Ophthalmic Surgery

eye-exams-diagnostic-calgary-SAEC

Eye Exams

The Southern Alberta Eye Center includes some of the most advanced ophthalmic diagnostic technologies in Western Canada.

Prescribed diagnostic tests and examinations vary from patient to patient depending on your eye condition and recommended treatment. The Southern Alberta Eye Center is equipped for comprehensive screening for all major eye conditions and diseases including, but not limited to, retinal conditions, cataracts, glaucoma, strabismus, amblyopia, and ocular oncology.

For patients seeking eye exams, please note that eye exams are typically booked through referral from your optometrist or family physician. Given the range of specialization within the Southern Alberta Eye Center, the examinations and analysis conducted during eye exams and diagnostic tests will vary between physicians and practices.

If you are looking to book an eye exam, please directly contact the practices located within our facility.

Calgary Retina Consultants |403-286-6802 | calgaryretina.com

Mitchell Eye Centre|403-258-1773 | mitchelleyecentre.com

oncology-surgery-calgary-SAEC

Oncology

Ocular oncology is the branch of ophthalmology dealing with tumors relating to the eye and its surrounding structures.Eye cancer can affect all parts of the eye, including the globe (the eye itself), the eyelids, the orbit, as well as the conjunctiva (the membrane that covers the inside of the eyelids and the sclera).

Examples ofintra-ocular tumors include:

  • Choroidal Melanoma
  • Ciliary Body Melanoma
  • Iris Melanoma
  • Circumscribed Choroidal Hemangiomas
  • Choroidal Osteoma

Examples of eyelid tumors include:

  • Basal cell Carcinoma
  • Squamous Cell Carcinoma
  • Examples of orbital tumors include:
  • Cavernous Hemangioma
  • Dermoid Cyst
  • Sphenoid Wing Meningioma
  • Ocular Lymphoma

Examples of conjunctival tumors include:

  • Squamous Cell Carcinoma
  • Primary Acquired Melanosis
  • Conjunctival Melanoma

Treatment of eye cancer can include observation, radiation, laser, and surgical excision. Should you and your surgeon decide that surgery is the correct option, you will you will receive your pre-operative instructions from your surgeon’s office prior to your surgery at SAEC. These instructions include not eating or drinking after midnight the night before your procedure. You will be asked to arrive at SAEC at a specified time, which will allow time for you to have your eye dilated for the procedure, and to meet the anaesthesiologist working with your surgeon that day. Your surgeon, anaesthesiologist, and yourself will determine the type of sedation that is necessary. In the operating room, there will be two additional nurses there to assist you and your surgeon, and the length of your surgical procedure will be dependant on the specifics of your situation. After your procedure, a nurse will go through your postoperative instructions with you, and ensure that you have made arrangements to be transported home with your friend or family member.

oculoplastics-surgery-calgary-SAEC

Oculoplastics

Oculoplastics, or oculoplastic surgery involve a number of surgical procedures that involve the face, tear ducts, eyelids, and eye socket (orbit). Various oculoplastic surgical procedures performed at SAEC surgical include (but are not limited to):

  • Eye lid or brow ptosis (drooping) repair
  • Blepharoplasty (removal of excess skin and subcutaneous fat around the eyes)
  • Entropions and ectropions (in-turning and out-turning of the lower eyelids, respectively) repair
  • Face lift
  • Chalazions (styes) drainage
  • Nasolacrimal duct obstruction (blocked tear duct drainage system) repair
  • Mohs reconstruction (reconstruction of eyelid following removal of cancerous moles)
  • Eyelid reconstruction following traumatic facial injury

Prior to surgery, you will receive your pre-operative instructions from your surgeon’s office, and these typically include not eating or drinking after midnight the night before your procedure. You will be asked to arrive at SAEC at a specified time, which will allow time for you to have your eye dilated for the procedure, and to meet the anaesthesiologist working with your surgeon that day. Your surgeon, anaesthesiologist, and yourself will determine the type of sedation that is necessary; typically, most oculoplastic surgery is done with some intravenous sedation, and local anaestheticis used to numb the skin around the eye. In the operating room, there will be two additional nurses there to assist you and your surgeon, and you can expect the surgical procedure to take approximately 10 to 45 minutes. After your procedure, a nurse will go through your postoperative instructions with you, and ensure that you have made arrangements to be transported home with your friend or family member.

glaucoma-surgery-calgary-SAEC

Glaucoma Treatment

Glaucoma is a progressive eye disease of the optic nerve at the back of the eye. The optic nerve is what receives light impulses from the retina, transmits these signals to the brain, and results in what we know as vision. Glaucoma typically occurs when elevated intraocular pressure within the eye cause damage to the optic nerveresulting in loss of peripheral vision, and if not treated, total blindness. The optic nerve is very sensitive to high intraocular pressures within the eye because it contains delicate nerve fibers that are easily damaged. Less commonly, glaucoma can occur with normal intraocular pressures, as a result of inadequate blood flow to the optic nerve.

Normally, aqueous humour (the fluid in the front third of the eye) flows out of the eye through a mesh-like channel. If there is anything that disrupts the outflow of this fluid, then fluid builds up, raising the pressure in the eye (intraocular pressure), and results in glaucoma. Glaucoma occurs most commonly in adults over the age of 40; however, can also occur in all ages, including infants. Often times the direct cause of glaucoma is unknown, although age, family history, diabetes, and certain medications containing steroids increase a person’s risk of glaucoma.

Glaucoma initially does not cause any symptoms, and many people do not recognize any change in vision until loss of peripheral vision becomes profound. Often times glaucoma is diagnosed through regular dilated eye examination with an optometrist or ophthalmologist, who are trained to recognize initial warning signs that can only be seen during a dilated eye examination. Other testing to monitor and diagnose glaucoma includes photographs of the optic nerve and visual field testing.

Treatment for glaucoma typically involves the use of one or more eye drops and occasionally oral medications to control intraocular pressure. If management is not successful through the use of drops or medications alone, then surgical options are considered.

Some of the procedures performed at SAEC surgical to treat glaucoma include:

Trabeculectomy: where a new channel is created to drain aqueous fluid, thereby decreasing the intraocular pressure in the eye.

Ahmed Valve: where a medical shunt is implanted and redirects the flow of aqueous humour out through a small hub to a chamber in the valve, and subsequently out of the eye. Ahmed valves are permanent.

Prior to surgery, you will receive your pre-operative instructions from your surgeon’s office, and these typically include not eating or drinking after midnight the night before your procedure. You will be asked to arrive at SAEC at a specified time, which will allow time for you to have your eye dilated for the procedure, and to meet the anaesthesiologist working with your surgeon that day. Your surgeon, anaesthesiologist, and yourself will determine the type of sedation that is necessary. An injection to freeze the eye, or topical drops and gel are most commonly used to numb the eye. In the operating room, there will be two additional nurses there to assist you and your surgeon, and you can expect the surgical procedure to take approximately 20 to 60 minutes. After your procedure, a nurse will go through your postoperative instructions with you, and ensure that you have made arrangements to be transported home with your friend or family member. You can expect to have a patch and shield in place over the eye until your follow up appointment the next day.

retina-surgery-calgary-SAEC

Retina Surgery

The retina is a very thin tissue that lines the back of the eye, and is responsible for transforming light rays that enter the eye into the images we see. The large peripheral portions of the retina are responsible for side vision (peripheral vision), and the small central area known as the maculais responsible for clear central vision needed for reading or fine small work. As with the rest of the human body, the retina requires oxygen and nutrients and is supplied both through a network of small arteries, and is extremely sensitive to any changes in circulation.

A retinal detachment is when a part of the retina separates from the tissue at the back of the eye. A retinal detachment can be caused by a number of factors, most commonly a result of a tear or hole in the retina. These retinal holes and tears may occur when the gel that fills the posterior two-thirds of the eye(vitreous humour) pulls away from where it was attached to the retina (posterior vitreous detachment or PVD). Once there is a tear in the retina, the vitreous gel can pass through the tear and build up underneath the retinal membrane; this build up of fluid under the retina weakens the membrane, and is what detaches the retina from the back of the eye. The severity, or extent, of the retinal detachment depends on the amount of fluid collects under the retina, and as fluid builds up behind the retina, more of the retinal membrane can become detached.

Symptoms of a retinal detachment can include sudden:

  • Flashes (flashing or cascading lights)
  • Floaters (dark spots or stringy-strands)
  • A shadow, curtain, or veil that covers part or all of the vision

Flashes of light occur when the vitreous gel tugs on the retinal membrane, and floaters are a result of small spots of vitreous gel that has clumped together. A shadow, curtain, or veil occurs as a result of the actual separation of the retina from the back of the eye. These symptoms warrant urgent consultation and examination by an ophthalmologist.It is important to note that some flashes and floaters can also occur with PVD, retinal holes and tears, and therefore, anyone experiencing these symptoms should be seen by an ophthalmologist to determine the specific cause.

Diagnosis of a retinal detachment is made by dilated eye examination by an ophthalmologist. Early diagnosis is crucial because visual improvement is much greater when the retina is repaired before the macula (central area of the retina) becomes detached. If the diagnosis of a retinal detachment is made, a surgical repair is required, and is performed by a retinal specialist.

There are a number of ways to surgically treat a retinal detachment, and some of the procedures performed at SAEC surgical include:

Pneumatic Retinopexy:

The retinal hole or tear is sealed with the use of laser or cryopexy (freezing). After this is complete, the surgeon injects a gas bubble into the posterior portion of the eye (vitreous cavity), and this gas bubble pushes the detached retina against the back part of the eye. This gas bubble slowly dissipates over a number of weeks. This surgery requires specific head positioning (such as head down) in order to keep the bubble in the position where it can maintain pressure on the retina against the back of the eye.

Scleral Buckle:

After the hole or tear in the retina has been sealed with either laser or use of a cryoprobe (freezing), a silicone buckle (band) is sewn to the outer wall of the eye and acts like a belt around the eye to keep the retina firmly pushed against the back of the eye. This band is not visible, and remains in place permanently. A gas or air bubble may also be placed into the vitreous cavity to keep the hole or tear in place against the scleral buckle until the healing process is complete. This procedure often requires specific head positioning for a number of weeks (such as head down) in order to keep the air or gas bubble in proper position.

Prior to surgery, you will receive your pre-operative instructions from your surgeon’s office, and these typically include not eating or drinking after midnight the night before your procedure. You will be asked to arrive at SAEC at a specified time, which will allow time for you to have your eye dilated for the procedure, and to meet the anaesthesiologist working with your surgeon that day. Your surgeon, anaesthesiologist, and yourself will determine the type of sedation that is necessary.For retinal surgery, most commonly an injection is used to freeze the eye. In the operating room, there will be two additional nurses there to assist you and your surgeon. Depending on the type of retinal repair you are having, your surgical procedure will typically take between 30 to 90 minutes. After your procedure, a nurse will go through your postoperative instructions with you, explain any required head positioning, and ensure that you have made arrangements to be transported home with your friend or family member. You can expect to have a patch and shield in place until your follow up appointment the following day.

cataract-surgery-calgary-SAEC

Cataract Surgery

A cataract is when the clear natural lens of the eye becomes cloudy and results in blurred vision. The natural lens of the eye is responsible for focusing the light that enters the eye onto the retina. Cataracts are painless, typically develop slowly, and occur as a result of a build-up of protein in the lens. This build up prevents light from passing clearly through the lens, causing decreased vision. Cataracts are very common, and often develop as a result of aging. They can also, however, occur as a result of certain medical conditions and medications, as well as from exposure to toxic substances, radiation and ultraviolet light. In addition, cataracts can develop as a result of a traumatic injury, or be congenital and occur in infants and young children.

Because cataracts typically develop gradually, one may not initially be aware of any changes in vision. Once a cataract has developed to the point of becoming bothersome, symptoms can include:

  • Generalized clouding of vision, or vision that appears foggy or filmy, often affecting both distance and near tasks
  • Changes in prescription glasses, with a gradual progression towards near-sightedness
  • A dulling of color and contrasts
  • Complaints of excessive glare, especially at night

Cataracts are diagnosed through a dilated eye examination with an ophthalmologist or optometrist. Treatment of cataracts is the surgical removal of the cataract (the cloudy natural lens) and implantation of an artificial intraocular lens. The decision to proceed with cataract surgery is typically based on the severity of the cataract, and the amount of difficulty it is causing in performance of regular activities of daily living.

Cataracts are most commonly removed through the use of a process called phacoemulsification. Using a microscope, the surgeon will use a very small ultrasonic probe to dissolve the cataract into tiny fragments that can be suctioned out using the same probe. Once the cataract is removed, the thin capsular bag that the cataract occupied is polished, and an artificial intraocular lens is placed into thatsame bag. The surgery is performed entirely through one or two very small incisions, and typically does not require any sutures. The intraocular lens that is placed in the eyeperforms the same function as a natural lens, and focuses the light that is entering the eye.

Prior to surgery, you will receive your pre-operative instructions from your surgeon’s office, and these typically include not eating or drinking after midnight the night before your procedure. You will be asked to arrive at SAEC at a specified time, which will allow time for you to have your eye dilated for the procedure, and to meet the anaesthesiologistworking with your surgeon that day. Your surgeon, anaesthesiologist, and yourself will determine the type of sedation that is necessary; typically, most cataract surgery is done with very minimal sedation, and you will be awake for the procedure. Cataract surgery does not normally involve significant pain, and topical drops or gel are most commonly used to numb the eye. In the operating room, there will be two additional nurses there to assist you and your surgeon, and you can expect the surgical procedure to take approximately 10 to 20 minutes. After your procedure, a nurse will go through your postoperative instructions with you, and ensure that you have made arrangements to be transported home with your friend or family member.