ophthalmology

Interesting Facts I Bet You Never Knew About Ophthamology part-3

Neuro Ophthalmology

Neuro-ophthalmology is an academically-oriented subspecialty that merges the fields of neurology and ophthalmology, often dealing with complex systemic diseases that have manifestations in the visual system. Neuro-ophthalmologists initially complete a residency in either neurology or ophthalmology, then do a fellowship in the complementary field. Since diagnostic studies can be normal in patients with significant neuro-ophthalmic disease,[1] a detailed medical history and physical exam is essential, and neuro-ophthalmologists often spend a significant amount of time with their patients.

Neuro-Ophthalmology

Common pathology referred to a neuro-ophthalmologist includes afferent visual system disorders (e.g. optic neuritis, optic neuropathy, papilledema, brain tumors or strokes) and efferent visual system disorders (e.g. anisocoria, diplopia, ophthalmoplegia, ptosis, nystagmus, blepharospasm, seizures of the eye or eye muscles, and hemifacial spasm)

Diabetic Retinopathy

Diabetic retinopathy is a condition that occurs in people who have diabetes. It causes progressive damage to the retina, the light-sensitive lining at the back of the eye. Diabetic retinopathy is a serious sight-threatening complication of diabetes.

normal eyediabetic retinopathy

Diabetes interferes with the body’s ability to use and store sugar (glucose). The disease is characterized by too much sugar in the blood, which can cause damage throughout the body, including the eyes.

The condition usually affects both eyes. The longer a person has diabetes, the more likely they will develop diabetic retinopathy. If left untreated, diabetic retinopathy can cause blindness.

Symptoms of diabetic retinopathy include:

  • Seeing spots or floaters
  • Blurred vision
  • Having a dark or empty spot in the center of your vision
  • Difficulty seeing well at night

Often the early stages of diabetic retinopathy have no visual symptoms. Early detection and treatment can limit the potential for significant vision loss from diabetic retinopathy.

Treatment for Retinopathy

Treatment of diabetic retinopathy varies depending on the extent of the disease. People with diabetic retinopathy may need laser surgery to seal leaking blood vessels or to discourage other blood vessels from leaking. People with advanced cases of diabetic retinopathy might need a surgical procedure to remove and replace the gel-like fluid in the back of the eye, called the vitreous. Surgery may also be needed to repair a retinal detachment.

Dry Eye Treatment

Dry eye syndrome is a chronic and typically progressive condition. Depending on its cause and severity, it may not be completely curable. But in most cases, dry eyes can be managed successfully, usually resulting in noticeably greater eye comfort, fewer dry eye symptoms, and sometimes sharper vision as well.

eye

Because dry eye disease can have a number of causes, a variety of treatment approaches are used.

The following is a list of dry eye treatments that are commonly used by eye doctors to reduce the signs and symptoms of dry eyes. Your eye doctor may recommend only one of these dry eye treatments or a combination of treatments, depending on the cause(s) and severity of the condition.

  • Artificial Tears
  • Restasis
  • Xiidra
  • Steroid Eye Drops
  • Lacrisert
  • Punctal Plugs
  • Meibomian Gland Expression
  • Warm Compresses
  • LipiFlow
  • Intense Pulsed Light
  • Nutritional Supplements
  • Home Remedies for Dry Eyes

Retinal Detachment

This serious eye condition happens when your retina — a layer of tissue at the back of your eye that processes light — pulls away from the tissue around it. Since the retina can’t work properly when this happens, you could have permanent vision loss if you don’t get it treated right away.

Retinal Detachment

You’re more likely to get one if you:

  • Are severely nearsighted
  • Have had an eye injury or cataract surgery
  • Have a family history of retinal detachment

A detached retina doesn’t hurt. It can happen with no warning at all. But you might notice:

  • Flashes of light
  • Seeing lots of new “floaters” (small flecks or threads)
  • Darkening of your peripheral (side) vision

If you have any of those symptoms, contact your eye doctor immediately. Sometimes it comes before full detachment. It usually has the same symptoms. If your retina gets torn, the fluid inside your eye can leak underneath and separate the retina from its underlying tissue. That’s retinal detachment.

Treatment for Retinal Detachment

There are several options:

Laser (thermal) or Freezing (cryopexy)

Both methods can repair a tear if it is diagnosed early enough. The procedures are often done in the doctor’s office.

Pneumatic Retinopexy

This works well for a tear that’s small and easy to close. The doctor injects a tiny gas bubble into the vitreous, a clear, gel-like substance between your lens and retina. It rises and presses against the retina, closing the tear. She can use a laser or cryopexy to seal the tear.

Scleral Buckle

In this surgical procedure, the doctor sews a silicone band (buckle) around the white of your eye (she’ll call it the sclera). This pushes it toward the tear until it heals. This band is invisible and is permanently attached. Laser or cryo treatment can seal the tear.

Vitrectomy

This surgery is used to repair large tears. The doctor removes the vitreous and replaces it with a saline solution. Depending on the size of the tear, she might use various combinations of vitrectomy, buckle, laser, and gas bubble to repair your retina.

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eye surgery

Interesting Facts I Bet You Never Knew About Ophthamology part-2

Refractive Corneal Surgery

  • Refractive error, such as nearsightedness (myopia), farsightedness (hyperopia), astigmatism or presbyopia, refractive surgery is a method for correcting or improving your vision. There are various surgical procedures for correcting or adjusting your eye’s focusing ability by reshaping the cornea, or clear, round dome at the front of your eye. Other procedures involve implanting a lens inside your eye. The most widely performed type of refractive surgery is LASIK (laser-assisted in situ keratomileusis), where a laser is used to reshape the cornea.
  • For people who are nearsighted, certain refractive surgery techniques will reduce the curvature of a cornea that is too steep so that the eye’s focusing power is lessened. Images that are focused in front of the retina, due to a longer eye or steep corneal curve, are pushed closer to or directly onto the retina following surgery.
  • Farsighted people will have refractive surgery procedures that achieve a steeper cornea to increase the eye’s focusing power. Images that are focused beyond the retina, due to a short eye or flat cornea, will be pulled closer to or directly onto the retina after surgery.
  • Astigmatism can be corrected with refractive surgery techniques that selectively reshape portions of an irregular cornea to make it smooth and symmetrical. The result is that images focus clearly on the retina rather than being distorted due to light scattering through an irregularly shaped cornea.
  • Refractive surgery might be a good option for you if you:
  1. Want to decrease your dependence on glasses or contact lenses;
  2. Are free of eye disease;
  3. Accept the inherent risks and potential side effects of the procedure;
  4. Understand that you could still need glasses or contacts after the procedure to achieve your best vision;
  5. Have an appropriate refractive error.

MyopiaHyperopia

There is no universally-accepted, best method for correcting refractive errors. The best option for you should be decided after a thorough examination and discussion with your ophthalmologist. If you are considering refractive surgery, you and your Eye M.D. can discuss your lifestyle and vision needs to determine the most appropriate procedure for you.

Glaucoma

Glaucoma is a disease that damages your eye’s optic nerve. It usually happens when fluid builds up in the front part of your eye. That extra fluid increases the pressure in your eye, damaging the optic nerve.

glaucomaHere are the signs of an acute angle-closure glaucoma attack:

  •   Vision is suddenly blurry
  •   Severe eye pain
  •   Headache
  •   Feel sick to your stomach (nausea)
  •  Throw up (vomit)
  •  Rainbow-colored rings or halos around lights

Treatment for Glaucoma

Glaucoma is usually controlled with eyedrop medicine. Used every day, these eye drops lower eye pressure. Some do this by reducing the amount of aqueous fluid the eye makes. Others reduce pressure by helping fluid flow better through the drainage angle.

Laser Surgery

There are two main types of laser surgery to treat glaucoma. They help aqueous drain from the eye. These procedures are usually done in the ophthalmologist’s office or an outpatient surgery center.

Trabeculoplasty

TrabecularThis surgery is for people who have open-angle glaucoma. The eye surgeon uses a laser to make the drainage angle work better. That way fluid flows out properly and eye pressure is reduced.

Iridotomy

iridotomyThis is for people who have angle-closure glaucoma. The ophthalmologist uses a laser to create a tiny hole in the iris. This hole helps fluid flow to the drainage angle.

Eye Cancer

An eye cancer starts in the eye. There are Two types of cancers can be found in the eye.

oculareye cancer

Primary Intraocular Cancer

It start inside the eyeball. In adults, melanoma is the most common primary intraocular cancer, followed by primary intraocular lymphoma. These 2 cancers are the focus of this document.

In children, retinoblastoma (a cancer that starts in cells in the retina) is the most common primary intraocular cancer, and medulloepithelioma is the next most common (but is still extremely rare). These childhood cancers are discussed in Retinoblastoma.

Secondary Intraocular Cancer

It start somewhere else in the body and then spread to the eye. These are not truly “eye cancers,” but they are actually more common than primary intraocular cancers. The most common cancers that spread to the eye are breast and lung cancers. Most often these cancers spread to the part of the eyeball called the uvea. For more information on these types of cancers, see our documents on them

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Laser Eye Surgery

Interesting Facts I Bet You Never Knew About Ophthamology part-1

Laser eye surgery is an umbrella term for several eye surgeries used to correct refractive errors. That means how your eye focuses light. The most common types of laser eye surgery include LASIK, PRK, LASEK and EpiLASIK.

Each of the four laser eye surgery procedures below uses the same special laser, called an “excimer” laser. This is the procedure to reshape the cornea. This is what corrects vision. But laser eye surgery can vary in the specifics of the procedure. Also on the recovery time and the surgical instruments used on you. You might be a better candidate for PRK, for instance, than for LASIK.

Your ophthalmologist should be able to determine from a comprehensive, laser-eye-surgery-specific eye exam which procedure is best for you. His recommendation will follow which procedure he thinks will give you the best possible outcome. Most patients achieve 20/20 or better vision after laser eye surgery.

LASIK (Laser in Situ Keratomileusis)

Lasik Banner

LASIK is the most common laser eye surgery. Its starts with the creation of a thin flap in the cornea. Your surgeon uses a blade or a laser to make this flap. The laser is considered more desirable by some doctors because of its precision, such as fewer visually significant complications; however, all-laser LASIK costs a bit more than LASIK that uses a blade. Once the flap is created, the excimer laser is used to reshape the cornea, which corrects the refractive error.

PRK (Photorefractive Keratectomy)

Photorefractive Keratectomy

PRK is the second most common type of laser eye surgery. Its starts with the removal of a portion of the surface of the cornea or epithelial tissue. There is no need for flap creation, and the removed tissue grows back. Some patients prefer PRK because they don’t want a corneal flap, and some patients are better candidates for PRK eye surgery than for LASIK (for instance, people with thin corneas). Once the epithelium is removed, a laser is used to reshape the cornea. The laser is the same (i.e., excimer) as the one used in LASIK.

LASEK (Laser Epithelial Keratomileusis)

Laser Epithelial Keratomileusis

LASEK is similar to LASIK and PRK, but it starts with the application of alcohol to the corneal epithelium. This loosens the outermost corneal cells and allows the surgeon to move them out of the way, without removing them, for the laser procedure. After reshaping the stroma with the excimer laser, the surgeon can replace the sheet of epithelial cells and put a contact lens to let it heal.

Epi-LASIK (Epithelial Laser in Situ Keratomileusis)

Epithelial Laser in Situ Keratomileusis

Epi-LASIK starts the way LASIK does, except the flap is thinner and made only of epithelial tissue. Once the flap is created, it is moved aside, just enough that the surgeon can reshape the stroma underneath with the excimer laser. The flap of epithelium is then replaced and covered with a contact-lens bandage to heal. Some consider Epi-LASIK a hybrid of LASIK and LASEK. Some surgeons believe Epi-LASIK is a good option because the flap exists only in the epithelium layer, and because there’s no alcohol used during the procedure.

Pediatric Opthalmology

Pediatric Opthalmology

A pediatric ophthalmologist is a medical and surgical doctor. All ophthalmologists have training in children’s eye disorders, but the pediatric ophthalmologist has additional training, experience, and expertise in examining children, and has the greatest knowledge of possible conditions that affect the pediatric patient and his/her eyes. Neurologic development of vision occurs up until approximately age 12 years. Misalignment of the eyes (strabismus), uncorrected refractive error (myopia, hyperopia, and astigmatism), and asymmetry of refractive error (anisometropia) between the two eyes can negatively affect this development and cause amblyopia (“lazy eye”). If these conditions are diagnosed and treated early, good vision can develop and can be maintained. Certain diseases elsewhere in the body, such as diabetes, can affect the eyes, and the pediatric ophthalmologist addresses

Medical Treatments

  • Prescriptions for glasses and/or contact lenses.
  • Amblyopia (“lazy eye”) therapy including glasses, patching, and pharmacologic treatment.
  • Topical and or/systemic therapy for eye infections, chalazia, glaucoma, blocked tear ducts, and inflammation on the eye or in the eye. Medicines include antibiotics, antivirals and steroids.

Surgical Procedures

  • Probe and Irrigation for congenital nasolacrimal duct obstruction (blocked tear duct).
  • Excision of chalazia.
  • Eye muscle surgery for strabismus.
  • Pediatric cataract extraction including the use of intraocular lenses (IOLs).

Additional treatments/surgeries performed by some include retinal examination and laser treatment of retinopathy of prematurity (ROP), surgical removal of pediatric orbital tumors/lesions, and surgery for glaucoma or ptosis (drooping eyelid) in the child.

Cataract Surgery

Cataract Surgery

  • A cataract is a clouding of the lens inside the eye, causing vision loss that cannot be corrected with glasses, contact lenses or corneal refractive surgery like LASIK.
  • In cataract surgery, the lens inside your eye that has become cloudy is removed and replaced with an artificial lens (called an intraocular lens, or IOL) to restore clear vision.
  • The procedure typically is performed on an outpatient basis and does not require an overnight stay in a hospital or other care facility.
  • Most modern cataract procedures involve the use of a high-frequency ultrasound device that breaks up the cloudy lens into small pieces, which are then gently removed from the eye with suction.
  • This procedure, called phacoemulsification or “phaco,” can be performed with smaller incisions than previous surgical techniques for cataract removal, promoting faster healing and reducing the risk of cataract surgery complications, such as a retinal detachment.
  • After all remnants of the cloudy lens have been removed from your eye, the cataract surgeon inserts a clear intraocular lens, positioning it securely behind the iris and pupil, in the same location your natural lens occupied. (In special cases, an IOL might be placed in front of the iris and pupil, but this is less common.)
  • The surgeon then completes the cataract removal and IOL implantation procedure by closing the incision in your eye (a stitch may or may not be needed), and a protective shield is placed over the eye to keep it safe in the early stages of your cataract surgery recovery.

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Dialysis

You Will Never Believe These Bizarre Truth Of Dialysis And Renal Replacement Therapy

Dialysis

Dialysis is a treatment that filters and purifies the blood using a machine. This helps keep your body in balance when the kidneys can’t do their job Properly functioning kidneys prevent extra water, waste, and other impurities from accumulating in your body. They also help control blood pressure and regulate the levels of chemicals in the blood, such as sodium, or salt, and potassium. They even activate a form of vitamin D that improves the absorption of calcium.

When your kidneys can’t perform these functions due to disease or injury, dialysis can help keep the body running as normally as possible.

Dialysis is an artificial way of cleaning your blood. There are two different types of dialysis:

  • Hemodialysis
  • Peritoneal Dialysis

Hemodialysis

Hemodialysis is the most common type of dialysis. It uses an artificial kidney, known as a hemodialyzer, to remove waste and chemicals from your blood. To get the blood to flow to the artificial kidney, your doctor will surgically create a vascular access, or an entrance point, into your blood vessels. This vascular access will allow a larger amount of blood to flow through your body during hemodialysis treatment. This means more blood can be filtered and purified.

Dialysis

The two type of vascular access designed for long-term dialysis treatments are an arteriovenous (AV) fistula, which connects an artery and a vein and an AV graft, which is a looped tube. For short-term use, a catheter may be inserted into the large vein in your neck.

Hemodialysis treatments usually last three to five hours. The treatment is typically needed three times per week. However, hemodialysis treatment can also be done in shorter, more frequent sessions.

Most hemodialysis treatments are done at a hospital, doctor’s office, or dialysis center. The length of treatment depends on your body size and the amount of waste in your body.

After you’ve been on hemodialysis for an extended amount of time, your doctor may feel that you’re ready to give yourself dialysis treatments at home. This option is more common for people who will need long-term treatment.

Peritoneal Dialysis

Peritoneal dialysis involves surgery to implant a catheter into your belly area. During treatment, a special fluid called dialysate flows into your abdomen. Once the dialysate draws waste out of the bloodstream, it’s drained from your abdomen.

Peritoneum

There are numerous different types of peritoneal dialysis, but the main ones are continuous ambulatory peritoneal dialysis and continuous cycler-assisted peritoneal dialysis. In continuous ambulatory peritoneal dialysis, your abdomen is filled and drained multiple times each day. Continuous cycler-assisted peritoneal dialysis, however, uses a machine to cycle the fluid in and out of your abdomen. It’s usually done at night while you sleep.

Peritoneal dialysis can be done at home. You’ll receive training on how to perform the steps of the treatment.

Renal replacement therapy

Renal replacement therapy (RRT) is therapy that replaces the normal blood-filtering function of the kidneys. It is used when the kidneys are not working well, which is called renal failure and includes acute kidney injury and chronic kidney disease. Renal replacement therapy includes dialysis (hemodialysis or peritoneal dialysis), hemofiltration, and hemodiafiltration, which are various ways of filtration of blood with or without machine. Renal replacement therapy also includes kidney transplantation, which is the ultimate form of replacement in that the old kidney is replaced by a donor kidney.

Renal replacement therapy

These treatments are not truly cures for kidney disease. In the context of chronic kidney disease, they are more accurately viewed as life-extending treatments, although if chronic kidney disease is managed well with dialysis and a compatible graft is found early and is successfully transplanted, the clinical course can be quite favorable, with life expectancy of many years. Likewise, in certain acute illnesses or trauma resulting in acute kidney injury, a person could very well survive for many years, with relatively good kidney function, before needing intervention again, as long as they had good response to dialysis, they got a kidney transplant fairly quickly if needed, their body did not reject the transplanted kidney, and they had no other significant health problems. Early dialysis (and, if indicated, early renal transplant) in acute renal failure usually brings more favorable outcomes.

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Thalassemia

The Latest Updates in Thalassemia Disorder

Thalassemia are inherited blood disease characterized by abnormal haemoglobin production. Hemoglobin is the protein molecule in purple blood cells that carries oxygen.

The disorder result is excessive destruction of red blood cells, which lead to anemia. Anemia can result in feeling tired and pale skin. There may also be done problem, yellowish skin, dark urine, enlarged spleen, and among children slow growth.

Types of thalassemia:

There are two main types of thalassemia

  • Alpha
  • Beta

Alpha-globin Thalassemia:

In alpha thalassemia, the haemoglobin does not produce that much protein.

Alpha-globin are sub-divided into four types:

  • One faulty gene
  • Two faulty gene
  • Three faulty gene
  • Four faulty gene
One faulty gene:

You have no signs of thalassemia. But it will affect your childrens.

Two faulty gene:

Your thalassemia signs will be mild. This condition is called as alpha-thalassemia trait.

Three faulty gene:

Your signs will be moderate to severe.

Four faulty gene:

This type of signs is rare. Affected fetuses have extreme anemia and commonly are stillborn. Babies born with this situation often die shortly after birth or require lifelong transfusion therapy. In rare cases, a baby born with this situation may be handled with transfusions and a stem telephone transplant, which is also called a bone marrow transplant.

Beta Thalassemia:

We need two globin genes to make beta-globin chains, one from each parents. If one or both faulty, beta thalassemia will occur.

Severity depends on how many genes are mutated.

Beta-globin are sub-divided into two types :

  • One faulty gene
  • Two faulty gene
One faulty gene:

This is called beta thalassemia minor.

Two faulty genes:

There may be moderate or severe symptoms. This is known as thalassemia major. It used to be called Colley’s anemia.

Beta thalassemia is more common among people of Mediterranean ancestry. Prevalence is higher in North Africa, West Asia, and the Maldive Islands.

Symptoms for Thalassemia:

Thalassemia signs and symptoms may include:

  • Weakness
  • Fatigue
  • Pale or yellow skin
  • Slow growth
  • Dark urine
  • Abdominal swelling
  • Facial bone deformities
  • Chest pain
  • Cold hand and feet
  • Leg cramps
  • jaundice and pale skin
  • drowsiness and fatigue
  • dizziness and faintness
  • poor feeding
  • shortness of breath
  • rapid heart beat
  • delayed growth
  • headaches
  • greater susceptibility to infections

Several type of thalassemia exist, Such as thalassemia intermedia, Cooley anemia and alpha-thalassemia. Some children show signs and symptoms of thalassemia at birth, while others may also improve them during the first two years of life. Some humans who have only one affected hemoglobin gene don’t experience any thalassemia symptoms.

Treatment for Thalassemia:

The treatment for thalassemia based on the type and severity of disorder involved. People who have alpha or beta thalassemia trait have mild or no symptoms. They did not required treatment.

There are three common standard treatments for severity of thalassemia. They are:

  • Blood transfusions
  • Iron chelation therapy
  • Folic acid supplements

Blood Transfusions:

Blood transfusion is the main treatment for people who have severe or moderate thalassemia. This treatment gives the healthy blood.

During a treatment, a needle is used to insert a intravenous line into one of your blood vessels. This process will take 1 to 4 hours. After the treatment t you will receive the healthy blood.

Red blood cells lives up to 120days. So, you need to continue the transfusion every 2 month to maintain the healthy blood cells.

If you have beta thalassemia intermedia or haemoglobin H disease, you may need blood transfusion on occasion.

Iron Chelation Therapy:

Regular blood transfusion can lead to excess of iron in the blood. This process is called iron overloaded. It will damage the heart, liver and other parts of the body. The red blood cell involves haemoglobin is an iron-rich protein.

To recover this damage, doctors use the iron chelation therapy. It will remove the excess of iron from the body. Iron chelation therapy uses two medicines to cure the damages:

  • Deferoxamine
  • Deferasirox

Folic Acid Supplements:

Folic acid is vitamin B that will help you to built the healthy red blood cells. Doctor may recommend floic acid supplements in addition to treatment with iron chelation therapy and/ or blood transfusion.

Other Treatments:

Blood and Marrow Stem Cell Transplant:

The healthy stem cells comes from you is called an autologous transplant. The stem cells comes from the other person is called donor. It is also known as allogeneic transplant.  Bone marrow transplant commonly used for blood cancers or blood related disease that reduce the number of healthy blood cells in the body. These procedures is also used for other disease.

For allogeneic transplant, your doctor will find a donor related to your blood. Your doctor consider using the cells from your close family members, who have registered with the national marrow donor program and who are not  related to you or form publicly stored umbilical cord blood.

Bone marrow transplant are commonly performed in hospital. Generally, You need to stay in hospital for one to two weeks before the transplant to prepare. During the treatment, We will insert a narrow tube in one of your large vein. Doctor will give the sleep medicine while the processing.  And then you receive the special medicines to destroy the abnormal stem cells and to weaken your immune system so it won’t reject the donor cells after the transplant.

After the transplant, doctor will check the blood count every day to check the new blood cells have started to grow in your bone marrow.  You want to stay near the hospital or you must come and check the blood cells in hospital for week or months. Before you leave the hospital, doctor will give the detailed instruction that you must follow to cure the prevent infection. Doctor will monitoring you until you become healthy.

 

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