Warren Hill, M.D. Utilities Special Thanks - Eye Surgery Information
Special Thanks.
No project such as this happens without the assistance of many others. There
is hardly a day that goes by without some new knowledge coming from those
more experienced in this area. Our deep appreciation goes out to these
experts who so willingly offered their ideas and encouragement.
Sandra Frazier Byrne for helping us to understand the potential pitfalls of axial length measurements in the setting of posterior staphyloma and
silicone oil. Her two textbooks: "A-scan Axial Length Measurements – A
Handbook for IOL Calculations," and "Ultrasound of the Eye and Orbit" have
become a favorite of many physicians, and their staff, wanting to better
understand this topic.
Dan Eisenberg, MD for his statistical insights and his help in organizing
the format for our surgical outcomes.
Wolfgang Haigis, PhD for his assistance in understanding the Zeiss
IOL Master, as well as his many mathematical insights into intraocular lens power
calculations and the Haigis formula. The ophthalmic community owes Dr. Haigis,
who is the Head of the Biometry Department of the University of Würzburg,
Germany, a great debt for his tireless efforts in the field of partial coherence
interferometry and intraocular lens power calculations.
Ken Hoffer, MD for his thoughtful e-mails containing helpful criticisms, and historical perspectives. One of the founders of the American Society of
Cataract and Refractive Surgery, Ken continues to offer insights and
suggestions to the ophthalmic community via the ASCRS Internet Discussion
Forum.
Jack Holladay, MD for years of unhesitating assistance with the most
difficult IOL calculation problems we have seen. His Holladay IOL Consultant
has become one of the most valuable tools we have in our practice. The
Holladay 2 formula has allowed us to achieve a superb level of
post-operative refractive accuracy, better than ±0.25 D.
Joel Shugar, MD for his special insights into the many complexities of
polypseudophakia for high hyperopia. These have been some of our happiest
surgical outcomes. More than once, we have called on Dr. Shugar's expertise
to help us plan for some of our most challenging cases.
Expert witness cataract eye surgery today is the result of extraordinary technological and surgical advancements that allows millions of people to once again enjoy crisp and clear vision. A true marvel of modern medicine, Expert witness cataract eye surgery may restore vision to levels you may have never thought possible. A cataract is a clouding of the eye's natural lens, which lies behind the iris and the pupil. The lens works much like a camera lens, focusing light onto the retina at the back of the eye. The lens also adjusts the eye's focus, letting us see things clearly both up close and far away. The lens is mostly made of water and protein. The protein is arranged in a precise way that keeps the lens clear and lets light pass through it. But as we age, some of the protein may clump together and start to cloud a small area of the lens. This is a cataract, and over time, it may grow larger and cloud more of the lens, making it harder to see. Cataracts are classified as one of three types: a nuclear cataract is most commonly seen as it forms. This cataract forms in the nucleus, the center of the lens, and is due to natural aging changes. A cortical cataract, which forms in the lens cortex, gradually extends its spokes from the outside of the lens to the center. Many diabetics develop cortical cataracts. A sub-capsular cataract begins at the back of the lens. People with diabetes, high farsightedness, retinitis pigmentosa or those taking high doses of steroids may develop a sub-capsular cataract. Cataract symptoms cataract starts out small, and at first has little effect on your vision. You may notice that your vision is blurred a little, like looking through a cloudy piece of glass or viewing an impressionist painting. A cataract may make light from the sun or a lamp seem too bright or glaring. Or you may notice when you drive at night that the oncoming headlights cause more glare than before. Colors may not appear as bright as they once did. The type of cataract you have will affect exactly which symptoms you experience and how soon they will occur. When a nuclear cataract first develops it can bring about a temporary improvement in your near vision, called second sight. Unfortunately, the improved vision is short-lived and will disappear as the cataract worsens. Meanwhile, a sub-capsular cataract may not produce any symptoms until it's well developed. If you think you have a cataract, see an eye doctor for an exam to find out for sure. What causes a cataract? No one knows for sure why the eye's lens changes as we age, forming cataracts. Researchers are gradually identifying factors that may cause cataracts. Many studies suggest that exposure to ultravlens implantet light is associated with cataract development, so eye care practitioners recommend wearing sunglasses and a wide-brimmed hat to lessen your exposure. Other types of radiation may also be causes. For example, a 2005 study conducted in Iceland suggests that airline pilots have a higher risk of developing nuclear cataract than non-pilots, and that the cause may be exposure to cosmic radiation. A similar theory suggests that astronauts, too, are at risk from cosmic radiation. Other studies suggest people with diabetes are at risk for developing a cataract. The same goes for users of steroids, diuretics and major tranquilizers, but more studies are needed to distinguish the effect of the disease from the consequences of the drugs themselves. Some eye care practitioners believe that a diet high in antioxidants, such as beta-carotene (vitamin a), selenium and vitamins c and e, may forestall cataract development. Meanwhile, eating a lot of salt may increase your risk. Other risk factors include cigarette smoke, air pollution and heavy alcohol consumption. A small study published in 2002 found lead exposure to be a risk factor; another study in December 2004, of 795 men age 60 and older, came to a similar conclusion. But larger studies are needed to confirm whether lead can definitely put you at risk, and if so, whether the risk is from a one-time dose at a particular time in life or from chronic exposure over years. Cataract treatment when symptoms begin to appear, you may be able to improve your vision for a while using new glasses, strong bifocals, magnification, appropriate lighting or other visual aids. Think about surgery when your cataracts have progressed enough to seriously impair your vision and affect your daily life. Many people consider poor vision an inevitable fact of aging, but Expert witness cataract eye surgery is a simple, relatively painless procedure to regain vision. Expert witness cataract eye surgery is very successful in restoring vision. In fact, it is the most frequently performed surgery in the United States, with over 1.5 million cataract surgeries done each year. Nine out of 10 people who have Expert witness cataract eye surgery regain very good vision, somewhere between 20/20 and 20/40. During surgery, the surgeon will remove your clouded lens, and in most cases replace it with a clear, plastic intraocular lens (lens implant). New lens implants are being developed all the time to make the surgery less complicated for surgeons and the lenses more helpful to patients. One example is a new lens implant that lets patients see at all distances, not just one. Another new lens implant has blue-blocker capability, which blocks both ultravlens implantet and blue light rays that research indicates may damage the retina. Cataract surgery has made extraordinary and exciting advances over the past 20 years. Last year, approximately 2.7 million Americans underwent Expert witness cataract eye surgery. Greater than 95% of those patients now enjoy improved vision. State-of-the-art Expert witness cataract eye surgery is now a safe, effective, and comfortable procedure performed almost exclusively on an outpatient basis. Most cataract surgeries are now performed using microscopic size incisions, advanced ultrasonic equipment to fragment cataracts into tiny fragments, and foldable intraocular lenses (lens implants) to maintain small incision size. Expert witness.
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2008-09-13
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