🤓 Don’t just eye the problem—iStent it!

The iStent is a tiny, medical device used to treat glaucoma, a condition characterized by high pressure inside the eye (intraocular pressure or IOP). Glaucoma is a serious eye disease that can damage the optic nerve and lead to permanent vision loss if left untreated.

Here’s a breakdown of what iStent is and how it works:
What is an iStent?
The iStent is a very small, non-magnetic titanium tube, often cited as the smallest medical device implanted in the human body.

It is designed to be a permanent implant that helps improve the drainage of fluid from the eye.

It is made from the same material used for replacing heart valves, so it is well-tolerated by the body and will not cause an allergic reaction.
The device will not set off airport scanners or cause problems if you need an MRI scan.

How Does it Work?
In a healthy eye, fluid (aqueous humor) continuously flows in and out to maintain a stable pressure. In people with glaucoma, the eye’s natural drainage system, specifically the trabecular meshwork, becomes blocked or less effective, causing fluid to build up and the pressure to rise.

The iStent works by creating a bypass or a permanent opening in this drainage channel. This increased outflow helps to lower the intraocular pressure.

The iStent Procedure
Minimally Invasive Surgery: The iStent procedure is considered a minimally invasive glaucoma surgery (MIGS).
Combined with Cataract Surgery: This combined approach is beneficial for patients who have both a cataract and open-angle glaucoma.

Stand-alone Procedure: In some cases, the iStent can also be implanted as a stand-alone procedure.

Recovery: Recovery is generally rapid. Patients are typically able to go home the same day. There may be some temporary blurry vision or a small amount of bleeding in the eye, but these side effects usually resolve quickly. You will be given antibiotic and anti-inflammatory eye drops to use after the operation.

Benefits and Limitations
Benefits: The main goal of an iStent is to lower eye pressure to prevent glaucoma from getting worse and to potentially reduce or eliminate the need for glaucoma eye drops. Studies have shown significant reductions in eye pressure and medication use after the procedure.

Not a Cure: The iStent will not cure glaucoma, reverse any damage that has already occurred to the optic nerve, or restore lost vision. It is a treatment to help manage the disease.

Suitability: The iStent is primarily suitable for patients with mild to moderate open-angle glaucoma. It is not recommended for all types of glaucoma or for those with very advanced disease. Your doctor will determine if you are a suitable candidate for the procedure

🤓 The PreserFlo MicroShunt is a game-changer for patients with uncontrolled glaucoma.

This small, implantable device provides a permanent solution to lower eye pressure, helping to prevent irreversible vision loss.

Here’s why it’s making a difference:
Minimally Invasive: A less traumatic procedure for the eye compared to traditional surgery.
Effective: Proven to significantly lower eye pressure and reduce reliance on daily eye drops.
Biocompatible: Made of a non-metallic, non-toxic material that is well-tolerated by the body.

This advancement is helping to redefine patient care and outcomes in ophthalmology:

What is a PreserFlo MicroShunt?
The PreserFlo MicroShunt is a small, 8-millimeter-long tube, also known as a stent, designed to help reduce eye pressure in patients with glaucoma. It is made of a synthetic, biocompatible material called SIBS (styrene-block-isobutylene-block-styrene) that is non-toxic and not rejected by the body. Because it’s not metallic, it will not set off airport scanners and is safe for MRI or CT scans.

Why might I need this surgery?
Glaucoma is an eye condition where high pressure inside the eye (intraocular pressure, or IOP) can damage the optic nerve, leading to vision loss. The PreserFlo MicroShunt is used when eye drops or laser treatments have not been successful in controlling your eye pressure, or if you are unable to use eye drops regularly. The goal of the surgery is to lower your eye pressure to prevent further damage and vision loss. It is important to note that this surgery will not cure glaucoma or restore any vision that has already been lost.

How does the surgery work?
The PreserFlo MicroShunt is implanted during a procedure that typically takes 45-60 minutes.

Anti-scarring medication: An anti-scarring agent, often Mitomycin C, is applied to the eye. This is a very important step as it helps to increase the long-term success of the surgery by preventing scar tissue from blocking the new drainage pathway.

Creating a new drainage pathway: The PreserFlo MicroShunt is inserted through a tiny tunnel into the front chamber of your eye. The other end of the tube is positioned under the conjunctiva.

What are the benefits of the PreserFlo MicroShunt?
Effective Pressure Reduction: Clinical studies have shown a significant reduction in eye pressure, which helps to prevent further vision loss from glaucoma.
Less Invasive: It is considered a minimally invasive glaucoma surgery (MIGS) and is less traumatic to the eye than traditional glaucoma surgery (trabeculectomy).
Reduced Need for Eye Drops
Faster Recovery

What are the risks and potential complications?
While the PreserFlo MicroShunt is designed to be a safer alternative to other surgeries, all surgical procedures carry some risks. Serious complications are uncommon.

🤓 Exploring a truly rare clinical phenomenon in ophthalmology today: Spontaneous Globe Subluxation.

Not all eye emergencies are caused by trauma.
A topic that continues to fascinate me is spontaneous globe subluxation, a rare condition where the globe surprisingly dislocates from its orbit. While shocking in appearance, immediate and careful repositioning can make all the difference.

This is a powerful reminder of the importance of recognizing unusual clinical presentations. I am grateful for the deep knowledge and training that prepared me to assess and manage such cases.

Spontaneous globe subluxation is a rare and striking condition where the eyeball protrudes out of the orbit, or eye socket, without any significant trauma. It can be a very distressing event for the patient and requires immediate medical attention.

What is Happening?
The eye is held in place by the eyelids, the orbital septum (a membrane that holds the eye in its socket), and the eyelid retractors. In spontaneous subluxation, these structures fail to secure the globe, allowing it to move forward. This can happen with simple actions like rubbing the eyes, straining, or sneezing.

Causes and Risk Factors
While it’s considered “spontaneous,” it’s not without an underlying cause. This condition is often associated with a few key factors:

Floppy Eyelid Syndrome: This is the most common cause. The eyelids are very loose, particularly when a person is sleeping on their side or stomach, which can cause the eye to fall out of the socket.

Shallow Orbits: Some people have naturally shallow eye sockets, providing less physical support for the eyeball.

Thyroid eye disease: In severe cases of untreated thyroid eye disease, this can manifest at home or during clinical examination

Obesity and Sleep Apnea: These conditions are often associated with floppy eyelid syndrome and can increase the risk of subluxation.

Diagnosis and Management
If you or someone you know experiences this, the first step is to remain calm and get to a medical professional immediately. The condition must be evaluated and managed by an ophthalmologist.

Immediate Management: The first priority is to manually reposition the globe back into the socket. This must be done carefully to avoid further damage. The ophthalmologist will use a specific technique to guide the eyeball back into place, often with the help of a local anesthetic to relax the patient.

Further Investigation: After the eye is back in place, it’s crucial to identify the underlying cause to prevent it from happening again. This may involve a detailed eye exam and a referral to other specialists to check for related conditions like sleep apnea.
Timely and correct management is essential to prevent serious complications such as damage to the optic nerve, which could lead to permanent vision loss.

Do your sunglasses really protect the eyes from the sun?

How do you select the correct sunglasses?

😊 Fun fact: Darkness of the glasses has nothing to do with UV protection

We all know that the UVA and UVB rays from the sun are harmful for our eyes.
Eye damage caused: cataracts, macular degeneration, sunburns, corneal damage

How to choose the best sunglasses?
When browsing the shelves, look for the CE mark or British standard BS EN ISO 12312-1:2013 as it guarantees a safe level of UV protection. UV 400 mark is the higher level of protection.

Do I need sunglasses on a cloudy day?
UV rays are not necessarily blocked by the sun, so your eyes are still at risk.

What about snow?
Snow reflects upto 80% of UV light into our eyes

Is polarised glasses the same as UV protection?
No, it is very different. Polarised glasses reduce glare but they do not necessarily block UV rays

See the images below for examples of CE mark

When it comes to protecting your eyes from the sun, choosing the right sunglasses is crucial. Contrary to popular belief, the darkness of the lenses does not determine their UV protection level. The real key lies in selecting sunglasses with proper UV defense to shield your eyes from harmful UVA and UVB rays.

Exposure to these rays can lead to various eye conditions such as cataracts, macular degeneration, sunburns, and corneal damage. So, how do you pick the best sunglasses? Look for the CE mark or the British standard BS EN ISO 12312-1:2013 when shopping for sunglasses. These markings ensure a safe level of UV protection, with the UV 400 mark signifying the highest level of defense.

Even on cloudy days, UV rays can penetrate through the clouds, posing a risk to your eyes. Similarly, in snowy conditions, up to 80% of UV light can be reflected into your eyes, emphasizing the need for protective eyewear.

While polarised glasses help reduce glare, they are not synonymous with UV protection. It’s essential to opt for sunglasses specifically designed to block UV rays to safeguard your eyes effectively.

Remember, when it comes to eye protection, prioritize UV defense by choosing sunglasses with the right certifications and markings. Stay safe and keep your eyes shielded from the sun’s harmful rays