A look at the eyes

Posted on 15 April 2014

Opthalmologists Dr Tristian Mann, from Mediclinic Sandton, and Dr Zoran Aleksic, from Mediclinic Cape Town, answer common questions related to eye health.

I have started wearing coloured contact lenses but I’ve heard they can be dangerous. Is this true?
Dr Mann:
‘I often tell patients, if you wear them, you’re looking for trouble. In patients who wear coloured contacts, I frequently see cases of corneal ulcers. You can actually lose vision as a result of wearing them. In corneal ulcers, you’ll see whitening – white spots form that are light sensitive and can cause tearing. If your eyes are gritty or tearing a lot, consult with an eye specialist, rather than an optometrist.’

My one eye is constantly forming tears when I’m not even crying. What’s up?
Dr Aleksic:
‘This if likely due to a partial or total blockage of the nasolacrimal duct that carries tears into the nasal cavity. That duct drains tears, and the overflow is what drops on your cheeks when you cry. Just like in a bath, if the plug is in and water keeps pouring from the taps, there will be an overflow – a chronic watery eye. We can unblock the duct and flush it out using a silicone probe. If there’s been scarring, however, we may need to operate.’

I’ve noticed a white blob that on the edge of the coloured part of my eye. What could this be?
Dr Mann:
‘It could be a pinguecula. Usually, it comes from sun exposure and allergies can make it worse. Once it touches the cornea, it becomes a pterygium, which is a fibrovascular growth. If it’s small, it’s generally okay. If it’s large, it can cause a stigmatism. If you want it removed for aesthetic reasons, or if it’s causing a stigmatism, we can take membrane from the normal conjunctiva and do a graft on the affected area. Then, there’s only a five to six percent chance of recurrence. If we just remove the pterygium and close up the surrounding tissue, there’s about a 40% chance of recurrence.

My son has developed little yellowish nodules scattered around his eyes. What could they be?
Dr Aleksic:
‘In kids, these nodules may be molluscum contagiosum. The skin tags are contagious, so they can spread to other areas of the body. If they don’t disappear with treatment, we can easily remove them.’

What new surgical techniques are available?
Dr Mann:
‘As far as advancements in laser eye therapy go, we have a new technique for vision correction called the ReLEx SMILE technique. Rather than cutting a big flap in the cornea and then using a laser on the corneal bed we make a small incision (called a ReLEx SMILE) into the eye and we use a femtosecond laser to separate tissues and pull the unwanted tissue out. This procedure takes less time and there are less dry eye side effects afterwards. There’s also the KAMRA inlay, for those who don’t want to wear reading glasses. We can pop in a disc smaller than a contact lens to replace your reading glasses.’

Are there any future surgical advances opthalmologists are looking forward to?
Dr Aleksic:
‘We’re waiting on new technology to get rid of reading glasses that won’t require an implant. It would restore physiology, rather than require aggressive surgery. We are also waiting on laser cataract surgery that uses light to prepare all the incision points for the surgeon. This will make it far easier for the surgeon to go in, remove the cataract and replace it with an implant.’

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Published in Ophthalmology

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