GHOST VESSELS

This is the patient below, a week after giving contact lenses that breath more oxygen. You can see the vessels without blood in them. This significantly decreases risks for inflammation and infections in the eye.

BLOOD VESSELS GROWING INTO CORNEA FROM EXCESSIVE CONTACT LENS WEAR

The above photos demonstrate blood vessels growing in to the cornea on a patient who wears their contact lenses every waking hour. You can see the redness also around the cornea/conjunctiva margin. These blood vessels grow because of decreased oxygen getting to the cornea. The body tries to compensate by growing blood vessels.

Unfortunately increased blood vessels to the cornea result in increased risk of future immune responses (episodes of redness, pain, inflammation, swelling, light sensitivity, and decreased vision) and also indicate an increased risk for severe corneal infection. These can result in corneal ulcers where the bacteria actually eat away at the cornea. These ulcers are treated aggressively to prevent loss of the eye or loss of vision . They result in permanent scars that, if located centrally, sometimes require a corneal transplant.

I refit this patient in to a lens that breathes about 5 times more oxygen than the standard contact lens. Even so, it is recommended that patients give their eyes a rest from their contact lenses a few hours in the evening and maybe a day or two during the week when possible. LASIK is actually less risky than continuing to wear the same lens the same amount of time.

It is tempting for contact lens patients to overwear their contact lenses either to save money or because of convenience. There are many people who get away with it without insult. However, when serious problems occur, it is almost invariably in those patients who overwear their contact lenses. Either they wear them from the time they get up to the time they go to bed every day, or they sleep in them on a regular basis, or they don't replace them when they're supposed to, or they don't replace their case when they should . Rarely do these individuals have a good pair of glasses that they like.

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.