CONGENITAL CATARACTS

This patient has small congenital cataracts. You should see a very faint, white dot in the center of the pupil. That small white dot is the opacity (any opacity in the lens of the eye is called a cataract). This particular type of cataract was present at birth and should not get worse with time. It only minimally affects the vision in the left eye of this patient (lower photo). These cataracts are anomalies of fetal development.

RETINOSCHISIS

This is really difficult to see and may required you click on the photo and enlarge it. This is a picture of a gentleman's retina in the superior temporal retina of the right eye. In the lower right, if you look close, the retina appears to bubble up. This bubbling up is not a retina detachment, but a "retinoschisis". A retinoschisis occurs when the outer layer of the retina pulls away from the inner layer of the retina, and then bubbles up. The retina is still attached because the inner layer is attached.

Retinoschisis generally does not lead to a ful retina detachment, but needs to be watched closely to see if risk for detachment increases.

WHITE WITHOUT PRESSURE

This is the photograph of the peripheral retina of a patient with about 10 diopters of near sightedness. The orange area is normal retina. The white area is the "stretched" area that often happens in very near sighted individuals. It is a risk factor for future retinal tears or holes that can lead to retina detachment which can potentially cause total blindness. Patients with a lot of near-sightedness should be dilated on a yearly basis.

VASOCONSTRICTORS CAUSE CHRONIC INFLAMMATION

European Journal of Ophthalmology:

"Chronic abuse of decongestant eyedrops can produce a clinical picture resembling an ocular pemphigoid. Histology suggests that late onset immunoreaction and chronic vasoconstriction cause chronic inflammation and neovascularization, respectively."

CATARACT & PVD

The top photo shows part of a Weiss' Ring that occurs from a posterior vitreous detachment (PVD). The vitreous is like a bag of gel that fills up the eyeball. At some point in most people's lives the bag pulls off the back of the eye, much like wallpaper falling off a wall. The patient can have symptoms of flashes of light and/or floaters. Sometimes it can pull on the retina, causing a tear, which could lead to a retina detachment and subsequent loss of vision. A PVD in and of itself is not dangerous, but the floater could bother a person enough that a retina specialist would have to do surgery to remove it.

The bottom photo is just of a very small amount of clouding of the lens of the eye. When it gets to a point that the patient loses vision, then it is considered a cataract. Of course those are easily fixed with surgery.

TILTED OPTIC NERVES

This optic nerve is tilted. It is of no negative consequence to this patient. It's tilted because instead of entering the eye perpendicular, it enters obliquely. This usually occurs in people that are very near sighted. Their eye is longer and so the optic nerve comes in at a different angle.

PINGUECULA

This is a picture of a pinguecula. It is a bump that can devcelop on the corner of the eye. It is usually from years of exposure to uv light. It can become red and irritated at times. It tends to dry out as well at times. The patient can use artificial tears as much as needed. If that is not good enough, the doctor can prescribe mild anti-inflammatory drops. In severe cases, the pinguecula can grow and can be excised surgically.