Dr. Arffa is a cornea specialist, who is often consulted by other eye doctors for advice and management of patients with abnormalities of the front portion of the eye, including the lids, conjunctiva, cornea, iris and lens. Common conditions include: keratoconus, corneal edema, recurrent erosions, red eyes, herpes simplex, corneal ulcer, and dry eye.
The pachymeter is an instrument that measures the thickness of the cornea using ultrasound. It is useful in monitoring the progression of certain disorders that cause the cornea to become thickened (or filled with water), such as Fuchs' dystrophy. It is also used to monitor the progresss of corneal transplants, and to determine whether the cornea is strong enough for procedures such as LASIK.
Corneal topography provides detailed information about the curvature of the cornea. Using a very sophisticated computer and software, thousands of measurements are taken and analyzed in just seconds. The computer generates a color map from the data. This information is useful to evaluate and correct astigmatism, monitor corneal disease, and detect irregularities in the corneal shape. The map is interpreted much like other topography maps. The cool shades of blue and green represent flatter areas of the cornea, while the warmer shades of orange and red and represent steeper areas.
This test is used to monitor the number, density, and quality of endothelial cells that line the back of the cornea. A microscope magnifies the cells thousands of times and the image is captured with a video camera. The number of cells within one square millimeter are counted and recorded. The endothelium of a young, ten-year-old, healthy cornea has approximately 3,500 cells in each square millimeter. Normal aging causes the cells to gradually decrease over time. By age 60, most people have approximately 2,500 cells per square millimeter. Corneal swelling and clouding develop if the cell count gets below 400.
The YAG laser is used to make small cuts or openings inside the eye. Most commonly it is used to perform capsulotomies, (see YAG laser capsulotomy-link) to open the membrane behind lens implants to improve vision. It is also frequently used to perform laser iridotomies, to create a small hole in the iris to prevent or treat acute glaucoma (see YAG laser iridotomy-link).