Corneal Transplants What Are They

Penetrating Keratoplasty (PK)
This type of cornea transplant replaces the full thickness of the cornea with a healthy and clear donor tissue and is required when a cornea has been severely damaged or disease, and where no other option of surgery remains. PK can be carried out under local or general anaesthetic and takes about one to two hours to complete. During surgery, a central 8mm button of cornea is removed and a similar sized button of the donor cornea is stitched in with tiny stitches. After surgery vision will stay misty and/or cloudy for a few days and will improve gradually for about 12-18 months. Individual stitches may be removed from three months after the surgery, but complete stitch removal is not performed until at least one year after the surgery. Following surgery, and once fully healed, around 75% of transplant recipients have adequate vision to drive legally, but to get the best results from vision, glasses or contact lenses may need to be worn.

Deep Anterior Lamellar Keratoplasty (DALK)
This type of cornea transplant is a partial thickness transplant and replaces the front 99% of the cornea with a donor cornea. Unlike penetrating keratoplasty, DALK keeps the back layers of the cornea, the Descemet’s membrane and endothelium layer, in place and it is used as an alternative to PK, when these back layers of the cornea are healthy. The surgery itself is carried out much the same as PK, but just less donor cornea is used. Again, stiches are used to keep the donor tissue in place, but as only part of the cornea has been replaced, healing and visual recovery are usually quicker than what are seen with PK. To get the best vision following surgery, glasses or contact lenses may need to be worn.

Endothelial Keratoplasty (EK)
This type of cornea transplant is a partial thickness transplant and replaces only the back layers of the cornea. Unlike to above two transplants, EK can be further split into two methods; Descemet’s stripping endothelial keratoplasty (DSEK) and Descemet’s membrane endothelial Keratoplasty (DMEK). Both DSEK and DMEK are very similar and the procedure to carry them out is the same, but DMEK differs as the donor cornea tissue does not include any stromal layer tissue. The consultant ophthalmic surgeon will decide which surgery is necessary, depending on the damage or disease that is present. EK transplants are used when there is a problem at the back of the cornea. To help keep the cornea clear, the cells lining the inside of the cornea pump fluid to stop the cornea from swelling, if there are not enough cells, due to disease or damage, then the cornea starts to swell and vision will become cloudy. The surgery is carried out differently when compared to PK and DALK; it will again be under either local or general anaesthetic but a very small incision is made between the coloured and white part of the eye. The eye surgeon removes the dysfunctional endothelial cells through this opening and a disc of donor cells is placed back inside the eye. The donor endothelial cells are pressed to the back of the cornea with an air bubble and the patient will need to lie still for about 1 hour following surgery to make sure the air bubble stays in place. Occasionally, a few stitches to close the incision may be needed. Vision will stay misty or cloudy for a few days, and will get better over 3-4 months, as with all types of corneal transplants glasses or contact lenses may be needed after surgery to get the best results from vision

Computer Eye Strain & Meibomian Gland Dysfunction

Computer eye strain is caused when you overuse your eyes and they become fatigued. Eye strain can occur when looking at a computer screen, or other device, for too long. Normally resting your eyes can help relieve the symptoms of computer eye strain. Symptoms of computer eye strain can include; headaches, difficulty focusing, dry eyes, watery eyes, eye discomfort, blurred vision, itchy eyes, and tired eyes.

Computer Eye Strain; How Does It Cause Meibomian Gland Dysfunction?

The meibomian glands are the tiny glands on the lower and upper eye lid margins that secrete oil, which when we blink, protection the surface of the eye. This oil helps keep the water element of your tears from drying out too quickly. Meibomian gland dysfunction (MGD) is a very common type of dry eye disease where the meibomian glands do not secrete enough oil or the quality of the oil is not good. Normally in MGD the glands get blocked and very little oil, if any, can get out and this causes the eye symptoms. Computer eye strain can cause MGD due to a reduction in blinking. Most people when using a computer or similar device do not blink as often as they should, this can be up to 60% less blinking than when not looking at a computer. If your blink rate is reduced, the oils will not be secreted as often which means the watery element in your tears evaporates quicker, drying out your eyes. Overtime this can cause the glands to block leading to meibomian gland dysfunction.

Treatment for Meibomian Gland Dysfunction

There are many different types of treatment that can help MGD sufferers and what suits one person may not suit another. If MGD has been linked to computer eye strain, then looking at the way you use a computer is a good place to start. Trying to reduce the time in front of a computer can be difficult, especially if you use a computer for work, but remembering to blink and keeping hydrated will help. Also try to follow the 20-20-20 rule; every 20 minutes’ look 20 feet away from your screen for 20 seconds. MGD sufferers will likely need to combine this with other at home’ treatments, such as heated eye masks, eye lid massaging, artificial tear drops, taking omega 3 supplements, and possibly taking other medication. There are other treatments that can be offered with an ophthalmologist or eye clinic that have great results in helping with MGD when used in conjunction with the at home’ treatments;

E-Eye Intense Regulated Pulsed Light (IRPL) The E-Eye device creates polychromatic pulsed light using the new IRPL (intense regulated pulsed light) technology. The E-Eye releases a flash of light that is made up of a pulse train, which is flashed on the treatment area (cheekbone and temple area around the eye). Within this treatment area nerve branches are located and these nerve branches are connected to meibomian gland nerves. When these nerve branches are flashed with the E-Eye (IRPL) it causes a stimulatory response within the meibomian glands and they start to resume secretion of the normal oil layer again and symptoms of eye dryness will disappear. Accordingly, it will be effective in 80% of patients affected by dry eye disease. From a single flash of IRPL it is possible to produce sub-flashes of varying intensities, this offers unparalleled therapeutic potentials, especially with the treatment of MGD, which is impossible with conventional IPL. The E-Eye emits a cold light’ and it is non-invasive, totally painless, and entirely harmless to the eyeball.

MiBo Thermoflo this is a therapeutic treatment to help relieve the suffering of MGD. MiBo Thermoflo works by gently heating and massaging the outer eye lids. MiBo Thermoflo delivers continuous controlled heat to the outer eye lid skin combined with ultrasound gel for a gentle massage. As the heat is deeply absorbed into the tissue it breaks down hardened oils in the meibomian glands. With a prescribed therapy plan the meibomian glands will release thinner and clearer oils which makes for a healthier tear film. MiBo Thermoflo is followed by gentle manual expression of the meibomian glands.

How Does Drinking Alcohol Affect Your Eyes

Drinking alcohol can of cause effects to your entire body including your eyes. A low intake of alcohol shouldn’t cause you any health problems but drinking alcohol heavily can potentially cause health problems including harmful effects to your eyes.

Here are a few of the effects heavy drinking can have on your eye health.

Pupils

Alcohol can cause slow pupil reactions. It slows down the iris’ ability to dilate and constrict. This might not seem to be too much of a problem at first but if you have been drinking alcohol, even a small amount, and then drive your pupils won’t react as quickly to oncoming car headlights, therefore dazzling your vision which could cause an accident. So even if you have drunk alcohol and it is under the legal limit for driving and you feel fine to drive, think again about the other effects the alcohol is having on your vision.

Vision

Drinking alcohol can not only affect your pupils but also your general visual performance, especially if you have been drinking heavily. The alcohol can weaken the eye muscles which can cause blurred or double vision and also can cause delayed reactions.

Peripheral Vision

Not only can your general vision be affected after heavy alcohol consumption but your peripheral vision can change. Alcohol can sometimes lower your peripheral vision sensitivity and this can give the sensation of tunnel vision.

Contrast Sensitivity

Another way alcohol can affect your eyes is by making them less contrast sensitive. This means it can be harder to tell the difference between shade of grey.

Eye Lid Twitching

Eye lid twitching can be caused by many factors and one of these is a high intake of alcohol. If you suffer with eye lid twitching and drink heavily, try to lower your alcohol intake and see if your eye lid twitching improves.

Eye Dryness

A study carried out by the Hallym University College of Medicine indicated that drinking alcohol, even a small amount, reduced tear breakup time and induced tear hyperosmolarity which in turn can result in eye dryness.

Optic Neuropathy

Optic neuropathy can also be caused by consuming alcohol in excessive amounts. It can cause loss of vision which is normally painless, lowered peripheral vision and issues with seeing and distinguishing colours. This is an ongoing condition which gets worse as time passes and is much more serious that the ones mentioned above. If you suspect you may have optic neuropathy or any eye concerns relating to alcohol consumption you should get an appointment with an ophthalmologist, who can carry out a thorough eye exam.

Eye Appearance

Apart from the effects alcohol can have on how your eyes work, it can also alter the appearance of your eyes. Drinking alcohol can make the blood vessels in your eyes dilate which makes them look very red, and long term heavy drinking could cause this to be a lasting effect.

Migraines

It has been shown that, in some people, alcohol can start off migraines or severe headaches. If this happens you can initially suffer with a visual aura at the start of the migraine or headache, which is temporary but can be visually debilitating causing blind spots or light patterns in your vision