¿HOW IS LASER SURGERY UTILIZED CORRECT VISION PROBLEMS? This is a safe procedure that modifies the curvature of the cornea, remodeling it and allowing images to focus on the retina permanently. Patients, who were previously using glasses or contact lenses to correct problems of nearsightedness, farsightedness or astigmatism, can now use excimer laser is an alternative.
IS IT RECOMMENDED TO OPERATE BOTH EYES AT THE SAME TIME? Surgery is usually done to both eyes at once, given that there is no surgical risk, achieving a faster recovery.
¿WHAT ARE THE SURGICAL TECHNIQUES?
LASIK: Using a microkeratome, a flap of corneal tissue (epithelium and part of the stroma) is lifted by one hand. The exposed stroma is treated with the excimer laser and modifies the corneal curvature and the flap is put back in place without points.
PRK: (photorefractive keratectomy) the corneal epithelium is removed; the excimer laser is applied to the exposed corneal stroma, correcting the visual defect. Immediately, a soft contact lens is placed for protection during the recovery of the epithelium. It is removed after 5 days.
LASEK: It is a combination of the above two procedures. Special solution is used to separate a thin layer of corneal epithelial tissue, which remains adhered. Excimer laser is applied in the exposed stroma, then the layer of tissue is placed in its original position, a contact lens is placed, to protect the area during recovery, and removed after 5 days.
AM I A CANDIDATE FOR LASER SURGERY EXCIMER? Patients should be 21 years old (this will ensure that the eye has matured and is properly developed) and not more than 65 years old, to get a good visual result. Their graduation lenses must be stable for at least one year before undergoing surgery. Must not have congenital abnormalities of the eye. Female patients must not be pregnant or nursing at the time of surgery, as fluctuations in hormones cause the lining of the eye, causing a refractive error. Patients are given a complete eye exam, topography and pachymetry, in both eyes, to assure that surgery is recommended.
OPHTHALMOLOGIST (Greek ofthalmos, eye and logos, treaty): is a physician who has studied the same as a general practitioner, plus three or more years specializing in ophthalmology and will be generally certified by an official institution of ophthalmology from his home country. As a medical specialist, he is fully trained to treat eye diseases and perform eye surgery, as well as for eye exams and prescribe glasses, examine the back of the eye, visual field testing and measuring intraocular pressure. OCULISTA (Latin oculus, eye): is synonymous with ophthalmologist.
OPTOMETRIST (Greek Optikos, vision, and metron, measure): has professional studies in order to measure graduation of sight, prescribe and adjust eyeglasses and teach the patient exercises to develop eye coordination and increase visual efficiency. The optometrist cannot prescribe drugs, treat eye diseases and carry out surgery. Patients with eye diseases should be sent to an ophthalmologist.
OPTICAL (Latin opticus, optics: Concentrating only in polishing eyeglass lenses and following the instructions of the ophthalmologist or optometrist.
It is defined as any injury caused by blunt or penetrating mechanisms on the eyeball and its peripheral structures, causing tissue damage of varying degrees of involvement with compromised visual function, temporary or permanent. Ocular trauma is a common cause of consultation in the emergency services; most often affects productive persons with an average of 30.6 years old, male sex accounts for 87%, children under 10 accounted for 4% of total patients. As for the activity during the trauma, 50% occur during labor, 25% playground and 5% for sports. In many countries, violence and car accidents have a high percentage. It is responsible for one third of the cases of unilateral blindness in the first decade of life. Its causes are varied, being of great importance to evaluate the patient with a full body examination and eye examination, paying close attention to symptoms and signs suggestive of serious eye disease. In some cases, clinical imaging as the Ultrasonography, Computed Axial Tomography or Magnetic Resonance is needed. In closed or open trauma, the examination will guide the therapeutic approach, being the most important, the initial vision of the eye exam. Finally it is important to mention that the resulting complications or ocular trauma can cause severe disability and impaired quality the life of people. Ocular trauma today is a public health problem; it is the third reason for hospitalization of ocular causes of visual impairment and second after the cataract. It is of great importance to legislate through public health policies with respect to ocular trauma, even more if we know that over 90% of injuries are preventable.
When should eyes be examined? When you often get headaches or eyestrain? When you are not sure what the words are written on the board or the sign of STOP on the cross street? When your vision seems normal and has no trouble? All children from the age the four or five years old or before they start school, should be examined and would correct visual defects before they caused trouble or be irreversible. Often a child does not realize he does not see well and perhaps does not complain if they feel a headache or tired eyes. For this reason, many communities have established preschool-screening programs to detect declines in vision, eye weakness and strabismus (crooked eyes), using the services of a trained medical practitioner, or ophthalmologist.
Although children are subjected to regular examination of sight when they go to school, these tests are not complete. It is possible that some of them need glasses or have an eye disease. Children should be examined each year, but it is best that an ophthalmologist will do a full review. Adults should have a complete eye exam every one to three years, in order to assure perfect eyesight.
The incidence of eye injuries during sports practice is not negligible with respect to other traumatic ocular pathologies. An accident with ocular impact during sports can be very mild, moderate or very serious, in the worst case, carrying functional and anatomical consequences for the organ of vision, sometimes irreparable. Furthermore, ocular trauma has certainly dramatic consequences and disabilities in young people, professionally active or, in some cases, will prevent having sport achievements.
Although there are many physiological defense mechanisms effectively to protect the eye against possible accidents everyday (bony structure of the orbit, eyelashes, eyelids, tear film and blinking reflex), the eyeball is a delicate organ, vulnerable and susceptible to trauma and injuries.
Eye traumas during sports are relatively rare, can occur in the context of any sport and are very diverse, both in its origin, severity and clinical presentation (penetrating trauma, blunt-blunt or penetrating). Although early diagnosis and appropriate treatment by a specialist ophthalmologist usually helps to improve the prognosis of these cases, it is true that in some situations, ocular injuries secondary to trauma are clinically irreversible. It is clear that for the right sport it is essential to be in good physical condition and of course, perfect eyesight. A visual correction significantly improves performance in sports and decreases the chance of accidental injury. Also in sports, it is essential to use the right material, avoid high-risk activities and use appropriate eye protection measures in each case (polycarbonate glasses). Awareness and prevention campaigns can help reduce such accidents.
A cataract is an opacity or cloudiness of the lens, which is normally transparent. You can have the appearance of small opaque points, or large opacity covering the entire lens. Normally it has a slightly yellowish tint, but when a cataract forms, often acquires a deep yellow or amber, which absorbs blue and yellow colors of the light passing through it. In other types of cataracts, the lens can turn brown, gray or white. By blocking the passage of light rays entering the eye, cataract vision decreases.
A cataract can be compared to a window. If the window is clean, everything on the other side will look crisp and clear. If you put soap in the glass, everything will be blurry. But the soap can be removed.
If the glass is covered with paint, you cannot see through it. That happens to a person who has cataracts. To do better, you have to change the painted glass with a clean and transparent. Cataract is as if the lens permanently painted and it can be surgically removed.
The cause of cataracts is still not yet totally defined, but the mechanism by which they occur is fairly well understood. Some cataracts exist from birth, while others are the result of various local or systemic disorders. There are different types of cataracts.
This type of cataract is due to defective development of the fetus, more likely to occur if the mother has had measles, chickenpox, or rubella during the first three months of pregnancy. Every child should be carefully examined by a pediatrician or family doctor during the first six months of life. If a cataract is detected, the child must visit an ophthalmologist. If congenital cataract affects only part of the lens and no vision decreases, it is necessary to operate. Usually these cataracts are stationary and do not increase in size. But if it does, the lens operation is required to restore vision.
The central visual acuity (vision macular) is developed in the early years of life. If the vision is badly damaged, surgery should not be delayed . The earlier the cataract is removed, the greater the chance the child will develop good vision with intraocular lens. However, if other birth defects exist in addition to cataract, normal vision will not be totally recovered with the operation.
This is the most common type of cataract. It usually occurs at age 50 or older, due to physical aging. Also poor nutrition, degeneration, or hereditary aspects may originate the formation of cataracts. There are three main types of senile cataract.
Nuclear Cataract: This hardening of the center of the lens can produce myopia. The person can see or read and probably do not use or even require corrective lenses for myopia. You may think your view is improving. Generally, this cataract is brown, in contrast to normal color beige or gray lens, and is slowly developing.
Cortical cataract: This cataract appears in the outer layer of the lens. It can evolve slowly, or grow rapidly and lead to loss of sight. Usually it is white. Both development and appearance are due to absorption of aqueous humor by the lens. As cortical cataract may swell and push forward the iris, it can cause secondary glaucoma. Therefore, this cataract should be removed, not only to improve vision, but also to prevent the glaucoma.
Cataract later: (subcapsular). This cataract is in the back of the lens surface; it cannot be visible to the naked eye, but only as a cloud in the black pupil space. The posterior cataract can progress slowly or quickly, but often affect vision soon, because of its central location.
The injury of the eye by a blow may cause rupture of the lens capsule. When this occurs, the lens absorbs aqueous humor, becomes cloudy or opaque, and interferes with vision. This cataract has to be removed to restore sight. However, the final visual outcome depends on the state of the other parts of the eye. If the trauma has also caused a detached retina, the retina should also be restore to recover vision. Ocular trauma can cause dislocation of the lens, secondary glaucoma or cause dislocation vision upsets. It may be necessary to remove the lens.
Eye Allergies:
During the summer, allergic conjunctivitis cases increase considerably. The sun, dust, temperature changes and pollination characterizing environmental change during the summer season, are the main factors for contracting conjunctivitis.
Besides allergy, other eye diseases, which can exist as, dry eye. When you have dry eye, the tear film allergens and toxic compounds that are in contact with the ocular surface allow an allergic inflammatory reaction.
It is important, when you begin to have the first symptoms, to visit an ophthalmologist and promptly diagnose associated diseases such as chronic blepharitis meibomianitis (inflammation of the eyelids and meibomian glands respectively).
To reduce allergies, sunglasses should be used. They reduce allergen contact with eyes. Install an Allergy filter in your air conditioning system. Reduce outdoor activities until mid-morning, since before, there's more pollen. Use swimming goggles, because chlorine worsens allergic conjunctivitis. Clean your hands frequently and avoid contact with eyes.
Protect from UV rays with sunglasses:
Excessive exposure to solar radiation, especially ultraviolet rays, can cause eye damage, typical of this time of year, as keratitis (damage to the surface of the cornea), conjunctivitis or premature cataracts. In addition, this radiation can accumulate in ocular structures and symptoms appear some time later.
Another factor is the continuing deterioration of the ozone layer, whose main function is to protect against harmful UV radiation to the eye. Therefore, it is important to wear sunglasses with UV protection, as these get protection from ultraviolet radiation, reducing the likelihood of glare and absorb solar luminosity.
Eye injuries in sport sunglasses tailored to each sport:
Ophthalmological emergencies typical of summer are trauma resulting from the practice of sports, especially sports such as tennis and squash, using small balls increase the risk of being hit by the ball in the eye.
There have been serious accidents where the impact of the ball causes the outbreak of the eyeball or cutting injuries on the surface thereof may cause functional and anatomical lesions, sometimes irreversible.
We recommend the use of eye protection tailored to each sport for the prevention of accidents. For example, cycling glasses avoid the impact of small bodies in the eye. In swimming pools, the use of protection will avoid ocular irritation due to water chlorination.
Eye health kids: children should wear sunglasses
Children are particularly vulnerable to the harmful ultraviolet rays and should pay special attention to prevent irritation and allergies.
The retina may be peeled or separated from the vascular layer of the eye; the choroid in the eye fundus, as it was wallpaper. If water is introduced through a hole in the upper part of the wall portion, it will peel. Retinal detachment is defined as a separation of the retina because of the liquid is flowing into the sub retinal space vitreous cavity, either through a tear or hole retinal detachment.
The formation of a bond between the vitreous and the retina-weakened point may exert traction and make a hole or tear in the retina, and then it is detached from the choroid. The detachment may be flat or move inside the eye. It can occur in all ages, though it happens more between 40 and 49 years old. The incidence in normal population is 0.02%, in myopic population of 2 to 5%, by afacos (non-crystalline) 6 to 7% and in pseudoafacos (intraocular lens) of 1 to 2%.
Predisposing injury should be suspected in patients with myopia, family history and contralateral eye to eye with detachment and surgical and non-surgical trauma. The incidence of tearing as in the myopic predisposing lesion is 10%, of which 7% develop retinal detachment; in the population is 0.5%. Treatment of retinal detachment with modern surgical technologies and endolaser use provide excellent results. It is also very important to provide the treatment as soon as possible after the release has happened.
Glaucoma, or increased pressure of the liquid (aqueous humor) that fills the eyeball in its front part. Is commonly considered as a tightening of the eye. Glaucoma is an infection or a tumor. Should not be confused with trachoma, which is an inflammation, or the glioma, a tumor. Many people believe that they become blind from glaucoma. This is not entirely true, especially if the disorder is diagnosed early, before it has decreased vision. The vision already lost cannot be recovered. Since measuring intraocular pressure with a tonometer during routine eye examination often discovers glaucoma, adults over 40 should get such reviews periodically, including this measurement, every one to two years.
The eyeball contains a fluid called aqueous humor is constantly flowing from the ciliary body to the anterior chamber, in front of the lens and iris and behind the cornea. Aqueous substances pass through a mesh (trabecular meshwork) to a conduit called Schlemm's canal, all situated in one angle formed by the iris and cornea. The liquid passes into the blood stream by the episcleral veins. If more aqueous humor exits the duct or canal of Schlemm, or if it rises slowly as the ciliary body, the presence of pigment in the iridocorneal angle will increase the fluid pressure in the interior eye and glaucoma occurs. Glaucoma can be controlled through medication use locally in the eye and / or systemic or taken orally, to act, either by decreasing the production of aqueous humor in the ciliary body, or providing or performing surgery or laser application of either the angle or the iris, to allow egress of aqueous humor from the eye, by a route other than the normal, that is through the trabecular meshwork into the canal of Schlemm.
• Chronic Glaucoma, simple, or wide angle or open.
• Acute glaucoma, congestive, or narrow-angle or partially closed.
• Glaucoma secondary to illness, inflammation, trauma or injury to the eye, cataract
intraocular tumor or obstruction of the veins or arteries of the eye.
• Congenital Glaucoma appears in children under 2 years of age.
The two largest existing forms of glaucoma: open-angle glaucoma, in which the aqueous humor has free access to the trabecular meshwork, and closed-angle glaucoma, in which the access of aqueous to the trabecular meshwork is obstructed. Both forms of glaucoma demonstrate a progressive optic neuropathy with visual field loss and characteristic structural changes, including thinning of the nerve fiber layer of the retina and an excavation of the optic nerve head. Intraocular pressure Glaucoma not defined, as there are persons with glaucoma intraocular pressure measurements, would be found on anyone without glaucoma.
A big problem has been that global population studies have shown that a large portion of the population has glaucoma, undiagnosed. In developed countries, 50% with glaucoma do not know they have it; this percentage rises to 62-75% in Hispanic population within the United States, and over 90% in under developing countries with poor access to health care. Glaucoma is the second leading cause of blindness worldwide.
It is a grayish growth and high elastic connective tissue that contains blood vessels that invade the cornea and grows on it. It may result from irritation by wind, solar heat, dust or smoke, and is common in people who live in hot climates, and tropical. If the pterygium grows to reach the center of the cornea, this may decrease or even produce loss of sight of the eye. Before that happens, it must be surgically removed. Some people confuse the pterygium with a cataract, believing that this is a cream or skin that grows over the eye, but in reality, the cataract is a clouding of the lens, which is located within the eyeball.
A bulging and thinning of the cornea, making it a conical shape. It usually affects both eyes and causes a severe astigmatism, so vision is blurred. It is possible that the glasses cannot correct the visual defect, and then you need to wear contact lenses or even do a corneal transplant to improve vision.
It is an inflammation of one Zeiss gland or Moll gland at the base of the tabs. It also is named due to the inflammation of the meibomian glands in the eyelid, although in this case the term that is commonly used is that of internal hordeolum or chalazion.
There is a serious condition, but it can be quite painful. The cause of this disorder is commonly a bacterial infection caused by Staphylococcus aureus. Styes are particularly common in children.
It is an infection of the eyelids, which is common in both children and adults, is characterized by itching, redness and flaking or crusting on the eyelashes, which can cause the eyelids to be bonded or glued together on waking. It is often associated with dandruff or seborrhea dermatitis; both disorders improve with medical treatment.
To me, the most important thing, are your eyes.
Dr. Gonzalo Anzueto Ophthalmologist
