By Dr. W. Gifford Jones
May 25, 1991
What instrument can shuck a bucket of oysters, correct typing errors, fuse atoms, lay a straight line for a garden bed, repair detached retinas and drill holes in diamonds? If this question were to be asked in Trivial Pursuit, the answer is, "The laser". Albert Einstein predicted the use of lasers in 1917. Now the "smart" laser used in computer-guided weapons that recently destroyed the Iraqi army, can also treat eye problems with pin-point accuracy.
A laser device produces a powerful beam of light. It acts much like the shaft of sunlight we used to focus through a magnifying glass as kids to start a fire. In medical use its advantage is that neither the doctor's hand nor the laser instrument touches human tissue. This means less chance of infection and pain. And unlike the scalpel, it can zero in on something the size of a single cell.
Lasers can help a number of diverse eye problems. Every year thousands of people with cataracts have their sight restored by the replacement of the diseased lens with an artificial one. The majority of patients do well. But several months later some patients notice impaired vision when the membrane at the back of the eye which supports the new lens becomes cloudy.
Ophthalmologists treat this condition with a procedure called a "posterior capsulotomy." Like precision bombing, the laser triggers microscopic explosions in the membrane to clear it and regain good vision. Since only the tip of the beam has enough energy to cause the explosions it travels through other tissues of the eye without damaging them.
Lasers are a tremendous boon to diabetic patients. Incredibly, five per cent of today's population are diabetic, and about half of them will develop degeneration of the retina. Diabetics tend to develop new blood vessels in the retina which obscure the visual image. In addition, these abnormal vessels often bleed into the vitreous, the clear gelatinous fluid in the back chamber of the eye, causing cloudy vision or blindness.
To help preserve eyesight ophthalmologists become welders using an argon laser. The green beams of the argon laser are absorbed by red objects. Consequently the red blood cells are heated up sealing off the intrusive blood vessels.
Laser therapy also benefits senior citizens. After the age of 65 some people develop macular degeneration, the area of the retina responsible for central vision. The problem is similarly due to abnormal blood vessels which grow beneath the macula. They leak
fluid and blood creating scar tissue which relentlessly destroys the macula. The end result is the same as having an ink spot at the centre of your glasses. Lasers destroy these vessels and help to restore sight.
Myopic (short-sighted) patients are more prone to develop retinal detachment as they age. Or the retina may become pulled away from the eye during an accident. Here again ophthalmologists use lasers to weld the retina back into its normal position.
It's estimated that two out of every 100 people over 35 years of age develop glaucoma. President Bush was diagnosed as having one type of glaucoma in which there's inadequate fluid drainage from the eye. This increases pressure within the eye and, if untreated, blindness results from continued pressure on the optic nerve. Lasers relieve the pressure by opening a hole to allow fluid to drain properly.
Research carried out for the Star Wars Program discovered a new exciting development. Today 150 North Americans wear either eyeglasses or contact lenses to correct near or farsightedness. Now computerized lasers have been produced to reshape corneas and correct these eye problems.
Lasers have been used in eye surgery for 20 years. But trying to reshape a cornea is a formidable task. Until now the end result depended on the technical skill of the surgeon and few have the hand-to-eye coordination of a John McEnroe.
This is where the Star Wars research comes into play. The Strategic Defence Initiative technology for the optical tracking of intercontinental ballistic missiles can also be used to track the random movements of the eye.
A new computerized instrument copies the design of the eye, follows it's movements and focuses on an area the size of a human cell, about 200 times smaller than the width of a human hair. The automated laser then corrects the curve of the cornea allowing the image to fall directly on the retina. Theoretically that patient can then toss away his eyeglasses.
It's too early to know how many people will enter the doctor's office to get a few zaps of laser light and achieve perfect vision through corneal sculpturing. But in this age, what seems impossible one day is fashionable the next.
W. Gifford-Jones M.D is the pen name of Dr. Ken Walker graduate of Harvard. Dr. Walker's website is: Docgiff.com
My book, �90 + How I Got There� can be obtained by sending $19.95 to:
Giff Holdings, 525 Balliol St, Unit # 6,Toronto, Ontario, M4S 1E1
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