♪ >> GOOD EVENING AND WELCOME TO "DOCTORS ON CALL."

I'M DR. RAY CHRISTENSEN, FACULTY MEMBER IN THE DEPARTMENT OF FAMILY MEDICINE & BIOBEHAVIORAL HEALTH AT THE UNIVERSITY OF MINNESOTA MEDICAL SCHOOL, DULUTH CAMPUS.

ALSO A FAMILY PHYSICIAN AT THE GATEWAY FAMILY HEALTH CLINIC IN MOOSE LAKE, MINNESOTA.

I AM YOUR HOST FOR OUR PROGRAM TONIGHT ON "CATARACTS & EYE PROBLEMS."

REMEMBER THAT PROGRAM'S SUCCESS IS VERY DEPENDENT ON OUR VIEWERS.

PLEASE CALL OR EMAIL YOUR QUESTIONS AND WE WILL DO OUR BEST TO ADDRESS THEM.

THE TELEPHONE NUMBERS AND EMAIL ADDRESS FOR YOUR QUESTIONS CAN BE FOUND AT THE BOTTOM OF YOUR SCREEN.

OUR PANELISTS THIS EVENING INCLUDE DR. TODD BRITTAIN, AN OPHTHALMOLOGIST WITH RELF EYECARE SPECIALISTS IN HERMANTOWN, AND DR. KEVIN TREACY, AN OPHTHALMOLOGIST WITH ST. LUKE'S EYE CARE.

VOLUNTEERS FOR THE GREAT GARDENING SHOW ARE ANSWERING OUR PHONES.

AND NOW ON TO TONIGHT'S PROGRAM.

GENTLEME, WELCOME, GREAT TO SEE YOU.

DR. TODD BRITTAIN, YOU ARE NEWEST OF THE PROGRAM.

I WOULD LIKE TO LET YOU START UP.

TALK ABOUT THE ANATOMY OF THE EYE.

>> I DID BRING MODELS WITH ME TODAY.

IF WE ARE LOOKING AT THE EYE, THE CLEAR PART OF THE EYE IS WHAT IS CALLED THE CORNEA.

THE WHITE PART OF THE EYE IS THAT SOLERA.

ATTACHED TO THE SCALERA CONTROLS THE EYE MOVEMENT.

WHEN WE LOOK BEHIND THE CORNEA, WE SEE THE IRIS, WHICH MAKES UP WHAT MOST PEOPLE THINK OF AS THE COLOR OF THEIR I.

BEHIND THE IRIS IS THE LENS.

THIS IS THE LENS THAT AS WE GET OLDER BECOMES A CATARACT OR A DISCOLORED LENS.

BEHIND THAT LENS IS A SPACE.

WITHIN THIS SPACE, IT IS WHAT WE CALL VITREOUS.

IT IS A JELLYLIKE SUBSTANCE, AND ON THE BACK OF THE EYE IS WHAT IS CALLED THE RETINA.

THE RETINA TAKES ELECTRICAL IMPULSES AND BRINGS IT BACK TO THE BRAIN, THE OPTIC NERVE.

>> KEVIN, DR. TREACY I THINK I WOULD LIKE TO START WITH THE LENS.

IT SEEMS LIKE MY AGE GROUP AND A LOT OF MY AGE GROUP ARE PROBABLY WATCHING, CATARACTS BECOME THE THING WE COME UP AGAINST.

I DO NOT THINK EVERYBODY GETS CATARACTS, BUT WHEN DO THEY COME, WHY DO THEY COME, AND, FURTHERMORE, WHAT CAN I DO TO KEEP FROM GETTING THEM?

>> ALL GOOD QUESTIONS.

IT IS A COMMON PROBLEM.

AS WE GET OLDER, IT BECOMES MORE COMMON.

IT CAN OCCUR AT ANY AGE.

IT CAN RELATE TO TRAUMA, VARIOUS MEDICATIONS, SMOKING CAN INCREASE THE RISK.

BEING OUT IN SUNLIGHT WITHOUT ULTRAVIOLET PROTECTION CAN ALSO CONTRIBUTE.

AT THE BOTTOM LINE IS, AGE, THE LENS INEVITABLY BECOMES MORE DENSE AND BECOMES CLOUDY ENOUGH TO INTERFERE WITH THE VISION, AND WHEN PEOPLE ARE HAVING TROUBLE DOING THINGS THEY NEED TO DO OR WANT TO DO, YOU CAN SEE IT.

I BELIEVE THERE IS AN IMAGE ON THE CAMERA THERE.

THAT LENS IS REALLY WHERE THE WORD CATARACT CAME FROM, REFERRING TO WATERFALL.

IF IT HAS THAT APPEARANCE IN THIS CASE, YOU CAN IMAGINE LIGHT IS NOT GETTING THROUGH THAT LENS .

IT SHOUD BE CLEAR.

YOU SHOULD NOT BE ABLE TO SEE IT AT ALL.

WHEN THAT BECOMES AN ISSUE, OUR GOAL IS TO REMOVE THE CLOUDY LENS AND REPLACE IT WITH A CLEAR LENS, AN IMPLANT.

IT USED TO BE WE DID NOT HAVE IMPLANTS.

WE HAD TO USE THESE THICK GLASSES THAT GAVE DISTORTION.

THE DEVELOPMENT OF IMPLANTS IS A WONDERFUL ADVANCE IN CARING FOR A CATARACT.

>> THOSE COKE BOTTLES, MY GRANDFATHER USED TO MISS THE DRIVEWAY AND WE HAD TO SHOVEL THEM OUT.

I DID LOOKING A FEW MONTHS AGO, I SEE THERE ARE SEVERAL TYPES OF LENSES THAT CAN PUT IN NOW.

I THOUGHT IT WAS BASICALLY A REGULAR TYPE LENS OR THERE WAS A CERTAIN LENS.

I SEE THERE ARE MANY THINGS YOU CAN DO AND YOU CAN CORRECT A LOT.

IS THAT TRUE?

>> YES, THAT IS TRUE.

THERE ARE MANY DIFFERENT TYPES OF LENSES.

THE LENS THAT TENDS TO BE COVERED BY YOUR INSURANCE ALLOWS US TO ESSENTIALLY CORRECT YOUR VISION EITHER DISTANCE OR UP CLOSE AS BEST AS YOU CAN WITHOUT GLASSES.

NOT BOTH.

THERE ARE LENSES THAT HAVE COME OUT OVER THE YEARS THAT DO ALLOW US TO CORRECT YOUR DISTANCE VISION AS WELL AS UP CLOSE TO REDUCE YOUR RELIANCE ON GLASSES.

THOSE LENSES ARE NOT COVERED BY INSURANCE BUT THERE ARE VARIOUS MODELS OF THOSE TWO CHOOSE FROM -- TO CHOOSE FROM IT SHOULD THAT BE A DESIRE OF YOURS TO BE FREE FROM GLASSES.

>> WHEN YOU PUT THOSE IN, I NOTE THERE WERE SOME THAT SAID THEY COULD FIX AN STIGMATISM, AND IRREGULARITY AND THE CORNEA.

THEY CAN DO A LOT OF THINGS WITH THEM.

SO THEY DO EXIST.

>> THEY DO EXIST.

>> IT HAS COME A LONG WAY.

WHEN I THINK BACK, I REMEMBER MY PATIENTS COMING BACK WITH STITCHES IN THE CORNEA.

YOU DO NOT DO THAT ANYMORE, DO YOU, KEVIN?

>> IT IS RARE TO REQUIRE STITCHES.

WE USED TO.

WE WILL LOOK AT THE MODEL AGAIN.

WHEN I STARTED PRACTICE, THE PROCEDURE WAS TO MAKE A LARGE INCISION, TAKE THE CATARACT OUT IN ONE PIECE AND WE COULD SHOW IT TO PEOPLE.

SOME OF THEM IT WOULD LOOK LIKE A BLACK M&M.

WE MAKE A SMALL INCISION THAT WE CONCEAL WITHOUT SUTURES, AND BASICALLY THE RECOVERY TIME IS FAST, THE VISUAL RESULTS ARE BETTER, SO IN ADDITION TO IMPLANTS IN GENERAL, NOW WE HAVE THE TYPE THAT CAN FOLD UP AND GO THROUGH SUCH A SMALL INCISION WE CAN DO A SELF SEALING INCISION.

>> IT HAS COME A LONG WAY.

THERE IS A QUESTION FROM BARBARA IN DULUTH.

HOW MANY TIMES CAN YOU DO A CATARACT SURGERY ON AND I -- AN EYE?

SHE HAS HAD TWICE.

>> CATARACT SURGERY IS IN GENERAL A ONE AND DONE PROCEDURE.

ONCE YOU'VE HAD YOUR CATARACT REMOVED IT IS NOT COMING BACK AGAIN.

SOME PATIENTS DO DEVELOP A SECONDARY CATARACT, A MEMBRANE THICK CLOUDS THE BAG THAT WE PUT THE IMPLANT INTO.

WE CALL IT A SECONDARY CATARACT BECAUSE IT GIVES YOU THE SAME SYMPTOMS THAT YOUR CATARACT INITIALLY GAVE YOU, BUT IT IS NOT A CATARACT.

WE TREAT THAT WITH A LASER PROCEDURE.

ONCE WE REMOVE A CATARACT, BARRING ANY COMPLICATIONS, WE ONLY HAVE TO DO IT ONCE.

>> ON QUESTION ON THE CATARACT ITSELF, IT IS MY UNDERSTANDING YOU NEED TO TAKE THEM OUT EARLIER THEN WHAT WE USED TO DO LATER.

THEY CAN GET HARDER AND MATURE.

IS THAT TRUE, KEVIN?

>> WHAT YOU NEED IS A RELATIVE WORD.

PEOPLE MAY FIND THEY ARE HAVING TROUBLE WITH VISUAL FUNCTION.

THE SURGERY USED TO CARRY IT MUCH MORE RISK, AND IN FACT WE WOULD WAIT UNTIL IT WAS WHETHER -- UNTIL IT WAS RATHER DENSE SO THAT THE BENEFITS OUTWEIGHED THE RISK.

WE ARE ALLOWING PEOPLE TO ENJOY THE BENEFITS EARLIER.

>> LET'S MOVE TO FLOATERS.

TODD, WHAT ARE FLOATERS?

>> FLOATERS ARE -- THAT IS A VERY GENERAL TERM.

TYPICALLY WHEN YOU TALK WITH SOMEONE AND THEY SAY THAT THEY ARE FLOATERS WHAT THEY ARE REFERRING TO IS A NATURAL PROCESS THAT OCCURS WITH THE VITREOUS OR JELLY IN THE EYE.

THAT VITREOUS STARTS TO LIQUEFY AND PULL AWAY FROM THE BACK OF THE EYE.

WE CAN SOMETIMES SEE THAT IN THE VISION.

IT CAN EVEN CAST A SHADOW.

A PATIENT OFTEN SAYS I NOTICED THIS BUG FLYING AROUND IN MY VISION.

WHAT IS THIS?

THAT IS TYPICALLY A FLOATER.

FLOATERS ARE PART OF THE NATURAL AGING PROCESS.

WE DO WORRY ABOUT THEM WHEN THE PATIENTS INITIALLY GET THE FLOATER BECAUSE THEY CAN TO BE RELATED TO RETINAL TEARS AND ATTACHMENTS.

PATIENTS OFTEN SEE FLASHING LIGHTS WHEN THESE ARE FLOATERS FIRST, AND THAT IS THAT JELLY PULLING AT THE BACK OF THE EYE OF THE RETINA.

WE WORRY ABOUT THE FLOATER PULLING A PIECE OF THE RETINA OFF WITH IT.

FLOATERS ARE GENERALLY A NUISANCE.

AT FIRST WE GET USED TO THEM TO THE POINT WE DO NOT NOTICE THEM ANYMORE.

>> ANOTHER QUESTION, IS THEIR ONGOING RESEARCH ON FLOATERS?

I ASSUME THERE IS.

IS THERE ANYTHING NEW OR DIFFERENT?

AS FAR AS I KNOW IT IS A NATURAL PROCESS.

>> THERE HAS ALWAYS BEEN A QUESTION ABOUT WHAT DOES THE VITREOUS DO?

IS IT THE SPACE OCCUPIED JELLY, BUT I THINK OVER THE YEARS WE HAVE STARTED TO REALIZE IT DOES HAVE AN ANTIOXIDANT PROPERTY.

WE FIND PATIENTS WHO HAVE FOUND THAT TO HAVE BEEN REMOVED CATARACT PROGRESS MORE QUICKLY.

THERE DOES SEEM TO BE SOME ROLE IN THE LENS BECOMING A CATARACT.

>> KEVIN, DRY EYES?

AND I SUPPOSE YOU CAN DRAW ALLERGY AND WITH THAT TOO.

DO YOU WANT TO GIVE US A PRIMER ON WHAT TO DO ABOUT IT?

>> BASICALLY, THE CORNEA IS ONE OF THE MOST RICHLY INNOVATED PART OF THE BODY SO ANY DISRUPTION OF THE CORNEAL SERVICE CAN BE VERY BOTHERSOME, AND SO DRYNESS IS A SPECTRUM.

THERE COULD BE OCCASIONAL DRYNESS.

THERE ARE PEOPLE THAT IT CAN BE DEBILITATING.

WE GAUGE OUR TREATMENT ACCORDING TO HOW SEVERE THEIR SITUATION IS LUBRICATING DROPS, MUCH EVERYTHING IN A BOTTLE.

OTHERS NEED TO USE NON-PRESERVED LUBRICATING DROPS OFTEN.

IF THAT IS NOT ADEQUATE THERE ARE WAYS TO PLUG UP THE DRAINAGE SYSTEM TO ALLOW THE TEARS THE PATIENT IS MAKING TO BE RETAINED AND LUBRICATE THE CORNEA BETTER.

OCCASIONALLY IT CAN BE SO SEVERE WE HAVE TO SUTURE THE EYELIDS CLOSED BUT THAT WOULD BE UNLIKELY.

AS FAR AS ALLERGIES, VERY COMMON AS WE COME INTO SPRINGTIME.

TYPICALLY THE HALLMARK OF THAT WILL BE ITCHING.

DRY ICE CAN HAVE ITCHING TOO.

THERE CONTINUE TO BE BETTER TOPICAL ANTIHISTAMINE DROPS AVAILABLE OVER THE COUNTER, WHICH I THINK I HAVE REALLY HELPED GREATLY ALLEVIATE THE SYMPTOMS.

>> LET'S TAKE A TOUR OFF OF THAT.

LET'S TALK ABOUT REDEYE FOR A MOMENT.

WHAT ARE SOME OF THE CAUSES OF A REDEYE?

AND WHAT ARE DANGEROUS RED EYES?

>> THAT COVERS A BROAD SPECTRUM OF OCULAR PATHOLOGY FROM THINGS LIKE ALLERGIES, INFLAMMATION, TOXICITY FROM DROPS, DRY EYE AS WE JUST DISCUSSED.

TIMES WHEN WE REALLY WORRY ABOUT REDEYE ARE REDEYE WITH PAIN, ANYTHING THAT MIGHT INDICATE INCREASED PRESSURE WITHIN THE EYE.

THAT SOMETIMES OCCURS WITH GLAUCOMA, CERTAINLY INFECTION IS SOMETHING WE WANT TO BE CONCERNED ABOUT AS WELL.

REDEYE COVERS SUCH A BROAD RANGE OF CONDITIONS, THAT IT IS IMPOSSIBLE WHAT PATIENTS CALL ME AND SAY THEY HAVE A REDEYE TO GIVE A DIAGNOSIS OVER THE PHONE.

IT REALLY DOES REQUIRE AN EXAM.

>> I THINK THAT IS AN IMPORTANT POINT TO REMEMBER.

KATHY FROM CARLTON, I HAVE SEEN DOUBLE FOR THE PAST TWO MONTHS, AND HER EYES ARE NOT CORRECTING WITH ANYTHING.

SHOULD SHE SHE -- SEE HER DOCTOR OR SOMEONE?

>> SHE DOES NEED AN EYE EXAM?

-- EXAM.

IS IT DOUBLE VISION EVEN WHEN THE OTHER EYE IS COVERED?

THAT COULD BE A SIGN OF CATARACT OR OTHER CONDITIONS IN THE EYE.

IF IT IS TRULY ONLY THEIR WAY TO BOTH EYES ARE OPEN, THAT WE ARE CONCERNED ABOUT THE MUSCLES ON EACH EYE AND ARE THEY WORKING TOGETHER?

WHY ARE THEY NOT WORKING TOGETHER?

THERE ARE TREATMENTS FOR DOUBLE VISION.

IT COULD REQUIRE PRISM GLASSES, MUSCLE SURGERY.

AN EXAM STARTS ALL OF THOSE THINGS OUT.

>> A PERSON FROM GRAND RAPIDS, DIAGNOSED WITH CATARACTS IN THE LEFT EYE.

IS IT NORMAL FOR IT TO BE GOOD ONE DAY AND CLOUDY THE NEXT?

>> THERE COULD BE VARIATIONS.

IT DEPENDS ON WHAT TYPE OF CATARACT THEY HAVE.

THERE ARE PATIENTS IN BRIGHT LIGHT SITUATION, THE PEOPLE BECOME SMALLER AND THAT IS FORCING THE LIGHT TO COME THROUGH A VERY DENSE PART.

AN EYE EXAM WOULD HELP SEE OF THE SYMPTOM IS ATTRIBUTE IT TO THE CATARACT OR NOT.

>> TODD, A CYST ON WHAT I AND THE TEAR DUCT HAS POPPED UP ON WHAT I.

SHOULD SOMEONE SEE SOMETHING?

>> THAT PERSON SHOULD DEFINITELY SEE SOMEONE.

IF >> -- >> I WILL CARRY ON TO DRIVE.

WHAT IS THE OUTLOOK FOR TREATMENT OF CHRONIC DRY EYE?

>> THE OUTLOOK IS LOOKING BETTER.

I THINK FOR A WHILE THERE WAS ONE COMPANY AND ONE DRUG ASIDE FROM ARTIFICIAL TEARS FOR TREATMENT OF DRY EYE AND NOW THERE ARE SEVERAL DIFFERENT TYPES OF DRUGS FOR CHRONIC DRYNESS.

THERE IS ALWAYS THE ARTIFICIAL TEARS.

GO TO ANY GROCERY AISLE THAT CARRIES ARTIFICIAL TEARS AND YOU WILL SEE THERE ARE A NUMBER OF CHOICES.

>> MACULAR DEGENERATION, KEVIN.

TELL US WHAT THAT IS?

>> IT REFERS TO THE CENTRAL PART OF THE RETINA, WHICH IS WHERE OUR READING AND FIND VISION IS PROCESSED, SO ANY DEGENERATION IN THAT AREA, A PERSON COULD HAVE A VERY OUT THE RETINA FORT MEADE BEAT 90%, BUT IT IS THAT CENTRAL 10%, IF THAT IS OBLITERATED OR DISEASED IN SOME WAY, THAT WILL REALLY AFFECT THEIR QUALITY OF LIFE.

THERE IS DRY DEGENERATION, WHICH IS MORE COMMON.

THERE IS WET DEGENERATION, BLOOD VESSELS AND A RESPONSE TO THE DEGENERATION PROCESS.

MOST PATIENTS CAN BENEFIT FROM AN OF MEDICINE IN THE EYE.

A LOT OF RESEARCH GOING ON HOW TO TREAT DRY DEGENERATION.

WE WILL SEE AN EPIDEMIC AS BABY BOOMERS COME OF AGE.

A LOT OF RESEARCH IN THIS AREA.

>> THE NEXT QUESTION IS DO VITAMINS HELP?

>> PEOPLE WITH INTERMEDIATE OR ADVANCED DEGENERATION, THERE IS SOME BENEFIT TO USING NUTRITIONAL SUPPLEMENTS, SO THAT IT A GOOD QUESTION.

FRUITS AND VEGETABLES ALSO PLAY A ROLE, AND WE ENCOURAGE PEOPLE TO MAINTAIN A WELL-BALANCED DIET.

>> THE BEST PLACE TO GET YOUR VITAMINS ARE FRUITS AND VEGETABLES AT THE STORE.

WE HAVE BEEN HERE BEFORE, BUT WHAT CAUSES THE DETACHED RETINA?

WE TALKED ABOUT A DETACHMENT.

WHY DOES IT DO THAT?

>> THERE ARE VARIOUS CAUSES OF RETINAL DETACHMENT.

THE MOST COMMON CAUSE WE SEEM IS WHAT IS CALLED A -- TEAR.

>> A WHAT?

>> EXACTLY.

YOU GET A TEAR IN THE RETINA, AND THAT VITREOUS STARTS TO TRAVEL BEHIND THE TEAR.

WE ALWAYS USE THE ANALOGY OF PEELING WALLPAPER OFF THE WALL.

THAT WALLPAPER IS ESSENTIALLY YOUR RETINA, AND THAT IS THE MOST COMMON CAUSE OF RETINAL DETACHMENT VARIED ANOTHER CAUSE WE SEE IS ADVANCED DIABETES AND THE BLOOD VESSELS START TO SCAR AND PULL THE RETINA AWAY.

THAT IS ANOTHER COMMON CAUSE OF RETINAL DETACHMENT.

>> SHIFTING AGAIN, BLUE LIGHT FROM COMPUTERS AND TELEVISION.

HOW DO THEY AFFECT THE EYE AND GET THAT CAUSE PERMANENT DAMAGE?

>> THE STUDIES SHOWED LOOKING AT EMISSIONS FROM THOSE TYPES OF SCREENS DOES NOT SUGGEST THAT IT IS CAUSING DAMAGE.

I THINK MORE COMMON, PEOPLE DOING PROLONGED WORK AT THE COMPUTER END UP WORKING AT A FIXED FOCAL DISTANCE AND THEY CAN DEVELOP STRAIN.

TAKING LOOK -- BREAKS TO LOOK OFF IN THE DISTANCE USUALLY HELPS PEOPLE KEEP COMFORTABLE, BUT I WOULD NOT WORRY ABOUT THE POTENTIAL FOR DAMAGE.

>> FUSCH DYSTROPHY, A COUPLE OF QUESTIONS CAME IN.

TODD, YOU'RE UP.

WHAT IS IT?

TALK ABOUT IT.

I DO NOT KNOW WHAT THAT IS.

>> IT IS A CONDITION THAT AFFECTS THE CORNEA.

AGAIN, I WILL GRAB THE MODEL.

THE CORNEA IS THE CLEAR PART OF THE EYE.

IT HAS VARIOUS PLAYERS.

FUSCH CORNEAL DYSTROPHY INVOLVES THE INNERMOST LAYER.

IT IS RESPONSIBLE FOR PUMPING FLUID OUT OF THE CORNEA.

FOR YOU TO SEE YOUR ABSOLUTE BEST IT NEEDS TO BE CRYSTAL CLEAR AND FREE OF FLUID.

WITH THIS CORNEAL DYSTROPHY, THE CELLS RESPONSIBLE FOR PUMPING FLUID OUT OF THE CORNEA DO NOT ALWAYS WORK AS WELL AS THEY SHOULD.

THIS MAY NOT BE AN ISSUE.

YOU HAVE A LOT OF THESE CELLS THAT ARE WORKING PROPERLY PICK UP THE SLACK AND THEY KEEP THE CORNEA CLEAR.

ON OCCASION THE REMAINING CELLS MAY LOSE THAT ABILITY OVER TIME AND THE CORNEA BECOMES CLOUDY.

THERE ARE CERTAIN TIMES WHEN WE WORRY ABOUT THESE CELLS GETTING DAMAGED.

ONE INSTANCE IS DURING CATARACT SURGERY.

THERE IS THE POTENTIAL FOR THOSE CELLS TO BECOME DAMAGED AND WE WORRY ABOUT THE CORNEA TAKING LONGER TO CLEAR AFTER SURGERY.

THERE ARE GREAT TREATMENTS FOR THIS DYSTROPHY.

CORNEAL TRANSPLANTS HAVE COME A LONG WAY, AND ANY TIME A PATIENT HEARS THE WORD TRANSPLANT THEY BECOME WORRIED.

THIS IS NOT A LIVER TRANSPLANT.

THIS IS A TRANSPLANT OF THE CELLS ON THE BACKSIDE OF THE CORNEA AND IT IS QUITE SUCCESSFUL.

A LOT OF PATIENTS WITH THIS DYSTROPHY DO VERY WELL AND NEVER NEED A TRANSPLANT.

>> GLAUCOMA, WE HAVE TO TALK ABOUT GLAUCOMA OF IT.

KEVIN, IT IS YOUR TURN.

>> GLAUCOMA IS ONE OF THE COMMON CAUSES FOR REVERSIBLE -- HE VISION LOSSES.

MACULAR DEGENERATION CAN BE REVERSIBLE, BUT GLAUCOMA, ONCE YOU LOSE VISION DUE TO THAT, YOU DO NOT GET IT BACK.

IS IT IT -- IT IS A DISEASE AFFECTING THE NERVE THAT RUNS FROM THE EYE TO THE BACK OF THE BRAIN.

THERE IS DAMAGE, AND IT BECOMES GREATLY REDUCED.

AS THAT HAPPENS WE START TO SEE CHANGES IN THE EYE EXAM.

PEOPLE AFTER THE AGE OF 40 SHOULD HAVE PERIODIC EXAMS TO LOOK AT THAT NERVE.

IT HAS BEEN RELATED TO HIGH-PRESSURE, BUT EVEN PEOPLE WITH NORMAL PRESSURE CAN DEVELOP GLAUCOMA MET -- GLAUCOMA DAMAGE.

SUBDIVISION CAN GO AND EVEN CENTRAL VISION CAN BE WIPED OUT.

>> THIS IS A CHANCE FOR YOU GUYS TO GLOW A BIT.

YOU DO CATARACT SURGERY.

HOW DOES THAT CHANGE IN SOMEBODY'S VISION?

THEY ASKED ABOUT COLOR.

YOU PUT IN THE NEW LENS AND WHAT IT IS LIKE FOR SOME PERSON TO LET THAT HAPPEN?

>> IT WOULD BE LIFE-CHANGING.

WE CAN CORRECT HEIGHT REFRACTIVE AREAS, PEOPLE WHO CANNOT SEE BEYOND THEIR NOSE TURNED OUT SEE THE WORLD.

COLOR PERCEPTION, THEY ARE OFTEN SURPRISED TO RESTORE THE FULL SPECTRUM.

AS THE CATARACT GETS DENSE IT DOES START TO TAKE AWAY BLUE LIGHT.

INKS BECOME MORE YELLOW.

SOME OF THE GREAT ARTISTS, IF YOU WATCH THEIR PAINTINGS OVER THE CENTURIES, YOU CAN WATCH THEIR CATARACTS PROGRESS IN THE COLOR PALETTE.

>> I AGREE.

THAT IS ONE OF THE BIGGEST THING A PATIENT NOTICES.

WE DO CATARACT SURGERY IN ONE EYE AT A TIME.

THE MOST COMMON THING I HEAR IS, WOW, WHAT A BIG DIFFERENCE IN THE COLOR.

THE BEST ANALOGY IS COMPARING AND INCANDESCENT BULB TO AN LED BULB, THE BRIGHT WHITE VERSUS THE SOFT YELLOW, THE SOFT YELLOW BEING A CATARACT.

>> WHERE DID THE YELLOW GO, BASICALLY?

>> UVITIS.

>> IT REFERS TO THE MIDDLE COAT OF THE EYE, AND YOU CAN HAVE INFLAMMATION IN THE FRONT OF THE EYE INVOLVING THAT LAYER, IN THE MIDDLE OF THE EYE AND THE BACK OF THE EYE.

IT REQUIRES AN EXAM TO SORT OUT WHAT TYPE IT IS, AND EACH ONE RESPONSE DIFFERENTLY TO TREATMENT.

WE TRIED TO BE AGGRESSIVE TO TAMPING DOWN INFLAMMATION IN THE EYE TO PREVENT COMPLICATIONS SUCH AS GLAUCOMA.

>> OPTIC NEURITIS, TODD?

>> OPTIC NEURITIS IS A CONDITION OF INFLAMMATION WITH THE OPTIC NERVE WITH A VARIETY OF CAUSES, EVERYTHING FROM INFECTIOUS TO INFLAMMATORY TO IDIOPATHIC, MEANING WE DO NOT KNOW WHY.

OPTIC NEURITIS, THE MOST COMMON CAUSE TENDS TO BE IDIOPATHIC, AND WE CAN TREAT THESE WITH STEROIDS, BUT THE INITIAL THING IS TO FIGURE OUT WHAT IS CAUSING IT.

>> IS GLAUCOMA SURGERY RISKY, KEVIN?

>> YES, YOU DO HAVE TO MAKE INCISIONS THAT COULD LEAD TO INFECTION.

YOU COULD END UP WITH A PRESSURE RUNNING TOO LOW.

THE RISK-BENEFIT RATIO IS AN IMPORTANT DECISION-MAKING PROCESS THE DOCTOR AND PATIENT HAVE TO DISCUSS.

WHAT IS THE LIKELIHOOD IT WILL WIPE OUT THEIR VISION DURING THEIR REMAINING YEARS OF LIFE?

>> TODD, LOOKING AT HEADLIGHTS AND SEEING SOME VERSE AND STARS, IS THAT CATARACTS -- SUDDEN BURSTS AND STARS, IS THAT CATARACTS?

>> IT COULD BE.

IT IS IMPORTANT TO HAVE REGULAR EYE EXAMS TO DETERMINE THE CAUSE.

>> IS IT DANGEROUS TO DO CATARACT SURGERY AFTER A DETACHED RETINA?

>> ONCE THE DETACHED RETINA AS BID REPAIRED IT IS ACTUALLY QUITE SECURE AND IT IS UNLIKELY TO DEVELOP RECURRENT DETACHMENT.

THERE MAY BE A HIGH RISK FOR DEVELOPING FLUID IN THE RETINA AND THAT CAN BE TREATED.

WE DO NOT GENERALLY SAY WE ARE NOT GOING TO DO SURGERY BECAUSE YOU HAVE HAD A DETACHMENT.

>> I WANT TO THINK OUR GUEST THIS EVENING, AND I WOULD TO APOLOGIZE TO THE MAIN QUESTIONS WE DO NOT GET ANSWERED -- DID NOT GET ANSWERED.

I WANT TO THANK OUR PANELISTS, DR. TODD BRITTAIN AND DR. KEVIN TREACY, AND OUR PHONE VOLUNTEERS FROM THE GREAT GARDENING SHOW.

PLEASE JOIN HOST DR. PETER NALIN FOR A PROGRAM ON "SPORTS & OUTDOOR INJURIES AND JOINT REPLACEMENT" WHEN HIS PANELISTS WILL BE DR. PATRICK HALL AND DR. CARL RASMUSSEN.

THANK YOU SO MUCH FOR WATCHING TONIGHT.

GOOD NIGHT.

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