When It’s Our Turn to Take Care of Them The unique challenges of caring for our community’s seniors

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CATARACTS, GLAUCOMA, AND SEVERE VISION IMPAIRMENT

By: Dr. Jacques Doueck

This month, Dr. Doueck interviews Dr. David Pinhas, an ophthalmologist, on the protocol and risk factors for common vision ailments.

Is there a procedure that people with very thick glasses can undergo so as not to be reliant on them?

Yes. Premium Intra Ocular Lenses (IOL) can be implanted so that the patient no longer needs glasses. 8%-10% of all lens surgeries are done in order to do away with glasses or contacts. And now multifocal IOL can take the place of progressive bifocals. Once these lenses are placed in the eye, over 97% of patients who are candidates for these lenses no longer need glasses altogether! Not for distance, intermediate, or near vision! And if chosen correctly, these individuals will never wear glasses again.

What is Lasik surgery?

Lasik surgery is a procedure in which a laser is used to make cuts in the cornea to correct a person’s vision. A partial cut is made in the cornea that extends about 90% of the width of the cornea. This grants access so that the surgeon can cut and shape the cornea. For those people who are susceptible to dry eyes, there are alternative laser surgeries, such as PRK. In this surgery, the top layer on the surface of the cornea (known as the epithelium) is removed. Then the laser reshapes the cornea. The laser removes tissue from the cornea very accurately, without damaging nearby tissues. The epithelium, which had been removed, grows back during the healing process.

What is Glaucoma?

A set of diseases that lead to elevated pressure of the eyes. Even without experiencing any signs or symptoms, the patient can be going blind from glaucoma due to excessive pressure in the eye. If not controlled, this can lead to permanent damage to the optic nerve and ultimately, a loss of vision.

Why is Glaucoma
called a “silent disease”?

Because glaucoma is painless, about half of people who have it don’t know they have it. Unfortunately, doctors cannot reverse damage from glaucoma once it’s been done. Vision loss is irreversible; you can’t get your vision back once it is lost. Your best protection is to get regular eye exams. By age 40, everyone should have a complete eye exam once every three years, at the very least. After age 60, eye exams should occur every year. During each eye exam, a person’s eye pressure is checked. While the eyes are dilated, we look for damage to the optic nerve
and we check the drainage of the eye.

What are the risk factors
for Glaucoma?

A family history is found in 20% of glaucoma cases. In the Jewish population, those of Eastern European descent are more commonly inflicted with it than those of Middle Eastern descent. African Americans are at the highest risk for Glaucoma. Diabetics have a three times greater chance of getting glaucoma than non-diabetics and the treatment for them is
more complicated.

How is Glaucoma treated?

Glaucoma is usually treated non-surgically. Most commonly, eye drops are used to keep the eye pressure within the normal range. If this does not help, a simple laser procedure is effective. For those with a very advanced disease, operating room procedures are recommended.

What are cataracts?

A cataract is not a layer of film over the eye. Rather, it is a clouding of the natural lens resulting in permanent damage. For those with cataracts, there is a lens inside the eye that becomes cloudy, reducing the level of overall vision. Age is the single most common risk factor where cataracts are concerned.

How are
cataracts treated?

By removing the damaged lens and surgically replacing it with an implantable lens.