made in the eye.

The lens is removed in one of the following ways, depending on the type of cataract:

• Phacoemulsification:

With this procedure, the doctor uses a tool that produces sound waves to break up the cataract into small pieces. The pieces are then suctioned out. This procedure uses a very small incision.

• Extracapsular extraction:

The doctor uses a small tool to remove the cataract in mostly one piece. This procedure uses a larger incision.

• Laser surgery:

The doctor guides a machine that uses laser energy to make the incisions and soften the cataract. The rest of the surgery is much like phacoemulsification. Using the laser instead of a knife (scalpel) may speed recovery and be more accurate.

After the cataract is removed, a manmade lens, called an intraocular lens (IOL), is usually placed into the eye to restore the focusing power of the old lens (cataract). It helps improve your vision.

The doctor may close the incision with very small stitches. Usually, a self-sealing (sutureless) method is used. If you have stitches, they may need to be removed later.

The surgery lasts less than half an hour. Most times, just one eye is done. If you have cataracts in both eyes, your doctor may suggest waiting at least 1 to 2 weeks between each surgery.

RETINAL DETACHMENT REPAIR

RETINAL DETACHMENT REPAIR

Overview

Retinal detachment repair is eye surgery to place a retina back into its normal position. The retina is the light-sensitive tissue in the back of the eye. Detachment means that it has pulled away from the layers of tissue around it.

This article describes the repair of rhegmatogenous retinal detachments. These occur due to a hole or tear in the retina.

Most retinal detachment repair operations are urgent. If holes or tears in the retina are found before the retina detaches, the eye doctor can close the holes using a laser. This procedure is most often done in the health care provider’s office

If the retina has just started to detach, a procedure called pneumatic retinopexy may be done to repair it.

• Pneumatic retinopexy (gas bubble placement) is most often an office procedure.

• The eye doctor injects a bubble of gas into the eye.

• You are then positioned so the gas bubble floats up against the hole in the retina and pushes it back into place.

• The doctor will use a laser to permanently seal the hole.

Severe detachments need more advanced surgery.

The following procedures are done in a hospital or outpatient surgery center:

• The scleral buckle method indents the wall of the eye inward so that it meets the hole in the retina. Scleral buckling can be done using numbing medicine while you are awake (local anesthesia) or when you are asleep and pain free (general anesthesia).

• The vitrectomy procedure uses very small devices inside the eye to release tension on the retina.

This allows the retina to move back into its proper position. Most vitrectomies are done with numbing medicine while you are awake.

In complex cases, both procedures may be done at the same time.

GLAUCOMA

Glaucoma is a group of eye conditions that can damage the optic nerve. This nerve sends the images you see to your brain. Most often, optic nerve damage is caused by increased pressure in the eye. This is called intraocular pressure.

GLAUCOMA

STRABISMUS

Strabismus is a disorder in which both eyes do not line up in the same direction. Therefore, they do not look at the same object at the same time. The most common form of strabismus is known as “crossed eyes.”

DACRYOCYSTITIS

DACRYOCYSTITIS

Description

Dacryocystitis is infection of the tear (lacrimal) sac usually due to a blockage in the tear (nasolacrimal) duct. The tear sac is a small chamber into which tears drain. The usual cause of dacryocystitis is a blockage of the nasolacrimal duct, which leads from the tear sac into the nose. Dacryocystitis may occur suddenly (acute) or be longstanding (chronic).

Symptoms

Often the dacryocystitis infection is mild. Sometimes, the infection is severe and can cause fever. Sometimes a collection of pus (abscess) may form, which can rupture through the skin, creating a passage for drainage.

In acute dacryocystitis, the area around the tear sac is painful, red, and swollen. The area around the eye may become red and watery and may ooze pus. Slight pressure applied to the tear sac may push thick material through the punctum (the opening at the inner corner of the eyelid near the nose).

Chronic dacryocystitis causes the skin over the small chamber into which tears drain (tear sac) to bulge. When pressure is applied, the bulge may not be painful, but a puslike or cheeselike material often comes out of the opening at the inner corner of the eyelid near the nose (punctum or tear duct). People with chronic dacryocystitis often also have chronic conjunctivitis (pink eye).

Diagnosis of Dacryocystitis

• Symptoms and a doctor’s examination

A doctor bases the diagnosis of dacryocystitis on the symptoms and examination findings.

Treatment

• For acute dacryocystitis, antibiotics followed by surgery

• For chronic dacryocystitis, surgery

Acute dacryocystitis is usually treated with an antibiotic taken by mouth. If a fever is present or if the infection is severe, antibiotics given by vein may be required. Applying warm compresses to the area several times a day also helps. After the acute infection resolves, doctors recommend that people have surgery to bypass the blockage (dacryocystorhinostomy [DCR]) so that infection does not recur. DCR is also the main treatment for chronic dacryocystitis.

IOL IMPLANTS: Lens Replacement After Cataracts

IOL IMPLANTS: Lens Replacement After Cataracts

An intraocular lens (or IOL) is a tiny, artificial lens for the eye. It replaces the eye’s natural lens that is removed during cataract surgery.

The lens bends (refracts) light rays that enter the eye, helping you to see. Your lens should be clear. But if you have a cataract, your lens has become cloudy. Things look blurry, hazy or less colorful with a cataract.

Cataract surgery removes this cloudy lens and replaces it with a clear IOL to improve your vision.

IOLs come in different focusing powers, just like prescription eyeglasses or contact lenses. Your ophthalmologist will measure the length of your eye and the curve of your cornea. These measurements are used to set your IOLs focusing power.

What are IOLs made of?

Most IOLs are made of silicone, acrylic, or other plastic compositions.

They are also coated with a special material to help protect your eyes from the sun’s harmful ultraviolet (UV) rays.

Monofocal IOLs

The most common type of lens used with cataract surgery is called a monofocal IOL. It has one focusing distance.

It is set to focus for up close, medium range or distance vision. Most people have them set for clear distance vision.

Then they wear eyeglasses for reading or close work

CHALAZION

A chalazion is a small bump in the eyelid caused by a blockage of a tiny oil gland.

CHALAZION

EYELID TWITCH

An eyelid twitch is a general term for spasms of the eyelid muscles. These spasms happen without your control. The eyelid may repeatedly close (or nearly close) and reopen. This article discusses eyelid twitches in general.

EYELID TWITCH