A community health education series from Stanford Hospital & Clinics
Clear Sight Into Fragile Globe: New Byers Eye Institute at Stanford Combines High Technology with Advanced Knowledge Jennifer Thompson was feeling pretty good about her cataract surgery until shortly after it began, and she heard the surgeon say, “I can’t proceed. There is something very wrong.”
“I think he was pretty shocked by what he saw,” said Thompson. “He told me I was in danger of losing my vision and my eye.” Without quick action, that was a strong possibility. As frightening as that possibility was, she was thinking of something else that frightened her even more. Her husband had died eight years earlier of melanoma. Its first symptom was vision blurred by a detached retina.
Delicate architecture Our eyes may be the most complex organs. Protected by our eyelids, which blink 14,000 times each day,
“I think he was pretty shocked by what he saw. He told me I was in danger of losing my vision and my eye.” – Jennifer Thompson, patient at Byers Eye Institute at Stanford Hospital & Clinics Venturing into retinal territory requires infinitesimal precision. “The retina has the consistency of wet tissue paper,” said Leng. “Touch it with an instrument and you will rip it.” By the time he saw Thompson, scar tissue was already forming on the retina’s surface, blocking her vision. The accumulating blood was seeping under the retina, like bubbles in wallpaper, lifting the retina off its contact with the interior of the eyeball and destroying the ability of her left eye to process light as coherent vision. Thompson went into surgery with Leng, a retinal specialist, and other Eye Institute colleagues expert in the cornea. Two hours later, she was in recovery. “I had zero pain,” she
said. But she did have to spend the next two weeks, asleep or awake, face down in the head cradle of a massage table. The goal: To hold all the repairs together long enough for them to be secure.
Norbert von der Groeben
What he saw was blood where blood was not supposed to be. Thompson’s left eye was hemorrhaging, several layers of its delicate tissue torn open in a pre-operative procedure. Thompson had emergency surgery, but it was clear she needed the most advanced level of eye care possible. She was referred to the Byers Eye Institute at Stanford Hospital & Clinics to see eye surgeon Theodore Leng, MD, the Institute’s Director of Ophthalmic Diagnostics.
each small globe is fronted by the stack of cornea, pupil, iris and lens that face forward; lining the interior of the globe is a thin layer of tissue called the retina, made up of several layers of neuronal cells. They have a biochemical response to light that sends information through the optic nerve to the brain.
“It wasn’t easy,” Jennifer Thompson was about to have cataracts removed from her left eye when she said, “but the surgeon suddenly stopped the procedure. Her eye was hemorrhaging and when you’re trythe accumulating damage to fragile tissues inside the eye was an immediate and ing to save your serious threat to Thompson’s vision. vision, that’s what you do.” Her advances in eye care, Blumenkson set up a three-way mirror so ranz said, including the invention she could watch television and her of many of the features of modern grandchildren could crawl under the ophthalmic laser delivery systems table to look up at her and talk. “It for the retina. The initial system, was pretty hilarious,” she said. developed in the 1960s, became the standard of care for eyes for decades, he said. In the last decade, new Stanford’s Byers Eye Institute, generations of scanning lasers have where Thompson went for her care, made treatments even more precise, opened this fall, bringing together a quicker and less painful. group of physicians and the latest in equipment for diagnosis and treatStanford patients were among the ment. This new building is a natural first on the West Coast to benefit progression of the groundbreaking from another recent development, work done in ophthalmology for dethe use of monoclonal antibodies to cades at Stanford, said Byers’ Direcstop leaking blood vessels that cause tor Mark Blumenkranz, MD. several types of blindness, especially in people with age-related macular degeneration, Blumenkranz said. Stanford physicians have been inThe macula is the central portion strumental in many of the major
History of eye care innovation
Norbert von der Groeben
After a two-hour surgery at the Byers Eye Institute at Stanford, performed by Theodore Leng, MD, Thomson’s vision is almost completely back to normal. Leng is keeping careful watch on her eye health, however. Thompson may yet need another surgery. 10 N The Almanac N April 20, 2011