Dr. Stella Onyekwelu

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Office Hours

Monday 9:00am - 6:00pm
Tuesday 9:00am - 6:00pm
Wednesday 9:00am - 6:00pm
Thursday 9:00am - 6:00pm
Friday 9:00am - 6:00pm
Saturday 10:00am - 4:30pm
Sunday CLOSED

Serving Alpharetta and Milton

Eminence Family Eyecare, LLC
6300 Atlanta Hwy, #101a
Alpharetta, GA 30004
Phone: (678) 825 - 4077
Fax: (678) 585 - 3909

 

We are frequently asked if it’s wise to have cataract surgery if you have Macular Degeneration.

Let’s start with some background.

  1. Cataracts and Age-related Macular Degeneration (AMD) are both leading causes of visual impairment in the elderly population.
  2. Cataracts develop when the normal clear lens gets cloudy with age. This is correctable with cataract surgery, which involves replacing the cloudy lens with a clear, artificial lens.
  3. While cataracts affect the front part of the eye, AMD causes damage to the retina, which is the inner back lining of the eye.

In the past, there was a concern about cataract surgery causing progression of AMD. It was thought that there was an inflammatory component to AMD and the normal inflammatory response after cataract surgery may lead to AMD progression.

But studies have looked at patients who underwent cataract surgery compared to patients who didn't have cataract surgery and the progression of AMD was not significantly different between the two groups. However, those patients with AMD who underwent cataract surgery had a significant improvement in vision.

AMD patients can further be characterized as having wet or dry AMD, and only those with wet AMD require treatment. Patients with wet AMD need injections to decrease the growth of new blood vessels and reduce fluid in the retina.

2015 study showed that after cataract surgery, there was an increase in fluid in the retina of patients with wet AMD. Therefore, in patients with wet AMD, we usually want the wet AMD to be stabilized before the patient has cataract surgery. Sometimes an injection may be given prior to cataract surgery to prevent any inflammatory changes that may be associated with cataract surgery.

The majority of the studies on the subject conclude that it is safe to have cataract surgery even if you have AMD and in most cases there is a significant improvement in vision. Removing the cloudy lens also helps the ophthalmologist to better monitor the status of the AMD.

 

Article contributed by Dr. Jan Pan.

So you’re going about your day and notice a slight twinge when you blink. It starts off as a mild awareness then proceeds to a painful feeling with every blink. You look in the mirror to see what could be causing it, and there you see a small red bump forming.

You decide to wait to see what happens and one of three things occurs. Either it gets bigger, redder, and more painful; it gets smaller and goes away; or it stays put and is no longer painful or growing in size. Let’s dive into one of the most common eye conditions we treat: hordeola (commonly known as “styes”) and chalazia.

Hordeola (or singular hordeolum), are infectious abscesses of the glands that line the eyelids. Bacteria that are naturally occurring on the eyelids and eyelashes can make their way into the gland and form what is essentially a pimple in the eyelid. If it goes untreated, hordeola can (rarely) lead to spreading of the infection throughout the eyelid (preseptal cellulitis) or even start to invade the orbit of the eye (orbital cellulitis).  At that point, infection can spread to the brain and even be life-threatening and require hospitalization. Thankfully it hardly ever gets to this point.

Treatment can consist of warm compresses, ointments, and oral antibiotics to kill the infection. Just like a pimple, it is not always necessary to be on antibiotics.  It’s actually the warm compresses that do the most good.  If you can get the mucous that is clogging the gland opening to thin out it will often just drain on its own without antibiotics.  Sometimes, however, if the warm compresses alone aren’t working then an antibiotic might be necessary.  Don’t buy the over-the-counter ointment called “Stye.” It is not going to make it any better and could further clog the glands.

Chalazia (or chalazion singular) often start off as hordeola, but are sterile in nature, meaning non-infectious. Once the infection clears out, what is left behind is often what amounts to a marble-like lump in the eyelid. These are often more difficult to treat, as they no longer respond to antibiotics. If small enough, people can just leave them alone and see if they go away on their own. Larger ones, however, can be rather unsightly. If it no longer responds to warm compresses or ointments, there can either be an injection of steroid to shrink it, or they can be excised.

We see these lumps and bumps on almost a daily basis in practice. Usually, they are very simple to treat and go away quickly.

Article contributed by Dr. Jonathan Gerard

Can I Have Cataract Surgery if I Have Ma...

February 20, 2020
Eminence Eyecare
We are frequently asked if it’s wise to have cataract surgery if you have Macular Degeneration. Let’s start with some background. Cataracts and Age-related Macular Degeneration (AMD) are both leading causes of visual impairment in the elderly population. Cataracts develop when the normal clear lens gets cloudy with age. This is correctable with cataract surgery, which involves replacing the cloudy lens with a clear, a...

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