Specialized Examination and Treatment of Eye Diseases

Ocular Health Services of De-lens Ophthalmics is a clinic where patients with ocular disease or at risk of developing ocular disease are examined and treated. Referrals for examination and/or treatment are accepted from Optometrists, hospitals, as well as from other physicians and healthcare workers. Such referrals may specify the examinations required. De-Lens then works closely with these practitioners to ensure that the latest diagnostic information is available to them, which will lead to improvements in the management of a person’s eye health. Patients may present without referral though usually past information on their care is requested. Emergency services are also provided.

Conditions monitored include: (scroll down to learn more about some of the listed diseases)

  • Glaucoma and other optic nerve diseases,
  • Diseases and disorders of the retina and vitreous (e.g. age-related macular degeneration, diabetic-related eye disease, peripheral retinal findings, etc.),
  • Ocular surface disease (e.g. dry eye, lid abnormalities, and facial nerve palsy),
  • Lid and other anterior segment diseases,
  • Ocular manifestations of systemic diseases and their therapies.

Specialized testing used in diagnosis and management includes:

Ocular Coherence Tomography (OCT)

Automated Visual Field Analysis,

Ophthalmic Ultrasound,

Pachymetry,

Fundus and Anterior Segment Photography

Nyktometry (Night Vision Test)

Referral to, or consultation with, other health care providers is initiated when secondary eye care is required or systemic disease concerns are identified.

Fundus Photography
Photographs of the fundus may be taken to note the appearance of the vitreous, optic nerve, retina and its blood vessels. A specialized digital camera will create a permanent record of your retinal condition that can be used for comparison at future visits. A bright flash of light will be experienced as the picture is taken. The procedure is simple, painless and the results can be viewed right away.

The fundus of the eye is the inner surface of the eye which includes the retina, macula, fovea, optic disc, and posterior pole. The fundus can also be examined with an ophthalmoscope.

What is Age Related Macular Degeneration (AMD)?
AMD is an acronym for Age-Related Macular Degeneration.  It is a progressive disease associated with aging that gradually destroys central vision and impairs ability to perform common daily tasks such as reading, driving or watching television. AMD is one of the leading causes of severe vision loss in adults over the age of 50. There are two forms of AMD- Dry AMD and Wet AMD.

  • Dry AMD is caused by accumulation of cellular debris in the macula which leads to damage in the light sensitive cells. This eventually leads to distortion of central vision.   Although Dry AMD progresses fairly slowly for most patients, treatment options still exists that may delay and possibly prevent dry AMD from advancing to a point where severe vision loss occurs.  One of the treatment options includes nutritional supplementation in the form of very specific high-dose vitamin therapy (AREDS).
  • The wet form of AMD is characterized by spontaneous leakage of blood and other fluids into the macular by tiny blood vessels. This destroys the ability of the macular to function properly.  Wet AMD is more serious than the Dry type because it can progress very rapidly, sometimes in a matter of weeks, causing loss of vision.  Wet AMD may be treated using drug therapy through injections in the eye and/or laser surgery.

Factors affecting risk of developing AMD:
Increasing age, family history of AMD, smoking, UV light exposure, obesity, blood pressure, eye color, and gender.

Doctors Comment:
You should expect better visual outcome if AMD is detected or diagnosed early.  Therefore it is important to understand if you are at risk, as this will help you and your eye care provider to develop a personalized program to manage the disease. It is of note that AMD cannot be reversed; however vision loss associated with it can be prevented or delayed through early detection, monitoring, diagnosis and treatment. You stand at a better chance to save your sight if you understand your risk level early………..Dr Echendu Damian OD, LLB, MSc.

What is Diabetic Eye Disease?
Diabetic eye disease includes a wide range of problems that can affect the eyes in people living with diabetes. Diabetes may cause a reversible, temporary blurring of the vision, or it can cause a severe, permanent loss of vision or even blindness.

Diabetes mellitus increases the risk of developing retinopathy, cataracts and glaucoma

  • In Diabetic retinopathy blood vessels in the retina of the eyes are damaged.
  • In Cataract the lens of the eye becomes cloudy and opaque disallowing light from passing through and as such leading to poor vision or blindness. Cataracts are known develop at an earlier age in people with diabetes.
  • Glaucoma-is a group of diseases that leads to optic nerve damage and loss of vision.  Persons with diabetes are nearly twice as likely to get glaucoma as other adults.

Diabetic Retinopathy – is the most common diabetic eye disease which affects retina. The retina is the light-sensitive tissue at the back of the inner eye. A healthy retina is necessary for good vision. In diabetics, increase blood-sugar and other abnormalities in metabolism causes damage to the blood vessels in the eye and every other part of the body.  This damage to the blood vessels leads to poor circulation of the blood to various parts of the body and the eye. Since the function of the blood is to carry oxygen and other nutrients, this poor circulation causes decreased oxygen delivery to tissues in different parts of the body including the eye and subsequent damage to those tissues.  In some people with diabetic retinopathy, blood vessels may swell and leak fluid.  In other people, abnormal new blood vessels grow on the surface of the retina.  if the retina of the eye is swollen, wrinkled, or otherwise structurally damaged, the vision in that eye will be blurry. Depending on the type, location, and extent of damage in the retina, the change in vision will range from minimal to severe and be temporary or permanent. Diabetic retinopathy usually affects both eyes.

Who is at RISK?
Everyone with diabetes should get a comprehensive dilated eye exam at least once a year because all people with diabetes either type 1 or type 2 is at risk. Studies have shown that the longer someone has diabetes, the more likely he or she will get diabetic retinopathy.
If you have diabetic retinopathy, you may need an eye exam more often. People with proliferative retinopathy can reduce their risk of blindness by 95 percent with timely treatment and appropriate follow-up care.

What do I do if I have already lost vision from DR?
If you have lost some sight from diabetic retinopathy or other ocular diseases, ask your eye care professional about low vision services and devices that may help you make the most of your remaining vision.  Ask for a referral to a specialist in low vision.

What is Glaucoma?
Glaucoma is a group of diseases that cause progressive damage to the optic nerve leading to loss of vision. Globally it is the second leading cause of blindness with no major causative factor. Glaucoma often runs in families.  There are several types of the disease and each is caused by a different disease process that tends to affect different racial groups.  Overall, people of African origin are more likely than Caucasians to get glaucoma.

Other risk factors for developing glaucoma include being over 45 years old, having high intraocular pressure (IOP; pressure in the eye), myopia (nearsightedness), diabetes, high blood pressure, and a history of an eye injury or infection.

Vision loss caused by eye diseases such as glaucoma can be prevented, or at least minimized, if diagnosed and treated early.