During the show, Dr. Christenbury and Dr. Ghaiy discussed several ophthalmologic health topics, such as the shape and lens of the eye, cataract surgery, LASIK surgery, ptosis, dermatochalasis, dry eye, ectropion, entropion, and keratoconus.
Dr. Christenbury emphasized how at least 50% of people need glasses to see as a child, and, when eyes stop changing in a person’s 20s, they’re eligible for PRK or LASIK surgery. When children require glasses, the need mostly stems from the inherent shape of the eye. He explained how people who are nearsighted typically have a longer eyeball shape than a typical eye shape, and that people who are farsighted usually have a shorter eyeball. As we grow older, the lens can become stiff and unable to stretch the same way to focus the beam–a condition known as Presbyopia, where the lens hardens as it ages.
According to Dr. Christenbury, “Cataracts are probably the number one cause of impaired vision or even blindness in the U.S.” A cataract forms when the clear lens inside the eye turns cloudy with age. Once a cataract has developed, it only slowly gets worse with time. The cataract can create problems reading and seeing at night, and the sole treatment is cataract surgery. Cataract surgery is an outpatient procedure that replaces the cloudy lens with a new clear lens. According to Dr. Christenbury, it is one of the most common surgeries performed at Eye Consultants of Atlanta.
The surgery replaces the cloudy lens with single focus lenses, reading lens, multifocal or trifocal lens, or extended range lenses. “Oftentimes, the lens can last you the rest of your life. It doesn’t really need to be replaced or removed. It’s sterile, inert, high-technology material that can remain in your eye the rest of your life.”
Dr. Christenbury went on to discuss the popular LASIK eye surgery. He explained the best candidates for LASIK are aged 18 to early 40s. Patients often have 90% better vision one day post-operation and see 100% better within a couple weeks. He then described some of the intricacies of the surgery, explaining how the first laser used in LASIK procedures makes a small inch flap in the cornea that is gently removed back. The second laser “reshapes the cornea in usually less than 30 seconds and, then, we replace the flap, smooth it out, and do that for each eye, and that’s it!” People in their 20s, 30s, and 40s are great candidates for LASIK, and Dr. Christenbury said that these days it’s easy to determine strong candidates with the abundance of advanced diagnostic equipment now available.
Dr. Ghaiy guided the audience through an introduction to ptosis surgery. Ghaiy explained how ptosis surgery becomes necessary when a patient experiences an abnormal, drooping upper eyelid as a result of a weakened eyelid muscle, usually, as a result of aging. An individual is aware of their condition because they cannot see as well. Dr. Ghaiy also treats patients who suffer from ectropion and entropion. Ectropion is a condition that occurs when a patient’s eyelid turns outward, leaving the inner eyelid surface exposed and vulnerable to irritation. Entropion is a condition in which your eyelid turns inward, so the eyelashes and skin rub against the eye surface. Both conditions cause persistent discomfort in patients. As these two conditions are frequently age-related issues, there is an outpatient procedure to help repair the involved eyelid by tightening the lid and its attachments.
Dr. Ghaiy spoke to his treatment of dermatochalasis, a medical condition that is commonly confused with ptosis in appearance, but they are both distinct conditions requiring different treatments. Dermatochalasis produces a laxity of eyelid skin or muscle as a result of excess skin, fat, or muscle in the area. Ghaiy mentioned that “people can develop excess skin over time,” and a blepharoplasty is “a very simple procedure to remove this skin for cosmetic or functional purposes.” The blepharoplasty removes the excess skin that surrounds the eye and reattaches remaining skin to healthy tissue. He emphasized the functional purpose of the procedure to restore peripheral vision, and an upper lid blepharoplasty typically accomplishes this end. A peripheral vision test can help gauge the necessity and success of the procedure. A lower lid blepharoplasty more often serves a cosmetic function and can help reduce tearing.
Dr. Christenbury finished the segment discussing his treatment of keratoconus, a condition which occurs when the cornea is shaped like the end of a football. Patients with this condition are not ideal candidates for LASIK surgery. The only treatment option is a corneal transplant, as it used to be a rare condition. Its prevalence was formerly thought to be 1/1,000. It’s now thought to affect 1/200 people. Our awareness of keratoconus has increased, and we have better diagnostic tools. The procedure involves corneal cross linking, forging a stronger, more rigid cornea and preventing it from getting weaker.
Dr. Christenbury received his undergraduate and medical degrees from Duke University. He completed his internship at Mount Sinai Beth Israel Medical Center. He completed residency training at the UCLA Stein Eye Institute and his fellowship training at Eye Consultants of Atlanta. Dr. Christenbury joined Eye Consultants of Atlanta in 2018 and practices at the Cumberland, Buckhead, and Lawrenceville locations. Dr. Christenbury specializes in cataract surgery, LASIK surgery, corneal transplants, and dry eye.
Dr. Ghaiy attended medical school at Albany Medical College in Albany, NY. He completed his internship in internal medicine at Albany Medical College and his residency in Ophthalmology at SUNY Downstate. His fellowship was in Oculoplastics, Orbital Surgery and Neuro-ophthalmology at the University of Texas Southwestern, Dallas, Texas. At Eye Consultants of Atlanta, Dr. Rajat Ghaiy’s medical interests and expertise include, but are not limited to, orbital surgery, reconstructive eyelid surgeries following tumor removal, functional and cosmetic eyelid surgeries, Botox, lacrimal surgeries (to help with drainage), and medical/surgical management of complex neuro-ophthalmologic problems.
Did you miss Dr. Christenbury and Dr. Ghaiy on “The Weekly Check-Up?” See below for the full segment: https://weeklycheckup.com/2021/10/24/drs-joseph-christenbury-and-rajat-ghaiy-of-eye-consultants/