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Ophthalmology Department
Services |
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Diagnostic Imaging
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Diagnostic Procedures
and Ophthalmic Services
Applanation tonometry
(intraocular pressure)
Aqueous and vitreal centesis
Binocular indirect ophthalmoscopy
CERF examinations
Conjunctival biopsy
Dacryocystorhinography
Doppler manometry (blood
pressure)
Direct Retinal Examinations
Electroretinography
Equine and large animal
examinations
Equine Subpalpebral lavage
Fluorescein Angiography
Fluorescein staining of the Cornea
Gonioscopy
High
Frequency Ocular and Orbital Ultrasonography
Melan Red and Blue Pupillary Light Test: SARD's Test
Nasolacrimal Flushes
Ocular Photography and Retinal Photography
Slit-lamp biomicroscopy
Superficial Corneal Keratotomies
Surgical
Procedures
Corneal transplants
Corneal ulcer grafts
Cryosurgery
for distichiasis, ectopic cilia, ocular tumors and
retinopexy
Enucleation (Eye Removal)
Eyelid
Reconstructive Surgery
Glaucoma implants:
Ahmed Valve, Cullen Shunts, Ex-Press
Intraocular lens implantation:foldable,
injectable and rigid IOL’s
Intrascleral prosthesis
Laser glaucoma :Endolaser and
Transscleral
Laser retinal therapy:Direct,
Indirect and via Endolaser
Luxated lens Removal
Orbital
Implants
Repair
of prolapsed nictitans gland (Cherry eye repair)
Repair of traumatic injuries to the
globe
Superficial
Keratectomy
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Technology
Understanding Cataracts
CATARACTS AND YOUR PET
Commonly asked questions and answers about cataracts
What is a
cataract?
The normal lens in
the eye is used to focus light on the retina. It is similar
in function to a camera lens, and the retina is the film in
the camera. A cataract is an opacity or cloudiness in the
lens. The cataract can be very small and not affect vision
or involve the entire lens and cause blindness.
What causes
cataracts?
The most common
cause of cataracts in dogs and cats is an inherited defect
in the lens. These cataracts usually occur at a young age
and are called juvenile cataracts. In addition, cataracts
may occur due to an injury to the eye, inflammation in the
eye, or a systemic disease such as diabetes. In an older
dog, the lens may develop into a cataract as a degenerative
aging process. It is normal for the lens to become slightly
gray to blue in color when a dog reaches approximately 8
years of age and when a cat is about 10 years of age. This
is called nuclear sclerosis, which means hardening of the
lens. Nuclear sclerosis occurs in every animal and does not
affect vision. Many times nuclear sclerosis is mistaken for
cataracts by clients.
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Are some breeds
of dogs and cats more likely to develop cataracts?
Cataracts are more
likely to be found in popular purebred dogs and cats since
the breeding of related animals will allow the abnormal
genes to be concentrated. However, all animals, including
birds, reptiles, and fish may acquire cataracts.
Is surgery the
only way to cure cataracts?
The only treatment
for cataracts is surgical removal. Many claims for
nonsurgical “cures” have been made by unscrupulous
individuals since the beginning of time, but all have been
proven to be ineffective.
Is my pet too old
for cataract surgery?
Old age is not
considered a disease. Therefore, if a pet is healthy and
does not have any serious ailments such as heart failure,
then general anesthesia can be recommended and cataract
surgery can be performed.
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Describe cataract
surgery and the care involved before and after surgery:
Cataract removal is
a delicate surgical procedure. A complete examination of
the eye is necessary to determine if a pet is a good
surgical candidate. An electroretinogram and ocular
ultrasound are required to test the retinal function of the
eye. Also, your pet’s general health is important. A blood
sample is submitted for laboratory evaluation to make sure
the pet’s internal organs are functioning normally. The lab
work may be performed at the regular veterinarian’s office.
Medications are administered prior to surgery, which is
usually performed in the morning, and pets are discharged
the same day. Extracapsular extraction and
phacofragmentation are the two most common techniques used
to remove cataracts. Phacofragmentation is the preferred
technique in veterinary medicine and is utilized by Dr.
Sapienza. This is the most modern technology available in
both human and veterinary
medicine for cataract removal.
The “one stitch cataract surgery” advertised on television
is performed with phacoemulsification. This procedure
utilizes ultrasonic vibrations to liquefy the lens, which is
removed from the eye through a small incision. The incision
is 3 millimeters in length, which is less then half the
width of a pencil eraser.
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After surgery,
additional medications are sent home with the pet as well as
complete instructions. Follow-up visits are important in
order to monitor the healing process. Most patients are
seen for up to 3 months after surgery, and topical drugs are
used forever in your pet’s eyes. NOTE: The success of the
surgery is directly related to the post-surgery treatment.
The pet will regain new vision as healing takes place in the
eye. Reports are sent to the regular veterinarian to keep
him/her informed about your pet’s progress.
Is it necessary
for my pet to lose all vision in the affected eye before
cataract surgery can be performed?
No. In fact, once
the cataract is showing signs of progression, even if it is
in one eye, surgery should be considered in the affected
eye. As the cataract matures or “ripens”, it will become
very hard and very difficult to
liquefy and remove through
the small incision. Other complications can occur in the
eye as the cataract ripens or grows which can make surgery
more difficult or in severe cases not possible.
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How will my pet
be able to see without a lens?
Most of the focusing
or bending of light rays occurs at the cornea and the lens
fine-tunes the focus of the image on the retina. The cornea
accounts for 75% of the eye’s ability to focus, and the lens
accounts for the remaining 25%. Following lens removal, the
pet will be far-sighted. Objects up close may appear
blurry. The vision is not focused as in a normal eye but is
adequate for pets to perform routine functions without
difficulty. The restord vision following cataract surgery
enables your pet to live out a normal life free from dangers
and insecurity.
What about an
artificial lens?
An artificial lens
is used in man to replace the lens, which has been removed.
This restores the vision to as close to normal as possible.
The use of lens implants in dogs is available by Dr.
Sapienza and is used routinely with phacoemulsification
cataract surgery.
What about laser
surgery?
Lasers have many
uses in human and veterinary ophthalmology; however, lasers
are not used routinely to actually remove a cataract.
Phacoemulsification is not laser surgery.
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What is
electroretinogram?
For cataract surgery
to be successful, the rest of the eye, except the lens, must
be healthy. Sometimes the lens is so cloudy that the retina
cannot be examined by the ophthalmologists. The
electroretinogram (ERG) is an electronic test, which enables
the ophthalmologist to determine if the retinal function is
normal. The painless test is performed prior to the surgery
and is done without the use of general anesthesia. If the
ERG results are normal, cataract surgery will be
recommended. An ocular ultrasound is also performed to
further evaluate the health of the eye.
What are the
benefits of cataract surgery?
The eye that is
blinded by a cataract will be visual if the cataract can be
removed without complications.
Complications can occur in
cataract patients just as they can with any health
condition, and a good result cannot be guaranteed.
Generally, cataract surgery is successful in up to 90% of
the cases, and pets will resume normal activity following
successful surgery. At the time of the initial examination,
Dr. Sapienza can advise you if your pet is a suitable
candidate for cataract removal surgery.
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Understanding Glaucoma
GLAUCOMA
Glaucoma, or an increase in intraocular
pressure, is one of the leading causes of blindness in dogs
and cats. The fluid produced within the eye, called the
aqueous humor, exits the eye through specialized drainage
areas. Glaucoma can be caused by a number of factors such as
a malformed drainage area (very common in Cocker Spaniels,
Basset Hounds, Chow Chow, Shar Pei, and other purebred
dogs), debris obstructing the drain holes, as well as tumors
cells or a dislocated lens blocking the fluid’s exit from
the eye.
Glaucoma can result in sudden vision
loss. Therefore, early diagnosis and treatment are imperative
for successful therapy. Equally important, the treatment of
the other clinically normal eye is many times necessary in
purebred dogs, as glaucoma is often a bilateral condition in
predisposed breeds.
Because glaucoma presents in a sudden and aggressive
fashion, the prognosis for affected patients is always
guarded. However, many medications (in the form of drops,
ointments, and tablets) are available in our fight against
glaucoma. Frequently, surgery will be recommended in addition
to medical therapy, for glaucoma is rarely controlled with
medications alone in our patients. Surgery is currently
considered an imperative step in the therapy of glaucoma in
both animals and humans. Available surgeries include: laser
glaucoma therapy (endolaser, transscleral), glaucoma implants,
cryotherapy (freezing procedure), and those procedures to
re-route the exit of aqueous humor from the eye. There are
less than 15 endolaser units in the USA, and Dr. Sapienza
utilizes the only endolaser in all of New York State! In
chronically blind and painful eyes, other options include an
intrascleral prosthesis, enucleation (eye removal), and
intraocular injections.
Dr. Sapienza extensively studied surgical
treatment options for glaucoma, and has published several
articles on the use of lasers, gonioimplants, and other
surgical interventions in prestigious veterinary ophthalmology
journals, and he will advise you about the potential therapies
available and those best suited for your pet.
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PLEASE NOTE:
Therapy must be tailored to each individual patient.
Intraocular pressure must be measured regularly and the eye
treated as prescribed for optimal successful outcome.
After Hours
Should a problem arise after
normal business hours, the Ophthalmology Department is covered by
the Animal Emergency and Critical Care Center
at Long Island Veterinary Specialists. It is always best to call in
advance when possible, however, if problems arise, do not hesitate
to bring your pet in immediately. This facility is staffed 24-hours
by veterinarians and
technicians ready to assist you and your pet.
Your
cooperation and understanding will help us focus our energies on
patient care. We are available to answer any questions you may
have during our daily patient updates.
