Ophthalmologists love gadgets and technical breakthroughs. Their offices are filled with a wide range of instruments ranging from simple ophthalmoscopes to complicated operating microscopes. In the last few decades, there has been an explosion of new technology in the visual sciences, which has resulted in several promising new techniques and advances. Diagnostic and surgical breakthroughs in this specialty include laser photocoagulation, micromanipulation, fluorescein angiography, and microsurgery. To be a good ophthalmologist and make the most of this technology, the specialty requires excellent visual and motor skills, depth perception, and color vision.
Pharmacologic treatments are important in ophthalmology. Primary open angle glaucoma, for instance, remains one of the largest causes of blindness in the world, affecting over 5 million people.2 Traditionally, topical beta-blocking medicine provided the main form of therapy, but several side effects limited their usefulness in certain patient populations such as asthmatics. Several new medications, including topical carbonic anhydrase inhibitors, alpha-2 agonists, and prostaglandin agonists, have made the medical treatment of glaucoma far more effective. In addition, advances in surgical techniques and the use of anti-metabolites, such as 5-fluorouracil and mitomycin C, have greatly improved filtration surgeries and dramatically improved postoperative wound healing. These advances have greatly improved the chances that patients with glaucoma will live into old age with their vision preserved.
The rapidly advancing technology has made surgical visual correction a safe reality for many people. LASIK, or laser-assisted in situ keratomileusis, is a procedure by which an excimer laser emitting ultraviolet beams removes precise amounts of corneal tissue based on a person's refractive error and corneal topography (essentially a road map of the cornea). It is estimated that 148 million people (52% of the population) wear some type of corrective eyewear and that approximately 1.8 million refractive surgery procedures were performed in 2002.3
For those who have near-perfect vision, imagine what it is like for someone to wake up every morning and be unable to see the alarm clock or to differentiate between the shampoo and conditioner bottles while taking a shower. The technology in the practice of ophthalmology—particularly LASIK—is having a dramatic effect on the quality of people's lives. Instead of always relying on glasses and being constantly reminded of their worsening vision, these patients' lives are transformed. They wake up with enormous smiles on their faces and perfect 20/20 vision for the first time in years.
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