Ophthalmology is a branch of medicine that deals with the diagnosis and treatment of eye disorders. An ophthalmologist is a physician who specializes in eye care. The credentials include a degree in medicine, followed by additional four to five years of residency training in ophthalmology. Residency training programs for ophthalmology may require a one-year internship with training in internal medicine, pediatrics, or general surgery. Additional specialty training may be sought in a particular aspect of eye pathology. Ophthalmologists are allowed to prescribe medications to treat eye diseases, implement laser therapy, and perform surgery when needed. Ophthalmologists typically provide specialty eye care - medical and surgical, and they may participate in academic research on eye disorders.
Myopia, also known as near-sightedness and short-sightedness, is an eye disorder where light focuses in front of, instead of on, the retina. This causes distant objects to appear blurry while close objects appear normal. Other symptoms may include headaches and eye strain. Severe near-sightedness is associated with an increased risk of retinal detachment, cataracts, and glaucoma.
A cataract is a cloudy area in the lens of the eye that leads to a decrease in vision. Cataracts often develop slowly and can affect one or both eyes. Symptoms may include faded colors, blurry or double vision, halos around light, trouble with bright lights, and trouble seeing at night. This may result in trouble driving, reading, or recognizing faces. Poor vision caused by cataracts may also result in an increased risk of falling and depression. Cataracts cause half of all cases of blindness and 33% of visual impairment worldwide.
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. For most people, LASIK provides a long-lasting alternative to eyeglasses or contact lenses.
Photorefractive keratectomy (PRK) and laser-assisted sub-epithelial keratectomy (LASEK) are laser eye surgery procedures intended to correct a person's vision, reducing dependency on glasses or contact lenses. LASEK and PRK permanently change the shape of the anterior central cornea using an excimer laser to ablate a small amount of tissue from the corneal stroma at the front of the eye, just under the corneal epithelium. The outer layer of the cornea is removed prior to the ablation.
Eye surgery, also known as ocular surgery, is surgery performed on the eye or its adnexa, typically by an ophthalmologist. The eye is a very fragile organ, and requires extreme care before, during, and after a surgical procedure to minimise or prevent further damage. An expert eye surgeon is responsible for selecting the appropriate surgical procedure for the patient, and for taking the necessary safety precautions. Mentions of eye surgery can be found in several ancient texts dating back as early as 1800 BC, with cataract treatment starting in the fifth century BC. Today it continues to be a widely practiced type of surgery, with various techniques having been developed for treating eye problems.
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 operations, such as photorefractive keratectomy, LASIK, Epi-LASIK and the phakic intraocular lens. Approximately 10% of all practicing ophthalmologists in the United States have performed several hundred thousand RK procedures.
Refractive eye surgery is 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.
Intraocular lens (IOL) is a lens implanted in the eye as part of a treatment for cataracts or myopia. If the natural lens is left in the eye, the IOL is known as phakic, otherwise it is a pseudophakic, or false lens. Such a lens is typically implanted during cataract surgery, after the eye's cloudy natural lens (cataract) has been removed. The pseudophakic IOL provides the same light-focusing function as the natural crystalline lens. The phakic type of IOL is placed over the existing natural lens and is used in refractive surgery to change the eye's optical power as a treatment for myopia (nearsightedness). This is an alternative to LASIK.
Charles David Kelman was an American ophthalmologist, surgeon, inventor, jazz musician, entertainer, and Broadway producer. Known as the father of phacoemulsification, he developed many of the medical devices, instruments, implant lenses and techniques used in cataract surgery. In the early 1960s, he began the use of cryosurgery to remove cataracts and repair retinal detachments. Cryosurgery for cataracts remained in heavy use until 1978, when phacoemulsification, a procedure Kelman also developed in 1967, became the modern standard treatment. Kelman was given the National Medal of Technology by President George H. W. Bush and recognized as the Ophthalmologist of the Century by the International Congress of Cataract and Refractive Surgery in Montreal, Canada. He was also inducted into the National Inventors Hall of Fame in Akron, Ohio, and received the 2004 Lasker Award.
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 its replacement with an intraocular lens. Metabolic changes of the crystalline lens fibers over time lead to the development of the cataract, causing impairment or loss of vision. Some infants are born with congenital cataracts, and certain environmental factors may also lead to cataract formation. Early symptoms may include strong glare from lights and small light sources at night, and reduced acuity at low light levels.
Epi-LASIK is a refractive surgery technique designed to reduce a person's dependency on eyeglasses and contact lenses. Invented by Dr. Ioannis Pallikaris, the technique is basically an automatic LASEK without alcohol; it can be better considered as superficial LASIK. The stromal bed is smoother than that obtained by mechanical methods or brush. Unlike alcohol (LASEK), there is no chance of damaging the limbal stem cells. It is also relatively less painful than LASEK.
- A device similar to a microkeratome slides over the surface of the cornea, just underneath the epithelial layer of cells while suction is applied.
- The result is a hinged sheet of epithelium that is at least partially viable.
- It is reflected out of the way so that the ablation can take place.
- The sheet is repositioned and a bandage soft contact lens is placed on the eye.
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 accommodation, high degree of farsightedness (hyperopia), and a deep anterior chamber. Complications include detachment of the vitreous or retina, and glaucoma.
Corneal cross-linking with riboflavin (vitamin B2) and UV-A light is a surgical treatment for corneal ectasia such as keratoconus, PMD, and post-LASIK ectasia.
Epiretinal membrane or macular pucker is a disease of the eye in response to changes in the vitreous humor or more rarely, diabetes. Sometimes, as a result of immune system response to protect the retina, cells converge in the macular area as the vitreous ages and pulls away in posterior vitreous detachment (PVD). PVD can create minor damage to the retina, stimulating exudate, inflammation, and leucocyte response. These cells can form a transparent layer gradually and, like all scar tissue, tighten to create tension on the retina which may bulge and pucker, or even cause swelling or macular edema. Often this results in distortions of vision that are clearly visible as bowing and blurring when looking at lines on chart paper within the macular area, or central 1.0 degree of visual arc. Usually it occurs in one eye first, and may cause binocular diplopia or double vision if the image from one eye is too different from the image of the other eye. The distortions can make objects look different in size, especially in the central portion of the visual field, creating a localized or field dependent aniseikonia that cannot be fully corrected optically with glasses. Partial correction often improves the binocular vision considerably though. In the young, these cells occasionally pull free and disintegrate on their own; but in the majority of sufferers the condition is permanent. The underlying photoreceptor cells, rod cells and cone cells, are usually not damaged unless the membrane becomes quite thick and hard; so usually there is no macular degeneration.
D. Jackson Coleman is a Professor of Clinical Ophthalmology at New York-Presbyterian Hospital at The Edward S. Harkness Eye Institute of Columbia University. He is the former John Milton McLean Professor of Ophthalmology and Chairman Emeritus at Weill Cornell Medical Center where he served as Chairman from 1979–2006. His specialties are retinal diseases and ultrasound, working with patients at Columbia University Medical Center. Coleman is also engaged in research involving ultrasound, which he has pursued throughout his career with colleague Ronald Silverman in the Department of Ophthalmology at the Columbia University Medical Center.
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.
Alfred Edward Maumenee, Jr. was an American ophthalmologist who pioneered treatments for retinal diseases, macular degeneration and glaucoma and was a leading surgeon for corneal transplants and cataracts.
Peter Szurman is a German ophthalmologist, scientist, and professor of ophthalmology in Sulzbach/Saar.
