Category Archives: ophthalmology

Impact of topical anti-fibrotics on corneal nerve regeneration in vivo

Recent work in vitro has shown that fibroblasts and myofibroblasts have opposing effects on neurite outgrowth by peripheral sensory neurons. Here, we tested a prediction from this work that dampening the fibrotic response in the early phases of corneal wound healing in vivo could enhance reinnervation after a large, deep corneal injury such as that induced by photorefractive keratectomy (PRK). Since topical steroids and Mitomycin C (MMC) are often used clinically for mitigating corneal inflammation and scarring after PRK, they were ideal to test this prediction. Twenty adult cats underwent bilateral, myopic PRK over a 6 mm optical zone followed by either: (1) intraoperative MMC (n = 12 eyes), (2) intraoperative prednisolone acetate (PA) followed by twice daily topical application for 14 days (n = 12 eyes), or (3) no post-operative treatment (n = 16 eyes). Anti-fibrotic effects of MMC and PA were verified optically and histologically. First, optical coherence tomography (OCT) performed pre-operatively and 2, 4 and 12 weeks post-PRK was used to assess changes in corneal backscatter reflectivity

Eye vision blog 1

Post-mortem immunohistochemistry was then performed at 2, 4 and 12 weeks post-PRK, using antibodies against α-smooth muscle actin (α-SMA). Finally, immunohistochemistry with antibodies against βIII-tubulin (Tuj-1) was performed in the same corneas to quantify changes in nerve distribution relative to un operated, control cat corneas. Two weeks after PRK, untreated corneas exhibited the greatest amount of staining for α-SM, PA-treated and MMC-treated eyes. This was matched by higher OCT-based stromal reflectivity values in untreated, than PA- and MMC-treated eyes. PA treatment appeared to slow epithelial healing and although normal epithelial thickness was restored by 12 weeks-post-PRK, intra-epithelial nerve length only reached 1/6 normal values in PA-treated eyes. Even peripheral cornea (outside the ablation zone) exhibited depressed intra-epithelial nerve densities after PA treatment. Stromal nerves were abundant under the α-SMA zone, but appeared to largely avoid it, creating an area of sub-epithelial stroma devoid of nerve trunks. In turn, this may have led to the lack of sub-basal and intra-epithelial nerves in the ablation zone of PA-treated eyes 4 weeks after PRK, and their continuing paucity 12 weeks after PRK.

Eye Vision Blog 2

Intra-operative MMC, which sharply decreased α-SMA staining, was followed by rapid restoration of nerve densities in all corneal layers post-PRK compared to untreated corneas. Curiously, stromal nerves appeared unaffected by the development of large, stromal, acellular zones in MMC-treated corneas. Overall, it appears that post-PRK treatments that were most effective at reducing α-SMA-positive cells in the early post-operative period benefited nerve regeneration the most, resulting in more rapid restoration of nerve densities in all corneallayers of the ablation zone and of the corneal periphery.

Eye vision blog 3

Blindness in Born Babies

PBlindness is one of the major problems in born babies. This can be caused by many different regions. Those are abnormalities in the developing of the eye, developing problems in eye structures, like prematurity related retinopathy, infections in eye, development problems or injury to parts of the brain responsible for vision.

Some of the factors:

  • Untimely, born in low weight, needing to be treated with oxygen at birth, or bleeding in the brain
  • retinoblastoma, congenital cataracts, or metabolic or genetic disease in family history
  • Infection of mother during pregnancy such as rubella, toxoplasmosis, cytomegalovirus, and some sexually transmitted infections including herpes, and  chlamydia
  • Problems in the central nervous system such as development are delay, cerebral palsy, seizures, or hydrocephalus.

They are many causes to vision loss but one is the most common condition is known as retinopathy of prematurity

Retinopathy of prematurity:

It is main eye problem in born babies born in before 31 weeks of pregnancy. Above 90% of all young child with retinopathy of prematurity are in the milder category and do not need treatment. Born children with more several diseases can develop impaired vision or blindness. About 1, 100-1500 born babies annually develop ROP that is requiring to surgical treatment. Some other reasons that cause vision loss at time of born babies.

Some other conditions:

Defects or abnormalities in the eye itself (coloboma, glaucoma, cataracts)

  • Infections, such as cytomegalovirus (CMV)
  • Neurological Visual Impairment (NVI)

Health of Retina

11Vitrectomy

The surgery vitrectomy is finished by a master, where the eye depression that loads up with vitreous diversion gel that is evacuated to give better access to the retina. This gives an assortment of repairs, including the freedom of scar tissue, repair of retinal separations utilizing laser and treatment of macular openings. After the medical procedure is done, silicone oil, saline or a gas bubble might be infused into the vitreous gel to help hold the retina in correct position.

Diverse kinds of vitrectomies are seen;

Foremost Vitrectomy

 In uncommon cases, the vitreous gel comes through the pupil into the anterior (front) chamber of the eye. This can happen:

  • Following eye injury (damage)
  • During complex cornea, cataract, or glaucoma medical procedure
  • As an effect of lens issues

Since releasing vitreous gel can prompt future issues, a front vitrectomy might be performed to limit hazard and to advance visual recuperation. All ophthalmologists have gotten eye medical procedure preparing in their residency and can play out a front vitrectomy.

Back Pars Plana Vitrectomy

 The vitreous is thought to fill in as a help for the layers of an infant’s eye amid development. In ordinary eyes, all through adulthood the vitreous is perfectly clear and fills the eye from the foremost or front (iris-focal point) to the back (optic nerve). This territory secured by 66% of the zone of the eye and is known as vitreous cavity, which along with the retinal pigment epithelium, retina, choroid, and sclera, shapes the back portion.

A vitrectomy did for ailments of the back portion is known as a pars plana vitrectomy. Normally its done by a retina expert.

Realities About Vitrectomy Surgery

The retina authority chooses the best gear to use for each situation from an extensive variety of instrumentation. Since in 1970s the principal vitrectomies were played out, the pattern has been toward more slender and littler microsurgical equipment.

  • Now numerous vitrectomy methodology can be done by suture less, self-fixing, cuts roughly in size of one portion of a millimeter, which is about the width of an eyelash. Regardless of it has a few impediments, little measure vitrectomy medical procedure is for the most part viewed as more agreeable than medical procedure with bigger instruments and by large offers speedier visual recuperation.
  • Lest the enduring has dangerous infection, approximately all vitrectomies are outpatient techniques performed either in a hospital or in a dedicated ambulatory surgery center; they don’t give torment or may give little torment and require anesthesia in insignificant sum.