The most frequently asked questions I get about diseases and conditions of the eye concern cataract surgery and glaucoma. The 1990s have brought a unique and dynamic change in cataract extraction. The use of topical anesthesia (using drops to totally anesthetize an eye), instead of an injection behind the eye, makes for a safer procedure that is painless and allows for an almost instantaneous visual recovery.
Regarding the surgery itself, it has progressed from a large incision with stitches to a micro incision of less than 3mm that has no stitches. The technique for removing the cataract is called phacoemulsification or “phaco.”
In this state-of-the-art process, a delicate surgical instrument is inserted through a microscopic incision in the eye. It generates ultrasonic (sound) waves that gently break up the cataract into small pieces. The cataract is then suctioned out through the microscopic opening. An intraocular lens is permanently inserted to give the patient excellent vision again.
Why does no-stitch microincisional cataract surgery make such a big difference?
1) Quick recovery—Most patients say they see well in 1-2 days after surgery.
2) Few restrictions—You can return to most activities the next day after surgery—drive, bend, wash your hair, do housework and even go to work.
Thus fulfilling the goal of an eye surgeon—helping patients to see their best to improve their quality of life.
The second big area in ophthalmology is the diagnosis and treatment of glaucoma. Glaucoma is a leading cause of blindness in the United States. But loss of sight is usually preventable if you get treatment early enough. Glaucoma is a disease of the optic nerve (which carries the images we see to the brain). The higher the pressure inside the eye, the greater the chance of damage to the optic nerve. Glaucoma is most prevalent in people over the age of 40 and is usually symptomless, a “silent” disease that can cause irreparable damage before it is discovered.
How is glaucoma diagnosed?
Prevention involves early detection through a comprehensive eye examination, especially after the age of 40. In addition, visual fields are performed to detect blind spots or shrinkage of the peripheral field of vision as well as a picture of the nerve analyzing any early deterioration.
A new test, pachymetry, quickly and painlessly measures corneal thickness that helps more accurately to determine the real intraocular pressure.
How is glaucoma treated?
Damage to the optic nerve cannot be reversed. The goal of glaucoma treatment is to prevent further damage and preserve the highest possible level of vision. The first line of defense is drops to lower the pressure, medication usually must continue for life to effectively reduce eye pressure and preserve vision.
In addition, laser treatments done in an office setting have been equally effective in lowering pressure. If these are not sufficient, then surgery is recommended to effectively lower eye pressure.
Treatment of glaucoma requires teamwork between you and your doctor. Your ophthalmologist can prescribe treatment, but only the patient can make sure they take their eye drops. These are new and exciting developments occurring in the field of ophthalmology making great promise for the future of clear vision and its preservation.
For additional information, visit Dr. Edward A. Gluck, P.C., at 157-02 Cross Bay Boulevard, Howard Beach. Telephone: 718-843-1489.