Elshatory Retina Associates, PLLC

     Nerve impulses convey humans' special senses. Without nerve impulses, humans are unable to feel, taste, smell, hear or see.  These impulses depend on special proteins known as ion channels, that allow electrolytes like sodium, potassium, and chloride to pass across cell membranes.  In single cell organisms, like algae, some of these ion channels are light-sensitive (light-gated ion channels); meaning, light can activate the ion channel, and subsequently affect a downstream cellular process (like cellular motility).  These light-gated ion channels have been utilized extensively in the past two decades to study neural circuits.  This technique is referred to as optogenetics.  Earlier this week, researchers in Pittsburgh, Switzerland and France reported results of using optogenetics for the first time in humans. A microbial protein conferring light sensitivity onto retinal ganglion cells was expressed using  viral-based gene therapy deliver...

  A patient who was initially doing well after a recent cataract surgery, experienced a sudden worsening of vision. Their eye became red, and they developed severe pain.  The vision had worsened from 20/30 (two lines from 20/20) to counting fingers (only able to count fingers of the examiner presented one foot away from their face).  I examined the patient, who had severe inflammation in the eye, and I performed an ultrasound of the eye, which showed dense inflammation in the vitreous cavity.  Fig. 1.  Ultrasound image of the eye showing grainy white dense material consistent with infectious/inflammatory debris. Normally, the vitreous cavity is clear, allowing light to pass through largely unimpeded to the retina.  In this case, the vitreous inflammation was due to a severe infection following cataract surgery known as endophthalmitis.  I discussed the diagnosis with the patient, and recommended treatment in the office, where I would first anesthetize ...

       Much like a cast immobilizes a limb and helps it heal, during retinal surgery, your surgeon may use an analogous immobilization/healing aid.  Surgery on the retina that requires removal of the vitreous gel (called a vitrectomy) sometimes requires placing a vitreous substitute that exerts a force on the retina to flatten the retina.  While the vitreous can be replaced with saline in cases where no such force is necessary, many retinal conditions such as retinal detachments and macular holes, require placing a gas mixture or oil in the eye.  This gas or oil makes the vision blurry, because light does not pass through the gas and oil the same way it does through vitreous gel or saline.  A retina specialist has special lenses that aid in focusing an image of their patient’s retina (on the specialist’s retina!) to assess the retina’s appearance and positioning.  Much like a cast for a broken bone prevents one from using a limb, these vitreo...

     Central vision is critical for many daily activities ranging from reading to driving.  Clear vision requires light be focused on a transparent tissue in the back of the eye called the retina.   The retina has different regions, but the portion of the retina responsible for our central vision is known as the macula, and within the macula, the finest acuity is provided by a specialized portion known as the fovea.  The fovea is where light is focused in our eyes to allow us to see fine details in the world around us.  Diseases involving the fovea affect our ability to perform our day to day activities.  One such condition is macular hole formation.  Macular holes develop when the clear gel inside the eye (the vitreous) tugs abnormally on the retina. This tugging creates a hole.  In rare cases, macular holes can develop after injury to the eye. Most of the time, it occurs because some people are born with abnormal attachments between th...

  Age-related macular degeneration (AMD) is a common cause of vision loss in people 50 years and older.  The single-most important factor in this condition is age, and the longer we live, the more common this condition becomes. A lot of progress has been made in the last ten years in the treatment of AMD with more innovative alternatives in trial today that will decrease the burden of treatment and increase its effectiveness. Many people with dry macular degeneration do well and have little to no visual symptoms.  Such patients require observation alone, as they only possess early features of the condition known as drusen, which are a deposition of material (protein and lipids) under the retina. If these drusen are large enough or numerous enough, an over-the-counter vitamin containing zinc, copper, lutein, xeaxanthin, vitamin C and vitamin E has been found to reduce the risk of progression to more advanced stages of macular degeneration by 25%.     Image s...

    Diabetes is a condition that can affect vision. This has become a health epidemic due to the increasing number of people with this disease. The result of diabetic changes in the eye do not always cause a noticeable change in vision. Diabetes can lead to anything from a mild blur in one’s vision to severe loss of vision. Remarkably, one cannot rely on their vision as an accurate predictor of one’s disease severity, as blindness can quickly develop in someone with previously normal vision. The fact that symptoms can be so unreliable in diabetic eye disease is the reason it is so important everyone with diabetes be evaluated by an eye doctor at regular intervals. Fortunately, many of the changes that occur in diabetes can be reversed, and as treatment options continue to expand and improve; the extent to which vision loss is permanent or is irreversible from diabetes is decreasing. The instances in which diabetes changes are not reversible can be due to interruption of...