Eyepedia

All you may want to know about sight – a reliable source of information. Please see the dictionary below:

The best nutrition for healthy eyes.
How to maintain healthy vision for many years?
How is the eye built?
A complete Ophthalmological Dictionary.

Tests

Cataract – surgeries and treatment in Warsaw

Also, a cloudy lens is removed and replaced with an artificial one.

CATARACT? NOT A PROBLEM FOR US!

Will cataract really happen to everyone? Yes, if you live long enough. Cataract, i.e. opacification of the lens, used to be the cause of blindness in the majority of elderly people. And now? Well, in the Retina Ophthalmological Clinic we deal with it in 15 minutes!

Initially your vision starts deteriorating and constant cleaning of glasses doesn’t help. Then on a sunny day you get an impression as if lightinings struck in front of your eyes. You see much better when the sun disappears behind clouds. Finally your eyesight deteriorates so much it’s difficult to do your daily tasks. What’s going on? Probably you suffer from cataract.

IT’S NATURAL

Cataract can’t be prevented with healthy lifestyle, a special diet or some eyedrops. It’s a natural symptom of getting older, such as wrinkles or grey hair. A course of the disease varies from patient to patient – sometimes it develops within several months, sometimes it takes years. The result is always the same: the deterioration of vision in the affected eye. It can appear simultaneously in both lenses. In 90% of cases cataract is a result of the aging of a body so it rarely starts before the age of 60 (and most commonly around the age of 80). Why do some people get cataract earlier than others? Different parts of a body age with a different speed.

WHAT TO DO WITH THIS?

Cataract is a progressive opacification of the lens. It can be treated by replacing the natural lens with an artificial one. It used to be believed that the opacification needs to be full in order for a surgery to be conducted. Now procedures are done in all stages of cataract
– the earlier the better, when the problem becomes disruptive in everyday life. This procedure is simple, effective and rarely results in complications.

DON’T BE SCARED

The cataract surgery can be provided to outpatients with a local anaesthetic. In our clinic it takes about a quarter of an hour. After a short rest the patient can go back home accompanied by someone. If cataract has affected both eyes, initially one eye is treated. The second one is operated several days later. The patient will see as well as before cataract and sometimes even better. How is it possible? It’s because the recent hit is a pseudo-accommodative lens replacing the natural cloudy one. When such lenses are implanted glasses become redundant as the patient sees from a short and a long distance equally well. We need to mention, however, that pseudo-accommodative lenses don’t provide good vision inbetween – for example while working on a computer.

HOW DOES THE CATARACT SURGERY LOOKS LIKE?
  • Before the cataract removal procedure an ophthalmic surgeon locally anaesthetizes the eye. The patient is fully conscious during the procedure.
  • The surgeon makes a 2 mm cut in the cornea and divides the cloudy lens into smaller parts to remove them from the eye, using a procedure called phacoemulsification (the device used in this procedure can be compared to a vacuum cleaner which simultaneously grinds down and sucks out parts of the lens). The aim of this treatment is to remove the content, i.e. the cloudy lens, while retaining its packaging – the capsule.
  • A new synthetic rolled up lens is being implanted in the empty capsule and uncurled inside. Now a new content is placed in the old packaging.
  • All done! The new lens is equipped with a yellow filter which protects the retina from the harmful influence of UV rays./li>
WHAT NEXT?

The next day after the procedure a doctor removes the dressing. The patient can move normally, shake his or her head or bend down without a fear that the lens would fall out. But just in case for 2-3 weeks he or she should avoid a significant physical effort. After the treatment the eye can’t be touched or get wet to prevent infection.
Next appointments are arranged in 3 and 6 weeks time – during the second one glasses may be fitted, if necessary.

HOW DO CATARACT TREATMENTS DONE IN OUR CLINIC DIFFER FROM THOSE DONE ELSEWHERE?

In our Clinic we implant lenses of the highest quality at no additional cost. They are customized to the needs of a particular eye:

  • Special lenses facilitating laser therapy for patients with lattice degeneration and diabetes.
  • Special lenses with additional UV filters in cases of age-related macular degeneration and retinal or choroidal nevi.

The procedure lasts approximately a quarter of an hour.
Attention! The cataract removal procedure is not the only eye surgery we do in the Retina Ophthalmological Clinic. We also perform retinal surgeries, we treat surgically AMD, i.e. age-related macular deterioration, we provide anti-glaucoma treatments and even plastic surgery procedures on eyelids and skin changes in the eye area.

CURIOSITIES

Do you know that:

  • Cataract surgeries are the most common ophthalmic procedures performed around the world.
  • Cataract is the most common cause of blindness! 20 million people are blind due to cataract, which is a half of all blind people in the world. These are people who did not subject themselves to a cataract removal surgery.
  • The first cataract removal surgery was performed around 3000 years ago in India by a nomadic doctor Susruta. He used a knife topped with a little ball. He pushed a cloudy lens inside. It stayed on the retina for the rest of the patient’s life. Most people had an improved vision for a couple of days but then their eyes were getting infected and they were losing sight altogether.
  • It wasn’t until the 18th century, when a French physician, Jacques Daviel, performed the first successful cataract surgery. He developed his technique after a request from a young painter who lost his sight due to cataract. The technique involved cutting through the cornea, cutting off ciliary zonules that held the lens and removing the lens altogether. Daviel performed over 400 procedures – only 50 od them were unsuccessful. After the surgery his patients wore thick glasses which replaced the removed lens.
  • The first artificial lens was implanted in 1952. We owe the discovery of a material suitable for manufacturing artificial lenses to an English physician, Harold Ridley. He observed a lack of inflammatory reactions in an eye of a pilot who ended up with chips of acrylic glass in his eyeball after the Battle of Britain.

Glaucoma – anti-glaucoma surgeries, treatment

WHAT IS GLAUCOMA?

We explained it here.

WHAT DOES THE DECISION ABOUT THE TYPE OF TREATMENT OF GLAUCOMA DEPEND ON?

On the stage of the disease and its character. If the disease is not yet advanced we start from a pharmacological treatment. In more advanced stages an anti-glaucoma surgery is required.

WHEN IS IT WORTH TO THINK ABOUT AN ANTI-GLAUCOMA SURGERY?

Such decision should be taken when eyes react badly to a pharmacological treatment or in cases when a treatment with eyedrops is impossible for some reason. If necessary, a planned cataract surgery (phacoemulsification) can be combined with a glaucoma treatment.

WHAT DO ANTI-GLAUCOMA SURGERIES AND TREATMENTS ENTAIL?

There are several types of them. An ophthalmic surgeon will choose the most appropriate one.
Trabeculectomy: a surgery aimed at creating an artificial fistula through which aqueous humour can escape from the anterior chamber of the eyeball. This surgery is very effective but unfortunately involves a risk of complications, including cataract – that’s why cataract is often operated together with glaucoma.
Trabulectomy with an ExPress draining implant: an improved version of trabulectomy. During this procedure a surgeon, using a very thin needle, places a microscopic implant made of stainless steel in a patient’s eye. Unfortunately, due to the use of a very precise implant, the cost of this procedure is higher than in case of traditional trabulectomy.
Canaloplasty: the newest, non-invasive method of treating glaucoma. During this procedure a surgeon clears existing tracts of passage of aqueous humour by reinforcing the canal with special prolene threads.
Laser iridectomy: a minimal opening in the iris is made using a very precise laser. This opening improves the exchange between the anterior and the posterior chambers of the eyeball. The surgery very often successfully stops the progress of glaucoma. We need to remember, however, that after such procedure the eye should be regularly assessed by a specialist – the opening is so tiny that it sometimes spontaneously heals and the surgery needs to be repeated.
Surgical iridectomy: very similar to laser iridectomy, as far as its course and results are concerned, but performed surgically. It is recommended to patients with contraindications for the laser procedure.
Cryotherapy of the ciliary body: applying low temperatures to the ciliary body (a part of the eye surrounding the retina). It is used in cases of advanced glaucoma when there is pain and very high intraocular pressure. If cryotherapy is repeated within 3-6 months, the pressure can be stabilized – the patient, however, needs to remain under doctor’s care.
Endoscopic cyclophotocoagulation: an incredibly modern method of reducing the production of aqueous humour. It consists of lasering ciliary processes which produce aqueous humour.

OCT test of both eyes

Fundus examination – fundus is in every body the only place where the condition of blood vessels can be assessed without opening any of the body cavities. Therefore, it is believed that the condition of the blood vessels in other organs is analogical to those from the fundus. All the vascular diseases such as hypertension, diabetes or arteriosclerosis evoke pathological changes in the eye’s blood vessels. It is assumed that the condition of the blood vessels in the whole body is analogical to the one in the eyes. Therefore, the stage of the general disease can be judged basing on the stage of the eye condition. Funduscopy is an examination for which the ophthalmologist needs to enlarge the pupil of the eye in order to assess the blood vessels’ condition on the largest possible area. The assessment of the blood vessels’ condition is being made for the needs of other specialists such as diabetologists, general physicians, cardiologists. For ophthalmologists from the Retina Ophthalmological Hospital who deal with posterior section of the eye diseases it is a very basic examination before planned retina surgeries, OCT macula lutea test, Avastin injection or other medication into the eye administration.

Funduscopy, examination of the retina, choroid and vitreous

Retina, choroid and vitreous tests are possible only after administering, often several times, drops dilating the pupil. Remember that after administering the drops, it will be more difficult for you to read because the droplets “turn off” the accommodation (the ability of the eye to see things from a distance and from close) and the sun will be hurting your eyes. Due to dilating the pupil the retina can be fully assessed from the beginning to the end i.e. up to the optic nerve. The vitreous can also be assessed and its relations with the retina. Dilatation also enables us to examine the layer under the retina, i.e. the choroid.

Removal of the foreign body from the cornea – essential when a foreign body thrusted into the cornea. The eye is anesthetized with drops, then the foreign body is removed and a dressing with neomycin ointment is put on.

Histopathological eye examination

Eye histopathological test is performed in case of doubts about the structures of the removed change. The whole or small portion of the change is preserved with a formalin solution and sent for the microscope examination.

Eye test

Although the eye is just the size of a ping pong ball, its internal structure is more complicated than the Swiss watch. Each eye structure is examined in a slightly different way, and the ophthalmologist selects a test method adapted to the problem. The test is carried out using biomicroscopes and magnifying lenses. Without pupil dilatation the outer half of the eyeball, professionally called the anterior section can be examined. Whereas, to examine the deeper half, drops should be administered in order to dilate the pupils. The test performed after pupil dilatation is called funduscopy.{ut1}In the process of examining fundus, blood vessel can be assessed. This test is also used in the assessment of the general condition in diseases like diabetes or hypertension. It is believed that the blood vessels condition is similar in the whole body.

Cornea test

Cornea is an external transparent lens with the eye’s highest optical strength (over 40 diopters). Its assessment is done before every eye surgery and especially before the cataract surgical removal. In the Retina Ophthalmological Hospital we perform the endothelial cells number test of the cornea. We measure the cornea’s thickness before every surgical procedure.

Eye diseases involving the cornea are characterized by high pain and severe tearing. In case of suspected corneal disease, the ophthalmologist uses fluorescein, a special yellow-orange substance for corneal coloration. If you suspect a dry eye, then after the coloration of the cornea the color does not persist on its surface only “bursts” leaving dry spots. In case of corneal inflammatory conditions or traumatic eye diseases, stained are the corneal lesions.

Measurement of the cornea thickness i.e. pachymetry is important in the treatment of glaucoma. Normal cornea is about 540 micrometers thick, about half a millimeter. In case of an augmentative cornea intraocular pressure measurement is understated and vice versa if the cornea is very thin the measurement is overestimated. Therefore, in order to determine the real pressure special tables are used to correct the cornea thickness.

Electrophysiology

The retina of the eye is a fiber of the brain that can turn the light into an electrical signal that reaches the brain through the optic nerve. Electrophysiology is a group of tests which allow to trace the electrical activity of both the retina and the optic nerve.

There are three types of electrophysiological tests:

  • Electroretinography that measures the electrical activity of the retina
  • Electrooculography measuring the effects of retinal pigmented epithelium and photoreceptors
  • visual-evoked potentials that reflect the power with which signals from the eye stimulate the visual cortex of the brain.

Electroretinography

The test consists in measuring the flow of electricity between the electrode placed on the cornea and the electrode placed on the forehead. The flow of electricity is shown in a graph called electroretinogram, resembling an ECG graph.

The retinal electrical function test is performed under conditions of adaptation of the eye to darkness and brightness. At the beginning the eye adapts to darkness for about 20 – 30 minutes. After this time the assessment is done. Then the eye is illuminated for about 10 minutes so that it adjusts to the light, and the measurements are made again. This allows to measure the function of photoreceptors responsible for vision in the dark, i.e. the rod cells and for vision in the light – the cone cells.

The visual evoked potentials The test is done in a sitting position. The patient looks at the monitor screen, where the checkerboard pattern shows. On it, with the right frequency, white fields turn black. This vibration of black and white fields stimulates the retina, which sends the signal to the brain. The device measures both the signal strength i.e. amplitude, as well as the time it takes for the stimulation to pass to the brain.

Gonioscopy

Gonioscopy – is an irideocorneal angle test. It is taken after desensitizing the eye with drops and putting on the eye a ganioscope or a Goldmann indirect goniolens, a small glass-like device containing several mirrors set at different angles. With this mirror setting, the angle of occlusion can be examined, its closure is one of the symptoms of glaucoma. In case of danger of closing the irideocorneal angle, treatment should be started in the ophthalmologist’s office or hospital. It consists of laser or surgical iridectomy.

OCT

OCT i.e. ophthalmological coherent tomography – is the most modern method of examining the retina.
Due to exceptional accuracy of 3 micrometers, it is possible to view and evaluate all layers of the retina as if we were looking at them under the microscope.
The test evaluates the most important part of the retina – the macula lutea.
Macula lutea allows us to see details, colors as well as to read and to write.
If the macula lutea is damaged the patient can see only the outline of objects, can walk around but does not recognize faces or bus numbers.
The most common macula lutea disease is age-related degeneration also called AMD.
Research results show that in developed countries about 30% of population above 70 years of age suffers from the age-related macular degeneration (AMD).
In the Retina Ophthalmological Hospital since 2008 we have been treating the macula lutea diseases with injections administered into the eye. One of them is Avastin injection.

Vitrectomy

Vitrectomy is a surgical procedure of removing the vitreous that is the gel filling the inside of the eye.
It is being performed in case of the blood effusion into the vitreous, retinal detachment, macular holes or preretinal membranes. The silicone oil, gas or fluid replaces the removed vitreous.

Dictionary

Accommodation

Accommodation is not an eye disease. It’s the ability to see objects from close and from far. When ageing we lose accommodation which means that we need glasses for reading or using the computer. Every few years the accommodation worsens which requires glasses adjustment. It is believed that people at the age of 65 and more do not have the accommodation and therefore a person this age without vision defect needs glasses of +3.5 diopters for reading.

Autofluorescence

WHAT IS AUTOFLUORESCENCE (FAF)?

It’s the most modern technique of examining the retina and more precisely speaking, it is an observation of changes on one of the retina layers – on the retinal pigment epithelium (RPE). Retinal pigment epithelium (RPE) can be compared to one, big chemical factory which goal is to dispose substances used in the process of vision. When aging the epithelial capacity is weakened and the unreleased substances are deposited in the form of lipofuscin. The test allows detection of the lipofuscin accretion inside the retinal cells. It can also detect the lack of lipofuscin which will be a sign of photoreceptors deficiency. If the test is repeated cyclically – it gives the ability to control the effectiveness of the treatment.

INDICATIONS

With the use of autofluorescence (FAF) the following conditions can be detected:

  • Age-related Macular Degeneration – AMD (both dry form and the wet one – exudative)
  • glaucoma
  • central serous retinopathy (CSR)
  • macular and retinal dystrophy (Stargardt’s disease, Juvenile vitelliform macular dystrophy – JVMD, rod cells and cone cells dystrophy, vitelliform macular dystrophy, Retinitis pigmentosa – RP)
  • idiopathic juxtafoveal retinal telangiectasia (IJT)
  • inflammation of the eye vascular membrane
  • optic disc drusen
  • intraocular tumors
  • macular holes
HOW DOES THE EXAMINATION LOOK LIKE?

It is quick, non-invasive and completely painless. Its goal is to make a scan of the retina with an ultramodern Topcon TRC plus device. During the test the patient sits comfortably and his or her head is placed on an ergonomic stand in front of the scanner lens. The test takes from few to ten minutes. Before the test the pupils need to be dilated – so dilating drops are being administered beforehand. Due to the test we receive the excellent quality documentation of color images of the retina cells. The results of the test are available immediately after it being performed. With the same device we can perform the fluorescein angiography test.

Autokeratorefractometer

Autokeratorefraktometr is not a vehicle. It is automatic, computer-controlled refraction measurement, i.e. vision defect and keratometry i.e. measurement of corneal curvature. Cornea is a thin transparent membrane localized in front of the iris which gives the eye its color. Its optic function resembles the one of the watch glass which enlarges the digits on the clock face. Each of us has his or her own, individually adjusted to the eye glass i.e. a focusing lens of a certain strength and curvature. The strength of the cornea amounts about 40 – 44 diopters and the radius of curvature about 7.8 mm. It’s worth adding that the autokeratorefractometer is a very basic device present in every ophthalmological clinic or office. In our ophthalmological hospital in Warsaw we have several of those devices.

AMD – Age-related Macular Degeneration

AMD (English: age-related macular degeneration – AMD) is an age-related macular degeneration which is a disease of the eye fundus around so called macula lutea. Macula lutea is part of the retina responsible for seeing details, reading, distinguishing colors. When aging the eye loses the ability of removing the residues of chemical processes occurring in it. The residues cause degeneration by being disposed under the retina. In the place of receptors deficiency – the central point – a black spot is seen. Untreated degeneration that the vision impeding black spot gradually enlarges. The disease usually affects both eyes but it can also appear asymmetrically. It usually reveals itself after 50-60 years of age.

AMD has two forms: dry and wet.

The dry form of AMD (the most frequent, about 90% of all cases) it has a milder course, and changes in the eye are progressing gradually.

It is treated with dietary supplements containing lutein, zeaxanthin, vitamins A, C, E and microelements – mostly selenium, zinc and copper. It is also recommended to change diet and introduce into it products rich in lutein and zeaxanthin (e.g. kale, spinach, parsley, lamb, Brussels sprouts, green peppers, pumpkin and others).

Wet form of AMD – 10% of all cases – it has a much heavier and rapid course. Severe deterioration of vision can occur within a few days. It is caused by ingrowth of blood vessels under the retina and repeated extravasation and fluid accumulation under the retina. Even though changes in the diet and dietary supplements are recommended, it is treated mostly with new generation medications – injections into the eye which allow to stop the disease and sometimes even reverse the symptoms.

If you notice that you have problems with reading, with recognizing faces and road signs and straight lines start to go crooked do not wait and go to see an ophthalmologist as soon as possible. In the vast majority of cases the AMD progression can be stopped or the disease can be healed.

Fluorescein angiography

Fluorescein angiography – this test evaluates blood circulation inside the retina and the choroid. After IV administering of the contrast – yellow-orange pigment called fluorescein – black and white images of eye vascularity are taken. The pigment flows through the eye like blood, so if somewhere the fluorescein starts to leak, we know that in this location the blood vessels are damaged. The location of the leak is precisely shown on images. After the test you will be yellowish orange. Also your urine will have the same color for about three days. Indications for the test are eye diseases which cause changes in blood vessels such as diabetes or age-related macular degeneration. In case of diagnosing abnormalities of blood vessels administration of Avastin is being considered. Avastin is a medication which causes disappearance of abnormal blood vessels.

Astigmatism

Astigmatism (incompatibility) is a vision defect and not an eye disease as many suggest. It can accompany both myopia and hyperopia. To understand it, it is best to imagine a globe with a meridian more or less convex than the rest. This uneven meridian causes the rays of light not to focus at one point, they only melt, resulting in human figures appearing elongated, and circles resembling ellipses. And as in the globe, the unequal meridian is defined by the axis, so the glass correcting the defect (may be negative or positive) is always marked with an axis position of 0 to 179 degrees.

Biometry

Biometry is the measurement of eye length, lens thickness, cornea, depth of the anterior chamber. The examination is performed with a special ultrasound head prior to cataract surgery to calculate the power of the implanted lens or in children with severe visual impairment to determine whether the eye defect is caused by a slow progression of the eye (high progressive myopia) or due to a one-time surge of whole body growth including the eye.

WHAT IS THE DIFFERENCE BETWEEN THE ULTRASOUND WITH THE FUNDUSCOPY AND THE REGUALR ULTRASOUND?

Sometimes the changes which can be examined with the ultrasound need to be confirmed with the funduscopy and therefore the pupil dilatation is necessary. The ultrasound cannot determine the colors of the examined change, its vascularity or inflammatory features.

Presbyope

Presbyope sees well from afar, but also to a certain extent. He or she wears plus-goggles, convex lenses that focus on the light rays. The greater the optical power of the lens you wear, the harder it is to read close up. A presbyope with strong lenses of about +3 diopters earlier than his or her pears needs reading glasses. For example, a person with a vision defect who needs +4 diopters for seeing from far will, at the age of 65, need +7,5 diopters for reading.

Endoscopic cyclophotocoagulation (ECP)

WHAT IS ENDOSCOPIC CYCLOPHOTOCOAGULATION?

Endoscopic cyclophotocoagulation (ECP) is the latest generation method of treating glaucoma. It gives hope to those patients in whom other methods failed. This procedure is also recommended to patients in whom other methods carry high risk of complications (for example in patients suffering from Sturge–Weber Syndrome).

WHAT IS THE PURPOSE OF PERFOMING THE ECP PROCEDURE?

Just like other anti-glaucoma procedures it is meant to reduce the pressure in the eyeball. Excessive eye pressure that persists over a prolonged period of time can significantly affect permanent deterioration of vision including loss of vision. The pressure in the eye rises when the process of draining eye feeding fluids is disturbed. Those fluids are produced by the ciliary body, a ring surrounding the iris.

WHAT IS THE CYCLOPHOTOCOAGULATION ABOUT?

Ophthalmologist say that it is a method of cyclodestruction. This is a very precise process: with a few advanced equipment – mini cameras and laser diodes of diameter of less than a millimeter – a part of the ciliary body of the affected eye is subjected to coagulation. Coagulation closes small blood vessel in the ciliary body and as a result the ciliary body produces less fluids and the pressure in the eye is reduced. The procedure is painless and performed under local anesthesia. All ailments should pass within few days up to two weeks after the procedure.

WHAT IS THE EFFICIENCY OF THIS PROCEDURE?

High. In about 90% of the patients the pressure is reduced by an average of about 30%. The pressure reduction can be observed immediately after the surgery. Although the damage done by the disease cannot be reversed, by controlling the intraocular pressure, further degeneration can be prevented or the disease process can be significantly slowed down. The successful effect of the treatment also allows for limiting or eliminating the administered medication. However, it must be remembered that the success of treatment consists of various factors, for example: the patient’s age, the type of glaucoma, the construction of the eye, other eye surgeries including anti-glaucoma surgeries as well as chronic diseases the patient suffers from (diabetes, hypertension, etc.). The patient’s mental attitude is also very important.

Chalazion

WHAT IS CHALAZION?

Chalazion is a type of abscess inside the eyelid – palpable change; as if a pea inside the eyelid. Sometimes it’s painful.

WHERE DOES THE CHALAZION COME FROM?

The sebaceous glands on the inner side of the eyelid get bunged up, they accumulate secretion in which infection may develop. Chalazion is often a result of recurring stye but unlike stye the chalazion does not heal itself. Do not wait! You need to see a doctor.

HOW DOES THE MEDICAL INTERVENTION LOOK LIKE?

If the chalazion is still small antibiotic therapy, including ointment and drops, should be enough. If the above should not be enough the doctor may decide about antibiotic injections being administered around the infected area. If that won’t work the chalazion needs to be surgically removed.

HOW THE PROCEDURE OF CHALAZION SURGICAL REMOVAL LOOKS LIKE?

It is being performed under local anesthesia. First the surgeon unfolds the eyelid (the chalazion is resent on its inner side), then he incises infected area and evacuates the accumulated fluid content. After the procedure, for the time recommended by the doctor, the patient should locally apply ointment or drops with antibiotic.

Stye

WHAT IS A STYE?

A stye or a swollen, reddened and painful lesion on the edge of the eyelid near the eyelashes of a characteristic grain shape, is a purulent inflammation of the eyelid. It is caused by staphylococcus bacteria. Edema can cover the entire eyelid, inflammation lasts several days. Stye on the eyelid gradually becomes similar to pustules – red spots appear on the tip of the red. Finally the stye cracks and symptoms are resolved. There is also a so-called internal stye, i.e. inflammation on the inside of the eyelid. The eyelid is swollen, it feels like there are grains of sand in the eye. The internal stye disappears gradually (without cracking).

HOW TO TREAT THE STYE? WILL RUBBING THE STYE WITH GOLD HELP?

As for the effectiveness of gold, opinions are divided – although if the gold object is disinfected, it certainly will not harm, because after all, gold has bactericidal properties. In no case should it be a gold ring just pulled off from your finger! It should be washed and disinfected first. To treat the stye the doctor can prescribe ointment or drops with antibiotic.

HOW TO TAKE CARE OF AN EYE WITH THE STYE? HOW TO AVOID RECURRENT INFECTIONS?

First of all, you cannot try to squeeze out the stye – this can lead to orbital tissue inflammation. During the infection do not wear contact lenses. It is best to get rid of mascara – if used immediately before the onset of the stye, it can be a habitat of bacteria. To prevent stye recurrence, avoid rubbing your eyelids and eyes with dirty hands. When stye recurs, it is important to get a special eye wash and wash your eyes and their surroundings in the morning and in the evening. You should also have the blood sugar level checked, the recurrent stye may be accompanied by diabetes.

WHAT TO DO IF THE CONDITION LASTS LONGER THAN 4 DAYS?

If symptoms persist or fever develops, go to an ophthalmologist who can order antibiotic treatment and / or culture from the infected mucus. Uncured, recurring internal stye may eventually turn into a chalazion.

Irideocorneal angle

Irideocorneal angle – you can say that it is an eye’s sink. This is through where the aqueous humour drains off and mixes with venous blood. Hence these veins are called water veins. Eye diseases in which it comes to the irideocorneal angle damage may develop into glaucoma. Lack of patency of the irideocorneal angle is one the glaucoma symptoms. Such condition requires a surgery performed in an ophthalmological hospital which allows to restore patency of the aqueous humour. In case of minor changes it is enough to perform a laser procedure in an ophthalmological office. This kind of procedure is called laser iridectomy.

Glaucoma

WHAT IS GLAUCOMA?

It is a diseases caused by the drainage disorder of the aqueous humour from the eye. Aqueous humour is a substance filling the anterior chamber of the eye. Its task is the nourishment of the cornea and disposal of harmful waste products. If the aqueous humour is not being disposed, the pressure in the eyeball rises, which in turn can damage the optic nerve and retina cells, it also narrows the field of vision and lowers visual acuity. Why the untreated glaucoma can cause blindness.

HOW THE GLAUCOMA IS BEING TREATED?

In most cases the treatment starts with the anti-glaucoma drops. The exception is an acute glaucoma attack, which is treated surgically. The goal of the treatment is to reach a target pressure. Target pressure is a pressure that does not cause further changes in the optic nerve and therefore the eye sight does not deteriorate further. If the use of drops does not lower the pressure to the desired level, we suggest surgical procedure.

IF I WILL BE DIAGNOSED WITH GLAUCOMA, WILL I HAVE TO USE DROPS FOR THE REST OF MY LIFE?

All the drops administered in glaucoma should be taken for the rest of the patient’s life, for glaucoma is an untreatable disease. The drops lower the intraocular pressure which is one of the risk factors for developing the disease. Depending on the severity of the condition, it is necessary to take one or two types of drops. Such treatment is very troublesome for patients, because each type of drops must be used at designated times. There are currently multi-component preparations available which simplify the adherence to treatment rules. Most glaucoma drops do not contain preservatives, so they are more patient-friendly.

WHAT IS THE ACUTE GLAUCOMA ATTACK?

This is the moment when the liquid outflow from the eye completely closes. The pain during the attack is very strong, comparable to the attack of kidney stones or myocardial infarction. It takes until the doctor’s intervention, it does not resolve spontaneously.

HOW TO SURGICALLY TREAT THE ACUTE GLAUCOMA ATTACK?

The acute glaucoma attack is treated surgically by restoring the circulation of the fluid in the eye. The procedure can be performed with the use of laser or surgically. In both cases a small hole is cut out in the eye hole which connects the two eye chambers with each other. The posterior chamber in which the fluid is produced, with the anterior chamber in which the fluid flows out. It resembles unclogging a drain of the sink.

WHO IS EXPOSED TO THE GLAUCOMA?

Professionally it’s called risk factors:

  • if one of the family members suffers from glaucoma
  • if you are over 35
  • if you suffer from constantly cold hands and feet
  • if you have low blood pressure (below 100/70)
  • if you are a myope and you wear glasses of more than -4 diopters
  • if you suffer from diabetes, arteriosclerosis or hypertension
  • if you suffer from migraines and recurring headaches

Very often at the beginning glaucoma doesn’t give any symptoms. Therefore, tests for patients from the risk group are so important. You should do eye examinations for glaucoma every 2 years until the age 50, and then – every year.

DOES THE PRESSURE IN THE EYE HAS ANYTHING TO DO WITH THE BLOOD PRESSURE?

No. These are two separate things which are measured in two different ways at different occasions. Eye pressure measurement (intraocular pressure measurement) should be part of every ophthalmological visit – it is important for the prevention of glaucoma. h5>WHAT ARE THE SYMPHOMS OF GLAUCOMA? The cunning of this disease is that it can be asymptomatic for a long time. The first disturbing sign can be the recurring migraine headaches. Other symptoms include rainbow rings around objects and rainbow spots, as well as deterioration of vision and reduced visual field. Such symptoms may develop slowly over several years, so it is difficult to see them (only in 20% of patients glaucoma develops very quickly). Untreated glaucoma can cause symptoms such as dizziness and nausea, intense and refractory conjunctivitis and problems with balance maintenance. However, we must remember that when symptoms occur, irreversible changes in the eye have already occurred. The later we start glaucoma treatment, the worse are its effects.

Stem cells

Stem cells work like a medication and a doctor in one. And in this case, a doctor who perfectly knows when anything wrong is happening in a given part of the body.

Stem cells implanted into the body are able to restore balance in the surrounding tissues. Stem cells help in curing some diseases for which the treatment has not been known to this date. In ophthalmology they are able to stop the deficiency of the optic nerve or partially rebuild it. Optic nerve deficiency was incurable and led to total blindness. Stem cells are also used for treating age-related macular degeneration or such congenital conditions as retinitis pigmentosa i.e. Stargardt disease.

How the stem cells are being implanted into the eye? The cell suspension is implanted into the eyeball with injection. This is done in the operating room while maintaining sterility, and the entire procedure is performed under local anesthesia by an ophthalmologist. At the ophthalmic nerve treatment, an injection into the orbital fat body can be administered.

The first injection should take effect after about 20 weeks, although in some cases the treatment needs to be repeated up to several times.

Early treatment can significantly improve vision. In more advanced cases, the procedure stops the progress of the disease.

The stem cells for the surgical purposes come from the Wharton jelly, i.e. the part of umbilical cord which does not contain blood vessels. In general, the placenta and the umbilical cord are burned in a hospital incinerator. It is enough to peel the umbilical cord from the blood vessels and to grind it to isolate the stem cells. The entire process of obtaining a sterile preparation takes about 2 months. In Poland, the Bank of Stem Cells performs the procedure.

Anterior chamber

Anterior chamber is a space limited to lens, iris and cornea. Within the anterior chamber there is a irideocorneal angle which damage is one of the glaucoma symptoms.

Pressure curve

Pressure curve is a measurement of the pressure in the eye during the day. In a patient treated for glaucoma, the pressure curve allows to assess if the drops used by him or her are sufficiently reducing the intraocular pressure.

Qualification for the cataract surgery

Qualification for the cataract surgery – it’s a complete eye examination including all the structures responsible for vision, ended with artificial lens calculation. The goal of the examination is to determine the visual acuity after the surgery. For example, if you operate on a person with glaucoma or macular degeneration, vision after surgery will be proportional to changes inside the eye. It doesn’t mean that the operation was not successful.

Myope

A myope can see well from close and wears minus glasses, i.e. biconcave lenses, diffusing light rays. The greater the short sightedness, the shorter the distance one can see from, for example a myope with the defect of minus one diopter sees well from a distance of one meter, while his or her colleague with a defect of minus ten diopters sees from a ten times shorter distance, i.e. ten centimeters.

Sudden eye pain

WHAT SHOULD ONE DO IF A SUDDEN EYE PAIN OCCURES?

If the pain persists for several hours, one must quickly see a specialist.

WHAT CAN CAUSE THE PAIN?

Causes of pain can be various. The most common ones are:

Mechanical eye damage (a scratch or a strong impact) – for example, when playing with children or animals or hitting the branches while picking mushrooms. Immediate pain and redness occur. You can cover the eye with a bandage to immobilize the eyelid irritating the eye every time you blink, and go to the doctor as soon as possible.

Burning – it happens to easy-going beachgoers, but also to welders. People with light complexion are especially exposed to eye-sunburns. Pain occurs when you come back from the beach (or during welding). You need to see a doctor immediately!

Notorious eye drying – common ailment among computer men. When working on a computer we often forget about blinking so our eyes dry out. Sometimes it is enough in order for the dried out and tired eyes to start hurting – and if we add to that the air conditioning which drains the air, the situation can get worse so much faster. During work, remember to flush your eye with saline (a medicine available over-the-counter in disposable packaging) and to relax your eyes – take your eyes off of the screen every few minutes and – preferably – look out the window as the green and blue colors relax your eyes). After work, apply compresses soaked with Euphrasia (Eyebright) infusion. Relaxation of any form is also recommendable (no thinking about work!).

Discharging eyes – if the eyes pain is accompanied by a discharge, you should definitely see a doctor.
If you cannot immediately see an ophthalmologist, you should use Sulfacetamid drops – but still see a doctor as soon as possible.

Allergies – since allergies are cyclical conditions, people suffering from them are usually well prepared for the attacks. But if it occurs suddenly and you have no medication on you or a doctor nearby who could give you the prescription, flushing eyes with saline solution should help (up to 10 times a day, several drops to each eye). By washing out the allergens, we reduce their concentration and, consequently, reduce the allergic reaction.

Glaucoma attack – if the aching eye is congested, the pupil enlarged, and you really cannot withstand the pain, immediately go to the hospital. Every minute of delay may lead to optic nerve damage.

Cataracts in older people – if a person diagnosed with cataract begins to feel pain in the eye that in addition is red and painful, he or she should go to a hospital or specialist clinic. It can be a glaucoma attack due to the lens rupture.

Patients with heart conditions, with hypertension and diabetes – in such cases the pain is located in the back of the eyeball and the patient has the filling of the eye being pushed out. The eye isn’t even reddened. The pain is caused by the oxygen deficiency in the tissues surrounding the eye. If you feel something like that you should see a doctor immediately.

Demodex disease

Demodex (demodex folliculorum) is a small parasite living in a human skin.
It causes a condition called demodex disease.
It has a rounded body with four pairs of short legs, a mouth and an abdomen resembling a long tail.
The human demodex is a cousin of mites.
Although it’s only about one-quarter of a millimeter long, it can beat a distance of more than one and a half centimeters in one day.
It lives about 18-25 days, laying about 20 eggs.
The eggs go through several stages of development from larvae through nymphs to adult form.
Demodex likes darkness, peace and stable temperature.
It feeds on hair follicles.
As far as the eye is concerned, it chooses the eyelashes where its mouth penetrates from the inside of the hair follicle.
If the amount of parasites is large and does not fit in the hair follicle, then the hair is moving or falling out.
Demodex feeds on dead cells of the skin epithelium, plasma and blood.
The symptoms of the demodex disease are eyebrows and eyelashes coming out, itching, as well as redness and irritation of the eyelids sometimes associated with chronic inflammation.

How can you get infected?

Due to its small size, the Demodex floats in the air and easily adheres to sweaty or oily skin.
Another source of infection may be the use of an infected person’s clothing.

How to treat the demodex disease?

If the body is not able to fight off the infection by itself, which happens sometimes, use different types of ointment, as well as hot eye patches.
Treatment usually takes about 2 months with a two week break to cover the next phases of parasite development.

Anterior section

Anterior section so it was easier to group eye diseases, the eye was divided into two sections.
Anterior and posterior section.

Anterior section starts with cornea and ends with lens. Anterior section includes conjunctiva, cornea, sclera in its anterior part, anterior chamber, iris, iridocorneal angle, lens. An ophthalmologist who specializes in the eye’s anterior section diseases pays particular attention to those structures. The most common reasons for the appointment with an ophthalmologist are anterior section of the eye diseases. It’s easy to notice them as they cause pain and redness of the eye, as well as excessive tearing.

Posterior section

Posterior section so it was easier to group eye diseases, the eye was divided into two sections.
Anterior and posterior section.

Anterior section starts with cornea and ends with lens. All the structures to the back from the lens belong to the posterior section of the eye. Posterior section includes retina with particular emphasis on macula lutea as part of the retina, choroid, optical nerve. The name of our ophthalmological hospital comes from Greek. That means that we concentrate on retina conditions using the most modern devices and techniques for examining the posterior part of the eye such as OCT, ultrasound and angiography. Posterior section of the eye conditions are not visible on the outside but they significantly worsen the vision.

Amnion

WHAT IS AMNION FOR?

Amnion is a natural biological dressing, used successfully in eye surgery.
It has extraordinary properties – it regenerates, stimulates cell growth, it can prevent or reduce the formation of scars.
From the perspective of an eye surgeon it is an extraordinary tissue.

WHAT IS AMNION?

It is a thin transparent membrane, forming the inner layer of the bag of waters.
It surrounds the baby throughout the pregnancy, thus absorbing the growth and regenerative factors serving as their reservoir at the end of pregnancy.
Amnion is collected from the placenta after the caesarean section.
In ophthalmological surgery it is used as a biological dressing on hard-to-heal corneal wounds.
Despite the fact that the human tissue, due to its specificity, does not require tissue compatibility tests, there is no risk of rejection.

WHEN DO WE USE AMNION TREATMENT?

In many diseases and injuries of the cornea and conjunctiva, and also after some surgeries.
Amnion helps, for instance, with recurrent epithelial or parietal defects, with burns at the surface of the eye, with keratopathy, with Erythema Multiforme (EM) as well as with various types of adhesions and scarring.
It can also provide excellent protection after corneal transplantation, after removal of the conjunctival tumor or after various types of anti-glaucoma procedures.
We use it whenever the eye wounds healing is ineffective or when we want to help restoring the balance in the cornea, for example after cataract surgery.

HOW PUTTING ON AN AMNION DRESSING LOOKS LIKE?

We want the amnion to stay on the eye as long as possible so it’s being stitched to the conjunctiva.
It’s done by a surgeon who uses special surgical microscope. The procedure is performed under local anesthesia and requires the thinnest possible insoluble surgical strands.
This natural “bandage” not only protects the wounded area, but also allows the regeneration agents to be permanently released for at least 2-3 weeks.
Throughout this time our enzymes will slowly support the absorption of the amnion, and eventually nothing remains of it.
After amniocentesis surgery, the patient sees very badly – as through a fog.
After the amnion is absorbed, the normal vision returns.

Conjunctival sac culture

Conjunctival sac culture some difficult to treat inflammations require determination of the type of bacteria and drugs that will most effectively eliminate it.

Refraction

Refraction is a vision defect. The majority of people has vision defect, i.e. professionally speaking the refraction defect. One can be a myope, a presbyope, or to have astigmatism or presbyopia. The vision defect is being determined at each ophthalmological office or hospital appointment.

Corneal pachymetry

Corneal pachymetry is a corneal thickness test. The corneal thickness matters if the intraocular pressure is to be precisely determined. The regular corneal thickness is about 540 micrometers, in case of thicker corneas the measurements are inflated.

Sedation – how do we anesthetize in Retina?

Eyelid treatments, minor conjunctivitis and injections to the eye are performed under local anesthesia.
We administer anesthetic drops and anesthetic gel, then inject anesthetic into the operation area.
This type of anesthesia does not carry the risk of complications as high as it happens in case of general anesthesia.
Intraocular procedures (cataract surgery and retina surgery related to glaucoma) are performed in sedation.

Sedation is a type of anesthesia in which a briefly acting analgesic and tranquilizer is administered at the same time the eye is being anesthetizing with drops or injection.{ut1}One needs to keep in mind that pain sensitivity is an individual characteristic.

If you suffer from eye pain after the procedure, you may take analgesic.
This does not affect the outcome of the procedure.

WARNING! If you are allergic to any analgesic or anesthetic, please inform your doctor during your preoperative appointment.

Eyelids spasm

Paroxysmal involuntary tonic spasm of the eyelids (i.e. blepharospasmus)

Paroxysmal eyelids spasm looks as though the eyelids suddenly started to contract which cannot be controlled.
The above tic may be exacerbated by hard light, stress, reading or driving, and dampened by other stimuli (rest, walk). Spasms involve the circular muscle of the eye which is located under the skin around the eye socket.
Sometimes, the intense eyelids spasm also engages other muscles of the upper part of the face, resulting in unnatural grimaces.

Usually symptoms occur on both sides. The disease usually occurs around the age of 60 and it is three times more common in women than in men.

Medicine has not found reasons for this condition yet. Untreated blepharospasmus can almost completely disable the patient from normal functioning, as uncontrolled eyelid spasms restrict simple daily activities such as reading, watching TV, shopping, or driving.

Sometimes blepharospasmus is so intense that it becomes the cause of the so-called temporary functional blindness – the patient cannot properly open his or her eyes.

How is paroxysmal eyelids spasm treated? Botulinum toxin injections (also known as botox or botulin) are administered to the ocular muscle.

Botox causes muscle relaxation, which leads to symptoms relief or its significant decrease. Botox, although poisonous in large doses, in small, topically administered, is a valuable medication.

It is also used in treating the focal dystopias or postural muscles spasticity, widely used in aesthetic medicine or in fight against excessive sweating.

Botox treatments are performed under local anesthesia by applying an anesthetic gel on the skin and performing several subcutaneous punctures along the circular muscle with a special thin needle.

The visible effect of the treatment can be noticed only after about two weeks.
The botox effect disappears after about 3 months, so in order to maintain the effect, the treatment should be repeated regularly.

Lenses

WHAT KIND OF LENSES ARE BEING IMPLANTED DURING THE CATARACT REMOVAL SURGERY?

The human lens is one of the most perfect optical instruments that nature has invented.
During the cataract removal, the patient’s lens is replaced with artificial one.
Artificial lenses must be made of top quality materials to mimic the properties of the natural ones.
In Retina, we use lenses produced by a German company Polytech-Domilens specializing in innovative solutions used in ophthalmic surgery.
After implanting more than 2.000 lenses of this company, we can ensure you that the vision after surgery is very good.
The materials from which the lenses are manufactured are all resistant to time.
They differ in their physical characteristics and technology, hence the differences in price.

HOW ARE VARIOUS TYPES OF LENSES DIFFERENT?

There are several factors involved here.
First, some of them are easier for surgeons to use during surgeries.
However, a qualified ophthalmologist can handle the implantation of any lens.
Second, they may have different effects for the patient.
More expensive lenses better protect the retina from sunlight.
Less often, they allow the formation of secondary cataracts.

IS IT WORTH INVESTING IN MORE EXPENSIVE LENSES?

Research on the effect of lenses made of different materials is ongoing, and new types of lenses are still being developed.
Some data show that it is worth investing in more expensive materials, others do not confirm it.
Our long-term observations of patients treated in Retina prove that also with cheaper lenses you can reach as great results as with the technologically advanced ones.

LENSES TYPES

Hydrophilic lens model AS66-Y – included in the price of the surgical procedure. Modern lens in natural yellow color stops the blue light (harmful solar radiation) to a greater extent than completely transparent lens.

Hydrophobic lens Y10 AS – additional payment of 300 PLN. It has a yellow color, so it still provides protection from sunlight.
Due to the additional surface area coverage with heparin, organic particles are rarely deposited on the surface, thus maintaining good translucency.
The manufacturer ensures that the lens is less likely to develop secondary cataracts.
These lenses are especially recommended for patients with macular degeneration, especially age-related macular degeneration (AMD).

Photochromic lens Aurium 404 – additional payment of 500 PLN. Combines the features of the aforementioned lenses.
In addition, as well as the photochromatic glasses the lens may become completely transparent or completely yellow depending on the intensity of light entering the eye.

Warning! In case of astigmatism we use the toric lenses manufactured by the Alcon lub HumanOptics company. They are assorted individually. Additional payment of 1500 PLN.

Presbyopia

Presbyopia is a Latin-derived word, a rather unattractive name for losing accommodation, i.e., the ability to adjust your eye potency so that you can read without glasses.
Presbyopia begins at the age of 40, it is then that the ophthalmologist often hears that someone sees well only his or her hands are too short.
At first, indeed, by distancing the text, the reading can be dealt with, then it is impossible to stave off the text anymore, because small letters are becoming unclear. Then it is time to wear reading or “computer” glasses.

Tonometer

Tonometer is a intraocular pressure measuring device. Its oldest type is a so called Schiotz tonometer, which resembles the look of weight and compasses. It is placed on the eye and the pressure is read on the basis of the tip’s lean out, the measurement is made using two weights. After the measurement the result is read on a special chart. Another method is applanation tonometry, it is also the method considered the most accurate.
The examination is performed after anesthetizing the eye and coloring the cornea with fluorescein – yellow-orange pigment, then the doctor lights blue light and approximates the prism to the cornea and reads the pressure on a special dial with a scale. It is also a good way to measure pressure without a contact method using an air tonometer so called air-puff, the measurement does not require anesthesia, can be performed in the eyes after surgery.
Elevated eye pressure can be a sign of glaucoma. The tonometer is one of the basic devices for every ophthalmic surgery. At the Retina Ophthalmological Hospital we use every kind of tonometer to match the type of eye disease.

Corneal topography

Topography means the landform and the mutual towards one another location of characteristic objects.
The topography of the cornea is used to examine its surface, both external and internal.
The examination is painless, takes a little while, and is performed using a corneal topographer with laser light.

Corneal topography allows astigmatism to be diagnosed.
It is used in assessments carried out before refractive or corrective surgeries, and also before cataract removal surgery. The data from the assessment allows to plan your operation and choose the right lens that will correct the astigmatism.

Topography is also used to diagnose keratoconus.
It is a congenital disease, which involves more and more distortion of the cornea, which begins to resemble a cone rather than a dome, which causes a very blurred vision.
The cornea at the top of the cone becomes so thin that it can break.
Retinal topography keeps track of changes in corneal thickness and changes in its shape, which allows timely treatment so not to allow for the cracks to occur.
In addition, a special computer program detects predispositions for this disease.
Treatment of the keratoconus is surgical, may involve the implantation of special implants causing the change of the corneal tension, and in very advanced cases it may involve corneal transplantation.

Sometimes the topographer is also used for congenital malformations in children such as microcornea or keratoglobus.
With the data from the camera it is easier to predict the direction of the disease.

UBM – ultrabiomicroscopy

UBM – ultrabiomicroscopy is a test performed with a special high frequency ultrasonic head.
The test allows to assess the width of the irideocorneal angle (this way the aqueous humour goes off), the patient’s own or artificial lens placement, tumors, cysts.

Ultrasound

Ultrasound – is a contact and painless test. A gel is applied to the eyelid, or directly into the eye, and then the head of the device which resembles a thick pen is applied.
The head generates harmless ultrasound, which through the structure of the eye bounce off of the encountered tissue, which is displayed on the screen in the form of black and white pictures or diagrams.
Ultrasound is used when the ophthalmological examination is impossible as in the case of bleeding, or difficult – for example when cataract is present, especially before the planned cataract surgical removal.
An ultrasound scan is used to determine the outcome of an operation, or the risk of an abnormal eye build.
If glaucoma is suspected an UBM test is performed i.e. ultrabiomicroscopy of the irideocorneal angle.
Narrow or closed irideocorneal angle is one of the glaucoma symptoms.

The Retina Ophthalmological Hospital has been organizing trainings in the field of ultrasonography since 2008.

Basic appointment

Basic appointment – includes an assessment of the sight defect (if applicable), measuring the pressure within your eye and a biomicroscopic examination of eyelids and eyelashes (professionally known as the ocular adnexa) with a slit lamp. Then we look at the anterior segment of the eye, i.e. the conjunctiva, the cornea, the iris and the lens. We finish by looking at the fundus to assess the optic nerve and the central area of the retina – especially the macula and the retina up to the equator of the eyeball. Remember: the eye is spherical. To assess the perimeter of the retina an application of pupil-dilating eyedrops is required.

Inserting punctual plugs

Inserting punctual plugs – in case of a dry eye syndrome, when a person doesn’t produce an adequate amount of tears, transparent plugs are inserted in his/her lacrimal canals which are situated closer to the nose in both eyelids. Usually canals in lower eyelids are being blocked, although sometimes plugs are being insterted in both eyelids. Many people are concerned they would be visible or fall out of the eye. Punctual plugs are built in such way they expand under the influence of tears and seal the lacrimal canal. They are transparent and dissolve within three years.

Ophthalmia

WHAT DOES OPHTHALMIA ACTUALLY MEAN?

It’s an inflammation of an eye, resulting in a congestion of eyeballs, eye-watering, heavy itching and burning, as well as an impression, as if sand grains were stuck under the eyelids. Bacteria-caused ophthalmia additionally results in a mucus and puss secretion. A developed infection causes blood vessels to overfill with blood, resulting in redness and swelling of the eye. Eye-watering is a result of the intensified activity of lacrimal and tarsal glands.
The conjunctiva is a thin film which lines both the inner side of the eyelids and the outer surface of the eyeball. The conjunctiva is very well innervated and thus sensitive, so an inflammation of this area is very irritating.

WHAT CAUSES OPHTHALMIA?

Ophthalmia can have different causes, such as infectious factors (bacteria, viruses, fungi), as well as non-infectious ones (physical or chemical irritation, allergies).

NON-INFECTIOUS INFLAMMATION:

An allergic inflammation manifests itself in a burning and itching sensation and a presence of a watery secretion in the conjunctival sac. It occurs seasonally (often in the spring, when most of the plants start to produce pollen). You can also experience an allergic inflammation due to the hypersensitivity to cosmetics or locally applied medicines.

A reactive inflammation is caused by staying in a polluted room, high temperature, smoke, bright light or by exposing one’s eyes to heavily chlorinated water or sea water. However, it can also happen as a result of an uncontrolled sight defect, after many hours spent in front of a computer or due to the intolerance of contact lenses. It is accompanied by itching, burning and eye-watering.

An inflammation caused by the tears deficiency can occur when the body is not producing enough tears or their chemical composition is incorrect. In such situation an illness known as the dry eye syndrome can develop.

INFECTIOUS INFLAMMATION:

A bacterial inflammation is characterized by redness and swelling, as well as mucus and puss secretion.

A viral inflammation usually manifest itself in eye-watering, significant redness and a feeling, as if a foreign object got stuck under the eyelids. You can get infected by having contact with infected tears or other secretions. How do we treat particular types of ophthalmia? A viral infection can be transferred to the cornea, which makes treatment considerably more difficult. Symptoms will then include a strong pain and photophobia, which practically prevent you from opening your eyes.

A fungal infection often occurs after an antibiotic or steroid treatment. Symptoms are not particularly distinctive – they usually include discomfort and a slight pain.

A chlamydia-caused inflammation occurs rarely, usually after a visit to a swimming pool. It mainfests itself with an intensive redness of the conjunctiva, swelling and a mucus and puss secretion.

HOW DO WE TREAT PARTICULAR TYPES OF OPHTHALMIA?

All types of ophthalmia require taking care of the eyes – they should not be excessively exposed to strong light, water and pollen and you should restrict the time you spend working with a computer screen or reading; you should also give up makeup and contact lenses. Moreover, you should have enough sleep – permanent sleep deprivation also irritates the conjunctiva!
Apart from that, regular inflammations can be treated with eyedrops without preservatives which don’t cause allergies (their ingredients include an eyebright and a common marigold); bacterial and viral inflammations are treated with an antibiotic cream; allergic inflammations – with orally taken antihistamines and anti-inflammatories; and ophthalmia caused by the tears deficiency is treated with tear substitutes, so-called artificial tears, which moisturize the eyes.

WHAT IF DESPITE A TREATMENT THE SYMPTOMS DON’T GO AWAY?

You need to see a specialist immediately – red eyes can be a symptom of keratitis, iritis or even of an acute case of glaucoma.

Eye injury

A WIRE IN THE EYE – AUTHENTIC STORY WITH A HAPPY ENDING
When dusk arrived and the day was slowly heading to the end, suddenly the telephone rang at the Retina Hospital.
The caller was clearly upset.
– Something happened with my eye!
– What exactly?
– asked Ania, the receptionist.
– I have something in it… it hurts.
I’m at the ER but they say it may take few more hours!
I won’t make it.
– Come as soon as possible. We’ll help you.

Half an hour later Adam showed up in Retina Hospital.
Unfortunately his eye looked horrible – swollen, glasslike and the conjunctiva was very red.
It was obvious that Adam was suffering.
– It doesn’t look like a normal foreign body in the eye – thought Ania and as doctor said she quickly administered anesthetic drops so that the patient waiting to be admitted wouldn’t have to suffer any longer.

After a while when the medication started to work, Adam properly told the whole story.
– I was working in a garage, removing rust from car parts with a metal brush…
You know, it had this drill-type of ending.
And suddenly my eye started to hurt like never before!
It must have been something from that brush.
– Weren’t you wearing the goggles?
– asked Ania.
– I couldn’t find them and the work had to be done fast. Who would think.
And this is the effect of the haste.
It’s good that at least it doesn’t hurt anymore.
When I was on my way to you…
– Did you drive?!
– Yes.
– That’s not good.
You should’ve ask someone for help or take a cab.
– Right, but I was in hurry.
– Adam smiled sadly.
– And again this damn haste.
Oh, I’m sorry for the “damn”!
– Don’t worry.
– Ania also smiled.
– It’s your turn. Come to the office, please.

Doctor Piotr Fryczkowski immediately started the examination.
It turned out that the patient’s condition was serious.
– Foreign body: the wire was reaching from the cornea through the iris and lens to the posterior capsule.
The diagnosis was: blood in the anterior chamber and an effusion in the vitreous body.
– It’s very good that you came so fast. We have to apply antibiotic to the eye as soon as possible in order to avoid the infection.
Who knows what was on that wire.
– Antibiotic to the eye?
Drops or an injection?
– Adam got worried.
– Injection.
Don’t worry. The eye was anesthetized and we’ll give you another medication.
Let’s go to the treatment room.
There we’ll decide on what to do.
We hope to get rid of it today. And if not, we will schedule a surgery for tomorrow.

– O my God! This wire is seriously huge!
– thought doctor Piotr when examining the patient’s eye under the surgical microscope.
– But the lens is not damaged so we can do something about it still today.
The sooner we get rid of this crud, the better for the patient…

The wire was removed.
The wound was supplied with antibiotic and a dressing.
– This is how what you had in your eye looks like.
– Doctor Piotr showed the patient a 7-millimeter long piece of a thick, crooked wire.
– This???
– Adam was horrified.
– And what about my eye?
Will I be able to see, doctor?!
– You were really very lucky not only because of the character of the injury but also because you came to us so fast.
If no infection occurs, the loss of sight will be small or even none.
You can go back to the reception now – Ania will tell you what to do.

– You have to buy those drugs and come tomorrow for a check-up – said Ania.
– Today you cannot take off or wet the dressing.
And you shouldn’t go back home on your own.
– Thank you.
I’ll call my wife.
I’ll see you tomorrow!
– One more thing – Ania smiled.
– I hope that from today on you will be using your goggles at work.
– I promise – said Adam solemnly.

An application of a contact lens

An application of a contact lens – in case of a cornea damage or illness a special dressing is applied that includes a contact lens.

Retina Ophtalmological Hospital in Warsaw is a modern medical facility with an excellent and experienced team of specialized physicians – including pediatric ophthalmologists. Retina opened in 2004. Since that time we have performed over 10,000 eye surgeries, hundreds of angiographic tests and ultrasounds, and have had over 15,000 patients.

The name of our hospital comes from Greek. Retina is an inner coat of the eyeball responsible for vision. A Patients’ ability to see is the most important for us, ophthalmologists. Knowledge and many years of experience help our team to achieve that goal.

We are unique in our non-standard approach to eye diseases, innovative solutions and patient-friendly approach. Knowledge and experience are not enough and need to be supported by tests, which we perform on the most up-to-date equipment.