After 40 years of blindness, injection of light-sensitive protein restores a man’s vision
The first successful clinical test of a technique called optogenetics has allowed a 58-year-old man to see for the first time in decades.
The man was able to see with the help of image-enhancing goggles after 40 years of blindness, thanks to an injection of light-sensitive proteins into his retina.
According to a study published by Nature Medicine on May 24, this is the first successful clinical application of optogenetics, a technique in which flashes of light are used to control gene expression and neuron firing.
The study revealed that the technique is widely used in laboratories to probe neural circuitry and is being investigated as a potential treatment for pain, blindness and brain disorders.
The clinical trial, run by the company GenSight Biologics, based in Paris, enrolls people with retinitis pigmentosa — a degenerative disease that kills off the eye’s photoreceptor cells, which are the first step in the visual pathway.
In a healthy retina, photoreceptors detect light and send electrical signals to retinal ganglion cells, which then transmit the signal to the brain.
GenSight’s optogenetic therapy skips the damaged photoreceptor cells entirely by using a virus to deliver light-sensitive bacterial proteins into the RGCs, allowing them to detect images directly.
GenSight is one of several companies developing optogenetics as a treatment for RP and other disorders of the retina.
In March, Nirenberg’s company Bionic Sight announced that four of the five people with RP it had treated with a similar optogenetic therapy and a virtual-reality headset had recovered some level of vision, although the full trial results have not yet been published.
Also, Swiss pharma giant Novartis is developing a therapy based on a different protein that is so light-sensitive that goggles might not be needed. That therapy has not yet entered clinical trials.
The researchers injected the virus into the eye of a man with RP, then waited four months for protein production by the RGCs to stabilise before testing his vision, the Nature Medicine reported.
José-Alain Sahel, an ophthalmologist at the University of Pittsburgh Medical Center in Pennsylvania and leader of the study, says that one of the challenges was regulating the amount and type of light entering the eye, because a healthy retina uses a variety of cells and light-sensitive proteins to see a wide range of light.
“No protein can replicate what the system can do,” he says. So the researchers engineered a set of goggles that captured the visual information around the man and optimised it for detection by the bacterial proteins.
Using a camera, the goggles analyse changes in contrast and brightness and convert them in real-time into what Sahel describes as a ‘starry sky’ of amber-coloured dots. When the light from these dots enters a person’s eye, it activates the proteins and causes the RGCs to send a signal to the brain, which then resolves these patterns into an image.
The trial participant had to train with the goggles for several months before his brain adjusted to interpret the dots correctly. “He was like an experimentalist, a scientist trying to understand what he was seeing and make sense of it,” Sahel says.
Eventually, he was able to make out high-contrast images, including objects on a table and the white stripes in a crosswalk. When the researchers recorded his brain activity, they found that his visual cortex reacted to the image in the same way as it would have if he had normal sight.
The man still can’t see without the goggles, but Sahel says that he wears them for several hours per day and that his vision has continued to improve in the two years since his injection.
Sahel says six other people were injected with the same light-sensitive proteins last year, but the COVID-19 pandemic delayed their training with the goggles.
A neurobiologist at the University of California, John Flannery says the study “is a big step for the field.
“The most important thing is that it seems to be safe and permanent, which is really encouraging.”
Flannery said while the image may never be as good as natural vision, it is exciting that the brain can interpret images accurately.
Other researchers are, however, calling for more studies.
Sheila Nirenberg, a neuroscientist at Weill Cornell Medical College in New York City says she looks forward to seeing whether the other people in the trial, including some who were injected with higher doses of the protein, have similar results.
“It’s interesting, but it’s an N of 1,” she says.
Karl Deisseroth, a neuroscientist at Stanford University in California who co-developed optogenetics as a lab technique, says the study is important because it is the first time that the technique’s effects have been shown in people.
“It will be interesting to try this with more light-sensitive opsins” that might not require goggles, he says. But he expects optogenetics to be most useful as a research tool that leads to therapies, rather than a therapy itself.
“What we hope to see even more of is optogenetics-guided human and clinical studies,” he says.
How to maintain health eyes
Good vision helps you perform well—at home, at work, or behind the wheel. That’s why it’s important to take a few simple steps to make sure you help keep your eyesight at its best. A regular eye exam is the best way to protect your eyesight – and an easy precaution to take. Here are some tips to help maintain eye health as you age.
Eat a Balanced Diet
As part of your healthy diet, choose foods rich in antioxidants, like Vitamins A and C; foods like leafy, green vegetables and fish. Many foods – especially fatty fish, such as salmon – contain essential omega-3 fatty acids that are important to the health of the macula, the part of the eye responsible for central vision.
An inadequate intake of antioxidants, consumption of alcohol or saturated fats may create free-radical reactions that can harm the macula – the central part of the retina. High-fat diets can also cause deposits that constrict blood flow in the arteries. The eyes are especially sensitive to this, given the small size of the blood vessels that feed them.
Your eyes are unique, and have their own set of nutritional needs. Ocuvite eye vitamins are specially designed to provide a balanced combination of nutrients dedicated to the health of your eyes.* Visit Ocuvite.com to learn more.
Exercise
Exercise improves blood circulation, which improves oxygen levels to the eyes and the removal of toxins.
Get a good night’s sleep
You’ll feel the difference when you get the sleep you need. You’ll look great, you’ll perform at home or work—and good rest will support the health of your eyes.
Wash your hands
Keeping your hands clean is so important when it comes to your eyes, especially if you’re a contact lens wearer. Before you touch your eye—and before you put in or remove a contact lens—wash your hands with a mild soap and dry with a lint-free towel. Some germs and bacteria that come from your hands can cause eye infections, like bacterial conjunctivitis (pink eye). When you touch your eye, whatever is on your fingers goes right onto your eye’s surface. This is one way that people catch colds—rubbing their eyes while they have cold virus germs on their hands.
Don’t Smoke
Smoking exposes your eyes to high levels of oxidative stress. While the connection has not been clearly identified, it is known that smoking increases your risk for a variety of health conditions affecting the eye. To help you quit, visit the American Lung Association’s free online smoking cessation program – Freedom From Smoking Online – at www.ffsonline.org.
Wear Sunglasses
To protect your eyes from harmful ultraviolet (UV) light, choose sunglasses with both UVA and UVB protection. Also, wearing a hat with a brim will greatly reduce the amount of UV radiation slipping around the side of your sunglasses.
Devices and Blue Light
You’re probably using digital devices for hours each day at work and at home. These devices are exposing your eyes to high energy blue light. It’s called blue light because the wavelengths emitted are near the bluer part of the spectrum. Lutein & Zeaxanthin are eye nutrients that are concentrated in the macula and help eyes filter blue light.* Lutein and Zeaxanthin cannot be produced by our bodies on their own, so they must be obtained through diet and/or supplements. If you don’t think you’re getting enough in your diet, visit Ocuvite.com to learn more.
Here are some other tips to help when you’re on your computer:
- Keep your computer screen within 20″-24″ of your eye.
- Keep the top of your computer screen slightly below eye level.
- Adjust lighting to minimize glare on the screen.
- Blink frequently.
- Take a break every 20 minutes to focus on an object 20 feet away for 20 seconds.
- Use lubricating eye drops to soothe irritated, dry eyes.
Glaucoma
Glaucoma
The increased pressure in your eye, called intraocular pressure, can damage your optic nerve, which sends images to your brain. If the damage worsens, glaucoma can cause permanent vision loss or even total blindness within a few years.
Most people with glaucoma have no early symptoms or pain. Visit your eye doctor regularly so they can diagnose and treat glaucoma before you have long-term vision loss.
If you lose vision, it can’t be brought back. But lowering eye pressure can help you keep the sight you have. Most people with glaucoma who follow their treatment plan and have regular eye exams are able to keep their vision.
Glaucoma Causes
The fluid inside your eye, called aqueous humor, usually flows out of your eye through a mesh-like channel. If this channel gets blocked, the liquid builds up. Sometimes, experts don’t know what causes this blockage. But it can be inherited, meaning it’s passed from parents to children.
Less-common causes of glaucoma include a blunt or chemical injury to your eye, severe eye infection, blocked blood vessels inside your eye, and inflammatory conditions. It’s rare, but eye surgery to correct another condition can sometimes bring it on. It usually affects both eyes, but it may be worse in one than the other.
CONTINUE READING BELOW
Glaucoma Risk Factors
It mostly affects adults over 40, but young adults, children, and even infants can have it. African Americans tend to get it more often, when they’re younger, and with more vision loss.
You’re more likely to get it if you:
- Are of African American, Irish, Russian, Japanese, Hispanic, Inuit, or Scandinavian descent
- Are over 40
- Have a family history of glaucoma
- Have poor vision
- Have diabetes
- Take certain steroid medications such as prednisone
- Have had an injury to your eye or eyes
- Have corneas that are thinner than usual
- Have high blood pressure, heart disease, diabetes, or sickle cell anemia
- Have high eye pressure
- Are nearsighted or farsighted
Types of Glaucoma
There are two main kinds:
Open-angle glaucoma. This is the most common type. Your doctor may also call it wide-angle glaucoma. The drain structure in your eye (called the trabecular meshwork) looks fine, but fluid doesn’t flow out like it should.
Angle-closure glaucoma. This is more common in Asia. You may also hear it called acute or chronic angle-closure or narrow-angle glaucoma. Your eye doesn’t drain like it should because the drain space between your iris and cornea becomes too narrow. This can cause a sudden buildup of pressure in your eye. It’s also linked to farsightedness and cataracts, a clouding of the lens inside your eye.
CONTINUE READING BELOW
Less common types of glaucoma include:
Secondary glaucoma. This is when another condition, like cataracts or diabetes, causes added pressure in your eye.
Normal-tension glaucoma. This is when you have blind spots in your vision or your optic nerve is damaged even though your eye pressure is within the average range. Some experts say it’s a form of open-angle glaucoma.
Pigmentary glaucoma. With this form, tiny bits of pigment from your iris, the colored part of your eye, get into the fluid inside your eye and clog the drainage canals.
Glaucoma Symptoms
Most people with open-angle glaucoma don’t have symptoms. If symptoms do develop, it’s usually late in the disease. That’s why glaucoma is often called the “sneak thief of vision.” The main sign is usually a loss of side, or peripheral, vision.
Symptoms of angle-closure glaucoma usually come on faster and are more obvious. Damage can happen quickly. If you have any of these symptoms, get medical care right away:
CONTINUE READING BELOW
Glaucoma Diagnosis
Glaucoma tests are painless and don’t take long. Your eye doctor will test your vision. They’ll use drops to widen (dilate) your pupils and examine your eyes.
They’ll check your optic nerve for signs of glaucoma. They may take photographs so they can spot changes at your next visit. They’ll do a test called tonometry to check your eye pressure. They may also do a visual field test to see if you’ve lost peripheral vision.
Glaucoma Treatment
Your doctor may use prescription eye drops, oral medications, laser surgery, or microsurgery to lower pressure in your eye.
Eye drops. These either lower the creation of fluid in your eye or increase its flow out, lowering eye pressure. Side effects include allergies, redness, stinging, blurred vision, and irritated eyes. Some glaucoma drugs may affect your heart and lungs. Be sure to tell your doctor about any other medications you’re taking or are allergic to.
Oral medication. Your doctor might also prescribe medication for you to take by mouth, such as a beta-blocker or a carbonic anhydrase inhibitor. These drugs can improve drainage or slow the creation of fluid in your eye.
CONTINUE READING BELOW
Laser surgery. This procedure can slightly raise the flow of fluid from your eye if you have open-angle glaucoma. It can stop fluid blockage if you have angle-closure glaucoma. Procedures include:
- Trabeculoplasty. This opens the drainage area.
- Iridotomy. This makes a tiny hole in your iris to let fluid flow more freely.
- Cyclophotocoagulation. This treats areas of the middle layer of your eye to lower fluid production.
Microsurgery. In a procedure called a trabeculectomy, your doctor creates a new channel to drain the fluid and ease eye pressure. This form of surgery may need to be done more than once. Your doctor might implant a tube to help drain fluid. This surgery can cause temporary or permanent vision loss, as well as bleeding or infection.
Open-angle glaucoma is most often treated with combinations of eye drops, laser trabeculoplasty, and microsurgery. Doctors tend to start with medications, but early laser surgery or microsurgery could work better for some people.
Infant or congenital glaucoma — meaning you are born with it — is usually treated with surgery because the cause is a problem with your drainage system.
CONTINUE READING BELOW
Glaucoma Prevention
You can’t prevent glaucoma. But if you find it early, you can lower your risk of eye damage. These steps may help protect your vision:
- Have regular eye exams. The sooner your doctor spots the signs of glaucoma, the sooner you can start treatment. If you’re over age 40 and have a family history of the disease, get a complete eye exam from an eye doctor every 1 to 2 years. If you have health problems like diabetes or are at risk of other eye diseases, you may need to go more often.
- Learn your family history. Ask your relatives whether any of them have been diagnosed with glaucoma.
- Follow your doctor’s instructions. If they find that you have high eye pressure, they might give you eye drops to prevent glaucoma.
- Exercise. Moderate activity like walking or jogging at least three times a week might help lower eye pressure.
- Protect your eyes. Use protective eyewear when playing sports or working on home improvement projects
About Us
Our Mission
To Be the Region’s Leading Eye Care Provider, Delivering the Most Advanced, Specialized Eye Care Services in a Compassionate, Patient-Centered Approach.
Buy freshlook contact lenses at N2000/pair with 120ml solution, storage case and picker within in Ajuwon Giwa Okearo Alagbole Akute
Buy Freshlook coloured contact lenses @ N2000/pair with 120ml solution and storage case and picker.
– Available quantity: 10, 000 pairs
– available colours: All freshlook colours…including all new unique colours
– Expiry Date: January 2024
– Made in USA
– Supply ability: 50, 000 pairs/ month
– Delivery coverage: Nigeria and West Africa
– Free pre-contact lens fitting examination and tutorial
– To order between 1 pair and 2000 pairs, call +2347030000001
– To order above 2000 pairs, call: +19093663551
Corneal layers and corneal transplant -Eye care perspective
What are the different layers of the cornea?
The cornea is the clear front wall of the eye, similar to a watch crystal. Functionally, the cornea has 3 main layers. All layers are clear and must be so to focus light properly.
The outer 10% of the cornea, the epithelium, is the protective skin layer that has sensation. It tells you to blink when your eyes are dry or if you get something in it. The epithelium protects the stroma from infection, scarring, drying out, and other potential harm. Just like the outer layer of your skin, the corneal epithelium sheds and regenerates itself every week. The new cells are grown by corneal epithelial stem cells. Therefore, an eye with an area of bad or opaque epithelium that blocks vision likely does not need a transplant to remove to opacity. Instead of the opacity typically only needs to be removed so that new healthy and clear epithelium can grow in (superficial keratectomy or SK). All other corneal layers do not regenerate and would need to be replaced or transplanted if removed.
The middle layer, the stroma, is the tough structural portion that makes up about 85% of the cornea thickness. The stroma is covered on the outside by the epithelium and on the inside by Descemet’s membrane.
The inner layer of the cornea, Descemet’s membrane, makes up 3 to 5% of its thickness. It is a thin Saran wrap-like membrane that has a single layer of extremely important endothelial cells living on its inner surface. The cornea needs oxygen and nutrients delivered to it, but it does not have blood flow like other parts of the body since blood vessels would make it opaque. The cornea is nourished by a clear fluid called aqueous humor. Aqueous inside the eye is made by arteries and is drained by veins. Descemet’s membrane limits the rate that aqueous humor can flow into the cornea. The endothelial cells pump out “used” aqueous humor so that it does not build up in the cornea which would otherwise make it opaque.
Is it possible to remove and/or transplant just one layer of the cornea?
Yes. We can explain the different types of cornea transplantation using the analogy of a wall. Think of the stroma as the drywall and bricks, Descemet’s membrane and endothelium as the wallpaper, and the epithelium as the temporary protective layers of clear coat that the owner must paint on the bricks from time to time.
Not that long ago, the only available surgery was a full thickness cornea transplant or penetrating keratoplasty (PK). With PK, all of the corneal layers are transplanted, and new epithelial cells grow over the new cornea in time. The entire wall is knocked out with a hammer, and a new wall and all its layers are brought in. The owner provides a new layer of clear coat over time. A prosthetic corneal transplant (keratoprosthesis (KPro) is an artificial full-thickness corneal transplant.
Selective keratoplasty surgeries are a huge advance over PK in that they allow us to replace just the portion of the cornea that is diseased.
-
- Superficial keratectomy (SK) and phototherapeutic keratectomy (PTK) remove the epithelium (and possibly some superficial stroma with PTK) so that new healthier epithelium can grow in. The corneal epithelium is the only layer of the cornea that regenerates. So, SK and PTK aren’t true transplants. They are like removing some imperfections in the layer of clear coat on the outside of the house so that the owner can lay down new clear coat. Conversely, an epithelial stem cell transplant is necessary when the owner’s can of clear coat runs out or goes bad. It becomes necessary to give the owner a new supply of clear coat, which involves transplanting in a special area of a donor cornea.
-
- Deep anterior lamellar keratoplasty (DALK) transplants all stroma but leaves the host’s healthy Descemet’s membrane and endothelium behind to allow less risk of rejection or less risk from blunt trauma. The entire wall is changed out, but the host’s own delicate wallpaper is left behind.
- Descemet’s membrane endothelial keratoplasty (DMEK) and Descemet’s stripping automated endothelial keratoplasty (DSAEK) replace Descemet’s membrane and endothelium without removing the host’s stroma. DMEK is more selective than DSAEK. Both DMEK and DSAEK remove old Descemet’s membrane and endothelium. DMEK adds a new Descemet’s membrane and endothelium only. DSAEK also adds a new Descemet’s membrane and endothelium but with an additional layer of donor stroma. Using the wallpaper analogy, in both DMEK and DSAEK the old wallpaper is removed. With DMEK, only new wallpaper is inserted. With DSAEK, a new piece of drywall that has new wallpaper on it is inserted on top of the old drywall.
Why do we need different types of transplants? Why not just do PK for everyone
PK has many limitations regarding vision, astigmatism, recovery time, rejection rate, and other risks. All types of selective transplants improve the outcomes when compared to PK. DMEK especially has many other benefits compared to DSAEK and PK. For example, performing PK for purely endothelial disease is outdated. It would be like knocking down the wall and bringing in a whole new wall when the only thing needed is new wallpaper!
Do I need to go on systemic immunosuppressive medications for a corneal transplant?
Not for most types of corneal transplants. Epithelial stem cell transplants are an exception. When someone gets a kidney or a heart transplant, they need to go on strong medications that make the immune system less aggressive and less likely to attack the transplant. These medications have some potentially significant side effects.
Because there are no blood vessels in the cornea, it is generally invisible to the immune system. Thus for corneal transplants, with the exception of epithelial stem cell transplants, we only need anti-inflammatory eye drops to prevent an immune system attack or rejection. Most patients get down to one drop a day after several few months.
Rarely, patients with aggressive immune systems require stronger systemic medications to prevent rejection. Even with aggressive immune systems, rejection is still very rare with DMEK and is more commonly seen with DSAEK, DALK, or PK. PK has the highest risk of rejection.
After a corneal transplant, do I have to take any precautions if I ever receive a vaccination?
There is some data to suggest that the increase in the immune system activity after vaccination, including the flu and shingles vaccines, may put the graft at a slightly increased risk for a rejection episode. To combat this, we typically recommend that if you were down to just one steroid drop a day, immediately following a vaccine you should increase the steroid drops to four times a day for one week, then two times a day for one week, and then go back to just one daily. If you have previously been told that you cannot take steroid drops due to pressure problems or other issues, ask your cornea surgeon for advice before getting a vaccine. transplant.
How long will my transplant last?
Traditional full thickness corneal transplants (PK) last about 20 years. Cell count studies show that, with the passage of time, transplants still lose endothelial cells gradually just like any other cornea, but usually at a faster rate. When the endothelial cell counts fall low enough, the transplant becomes opaque and fails. Since DMEK and DSAEK are relatively new, it is not possible to say how long they will last; however, preliminary data is encouraging, especially for DMEK. There is variation between transplants, but early data suggest some transplants can even last one’s lifetime. Either way, the replacement of a transplant is possible.
Dr. Tenkman is studying variables that may reveal which donors have cells that are more resistant to death and also surgical techniques that are minimally harmful to endothelial cells. Many surgeons suggest it is normal to lose 30 to 50% of the donor’s endothelial cells during surgery. We have some early data suggesting less than 10% cell loss from surgery when selecting a specific subset of donors.
Does a rejection episode mean that I will lose my cornea transplant?
No. If untreated, a rejection episode can cause significant damage. But usually, the episode stops with an increase in anti-inflammatory eye drops. Patients are instructed to RSVP: come see us if they develop Redness, Sensitivity to light, Vision reduction, or Pain. It’s key to see us right away for prompt diagnosis and treatment.
Will I need glasses after my transplant? Could laser vision correction be done to reduce any postoperative need for glasses?
Whether or not you need glasses after your transplant depends on many factors. DMEK transplants reduce glasses dependence the most often. DSAEK is less predictable. DALK and PK can both frequently cause high astigmatism that needs glasses or even hard contacts to attain good vision.
Some patients are candidates for ASA (advanced surface ablation) to minimize their dependence on glasses or contacts after corneal transplant surgery. ASA is a laser vision correction procedure similar to LASIK. Whether or not ASA could be done to reduce dependence on glasses or contacts after surgery depends on several factors and is taken on a case by case basis.
What are the costs and risks of a cornea transplant?
Corneal transplant tissue is donated, but still typically costs $3,700 or more. The fees go to the eye banks that must harvest the corneas, screen for possible diseases that could be transferred to the patient, transport, and process the corneas, and deliver them to the surgery center… all within just a few days. The cost of receiving a transplant includes not just the tissue, but the surgery center, surgeon, and anesthesia fees. Fortunately, these costs are less at an outpatient surgery center and are typically covered by Medicare and private insurance, although patients may be responsible for deductibles and co-payments. Generally, DMEK and DSAEK can be performed in an outpatient surgery center whereas DALK and PK more often have to be done at a hospital. Having surgery at a hospital can increase costs several-fold.
The risk of infection from a corneal transplantation procedure is about the same as following a routine blood transfusion. The risk of receiving a disease from a transplant is very low.
Other risks include primary graft failure, rejection, graft dislocation, cataract formation, glaucoma, infection, irregular astigmatism, double vision, bleeding, iris damage, vitreous prolapse, and cystoid macular edema. Most of these complications are quite rare but are theoretically possible with all types of eye surgery. Patients using steroid drops, which all corneal transplants require, have to be followed for the development of increased pressure. High eye pressure usually gives no symptoms, so follow up is crucial to allow the doctor to treat as necessary with medication or procedures. Patients are usually seen every 3 to 6 months for life depending on the strength of steroid used.
In our hands, the overall success rate for a DMEK or DSAEK graft attaching and working well is about 99%. Should the transplant fail due to rejection or otherwise, it would need to be repeated.
Because the time to heal is longer for DALK and PK, and because they involve more risk, the odds of a DALK or PK failing to restore vision is more significant than for DMEK or DSAEK. DALK and PK have several additional risks.
- DALK, and more so PK, have a higher risk of bleeding during surgery while the patient’s own cornea is removed and the eye is depressurized. Although not common, such bleeding can do significant damage to the eye.
- DALK, and more so PK, also have a significant risk of rejection. Higher doses of steroid drops may be necessary in here to prevent or treat rejection, which can increase the risk of increased eye pressure (glaucoma).
- DALK and PK involve a 360-degree corneal incision. Such large corneal wounds don’t heal with full strength and are at risk to split open with moderate blunt trauma (ie if a patient fell and hit their face in the shower). If the wound were to split open, it could lead to loss of the eye.
- DALK and PK require about 16 sutures. These sutures are not removed for many months or even over a year. The sutures are buried in a manner so they cause no pain to the patient. However, they commonly become loose and can cause a foreign body or sandy sensation. More significantly, a loose suture is a risk for infection (corneal ulcer). Corneal ulcers can be more serious in the setting of a corneal transplant because the immune system in the area is suppressed by steroid eye drops.
- DALK and PK commonly heal with large amounts of astigmatism. The normally spherical corneal surface becomes like an irregularly shaped egg. Since the smooth corneal shape largely determines focus, an irregular cornea causes blurred vision. Corneal astigmatism is measured in diopters. In routine patients who have not had had a corneal transplant, we consider 1 diopter mild astigmatism, 2 diopters moderate astigmatism, and 3 diopters high astigmatism. DALK and PK average about 4 to 5 diopters of astigmatism. A common range is 2 to 10 diopters of astigmatism. Regarding astigmatism risk, there are controllable and uncontrollable causes. The surgeon can try to sew the graft as evenly as possible to reduce risk of severe astigmatism; however, the surgeon cannot control the natural tension lines in the cornea or how symmetrically the tension lines will balance as the wound heals. Severe or irregular astigmatism cannot be corrected with glasses. Special hard contact lenses are often necessary. On average, one-third of all DALK and PK patients need hard contact to see their best due to astigmatism. Therefore, at Bennett & Bloom, we never perform DALK or PK for keratoconus patients to try to get out of contact lenses. The patient could go through all the added cost and risk of surgery only to end up where they started… or worse. DALK and PK are reserved for severe disease that cannot be fixed by contact lens wear
For corneal transplant at Bennet & Bloom Eye center in the USA or for medical tourism in the USA, contact Eyeupdate Clinic & Optical Supplies, 01 Ajuwon junction, Off Elliot bus stop, Iju Ishagah, Lagos.Tel: +2347030000001, +19093663551
Muscles, Nerves, and Blood Vessels in the Human Eye
Muscles enable you to move your eyes. Ocular nerves allow you to interpret what you see and blood vessels keep your eyes oxygenated. Six muscles, collectively called the extraocular muscles, move the eyeball. A seventh muscle moves the eyelid and is also found in the orbit.
The muscles of the human eye
The following muscles help your eyes move around.
Muscles enable you to move your eyes. Ocular nerves allow you to interpret what you see and blood vessels keep your eyes oxygenated. Six muscles, collectively called the extraocular muscles, move the eyeball. A seventh muscle moves the eyelid and is also found in the orbit.
The muscles of the human eye
The following muscles help your eyes move around.
-
Levator palpebrae superioris: Originates on the sphenoid bone above the optic canal. It inserts into the superior tarsis and skin of the eyelid. It’s innervated by the oculomotor nerve and elevates the superior eyelid.
-
Superior oblique: Originates on the sphenoid bone and inserts into the sclera deep to the superior rectus muscle. It’s innervated by the trochlear nerve and abducts, depresses, and medially rotates the eyeball.
-
Inferior oblique: Originates on the anterior part of the orbital floor and inserts onto the sclera deep to the lateral rectus muscle. It’s innervated by the oculomotor nerve and abducts, elevates, and laterally rotates the eyeball.
-
Superior rectus: Originates on the common tendinous ring and inserts into the sclera behind the corneoscleral junction. It’s innervated by the oculomotor nerve, and it elevates, adducts, and medially rotates the eyeball.
-
Inferior rectus: Originates on the common tendinous ring and inserts into the sclera behind the corneoscleral junction. It’s innervated by the oculomotor nerve and depresses, adducts, and laterally rotates the eyeball.
-
Medial rectus: Originates on the common tendinous ring and inserts into the sclera behind the corneoscleral junction, this muscle is innervated by the oculomotor nerve and adducts the eyeball.
-
Lateral rectus: Originates on the common tendinous ring and inserts into the sclera behind the corneoscleral junction. It’s innervated by the abducent nerve and abducts the eyeball.
The nerves of the eye
The eyes are served by the following cranial nerves and their branches:
-
Optic nerve (CN II): Sensory nerve that transmits impulses from the retina to the brain
-
-
Oculomotor nerve (CN III), trochlear nerve (CN IV), and abducent nerve (CN VI): Enter the orbital space through the superior orbital fissure to innervate the extraocular muscles.
-
Ophthalmic nerve (part of the trigeminal nerve, CN V): This nerve has three branches:
-
The lacrimal nerve runs to the lacrimal gland and gives off branches to the conjunctiva and skin of the superior eyelid.
-
The frontal nerve enters through the superior orbital fissure and provides sensory innervation to the superior eyelid, scalp, and forehead.
-
The nasociliary nerve is the sensory nerve to the eyeball. It also has branches that serve the orbit and other parts of the face. One of its branches, the infratrochlear nerve, supplies the eyelids, conjunctiva, and lacrimal sac.
-
-
Ciliary ganglion: This group of postsynaptic parasympathetic nerve cell bodies is associated with the oculomotor nerve and ophthalmic nerve (CN V1). Presynaptic parasympathetic fibers from the oculomotor nerve synapse on the cell bodies of postsynaptic parasympathetic neurons in the ciliary ganglion.
Short ciliary nerves emerge from the ciliary ganglion and enter the eye. The short ciliary nerves contain postsynaptic parasympathetic fibers from the ciliary ganglion, afferent fibers of the nasociliary nerve, and postsynaptic sympathetic fibers from the internal carotid plexus. Postsynaptic parasympathetic fibers innervate the ciliary muscle and sphincter pupillae muscle. Afferent fibers convey sensory impulses from the iris and cornea. Postsynaptic sympathetic fibers innervate the dilator pupillae muscle.
The long ciliary nerves contain afferent and postsynaptic sympathetic fibers from the nasociliary nerve. Long ciliary nerves bypass the ciliary ganglion and run to the iris, cornea, and dilator pupillae muscle.
The blood vessels
Blood flow to the orbit (and beyond) comes from branches of the internal carotid artery, chiefly via the ophthalmic artery and its branches:
-
Ophthalmic artery: Branches from the internal carotid artery and passes through the optic canal into the orbital cavity
-
Central artery of the retina: Runs from the ophthalmic artery to the eyeball alongside the optic nerve; it branches at the optic disc and supplies the retina
-
Supraorbital artery: Starts at the ophthalmic artery and exits the orbit at the supraorbital notch to supply the forehead and scalp
-
Supratrochlear artery: Runs from the ophthalmic artery to the forehead and scalp
-
Lacrimal artery: Runs from the ophthalmic artery along the lateral rectus muscle to supply the lacrimal gland, conjunctiva, and the eyelids
-
Dorsal nasal artery: Branches from the ophthalmic artery and runs along the nose to supply it with blood
-
Short posterior ciliary arteries: Branch from the ophthalmic artery and pierce the sclera at the edge of the optic nerve; they supply the choroid and the rods and cones of the retina
-
Long posterior ciliary arteries: Branch from the ophthalmic artery and pierce the sclera to supply the ciliary body and iris
-
Posterior ethmoidal artery: Leaves the ophthalmic artery to supply blood to ethmoidal cells
-
Anterior ethmoidal artery: Runs from the ophthalmic artery to supply ethmoidal cells, frontal sinus, nasal cavity, and skin over the nose
-
Anterior ciliary artery: Runs from the muscular branches of the ophthalmic artery through the sclera near the rectus muscles and forms an arterial network in the iris and ciliary body
-
Infraorbital artery: Runs from the maxillary artery along the infraorbital groove and out to the face
Blood is returned from the orbits via the superior and inferior ophthalmic veins, which pass through the superior orbital fissure into the cavernous sinus. The central vein of the retina may join an ophthalmic vein or enter the cavernous sinus directly. Vorticose veins drain the vascular layer of the eyeball, and the scleral venous sinus encircles the anterior chamber of the eyeball.
-
How alcohol affects your eyes -Eye care perspective
Although light consumption of alcohol probably won’t cause any health problems, drinking alcohol excessively can have harmful effects on your body, including your eyes. Heavy drinking of alcohol may cause problems with your vision and overall eye health including the following:
-
- Decreased visual performance: Your overall visual performance may be altered since drinking heavily impairs brain function. You may have blurred vision or double vision due to weakened eye muscle coordination. You may also experience delayed reactions while driving.
- Slow pupil reactions: Alcohol tends to affect the speed at which your iris constricts and dilates. A driver that has been drinking alcohol cannot adapt as quickly to oncoming headlights.
- Decreased peripheral vision: Drinking alcohol has also been shown to decrease the sensitivity of your peripheral vision. This may give you the effect or perception of having tunnel vision.
- Decreased contrast sensitivity: Drinking too much alcohol can alter your contrast sensitivity, or how precise you can discern between shades of gray. Driving in rain or fog will be much more dangerous.
- Optic neuropathy: Also referred to as tobacco-alcohol amblyopia, people who drink or smoke in excess can develop optic neuropathy. You might develop a painless loss of vision, decreased peripheral vision or reduced color vision. Even though studies have shown the vision loss to be a result of a nutritional deficiency, some professionals believe that the condition develops because of toxic effects of alcohol and tobacco.
- Frequent migraines: Alcohol has been shown to be a trigger for severe migraine headaches in some people. You may experience a temporary, but debilitating visual aura before the onset of the headache. The visual aura may appear as blind spots, graying of vision or zig-zag patterns of light.
- Poor cosmetic appearance: Drinking can cause eye redness. Alcohol causes the blood vessels in your eyes to expand, making them more prominent.
If you have any issues with your eyes, visit or call : Eye update Eye clinic & optical supplies, 01, Ajuwon junction, Ajuwon bus stop, Akute/Ajuwon road, off Elliot bus stop, Iju-Ishagah. Tel: 08034971582
Postal Codes of Streets in Ojodu Lagos Nigeria
Ojodu Streets Zip Codes
Address:
Area: Ojodu, Lagos, Lagos State. Associated Zip Code: 100213
District Name: Area: Ojodu
Local Government Area: Lagos
State: Lagos State
Associated Zip Code: 100213
Streets: (260)
Street name Zip Code
Raimi St St. 100213
Rasheed Baruwa St. 100213
Regina Ola Ore St St. 100213
Sogo St St. 100213
Sowebo Oladipupo St. 100213
Soyemi St St. 100213
Sule Abore St St. 100213
Taiwo Ishola St. 100213
Taiwo Okolu St. 100213
Tijani Bello St St. 100213
Unity Cl St. 100213
Zinzon S St. 100213
Alara St St. 100213
Adesina St St. 100213
Funsho St St. 100213
Tobun St St. 100213
Olumo St St. 100213
OlasimboSt St. 100213
Olu Osifeso St St. 100213
Remi Abuah St St. 100213
Majaro St St. 100213
Akintunde St St. 100213
Mobolaji St St. 100213
Johnson St St. 100213
Araromi St St. 100213
Ajayi St St. 100213
Aderibigbe St St. 100213
Lawal St St. 100213
Adebiyi St St. 100213
Abiodun St St. 100213
Adesina St St. 100213
Barikisu Iyade St St. 100213
University Rd St. 100213
Davies St St. 100213
Ayodele St St. 100213
Amusa St St. 100213
Sule St St. 100213
Abudu St St. 100213
Amen St St. 100213
Ajayi Bembe St St. 100213
Obadina St St. 100213
Mosuro St St. 100213
Sadiku St St. 100213
Ebun St St. 100213
Balogun St St. 100213
Are Ago St St. 100213
Abule Ijesha Rd St. 100213
Morris Rd St. 100213
Eletu Odibo St St. 100213
Shodipe St St. 100213
Saka Ln St. 100213
Martins St St. 100213
Odenike St St. 100213
Shobowale St St. 100213
Otun St St. 100213
Oduntan St St. 100213
Oguntuga St St. 100213
Silver St St. 100213
Bailey St St. 100213
Akinsola St St. 100213
Bamigbopa St St. 100213
Alaka St St. 100213
Mosuro St St. 100213
Bankole St St. 100213
Lemboye St St. 100213
Ogabi St St. 100213
Iwaya Rd St. 100213
Owodunni St St. 100213
Memuda St St. 100213
Ogunkoya St St. 100213
Abiye St St. 100213
Ijebu Quarters St. 100213
Oloto St St. 100213
Victoria St St. 100213
Ajoke St St. 100213
Aderupoko St St. 100213
Imoru St St. 100213
Audu Bale St St. 100213
Adegbenro St St. 100213
Salami St St. 100213
Church St St. 100213
Akanni St St. 100213
Omitogun St St. 100213
Yey St St. 100213
Ogunbiyi St St. 100213
Omotola St St. 100213
Arowolo St St. 100213
Balogun St St. 100213
Moshalashi St St. 100213
Akintola St St. 100213
Owode St St. 100213
Pedro St St. 100213
Omiaro St St. 100213
Ogbwe St St. 100213
Oyewale St St. 100213
Onituere St St. 100213
Ogundimu St St. 100213
Joseph Marrison St St. 100213
Gbede St St. 100213
Dacosta St St. 100213
Ogayemi St St. 100213
Afolabi Ayorinde St St. 100213
Wugbo St St. 100213
Yovi St St. 100213
Akinlehinb St St. 100213
Ayato St St. 100213
Oke Anaiye St St. 100213
Igbore St St. 100213
Development St St. 100213
ALh. Rainmi St. 100213
Araromi St St. 100213
Iman Ln St. 100213
Wright St St. 100213
Makoko Rd St. 100213
Dany Est St. 100213
Akinbo St St. 100213
Erejuwa St St. 100213
Ramotu St St. 100213
Olaiya St St. 100213
Church St St. 100213
Ajelekoko St St. 100213
Igbehin Adun St St. 100213
Abudu St St. 100213
Rafiu St St. 100213
Adetia St St. 100213
Olulu St St. 100213
Olumide St St. 100213
Sariyu St St. 100213
Obalomu St St. 100213
Falodun St St. 100213
Olayide St St. 100213
Alafia St St. 100213
Oluwatoyin St St. 100213
Bale St St. 100213
Alh.Sule St St. 100213
Alh. Raimi St. 100213
St Finbar College St St. 100213
Moronfolu St St. 100213
Community Rd St. 100213
Obayan St St. 100213
Amos Bakare St St. 100213
Afolabi Brown St St. 100213
Funmilayo Oyaronke St St. 100213
Tunde Bello St St. 100213
Emily Akinola St St. 100213
Iyiola Olawale St St. 100213
AdeyinkaOsijo St St. 100213
Abdulahi St St. 100213
Wulemotu Ajoke St St. 100213
Abayomi St St. 100213
Olarewaju St St. 100213
Rikett Cl St. 100213
Ayetoro St St. 100213
Oyenuga St St. 100213
Oridami St St. 100213
Itesiwaju St St. 100213
Sholanke St St. 100213
Shuwu Court St. 100213
Mafowoku St St. 100213
Adenuga Kajaro St St. 100213
Ojo St St. 100213
Abiodun Cl St. 100213
Bandi Adewale St St. 100213
Olorunjare St St. 100213
Ayinde St St. 100213
Onafeko St St. 100213
Adetayo Osho St St. 100213
Osanyinpeju St St. 100213
Abatan Rd Rd. 100213
Alonge St St. 100213
Abigi St St. 100213
Awolaja St St. 100213
Abiodun St St. 100213
Oluwole St St. 100213
Adebisi Awosoga 100213
Animashaun St St. 100213
Adebolawale St St. 100213
Adegoke Ajayi St St. 100213
Ademola Ajasa 100213
Adeniyi Oke St St. 100213
Adewale 100213
Adewale Adegun 100213
Adeyemo Akapo 100213
Adisa Ambali Cl Cl. 100213
Agoro 100213
Aina St St. 100213
Ajana Cl Cl. 100213
Ajayi St St. 100213
Akin Oladeguro 100213
Akinola St St. 100213
Akinsanya St. 100213
Akiode Cr St. 100213
Alh. Abass St St. 100213
Alh. Ashafa St St. 100213
Alh.Bakare St. 100213
Alh. Bashiru St St. 100213
Ali Baogun St. 100213
Animashaun St St. 100213
Anu Oluwapo St St. 100213
Ayo Alabi St St. 100213
Babatunde Ladega St. 100213
Bakare St St. 100213
Bamako St St. 100213
Bank Shonibare St St. 100213
Banni St St. 100213
Basiaru St St. 100213
Beatrice Spencer St. 100213
Bisi Gbadina St St. 100213
Bosude St St. 100213
Bunuyo Cl St. 100213
Burdland St St. 100213
College Rd St. 100213
Arogangan St. 100213
Debo Aina St. 100213
Efon Alaye St. 100213
Foly St St. 100213
Gbenga Kilo St St. 100213
Gbite St St. 100213
Gbolahon Owolabi Cl St. 100213
Ibadan Ewy St. 100213
Ibrahim Adekunle St St. 100213
Ifo Cl St. 100213
Irepodun St St. 100213
Isale Tapa St St. 100213
Isheri Holiday Inn St St. 100213
Isheri Rd St. 100213
Ishola Bello St St. 100213
Ivern Ave St. 100213
Jacob Runsance Cl St. 100213
Jide Ayo St. 100213
Kadiri St. 100213
Kayode Ali Cl St. 100213
Kupoluyi St St. 100213
LSDPC Quarters St. 100213
Lola Holloway St. 100213
Mafaosky Cl St. 100213
Moses Adebayo St St. 100213
Muyibo St St. 100213
Muyiwa Oyefusi St. 100213
New Isheri Rd St. 100213
Oba Bobington Ashoye St. 100213
Obafolabi St St. 100213
Oboku St St. 100213
Odozi St St. 100213
Ogunbiyi Akande St. 100213
Ola Oluwa St St. 100213
Oladipupo Oluwole St St. 100213
Olajide Ave St. 100213
Olaleke Taiwo St St. 100213
Olanipekun St. 100213
Olatunde Badmus St. 100213
Olawale St. 100213
Olumuyiwa St. 100213
Oluwadamilola Falade St. 100213
Oluwatoyin Cl St. 100213
Omofade Cr St. 100213
Omorogie St St. 100213
Orimeta St St. 100213
Popoola Oyinloye Cl St. 100213
Popola St St. 100213