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Laser Eye Surgery: All you need to know!

Deciding to get laser eye surgery can often be a huge decision, not helped by some common myths surrounding the process and the potential side effects.

But, regaining your sight can also be one of the most rewarding things you’ll ever do, so we thought we’d bust those myths (and horror stories!) and find out what really happens if you opt for surgery.

Mr David Allamby is a specialist laser eye surgeon and founder of London’s Focus Clinic.

He’s not only one of the most respected vision experts in the world, but he’s also treated a host of celebrities, including model David Gandy, Olympian Victoria Pendleton, TV host Laura Whitmore and Love Island’s Scott Thomas.

Here, he lifts the lid on everything you ever needed to know about surgery to correct vision:

How does it work?

The most popular form of laser eye surgery is called LASIK – aka ‘laser-assisted in-situ keratomileusis’. It works by changing the curvature of the cornea, the transparent, curved window at the front of the eye. Something called an ‘excimer laser’ evaporates a really thin layer of collagen within the upper layers of the cornea and surgically reshapes the overall dome.

This means light entering at the front of the eye comes to a clear focus on the retina at the back of the eye, ensuring you can see clearly. And several studies have shown that once the shape of the cornea is adjusted, the change is ‘permanent’.

Will I ever need to wear contacts / glasses ever again?

It’s a common myth that surgery will ‘wear off,’ but your surgery for short-sightedness should last many, many years or indeed for your lifetime. The same applies for correcting astigmatism.

Long-sightedness and the need for reading glasses are age-related problems, and so re-treatment may be needed in the future.

At our clinic, we give short-sighted patients a ten-year guarantee on their laser surgery – ten times longer than other clinics.

So, in the extremely rare circumstance that you require re-treatment in the first 10 years post-treatment, the cost of the repeat surgery is free!

Might I need to wear reading glasses?

As we age, the lenses in our eyes lose some of the elasticity that lets them focus on objects up-close. This is just part and parcel of growing old and known as ‘presbyopia’, and is the reason why many people aged 40 and over will need reading glasses.

But there are solutions.

We offer two techniques that can help patients already suffering from presbyopia—the ‘LASIK Blended Vision’ procedure, or alternatively Refractive Lens Exchange (RLE). The choice will depend on your age and prescription.

Also, contrary to common misconceptions, if you’re under 40, LASIK surgery will NOT cause you to need reading glasses prematurely.

How long does the procedure take? 

The laser aspect of the surgery lasts for just a few minutes per eye and takes around 10 minutes in total.

The rest of the time—your appointment will last for about 90 minutes—simply involves the surgeon carrying out a series of checks to ensure complete accuracy.

After surgery, you’ll spend about twenty minutes in a patient recovery room, essentially relaxing while eating tea and biscuits!

How long is recovery time / will I need much time off work? 

With LASIK, most patients have a little discomfort immediately after surgery, as your eyes need a few hours to heal.

You’ll also need someone to drive you home or help with a taxi, too, and you should rest up for the remainder of the day. If in London, you mustn’t use the tube on the way home, to avoid dust or dirt being blown into your face.

Your eyes might also feel a little dry and scratchy, though this won’t last long and eye drops can relieve the symptoms.

You’ll have a follow-up appointment at the clinic the following morning after surgery, and most people are then able to return to work immediately afterwards.

Do I have to stop wearing contact lenses pre-surgery?

Contact lenses can alter the shape of your corneal surface, so it’s important you take them out long enough for your cornea to return to its natural shape before surgery.

Typically, if you wear regular soft contact lenses or extended wear lenses, you’ll need to take them out a week before surgery.

But if you wear Rigid gas permeable (RGP) lenses, and have been doing so for some time, you might need to go without contacts for 4-8 weeks before coming in for your treatment.

It’s also fine to switch to soft lenses for most of this time if you’d rather not wear glasses for that long.

How long will it take after the surgery for me to be able to see?

Most patients who have LASIK will have good vision straight after surgery. However, in some cases, it can take up to 24 hours for your 20/20 (or better) vision to come into effect.

It’s also important to remember that laser eye surgery doesn’t hurt. Most patients don’t find it an uncomfortable procedure, more strange and rather ‘sci-fi’!

How do they stop your eyes from blinking during the surgery?

During surgery, your eyes are gently held open by a device which makes sure you can’t blink.

You’re given anaesthetic drops so that you don’t get any pain, and it’ll feel like you’re blinking normally, even though your eyelids aren’t opening and closing. The muscle to blink still twitches, but the lids don’t close.

Some people worry that if they move—or sneeze!—it will affect the results. But it’s impossible to do so. During the time the laser is running, sophisticated tracking technology rapidly analyses the position of the eye to make sure it’s always in exactly the right position.

And this all takes place faster than you can physically move your eyes anyway. All you have to do is look at the flashing green light directly in front of you and your surgeon will do the rest.

What happens if something goes wrong?

As with everything, when you’re choosing a surgeon you need to think carefully and check their results. You should ask questions like, “What percentage of patients get 20/20 vision after surgery?”

Be aware that the main risk in laser eye surgery is a surgeon who selects and treats people who aren’t actually good candidates for surgery in the first place.

You should choose a specialist surgeon who works in a lower volume setting, and who can, therefore, take the time to properly assess and treat you.

As with any surgery, there are potential risks, but treatments are available for almost all complications that affect your vision.

Serious complications with LASIK are actually very rare if the patient is well selected.

The chance of having a significant complication affecting your vision (in one eye or the other) from LASIK is around 1 in 10,000. The risk of infection is even less, at 1 in 20,000.

What precautions do I need to take following the surgery? 

It’s bad news if you like swimming or hot showers—we recommend avoiding getting water in your eyes for the first 48 hours after surgery and you should keep away from saunas and steam rooms for around two weeks.

You should also skip sporting activities for the first week after treatment, which will give your eyes time to heal properly. As for flying, you can take short-haul flights the next day after surgery and you can travel long-haul around a week after treatment.

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Original Author: Georgia Farquharson

Original Date: November 29, 2017

Newcastle scientists eye-up cornea ‘breakthrough’

Artificial corneas have been grown using a new method described as “revolutionary”.

Scientists at Newcastle University have developed a process they say makes them fit better and offer better vision.

Lead researcher and Professor of Tissue Engineering Che Connon said this had “never been seen before”.

Cells grown on a curved rather than flat surface were “crawling over the dome in a lattice-like structure, similar to a pie crust”, he said.

The cells produced “large amounts” of aligned collagen in the same way it is found in a human eye, Prof Connon said.

“There were no easy ways to recreate it in a dish – until now,” he added.

The corneas, which are stronger and more transparent than previous artificial versions, take three months to produce.

The “breakthrough” could solve the shortage of donated human corneas in the UK, Europe and the USA, the university said.

The increase in laser eye surgery, which makes corneas unusable for transplant, has reduced the supply, it added.

The new technique also provides an alternative to plastic corneas, which the body can reject.

It could “revolutionise how artificial tissues are traditionally grown in laboratories around the world”, the university said.

The research, published in the journal Advanced Biosystems, was conducted with scientists from the University of California.

Newcastle University first author Dr Ricardo Martins Gouveia said the research suggested “we will be able to produce corneas that are more similar in shape and form to the natural eye”.

“We think our team will be able to test these in humans within two years.”

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Original Date: Oct 20 2017

Original Author: Tyne and Wear

SMC unveils next-generation refractive surgery

Samsung Medical Center (SMC) has introduced the latest innovation in Lasik surgery technology called the “Excimer Laser EX500” with Contoura Vision, the hospital said Thursday.

Lasik— commonly referred to as laser eye surgery or laser vision correction– is a type of refractive surgery for the correction of myopia, hyperopia, and astigmatism. For most people, Lasik provides a long-lasting alternative to eyeglasses or contact lenses.

Contoura Vision won the approval of the U.S. Food and Drug Administration in 2013 and was selected as a next-generation refractive surgery by the American Cataract and Refractive Society in 2016.

The corneal topography maps the surface curvature of the cornea by lasering 22,000 dots on the outer structure of the patient’s eye, and then the surface of the patient’s rugged cornea is classified by height and smoothness.

Patients with an irregular corneal shape as well as refractive errors such as myopia and astigmatism can be corrected at the same time. Discomforts such as light blurring or night vision deterioration, which is considered to be typical side effects of vision correction, is lower than that of conventional correction.

According to the FDA, the rate of visual acuity of 1.0 or better after three months has been reported to be 92.6 percent. 98.4 percent of the patients said they were satisfied with the results.

“The corneal shape and refractive index differ from person to person, and Contura Vision is a state-of-the-art vision correction system that is tailored to individual corneal conditions,” said Professor Jung Tae-young정태영 from the Department of Ophthalmology at SMC. “We expect it will improve the satisfaction of patients by reducing irregular astigmatism that is difficult to correct.”

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Original Author: Constance Williams

Original Date: 11/2/17

An Eye Scan for Alzheimer’s Disease?

Neurodegenerative diseases are tough nuts to crack, not just because of the inherent difficulties of sorting through what has gone awry, and why, but also due to a dearth of biomarkers that could help spot the diseases and track their progression. This inability to easily diagnose many forms of neurodegeneration means that the diseases can’t be treated early in their progression. The lack of biomarkers also hinders the certainty with which researchers running clinical trials can assess whether and how well experimental treatments of the diseases are working. A simple, noninvasive eye scan now being developed for Alzheimer’s disease (AD), however, may help address both shortcomings.

AD researchers already utilize amyloid positron emission tomography (PET), in which tracers are injected into patients’ brains to make the disease’s characteristic amyloid plaques detectable by PET imaging. But the scans are very expensive, spurring the continuing hunt for biomarkers. “What we now know is that the disease essentially occurs about 20 years before a patient becomes symptomatic,” says Cedars-Sinai Medical Center neuroscientist and neurosurgeon Keith Black. “And by the time one is symptomatic, they’ve already lost a lot of their brain weight; they’ve already lost a significant number of brain cells; they’ve already lost a significant amount of connectivity.” What’s needed, he says, is a way to detect the disease early so it can be treated—with drugs, lifestyle interventions, or both—before it’s too late.

So Black has been working with Cedars-Sinai colleague Maya Koronyo-Hamaoui and others on a different way of peering into the skull. “The retina is really part of the brain” and shares many cell types with it, explains Koronyo-Hamaoui, so it makes sense that people who have amyloid plaques in their brains might also have them in the retina. To find out whether that’s the case, Koronyo-Hamaoui has led animal studies that showed the quantity of plaques in the retina correlates with levels in the brain (NeuroImage, 54:S204-S217, 2011).

What we would like to see is extension of this data across different stages of Alzheimer’s disease, and how it relates
to other biomarkers, such as amyloid imaging.—Douglas Galasko, University of California,
San Diego, School of Medi­cine

In a new study, the researchers analyzed brains and eyes from cadavers of humans with and without AD, and found that plaques tend to cluster in a far corner of the retina, the superior quadrant, an area not typically examined by ophthalmologists.

To visualize the plaques in living people, the researchers had volunteers eat a chocolate pudding spiked with curcumin—which gives the spice turmeric its deep-yellow color—2 or 10 days prior to scanning their eyes. Previous experiments had shown that curcumin fluoresces when bound to the characteristic amyloid-β plaques of Alzheimer’s, and the team selected a form of the substance with relatively high bioavailability, Koronyo-Hamaoui says.

The researchers then used a modified ophthalmoscope to look at the superior quadrant in the retinas of AD patients, and compared the readings with those of healthy volunteers. Those with the disease showed twice as much amyloid-β–linked fluorescence in that area of the eye, the team reports (JCI Insight, 2:e93621, 2017).

This latest study is “an interesting and novel and promising step,” says Douglas Galasko, a neurologist at the University of California, San Diego, School of Medicine who was not involved in the work but has collaborated in the past with some of its authors. “What we would like to see is extension of this data across different stages of Alzheimer’s disease, and how it relates to other biomarkers, such as amyloid imaging.”

While previous studies from the Cedars-Sinai group have suggested amyloid-β deposition on the retina could reflect similar aggregations in the brain, “I think that this is much stronger,” in part because the researchers analyzed tissue from both the human retina and the brain, says eye researcher Bang Bui of the University of Melbourne who was not involved in the work. As for the scans of living patients, “I think it’s good proof of principle and certainly really exciting to take things from there, to go forward with this, and maybe to a larger clinical trial,” he adds.

The development of a simple noninvasive procedure using a device that’s already in wide clinical use is particularly exciting, Bui tells The Scientist. Koronyo-Hamaoui, Black, and two other coauthors of the study have founded a company, NeuroVision Imaging, that is now working on getting US Food and Drug Administration approval for the modified ophthalmoscope as a detector of fluorescence in the eye.

If further testing confirms the results, Black envisions people in their 50s and 60s one day getting routine eye scans for Alzheimer’s disease as part of their yearly checkups. “If we could potentially stop the disease . . . I think that’s a realistic possibility—that’s an excellent outcome,” he says. “If we could delay the onset of the symptomatic phase of the disease for 5 years or 10 years, that’s also a wonderful outcome.”

Original Source:

Original Date: Nov 1 2017

Original Author: Shawna Williams

Reducing risk for eye stroke

When people think of strokes, they immediately think of an abnormality occurring in the brain.

However, it can happen in the eyes too. This type of stroke is referred to as retinal artery occlusion or stroke of the eye.

Stroke of the eye is a frightening condition that causes people to lose vision in one eye in a matter of hours or days.

It strikes up to 6,000 people a year in the United States, according to the National Institutes of Health.

A stroke affecting the eye is a blockage in the blood vessels in your retina, the light-sensitive tissue at the back of your eye.

“This can happen due to certain risk factors such as diabetes, high blood pressure, high cholesterol, glaucoma, small optic nerve ratio and many other things,” said optometrist Dr. Ashley Setterberg.

The most common symptom of a stroke affecting the eye is a sudden painless vision loss.

“So it can start and gradually increase over hours to days. You can have floaters which are small gray spots floating around in your vision. You can have blurry vision, which steadily worsens in one section of your field of vision or all of one eye. And you can have complete vision loss that can occur suddenly, or gradually over time,” said Setterberg.

While it may not always be possible to prevent eye strokes from occurring, there are a few things you can do to help decrease the chances of having one.

“We can see quite a few symptoms from a regular dilated eye exam, fundus photos, and other special testing. There are different treatments, such as injections into the eye, eylea  steroids, and even anti-blood clotting agents. It is very important  to have these annual eye exams, so we can catch any signs that may be a precursor to it or a risk factor,”said Setterberg.

Experiencing a sudden loss of vision can be a scary situation. If you or anyone you know happens to find themselves experiencing vision loss possibly caused by an eye stroke, seek medical attention immediately.

A cerebral stroke, which affects blood flow to the brain, can also cause sudden vision loss or changes in vision. For this reason, any sudden changes to vision require emergency medical attention.
The longer any stroke is left untreated, the more likely it is that the affected organs will be permanently damaged.

Who Is At Risk for a Stroke Affecting the Eye?
Men are more likely to have a stroke involving the eye than women. The disease is most commonly found in people in their 60s. Having certain diseases increases your risk of an eye stroke. These include:

  • Cardiovascular disease
  • Diabetes
  • High cholesterol
  • High blood pressure; and
  • Narrowing of the carotid or neck artery

Most people know that high blood pressure and other vascular diseases pose risks to overall health, but many may not know that high blood pressure can affect vision by damaging the arteries in the eye.

Eye stroke symptoms:
Floaters – Small gray spots floating around in your field of vision. Floaters occur when blood and other fluids leak and then clump up in the fluid inside the eye.

Pain or pressure – Can signal a problem with the eye, however, true eye strokes are often painless.

Blurry vision – Steadily worsens in one section of your field of vision or all of one eye.

Complete vision loss – Can occur suddenly, or gradually over time.

Prevention tips for stroke of the eye:
Properly manage your diabetes – Keep glucose levels in ideal ranges as set by your doctor.

Treat your glaucoma – This condition raises intraocular pressure, increasing your risk for eye stroke. Follow the treatment plan as prescribed by your doctor to avoid any possible complication.

Control blood pressure – Poorly controlled blood pressure is a major risk factor for the contribution of eye strokes, therefore, keeping blood pressure controlled with diet and exercise, plus any prescribed medications, will help a great deal.

Manage cholesterol levels – Diet and exercise will help reduce levels in addition to any prescribed medication.

Original Source:

Original Date: Oct 25 2017

Original Author: Roland Rodriguez

Dyslexia link to eye spots confusing brain, say scientists

French scientists say they may have found a potential cause of dyslexia which could be treatable, hidden in tiny cells in the human eye.

In a small study they found that most dyslexics had dominant round spots in both eyes – rather than in just one – leading to blurring and confusion.

UK experts said the research was “very exciting” and highlighted the link between vision and dyslexia.

But they said not all dyslexics were likely to have the same problem.

People with dyslexia have difficulties learning to read, spell or write despite normal intelligence.

Often letters appear to move around and get in the wrong order and dyslexic people can have problems distinguishing left from right.

Human beings have a dominant eye in the same way that people have a dominant left or right hand.

Shape of spots

In the University of Rennes study, published in the journal Proceedings of the Royal Society B, scientists looked into the eyes of 30 non-dyslexics and 30 dyslexics.

They discovered differences in the shape of spots deep in the eye where red, green and blue cones – responsible for colour – are located.

In non-dyslexics, they found that the blue cone-free spot in one eye was round and in the other eye it was oblong or unevenly shaped, making the round one more dominant.

But in dyslexic people, both eyes had the same round-shaped spot, which meant neither eye was dominant.

This would result in the brain being confused by two slightly different images from the eyes.

Researchers Guy Ropars and Albert le Floch said this lack of asymmetry “might be the biological and anatomical basis of reading and spelling disabilities”.

They added: “For dyslexic students, their two eyes are equivalent and their brain has to successively rely on the two slightly different versions of a given visual scene.”

No single cause

Prof John Stein, dyslexia expert and emeritus professor in neuroscience at the University of Oxford, said having a dominant spot in one eye meant there were better connections between the two sides of the brain and therefore clearer vision.

He said the study was “really interesting” because it stressed the importance of eye dominance in reading.

But he said the research gave no indication of why these differences occurred in some people’s eyes.

He said the French test appeared to be more objective than current tests, but was unlikely to explain everyone’s dyslexia.

Dyslexia is usually an inherited condition which affects 10% of the population, but environmental factors are also thought to play a role.

“No one problem is necessary to get dyslexia and no one problem is behind it,” Prof Stein said.

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