PERIPAPILLARY ATROPHY

This is a common occurance in people that are very near sighted. The optic nerve is surrounded by a white area. This area is not useful for vision, so this patient has an enlarged blind spot on their visual field. However, it is not progressive.

ANOTHER CHOROIDAL NEVUS

This is another patient with a choroidal nevus. This is a benign pigmented lesion on the retina that has very low potential for growth to become a malignant melanoma. It is photographed and watched on a regular basis.

CHOROIDAL NEVUS

This is a small "freckle" on the back of the eye. We watch it to make sure it doesn't grow into something like a melanoma.

LASER TREATMENT FOR RETINAL TEAR AND CATARACT

Below is a photo of scars on the retina from laser after a patient received treatment for retinal tear.



Below is the mild cataract in the left eye of the same patient.

Below is the catarct in the right eye of the same patient. Note how much thicker it is.

HERPES SIMPLEX DISCIFORM KERATITIS

These are photographs of the eyes of a 32 year old patient with herpes simplex disciform keratitis. The photo below is of the normal left cornea.

The photo below shows what the normal left eye looks like with fluorescein dye and red-free light. All you can really see is the tear film along the upper and lower lid, but there is no other staining.

The picture below shows the diseased right cornea with stain. There are bright dots associated with damage to surface corneal cells. There are darker spots corresponding to individual surface cells that are swollen.

The picture below is the diseased right eye showing extreme swelling of the cornea. The lines are folds on the back surface of the cornea that occur when the cornea becomes swollen. The cornea is thick (about 689nm thick compared to the normal left eye of 499nm). A swollen cornea also begins to become cloudy.

The photo below shows the well-demarcated edge separating normal cornea from swollen cornea. The disc appearance gives the disease it's "disciform" name.

I started this patient on aggressive topical antiviral and anti-inflammatory medication, which she'll need to be on for at least a month before I taper the dosage down.

Herpes Simplex Virus is a very common virus which most people harbor. For most people it causes no or mild symptoms. But in some people it can cause cold sores or active cornea disease. This particular case of "disciform" keratitis is actually not from active infection, but from inflammatory reaction to the virus' presence.

RETINAL HOLES

POST OPERATIVE ABRASION

Very rarely a patient might get a corneal abrasion after cataract surgery. This can come either from a rupture of a bullous keratopathy (which looks like a blister from inflammation that occurs under the outer epithelial layer), or from the eye opening under a pressure patch and being scratched by the patch.


The above photo is the normal left eye with dye in the eye, to stain the tears.

Here's the abrasion in the right eye the evening of surgery. The patient was in a lot of pain. We put antibiotic ointment in the eye and pressure patched the eye.

This is the corneal abrasion the day after surgery. You can see the edges well demarcated. At this point we used a pressure patch, had the patient take antiobiotic drops four times a day, and kept the steroid at a low dose to help with post-op inflammation, without inhibiting wound healing. A delicate balance.

The above photo is 4 days after surgery. The epithelium has grown over the abrasion and the edges are now fusing together. The patient will feel a foreign body sensation until this is totally healed. It may take about a week or so until it heals completely, during which time the vision will be blurry. But ultimately this patient will see just as well as if the abrasion never occurred.