Eye Diseases And Procedures

Eye Diseases And Procedures

Dr. Berke provides thorough eye exams for evaluating medical eye diseases and vision disorders, including assessing existing and previously-diagnosed issues, and determining if an un-diagnosed issue is present based on the specific signs and symptoms of the patient.  He helps patients with conditions including, but not limited to glaucoma, age-related macular degeneration, cataracts, eye infections, dry eye, allergies, inflammation, post-surgical issues and more.

Eye Diseases And Procedures Q & A

Super Vision Center

What is Glaucoma?

Glaucoma is a category of eye disease that occurs when the optic nerve fibers become damaged and it disrupts the transmission of information to the brain.  It is one of the leading causes of blindness in the U.S..  Chronic glaucoma has no symptoms at first, but progressively can steal your sight.  Over 3.3 million Americans are estimated to have glaucoma, the “sneak thief of sight.”  About 2% over age 40 have it and 4 times more in blacks.  Another 2 million don’t know they have it.  Glaucoma is treatable, and the earlier it is diagnosed and treated, the less chance there is of vision loss occurring.  There are three treatments used: eye drops, microsurgery, and laser surgery.  The drops decrease the production of fluid in the front section of the eye and/or increase the fluid outflow thus decreasing the intra-ocular pressure.  Laser surgery increases eye fluid outflow as well or it can repair a blockage.  Microsurgery is used to create an additional channel for the fluid to drain out of the eye.  View:  National Eye Institute regarding Glaucoma.

What is Diabetic Eye Disease?

Diabetic eye disease is used to describe a group of eye conditions which are common in those with diabetes.  All of the conditions can lead to serious vision loss or blindness.  Diabetic retinopathy is the most common diabetes-related disease and is the foremost cause of blindness in adults in the US.  It is the result of fluctuations in the retinal blood vessels linked to blood sugar levels. In some cases of diabetic retinopathy, retinal blood vessels can become inflamed and then leak fluid.  In other cases, abnormal blood vessels grow on the surface of the retina itself.  For patients with progressed forms of the disease, Dr. Berke often recommends laser surgery where an intense beam of light is aimed at the retinal vessels to stop leaking.  Laser surgery and proper follow-up care can minimize the likelihood of blindness by up to 90% when treatment begins as early as possible.  View:  National Eye Institute regarding Diabetic Retinopathy.

What is Macular Degeneration?

The Macula is the central vision zone of your retina.  The part you use to look directly at the object of your choice.  Age related macular degeneration (AMD) is a retinal disease that affects the sharp, central vision which can make reading and driving impossible.  Currently, more than 2 million Americans have AMD.  There are two forms, dry (90%) and wet (10%).  AMD is caused by degeneration in the central section of the retina, the macula, and is somewhat treatable but currently not curable.  When cells in the macula break down, images are not collected properly and as the disease progresses, individuals can experience blurred or wavy vision eventually leading to central vision loss.  For wet AMD the most common treatment is vascular endothelial growth factor (anti-VEGF) injection therapy.  An injection in the eye may sound intimidating, but the shot is not painful as the eye is anesthetized first. The procedure takes about 15 minutes and the effects can last around a month and occasionally longer.  Studies have shown that special formulations of vitamins, minerals and large amounts of anti-oxidants and protein dyes like lutein, zeaxanthine and meso-zeaxanthine slow down the process. Click here to learn more:  AMD.  National Eye Institute regarding Macular Degeneration.

In order to learn more about the benefits of the necessary macular nutrients: proteins, caratenoids, trace metals and minerals needed and the best delivery system to be absorbed by your body, view this page: Lumega Z.
Full disclosure:  I have no financial interest in Lumega-Z.

Taking nutrients have been proven beneficial and help slow the progression of AMD but there is another side to the story.  Take a listen to this very informative video by Chris A. Knobbe, MD, Professor of ophthalmology at the University of Texas, regarding modern processed foods vs. ancestral diet.  Very interesting.  AMD is a leading cause of irreversible vision loss and blindness in developed nations.  1 in 3 adults >75, and 1 in 11 >age 50.   Prior to 1930 it was virtually unheard of.  Dr. Knobbe discusses prevention and treatment with whole foods and ancestral diet.

What is a Cataract?

A cataract is a clouding of the normally clear lens inside the eye and is a part of our natural aging process.  The Latin word for ‘cloudy’ is ‘cataract.’  It blocks light from reaching the back of the eye and interferes with vision.  The most common symptoms include: cloudy, blurry or double vision; glare or light sensitivity; halos around lights and poor night vision; fading/dullness of color perception and frequent changes of your eye prescription.  22.3 million Americans have cataracts.  More than 3 million surgeries are done per year and it is one of the fastest, safest and best resulting surgeries of all time.  Cataracts are the most common cause of vision loss globally.3 The U.S. market is expected to grow to 5.4 million cataract surgeries by 2025.2  With the aging population, the number of people in the U.S. with cataracts is expected to double by 2050.1  Cataract surgery removes the cloudy lens.  Recovery is a matter of a few days.  Before 2011, cataract surgery was done with a blade but nowadays there is even laser assisted cataract surgery for better precision.  Today there are different types of lens implants to choose from.  These include: standard or monofocal lenses; multifocal or accommodating lenses like the Crystalens® and the AcrySof IQ Vivity IOL (Vivity) that mimic the eye’s natural focusing ability for distance and near; and toric lenses for astigmatism.  View:  National Eye Institute regarding Cataract.
1. Cataract Data and Statistics. National Eye Institute. Accessed December 21, 2020. https://www.nei.nih.gov/learn-about-eye-health/resources-for-health-educators/eye-health-data-and-statistics/cataract-data-and-statistics.
2. 2020 IOL Market Report – Mid Year Update, Market Scope, 08/28/2020, pp5, Table 47: Forecast for the IOL Market in the United States.

What is Presbyopia?

Translated from Latin, presbyopia literally means aging (presby) eye (opia).  By the time you are in your 40’s or beyond, your eyes have begun to lose the ability to focus at near and you can have headaches, eyestrain at close work, blurry vision and eye fatigue.  Jokingly we say you don’t need glasses, your arms are to short.

Classically you turn to reading glasses or contact lenses.  Nowadays there are several alternatives to glasses and they include: Corneal surgical inlay (which are tiny lenses inserted into the cornea like the KAMRA™), refractive lens exchange (RLE – replaces your eye’s natural lens with an implant) , refractive surgery, monovision or multifocal contacts.  View:  National Eye Institute regarding Presbyopia.

What is Pterygium?

Pterygium (surfer’s eye) is a non-cancerous growth on the cornea (the clear front window of the eye) and the conjunctiva (a thin membrane covering the white of the eye).  While not usually a serious condition, pterygium has the potential to grow large and permanently  distort your vision if it approaches the pupil center.   Pterygium is a growth of fleshy tissue in one or both of the eyes.  If you have pterygium, you’ll likely experience eye irritation, discoloration, and excessive tearing.  The condition can also cause an uncomfortable “foreign body sensation” in your eye.

Pterygium is most commonly attributed risk factors are, chronic exposure to wind, smoke or dust and is most prevalent in people who live in tropical climates or in those who spend significant amounts of time exposed to sunlight (UV).  It’s typically seen in individuals between the ages of 20 and 40, and is likely to affect men more than women.
In many cases treatment is not necessary.  Sometimes OTC artificial tears and lubricants are used to reduce dryness and inflammation.  It can be removed surgically and grafts may be used and Mitomycin C to prevent re-occurrence and give the eye the best cosmetic appearance.   View:  National Eye Institute regarding Pterygium.

What is Keratoconus?

Keratoconus is a fairly uncommon eye condition, affecting roughly 1 in 2,000 people.  The disease causes progressive weakening and thinning of the cornea, which causes it to bulge into a cone shape.  It is typically not correctable with glasses, requiring specialty contact lenses, or in severe cases if left untreated, a corneal transplant.
The first signs of keratoconus usually appear in your early teenage, rapid growth years.  In most people, the condition stabilizes in their 40s or 50s.
In addition to blurred or distorted vision, symptoms of keratoconus can include astigmatism, sensitivity to light, and frequent prescription changes.  The condition can make everyday activities like riding a bike or reading a magazine very difficult.
Keratoconus affects individuals throughout the world, and doesn’t have a significant geographic or cultural footprint.  Keratoconus has a hereditary component, and is also strongly linked to vigorous eye rubbing and Down’s Syndrome.  National Eye Institute regarding Keratoconus.
Treatments: Keratoconus is a progressive disease of the cornea.  With collagen cross-linking (CXL), you can halt the progression of keratoconus by strengthening your cornea.  This ground-breaking, FDA approved procedure, has helped tens of thousands of people around the world.  Here’s a short video on crosslinking,  CXL.

The surgical implantation of intracorneal ring segments or Intacs® is a minimally invasive surgical option to improve the corneal shape in patients with keratoconus, a condition in which the cornea develops a cone-like bulge.  Intacs® are clear, thin corneal implants that are surgically inserted via a thin channel created by a femtosecond laser in the periphery of the cornea.  They are safe and removable.  Here is a sort video:  Intacts®

What is Oculoplastic Surgery?

Oculoplasty is a type of surgery performed on the areas around your eyes—eyelids, tear ducts, and eye socket—by ophthalmologists specially trained in plastic or reconstructive surgery. You may elect to undergo an oculoplastic procedure for medical or for cosmetic reasons.

Some medical conditions commonly treated with oculoplasty include:

  • Skin cancers or other growths in or around your eyes
  • Eye problems caused by thyroid disease
  • Weakness around your eyes or eyelids caused by Bell’s palsy
  • Eyelids that turn inward (entropion) or outward (ectropion)
  • Droopy upper eyelids (ptosis)
  • Excess skin and aging changes around the eyes

Oculoplasty can also be used to treat injuries to your eye or eye area as well as eye-related birth defects.

  • In addition to medical conditions, oculoplasty is also commonly used for cosmetic purposes, like repairing sagging or drooping eyelids (eyelid lifts) and improving the appearance of wrinkles in the forehead and between the eyes (forehead lifts).

What are Blepharoplasty and Cosmetic procedures?

Laser blepharoplasty eye surgery, also known as laser eyelid surgery, is a surgical procedure to rejuvenate eyelid tissues (skin, muscle, or fat). Blepharoplasty is performed for both cosmetic and vision correction purposes.

a number of nonsurgical cosmetic options that patients may consider—whether to enhance natural features, or for medical reasons.

Here’s a site to behold by a world famous oculoplastic surgeon, Richard Weiss:  BOTOX®

What are LASIK, PRK and SMILE Procedures?

LASIK—short for Laser-Assisted-In-Situ Keratomileusis—is the most commonly performed laser eye procedure in the world. It’s one of the safest and most effective ways to correct vision.

Photorefractive Keratectomy, more commonly called PRK, is a laser vision correction procedure. PRK is often a good solution for people with thinner than normal corneas—but your surgeon will be able to determine which procedure is best for your individual needs.

SMILE—Small Incision Lenticule Extraction—is the latest innovation in laser vision correction.  SMILE eye surgery is a minimally invasive procedure that does not require a corneal flap.  It has successfully been performed on half a million patients worldwide.

SMILE can be used in some cases of thin corneas, dry eyes, or contact lens intolerance.  Similar to LASIK and PRK, your  surgeon will determine which laser vision correction is right for your individual needs based on your exam and vision goals.

SMILE causes less disruption of the corneal nerves than other laser vision procedures. As a result, you may have even lower chances of dry eye.

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