DEFINITION: By covering the internal part of the eye, the retina is the layer which communicates with the brain (the network layer) by signalling the vision through the optic nerve. The vitreous, which fills the inside of the eye is of a gel consistency and with ageing or as a result of some eye diseases, it loses the properties of vitreous tissue and starts to liquefy. As a result, the retina separates from its points of attachment. Most of the time, no problems develop during this process, but occasionally during this separation, one or more areas of the retina may be torn. The liquefied vitreous passing from these torn areas may separate from the retinal layer and the disease known as retinal detachment develops. Vision is permanently severely affected and thus this disease must be treated promptly.Figure 1. Fundus photography of a patient diagnosed with regmatogen retinal detachment (left) and the other healthy eye of the same patient (right).CAUSES and RISK FACTORS: The most significant… More
Macular Hole
DEFINITION: This hole develops in the center of the macula which enables the central vision. It has four phases. It mostly emerges by the detachment of the vitreus from the macula due to aging. It occurs in 3 cases out of 1000. Once one of the eyes is affected, the risk of development in the other eye within 5 years is 10%.Figure 1. Preoperative (left) and postoperative (right) Multicolor optical coherence tomography images of a patient operated for full thickness macular hole at our hospital.RISK FACTORS: It mostly affects individuals who have no eye diseases and who are over 50 years of age. It is more common in women. It may also develop due to high myopia, trauma, intraocular inflammation, retinal detachment and other eye diseases.FINDINGS: The disease starts with distorted and blurred vision in the center of vision. With the expansion of the hole over weeks and months, central vision is seriously affected.Figure 2. Preoperative (left) and postoperative (right) B scan optical coherence… More
Ultrasonography
Ocular ultrasonography is a diagnostic method by which the lens, vitreus, retina and soft tissues around the eye are visualised. Using the reflection of sound waves off tissue, this is a non-invasive, painless, easy-to-apply test which provides information about the posterior segment of the eye, particularly the retina. Evaluation requires experience.When the internal structures of the eye cannot be evaluated because of blurred surroundings such as internal bleeding in cataract, it is a useful method in the diagnosis and monitoring of in retinal detachment, foreign body in the eye or tumours. Figure 1. B-scan ultrasound image of a healthy individual (left) and a patient diagnosed with dense vitreous hemorrhage (right). More
Ptosis (Looseness Of The Eyelid)
DEFINITION: It is the looseness of the eyelid due to a malfunction of the muscle supporting the eyelid congenitally or later in life.Figure 1. Preoperative (left) and postoperative (right) external appearance of patient operated with the diagnosis of congenital ptosis at our hospital.CAUSES AND RISK FACTORS: The eyelid may move downward due to a developmental disorder of the eyelid muscle, palsy of the nerves here, detachment of the muscle because of aging or the mechanical effect of masses in the eyelid.FINDINGS: Findings change according to the cause of the eyelid looseness. In congenital ptosis, both opening and closing the eyelid are dysfunctional, while in ptosis caused by aging, only opening the eyelid is dysfunctional. In both cases, the eye seems as if it is smaller.Figure 2. Preoperative (left) and postoperative (right) external appearance of patient operated with the diagnosis of senile ptosis at our hospital.DIAGNOSIS: There is a standard measuring method to measure… More
Glaucoma
DEFINITION: Disruption to the internal eye fluid or increased resistance to the external flow results in internal pressure more than the eye can tolerate and thereby a group of diseases characterised by irreversible damage to the optic nerve.Figure 1. Appearance of the normal optic disc (left) and glaucomatous optic disc (right).SYMPTOMS AND FINDINGS: In open angle type glaucoma, the disease gives no indications until the advanced stage at which vision loss develops. The progressive course of the disease is generally slow and initially the patient is not aware of impairments in the field of vision.In acute closed angle type glaucoma the prevention of internal eye fluid circulation results in high levels of internal eye pressure. In these cases, clouded vision, coloured circles around light, severe pain in and around the eye, redness of the eye and nausea and vomiting may be seen. In congenital glaucoma cases, there are findings of watering of the eyes, large diameter cornea and loss of… More