Do I have cataracts?
Signs of decreased vision can be subtle. Difficulty driving at night and reading small print...or just feeling "I have to change my glasses" are common complaints.
Many people can't tell they have cataracts because it happens gradually. For this reason, an annual eye exam by an ophthalmologist is especially important after the age of 60.
If you do have cataracts, don't worry. Cataract surgery is both advanced and safe. Small incisions, stitch-less laser cataract surgery is available, and advanced-technology lens implants can treat astigmatism and offer spectacle-independence.
A custom-tailored surgical plan is created and discussed with you on a one-to-one basis with Dr. Christopoulos. She is a fellowship-trained cornea specialist and cataract surgeon who is uniquely qualified to understand the details of your eyes.
Do you feel that your glasses need to be updated to help you see better?
Do you need more light to read or find it difficult to discern smaller numbers, e.g. "3" vs. "8"?
Do you find glare from car headlights at night (or day) dazzling or find reading street signs difficult?
Do you use a magnifier to read? Do you find small print on the TV difficult to read?
Do you see colors differently than your friends, e.g. confusing black and blue?
Have your habits changed on account of your vision? Do you read less, avoid driving at night, find sewing or other hobbies more difficult?
What is glaucoma?
Glaucoma is a multifactorial eye disease involving the optic nerve. The optic nerve connects the eye to the brain and functions like the plug in a computer powering the eye to see. It can be a problem in patients with high, average, or even low eye pressures.
Because glaucoma is potentially a silent blinding disease, screening during your comprehensive eye exam is important. One drop a day or laser treatment is most commonly needed to halt progression and prevent a shrinking field of vision.
Those of African American decent, with high intra-ocular pressures, the appearance of large optic nerves on eye exam, sleep apnea, migraine headaches, Raynaud's syndrome, etc. may need to be screened.
Those who are being treated for glaucoma and have cataracts may benefit from minimally-invasive glaucoma surgery at the time of cataract surgery. It is safe and requires no additional recovery.
What is Age-Related Macular Degeneration?
Age-related macular degeneration affects the retina causing patients to lose central vision. Peripheral vision remains undisturbed.
There are dry and wet forms of macular degeneration and both can vary from mild to severe. There is no treatment for the dry form. Eye injections are necessary for the wet form.
Newer technology at Eyepolis, Optovue RTVue (OCTA), allows cross-sectional, non-invasive imaging of the retina and measures response to treatment.
Dr. Christopoulos was the first ophthalmologist in western Pennsylvania to implant a miniature telescope into the eye of patients with advanced macular degeneration.
Good nutrition, not smoking, and sun eye protection are very important for all patients.
How Do I Treat My Dry Eyes?
Those with dry eyes describe them as feeling "cracked" or "sandy and gritty" with sometimes variable vision between blinks. More confounding to patients is that eyes can actually be watery. The body tries to wet dry eyes and sometimes over does it!
Dry eyes are very common. It can be related to contact lens over wear, environment, hormonal changes, eyelid sag, clogged eyelid oil glands, medication, and immune diseases such as Sjogren's and rheumatoid arthritis.
Computer dry eye is real. Following the 20-20-20 rule can help. Every 20 minutes, look 20 feet away from computer screens and blink for 20 seconds. Your blink reflex decreases when you stare at screens. Blinking not only helps coat the surface of the eye, it helps to squeeze oil form eyelid glands that keep the eyes from becoming dry.
Over-the-counter tear drops, prescription dry eye treatments, and serum drops may be helpful. Dr. Viki is a Cornea specialist and will discuss an appropriate therapeutic plan for your eyes.
What is Keratoconus?
Keratoconus is the most common corneal dystrophy in the U.S. and can start in one's teens. Progressive thinning of the cornea causes pointing. This increases astigmatism causing a less-than-perfect image. Eye rubbing is thought to be one culprit.
Cornea specialists like Dr. Christopoulos have high-tech diagnostic instruments, topographers, to help diagnose and stage keratoconus. It typically affects one eye more than the other.
Patients often need to transition from glasses to hard contact lenses. Hybrid contact lenses that combine quality of vision of a hard contact lens with the comfort of a soft contact lens are also an option. Some require either partial-thickness or full-thickness corneal transplantation while others are sometimes helped by corneal collagen cross-linking.
Those with keratoconus are encouraged to treat their allergies and to not rub their eyes.
What is Fuchs' Corneal Dystrophy?
Fuchs' is a common dystrophy that affects the inside of the clear cap of the eye, the cornea. It causes blurred vision, glare, and swelling as it progresses. Glare makes night-time driving difficult. Inheritance is from one parent and passed to children 50:50. It usually manifests in older age.
Non-invasive imaging with corneal OCT (optical coherence tomography) allows a cross-sectional view of the cornea and a way to monitor progression. The decision to correct surgically, however, is based on clinical appearance, vision, and disability.
Innovation in corneal transplantation allows easier recovery and quicker improvement in vision. Dr. Christopoulos was one of the first corneal surgeons to perform Descemet's Stripping Endothelial Keratoplasty (now ultra-thin DSEK) at the University of Pittsburgh Eye Center in 2005.
