Diagnostic means

Pachymetry

It consists of measuring the thickness of the cornea, a transparent structure located in the anterior segment of the eye. It is done in a painless way, after the administration of a drop of anesthetic eye drops. It is used in the following diseases:

• Glaucoma: the influence of corneal thickness on intraocular pressure values ​​is currently considered one of the most important diagnostic elements for patients with glaucoma and those suspected of having it. As a general rule, a thick cornea reduces the risk of glaucoma, while a thin cornea increases it.
• Corneal dystrophies: the determination of the thickness of the cornea has an important value in the follow-up and control of patients with non-ectatic dystrophies such as Fuchs’ dystrophy, as well as in the evolutionary follow-up of corneal edema.
• Study of endothelial function in patients who must undergo cataract surgery.
• Study and follow-up of patients who are candidates for refractive surgery.
• Previous and postsurgical study of corneal transplantation.

Optic nerve OCT

It is a structural test that analyzes the thickness of the retinal nerve fiber layer around the optic nerve and the ganglion cell layer at the level of the macula. Its usefulness is mainly in the study of patients with suspected glaucoma, but also in some neuro – ophthalmological and systemic diseases.

The test consists of analyzing the layer of nerve fibers and / or ganglion cells with a laser beam, which calculates its thickness. Given that the anatomical substrate of glaucoma is a decrease in these layers, a normal examination makes it possible (in many cases) to rule out the diagnosis of glaucoma, while a pathological examination is very much in favor of the diagnosis. It is also very important for the follow-up of patients diagnosed with glaucoma as a complement to functional tests (campimetry), since it can allow anticipating glaucomatous damage earlier than if only by following up with campimetry.

The test is performed with a Topcon 2000 OCT, capable of retinal and papillary OCT, as well as simultaneous retinography. To carry out this test, it is convenient to obtain images of diagnostic quality, the dilation of the pupil. The result is delivered immediately. The patient should be careful to avoid potentially dangerous activities, such as driving, for at least six hours after the test.

Posterior segment ultrasound

Posterior segment B-mode ultrasound is a non-invasive test, which is useful in all those diseases where there is an opacity of the ocular media that makes it difficult to correctly visualize the fundus, as well as those inflammatory diseases, tumours or those that occur with Vitreous opacities and vitreoretinal tractions or retinal detachment. Among them are:

• Dense cataracts
• Diabetic retinopathy
• Intraocular hemorrhages
• Vitreoretinal tractions and degenerations
• Epiretinal membranes
• Macular hole study
• Retinal detachments
• Retinoschisis
• Asteroid hyalitis
• Vitreous detachments, partial and total
• Diagnosis of optic nerve drusen
• Differential diagnosis of papilledema
• Diagnosis of intraocular foreign bodies
• Tumour and cystic pathology of the posterior segment
• Inflammatory pathology: posterior scleritis
• Traumatic pathology
• Anterior orbital pathology.

Anterior segment ultrasound (Ultrasonic biomicroscopy)

The anterior segment B-mode ultrasound is a non-invasive test that is useful in all those diseases that affect the structures of the anterior segment of the eye that cannot be directly visualized through the cornea, or when a disease or a Trauma hinders normal visualization of ocular structures. These diseases include:

• Study of the tumour pathology of the iris and ciliary body
• Study of the positioning of the crystalline lens and intraocular lenses
• Ectatic corneal pathology
• Determination of the depth of corneal lesions
• Study of patients with narrow anterior chamber and acute glaucoma
• Study of the pars plana and peripheral retina
• Study of patients undergoing filtering surgery (glaucoma)
• Study of patients undergoing vitrectomy
• Eye trauma:
  • Ora serrata dialysis
  • Cyclodialysis
  • Traumatic hyphema
  • Iris detachments
  • Intraocular foreign bodies
• Study of ocular hypotonia.

In our Center we have an Ellex EyeCubed ocular ultrasound equipment, with the ability to perform posterior segment B-mode ultrasound, 20 MHz anterior segment ultrasound (ultrasonic biomicroscopy), biometry with intraocular lens calculation and standardized A ultrasound. Its database allows to store the different tests, to be able to carry out subsequent evolutionary comparisons.

To carry out this test, no previous preparation is necessary, only the administration of an anesthetic eye drops. The test is performed with the patient fully stretched. Good collaboration is needed from the patient, who must move his eyes in the direction indicated (up, down, right, left).

Biometry

Biometry is a fundamental test for cataract surgery. It consists of measuring the anteroposterior size of the eye and its keratometric values ​​in order to subsequently determine through mathematical formulas which intraocular lens is the ideal to implant during the intervention.

In our Center we have a biometric equipment for interferometry IOLMaster 500. For cases in which this is not possible, we have an Ellex EyeCubed ocular ultrasound equipment, with the ability to perform B-mode posterior segment ultrasound, 20 anterior segment ultrasound MHz (ultrasonic biomicroscopy) and biometry with intraocular, contact and immersion lens calculation. The intraocular lens calculation can be performed with the formulas Holladay I, Holladay II, SRK-T, Haig is and Hoffer-Q.

Classically, biometriy has required direct contact of the biometer probe with the eye. Another alternative is to perform an immersion ultrasound, in which a layer of liquid is interposed between the probe and the surface of the eye. The results with immersion biometry are considered more reliable than those of contact biometry, since the anatomical relationship between the different ocular structures is not altered.

Retinography

It is a technique used for the registration, interpretation and following retinal and optic nerve pathologies. Its usefulness lies in the avoidance of subjectivity in the examinations, both carried out by the same physician and for other colleagues, providing an objective image, which can also be compared in successive visits.

Among its indications are:

• Early diagnosis and monitoring of glaucoma
• Follow-up of tumours and pigmented lesions of the fundus
• Follow-up of any retinal pathology, when you want to have an objective image.
• Follow-up of vascular retinopathies:
  • Diabetic retinopathy
  • Arterial occlusions
  • Venous occlusions
• Follow-up of degenerative pathology of the retina:
  • Age-related macular degeneration
  • Hard and soft drusen
  • Retinal dystrophies.

In our Center we have a Topcon OCT 2000 posterior segment photography equipment, capable of performing high-resolution retinographies with and without mydriasis.

Dilation is generally not necessary to perform this test, although in certain cases a complete pupillary dilation is required. For this reason, vision may be blurry for 4-8 hours after it is performed, and driving and potentially dangerous activities are not recommended during this time. Although it is not strictly necessary, it is considered advisable for the patient to come accompanied.

Optical coherence tomography (OCT) of the retina

It is a technique used for the diagnosis of diseases of the central region of the retina (macula). A laser beam measures the thickness of the retina, presenting the results as color-coded or black and white. The result is an almost anatomical section of the retina, which in many cases avoids more aggressive tests, such as fluorescein angiography. In diseases such as macular degeneration, diabetic retinopathy, retinal vascular pathology or different maculopathies, the performance of this test is considered the choice at the present time, as in most patients who are being studied for decreased vision.

The test is performed with a Topcon 2000 OCT, capable of retinal and papilla OCT. To carry out this test, and in order to obtain images of diagnostic quality, the dilation of the pupil is usually needed. The result is delivered immediately. The patient should be careful not to engage in potentially dangerous activities, such as driving, for at least six hours after the test.

Anterior segment optical coherence tomography (OCT)

It is a technique that is used, fundamentally, to assess the state of the different structures of the anterior chamber and the chamber angle. The test is performed with a Topcon 2000 OCT, capable of performing OCT of the retina, papilla and anterior segment.

Corneal topography

It is a technique that is used when it is interesting to know the shape of the anterior surface of the cornea. Normally, it is round, and in certain diseases it becomes oval or altered:

• Irregular astigmatisms
• Corneal and / or corneoconjunctival degenerations (pterygium)
• Ectatic corneal dystrophies:
  • Keratoconus
  • Pellucid marginal degeneration
• After cataract surgery
• Before or after a corneal transplant
• After prolonged use of contact lenses
• After refractive surgery
• Eye trauma with corneal wounds
• Corneal opacities

A Nidek Magellan surveyor is available at our Center. No specific preparation is necessary to perform this test.

Pediatric Photoscreening with Plusoptix

It is a technique used to detect visual problems in children between 6 months and 3 years old, when their collaboration for a conventional ophthalmological consultation is more deficient. This test is especially important in cases where the parents have had strabismus, lazy eye, or other visual defects, such as severe nearsightedness, farsightedness, and astigmatism.

This test allows us to detect the presence of graduation defects, media opacities (cataracts, alterations of the vitreous cavity) and alterations in the dynamics and statics of both eyes (asymmetries, strabismus).

Our Center has a Plusoptix team. By performing this test, no specific preparation is necessary. The result is delivered immediately.

Specular Microscopy (Endothelial Count)

It is a technique used to evaluate possible endothelial dysfunctions, cornea guttata , and Fuchs’ dystrophy. It is usually performed routinely before cataract surgery to assess the risk of decompensation.

In our Center there is a Nidek CEM 500 equipment. No specific preparation is necessary to carry out this test. The result is delivered immediately.

YAG laser iridotomy

The YAG laser emits non-thermal light energy. Its action is based on the ability to produce a break or cut the ocular tissues.

A hole in the pupil (iridotomy) is recommended for all people who suffer a sudden increase in pressure in the eye (acute glaucoma), and people with a narrow anterior chamber who may suffer increases in intraocular pressure. In general, these are hyperopic patients or patients with incipient cataracts and a narrow anterior chamber.

In our Center we have a Nd: YAG Nidek YC-1600 laser equipment. The treatment is done in the outpatient area, with previous application of drops to contract the pupil. The patient sits at the device and is instructed to keep the eye open. Subsequently, a few drops of anesthetic are administered and, afterwards, the treatment is done. In some patients it is necessary to use a special contact lens.

Immediately after the treatment, vision will be poor in the affected eye, so it is recommended that you come with someone. You can wear dark glasses. You should not drive or use potentially dangerous machinery while the glare effect lasts. If you have pain, you can take the pain reliever you usually use, although it is wise to avoid aspirin and derivatives. If a treatment with drops is prescribed, it will only be done for the prescribed time. It is advisable to take a relative rest and avoid violent physical efforts for 24-48 hours after treatment. It is not necessary to go to the consultation on an empty stomach.

In general, one eye is treated every day, except in exceptional situations (acute glaucoma).

If you need more information regarding treatment or your condition in general, please do not hesitate to ask before starting treatment.

YAG laser capsulotomy

The YAG laser emits non-thermal light energy. Its action is based on the ability to produce a break or cut the ocular tissues.

Most cataract patients present, at one time or another, an opacity of the posterior capsule (“dirty lens”). When the decrease in vision that it causes is significant, it is advisable to perform a capsulotomy with an Nd: YAG laser (“cleaning the lens”). It is recommended not to perform this technique in the first six postoperative months, and in no case before three months.

In our Center we have a Nd: YAG Nidek YC-1600 laser equipment. The treatment is done in the consultation, with previous application of drops to dilate the pupil. The patient sits at the device and is instructed to keep the eye open. Subsequently, a few drops of anesthetic are administered and, afterwards, the treatment is done. In some patients it is necessary to use a special contact lens.

Immediately after the treatment, vision will be poor in the affected eye, so it is recommended that you come with someone. During the first days, the visualization of “floaters” is very frequent. You can wear dark glasses. You should not drive or use potentially dangerous machinery while the effect of the pupillary dilation and glare lasts. If you have pain, you can take the pain reliever you usually use, although it is wise to avoid aspirin and derivatives. If a treatment with drops is prescribed, it will only be done for the prescribed time. It is advisable to take a relative rest and avoid violent physical efforts for 24-48 hours after treatment. It is not necessary to go to the consultation on an empty stomach.

In general, one eye is treated every day, except in exceptional situations.

If you need more information regarding treatment or your condition in general, please do not hesitate to ask before starting treatment.

Retinal Photocoagulation with Argon Laser

The argon laser emits waves with thermal action, which cause a burn (photocoagulation) to the ocular tissues on which it acts. For this reason, it is indicated for the following diseases, among others:

• Diabetic retinopathy
• Vascular occlusions of the retina (thrombosis)
• Glaucoma
• Treatment of retinal tears, or areas of high risk of having them.

In our Center we have an Ellex Integré laser. The treatment is done in the outpatient area, with previous application of drops to dilate the pupil. Subsequently, a few drops of anesthetic are administered and then a lens is put on to focus the laser and allow a correct visualization of the eye. At the same time, the lens prevents accidental closing of the eye.

Immediately after the treatment, vision will be poor in the affected eye, so it is recommended that you come with someone. You can wear dark glasses. You should not drive or use potentially dangerous machinery while the effect of the pupillary dilation and glare lasts. If you have pain, you can take the pain reliever you usually use, although it is wise to avoid aspirin and derivatives. If a drop treatment is prescribed, it will only be done for the prescribed time and in the treated eye. It is advisable to take a relative rest and avoid making significant physical efforts for 24-48 hours after treatment. It is not necessary to go to the consultation on an empty stomach.

In general, one eye is treated every day, except in exceptional situations. Depending on the disease, up to 4-6 sessions may be necessary for each eye.

If you need more information regarding treatment or your condition in general, please do not hesitate to ask before starting treatment.

Glaucoma Treatment: Argon Laser Trabeculoplasty

Some glaucoma patients show an insufficient response to treatment with drops. In these cases, and as a step prior to surgery, a laser trabeculoplasty can be performed. Treatment consists of applying laser burns to the trabecular meshwork, which is the natural drainage site for fluid from the eye. Burns “stretch” the trabecular meshwork, increasing the size of the drainage holes and favouring the removal of fluid from the eye.

The argon laser emits waves with thermal action, which cause a burn (photocoagulation) of the ocular tissues on which it acts. In our Center we have an Ellex Integré laser. The treatment is done in the consultation, with previous application of drops to contract the pupil. Subsequently, a few drops of anesthetic are administered and a lens is put on to focus the laser and allow good visualization, while preventing the eye from closing.

Immediately after the treatment, vision will be poor in the affected eye, so it is recommended that you come with someone. You can wear dark glasses. You should not drive or use potentially dangerous machinery while the glare lasts. If you have pain, you can take the pain reliever you usually use, although it is wise to avoid aspirin and derivatives. If a drop treatment is prescribed, it will only be done for the prescribed time and in the treated eye. It is advisable to take a relative rest and avoid making significant physical efforts for 24-48 hours after treatment. It is not necessary to go to the consultation on an empty stomach.

In general, one eye is treated every day, except in exceptional situations. Depending on the disease, several sessions may be necessary for each eye, which can be repeated in the future depending on the response.

If you need more information regarding treatment or your condition in general, please do not hesitate to ask before starting treatment.