Surgical Procedures

All consulting/surgery is performed under the expert and caring guidance of Dr. Wendy Marshman MB BS, MD, FRANZCO, who offers extensive experience from many years in private practice and surgery.

Dr. Marshman organises elective surgery well in advance and in many cases, this is performed on a day stay basis. Please notify us immediately of any change in plans or circumstances which may affect your surgery.

Appointments

To make an appointment to see one of our doctors, please call
(03) 9804 3818 during the business hours of Monday closed, Tuesday to Thursday 8:30am to 5:00pm and Friday 8:30am to 1:00pm.

Overview

A cataract occurs when the lens inside the eye becomes cloudy. The lens is located behind the pupil and is responsible for focusing light that enters the eye.

Light passes through the lens and hits the retina, which is a layer of photoreceptors located along the inside of the eye. Photoreceptors are cells that turn light into electrical signals which then travel to the brain.

If light is unable to pass correctly through the lens, the image projected on the retina will be distorted, resulting in decreased quality of vision.

Cataracts may develop in one eye, although they most commonly occur in both (however they may not develop at the same rate). Cataracts are diagnosed by an eye examination.

Symptoms, Causes, and Risk Factors

Symptoms

• Cloudy or blurry vision

• Decreased vision at night

• Sensitivity to light

• Double vision (halos) around lights

• Difficulty reading in dim light

• Short sightedness

Causes and Risk Factors

• Age: people over 50 are particularly vulnerable

• Trauma

• Radiation

• Genetics

• Smoking

• Diabetes

• Corticosteroid medication

Treatments

In cataract surgery, vision is restored by removing the cloudy lens and replacing it with an artificial lens.

Overview

Macular Degeneration occurs when a disease damages the retinal pigment epithelium (RPE, the layer of cells underneath the retina). It results in the painless progressive loss of central vision, but has no impact on peripheral vision and will not cause a total loss of vision

It is best to identify macular degeneration early. This can be done by booking an eye examination and could be crucial in preserving vision. Late stages of macular degeneration can be categorised as wet or dry, with most cases being dry.

In wet macular degeneration, the protein vascular endothelial growth factor (VEGF) that triggers the formation of new blood vessels causes the growth of new, abnormal blood vessels. The new blood vessels leak blood and fluid in and under the retina. Dry macular degeneration is caused by the gradual loss of retinal cells.

Symptoms, Causes, and Risk Factors

Symptoms

Often there are little to no symptoms at the early stages but as the disease progresses, vision will deteriorate.

• Blurred vision and/or difficulty reading in dim light

• Straight lines appearing wavy or distorted

• Blurry areas on a page

• Increased sensitivity to glare

Causes and Risk Factors

• Age

• Genetics

• Smoking

Treatments

Wet macular degeneration is treated by the intravitreal (into the eye) injection of a chemical called anti-VEGF.

There is currently no treatment for dry macular degeneration, however research is being conducted. Early diagnosis is important because lifestyle changes including healthy eating, vitamin supplements, and quitting smoking can be made to slow the progression.

Overview

Blepharospasm is the involuntary twitching, blinking, or spasms of the eyelid. It occurs gradually, with the movements becoming more intense over time. The spasms most often occur during the day and stop at the night. More intense symptoms may force the eye to remain closed for extended periods of time.

Symptoms, Causes, and Risk Factors

Symptoms

• Spasms in response to triggers, e.g., bright lights

• Frequent eye spasms throughout the day

• A spasm that forces the eyelid shut for extended periods of time.

Schedule an eye examination if any of the following occur:

• Eyelid twitching that continues for more than two weeks

• Your eye closes completely when it spasms

• Other parts of your face begin to twitch

Causes and Risk Factors

Blepharospasm is thought to be caused by abnormal brain activity, however, doctors are unsure of why this occurs.

Overview

Strabismus, or a squint, occurs when there is misalignment of the eyes. This usually involves one eye focused on one spot and while the other turns upwards, downwards, inwards, or outwards. There are four types of strabismus, which are classified by the direction that the eye turns.

• Exotropia (outward)

• Esotropia (inward)

• Hypertropia (upwards)

• Hypotropia (downwards)

Strabismus may be constant or intermittent, and most often occurs in young children. It can be present from birth or become apparent later, so it is recommended that children undergo routine eye checks starting at 9 months. Strabismus is most often caused by the extraocular muscles that control the movement of the eye and eyelid not working together.

Symptoms, Causes, and Risk Factors

Symptoms

• Misaligned eyes

• Eyes move separately

• Head tilting or closing one eye

• Poor depth perception

• Double vision

• Frequent squinting

Causes and Risk Factors

• Children may be born with it or develop strabismus early in life for no apparent reason.

• Genetics\Family history

• Children are more at risk than adults

• Uncorrected farsightedness or short-sightedness

• Medical Conditions such as Downs Syndrome or Cerebral Palsy

Treatments

Treatment options include glasses if the squint is being caused by vision problems. Eye patches can be used to cover the functional eye which forces the other eye to develop stronger extraocular muscles. An injection of Botox into the muscle on the surface of the eye can help the eye align properly. Other treatments include eye drops, and eye exercises.

Overview

A chalazion is a lump that forms on the upper or lower eyelid due to a blocked oil (meibomian) gland. Meibomian glands produce oil that lubricates the surface of the eye. If the opening of the gland is blocked, it can lead to a build-up that causes swelling.

Chalazions are usually painless and disappear within a few weeks, however, if they impact vision or does not disappear surgery may be required. A chalazion can often be confused with a stye, which has similar treatments and presents as a painful bump on the edge of the eyelid.

Symptoms, Causes, and Risk Factors

Symptoms

• A painless swelling or bump on the eyelid

• Blurry vision

Causes and Risk Factors

• Inflammatory conditions (e.g., acne, rosacea, inflammation of the eyelid)

• Viral infections

Treatments

Treatments for a severe and persistent chalazion include a corticosteroid injection to reduce the swelling, antibiotics, or draining the chalazion under local anaesthetic.

Overview

A blocked tear duct prevents the normal draining of tears from the eye. Tears are secreted from lacrimal glands on the outside of each eye and drain through puncta (holes) in the eyelids, they are then transported to a tear duct that empties them into the nose. Blocked tear ducts occur most commonly in infants but can also occur in adults. The build-up of tears can cause eye watering, irritation, and swelling.

Symptoms, Causes, and Risk Factors

Symptoms

• Redness and irritation

• Eye discharge or mucus

• Formation of a crust on the eyelid

• Eye infections

• Blurred vision

• Pain and swelling

• Watery eyes

• Bloody tears

• Fever

Causes and Risk Factors

• Eye, tear duct system, or nasal passage infections

• Eye injuries or trauma

• Tumours

• Swelling

• Age (common in infants)

Treatments

Often, blocked tear ducts go away without treatment, however, in severe cases surgery may be required.

Overview

Glaucoma refers to a group of eye diseases where damage to the optic nerve results in lost vision. The loss is usually gradual and is a leading cause of blindness in people over 60. Regular eye examinations are important to detect glaucoma early and begin treatment.

The optic nerve is responsible for carrying electric signals from the retina to the brain. Damage to the optic nerve is usually associated with increased pressure in the eye (although normal pressure glaucoma can also occur).

Fluid in the eye drains through a tissue where the iris and the cornea meet. If there is too much fluid, or the fluid is unable to drain, there is an increase in eye pressure.

Symptoms, Causes, and Risk Factors

Symptoms

• Patchy peripheral or central vision

• Tunnel vision

• Headaches

• Eye pain

• Blurred vision

• Seeing halos around lights

• Nausea and vomiting

• Eye redness

Causes and Risk Factors

• Age (people over 60 are vulnerable)

• A family history of glaucoma

• High eye pressure

• High or low blood pressure

• Diabetes, heart disease, and sickle cell anaemia

• Short-sightedness or long-sightedness

• Previous eye surgery or eye injury

Treatments

There is no cure for glaucoma and treatment aims to slow and prevent damage. This is done by using eye drops, and surgery to create a new channel to allow the fluid to drain.