Eye Lid Surgery Health Feed

Corneal cross-linking refers to a treatment for an eye problem known as keratoconus. During this condition, the front portion of the eye known as the cornea becomes thin and gradually get weaker over a period of time. This makes it bulge into a cone shape, which could make one's vision totally distorted and make it very hard to see. During corneal cross-linking, doctors or ophthalmologists use special eye drops along with ultraviolet light to make the tissues lying in the cornea stronger. This prevents the bulge from getting worse.

It is known as cross-linking because it adds a special connection between the collagen fibers in one's eye. They work like support beams to help the cornea remain stable. At this point in time, it is the only treatment that can stop this condition from getting worse. It can also help people avoid going for a corneal transplant, which is major surgery.

Treatment Procedure -

An ophthalmologist can carry out this cross-linking procedure in his or her clinic. The procedure is described as follows:

• First, the patient would receive drops that get the eyes numb along with a medicine to calm him or her down.

• Then, the doctor would put in riboflavin eye drops, containing Vitamin B2, which allow the patient's cornea to absorb a light lot better.

• For the remainder of the procedure, patients would simply lie back in a chair and look up at a light. There will be no pain as the eyes remain numb.

Types Of Cross-Linking -

There are two types of cross-linking:

• Epithelium-off

• Epithelium-on

Epithelium-off is when the doctor removes the epithelium before he or she puts the drop. Certain experts feel that this allows one’s eye to absorb the vitamins and light lot better but takes much longer to recover and has more risks as well.

During Epithelium-on, one’s epithelium is left alone. This means that patients will not have any pain and the recovery process will also be short.

Tips From Ophthalmologists - 

Let us look at the valuable tips from Ophthalmologists, with regard to this procedure of Cross-Linking, which patients undergo for Keratoconus. They include:

• Cross-Linking is ideal for all those, who have recently got diagnosed with Keratoconus.

• This procedure does not reverse the changes in the cornea, which have already taken place.

• Patients must not wear contact lenses for a couple of weeks before undergoing this treatment.

• Patients should also ask if there are restrictions with regard to certain foods or medicines during this time.

• It is important not to wear any makeup, perfume or apply after-shave on the day of the procedure. One can have a light meal and take fluids before going for the treatment.

• Once patients have undergone the cross-linking procedure, they might require new glasses or contact lenses.

Thanks to cosmetic surgery, today, it is possible to alter your facial features any way you want. For some it's a way to reverse signs of aging while for others it may be to restructure a part of their face that they are not comfortable with. Whatever be your reason, here are ten tips to ensure safer facial cosmetic surgery.

1. Have the right motivation: Cosmetic surgery will change the way you look, not your lifestyle. Do not undergo such a surgery if you think it will give you a new lifestyle.
2. Have realistic expectations: Going under a plastic surgeon's knife can alter your facial feature, but only up to a limit. You may want your nose to look like that of your favourite actress, but the end result of the surgery will depend on the bone and cartilage structure of your nose. Having unrealistic expectations can take away from the satisfaction of plastic surgery. 
3. Find a surgeon who shares your aesthetic sense: If you and your surgeon do not share the same ideas on what looks good, you may end up with a result you are not satisfied with. Before deciding on a doctor, take a look at photographs of their earlier clients.
4. Be wary of promotions that offer to pay for your surgery: Cosmetic surgery is expensive, but do not try and save money by choosing to work with inexperienced doctors. 
5. Meet the entire surgical team: Along with the doctor it is also important to meet the other members of the surgical team. Also, take a look at the facilities offered and the type of surgical atmosphere available.
6. Have a clear written plan for the surgery and possible follow up procedures: Cosmetic surgeries often require multiple procedures. Ask your doctor for a clear plan with all the costs involved. 
7. Ensure that you have an aftercare plan: On the off chance that something does not go according to plan, ensure that you know what is to be done and insist on an aftercare treatment from your doctor.
8. Have a strong support system in place: It will take a few months for the effects of your surgery to be visible. Until then, your face may appear swollen and bruised. Get support from your friends and family as this may keep you indoors for awhile. 
9. Be aware of the risks: Like any other surgery, this one too has risks associated with it. Ensure that you are aware of these risks so that you can make an informed decision. 
10. Don't rush your decision: Lastly, take your time deciding on the exact procedure you want. Remember that the effects of cosmetic surgery are permanent.

The cornea is the front layer of eyes that helps in focusing light to see objects clearly. In a cornea transplant surgery, the damaged cornea tissue is replaced by healthy donor tissue. In medical terms, it is known as keratoplasty for a corneal graft. The cornea needs to be clear, smooth, and healthy for a good vision.  An unhealthy cornea leads to blurry vision.

Before transplanting cornea, doctors also try to treat the problem with other methods. However, if the condition is not getting better, Corneal Transplantation is advised.

Causes:

A damaged Cornea leads to blurry and changed vision. The damage can affect the daily life of the sufferer. A cornea surgery may need for the following reasons:

1. Change of shape of cornea (keratoconus)

2. Swollen or cloudy cornea

3. Bacterial, viral, or fungal infection in cornea

4. Other refractive surgeries

5. Eye injury

6. Hereditary conditions (dystrophies)

7. Thinning of cornea

Diagnosis:

The cornea can heal itself from minor infections and injuries during which itching, redness, pain, blurred vision, and sensitivity towards light are some common symptoms. But, if it continues for a long time, one should see an eye specialist to determine the severity of the condition and undergo some lab tests. The patients sometimes are prescribed with medications before the surgery depending on the severity of their corneal damage. 

Treatment:

Following are the Corneal Transplantation options depending upon the severity of the condition:

1. Full Thickness Corneal Transplant: It is also known as Penetrating Keratoplasty (PK). This transplant is needed when both the inner and outer layers of the cornea are damaged. In this type of transplant, all the layers of the cornea are replaced by healthy tissues. The recovering period of this surgery can take more than a year, which is the longest as compared to the other types of corneal surgeries. It has a higher risk as the immune system of the patient can attack the donor’s cornea.

2. Partial-Thickness Corneal Transplant: It is also known as Deep Anterior Lamellar Keratoplasty (DALK). In this type of surgery, only the outer and middle layers of the cornea are replaced by the new ones. It is done to treat the bulging of the cornea (keratoconus). The procedure and recovery from this surgery takes less time than the full thickness corneal transplant.

3. Endothelial Keratoplasty: This transplant is used for post-cataract surgery complications. It is needed when the innermost layer (endothelium) of the cornea is damaged. With this surgery, the innermost layer of the cornea is replaced with the new and healthy one. In this surgery, most part of the cornea is left untouched lowering the chances of corneal rejection past surgery. The healing process of this type of surgery is quicker than the other two.

Post-surgery Prevention:

Some of the preventive measures one should follow after the surgery are:

1. Avoid using electronics like mobile, television, laptop, etc.

2. Avoid rubbing of eyes.

3. Avoid exposure to sun or very bright light.

4. Avoid exposure to dust.

5. Do not use any eye-drops without doctor’s suggestion.

Take Away:

Corneal transplant is indeed a subject of concern and it is an important surgical transplant. The damaged cornea can lead to blindness or very close to blindness condition if not taken seriously. But with today’s technology, one can easily go through the surgery and taking certain precautions leads to a normal healthy life. However, consulting an experienced and skilled cornea consultant for the transplant-related queries is always advisable.

Keratoconus is a progressive vision disorder which occurs when the normally round cornea becomes thin and cone-shaped, and bulges out, deflecting the light entering the eye leading to a distorted and blurry vision.

Causes of Keratoconus
Weakening of the collagenous fibre, which holds the cornea in its regular place, leads to its bulging out. Decreased levels of antioxidants in the cornea too cause the condition by damaging the fibre from external pollutants. It is also seen running into families, though there is no concrete evidence of it yet. Therefore, it can be stated that even though the exact cause of the condition is unknown, it seems to be affected by genetic, hormonal, and environmental factors.

Diagnosis of Keratoconus is easy, mainly from routine eye examination by an expert ophthalmologist.

Implications on Vision
Though Keratoconus itself does not lead to blindness, it causes poor vision by an unclear cornea which is unable to focus light properly on the retina, leading to a distorted, blurry vision and glare. It changes the shape of the cornea, leading to its thinning and scarring, making it lose its transparency. Keratoconus progresses very fast in young patients, and hence it is important that immediate medical help is sought. Some of the symptoms of the condition include eye pain and strain, sudden change of vision in one or both eyes, double vision with just one eye, sensitivity to light, glare, headaches, blurry and distorted vision, seeing halos or light streaks and inability to drive after dark.

Treatment of Keratoconus
Only prescription glasses are generally recommended to correct the vision in the early stages of Keratoconus. However, this is not a permanent solution because this condition rapidly progresses leading to further deterioration of the vision. In that case, one of the following treatments might be recommended by the ophthalmologist depending on the severity of the condition.

● Hybrid or rigid contact lenses can be prescribed to improve vision by masking the shape of the cornea. But, that does not prevent further deterioration of vision.
● When the vision is no longer correctable by using glasses or contact lenses, corneal ring segments are employed. These plastic segments are implanted into the cornea by a surgical procedure and they keep the shape of the cornea intact, leading to refractive correction of vision eventually.
● Corneal collagen cross-link stops the progression of the Keratoconus. In this procedure, the outer layer of the epithelial tissue on the cornea is removed. It is then enriched with riboflavin and collagen, which are activated by the application of ultraviolet light to strengthen the cornea by improving its rigidity significantly. It requires some weeks of care after the procedure.
● Keratoplasty or corneal transplantation is employed only when no other option works for an individual. It is a complex surgical procedure in which a donor cornea replaces the defective cornea. Eventually, corneal cells grow and fuse with the donor cornea during the process of recovery, which can take up to almost a year.

People with even a small degree of the condition should not opt for the LASIK as it may worsen the condition.

Urgent referral is not required in Keratoconus as the condition manifests itself slowly, generally over a span of months and years. However, symptoms should not be ignored and medical help should be sought as soon as possible.