Your Vision

The problem:

The central vision is decreased due to age related changes at the central part of the retina called the macular.

The cause:

Treatment:

Laser treatment is sometimes indicated for the 'wet' form of AMD. In the past few years there have been advancements made in slowing down and in some cases even stopping the progression of AMD. Anti-VEGF drugs such as Lucentis (Ranibizumab) and Avastin are now available to help in the treatment of AMD. These drugs inhibit the growth of new blood vessels. 95% of patients using these drugs maintain their baseline vision and 45% will improve their baseline vision. Optimum lighting, glasses and sometimes magnifying devices are also helpful in this condition.

Prognosis:

This condition never causes complete blindness, although it does decrease central vision. The side or peripheral vision is retained. Thus a patient with severe AMD will still be able to get around independently.

Often the condition presents in one eye only and the other retains normal vision. It is important to monitor the other eye by looking at a piece of graph paper to check for increasing distortions or missing vision.

To check your central vision, hold the grid below where you like to read. One eye at a time, focus on the central spot. The lines on the grid should appear straight and there should be no blank spots.

Retinal detachments often develop in eyes with retinas weakened by a hole or tear. This allows fluid to seep underneath, weakening the attachment so that the retina becomes detached - similar to wallpaper peeling off a damp wall. When detached, the retina cannot compose a clear picture and vision becomes blurred and dim.

If found early, it may only be necessary to have laser or freezing treatment however an operation will often be needed to repair a hole or put the retina back in place.

As the vitreous pulls free from the retina, it is often accompanied by light flashes or floaters. Floaters are caused by tiny bits of vitreous gel or cells that cast shadows on the retina. Flashes occur when the vitreous tugs on the sensitive retina tissue. There are other more serious causes of flashes and floaters, however. Retinal tears, retinal detachment, infection, inflammation, haemorrhage, or an injury such as a blow to the head may also cause floaters and flashes.

Signs include black spots or "spider webs" that seem to float in the vision in a cluster or alone, spots that move or remain suspended in one place, flickering or flashing lights that are most prominent when looking at a bright background like a clear, blue sky.

Surgical removal of the vitreous (vitrectomy) may be considered if the vision is significantly affected though this treatment is rare as most floaters typically become less bothersome over a period of weeks to months as they settle below the line of sight.

Keratoconus is usually a bilateral condition but one eye can progress faster than the other. Familial occurrence has been noted although most cases show no definitive inheritance pattern. Patients with Keratoconus should NOT have Refractive Surgery.

Treatment:

Glasses and Hard contact lenses to correct the refractive error induced by Keratoconus are the first step in providing adequate vision. As keratoconus progresses, the quality of one's vision deteriorates and contact lenses or glasses no longer become a satisfactory solution for most people. For many a corneal transplant was the only option. Intacs - prescription inserts are a new option between contacts and a corneal transplant that may be the best possible option to stabilize the cornea and improve vision.

How Intacs work?

Imagine your cornea as a tent with a curved top. If you push out the sides of the tent, the top flattens. Similarly, when Intacs inserts are placed in the sides of the cornea, they flatten it just enough to correct keratoconus.