Eye

SMART LENS

Contents

Who Can Wear Smart Lenses?

How is Smart Lens Surgery Performed?

How Do Smart Lenses Benefit Patients?

Let’s Call You Immediately

Who Can Wear Smart Lenses?

Smart Lenses, which are usually worn in cataract surgery, can be applied to most of the cataract patients if the person does not have a different obstacle to the Smart Lens. Apart from this, Smart Lens (GIM) application can be applied for our young patients who cannot have laser due to severe hyperopia or high myopia, but who want to get rid of glasses or lenses.

In addition, Smart Lens operation can be preferred in patients who have undergone laser surgery before, but who have problems with vision loss or not being able to see far or near clearly due to the deformation of the natural lens in the eye over time.

In patients who will have a Smart Lens operation, the appropriate Smart Lens is decided by considering the patient’s occupational position, age, social life, reading habits and daily habits

How is Smart Lens Surgery Performed?

In the Smart Lens (GIM) placement operation, the same procedures are performed as in standard cataract surgery. Just like in cataract surgery, the natural lens in the eye is removed and replaced with a Smart Lens, which is suitable for the structure of the eye and will increase the patient’s vision quality. In Smart Lens surgeries, unlike cataract surgery, Smart lens (intraocular lenses that provide clear vision at all distances) are placed inside the eye instead of the standard lens (for clear vision at a distance but requires glasses for close vision).

How Do Smart Lenses Benefit Patients?

Thanks to the Smart Lens (GIM), the patient has clear vision from any distance without the need for glasses or lenses. Smart Lenses are lenses with a focusing feature, which we can call close, medium and long distance depending on their multifocal design. These lenses, which are worn during the cataract operation, remain in the eye for life. Smart Lens operations take an average of 10 minutes and do not require stitches. Thanks to this operation, the most plain and simple solution to the patient’s vision problem is found and the patient’s vision is improved.

In patients who underwent Smart Lens operation, the eye number does not change again and the possibility of cataracts is eliminated.

CHILD EYE HEALTH

Even if your child has no complaints, you will have taken a big step for your child with an eye examination that you will have at 6 months of age for babies and every year for children. In addition to the precautions, if you notice one or more of the symptoms listed below in your child, you should immediately consult an ophthalmologist.

Squinting or closing one eye

A white or hazy color in the pupil that should appear black

Keeping objects close to your eyes at all times

Don’t look down with your head

rubbing your eyes frequently

Inward or outward shifting of one or both eyes

premature birth

Diagnosis of lazy eye in the family

DIABETIC RETINOPATHY

Contents

Diabetic Retnopathy Symptoms

Causes of Diabetic Retinopathy

Diabetic Retinopathy Treatment

Ways to Prevent Diabetic Retinopathy

Diabetic retinopathy is a complication of diabetes that results from damage to the light-sensitive tissue (retina) at the back of the eye. Diabetic retinopathy also causes new blood vessels to form on the retinal surface. These new veins can bleed easily. Diabetic retinopathy is an eye disease that can cause blindness if it is not diagnosed and treatment is delayed.

In the stages of diabetic retinopathy, it usually takes several years to reach the sight-threatening stage.

The retina consists of a layer of light-sensitive cells that convert the light coming from the back of the eye into electrical signals and send images to the brain. The retina needs a constant supply of blood, which it receives from a network of small blood vessels. Constantly high blood sugar can damage these blood vessels in 3 stages over time:

• Background Retinopathy: In this disease, which is caused by the formation of small swellings in the blood vessels, small hemorrhages may occur and there is usually no factor affecting vision.
• Pre-proliferative Retinopathy: In this case, intraocular bleeding is more than in Background Retinopathy. In Pre-proliferative retinopathy, blood vessels are also affected, as are more severe and widespread changes.
• Proliferative Retinopathy: In this stage, scar tissue and new blood vessels develop in the retina, which are very easy to bleed and are extremely weak. This may cause vision loss in some patients.

As with any disease, early diagnosis is very important in eye diseases. In the early diagnosis of Diabetic Retinopathy, you can continue the treatment with easier stages without the need to change your lifestyle.

Diabetic Retnopathy Symptoms

Diabetic retinopathy is a very insidious disease, so if you don’t go for regular eye exams in the early stages, you probably won’t notice it. Because this disease does not tend to show obvious symptoms until it reaches advanced stages.

Diabetic eye screening can be diagnosed early by taking pictures of the eye as a result of regular eye screening.

If you experience one or more of the following symptoms, it would be beneficial to consult your eye doctor immediately.

• progressively worsening vision
• Sudden vision loss
• Floaters in the field of view
• Blurred or irregular vision
• Eye pain and redness

If you have the above symptoms, it does not necessarily mean that you have diabetic retinopathy. However, it is very important for people with these symptoms to have their eyes checked. It is useful to consult an ophthalmologist as soon as possible without waiting until the next control appointment.

Causes of Diabetic Retinopathy

Diabetic retinopathy is a serious eye disease that can lead to blindness if not treated. If the blood sugar level stays too high for a long time, the retina is damaged and the structure of the capillaries in the retina deteriorates. This leads to cell loss, resulting in deterioration of vascular permeability, accumulation of liquid and oily substances in the yellow spot region, and subsequent occlusion of the capillaries and the emergence of areas that cannot be fed. In this case, the retina forms new vessels that can bleed easily. As a result of bleeding in these vessels formed in the retina, blood may leak into the posterior cavity of the eye. In addition, vascular membranes form in the retina, and as a result, serious vision loss may occur, as well as painful eye pressure elevations.

Pregnancy, hypertension, high blood lipids (Hyperlipidemia) and kidney diseases are other factors that aggravate retinopathy.

Diabetic Retinopathy Treatment

In the first three stages of diabetic retinopathy, there is no need for treatment if there is no macular edema, but blood sugar, blood pressure and cholesterol values ​​should be kept under control in order to prevent the progression of diabetic retinopathy.

Generally, if there are new vessels formed in the retina in the advanced stages of the disease, laser treatment should be applied to the entire retina (except the visual center). Laser treatment, which usually lasts two or three sessions, should be performed before bleeding begins. Otherwise, laser treatment is not possible in cases with severe bleeding.

In the stages of diabetic retinopathy where bleeding is intense, an operation called virectomy in which the bleeding is surgically cleaned is necessary. During the virectomy, the bleeding inside the eye is completely cleared and laser treatment can be applied if necessary in the same surgery.

Ways to Prevent Diabetic Retinopathy

Some lifestyle changes are necessary to prevent diabetic retinopathy or to slow its progression. Healthy eating and weight control are very important. Especially diabetic patients should quit smoking, smoking increases the risk of complications by narrowing blood vessels. It is also useful to keep the blood sugar value as close to normal as possible. The ideal blood glucose level should be 90-130 milligrams per deciliter (mg/dL) before a meal and 180 after a meal (mg/dL). Insulin etc. to control your blood sugar level. You may need to take medications.

EYE HEALTH AND DISEASES

Diagnosis and treatment of eye problems that individuals of all ages may encounter are handled in the eye diseases unit of hospitals and health institutions. Eye diseases that are named and treated according to the region and type of discomfort are examined in 3 different sections as cornea, retina and eyelid and its surroundings. Regular and periodic eye examinations are important in the early diagnosis of eye diseases, as well as enabling the early diagnosis of diseases such as diabetes and high blood pressure. For this reason, having an eye examination at least once a year is among the requirements of a healthy life.

About the Chapter

The eye, which is one of our most important sense organs, becomes healthy with operations that are decided upon with very meticulous examinations. Having the most important ophthalmologists in the world, Turkey is among the world’s leading centers for eye surgeries. Thanks to thousands of tourists, especially from Europe and the Middle East, our country gains significant gains from health tourism. Among the applications made to the eye unit, complaints such as burning and stinging in the eye, decreased vision, severe itching and redness, sensitivity to light, decreased vision distance, blurred vision are expressed. After the examinations and analyzes performed by specialist ophthalmologists, the applications to be made are determined and both medical and surgical interventions are performed. In such possible ailments, it is necessary to see an ophthalmologist without delay and be treated.

Applications

As mentioned at the beginning, eye diseases are examined in 3 different regions and treatments are carried out with necessary applications.

Corneal Diseases

Diseases such as myopia and hyperopia occur in the cornea section, which reflects the light and sends it in, and is located in the front of the eye. Among the applications performed by ophthalmologists in this region, corneal transplantation is an important surgical application. Diseases that occur in the anterior transparent layer due to various diseases are the practice of transplanting healthy corneas taken from cadavers to the patient. In such applications, the healthy corneas in the donated eye organs are cut with a diameter of 6-9 mm and replaced with a piece of the same size cut from the cornea of ​​the recipient and surgically sutured to the area. Thanks to the developing technology and sensitive devices, ophthalmologists using laser technology perform corneal changes without damaging the healthy part of the eye.

Retinal Diseases

The vascular structure located at the back of the eye organ is called the retina. Optic nerves transmit the light they receive from the cornea to the brain in the section where diseases related to vascular problems occur, providing the formation of vision. Disturbances in the retinal region are effective enough to cause permanent blindness. Yellow spot, retinal detachment is among the diseases that occur in the retinal region. Applications in the diagnosis and treatment of retinal diseases due to diseases such as diabetes or hypertension,

• Detailed eye examinations,
• OCT (Optical Cohorens Tomography)
• Fundus Floressein Angiography,
• Applications such as Eye Ultrasonography.

In the treatment of retinal diseases, Argon Laser photocoagulation or intraocular injections are used.

Diseases Occurring in and Around the Eyelid

Diseases called oculoplasty include styes, chalazion, and droopy eyelids. If the sty caused by the inflammation of the follicles located at the bottom of the eyelashes becomes chronic, it is an eye disease that requires surgical applications if the ophthalmologist deems it necessary. The disease called blepharitis also occurs around the eyes. The disease caused by infections at the base of the eyelashes causes stinging and pain in the eyelids. Usually, the treatment of the disease is provided by the application of drugs by the physicians. If left untreated, it can lead to more serious eye problems.

The disease called ptosis, which is caused by the drooping of the eyelid, is also among the diseases that occur in and around the eyelid. This disease, which is generally seen in traumatized individuals and the elderly, provides the opportunity to regain a healthy eye structure only as a result of surgical intervention. As a result of not being treated and intervened, the difference is the source of eye problems.

Lid tumors, on the other hand, occur due to masses formed in the eyelid. It can be treated by specialist ophthalmologists with surgical applications without damaging the anatomical and physiological structure of the eye. Since lid tumors that negatively affect facial aesthetics can cause serious damage to the body, they should be treated in a short time by specialist ophthalmologists.

What is Cataract?

Cataract is an eye disease that occurs as a result of the natural lens of the eye, which is in the eye and provides vision, loses its transparency over time and becomes dull. In other words, the patient feels as if he is looking through a foggy glass.

What Are the Symptoms of Cataract?

• Gradual decrease in vision
• Sensitivity to light
• Difficulty reading
• double vision
• Decreased/fogging night vision
• Seeing colors more dull
• Frequent changes in eye numbers

Causes of Cataract

Cataracts are usually caused by injury over time or as a result of a blow to the eye, and as a result, the eye changes the tissue that makes up the lens. In addition, inherited genetic disorders can increase the risk of cataracts. Other eye diseases, past eye surgeries and conditions such as diabetes are also known to affect cataracts. In addition, long-term use of steroid drugs can also show its effect on cataracts.

How Does a Cataract Occur?

Cataract is located in the lens at the back of the colored part of the eye (iris). The lens, like a camera, focuses the light coming into the eye and creates a clear and sharp image on the retina. As we age, the lenses in the eye lose their transparency and become less flexible and thicker. Other medical conditions besides aging cause the tissues within the lens to break down and clump together. For this reason, small areas inside the lens become dull and the quality of vision decreases.

 Cataracts usually develop in both eyes, although not equally. A cataract that does not develop to the same degree can make a difference in the quality of vision between the two eyes.

Risk Factors for Cataract

• Old age
• Diabetes
• Exposure to direct sunlight
• Smoking
• Overweight
• Hypertension
• Eye injuries or inflammation
• Long-term use of corticosteroid drugs
• Excessive alcohol consumption

Cataract Treatment

Cataract is an eye disease that can only be treated with surgery. When the effect of cataract on vision reaches a certain level, it must be treated. In cataract patients who are at the beginning level, cataract surgery can be performed at an early stage if it negatively affects the patient’s life, considering their occupational functions and daily lives.

In cataract operations, the natural lens in the eye, which becomes dull over time or as a result of the impact on the eye, is removed and replaced with an artificial lens. However, in some patients, the use of artificial lenses may not be appropriate. In this case, patients can improve their vision with glasses or contact lenses if needed after cataract surgery.

Cataract operations are operations that take a very short time and are usually treated on an outpatient basis. However, some patients may need to rest in the hospital in exceptional circumstances.

During the cataract operation, the area around the eyes is anesthetized with local anesthesia, usually the patient is awake throughout the operation. Cataract operations are generally safe operations, as well as operations that carry the risk of infection and bleeding. It is natural for the patient to feel discomfort in the eye for a few days after the procedure, full recovery usually takes place within eight patients.

KERATOCONUS

Keratoconus is a progressive eye disease in which the normally rounded cornea becomes thinner and tapered over time.

Normally, the cornea is like a ball, but in some cases, the structure of the cornea is not strong enough to maintain this shape and the cornea starts to stick out like a cone. This condition is called keratoconus.

Keratoconus can occur in one eye or in both eyes. This eye disease, which usually starts in adolescence or in the 20s, can correct vision problems with glasses or soft contact lenses. In advanced stages, rigid gas permeable contact lenses or other types of lenses can be used. In more advanced stages of keratonus, corneal transplantation may be required.

Contents

Keratoconus Causes

Keratoconus Symptoms

Keratoconus Treatment

Surgery and Cornea Transplantation

Intra-Corneal Rings

Corneal Cross Linking (CCL)

Keratoconus Causes

The weakening of the corneal tissue leading to keratoconus is due to an imbalance of enzymes in the cornea. This imbalance makes the cornea more vulnerable to oxidative damage by components called free radicals, and the cornea gradually weakens and begins to taper. Genetic factors play a role in weakening the cornea and making it more susceptible to oxidative damage.

Keratoconus can also be related to direct and prolonged exposure to ultraviolet rays from the sun, excessive eye rubbing, improperly used contact lenses, and chronic eye irritation.

Keratoconus Symptoms

Keratoconus symptoms may change gradually as the disease progresses. The symptoms are as listed below:

• Blurred and/or distorted vision
• Difficulty in night vision (increased sensitivity to light and glare)
• Frequent changes in eye numbers
• Sudden worsening or blurred vision

Keratoconus Treatment

Keratoconus treatment may vary depending on the rate of progression of the disease and the severity of the condition.

In the first stages of keratoconus, that is, in the mild form of the disease, vision can be corrected with glasses or contact lenses. However, in the advanced stages of the disease, when the cornea becomes thinner and sharper, glasses or contact lenses may not provide sufficient vision to the patient. In some keratoconus patients, the cornea may become scarred, making it difficult to use contact lenses. These conditions may require surgery.

Surgery and Cornea Transplantation

Corneal transplant, also known as keratoplasty; It is a common, safe and effective method. However, some patients may need glasses or contact lenses after corneal transplantation.

In corneal transplantation, the cornea with keratonus in the eye is removed and replaced with a new cornea from the donor. Since the cornea does not have a direct blood supply, the cornea used as a donor does not need to match the patient’s blood type. The visual result at the end of the operation is usually; It is perfect regardless of the severity of the disease, surgical technique and other factors.

Intra-Corneal Rings

Intra-corneal rings, in patients who are not suitable or do not prefer to use contact lenses; It can be applied as a good alternative if keratoconus is not in advanced stages. During the operation, topical anesthesia is applied, channels are opened into the cornea with Femtosecond Laser (Intralase) and rings are placed in these channels. Thanks to these rings, the shape of the cornea is corrected and the existing visual defect can be reduced. It is also possible to remove these rings, that is, to reverse the operation.

Corneal Cross Linking (CCL)

With crosslink treatment, the bonds in the cornea can become stronger. The aim of this treatment is to strengthen the bond between the collagen fibers in the cornea and to make the cornea stronger by using ultraviolet A and riboflavin (vitamin B2). During the treatment, riboflavin is dripped onto the cornea for a long time, and then UV-A is applied on the cornea to target the formation of cross-links. Studies have proven that Corneal Cross Linking treatment stops the progression of keratoconus defect. In addition, visual increases may occur due to the strengthening of the corneal structure and partial decrease in corneal steepness.

RETINAL DISEASES

Contents

What is Retinal Detachment?

Retinal Detachment Causes and Symptoms

Diagnosis of Retinal Detachment

Macular Degeneration

Causes of Macular Degeneration

Macular Degeneration Symptoms

Types of Disease

What is Retinal Detachment?

Although retinal detachment is more common in middle age and older people, it is an eye disease that can occur at any age and threatens vision seriously. In this disease, which requires urgent treatment, partial or complete loss of vision may occur if treatment is delayed. Retinal detachment occurs when the pigment epithelium under the retinal nerve layer is separated from its layer. It is usually caused by the leakage of fluid between these two layers, due to tears or holes in the retina. Retinal detachment, which is very common in high myopia patients, is seen in 1 out of every 10,000 people. The retinal layer is stretched as the anterior and posterior diameter of the eye increases, and the stretched area begins to thin and deteriorate. Some familial and degenerative diseases may also cause thinning and deterioration around the retina in these complications. Again, in line with these reasons, the vitreous gel may also begin to deteriorate by losing its homogeneity; The gel consistency changes and may gradually separate from the retina. This separation is called vitreous detachment. As the vitreous gel, which shrinks and becomes opaque in this disease, passes through the visual axis in the eye, it may be perceived by the patient as small images floating in front of the eye or as a foggy vision.

Retinal Detachment Causes and Symptoms

Retinal diseases are among the eye diseases that can result in permanent blindness unless the necessary treatment is applied. Symptoms such as flashes of light, small floating images or sudden vision loss can be a sign of an important retinal disease such as Retinal Detachment. In this eye disease, where early diagnosis is very important in its treatment, it is possible to prevent this complication, which can progress to loss of vision, with detailed examination, timely and most importantly correct treatment. Retinal surgeries require great sterilization and use of advanced technology. Since it is a very important surgery, it is an operation that can result in vision loss if the necessary environment is not prepared.

Diagnosis of Retinal Detachment

In the diagnosis of retinal detachment, the pupils are dilated with drops that the doctor deems appropriate, and the thin and distorted areas around the retina, the holes/tears and detached areas are detected. The ophthalmologist examines the inside of the eye with various equipment and an examination microscope and detects the tear or detachment in the eye. If necessary (cataract, hemorrhage or if the retina cannot be seen for any other reason), an eye ultrasonography is requested.

Macular Degeneration

Obesity, which continues to increase rapidly in today’s world, can invite eye diseases like many other diseases. Excess weight can cause 95% vision loss and yellow spot disease, known as advanced age disease. It is known that obesity is one of the reasons for the rapid increase in the incidence of Yellow Spot Disease (Macular Degeneration), which is known as the disease after the age of 50, which is caused by the deterioration of the function of the yellow spot layer, where 90% of the vision occurs.

If we define this disease called yellow spot disease or Macular Degeneration; we can say that the eye, the visual center is damaged. In macular degeneration, vision gradually decreases and the center becomes a dark focus. The dark focus formed in the visual center is not exactly a loss of vision. However, over time, it reduces the quality of life of the patient and becomes an effect on his daily life. In the treatment of the disease, a treatment method called Photodynamic Therapy is used. After the treatment, anti-VEGF (inhibiting the growth factor of the vessels in the eye) drugs are used with the help of injection into the eye (vitreus).

Causes of Macular Degeneration

• Direct and prolonged exposure to sunlight
• Vitamin deficiency
• Excess weight (Obesity)
• Atherosclerosis
• Smoking
• Blood pressure diseases
• Heart enlargement

Macular Degeneration Symptoms

Like some eye diseases, macular degeneration may not show serious symptoms in the early stages. For this reason, periodic eye examinations are of great importance in the diagnosis of the disease. Symptoms of the disease can be listed as follows:

• Distorted vision
• Seeing objects smaller
• Seeing a dark spot in the viewed area

The presence of defective capillaries can be detected by taking pictures of the eye for 10 minutes with a special dye (Fluorescein) injected into the body with the help of arm veins. In some patients, this examination may not be sufficient and a second angiography called indocyan green angiography may be required, which is used to investigate the eye more deeply.

Types of Disease

• Dry Type

It occurs as a result of the accumulation of drusen, that is, oily material under the retina layer in the eye. It progresses very slowly and takes a long time to lead to decreased vision.

• Age Type

This type occurs as a result of the broken capillaries formed in the eye moving towards the retina. This disease can cause sudden vision loss and is less likely to be seen in the dry type. Despite this, 80% of the patient group with severe vision loss consists of such patients. Especially in patients with membrane (choroidal neovascular membrane-CNVM) formation in the eye, the other eye is also at risk.

• Age-Related Macular Degeneration

Yellow spot disease, age-related macular degeneration, is an eye disease that occurs in the visual center as age progresses. It is known as the leading cause of vision loss, especially in patients aged 65 and over. Considering the incidence of the disease; While it is 3% for 65 years and older, it reaches 15% for those over 75 years old. In addition, the incidence increases with increasing age in both eyes.