A cataract is a clouding of the lens in the eye that affects your vision with most cataracts being related to aging and more in older people. The vision may get duller or blurrier, because clusters of protein reduce the sharpness of the image reaching the retina. This protein causes the clear lens to slowly change, adding a brownish/yellowish tint to your vision.
A cataract can occur in either or both eyes.
Types of cataracts
- Sub-capsular cataract: This occurs at the back of the lens. People with diabetes or those taking high doses of steroid medications have a greater risk of developing a subcapsular cataract.
- Nuclear cataract: This forms deep in the central zone (nucleus) of the lens and are usually associated with aging.
- Cortical cataract: This is characterised by white, wedge-like opacities that start in the periphery of the lens and work their way to the centre in a spoke-like formation. This type of cataract occurs in the lens cortex, which is the part of the lens that surrounds the central nucleus.
If you are undergoing surgery to remove the cataract there two main types of surgeries available, your consultant will talk you through your options and this will include:
- Phacoemulsification (or Phaco): A small incision is made on the side of the cornea. Your doctor inserts a tiny probe into the eye and the device emits ultrasound waves that soften and break up the lens so that it can be removed by suction. Most cataract surgery today is done by phacoemulsification, this type of surgery can also be called 'small incision' cataract surgery.
- Extracapsular surgery: A longer incision is made on the side of the cornea and removes the cloudy core of the lens in one piece, the remaining parts of the lens are then removed by suction.
After the natural lens has been removed, it is replaced by an artificial lens, called an intraocular lens (IOL). An IOL is a clear, plastic lens that requires no care and becomes a permanent part of your eye. Light is focused clearly by the IOL onto the retina, improving your vision.
Age-related macular degeneration, also referred to as AMD or ARMD, is the leading cause of vision loss and blindness over the age of 60.
Macular degeneration is diagnosed as either dry (non-neovascular) or wet (neovascular).
Dry AMD is an early stage of the disease and may result from the aging and thinning of macular tissues, depositing of pigment in the macula or a combination of the two processes. Dry macular degeneration is diagnosed when yellowish spots known as drusen begin to accumulate in and around the macula. It is believed these spots are deposits or debris from deteriorating tissue. Gradual central vision loss may occur with dry macular degeneration but this is usually not as severe as wet AMD symptoms.
Wet AMD with this type new blood vessels grow beneath the retina leaking blood and fluid. This leakage causes permanent damage to the light-sensitive retinal cells, which die off and create blind spots in central vision.
Choroidal neovascularization (CNV) is the underlying process causing wet AMD and abnormal blood vessel growth. It falls into two categories:
- Occult:New blood vessel growth beneath the retina is not as pronounced, and leakage is less evident in the occult CNV form of wet macular degeneration, which typically produces less severe vision loss.
- Classic: When blood vessel growth and scarring have very clear, delineated outlines observed beneath the retina, this type of wet AMD is known as classic CNV, usually producing more severe vision loss.
Glaucoma refers to a group of eye disorders that all cause damage to the optic nerve, which carries information from the eye to the brain.
In most cases, glaucoma is associated with higher-than-normal pressure inside the eye — a condition called ocular hypertension. However Glaucoma usually has few or no initial symptoms. It can also occur when intra ocular pressure (IOP) is normal. If left untreated or uncontrolled, glaucoma first causes peripheral vision loss and eventually can lead to blindness.
Types of Glaucoma
The two major categories of glaucoma are open-angle glaucoma (OAG) and narrow angle glaucoma. The "angle" in both cases refers to the drainage angle inside the eye that controls the outflow of the watery fluid (aqueous) that is continually being produced inside the eye.
Other methods of monitoring glaucoma involve the use of sophisticated imaging technology — such as Scanning Laser Polarimetry (SLP), Optical Coherence Tomography (OCT) and Confocal Scanning Laser Ophthalmoscopy, Visual Field Test and Gonioscopy.
Treatment for Glaucoma
Depending on the type of glaucoma you have, there are different treatment options.
Non-surgical options include the use of topical eye medications (glaucoma eye drops) or oral medications (pills). A laser procedure known as selective laser trabeculoplasty (SLT) may be equally as effective as glaucoma eye drops for lowering internal eye pressure.
A laser procedure known as selective laser trabeculoplasty (SLT) may be equally as effective as glaucoma eye drops for lowering internal eye pressure.
Another procedure called a trabeculectomy creates an artificial drainage area. This method is used in cases of advanced glaucoma where optic nerve damage has occurred and the IOP continues to soar.
Ocular oncology covers the management of all tumours involving the eye, eyelid, orbit and lacrimal glands. Ocular tumours affect adults and children, and tumours may occur in one eye or may involve both eyes. Eye cancer can affect all parts of the eye.
Types of Ocular Oncology
- Choroidal melanoma
- Choroidal hemangioma
- Eyelid tumour
- Conjunctival tumour
Treatment for Eye Cancer
Depending on the type of cancer and location your treatment options may include:
- External beam radiation
- Radiation plaque therapy (also called brachytherapy)
- Surgical excision of the tumours
Oculoplastics physicians or tumour surgeons offer reconstructive surgery and prosthetic devices, tailored to each individual patient's case. Eyelid and orbital tumours are more likely to be managed within oculoplastic or orbital specialist services.
Vision correction surgery is also know as refractive and laser eye surgery. It is any surgical procedure used to correct vision problems such as, near-sightedness (myopia), farsightedness (hyperopia), astigmatism or presbyopia.
Refractive surgery encompasses a variety of techniques, in which a laser is typically used to remove tissue from the cornea to re-shape its surface, thereby correcting refractive errors and allowing reduced dependence from the use of spectacles and contact lenses.
Although there are several types of surgical techniques to correct refractive errors, laser refractive correction has become the most common approach, as the use of the laser allows for a great degree of precision and predictability in terms of the outcome for the patient.
The procedure is usually painless and the improvement in vision is noticeable almost immediately. In most cases, the patient can quickly return to their daily activities.