Anatomy
This looks a complicated drawing but basically, I address problems with the lens (which sits like a smartie just behind the coloured bit of the eye), the retina (which is the wallpaper that lines the eye wall) and the central part of the retina the Macula which is the only part of the eye we can see detail with.
The lens can become cloudy (Cataract), the retina can Detach and the macular can develop holes or wrinkles. The Jelly can become obscured by floaters which might be blood in diabetes or tears of the retina. Diabetes causes problems of leakage of the blood vessels seen on the retina and can block vessels resulting in new ones growing onto the retina and into the jelly. Trauma can interfere with any structure.
Some games to play to understand how the eye fools you!
The eye is incredible and fools us into thinking that we see clearly all over, in colour all over and as a single, uninterrupted view second to second.
In fact most of what we see is blurred, double, black and white and goes completely when we move our eyes! It is not surprising we can loose a lot of vision before we become aware of it and this is why it is important to see an optometrist regularly.
Blurred?
Just look at a clock, hopefully you can read it? Now look a little to the side and try to read the clock using your side vision. It is blurred. The only part of the retina that sees detail is right in the centre of the macula where there is a little dip called the Fovea. All the layers of the retina move out the way to allow the light direct access to the light sensitive cones. I will often show you a coloured scan of this part of the retina in consultation (OCT scan) to show you this dip or lack thereof! This is important for several reasons. If you have macular degeneration you loose this central part of the retina and the entire world becomes blurred. Because most of our world is blurred we can loose a lot of our peripheral vision before we become aware of it and this happens in retinal detachment.
Double?
Hold out a pencil in each hand, one closer to your face one further away. If you look at the front pencil the one behind goes double. If you close your right eye, the right pencil behind should disappear. Now look at the further pencil, the closer one now becomes double. Close your right eye again and this time the left pencil disappears! We learn to suppress (ignore) this double vision, the brain is very good at learning to ignore things.
Uninterrupted view?
Every time you move your eyes your brain shuts off vision briefly in order to stop the world smudging every time you move. Look into a mirror and then look from eye to eye. You never see your eye move! You went blind for a split second.
Below is a video clip of the jelly being removed from an eye. Have a look at the diagram above and see if you can match up some of the structures, especially the optic disc.
This looks a complicated drawing but basically, I address problems with the lens (which sits like a smartie just behind the coloured bit of the eye), the retina (which is the wallpaper that lines the eye wall) and the central part of the retina the Macula which is the only part of the eye we can see detail with.
The lens can become cloudy (Cataract), the retina can Detach and the macular can develop holes or wrinkles. The Jelly can become obscured by floaters which might be blood in diabetes or tears of the retina. Diabetes causes problems of leakage of the blood vessels seen on the retina and can block vessels resulting in new ones growing onto the retina and into the jelly. Trauma can interfere with any structure.
Some games to play to understand how the eye fools you!
The eye is incredible and fools us into thinking that we see clearly all over, in colour all over and as a single, uninterrupted view second to second.
In fact most of what we see is blurred, double, black and white and goes completely when we move our eyes! It is not surprising we can loose a lot of vision before we become aware of it and this is why it is important to see an optometrist regularly.
Blurred?
Just look at a clock, hopefully you can read it? Now look a little to the side and try to read the clock using your side vision. It is blurred. The only part of the retina that sees detail is right in the centre of the macula where there is a little dip called the Fovea. All the layers of the retina move out the way to allow the light direct access to the light sensitive cones. I will often show you a coloured scan of this part of the retina in consultation (OCT scan) to show you this dip or lack thereof! This is important for several reasons. If you have macular degeneration you loose this central part of the retina and the entire world becomes blurred. Because most of our world is blurred we can loose a lot of our peripheral vision before we become aware of it and this happens in retinal detachment.
Double?
Hold out a pencil in each hand, one closer to your face one further away. If you look at the front pencil the one behind goes double. If you close your right eye, the right pencil behind should disappear. Now look at the further pencil, the closer one now becomes double. Close your right eye again and this time the left pencil disappears! We learn to suppress (ignore) this double vision, the brain is very good at learning to ignore things.
Uninterrupted view?
Every time you move your eyes your brain shuts off vision briefly in order to stop the world smudging every time you move. Look into a mirror and then look from eye to eye. You never see your eye move! You went blind for a split second.
Below is a video clip of the jelly being removed from an eye. Have a look at the diagram above and see if you can match up some of the structures, especially the optic disc.
Vitrectomy (NOT Vasectomy!!)
We like to shorten everything and so Vitrectomy becomes 'Vity'. Vitrectomy means taking the Jelly (Vitreous) out of the eye. My daughter (10) gets the terms confused, I can assure you I will not! This is the basic technique I use before going on to do other things inside the eye. I have to get the jelly out to give me access to the retina to do other things like peeling membranes, fixing the retina etc.
In this clip you will see the jelly moving around as a whitish cloud in the beam of light from my light pipe on the right of the screen. I am sitting at the top of the eye and in my right hand is a light pipe and in my left is the cutter which looks silver and contains a tiny guillotine which cuts the jelly into tiny fragments 5000 times per minute and then sucks them away. You can just see the cutter as the silver tube on the left of the screen. In the background you can see the retina with its blood vessels and the optic nerve or optic disc, which is the white oval structure in the centre from which the blood vessels emerge. The optic disc is only 1.5mm across so that gives you an idea of how small all this is!
In this clip you will see the jelly moving around as a whitish cloud in the beam of light from my light pipe on the right of the screen. I am sitting at the top of the eye and in my right hand is a light pipe and in my left is the cutter which looks silver and contains a tiny guillotine which cuts the jelly into tiny fragments 5000 times per minute and then sucks them away. You can just see the cutter as the silver tube on the left of the screen. In the background you can see the retina with its blood vessels and the optic nerve or optic disc, which is the white oval structure in the centre from which the blood vessels emerge. The optic disc is only 1.5mm across so that gives you an idea of how small all this is!