by Malouf Eye | May 9, 2023 | Cornea
A pterygium is a common eye condition that affects many people across the world. Generally, pterygium is a non-cancerous growth on the surface of the eye that can grow over time, distort vision and impact the appearance of the eye. Fortunately, if the growth is causing significant problems, treatment is available. The most comprehensive and common treatment is surgical excision.
When is Surgery Needed for a Pterygium
Pterygium surgery involves the removal of the entire growth from the surface of the eye. Surgery may be required if the growth encroaches on the visual axis or creates astigmatism, which requires vision correction.
This can be seen by observing how close the pterygium comes to reaching the center of the pupil and whether or not new glasses or contact lenses are needed due to the increase in astigmatism power of the cornea.
Who Develops a Pterygium
Developing a pterygium can be completely unexplained, but there are factors that increase the risk and prevalence of a pterygium beginning.
Patients at risk include those who frequently expose their eyes to sunlight, wind, and dust, as well as patients with past history of pterygium recurrences.
Construction workers are notoriously susceptible to developing a pterygium given the demands of the profession.
The Pterygium Surgery Procedure
Pterygium surgery is an outpatient procedure and typically lasts around thirty minutes. Local anesthesia is used to numb the eye, so you won’t feel any pain or discomfort throughout the surgery.
The steps to remove the pterygium and repair the eye will vary based on the size of the pterygium and its position on the eye.
The surgeon will remove the pterygium, cutting it out along with the abnormal surface tissue over the white of the eye or sclera.
It may also involve removing a small portion of the sclera when needed to completely remove the lesion.
After removing the pterygium, the gap in the sclera will be filled with a graft from your own conjunctiva, the mucus membrane of the eye, or can be filled with outside sources such as stem cells or amniotic tissue.
Once the graft is in place, an eye patch is placed and the procedure is complete.
Recovery from Pterygium Surgery
Most patients can resume their normal activities within one to two days after the procedure. It is important to follow your eye doctor’s instructions after the surgery to ensure proper healing.
To speed recovery, avoid strenuous exercise, use ice or cool compresses, wear protective goggles and sunglasses, and make sure to use all medication eye drops as directed.
Additional follow-up visits are needed to verify that the entire pterygium was removed and that the graft is healed properly.
Benefits of Pterygium Excision
A pterygium excision is not a small procedure – it requires multiple incisions, excision, and grafting. Despite this, the procedure is very safe and effective.
This procedure is the main treatment for any pterygium that is creating symptoms – it will improve the appearance of the eye, reduce astigmatism, and improve the clarity of sight in the eye.
Dr. Jorge Malouf and the staff of the Malouf Eye specialize in a variety of ophthalmologic conditions and treatments including cataract surgery, glaucoma surgery, strabismus surgery, neuro-ophthalmology exams, oculoplastics, diabetes and more. Call our ophthalmologist in Tampa, FL today at 813-798-2020 if you are interested in learning more about pterygium surgery Our eye doctor provides only the highest quality eye care and surgical services amongst eye doctors in the Tampa, Florida area.
by Malouf Eye | Apr 24, 2023 | Cataracts
Selecting an artificial intraocular lens to be implanted during cataract surgery requires several measurements and factors including the length of the eye, the refraction of the eye, any previous eye surgery, and the goals for after cataract surgery. In a visit before the surgery, many of these measurements will be taken and then any viable options will be presented and discussed so that the best choice can be made. Once the lens is selected, the cataract surgery can proceed and the selected lens will be implanted during the surgery.
Lens Options for Cataract Surgery
There are many different models and types of intraocular lens implants to consider for cataract surgery.
The main categories of intraocular lens implants are standard single-vision implants, toric lens implants for astigmatism, multifocal lens implants to reduce the need for reading glasses, and light adjustable lens implants to have the ability to refine the prescription after the surgery.
Beyond selecting the type of lens, the lens must also have precise size, power, and alignment for each patient’s eyes.
Measurements for Lens Implants
There are several measurements and data which will be collected prior to selecting a lens type or parameters.
The biggest measurement is done using an ultrasound biometer. This instrument measures the length of the eye, the prescription of the eye, the thickness of the lens and cornea, and the depth of the anterior chamber.
Additional measurements that will be taken care of are refraction which provides the glasses prescription for each eye, corneal topography which provides an assessment of the shape of the front of the eye, and brightness acuity testing which provides an objective measure of the density of the cataract.
Best Vision After Cataract Surgery
The biggest goal for most patients is to attain the best possible vision after cataract surgery.
This can include distance vision that does not require glasses, less dependence on reading glasses, and improved vision with glasses on.
A cataract naturally impairs vision and makes everything cloudy or hazy, but cataract surgery can also be an opportunity to reduce the need for glasses for the best vision.
To ensure that the vision is as good as possible, the surgeon or doctor will make recommendations on the types of lenses which are available in the needed powers and parameters after the measurements are made.
When a Standard Lens is Selected
A standard intraocular lens is the oldest, most reliable lens option. This type of lens only corrects distance vision and does not include any astigmatism or reading correction.
These lenses are best for a patient who wants to wear glasses with a bifocal after the surgery or a patient who has significant other eye problems such as keratoconus, glaucoma, macular degeneration, or retinitis pigmentosa.
When a Toric Lens is Selected
A toric intraocular lens is similar to a standard lens but includes a correction for any astigmatism component to the prescription.
These lenses often allow the patient to wear only reading glasses after the surgery and have excellent distance vision without any correction.
Often, these lenses are selected for individuals who are okay with the occasional use of reading glasses as needed and are more concerned with optimal distance vision.
When a Multifocal Lens is Selected
A multifocal lens has built-in correction for the distance, intermediate, and near. These lenses are designed to reduce the reliance on glasses at all distances and situations.
These types of lenses are best for healthy individuals who want total freedom from glasses or contact lenses.
While these lenses are designed for clear vision at all distances, the clarity of the vision is sometimes less than standard or toric lenses in the distance.
These lenses should be avoided in patients with concurrent eye problems or previous eye surgeries.
When a Light Adjustable Lens is Selected
A light adjustable lens is a special type of lens that can be altered after the surgery to change the prescription. These lenses are best for individuals who have unstable refractions due to previous surgery or progressive eye conditions.
Not all surgery centers will offer these lenses and it may require a specialty clinic to find this type of intraocular lens.
Dr. Jorge Malouf and the staff of the Malouf Eye specialize in a variety of ophthalmologic conditions and treatments including cataract surgery, glaucoma surgery, strabismus surgery, neuro-ophthalmology exams, oculoplastics, diabetes and more. Call our ophthalmologist in Tampa, FL today at 813-798-2020 if you are interested in cataract surgery. Our eye doctor provides only the highest quality eye care and surgical services amongst eye doctors in the Tampa, Florida area.
by Malouf Eye | Apr 10, 2023 | Cornea, Dry Eye
Symptoms of dry eyes can go beyond occasional irritation and discomfort. For many, even with basic treatments, the symptoms of dry eyes can lead to decreased vision and impact eye health long-term. If initial treatments are insufficient at controlling the symptoms of dry eyes, more advanced procedures may be needed. Among these procedures is the implantation of punctal plugs. Punctal plugs are small devices that fit inside the punctum of the eyelid where tears naturally drain. When placed, the punctal plug will reduce the rate at which tears drain from the front of the eyes and improve the symptoms of dry eyes.
How Tears Drain
Tears are designed to be secreted onto the surface of the eye on the temporal side and then moved towards the nose with blinks.
The structure of a blink pushes the tears toward the nose and the edge of the eyelid.
At the edge of the eyelid near the nose, on both the upper and lower eyelid, there is a small opening called the punctum.
This small opening leads to a canal that connects to the nasal drainage system.
Tears that are pushed towards the nasal side of the eye can be forced into the punctum and then drain through the nasal passage.
How a Punctal Plug Works
If tears are drained too quickly or are not produced rapidly enough, a punctal plug can aid in relieving the symptoms of dry eye.
Dryness can be due to a lack of or insufficient tear film over the eyes.
By increasing the amount of tears remaining on the eyes, the punctal plugs can improve the tear film.
Often, a punctual plug is placed in both of the lower puncta on each eye. These are the easiest to place and contribute the most benefit to dry eye treatment.
Types of Punctal Plugs
There are two main types of punctal plugs. There are temporary or dissolvable punctal plugs and permanent punctal plugs.
The temporary plugs are designed to naturally absorb over a set amount of time — typically 90 days.
These plugs can provide relief from dry eye for a short period while other treatments are initiated or can be a trial before placing a permanent punctal plug.
A permanent punctal plug is designed to remain in the eye until it is removed by an eye doctor.
These plugs are much larger and can often be seen protruding from the punctum when the lower eyelid is turned outward.
When Punctal Plugs are Used
Not all cases of dry eyes will require punctal plugs for treatment.
In fact, the majority of dry eye cases can be managed with over-the-counter artificial tears or warm compresses.
These measures are less invasive and can be done on an as-needed basis.
However, if there are symptoms that remain after these types of treatments are used, more advanced treatments are indicated.
Punctal plugs can be an effective and simple solution in these cases as they can be done on the same day, in the office, and provides long-lasting relief of symptoms.
Dr. Jorge Malouf and the staff of the Abraham Eye Center specialize in a variety of ophthalmologic conditions and treatments including cataract surgery, glaucoma surgery, strabismus surgery, neuro-ophthalmology exams, oculoplastics, diabetes and more. Call our ophthalmologist in Tampa, FL today at 813-798-2020 if you are interested in punctal plugs. Our eye doctor provides only the highest quality eye care and surgical services amongst eye doctors in the Tampa, Florida area.
by Malouf Eye | Mar 29, 2023 | Cornea
Corneal arcus is a finding in the front of the eye that is extremely common in the elderly population. There is a lightly colored ring around the colored part of the eye, the iris. This ring is composed of excess cholesterol and other fat compounds. While not considered a normal finding, corneal arcus is not a concern for causing any additional complications or symptoms. Usually, corneal arcus will be monitored at yearly eye appointments unless it occurs in a much younger individual in which case it may indicate abnormal cholesterol levels and warrants a referral for blood work.
Layers of the Cornea
The cornea is the clear outer structure of the eye which is responsible for bending light into the eye. The cornea is composed of several layers. The top layer of the cornea is called the corneal epithelium, beneath it is Bowman’s membrane, then the corneal stroma, followed by Descemet’s membrane, and the final layer is the corneal endothelium.
Each layer has specific functions and purposes for ocular health. The largest layer is the corneal stroma which is responsible for the storage of nutrients and holding needed vitamins for the eye.
Cholesterol Buildup in the Eye
When there is excess cholesterol or fat in the body, the excess begins to be deposited into storage areas of the body.
One of these such areas is the corneal stroma. The stroma functions as a long-term storage option for these unnecessary fat compounds.
When these cholesterol and fat compounds begin to accumulate, the corneal stroma begins to show evidence of this type of buildup.
This ring of buildup is the beginning of the corneal arcus, and it will be viewable during a comprehensive eye examination.
Symptoms of Corneal Arcus
The only true symptom or sign of corneal arcus is the discoloration that forms as a ring in front of the iris.
This ring is the visualization of the cholesterol buildup in the corneal stroma.
While the ring of cholesterol is visible from the outside of the eye, it does not have any impact on the actual vision of the eye.
The corneal arcus does not alter the shape or function of the cornea in any way. Since it is only passively visible and does not impact the function or vision, it is rarely considered a concern.
When Corneal Arcus is a Concern
While corneal arcus itself does not pose any threat to vision or eye health, it can be indicative of a greater health issue.
Usually, corneal arcus will only form in the elderly population, specifically those over 65.
If corneal arcus develops in a much younger individual, it may be because cholesterol or other fat compound levels are extremely high or unstable.
The condition, called hypercholesteremia, is common in the American population but it must be very advanced in order to form corneal arcus.
If corneal arcus is found in these younger individuals, it warrants a complete blood panel and referral to the primary care provider.
Dr. Jorge Malouf and the staff of the Abraham Eye Center specialize in a variety of ophthalmologic conditions and treatments including cataract surgery, glaucoma surgery, strabismus surgery, neuro-ophthalmology exams, oculoplastics, diabetes and more. Call our ophthalmologist in Tampa, FL today at 813-798-2020 if you are interested in learning more about corneal arcus. Our eye doctor provides only the highest quality eye care and surgical services amongst eye doctors in the Tampa, Florida area.
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