DEYAA GHALEB/ EYE ON LINE
DR's. HOUSE DEYAA GHALEB
I'M AN OPHTALMOLOGIST AT CAIRO UNIVERSITY HOSPITAL. My intrest in
ophthalmology research is corneal preservation& corneal banking . I'm creating a new media to
preserve corneal tissue more than 15 days at room temp.
http://www.deyaa.ghaleb.20m.com/index.htm
Curriculum Vitae
Name Dr. Deyaa El-Din Haider Abbas Ghaleb
Date of Birth December 28, 1961 in Cairo
Maritial Status Married with 3 children
Address 8, Road 86, Maadi, Cairo, Egypt
P.O.Box 264
phone (+202) 521 6289 fax (+202)521 6514
office (+202) 358 4438
mobile (+2012) 319 0318
Qualifications
M.B.,B.Ch. (June,1986) Faculty of Medicine, Zagazic University.
M.Sc. Ophtalmology (April, 1994), Faculty of Medicine, Cairo University
M.D. Ophtalmolgy Registered, Faculty of Medicine, Cairo University (March , 1996)
M.Sc. Thesis Title
Resistent Corneal Ulcers
M.D. Thesis Title
Evaluation of an Invitro System of Corneal storage
Present Position
Ophtamologist, Cairo University, Students Hospital
Professional Background
1991 - 1994 Opthalmic Registrar, Cairo University, Students Hospital
1990 - 1991 Opthalmic Resident, Cairo University, Kasr el Aini Hospital
1987 - 1990 Opthalmic Resident, Cairo University, Students Hospital
1986 - 1987 One year as House Officer in Zagazic University Hospitals / Two months in Opthalmology Department
Languages
Fluent English & Arabic (spoken and written)
Professional Trainings Abroad
Scientific visit to Germany training in an Optholmological Clinic in Munich (Dr. Susanna Vogel, 1996)
Scientific visit to Ulleval Hospital as a research Fellow at the Eye Department University of Oslo, Norway (1995 - 1996)
Scientific visit to Ulleval Hospital as a research Fellow at the Eye Department University of Oslo, Norway (1994)
Scientific visit to Ulleval Hospital as a research Fellow at the Eye Department University of Oslo, Norway (1992)
Scientific visit to Eli-Lilly Research Center Indianapolis U.S.A. (1983)
Scientific visit to Drug Industries in West-Germany (1982)
Membership in Medical Societies
Member of the Optholmological society of Egypt
Meetings Attended
International Congress of Allergy and Immunology (ICACIXV, EAACI'94) at Stockholm, Sweden (1994)
Annual Meeting of the Opthomological Society in Egypt(1987/88/89/91/92/93/94/95/96/97/98/99/2000/01/02/03/04/05)
Combined Annual Meeting of the Opthamological Society of Egypt, the Saudi Opthamological Society and the Pan Arab Council of Opthamology (1991)
Main Intrest
Anterior Segment Surgery
Corneal Transplantation
Cat. Surgery with I.O.L. Inplantation
Cornea
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 the most intense pain we can experience.
What Can Cause Corneal Injury?
Knives, pencils, and other sharp objects can cause severe injury to the cornea. Fireworks, exploding batteries, and toxic chemicals, especially alkalis, can also result in severe scarring of the cornea. In fact, protection of the cornea is the reason emergency washing 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 are frequent causes of severe corneal damage and ulceration. Abnormal steepening of the cornea ( keratoconus ), degeneration occasionally following cataract surgery (corneal edema or swelling), and some aging processes can also affect the clarity and health of the cornea. Some disorders of the cornea are inherited, and can lead to corneal clouding and loss of sight.
What Is A Corneal Transplant?
If the cornea becomes cloudy, 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 transplant comes from an eye bank. The process begins at 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 tissue is available. The operation consists of a transfer of the clear central part of the cornea from the donor's eye to the patient's eye. Soon after the operation, the patient can walk about and resume activity.
What is a Corneal Abrasion?
A scratch on the front portion of the eye is called a corneal abrasion. Most corneal abrasion injuries are due to a fingernail, paper, or foreign body. Due to the extreme sensitivity of the cornea, a corneal abrasion can be very painful, even when it is a minor scratch.
How is a Corneal Abrasion Treated?
If something becomes lodged in the eye, it is imperative to seek medical care immediately. With the use of fast-acting anesthetic drops, most small foreign objects can be removed quickly and painlessly.
Antibiotic drops are usually applied to ward off infection. Other anti-inflammatory drops may be used to keep you comfortable while the cornea heals.
To protect the eye and promote healing, the eye is usually patched. Patching takes the form of either a eyepad or a bandage soft contact lens. Although patching may be inconvenient, it helps to minimize movement of the eyelids, which would interfere with the healing process. Corneal tissue heals rapidly. Improvement is usually noticed within 24 hours.
Patients must consult with an ophthalmologist who can provide the appropriate level of care necessary. If you wish to inquire about cataract services, please call 00 2012 319 0318 for a medical referral or to receive additional information
EXTERNAL DISEASE AND CORNEA
External disease and cornea is a subspeciality which encompasses congenital, inflammatory, allergic, degenerative, and neoplastic conditions affecting the anterior aspect of the eye (including eyelids, conjunctiva, cornea, iris, and lens). The clinic is equipped with the latest diagnostic technology inc-luding computerized endothelial cell analysis, corneal topographic mapping, ultrasonic pachymetry, a dedicated on-site ophthalmicmicrobiology laboratory, and a wide range of photographic equipment including computer enhanced analysis. It acts as a referral centre for patients with complex medical problems, as well as those requiring corneal surgery. Corneal transplantation can restore vision to patients affected with corneal degenerations, dystrophies, trauma and following corneal infections such as herpes which may leave a dense scar.
Keratorefractive surgery is currently one of the most controversial but exciting topics in ophthalmology. The ability to correct myopia, hyperopia and astigmatism with the Excimer laser has caught the
enthusiasm of the public and over five hundred thousand patients world-wide have already been treated using these procedures. The Eye Institute was the first academic centre in Canada to acquire an Excimer laser which is used for the correction of refractive
errors, removal of corneal scars and opacities and research related to wound healing. Over 1000 patients have been treated and are being followed.
Although cataract surgery with insertion of a plastic (intraocular) lens is one of the most common and successful surgical procedures performed by ophthalmologists, subspecialists in cornea are frequently asked to handle more complex cases requiring cataract extraction,corneal transplantation, and reconstruction of the front of the eye.
Research in external disease and cornea is focused on the management and clinical outcome of refractive errors treated with the Excimer laser, as well as laboratory studies of basic wound healing following laser therapy. In addition, a number of clinical trials are in progress to evaluate new antibiotics and anti-inflammatory drugs.
CATARACTS
Cataracts or a clouding of the natural focusing lens of the eye is
the most common cause of blindness in the world. Most industrialized
countries are able to provide treatment for blindness caused by
cataracts but there remain millions of people worldwide who do not
have access at present to modern cataract surgical techniques.
The lens of the eye, located behind the colored iris and pupil is
normally clear and capable of changing shape to alter focus from
distance to near. With age or other causes the lens becomes clouded
and images focused on the retina in the back of the eye become
blurred. Also with age the lens becomes less capable of adjusting
its shape to focus at different distances. People who once were able
to see clearly at distance and at near find that as they become older
their near or reading vision decreases and they need assistance with the aid of reading glasses.
How are cataracts managed ?
TREATMENT
The majority of cataracts are managed by surgery.This entails removal
of the natural lens by various techniques, intracapsular or extraca-
psular or phacoemulsification using ultrasound waves. Many patients
have read in the lay press of the use of lasers to remove the cataract
. In upto 50% of patients undergoing cataract surgery, a clouding of
the capsule that is left behind after the initial surgery is removed
with the laser. This is painless and performed in the office. No one
in the world is using laser as a primary method of removing cataracts.
Almost all patients have the lens replaced with a man-made lens made
of polymethyl-methacrylate or silicone. Preperatively the eye is
measured with painless ultrasound waves to determine the power of the
lens to be inserted. Within a certain amount of inherent error your
surgeon will be able to insert an appropriately powered lens to set
your vision for distance or near. Generally, most surgeons elect to
set the vision for distance and then have the patient use reading
glasses for near visual tasks. This varies between patient and should be discussed prior to surgery.
Almost all patients undergo the procedure as an outpatient and are
discharged within 3 hours. Medical problems such as severe heart
disease, diabetes and other diseases may require a short hospitaliza-
tion before and after the surgery. Only on rare occasions are patien-
ts placed under general anesthesia. The use of a local anesthetic and
intravenous sedation allows for a painless procedure with almost imme-
diate recovery.
Who needs to have cataract surgery ?
INDICATIONS FOR CATARACT SURGERY
There are two major reasons to have catarct surgery performed.
Automobile licencing requirements Interference with activities of
daily living
AUTOMOBILE LICENCING REQUIREMENTS
One of the most common reasons for undergoing cataract surgery is to
continue driving an automobile. Each province or state has minimal
visual standards that must be met to continue to safely operate a
motor vehicle.
If vision begins to deteriorate from cataract surgery and begins to
fall below this visual threshold then the patient has two choices.
First he or she may consider to stop driving. This is usually not a
common path to be followed as many patients particularly those that
are older, consider an automobile essential to their sense of
independence.
The most commonly selected option is to proceed with cataract
extraction and lens implantation so that driving may continue after
recovery from the surgery. It is common practice to perform the
surgery when the vision is still good enough to drive but showing
signs of deterioration. By anticipating this fall in vision the
surgeon intends to correct one eye before the other so that the
patient may continue driving throughtout this period. If the surgeon
waits until the vision is substandard then the patient's driver's
licence will need to be temporarly revoked until visual recovery has
been obtained.
Patients need to understand that in most jurisdictions a physician is
required by law to revoke the licence of any individual that does not
meet the minimum standard for driving. To allow a patient to drive
that has substandard vision not only puts the community at risk but
also creates an enormous liability for the physician should the
patient become involved in an accident. Patients who disagree with a
physicians revocation of their driver's licencse should contact their
local department of motor vehicles for clarification.
INTERFERENCE WITH ACTIVITIES OF DAILY LIVING
The interference of activities of daily living (ADL) assess on an
individual basis the visual demands of each patient. For example some
patients do not drive and therefore although their vision may be
decreased it still allows them to read large print books, watch TV,
cook and play cards. If however they find that they are not able to
enjoy activities that are a quality of life issue then certainly they
should consider cataract surgery.
For example a patient interested in photography may have very high
visual demands that require surgery whereas the patient who enjoys
hours of TV and does not drive may be quite content with vision in
the range of 20/60 to 20/100.
Risks of cataract surgery:-
RISKS OF CATARACT SURGERY
As with any surgical procedure risks, though infrequent are an
inherent part of cataract surgery. With the development of modern
cataract techniques risks are greatly minimized from that of a
decade ago. Still many severe complications can occur that can
lead to poor visual outcome or even complete loss of vision or
possibly even loss of the eye. Most surgeons quote success rates
of 20/40 vision or better in normal healthy patients in 95-97% of
cases.
Diseases such as diabetes can reduce postoperative visual results
and increase risk of complications. Your surgeon should be able to,
after taking an appropriate medical history and complete eye
examination estimate your risk for the procedure. Patients must
always decide with guidance from their surgeon whether the benefits
of the surgery will outweigh the risk, though infrequent of the
procedure.
Factors that increase rate of complications
high myopia or near-sightedness
diabetes
hypertension
previous complications experienced in other eye
history of ocular trauma
glaucoma or raised pressure within the eye
iritis or inflammation of the eye
recurrent ocular infections
pseduoexfoliation syndrome
Most common complications of cataract surgery
These complications can vary both in severity and have variable
response to treatment. The two most severe complications are
Postoperative intraocular infection
Intraoperative or postoperative bleeding within or around the eye
Both the above occur approximately in one in 5,000 to one in 10,000
cases and can lead to severe visual loss, blindness or loss of the
eye. Management is variable depending upon degree and response to
treatment. For example some bacteria are more virulent than others
and response to antibiotic treatment is becoming less effective in
certain types of micro-organisms.
Other complications include but are limited to
retinal detachment
corneal clouding or decompensation
chronic fluid accumulation in the retina
persistent ocular inflammation
incorrect lens power of intraocular lens
astigmatism
To reiterate, this page describes some of the more common
complications that can occur but is certainly not all inclusive.
For more detailed information speak with the surgeon prior to surgery.
Some but not all the above complications are amenable to treatment.
Who is a candidate for cataract sugery ?
IDEAL CANDIDATE FOR CATARACT SURGERY
The ideal candidate for cataract surgery is one that has good general
health and whose sole cause of reduced visual acuity is due to
clouding of the native lens.
GENERAL MEDICAL HEALTH
Over recent years we have been able to consider many more patients
for cataract surgery because of the increased utilization of local
anesthesia. Previously, many patients were denied surgery beacuse of
their inability to tolerate a general anesthetic where the patient is
put completely to sleep. With the advent of improved intravenous
techniques we can now offer surgery to many more patients of poor
health.
In additon with the advent of phacoemulsification and the utilization
of a very small surgical wound into the eye the procedure is much
saferfor the eye in patients with severe respiratory disease. The
self-sealing wound of the the phaco technique greatly reduces the
threat of loss of the contents of the eye.
OCULAR EXAMINATION
A complete examination of the eye is essential prior to any surgery
so as to assess the potential for visual restoration after an
uncomplicated cataract extraction.
Many conditions of the eye can exist preoperatively that will
influence the final outcome despite a perfect surgical result.
Conditions that may reduce the expectation of good visual result
include
glaucoma
AMD or age-related macular degeneration
corneal clouding
damage to the optic nerve from glaucoma or other causes
amblyopia or lazy eye
What is the normal postoperative course after cataract surgery ?
Postoperative Care in Cataract Surgery
It is important to be aware that every patient is an individual and
as such variations exist. These differences can account for variable
recovery rates. Those people with denser cataracts may require more
energy for the ultrasound equipment to fragment the nucleus if the
phacoemulsification technique is used. In fact some surgeons believe
it is safer in very dense cataract to use some of the older
techniques in these cases. The corneal cells of the endothelial
surface may vary in number, size and shape. Those corneas with many
healthy corneal cells are more able to maintain or attain a clear
cornea sooner after surgery. Also many patients may have other
diseases of the eye such as glaucoma or age-related macular
degeneration that may affect the outcome of the their surgery.
Many other factors may influence the outcome and healing time
required in each patient and concerns of the patient should be
thoroughly discussed with their surgeon.
My Favorite Links
american academy of opthalmology
HOME PAGE
opthalmology
Email: dghaleb@link.net
