Ophthalmology

Ophthalmology (, OFF-thal-MOL-ə-jee) is the branch of medicine that deals with the diagnosis, treatment, and surgery of eye diseases and disorders. Ophthalmologists also diagnose systemic (other parts of the body) diseases using changes seen in the eyes. An ophthalmologist is a physician with an MD or DO degree who undergoes specialty training in medical and surgical eye care. In the United States, following graduation from medical school, one must complete a four-year residency in ophthalmology to become an ophthalmologist. Following residency, additional sub-specialty training (or fellowship) may be sought in a particular aspect of eye diseases. Ophthalmologists prescribe medications to treat eye diseases, implement laser therapy, and perform surgery when needed. Ophthalmologists provide both primary and specialty eye care—medical and surgical. Most ophthalmologists participate in academic research on eye diseases at some point in their training, and many include research as part of their career. Ophthalmology has always been at the forefront of medical research with a long history of advancement and innovation in eye care. A former term for this medical branch is oculism.

Diseases A brief list of some of the most common diseases treated by ophthalmologists:

Cataract Excessive tearing (tear duct obstruction and others) Proptosis (bulging eyes) Graves' ophthalmopathy Eye, lid and orbit tumors Ptosis (drooping eyelid) Diabetic retinopathy Dry eye syndrome Glaucoma Macular degeneration Retinal detachment Endophthalmitis (infection in the eye) Refractive errors (glasses, contact lenses, surgery including LASIK) Strabismus (misalignment or deviation of eyes) Uveitis (Eye inflammation) Eye injury Globe rupture Orbital fracture

Diagnosis

Eye examination The following are steps often performed during a complete eye examination that enable diagnosis:

Visual acuity assessment Ocular tonometry to determine intraocular pressure Extraocular motility and ocular alignment assessment Slit lamp examination Dilated fundus examination Gonioscopy Refraction

Specialized tests Optical coherence tomography (OCT) is a medical technological platform used to assess ocular structures. Physicians then use the information to assess the staging of pathological processes and confirm clinical diagnoses. Subsequent OCT scans are used to assess the efficacy of managing diabetic retinopathy, age-related macular degeneration, and glaucoma. Optical coherence tomography angiography (OCTA) and fluorescein angiography to visualize the vascular networks of the retina and choroid. Electroretinography (ERG) measures the electrical responses of various cell types in the retina, including the photoreceptors (rods and cones), inner retinal cells (bipolar and amacrine cells), and the ganglion cells. Electrooculography (EOG) is a technique for measuring the corneo-retinal standing potential that exists between the front and the back of the human eye. The resulting signal is called the electrooculogram. Primary applications are in ophthalmological diagnosis and in recording eye movements. Visual field testing to detect dysfunction in central and peripheral vision which may be caused by various medical conditions such as glaucoma, stroke, pituitary disease, brain tumours or other neurological deficits. Corneal topography is a non-invasive medical imaging technique for mapping the anterior curvature of the cornea, the outer structure of the eye. Ultrasonography of the eyes may be performed by an ophthalmologist.

Ophthalmic surgery

Eye surgery, also known as ocular surgery, is surgery performed on the eye or its adnexa by an ophthalmologist. The eye is a fragile organ and requires extreme care before, during, and after a surgical procedure. An eye surgeon is responsible for selecting the appropriate surgical procedure for the patient and for taking the necessary safety precautions.

Subspecialties Ophthalmology includes subspecialities that deal either with certain diseases or diseases of certain parts of the eye. Some of them are:

Anterior segment surgery Cornea, ocular surface, and external disease Glaucoma Neuro-ophthalmology Ocular oncology Oculoplastics and orbit surgery Ophthalmic pathology Pediatric ophthalmology/strabismus (misalignment of the eyes) Refractive surgery Medical retina, deals with treatment of retinal problems through non-surgical means Uveitis Veterinary specialty training programs in veterinary ophthalmology exist in some countries. Vitreo-retinal surgery, deals with surgical management of retinal and posterior segment diseases Medical retina and vitreo-retinal surgery are sometimes combined, and together they are called posterior segment subspecialization.

Etymology The Greek roots of the word ophthalmology are ὀφθαλμός (ophthalmos, "eye") and -λoγία (-logia, "study, discourse"), i.e., "the study of eyes". The discipline applies to all animal eyes, whether human or not, since the practice and procedures are quite similar with respect to disease processes, although there are differences in the anatomy or disease prevalence.

History

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