Eye

What is glaucoma?
 
Glaucoma is one of the leading causes of permanent blindness in the world. It effects over one hundred million people worldwide. Glaucoma takes away a victim's sight slowly but relentlessly, without any warning signs in most cases. Visual damage from glaucoma is irreversible and permanent. Blindness from glaucoma, however, can be prevented with proper preventative eye care. Glaucoma is a disease of the optic nerve, which is the nerve that connects your eye to your brain. This nerve transmits visual information from the eye to the brain, thereby allowing you to see. In most cases, glaucoma damage progresses very slowly, over a period of several years. However, sometimes this damage can progress more rapidly. As the damage to the nerve progresses, a person begins to lose vision. This loss of vision begins with the side, or peripheral, vision. This is vision that you may not be aware of, but that is very important in everyday activities such as walking and driving. The loss of this peripheral vision progresses as long as the disease is not treated. If treatment is not given, then the visual loss can progress until it begins to involve the central and reading vision. It is at this point that a victim of glaucoma may begin to notice trouble with their vision. If treatment is still not given, the vision in the eye can be lost. Visual loss from glaucoma is irreversible. Because vision loss from glaucoma can never be restored, it is critical to detect glaucoma before significant damage has occurred to the nerve. Proper treatment for glaucoma can be prevent further loss of vision.

What causes glaucoma?
High pressure inside the eye is known to cause glaucoma. The normal eye continuously produces and drains fluid internally in order to maintain the normal shape and pressure of the eye. This normal shape and pressure is necessary for you to see properly. In glaucoma, there may be a blockage of fluid drainage or an excess of fluid production, which leads to high pressure inside the eye. If you have high eye pressure, the increased pressure may damage your optic nerve. Some people, however, are able to tolerate high eye pressure without developing glaucoma. The reason for this is unknown. The Ocular Hypertension Treatment Study is currently underway to investigate whether all people with increased eye pressure need treatment to prevent glaucoma.

Some people develop glaucoma even without evidence of increased pressure inside the eye. In fact, recent studies show that up to 50% of people with glaucoma may not have high eye pressure measurements. For example, people of Japanese descent are more prone to have glaucoma without elevated eye pressure.

Many studies are in progress to discover the reason for glaucoma damage in people who do not have increased eye pressure. The two leading theories are that damage to the nerve is caused by poor circulation to the nerve, or that abnormally high concentrations of naturally occurring chemicals or hormones cause the damage.
Scientists who believe that poor circulation causes glaucoma have used special ultrasound testing to show decreased blood flow to the eyes of some people with glaucoma. Many of these people with "normal pressure" glaucoma also have other problem with their circulation, such as heart disease, poor circulation to their legs and feet, or hardening of the arteries.

Other scientists have shown increased concentrations of glutamate and other chemicals in the eyes of people with glaucoma. These chemicals are naturally produced by the body, and in normal amounts, help with normal eye functions. In abnormally high concentration, however, these naturally-occurring chemicals can actually harm the very nerve tissues from which they are produced. The scientists still have not discovered why the body produces abnormally high amounts of these chemicals in eyes with glaucoma.
Doctors and scientists are working to discover treatments to poor circulation to the optic nerve and treatments to decrease the concentration of these harmful hormones in the eye. Studies are under way to determine if improving circulation or decreasing the hormone concentration will help stop damage from glaucoma.

Who is at risk?
Glaucoma can strike people of any age, sex, and race. Certain individuals, however, are at increased risk. Those at increased risk include persons of African descent, those with a family history of glaucoma, and possibly those with nearsightedness or high blood pressure. The risk of glaucoma also increases as one gets older. The risk of glaucoma increases markedly in people of African descent over the age of 35 years, and in people of Caucasian descent over the age of 50 years. Other risk factors for glaucoma include diabetes and a history of trauma to the eye.

How is glaucoma diagnosed?
When the ophthalmologist examines your eye, he or she can detect glaucoma damage by the appearance of your optic nerve. A normal healthy nerve has a small cup-shaped hole in the center (see photo). As damage from glaucoma progresses, this hole in the center of the nerve enlarges, and replaces the healthy tissue of the nerve (see photo). Your eye doctor can detect progression of the disease by periodically examining the appearance of the nerve.Your doctor may also take photographs of the nerve in order to document the appearance at a specific point in time. This allows better comparison in the future to be certain that the disease has been stabilized. These photographs, called disc photos, are particularly helpful if your doctor believes that you are a "glaucoma suspect". A glaucoma suspect is a person whose optic nerve appearance is suspicious for glaucoma, but does not demonstrate definite glaucoma damage. If you are a glaucoma suspect, your doctor will want to examine your optic nerve two or there times a year, and compare to the baseline disc photos to detect definite glaucoma damage as soon as it occurs. This will allow your doctor to begin treatment before the glaucoma has a significant effect on your vision.

Another way to measure the amount of damage to the nerve is to measure the amount of peripheral or side vision that has been lost. Glaucoma does not effect your central reading vision until the late stages of the disease. At this late stage, vision may already be deteriorated to the point of partial blindness. Therefore, it is important to measure the peripheral vision in the early stages of the disease, so that proper treatment can be given to prevent blindness. This is accomplished with visual field testing (see photo), which is an examination that measures the amount of vision lost.
To test the visual field, your doctor uses an instrument that flashes lights of various intensities. You place your head against a head rest and stare at a target light directly in front of the eye being tested. The machine then flashes lights in your peripheral (side) vision. Some of these lights are bright and easy to see. Others are so dim that they are impossible to see even if you have no visual damage. Most lights are somewhere in between. When you see the light, you press a button and the machine registers your response. The machine then prints out a map showing any areas that you cannot see properly. Your eye doctor can repeat this measurement periodically to determine if the glaucoma treatment has been effective in stabilizing the damage.
There are other types of specialized testing that have recently become available, such as measurement of the thickness of the nerve with a technique called scanning laser polarimetry (GD Nerve Fiber Analyzer) (see photo), and short wavelength perimetry, which uses colored lights to test the visual field (peripheral vision). Both of these technologies are particularly helpful if a person is suspected of having glaucoma, but there is no definite damage visible (glaucoma suspect).

Are there different types of glaucoma?
The most common type of glaucoma is open angle glaucoma. Open angle means that there is no visible obstruction to the drainage area inside the eye. It is thought that there may be an invisible obstruction to fluid drainage in the trabecular meshwork, which is the structure in the eye that drains the fluid.
Another type of glaucoma is narrow angle glaucoma. In this condition, an obstruction to the drainage area inside the eye occurs. This type of glaucoma is most common in persons of Chinese descent and Vietnamese descent, and less common in persons of African and Caucasian descent. However, it can effect a person of any race. This type of glaucoma may cause symptoms of sudden pain, redness, blurred vision, and colored haloes around lights. This condition is called acute narrow angle glaucoma, and must be treated immediately. Failure to treat this condition immediately can cause permanent loss of vision. Sometimes narrow angle glaucoma is a chronic condition that does not cause any symptoms, like open angle glaucoma. Your doctor can determine if you are at risk of narrow angle glaucoma by performing a procedure called gonioscopy.

How is open angle glaucoma treated?
There are several ways to treat this problem. Most commonly, treatment begins with eye drops that are designed to lower the pressure in the eye. These drops are from once to four times daily, depending on the medication. These drops are designed to decrease the amount of fluid produced in the eye, or to increase the amount of fluid drained from the eye. There are also oral medications that are available to lower the eye pressure. Like all medications, these eye drops can have side effects. When treatment with eye drops is started, you should discuss with your doctor the potential side effects and interactions with other medication that you may be taking.

Another way of treating glaucoma is with a laser. This laser is designed to increase the amount of fluid drained from the eye, thereby lowering the pressure in the eye. The laser treatment is usually performed in the office, takes only a few minutes, and is normally painless. The third way to treat glaucoma is with microsurgery in the operating room. In this procedure, a small drainage hole is created in the eye, usually behind the eye in the eye socket. This drainage allows the eye pressure to be lowered, thereby preventing further damage from glaucoma.

Open angle glaucoma is generally a disease that stays with an affected person for life. Whether the treatment has been with medications, laser, or microsurgery, the victim of glaucoma must continue to be monitored by the ophthalmologist several times a year. Your doctor will monitor the eye pressure, the appearance of your optic nerve, and will periodically test the peripheral, or side, vision (visual field) to be certain that the disease has been stabilized, and that further loss of vision will not occur.

How is narrow angle glaucoma treated?
Your ophthalmologist will check to see if you have a narrow drainage area in your eye in order to know if you are at risk of developing narrow angle glaucoma. Your doctor will perform an examination known as gonioscopy to evaluate your risk. If you are at risk for narrow angle glaucoma, your ophthalmologist will recommend a preventive laser treatment. If you already have narrow angle glaucoma, this sometimes is cured with laser treatment. Sometimes narrow angle glaucoma is a chronic condition that is treated with the same medicines or microsurgery described above for open angle glaucoma.

How can I be sure that Glaucoma does not affect my vision?
The best way to prevent visual loss from glaucoma is through regular eye examinations by an ophthalmologist. Eye examinations are recommended for adults as follows: once yearly between the ages of 19-35, three times between the ages of 35-50, every two years between the ages of 50-65, and yearly thereafter. More frequent examinations are recommended if you have any problems with your vision or have a family history of glaucoma (every 1-2 years). More frequent examinations are also recommended if you have certain medical conditions, such as diabetes or high blood pressure. For children, routine yearly screening examinations by the pediatrician are usually sufficient, unless an eye appears abnormal, or the child has trouble seeing.

The IntraLase' FS60 Laser brings a new level of safety and assurance to vision correction surgery by providing an all-laser approach for optimal precision. Now, the accuracy of a computer-controlled laser may be used to create the corneal flap for LASIK, providing unprecedented control and the ability to customize the flap for each of our patients.

Traditionally, the creation of a corneal flap was performed with a mechanical, hand-held device (known as a microkeratome) which moved across the cornea to cut the flap.
 

Because many LASIK complications are attributed to the unpredictable performance of the microkeratome, the new IntraLASIK? all-laser surgical approach is being eagerly embraced across the US.  Now, the IntraLase FS laser is a safer, computer-controlled alternative to a mechanical microkeratome for creating corneal flaps in the LASIK procedure. Although mechanical microkeratomes are safe, they can cause complications in 1 in 2500 or 5000 cases. Using the IntraLase FS60 Laser takes LASIK safety to the next level by significantly reducing the chance for removing that rare complication.

LASIK using the IntraLase FS60 Laser is many times referred to as IntraLASIK. To make the corneal flap, the IntraLase FS60 Laser is focused into a tiny spot of energy that passes harmlessly through the outer layers of the cornea until reaching its exact focal point within the central layer of the cornea.  There, the corneal flap procedure is initiated, silently and painlessly, with remarkable precision.  The IntraLase FS60 Laser can also be used to create the channels and entry cuts for placement of Intacs.  Using the IntraLase FS60 Laser for this procedure assures that the two segments are placed at the exact same depth and removes the need for making the more surgically difficult mechanical channel.
Researchers are exploring the possibility of using the IntraLase FS Laser in other procedures, such as cornea transplants and glaucoma treatment.

Why we've invested in the IntraLase FS60 Laser:
•    IntraLASIK provides our patients with an extra margin of safety by eliminating potential complications from mechanical microkeratomes.
•    IntraLASIK allows us to perform LASIK on patients with thin corneas because we can make a more precise shallow flap, which allows us to correct higher levels of refractive error.
•    IntraLASIK provides both the patient and the surgeon with a higher level of confidence knowing the creation of the flap will be without complications. Patients and surgeons relax more during the procedure making it more enjoyable for all.
•    IntraLASIK makes laser vision correction an all laser procedure, which significantly adds to its precision and predictability.
•    IntraLASIK also creates better fitting flaps.  Once put back in place, these flaps form a tight seal, making flap dislocation after the procedure more difficult.
•    The corneal flap procedure with IntraLASIK, using the IntraLase FS60 Laser is painless and more comfortable as there is much less pressure placed on the cornea with the laser vs the mechanical microkeratome.

The Femtosecond Laser
Whereas traditional LASIK uses a microkera-tome (micro-blade) to cut the corneal flap, IntraLase produces the flap by using a laser. By replacing the mechanical microkeratome with a femto-second laser, IntraLase makes it possible to perform a complete LASIK treatment without using hand-held mechanical devices.

In 2001, the IntraLase FS femtosecond laser used by us was the only laser of its kind to be FDA approved by the American Food and Drug Administration. There have been over 200 000 successful IntraLase procedures performed in the United States.

What is a Femtosecond Laser?
A femtosecond laser is an infrared laser that can treat tissue very precisely with significantly less heat created than other laser treatments ? a big advantage in eye laser surgery. Femtosecond lasers work with ultra-short impulses of light (10-15 seconds) that last only a quadrillionth of a second to create a spot as tiny as 1/100mm. To illustrate the extremely short pulse time: Light travels 7.5 times around the earth in one second, however, only one half of the thickness of a hair in a femtosecond!

What does the patient feel?
•    Treatment is under topical anesthetic (drops)
•    Preparation of the flap is completely free of pain
•    Patient can't see the laser beam
•    Procedure lasts 40-50 seconds per eye
How IntraLase works:
Traditional LASIK uses a microkeratome (micro-blade) in the first step to cut the corneal flap that is opened up to expose the deeper underlying corneal tissue that is then treated in a second step by an excimer laser. The flap is then laid back in place and protects the area where corneal tissue was removed.

IntraLase prepares the corneal flap with a laser rather than a mechanical keratome. Contrary to traditional lasers, the energy of the laser beam from a femtosecond laser doesn't affect the tissue on the surface of the cornea, but rather reaches a specific predetermined depth inside the cornea. Very high energy levels can be achieved through intense focusing of the laser beam. The point of focus of the laser beam allows material to be divided at the molecular level such that tissue is gently separated. The surrounding corneal tissue remains undisturbed without damage.
The femtosecond laser scans the cornea starting at one edge and works its way towards the other side (Fig. 3a). The laser beam produces a layer of tiny bubbles in exactly the desired depth location of the cornea. This enables the corneal flap to be opened and lifted to the side like in traditional LASIK. The final treatment with and excimer laser is then identical to traditional LASIK (Fig.3c).

Application of the Femtosecond Laser:
•    LASIK surgeries: For patients with thinner corneas or a higher nearsightedness or farsightedness
•    Diseases such as opacities in the cornea or warping of the cornea
•    Reliable and gentle preparations of corneal flaps for LASIK treatments

What are the advantages of IntraLase with respect to traditional LASIK?

Precision of the Flap Thickness
The femtosecond laser is able to produce a much more reliable and precise corneal flap than a microkeratome. A femtosecond laser can create a flap within 10µm of the desired thickness whereas the traditional keratome is only accurate within 20-40µm. IntraLase offers more security to its patients even though side effects are very rare when using a microkeratome (1:1000).

High Nearsightedness, Thin Cornea
IntraLase offers the opportunity to treat patients with a very thin cornea or a very high nearsightedness who previously weren't candidates with a microkeratome. The precision of IntraLase allows a thinner flap to be created such that more underlying tissue remains available to treat higher amounts of nearsightedness.

CATARACT is the opacification of the natural lens. Because cataract is the most commonly performed operation in our hospital we have the principle of providing all the recent advances in the diagnosis and treatment of this disorder. Professor Mahmut Kaskaloglu is one of the most respected eye surgeons in Turkey and he performs all of the cataract operations in our hospital. Professor Kaskaloglu is a member of the American Academy of Ophthalmology, American Society of Cataract and Refractive Surgery, International Society Refractive Surgery, European Society of Cataract and Refractive Surgery. He teaches cataract surgery in courses and live surgery sessions all over Europe and Middle East. 25 years experience and the latest technology at our disposal explain the high success rate in our hospital. After the diagnosis is made the patient is examined by two state of the art systems. ZEISS IOLMASTER calculates the power of the intraocular lens to be implanted and ORBSCAN measures the corneal surface and thickness so that we can correct any preexisting astigmatism.
 
Technically the operation is called "Phacoemulsification with intraocular lens implantation."

On the day of the surgery after being evaluated by the anesthetist, drops are instilled to widen the pupil. Operation is done under topical anesthesia, which means "ONLY DROPS, NO INJECTION". We use sound wave energy to remove the cataract through a very small incision, which means "NO STITCH". Average duration of the surgery is less than 10 minutes. The patient can go home after the operation.

Following routine eye examination we evaluate the cornea with Orbscan which scans the cornea for detailed topography. This way we can prescribe the correct contact lens for the individual. We stock most standard contact lenses. Other lenses as well as cosmetic and fun lenses are delivered in a few days. Take advantage of our competitive prices. Ask your doctor about free trial lenses. We can provide you with free samples of major brand disposable lenses. Over age 40? Need reading glasses? CibaVision Progressive disposable contact lenses provide an excellent solution for the young reading glass user. These contact lenses will change the quality of your life. Ask for a free pair.
 

What are contact lenses?
Contact lenses are thin, curved plastic disks designed to cover the cornea, the clear front covering of the eye. Contacts cling to the film of tears over the cornea because of surface tension, the same force that causes a drop of water to cling to the side of a glass.

Contact lenses are used to correct the same conditions that eyeglasses correct:
•    Myopia (nearsightedness)
•    Hyperopia (farsightedness)
•    Astigmatism (distorted vision)
•    Presbyopia (trouble reading with age)
Special tinted contacts can be used to change the color of the eyes to various degrees. Contact lenses are sometimes used therapeutically in eye diseases where an uneven cornea blurs vision, such as keratoconus or scarring. They are also sometimes used for corneal abrasions to assist in healing.

What types of contact lenses are available?

PMMA lenses
Rigid contacts were the first lenses; they were developed in the 1960's. They are made of a type of plastic called PMMA, which is very durable, but does not allow oxygen in the air to directly reach the cornea. When the eye blinks, the lens moves, which allows the oxygen dissolved in the tears to reach the cornea. While rigid lenses are probably the least comfortable type of contacts to wear, some users prefer them for their durability and lower cost.

Gas-permeable lenses
Newer rigid lenses made of plastic combined with other materials, such as silicone and fluoropolymers, allow oxygen in the air to pass directly through the lens. They are called gas permeable. Gas-permeable lenses are less durable than conventional rigid lenses but are more comfortable. Some gas-permeable lenses are extended wear and may be worn overnight for up to seven days.

Soft contact lenses
These lenses are made of plastic materials that incorporate water. The water makes them soft and flexible, as well as allowing oxygen to reach the cornea. Most of the contact lens wearers use soft contact lenses. Some soft contact lenses are extended-wear lenses, which means they are designed to be left in the eye overnight. It is recommended that extended-wear lenses be removed weekly, at a minimum, for thorough cleaning and disinfection. Some contact lenses are approved for wear up to 30 days. Soft daily wear lenses should never be used as extended-wear lenses. Extended-wear lenses can be used as daily-wear lenses. Studies have shown increased risk of corneal infections associated with extended wear contact lens use.

Disposable soft contact lenses
Disposable lenses for daily or extended wear have recently become available. The lenses are discarded and replaced each week. These lenses are convenient and may reduce the chance of allergic reaction and deposit formation.
Toric contact lenses Toric lenses correct moderate astigmatism. They are available in both rigid and soft materials.

Bifocal contact lenses
These lenses correct both reading and distance vision. They can eliminate the need for reading glasses.

What does the price include?
When comparing the price of contact lenses, it's important to consider what services are included. Does the fitting include a thorough eye examination and follow-up? Can you exchange lenses during the initial fittinge? If you need treatment for an eye condition not directly related to the contact lenses, such as inflamed eyelids or dry eyes, there may be additional charges.

What are the risks of wearing contact lenses?
Rigid lenses that are not gas permeable are more likely to scratch the cornea if the lens does not fit properly of if the lens is worn while sleeping. They are also more likely to slide off the cornea and become hidden under the lid.

Rigid lenses traditionally had a reputation for "popping out" of the eye. New lens designs have minimized the chance of losing a contact even during vigorous exercise. Rigid gas-permeable lenses may allow more protein build-up than rigid non-gas-permeable lenses. Protein build-up results in discomfort, blurring and intolerance to the lenses. You will need special cleaning solutions to dissolve the protein.

Daily-wear lenses should never be worn as extended-wear lenses. Misuse can lead to temporary and even permanent damage to the cornea. People who wear any type of lens overnight have a greater chance of developing infections of the cornea. These infections are often due to poor cleaning and lens care.

What is the proper care of contact lenses?
Contact lenses must be properly cleaned and disinfected when you remove them to kill germs and prevent infection. At the time you insert your contact lenses, you should thoroughly rinse the case with warm water and allow it to dry. All contact lens cases need frequent cleaning, including disposable lens cases.

Soft extended-wear contacts are the most likely to have protein build-up and cause lens-related allergies. Soft daily-wear lenses are less likely to create problems. Rigid gas-permeable or disposable lenses may be good choices for someone with allergies.

Homemade saline solutions have been linked to serious eye infections and should never be used.
Any eye drops, even nonprescription ones, can interact with all types of contact lenses. Check with you ophthalmologist before you use any eye drops.

Who should not wear contact lenses?
Most people who need vision correction can wear contact lenses, but there are some exceptions.
Some of the conditions that might keep you from wearing contact lenses are:
•    Frequent eye infections
•    Severe allergies
•    Dry eyes (improper tear film)
•    A work environment that is very dusty or dirty
•    Inability to handle and care for the lenses properly

Retina & Diabetes Department:
In this department we diagnose and treat diabetic retinopathy and other retinal diseases. Main diagnostic device is digital fluorescein angiography and digital indocyanin green angiography. Major treatment device is the argon laser. With the digital angiography diagnosis fast and accurate and if indicated argon laser photocoagulation is performed without delay. A major breakthrough in the treatment of Macular degeneration is photodynamic therapy (PDT). This treatment is being applied in our clinic with success since May 2000.

Diabetic retinopathy:
Diabetic retinopathy is one of the most frequent causes of blindness in the world. However blindness caused by diabetes is preventable with proper control of diabetes and with yearly eye examinations through dilated pupils.
Diabetes causes a problem with the blood vessels in the body. The blood vessels begin to leak fluid, blood, and protein. In the eye, this leakage is seen in the retina as retinal bleeding and swelling. This blood and swelling interferes with the normal function of the eye, resulting in decreased vision. If this condition is not corrected, visual loss can be permanent. This type of retinopathy is called background, or non-proliferative, retinopathy.
Eventually, the abnormal blood vessels in the eye begin to grow. These abnormally growing blood vessels are very fragile, and especially prone to bleeding. These abnormal blood vessels may cause a large sudden hemorrhage, called a vitreous hemorrhage that can result in rapid complete loss of vision. Usually, this visual loss is not permanent, but vision may not return to normal after this hemorrhage. This type of retinopathy is called proliferative retinopathy.

The best treatment for diabetic retinopathy is PREVENTION. All diabetics should check their own blood sugar daily and record the results in a journal. This should be shown to the primary medical doctor at each follow-up visit so that tight control of blood sugar can be achieved. This means that all fasting blood sugar measurements should fall within a very narrow range. If your blood sugar tends to fluctuate a lot, your doctor must adjust your medications and your diet to optimize control of your diabetes. This is the best way to prevent blindness from diabetes. Diabetes can cause premature development of cataracts. A cataract is a clouding of the lens of the eye, which can cause blurred vision, glare, and difficulty focusing. The abnormal vessels in proliferative retinopathy are not limited to the retina of the eye. Sometimes, these abnormal blood vessels grow on the iris of the eye and cover the drainage angle. This blockage of the drainage angle results in accumulation of aqueous humor fluid in the eye, increased pressure in the eye, and, ultimately, in a type of glaucoma called neovascular glaucoma.

If prevention of diabetic retinopathy has failed, your ophthalmologist  can use a laser to cauterize the abnormal blood vessels to stop the leakage of fluid and blood. However, these problems will continue to recur as long as the diabetes is not medically controlled.

Macular degeneration:
Macular degeneration is often related to aging thus the term age-related macular degeneration. It is often abbreviated as AMD or ARMD. Most patients with AMD begin to notice problems sometime after age 50. Age-related macular degeneration (AMD) is the most common cause of legal blindness among people over age 60 in the Western world. Although 13 million Americans have some form of AMD (either the dry or wet form), abnormalities associated with wet AMD occur in approximately 8.5 million Americans over age 40. The cause of AMD is still unknown; however, researchers are exploring several theories as to how the disease develops. AMD is a challenging disease for both patient and doctor, because there are very few treatment options and no proven preventative therapy. Laser photocoagulation is the one treatment proven to be effective in clinical trials, but only a minority of patients with AMD are good candidates for treatment. Visudyne®, a photodynamic therapy or PDT, is a promising treatment that has recently received FDA approval in the United States. The treatment uses light-activated drugs to potentially halt or slow anormal cell growth.


Photodynamic Therapy :
Visudyne®, therapy, is a drug used in a platform technology called photodynamic therapy (PDT) , where light-activated drugs are used to treat a wide range of medical conditions. Any disease associated with rapidly growing tissue, including the formation of abnormal blood vessels, can potentially be treated with this technology. In addition to applications in cancer, photodynamic therapy has shown promise as a breakthrough treatment in ophthalmic, autoimmune (affecting the immune system) and cardiovascular diseases. How it Works Photodynamic therapy consists of a two-step process beginning with administration of the drug, or "photosensitizer," by intravenous injection. While circulating in the bloodstream, the drug attaches to molecules called lipoproteins. Because cells undergoing rapid proliferation (cell division and growth) require a greater amount of lipoproteins than non-dividing cells, the drug is delivered more quickly and in higher concentrations to these types of cells. Once the concentration of drug reaches appropriate levels in target cells, it is activated with a pre-calculated dose of light at a particular wavelength much less damaging than the current thermal or hot laser treatment which can leave permanent blind spots. The activated drug subsequently causes the conversion of normal oxygen found in tissue to a highly energized form called "singlet oxygen." The singlet oxygen, in turn, causes cell death by disrupting normal cellular functions. The therapeutic effect is not observed until drug and light are combined. Because the light is shone directly at the targeted tissue and the drug accumulates in these cells, it reduces damage to normal surrounding tissue, allowing for the treatment to be administered again as needed. Because photodynamic therapy is a minimally invasive procedure that can be performed on an out-patient basis, it appears to be a cost-effective alternative to other treatments. The type of light source used varies depending on the indication being treated. In ophthalmology, diode laser light is shone through the slit lamp of a microscope into the patient's eye.

Millions of people all over the world are enjoying life without dependence on glasses thanks to LASIK procedure. In the year 2001 1,600,000 LASIK procedures are performed in the US alone making it the most popular eye surgery. LASIK is to reshape the front surface of the cornea by excimer laser to correct refractive disorders.

Latest innovation in Lasik surgery 'Intralase FS-60" is installed. We will have the latest,improved model with a fast 60Hz rate.

Wavelight Allegretto Eye-Q System Laser has a very fast eye tracker system which ensures accurate positioning of the laser beam on the corneal surface thus enabling us to perform custom ablation, that is laser treatment tailored just for you to treat any aberrations of your eye.
Our Hospital is a member of the American Academy of Ophthalmology, American Society of Cataract and Refractive Surgery, International Society Refractive Surgery, European Society of Cataract and Refractive Surgery.

State of the art technology combined with the experience we have since 1992 explain the high patient satisfaction in our hospital. Another reason for our high success is the fact that our laser systems are maintained by the same engineer, prepared by same nurse and operated the same surgeon. No one else is allowed to touch our equipment.

Patients from all over Europe including England,Ireland, France, Norway, Denmark, Sweden, Holland,Belgium, France, Germany and Greece come to Izmir for Lasik treatment. We also have many patients from the American Community in Izmir. Our patients prefer to have Lasik in Izmir, Turkey because of the high quality of service we offer and the low price of Lasik in Turkey.
    
LASIK procedure: After routine eye examination the patient is examined by Orbscan corneal topographer. Only drops are used to anesthetize the eye and after lifting a very thin layer of cornea with the Hansatome, excimer laser is applied. The presence of high speed eye-tracker on our system ensures accurate treatment even if the patient moves the treated eye. Normally the patient can resume normal activity the next day.

LASIK FAQ:
What do I do on the day of the surgery? You will come to the clinic on the appointed time wearing casual clothes. Please do not use any perfume and remove any make-up. The procedure takes only a few minutes but plan your day so that you can spend 2-3 hours at the clinic.

Is LASIK painful?
We can say that the procedure is painless however some patients complain of brief sense of pressure. A few hours after the procedure there may be temporary stinging, burning and tearing. There may also be some pain. In that case you may take any painkiller.

When will my vision be normal?
Most patients will have very good vision next morning. However final healing will take a few months.

When can I go to work?
Depending on your occupation, you may start work in 1-2 days.

Will my health insurance or social security pay for the operation? Generally speaking they will not. However some insurance companies may pay for special cases.You should consult your health care company.

Will my eye be covered after the operation and will I use any medication?
After the operation we will give you protective glasses to be worn that night. You will be asked you use drops for one month.

What kind of disorders can be corrected by LASIK? We can correct nearsightedness, farsightedness and astigmatism.
When should I remove my contact lenses? You should remove soft lenses one week before and hard lenses 3 weeks before surgery.

Will I need glasses after LASIK?
Majority of the patients can function without spectacles. Patients over 40 may need reading glasses.

Can LASIK be performed on both eyes on the same session?
Yes, this is the standard procedure in our clinic.

What will the refractive power of my eye be after LASIK? LASIK is a major eye surgery. Because it is done in a very short time, without discomfort does not change this fact. We cannot guarantee any results. However we are going to do detailed examinations before the operation to achieve an optimum outcome for each patient. We are not going to operate on you if we do not believe that you will be satisfied after the operation. We have 10 years experience and several thousands of happy patients.

What are the risks of LASIK?
Although the risks are low there are many complications associated with LASIK. To name a few :infection,undercorrection. We have not had not even one case of infection however it is always a possibility. Our undercorrection rate is very low. This link will give you detailed list of side effects. We will tell you about these and other possible complications verbally and you will be asked to read and sign the consent form with details of the possible complications.