Refractive Surgery (Elimination of Dependency on Spectacles)
Refractive disorders occur depending on refractive capacity of the cornea and structure/anteroposterior length of the lens. There are 3 primary types of refractive disorders: Myopia, hypermetropia and astigmatism, which are also known as refraction errors. Refraction errors are mitigated with the help of optic products like spectacles and contact lenses, and can be corrected through refractive surgery, which includes laser applications and intraocular lens implantation. Based on examination and investigation findings, patients with refractive errors undergo the most suitable refractive surgery procedure. Refractive laser surgeries are performed at our department to eliminate dependency on spectacles. These include the flap-free wavefront-backed PRK and LASIK operation, which involves a flap. In cases where the use of a laser is not practical for correction of myopia, hypermetropia or astigmatism, intraocular lens (phakic) implantation is successfully performed as well.
Cataract and Intraocular Lens Surgery
Currently the most recognized technique for cataract surgery around the world, suture-free phacoemulsification under drip anesthesia is performed at our department. In this procedure, the eye is anesthetized with drops instead of an injection. Cataract surgery is performed through a tiny incision measuring approximately 2 millimeters on the transparent layer, and an appropriate lens is performed in the ocular zone. The patient does not need to be hospitalized afterwards, and is bound to regain their former pre-cataract visual acuity. Ordinary and complex (high-risk) cataract surgeries are routinely performed at our clinic. Once the cataractous lens has been cleaned, a monofocal (far focus), multifocal (known commonly as ‘smart lens’; near, intermediate and far focus) toric (astigmatism correction) or next-gen monofocal (ring/glare reduction, far to intermediate focus) can be selected and implanted to the eye in accordance with the patient’s preferences and indications. Other procedures aimed at complex cases (such as pupilloplasty, iris repair, intraocular lens fixation to iris/sclera etc.) are successfully performed at our clinic too.
Cornea and Ocular Surface Unit
Cornea is a transparent, dome-like anatomic structure positioned in front of the ocular globe. Cornea and the structures in its periphery are called the ocular surface. There is a lacrimal layer on it, which keeps the ocular surface smooth and damp and protects it from external factors. Diseases of cornea, conjunctiva and eyelids are addressed separately, and also collectively as ocular surface diseases. Ocular surface diseases like infections of eyelids and eyelash roots (blepharitis), ocular membrane (conjunctivitis) and corneal infections associated with bacteria, viruses, fungi and parasites (keratitis) as well as congenital and acquired structural disorders of cornea (e.g.: keratoconus, corneal edema, neurotrophic keratopathy etc.) are among the conditions in which our clinic is specialized.
In addition to diagnostic procedures like biomicroscopic examination for diagnosis of corneal and ocular surface diseases, confocal microscopy, meibography, tear osmolarity test (TearLab) and clinical microbiology tests, medical and surgical treatment methods are successfully practiced. These treatments include medical therapy and punctum plug implantation for dry eyes; amniotic membrane cover and tarsorraphy for advanced ocular surface disorders; corneal collagen cross-linking, intrastromal corneal ring segment implantation (ICRS) and special contact lens applications for keratoconus; and cornea transplantation procedures (phototherapeutic, penetrating, deep frontal lamellar, Descemet’s membrane endothelial keratoplasty).
Our department also carries out numerous leading scientific studies in diagnosis and treatment of corneal and ocular surface diseases.
Our retina unit is equipped with the facilities required for color fundus photography, fundus autofluorescence imaging, multicolor imaging, optic coherence tomography, fundus fluorescein angiography and indocyanine green angiography, which are all investigations aimed at diagnosis of all retinal diseases. Intraocular drug injections for age-related macular degeneration, which is also known as ‘yellow spot’ disease and currently the most prominent reason underlying loss of vision around the world, is successfully performed at our clinic. Differential diagnosis of various other conditions that are often mistaken for age-related yellow spot disease is also conducted without error thanks to our specialized physicians and advanced diagnostic technology. For treatment of diabetic retinopathy -a condition that develops secondary to diabetes- and retinal venous occlusion, we utilize argon laser photocoagulation and intraocular drug injection methods. Hereditary retinal conditions like night blindness (retinitis pigmentosa), cone dystrophy and Stargardt disease are routinely treated by means of PRP administration into the membrane.
Furthermore, ‘vitrectomy’ and other surgical techniques are carried out to successfully treat other conditions requiring surgical intervention, including diabetic retinopathy, intraocular bleeding (vitreus hemorrhage), retinal detachment, macular hole and epiretinal membrane.
We are also developing novel treatment options with a focus on various retinal diseases as part of the leading regenerative medicine studies conducted in collaboration with Koç University Laboratories.
Ocular Immunology and Uveitis
Uveitis is described as inflammation of the uveal tissue of eyes. It is condition that results from infections like herpes virus, toxoplasmosis, tuberculosis or syphilis or due to inflammation of the eyes secondary to other autoimmune conditions like rheumatoid arthritis, Behcet’s disease, ankylosing spondylitis and sarcoidosis. Sometimes, uveitis is not necessarily accompanied by another disease. Such cases are categorized as idiopathic. Uveitis cases are evaluated by specialized physicians, who carry out necessary diagnostic studies and draft a suitable treatment and follow-up plan at our unit. In addition to medical treatment of uveitis, ocular complications associated with uveitis are taken under control and essential surgical interventions are performed afterwards.
Ocular Hypertension (Glaucoma)
Glaucoma, i.e. ocular hypertension
disease, is a chronic disease that is accompanied with optic nerve damage, often runs a subtle course of progression, and threatens public health. Patients presenting to our clinic with early or late-stage glaucoma go through diagnostic tests and receive medical or surgical treatment under the light of current medical literature.
Applanation tonometer, Tono-Pen, non-contact tonometer or iCare tonometer are utilized to measure intraocular pressure. A computerized visual field test with different color adjustments is performed at our unit in order to identify visual field defects. Retinal nerve fiber layer is evaluated under optic coherence tomography (OCT) for the purpose of detecting optic nerve damage. Additionally, ultrasound Biomicroscopy is utilized in diagnosis of some specific subtypes of glaucoma. Thanks to all of these tests, glaucoma, a chronic disease, is diagnosed, treated and followed in a robust manner.
Treatment options include drops for reducing intraocular pressure and a range of surgical procedures from laser iridotomy to trabeculoplasty, combine cataract and trabeculoplasty surgery, seton operations and Ahmed valve tube implantation.
We are also conducting leading studies on diagnosis and treatment of glaucoma in collaboration with Koç University Laboratories.
As can be inferred from the name, the neuro-ophthalmology unit is a subbranch concentrating on ophthalmologic conditions associated with the brain, which looks into ocular or visual field disorders, synchronization disorder of eye movements and abnormalities of the pupil that may accompany optic nerve or cerebral diseases. Ophthalmologists specialized in this field most often treat optic neuritis resulting from involvement of the optic nerve by multiple sclerosis, ischemic optic neuropathies or papilledema, which might be caused by increased intraocular pressure. Disorders associated with cranial tumors, myasthenia gravis, ocular muscle paresis, pupillary abnormalities and cancer (paraneoplastic syndromes) are included in the field of interest for this subbranch.
To diagnose this group of diseases, color vision examination, pupillary examination, pharmacologic tests, computerized visual field test, color fundus photography, ocular ultrasound and optic nerve tomography are employed at the clinic. Eligible cases are also referred to the department of neurology for visual evoked potentials test (VEP).
Interdisciplinary work is essential in treatment of neuro-ophthalmologic diseases. Therefore, treatment plans are drafted in collaboration with the departments of neurology, neurosurgery, internal medicine and radiology.
Pediatric Ophthalmology and Strabismus Unit
Treated and followed in only a few medical centers in our country, retinopathy of prematurity (ROP) is a prevalent condition among premature infants. The specialized physicians at our polyclinic treat infants diagnosed with this condition, including those who are staying in incubators at the neonatal intensive care unit or present on outpatient basis. Treatment options for ROP include intravitreal drug injection and laser photocoagulation. Backed up modern surgical equipment, our experienced team practices medical and surgical treatment for pediatric cases of congenital cataract, strabismus and amblyopia (lazy eye) in addition to conducting routine eye checks for healthy children. Non-contact automatic refractometer measurements are carried among the pediatric population below 3 years of age. The Krimsky test -which employs prismatic glasses- and Worth 4-dot test are conducted in examinations for strabismus and amblyopia. The Titmus test for stereopsis is also available at our clinic.
Oculoplastic Surgery (Ocular Cosmetic Surgery) and Orbital Surgery
Our oculoplastic and orbital surgery unit performs interventions and operations aimed at treatment of eyelid diseases, lacrimal canal disorders, orbital implant problems, thyroid orbitopathy, eyelid and orbital tumors as well as all cosmetic procedures around the eye. Among the polyclinic services provided by the oculoplastic surgery unit are biomicroscopic examination, Hertel exophthalmometer, Humphrey visual field test and Ishihara color vision test. Punctum plug and perforated punctum plug applications are carried out to treat dry eyes and epiphora as well. Treatment of congenital or acquired ptosis, trichiasis, entropion and ectropion pathologies of eyelids are treated with modern surgical techniques. Endonasal or external dacryocystorhinostomy are surgical procedures aimed at lacrimal system disorders. Thyroid orbitopathy cases are diagnosed and followed in coordination with the department of Endocrinology. We provide medical treatment, orbital decompression surgery and radioactive iodine therapy options in accordance with patient preferences and clinical indications. On the cosmetic side, upper and lower blepharoplasty operations, reposition of fat pads and Botox injections can be performed to improve the cosmetic appearance of the areas around the eyes.
Ocular Oncology Unit
Ocular Oncology is the branch that focuses on tumors afflicting the eyes or their periphery. Differential diagnosis of all types of ocular oncology cases is rendered by use of advanced radiologic, medical and ophthalmic instruments. Our unit is well capable of treating all tumors that may be found in or around the eyes, including some severe cases like malignant melanoma and retinoblastoma. Treatment of ocular tumors at our clinic includes radiotherapy, plaque radiotherapy, cyber knife, chemotherapy and surgical excision.
Contact Lens Unit
Contact lenses are widely used in correction of refractory disorders. Manufacturing technologies in this field have followed in the footsteps of advancements in biotechnology. Currently, soft contact lenses provide an alternative to spectacles in numerous conditions. Contact lens trial sets by a number of different contact lens manufacturers, all approved by the Ministry of Health, are available at our contact lens unit. These allow each patient to try on different options for a precise prescription. It is possible for new users with no prior history of contact lens use to find out whether or not their eyes are suitable, whereas anterior and posterior surfaces of long-time contact lens users can be evaluated through corneal topography at our unit. Schirmer test and non-invasive tear film breakup time tests are other investigations specifically designed to determine tear quantity and functions.
Aside from contact lenses suitable for myopia (minus refractive error) and hypermetropia (positive refractive error), toric (astigmatic) contact lenses can be tried on at our polyclinics, where satisfactory results are attained for refractive error margins up to -3.0 diopters. As an alternative to multifocal glasses and intraocular lenses designed for both near and far vision, we offer multifocal contact lenses that enable clear vision in close, intermediate and far distances.
On top of the various usage cases described above, contact lenses can be utilized almost like a ‘band-aid’ for therapeutic purposes in corneal diseases or following refractive surgeries. If the corneal hue has changed because of underlying ocular conditions, special colored contact lenses are also a prosthetic option for matching the color of the intact eye for a satisfactory cosmetic appearance.
Low Vision Rehabilitation Unit
Patients who experience advanced loss of vision due to conditions such as retinitis pigmentosa (night blindness), cone dystrophy, Stargardt disease, age-related macular degeneration (yellow spot disease), diabetic retinopathy, glaucoma and retinopathy of prematurity are assisted at this unit to restore adequate vision by use of special spectacles, devices and methods of rehabilitation.