Ophthalmology

Ophthalmology Science of the Eyes

Ophthalmology is a branch of medicine specializing in the anatomy, function and diseases of the full visual pathway, including the eye, brain, and areas surrounding the eye.

An ophthalmologist is a medical doctor, M.D., who is specialized in eye and vision care.

Ophthalmologists are trained to provide the full spectrum of eye care, from prescribing glasses and contact lenses to complex and delicate eye surgery. They may also be involved in scientific research into the causes and cures of eye diseases and vision problems.

Ophthalmologist Training

  • 4 years of medical school and a year of internship.
  • 3 years of residency (hospital-based training) in ophthalmology. Residency includes: training in prevention, diagnosis, and medical and surgical treatment of eye conditions and diseases.
  • 1-2 years of training in a sub-specialty, such as Glaucoma, Pediatric Ophthalmology, Retina, Cataract Care, or Refractive Surgery.

Learn more about our doctors’ education and areas of specialty by visiting our Ophthalmologists.

How the Eye Works

The individual components of the eye work in a manner similar to a traditional camera. Each part plays a vital role in providing clear vision:

First: Light coming from objects passes through the cornea, a clear protective shield in the front of your eye.

Next: The light goes through the pupil, an adjustable opening (often called aperture) in the center of the iris, or colored part of your eye.

Then: Behind the pupil is the lens. Muscles inside your eye control the shape of the lens, focusing it (as a camera lens does) to view objects at different distances.

Last: The light rays pass through the dark chamber of your eyeball to the retina (in the camera, this is the film) at the back of your eye. The retina contains nerve cells that signal to your brain through the optic nerve. As your brain receives the messages, you see the object before you.

Common Eye Problems We Treat:

Vitreoretinal Specialists

At North Carolina Eye Ear Nose & Throat, we have a team of ophthalmologists who specialize in and have extensive knowledge of the retina and vitreous as well as the treatment of diseases and disorders affecting these important parts of the eye.

Those diseases may include, but are not limited to, the following:

The cornea is the eye’s outermost layer. It is the clear, dome¬≠shaped surface that covers the front of the eye. It plays an important role in focusing your vision as it is responsible for transmitting light into the back of the eye.

What causes cornea problems?

Eye disease and injuries can damage the cornea. Here are some common eye problems that can lead to a damaged cornea:

  • Keratoconus, where the cornea is cone shaped rather than dome-shaped
  • Fuchs’ dystrophy, where cells in the inner layer of the cornea are not working effectively
  • Eye infections or injuries that scar the cornea
  • Corneal abrasion is a scratch or scrape on the cornea.
  • Corneal ulcer is an open sore on the cornea. 
  • Pterygium is a pinkish, triangular tissue growth on the cornea.

Corneal Surface Disease and Treatment

Photo-therapeutic Keratectomy (PTK) is used to treat corneal surface diseases and scars. PTK is not used to reduce dependency on glasses or contacts but rather to produce a smoother, clearer cornea.

Corneal Transplants


Corneal Transplant overview

View Video If your cornea cannot be healed or repaired, your ophthalmologist may recommend a corneal transplant. This is when the diseased cornea is replaced with a clear, healthy cornea from a human donor. 

Penetrating Keratoplasty 
Penetrating keratoplasty (PK) or full thickness cornea transplant replaces the entire cornea with a clear donor cornea. Getting complete vision back after PK may take up to 1 year or longer. With a PK, there is a slightly higher risk than with other types of corneal transplants that the cornea will be rejected. This is when the body’s immune system attacks the new cornea tissue.

Deep Anterior Lamellar Keratoplasty (DALK)
Partial thickness corneal transplant (deep anterior lamellar keratoplasty, DALK) replaces the front and middle layers of the cornea while keeping the endothelial layer, or thin back layer, in place. DALK is commonly used to treat keratoconus or bulging of the cornea.

Healing time after DALK is shorter than after a full cornea transplant. There is also less risk of having the new cornea rejected.

Endothelial Keratoplasty

In some eye conditions, the innermost layer of the cornea called the “endothelium” is damaged. This causes the cornea to swell, affecting your vision. Endothelial keratoplasty is a surgery to replace this layer of the cornea with healthy donor tissue. It is known as a partial transplant since only this inner layer of tissue is replaced.

There are a few types of endothelial keratoplasty. They are known as:

DSEK (or DSAEK) Descemet’s Stripping Automated Endothelial Keratoplasty
View Video


DMEK Descemet’s Membrane Endothelial Keratoplasty

View Video
Each type removes damaged cells from an inner layer of the cornea called Descemet’s membrane. The damaged corneal layer is removed through a small incision. Then the new tissue is put in place. Just a few stitches—if any—are needed to close the incision. Much of the cornea is left untouched. This lowers the risk of having the new cornea cells being rejected after surgery.

Some things to know:

With DSEK/DSAEK surgery, the donor tissue may be easier to transplant and position because it is thicker than the donor tissue in DMEK surgery.

In DMEK surgery, the donor tissue is thin and can be more difficult to transplant. However, recovery is quicker because the transplant tissue is thinner.
Your eye surgeon will choose the type of surgery based on your cornea’s condition.

North Carolina EENT has offices in Cary, Durham, Chapel Hill, Roxboro for treatment of Cornea Disease.

Contact us today!  Make an appointment at one of our nearby offices, to discuss treatment options.

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