Published: 2022-11-16

Talking about how the eye and pancreas are related, why depression affects eyesight, and a sensation named "iStent" - a new miraculous treatment that controls intraocular pressure of patients with glaucoma. It is a titanium shunt that is kind of like an underwater tube that connects drainage to the anterior chamber of the eye.



part 1


Let’s talk about glaucoma.  Everyone knows that the eye needs fluid, but when it’s too little it’s dangerous.  Correct?

 Yes, but when it’s too much that’s also dangerous.  Therefore, the best treatment option for glaucoma is to make it so that liquid continues to be secreted to provide irrigation for the eye, but that it is able to drain as well.  But this is difficult, because there’s always a struggle – pressure is too high or too low.  What can we do?  Now there’s a new method, namely the iStent, a titanium shunt that is kind of like an underwater tube that connects drainage to the anterior chamber of the eye.

This thing, as I understand it, helps reduce pressure.  But it is, so to speak, the Biblical “log in your eye”, right?  Is it safe?

 The safety of any technology always depends on the hands.  In the right hands, the introduction of a microshunt is completely safe, adds only 1-2 minutes to the operation, and is without any postoperative complications usually associated with pressure being too low.  It could be called a kind of internal valve, not to be confused with an outside one, where barbaric glaucoma procedures are done that create a flap in the eye and are fraught with difficulties in regulating pressure.  In the hands of an experienced surgeon, a microscopic shunt made of hard, stainless metal is not only safe, but extremely useful.


Moving on to our eternal enemy.  Today, we can speak boldly about the diabetes epidemic.  How is this related to the eyes?  After all, the pancreas seems pretty far away.

 Diabetes strongly affects the eye, namely the retina.  They have a huge number of blood vessels and an accordingly large energy demand.  And it often happens that the patient doesn’t notice any other symptoms…  They’re overweight, haunted by fatigue, or overexerted, but think that it’s happening for other reasons or all age-related.  This is a common situation that we have in the office:  a person comes into the office and says they’re over 40 and they need glasses for farsightedness.  However, we examine their eyes not only for glasses, but also look at the retina.  We have magnificent machines that take high-resolution pictures of the retina and can detect characteristic changes.  “Do you have diabetes?” I ask.  “No, diabetes?  My mom has it, my dad had it, but I do not.  I’m lucky!” they say.  Then I advise to go to a family doctor and have a complete examination for diabetes.  There, a person goes in on an empty stomach and is given special tests, so the full picture comes into view.

What changes in the life of someone who has diabetes, but shows no symptoms?

They start to treat it, usually with pills, and they’re given a nutritionist, they try to diet, start exercising, and if possible lose weight.  After a while, many say, “I feel great!”, while others simply forget or shrug their shoulders, but this disease is extremely vindictive and will always remind you it’s there.

So, thanks to the eyes, we can learn about diabetes earlier than if we didn’t go to the ophthalmologist?  

 Not just diabetes, but other diseases, like hypertension, kidney problems, thyroidism, etc.


Let’s talk about something optimistic.  What do you think about the connection between vision and mood?  Does it exist?

 It’s simply a fact.  So much that it’s in our office motto:  “Life is beautiful – see it!”  But in order to see the beauty of the world, you need normal vision, right?  So when you look at the world through cataracts or myopia, then your mood does not improve.  Experiments by Israeli scientists show that people with depression have significantly impaired vision.  There’s also an inverse causal relationship, where sharply impaired vision can affect the perception of life itself.

What did the experiment consist of?

 People suffering from depression were told to view special images.  It turns out that subjects in this state either saw some fragments indistinctly, or not at all.  In other words, depression worsens the brain’s ability to process visual information.

It seems so obvious to me that you wouldn’t need experiments.  People who are depressed are apathetic about almost everything.  So when you’re already not happy, you’re not up for noticing these fragments. 

 It’s better to talk about these things with a psychologist, but it would be interesting if you could possibly diagnose depression through visual tests and in the same way monitor the effectiveness of treatment.

Ophthalmology, it turns out, touches on all aspects of our lives?

Vision uses 65% of the brain’s energy.  Our eyes can distinguish over 500 shades of grey.  In the course of our lives, we are able to perceive more than 24 million images – but only on the condition that we see well.  If we wear the wrong glasses, ignore cataracts, or the like, it will quickly affect your overall condition.  Poor vision worsens mood, but perfect vision can easily improve it.  It’s worth it to see clearly, because the world really is beautiful!