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The LASIK Directory Blog

Welcome to the LASIK Blog, a resource for people interested in LASIK surgery. This consumer-friendly blog is intended to be used as a central resource to answer common questions about LASIK and to point you in the right direction.

Thursday, July 31, 2008

A New Glaucoma Treatment

Glaucoma treatments are unable to reverse any damage done to the optic nerve. But they can and do reduce the intraocular pressure (IOL) so as to prevent any more nerve damage. Glaucoma increases the IOL because it impairs the balance between two eye functions:

  • Production of eye fluids
  • Drainage of those fluids

In some cases the fluid is over-produced, and in others the drainage system is blocked to a greater or lesser extent. This new treatment is known as a Canaloplasty and targets part of the drainage system called Schlemm's canal.

Schlemm's canal

This tiny channel runs around the outside of the iris, in the back surface of the cornea. Its function is to collect excess aqueous humor (fluid) from the eye's anterior chamber (front chamber between cornea and lens), and send it into the bloodstream. Blockage of this canal or its little feeder channels is one of the causes of glaucoma.

Canaloplasty Procedure

In a canaloplasty, the eye surgeon threads a microcatheter (flexible tube) into the length of Schlemm's canal, with a light at its tip and a suture attached to the back end. The tube is filled with a viscoelastic gel which helps widen Schlemm's canal as it's distributed. The surgeon withdraws the microcatheter and ties off the suture, applying a little tension to it. Now Schlemm's canal will stay widened and function better for drainage of aqueous humor.

A canaloplasty is done with the use of an ultrasound imaging system, giving the eye surgeon a clear picture of what he is doing. It is an innovative procedure and thought by many to be very promising. It is "non-penetrating", meaning that it does not pierce completely through the cornea. It penetrates only as far as Schlemm's canal, towards the back of the cornea.

A good canaloplasty candidate has the most common type of glaucoma and has not had any previous glaucoma surgeries. Please see our article on Glaucoma Types for more information.

The most common forms of glaucoma do not give any early symptoms. If you are over the age of about 40, you should have your eyes checked for glaucoma at least every year. To find a qualified glaucoma surgeon in your area, please use the links below.

Monday, July 21, 2008

Minimize Your Vision Loss

Aging affects our vision, even if it's just in causing presbyopia and imposing that daily task of not misplacing the reading glasses. But there are many other ways aging can cause gradual loss of vision, and you can minimize or even prevent much of this loss. If you at present have no regular eye doctor, please, for your vision's sake, choose one now from this page:

  • You can use the drop-down menu at the top right corner of this page; or
  • Use the links at the bottom of the page

All the eye doctors you can contact from this page offer LASIK. They also offer many other services, and will be able to diagnose any early vision problems you might have, and begin treating them so as to minimize your vision loss.

Eye Disease Tests You Might Need

An eye pressure test -- to check for glaucoma. The eye's internal pressure can build up without you noticing, and damage the optic nerve, quietly destroying peripheral vision. By the time you start to notice it, that vision is permanently lost.

Visual field test -- to see if any peripheral vision is lost

A retinal exam -- to look closely at the eye's inside structures. The pupil is a natural window into the eye. By dilating it with special eyedrops, then using a lighted microscope your eye doctor can see the beginnings of many eye diseases:
  • Damage on the optic nerve indicates glaucoma
  • Damage on the macula indicates Age-Related Macular Degeneration (ARMD)
  • Damage on the lens indicates cataracts
  • Damage on the blood vessels can point towards blood problems, such as diabetes, high blood pressure, or high cholesterol.

A slit lamp exam -- another way to see the eye's inside structures. It's also used to examine the cornea for dry eye syndrome, scarring, and cancerous changes; and the sclera for lesions or growths

Vision testing -- this will give you a glasses or contact lens prescription if you need one, and catch presbyopia creeping up, as it does when we reach our 40s. It will also tell your eye doctor whether you might have other health problems, such as undiagnosed diabetes or thyroid dysfunction. Many general health conditions affect the eyes in specific ways.

Annual eye testing is a wise thing to do if you'd like to keep your clearest vision possible, for as long as possible. Eye tests are typically painless, quick, and covered by insurance policies. Don't delay if you need to find a good eye doctor. Use the links below or the menu at the top of this page, and your eyes will thank you.

Tuesday, July 15, 2008

Updated Crystalens HD Approved

On June 30, Bausch & Lomb announced that they had been given FDA approval to market Crystalens HDTM in the U.S. Crystalens is one of the intraocular lenses (IOLs) commonly used in a cataract surgery, or to treat presbyopia. There are two other IOLs used for these purposes, but they are multifocal, whereas Crystalens is accommodating.

What is Accommodation?

The eye's lens can change its shape, its curvature. When light enters the eye, the cornea bends it (refracts it), and it then passes through the lens, which refracts it again. In a 20/20 eye, this focuses the light clearly on the retina and all is well.

When the light entering the eye is coming from a distant object, it needs less refraction to focus on the retina. When it's coming from a nearby object, it needs more. Since the cornea cannot change its shape, the lens accommodates itself to the differing refraction needs. It becomes more convex for nearby objects and flatter for far objects. This happens automatically and we don't notice it as we glance from far to near.

If the lens is removed to treat cataracts or presbyopia, and replaced with an IOL, that accommodative ability is lost. The first IOLs were monofocal -- set for either distance or near vision. So you had to wear glasses for whichever distance the IOL did not correct.

How Crystalens Accommodates

A Crystalens IOL has a tiny hinge on each side and is attached to the eye's ciliary muscles which used to control the lens shape. Now they control the position of the Crystalens. They move it slightly forward to mimic increased curvature for near objects; and slightly back to mimic increased flatness for far objects.

Crystalens is the only FDA-approved accommodating IOL, and the Crystalens HD is its fourth generation. The surface has been reshaped so as to increase a person's depth of focus. In other words, it gives clearer near vision without reducing clarity for intermediate or far vision. It does this also without increasing any night vision problems like halos around light sources, or starbursts.

Bausch & Lomb began shipping Crystalens HD last week. Eye surgeons are instructed to use the same surgical protocols as they have previously used -- in other words, the procedure will be the same.

To locate a highly qualified ophthalmologist in your area, please refer to the links below.

Wednesday, July 09, 2008

How Disabling is Blindness?

The first worldwide Glaucoma Day was held this year in March, with much publicity, free testing by ophthalmologists, and free information given out. Glaucoma causes blindness if left untreated long enough. Cataracts also cause blindness when left untreated, and the treatment is to remove the entire lens from the eye, replacing it with an artificial lens such as Crystalens, ReSTOR, or ReZoom.

Then there's diabetic retinopathy which also causes blindness and is hard to treat at all. Eye injuries and inherited eye conditions cause their quotas of blindness, so worldwide, there must be many blind people and probably nobody has ever counted the number.

A Blind Man's Life Recounted

A story was published yesterday about one Mike May, now aged 54, whose eyes were damaged by a chemical explosion when he was three. The corneas (clear front part) were so scarred that he became blind. As a blind man:

  • He competed in the Paralympics and won three gold medals for downhill skiing
  • He has a guide dog and can get around with no trouble in daily life
  • He is married with two sons
  • For a while he was a member of the CIA
  • In 1976 he went to Ghana with his guide dog, living with a local family and talking and singing with local children until he contracted malaria and returned home
  • He has since traveled with his dog to Brazil, Europe, Puerto Rico, and Mexico
  • He regularly gives inspirational talks to both small and large audiences

Some Vision Restored

In 2000 Mike May had a stem cell corneal transplant and regained some of his vision, although he's still legally blind. On Monday, he addressed a full auditorium about his experience with blindness and the corneal transplant results. The occasion was part of the Conference on Low Vision in Montreal, Canada.

His newly restored vision allows him to run and catch a ball accurately, yet he says he has no depth perception. He sees colors and has good contrast vision but can't recognize people's faces and can't read.

In May, 2007, a book was published called Crashing Through about Mike May's life so far. Fox 2000 is working on a movie based on that book. You can see many photos and read more about this man's productive life on the Sendero Group website.

If you are looking for an excellent and experienced eye surgeon in your area, please use the links below.

Tuesday, July 01, 2008

Stages of Glaucoma Treatment: Part 2

In Part 1 of Stages of Glaucoma Treatment, we covered the first stage of treatment, which is daily eyedrops designed to lower the intraocular pressure. If these eyedrops are ineffective, the following surgical choices are available

1. Trabeculoplasty

One of the structures of the eye is called the trabecular meshwork. It is a spongy tissue near the cornea which drains the aqueous humor (fluid between the cornea and the lens) from the eye. Aqueous humor is not the same as the tears which moisten the eye's surface.

There is a gland behind the iris called the ciliary body which produces the aqueous humor. When the drainage is somehow impaired or slowed, while the ciliary body continues producing more fluid, pressure builds up in the eye, and this is part of glaucoma. That increased pressure can block some of the blood flow to the optic nerve and cause blind spots to develop.

A trabeculoplasty uses a laser to open up the trabecular meshwork a little more, improving fluid drainage. The laser vaporizes tiny pieces of trabecular tissue.

2. Trabectome

A trabectome is a more recently-devised treatment which makes a very small incision in the cornea. A probe is used through that opening to remove a little of the trabecular meshwork, making more space for fluid to drain out of the eye.

3. Trabeculectomy

This is another surgery to increase fluid drainage and is also called filtration surgery. It is performed at the eye's drainage angle – that is, where the white part (sclera) and colored part (iris) connect. A tiny drainage hole is cut and partially covered by a flap of tissue made in the sclera and the conjunctiva (membrane over the sclera). This creates a new drain and allows outgoing fluid to bypass the trabecular meshwork.

If you are over 40 years of age, please visit an experienced eye doctor for a glaucoma screening every two years or so. You should go more often if you have any of the risk factors for glaucoma:

  • Diabetes
  • Any past eye injury
  • African or Hispanic background
  • Long-time use of any corticosteroid preparation
  • Family history of glaucoma

To find a qualified ophthalmologist in your area, please use the links below.

 
Click on a link to find a LASIK surgeon in that state.

Disclaimer: The content on our website and this page about LASIK surgery is for informational purposes only. To learn more about LASIK surgery in your area and situation, please contact a LASIK surgeon above or click here to let us find an eye doctor for you.