What is herpes zoster?

Herpes zoster is a disorder caused by a virus that affects the skin with a characteristic rash consisted of small bubbles full of fluid that end up as scabs and may leave permanent scars.

What causes herpes zoster?

The varicella zoster virus that causes chicken pox is also responsible for herpes zoster. After remaining for years in dormant condition, the virus is reactivated, usually affecting the elderly or people with reduced immune reactions.

What causes its symptoms?

The first symptom is usually an acute pain or itch in the affected area. Redness of the skin follows and, subsequently, there appear a few or many of the characteristic bubbles. Their spread follows the course of the affected nerve.

The pain is usually very intense and is accompanied by a burning sensation, swelling and very sensitive skin. The rash will last about 3-6 weeks but many people feel pain for months or even years later. This protracted situation is called “postherpetic neuralgia”.

How does the virus of herpes zoster affects the eye?

Herpes zoster usually affects nerves around the eye, especially the nerve that is distributed in the upper eyelid and the forehead. If the virus affects the nerves that directly feed the eyeball, it may cause serious eye problems, like corneal ulcer, intraocular inflammation and glaucoma. These problems may appear at the same time with the rash or after weeks after the bubbles have receded. Constant pain is the result of the injuries of the nerves, which might stay sensitive for years after infection.

What is the treatment for herpes zoster?

The usual procedure is to alleviate pain and prevent further infection of the skin with moist compresses, rubbing of the scabs and other measures. Antiviral drugs, steroids taken orally or other medication may help in some cases. If the eyeball is infected, drops, ointment or orally taken medication might be needed. Most people recover without complications. Unfortunately, however, despite existing medication, there are some with permanent eye damage due to the disease and continue to feel pain after the rash has subsided.

Remember:our ophthalmologist is the best source for responsible answers on issues related to your eyes and their health. Under no circumstances is information taken from our website intended to replace him. Seek your doctor for complete information.

What is lacrimation?

In some people, tears pool in the eye, either because of excessive production or because of poor drainage. Excess tears make the eye seem moist and allow tears to concentrate along the lower eyelid and subsequently drop to the cheek. This condition is called lacrimation.

How are tears produced and stored?

Small glands, found in the surface tissue of both the white of the eye (the sclera) and the one that covers the eyelids from the inside, continuously produce small quantities of tears, in order for the eyeball to remain healthy and, at the same time, lubricated, facilitating its movement. A bigger gland, called lacrimal, which is found under the upper eyelid, responds to emotional situations or eye irritation producing larger quantities of tears.

After tears are dispersed on the surface of the eyeball, they go inside a small opening that exists in every eyelid (lacrimal punctum) and are drained through a small tube (lacrimal canaliculi) to the lacrimal sac and from there there, through the nasolacrimal duct, to the nose. This explains the “runny” nose when we cry, since excess tears reach the nose through the natural drainage system of the eye.

What are the causes that can lead to lacrimation?

Overflow of tears can be caused when injuries, congenital malformations and infections, especially of the lacrimal sac, prevent drainage of the tears to the lacrimal punctum, the canaliculi, the sac or the nasolacrimal duct.
Furthermore, eye inflammations, eyelid disorders, eyelashes turned towards the cornea, exposure to strong winds, glaucoma, certain medicines, even tired eyes can bring excessive tear excretion.
However, excessive tear excretion is not always much larger than normal or does not always indicate an obstruction of the drainage system. People with dry eyes (xerophthalmia) often complain about lacrimation. This happens because the quantity of the tears that is excreted is too small to adequately moisten the eye, so it is usual for the lacrimal gland to react with producing additional tears that cause episodes of overflow, even though the basic problem is production of few tears or even dry eyes.

Excessive production of tears may be caused by:

Emotional situations
Dry eyes
Natural irritations (wind, smoke, vapors)
Infections and allergic reactions
Foreign objects on the surface of the eye
Glaucoma

Poor drainage of tears may be caused by:

Anomalies in the position of the eyelid or the lacrimal punctum
Faulty blinking
Infections
Orbital injuries (fracture, segmentation)
Congenital anomalies
Burn or radiotherapy complications

How can the cause of excessive lacrimation be defined?

In order to find which one of these factors causes excess tear excretion, the patient will have to undergo a full ophthalmological examination. The ophthalmologist may try to poor fluid through the drainage system towards the nose or perform other tests like measuring tear production or collecting tears from the nose.

How is excessive lacrimation treated?

Treatment always depends on verifying the cause of lacrimation (causal treatment). So, if it is caused by an eyelash turned to the cornea, it will need to be removed. If the problem is dry eyes, then a restorative therapy is in order with artificial tears or even obstruction of the lacrimal punctum with special plugs that will prevent the natural and artificial tears from draining out of the eyes (with either temporary collagen plugs that will be absorbed or permanent silicone plugs).

If the drainage system is obstructed, then the doctor will try to open or bypass it. So, when there is a small constriction of the drainage system, modern atraumatic microsurgery techniques that open the canal with the use of proper equipment and special lacrimal tubes offer essential help and prevent a total obstruction of the system. In cases of total obstruction, the sedition of tears within a closed system may allow for the development of microbes and lead to inflammation (dacryocystitis). Those infections can not only affect the patients' quality of life, but also demand careful monitoring and proper treatment in order not to endanger vision or the patients' general health. Patients with cataract and obstructed tear ducts need special attention because if cataract surgery is done, even with the most advanced techniques, before treating the obstructed duct, it may cause a serious infection inside the eye that will result in severe damage of vision.

Patients with chronic systemic disorders that affect the organism's defenses, like diabetes, or immunosuppressed individuals must be treated early because they are in even bigger danger for a possible spreading of the infection to nearby tissues.

Remember: Your ophthalmologist is the best source for responsible answers on issues related to your eyes and their health. Under no circumstances is information taken from our website intended to replace him. Seek your doctor for complete information.

What is blepharitis?

Blepharitis is a common and persistent inflammation of the eyelids and often affects people with oily skin, dandruff or dry eyes. Bacteria that live naturally on everyone's skin surface around the eyes may, in some people, develop on the skin at the base of the eyelids. This results in eye irritation, which, in combination with the occasional oily secretions due to increased activity of adjacent glands, creates “scales” or chalazia along the eyelashes and the eyelids.

Image 2: Chalazion

In blepharitis, both eyelids are covered with oily secretions near the base of the eyelashes. The eye is irritated and may be inflamed.

How can blepharitis be diagnosed?

In some cases, exfoliation or bacteria cause only a small irritation and itch, but in some cases they can cause redness, pinches, sand or burning sensation. Some people may develop allergies to exfoliation or the bacteria that surround them. This may lead to more serious complications, like inflammation of the tissues of the eye, especially of the retina.

How can blepharitis be diagnosed?

Blepharitis is diagnosed during an ophthalmological exam.

How is blepharitis treated?

Blepharitis can be a persistent problem. Even though there is no special treatment, it can be controlled through a regular hygiene program and with the help of medication.

How can blepharitis be treated through a hygiene program?

To keep blepharitis under control, you need to follow a regular program of eye hygiene.

At least twice a day, douse a clean towel in warm water (not hot). After wringing, place it on the closed eyelids for one to three minutes. As it loses temperature, douse it again once or twice. This will soften and loosen exfoliation and secretions. More importantly, it helps liquefy the oily secretions from the sebaceous glands of the eyelids, whichLight washing of the eyelashes (not the eye) with Baby Shampoo (which must be diluted with a 1 to 10 ratio).
If an antibiotic ointment has been prescribed, dab the base of your eyelashes (usually before sleeping at night) using the edge of your finger or a cotton swab, and gently rub the area.

Simple, everyday hygiene measures will reduce the number of additional medication needed to control blepharitis and its symptoms.

How much does medication help with blepharitis?

There are many drugs to treat blepharitis; they include steroids (cortisone) and antibiotics in the form of ointment or drops or, in some cases, they could be taken orally for systematic treatment both of severe blepharThese steroid medicines can be used to reduce the inflammation. While they often succeed in accelerating symptom relief, they may cause unpleasant side-effects after long-term use. That is why they should be administered only after an ophthalmological examination and not arbitrarily.

Antibiotics can be used to reduce the bacteria contained in the eyelids.

Artificial tears may be used to relieve symptoms of dry eyes (drops that don't need prescription – we suggest using a brand with no preservatives).

When the acute phase is over, something that can take a few weeks, some milder medication can help control blepharitis. We should, however, point out, that medication alone is not enough. Everyday cleaning routine, as described above, is quite important.

Remember: Your ophthalmologist is the best source for responsible answers on issues related to your eyes and their health. Under no circumstances is information taken from our website intended to replace him. Seek your doctor for complete information.

What is color blindness?

Color blindness is the inability to see color. It is not some form of blindness, but when you are color blind, it is difficult for you to distinguish between certain colors, like red and green or blue and yellow. The inability to see red-green is the most common form of color blindness. Less common seems to be the inability to see blue-yellow. Contrary to popular belief, it is very rare for a color blind person to only see shades of gray.

Is color blindness inherited?

Color blindness may be inherited or caused by disorders of the optic nerve or the retina.

Acquired color blindness affects only the eye that presents a problem and may worsen with time. Patients with color blindness that is caused by other disorders usually have difficulty distinguishing blue and yellow colors.

Inherited color blindness is much more frequent. It affects both eyes and does not worsen with time. This type of color blindness is found in 8% of all males and 0.4% of all females. Color blindness is connected to the X chromosome and in almost all cases it is carried from mother to son.

Color blindness may be partial and only affect some colors or total and affect all colors. Total color blindness is very rare. The patients with total color blindness usually present other ophthalmological problems.

What causes color blindness?

Our eyes are capable of distinguishing colors, as well as brightness, because at the posterior segment there are cells known as cones and rods. Cones recognize color and rods brightness. Cones are gathered in the central area of the retina and contain three light-sensitive pigments: red, green and blue. Those with color blindness have partial or total lack of one or more of the above pigments. Depending on the number of cones in each patient with color blindness, the degree of color blindness varies. A person that is red and green color blind does not have enough red and green cones. This, of course, does not mean that the patient sees everything in black and white, but that he confuses red with green or brown, as well as blue with purple. Color confusion in the color blind patient depends on lighting conditions. For example, the person that can't distinguish green might, under intense sunlight, distinguish a strong green as green. On the other hand, under low artificial light he may confuse the green color with brown or even red.

Patients with normal color perception are called trichromats..

Patients with partial color blindness and lack of one pigment are called anomalous trichromats (this is the most frequent type of color blindness). A color blind patient of this type has total lack of one cone pigment.
What are the symptoms of color blindness?
The symptoms of color blindness depend on various factors, for example if the problem is inherited or acquired, partial or total.

Difficulty in recognizing red and green (most common conditions)
Difficulty in recognizing blue and yellow (less common conditions)

The symptoms for more serious inherited problems of color blindness and some types of acquired color blindness may be:

Objects appear in various shades of grey (this appears in total color blindness and is very rare)
Decreased vision
Nystagmus

Can color blindness be diagnosed?

Color blindness can be detected with special chromatic tables called Ishihara Test (Image 1). In every table there is a number formed by colored dots. The patient must recognize the number on the table in his hands under well-lit conditions. As soon as color blindness is diagnosed, a more thorough examination of the condition is in order.

Can color blindness be cured?

Color blindness cannot be cured. Nonetheless, its diagnosis from an early age is very important since during the school years a large portion of instructive material is based on color perception. Knowing the problem makes it easier for the child to face any learning difficulties based on color perception. So, if your child is color blind, you should notify his teacher, so that the lessons can be organized in such a way that will help with these learning difficulties.

The person that suffers from this eye condition should not be working with machinery or buttons with red or green colors and will have to find different ways to tell the colors of pills, objects, etc. It is important to point out that there are ways to help someone overcome this difficulty to distinguish colors. For example, someone with color blindness might tell his clothes apart in the closet by tagging them or placing them by color, so that it's easier for him to find them. Another example is that the red light of traffic lights is always on the top, even if we can't see its color.

Finally, we should mention that color blindness has some “advantages”. People with color blindness seek outlines to compensate for color confusion, that's why they can, for example, easily distinguish anything or anyone that is camouflaged. Furthermore, these people have sharper night vision than people with normal vision.

Remember: our ophthalmologist is the best source for responsible answers on issues related to your eyes and their health. Under no circumstances is information taken from our website intended to replace him. Seek your doctor for complete information.

LASIK METHOD (Conventional Lasik and Femto Lasik):

This method is effective and painless. It is used to correct medium to high degrees of myopia and astigmatism, while it is the only method to correct hyperopia.

The advantages of this method are many, because treatment occurs on the corneal layer after creating a protective tissue (flap). There are two ways to create the flap.

Conventional LASIK with mechanical microkeratome
  

Femto-Lasik με Femtosecond laser

Postoperative medication lasts only ten days, while the vision is fairly good from the very first day. The degree of correction is calculated by specialized software.

There is conventional LASIK, where the flap is created with a mechanical microkeratome and FEMTO-LASIK, where it is created with a femtosecond laser. With the new Femtosecond laser technology, the surgeon is able to exclusively use laser during all the stages of the surgery, even the first stage, so that the LASIK procedure can be completed without the need to apply a “scalpel” in any of the stages. Its name is derived from the number of pulses per second in which this particular laser operates.

In particular, microscopical, rapid laser pulses are used, which operate in the infrared zone of the light spectrum and, in combination with the extremely short time of activity and the slight amount of energy, they achieve photodisruption of the tissue on which they fall (in our case, the cornea). Photodisruption is visible in the form of a bubble, which, in the end, is the force with which the femtosecond laser cuts the tissues. Subsequently, the doctor creates the flap by lifting the tissue of the cornea towards the back, at the point where the bubbles have been formed due to the light pulses. The creation of the flap lasts merely 15 seconds. That is the time when the surgeon can move on to the second stage of the procedure, that is the full correction of the refraction and the restoration of vision.

EXTERNAL LINKS ABOUT FEMTO-LASIK

Femtosecond laser lasik, virtual laser procedure (youtube)
Femtosecond laser and cataract procedure

Refractive surgery has brought a revolution in myopia, hyperopia and astigmatism correction. We are already in the third decade of laser use and we can really observe that precision and safety are already here. With the use of this impressive technology, we can forever eliminate our dependence on corrective glasses or contact lenses.

There are two methods of effective correction of high or low degrees of myopia, hyperopia and astigmatism: PRK and LASIK (conventional LASIK, where the creation of the flap is done with a mechanical microkeratome and FEMTO-LASIK, where it is done with a femtosecond laser). The difference between these two methods lies in the fact that, in the first, the correction occurs on the surface of the cornea, while in the second in its interior. In PRK there is some minor discomfort the first 2-3 days, while in LASIK the discomfort is insignificant and eyesight restoration happens almost immediately, on the very first day. The final result is the same in both cases. An important role in the patient's decision to do away with glasses and contact lenses plays the trust and relationship between doctor and patient. The most important part of a refractive surgery is thorough preoperative tests, which will show us if the patient is eligible for a procedure in that particular area. Detailed and thorough preoperative tests ensure the success of the procedure. Timewise, the procedure lasts only a few minutes and it is never longer than 5 or 6 minutes for both eyes. The doctor uses local anesthesia and the patient feels no pain. It is important to note that the correction is permanent and in the very few cases where some degrees of the condition remain, then an additional laser procedure can be done to achieve full correction. The 25 years of laser use allow us to say that the possibility of serious complications is negligible. Even those rare complications can be treated. We are in a position to say with absolute certainty that the chances of infection from contact lenses are more than the possible complications of refractive surgery.

Keratoconus is a non-inflammatory disorder of the cornea, which is characterized by the presence of a progressive deformation of its surface. The cornea gradually takes a “conical” shape (it expands by creating an extrusion), deforming the reflection formed in the fundus of the eye. A progressive thinning can also be observed, as well as scarring, and finally opacity in the area where the cone has formed. Despite ongoing research, the causes of keratoconus are essentially unknown. It is generally considered a genetic disease caused by multiple factors, mainly irregularities in the structure or the metabolism of various segments of the cornea. It used to be considered a rare disorder, perhaps because there weren't any diagnostic means to detect it in the early stages. Today we know that keratoconus is not so rare. There are more than 20,000 people in Greece with keratoconus (approximately 1 for every 2,000 people). It usually appears in adolescence and progresses relatively fast, while later the rhythm of deterioration decreases and stops at around 35 years of age. Physical examination does not always provide evidence for a positive diagnosis. However, keratometry can give altered parameters. The patient presents an irregular progressive astigmatism that previously did not exist. In more advanced stages, the diagnosis is easier and with the help of a slit lamp, the cornea can present the known conical form, as well as thinning and haze of its central area. Nonetheless, positive diagnosis occurs with the help of an electronic device and a test called “corneal map” (corneal topography). In this test, a 2D image of the corneal topography is taken and, based on that, we can diagnose even the subclinical forms (those that haven't presented any symptoms). It is strongly believed today that the riboflavin method can substantially delay or even stop the development of keratoconus, saving the patient from a potential corneal transplant. This method is still evolving and is called C3-R (Corneal Collagen Crosslinking with Riboflavin). Through lab tests and clinical examinations, it has been proven that it reinforces the inner structure of the cornea, stabilizing its architecture and, specifically, strengthening the bonds of the corneal collagen fibers, which are among the basic ingredients for maintaining its structure.

C3-R treatment can be done at the clinic and lasts about 60 minutes. During the treatment, drops of a riboflavin (B2) mix are instilled, which are then activated with UV rays.

Cataract is a haze of the natural lens inside the eye. This lens, which is found behind the iris (the colored part of the eye) is capable of moving and changing shape, so that it can function exactly like the lens of a camera, by focusing bright images on the retina, which, in turn, sends them to your brain. The human lens, consisted mainly of protein and water, can present some haze, in such a degree that the light and images are not allowed to reach the retina. Eye damage, certain disorders or even some medicine can cause this haze. In more than 90% of the cases, however, this haze is cause by the aging process. Cataract isn't a deposition in the eye and cannot be removed with diet or laser. The best way to treat cataract is to remove the old, hazy lens and to replace it with an artificial one. Cataract can be the cause of the blurring of clear images, the dimming of bright colors or a decrease in vision at night. It is also possible that it is the reason why reading or bifocal glasses that used to help you read or perform simple tasks, cannot help you any longer. Unfortunately, it is not feasible to prevent cataract, but only to remove and replace it with an artificial lens which can restore your vision and significantly improve quality of life. The proper time to remove cataract is when the quality of your vision starts causing restrictions in your activities and your enjoyment of life.

Modern technologies, as well as our top-ranking scientific, personnel make us capable of developing pioneering methods to treat even the most demanding eye disorders, like Inflammations, Glaucoma, Age-Related Macular Degeneration, Diabetic and Hypertensive Retinopathy, Retinal Detachment, Strabismus, Optic Neurolopathies etc., even in the most difficult of cases.

George Chronopoulos

Ophthalmologist Surgeon

Eyeclinic's gem, recognized worldwide as the top Excimer Laser with the most advanced technical features, the fastest Laser source at 500Hz that reduces treatment time (less than two seconds per diopter) and performs quick refractive procedures. It has the fastest and most precise Eye Tracker with a reaction time of 2 ms (millisecond), it is able to track eye movements of all dimensions and recalibrates all the laser shots according to the micromovements of the eye, thus correcting the entire optical zone in a precise and uniform way. Because of its advanced technology, it incorporates OLCR online non-contact pachymetry, perfect for safe, real-time control of the thickness of the flap and the tissue that remains before the start of the treatment, as well as the changes in the thickness of the cornea, with continuous measurements before, during and after the procedure. Allegretto EX-500 transcends its role and is capable of increasing and reducing the thermal load on the cornea, creating an even smoother sculpting of the ocular surface, in combination with the revolutionary pulse technology of the FS-200 Femtosecond laser (creation of a smooth and very thin flap without the use of a blade). It is the new generation of correction for myopia, astigmatism, hyperopia, and corneal surface deterioration.