EYE Surgery Details
Smile Lasik surgery:
• An example of refractive surgery that treats nearsightedness, farsightedness, and
astigmatism is LASIK surgery. A more recent form of laser eye surgery that has been
accessible for more than 15 years is Smile LASIK.
• In order to restructure the cornea and rectify eyesight, a tiny, precise incision is made in
the cornea using a femtosecond laser.
• Smile LASIK is typically regarded as being less safe than other laser eye procedures
like regular LASIK or PRK. This is due to the surgery being more recent and
uncommon, and the lack of long-term evidence needed to evaluate its usefulness and
safety.
• In addition, Smile LASIK surgery is irreversible since a little, precise portion of the
cornea is removed. This implies that it might not be able to reverse the surgery if there
are any difficulties or if the desired outcome is not obtained.
• Every person's eyes are different, so it's vital to remember that the safety and success
of any form of eye surgery rely on a number of variables, including the patient's
lifestyle, health, and eye anatomy. It is vital to explore the possible risks and
advantages of any eye surgery, including Smile LASIK, with a licenced eye doctor or
surgeon.
Evidence based articles:
Here are some evidence-based links related to Smile LASIK surgery:
• American Society of Cataract and Refractive Surgery (ASCRS) - "SMILE - Small
incision lenticule extraction”. (https://www.researchgate.net/publication/
346108536_SMILE_-_Small_incision_lenticule_extraction)
• Journal of Refractive Surgery - "Comparison of Small-Incision Lenticule Extraction and
Femtosecond Laser–Assisted LASIK for Myopia Correction: A 6-Month Follow-up
Study" - This study compared the safety and efficacy of SMILE and femtosecond laser-
assisted LASIK in correcting myopia. The study found that both procedures were safe
and effective, but that SMILE resulted in less dry eye symptoms and better visual
quality. (https://journals.healio.com/doi/full/10.3928/1081597X-20150521-02)
• “Comparison of refractive and visual outcomes between image-guided system-
assisted small-incision lenticule extraction and wavefront-optimized FS-LASIK in
treatment of high astigmatism”. (https://pubmed.ncbi.nlm.nih.gov/34694256/)
Phacol lense replacement
• A surgical treatment known as phacoemulsification (phaco) is performed to replace the
eye's natural lens, which has become clouded owing to cataracts, with an artificial
intraocular lens. (IOL). Given that cataracts often begin to grow in adults over the age of
50 to 52, this surgery is frequently carried out on them.
• A multifocal IOL, such as the IOL-Multifocal, is one form of IOL that is frequently
utilised in phacoemulsification. It eliminates the need for glasses or contact lenses by
enabling good vision at a variety of distances.
• Although multifocal IOLs have been around for more than five years, ophthalmology
has used them for a longer period of time.
• For the vast majority of patients, they are often regarded as safe and successful, but
like any surgical operation, there are possible dangers and pitfalls that should be
examined with an eye specialist.
• Multifocal IOLs have the benefit of being reversible, which allows for replacement or
removal if necessary. However, because it comes with a unique set of dangers and
potential consequences, this is often not advised unless there is an issue with the lens
or the eye.
• It is crucial to remember that the success of any phacoemulsification and IOL
implantation treatment depends on a number of variables, including the patient's
lifestyle, health, and ocular anatomy. Consult a trained eye doctor or surgeon about the
possible dangers and advantages of the surgery if you're thinking about having it done.
Evidence based articles:
Here are some evidence-based links related to phacoemulsification and multifocal IOLs:
• American Academy of Ophthalmology - "Cataract in the Adult Eye Preferred Practice
Pattern" - This article provides an overview of the preferred practices for the diagnosis
and management of cataracts, including the use of phacoemulsification and IOL
implantation. The article includes references to several studies that have been
conducted on the safety and efficacy of these procedures. (https://www.aao.org/
education/preferred-practice-pattern/cataract-in-adult-eye-ppp-2021-in-press)
• Cochrane Database of Systematic Reviews - "Multifocal versus monofocal intraocular
lenses after cataract extraction”. (https://www.cochranelibrary.com/cdsr/doi/
10.1002/14651858.CD003169.pub4/full)
• Journal of Cataract and Refractive Surgery - "Visual Outcomes and Optical Quality of
Accommodative, Multifocal, Extended Depth-of-Focus, and Monofocal Intraocular
Lenses in Presbyopia-Correcting Cataract Surgery: A Systematic Review and Bayesian
Network Meta-analysis”. (https://pubmed.ncbi.nlm.nih.gov/36136323/)
Other Surgical Methods:
Yes, there are further surgical techniques for correcting eyesight, such as:
• A laser is used in LASIK (Laser-Assisted In Situ Keratomileusis), a kind of refractive
surgery, to reshape the cornea, the transparent front surface of the eye. The cornea's
new shape aids in better light focus on the retina, which can enhance eyesight. People
who are above 18 and have steady eyesight are frequently candidates for LASIK.
• The procedure known as PRK (Photorefractive Keratectomy) employs a laser to
reshape the cornea, but unlike LASIK, it does not involve making a flap in the cornea.
Instead, the cornea's outer layer is removed, and the underlying tissue is exposed to
the laser. People who have thinner corneas or other conditions that make LASIK less
acceptable frequently undergo PRK.
• The refractive procedure known as LASEK (Laser Epithelial Keratomileusis)
incorporates aspects of both LASIK and PRK. Similar to PRK, the cornea's outer layer
is removed, however with LASIK a tiny flap is made on the cornea's surface. The flap is
then restored once the underlying tissue has been treated with the laser.
• Refractive Lens Exchange (RLE): Similar to cataract surgery, this form of surgery
involves replacing the eye's native lens with an artificial lens. People who have high
degrees of myopia (nearsightedness) or hyperopia (farsightedness), or who are poor
candidates for other forms of refractive surgery, are frequently treated with RLE.
• Phakic Intraocular Lens (PIOL) Implantation - This is a type of surgery that involves
implanting an artificial lens in front of the natural lens of the eye. PIOL implantation is
typically performed on people who have high levels of myopia or hyperopia, or who are
not good candidates for other types of refractive surgery.
• Implanting a phakic intraocular lens (PIOL) entails placing a synthetic lens in front of
the eye's natural lens during surgery. People who have severe myopia or hyperopia or
who are poor candidates for other forms of refractive surgery frequently undergo PIOL
implantation.
Evidence based articles for these methods:
LASIK:
• "Comparison of clinical outcomes of LASIK, Trans-PRK, and SMILE for correction of
myopia" by Chang, Jin-Yu et al. (2021) published in Scientific Reports: https://
journals.lww.com/jcma/Fulltext/2022/02000/
Comparison_of_clinical_outcomes_of_LASIK,.3.aspx
• "Long-term Outcomes After LASIK Using a Hybrid Bi-aspheric Micro-monovision
Ablation Profile for Presbyopia Correction" published in the Journal of Refractive
Surgery: https://pubmed.ncbi.nlm.nih.gov/32032429/
PRK:
• "Laser-based refractive surgery techniques to treat myopia in adults. An overview of
systematic reviews and meta-analyses, https://onlinelibrary.wiley.com/doi/full/10.1111/
aos.15160
• "Efficacy, Predictability, and Safety of Laser-Assisted Subepithelial Keratectomy for the
Treatment of Myopia and Myopic astigmatism, https://www.ncbi.nlm.nih.gov/pmc/
articles/PMC3401800/
LASEK:
• "Laser‐assisted subepithelial keratectomy (LASEK) versus laser‐assisted in‐situ
keratomileusis (LASIK) for correcting myopia : https://www.ncbi.nlm.nih.gov/pmc/
articles/PMC5408355/
• "Factors Affecting Long-term Myopic Regression after Laser In Situ Keratomileusis and
Laser-assisted Subepithelial Keratectomy for Moderate Myopia: https://www.ekjo.org/
journal/view.php?number=1253
RLE:
• "Toric intraocular lenses for correction of astigmatism in keratoconus and after corneal
surgery" published in the PubMed article: https://www.ncbi.nlm.nih.gov/pmc/articles/
PMC4922777/
• "Refractive lens exchange for myopia: a new perspective?" by Richard Packard
published in the PubMed: https://pubmed.ncbi.nlm.nih.gov/15650580/
PIOL Implantation:
• "Phakic intraocular lens implantation for the correction of myopia: a report by the
American Academy of Ophthalmology: https://pubmed.ncbi.nlm.nih.gov/19883852/
• "Phakic intraocular lenses: a comprehensive review”, https://journals.lww.com/ijo/
Fulltext/2020/68120/Phakic_intraocular_lenses__An_overview.24.aspx
Other Surgical Methods:
Yes, there are several non-surgical methods for vision correction, including:
• Glasses: Correcting refractive defects including myopia (nearsightedness), hyperopia
(farsightedness), and astigmatism using glasses is a popular and efficient option. They
function by bending light as it enters the eye, assisting with proper retinal focus.
• Contact Lenses: Another non-surgical way to address refractive problems is with
contact lenses. They function similarly to glasses but are worn on the eye rather than in
front of it.
• Orthokeratology: To temporarily reshape the cornea, orthokeratology, sometimes
referred to as ortho-k or corneal reshaping therapy, requires wearing special contact
lenses overnight. Myopia and other refractive faults may be improved with the aid of
this.
• Vision Therapy: To enhance the function of the visual system, a number of exercises
and activities are used in vision therapy. It is frequently employed to cure ailments
including strabismus (eye turn) and amblyopia. (lazy eye).
• Low vision aids: can assist persons with vision loss brought on by illnesses like
macular degeneration and glaucoma see more clearly. Low vision aids include
magnifying glasses and telescopes.
After how many years need to make one more surgery?
• The extent of the patient's refractive defect, the type of technique used, the patient's
age, and any changes in their vision over time can all influence whether they require
further surgery following a vision correction procedure.
• The outcomes of LASIK and other corneal refractive procedures are often long-lasting.
Nevertheless, in some circumstances, the refractive error may alter over time as a result
of ageing-related changes in the eye or other causes, necessitating a surgery for
augmentation. Enhancements are frequently carried out at least six months following
the first surgery and can be required years later.
• The implanted lens is often permanent after phakic intraocular lens (PIOL) implantation.
As with any surgery, there is a little possibility of problems or the requirement for more
surgery in the future.
• Similar to cataract surgery, refractive lens exchange (RLE) usually results in a
permanently implanted lens. As with any surgery, there is a little possibility of problems
or the requirement for more surgery in the future.
• Before having any surgery or upgrades for vision correction, it's crucial to explore the
possibility with your eye doctor or surgeon. It's crucial to schedule routine follow-up
visits with your eye doctor to check your vision and catch any changes that could call
for extra care.
Evidence Based articles:
• “Attitude toward refractive error surgery and other correction methods: A cross-
sectional study”. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8632833/
• “Outcomes of Refractive Surgery Consultations at an Academic Center: Characteristics
Associated with Proceeding (or Not Proceeding) with Surgery”. https://
www.ncbi.nlm.nih.gov/pmc/articles/PMC7152937/
• “Enhanced recovery after surgery (ERAS) protocols: Time to change practice?”. https://
www.ncbi.nlm.nih.gov/pmc/articles/PMC3202008/
• “Phakic intraocular lenses: An overview”. https://www.ncbi.nlm.nih.gov/pmc/articles/
PMC7856940/
• “Refractive Lens Exchange (RLE)”. https://www.allan.vu/procedures/lens-exchange/
What lenses can be mounted on Iphone / Android camera to make an eye
background check?
Answer with Reference links:
• The PanOptic ophthalmoscope: used by the Welch Allyn iExaminer System may be
connected to an iPhone or Android smartphone. The retina, optic nerve, and eye
fundus are all beautifully photographed and saved by the iExaminer app. https://
www.welchallyn.com/en/microsites/iexaminer.html
• Volk Eye Check: This system makes use of an external lens that snaps onto a tablet or
smartphone's camera. The lens enables imaging of the retina and the anterior and
posterior parts of the eye. https://www.mercoframes.com/product/volk/eyecheck
• D-EYE: This method makes use of a tiny lens that is attached to a smartphone's
camera. The lens's light source and prism make it possible to image the retina. The D-
EYE system is intended for screening for retinal diseases including macular
degeneration and diabetic retinopathy. https://www.d-eyecare.com/
• Pictor Plus: This apparatus makes use of a hand-held camera that may be connected
to an iPhone or Android smartphone. The camera features an integrated lens that can
record pictures of the retina, optic nerve, and anterior part of the eye in high quality.
https://www.deviceoptical.com/pd_volk_pictor_plus.cfm
• Peek Retina: An iPhone or Android smartphone may be equipped with this clip-on
camera. Images of the retina are captured using a light and a mirror and may later be
seen and saved on a smartphone. https://peekvision.org/en_GB/about-peek/peek-
retina/
• Eyenaemia: is a smartphone-based technology that takes pictures of the eyes using a
lens attachment. It is intended to check the retina's colour in order to detect anaemia.
https://www.globalgiving.org/projects/eyenaemia/
• Nidek AFC-330: This device combines a cellphone app with a portable camera.
Images of the eye are taken using the camera, and they may be seen and examined
using the app. https://www.nidek-intl.com/product/ophthaloptom/diagnostic/
dia_retina/afc-330.html
• The HEINE mini3000 ophthalmoscope: is compatible with the HEINE iC1 smartphone
adapter. It enables detailed imaging of the retina and other eye structures. https://
www.heine.com/en/products/opthalmic-instruments/direct-ophthalmoscopes/detail/
31445-heine-mini-3000-ophthalmoscope
Visuref 100 device:
• The Visuref 100 is a tool for measuring and evaluating refractive error, as well as other
elements of visual function including contrast sensitivity and visual acuity. It is a
complex piece of machinery that needs expert instruction to operate correctly.
• For accurate measurements of the optical characteristics of the eye, it combines
wavefront analysis, autorefraction, and other methods.
• Even while it could be difficult to duplicate the Visuref 100's complete capability in a
smaller or more portable device, there are chances to use smartphone technology to
monitor eye problems.
• Using a smartphone app, users may test their refractive error and other elements of
vision using a device like the EyeQue Personal Vision Tracker, which is a tiny gadget
that links to a smartphone.
• Mobile applications may also be used to monitor eye health and spot possible issues,
in addition to these specialised instruments. For instance, the EyeXam app lets users
test their visual acuity, colour vision, and contrast sensitivity and, depending on the
findings, gives details on possible eye diseases.
Evidence based articles:
• D-EYE smartphone retinal imaging system: "Smartphone-based Fundus
Photography for Screening of Plus-disease Retinopathy of Prematurity" (https://
www.ncbi.nlm.nih.gov/pmc/articles/PMC6824990/)
• "Smartphone-based fundus photography: SMARTPHONE-BASED DILATED
FUNDUS PHOTOGRAPHY AND NEAR VISUAL ACUITY TESTING AS INEXPENSIVE
SCREENING TOOLS TO DETECT REFERRAL WARRANTED DIABETIC EYE
DISEASE" (https://pubmed.ncbi.nlm.nih.gov/26807627/)
• "Self-Testing of Vision in Age-Related Macula Degeneration: A Longitudinal Pilot Study
Using a Smartphone-Based Rarebit Test" (https://www.ncbi.nlm.nih.gov/pmc/articles/
PMC4466471/)
• EyeQue Personal Vision Tracker: (https://store.eyeque.com/
personal%20vision%20tracker.html)
• "Development and Validation of a Smartphone-Based Visual Acuity Test (Vision at
Home)" (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6701871/)
• EyeXam app: "Use of Mobile Apps for Visual Acuity Assessment: Systematic Review
and Meta-analysis" (https://www.researchgate.net/publication/
363799822_Use_of_Mobile_Apps_for_Visual_Acuity_Assessment_Systematic_Revi
ew_and_Meta-analysis)
• "http://eyexam.com/virtual/"
Will lenses make eye muscles weeker?
• The eye muscles do not become weaker if we wear corrective lenses, such as glasses
or contact lenses. In fact, glasses can aid in proper eye focus, which may lessen
eyestrain and tiredness.
• The muscles in the eyes govern the shape of the lens inside the eye, which helps to
concentrate light on the retina. When corrective lenses are worn, they function in place
of the eye's lens to refract light. The eye muscles may concentrate more easily as a
result, yet this does not make the muscles weaker.
“Contact lenses vs spectacles in myopes: is there any difference in accommodative and
binocular function?” https://pubmed.ncbi.nlm.nih.gov/21104269/
How to rejuvenate the eyesight?
• Get routine eye exams: Having a thorough eye exam will help identify any issues with
the eyes early on and guarantee that the prescription is up to date.
• Practice good eye hygiene: Maintain excellent eye hygiene by using the right lighting
while reading or using a computer, wiping hands before contacting the eyes, and
avoiding rubbing the eyes.
• Exercise your eyes: Focusing on far-off things, blinking regularly, and rotating the eyes
are all eye workouts that can help to strengthen the eye muscles and enhance the
vision.
• Keep up a healthy diet: Consuming a diet high in fruits, vegetables, and omega-3 fatty
acids will aid to support excellent eye health.
• Wear the appropriate eye protection: Use sunglasses to shield the eyes from the
sun's damaging UV rays, and use safety glasses or goggles while performing activities
that might injure the eyes.
Evidence based articles and links:
• “A thorough eye exam can aid in the early detection of eye disorders and ailments that
could result in vision loss, according to the American Optometric Association. The
group advises that persons between the ages of 18 and 64 get a thorough eye checkup
at least every two years, and adults over 65 get one every year”. https://www.aoa.org/
patients-and-public/caring-for-your-vision/comprehensive-eye-and-vision-examination/
recommended-examination-frequency-for-pediatric-patients-and-adults
• “Effects of yogic eye exercises on eye fatigue in undergraduate nursing students.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4932063/
• “Nutrients for Prevention of Macular Degeneration and Eye-Related Diseases”. https://
www.ncbi.nlm.nih.gov/pmc/articles/PMC6523787/
• “The Sun, UV Light and Your Eyes”. https://www.aao.org/eye-health/tips-prevention/
sun
• “Computer vision syndrome”. https://www.aoa.org/healthy-eyes/eye-and-vision-
conditions/computer-vision-syndrome?sso=y
How eyesight affects headaches, blood pressure, migraines, stress?
• Headaches: Eye strain and exhaustion may also cause tension headaches. A
headache may result from strained or fatigued muscles in the area surrounding the
eyes. As the eyes have to work harder to focus, this is particularly frequent in those
who spend a lot of time gazing at digital devices.
• Blood pressure: High blood pressure can harm the retina's tiny blood vessels,
impairing vision. On the other hand, certain drugs used to lower blood pressure might
alter eyesight, resulting in blurred vision or difficulties concentrating.
• Migraines: A number of things, including visual stimulation, can cause migraines.
Some people can have migraines as a result of bright or flashing lights, flickering
displays, or other visual stimuli. Additionally, some persons have momentary blindness
or spots in their vision as a result of migraine-related visual abnormalities.
• Stress: Stress can tighten the muscles that surround the eyes, resulting in eye fatigue
and strain. Stress can also worsen dry eye syndrome, a disease in which the eyes don't
produce enough tears to keep comfortable and moist.
Evidence based articles and links:
• “Screen time exposure and reporting of headaches in young adults: A cross-sectional
study”. https://pubmed.ncbi.nlm.nih.gov/26634831/
• “How High Blood Pressure Can Lead to Vision Loss”. https://www.heart.org/en/health-
topics/high-blood-pressure/health-threats-from-high-blood-pressure/how-high-blood-
pressure-can-lead-to-vision-loss
• “Visual stimuli are common triggers of migraine and are associated with pattern glare”.
https://pubmed.ncbi.nlm.nih.gov/17040340/
• “Mental stress as consequence and cause of vision loss: the dawn of psychosomatic
ophthalmology for preventive and personalized medicine”. https://
www.ncbi.nlm.nih.gov/pmc/articles/PMC5972137/
Risks assumptions & recommendations could be advised on different stages for the
below diseases:
1. Cataract:
As people age, cataracts, a frequent eye ailment, often damage them. When the eye's
normally clear lens develops a cataract, visual issues result. For various phases of
cataracts, the following risks, presumptions, and suggestions are provided:
First stage
Risks:
• Mild vision modifications, such as mildly foggy or blurry vision
• heightened glare sensitivity
• Nighttime driving is challenging.
Assumptions:
• Cataracts may develop gradually and not immediately require treatment.
• If symptoms are minor, early therapy may not be essential.
Recommendations:
• Plan routine eye examinations to track the development of cataracts.
• To lessen sensitivity to glare, use anti-glare coatings on your sunglasses or eyeglasses.
• When reading or engaging in other tasks that call for clear eyesight, use bright lighting.
Intermediate stage:
Risks:
• Moderate visual alterations, such as increased haziness or blurriness
• More difficulties when driving at night
• Difficulty reading or engaging in other tasks that need clear eyesight
Assumptions:
• Cataracts are becoming worse and could need treatment soon.
• Changes in vision may have a more significant effect on daily living.
Recommendations:
• Consult an ophthalmologist to go about your alternatives for therapy.
• For reading or other tasks that call for clear eyesight, use brighter lighting.
• To enhance eyesight, think about adjusting your prescription for eyewear.
Advanced stage:
Risks:
• Vision alterations that be severe, a such vision that is very blurry or foggy
• Significant difficulties with everyday tasks including driving or reading
• Fall risk that is exacerbated by a lack of depth awareness
Assumptions:
• Treatment for cataracts is necessary to regain eyesight
• A considerable influence of vision changes on day-to-day existence
Recommendations:
• Discuss treatment options with an ophthalmologist, which may include cataract
surgery.
• Driving and other tasks requiring clear eyesight should be avoided until your vision has
returned.
• Reduce your chance of falling by taking precautions like using a cane or walker.
Evidence based articles:
First Stage:
“Preoperative Antibiotic Prophylaxis”: https://www.ncbi.nlm.nih.gov/books/NBK442032/
Intermediate Stage:
“IOL Implants: Lens Replacement After Cataracts”: https://www.aao.org/eye-health/
diseases/cataracts-iol-implants
Advanced Stage:
“Glaucoma and Eye Pressure”: https://www.nei.nih.gov/learn-about-eye-health/eye-
conditions-and-diseases/glaucoma/glaucoma-and-eye-
pressure#:~:text=Research%20shows%20that%20high%20eye,stop%20vision%20loss
%20from%20glaucoma.
2. Glaucoma:
Glaucoma is a disorder that damages the optic nerve and can result in blindness and
visual loss. There are various phases of managing glaucoma, and each has its own
dangers, presumptions, and suggestions.
Screening and diagnosis
• Screening test findings that are falsely positive or falsely negative might result in
unneeded therapy or a missed diagnosis, respectively.
• Delay in diagnosis may cause permanent eyesight loss.
Assumptions:
• Regular eye exams are required to spot glaucoma's early warning signals.
• High-risk individuals should get screenings more regularly, such as those who are over
60 years old or have a family history of glaucoma.
• The existence of recognisable optic nerve alterations and visual field abnormalities
serves as the basis for glaucoma diagnosis.
Recommendations:
• Every 1-2 years for those at risk, such as those over 40, and every 6-12 months for
those at high risk should have routine eye exams.
• Teach patients the value of yearly eye exams and exhort them to consult a doctor if
they experience any changes in their eyesight.
Treatment begins:
Risks:
• It's possible for medications to have side effects including eye discomfort, redness, or
changes in blood pressure.
• Medication noncompliance might result in disease progression and eyesight loss.
Assumptions:
• The primary glaucoma risk factor, intraocular pressure, can be decreased with
medication.
• The risk of vision loss can be decreased by compliant individuals.
Recommendations:
• Give the right medicine prescription to lower intraocular pressure.
• Inform patients about the value of taking their medications as prescribed and any
possible negative effects.
• In order to track therapy effectiveness and drug acceptability, encourage patients to
regularly attend follow-up consultations.
Monitoring:
Risks:
• Despite therapy, disease progression is still possible.
• If the intraocular pressure is not sufficiently regulated, medication adjustments may be
required.
Assumptions:
• In order to assure therapy effectiveness and identify illness progression, regular
monitoring is required.
• If the intraocular pressure is not sufficiently regulated, medication adjustments may be
required.
Recommendations:
• Make routine follow-up consultations to track the effectiveness of your therapy and the
development of your illness.
• To obtain sufficient intraocular pressure management, alter medication as needed.
Surgical Intervention:
Risks:
• Complications from surgery, such bleeding or infection, are possible.
• It's possible that surgery doesn't always work to lower intraocular pressure.
Assumptions:
• Surgery is only recommended for people who continue to deteriorate after medical
treatment or who are unable to take medicine.
• Surgery can lower intraocular pressure and decrease or stop the course of the illness.
Recommendations:
• Send them to a glaucoma expert for a diagnosis and potential surgical procedure.
• Inform patients about the probable need for postoperative medicine, as well as the
advantages and hazards of surgery.
Evidence Based Links and articles:
Screening and Diagnosis:
• “Primary Open-Angle Glaucoma Preferred Practice Pattern(®) Guidelines®. 2020”.
https://pubmed.ncbi.nlm.nih.gov/26581556/
• “National Eye Institute. Glaucoma. 2021.” https://www.nei.nih.gov/learn-about-eye-
health/eye-conditions-and-diseases/glaucoma
Treatment Initiation:
• European Glaucoma Society. Terminology and Guidelines for Glaucoma, 5th Edition.
2021. https://pubmed.ncbi.nlm.nih.gov/34675001/
Monitoring:
• Heijl A, Leske MC, Bengtsson B, et al. Reduction of intraocular pressure and glaucoma
progression: results from the Early Manifest Glaucoma Trial. Arch Ophthalmol.
2002;120(10):1268-1279. https://pubmed.ncbi.nlm.nih.gov/12365904/
Surgical Intervention:
• Gedde SJ, Herndon LW, Brandt JD, et al. Surgical complications in the Tube Versus
Trabeculectomy Study during the first year of follow-up. Am J Ophthalmol.
2007;143(1):23-31. https://pubmed.ncbi.nlm.nih.gov/17054896/
3. Diabetic retinopathy:
A consequence of diabetes called diabetic retinopathy damages the blood vessels in the
retina, which can result in vision loss and even blindness. There are various stages in the
treatment of diabetic retinopathy, and each has its own dangers, presumptions, and
recommendations.
Screening and diagnosis
Risks:
• Delay in diagnosis may cause permanent eyesight loss.
• Screening test findings that are falsely positive or falsely negative might result in
unneeded therapy or a missed diagnosis, respectively.
Assumptions:
• Regular eye exams are required to find diabetic retinopathy's early warning signals.
• In order to identify diabetic retinopathy, people with diabetes should undergo routine
eye exams.
Recommendations:
• Every one to two years, diabetics should get routine eye exams.
• Inform patients of the value of routine eye exams and nudge them towards seeking
care if they notice any changes in their vision.
Treatment Initiation:
Risks:
• Medication side effects might include things like eye discomfort, redness, or changes
in blood pressure.
• Disease progression and eyesight loss may result from noncompliance with
medication.
Assumptions:
• The risk of vision loss can be decreased by medications that inhibit the development of
diabetic retinopathy.
• Patients who comply can lower their chance of losing their vision.
Recommendations:
• Prescribe the proper treatment, such as corticosteroids or injections of anti-VEGF, to
delay the growth of diabetic retinopathy.
• Inform patients about the value of taking their medications as prescribed and any
possible negative effects.
• In order to track therapy effectiveness and drug acceptability, encourage patients to
regularly attend follow-up consultations.
Monitoring:
Risks:
• Despite therapy, disease progression is still possible.
• Depending on how diabetic retinopathy develops, medication adjustments can be
required.
Assumptions:
• In order to assure therapy effectiveness and identify illness progression, regular
monitoring is required.
• Depending on how diabetic retinopathy develops, medication adjustments can be
required.
Recommendations:
• Make routine follow-up consultations to track the effectiveness of your therapy and the
development of your illness.
• To obtain optimal management of diabetic retinopathy, change the dosage of the
medicine as needed.
Surgical Intervention
Risks:
• Complications from surgery, such bleeding or infection, are possible.
• Surgery may not always be successful in improving vision.
Assumptions:
• Surgery is reserved for patients with advanced diabetic retinopathy or those who do
not respond to medication.
• Surgery can improve vision and prevent vision loss.
Recommendations:
• Send patients to a retinal specialist for an assessment and potential surgical procedure.
• Inform patients about the probable need for postoperative medicine, as well as the
advantages and hazards of surgery.
Evidence based articles and links:
• “Standards of Medical Care in Diabetes—2022 Abridged for Primary Care Providers”.
https://diabetesjournals.org/clinical/article/40/1/10/139035/Standards-of-Medical-Care-in-
Diabetes-2022
• “Management of Diabetic Retinopathy”. https://www.ncbi.nlm.nih.gov/pmc/articles/
PMC4052230/
• “Management of diabetic retinopathy: a systematic review”: https://
pubmed.ncbi.nlm.nih.gov/17712074/
• “Treatment of diabetic retinopathy: Recent advances and unresolved challenges”.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4999649/
4. Hypertension retinopathy:
Hypertensive retinopathy is a complication of high blood pressure that affects the eyes.
To avoid vision loss and other complications, hypertensive retinopathy must be properly
managed. Here are some hazards, assumptions, and suggestions that might be given on
different phases for hypertensive retinopathy:
Early Stage:
Risks:
• Hypertensive retinopathy symptoms or risks may not be apparent at this time.
However, if the disease is not treated, it may worsen and proceed to more advanced
stages of hypertensive retinopathy.
Assumptions:
• The patient may not exhibit any symptoms at this time or may exhibit only minor
symptoms, like blurred vision.
Recommendations:
• Control blood pressure to prevent further damage to the eyes.
• Get frequent eye exams to monitor the evolution of hypertensive retinopathy and
discover any abnormalities early.
• Maintain a healthy diet and get regular exercise to control your blood pressure.
• Quit smoking if you are a smoker as it can worsen hypertensive retinopathy.
• Consult with an ophthalmologist for any questions or concerns.
Moderate Stage:
Risks:
• At this point, there is a higher risk of vision loss and progression to more severe stages
of hypertensive retinopathy.
Assumptions:
• At this stage, the patient may experience blurred vision, floaters, or other visual
symptoms.
Recommendations:
• Continue to control blood pressure to prevent further damage to the eyes.
• Maintain a nutritious diet and do regular exercise to control your blood pressure.
• To track the development of hypertensive retinopathy and catch any changes early, get
regular eye exams every six months.
• Consider laser treatment or other procedures to prevent further damage to the eyes.
• Consult with an ophthalmologist for any questions or concerns.
Severe Stage:
Risks:
• At this stage, there is a high risk of vision loss and other complications such as
glaucoma and retinal detachment.
Assumptions:
• At this stage, the patient may experience severe visual symptoms such as black spots
or vision loss.
Recommendations:
• Seek immediate medical attention if you experience sudden vision loss or other severe
visual symptoms.
• Control blood pressure to prevent further damage to the eyes.
• Maintain a nutritious diet and do regular exercise to control your blood pressure.
• Get regular eye exams every three months to monitor the progression of hypertensive
retinopathy and detect any changes early.
• Consider laser treatment or other procedures to prevent further damage to the eyes.
• Consult with an ophthalmologist for any questions or concerns.
Evidence based articles and links:
• “Hypertensive Retinopathy”. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5959942/
• “The Hypertensive Retinopathy”. https://eyewiki.aao.org/Hypertensive_Retinopathy
• “What are the different stages of hypertensive retinopathy?”. https://
www.medicalnewstoday.com/articles/hypertensive-retinopathy-stages
5. Age-related macular degeneration (AMD):
Age-related macular degeneration (AMD) is a progressive eye disease that affects the
macula, the part of the eye responsible for central vision. Here are some risks,
assumptions, and recommendations that may be recommended at different stages of
AMD.
Early stage:
Risks:
• At this stage, the risks or symptoms of AMD may not be visible. But if the condition is
not treated, it can progress and lead to more severe stages of AMD.
Assumptions:
• At this stage, the patient may have no or only mild symptoms, such as difficulty
reading or seeing details.
Recommendations:
• Get regular eye exams to monitor the progression of AMD and detect changes early.
Follow a healthy diet that includes plenty of fruits, vegetables, and fish to reduce your
risk of developing AMD.
• If you are a smoker, stop smoking because it can make AMD worse. Consult your eye
doctor with any questions or concerns.
Intermediate Stage:
Risks:
• At this stage, there may be a better chance of imaginative and prescient loss and
development to extra excessive tiers of AMD.
Assumptions:
• At this stage, the affected person can also additionally revel in blurred imaginative and
prescient or blind spots withinside the valuable imaginative and prescient.
Recommendations:
• Follow a wholesome weight loss program wealthy in fruits, vegetables, and fish to
lessen the chance of AMD development.
• Consider taking dietary supplements which includes diet C, diet E, zinc, copper, and
lutein to gradual the development of AMD.
• Quit smoking in case you are a smoker as it is able to get worse AMD.
• Get ordinary eye assessments each six months to display the development of AMD
and stumble on any modifications early.
• Consider laser remedy or different approaches to save you in addition harm to the
eyes.
• Consult with an ophthalmologist for any questions or concerns.
Advanced Stage:
Risks:
• At this stage, there may be a excessive chance of imaginative and prescient loss and
different headaches which includes glaucoma and retinal detachment.
Assumptions:
• At this stage, the affected person can also additionally revel in excessive visible signs
and symptoms which includes entire lack of valuable imaginative and prescient.
Recommendations:
• Seek instant scientific interest in case you revel in unexpected imaginative and
prescient loss or different excessive visible signs and symptoms.
• Follow a wholesome weight loss program wealthy in fruits, vegetables, and fish to
lessen the chance of AMD development.
• Quit smoking in case you are a smoker as it is able to get worse AMD.
• Get ordinary eye assessments each 3 months to display the development of AMD and
stumble on any modifications early.
• Consider laser remedy or different approaches to save you in addition harm to the
eyes.
• Consult with an ophthalmologist for any questions or concerns.
Evidence based articles and links:
• “Age-related Macular Degeneration (AMD): A Review on its Epidemiology and Risk
Factors”. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5891426/
• “The Age-Related Eye Disease Study 2 (AREDS2): Study Design and Baseline
Characteristics (AREDS2 Report Number 1)”. https://www.ncbi.nlm.nih.gov/pmc/
articles/PMC3485447/
• “Systematic review and meta-analysis of the association between complement factor H
Y402H polymorphisms and age-related macular degeneration”. https://
pubmed.ncbi.nlm.nih.gov/16905558/
• “Effect of Omega-3 Fatty Acids, Lutein/Zeaxanthin, or Other Nutrient Supplementation
on Cognitive Function: The AREDS2 Randomized Clinical Trial”. https://
pubmed.ncbi.nlm.nih.gov/26305649/
• “Efficacy and Safety of Anti-Vascular Endothelial Growth Factor Monotherapies for
Neovascular Age-Related Macular Degeneration: A Mixed Treatment Comparison”.
https://pubmed.ncbi.nlm.nih.gov/34992542/
What are the rest eyesight diseases other than this, cataract, glaucoma, diabetic
retinopathy, hypertension retinopathy, age related macula degeneration?
• Refractive Errors - those are not unusualplace imaginative and prescient troubles
along with myopia (nearsightedness), hyperopia (farsightedness), astigmatism, and
presbyopia (age-associated close to imaginative and prescient loss).
• Amblyopia (Lazy Eye) - that is a circumstance in which one eye does now no longer
expand everyday imaginative and prescient throughout childhood. It can result in
imaginative and prescient loss withinside the affected eye if left untreated.
• Strabismus - that is a circumstance in which the eyes aren't well aligned, inflicting
double imaginative and prescient or a watch to show in or out.
• Conjunctivitis (Pink Eye) - that is an infection of the conjunctiva, the skinny membrane
that covers the white a part of the attention and the interior of the eyelid. It can purpose
redness, itching, and discharge.
• Dry Eye - that is a circumstance in which the eyes do now no longer produce sufficient
tears or the tears evaporate too quickly, inflicting discomfort, irritation, and blurred
imaginative and prescient.
• Retinal Detachment - that is a severe circumstance in which the retina separates from
the lower back of the attention. It can purpose imaginative and prescient loss or maybe
blindness if now no longer handled promptly.
• Color Blindness - that is a genetic circumstance in which someone can not distinguish
positive shades or see them in a different way than maximum people.
• Optic Neuritis - that is an infection of the optic nerve that may purpose imaginative
and prescient loss, pain, and different symptoms.
Evidence based articles and links:
• Refractive Errors: https://www.aao.org/eye-health/diseases/refractive-errors
• Amblyopia: https://www.aao.org/eye-health/diseases/amblyopia-lazy-eye
• Strabismus: https://www.aao.org/eye-health/diseases/what-is-strabismus
• Conjunctivitis: https://www.aao.org/eye-health/diseases/pink-eye-conjunctivitis
• Dry Eye: https://www.aao.org/eye-health/diseases/what-is-dry-eye
• Retinal Detachment: https://www.aao.org/eye-health/diseases/detached-torn-retina
• Color Blindness: https://www.aao.org/eye-health/diseases/what-is-color-blindness
• Optic Neuritis: https://www.aao.org/eye-health/diseases/what-is-optic-neuritis