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Dr Zoran Aleksic

FCS (SA) Ophth Eye Specialist
Practice located in CBD / Oranjezicht

Dr Zoran Aleksic is an Ophthalmic surgeon specialising in laser refractive and cataract surgery. Graduated at Belgrade Medical School 1991.

Before specialising he was involved in provision of eye care in Pietermaritzburg ( Edenadale Hospital, Greys Hospital) in satellite unit of Medical School, University of Natal and during his training was involved in eye care provision in the post of registrar of Ophthalmology at Frere Hospital, East London.

He did specialist training at University of Cape Town, Grootte Schuur Hospital and Red Cross Children Hospital. He has been involved in Laser Refractive Surgery during his specialist training and started to perform laser in private practice from 1999.

He is registered with the following professional organizations:

  • Health Professions Council of South Africa
  • South African College of Surgeons
  • British General Medical Council
  • British Specialist Register
  • Ophthalmic Society of South Africa
  • South African Society of Cataract & Refractive Surgeons
  • European Society of Cataract and Refractive Surgeons

He has extensive experience with Nidek and Allegretto Wavelight laser systems.

Dr Aleksic's consulting rooms are conveniently situated in Oranjezicht (Mediclinic Cape Town) which is easily accessible with ample patient parking available. The clinic is located close to well known Mount Nelson Hotel.

Contact Us

Contact details

T: 021 426 48 42
F: 021 426 48 43
info@eyesurgery.co.za

Room 3010, Cape Town Medi Clinic, 21 Hof Street, Oranjezicht, Cape Town
GPS: S 33 56.163', E 18 24.619'

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About Us

Dr Zoran Aleksic FCS (SA) Ophth, is an eye surgeon, who specializes in cataract and laser refractive surgery (Lasik / PRK laser refractive surgery for short sightedness and far sightedness and astigmatism).

The treatment centre also performs general eye surgeries, eye tests, refractive laser surgery screening tests, daily testings for diabetes , glaucoma, and Age Related Macula Degeneration.

More exclusively Dr Aleksic offers cosmetic eye surgery, Botox injections and procedures to patients requesting enhancement for medical or cosmetic reasons.

The fully equipped optical dispensing practice operates from our rooms.

Our contact lens clinic supports patients with hard and soft lenses, the dispensing area also possesses a range of elegant and stylish frames and trendy day to day readers.

Dr Aleksic’s consulting rooms are conveniently situated in Oranjezicht (Mediclinic Cape Town) which is easily accessible with ample patient parking available. The clinic is located close to well known Mount Nelson Hotel.

Our contact details may be viewed by clicking on the side bar on the left side of your screen. Our contact telephone number can be viewed on the top right of your screen.

  • Testimonials

    "I am ecstatic with the results from the LASIK procedure - I never expected to get 20/20 vision again! The service was very professional, especially the procedure. I took great comfort from having every little step explained to me during the procedure and would highly recommend Dr Zoran and his team." -J.F D

  • Testimonials

    “I found Dr Aleksic both professional and friendly. Him and his staff put my mind at ease throughout the process and I am very happy with the results of my operation. I would recommend his practice to my friends and family.” -C.W

  • Testimonials

    “If I had known how wonderful the lasik procedure is, I'd have done it a lot sooner. Having worn glasses my whole life, I had no idea how amazing it is to wake up and see clearly. Dr. Aleksic was more than competent and friendly and even managed to totally correct my very high prescription. Absolutely recommended!" -M.N

  • Testimonials

    "Lasik surgery has changed my life and all my life experiences! I wore glasses from the age of 5 up until the age of 26 and the change of life quality has been more than I could ever have imagined. All I have are praises and honestly the best money I have spent on myself so far!" - M.B

  • Testimonials

    I was very concerned about the procedure beforehand, but after the first examination I saw all the modern and state of the art equipment and I decided to proceed. I don't regret it for one second. I can drive again without glasses and see so much better then before. My wife had the same procedure done and is also very happy. The service I received was qualified, friendly and professional. I recommend it to everybody. P.S

  • Testimonials

    “Dr Aleksik came highly recommended to me by two of my friends, both of whom had the LASIK procedure performed on them. I found his approach to be extremely thorough and professional, yet performed in a reassuring and light hearted manner. My only regret is that I did not have this done sooner - I now have perfect eyesight in both eyes.” -A.J

Laser eye surgery

Find out about Laser eye surgery.

Laser eye surgery

Laser surgery is performed in a doctor's office or eye clinic. Before the surgery, Dr Aleksic will: Dilate your pupil and apply drops to numb your eye. In some case, the doctor also may numb the area behind the eye to prevent any discomfort. The lights in the office will be dim. As you sit facing the laser machine, your doctor will hold a special lens to your eye. During the procedure, you may see flashes of light. These flashes may eventually create a stinging sensation that may make you feel a little uncomfortable.

The long eye / Short-sightedness(Myopia)

Short-sightedness (Myopia) is caused by an imbalance between the curvature of the cornea (the front window of the eye) and the focal length of the eye which is too long. With short-sightedness near vision is better then far vision. Excimer laser works by shaving a microscopic tissue layer off the front to the cornea. This flattens the curvature of the cornea and thus corrects the focus.

The oval eye / Astigmatism

Astigmatism is commonly associated with shortsightedness. With astigmatism the eye is not perfectly round, the curvature from the top to bottom is different to the curvature from side to side – much like the shape of a rugby ball. The shape is corrected with the laser.

The short eye / Far-sightedness

Farsightedness is caused by the eye being too short. With far sightedness both distance and near vision are not in perfect focus. Near vision is worse then far ( this is the opposite of short-sightedness).

Visit the American Academy of Ophthalmology website | European Cataract and Refractive Surgery Society Website

Correcting focus errors with laser surgery

Before surgery detailed measurements are done on the focus of the eye and shape of the cornea. This data is transferred to the computer that controls the laser and the optimum treatment profile is generated for the eye. The two most commonly performed laser techniques are LASIK and PRK. Both of these treatments are done with the same laser machine and the long term results are the same.

LASIK technique involves lifting a very thin flap of tissue off the cornea (much like an onion skin), the laser treatment is performed on the exposed corneal tissue after which the flap is put back into position. LASIK has the advantage that there is very little discomfort after surgery and the vision recovers very quickly.

PRK laser treatment is done directly onto the corneal surface without a flap. It takes a few days for the surface to heal and vision takes longer to recover. We may use the PRK technique if your cornea is not thick enough to do the LASIK technique. Your surgeon will advise which is the best technique for you.

Wavefront optimized laser surgery

The WaveLight EX500 is the fastest growing laser system both in Europe and the USA and is soon expected to overtake the older systems as the laser chosen by most laser specialists. Our Cape Town Laser Vision facility upgraded to the WaveLight EX500, making it the most up-to-date laser in Southern Africa at the time of writing. We are committed to keeping CT Laser Vison at the leading edge of technology.

Older laser systems correct shortsightedness and astigmatism in the same way as spectacles and contact lenses. Technology now allows the measurement of Higher Order Aberration. These are additional irregularities of the corneal shape that cannot be measured with conventional glasses testing. Higher Order Aberration (HOA) is measured in two ways. Wavefront analysis looks at the way light reflected off the retina passes through the lens and cornea to detect errors in the focus. Scheimpflug imaging uses a rotating camera to create 3-Dimensional maps of the cornea to detect shape irregularities.

When treating the cornea Scheimpflug imaging has the advantage that it measures only the cornea and is not influenced by irregularities of the lens, unlike wavefront analysis which is influenced by the lens.

The most important HOA is spherical aberration, which is a mismatch between the curvature at the centre of the cornea and the curvature at periphery of the cornea. Older lasers tend to cause spherical aberration by flattening the centre of the cornea more than the peripheral cornea, this can affect the quality of vision and affect night vision. The Allegretto Wavelight system uses Scheimpflug imaging to analyse the corneal shape for irregularities. A small percentage of patients will require a customised ablation to correct these irregularities. Unlike most other lasers the Allegretto Wavelight does a standard wavefront optimized ablation on all patients. This reduces spherical aberration and is believed to account for the superior results. This is widely considered to be the treatment of choice and is leading the development of this technology.

Results of laser surgery

Lasik is a quick and painless procedure that takes about 30 minutes for treatment of both eyes. The procedure is done with local anaesthetic, we might use a mild sedative if you feel nervous. The vision will be blurred and your eyes will be scratchy for a few hours after treatment. You will need someone to drive you home after surgery. The majority of patients are able to drive the next day and can go back to work within 48 hours. Some precautions are necessary after surgery. You will wear protective shields for the first 2 nights, you may not swim or wear make-up for the first week and will not be able to do contact sports for one month.

The majority of patients will have 20/20 vision after surgery without glasses. Less than 5% of patients don't achieve full correction with the first treatment and a second treatment is needed – there are no additional costs for the second treatment. Patients over the age of 45 years will need reading glasses after treatment – usually standard off-the-shelf readers. As we get older the natural lens of the eye loses its ability to flex and change focus from distance to near – an aging change called presbyopia. Laser treatment primarily corrects distance vision. Younger patients can see both far and near after surgery but over the age of 45 readers are needed.

Minor side effects may include a deterioration of night vision and haloes around lights at night in some patients. These effects are mild and improve after 3-6 months. Patients may have slightly dry and scratchy eyes and lubricant drops are routinely used during the first month. The risks of serious side effects such as infection, scarring or distortion of the shape of the cornea are extremely low. Lasik is one of the safest and most commonly performed surgical procedures of this decade.

Some facts about LASIK with WaveLight technology:

  • 93% of nearsighted patients see 20/20 or better.
  • 92% of patients described their vision as “good” or “excellent.”
  • 3/4 of nearsighted patients actually see better than 20/20!

For more detailed and technical info please visit www.myoptilasik.com, the official website of Allegretto WaveLight.

For more information please visit the video information page.

Am I suitable?

Simply fill in the form below and we’ll let you know if you’re suitable for laser eye surgery.

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Cataracts

Find out about cataracts.

Cataracts

What is a cataract?

The lens is made mostly of water and protein. The protein is arranged to let light pass through and focus on the retina. Sometimes some of the protein clumps together and starts to cloud a small area of the lens. This is a cataract. Over time, the cataract may grow larger and cloud more of the lens, making it hard to see.

Although researchers are learning more about cataracts, no one knows for sure what causes them. Scientists think there may be several causes, including smoking and diabetes. Or, it may be that the protein in the lens just changes as it ages. Scientists do know that a cataract won't spread from one eye to the other, although many people develop cataracts in both eyes.

Click here to download the Toric IOL brochure | Click here to view our Cataract Info Brochure

Visit the American Academy of Ophthalmology website | European Cataract and Refractive Surgery Society Website

Cataract Vision

A cataract is a cloudy area in the eye's lens that can cause vision problems. The most common type is related to ageing. More than half of all the people age 65 and older have a cataract. In the early stages, stronger lighting may lessen the vision problems caused by cataracts. At a certain point, however, surgery may be needed to improve vision. Today, cataract surgery is safe and very effective.

Cataract Surgery

For an early cataract, different eyeglasses, magnifying lenses, or stronger lighting may improve vision. If these measures don't help, surgery is the only effective treatment. Dr Aleksic removes the cloudy lens and replaces it with a substitute lens.

A cataract needs to be removed only if it affects your vision so much that it interferes with your daily activities. You make that decision. If you have cataracts in both eyes, the surgeon will not remove them both at the same time. You will need to have each done separately. Sometimes, a cataract should be removed even if it doesn't bother you. For example, if it prevents examination or treatment of another eye problem such as age-related macular degeneration or diabetic retinopathy, a cataract should be treated.

If you've chosen to have surgery, it's helpful to know more about it. This section describes the types of cataract surgery, lens substitutes, and what you can expect before and after surgery.

Is cataract surgery effective?

Cataract removal is one of the most common operations performed in the world today. It is also one of the safest and most effective. More than 90 percent of people who have cataract surgery have better vision afterward. However, even with the best results, your vision may not be as good as before the cataract.

How is a cataract removed?

The lens is enclosed in a capsule, an outer covering that holds it in place. There are many different techniques for cataract surgery, but all fall into one of two basic categories:

Extracapsular surgery: Doctor Aleksic opens the front of the capsule and removes the lens, leaving the back of the capsule in place. Sound waves (ultrasound) may be used to soften and break up the cloudy lens so that it can be removed through a narrow hollow tube. This is called phacoemulsification or phaco.

Currently, lasers cannot be used to remove a cataract. Although scientists are working on ways to use lasers in cataract surgery, these techniques are still being studied.

What are the choices for a lens substitute?

The lens is important for focusing. When it's removed, it usually needs to be replaced. There are three types of substitute lenses: an intraocular lens (IOL), a contact lens, or cataract glasses. Today, about 90 percent of patients choose an IOL. Of them, about 90 percent achieve 20/40 vision or better.

Intraocular lens: An IOL is a clear, acrylic lens that is placed in your eye during cataract surgery. It requires no care. With an IOL, you'll have better vision and won't feel or see the new lens. A few people cannot have an IOL because their eye structure isn't suitable, or they have certain other eye diseases.

What happens before surgery?

Before surgery, Dr Aleksic's staff will do some tests. These tests include measurement of the length of the eye and curvature of the cornea (the clear, dome-like structure that protects the front of the eye) and the shape of the eye. This information helps him choose the right type of IOL. Other tests may help to determine the health of the retina and to guide the surgery. Photographs of your eye may also be taken before or after surgery.

Most people stay awake during surgery, while others may need to be put to sleep for a short time. If you are awake, you'll have drugs to relax you and to numb the nerves and keep the eye from moving.

What happens after surgery?

Most people who have cataract surgery can go home the same day. Others may have some minor problems, such as bleeding, and may need to stay in the hospital overnight or for a few days. It's normal to feel itching, sticky eyelids, and mild discomfort for a while after cataract surgery. Some fluid discharge is also common. In most cases, healing will take about 6 weeks. If you have discomfort, Dr Aleksic may suggest a non-aspirin pain reliever every 4-6 hours (aspirin can cause bleeding). After 1-2 days, even moderate discomfort should disappear. After surgery, we will schedule exams to check on your progress.

You will use eyedrops to help healing and to prevent infection or inflammation. For a few days after surgery, you may also take eyedrops or pills to control the pressure inside your eye. You will have instructions as to how to use any post-operative medication. Problems after surgery are rare, but they can occur. These can include infection, bleeding, higher pressure inside the eye, inflammation (pain, redness, swelling), and detachment of the retina. With prompt medical attention, these problems can be treated. Certain symptoms could mean that you need prompt treatment. If you have any of the following symptoms, call us immediately: unusual pain, loss of vision, or flashing lights.

When will my vision be normal again?

After the surgery, you can read and watch TV almost right away, but your vision may be blurry. You normally can drive on the second day afer the surgery. The healing eye needs time to adjust so that it can focus properly with the other eye-especially if the other eye has a cataract. This healing period may take a few weeks. We can suggest ways to improve your vision during this time.

How long it will be before you can see normally depends on the vision in your other eye, the lens substitute you choose, and your vision before surgery. With an IOL, for example, you may notice that colours are brighter. It doesn't take long to adjust to these changes.

What is an "after-cataract"?

Sometimes people who have extracapsular surgery develop an after-cataract. When this happens, the back part of the lens capsule left in the eye becomes cloudy and keeps light from reaching the retina. Unlike a cataract, an after-cataract is treated with a laser. In a technique called YAG capsulotomy, Doctor Aleksic uses a laser beam to make a tiny hole in the capsule to let light pass through. This is a painless outpatient procedure.

What can you do to protect your vision?

Although we don't know how to protect against cataracts, people over the age of 60 are at risk for many vision problems. If you are age 60 or older, you should have an eye examination through dilated pupils. This kind of exam allows your eye care professional to check for signs of age-related macular degeneration, glaucoma, cataracts, and other vision disorders.

For more information please visit the video information page.

"An artist is not paid for his labour but for his vision."

James Whistler

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About Us

Find out about what we can do for you.

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Mykita

A constant search for innovation, the visionary use of materials and a wealth of experience in eyewear design are the defining elements behind MYKITA’s collections. A key factor in the company’s success is its holistic business philosophy, which brings together expertise from all disciplines under a single roof, the MYKITA HAUS. It thrives on the power of a self-contained network that enables interdisciplinary research and the transfer of technologies. This all-encompassing mentality is also reflected in the MYKITA Shops; the unique retail concept unites the firm’s own design principles with optical precision made in Germany.

MYKITA’s eyewear collections are available at the firm’s own shops in Berlin, Paris, New York, Monterrey, Cartagena, Zurich, Vienna and Tokyo as well as at selected opticians and fashion outlets in over 70 countries.

MYKITA’s COLLECTION NO2 plays heavily with the shape of the frames, ever introducing new variations in the thickness of the outer contour and the size of the lenses. The patented, resilient screwless hinge system is the result of a new metal-injection moulding technique. This is visible technology with a refined style – the quintessence of the MYKITA form and function philosophy.

The key feature of MYKITA’s COLLECTION NO1 is the patented snap-hinge design, comprising simple plug connections that render traditional soldered joints and screws redundant. Each part of the frame is cut out of a 0.5 mm stainless steel sheet and then folded into form by hand. As well as being light and comfortable to wear, the frames can be easily adjusted to each wearer’s face.

Visit the MYKITA Blog.

Porsche Design

Porsche Design is truly unique. Fundamental, not decorative. Engineered, not just perfectly designed. Luxury as a result of sheer purity. Each object is reduced to its essential function. From that a clean linear shape is derived. Only the most advanced materials of the highest quality are selected for the making of the product. Finest traditional craftsmanship is combined with the most modern technology. A convincing example are Porsche Design glasses and sunglasses. Their design is derived from the precise knowledge of optics and physiognomy. Example for timeless aesthetics. Mirror of classic modernism. And the uncompromising essence of Porsche Design: Passion. Performance. Purism. Precision.

Visit the Porsche Design website.

LAFONT

More than 30 years of creation, Lafont constantly works on their design with a mix of quality materials, craftsmanship and high technology manufacturing. The line, made in France, offers many unique choices and more than 200 colors in the collection.

Visit the LAFONT Blog.

"Never bend your head.
Always hold it high. Look the world straight in the eye."

Helen Keller

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CATARACT SURGERY IN PATIENTS WHO HAVE HAD PREVIOUS LASER REFRACTIVE SURGERY
ASSESSMENT FOR LASER SURGERY
POSSIBLE RISKS AND COMPLICATIONS WITH CATARACT SURGERY
AN EXPLANATION OF CATARACT SURGERY
Pterygium
PRK
Intra Ocular Lens Implant
Lasik
Keratoconus
Floaters
Corneal Transplant Types
Glaucoma and optic nerve damage
Cataract
Age Related Macula Degeneration
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Our Equipment

We are proud to offer the latest cutting edge equipment that includes:

  • OCT
  • Wavelight EX500
  • Camera
  • IOL master
  • Pentacam
  • Visual field machine
glaucoma
pterygiums
diabetes
corneal grafts
macular

Glaucoma

Glaucoma is a group of diseases that can lead to damage to the eye's optic nerve and result in blindness. Open-angle glaucoma, the most common form of glaucoma, affects about 3 million Americans (USA statistics); half of whom don't know they have it. It has no symptoms at first, but over the years it can steal your sight. With early treatment, you can often protect your eyes against serious vision loss and blindness.

What is the optic nerve?

The optic nerve is a bundle of more than 1 million nerve fibres. It connects the retina, the light-sensitive layer of tissue at the back of the eye, with the brain. A healthy optic nerve is necessary for good vision.

How does glaucoma damage the optic nerve?

In many people, increased pressure inside the eye causes glaucoma. In the front of the eye is a space called the anterior chamber. A clear fluid flows continuously in and out of this space and nourishes nearby tissues. The fluid leaves the anterior chamber at the angle where the cornea and iris meet (see diagram). When the fluid reaches the angle, it flows through a spongy meshwork, like a drain, and leaves the eye.

Open-angle glaucoma gets its name because the angle that allows fluid to drain out of the anterior chamber is open. However, for unknown reasons, the fluid passes too slowly through the meshwork drain. As the fluid builds up, the pressure inside the eye rises. Unless the pressure at the front of the eye is controlled, it can damage the optic nerve and cause vision loss.

Who is at risk?

Although anyone can get glaucoma, some people are at higher risk than others. What are the symptoms of glaucoma? They include:

  • Black population over the age 40
  • Everyone over the age of 60
  • People with family history of glaucoma

At first, open-angle glaucoma has no symptoms. Vision stays normal, and there is no pain. As glaucoma remains untreated, people may notice that although they see things clearly in front of them, they miss objects to the side and out of the corner of their eye. Without treatment, people with glaucoma may find that they suddenly have no side vision. It may seem as though they are looking through a tunnel. Over time, the remaining forward vision may decrease until there is no vision left.

How is glaucoma detected?

Most people think that they have glaucoma if the pressure in their eye is increased. This is not always true. High pressure puts you at risk for glaucoma. It may not mean that you have the disease. Whether or not you get glaucoma depends on the level of pressure that your optic nerve can tolerate without being damaged. This level is different for each person.

The same scene as it might be viewed by a person with glaucoma.

Although normal pressure is usually between 12-21 mm Hg, a person might have glaucoma even if the pressure is in this range. That is why an eye examination is very important. To detect glaucoma, Dr Aleksic will do the following tests:

  • Visual acuity: This eye chart test measures how well you see at various distances.
  • Tonometry: This standard test determines the fluid pressure inside the eye. There are many types of tonometry. One type uses a purple light to measure pressure. Another type is the "air puff," test, which measures the resistance of the eye to a puff of air.
  • Pupil dilation: This examination provides your eye care professional with a better view of the optic nerve to check for signs of damage. To do this, Dr Aleksic places drops into the eye to dilate (widen) the pupil. After the examination, your close-up vision may remain blurred for several hours.
  • Visual Field: This test measures your side (peripheral) vision. It helps Dr Aleksic to find out if you have lost side vision, a sign of glaucoma.

Can glaucoma be treated?

Yes. Although you will never be cured of glaucoma, treatment often can control it. This makes early diagnosis and treatment important to protect your sight. Most doctors use medications for newly diagnosed glaucoma; however, new research findings show that laser surgery is a safe and effective alternative. Glaucoma treatments include:

1) Medicine:
Medicines are the most common early treatment for glaucoma. They come in the form of eyedrops and pills. Some cause the eye to make less fluid. But most lower pressure by helping fluid drain from the eye. Glaucoma drugs may be taken several times a day. Although most people have no problems, some medicines can cause headaches or bother the eye. Drops may cause stinging, burning, and redness in the eye. Us to show you how to put the drops into your eye. In addition, tell us about other medications you may be taking before you begin glaucoma treatment.

Many drugs are available to treat glaucoma. If you have problems with one medication, tell us. Treatment using a different dosage or a new drug may be possible. You will need to use the drops and/or pills as long as they help to control your eye pressure. This is very important. Because glaucoma often has no symptoms, people may be tempted to stop or may forget to take their medicine.

2) Laser surgery (also called trabeculoplasty):
Laser surgery helps fluid drain out of the eye. Although Dr Aleksic may suggest laser surgery at any time, it is often done after trying treatment with medicines. In many cases, you will need to keep taking glaucoma drugs even after laser surgery. Laser surgery is performed in Hospital or eye clinic. Before the surgery, we will apply drops to numb the eye. As you sit facing the laser machine, Dr Aleksic will hold a special lens to your eye. A high-energy beam of light is aimed at the lens and reflected onto the meshwork inside your eye. You may see flashes of bright green or red light. The laser makes 50-100 evenly spaced burns. These burns stretch the drainage holes in the meshwork. This helps to open the holes and lets fluid drain better through them.

Dr Aleksic will check your eye pressure shortly afterward. He may also give you some drops to take home for any soreness or swelling inside the eye. You will need to make several follow-up visits to have your pressure monitored. Once you have had laser surgery, over the entire meshwork, further laser treatment may not help. Studies show that laser surgery is very good at getting the pressure down. But its effects sometimes wear off over time. Two years after laser surgery, the pressure increases again in more than half of all patients.

Conventional Surgery

The purpose of surgery is to make a new opening for the fluid to leave the eye. Although Dr Aleksic may suggest it at any time, this surgery is often done after medicine and laser surgery have failed to control your pressure. Surgery is performed in a clinic or hospital. Before the surgery, Dr Aleksic will give you medicine to help and relax the body and then sprays local anaesthetic around the eye to make it numb. Removal of a small piece of tissue from the white (sclera) of the eye is made, this creates a new channel for fluid to drain from the eye. But surgery does not leave an open hole in the eye. The white of the eye is covered by a thin, clear tissue called the conjunctiva. The fluid flows through the new opening, under the conjunctiva, and drains from the eye.

You must put drops in the eye for several weeks after the operation to fight infection and swelling. (The drops will be different than the eyedrops you were using before surgery.) You will also need to make frequent visits to your eye care professional. This is very important, especially in the first few weeks after surgery. In some patients, surgery is about 80 to 90 percent effective at lowering pressure. However, if the new drainage opening closes, a second operation may be needed. Conventional surgery works best if you have not had previous eye surgery, such as a cataract operation.

Keep in mind that while glaucoma surgery may save remaining vision, it does not improve sight. In fact, your vision may not be as good as it was before surgery. Like any operation, glaucoma surgery can cause side effects. These include cataract, problems with the cornea, inflammation or infection inside the eye, and swelling of blood vessels behind the eye. However, if you do have any of these problems, effective treatments are available.

What are some other forms of glaucoma?

Although open-angle glaucoma is the most common form, some people have other forms of the disease. In low-tension or normal-tension glaucoma, optic nerve damage and narrowed side vision occur unexpectedly in people with normal eye pressure. People with this form of the disease have the same types of treatment as open-angle glaucoma.

In closed-angle glaucoma, the fluid at the front of the eye cannot reach the angle and leave the eye because the angle gets blocked by part of the iris. People with this type of glaucoma have a sudden increase in pressure. Symptoms include severe pain and nausea as well as redness of the eye and blurred vision. This is a medical emergency. The patient needs immediate treatment to improve the flow of fluid. Without treatment, the eye can become blind in as little as one or two days. Usually, prompt laser surgery can clear the blockage and protect sight.

In congenital glaucoma, children are born with defects in the angle of the eye that slow the normal drainage of fluid. Children with this problem usually have obvious symptoms such as cloudy eyes, sensitivity to light, and excessive tearing. Surgery is usually the suggested treatment, because medicines may have unknown effects in infants and be difficult to give to them. The surgery is safe and effective. If surgery is done promptly, these children usually have an excellent chance of having good vision.

Secondary glaucomas can develop as a complication of other medical conditions. They are sometimes associated with eye surgery or advanced cataracts, eye injuries, certain eye tumors, or uveitis (eye inflammation). One type, known as pigmentary glaucoma, occurs when pigment from the iris flakes off and blocks the meshwork, slowing fluid drainage. A severe form, called neovascular glaucoma, is linked to diabetes. Also, corticosteroid drugs-used to treat eye inflammations and other diseases-can trigger glaucoma in a few people. Treatment is with medicines, laser surgery, or conventional surgery.

What can you do to protect your vision?

If you are being treated for glaucoma, be sure to take your glaucoma medicine every day and see us regularly. You can also help protect the vision of family members and friends who may be at high risk for glaucoma, the black population over age 40 and everyone over age 60. Encourage them to have an eye examination through dilated pupils every two years.

For more information please visit the video information page.

Pterygium

A pterygium is a triangular-shaped growth of fleshy tissue on the white of the eye that eventually extends over the cornea. This growth may remain small or grow large enough to interfere with vision. A pterygium can often develop from a pinguecula.

Some pterygia may become red and swollen on occasion, and some may become large or thick, making you feel like you have something in your eye. If a pterygium is large enough, it can actually affect the shape of the cornea’s surface, leading to astigmatism.

It is not entirely clear what causes pterygia and pingueculae to develop. Ultraviolet (UV) light from the sun is believed to be a factor in the development of these growths. Other factors believed to cause pterygia and pingueculae are dry eye and environmental elements such as wind and dust.

If you have a pterygia and it is causing discomfort, has grown over your cornea (the window) of your eye or is bothering you, you should be assessed so that you can decide whether it should be surgically removed. The surgery is done in theatre as a Day case. Dr Aleksic prefers to use tissue glue to secure the graft over the area where the pterygia was. This technique caused much less discomfort than sutures/ stitches.

For more information please visit the video information page.

Diabetic retinopathy

Diabetic retinopathy is a potentially blinding complication of diabetes that damages the eyes retina. It affects half of all patients diagnosed with diabetes.

At first, you may notice no changes in your vision. But don't let diabetic retinopathy fool you. It could get worse over the years and threaten your good vision. With timely treatment, 90 percent of those with advanced diabetic retinopathy can be saved from going blind.

It is advisable that everyone with diabetes to has an eye examination through dilated pupils at least once a year.

What is the retina?

The retina is the light- sensitive tissue at the back of the eye. When light enters the eye, the retina changes the light into nerve signals. The retina then sends these signals along the optic nerve to the brain. Without a retina, the eye cannot communicate with the brain, making vision impossible.

A diagram of the eye detailing the postion of the retina

How does diabetic retinopathy damage the retina?

Diabetic retinopathy occurs when diabetes damages the tiny blood vessels in the retina. At this point, most people do not notice any changes in their vision.

Some people develop a condition called macular oedema. It occurs when the blood vessels leak fluid and lipids onto the macula, the part of the retina that lets us see detail. The fluid makes the macula swell, blurring vision. As the disease progresses, it enters its advanced, or proliferative stage. Fragile, new blood vessels grow along the retina and the clear, gel-like vitreous that fills the inside of the eye. Without timely treatment, these new blood vessels can bleed, cloud vision and destroy the retina.

Who is at risk for this disease?

All people with diabetes are at risk – those with Type 1 diabetes (juvenile onset) and those with Type 2 diabetes (adult onset). During pregnancy, diabetic retinopathy may also be a problem for women with diabetes. It is recommended that all pregnant women with diabetes have dilated eye examinations each trimester to protect their vision.

What are the symptoms?

Diabetic retinopathy often has no early warning signs. At some point, though, you may have macula oedema. It blurs vision, making it hard to do things like read and drive. In some cases, your vision will get better or worse during the day.

As new blood vessels form at the back of the eye, they bleed (haemorrhage) and blur vision. The first time this happens it may not be very severe. In most cases, it will leave just a few specks of blood, or spots, floating in your vision. They often go away after a few hours.

These spots are often followed within a few days or weeks by a much greater leakage of blood. The blood will blur your vision. In extreme cases, a person will only be able to tell light from dark in that eye. It may take the blood anywhere from a few days to months to clear. You should be aware that large haemorrhages tend to happen more than once, often during sleep.

How is it detected?

Diabetic retinopathy is detected during an eye examination.

Visual acuity test
This eye chart test measures how well you see at various distances.

Ophthalmoscopy
This is an examination of the retina in which Dr Aleksic looks through a device with a special magnifying lens that provides a narrow view of the retina, wearing a headset with a bright light, looks through a special magnifying glass and gains a wide view of the retina.

Tonometry
A standard test that determines the fluid pressure inside the eye. Elevated pressure is a possible sign of glaucoma, another common eye problem in people with diabetes.

Dr Aleksic looks at your retina for early signs of the disease, such as:

  • leaking blood vessels
  • retinal swelling, such as macular oedema
  • pale, fatty deposits on the retina- signs of leaking vessels
  • damaged nerve tissue, and any changes in the blood vessels.
Should your doctor suspect that you need treatment for macular oedema, he or she may ask you to have a photo of your retina to document it's appearance. A more detailed test is a Fluorescein angiogram. This is a test of the retina, a special dye, fluorescein, is injected into your arm. Pictures are then taken as the dye passes through the blood vessels in the retina. This test allows Dr Aleksic to find the leaking blood vessels.

How is it treated?

The retina prior to and after focal laser treatment

There are two treatments for diabetic retinopathy. They are very effective in reducing vision loss from the disease. In fact, even people with advanced retinopathy have a 90 percent chance of keeping their vision when they get treatment before the retina is severely damaged. These two treatments are laser surgery and vitrectomy. It is important to note that although these treatments are very successful, they do not cure diabetic retinopathy.

For more information please visit the video information page.

Corneal grafts

What is the cornea?

The cornea is the clear front window of the eye. It transmits light to the interior of the eye allowing us to see clearly. Corneal injury, disease or hereditary conditions can cause clouding, distortion and scarring.

Corneal clouding, much like frost on a glass windowpane, blocks the clear passage of light to the back of the eye, reducing sight sometimes even to the point of blindness. In addition, corneal injury and disease can be painful, sometimes it is the most intense pain we can experience.

What can cause corneal injury?

Knives, pencils, glass and any sharp object can cause severe injury to the cornea. Fireworks, exploding batteries and toxic chemicals (especially alkalis) can result in severe scarring of the cornea. In fact, protection of the cornea is the reason the emergency washing out of the eye is absolutely necessary when the eye is exposed to toxic chemicals. Most corneal injuries are preventable with protective glasses and proper precautions when dealing with hazardous substances.

What causes corneal disease and degeneration?

Infections, whether bacterial, fungal or viral, frequently result in corneal damage and ulceration.

Abnormal steepening of the cornea (keratoconus), corneal oedema and swelling and some aging processes affect the clarity of the cornea. Some disorders of the cornea are inherited and can lead to corneal clouding and loss of sight.

Normal corneal topography

Abnormal steepening of the Cornea (Keratoconus)

What is a corneal transplant?

If the cornea is no longer clear, the only way to restore sight is to replace or transplant the cornea. Corneal transplantation (Keratoplasty) is the most successful of all tissue transplants. An estimated 15-20 000 corneal transplants are done each year in the United States. The success rate depends on the cause of the clouding. For example, corneal transplants for degeneration following cataract surgery and those for keratoconus both have high success rates, while corneal transplants for chemical burns have lower success rates.

How are corneal transplants done?

Corneal tissue for transplantation comes from an eye bank, in our case from the South African Eye Bank. The process begins with the death of someone who has been generous enough to be a donor. Names of patients needing corneal transplants are placed on a waiting list until the tissue is available. Unfortunately there are very few people who donate their corneas, so the waiting list is very long. It is possible to purchase corneas from overseas, but this is costly.

The operation consists of transfer of the clear central part of the cornea full thickness or partial thickness (lamellar keratoplasty) from the donor's eye to the patient's eye. The surgery is performed under general anaesthetic.

What happens after surgery?

Return of best vision after corneal transplant surgery may take up to a year after the operation, depending on the rate of healing and the health of the eye in general

As with any kind of transplant, rejection of the donated tissue can take place. The major signs of graft rejection are redness of the eye or a decrease in vision. If these symptoms occur, contact us urgently.

Why are regular medical eye examinations important for everyone?

Eye disease can strike at any age. Many eye diseases do not cause symptoms until the disease has done damage. Since most blindness is preventable if diagnosed and treated early, regular medical examinations by an ophthalmologist are very important.

For more information please visit the video information page.

Age-related macular degeneration

Age-related macular degeneration (AMD) is a disease that affects your central vision. It is a common cause of vision loss among people over age of 60. Because only the centre of your vision is usually affected, people rarely go blind from the disease. However, AMD can sometimes make it difficult to read, drive, or perform other daily activities that require fine, central vision.

What is the macula?

The macula is in the center of the retina, the light-sensitive layer of tissue at the back of the eye. As you read, light is focused onto your macula. There, millions of cells change the light into nerve signals that tell the brain what you are seeing. This is called your central vision. With it, you are able to read, drive, and perform other activities that require fine, sharp, straight-ahead vision.

How does AMD damage vision?

AMD occurs in two forms:

Dry AMD, affects about 90 percent of those with the disease. Its cause is unknown. Slowly, the light sensitive cells in the macula break down. With less of the macula working, you may start to lose central vision in the affected eye as the years go by. Dry AMD often occurs in just one eye at first. You may get the disease later in the other eye. Doctors have no way of knowing if or when both eyes may be affected.

Wet AMD, although only 10 percent of all people with AMD have this type, it accounts for 90 percent of all blindness from the disease. It occurs when new blood vessels behind the retina start to grow toward the macula. Because these new blood vessels tend to be very fragile, they will often leak blood and fluid under the macula. This causes rapid damage to the macula that can lead to the loss of central vision in a short period of time.

Who is at risk for AMD?

Although AMD can occur during middle age, the risk increases as a person gets older. Results of a large study show that people in their 50s have about a 2 percent chance of getting AMD. This risk rises to nearly 30 percent in those over age 75. Besides age, other AMD risk factors include:

  • Gender: Women may be at greater risk than men, according to some studies.
  • Smoking may increase the risk of AMD.
  • Family History; People with a family history of AMD may be at higher risk of getting the disease.
  • Cholesterol; People with elevated levels of blood cholesterol may be at higher risk for wet AMD.

What are the symptoms of AMD?

Neither dry nor wet AMD causes any pain. The most common symptom of dry AMD is slightly blurred vision. You may need more light for reading and other tasks. Also, you may find it hard to recognize faces until you are very close to them. As dry AMD gets worse, you may see a blurred spot in the center of your vision. This spot occurs because a group of cells in the macula have stopped working. Over time, the blurred spot may get bigger and denser, taking more of your central vision. People with dry AMD in one eye often do not notice any changes in their vision. With one eye seeing clearly, they can still drive, read, and see fine details. Some people may notice changes in their vision only if AMD affects both of their eyes.

An early symptom of wet AMD is that straight lines appear wavy. This happens because the newly formed blood vessels leak fluid under the macula. The fluid raises the macula from its normal place at the back of the eye and distorts your vision. Another sign that you may have wet AMD is rapid loss of your central vision. This is different from dry AMD in which loss of central vision occurs slowly. As in dry AMD, you may also notice a blind spot. If you notice any of these changes in your vision, contact your eye care professional at once for an eye exam.

How is AMD detected?

AMD is detected during an eye examination that includes:

1) Visual acuity test
This eye chart test measures how well you see at various distances. Pupil dilation: This examination enables Dr Aleksic to see more of the retina and look for signs of AMD. To do this, drops are placed into the eye to dilate (widen) the pupil. After the examination, your vision may remain blurred for several hours.

2) Tonometry:
This is a standard test that determines the fluid pressure inside the eye. Increased pressure is a possible sign of glaucoma, another common eye problem in people over age 60.

One of the most common early signs of AMD is the presence of drusen. Drusen are tiny yellow deposits in the retina. Dr Aleksic can see them during an eye examination. The presence of drusen alone does not indicate a disease, but it might mean that the eye is at risk for developing more severe AMD.

While conducting the examination, Dr Aleksic may ask you to look at an Amsler grid. This grid is a pattern that resembles a checkerboard. You will be asked to cover one eye and stare at a black dot in the center of the grid. While staring at the dot, you may notice that the straight lines in the pattern appear wavy to you. This may be a sign of wet AMD.

If Dr Aleksic suspects you have wet AMD, you may need to have a test called OCT (Optical Coherence Tomography), which is done in his rooms. This is a digital photo of the layers of your retina. It documents any areas of your retina that are swollen or scarred. This can help determine whether you need to consider treatment for AMD or not.

If Dr Aleksic does not get enough information from the OCT test, he may ask you to have fluorescein angiography of your eyes. In this test, a special dye is injected into a vein in your arm. Pictures are then taken as the dye passes through the blood vessels in the retina. The photos help the doctor to evaluate leaking blood vessels to determine whether they can be treated.

How is AMD treated?

Dry AMD currently cannot be treated. But this does not mean that you will lose your sight. Fortunately, dry AMD develops very slowly. You may lose some of your central vision over the years. However, most people are able to lead normal, active lives-especially if AMD affects only one eye.

Some cases of wet AMD can be treated with an injection of a drug. Avastin or Kenacort may be used.

Avastin therapy
Avastin is a non-scheduled drug, which has been available for the last few years to treat wet AMD. It is injected into the eye and is usually done once a month over 3 months. It is used to try to shrink the swollen area and in doing so, very often some vision can be restored or stablises. There is no guarantee how much one's vision will be improved, it takes time for the drug to work and it is most effective when it is used monthly over a 3 month period. In some cases there is no improvement, but at this stage Avastin treatment is the best option to try to prevent further damage and restore some vision.

Laser Surgery
In some cases, wet AMD is treated with laser. The treatment involves aiming a high energy beam of light directly onto the leaking blood vessels to seal them. Laser treatment is best applied soon after the new blood vessels develop, before they have reached and damaged the fovea-the central part of the macula. But even if the blood vessels are growing right behind the fovea, the treatment can be of some value in stopping further vision loss.

How is laser surgery performed?

Laser surgery is performed in hospital or eye clinic.Before the surgery, he or she will:

1) Dilate your pupil and
2) apply drops to numb the eye. In some cases, he or she also may numb the area behind the eye to prevent any discomfort.

The lights in the office will be dim. As you sit facing the laser machine, your eye care professional will hold a special lens to your eye. You may see flashes of bright green or red light. You can leave the office once the treatment is done, but you will need someone to drive you home. Because your pupils will stay dilated for a few hours, you also should bring a pair of dark sunglasses. For the rest of the day, your vision may be a little blurry. Your eye may also hurt a bit. This is easily controlled with drugs that your eye care professional can suggest. You will need to make frequent follow-up visits. During each exam, you may have fluorescein angiography to make sure that the blood vessels are not still leaking. If the vessels continue to leak, you might need more laser surgery.

What can you do to protect your vision?

Dry AMD. If you have dry AMD, you should have your eyes examined through dilated pupils at least once a year. This will allow Dr Aleksic to monitor your condition and check for other eye diseases as well. You should also obtain an Amsler grid from an eye care professional to use at home. This will provide you with a quick and inexpensive test to evaluate your vision each day for signs of wet AMD. It works best for people who still have good central vision. You should check each eye separately-cover one eye and look at the grid, then cover your other eye and look at the grid. You also may want to check your vision by reading the newspaper, watching television, and just looking at people's faces. If you detect any changes, you should have an eye exam.

Wet AMD. If you have wet AMD, it is important not to delay laser surgery if your eye care professional advises you to have it. After surgery, you will need to have frequent eye examinations to detect any recurrence of leaking blood vessels. Studies show that people who smoke have a greater risk of recurrence than those who don't. In addition, you should continue to check your vision (at home with the Amsler grid or other methods) as described under dry AMD and schedule an eye exam immediately if you detect any changes.

What can you do if you have already lost vision to AMD?

Normal use of your eyes will not cause further damage to your vision. Even if you have lost sight to AMD, you should not be afraid to use your eyes for reading, watching TV, and other usual activities. Low vision aids are available to help you make the most of your remaining vision. Low vision aids are special lenses or electronic systems that make images appear larger. If you need low vision aids, Dr Aleksic can often prescribe them or refer you to a low vision specialist. In addition, groups and agencies that offer information about counselling, training, and other special services are available. You may also want to contact a nearby school of medicine or optometry as well as a local agency devoted to helping the visually impaired.

For more information please visit the video information page.

"The eyes are the gateway to the soul."

Herman Melville

EYE SURGERY TRAILER