RK and AK scars

This is a cornea of a patient who had radial keratatomy. You can see the radial scars that decrease near-sightedness. The circumferential scar at around 10:00 is an AK scar, which decreases astigmatism.

RED CONTACT LENS FOR COLOR BLINDNESS

This lens enables a color blind individual to distinguish colors they ordinarily cannot distinguish.

OPTIC NERVE SUSPICIOUS FOR GLAUCOMA

The above photo is a normal appearing optic nerve. The arrows point to the edge of a crater that we call the "cup", from which the blood vessels emerge. The margin of the optic nerve is very healthy looking, with good blood supply.

In the bottom picture you can see that there is a lot less healthy-looking margin and a deeper cup. Many people are just made this way with no damage to their eye. But when a patient has glaucoma, the cup always gets deeper and wider like this. So looking at this nerve, I don't know if the patient has glaucoma or if they are just made that way. I will run a computerized visual field test to rule out any loss of vision from glaucoma.

Glaucoma causes a loss of vision in the periphery, so subtly that you don't notice it until it's too late. By the time you notice it it takes only weeks to months to go completely blind. One of the main factors involved in the optic nerve becoming damaged is pressure in the eye. This pressure pinches off blood supply to the optic nerve causing the nerve fibers to die.

OLD RETINA TEAR

The lower arrow points to the "operculum" floating in the eye. the upper arrow points to the scarring from the old hole. No repair necessary on this inferior hole. But watch for flashes of light, increased floaters, or shadow in vision.

ROXY'S OPTIC NERVE

Ok. Her name is not Roxy but she wanted the picture for her Facebook. A totally normal optic nerve.

SUSPICIOUS NEVUS

Nevus that needs to be watched for conversion to melanoma at least yearly.

SUSPICIOUS NEVUS

This is what we call a suspicous nevus. It is a dark spot on the back of the eye, like a mole. It has some elevation and needs to be watched very closely for growth. I sent this one to a retina specialist for an opinion. This is the good eye of an 87 year old patient.

CORTICAL CATARACT

A cortical cataract is one that starts on the edge of the lens of the eye and works its way in. The first one shows very small cortical changes. The second one is the same patient in the other eye, showing a little more extension of the cataract. The third one is a different patient with a more classic look. Both of these patients see 20/20 with their correction.

DRY EYE SIGNS

Here's a really good picture of a patient with dry eyes. Fluorescein dye was placed in the eye and a red-free light was shined on the eye to make the tears glow. You can see that within a few seconds the tears break up on the surface of the eye. You can also see damaged surface cells inferiorly.

DRY EYE DAMAGE

The big glowing area is actually fluorescence that indicates damaged surface cells on the eye. This occurs in moderate to severe dry eye. This patient has irritated eyes, especially towards the end of the day. Treatment has to be quite aggressive with this patient. It often takes more than just store bought artificial tears.

RETENTION CYST

While this may look scary, it is really not harmful. These are little pockets of fluid. They can be drained if they are bothersome to the patient.

CLOUDY CORNEAL TRANSPLANT

This is an eye of a patient who had a corneal transplant a long time ago. Most corneal transplants turn out pretty well. This one happens to be somewhat cloudy, likely from low-grade inflammation following the surgery.