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General Eye Examination

It is recommended to use soft tone yellow lighting in the work environment. It is necessary to sleep in a dark environment for the eyes to rest.

Even if babies do not have any eye complaints, periodic eye examinations are recommended starting at age 1. These examinations help early diagnosis of diseases such as lazy eye, which is common in babies.

People who work on the computer or play games for a long time may experience problems such as allergies, dryness and inflammation of the eyelashes. This can trigger distant vision impairment. It is important to take breaks and blink at intervals to rest your eyes.

People with colored eyes are generally more sensitive to the sun. They are at higher risk of developing redness, so it is important to wear sunglasses.

Laser Surgery

There are many factors to consider when determining whether you are a candidate for eye laser surgery. These factors depend on various parameters such as the health of your eyes, your general health, your age, and the type and degree of your vision defect.Here are the characteristics sought in an ideal candidate for eye laser surgery: It is generally recommended that candidates be at least 18 years old. This ensures that the eyeglass or contact lens prescription is stable for several years. An unstable eye prescription means that the laser correction may also change over time. Whether the surgery is applicable depends on the degree of myopia, hyperopia, and astigmatism. There are certain limits for each technology. For example, SMILE technology may not be recommended for very high myopia. Adequate thickness of the cornea ensures that the integrity of the cornea is preserved during laser correction. A thin cornea can make some laser procedures risky. Laser surgery may not be suitable for individuals with eye diseases or disorders such as dry eyes, keratoconus, glaucoma, and cataracts. Laser surgery may be risky for people with systemic diseases such as diabetes, rheumatoid arthritis, lupus, or those taking medications that weaken the immune system.

1. LASIK (Laser-assisted in situ keratomileusis): In LASIK, a thin flap (lid) is created from the surface of the cornea. This is done either with a device called a microkeratome or, in newer techniques, with a femtosecond laser. Once the flap is lifted, the excimer laser focuses on the tissue beneath the cornea and vaporizes it. This action of the laser changes the shape of the cornea, correcting vision defects. Once the shaping process is complete, the corneal flap is placed back in its original position. This flap acts as a natural band and heals quickly. 2. PRK (Photorefractive keratectomy): In this procedure, the epithelium, the outermost layer of the cornea, is completely removed. This can be done with an alcohol solution or a spatula. The excimer laser is then applied directly to the cornea, changing the shape of the cornea. The epithelium heals naturally as it grows back into the treated area. This process can take longer than LASIK and is usually associated with more discomfort. 3. LASEK (Laser-Assisted Subepithelial Keratomileusis): In LASEK, the epithelial layer is not completely removed; instead, it is softened with an alcohol solution and lifted as a flap. The cornea is then shaped using an excimer laser. Finally, the epithelial flap is placed back in its original position. 4. SMILE (Small Incision Lenticule Extraction): A femtosecond laser is used to create a small, lens-shaped tissue (lenticule) inside the cornea. The created lenticule is removed through a small 3-4 mm incision. SMILE has become a very popular technique, especially in the treatment of myopia, and offers a less invasive approach to the cornea.

Each laser technology has refractive error limits that it can treat. These limits may vary depending on the laser equipment used, the patient's eye structure, the thickness of the cornea and other factors. It should also be noted that these limits may change over time depending on technological developments. Here are the generally accepted limits of frequently used laser technologies: LASIK (Laser-Assisted In Situ Keratomileusis): Myopia: It is generally used for myopia ranging from -1.00 D to -10.00 D. Hyperopia: It can be used for hyperopia ranging from +1.00 D to +4.00 D. Astigmatism: It can be used for astigmatism ranging from ±1.00 D to ±6.00 D. PRK (Photorefractive Keratectomy): Myopia: It is generally used for myopia ranging from -1.00 D to -8.00 D. Hyperopia: It can be used in hyperopia cases from +1.00 D to +3.00 D. Astigmatism: It can be used in astigmatism cases from ±1.00 D to ±4.00 D. LASEK (Laser Epithelial Keratomileusis): Myopia: It can be used in myopia cases from -1.00 D to -8.00 D. Hyperopia: It can be used in hyperopia cases from +1.00 D to +3.00 D. Astigmatism: It can be used in astigmatism cases from ±1.00 D to ±4.00 D. SMILE (Small Incision Lenticule Extraction): Myopia: It can be used in myopia cases from -1.00 D to -10.00 D. Astigmatism: It can generally be used in cases of astigmatism from ±1.00 D to ±5.00 D. (The SMILE method is generally not recommended for hyperopia.)

Laser refractive surgery involves a series of procedures that aim to change the refractive power of the eye to reduce or eliminate the need for glasses and contact lenses. The most common refractive surgery methods are LASIK, PRK, LASEK, and SMILE. Here is a general comparison of these techniques: LASIK (Laser-Assisted In Situ Keratomileusis): A microkeratome or femtosecond laser is used to cut the top layer of the cornea into a temporary flap. Then an excimer laser is used to shape the corneal tissue underneath. Advantages: Fast recovery time. Low pain. High success rate. Results: Excellent vision is achieved for most people. PRK (Photorefractive Keratectomy): The surface layer of the cornea (epithelium) is removed and the cornea is shaped with an excimer laser. Advantages: No risk of flap complications in LASIK. May be more suitable for patients with thin corneas. Results: Similar results to LASIK, but recovery time is longer. LASEK (Laser Epithelial Keratomileusis): Epithelium is manipulated using alcohol and cornea is reshaped with excimer laser. Advantages: Similar to PRK, but epithelium is preserved. May be suitable for patients with thin corneas. Results: Similar results to LASIK and PRK. SMILE (Small Incision Lenticule Extraction): A small lens (lenticule) is created inside the cornea using a femtosecond laser and this lenticule is removed through a small incision. Advantages: No flap is created in the cornea, which reduces the risk of complications. The risk of dry eyes is lower. Results: Similar results to LASIK.

Eye laser surgery, like any surgical procedure, has some potential side effects and complications. Some of these side effects may be temporary and improve over time, but some may be permanent. The right patient selection, preoperative evaluation, and the knowledge and skill of an experienced surgeon can minimize the risk of these side effects. However, it is important to keep in mind that every surgical procedure carries some risks. Here are the most common side effects: Dry Eyes: Many patients experience temporary dry eyes after surgery. This can be caused by decreased tear production and cutting of the nerves that cause dry eyes. It can usually be managed with artificial tear drops or other treatments, but in some cases it can be permanent. Visual Disorders: Problems such as ring glare, reflections, or double vision may occur. These types of symptoms are usually more noticeable during night driving. Under or Over Correction: Sometimes the surgical procedure does not fully correct the refractive error in the eye, or it corrects it too much. This may cause the patient to still need to wear glasses or contact lenses. Astigmatism: Astigmatism may develop after the surgery or existing astigmatism may worsen. Flap Complications (Especially in LASIK): If the flap does not fit properly, wrinkles or shrinkage may occur in the tissues underneath. Rarely, microscopic dirt or air bubbles may form under the flap. Abnormal Growth of the Surface Epithelium (Especially in PRK and LASEK): The epithelium, the surface layer of the cornea, can grow beyond its normal outer borders. Infection: Although rare, there is a risk of infection after any type of eye surgery. Vision Loss: In very rare cases, laser refractive surgery can cause permanent vision loss. Wavy Vision: Some patients perceive a wavy or distorted image due to an irregular corneal surface. Night Vision Problems: Some patients may have poor vision at night.

Low Vision Rehabilitation

Vision rehabilitation is a program that aims to help individuals with visual impairments become more independent in their daily lives and increase their quality of life. This program includes improving the person's visual functions, learning alternative vision strategies, and using assistive devices when necessary.

A vision rehabilitation program usually involves a multidisciplinary approach. Professionals such as a vision specialist, therapists, rehabilitation specialists, and technologists create a program based on the individual's needs. This program may include vision assessment, education and counseling sessions, exercises to improve visual skills, and the provision of optical and technological supports when necessary.

Vision rehabilitation may be recommended for individuals who have experienced vision loss as a result of various conditions, such as cataracts, glaucoma, eye diseases such as retinitis pigmentosa, macular degeneration, eye trauma, or neurological conditions.

The duration of vision rehabilitation depends on the individual's needs and the degree of visual impairment. For some people, a short-term program may be sufficient, while for others, a long-term process may be required. Progress is usually achieved through regular sessions and the program is updated as necessary.

The results of vision rehabilitation can vary from person to person, but generally allow an individual to become more independent in their daily lives, perform basic tasks, and have an improved quality of life. This program can increase a person's self-confidence and encourage social participation.

Cornea Treatments

Corneal transplant surgery is the process of replacing damaged or pathological parts of the cornea with a healthy donor cornea. Since the cornea has different layers, the transplantation process can be performed by replacing only the damaged or pathological layers or by replacing the entire cornea. Therefore, corneal transplantation can be done in various types: 1. Penetrant Keratoplasty (PKP): This type of corneal transplant is a traditional corneal transplant method in which the entire cornea is replaced. In this procedure, the patient's entire cornea is removed and a full-layer cornea taken from the donor cornea is transplanted instead. 2. Deep Anterior Lamellar Keratoplasty (DALK): In this method, only the front part (anterior part) of the cornea is replaced, preserving the endothelial layer. It can be preferred especially in diseases such as keratoconus. 3. Endothelial Keratoplasty: This is a type of transplant in which only the endothelial layer of the cornea is replaced. The most common types of endothelial keratoplasty are: - Descemet’s Stripping Automated Endothelial Keratoplasty (DSAEK): A procedure in which a thin slice of tissue containing the back layers of the cornea (endothelium and Descemet’s membrane) is taken from the donor cornea and transferred to the patient’s cornea. - Descemet’s Membrane Endothelial Keratoplasty (DMEK): A very thin slice of tissue containing only the endothelial cells and Descemet’s membrane is taken from the donor cornea and transferred to the patient’s cornea. This technique uses a thinner slice of tissue than DSAEK. 4. Epithelial-Surface Lamellar Keratoplasty: This is a type of corneal transplant that targets the surface layers of the cornea. When deciding which type of corneal transplant to perform, the patient’s current corneal pathology, general health, previous eye surgeries, and potential risks are taken into consideration. Choosing the right type of transplant is critical to achieving optimal vision outcomes.

Corneal transplantation is a complex procedure that carries some risks associated with eye surgery. As with any surgical procedure, corneal transplantation can lead to some complications. Here are the potential risks of corneal transplantation surgery: 1. Intraocular Infection: The risk of infection in the eye may increase after surgery. Serious intraocular infections can be dangerous enough to lead to blindness. 2. Graft Rejection: This is when the body perceives the transplanted cornea as a foreign substance and is rejected by the immune system. While mild rejection can be controlled with medications, severe rejection can cause the graft to fail. 3. Increased Intraocular Pressure: In some patients, increased intraocular pressure may occur after corneal transplantation. This can lead to the development of glaucoma. 4. Astigmatism: Post-transplant stitches or the shape of the transplant can cause a vision disorder known as astigmatism. 5. Corneal Clouding: Sometimes, the transplanted cornea may not be transparent or may become cloudy over time. 6. Graft Failure: This is when the transplanted cornea fails to function. This can happen immediately after surgery or months or years after surgery. 7. Cataract Formation: Corneal transplantation can cause cataracts to progress rapidly in some patients. 8. Corneal Neuralgia: Damage to the corneal nerves after surgery can cause pain or discomfort. 9. Corneal Perforation: In rare cases, there is a risk of corneal perforation or tearing during surgery. 10. Bleeding and Edema: Bleeding or edema may occur in the eye. 11. Retinal Complications: In rare cases, corneal transplantation can lead to retinal complications, which can lead to vision loss.

Here are some important things to consider after a corneal transplant: 1. Medications: Use the drops and other medications prescribed by your doctor exactly as prescribed and as often as recommended. These medications are usually given to prevent infection, reduce inflammation, and prevent graft rejection. 2. Eye Protection: You can use a soft eye patch or protective glasses to protect your eye from impacts. This is especially important in the first few days. 3. Activity Restrictions: Avoid heavy lifting, bending, and strenuous physical activity for a certain period after surgery. 4. Eye Cleaning: You may have crusting or discharge in your eye. Be careful when cleaning these and do as your doctor recommends. 5. Water Contact: Avoid swimming, hot tubs, or baths in the first weeks after surgery. It is important to prevent your eye from coming into direct contact with water. 6. Scratching and Rubbing: Be careful not to scratch your eye. Scratching can damage the stitches in the surgical area. 7. Regular Checkups: It is important to go to checkups as often as your doctor tells you to, to diagnose and treat complications early. 8. Abnormal Eye Symptoms: If you notice any abnormal symptoms in your eye, such as increased redness, pain, sensitivity to light, blurred vision or eye discharge, contact your doctor immediately. 9. Graft Rejection: If you notice any signs of graft rejection, such as severe eye redness, sensitivity to light or loss of vision, contact your doctor immediately. 10. Nutrition: A balanced diet is important for maintaining your overall health and eye health. Foods containing vitamin C, vitamin E and omega-3 fatty acids may be particularly beneficial. 11. Sleep: Adequate rest and sleep support the healing process. 12. Smoking and Alcohol: Smoking can slow down the healing process and increase the risk of complications. You should also be careful about alcohol consumption and follow your doctor's recommendations.

When to remove stitches after corneal transplant (keratoplasty) depends on several factors, but here is some general information: 1. Type of Stitches: Thin, non-absorbable stitches are usually used in corneal transplants. These stitches do not absorb on their own over time, so they usually need to be removed manually. 2. Type of Surgery: In penetrant keratoplasty surgery, where the entire cornea is transplanted, the stitches are usually left in place for a longer period of time. In cases where partial corneal transplants are performed (e.g. DALK or DSEK), the length of time the stitches remain may vary. 3. Speed ​​of Healing: Each patient's healing process is different. The doctor closely monitors the healing process and decides when to remove the stitches. 4. Complications: If there is a problem in the eye, such as astigmatism, some stitches may be removed earlier, while others may be left in place for a longer period of time. Also, if a complication such as a stitch site infection develops, the stitches may need to be removed. In general, the time it takes to remove stitches after a corneal transplant can range from a few months to a few years. In most cases, stitches are removed 12-18 months after surgery, but sometimes they can remain in the eye for longer. The most accurate information about when to remove stitches is provided by the ophthalmologist performing the surgery. Local anesthesia is usually used during stitch removal, and the procedure is quite quick.

The increase in vision after corneal transplantation (keratoplasty) may vary from patient to patient and depends on the type of surgery. However, in general we can say the following: Immediately After: Immediately after surgery, vision is usually blurry. This depends on the drops used, edema (swelling) in the eye, and other factors. The First Weeks: During the first few weeks, most patients notice that the blurriness in the eye decreases and their vision gradually improves. However, full clarity of vision is not achieved during this time. The First Months: Vision gradually improves during the first few months. As the cornea heals, some visual disorders such as astigmatism may also improve. 6 Months – 1 Year: In most patients, vision stabilizes within 6 months to 1 year. In some patients, this process may take longer. Removal of Stitches: After the stitches are removed in penetrant keratoplasty surgery, where the entire cornea is transplanted, vision may improve further. Since stitches can cause vision problems such as astigmatism, removing them can also reduce these problems. Differences Depending on the Type of Surgery: Partial corneal transplants (e.g. DALK, DSEK, DMEK), where only a certain layer of the cornea is transplanted, usually offer a faster recovery time. After these types of surgeries, vision recovery can begin earlier. Finally, the recovery process and results may be slightly different for each patient. You can help to get the best results by following your doctor's recommendations and attending regular checkups after surgery.

Retinal Treatments

After vitrectomy, silicone oil is placed in the eye to stabilize the retina and prevent recurrent detachments that may occur due to certain pathologies in the retina. Silicone oil helps the retina stay in place by creating a barrier where it comes into contact with water in the eye. There is no specific time frame for when silicone oil is removed, and this is determined by the patient's specific condition, retinal healing, and potential complication risks. However, in general, the following can be said: Depending on Healing Status: Silicone oil is removed at a point when the retina is completely stable and the risk of recurrent detachment is minimized. This can range from a few months to a few years. Complication Risks: Silicone oil can cause some complications when left in the eye for a long time, so early removal may be recommended in some cases. These complications may include increased intraocular pressure, silicone oil leaking into the front of the eye, and cataract development. Doctor's Recommendation: The decision on when to remove silicone oil is based on the evaluations and recommendations of the retina specialist. Removal of silicone oil is usually done surgically and is similar to the initial vitrectomy procedure. It is important for the patient to regularly monitor the pressure in the eye after surgery and follow the doctor's recommendations carefully.

The increase in vision after retinal surgery may vary depending on the condition that caused the surgery, the type of surgery, the tampon used (gas, silicone oil, etc.), and possible complications. Gas Tampon: If a gas tampon was used to hold the retina in place, it may take several weeks to several months for the gas to completely resorb (disappear). Vision may be blurry during the gas tampon resorption process. Vision usually improves when the gas is completely removed, but the exact level of vision depends on the health of the retina and the success of the surgery. Silicone Oil: Silicone oil can be used in serious conditions such as retinal detachment. Vision may not improve immediately after the silicone oil is placed. Full vision recovery may occur in the weeks or months after the silicone oil is removed. By Type of Surgery: For example, after macular hole surgery, full vision recovery may take several weeks to several months. The duration of vision recovery after surgery may vary for other conditions such as diabetic vitreoretinopathy or retinal detachment. Complications: Post-surgical complications (e.g. infection, intraocular hemorrhage) may prevent immediate vision recovery. In general, it is important to be patient for vision to fully recover after retinal surgery. Vision may begin to improve immediately after surgery, but full recovery may take weeks or months. The recovery process is different for each patient, so regular post-surgical checkups and adherence to recommended treatment protocols are essential for early diagnosis and treatment of potential problems.

Travel restrictions apply after vitrectomy, especially if a gas tampon has been placed in the eye. Expansion of the gas tampon can be risky due to the decrease in atmospheric pressure at high altitudes. This expansion can cause increased intraocular pressure and potentially lead to serious complications. Travel Restrictions: Travel by Air: When gas is injected into the eye, air travel should generally be avoided until the gas has completely resorbed and disappeared. This period can range from a few weeks to a few months, depending on the type of gas used. Travel to High Altitudes: Travel to high altitudes (e.g. mountains) may also be restricted for similar reasons. Points to Consider After Vitrectomy: Sleeping Position: As mentioned earlier, it is important to maintain the sleeping position recommended by the doctor, especially when a gas tampon is used. Eye Hygiene: There is a risk of infection in the eye after surgery. Therefore, care should be taken to prevent water and other contaminants from entering the surgical site. Medications: It is important to use the medications prescribed by the doctor (antibiotic drops, anti-inflammatory drops, etc.) according to their instructions. Activity Restrictions: Heavy lifting, bending, and intense physical activities should be avoided. Eye Pain and Redness: If you experience increased pain, redness, vision loss, or any abnormality in your eye after surgery, you should immediately consult a doctor. Regular Checkups: It is critical not to skip checkups at the times specified by your doctor after surgery, to closely monitor the recovery of your retina and potential complications. Recommended restrictions and precautions may differ for each patient. Therefore, it is important to follow your doctor's recommendations closely and seek medical attention immediately if you have any doubts or problems.

The position of the patient after vitrectomy may vary depending on the type of tamponade (e.g., gas or silicone oil) placed in the eye during surgery and the reason for the surgery. A specific position is recommended because the goal of the surgery is to stabilize the retina after it is in place and to apply proper pressure to the retina. Sleeping Positions: Face Down: If gas has been injected into the upper part of the eye, the patient may be asked to lie face down so that the gas can press against the retina. Side Lying: Sometimes the patient may be asked to lie on only one side so that the gas or silicone oil is pushed toward a specific retinal area. Supine: Rarely, the patient may be advised to lie on his or her back, but this is generally less common than the face down or side lying positions. Duration: The duration of the supine position may vary depending on the type of tamponade used and the reason for the surgery. In general: For gas: The patient should maintain the recommended lying position for 1 to 3 weeks, usually. However, this period may vary depending on the type and amount of gas. For Silicone Oil: Unlike gas, silicone oil can remain in the eye for a long time and therefore a special sleeping position is generally not required. However, in some special cases, a certain sleeping position may be recommended.

Vitrectomy is a surgical procedure performed to completely or partially remove the gel-like part of the eye called the vitreous. This procedure is frequently used in the treatment of various pathologies, especially those related to the retina. Buffer Materials: Various buffer materials are used to stabilize and hold the retina in place after vitrectomy: Gas: Used especially for the treatment of retinal detachment and macular hole. The air remaining in the gas is replaced by the eye's natural fluid over time. Silicone Oil: Used when a longer-lasting buffer effect is needed. Silicone oil must then be removed surgically. Perfluorocarbon Liquids: Used to flatten and stabilize the retina during surgery, but are not left in the eye after surgery. Possible Complications: Potential complications after vitrectomy include: Intraocular bleeding Infection (endophthalmitis) New retinal detachment Accelerated cataract formation Increased intraocular pressure Leakage of silicone oil or gas out of the eye Healing Process: The healing process after vitrectomy can vary depending on the reason for the surgery and the type of packing material used. In general: There may be mild pain, redness, or swelling in the eye for the first few days. When gas or silicone oil is used, patients may be asked to keep their head in a certain position. Eye drops are prescribed to prevent infection and inflammation. Full vision recovery may take weeks or months.

Cataract

The symptoms of cataracts usually increase over time and their effects on vision become noticeable. Common symptoms of cataracts include: Blurred or dull vision Fading or yellowing of colors Flares or distortions in lights Poor night vision Double vision in the eyes Reduced visual acuity If you notice these symptoms, it is important to consult your eye doctor. Early detection of cataracts can be managed with appropriate treatment and can prevent vision loss.

During cataract surgery, the eye's natural lens is removed and replaced with an artificial lens (intraocular lens - IOL). There are several different types of these lenses, each with different features and selected according to the patient's needs and preferences. Single-Focal Lenses: These lenses provide vision at a single focal length. They are usually optimized for seeing distant objects clearly. Patients who choose these types of lenses can see up close with their near-sighted glasses. Trifocal lenses: These lenses provide vision at three different focal lengths: far, intermediate and near. A small section integrated under the far-sighted glasses improves clear vision at near distances. This allows users to achieve clear vision at far, intermediate and near distances, so they can do a variety of activities with a single lens. Smart (Accommodative) Lenses: These lenses respond to the movement of the eye muscles and try to change focus, allowing you to see near and far objects without glasses. Toric Lenses: Designed for astigmatism correction. These lenses are suitable for patients with irregular corneal shapes and astigmatism. Blue Light Filter or Yellow Filter Lenses: These filter out some of the blue light that can damage the retina. These lenses are suitable for some patients at risk of age-related macular degeneration.
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