Ophthalmology

Ophthalmology is the branch of medicine that deals with the anatomy, physiology and diseases of the eye. An ophthalmologist is a specialist in medical and surgical eye problems. Since ophthalmologists perform operations on eyes, they are both surgical and medical specialists. A multitude of diseases and conditions can be diagnosed from the eye.
Ophthalmology includes subspecialities which deal either with certain diseases or diseases of certain parts of the eye. Some of them are:
  • Anterior segment surgery
  • Retinal ophthalmology, which emphasizes such things as laser treatment of the retina and actual retinal surgery
  • Cornea, ocular surface, and external disease
  • Glaucoma
  • Cataracts – not usually considered a subspecialty per se, since most general ophthalmologists perform cataract surgery
  • Medical retina, deals with treatment of retinal problems through non-surgical means.
  • Neuro-ophthalmology
  • Ocular oncology
  • Kidney dialysis is a procedure that is a substitute for many of the normal functions of the kidneys.
  • Dialysis allows patients with kidney failure a chance to live productive lives.
  • There are two types of dialysis: hemodialysis and peritoneal dialysis.
  • Each type of dialysis has advantages and disadvantages. Patients can often choose the type of long term dialysis that best matches their needs.
There are two main types of dialysis: "hemodialysis" and "peritoneal dialysis."

Hemodialysis : The blood circulates outside the body of the patient - it goes through a machine that has special filters. The blood comes out of the patient through a catheter (a flexible tube) that is inserted into the vein. The filters do what the kidney's do; they filter out the waste products from the blood. The filtered blood then returns to the patient via another catheter. The patient is, in effect, connected to a kind of artificial kidney.

Peritoneal dialysis : A sterile (dialysate) solution rich in minerals and glucose is run through a tube into the peritoneal cavity, the abdominal body cavity around the intestine, where the peritoneal membrane acts as a semi-permeable membrane.
The abdomen is the area between the chest and hips - it contains the stomach, small intestine, large intestine, liver, gallbladder, pancreas and spleen. Peritoneal dialysis uses the natural filtering ability of the peritoneum - the internal lining of the abdomen. In other words, peritoneal dialysis uses the lining of the abdomen as a filter of waste products from the blood.

Kidney failure tends to happen gradually. Even if just one kidney works, or both work partially, normal kidney function is still possible. So, it can be a very long time before any symptoms are noticed by the patient. When symptoms do occur they tend to be different from person-to-person, making it harder for doctors to diagnose kidney failure quickly. The following symptoms may be present:
  • Fatigue (tiredness)
  • Frequent need to urinate, especially at night. Frequency grows with time
  • Itchy skin
  • Erectile dysfunction (men have difficulty getting and/or sustaining an erection)
  • Nausea
  • Shortness of breath
  • Water retention (swollen feet, hands, ankles)
  • Blood in urine
  • Protein in urine
Each of the two types of dialysis, hemodialysis and peritoneal dialysis, has advantages and disadvantages. It is up to the patient and their kidney doctor to decide which of these procedures is best by considering her/his life style, other medical conditions, support systems, and how much responsibility and participation in the treatment program he/she desires. The patient must realize that because of their specific medical condition, they may not be a candidate for one or the other type of dialysis. Each patient must view the two types of dialysis procedures from her/his own perspective.

Regardless of which type of dialysis is chosen , patients have certain responsibilities such as following a diet program, watching their fluid intake and taking special vitamins and other medicines to control blood pressure and calcium and phosphorus balance.

For many patients, the major advantage of hemodialysis is minimal participation in the treatment. However, patients are required to adhere to a specific schedule and travel to the dialysis unit three times a week. Hemodialysis also requires stricter diet control and fluid control than peritoneal dialysis.