Diseases and Surgery of the Eye
We strive to provide our patients with the finest in ophthalmology care in the Chicago, Illinois area.
Comprehensive testing is available for macular degeneration and early detection of glaucoma.
A cataract is a loss of transparency, or clouding, of the normally clear lens of the eye. As one ages, chemical changes occur in the lens that make it less transparent. The loss of transparency may be so mild that vision is hardly affected or so severe that no shapes or movements are seen, only light and dark. When the lens gets cloudy enough to obstruct vision to any significant degree, it is called a cataract. Glasses or contact lenses cannot sharpen your vision if a cataract is present.
People at risk for developing cataracts are over 55 years old, have had eye injuries or disease, have a family history of cataracts, smoke cigarettes or use certain medications. There is no pain associated with the condition, but there are several symptoms that indicate failing vision due to cataracts. These include:
- Blurred/hazy vision
- Spots in front of the eye(s)
- Sensitivity to glare
- A feeling of "film" over the eye(s)
- A temporary improvement in near vision
Reducing the amount of ultraviolet light exposure by wearing a wide-brim hat and sunglasses may reduce your risk for developing a cataract but once developed there is no cure except to have the cataract surgically removed. Outpatient surgical procedures can remove the cataract. The time to have the surgical procedure is when your vision is bad enough that it interferes with your lifestyle.
Cataract surgery is a very successful operation. One and a half million people have this procedure every year and 95% have a successful result. As with any surgical procedure, complications can occur during or after surgery and some are severe enough to limit vision. But in most cases, vision, as well as quality of life, improves. There is no discomfort during the procedure. Patients usually go home without any eye patches and resume normal activity the next day. Please read more about cataract treatment here.
No Stitch Cataract Surgery
Dr. Szatkowski performs a state of the art version of cataract surgery commonly known as no stitch, no injection. In this technique (picture right), the cataract is removed using an ultrasound probe that enters the eye through a tiny 3 millimeter incision in the cornea. The cataract is broken up and vacuumed out and then an intraocular lens implant is placed.
With the recent advance of foldable IOLs, artificial lenses can be implanted through the same small incision that is created in the phaco procedure. These IOLs are made of a flexible material, allowing them to be folded for implantation. Once inside the eye, the lens unfolds and returns to its original shape.
The procedure is quick and painless, with no needles required around the eye. The eye is numbed with eyedrops only and there is no need for a patch postoperatively. The vision begins to recover within minutes and most patients recover excellent vision within a few days. A full return to normal activities is possible the next day.
Glaucoma is the term for when the pressure inside the eye rises high enough to damage the optic nerve. The condition often develops over many years without causing pain - so you may not experience vision loss until the disease has progressed. Glaucoma cannot be prevented, and vision lost to it cannot be restored. Left untreated, glaucoma can cause blindness. For these reasons, regular eye exams and early detection are critical.
The high eye pressure associated with glaucoma is caused by blockages in the eye's fluid drains. No one knows yet why the blockages form.
Symptoms are occasionally present and should be taken as warning signs that glaucoma may be developing; these include blurred vision, loss of peripheral vision, halo effects around lights and painful or reddened eyes. People at the greatest risk include those who are over the age of 40, diabetic, near-sighted, African-American, or who have a family history of glaucoma.
Once diagnosed, glaucoma can be controlled. Treatments to lower pressure in the eye include non-surgical methods such as prescription eye drops and medications, laser therapy, and surgery.
Selective Laser Trabeculoplasty (SLT) is an advanced laser system that improves the flow of fluid in the eye, lowering eye pressure for patients with glaucoma.
Using a focused, narrow wavelength, SLT targets specific cells of the eye -- those containing melanin, a natural pigment -- leaving surrounding cells intact. The procedure is painless and has no side effects, although patients are given anti-inflammatory eye drops before and after treatment. Eye pressure may drop as quickly as a day after the procedure.
During a trabeculectomy, a "trapdoor" is created in the wall of the eye at the edge of the cornea (the clear front of the eye). Under this trapdoor, a small channel is created in the wall of the eye. The trapdoor is then secured using one or more sutures, allowing fluid to leave the eye in a controlled manner. The fluid then drains into a small bleb, or blister, that forms just under the skin that covers the eye. Typically, the entire surgery is hidden under the upper eyelid. Although trabeculectomy was first developed over 30 years ago, our doctors are trained in the latest techniques allowing for safer and more effective surgery.
Patients with diabetes are at an increased risk of developing eye diseases that can cause vision loss and blindness, such as diabetic retinopathy, cataracts and glaucoma. These and other serious conditions often develop without vision loss or pain, so significant damage may be done to the eyes by the time the patient notices any symptoms. For this reason it is very important for diabetic patients to have their eyes examined once a year. Diagnosing and treating eye disease early can prevent vision loss. It is also important to maintain a steady blood-sugar level, take prescribed medications, follow a healthy diet, exercise regularly and avoid smoking.
"Dry eye" is the term for when your eyes are insufficiently moisturized, either because they do not produce enough tears or because the tears have an improper chemical composition. It often occurs during the natural aging process, but it can also form as a result of eyelid or blinking problems, certain medications (antihistamines, oral contraceptives, antidepressants), climate (low humidity, wind, dust), injury, and various health problems (arthritis, Sjogren's syndrome).
In addition to being uncomfortable, dry eye can damage eye tissue, scar the cornea and impair vision. Dry eye is not preventable, but it can be controlled before harm is done to your eyes. Regular eye exams can detect dry eye early, even before symptoms become noticeable. Symptoms include:
- Irritated, scratchy, dry, uncomfortable or red eyes
- A burning sensation or feeling of something foreign in your eyes
- Blurred vision
Treatment for dry eye can take many forms. Non-surgical methods include blinking exercises, increasing humidity at home or work, and use of artificial tears or moisturizing ointment. Restasis® drops are also available by prescription to increase tear production in a certain segment of the population of dry eye patient. If these methods fail, punctal plugs may be inserted in the corners of the eyes to limit tear drainage, or the drainage tubes in the eyes may be surgically closed.
The macula is a part of the retina in the back of the eye that ensures that our central vision is clear and sharp. Age-related macular degeneration (AMD) occurs when the arteries that nourish the retina harden. Deprived of nutrients, the retinal tissues begin to weaken and die, causing vision loss. Patients may experience anything from a blurry, gray or distorted area to a blind spot in the center of vision.
AMD is the number-one cause of vision loss in the U.S. Macular degeneration doesn't cause total blindness because it doesn't affect the peripheral vision. Possible risk factors include genetics, age, diet, smoking and sunlight exposure. Regular eye exams are highly recommended to detect macular degeneration early and prevent permanent vision loss.
Symptoms of macular degeneration include:
- A gradual loss of ability to see objects clearly
- A gradual loss of color vision
- Distorted or blurry vision
- A dark or empty area appearing in the center of vision
There are two kinds of AMD: wet (neovascular/exudative) and dry (non-neovascular). About 10-15% of people with AMD have the wet form. "Neovascular" means "new vessels." Accordingly, wet AMD occurs when new blood vessels grow into the retina as the eye attempts to compensate for the blocked arteries. These new vessels are very fragile, and often leak blood and fluid between the layers of the retina. Not only does this leakage distort vision, but when the blood dries, scar tissue forms on the retina as well. This creates a dark spot in the patient's vision.
Dry AMD is much more common than wet AMD. Patients with this type of macular degeneration do not experience new vessel growth. Instead, symptoms include thinning of the retina, loss of retinal pigment and the formation of small, round particles inside the retina called drusen. Vision loss with dry AMD is slower and often less severe than with wet AMD.
Recent developments in ophthalmology allow doctors to treat many patients with early-stage AMD with the help of lasers and medication.
Strabismus or tropia are the medical terms for eye conditions commonly called by various names: crossed eyes, wandering eyes, deviating eye, etc. Strabismus is caused by a lack of coordination between the eyes; as a result, the eyes look in different directions and do not focus simultaneously on a single point. Left untreated, strabismus can lead to visual impairment, loss of binocular vision, and blindness in the weaker eye. Treatment aims to improve or restore normal, two-eyed (binocular) vision by realigning the eyes so that they look at the same point at the same time. If the eyes are only slightly misaligned, wearing glasses can sometimes correct strabismus. However, surgery is often the only way to align the eyes and improve binocular vision. During surgery, the muscles around the eye are loosened or tightened by changing their length or position. Altering the pull of the muscles brings the eyes back into line with each other. In strabismus surgery for adults, the eyes are straightened through adjustable muscle surgery.