GLAUCOMA

Glaucoma is a group of eye conditions that damage the optic nerve, often due to abnormally high intraocular pressure (IOP). It is a leading cause of irreversible blindness worldwide if left untreated.
Types of Glaucoma

1. Primary Open-Angle Glaucoma (POAG)
   1.Most common type (90% of cases).
   2.Gradual loss of peripheral vision due to slow clogging of drainage canals.
   
2. Angle-Closure Glaucoma (Acute or Chronic)
   1.Sudden rise in eye pressure due to blocked drainage angle.
   2. Symptoms: Severe eye pain, headache, nausea, blurred vision, halos around lights.
   3. Medical emergency requiring immediate treatment.
3. Normal-Tension Glaucoma
   1. Optic nerve damage occurs despite normal IOP.
   2. Linked to poor blood flow or nerve sensitivity.
4. Secondary Glaucoma
   1. Caused by other conditions (e.g., diabetes, trauma, inflammation, steroid use).
5. Congenital Glaucoma
   1.Rare, present at birth due to abnormal eye development​

Risk Factors

• Age (over 60)
• Family history of glaucoma
• High intraocular pressure (IOP > 21 mmHg)
• Thin corneas
• Extreme nearsightedness or farsightedness
• Diabetes, hypertension, or poor circulation

Symptoms
Early stages: Often none (silent thief of sight).
Later stages:

• Loss of peripheral (side) vision
• Tunnel vision (advanced cases)
• Blurred vision, halos around lights (acute angle-closure)

Diagnosis

• Tonometry (measures eye pressure)
• Ophthalmoscopy (examines optic nerve damage)
• Perimetry (visual field test)
• Gonioscopy (checks drainage angle)
• Optical Coherence Tomography (OCT) (assesses nerve fiber layer)

DIABETIC RETINOPATHY

Diabetic retinopathy is a diabetes-related eye condition and a leading cause of blindness in adults. It occurs when high blood sugar levels damage the blood vessels in the retina, the light-sensitive tissue at the back of the eye.
Stages of Diabetic Retinopathy:

1. Mild Non proliferative Diabetic Retinopathy (NPDR)
   - Small areas of swelling (microaneurysms) in retinal blood vessels.
   
2. Moderate NPDR
   - Blood vessels swell and distort, possibly causing fluid leakage.
   - May lead to diabetic macular edema (DME), affecting central vision.
   
3. Severe NPDR
   - More blood vessels become blocked, depriving the retina of oxygen.
   - The retina signals for new blood vessels to grow (neovascularization).
   
4. Proliferative Diabetic Retinopathy (PDR) – Advanced Stage
   - New, fragile blood vessels grow abnormally on the retina.
   - These vessels can bleed into the vitreous (vitreous hemorrhage), causing floaters or vision loss.
   - Can also lead to retinal detachment and severe vision loss.
   

Symptoms:

• Blurred or fluctuating vision
• Dark spots or floaters
• Poor night vision
• Colors appearing faded
• ​Vision loss (in advanced stages)

Risk Factors:

• Long duration of diabetes (especially if poorly controlled)
• High blood sugar & blood pressure
• High cholesterol
• Pregnancy (gestational diabetes)
• Smoking

Diagnosis:

• Dilated eye exam (fundoscopy)
• Optical coherence tomography (OCT) for detailed retina imaging
• Fluorescein angiography to check blood vessel leakage

MACULA DEGENERATION

Macular degeneration, also known as age-related macular degeneration (AMD), is a common eye condition that affects the macula—the central part of the retina responsible for sharp, detailed vision. It is a leading cause of vision loss in people over 50 years old.
Types of Macular Degeneration

1. Dry (Atrophic) AMD (90% of cases)
   
   • Gradual breakdown of light-sensitive cells in the macula.
     
   • Formation of drusen (yellow deposits) under the retina.
     
   • Progresses slowly, leading to blurred or reduced central vision.
     
2. Wet (Neovascular/Exudative) AMD (10% of cases)
   
   • Abnormal blood vessels grow under the retina, leaking fluid/blood.
     
   • Causes rapid and severe vision loss if untreated.
     
   • More aggressive but treatable with medications.
     

​Symptoms

• Blurred or distorted central vision
  
• Dark or empty spots in vision (scotomas)
  
• Difficulty reading or recognizing faces
  
• Straight lines appearing wavy (metamorphopsia)
  

Risk Factors

• Age (over 50)
  
• Genetics (family history)
  
• Smoking (major modifiable risk)
  
• Race (more common in Caucasians)
  
• Cardiovascular disease & high blood pressure
  
• Obesity & poor diet (low in antioxidants)
  

Diagnosis

• Comprehensive eye exam (dilated retina exam)
  
• Amsler grid test (checks for distortions)
  
• Optical coherence tomography (OCT) (detailed retina imaging)
  
• Fluorescein angiography (checks for leaking blood vessels)
  

CATARACTS

Cataracts are a common eye condition where the lens of the eye becomes cloudy, leading to blurred vision, glare sensitivity, and difficulty seeing at night. They typically develop slowly with age but can also result from injury, diabetes, or prolonged steroid use.
Primary Causes:

• Aging (most common, usually after age 60)
• UV radiation exposure (prolonged sunlight without protection)
• Diabetes (high blood sugar speeds up cataract formation)
• Smoking & excessive alcohol use
• Eye trauma or injury
• Steroid medications (long-term use)
• Congenital cataracts (present at birth)

Symptoms of Cataracts
​Symptoms develop gradually and may include:
✔ Blurry or cloudy vision (like looking through a foggy window)
✔ Increased sensitivity to glare (especially at night from headlights)
✔ Faded or yellow-tinted colors
✔ Double vision in one eye
✔ Frequent prescription changes (glasses/contacts no longer help)
✔ Difficulty reading or seeing in dim light

​Treatment OptionsNon-Surgical Management (Early Stages)

• Stronger glasses/contacts (temporary solution)
  
• Anti-glare sunglasses (for light sensitivity)
  
• Brighter lighting (helps with reading)
  

Surgical Treatment (Advanced Cases)

• Phacoemulsification (most common):
  
  • A small incision is made, and ultrasound breaks up the cloudy lens.
    
  • An artificial intraocular lens (IOL) replaces it.
    
• Laser-assisted cataract surgery (more precise, but not always necessary)
  
• Recovery time: Usually a few days to weeks, with full healing in about a month.
  

✅ Success Rate: Over 95% of cataract surgeries improve vision.

DRY EYE SYNDROME

Dry Eye (Dry Eye Syndrome) is a common condition where the eyes do not produce enough tears, or the tears evaporate too quickly, leading to inflammation and discomfort. It can affect people of all ages but is more common in older adults, women, and those who use digital screens frequently.
Symptoms of Dry Eye:

• Stinging or burning sensation
• Redness
• Gritty feeling (like something is in the eye)
• Blurry vision (often improving with blinking)
• Watery eyes (reflex tearing due to irritation)
• Sensitivity to light
• Discomfort when wearing contact lenses

​Common Causes:
​✔ Decreased tear production (due to aging, medical conditions like Sjögren’s syndrome, or medications like antihistamines)
✔ Increased tear evaporation (from screen use, dry air, wind, or not blinking enough)
✔ Eyelid problems (e.g., blepharitis, meibomian gland dysfunction)
✔ Environmental factors (low humidity, smoke, air conditioning)
✔ Extended contact lens use
✔ Hormonal changes (e.g., menopause)

​Treatment & Management:

1. Artificial Tears (OTC lubricating eye drops)
2. Prescription Medications (e.g., cyclosporine [Restasis], lifitegrast [Xiidra])
3. Warm Compresses & Eyelid Hygiene (for meibomian gland dysfunction)
4. Punctal Plugs (to block tear drainage)
5. Amniotic Membrane

PUNCTAL PLUGS

Punctal plugs (also called lacrimal plugs) are tiny medical devices inserted into the puncta (small openings in the inner corners of the eyelids) to block tear drainage. They help keep the eyes moist by preserving natural tears or enhancing the effect of artificial tears.
Types of Punctal Plugs:

1. Temporary (Dissolvable) – Made of collagen, these dissolve over time (days to weeks).
2. Semi-permanent – Made of silicone or acrylic, these can last months to years and may need removal by a doctor.

---

AMNIOTIC MEMBRANE

Amniotic membrane, a natural tissue from the placenta, is used in ophthalmology as a biological bandage for ocular surface reconstruction, offering anti-inflammatory, anti-scarring, and anti-microbial properties to promote healing and protect damaged eye tissue. 
What it is:
Amniotic membrane is the tissue closest to the developing baby in the womb, part of the placenta. 
Why it's used:
It's used in eye care to treat conditions like corneal defects, dry eye, chemical burns, ulcers, and other ocular surface diseases. 
How it works:

• It acts as a barrier, protecting and supporting the epithelium (outer layer of the cornea) as it heals. 
• It promotes cellular regeneration and provides a scaffold for stem cell growth. 
• It reduces inflammation and scarring. ​
• It has anti-inflammatory, anti-scarring, anti-microbial, and anti-fibrotic properties. 

​
​

Procedure:

• The amniotic membrane is placed over the cornea and ocular surface. 

• It can be attached with sutures or fibrin glue. 

• In some cases, a bandage contact lens is used to keep the membrane in place. 

Benefits

• Less scarring. 

• Reduced inflammation. 

• Improved patient comfort and vision. 

• Faster healing. ​