Treatments for Eye Conditions

Outlook Eye Specialists provide a variety of eye treatments for a number of conditions for medical treatment. Here are some of the common forms of eye treatments we offer.

LUCENTIS/EYLEA

These are the trade names of the two drugs which are officially approved in Australia for treatment of wet age-related macular degeneration. Both are very effective at treating this condition. They have been shown to be quite effective in other ocular conditions like retinal vein occlusions and diabetic retinopathy as well.

In wet age-related macular degeneration the eye produces a chemical called vascular endothelial growth factor, which helps develop abnormal blood vessels in the macular region of the eye which bleed and leak fluid. The above drugs are agents that block vascular endothelial growth factor and hence stop its harmful effects in the eye. Like most drugs, this effect wears off over time and the drug needs to be used again. Both drugs are delivered via intravitreal injections (see information regarding intravitreal injections).

The frequency of using these drugs via intravitreal injections varies for individual patients, but very often initially they are delivered monthly for the first three months and then less frequently after this. Most often it is necessary to have ongoing injections for the long-term.

PTERYGIUM

Pterygium is a very common ocular surface problem, which is particularly common in sunny environments where patients spend time outdoors. It is a benign fibro-vascular growth shaped like an arrow growing across the white of the eye onto the coloured part of the eye. They tend to be on the nose side of the eye, but can be on the ear side as well.

They are not a type of cancer, but they can quite often slowly grow over time.

Often they do not cause any problems for patients but, if they are growing and threatening vision, or causing significant irritation because of their elevation on the surface of the eye, then surgical removal is a very good option. If patients are not happy with the appearance, this is also a reason to consider surgery.

It is certainly better to surgically intervene before the vision is compromised. The irritation and burning and foreign body sensation that is sometimes associated with pterygia can be managed with lubrication drops initially but, if these do not control things, then surgery is appropriate. The surgery involves removal of the pterygium and then a conjunctival graft placed in the area from which the pterygium was removed in order to stop the pterygium from growing back.

YAG CAPSULOTOMY

Cataract surgery is a very common procedure. At the time the cataract is removed, an intraocular lens is placed in the bag that surrounds the cataract. Over time this bag, that is a naturally occurring part of the eye, can become cloudy and it can feel to the patient like the cataract is growing back. Although cataracts never grow back, this blurring of vision from the clouding of the bag can occur over time after cataract surgery and is very effectively treated with a YAG laser capsulotomy.

The procedure is done in the rooms with local anaesthetic eye drops to numb the surface of the eye and a contact lens is applied to the eye in order to focus the laser on the bag capsule which is cloudy. The laser clears away the bag cloudiness and this allows the light to pass through the clear intraocular lens unimpeded again.

YAG laser capsulotomy is a painless procedure and is only necessary in some patients after they have had cataract surgery, as the bag cloudiness does not occur in everyone.

LASER RETINOPEXY

This is a very common treatment needed for a variety of retinal disorders, including acute retinal tears, diabetic retinopathy and retinal vein occlusions.

The laser treatment is done in the consulting rooms and most often the eye is numbed with local anaesthetic drops and then a contact lens applied that focuses the laser on the appropriate area of the retina that needs treatment. During the treatment there are a series of flashing lights, which are bursts of laser, and these are delivered by the Surgeon to the troubled area. The number of shots of laser depends on the condition being treated.

One of the most common reasons for retinal laser is an acute retinal tear caused by the vitreous starting to move in the eye from the aging process. This can lead to a retinal tear and a retinal detachment. It is important to treat the retinal tear early, before it progresses to retinal detachment and the appropriate treatment for the tear is retinal laser to “spot weld” the area.

There can be some discomfort from the retinal laser, as it does generate heat in the eye and this discomfort will be managed by the Surgeon appropriately. The area that is lasered scars over 1-2 weeks after the laser, but this is a painless process.

INTRAVITREAL INJECTIONS

Intravitreal injection of a drug is a very common and effective treatment option for a number of eye conditions, including wet age-related macular degeneration, retinal vein occlusions and diabetic maculopathy. They are very effective at treating the above conditions, particularly when the problem is caught early. They are very effective at preventing further vision loss and the vision does improve in a significant proportion of patients.

The injection is always done with anaesthesia, which is most often a gel drop that numbs the surface of the eye.

The injection is done under sterile conditions and is delivered into the mid-vitreous cavity of the eye. The injection is done from the side and hence is not seen by the patient. The injection is most often painless, but there can be some mild discomfort during it and after for a few hours. There is commonly a floater in the vision for a day or two after the injection, which is the drug inside the eye.

Like all drugs, the affect wears off over time and hence it is very common to need repeat intravitreal injections over time.

The most common drugs that are used for intravitreal injection are Lucentis, Eylea, Avastin and Triesence.

Intravitreal injections can either be done in the consulting rooms, or in a day surgery.

SLT Laser

SLT laser, or selective laser trabeculoplasty, is a type of laser treatment that decreases the intraocular pressure in patients who have glaucoma. It is generally used in people who are not getting adequate decreased pressure in their eye from drops alone.

The laser stimulates the part of the eye (trabecular meshwork) through which the ocular fluid drains out of the eye. This results in better drainage and decreased intraocular pressure in the eye.

The laser is done in the consulting rooms under local anaesthetic drops. A contact lens is applied to the eye and this contact lens allows focusing of the laser on the appropriate area that needs treatment. The treatment is painless. The patient does not notice any change in their eye, but over time the treatment should bring down the intraocular pressure when it is measured.

The treatment does often need to be repeated, as it does wear off over months.