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Ophthalmology is a surgical subspecialty within medicine that deals with the diagnosis and treatment of eye disorders.
Glaucoma is a group of eye diseases that result in damage to the optic nerve and cause vision loss. The most common type is open-angle glaucoma, in which the drainage angle for fluid within the eye remains open, with less common types including closed-angle glaucoma and normal-tension glaucoma. Open-angle glaucoma develops slowly over time and there is no pain. Peripheral vision may begin to decrease, followed by central vision, resulting in blindness if not treated. Closed-angle glaucoma can present gradually or suddenly. The sudden presentation may involve severe eye pain, blurred vision, mid-dilated pupil, redness of the eye, and nausea. Vision loss from glaucoma, once it has occurred, is permanent. Eyes affected by glaucoma are referred to as being glaucomatous.
Cataract surgery, also called lens replacement surgery, is the removal of the natural lens of the eye that has developed an opacification, which is referred to as a cataract, and usually its replacement with an artificial intraocular lens.
Aphakia is the absence of the lens of the eye, due to surgical removal, such as in cataract surgery, a perforating wound or ulcer, or congenital anomaly. It causes a loss of ability to maintain focus (accommodation), high degree of farsightedness (hyperopia), and a deep anterior chamber. Complications include detachment of the vitreous or retina, and glaucoma.
A glaucoma valve is a medical shunt used in the treatment of glaucoma to reduce the eye's intraocular pressure (IOP).
Trabeculectomy is a surgical procedure used in the treatment of glaucoma to relieve intraocular pressure by removing part of the eye's trabecular meshwork and adjacent structures. It is the most common glaucoma surgery performed and allows drainage of aqueous humor from within the eye to underneath the conjunctiva where it is absorbed. This outpatient procedure was most commonly performed under monitored anesthesia care using a retrobulbar block or peribulbar block or a combination of topical and subtenon anesthesia. Due to the higher risks associated with bulbar blocks, topical analgesia with mild sedation is becoming more common. Rarely general anesthesia will be used, in patients with an inability to cooperate during surgery.
Glaucoma is a group of diseases affecting the optic nerve that results in vision loss and is frequently characterized by raised intraocular pressure (IOP). There are many glaucoma surgeries, and variations or combinations of those surgeries, that facilitate the escape of excess aqueous humor from the eye to lower intraocular pressure, and a few that lower IOP by decreasing the production of aqueous humor.
Johnson & Johnson Vision (JJV) is a subsidiary of Johnson & Johnson and is composed of two divisions, Johnson & Johnson Surgical Vision and Johnson & Johnson Vision Care. Services include Intraocular lenses, laser vision correction systems, phacoemulsification systems, viscoelastic, Microkeratomes and related products used in cataract and refractive surgery.
The Trabectome is a surgical device that can be used for ab interno trabeculotomy, a minimally invasive glaucoma surgery for the surgical management of adult, juvenile and infantile glaucoma. The trabecular meshwork is a major site of resistance to aqueous humor outflow. As angle surgeries such as Trabectome follow the physiologic outflow pathway, the risk of complications is significantly lower than filtering surgeries. Hypotony with damage to the macula, can occur with pressures below 5 mmHg for instance after traditional trabeculectomy, because of the episcleral venous pressure limit. The Trabectome handpiece is inserted into the anterior chamber, its tip positioned into Schlemm's canal, and advanced to the left and to the right. Different from cautery, the tip generates plasma to molecularize the trabecular meshwork and remove it drag-free and with minimal thermal effect. Active irrigation of the trabectome surgery system helps to keep the anterior chamber formed during the procedure and precludes the need for ophthalmic viscoelastic devices. Viscoelastic devices tend to trap produced debris or gas bubbles and diminish visualization. The Trabectome decreases the intra-ocular pressure typically to a mid-teen range and reduces the patient's requirement to take glaucoma eye drops and glaucoma medications. The theoretically lowest pressure that can be achieved is equal to 8 mmHg in the episcleral veins. This procedure is performed through a small incision and can be done on an outpatient basis.
Eric John Arnott, MA, FRCS, FRCOphth was a British ophthalmologist and surgeon who specialized in cataracts, a condition which in many parts of the world still remains the principal cause of blindness. He is known for inventing new surgical techniques for treatment of various ophthalmological disorders, and received professional awards for his contributions.
The USC Gayle and Edward Roski Eye Institute, part of Keck School of Medicine of USC, is a center for ophthalmic care, research and education located in downtown Los Angeles, California. It has subsidiary clinics in Pasadena, Beverly Hills and Arcadia. It was allied with the Doheny Eye Institute from 1975 until 2013, when Doheny allied with University of California Los Angeles.
Rohit Varma is an Indian-American ophthalmologist and professor of ophthalmology and preventive medicine. In 2014, he was named director of the USC Eye Institute and chairman of the Department of Ophthalmology for Keck School of Medicine of USC. In March 2016, Varma was named the interim dean of the Keck School of Medicine, and in November was named dean. In October 2017, USC announced that he stepped down as dean. In October 2018, Varma became the founding director of the Southern California Eyecare and Vision Research Institute.
Micro-invasive glaucoma surgery (MIGS) is the latest advance in surgical treatment for glaucoma, which aims to reduce intraocular pressure by either increasing outflow of aqueous humor or reducing its production. MIGS comprises a group of surgical procedures which share common features. MIGS procedures involve a minimally invasive approach, often with small cuts or micro-incisions through the cornea that causes the least amount of trauma to surrounding scleral and conjunctival tissues. The techniques minimize tissue scarring, allowing for the possibility of traditional glaucoma procedures such as trabeculectomy or glaucoma valve implantation to be performed in the future if needed.
Keiki R. Mehta, an Indian ophthalmologist, medical researcher and writer, is considered by many as the father of Phacoemulsification in India. He is the Chief Surgical and Medical Director at Mehta International Eye Institute, a Mumbai-based specialty eye hospital founded by him. He is known to be the first surgeon to perform a Radial keratotomy in India and is credited with the development of the first soft eye implant in the world, and the Keiki Mehta BP Valve Glaucoma Shunt, a medical implant used in the treatment of neovascular‚ congenital and uveitic glaucoma. He is a recipient of several honours including the Grand Honors Award of the National Eye Research Foundation, Chicago and the Triple Ribbon Award of the American Society for Cataract and Refractive Surgery. The Government of India awarded him the fourth highest civilian honour of the Padma Shri, in 2008, for his contributions to Medicine.
Robert E. MacLaren FMedSci FRCOphth FRCS FACS VR is a British ophthalmologist who has led pioneering work in the treatment of blindness caused by diseases of the retina. He is Professor of Ophthalmology at the University of Oxford and Honorary Professor of Ophthalmology at the UCL Institute of Ophthalmology. He is a Consultant Ophthalmologist at the Oxford Eye Hospital. He is also an Honorary Consultant Vitreo-retinal Surgeon at the Moorfields Eye Hospital. MacLaren is an NIHR Senior Investigator, or lead researcher, for the speciality of Ophthalmology. In addition, he is a member of the research committee of Euretina: the European Society of Retina specialists, Fellow of Merton College, in Oxford and a Fellow of the Higher Education Academy.
James C. Tsai is a physician and scientist who serves as president of the New York Eye and Ear Infirmary of Mount Sinai. He also serves as the Delafield-Rodgers Professor of Ophthalmology at the Icahn School of Medicine at Mount Sinai and Chair of the Department of Ophthalmology at the Mount Sinai Health System.
Michael Belkin is an Israeli academic and researcher working in ophthalmology, Professor Emeritus of Ophthalmology at Tel Aviv University. His research brought about advances in glaucoma treatment such as the ExPress glaucoma implant, the Ioptimate CO2 laser glaucoma surgery and a fast, non-contact glaucoma laser treatment.
Secondary glaucoma is a collection of progressive optic nerve disorders associated with a rise in intraocular pressure (IOP) which results in the loss of vision. In clinical settings, it is defined as the occurrence of IOP above 21 mmHg requiring the prescription of IOP-managing drugs. It can be broadly divided into two subtypes: secondary open-angle glaucoma and secondary angle-closure glaucoma, depending on the closure of the angle between the cornea and the iris. Principal causes of secondary glaucoma include optic nerve trauma or damage, eye disease, surgery, neovascularization, tumours and use of steroid and sulfa drugs. Risk factors for secondary glaucoma include uveitis, cataract surgery and also intraocular tumours. Common treatments are designed according to the type and the underlying causative condition, in addition to the consequent rise in IOP. These include drug therapy, the use of miotics, surgery or laser therapy.
Peter Szurman is a German ophthalmologist, scientist, and professor of ophthalmology in Sulzbach/Saar.
Uveitic glaucoma is most commonly a progression stage of noninfectious anterior uveitis or iritis.
References
- ↑ "Gavin Herbert Eye Institute goal: Eliminate blindness". Orange County Register. 17 August 2012. Retrieved 28 November 2020.
- ↑ "AAO Member Obituaries". 13 April 2021. Retrieved 14 August 2021.
