Laser And Refractive Eye Surgery
There are 2 types of laser corrective eye surgery.
PRK (Photorefractive Keratectomy)
The first is called PRK (Photorefractive Keratectomy) which is less expensive to have, involves surface ablation with an excimer laser and takes a little longer to heal (2-3 weeks).
PRK can be used to treat long-sightedness, short-sightedness and astigmatism but your eye surgeon will tell you after doing some tests whether you are a good candidate or not.
The second type involves making a corneal flap using (in our setting) a Femtosecond Laser. Then the excimer laser is used to ablate the cornea as with PRK. NASA encourages all its astronauts to have this laser corrective surgery
There are only 2 femtosecond lasers in Gauteng and one in the Cape. The procedure is more expensive and the healing is quicker. Both PRK and Femtosecond laser have equal visual results in the long term (after 3 months).
Cataracts are one of the leading causes of blindness in Africa but can be surgically removed, as soon as the vision is influenced. There are many causes for cataracts, including toxins, trauma and age.
What is A Cataract?
A cataract is the lens inside the eye that gets more rigid and less clear with time. The lens is a very important refractive element in the eye, with a huge influence on your vision.
What to expect with cataract surgery?
Cataract Surgery is done under local anaesthesia in most hospitals. It is not necessary for patients to stay over in the hospital after surgery. And in most cases your vision is hugely improved the day after surgery, which makes cataract surgery one of the most successful surgeries to undergo, if not the most successful.
The latest technology used for cataract surgery is through a micro incision and phacoemulsification which is an ultrasound technique. This means that the incision that the surgeon makes is only a 2 millimetres big and does not need stitches in most cases, which means that the patient is much more comfortable after surgery.
After cataract surgery most refractive errors can be eliminated, meaning patients who had to wear glasses before their surgery would in most gases not need glasses after surgery except for reading glasses.
A retinal detachment is a medical emergency because it is sight threatening.
The main symptoms of retinal detachment
Patients sees flashes of Light often accompanied by Floaters (ittle black spots moving around in front of your eye)
What looks like a black curtain. The other eye has to be closed to see this!
There are certain risk factors for retinal detachment, which include:
- High Myopia more than -5.00
- Trauma to the eye
- Patients whom had cataract or other eye surgery
- It is very important to visit your ophthalmologist regularly, at least once a year if you have any of these risk factors. And it is even more important to see your ophthalmologist immediately when you experience any of the above symptoms.
Retinal detachments have to be treated surgically. The quicker a patient presents to the doctor, the better the outcome, although 15% of people may need repeat surgeries for the final reattachment of the retina.
Macular degeneration is also known as Age Related Macular Degeneration (AMD), because of the prevalence of the condition in older people.
It is much more common among white people older than 50 and the risk of developing macular degeneration also increases a lot when people smoke, eat badly and have hypertension and high cholesterol. Also when they are very overweight.
Basically though it’s about genetics. If you are white (or have white ancestry), have blue eyes and are 60 years or older you should have a retinal exam and may be an OCT and autofluorescence photo of your retina by an ophthalmologist.
There are two types of AMD; the wet type and the dry type.
Dry Macular Degeneration
90% of all AMD is dry. It is a slowly progressive disease, but can turn into wet at any time. This is why people should use a Amsler Grid test at home regularly to see if there is any progression of the disease.
It is also very important to control hypertension and high cholesterol, as well as stay at a healthy weight
Eating habits can have an influence on AMD, therefore it is very important to eat lots of spinach, broccoli and yellow and red peppers that are rich in Lutein, Zeaxanthin and Selenium. Your doctor can also prescribe certain vitamins that contain these compounds.
Wet Macular Degeneration
10% of AMD is wet. Wet AMD can progress very quickly into a very serious blinding condition if not treated by anti-vegF injections into the eye by an Opthalmologist.
The treatment for wet AMD is regular injections into the eye. There are 2 types of injections that are often used. They are called Avastin and Lucentis injections. These will help decrease the progression of the AMD and may even improve vision back to normal in many patients. Keep in mind that there is no cure for AMD yet.
What is Glaucoma?
Glaucoma is a group of diseases that damage the optic nerve of the eye, and can result in loss of vision and blindness.
Glaucoma can be classified into two main type’s:
- Open angle Glaucoma
- Closed angle Glaucoma
The dangerous aspect of this disease is that most of the time the patient has no idea he or she has glaucoma (until it is too late and there is permanent loss of vision that is noticeable to the patient!).
The only way of knowing you have glaucoma is by being tested by an eye specialist. Lots of things have to be looked at by the eye specialist to come to a diagnosis of glaucoma. Tests like ocular pressure, fundus examination and OCT (special camera) plus visual fields checking your peripheral vision need to be performed.
Often the patient with glaucoma can use eye drops to lower the pressure. You will most likely have your pupils dilated by eye drops by your specialist so make sure you go with another person who can drive you home!
Sometimes ALT or SLT lasers can treat glaucoma for a few years or permanently. It depends on each individual and your doctors opinion.Surgery is often the third line of treatment as less invasive methods are usually preferred initially.
Remember if you have a family history of glaucoma you need a specialist to see you every year after the age of 40. If no family history, a test every year is not a bad idea but every 2 years is probably fine after age 40.Book Consultation