RECURRENT CORNEAL EROSION

This patient presented complaining of pain when he woke up one morning. He has also had pain in the eye a couple afternoons. On examination he has this small irregularity just below the pupil on the cornea. This irregularity causes adhesion between the lid and the cornea during sleep and then when waking up the outer protective cells of the cornea come off with the lid, exposing the unprotected layers beneath.

Treatment is usually artificial tears to start with. If that is not enough, then a special ointment at bedtime helps. If that doesn't help, then surgery to flatten the area of the cornea is indicated.

How does the irregularity start to begin with? It can occur from a genetic disorder that causes an irregular corneal surface, or from scarring from a previous injury, or a focal scar from a previous herpes simplex virus infection.

POSTERIOR SUBCAPSULAR CATARACT

This is an opacity on the back of the lens of the eye.

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.