Central Coast Eye

Macular degeneration, also known as age-related macular degeneration (AMD), is a common condition in older adults and the leading cause of vision loss in people age 50 and older. Macular degeneration affects the macula, the part of the retina responsible for the crisp, detailed central vision needed for reading or driving. Types Of Macular Degeneration Macular degeneration can be classified as either dry (non-neovascular) or wet (neovascular). Dry macular degeneration is the more common diagnosis, and is considered to be an early stage of the disease. This form of the disorder usually develops as the macular tissues thin during aging. Deposits of pigment within the macula may also occur. In only about 10 percent of patients does the condition progress to the more advanced form of the disease. If this occurs and the patient develops wet macular degeneration, new abnormal blood vessels develop beneath the macula, causing a leakage of blood and fluid. This leakage can lead to the creation of blind spots and permanent damage to central vision. With either type of macular degeneration, peripheral vision is maintained. Risk Factors For Macular Degeneration As people age, everyone is at risk for macular degeneration, but some people are at elevated risk due to genetic and/or environmental factors. Some individuals have a genetic variant known as complement factor H that makes them more likely to develop this condition. Nearly half of the cases of blindness associated with macular degeneration are linked to this genetic deficiency. Macular degeneration is most common in females and people with light skin or eye color, and the risk for all patients increases as they age. Over 30 percent of adults age 75 and older have been diagnosed with advanced or intermediate age-related macular degeneration. Other factors that may increase the risk of developing macular degeneration include: Obesity Smoking High fat diet Elevated cholesterol levels Prolonged sun exposure High blood pressure Certain medications Patients can minimize their risk of macular degeneration by exercising, eating a diet rich in Omega-3 fatty acids, and getting regular eye examinations. Symptoms Of Macular Degeneration Patients with dry macular degeneration may notice gradual changes to their vision, including: Shadowy areas in the central vision Fuzzy and distorted vision Difficulty perceiving color Difficulty seeing fine details Blind spots in central vision If the disease progresses to the wet form, patients may also perceive straight lines as wavy or crooked, and have larger and larger blind spots, increasingly losing central vision. With wet macular degeneration, central vision loss can occur rapidly, sometimes in as little as a few days or weeks. Macular degeneration may necessitate many lifestyle changes as it progresses. Patients may lose the ability to drive, have difficulty reading, and have difficulty recognizing faces. Because they retain peripheral vision, however, they usually remain capable of managing independently. Diagnosis Of Macular Degeneration The ophthalmologist may be able to detect early signs of macular degeneration through a regular eye examination while the patient is still asymptomatic. Any signs of this condition can be further confirmed by testing a patient’s central vision with an Amsler grid test. Treating detecting macular degeneration and other serious eye conditions as early as possible can help to prevent permanent loss of vision. Treatment Of Macular Degeneration While there is no cure for macular degeneration, there are several treatment options available to help patients manage this condition and preserve their vision. The best treatment option for each patient depends on the severity and type of the condition, as well as how much, if any, permanent vision loss has occurred. Intraocular injections of vascular endothelial growth factor are often successful in stopping abnormal blood vessel growth in wet macular degeneration. The medications are injected into the vitreous of the eye on a monthly basis to control the damaging effects of wet macular degeneration. Photodynamic therapy is also effective in removing the newly developing abnormal blood vessels characteristic of wet macular degeneration. Many patients also benefit from vitamin and mineral supplements, which help to clear out toxic substances that may build up. It is essential for patients with macular degeneration, wet or dry, to seek continuous medical treatment to manage the condition and prevent permanent vision loss.

Diabetic retinopathy is a complication of diabetes that affects the eyes. The length of time a person has diabetes determines his or her likelihood of developing diabetic retinopathy. It is the most common diabetic eye complication, and a leading cause of blindness in American adults. Diabetic retinopathy causes the blood vessels that supply nourishment to the retina, the light-sensitive lining in the back of the eye where vision is focused, to weaken, swell and leak, causing a loss of vision. Symptoms Of Diabetic Retinopathy In the early stages of diabetic retinopathy, patients usually do not show symptoms, and treatment is not always required. Patients have to monitor their blood-sugar levels to prevent the condition from worsening. If it does, prompt treatment is necessary to preserve vision. Patients who develop diabetic retinopathy may not, at first, notice any changes to their vision. In its earliest stages, the condition causes tiny areas of swelling in the small blood vessels of the retina. Once symptoms are present, they include the following: Blurred or double vision Seeing flashing lights, blank spots or dark floaters Pain or pressure in either or both eyes Problems with peripheral vision In its advanced stages, diabetic retinopathy can cause irreversible blindness. During any stage of diabetic retinopathy, a condition known as macular edema can develop. Macular edema is the buildup of fluid in the macula, the light-sensitive part of the retina that allows objects to be seen with great detail. As the macula swells, vision becomes blurred. About half of the people with proliferative retinopathy (the most advanced stage) are diagnosed with macular edema. Stages Of Diabetic Retinopathy Diabetic retinopathy has four stages, each one increasingly serious: Mild nonproliferative retinopathy Moderate nonproliferative retinopathy Severe nonproliferative retinopathy Proliferative retinopathy As the disorder worsens, more and more blood vessels are affected. By the time a patient has proliferative retinopathy, the body is creating new blood vessels to replace the ones that are blocked. The problem is that the new blood vessels have very thin walls. If they leak blood, severe vision loss or blindness can result. Diagnosis Of Diabetic Retinopathy Diagnosis of diabetic retinopathy requires a thorough eye examination that includes the following: Visual-acuity test Dilated-eye examination Tonometry test Retinal exam Fluorescein angiogram Prior to some of these tests, eye drops containing a stain are administered so that the doctor can see the blood vessels more clearly. Treatment Of Diabetic Retinopathy Other than controlling blood pressure, blood cholesterol and blood sugar, treatment is not needed during the first three stages of diabetic retinopathy. The fourth stage, proliferative retinopathy, is treated with a laser surgery known as scatter laser treatment. During the procedure, the abnormal blood vessels are ablated, causing them to shrink. This procedure works best once the blood vessels begin to bleed. Severe blood-vessel bleeding may need to be surgically corrected with a vitrectomy, during which blood is removed from the eye. Treatment for macular edema usually includes a laser procedure called focal laser treatment. During this procedure, several hundred small laser burns are made in the areas of retinal leakage to reduce the amount of fluid in the retina. This helps reduce the risk of vision loss, and may improve lost vision in a small number of cases. Focal laser treatment is performed in a doctor’s office, and can usually be completed in just one session. Reducing The Risk Of Diabetic Retinopathy A patient with diabetes should have an annual comprehensive dilated-eye exam. In the United States, more than 40 percent of diabetics have some form of diabetic retinopathy. The risks of developing diabetic retinopathy can be minimized by doing the following: Monitoring changes in vision Keeping blood-glucose levels low Monitoring and managing blood pressure Eating a healthy diet Participating in a regular exercise routine Monitoring and managing cholesterol levels Patients with proliferative retinopathy can reduce their risk of blindness by 95 percent by keeping up with medical examinations, and promptly getting necessary treatment.

Retinal detachment occurs when the retina of the eye is pulled away from the underlying tissue to which it is attached. A retinal detachment is a medical emergency which can lead to permanent blindness if left untreated. In most cases, the detachment is a slowly progressing issue which must be treated once symptoms are realized. In some cases, a detachment occurs due to a trauma which causes a tear in the retina, allowing fluid to enter the vitreous and pull on the retinal tissue. Causes Of A Retinal Detachment Retinal detachment can be complication of cataract surgery. A severe inflammation may alter the position of the retinal tissue and begin the detachment process. Other causes of a retinal detachment may be as follows: Nearsightedness A retinal tear Family history of retinal detachment Glaucoma Cataract surgery Trauma Existing eye condition Symptoms Of A Retinal Detachment Symptoms of retinal detachment may progress slowly or rapidly, but both should be reported to a medical doctor as soon as possible so as to minimize the risk of vision loss. Some of the symptoms of a retinal detachment include: A sudden decrease in visual acuity A sudden increase in the amount of “floaters” in vision Bright flashes in the periphery An unnatural “curving” of straight lines Loss of central vision A dense shadow throughout the visual field The patient should be taken to an emergency room as quickly as possible. Diagnosis Of A Retinal Detachment Diagnosis of a retinal detachment is made after a thorough medical eye examination and the performance of the following diagnostic tests: Dilated eye examination Ultrasound of the eye Fundus photography of the retina Visual acuity test Slit-lamp examination Electroretinogram Fluorescein angiography Ophthalmoscopy Treatment Of A Retinal Detachment A retinal detachment may be treated in many ways, which may include one or both of the following: Cryotherapy Laser photocoagulation Pneumatic retinopexy Scleral buckle Vitrectomy Most surgeries to repair a retinal detachment are successful. In some cases, a second procedure will need to be performed. After a successful procedure, vision will take time to improve but may not return to previous levels of acuity.

Glaucoma is a group of related diseases that damage the optic nerve, resulting in vision loss and possible blindness. Glaucoma, a leading cause of blindness and visual impairment in the United States, can affect patients of all ages. Many people affected with glaucoma do not experience any symptoms and may not be aware that they have the disease until they have lost a significant amount of vision. With early detection and treatment, however, eyes can be protected against the serious loss of vision or blindness. Catching glaucoma at an early, treatable stage is one important reason to have thorough eye examinations regularly. Risk Factors For Glaucoma There are several factors that increase the risk of developing glaucoma, including: Being over 60 Being of particular descent, such as African-American or Asian Having a family history of glaucoma Having elevated intraocular pressure Having poor vision or other eye disorders or injuries Having certain medical conditions, like diabetes Taking certain medications, such as corticosteroids for prolonged periods Patients with risk factors for the disorder should be especially vigilant about having regular eye examinations. Causes Of Glaucoma Certain diseases or conditions can contribute to the development of glaucoma. These include: Increased pressure within the eye Severe eye infection Injury to the eye Blocked blood vessels Inflammatory conditions of the eye Glaucoma is considered primary if its origin is unknown and secondary if it results from another medical condition. Types Of Glaucoma There are several types of glaucoma. The two major types are primary open-angle glaucoma, in which fluid drains too slowly from the drainage channels (trabecula) of the eye, and angle-closure (narrow-angle) glaucoma, which occurs when the trabecula become blocked. Approximately 95 percent of glaucoma patients suffer from primary open-angle glaucoma. Other types of glaucoma, which occur much more rarely, include: Low Tension Glaucoma Congenital Glaucoma Secondary Glaucoma Pigmentary Glaucoma Pseudoexfoliation Glaucoma Symptoms Of Glaucoma It is important to remember that patients with early stage glaucoma are most often asymptomatic. When symptoms occur, they vary depending on the type of glaucoma and can occur in one eye or both eyes. The symptoms of open-angle glaucoma include: Dim or blurred vision Gradual loss of peripheral vision Tunnel vision (at advanced stages) The symptoms of angle-closure glaucoma encompass systemic, as well as eye symptoms, including: Severe eye pain Nausea and vomiting Sudden visual disturbance Blurred vision Halos around lights Red eyes Headache Either type of glaucoma may be a primary or secondary disorder. Diagnosis Of Glaucoma The diagnosis of glaucoma is made after a comprehensive medical examination of the eye and a review of the patient’s medical history. Tests are conducted to confirm the diagnosis. Testing may include some of the following: Tonometry Dilated eye examination Visual field test (perimetry) Retinal evaluation Pachymetry Gonioscopy Visual acuity test Once glaucoma has been diagnosed, treatment should begin as soon as possible to help minimize the risk of permanent vision loss. Treatment Of Glaucoma There is no cure for glaucoma, so treatment focuses on relieving symptoms and preventing further damage. Some of the treatment methods for glaucoma are as follows: Medication Eye drops or oral medication may be used to either reduce fluid production in the front of the eye or to help drain excess fluid. Side effects of the medication may result in redness, stinging, irritation or blurred vision. Regular use of the medication is needed to keep the eye pressure under control. Laser Surgery Trabeculoplasty, iridotomy or cyclophotocoagulation are laser procedures that aim to increase the outflow of fluid from the eye or eliminate fluid blockages. Other Surgery A trabeculectomy may be used to create a new channel to drain fluid from the eye and reduce the pressure that causes glaucoma. Surgery is performed only after medication and laser procedures have been unsuccessful. While patients with early stage glaucoma may not experience any symptoms, prompt treatment is required to preserve their vision.

A cataract is a clouding of the lens of the eye; cataract surgery is performed to improve vision by replacing the clouded lens with an artificial one. Cataracts affect millions of people in the United States each year. Most cataracts are the result of aging, though some form as a result of genetic factors, disease or injury. Cataract surgery is common, and considered safe and effective. Reasons For Cataract Surgery Cataracts can cause blurry vision, and increase the glare from lights. In their early stages, cataracts usually are not troublesome but, as they thicken, surgery to remove them may be required. Typically, surgery is needed because cataracts are interfering with everyday activities, or the treatment of another eye problem. Candidates For Cataract Surgery Cataracts caused by aging develop gradually, and patients may not notice the early vision changes they cause. It is only when their cataracts start interfering with vision that patients may become aware of them. An ophthalmologic examination will detect cataracts, and rule out other causes for vision issues, such as glaucoma or macular degeneration. Patients who become aware of visual difficulties related to cataracts usually experience, especially at night, clouded, blurred or dim vision. Benefits Of Cataract Surgery Cataract surgery's benefits are many, greatly enhancing the quality of life. They include the following: Improved quality of vision (sharper images, brighter colors) Less difficulty with routine tasks (particularly night driving) Decreased dependency on eyeglasses Greater independence, regardless of age or disability Greater safety Research indicates that the improved vision provided by cataract surgery reduces the risk of falls, making exercise, sports and hobbies safer. This, combined with the improved ability to read, recognize faces, and perform everyday activities with greater ease, results in improved physical health, increased sociability and longer life expectancy. The Cataract Surgery Procedure After the pupil is dilated, and the area in and around the eye is numbed with anesthesia, a tiny incision is made to insert an ultrasonic probe. The probe emulsifies (breaks up) the cloudy lens into tiny pieces that are then suctioned out of the eye. Once the cloudy lens has been removed, an artificial lens is implanted. The new lens, known as an intraocular lens (IOL), is often inserted through the original incision. Some varieties of IOLs serve multiple purposes, such as blocking ultraviolet light or working as bifocals. Depending on the type of IOL used, sutures may or may not be needed. Surgery is usually performed on an outpatient basis in a doctor's office, takes only 20 to 30 minutes, and is relatively painless. A very high percentage of patients demonstrates improved vision after the procedure. Risks Of Cataract Surgery Although cataract surgery is a common procedure and considered quite safe, any surgery poses risks. In the case of cataract surgery, there is a slightly increased risk of retinal detachment, a painless but dangerous condition. Other risks of cataract surgery include bleeding and infection. The risk of complications after cataract surgery is greater if the patient has another eye disease or serious medical condition. Danger signs of complications after cataract surgery include increased pain in or redness of the eye, light flashes or floaters, diminished vision, nausea, vomiting or intense coughing. Recovery From Cataract Surgery Immediately after surgery, an eye patch is worn; some doctors advise wearing a protective shield, even when sleeping, for several days. Vision may be blurry at first, but improves within a few days. Some itching and discomfort are also present for a few days, but it is important that a patient not rub or exert pressure on the treated eye. Heavy lifting should be avoided. Eye drops to prevent inflammation and infection, and control eye pressure are prescribed. Even though full healing can take up to 2 months, because cataract surgery is performed on one eye at a time, daily activities can be resumed in a few days. Most patients need to wear eyeglasses, for at least some tasks, after surgery. If the other eye also has a cataract, which is usually the case, the second surgery is scheduled a month or two after the first.