PIGMENTARY DISPERSION

This photo is of what we call "Kruckenburg's Spindle". It's the pigment cells on the back surface of the cornea. It occurs because zonules from the lens of the eye (behind the iris), rub up against the back surface of the iris, and slough off the dark pigment cells, which then float to the front of the eye and attach to the cornea. The cells also go in the "angle" of the eye where fluid drains. If the drain becomes too clogged up, it can cause pressure to rise, increasing the risk for glaucoma (damage to the optic never because of that pressure).

MACULA ON RETINAL DETACHMENT

This is a picture of a retinal detachment. You can see the optic nerve in the center of the photo, but it's hazy for two reasons. First I focused the camera more forward on the detached retina (above), and there's blood in the eye. The detachment is the billowing, whitish membrane you see above. Normally the retina is attached to the back of the eye. There is no vision wherever the retina detaches off the back of the eye. This patient has a "macula-on" detachment which means, if we get this repaired soon enough, he should have most, if not all his central vision restored.

GREAT LASIK FLAP

This is one of the best LASIK flaps I've ever seen. It is so faint that if the patient hadn't told me he had LASIK, I wouldn't have known. The arrows point to the edge of the flap. Usually the line is much more distinguishable. Good job.

CHOROIDAL NEVUS AND ANTERIOR CAPSULAR CATARACT

The first picture below is of a choroidal nevus. This is a pigmented area. The white spot on top of it is drusen, which often forms on nevi. This patient will be followed at first on a 6th month basis to make sure it does not progress to melanoma.



This same patient has an anterior capsular cataract in the right eye. This is a very rare cataract. It does cause some vision decrease, but not enough to justify cataract surgery.

POSTERIOR SUBCAPSULAR CATARACT

Below is the left eye of a patient with a cataract on the back of the lens. The picture on the bottom is of the other eye. This type of cataract can occur spontaneously, or from use of corticosteroids, trauma, or diabetes. It has not yet reached the point where it significantly decreases vision, but this type of cataract has a tendency to grow fairly rapidly and significantly decrease vision at some point.

GLAUCOMA

Below is the right optic nerve in a patient with glaucoma. There is deep cupping when compared with the picture below it of a normal optic nerve. The patient had a visual field test that showed the beginning of vision loss, right eye more so than left. The patient was given drops to lower pressure at least 25% and will return in a few weeks for a follow-up.

CONTACT LENS OVERWEAR

This patient wears standard disposable contact lenses all day long. You can see from the photos before that there are blood vessels growing into the cornea and inflammation associated with the cornea being starved from oxygen. Solution for this is to get refit in a contact lens that breathes more oxygen and wear glasses more. A little less convenvient but the eyes are worth it! As I've been telling patients lately, we'll go through a lot of cars in our lives but only one set of eyes.