Keratoconus (KC) is a disorder of the eye that results in progressive thinning of the cornea. This may result in blurry vision, double vision, nearsightedness, irregular astigmatism, and light sensitivity leading to poor quality-of-life. Usually both eyes are affected. In more severe cases a scarring or a circle may be seen within the cornea.
Far-sightedness, also known as long-sightedness, hypermetropia, and hyperopia, is a condition of the eye where distant objects are seen clearly but near objects appear blurred. This blur is due to incoming light being focused behind, instead of on, the retina due to insufficient accommodation by the lens. Minor hypermetropia in young patients is usually corrected by their accommodation, without any defects in vision. But, due to this accommodative effort for distant vision, people may complain of eye strain during prolonged reading. If the hypermetropia is high, there will be defective vision for both distance and near. People may also experience accommodative dysfunction, binocular dysfunction, amblyopia, and strabismus. Newborns are almost invariably hypermetropic, but it gradually decreases as the newborn gets older.
LASIK or Lasik, commonly referred to as laser eye surgery or laser vision correction, is a type of refractive surgery for the correction of myopia, hyperopia, and an actual cure for astigmatism, since it is in the cornea. LASIK surgery is performed by an ophthalmologist who uses a laser or microkeratome to reshape the eye's cornea in order to improve visual acuity.
An optical system with astigmatism is one where rays that propagate in two perpendicular planes have different foci. If an optical system with astigmatism is used to form an image of a cross, the vertical and horizontal lines will be in sharp focus at two different distances. The term comes from the Greek α- (a-) meaning "without" and στίγμα (stigma), "a mark, spot, puncture".
Radial keratotomy (RK) is a refractive surgical procedure to correct myopia (nearsightedness). It was developed in 1974 by Svyatoslav Fyodorov, a Russian ophthalmologist. It has been largely supplanted by newer, more accurate operations, such as photorefractive keratectomy, LASIK, Epi-LASIK and the phakic intraocular lens.
Refractive surgery is an optional eye surgery used to improve the refractive state of the eye and decrease or eliminate dependency on glasses or contact lenses. This can include various methods of surgical remodeling of the cornea (keratomileusis), lens implantation or lens replacement. The most common methods today use excimer lasers to reshape the curvature of the cornea. Refractive eye surgeries are used to treat common vision disorders such as myopia, hyperopia, presbyopia and astigmatism.
An Intraocular lens (IOL) is a lens implanted in the eye usually as part of a treatment for cataracts or for correcting other vision problems such as short sightedness and long sightedness; a form of refractive surgery. If the natural lens is left in the eye, the IOL is known as phakic, otherwise it is a pseudophakic lens. Both kinds of IOLs are designed to provide the same light-focusing function as the natural crystalline lens. This can be an alternative to LASIK, but LASIK is not an alternative to an IOL for treatment of cataracts.
Corneal cross-linking (CXL) with riboflavin (vitamin B2) and UV-A light is a surgical treatment for corneal ectasia such as keratoconus, PMD, and post-LASIK ectasia.
A keratoscope, sometimes known as Placido's disk, is an ophthalmic instrument used to assess the shape of the anterior surface of the cornea. A series of concentric rings is projected onto the cornea and their reflection viewed by the examiner through a small hole in the centre of the disk. A regular-shaped cornea should show equally spaced symmetric reflections. If the patient is suffering from astigmatism or from a corneal dystrophy, the rings will be distorted.
Astigmatism is a type of refractive error due to rotational asymmetry in the eye's refractive power. This results in distorted or blurred vision at any distance. Other symptoms can include eyestrain, headaches, and trouble driving at night. Astigmatism often occurs at birth and can change or develop later in life. If it occurs in early life and is left untreated, it may result in amblyopia.
Pellucid marginal degeneration (PMD) is a degenerative corneal condition, often confused with keratoconus. It typically presents with painless vision loss affecting both eyes. Rarely, it may cause acute vision loss with severe pain due to perforation of the cornea. It is typically characterized by a clear, bilateral thinning (ectasia) in the inferior and peripheral region of the cornea, although some cases affect only one eye. The cause of the disease remains unclear.
Corneal pachymetry is the process of measuring the thickness of the cornea. A pachymeter is a medical device used to measure the thickness of the eye's cornea. It is used to perform corneal pachymetry prior to refractive surgery, for Keratoconus screening, LRI surgery and is useful in screening for patients suspected of developing glaucoma among other uses.
Avi Wallerstein is a Canadian ophthalmologist and laser eye surgeon who specializes in surgical vision correction, also termed refractive eye surgery. He practises in Montreal and Toronto. In 2001, he co-founded LASIK MD with Mark Cohen. LASIK MD is Canada's largest provider of laser refractive surgery, performing over 60,000 procedures a year. He is one of only 14 certified CLasik instructors in North America.
Keratoprosthesis is a surgical procedure where a diseased cornea is replaced with an artificial cornea. Traditionally, keratoprosthesis is recommended after a person has had a failure of one or more donor corneal transplants. More recently, a less invasive, non-penetrating artificial cornea has been developed which can be used in more routine cases of corneal blindness. While conventional cornea transplant uses donor tissue for transplant, an artificial cornea is used in the keratoprosthesis procedure. The surgery is performed to restore vision in patients with severely damaged cornea due to congenital birth defects, infections, injuries and burns.
The Alpins Method is a system to plan and analyze the results of refractive surgical procedures, such as laser in-situ keratomileus (LASIK). The Alpins Method is also used to plan cataract/toric intraocular lens (IOL) surgical procedures.
Peter S. Hersh is an American ophthalmologist, researcher, and specialist in LASIK eye surgery, keratoconus, and diseases of the cornea. He co-authored the article in the journal Ophthalmology that presented the results of the study that led to the first approval by the U.S. Food and Drug Administration (FDA) of the excimer laser for the correction of nearsightedness in the United States. Hersh was also medical monitor of the study that led to approval of corneal collagen crosslinking for the treatment of keratoconus. He was the originator, in 2015, of CTAK for keratoconus, patent holder, and co-developer.
The aim of an accurate intraocular lens power calculation is to provide an intraocular lens (IOL) that fits the specific needs and desires of the individual patient. The development of better instrumentation for measuring the eye's axial length (AL) and the use of more precise mathematical formulas to perform the appropriate calculations have significantly improved the accuracy with which the surgeon determines the IOL power.
Post-LASIK ectasia is a condition similar to keratoconus where the cornea starts to bulge forwards at a variable time after LASIK, PRK, or SMILE corneal laser eye surgery. However, the physiological processes of post-LASIK ectasia seem to be different from keratoconus. The visible changes in the basal epithelial cell and anterior and posterior keratocytes linked with keratoconus were not observed in post-LASIK ectasia.
Corneal ectatic disorders or corneal ectasia are a group of uncommon, noninflammatory, eye disorders characterised by bilateral thinning of the central, paracentral, or peripheral cornea.
Anastasios John Kanellopoulos is a Greek-American eye surgeon specializing in corneal transplantation, cornea crosslinking for keratoconus, complicated cataract surgery and complicated glaucoma. Widely known for research and clinical contributions in micro-incision cataract, customized laser refractive surgery and corneal cross-linking propagation and most innovations, reducing corneal transplants for advanced keratoconus.
