Zeiss Computerized Corneal Topography: This technology allows us to map the front surface of the eye, the cornea. The computerized corneal topographer is used to measure the corneal contour and curvature of every point on the corneal surface. The instrument provides us with a corneal map which can help us diagnose early corneal disease and to help us design a specialty contact or scleral lens for a particular cornea. This map is much like an architectural plan. Every cornea is unique and different. The different colors that you see on the monitor on the wall indicated the “hills and valleys” of a cornea. Without these corneal maps, it would be very difficult to create the lenses we are now creating for our “high need” patient population. With this instrument we can detect at a very early stage corneal conditions such a Keratoconus, Pellucid Marginal Degeneration and a host of other corneal conditions. In addition, this instrument is invaluable in helping us to design specialty contact and scleral lenses.
This unique technology allows us to view three dimensional in-vivo images of the retina, optic nerve and the nerve fiber layer. In addition, the individual layers of the retina can be virtually separated and studied. The result is the ability to detect retinal and optic nerve disease (such as macular degeneration and glaucoma) in the earliest stages. What you are viewing in the image shown on the monitor on the wall is a full detachment of the retina which required emergency surgery.
The Oculus Keratograph Topographer allows us to measure and analyze the moisture level, both qualitatively and quantitatively of the corneal surface. In addition, this instrument allows us to image three dimensionally the corneal surface and the oil producing (Meibomian) glands of the eyelids. The dysfunction of the Meibomian glands is the most frequent cause of dry eye. A healthy tear layer not only helps promote long term contact lens comfort, it is also essential for healthy eyes.
The very special software of the Oculus Keratograph also provides us with a three dimensional image of the corneal surface. This three-dimensional ocular image helps us to create a more detailed scleral lens design than was previously possible.
The digital retinal camera is used to analyze and examine the interior tissues of the eye. Many systemic diseases such as diabetes, hypertension, blood and neurologic disorders can be diagnosed with the use of this instrument. The image seen on the monitor is the ocular fundus, which is the most posterior structure of the eye. The red structure seen here is the retina. The small yellow-like structure is the optic nerve with blood vessels emanating from it.
Specular Microscope
Specular Microscopy plays a significant role in evaluating the health of the cornea. The Specular Microscope is unlike any other microscope. It is used to evaluate the cells comprising the back surface of the cornea, the endothelium. With aging, trauma, disease and surgery, the endothelial cells can become compromised. The endothelial cells pump oxygen into the cornea. These cells don’t replicate. One they die, new cells are not created to take their place. These cells are responsible for the cornea maintaining its transparency. This instrument allows us to detect any disorders of the corneal endothelium in the earliest stages.
Contact Lens
The contact lens refer to either a soft or gas permeable lens that rests on the front surface of the eye. Many corneas with conditions such as keratoconus, post-refractive surgical complications, chronic dry eye, corneal dystrophies and disease and many other ocular conditions cannot support this type of lens. In other words, a “contact” lens has contact with the front surface of the eye, the cornea.
Cornea
The clear front surface of the eye. The cornea is to the eye what a watch crystal is to your wristwatch.
Corneal Transplant Complications
Like all invasive procedures, corneal transplant surgery does have risks. It may take up to a year for the cornea to “seat” properly. In addition during the first year after the corneal transplant surgery is done, the contour and curvature of the cornea may change. Most patients who undergo a corneal transplant will need to wear a specialty contact or scleral lens for vision and ocular comfort purposes.
Ectasia
Post-LASIK Ectasia is a devastating complication of LASIK. This complication can occur weeks to years after the LASIK surgery is done. LASIK surgery thins out the cornea, which is the front surface of the eye. Because of the thinned out cornea, the pressure within the eye against the weakened corneal “wall” can cause the cornea to “buckle” or protrude. In other words vision will become severely compromised and the cornea will become distorted. There is no surgical or medical cure to restore the cornea to it’s pre-ectasia condition. The only technology that will permit this eye to see clearly once again is a gas permeable scleral lens.
GVR Scleral lens
A GVR Scleral lens does not have contact with the front surface of the eye ( the cornea). Instead, the lens is supported by the white portion of the eye, known as the sclera. There is a space between the back surface of the scleral lens and the front surface of the eye. This space is filled with pure, unpreserved saline solution. In other words, the cornea is always in a liquid environment. We refer to our unique scleral lens as the GVR (Global Vision Rehabilitation Center) Scleral lens. This is because we design our scleral lens using proprietary software and computer imaging technology. We create the design and tell our laboratory exactly how it is to be made.
Gas Permeable Material
This is the material that our scleral lenses are made from. Oxygen from outside of the eye penetrates the scleral lens and enters to cornea. The cornea is the only tissue in our body that has no blood vessels. For this reason it is important that the correct materials are used to fabricate the lens and to design the lens so that no contact is made with the compromised cornea.
Keratoconus
Keratoconus is a protrusion and thinning of the cornea. This can occur in the center or peripheral areas of the cornea. The end result of keratoconus is blurred, distorted vision than is best corrected with a specialty contact or scleral lens. Advanced cases of keratoconus can best be corrected with gas permeable scleral lenses.
Post-Refractive Surgical Complications
This refers to the unexpected loss of vision and ocular comfort that patients who have undergone LASIK, Radial Keratotomy, PRK and other vision altering eye surgeries have experienced. These complications include double vision, glare, halos loss of vision in low light situations, fluctuating vision, vitreous floaters and chronic dry eyes. Many of these conditions can take place years after the surgery was done.
Sclera
The white portion of the eye.
Below are pictures of Dr. Edward Boshnick and some of the Keratoconus patients who have visited him for scleral lenses.
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Dr. Edward Boshnick
Snapper Creek Professional Center
7800 SW 87 Ave Suite B-270
Miami, Florida 33173
305.271.8206
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