Contact Lenses

Can I use the daily disposable contact lenses more than once?

No, daily disposable contact lenses are designed for single use only.

Can my contact lens be “lost” behind my eye?

No, a thin, but strong, membrane, called the conjunctiva, lines the inside of your eyelids and curls back on itself to cover the white part of the eye. Lenses cannot pass through it. However, your contact lenses may slide under your eyelids or become displaced. If this occurs, try looking in the direction of the lens to get it to move back to the correct position. If you wear soft contact lenses, they will tend to center automatically on the cornea. If you wear rigid gas permeable lenses, you may need to manipulate a displaced lens through the eyelid.

Can I use other solution e.g. Saline solution apart from contact lens solution to clean and disinfect my contact lenses?

No, You can only use contact lens disinfecting solutions to clean and disinfect your contact lenses. Preserved saline can be used to rinse contact lenses but not as soaking and disinfecting solution.

Is it OK to swim while wearing contact lenses?

It is advised not to wear contact lenses while swimming. Exposing your contact lenses to pool water places you at risk of discomfort due to chlorine and infection from bacteria or other microorganisms which can be sight threatening.

Can I wear contact lenses while traveling by plane?

The low humidity in aircraft cabins contributes to dry eye symptoms and contact lens discomfort. It may help to put lubricating drops in your eyes before you enter the airplane or during flight. If symptoms persist or become severe, it is probably easiest and best to wear eyeglasses when flying.

I have reading difficulty , can I still wear contact lenses?

Presbyopia is a vision condition in which the eye cannot focus on near objects. In most cases, reading glasses or bifocal glasses are prescribed to correct presbyopia. But contact lenses can be prescribed also. Special multifocal contact lenses are available but vision may not be as optimal as eyeglasses. As an alternative, many practitioners prescribe monovision where one eye is fitted with a distance lens and the other with a reading lens. Monovision needs a period of adaption. Reading glasses can be worn over contact lenses for near task.

I wear contacts only occasionally, at most once or twice a week. Which type of contact lens may be best for me?

A soft lens is more appropriate for occasional wear. Often customers find daily lenses the most convenient – no solutions and cases to bother with. Comfort is better from the outset and adapting is easier.

Can I sleep in my contact lenses?

It depends on the type of lens you’re wearing, the composition of your tear film, your general eye health, and other factors.

RGP contact lenses and certain soft lenses can be slept in, but never wear them while sleeping unless your eye care practitioner says you can.

Who shall I see for contact lenses ?

Qualified and registered optometrists and some opticians who are licensed to fit contact lenses.

Can I change my eye colour with contact lenses ?

Yes, Colour Soft contact lenses are available that will change the colour of your eyes, even if you don’t require vision correction. Costume lenses for theatrical purposes are also available.

All colour contacts lenses are prescribed medical devices that must be fitted and followed up by your eye care professional. Never share colour contact lenses with anyone. Sharing lenses can lead to serious eye infection and vision impairment.

Are contact lenses hard to take care of?

It differs from lens to lens:

RGP contacts, which last for more than one year, need daily cleaning and disinfecting.
Daily disposable soft lenses are worn once, then discarded, with no maintenance required.
Other disposable soft lenses are usually cleaned at the end of the day, then soaked in disinfecting solution until they’re worn again, and may be replaced weekly, bi-weekly, or monthly.
Soft lenses that are replaced quarterly or annually might require weekly enzyming in additional to daily care.

If I have astigmatism, can I wear contact lenses?

es. Contact lenses for astigmatism are called toric lenses, and they come in both soft and RGP contact lens materials. There are custom made soft toric contact lenses which can correct astigmatism as high as 6.00D. Low astigmatism can be corrected using spherical RGP contact lenses.

Can contact lenses slow or control short sightedness?

It has been shown that RGP contact lenses, may slow the progression of short sightedness (myopia). Myopia control is one reason why RGP contacts are an excellent choice for many school-aged children and teens. There is still on going research in this area.

Are contact lenses better for sporting activities?

Yes, contact lenses are the best vision correction option for sports. They can enhance visual skills like depth perception, peripheral awareness, and eye-hand/eye-foot coordination.

Contacts lenses offer a competitive advantage because they stay in place under dynamic conditions, provide a wider vision field, and eliminate the risk of glasses-related injuries. Contact lenses also make it easy to wear protective goggles.

Can contact lenses be used by children and infants ?

Yes, contact lenses have frequently been used in premature infants, who sometimes have vision problems. With proper care and lens maintenance, infants, young children, teens, and adults of all ages can wear contacts successfully.

Are contact lenses good for my eyes? Can they damage my cornea?

Contact lenses have proven to be a healthy vision correction for millions of people. But only your eye care professional can determine if they are healthy for you.

If you follow all prescribed steps for inserting, removing, and caring for them, contact lenses will continue to be safe and effective. You also need to see your eye care professional regularly to ensure long-term corneal health.

Diabetic Retinopathy

What are the treatment options available to treat diabetic retinopathy?

Laser photocoagulation treatment is given to eyes with severe stage of diabetic retinopathy, as well as to macula oedema. Another treatment option for macula oedema is by giving injection of drug into the eye cavity. If you develop bleeding into the eye cavity, or retinal detachment from diabetic retinopathy (advance stage), you will require to undergo a procedure called vitrectomy surgery.

What are the different types of diabetic retinopathy?

Diabetic retinopathy is classified as either non-proliferative diabetic retinopathy (NPDR) or proliferative diabetic retinopathy (PDR). NPDR, is an early stage where tiny blood vessels in the retina leak blood or fluid. Vision is still good at this stage. However, vision is affected when there is leakage involving the macula (macula oedema). PDR is present when abnormal vessels grow on the surface of the retina. This is due to insufficient blood flow to the retina, as a result of significant damage to retinal blood vessels. This new growth can cause scar tissue development or retinal detachment, which can lead to vision loss.

Is diabetic retinopathy curable?

No. Early detection and treatment can slow the progression of diabetic retinopathy, but is not likely to reverse any vision loss. Hence, it is important to treat diabetic retinopathy at the stage where your vision is still good.

What should I do to protect my eyes from diabetic retinopathy?

You should ensure good diabetes control at all times, as well as blood pressure control if you have concomitant high blood pressure. You should have a comprehensive dilated eye examination at least once a year so that treatment can be given as soon as possible. Those with proliferative retinopathy can reduce their risk of blindness by 95 percent with timely treatment and appropriate follow-up care.

Which doctor should I see if I have diabetes?

Besides your regular doctor treating your diabetes, you should see an ophthalmologist (eye specialist) regularly for a thorough eye examination to detect development of diabetic retinopathy.

Do I know if I have diabetic retinopathy?

In the early stages, you do not know as your vision is still good. But over time, diabetic retinopathy can get worse and cause vision loss.

Who is at risk of developing diabetic retinopathy?

All diabetics are at risk of developing diabetic retinopathy, especially those with poorly controlled diabetes, and duration of diabetes of 5 years and above.

What is diabetic retinopathy?

Diabetic retinopathy is a condition in which high blood sugar levels damage the blood vessels of the retina. It usually affects both eyes.

Dry Eye

Please give 5 complications that could happen if one does not seek an early treatment.

a. Complications due to inappropriate self medication (usually with steroid drops) resulting in cataract and glaucoma
b. Persistent corneal epithelial defect- pain and discomfort
c. Corneal ulcer (infection)- potentially blinding condition
d. Blurred vision due to corneal damage
e. Changes in refractive error e.g. astigmatism from persistent eye rubbing

Do you get a lot of patients visiting you for dry eye symptoms? If yes, why do you think so and is it necessary? If no, what could be the hindrance and what could be done to encourage the patient to seek an early treatment?

A significant proportion of patients have dry eye symptoms. Most of these patients have tried over the counter eye drops to no improvement. A large proportion has other eye conditions e.g. blepharitis, meibomian gland dysfunction etc which should be treated in order for the dry eye symptoms to improve. If treated appropriately, symptoms will improve in most patients.

Which treatment option is the preferred choice now? Why is it so?

Depending on the severity, causes and types of dry eyes. Consult eye specialist (ophthalmologist) if symptoms of dry eye persist.

Please share with us on the treatment options for dry eye

a. Over the counter medication
1. Tear supplements/ lubrication
Types
Preservative or Preservative free (preservative free better but more expensive)
Viscosity (more viscous for more severe dry eyes)
Different components
2. Gel tears
3. Ointment
b. Prescribed medication
1. Steroids drops (use with care as this can cause cataract and glaucoma with long term)
2. Cyclosporine drops- added advantage of increasing tears production
3. Antibiotics- to improve meibomian gland function and reduce bacterial load on the eyelids
Antibiotic drops
Oral antibiotics e.g. doxycycline, erythromycin
c. Surgery
1. Punctal occlusion – only in severe dry eyes
Temporary occlusion with silicone plugs
Permanent occlusion
d. Others
1. Taping eye lids shut when sleeping in those who sleep with eyes partially exposed due to incomplete lid closure
2. Avoiding dry conditions e.g. airconditioned room etc

What about medicine? Is there any drug that could increase the chances of having dry eye symptoms?

a. Any medication that is diuretic in nature can cause dry eyes
Alcohol ! (often used as a drug!)
Diuretics e.g. some hypertension medication
Angiotension converting enzyme inhibitors (hypertensive medication)
b. Anti histamines and decongestants
c. Sleeping pills
d. Birth control pills
e. Certain anti depressants
f. Opiate based analgesics e.g. morphine

Is there any link between the incidence of dry eye and pre-existing medical conditions eg hypertension, diabetes, etc?

a. A few medical conditions that increase the incidence of dry eyes are
Autoimmune diseases e.g. rheumatoid arthritis, Sjogren syndrome
Post menopause
Steven Johnson syndrome
b. Certain eye diseases
Allergic eye disease
Blepharitis
Post viral conjunctivitis
Post refractive surgery

Please share more on the group who are at higher risk of getting dry eye

a. People over age 50-
reduction in tears production, decreasing tear quality,
Corneal damage
b. Women approaching menopause
Hormonal changes. Reduction in tear production. Imbalance of the components in tears. Tears has 3 basic components
Lipid (oil) component (outer layer)- secreted by meibomian glands found in the lid margin. Contains fatty acids. Function by smoothening the tear film and preventing excessive evaporation of the watery layer.
Watery component (middle layer)- secreted by tear glands. Contains mostly water and a bit of electrolytes. Function by cleansing the eyes and washes away foreign bodies and irritants.
Mucus component (inner layer) – secreted by mucus cells on the conjunctival surface. Acts by attracting (holding on to the water layer). Also protects the surface of the cornea from damage.
c. People working in front of computers for long hours
When we concentrate (whether reading or computer activity), the blink rate is reduced. A normal blink rate is between 6-8 times a minute. It has been documented that when concentrating in near vision activity (e.g. reading, computer) the blink rate may be reduced to less than 1 per minute. This in effect causes the eyes to dry out resulting in ocular discomfort.
d. Travellers
Eyes dry out easily during in-flight because the in flight air is particularly dry. For people with dry eyes they should carry with them artificial tears.
e. People with degenerative diseases eg, ankylosing spondilytis, arthritis, Sjogren’s syndrome, etc
People suffering autoimmune disease such as rheumatoid arthritis, Sjogren syndrome has dry eyes that may be severe. These autoimmune disease affects the mucus membrane of the eyes as well as the tear producing glands resulting in some cases severe dry eyes. If normal tears supplement is insufficient they may require additional anti-inflammaroty treatment such as cyclosporine eye drops and surgical treatment such as occlusion of the punctum drainage ducts.
f. Contact lens wearers
Regular contact lens wearer complains of frequent dry eyes. Contact lens affects the tear film of the eye as well as reducing the oxygen availability to the cornea. This often results in micro breaks on the surface of the cornea resulting in discomfort and sensation of dryness. Tear supplements should be used if wearers have any discomfort. The tears supplement should be preservative free if used in conjunction with contact lens. However if the discomfort persists, contact lens used should be discontinued and patient should seek medical advice.
Patient may also consider contact lens made of newer material (silicone hydrogel) which allows higher oxygen permeability. This results in better comfort and less dry eyes symptoms.

What are the common symptoms of dry eye?

Gritty sensation
Foreign body sensation
Mucus discharge in the morning
‘watery eye’- this is due to reflex tearing as a result of ocular surface discomfort
Eyebags

Will my crows feet disappear with removal of eyebags?

No. you will need botox for the crows feet.

When can i get back to work?

One will have to take leave for about one week depending on the extent of the swelling.

How long is the surgery?

About an hour each for both the upper and lower lids.

Will there be scaring after eyebag removal?

Most often the healing is good unless one is prone to keloid formation.

Glaucoma

If I am already blind from glaucoma, can surgery still help me?

NO, once you are blind from glaucoma, it is irreversible, surgery will not help at this stage.

What are the types of surgery that can be done to prevent progression of glaucoma?

Surgery can be done to create new channel for the fluid to come out of the eye. The aim of the surgery is to lower the eye pressure to preserve vision and not improve vision. The most common surgery done is called trabeculectomy where a new channel is created in the wall of the eye to allow fluid to flow out. Another surgery is called implantation of glaucoma drainage device where a silicone tube is inserted into the anterior chamber to drain fluid out onto a plate. If surgery is successful, you may not require eyedrops anymore or require less eyedrops. However you will still need to return for regular follow up.

What are the types of laser that can be used to treat glaucoma?

For angle closure, the treatment is called a laser iridotomy, ie using a laser to puncture a hole in the iris to relieve pupillary block. For open angles another type of laser called trabeculoplasty can be use to increase outflow through the trabecular meshwork. For late stage glaucoma laser can be used to ablate ciliary processes that produce aqueous and this is called cyclophotocoagulation.

What if the eyedrops I am using cannot control my glaucoma?

Your eye specialist will advice you regarding the need for further treatment such as laser or surgery to lower your intraocular pressure to prevent further deterioration.

How is glaucoma treated?

Most of the time the treatment is using eyedrops to lower the intraocular pressure. However, in a certain type of glaucoma, called primary angle closure, the definitive treatment is by laser. Treatment and follow up is life-long.

How is glaucoma diagnosed?

By examination of your eyes by an eye specialist. The doctor will check your vision, measure your intraocular pressure, assess your anterior chamber angle and optic disc. If necessary he will need to order special test such as Visual field test and Optical Coherent Tomogram (OCT) of your optic discs.

Can stress, excessive crying, lack of sleep make my glaucoma worse?

NO.

What are the activities that I cannot do if I am diagnosed to have glaucoma?

There are no restrictions to food or activity. You should stop smoking as it would make your glaucoma worse. Make sure you put your eyedrops regularly as instructed by your doctor. It is not advisable to wear tight neck ties for long hours and to put your head down below your waist for long durations (such as doing head-stand).

Is there a cure for glaucoma?

There is no definite cure but blindness is preventable if detected early. Follow up is life-long even after laser or surgery has been done.

What can I do to prevent glaucoma?

Nothing. There are no preventive measures for glaucoma other then early detection by screening.

How do I know if I have glaucoma?

Majority of patients who have glaucoma do not have any symptoms. The best way for early detection of glaucoma is for an eye specialist to check your eyes (screening test).

Glaucoma Eye Drops

When my eyes feel dry, can I take more of my glaucoma drops?

No, you should not. In many instances, the glaucoma drops themselves have a side effect of causing dry eyes. Increasing their use would not only exacerbate the dryness but also not follow the prescribed dosing interval.

I experience redness in the eye after instilling my glaucoma eye drops, should I stop?

Some glaucoma drops may cause stinging, burning, and redness in the eyes, especially initially, when you first started. The symptoms should be better in within weeks. However, if they become intolerable, tell your ophthalmologist/pharmacist, discuss about reducing the dose or a new drug may be possible.

Some people have no problems at all with glaucoma drops.

Glaucoma drops are so expensive. Can I take my drop every other day to save on the drops?

No. There are very specific scientific studies to determine the best times and how often medications should be administered. The labeling on your bottle as directed by your ophthalmologist/pharmacist should specifically be followed.

What happens if I forget to take my eye drops or miss a dose of my eye drop?

The purpose of the drops you take for glaucoma is to lower your eye pressure. Taking your eye drops consistently (compliance) reduces the likelihood of pressure fluctuation (diurnal variation). Inconsistent use of drops will vary the intraocular pressure (IOP) and has been scientifically proven to be detrimental to your glaucoma.

If you take a twice-daily drop, each drop works for twelve hours. If you take a once-daily drop, the medication works for approximately 24 hours. If you don’t take your medications, the pressure is not lowered. Therefore, in this period of time, your glaucoma could continue to slowly progress. Just as with high blood pressure, the glaucoma medication is critical regardless of whether you are experiencing symptoms. Preservation of sight is dependent upon maintaining a regular regimen of medication as prescribed by your doctor. While missing a single occasional dose will not cause you to go blind, you should make every attempt to get yourself into a routine of taking your drops every day at the same time. If you are traveling or are out for the evening, plan ahead.

Therefore, when you miss a morning dose of your medicine, take it later in the day when you remember. If you forget your evening dose, use it in the morning when you remember. Continue your regular dosing thereafter, even if it seems like you are doubling up within a few hours.

Again, let me emphasize that skipping even a few doses can greatly increase the risk of visual loss. If you are due for an appointment with your ophthalmologist, and have not been taking the medication regularly, it is essential that you inform your ophthalmologist. Otherwise, the doctor may increase the dosage, thereby precipitating unwelcome side-effects.

How should I use my glaucoma eyedrops properly?

If eyedrops have been prescribed for treating your glaucoma, you need to use them properly and as instructed by your eye care professional. Proper use of your glaucoma medication can improve the medicine’s effectiveness and reduce your risk of side effects. To properly apply your eyedrops, follow these steps:

First, wash your hands. Check the dropper tip to make sure it is not chipped or cracked. Avoid touching the dropper tip against your eye or anything else, avoid contaminating the bottle.
Hold the bottle upside down.
Tilt your head back.
Hold the bottle in one hand and place it as close as possible to the eye.
With the other hand, pull down your lower eyelid. This forms a pocket.
Place one drop into the lower eyelid pocket. If you are using more than one eyedrop, be sure to wait at least five to ten minutes before applying the second eyedrop.
Close your eye OR press the tear duct lightly with your finger for at least one minute. Either of these steps keeps the drops in the eye and helps prevent the drops from draining into the tear duct, which can increase your risk of side effects.
Wipe away any excess liquid from your face with a tissue, helps to avoid irritation to your skin.
Oculoplastics

What is the cost of prosthesis?

It will cost about RM 1500 to 2000. This comes as a package. It includes a couple of visits for impression and complete fitting of the prosthesis.

Will the prosthesis move along with eye movement?

There will be limitation of movement unless it is pegged.

When can I get prosthesis after removing my eye?

A temporary prosthesis called conformor will be placed immediately after surgery. Permanent prosthesis will be fitted about 6 to 8 weeks after surgery.

Once my eye is removed will it shrink?

Yes, it will become phthysical [shrink]. In order to prevent this, an orbital implant is placed in the socket to maintain the volume in the socket. There are several types of implants. You should discuss this with your ophthalmologist.

Can I have normal thyroid hormones with all my eye signs?

Yes, you can. However you need to follow up with the ophthalmologist or endocrinologist on a long term basis. The reason is the hormonal levels can become abnormal after your eye symptoms have resolved.

Can Graves’ disease cause blindness?

Yes it can, by damaging the cornea or the optic nerve. But in present time with appropriate diagnosis, investigations and treatment, this rarely happens.

Does it affect both eyes?

It is very common for one eye to be affected although the most common cause of bilateral protrusion of both eyes is due to thyroid eye disease.

When can I use my contact lenses?

Yes, a week after surgery.

How much time do I need to be away from work?

The bruising and swelling will settle within one to two weeks. It will take about one month for full recovery. Most patients resume work within one to two weeks.

Will the scars be visible following blepharoplasty or ptosis correction?

The incision for the above procedure is done on the skin crease or eyelid folds. They will be hardly visible. Vitamin E oil can be used to reduce the scaring.

Will the surgery be painful?

A local anaesthetic will be injected into the eyelids to make one, free of pain during the procedure .After the surgery there will be mild pain which is relieved with pain killers like paracetamol on the day of the surgery.

Who is an oculoplastic surgeon?

They are eye specialists who are specialized in performing eyelid and facial plastic surgery around the eyelids. This involves correction of eyelid malpositions, re-construction following removal of eyelid tumours, cosmetic surgeries of the eyelids such as removal of eye bags and fat, drooping of the lids and brow and removal of lesions around the lids. They also perform surgeries and treat diseases related to the lacrimal system, socket and orbit.

Pattern-Scanning (PASCAL) Retinal Laser

What are the clinical indications for PASCAL?

The PASCAL Retinal Photocoagulator is best used for treatment of ocular pathology and for use in the photocoagulation of both posterior and anterior segments including:

Retinal photocoagulation, pan retinal, focal and grid photocoagulation for vascular and structural abnormalities of the retina, and choroid including:
Proliferative and non proliferative diabetic retinopathy
Choroidal neovascularization
Branch and central retinal vein occlusion

How does PASCAL reduce patient discomfort?

Since each burn is rapidly delivered, and of shorter duration, the PASCAL Method can minimize choroidal heating, allowing the patient to better tolerate each treatment.

PASCAL has demonstrated a reduction in the duration of a typical session for proliferative diabetic retinopathy patients. The total number of required treatment sessions may also be significantly reduced.

What are the benefits of PASCAL Method?

The PASCAL photocoagulation method is consistent with standard protocols. Based on clinical testing, it also seems to offer significant doctor and patient benefits

Performance: Improved physician speed and efficiency. Reduced treatment time.
Enhanced Patient Comfort: A substantially more comfortable therapeutic experience, potentially leading to improved patient compliance.
Advanced Precision: Macular Grid treatment provides an improved margin of safety and dosimetry control when compared with single shot treatments. Unlike the irregular pattern placement obtained in single shot photocoagulation, PASCAL delivers more even pattern burns.
Ease of use: Accelerated learning curve.
Reproducibility: Predictable burn size with consistent patterns leading to more precise treatment comparisons and adherence to specifics treatment protocols.

What is pattern scanning?

By both scanning the laser spot placement and controlling laser light emission, the PASCAL photocoagulation method delivers a predetermined physician-selected pattern.

The aiming beam displays the pattern, enabling the physician to place it in more precise, personalized, safe, and comfortable locations.

How does the PASCAL Photocoagulation Method work?

PASCAL technology deploys a proprietary semi-automated pattern generation method using short laser pulse durations of typically 20 ms (five times shorter than conventional systems).

These laser pulses are delivered in a rapid pre-determined sequence resulting in precise even burn patterns as well as improved safety, patient comfort, and a significant reduction in treatment time when compared to single-shot photocoagulation. For maximum treatment efficiency, PASCAL photocoagulation offers four physician-selected pattern types.

What does PASCAL treat?

PASCAL Photocoagulation is used to treat a variety of retinal diseases such as diabetic retinopathy, age-related macular degeneration, and retinal vascular occlusive disease.

What is the PASCAL® Photocoagulator?

The PASCAL (Pattern Scan Laser) Photocoagulator is a fully integrated pattern scan laser photocoagulation system designed to treat diabetic retinopathy using a single shot or a predetermined pattern array of up to 25 spots.

This technology uses proprietary scanning patterns to permit rapid photocoagulation thus reducing burn session time, improving patient comfort as well as insuring excellent physician performance and efficiency.

Retinal Detachment

Will I regain my vision completely after retinal detachment repair?

Usually no. There is usually some irreversible damage done to the retina after retinal detachment. The exception will be someone with a very early retinal detachment that spares the centre of the retina ( ie, the macular). It is therefore paramount to repair retinal detachment as soon as possible.

Can I delay the repair of my retinal detachment to a later date?

No. Generally, retinal detachments should be repaired as soon as possible to minimize damage to the retina.

Stem Cells

Are there any research on the use of stem cells in eyes being conducted in Malaysia?

Yes. At UKM, we are conducting research on the use of adult stem cells in generating new human corneas as well as looking at regenerating retina and optic nerve. If you are thinking of donating any money towards this area of research, please contact Dr.Then Kong Yong at International Specialist Eye Centre.

What are the eye diseases that can be treated with stem cells?

The only proven eye condition that can be treated with corneal epithelial stem cell is a condition known as corneal epithelial stem cell deficiency. There are many researches going on at present looking into the use of stem cells to treat eye diseases. Diseases that can potentially be treated with stem cells include optic neuropathy, autoimmune diseases, age-related macular degeneration, retinal detachment, corneal dystrophies, multiple sclerosis and retinitis pigmentosa. These are under various stages of clinical trials at the moment.

Are stem cells found in eyes?

Adult stem cells have been found in cornea, conjunctiva and retina.

Where are stem cells found?

Stem cells are found in many parts of our body. One particular type of stem cell known as mesenchymal stem cell is found in placenta, bone marrow, fats and cornea. These stem cells have been shown to be capable of generating a whole range of cell types such as nerve, bone, cartilage, etc. Another type of stem cell known as haematopoetic stem cells that are found in bone marrow and cord blood have been use for many years to treat blood diseases.

What are the controversies surrounding the stem cells?

The use of fetal and embryonic stem cells is still controversial. Certain religious organisations oppose the use of fetal and embryonic stem cells. However, there are no controversies surrounding the use of adult stem cells, especially cells derived from your own.

What are the types of stem cells?

Stem cells can be divided into embryonic, fetal or adult stem cells. Embryonic stem cells are derived from embryos that are a few days old. Fetal stem cells are derived from aborted fetuses. Adult stem cells are derived from discarded placenta or at any stages after birth. Embryonic stem cells can be divided into almost all types of cells whereas adult stem cells have limitation as to what type of cell they can be divided to.

What are stem cells?

Stem cells are cells that are capable of dividing into its own or into another different cell type. Unlike cancer cells which divide uncontrollably, stem cells divide in a controlled manner.

Uveitis

How is uveitis treated?

Uveitis is a potentially serious problem that requires prompt and appropriately aggressive treatment. Late and under treatment often results in more and secondary problems including glaucoma (raised eye pressure), cataract (clouding of the internal lens), scarring and bleeding of the internal structures such as retina. For many, eye drops treatment is adequate; for some, local injections and oral medications is required. Unwanted side effects can usually be avoided when the correct medication,dose, regime and duration is implemented in the appropriate manner.

Are there different types of uveitis?

There are different types of uveitis depending on classifications: some distinguish different types according to the main area of inflammation in the eye eg. anterior uveitis (also known as iritis), some depending on the main structures that are involve eg. chorioretinitis (involving the choroid and retina) and some depending on the source of trigger eg. Syphilis.

How is uveitis diaqnosed?

The most important step is a careful and thorough history and complete eye examination by an eye specialist and preferably by one with a special interest in uveitis. In most cases this leads to a correct diagnosis and few if any test is required. Inexperience ophthalmologist usually request for multiple tests including brain scans and biopsies! This is often superfluous and sometimes creates more confusion rather than enlightens.

What causes uveitis?

This is essentially an altered response of the eye and immune system to an external trigger such as an infection resulting in inflammation. Some are due to viruses and some may be related to disease in other parts of the body such as arthritis and blood vessels. As such, uveitis is a heterogenous group of condition which manifest in varying forms of inflammation involving different parts of the eye.

What are the symptoms of uveitis?

Typical symptoms include blurring of vision with floaters, pain with light sensitivity and varying degrees of red eye. Not all of these may exist together and symptoms may vary in severity from person to person. It is essential for all patients to have a full ocular examination with full pupil dilation.

What is uveitis?

The eye is similar to a tennis ball with different layers of tissue surrounding a central gel-filled cavity. Uveitis involves inflammation of the central layers of the eye. Often there are adjacent inner or outer layers, as well as the central cavities of the eye which are also involved. These layers contain important structures in the eye, such as blood vessels that nourish the eye and ‘cameras’ that form images and these may be damaged in inflammation resulting in visual problems.