Keratoconus

Keratoconus

We see through the cornea, which is the clear, central part of the front surface of the eye. Normally, the cornea has a spherical shape, but sometimes, however, the structure of the cornea is just not strong enough to hold this round shape and the cornea bulges outward like a cone. This condition is called keratoconus.

What Causes Keratoconus?

Tiny fibers of protein in the eye called collagen help hold the cornea in place and keep it from bulging. When these fibers become weak, they cannot hold the shape and the cornea becomes progressively more cone shaped.

Keratoconus may run in families, and appears more often in people with certain medical problems, including certain allergic conditions. It's possible the condition could be related to chronic eye rubbing. Quite  often, though, there is no eye injury or disease that explains why the eye starts to change.

Keratoconus usually starts in the teenage years. It can, though, begin in childhood or in people up to about age 30. It's possible it can occur in people 40 and older, but that is less common.

The changes in the shape of the cornea can happen quickly or may occur over several years. The changes can result in blurred vision, glare and halos at night, and the streaking of lights. 

The changes can stop at any time, or they can continue for decades. In most people who have keratoconus, both eyes are eventually affected, although not always to the same extent. It usually develops in one eye first and then later in the other eye. With more advanced form of the condition, glasses do not offer satisfactory vision correction, and specialist contact lenses are generally fitted to achieve best acuity. In advanced stages, a corneal transplant may be required.

 A recent surgical alternative to corneal transplant is the insertion of intrastromal corneal ring segments. A small incision is made in the periphery of the cornea and either one or  two thin arcs of polymethyl methacrylate are slid between the layers of the stroma on one or both  sides of the pupil before the incision is closed. The segments push out against the curvature of the cornea, flattening the peak of the cone and returning it to a more natural shape. The procedure, carried out on an outpatient basis under local anaesthesia, offers the benefit of being reversible and even potentially exchangeable as it involves no removal of eye tissue.

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#keratoconus #kerarings #intacs 

Managing Dry Eye

Managing Dry Eye

Dry eye problems affect a large proportion of the population, and are caused by multitude of factors , including the environment, age , gender, systemic conditions, medication and surgery.
As refractive surgeons, we spend a lot of time managing dry eye, both pre, and post-operatively.
Once patients understand the mechanics of the tear film, and the significance of dry eye, their understanding of the benefits, and use of simple lubrication and lid health regimens increases, and so does their visual comfort,  and quality of life.

The use of preservative free lubricants on a daily basis is important following LASIK and other corneal refractive procedures, to enhance recovery, provide comfort , and stability of vision. Gel lubricants are useful for night time application, being thicker and longer lasting. With more of the work force spending increasing time in front of computer monitors, in air conditioned environments, we see a far greater incidence of dry eye than we might have seen a few decades ago. Studies also show that the natural blink rate of computer users appears to slow, as we stare at the screens, thereby compromising the lubrication process further.
The symptoms of dry eye include a burning, stinging , or foreign body sensation, intermittent blurring of vision, and tiredness. Dry eye conditions range from mild to severe, sometimes resulting in highly debilitating situations, and intensive  forms of treatment. Fortunately , most conditions are manageable, and respond well to regular maintenance.

#dryeye #lasik

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Educating 
Part of our mission is to educate the public about developments in eye care and refractive surgery, and in that context, Dr Paul regularly takes part in radio interviews to educate and inform. Have a listen to a fascinating radio interview held earlier this year around the time we invested in the new LenSx Femtosecond laser to assist in cataract surgery.    

http://walasereye.com.au/upload/media/DrRobertPaul-945.mp3

#94.5  #Mix94.5

New development in Femtosecond Cataract surgery

Our use of the Alcon LenSx Femtosecond laser for assisting in cataract surgery continues to become the procedure of choice for almost all of our patients. For the surgeon and patient alike, the accuracy and final visual outcome are highly rewarding, and patients continue to benefit from this remarkable process .

Recently, the introduction of a soft contact lens fitted to the suction dock has enabled a change in the laser power setttings, creating a perfect, free floating capsulotomy, which is subsequently far easier to extract.  We expect the demand for the surgery to increase, and look forward to providing this exceptional service.

Making the decision

You may have relied on glasses or contact lenses for many years, but are finding the restrictions placed on you by these aids, or the inconvenience created by them when wanting to play sport or socialise more bothersome. For others , the dependency on glasses creates frustration, and that in itself becomes a motivator. The difficulties most refractive surgeons face are  the host of misunderstandings and misconceptions surrounding the technology, it's potentials and limitations , and perceptions created by media and the public alike.
Everyone has a different reason for seeking refractive surgery, but for everyone it's a choice for a new lifestyle, free from glasses or contacts. Suitability depends on the amount and nature of one's refractive error, plus a number of other factors. Those patients most satisfied with the results have realistic expectaions and clearly understand the potential outcome.
The sophistication of modern refractive surgery technology is remarkable, and offers safe, reliable and trusted results. For those aged over 45, the Kamra inlay, implantable contact lenses ( ICL ) and multifocal lens implants offer a range of correction options when near vision, or both distance and near corrections are required.
In short, refractive surgery holds exciting potential for a very broad range of the population requiring vision correction.