Ophthalmology

What are refractive errors (Myopia, Hypermetropia, Astigmatism)?

In order to visualize images, the eye works in a similar way to a photographic camera. In other words, it has lenses that form a sharp image of the outside world on a sensitive film (the retina) that receives these images and, through the optic nerve, sends them to our brain so that we can see- the

To see these images clearly, the "captured" images must be focused exactly on the retina. An eye is said to have a refractive error when the power of the lenses (crystalline and cornea) focus the images either in front (myopia) or behind (hypermetropia) of the retina.

myopia
A person with myopia has difficulty (blurred vision) focusing on distant objects, while seeing close objects correctly. Myopia can cause headaches and eye strain.

Hypermetropes have a blurred perception of nearby objects, unlike myopes. Farsightedness can cause headaches and eye pain, tearing and frequent blinking. To detect hypermetropia correctly, it is necessary to dilate the pupil with cycloplegic drops.

Astigmatism
A person with astigmatism perceives a distorted view of things, both far and near. It is a problem of the curvature of the cornea, so that the images that are perceived are distorted. Astigmatism is usually associated with Myopia or Hypermetropia.

These refractive errors can be corrected with glasses, contact lenses or definitively through surgery.

What is Laser Refractive Surgery?

Laser Refractive Surgery is an effective and safe technique for the correction of Myopia, Hypermetropia and/or Astigmatism.

Through the application of the laser, the curvature of the cornea is modified, thus correcting the refractive defect definitively, with minimal discomfort for the patient and with a rapid recovery of their visual function.

In our center you can solve your problem of dependence on glasses or contact lenses. We have the most advanced technology in the field of Ophthalmology. Our state-of-the-art laser allows for personalized surgeries.

What is eye strain (presbyopia)?

It is a disorder known as "tired vision", and manifests itself as a progressive decrease in near vision that occurs physiologically in all people from the age of 40-45.

This physiological problem consists in the loss of close focus by the lens, a transparent lens located inside the eye behind the pupil.

Normally when looking at distance the lens is flat and when you switch to looking up close the lens pumps to change focus. This mechanism is regulated by a muscle called the ciliary muscle.

Why does it appear?

As a result of aging:

• The ciliary muscle loses elasticity and power
• The lens loses elasticity
• Because of this, the eye loses its ability to focus on close objects.
• Initially the person starts by moving the reading away, looking for an ideal focus distance or looking for well-lit areas.

Who does it affect?

The onset of presbyopia is inevitable. It begins to manifest itself between the ages of 40 and 45 and reaches practically 100% of the population over 50 years of age.

It affects both myopes and hypermetropes and astigmatism. The latter must use two different optical compensations, one for distant vision and the other for near vision.

Other factors that accentuate presbyopia are:

• diabetes
• Anemia
• Certain medications

symptoms

• The main symptom is difficulty focusing on close objects
• There is a tendency to increase the distance between the object and the eyes, a characteristic sign of presbyopia (extending the arms to read)
• The search for more illuminated areas for the practice of close work
• They may also have symptoms such as headache, heaviness in the eyes, itching and red eye

How can it be corrected?

The usual correction of presbyopia until now was done with glasses, or with two glasses, one for distance and the other for near, or by bifocal or multifocal glasses, or with the use of multifocal contact lenses.

Today it can be permanently corrected through surgery.

Eye strain surgery (presbyopia)

Surgery will allow, in the majority of cases, to see both near and far without the need to use glasses.

Today there are different surgical options for the correction of presbyopia:

• Surgery to implant pseudophakic bifocal, multifocal or accommodative intraocular lenses.
• Presbyopia can also be corrected using new laser surgical techniques.

The type of surgery will depend on each specific patient.

This is why we offer a Free Informational Surgery Visit, where the Doctor evaluates in a personalized way which is the most suitable intervention for each specific patient.

What are cataracts?

Cataract is the loss of transparency of the lens that produces a progressive loss of vision.

Cataract usually occurs in elderly people (senile cataract), it usually appears after the age of 65, and affects more than half of the population over 85 years of age.

It can also occur, less frequently, in young people (congenital cataract) or be caused by accidents (traumatic cataract).

symptoms

• blurred vision
• Loss of color sharpness
• Poor night vision
• Frequent glares
• Sensation of seeing fog

How can they be corrected?

The only effective way to remove a cataract is through surgery.

Cataract surgery

The operation consists of the extraction of the opacified lens and the placement of an intraocular lens in its place.

It is not necessary to wait until you lose all vision to have surgery.

Surgical techniques

The technique most used today is called phacoemulsification, which aims to replace the opaque crystalline lens with an artificial lens that allows the patient to recover lost vision.

• Rapid and outpatient intervention.
• No general anesthesia.
• No stitches.
• Once the operation has been performed, the patient can return home on his own foot and with the eye uncovered.
• Very fast visual recovery.

Advantages of surgery

• Safe and effective technique
• Thousands of people operated
• Quick and painless intervention
• The intervention lasts 10 min. by eye
• Ambulatory surgery
• No general anesthesia
• No waiting list

What is glaucoma?

Glaucoma is a serious disease that is considered one of the main causes of blindness in Spain. More than a million people suffer from it and nearly 50% of them do not know that they are affected by glaucoma, since it is an eye disease that in most cases does not present symptoms, that is why Glaucoma is known like: "the silent disease of the eyes".

This pathology is caused by an injury to the optic nerve caused, in general, by an increase in eye tension as a result of the deficient evacuation of the aqueous humor by our eyes. This injury causes irreparable damage to the optic nerve, so it causes a progressive loss of vision that can even lead to total blindness.

symptoms

If you suffer from glaucoma, you may not notice the symptoms at first. If you notice symptoms, your vision may already be significantly affected.

Some common symptoms are:

• Frequent change of glasses because none is satisfactory.
• Difficulty seeing in dark places (for example: the cinema).
• Loss of peripheral vision.
• Ring-shaped rainbow around the lights.
• Difficulty focusing vision on very close objects.
• These symptoms are not always signs of glaucoma, but if you notice any of them, it is advisable to see an ophthalmologist.

Treatment

The goal of treatment is to preserve useful vision by lowering intraocular pressure. Established lesions are generally irreversible, therefore, treatment is aimed at stopping the disease and preventing the progress of visual impairment.

Eye drops are usually used to help produce less fluid in the eye or facilitate its drainage. It is the initial treatment of the disease, but the drop in pressure is usually not greater than a 30%.

When "silent blindness" has appeared, the solution to our problem is through surgery. Trabeculectomy has been the standard intervention in the surgical treatment of glaucoma, although new advances point towards a new, much less invasive surgery.

In our center we practice the so-called non-perforating deep sclerectomy, an intervention that avoids penetrating the inside of the eye. In this way, the complications associated with glaucoma surgery decrease very significantly, since these are mainly due to the sudden drop in tension caused by the perforating techniques. The postoperative period is much more comfortable for the patient and his recovery is much faster.

How to prevent glaucoma

The glaucoma prevention exam is painless and quick. Every person older than 35 should, at least once a year, take their intraocular pressure, have a pachymetry (measures the thickness of the cornea) or perform a Visual Field.

If your eye pressure is very close to the upper level of the parameters established as normal, it should be monitored in order to discover possible future increases.

If the pressure is higher than normal, the specialist will look at the optic nerve to determine if it has been damaged and look for visual field loss to confirm the diagnosis.

A great means of help for us is COMPUTERIZED CAMPIMETRY, since in case of suspicion of glaucoma, it gives unequivocal signs of confirmation or not. In case of confirmed glaucoma, it establishes a fundamental guideline for prognosis and treatment.

The appearance of the Optical Coherence Tomograph and the GDX allow us to prevent the appearance of this disease by making an early diagnosis and continuous monitoring.

AMD (Age-Related Macular Degeneration)

AMD has become one of the most common causes of visual loss in people over 65 worldwide. One of the most characteristic symptoms is when the patient says that straight lines are curved or there is a blind spot in the center of the visual field.

We differentiate between two types: dry AMD and wet AMD;

Wet AMD is the most dangerous of the two, as it evolves very quickly and can irreversibly affect the retina. It is very important to detect it in time, because if it is detected in time it has a solution (with the NEW anti-angiogenic and laser treatments)

Dry AMD evolves more slowly and is less dangerous than wet AMD, but it is important to follow up with frequent visits to an ophthalmologist specializing in the retina.

Diabetic Retinopathy

Diabetic Retinopathy is the 1st cause of blindness in the Western world. Diabetes alters the blood vessels of the retina and the whole organism. Although eye disorders can go unnoticed, they are discovered during an ophthalmological examination or when the patient's vision becomes cloudy or loses it completely, which is why we recommend ophthalmological examinations at least once a year.

We distinguish two types:

• Basic or Background Diabetic Retinopathy decreases the patient's central vision but preserves lateral vision. It cannot read or recognize faces.
• Proliferative Diabetic Retinopathy, the blood vessels that tend to break and bleed are closed.

The most significant treatment consists of using the Laser to close or photocoagulate the leaking blood vessels. With this treatment, no surgery is needed and it can be done in the doctor's office.

However, the laser cannot be used in all patients. If the vitreous humor is full of blood, a vitrectomy is performed.

Detachment of the Vitreous

With age, the vitreous tends to deteriorate by losing water and decreasing its volume, and by becoming smaller, it tends to stretch the retina to separate. The vitreous is a transparent gelatinous body, which is attached to the retina at several points and is mostly composed of proteins.

The most characteristic symptoms are seeing flying flies and/or luminous flashes, even like spider webs.

Vitreous Detachment does not involve any treatment at first, only constant reviews by an ophthalmologist specializing in retina because it can result in retinal detachment.

Retinal detachment

It occurs when, due to a blow, a sprain or excessive traction, the retina or part of it detaches from its usual place. Vision becomes defective and certain areas of the visual field are lost.

Some patients describe it "as if a curtain were drawn" in front of the eye.

There are conditions that can increase the chance of having a retinal detachment:

• Myopia magna or high myopia
• Weak areas in the peripheral retina
• Family history of retinal detachment
• Eye trauma
• Previous complicated eye surgery

The treatment for a retinal detachment depends on each case, although it always ends in effective outpatient surgery.

Other diseases of the retina

There are other diseases that can affect different parts of the retina such as the macula or the optic nerve, all treated by our specialists.

• Hypertensive retinopathy
• Retinopathy of toxemia of pregnancy
• Retinitis
• Retinosis pigmentosa

Corneal ectasias

They occur when the cornea presents a progressive thinning and a protrusion that leads to an exaggerated increase in its curvature, producing poor vision. In advanced states, the patient may not tolerate optical correction (neither glasses nor contact lenses). A cornea transplant may be needed in very advanced cases.

Among the most important corneal ectasias we find keratoconus, keratoglobo and pellucida marginal degeneration.

The general symptoms are continuous itching and dry eye sensation. In advanced states, symptoms can worsen.

There are different treatments depending on the progression of the ectasia. The traditional solution has been corneal transplant surgery, and the latest advances are the implantation of INTACS, the crosslinking technique or a combination of both.

keratitis

It is an inflammation of the cornea, which can be due to different causes.

The general symptoms depending on the type of keratitis are eye pain, dryness, sensation of sand, photophobia, red eye, corneal opacity, corneal irritation, foreign body sensation, etc.

In some cases, it can be associated with inflammation of the conjunctiva (conjunctivitis).

These symptoms can appear to a greater or lesser extent depending on the cause that has caused the keratitis from trauma to exposure to UV radiation or toxic products, to infectious keratitis due to bacteria or viruses...

The treatment will depend on the type of keratitis that affects us.

dry eye

It is usually an affectation of the tear that can lead to eye discomfort and inflammation of both the cornea and the conjunctiva.

This dry eye can be due to both physiological (natural) causes and a pathology.
The symptoms are eye irritation, sensation of sand or a foreign body, dry eyes, decreased visual acuity, photophobia...

The treatment will depend on the degree of dry eye, we can treat with drugs, tear plugs or surgical intervention in the most severe cases.

What is oculoplasty?

It is a sub-specialization of medical-surgical ophthalmology that deals with the facial structures that surround the eye (eyelids, tear ducts, orbit).

Both women and men cannot avoid the passing of the years, but we can achieve a natural, harmonious and balanced appearance.

Through our surgery and aesthetic medicine unit, we diagnose, treat and advise each patient in a personalized way with the aim of achieving a healthy appearance and a good face, without wrinkles but with expressiveness and naturalness.

Eye bags – Blepharoplasty or eyelid surgery

It consists of administering microinjections of this natural substance that is a temporary muscle relaxant.

The treatments are carried out in the doctor's office and do not require admission. The aim is to attenuate and eliminate expression wrinkles on the forehead, sides of the eyes, crow's feet and between the eyebrows.

Wrinkles of expression: "crow's feet" - Botulinum Toxin Type A

It consists of administering microinjections of this natural substance that is a temporary muscle relaxant.

The treatments are carried out in the doctor's office and do not require admission. The aim is to attenuate and eliminate expression wrinkles on the forehead, sides of the eyes, crow's feet and between the eyebrows.

What is strabismus?

Strabismus is the misalignment of the eyes.

If the muscles of one eye do not work in a coordinated way with those of the other eye, a strabismus occurs, that is to say, a real deviation of the eyes known vulgarly as "ull guenyo".

It produces a loss of stereoscopic vision (depth) that may be reversible depending on the age of the patient and the type of strabismus.

Types of strabismus

• Convergent strabismus: They are the most common and are when the eyes deviate towards the nose.
• Divergent strabismus: These are the eyes turned outwards, they are less frequent and they are disturbed by the bright light of the sun, they are controlled with glasses but most require surgical intervention.
• Vertical strabismus: the eye deviates upwards or downwards.
• Congenital strabismus: Present at birth and not improved with glasses.

Treatments for Strabismus

• Surgery: It is a safe surgery, but the eyes are not always perfectly aligned after the first operation and sometimes require more than one operation in order to be able to put them completely straight.
• Glasses: They affect the position by changing the person's reaction to the focus. The prisms change the direction of the light and therefore the images, which causes the change in the position of the eye.
• In certain cases it can be corrected with eye exercises.

What is pediatric ophthalmology?

It is a subspecialty within ophthalmology dedicated to treating children's eye problems.

It is never too early to scan a child, even a baby can be scanned if it is accurate. Postponing the eye exam until the child is older is wrong and can be very serious. The earlier an eye problem is diagnosed, the sooner it can be treated and therefore the prognosis is better.

How can you detect that a child does not see well?

• If when you read you zoom in or out excessively
• He frequently swears
• In the morning his eyes are stuck
• He has red eyes
• His eyes are crying
• He rubs his eyes continuously
• Squint to look
• Tilt your head to one side when reading
• He is bothered by the sun or does not adapt well to the dark
• School performance is low
• He is easily distracted

In any of these cases, a visit to a Pediatric Ophthalmologist is recommended to prevent visual defects.

It is important to screen premature babies and children who have relatives with refractive defects or vision problems.

The sooner an eye problem is diagnosed, the sooner it can be treated.