General ophthalmology
Ocular pathologies are conditions that affect the eyes as well as the structures around the eye.
These pathologies can cause very variable symptoms such as blurred vision, eye pain, redness, itching and finally double vision.
All these eye pathologies can be assessed and diagnosed in consultation at our ophthalmological center located in Geneva. Once the diagnosis has been made, Doctor Bela will be able to prescribe the appropriate treatment and provide eye monitoring in the office to ensure your visual health. Here are some examples of eye pathologies affecting adults and children:
- retinal detachment
- glaucoma
- cataract
- macular degeneration (AMD)
- diseases affecting the cornea such as keratoconus
- eyelid pathologies such as benign or malignant tumors.
Cataract
What is cataract?
Caractar is an eye disease most often linked to natural degeneration of the lens. The crystalline lens is the natural lens located inside the eye which, when transparent, ensures clear vision from a distance as well as up close. With age, a progressive opacification of the lens forms, called cataract. Cataract can affect one or both eyes at the same time with a slow or rapidly progressive course. Most of the time it is a degenerative disease but it can also be associated with a traumatic or iatrogenic context with long-term corticosteroid use.What are the signs of cataracts?
Symptoms associated with lens disease are:- decreased vision
- dazzled by the lights
- the need to change glasses frequently
- the reduction of contrasts and colors making close vision more difficult
- The last stage is a permanent loss of vision despite changing glasses.
What means of screening?
Caractar is detected during an eye exam. It is therefore important to consult your ophthalmologist as soon as you notice any changes in your vision.
What is the treatment for cataracts?
Only surgery can eliminate the clouded lens. It is replaced by an artificial lens placed in the eye.
The operation is performed under local anesthesia only with drops and lasts approximately 30 minutes.One eye is operated on at a time 1 week from minimum interval.
In the first days, driving and reading are sometimes still impossible. After a few days to weeks, the eye is completely healed and you will be given a new glasses prescription.
Cataract surgery is the most commonly performed surgery in the world and has one of the best success rates.
GLAUCOMA
What is glaucoma?
Glaucoma is an eye disease characterized by progressive damage to the optic nerve. This condition is most often associated with elevated intraocular pressure, i.e. high pressure inside the eye, which is not correlated with high blood pressure. However, there are forms of glaucoma with normal intraocular pressure.
What are the signs of glaucoma?
Glaucoma is one of the leading causes of blindness worldwide because it is an asymptomatic disease leading to progressive and permanent loss of visual field.
What means of screening?
Glaucoma being asymptomatic, it is essential to organize screening for this disease by taking annual eye pressure from the age of 60.
You must combine several examinations carried out at your ophthalmologist’s office. Doctor Bela will carry out regular glaucoma screening in consultation using the following examinations:
- eye pressure measurement
- optic nerve examination
- visual field to identify possible blind areas
other tests may be necessary for diagnosis
What are the Risk factors
In certain cases, screening must be organized even before the age of 60 when there are risk factors for glaucoma:
- family history
- African or Hispanic origins
- strong myopia or hyperopia
- a cardiovascular area: high blood pressure, vascular problems, diabetes, obesity
- a microcirculatory problem such as Raynaud’s syndrome
- repeated migraines
- nocturnal hypotension
- prolonged treatment with corticosteroids
- previous eye trauma
How to treat glaucoma?
If it is not possible to cure vision loss, treatment can stop the progression of glaucoma and its progression to blindness.
Depending on the severity of glaucoma at the time of diagnosis, several treatments can be offered to control the disease and stabilize eye pressure. As a first intention, eye drops will be prescribed to you, sometimes combined with laser treatment.
A regular check-up will then be organized with blood pressure measurement, analysis of the optic nerve and visual field. When medical treatment is no longer sufficient, glaucoma surgery should be considered.
diabetes and diabetic retinopathy
What is diabetic retinopathy?
Diabetes is a metabolic disease present since birth or occurring secondarily depending on environmental factors such as nutrition.
In both cases it is a disease resulting in the alteration of small blood vessels leading to retinal edema or growth of blood vessels and intraocular hemorrhage.
This can therefore have a long-term consequence on the vessels irrigating the retina located at the back of the eye. If left untreated, it can cause significant loss of vision leading to blindness.
What are the symptoms of diabetic retinopathy
In the initial stages of people with diabetes, most have healthy eyes.
There are then no symptoms for most of its course.
When diabetes affects the eye, it is called diabetic retinopathy. We can then see:
- new vessels on the retina which manifest as floaters in the visual field or a significant loss of vision.
- Macular edema leading to discomfort in central vision, difficulty reading, reduced contrast or distorted vision.
Diabetic retinopathy can be classified into two categories: non-proliferative and proliferative forms. Non-proliferative forms do not cause symptoms in its early stages and in some cases can be partially reversible with rebalancing of the diabetes.
The more serious forms are proliferative diabetic retinopathy because this causes new abnormal blood vessels in the retina, subsequently causing fluid in the retina as well as retinal detachments which can damage your vision.
In very severe stages, these vessels can cause neovascular glaucoma leading to total loss of vision due to prolonged hypertension or retinal detachment.
This disease is one of the leading causes of blindness in adults worldwide. It is therefore vital to have regular annual screening by your ophthalmologist if you have diabetes.
What are the screening methods?
In our ophthalmology center in Geneva, Doctor Bela and her team are at your service to ensure your visual health and carry out regular screening for all eye diseases.
Screening for diabetic retinopathy consists of measuring your vision combined with a thorough examination of the retina, the frequency of which is determined upon diagnosis of diabetes and depending on the condition of the eyes and the progression of the disease.
This screening must be carried out at least every year.
If there are no signs of retinopathy after 3 years, the examinations can be spaced out. Conversely, if signs of retinopathy are observed, treatment will be instituted and checks will be carried out closer together.
What are the treatments?
The first step of treatment is to obtain a strict balance of your diabetes as well as all cardiovascular parameters: blood pressure, weight, cholesterol and stopping smoking.
Doctor Bela, your ophthalmologist in Geneva, collaborates with all endocrinologists to ensure your visual health and preserve your vision.
Advanced non-proliferative forms require laser treatment to reduce the risk of retinal ischemia and the occurrence of new vessels.
Proliferative forms require, in addition to laser treatment, intravitreal injections of anti-vegf drugs to avoid new vessels and the risks of neovascular glaucoma and retinal detachments. Sometimes retinal surgery is necessary.
Diabetic macular edema is also treated with intraocular injections of anti-VEGF products and then, in a later phase, laser treatment if necessary.
These treatments aim to limit vision loss and regain visual acuity.
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What are the risk factors?
The prevalence of diabetic retinopathy is estimated at one third of diabetic patients. In a small proportion of these patients, vision is seriously damaged.
The recognized risk factors are:
- High values of glycated hemoglobin, marker of blood sugar balance over the last three months.
- Poor cardiovascular balance: high blood pressure, hyperlipidemia or hypercholesterolemia
- Smoking
- Duration of diabetes
- Pregnancy and puberty
AMD
What is age-related macular degeneration?
AMD or age-related macular degeneration is an eye disease that affects the center of the eye called the macula. This is a central area at the level of the retina where visual acuity
and color vision are maximal.
At an advanced stage of the disease, central vision is completely impaired and the eye only sees the periphery of the image.
Age-related macular degeneration is the most common cause of visual impairment in people over 50.
There are two types of age-related macular degeneration:
- the dry form or atrophic which represents the majority of cases. This is the accumulation of deposits inside the retina which gradually causes blurred and distorted vision. However, vision loss may be slower in this form of age-related macular degeneration.
- the wet or exudative form of AMD is fortunately rarer but more severe. It represents the main cause of blindness in this disease. It is characterized by the growth of new vessels in the retina. These new vessels are fragile and cause fluid to leak out of the vessels, which is called exudation.
What means of screening?
Regular screening makes it possible to diagnose and better control the progression of the disease. LA Doctor Bela or your ophthalmologist in Geneva will carry out a complete and dilated examination of your fundus. In the event of loss of vision, a retinal examination called OCT will also be carried out. In severe forms, a retinal angiogram will be carried out in a center specializing in retina.
What is the treatment for AMD?
Unfortunately, there is currently no effective treatment to slow down or cure this disease. For the dry form, many treatments are currently in the pre-clinical phase. A healthy lifestyle with a balanced diet is recommended. Food supplements are also marketed with the nutrients necessary for the proper functioning of retinal cells. In severe so-called wet forms, the exudation will be responsible for a rapid deterioration of vision and requires treatment with repeated intravitreal injections of antiVEGF drugs in order to fight against the progression of these abnormal vessels. Other therapies exist such as laser photocoagulation or photodynamic therapy (PDT). In advanced stages, low vision rehabilitation makes it possible to better use peripheral vision, which is preserved.What are the Risk factors?
Age-related macular degeneration is not a hereditary genetic disease but it is known that it can be associated with risk factors such as smoking, prolonged exposure to the sun, obesity, diet poor in essential nutrients and high blood pressure.
amblyopia strabismus and pediatric consultation
What is strabismus?
Strabismus is an eye disease characterized by a lack of coordination of the two eyes. Indeed, at birth vision develops in parallel in both eyes thanks to coordination of the eye muscles allowing the projection of an image from each eye simultaneously into the brain.
The two images are superimposed into a single image in the brain which will create three-dimensional vision.
In some people with strabismus one of the two eyes is deviated:
outwards, it is then a divergent strabismus.
or inwards, it is then a convergent strabismus.
There are also other types of so-called vertical strabismus where the eye is deviated upwards or downwards, this is then hypo or hypertropia.
The deviation can be constant or intermittent, present since childhood or acquired in adulthood.
In children, this shift in eye mobility will create a dissociation of images in the brain, preventing the development of three-dimensional vision.
In adults, this shift causes diplopia or double vision.
What are the ways to screen for strabismus?
In children, screening is carried out by the pediatrician or at school during check-ups from 0 to 6 months, then at each visit. If there is strabismus, even intermittent, a consultation with an ophthalmologist is indicated. The presence of strabismus or limited vision in children warrants early check-up by the ophthalmologist, around the age of 1 year, even in the absence of strabismus.
What are the treatments?
In children: In childhood, this strabismus is most often associated with a difference in vision between the two eyes. One of the two eyes will then begin to rest, the eye will be gradually deviated and vision will not develop completely in this eye, this is what we call amblyopia. This is reversible before the age of seven thanks to early detection, appropriate optical correction and sometimes even occlusion of one of the two eyes.
Sometimes when strabismus cannot be treated conservatively in childhood, eye muscle surgery is necessary to realign the eyes and allow the normal development of binocular vision.
In adults, if vision developed correctly in childhood, the deviation of one eye will cause a shift in the images in the brain, which causes double vision, also called diplopia. Generally these are neurological causes that must be quickly investigated and diagnosed in order to prescribe an appropriate treatment.
Once the neurological emergency has been eliminated, glasses with integrated prisms will eliminate double vision. After stabilization, a strabismus operation may be considered.
myopia and astigmatism presbyopia
What is a refractive and accommodative disorder?
Hyperopia, myopia and astigmatism are grouped under the term retractive disorders. These are problems with focusing light on the retina of the eye leading to blurred or distorted vision. These refractive errors can be due to variation in the size of the eye along its length. When the eye is too big we speak of myopia; when the eye is too small we speak of hyperopia. These refractive disorders can also be associated with a problem with the curvature of the cornea at the front of the eye. This is called astigmatism.
Presbyopia is an accommodative disorder. It is a degenerative disorder linked to a weakening of the muscles holding the lens in the eye. These muscles make it possible to accommodate vision, that is to say, to modify the shape of the lens in order to modify the focus of the eye, like a camera. From the age of 40 these muscles weaken, accommodation can no longer be done correctly. Near vision is then made more difficult and an optical prescription will be made for reading glasses.
What are the signs?
For refractive disorders, vision appears:
- blurred from a distance for myopia
- blurred up close for hyperopia
- distorted for astigmatism
For presbyopia, near vision is made more and more difficult without glasses.
What are the screening methods?
Refractive and accommodative disorders are detected by a vision test and the use of cycloplegiant drops, which temporarily paralyze accommodation.
What is the treatment for refractive and accommodation disorders?
Most of these refractive disorders can be treated with laser. This consists of treating the thickness or curvature of the cornea in order to modify vision and allow clear vision without glasses. It will first be necessary to eliminate pathologies that contraindicate laser treatment, such as a corneal disease called keratoconus.
For accommodative disorders, rehabilitation sessions can be offered with an orthoptist at the office. Often, an optical prescription will be made in addition for reading.
In some cases, presbyopia can also be corrected with laser.
Doctor Bela, your ophthalmologist in Geneva is there to ensure your visual health, carry out the necessary vision screenings as well as discuss possible treatments together to eliminate your refractive problems.
chalazion stye
What is a chalazion?
Chalazion and stye are two eye conditions that can cause a painful lump to appear inside the eyelids.
What are the symptoms?
A chalazion is an often non-painful and non-infectious swelling that forms in the eyelid following obstruction of a gland called the meibomian gland.
Inside this gland, an essential oily phase is secreted to protect tears from evaporation. When this gland becomes blocked, the contents of the gland thicken, forming a ball inside the eyelid.
What are the risk factors?
The origin of the chalazion cannot be defined with precision. However, there are various factors that favor its appearance:
- Blepharitis, or chronic inflammation of the eyelids
- Seborrheic dermatitis
- Allergic dermatitis
- Air pollution
- Dry eyes
- Wearing contact lenses
- Certain autoimmune, bacterial or parasitic diseases
- Exposure to UV rays
What are the treatments for chalazion?
The treatment is initially conservative with hot water compresses and eyelid massages to unclog the gland.
The stye is linked to an infection of the meibomian gland secondary to bacteria.
This swelling is generally red and painful and associated with a secretion of pus with sometimes a white dot visible on the edge of the eyelid. The treatment is initially conservative with the application of hot compresses and eyelid care combined with an anti-inflammatory and antibiotic ointment.
When conservative treatment is not effective, surgical intervention must then be proposed in order to incise the gland to empty its contents.
posterior vitreous detachment floating bodies
What is posterior vitreous detachment?
Posterior vitreous detachment is a benign eye disease that occurs when the gel in the back of the eye, called the vitreous, partially or completely detaches from the retina.
In general it is an asymptomatic condition occurring in elderly people spontaneously and in a degenerative manner. Sometimes it can also occur in younger people following eye trauma or in cases of illness that weakens the retina such as myopia.
What are the symptoms?
In cases where posterior vitreous detachment is symptomatic patients may describe floaters or flies corresponding to the detached vitreous, floating inside the eye.
Another symptom may be flashes of light linked to the traction of the vitreous on the retina at the site of the detachment.
What means of prevention?
A fundus examination is systematic in these cases and must be carried out quickly in consultation in order to test vision, dilate the pupil and examine the retina to eliminate an associated retinal tear.
The feared complication in this case is that of a retinal detachment.
What are the ways to treat vitreous detachment?
Treatment of posterior vitreous detachment is conservative. No laser or eye drops are prescribed initially. In the event of a tear or associated retinal detachment, laser treatment or retinal surgery will need to be offered to avoid permanent loss of vision.
Doctor Bela, your ophthalmologist in Geneva, is able to see you if you have these kinds of symptoms.
What are the most serious eye diseases?
The most serious eye diseases are those that can lead to severe and permanent loss of vision if left undiagnosed and untreated.
Glaucoma is one of these, because it is caused by excessively high pressure in the eye, which causes no symptoms and is painless. This gradually destroys the optic nerve, resulting in permanent loss of vision that can lead to blindness. Age-related macular degeneration or AMD, especially in its wet or exudative form, can permanently alter the cells of the retina and cause permanent loss of vision. Retinal detachment, if not diagnosed early enough and operated on in time, can lead to permanent vision loss. Advanced forms of diabetic retinopathy can also lead to permanent vision loss. Infectious keratitis secondary to contact lens wear can be a serious infection of the cornea, leading to permanent loss of vision. Consult your ophthalmologist in Geneva at the slightest symptom.
Dr Bela and her team are available to test your vision and take care of your visual health.
What are the symptoms of eye stroke?
Stroke can affect vision when the area of the brain responsible for vision, and therefore the eye, is temporarily or permanently damaged. Ischaemic stroke is the blockage of an artery in the brain. By the same mechanism, this blockage may sometimes be caused by an obstruction in an artery supplying the retina. This is an occlusion of the central retinal artery. The symptoms are a sudden, painless loss of vision and a white eye. An emergency consultation is required to carry out an assessment and treatment identical to that for a cerebrovascular accident.
What is blepharospasm?
Vision is formed by the superimposition in the brain of two images on the retina of each eye. When both eyes are working simultaneously, these two images are superimposed to form a three-dimensional image. During eye movements, the eye muscles work in synchrony to ensure that the images are always superimposed in the brain. When a muscle responsible for eye movements is affected by a neurological disease, a neuromuscular disease or a muscular disease, one of the two eyes is affected in its movements. This causes a shift in the two images projected by each eye to the brain. This shift is responsible for double vision, known as diplopia.
why your vision may be blurred at times
Clear vision depends on the integrity of all the eye's structures, from the cornea and lens to the retina. When one of the eye's structures is affected by a disease, this can lead to a reduction in vision. This is the case, for example, with a corneal infection, which disrupts the transparency of the cornea and reduces vision. This is also the case with a clouding of the crystalline lens, known as a cataract, which also causes a loss of contrast and blurred vision. This is also the case with retinal diseases such as AMD (age-related macular degeneration) or optic nerve diseases such as glaucoma, which cause a disturbance in the transmission of the image formed on the retina to the brain, resulting in blurred vision. Don't wait, consult your ophthalmologist in Geneva at the slightest ocular symptom. Doctor Bela is at your service for a screening and a complete examination of your vision to ensure your visual health on a daily basis.
can screens lead to eye diseases?
Yes, prolonged and excessive exposure to screens can contribute to the development of certain eye diseases. The symptoms are red eyes, intermittent blurred vision, burning eyes and sometimes chronic headaches. This can happen on a computer screen, television or mobile phone. It is therefore advisable to take regular breaks every 20 minutes by closing your eyes or looking into the distance for 20 seconds. You will need to wear suitable optical correction depending on your vision test. You should also make sure that your direct and indirect lighting is appropriate, and if you spend long periods on a computer screen, don't forget to apply artificial tears regularly during the day. If the headaches persist and the symptoms worsen, consult your ophthalmologist in Geneva without delay.