Cataract

What is cataract?

 

 cataract is a clouding of the normally clear lens of your eye. For people who have cataracts, seeing through cloudy lenses is a bit like looking through a frosty or fogged-up window.
Clouded vision caused by cataracts can make it more difficult to read, drive a car (especially at night) or see the expression on a friend's face.
Most cataracts develop slowly and don't disturb your eyesight early on. But with time, cataracts will eventually interfere with your vision.
At first, stronger lighting and eyeglasses can help you deal with cataracts. But if impaired vision interferes with your usual activities, you might need cataract surgery. Fortunately, cataract surgery is generally a safe, effective procedure.

Diagnosis

Both ophthalmologists and optometrists may detect and monitor cataract growth and prescribe prescription lenses for visual deficits. However, only an ophthalmologist can perform cataract extraction.

Cataracts are easily diagnosed from the reporting of symptoms, a visual acuity exam using an eye chart, and by examination of the eye itself. Shining a penlight into the pupil may reveal opacities or a color change of the lens even before visual symptoms have developed. An instrument called a slit lamp is basically a large microscope. This lets the doctor examine the front of the eye and the lens. The slit lamp helps the doctor determine the location of the cataract.

Some other diagnostic tests may be used to determine if cataracts are present or how well the patient may potentially see after surgery. These include a glare test, potential vision test, and contrast sensitivity test.

Causes and symptoms

Recent studies have been conducted to try to determine whether diet or the use of vitamins might have an effect on the formation of cataracts in older people. The results have been mixed, with some studies finding a connection and other studies finding none. Much interest has been focused on the use of antioxidant supplements as a protection against cataracts. Antioxidant vitamins such as vitamins A, C, E and beta-carotene help the body clean-up oxygen-free radicals. Some vitamins are marketed specifically for the eyes. Patients should speak to their doctors about the use of such vitamins.

Smoking and alcohol intake have been implicated in cataract formation. Some studies have determined that a diet high in fat will increase the likelihood of cataract formation, while an increase in foods rich in antioxidants will reduce the incidence. More research is needed to determine if diet, smoking, alcohol consumption, or vitamins have any connection to the formation of cataracts.

There are several common symptoms of cataracts:

• gradual, painless onset of blurry, filmy, or fuzzy vision
• poor central vision
• frequent changes in eyeglass prescription
• changes in color vision
• increased glare from lights, especially oncoming headlights when driving at night
• "second sight" improvement in near vision (no longer needing reading glasses), but a decrease in distance vision
• poor vision in sunlight
• presence of a milky whiteness in the pupil as the cataract progresses.

Treatment

For cataracts that cause no symptoms or only minor visual changes, no treatment may be necessary. Continued monitoring and assessment of the cataract is needed by an ophthalmologist or optometrist at scheduled office visits. Increased strength in prescription eyeglasses or contact lenses may be helpful. This may be all that is required if the cataract does not reduce the patient's quality of life.

Cataract surgery—the only option for patients whose cataracts interfere with vision to the extent of affecting their daily lives—is the most frequently performed surgery in the United States. It generally improves vision in over 90% of patients. Some people have heard that a cataract should be "ripe" before being removed. A cataract is considered ripe or mature when the lens is completely opaque. Most cataracts are removed before they reach this stage. Sometimes cataracts need to be removed so that the doctor can examine the back of the eye more carefully. This is important in patients with diseases that may affect the eye. If cataracts are present in both eyes, only one eye at a time should be operated on. Healing occurs in the first eye before the second cataract is removed, sometimes as early as the following week. A final eyeglass prescription is usually given about four to six weeks after surgery. Patients will still need reading glasses. The overall health of the patient needs to be considered in making the decision to operate. However, age alone need not preclude effective surgical treatment of cataracts. People in their nineties can have successful return of vision after cataract surgery.

Surgery to remove cataracts is generally an outpatient procedure. A local anesthetic is used and the procedure lasts about one hour. Removal of the cloudy lens can be done by several different procedures. The three types of cataract surgery available are:

• Extracapsular cataract extraction. This type of cataract extraction is the most common. The lens and the front portion of the capsule are removed. The back part of the capsule remains, providing strength to the eye.
• Intracapsular cataract extraction. The lens and the entire capsule are removed. This method carries an increased risk for detachment of the retina and swelling after surgery. It is rarely used.
• Phacoemulsification. This type of extracapsular extraction needs a very small incision, resulting in faster healing. Ultrasonic vibration is applied to the lens to break it up into very small pieces which are then aspirated out of the eye with suction by the ophthalmologist. A new liquid technique that its inventor says may one day replace ultrasound has been invented, but has not yet been proven in clinical trials.

A replacement lens is usually inserted at the time of the surgery. A plastic artificial lens called an intraocular lens (IOL) is placed in the remaining posterior lens capsule of the eye. When the intracapsular extraction method is used, an IOL may be clipped onto the iris. Contact lenses and cataract glasses (aphakic lenses) are prescribed if an IOL was not inserted. A folding IOL is used when phacoemulsification is performed to accommodate the small incision.

Antibiotic drops to prevent infection and steroids to reduce inflammation are prescribed after surgery. An eye shield or glasses during the day will protect the eye from injury while it heals. During the night, an eye shield is worn. The patient returns to the doctor the day after surgery for assessment, with several follow-up visits over the next two months to monitor the healing process.

Glaukoma

What Is Glaucoma?

Glaucoma is a group of eye diseases causing optic nerve damage. The optic nerve carries images from the retina, which is the specialized light sensing tissue, to the brain so we can see. In glaucoma, eye pressure plays a role in damaging the delicate nerve fibers of the optic nerve. When a significant number of nerve fibers are damaged, blind spots develop in the field of vision. Once nerve damage and visual loss occur, it is permanent. Most people don't notice these blind areas until much of the optic nerve damage has already occurred. If the entire nerve is destroyed, blindness results. Glaucoma is a leading cause of blindness in the world, especially in older people. Early detection and treatment by your ophthalmologist are the keys to preventing optic nerve damage and vision loss from glaucoma.

What are the Different Types of Glaucoma?

1.Open-angle glaucoma

Chronic open-angle glaucoma is the most common form of glaucoma. The "open" drainage angle of the eye can become blocked leading to gradual increased eye pressure. If this increased pressure results in optic nerve damage, it is known as chronic open-angle glaucoma. The optic nerve damage and vision loss usually occurs so gradually and painlessly that you are not aware of trouble until the optic nerve is already badly damaged.

2.Nail-Patella syndrome

Nail-patella syndrome(NPS) is a rare genetic disorder (estimated to occur in one in 50,000 newborns) that causes abnormalities of bone, joints, fingernails, kidneys,glaucoma.

3. Angle-closure glaucoma

Angle-closure glaucoma results when the drainage angle of the eye narrows and becomes completely blocked. In the eye, the iris may close off the drainage angle and cause a dangerously high eye pressure. When the drainage angle of the eye suddenly becomes completely blocked, pressure builds up rapidly, and this is called acute angle-closure glaucoma. The symptoms include severe eye pain, blurred vision, headache, rainbow haloes around lights, nausea and vomiting. Unless an ophthalmologist treats acute angle-closure glaucoma quickly, blindness can result. When the drainage angle of the eye gradually becomes completely blocked, pressure builds up gradually, and this is called chronic angle-closure glaucoma. This form of glaucoma occurs more frequently in people of African and Asian ancestry, and in certain eye conditions.

Other Types of Glaucoma

Not all types of glaucoma are characterized by eye pressures. In normal-tension or low-tension glaucoma, the optic nerve suffers damage with the resulting visual field loss even though normal eye pressures are maintained. Eyes afflicted with this condition are far more susceptible to optic nerve damage with any increase in the intraocular pressure compared to other eyes.

1.Pigmentary glaucoma

Pigmentary glaucoma is a condition that typically affects young, nearsighted, Caucasian males. This condition is characterized by the iris bowing backwards, and coming into contact with the support structures that hold the lens in place. This position disrupts the cells lining the back surface of the iris containing pigment, and results in a release of pigment particles into the drainage system of the eye. This pigment can clog the drain and can lead to an increase in eye pressure. This form of glaucoma responds well to laser treatment.

Other types of glaucoma may be caused by injuries to the eye, tumors, and other eye diseases. A rare type of glaucoma can even be present in children at birth.

2. Exfoliation syndrome

Exfoliation syndrome is a common form of open-angle glaucoma that results when there is a buildup of abnormal, whiteish material on the lensand drainage angle of the eye. This material and pigment from the back of the iris can clog the drainage system of the eye, causing increased eye pressure. This form of glaucoma responds well to laser treatment.

Who is at Risk for Glaucoma?

High eye pressure alone does not mean that you have glaucoma, but it is an important risk factor your ophthalmologist will use to determine your risk for developing the disease.

The most important risk factors include:

• age
• elevated eye pressure
• African ancestry
• thin cornea
• family history of glaucoma
• nearsightedness
• past injuries to the eyes
• steroid use
• a history of severe anemia or shock

What are the Warning Signs

Unfortunately, most cases of glaucoma do not occur with readily noticable symptoms that warn of the irreversible optic nerve damage being done. However, the presence of the following warning signs, indicates that you need a thorough examination by an eye doctor:

• Unusual trouble adjusting to dark rooms
• Difficulty focusing on near or distant objects
• Squinting or blinking due to unusual sensitivity to light or glare
• Change in color of iris
• Red-rimmed, encrusted or swollen lids
• Recurrent pain in or around eyes
• Double vision
• Dark spot at the center of viewing
• Lines and edges appear distorted or wavy
• Excess tearing or "watery eyes"
• Dry eyes with itching or burning; and
• Seeing spots, ghost-like images

The following may be indications of potentially serious problems that might require emergency medical attention:

• Sudden loss of vision in one eye
• Sudden hazy or blurred vision
• Flashes of light or black spots
• Halos or rainbows around light

Treatment

The treatment for glaucoma depends upon the nature and severity of each case. In general, glaucoma cannot be cured, but it can be controlled. Eye drops, pills, laser procedures, and surgical operations are used to prevent or slow further damage from occurring. With any type of glaucoma, regular eye examinations are very important to detect progression and to prevent vision loss. Because glaucoma can worsen without your being aware of it, your treatment will likely need to be changed over time to achieve a lower "target eye pressure."

Laser Surgery

Laser surgery is also effective for glaucoma treatment. Trabeculoplasty is laser treatment to enhance the eye drain age function to control eye pressure within the eye when treating open-angle glaucoma. Iridotomy is laser treatment to create tiny holes in the iris to improve the flow of eye fluid to the drain when treating narrow angle glaucoma.

Medicines

Glaucoma is often treated with eye drops taken regularly several times a day, sometimes in combination with pills. These medications will alter the circulation of eye fluid and lower eye pressure, either by decreasing the production of fluid within the eye, or by increasing the flow leaving the drainage angle. It is important to tell all of your doctors about the eye medications you are using because glaucoma medications can have side-effects. You should notify your ophthalmologist immediately if you think you may be experiencing side-effects. Side-effects from some eye drops may include a stinging sensation, red eyes, blurred vision, headaches, or changes in pulse, heartbeat or breathing. Side-effects from pills may include tingling of fingers and toes, drowsiness, loss of appetite, bowel irregularities, kidney stones, anemia or bleeding disorders.

Baby acne

Baby acne is acne that develops on a newborn's skin. Baby acne can occur anywhere on the face, but usually appears on the cheeks, nose and forehead. Baby acne is common — and temporary. There's little you can do to prevent baby acne. The best treatment for baby acne is usually none at all.

Baby acne is a harmless skin condition seen on infants from birth to 7 months old. Doctors suspect that as a mother's hormones begin functioning in a baby's body, it causes the oil glands to clog and the acne to appear.Boys are said to be more susceptible to baby acne than girls.These reddish or white bumps, called milia, can appear at birth, but most commonly appear some time within the first 4 weeks after birth. Although it is harmless and usually clears up after a few weeks or months, many parents want to know how to treat baby acne because of the reddish, blotchy appearance it gives to their baby's skin.

How to get rid of acne

Acne is a skin condition that occurs when your hair follicles become plugged with oil and dead skin cells. Acne most commonly appears on your face, neck, chest, back and shoulders. Acne can be distressing and annoyingly persistent. Acne lesions heal slowly, and when one begins to resolve, others seem to crop up.

Depending on its severity, acne can cause emotional distress and lead to scarring of the skin. The good news is that effective treatments are available — and the earlier treatment is started, the lower your risk of lasting physical and emotional damage.

Your skin is your largest organ, and it does a lot more than simply prevent you from spilling out all over the place. Skin cells are constantly replacing themselves, making a journey from the inner edge of your epidermis (your skin's outermost layer) to the outside of your skin. As a skin cell ages and approaches the skin's surface, the dying cell flattens out. Once on the surface, it joins countless other dead skin cells and forms a protective layer that helps protect you from bacteria and viruses.

While acne usually affects teenagers and 20somethings the most, anyone of any age can get acne, even babies. Our instinctual response -- picking at it, rubbing it and canceling our social engagements -- doesn't help in the least, but fortunately, there are some treatments available that can.

Inside your hair follicles, there are small glands producing oil called sebum. This oil mixes with skin cells in the follicle and joins them on the journey outward. But when there's too much sebum, too many dead skin cells or something on the surface that blocks their exit from the follicle, a blockage can occur. Bacteria joins the party, and the result is acne vulgaris, the most common form of acne.

1.The wonders of garlic
Garlic is thought to be a good natural remedy for acne because of its supposed antibacterial properties. You can either ingest it, or apply it topically to help reduce the severity of your breakouts and prevent them in the future. If you can get the juice from the garlic, great, if you can’t, mashing it up and putting it in some water is fine. Never, ever, ever, apply garlic to your skin without diluting it first. If you’re hesitant about the garlic smell, look at the silver lining-others may be a bit taken aback, but you won’t have to worry about Dracula creeping around either.

2. Apply some apple cider vinegar

Apple cider vinegar is a powerhouse when it comes to acting as an acne remedy. Why? It kills off the bacteria that may be causing all the trouble in the first place. It also becomes alkaline, and balances the pH of your skin, which in turn makes it harder for bacteria to thrive. To top it off it’s an astringent, like lemon juice, and will help dry up excess oil. Keeping that in mind, don’t overdo and dry out your skin too much. This could cause the sebaceous glands overproduce to compensate, therefore triggering an outbreak.

3.Make a cinnamon and honey mask
Honey is sticky, and cinnamon is spicy, and it seems like they’re both things you’d want to avoid getting near your skin. Surprisingly, while it may sound strange, honey and cinnamon make a (literally) killer combo when it comes to acne. Cinnamon has antimicrobial properties, so it can help stop bacteria from getting out of hand. If it does, the honey is a natural anti-biotic, ready and waiting to wipe the little buggers out.

4.Whip up some 'whites'
Egg whites are an easy and affordable way to help reduce acne and fade scars left by unfortunate blemishes. The reason people have found egg whites to be helpful for their skin is because they’re chock full of proteins and vitamins that both combat acne, and help to rebuild your skin cells. They also soak up excess oil, which means excess sebum, (exactly what you were thinking right?) which means less stuff for bacteria to feed on. Hooray! Just make sure to use a good moisturizer afterwards, as they can dry your skin out a bit.

5.The land of milk and honey (or yogurt)
While there is quite a bit of hub bub around dairy products causing acne, applied topically it seems that milk can improve your outbreaks and skin tone. The reason it is suggested that milk would cause acne is because of the extra hormones in it-but unless it’s ingested, this doesn’t really do much. For the most part, it just soothes the irritated skin, and helps tone down the redness. Cleopatra swore on the milk baths she took, and well, she was Cleopatra. You could also use yogurt. The acids in it are antibacterial while the fat provides moisture, making it quite nourishing for skin.

6. Make an orange peel paste
Oranges. They taste rejuvenating and refreshing, and our skin may find them just as appealing as our taste buds do. Acne that is caused by bacteria and extra oil/dead skin cells clogging up pores may improve with the use of an orange peel face mask of sorts, thanks to the vitamin C, citric acid, and it’s astringent properties. The vitamin C is particularly helpful because it promotes the growth of new healthy cells, keeping your skin in better condition overall.

7.Mix strawberries and honey
Honey and strawberries make a home remedy for acne that sounds pretty sweet (pun intended) and it combines two things that are used commonly in pricey, often time’s harsh, facial scrubs and cleansers. Strawberries may seem random, but consider the fact that they’re high in salicylic acid. Salicylic acid-a primary ingredient in many commercial acne treatments- encourages the epidermis to shed its cells more readily, opening up clogged pores, and neutralizing bacteria. It also shrinks up the pores a little bit, which prevents them from clogging up as much in the future, and encourages new cell growth. Honey also works against bacteria that may be behind your acne, and is an anti-inflammatory.

8.Utilize a banana peel
Bananas are full of all sorts of goodness-even the part we don’t eat. Their peels contain something called lutein, an extremely powerful antioxidant that reduces swelling and inflammation, and encourages healthy cell growth. So…rubbing a banana peel on your face can reduce the redness, obviousness, and discomfort of acne.

9.Dab some lemon juice on it
Lemon juice can help get rid of breakouts for a number of reasons. It is rich in vitamin C, which is good for all types of skin, and it’s a citric acid, so it helps ‘exfoliate’ the skin as well. Most importantly though, it is an astringent. An astringent will cause a contraction of body tissues, and will therefore dry out the blemish itself. It is also a natural skin whitener, which helps reduce redness. If you misplace a dab you may get a little white spot, but don’t panic- it will go away on its own accord. Rinse off any lemon juice before going out in the sun, as it may make you more sensitive to it.

10.Wash your pillowcase
Technically, a pillowcase should be washed at the very least once a week. While most of us don’t practice this, when it comes to keeping your skin fresh and healthy, it might help to get a little picky about your pillowcase. If you never wash it, all the stuff that gets rubbed onto it then comes in contact with your face for around 6-8 hours every night, and can exacerbate your acne. Keeping a clean, comfy place to rest your weary head is worth the hassle of stuffing your pillow back into its case-the real reason we avoid washing it-if it could prevent future breakouts.