On Tuesday evening, April 29, the Navigating the Medical System presented an eye-opening virtual lecture hosted by Congregation Etz Chaim. Dr. Mel Breite, Founder and Director of the Navigating the Medical System Lecture Series, introduced the guest speaker, Sirikishan Shetty, MD, the director of New York Presbyterian Eye Center in Fresh Meadows, Queens.

Dr. Shetty shared an informative, clear lecture. He began with the anatomy of the eye. The dark center is the pupil, the surrounding colored area is the iris, the sclera is the white and the conjunctiva is the clear membrane. The retina is the lining of the eye, and it connects to the optic nerve, which connects to the brain.

He began with cataracts, which are a clouding of the natural lens inside the eye, and they are the leading cause of preventable blindness. One in six people has cataracts. The incidence increases as we age. It is hardly ever an emergency. It usually stays the same or gets worse with time. It can cause blurriness, or light sensitivity, or double vision, or it can cause someone to need to change his or her eyeglass prescription frequently. Cataracts do not cause tearing or flashing lights. If you experience fluctuation in vision, it is not from cataracts. Common types of cataracts include nuclear cataracts, which are progressive and slower. They cause yellowing in the center of the lens. The other type of cataracts is cortical cataracts. This type can progress quickly. It causes white wheel spokes and cloudiness from the outer part of the lens. People can experience multiple types of cataracts.

Dr. Shetty explained that treatment for cataracts is only necessary if they are causing vision problems. Treatment involves removing the clouded lens and replacing it with an artificial lens implant. The artificial lens implant is needed for focusing light. The surgery is done with ultrasound and a vacuum and it is done in an operating room setting. It takes around 15 to 29 minutes. It does not require a hospital admission and it does not require general anesthesia. The doctor administers some sedation and a numbing medicine to the eye. Usually, cataract surgery is done on one eye at a time. Recovery is pretty quick. Eye drops have to be used for a few weeks to help the healing process and to prevent infection. The intraocular lens implant is made of acrylic or plastic. It offers an added benefit in that it can correct near-sightedness or far-sightedness or astigmatism. The implant lasts a lifetime.

Next, Dr. Shetty spoke about glaucoma. Glaucoma is due to damage to the optic nerve, which causes progressive loss of peripheral vision. There is a loss of the field of vision and it is typically caused by high eye pressure. The key with this is to detect it early, because loss of vision from this cannot be restored.

Symptoms include blurry vision and reduced peripheral vision. Tests for glaucoma include checking eye pressure and checking the field of vision. When the eye is dilated, the doctor can check the optic nerve. Treatment is aimed at lowering eye pressure. Eye drops and laser treatments (or surgery) can be used to lower eye pressure. The goal with these treatments is to prevent further loss of vision.

Next, Dr. Shetty spoke about macular degeneration, which is damage to the central part of the retina. This is the leading cause of severe visual acuity in Americans over age 50. The dry type is retinal drying, and the wet type involves abnormal blood vessel growth behind the retina. Risk factors include age, being female and/or being Caucasian, family history, smoking, obesity, or cardiovascular disease. Symptoms include blurry vision, blind spots in vision, sudden worsening of vision, or distortion of vision where straight lines appear wavy. Treatment for dry AMD (age-related macular degeneration) is vitamins such as Ocuvite or Preservision. For wet AMD, there are good treatments with injections into the eyeball. This reduces abnormal blood vessels, fluid leakage, and bleeding. With this treatment, you can slow AMD and improve vision. The injections need to be administered every one to three months. Wet AMD may require a laser treatment, as well.

Following the lecture, there was a short Q&A session. Dr. Shetty shared that head trauma from an accident could cause vision damage. He shared that to prevent eye disease we should not smoke, we should wear UV sunglasses in the sun, and we should eat leafy green vegetables, which are good for the retina. We should also control our blood pressure, sugar levels, and cholesterol levels. Omega-3 fatty acid supplements can be helpful.

The community is grateful for this extremely informative lecture.

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