special feature
The architecture of sight
Protecting Your Eyes · Our mothers weren’t joking about carrots being good for our eyes. So are leafy green vegetables. A balanced diet, said Theodore Leng, MD, of Stanford’s Byers Eye Institute, is an important part of healthy eyes. · Wear a hat or sunglasses or both, Leng advises. Ultraviolet light can cause cancers on the surface of the eye, in addition to skin cancer on the eyelid. · Ultraviolet light is also a likely impetus for cataract development and may also be a factor in macular degeneration. That condition, very often related to increasing age, is caused by cellular debris that accumulates between the retina and the choroid, another layer of tissue in the eye. · Knowing the symptoms of retinal detachment can also prevent complete loss of vision. Those symptoms, which are painless, include the sudden
appearance of floaters, debris that looks like bits of string or hair or spots. Sudden flashes of light in one or both eyes and a shadow over one area of vision can also mean trouble. · Talk to your doctor if there is a family history of eye problems. Some diseases have a genetic component. The Byers Eye Institute at Stanford is home to six specialized care centers. It offers the latest technologies for diagnosis and treatment. Its professional staff includes 25 eye care specialists in all services, including cataract evaluation and surgery, oculoplastic surgery, cornea and external eye disease, glaucoma, and neuro-ophthalmology. It opened in fall 2010 in a $26.3 million building at 2452 Watson Court, Palo Alto.
Cornea: transparent protective tissue Iris: muscular ring that controls amount of light entering the pupil Pupil: allows light through to retina Lens: changes shape to allow focus at various distances Retina: thin layer of tissue whose photoreceptor cells transmit signals to optic nerve and visual Optic process centers Nerve Pupil in the brain Macula: central Macula portion of the Lens retina that Iris processes central field of vision and Retina enables vision acuity Cornea
For more information about the Byers Eye Institute at Stanford, visit stanfordhospital.org/eyeinstitute or call 650.723.6995. Join us at stanfordhospital.org/socialmedia.
of the retina; it can become clouded with material that obscures vision.
“The retina has the consistency of wet tissue paper. Touch it with an instrument and you will rip it.” – Theodore Leng, MD, Director of Ophthalmic Diagnostics, Byers Eye Institute at Stanford Hospital & Clinics
More than 1,000 surgeries were performed at the Eye Institute last year; 40,000 patient visits covered treatment of cataracts, diabetic retinopathy, glaucoma, lid and orbital problems, corneal disease and vitrioretinal diseases such as age-related macular degeneration and diabetic retinopathy.
Complexity overcome With Thompson, the first challenge was diagnosis. At Stanford, physicians use specialized cameras and scanning equipment that produce a microscopic-level image of the eye’s structures without having to remove any tissue from the eye. A low-intensity laser light beam allows information about the retina, even the optic nerve, to be gathered in ways previously not thought possible, said Blumenkranz. That data is then processed with software that constructs the image.
While repairing Thompson’s injury required great surgical skill, “she was very lucky,” Leng said. “It was a glancing injury which, fortunately and miraculously, did not cut the retina.”
“I feel nothing short of lucky, thanks to the skills, empathy, concern and knowledge of Dr. Leng and his team.” – Jennifer Thompson, patient at Byers Eye Institute at Stanford Hospital & Clinics The surgery was conducted with a raft of special devices designed to cope with the challenge of an organ that is 90 percent water
Norbert von der Groeben
Current research at Stanford includes continuing development of microsurgical devices and lasers that operate in femtoseconds—that’s a millionth of a billionth second. Stanford physician-scientists are also investigating how semiconductor chips might be used to help patients whose retina is intact, but who, because of genetic disorders, have lost the rods and cones in the retina necessary to translate light into images.
The Institute has also been nationally recognized as a center for clinical studies in refractive surgery, including LASIK and PRK.
Jennifer Thompson is an active grandmother who knits for her two granddaughters. She loves to bake, especially scones, a traditional tea time treat in her native New Zealand. If she had lost the vision in her left eye, she would now have a far different life, one marred by difficulties in reading, driving and other daily activities.
and only about one inch long. “As a young medical student,” Leng said, “you have no idea of how complicated the eye is.” The complexity of the eye, he said, means there are more things that can go wrong. When he embarked upon his education in eye care, “they give you a set of books that stretches out three feet—and that’s the basic knowledge,” he said. “Then we specialize even more.” “I feel nothing short of lucky,” Thompson said, “thanks to the skills, empathy, concern and knowledge of Dr. Leng and his team.” They even returned her calls on Christmas Eve and New Year’s Day, she said. “They made sure they were available. I was totally impressed.” She may need to have more surgery. There is still some scar tissue that Leng may have to remove, but her vision in her left eye is currently 20/30, just 10 vision feet below normal. Because of the damage, however, even repaired, Thompson knows that left eye has some weakness. That hasn’t stopped her from being an active grandmother to her two granddaughters or from taking a long visit to back home to New Zealand. “I flew with no problem at all!” she said.
Stanford Hospital & Clinics is known worldwide for advanced treatment of complex disorders in areas such as cardiovascular care, cancer treatment, neurosciences, surgery, and organ transplants. Consistently ranked among the top institutions in the U.S. News & World Report annual list of “America’s Best Hospitals,” Stanford Hospital & Clinics is internationally recognized for translating medical breakthroughs into the care of patients. It is part of the Stanford University Medical Center, along with the Stanford University School of Medicine and Lucile Packard Children’s Hospital at Stanford. For more information, visit stanfordmedicine.org. April 20, 2011 N The Almanac N 11