POSTERIOR CAPSULAR FIBROSIS

BEAR TRACKS

ACUTE ZONAL OCCULT OUTER RETINOPATHY (AZOOR)

AZOOR is a rare retinal inflammatory disorder that can occur in young myopic females.  Often it occurs in only one eye.  It effects most often the temporal retina and spares the macula.  It results in the type of scarring that you see below.  This patient was myopic with normal central visual acuity.   

ABMD Dots

These are likely the "dots" that we sometimes see in anterior basement membrane dystrophy.

LATTICE DEGENERATION

BAND KERATOPATHY

Band keratopathy affects the cornea, the front clear window of the eye. Band keratopathy is a calcium deposit that appears grayish with holes in the middle, like swiss cheese.  It starts from the 9:00 and 3:00 edge of the cornea and works it's way toward the center.  Rarely it can encroach on the visual axis, and in these cases it can be removed by a process called chelation. 

Band keratopathy can be caused by anything that increases calcium in the body. Some of these are as follows:  kidney disease, excessive vitamin D, high thyroid levels, sarcoidosis, lupus and Paget’s disease. Also there is calcium in the tears. 

Band keratopathy can be associated with several other eye conditions including severe glaucoma, chronic uveitis, corneal dystrophies, and phtisis bulbi (shrunken eye from severe loss of vision). 

In most situation band keratopathy has no symptoms.  Occasionally it can cause redness, irritation, and vision loss, depending on how advanced it is.  

Chelation is a process that uses a special chemical and an excimer laser to remove the deposits.  

DIABETIC RETINOPATHY

Diabetic retinopathy has been the number one cause of preventable blindness in the United States.  Fortunately treatments have improved through the years.

The pictures below show patients with moderate non-proliferative diabetic retinopathy.  There are various types of hemorrhages.  Cotton wool spots are areas of focal oxygen deprivation.  microaneurysms are outpouchings of capillaries that can leak.  Exudates are the leakage of blood serum from capillaries.

If the oxygen deprivation is severe enough, new blood vessels (neovascularization) will begin to form in the attempt to reperfuse the retinal tissue.  However, these new blood vessels are very leaky and certain contents from the blood destroy the retina, thereby causing severe vision loss.   When new blood vessels grow, retina specialists often will perform pan-retinal photocoagulation, or PRP.  PRP selectively destroys much of the peripheral retina, thereby decreasing the oxygen deman in the eye.  This decreased oxygen demand allows the most important central part of the eye to receive enough oxygen to prevent neovascularization.   The photo below shows the laser scars that result in the peripheral retina from PRP.