Andrew A. Dahl, MD, is a board-certified ophthalmologist. Dr. Dahl's educational background includes a BA with Honors and Distinction from Wesleyan University, Middletown, CT, and an MD from Cornell University, where he was selected for Alpha Omega Alpha, the national medical honor society. He had an internal medical internship at the New York Hospital/Cornell Medical Center.
Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
There are several forms of laser therapy for glaucoma. Laser iridotomy (see the section above on angle-closure glaucoma) involves making a hole in the colored part of the eye (iris) to allow fluid to drain normally in eyes with narrow or closed angles.
Laser trabeculoplasty is a laser procedure performed only in eyes with open angles. Laser trabeculoplasty does not cure glaucoma but is often done instead of increasing the number of different
eyedrops or when a patient's intraocular pressure is felt to be too high despite the use of multiple
eyedrops (maximal medical therapy). In some cases, it is used as the initial or primary therapy for open-angle glaucoma. This procedure is a quick, painless, and relatively safe method of lowering the intraocular pressure. With the eye numbed by anesthetic drops, the laser treatment is applied through a mirrored contact lens to the angle of the eye. Microscopic laser burns to the angle allow fluid to better exit the drainage channels.
Laser trabeculoplasty is often done in two sessions, weeks or months apart. Unfortunately, the improved drainage as a result of the treatment may last only about two years, by which time the drainage channels tend to clog again. There are two types of laser trabeculoplasty: argon laser trabeculoplasty (ALT) and selective laser trabeculoplasty (SLT). ALT is generally not repeated after the second session due to the formation of scar tissue in the angle. SLT is less likely to produce scarring in the angle, so, theoretically, it can be repeated multiple times. However, the likelihood of success with additional treatments when prior attempts have failed is low. Thus, the options for the patient at that time are to increase the use of
eyedrops or proceed to surgery.
Laser cyclo-ablation (also known ciliary body destruction, cyclophotocoagulation or cyclocryopexy) is another form of laser treatment generally reserved for patients with severe forms of glaucoma with poor visual potential. This procedure involves applying laser burns or freezing to the part of the eye that makes the aqueous fluid (ciliary body). This therapy destroys the cells that make the fluid, thereby reducing the eye pressure. This type of laser is typically performed after other more traditional therapies have failed.
Glaucoma surgery
Trabeculectomy is a delicate microsurgical procedure used to treat glaucoma. In this operation, a small piece of the clogged trabecular meshwork is removed to create an opening and a new drainage pathway is made for the fluid to exit the eye. As part of this new drainage system, a tiny collecting bag is created from conjunctival tissue. (The conjunctiva is the clear covering over the white of the eye.) This bag is called a "filtering bleb" and looks like a cystic raised area that is at the top part of the eye under the upper lid. The new drainage system allows fluid to leave the eye, enter the bag/bleb, and then pass into the capillary blood circulation (thereby lowering the eye pressure). Trabeculectomy is the most commonly performed glaucoma surgery. If successful, it is the most effective means of lowering the eye pressure.
Aqueous shunt devices (glaucoma implants or tubes) are artificial drainage devices used to lower the eye pressure. They are essentially plastic microscopic tubes attached to a plastic reservoir. The reservoir (or plate) is placed beneath the conjunctival tissue. The actual tube (which extends from the reservoir) is placed inside the eye to create a new pathway for fluid to exit the eye. This fluid collects within the reservoir beneath the conjunctiva creating a filtering bleb. This procedure may be performed as an alternative to trabeculectomy in patients with certain types of glaucoma.
Viscocanalostomy is an alternative surgical procedure used to lower eye pressure. It involves removing a piece of the sclera (eye wall) to leave only a thin membrane of tissue through which aqueous fluid can more easily drain. While it is less invasive than trabeculectomy and aqueous shunt surgery, it also tends to be less effective.
The surgeon sometimes creates other types of drainage systems. While glaucoma surgery is often effective, complications, such as infection or bleeding, are possible. Accordingly, surgery is usually reserved for cases that cannot otherwise be controlled.
Headaches can be divided into two categories: primary headaches and secondary headaches. Migraine headaches, tension headaches, and cluster headaches are considered primary headaches. Secondary headaches are caused by disease. Headache symptoms vary with the headache type. Over-the-counter pain relievers provide short-term relief for most headaches.
Diabetes mellitus is a chronic condition characterized by high levels of sugar (glucose) in the blood. The two types of diabetes are referred to as type 1 (insulin dependent) and type 2 (non-insulin dependent). Symptoms of diabetes include increased urine output, thirst, hunger, and fatigue. Treatment of diabetes depends on the type.
Sarcoidosis, a disease resulting from chronic inflammation, causes small lumps (granulomas) to develop in a great range of body tissues and can appear in almost any body organ. However, sarcoidosis most often starts in the lungs or lymph nodes.
Retinal detachment is the separation of the retina from its attachments to the underlying eye tissue. Symptoms of retinal detachment include flashing lights and floaters. Highly nearsighted young adults and those who've had cataract surgery are at higher risk for retinal detachment.
Marfan syndrome is hereditary condition affecting connective tissue. A person with Marfan syndrome may exhibit the following symptoms and characteristics: dislocation of one or both lenses of the eye; a protruding or indented breastbone; scoliosis; flat feet; aortic dilatation; dural ectasia; stretch marks; hernia; and lung collapse. Though there is no cure for Marfan syndrome, there are treatments that can minimize and sometimes prevent some complications.
Optic neuritis is inflammation of the optic nerve, the structure that connects the eye to the brain. The precise cause of optic neuritis is unknown, but it is thought to be a type of autoimmune disorder. Optic neuritis most commonly develops due to an autoimmune disorder that may be triggered by a viral infection.
A cataract is an eye disease that causes the eye's lens to become cloudy and opaque with decreased vision. Causes of cataracts include diabetes, hypothyroidism, certain genetic illnesses, hyperparathyroidism, atopic dermatitis, and certain medications. Symptoms and signs include a decrease in vision and a whitish color to the affected eye. Treatment depends upon the patient's specific visual needs and may involve cataract surgery.
Many common eye disorders resolve without treatment and some may be managed with over-the-counter (OTC) products. It's important to visit a physician or ophthalmologist is the problem involves the eyeball itself or the condition hasn't improved after 72 hours of use of an eye-care OTC product.
Birthmarks and other abnormal skin pigmentation is caused by the body's inability to produce enough melanin. Abnormal skin pigmentation can cause conditions such as vitiligo, pigmentation loss, melasma, albinism, port wine stains, macular stains and hemangioma.
Uveitis is inflammation of the eye. Symptoms include blurred vision, eye pain, eye redness, and floating spots before the eyes. Treatment may involve prescription eyedrops, antibiotics, and wearing dark glasses.
The most common cause of a black eye is due to an injury to the face or head. Most black eye injuries are minor and heal on their own, however, some may lead to significant injury. In addition to trauma to the face, cosmetic surgery can cause a black eye(s) as a side effect. People should be aware of the situations in which medical care should be sought immediately for a black eye.
Blindness is the state of being sightless. Causes of blindness include macular degeneration, stroke, cataract, glaucoma, infection and trauma. Symptoms and signs may include eye pain, eye discharge, or the cornea or pupil turning white. Treatment of blindness depends upon the cause of the blindness.
Iritis is inflammation of the iris, the colored portion of the eye. Symptoms include a red, painful eye, blurry vision, and light sensitivity. Treatment usually involves cortisone eyedrops.
Becoming infected with chickenpox during pregnancy could cause birth defects in your unborn child. Likewise, shingles could also cause problems for your unborn child. If you are pregnant and haven't had chickenpox, avoid exposure to infected people. Zostavax, the shingles vaccine, can reduce the incidence of shingles by half. Women should wait at least three months after receiving the vaccine before trying to get pregnant.
Diabetes and eye problems are generally caused by high blood sugar levels over an extended period of time. Types of eye problems in a person with diabetes include glaucoma, cataracts, and retinopathy. Examples of symptoms include blurred vision, headaches, eye aches, pain, halos around lights, loss of vision, watering eyes. Treatment for eye problems in people with diabetes depend on the type of eye problem. Prevention of eye problems include reducing blood pressure, cholesterol levels, quitting smoking, and maintaining proper blood glucose levels.
eye. Read about symptoms, signs, diagnosis, treatment, and prognosis.
Coats' disease is a rare eye condition that typically progresses to vision loss or blindness in one eye. Gradual vision loss is usually the first symptom, followed by a cloudy white or yellow pupil due to the presence of a cataract. Treatment focuses on limiting the blood vessel progression and may involve cryotherapy or laser photocoagulation.
Klippel-Trènaunay-Weber (KTW) syndrome is a condition characterized by port-wine stains or birthmark malformations in the skin, soft tissue and bony growths (generally involving a limb), and vascular anomalies (varicose veins). The cause of Klippel-Trènaunay-Weber syndrome is not known, however, recently, there have been some cases that run in families. There is no significant treatment for Klippel-Trènaunay-Weber syndrome.
Disease prevention in men includes routine screening tests that are part of basic prevention medicine. Take an active role in your own health care and discuss screening tests with your doctor early in life. Age of screening and timing of screening depends upon the condition being assessed.
Disease prevention in women includes screening tests that are a basic part of prevention medicine. All screening tests
are commonly available through your general doctor. Some specialized tests may be available elsewhere.