Not just laser eye surgery: innovations in ophthalmology you should know about
In the not-so-distant past, people visited an ophthalmologist mainly when their glasses no longer fit or when they were diagnosed with conditions like cataracts. Today, thanks to advanced examinations, more precise treatments, and a broad view of all parts of the eye, it is possible to identify problems earlier, tailor more accurate solutions, and in some cases, prevent significant deterioration down the road.
Certain vision problems develop gradually, without us noticing. A little more blurriness while driving at night, a little more glare from car headlights, a little more rubbing of the eyes due to dryness or allergies. Many assume that such changes are a natural part of aging, working in front of screens, or life itself, and only when the difficulty becomes a real challenge do they turn to an examination. But experts emphasize that vision problems do not always start developing when we feel them. They can start years earlier, stemming from various problems in the cornea, lens, or retina, from intraocular pressure, or from the tear mechanism. Therefore, the challenge today is not just to treat a specific complaint, but to understand and diagnose the eye as a complete system.
In many cases, the patient does not even know how to explain what has changed for them, says Dr. Yosef Duev, a senior ophthalmologist and surgeon, medical director at Dr. Linger Medical Centers in Jerusalem. He might say, for example, that he has a kind of 'curtain' in his vision, that he is blinded at night, or that he suddenly finds it hard to read. From this complaint, one must understand where the problem really lies. When the difficulty in vision is just the tip of the iceberg. Blurriness, glare, dryness, or difficulty reading might feel like a distinct and clear difficulty, but in ophthalmology, they can sometimes be a sign of a wide range of completely different conditions. For one patient, the source will be in the cornea, for another in the natural lens of the eye, for a third in the retina or intraocular pressure. Therefore, even someone who comes for an examination due to a desire to remove glasses or correct their vision needs a comprehensive diagnosis that looks at the entire eye and not just the number in the glasses. This approach allows for the timely identification of problems that have not yet turned into a real crisis.
The great advantage in our work is the ability to connect between different areas of expertise, emphasizes Dr. Duev. For example, in cataract surgery, we are not just talking about removing the cloudy lens. We are also talking about correcting vision, checking which lens will serve the patient in the best way, whether there is a cylinder that needs to be addressed, what the state of the cornea and retina is, and what their daily routine looks like, in order to understand which solution will truly lead to an improvement in quality of life after the surgery.
The leap in cataract treatment
Cataract surgeries have long since ceased to be just about replacing a cloudy lens. In the past, the main goal was to restore the patient to vision as normal as possible. Today, thanks to advanced intraocular lenses (premium lenses) and more accurate examinations, it is possible in many cases to plan the surgery as part of a broader and more tailored vision solution. Alongside regular lenses, there are now multifocal lenses that allow for vision correction for different ranges and toric lenses that also correct a cylinder. The meaning is that in suitable cases, it is possible to significantly reduce dependence on glasses after the surgery.
Once, the options in such a surgery were much more limited, says Dr. Duev. We could aim the lens for good vision for only one range, for far or for near. Today there are lenses that provide an answer for far, for computer work, for reading, and for a cylinder. The same concept is also relevant for people in their 40s and 50s, who do not suffer from cataracts but are starting to experience difficulty reading up close. In suitable cases, and after a careful examination, one can consider surgery to replace a clear lens - a procedure similar to cataract surgery called CLEAR LENS. According to Dr. Duev, the surgery usually lasts about 10-12 minutes, and many patients already arrive the next day at about 80 percent of the expected improvement.
Keratoconus: stop the problem before it progresses
In keratoconus, early diagnosis can change the course of the disease. It is a disease of the cornea that usually appears in adolescence or at a young age. In a normal state, the cornea has a relatively convex and regular shape. In keratoconus, it becomes thinner and gradually changes its shape, so that light rays do not refract in it in a regular way. The result can be blurred and smeared vision that is difficult to correct using regular glasses.
Keratoconus is a disease that is very important to diagnose in time, emphasizes Prof. Boris Knyazer, director of the Cornea and Corneal Transplantation Unit at Soroka Medical Center, and a senior surgeon at Dr. Linger Beer Sheva (Sheva Einayim). According to him, in some areas of the country, the disease is more common, among other things due to a combination of genetic tendency, allergies, and repeated eye rubbing. The main treatment intended to stop the progression of the disease is called cross-linking, or strengthening the cross-links in the cornea. During the treatment, vitamin B2 is dripped into the cornea and then it is exposed to ultraviolet light in a controlled dosage. The goal is not to eliminate the disease, but to stop it in time, emphasizes Prof. Knyazer. With appropriate treatment, and with avoidance of eye rubbing, stabilization rates can reach about 90 percent.
Keep what you can, treat what you need
Even when the corneal disease is already progressing, the goal is not necessarily to replace everything - but to preserve as much as possible of what is still healthy. In very advanced stages, when it is no longer possible to improve vision with the help of glasses, special contact lenses, or stabilizing treatments, a corneal transplant may be required. But even this field has undergone a significant change in recent years. Today, instead of replacing the entire cornea, it is possible in some cases to perform layered transplants that replace only the damaged layer and preserve healthy parts of the original cornea.
Technology is important, but it does not replace the patient's cooperation. Surgery is one stage in treatment, but definitely not the last one, clarifies Prof. Knyazer. After corneal surgery for example, there is huge importance to follow-up, to correct use of eye drops, to check-ups, and to the patient's cooperation. Medical success is almost always a result of joint work. Vision is something that deserves a broader look: modern ophthalmology does not settle for point correction of vision, but examines the source of the problem, the state of the entire eye, the patient's lifestyle, and the chance to prevent deterioration in the future.
