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As technology continues to advance, so does the field of the optometric industry. The development of innovative tools and techniques has allowed for more accurate and comprehensive examinations. One such technology is Optos, a revolutionary system that utilizes ultra-widefield retinal imaging technology to provide optometrists with a detailed view of the entire retina.

How Does Optos Work?

Optos technology is based on the principle of ultra-widefield retinal imaging, which allows for a wider and more detailed view of the retina compared to traditional imaging techniques. The Optos system consists of a specialized camera that captures high-resolution images of the retina using scanning laser ophthalmoscopy (SLO) and optical coherence tomography (OCT) technologies. SLO provides a wide-field view of the retina, while OCT allows for cross-sectional imaging, providing valuable insights into the various layers of the retina.

The Optos camera is designed to capture images through a process called optomap, which captures up to 200 degrees of the retina in a single image. This wide-field view provides optometrists with a comprehensive picture of the retina, enabling them to detect abnormalities that may not be visible with traditional imaging techniques. The optomap image can be instantly viewed and analyzed by your eye doctor, allowing for a more efficient and accurate diagnosis.

Common Eye Conditions Detected by Optos

Optos technology has the capability to detect a wide range of eye conditions, including but not limited to, diabetic retinopathy, macular degeneration, glaucoma, and retinal tears or detachments. Diabetic retinopathy is a condition that affects individuals with diabetes, causing damage to the blood vessels in the retina. Optos can capture detailed images of the retina, enabling optometrists to detect any signs of diabetic retinopathy and initiate appropriate treatment.

Macular degeneration is another common eye condition that can be detected using Optos. This condition affects the macula, the central part of the retina responsible for sharp, central vision. Optos allows for a comprehensive view of the macula, identifying any changes or abnormalities that may indicate the presence of macular degeneration.

Glaucoma, a condition characterized by damage to the optic nerve, can also be detected using Optos. The wide-field view provided by Optos allows for a thorough examination of the optic nerve and the surrounding structures, facilitating early detection and intervention.

Finally, Optos technology is particularly effective in detecting retinal tears or detachments. These conditions can lead to sudden vision loss and require immediate medical attention. Optos allows for a comprehensive view of the retina, identifying any signs of retinal tears or detachments and initiate prompt treatment.

Strabismus is a relatively common condition, affecting about 2-4% of the population worldwide. It is one of the most frequent eye disorders seen in children, though it can also develop in adults due to conditions like stroke or trauma. In the United States alone, it is estimated that around 12 million people are affected by strabismus, with varying degrees of severity. Early diagnosis and treatment are essential, as untreated strabismus in children can significantly impair visual development.

What is Strabismus?

Strabismus, commonly referred to as crossed eyes, is a condition in which the eyes do not properly align with each other when looking at an object. One eye may turn in, out, up, or down, while the other eye focuses correctly. This misalignment can be constant or intermittent and may affect one or both eyes. Strabismus occurs when the muscles controlling eye movement do not work together correctly, leading to difficulty in focusing both eyes on a single point. This condition can lead to visual issues such as double vision and, in some cases, can result in amblyopia (lazy eye) if left untreated.

How Does Strabismus Develop?

Strabismus develops when there is a disruption in the coordination of the muscles that control eye movement, leading to a misalignment of the eyes. This disruption can result from various causes, including genetic factors, neuromuscular conditions, or problems with the nerves that transmit signals to the eye muscles. In some cases, it may be present at birth, while in others, it can develop later in childhood or adulthood due to conditions such as cerebral palsy, Down syndrome, or even trauma to the eye or brain.

Signs and Symptoms of Strabismus

The primary symptom of strabismus is the visible misalignment of the eyes. However, there are other signs and symptoms that may indicate the presence of this condition:

• Blurred or double vision

• Headaches or eye strain

• Difficulty with depth perception and spatial awareness

• Reduced visual acuity in one eye

• Frequent eye rubbing or squinting

• Tilting or turning the head to compensate for the misalignment

A tonometer refers to the equipment that is used in tonometry – a test that measures the pressure inside your eyes, also known as intraocular pressure or IOP for short. Tonometry is rarely performed at your average comprehensive eye exam unless you are at high risk of or have been already diagnosed with glaucoma. Fortunately, tonometry can be used to detect changes in eye pressure before they cause any symptoms, enabling prompt action to be taken before your vision is affected.

About Glaucoma

Glaucoma is a common eye condition that occurs when the optic nerve, which connects the eye to the brain, becomes damaged. It’s normally caused by fluid building up in the front part of the eye, which causes the pressure inside the eyes to build. As the pressure increases, the optic nerve becomes increasingly damaged, and this prevents messages from being transmitted between your eyes and brain effectively. As a result, the patient’s vision becomes compromised. Without treatment, the level of vision loss will continue to increase. Unfortunately, any vision that has been lost as a result of glaucoma cannot be restored.
 

Most of the time, glaucoma develops very slowly which means that many people don’t realize that they are affected until some damage to their vision has already occurred. However, occasionally glaucoma can develop quickly, and symptoms do occur.

Glaucoma symptoms can include:

• Red eyes

• Intense headaches

• Tenderness around the eyes

• Eye pain

• Seeing rings/halos around lights

• Blurred vision

• Nausea and vomiting

If you notice any of these symptoms, it’s important that you make an appointment with your eye doctor right away so that you can be assessed. You are likely to have a tonometry test as part of this assessment.

If you’ve been diagnosed with glaucoma, you’re probably already familiar with the typical options in glaucoma treatment – eye drops, laser treatment or traditional surgery. While these are certainly effective, especially when glaucoma is diagnosed early, researchers have been working hard to offer new glaucoma treatments. Their goal is not only to improve outcomes but also reduce the treatment’s side effects and frequency of use.

What is the Goal of Glaucoma Treatment?

Before we dive into the new options, it’s important to understand the goal of any glaucoma treatment. At present, glaucoma is not curable. However, treatment can significantly slow the progression of the disease. Glaucoma damages your eye's optic nerve. Extra fluid builds up in the front part of your eye (cornea), which increases the pressure in your eye. Reducing this pressure is the primary objective of any glaucoma treatment. This is often referred to as intraocular pressure or IOP.

What are the Limitations of Standard Glaucoma Treatments?

Eye drops for glaucoma treatment seem like an easy option but there are several challenges that can reduce its effectiveness. It can be difficult to get all the medicine in the eye, especially for older adults with less of a steady hand. In addition, since it must be applied daily, individuals may forget. Since the drops have no perceivable benefit because early stages of glaucoma have no symptoms, patients might make it a lower priority which is understandable since it may also have unpleasant side effects like burning, red eyes.

Beyond eye drops, laser surgery is a less invasive option. The laser opens clogged tubes and drains fluid. It can take a few weeks to see the full results. If laser surgery or drugs don’t relieve your eye pressure, you may need a more traditional operation. You would have to go into the hospital and will need a few weeks to heal and recover. Although usually effective, glaucoma surgery can make you more likely to get cataracts later on. It can also cause eye pain or redness, infection, inflammation, or bleeding in your eye.

What are Recent Advances in Glaucoma Treatment?

Alternatives or Improvements to Eye Drops

The Glaucoma Research Foundation reported several new developments on the horizon. These technologies focus on reducing patient error in applying eye drops which would make the medication more effective and improve the quality of life for the patient. Here are some of the products underway:

• A polymer, like a contact lens, would contain the drug; it would sit under the eyelid and release the medication over several months

• Microneedles would inject medication into a specific spot to be most effective

• Implantable extended-release devices using engineered highly precise microparticles and nanoparticles

• Polymer-based intraocular delivery technologies that would allow customizable sustained release

• Drops that allow the medication to get into the eye more easily

• Tear duct plugs that release medication

In addition, people with glaucoma who take more than one eye drop per day are beginning to see those medications available as a single, combined eye drop. New products include Cosopt (timolol and dorzolamide), Combigan (timolol and brimonidine) and Simbrinza (brinzolamide and brimonidine).
 

Understanding PRK: Is It Right for You?

PRK or photoreactive kerectomy is a surgical procedure that was the precursor for the surgery known as Lasik. The biggest difference between the two procedures is how the first portion of the operation is conducted. Additional variability between the two procedures includes recovery, risk factors, and the patient’s overall needs. Understanding these differences can help you decide if PRK is an appropriate solution for your vision issues.

How it Works

PRK utilizes a laser to correct farsightedness (hyperopia), nearsightedness (myopia), and astigmatism. During a PRK operation, a laser is used to remove the exterior epithelial cells from the cornea. This procedure uses an excimer laser to remove the cells which are then discarded. A contact “bandage” is placed over the eye, and the cells can heal over the course of a few days. Your doctor will then remove the contact lens when the eye has healed enough to be exposed.

While the results are like that of Lasik, PRK does take some additional healing time. This is due to the time that must be allowed for the epithelial cells to heal and regrow on the eye. Additionally, Lasik patients generally experience less discomfort and faster results. PRK results can take a few weeks to fully materialize.

This isn’t to say that PRK doesn’t have its own benefits too. This procedure is well-suited for patients that have had previous eye surgeries and may have thin corneas. Because PRK does not make an incision into the cornea and only removes the epithelial cells, it leaves more of the stromal tissues which underly the epithelial tissue. PRK does not run the risk of “flap” issues that can arise from Lasik, and the risk of removing too much of the cornea is reduced. However, if you are considering PRK, you should consult with your medical professional to identify the right procedure for your specific case.

Before the Surgery

When you meet with your eye specialist to discuss your options, there are several factors that they will consider. Your potential surgeon should conduct a thorough eye exam during which they will measure your eye moistness, pupil size, corneal thickness, and corneal curvature. Your doctor should also review your medical and family history to identify any possible concerns about your suitability. Make sure that you bring a list of your medications and previous operations. Finally, you may be required to stop wearing contact lenses for a period before the operation. This can allow your cornea to return to its natural shape before the operation.

Premium IOLs or intraocular lenses are lenses that are placed in the eye during cataract surgery. The lens placement is designed to restore the natural lens shape. These lenses can also be placed as a vision correction device called refractive lens exchange. Premium IOLs offer advanced features beyond the single vision IOL’s that are also offered. These features include aspheric, toric, accommodating, and multifocal IOL’s.

Understanding Premium IOL Types

Aspheric Lenses

These lenses closely match the natural curve of the eye. Typical lenses were uniformly curved making it easier to manufacture, but at the same time increasing the chance of causing imperfections in vision. Aspheric lenses help to reduce imperfections and improve clarity, especially at nighttime.

Toric IOLs

These lenses are specifically designed to help correct nearsightedness, farsightedness, and astigmatism.

Accommodating IOLs

Accommodating IOL’s can tilt slightly forward when you look at objects that are close to the eye. This helps to improve visibility when you are performing actions like reading a book. While they are not necessarily as sharp as bifocals, patients have a reduced need to use reading glasses while still maintaining excellent distance vision.

Multifocal IOLs

If you require a bifocal or trifocal lens in your glasses, this may be a likely choice for you. Different portions of the lens allow for better vision at different ranges. However, there are some overall sacrifices with vision clarity at a distance.

Eye disease that is caused by diabetes is currently the number one cause of blindness and vision loss. Due to the increased risk in diabetic patients, doctors recommend that people over 30 with diabetes get an annual dilated eye exam. Diabetic patients under 30 should get this exam five years after they have been diagnosed.

Diabetic retinopathy is a condition that is caused by damage to the retina. Patients that have diabetes may also have experienced extended periods of time where their blood sugar was elevated. The high levels of blood sugar damage the retina’s walls which leave them susceptible to leaking. When fluid accumulates in the retina or macula, it causes vision loss.

To make these matters worse, if prolonged high blood sugar levels are seen again, the retina will be oxygen-depleted. This causes the abnormal growth of new blood vessels. This condition is called neovascularization. This blood vessel type is weak and prone to leaking. As these blood vessels leak, they introduce blood into the eye. Excessive bleeding into the eye can cause blindness.

Treatment

While a healthy diet and exercise can be beneficial to your optical health, diabetic retinopathy is a condition that is caused by damage to the retinal wall. While this damage can sometimes be corrected, simple diet changes won’t reverse the effects.

It is essential to catch the condition in the earlier stages to reduce the effects. This can also help patients understand the importance of monitoring their blood sugar so that repeat events can be limited. Treatment options are even more successful when diabetic retinopathy is caught early. These options include vitrectomy, scatter photocoagulation and focal photocoagulation.

During both scatter, and focal photocoagulation the doctor will use lasers to help alleviate the condition. The lasers make small burns on the retina aimed at the blood vessels. These burns will help to seal the blood vessels to prevent more leakage and stop them from growing larger.

When using scatter photocoagulation, hundreds of small burns are made in a specific pattern during two additional appointments. Scatter coagulation should be used on patients who do not have advanced diabetic retinopathy.

Focal photocoagulation specifically targets the leaking blood vessels that are in the macula. Unfortunately, this procedure is not aimed to correct the blurry vision associated with diabetic retinopathy, but it does stop it from progressing further. Once the retina has detached, neither form of photocoagulation can be used.

Vitrectomy is a surgery that helps to remove scar tissue and/or the fluid that is clouded with blood that has been leaked into the eye. This operation is the most successful when performed before the disease has progressed too far. When the operation only targets removing the fluid, success rates are very high for the procedure. When the procedure also aims to reattach the retina, the failure rate is around 50%.
 

Millions of patients are diagnosed with diseases and conditions of the eye every year. Some of which may not display symptoms until there is irreversible damage to the patient’s vision. The outcome of eye disease can range from temporary discomfort to total loss of vision, which is why all eye problems and diseases should be taken seriously and regular eye check-ups are absolutely essential.

What Are The Causes of Eye Disease?

The main causes of eye problems can be divided into five groups:

• Inflammation of the eye and surrounding structures caused by a bacterial, viral, parasitic or fungal infection.

• Injuries to the eye and surrounding structures, either as a result of trauma or an object in the eye.

• Genetically inherited eye diseases, many of which may only manifest later in life and affect the structures and the functioning of the eye which therefore can impair visual abilities. In some cases, however, children are born with these conditions.

• Diseases or conditions, such as migraine or diabetes, which can affect other organs of the body, such as the eyes.

• External causes, such as allergies or eye strain due to over-use, or as a side effect of medication.

What Are The Symptoms of Eye Disease?

The three symptoms indicative of eye disease are changes in vision, changes in the appearance of the eye, or an abnormal sensation or pain in the eye.

Changes in vision can include the following symptoms:

• Nearsightedness is caused by an elongation of the eyeball over time, making it difficult to clearly see objects far away.

• Farsightedness is caused by the shortening of the eyeball, making it difficult to see objects that are close-by clearly.

• Blurry or hazy vision, or loss of specific areas of vision, which can affect one or both eyes and is the most common vision symptom. Any sudden changes in vision should be a cause of concern.

• Double vision means a single clear image appears to repeat itself. This could be accompanied by other symptoms like headaches, nausea, a droopy eyelid, and misalignment of the eyes.

• Floaters are specks or strands that seem to float across the field of vision. These are shadows cast by cells inside the clear fluid that fills the eye. These are usually harmless, but should be checked out as they could point to something serious such as retinal detachment.

Eyelid rejuvenation surgery is a medical procedure that is designed to reduce the appearance of bagginess from the lower eyelids and sagging from the upper eyelids. This operation is often used for cosmetic surgery to reduce the appearance of aging.

This surgery can also be considered when the eyelids are interfering with a patient’s ability to see. Sometimes a sagging upper eyelid can partially obscure the eyeball, interfere with a person’s ability to look in certain directions or interfere with their peripheral vision.

Why Do My Eyelids Sag?

As our skin ages, it often loses its elasticity. This doesn’t allow the skin to rebound back to its original shape and we see the appearance of wrinkles and bulges that aren’t due to weight gain. While these wrinkles can occur all over the body, they typically first appear in the face and eyes. Any additional skin on or near the eyelids can cause the eyelid to sag or droop over the eyelashes and into the frame of vision.

The eyelids also contain some fat to protect and cushion the eyeball. The fat is held in place by a thin membrane. As we age, the membrane can weaken and will no longer keep the fat in place. This fat can create bulges in the upper and lower eyelids.

What Can I Do About Eyelid Sag or Bulging?

There are several non-surgical treatments on the market to help treat sagging skin or reduce the appearance of wrinkles, but it is important to use additional caution when applying any product near the eyes. Always make sure that the product is designed to be used in the predetermined area. If you have questions about a specific product, you should contact your health care provider.

Many individuals find that non-surgical options don’t have enough or any effect on their eyelids. In these instances, they can consider working with a licensed medical professional to weigh their options. Eyelid rejuvenation (blepharoplasty) is also commonly called an eye lift.

There are several different methods for achieving your desired results. Typically, an incision is made into the eyelid, and then the excess skin or fat cells are removed by laser or scalpel. Additionally, your surgeon may suggest that you also get laser resurfacing done in combination with your surgery.

What to Expect

Eyelid surgery can be done in a local office or a surgery center. If you are completing the operation in an office environment, you can probably expect that you will be treated with a local anesthetic and an oral sedative. If you are in a surgery center, it’s likely that you will receive an intravenous anesthetic. The surgery takes about two hours to complete if you are getting all four eyelids done (upper and lower lids). When you are getting all four eyelids corrected, the surgeon will likely opt to work on both upper eyelids first and then move to the lower eyelids. While the upper eyelids will have three to six stitches, the lower eyelids may not have any. The stitches should remain in place for three to six days.
 

LASIK (laser-assisted in situ keratomileusis), is the most popular refractive surgical procedure. In this procedure, a laser is used to permanently change the shape of the cornea (the clear covering on the front of the eye) to correct common vision problems such as nearsightedness, farsightedness, astigmatism, and presbyopia. This improves vision and reduces a person's need for glasses or contact lenses.

LASIK uses an excimer laser (an ultraviolet laser) to remove a thin layer of corneal tissue, giving the cornea a new shape, so that light rays are focused clearly on the retina. In the case of a nearsighted person, the goal of LASIK is to flatten the too-steep cornea; with farsighted people, a steeper cornea is desired. LASIK can also correct astigmatism by smoothing an irregular cornea into a more normal shape.

LASIK is an outpatient surgical procedure with no need to stay at the surgery center overnight as it will take 10 to 15 minutes to perform for each eye. The procedure is done while the patient is awake, but the patient may request mild sedation. The only anesthetic used is eye drops that numb the surface of the eye. LASIK can be done on one or both eyes during the same session.

How to Prepare for LASIK Eye Surgery?

Before LASIK eye surgery, the eye surgeon will evaluate the patient’s medical history and perform a full eye examination, including measuring corneal thickness, refraction, corneal mapping, eye pressure, and pupil dilation. Afterward, the surgeon will discuss what to expect during and after the procedure.

On the day of the surgery, eat a light meal before going to the doctor and take all prescribed medications, if any. Do not wear eye makeup, creams, perfumes or lotions on the day before and the day of surgery, or have any bulky hair accessories that will interfere with positioning head under the laser.

Contact lenses shouldn't be worn for at least three days prior to the evaluation. In the case of, rigid gas permeable contact lenses, they should not be worn for at least three weeks before. Patients should arrange for a ride home from the place of surgery, as their vision might be blurry.