Yag Laser Eye Treatment

PCO (Posterior Capsular Opacification) is a common occurrence after cataract surgery and is easily treatable. PCO is when there is thickening of the back (posterior) of the lens capsule causing clouding of vision. YAG Laser is used to make an opening in this thickened capsule (Capsulotomy) to clear vision in PCO and Glaucoma. It is a safe in-office procedure.

How is the YAG laser eye treatment carried out?

• The laser treatment is carried out while sitting at a machine similar to the microscope we routinely use to examine the eye
• Local anaesthetic drops is given and a contact lens may be placed on your eye to steady it and focus the laser beam
• The laser light is invisible but a bright light is used so that the thickening or scarring can be seen
• Each laser shot lasts a fraction of a second and you will hear a clicking sound at the same time

What happens after YAG laser eye treatment?

• Vision is then restored back to the level it was before the scarring happened
• It may take a few days before your vision is fully restored
• Drops may be given for you to use after the procedure
• We advise that you do not drive yourself home after your procedure
• Does not require any incisions or stitches, you are normally able to return to your daily activities straight away.

Red Eye

Causes

• Allergies
• Blepharitis
• Complication from a recent surgery
• Contact lens complication (can be very serious)
• Conjunctivitis
• Dry eye
• Eye surface abrasion
• Eye surface ulcer (serious)
• Episcleritis
• Foreign body
• Glaucoma (sight threatening)
• Infection
• Inflammation
• Iritis (serious)
• Keratitis (Very serious)
• Scleritis (Very serious)
• Uveitis (Very serious)

Vision assessment
Why is vision assessment in a red eye examination important?

• Red eye can be more than just conjunctivitis
• To assess if vision is affected
• To establish baseline vision
• To allow future comparison in follow up appointments
• To monitor progression
• To assess efficacy of treatment regime

Eye Pressure measurement
Why is eye pressure measurement important in a red eye clinical examination?

• High eye pressure can cause a red eye (Ocular hypertension)
• Very low eye pressure can cause a red eye (Ocular hypotension)
• Red eye as a result of very high eye pressure or very low eye pressure is sight threatening
• Red eye as a result of abnormally high or abnormally low eye pressure is an ocular emergency

Digital Slit Lamp Examination
Why is slit lamp examination important in a red eye clinical assessment?

• Most important tool in all high level eye examination
• Examination of the external eye
• Eye lid disorders such as blepharitis, everted eye lid (ectropion), inverted eye lid (entropion), inflammation, infection
• Disorders of the conjunctiva such as conjunctivitis, melanoma, haemorrhage, allergies
• Disorders of the cornea such as ulcers
• Disorders of the anterior chamber of the eye such as Uveitis which if left untreated can lead to visual impairment
• Examination of the internal eye

Ophthalmic Imaging

Retinal imaging
Colour fundus photograph
Specially modified cameras may be used to acquire photographs of the ocular fundus.
In combination with light filters and injections of intravenous contrast material, fundus cameras can be used to perform fundus fluorescein angiography (FFA) and indocyanine green angiography (ICG). In combination with light filters alone, they can also be used to perform monochromatic imaging and fundus autofluorescence.
The ability to acquire colour photographs of the ocular fundus is an essential part of an advanced eye examination. Colour fundus photography is essential to the diagnosis and monitoring of most posterior segment diseases as well as for disease screening

Fundus AutoFluorescence (FAF)
Many structures in the posterior segment possess innate fluorescent properties or “fundus autofluorescence” (FAF), that is, they fluoresce even in the absence of any exogenous contrast agent.
Blue-peak autofluorescence system, with an excitation wavelength of 488nm, is an essential requirement for highly specialised retinal clinics. It plays a crucial role in the diagnosis and monitoring of patients with inherited retinal disease and in the assessment of patient with toxic retinopathies (e.g. hydroxychloroquine retinopathy).
It also has an emerging role in the diagnosis and monitoring of geographic atrophy in patients with “dry” AMD.

Ocular Coherence Tomography (OCT)
OCT provides high-resolution images of the neurosensory retina in a non-invasive manner. OCT is analogous to ultrasonography, but measures light waves rather than sound waves. Each OCT device incorporates image analysis software that provides measurement of retinal thickness via automated detection (“segmentation”) of the inner and outer retinal boundaries. Using these techniques, it is possible to measure retinal thickness at multiple locations and to construct retinal thickness maps corresponding to the Early Treatment of Diabetic Retinopathy Study (ETDRS) subfields. Access to OCT imaging is an essential requirement for high quality eye care service. OCT imaging plays a central role in the detection, diagnosis, and long-term monitoring of nearly all posterior segment diseases. It also plays an important role in the assessment of unexplained visual loss in patients with normal biomicroscopic examination, particularly when combined with FAF imaging.
CT (Optical Coherence Tomography) has truly revolutionized eye care in the world.