Conditions and Treatments
Conditions and Treatments descriptions
Anisocoria is unequal pupil size. A pupil is the black center of the eye.
Pupils sometimes differ in size temporarily due to eyedrops, medication or unknown reasons. But pupils that differ in size by more than 1 mm and do not return to equal size may be a sign of a neurologic disorder.
Medical professionals may order blood tests to determine the cause of anisocoria.
BOTOX® Therapy and Injections is a nonsurgical way of smoothing wrinkles (or furrows) between eyebrows. Using tiny needles, physicians repeatedly inject a prescription medicine into the muscle between the brows.
Over a few days, the medicine relaxes the muscle, flattening the wrinkles. Results last a few months. Then the injections can be repeated. Read more about BOTOX® Therapy
Tattooing, or injecting colored ink into, the cornea changes the appearance of the eye.
Some patients request a corneal tattoo to disguise a discoloration in their eye caused by a disease or accident. For example, a scar on a cornea can look like an opaque spot in a patient's eye. A corneal tattoo can make the spot blend in with the eye's normal color.
Sometimes corneal tattooing can help improve vision by reducing glare, a common problem in patients who have a damaged iris.
Dermatochalasis is sagging eyelid skin, either above or below the eye. People with dermatochalasis say the condition makes them appear tired or sad.
Besides cosmetic concerns, the condition can block vision above or to the sides of the eye.
While dermatochalasis can occur in people of any age, it's more common in elderly people. It can be linked to thyroid eye disease, renal failure and other diseases, or just genetics.
Dermatochalasis can be corrected with blepharoplasty, eyelid lift surgery.
Diode cyclophotocoagulation (CPC) is a glaucoma treatment, typically for patients who have not been helped by other, more conservative, treatments.
During diode CPC, a laser destroys part of the eye that produces fluid. A decrease in fluid production decreases the pressure inside the eye. And that can help slow vision loss linked with glaucoma. The procedure will not cure glaucoma and may not stop vision loss completely.
Diode CPC is done in the operating room as outpatient surgery that takes only minutes. Anesthesia is either general or local and no incision is required. Multiple treatments may be necessary.
Diplopia is double vision - seeing two images of the same object. It can be caused by a variety of conditions. The first step is to discuss the cause and any implications of the diagnosis for vision.
Enucleation is the surgical removal of an eye - most often due to a cancerous tumor in the eye, severe trauma to the eye, or severe pain in a blind eye.
An artificial eye can be implanted a few weeks after enucleation.
Epiretinal membrane, also called macular pucker, is scar tissue that forms over the macula, the part of the retina that provides sharp, central vision. This scar tissue forms naturally when the vitreous - the gel inside the eye - ages, shrinks and pulls away from the retina. It can cause blurry or distorted vision.
Usually, vision problems are mild and no treatment is needed. But in severe cases, where daily routine is affected by distorted vision, an ophthalmologist may recommend a vitrectomy. A vitrectomy is a surgical procedure that removes the vitreous gel and scar tissue in order to improve visual function.
Evisceration is the surgical removal of an eye, leaving the outer white part (sclera) and muscles in place. It's usually done to reduce pain or improve the appearance of a blind eye.
An artificial eye can be implanted a few weeks after evisceration.
Eye Muscle Repair
Eye Muscle Surgery: Procedure involving repositioning of the eye muscles to restore normal ocular alignment.
The surgery can be performed under general or local anesthesia. The procedure is performed as outpatient surgery and typically takes less than one hour.
Intacs® corneal implants are for patients with keratoconus, a disease that causes gradual vision loss due to thinning of the cornea. Intacs implants are inserted into the eye to reshape and support the cornea. They help improve vision that can no longer be corrected by glasses or contact lenses.
The Intacs procedure is not as invasive as a corneal transplant, and recovery is faster.
Iridoplasty is a laser surgical procedure to treat some types of glaucoma. During the procedure, a laser is used to shrink the iris, thereby widening the anterior chamber angle where the internal drain of the eye is located. That helps fluid within the eye drain more freely, correcting or preventing an angle closure type Glaucoma.
A laser iridoplasty takes only minutes and requires only topical anesthesia.
Iridotomy is a laser surgical procedure to treat some types of glaucoma. During the procedure, a laser is used to make a microscopic hole in the iris, typically hidden under the upper eyelid. This hole allows fluid within the eye to flow freely, from behind the iris thereby correcting or preventing an angle closure type Glaucoma.
A laser iridotomy takes only minutes and requires only topical anesthesia.
Inflammation of the colored part of the eye, associated with extreme discomfort. Iritis is often a harolding sign of an underlying disease and must be investigated if severe or recurrent.
Keratitis (corneal melt)
Inflammation of the cornea leading to loss of integrity of the eyeball, leading to a high risk of blindness if not managed appropriately.
Keratoprosthesis is an artificial cornea that can be implanted in patients who cannot be helped by a standard cornea transplant, which uses tissue from a human donor. Patients who have keratoprosthesis typically have had one or more unsuccessful cornea transplants.
Keratoprosthesis surgery takes about one and a half hours and requires either general anesthesia or local anesthesia with intravenous sedation. Once the plastic cornea is sutured in place, a soft contact lens is placed over it.
Patients must wear the contact lens around the clock and use antibiotic eye drops every day, for as long as they have the keratoprosthesis. Patients also will have ongoing follow-up exams with their surgeon.
Lacrimal (Tear Duct) Surgery
For babies that need surgery for a blocked tear duct, doctors typically perform probing - sliding a thin wire through the blocked duct to open it. This outpatient procedure is done with local or general anesthesia depending on the baby's age.
For adults, treatment depends on the cause of the blocked tear duct. Surgical options include:
• Probing (see above)
• Intubation - Inserting a tube through the duct to keep it open so tears can drain.
• Infracturing - Breaking and repositioning a bone in the nose that is pressing against the tear duct.
• Balloon dacryocystoplasty - Inserting a tiny balloon into the tear duct. As the balloon is inflated, it expands the blocked duct. Then, the balloon is deflated and removed.
• Dacryocystorhinostomy - Implanting a tiny tube from the tear duct sac to the nose, creating a new canal to bypass the blocked one.
• Endoscopic dacryocystorhinostomy - Inserting an endoscope (a tube with a tiny camera) through the tear duct opening and making an incision to open a new canal for tears to drain.
• Laser dacryocystorhinostomy - Inserting an endoscope with a laser through the tear duct opening and using the laser to make a hole in the nasal bone for tears to drain.
Latisse™ Eyelash Growth
LATISSE™ solution is a prescription medication used to grow longer, thicker eyelashes. Patients apply the prescription daily to their eyelashes. Eyelashes grow over several weeks.
With macular edema, the macula, in the middle of the eye, becomes swollen with fluid. The swelling can be caused by eye surgery, injury, diabetes, macular degeneration, side effects of medication or other conditions.
A patient with macular edema may have blurry vision. Colors may not appear as vivid.
Treatment depends on the condition causing macular edema. If it's caused by diabetes or another disease, that disease should be treated first. If it's due to a side effect of medication, the prescription can be changed. If it's related to an injury or surgery, the patient may be prescribed anti-inflammatory pills or eye drops.
Typically, vision returns to normal after macular edema is treated.
A macular hole is a small break in the macula, in the middle of the eye. A patient with a macular hole may have blurry or distorted vision.
Sometimes macular holes can heal themselves. Other times, outpatient surgery is needed. In this surgery, a vitrectomy, eye fluid is removed and replaced with a bubble of gas. The bubble inside the eye presses the edge of the macular hole in place as it heals.
Patients must remain facedown for several days after surgery, so the bubble stays in place and the hole seals. Eventually, the bubble is absorbed and the eye refills with its natural fluid.
Also called fat transfer, microlipoinjection can fill in wrinkles and recontour a patient's face. Fat is liposuctioned from another part of the patient's body, such as the buttocks or thighs. Then it is injected into areas of the patient's face, plumping up wrinkles and other hollow areas.
This outpatient procedure requires only local anesthesia.
Optic neuropathy is damage to the optic nerve, which carries images from the eye to the brain.
The most common cause of this damage is poor blood flow. Other causes include shock, radiation, toxic substances, trauma and various diseases of the brain and central nervous system.
People with optic neuropathy lose their ability to see fine detail. Colors appear less vibrant.
Vision loss cannot be restored, but further loss can be prevented. Treatment depends on diagnosis of the disease causing optic neuropathy.
Orbital decompression involves removing bones of the eye socket, most often in patients with Graves' disease. Graves' disease is associated with bulging eyes and other conditions caused by enlarging eye muscles and fat. Removing parts of the eye socket opens up the area, creating space so the eye can return to a more normal position.
This surgery requires general anesthesia and is performed entirely through the patient's nostrils.
Inflammation of the retina that can create loss of tissue and can cause quick onset of permanent blindness.
Swelling and redness of the white part of the eye, potentially blinding condition. It is often associated with immune disfunction such as rheumatoid arthritis or infections.
Tear Duct Blockage
Blocked tear ducts prevent tears from draining normally from the eye into the nose. Sometimes tear ducts become swollen and infected.
While most common in babies, blocked tear ducts also can occur in older adults due to aging, infection or injury.
Symptoms of blocked tear ducts include:
• Excessive tearing
• Eyelids that stick together
• Mucus in the corner of the eye
• Inflammation around the eye or nose, if infection occurs
Typically, no treatment is needed. Blocked tear ducts often clear up on their own, although massaging the lacrimal sac may speed healing and antibiotics may be needed to fight infection.
Babies who have blocked tear ducts beyond 9 months of age may benefit from outpatient surgical techniques, such as simple probing, balloon dilation or inserting tubes in the tear ducts.
Trabeculectomy is a surgical procedure to treat some types of glaucoma. In this procedure, part of the drainage tissue in the eye (the trabecular meshwork) is removed, allowing fluid to drain out of the eye more easily, thereby lowering the eye pressure.
Otherwise, fluid can build up in one area and increase eye pressure, which can lead to vision loss.
The procedure usually takes about an hour and requires local or general anesthesia in the operating room.
Trabeculoplasty is a laser surgical procedure to treat some types of glaucoma. In this procedure, a laser is used to alter the drainage tissue in the eye (the trabecular meshwork), to improve the flow of fluid out of the eye flow (this drainage is internal, not tear fluid), thereby lowering pressure. The procedure is done in the office and since no needles or injections are needed, it is nearly always painless.
The procedure only takes minutes and requires only topical anesthesia.
Tube-shunt surgery is a surgical treatment for some types of glaucoma. In this procedure, a flexible plastic tube is implanted in the eye to help drain fluid from the eye. Otherwise, fluid can build up and increase eye pressure, which can lead to vision loss.
The procedure usually takes about an hour and requires local or general anesthesia in the operating room.
Vitreous hemorrhage is bleeding inside the gel-like substance that fills the eye. The bleeding blocks light from moving through the eye. This causes vision changes, including:
• Blurry vision
• Light flashes
• Floating "spots" in the field of vision
Vitreous hemorrhage can be caused by:
• Aneurysm of a blood vessel in the eye
• Eye trauma
• Retinal tear or detachment
And it can be associated with diseases, like diabetes, hypertension, sickle cell anemia and carotid artery disease.
Many times, hemorrhages clear up on their own without treatment, although it may take months for vision to be fully restored. For severe hemorrhages, an ophthalmologist may perform a vitrectomy. A vitrectomy is a surgical procedure that removes the vitreous gel and blood.