Definition of Phacoemulsification

Phacoemulsification: A procedure in which the lens clouded by a cataract is broken up by ultrasound, irrigated, and suctioned out. Most cataract surgery today is performed using phacoemulsification. Before the advent of this technique, people with cataracts could expect a 10-day hospital stay followed by a lengthy recovery. Today, it is an outpatient procedure. Instead of making a large incision in the eye and removing the lens, the ophthalmologist can make a tiny one and then insert an ultrasonic tip which, vibrating thousands of times a second, breaks up the cataracts without damaging the surrounding tissue. The remains of the cataract are suctioned out. Phacoemulsification was introduced in 1967 by Charles D. Kelman, an American ophthalmologist (1930-2004). In his memoir, "Through My Eyes: The Story of a Surgeon Who Dared to Take On the Medical World" (Crown, 1985), Dr. Kelman described how he went to a dentist have his teeth cleaned. "I sat in his chair, as he reached over, took a long silver instrument out of its cradle and turned it on," Dr. Kelman wrote. "A fine mist came off the tip but the tip didn't seem to be moving. He applied the tip to my teeth, and I felt an exquisite vibration and heard a high-pitched sound." Dr. Kelman asked, "What is that thing?" An ultrasonic probe, came the reply. "I knew this was the moment," Dr. Kelman wrote. The word "phakos" in Greek is a "lentil" (a lentil bean). The prefix "phaco-" therefore refers to the lens which is lentil-shaped. What is a cataract? Cataracts are clouding of the lens portion of the eye. The result is much like smearing grease over the lens of a camera and impairs normal vision.

Cataracts will affect most people if they live long enough. This disorder affects 60 percent of people older than 60 and occurs when the normally clear, aspirin-sized lens of the eye starts to become cloudy. impairing vision. Experts estimate that over 1.2 million Americans are diagnosed annually with cataracts that require treatment. As their is are growing numbers of elderly in the United States, the incidence of cataracts is increasing. These persons often want to continue driving cars, reading and traveling-activities for which clear sight is vital. Until recently, anyone who developed cataracts and needed surgery faced a procedure that involved pain and often less than satisfactory results. Until the late 1970s, doctors removed the cloudy lens in a surgical procedure that required a hospital stay of five to seven days. Afterward, the patient had to wear thick "Coke bottle" glasses or contact lenses neither of which could completely restore vision to its previous level. Today, there's little need for such complicated treatment. Advances in medicine have made cataracts much less worrisome. Now, the clouded lens is surgically removed and replaced with a plastic intraocular lens (IOL) in an hourlong operation that often requires no hospitalization. "The intraocular lens has revolutionized the treatment of cataracts." says Carl Kupfer. M.D., director of the National Eye Institute in Bethesda, Md. "Implantation of the lens is one of the most successful operations in medicine."

How does a cataract form? A cataract forms in the eye's lens. the transparent structure behind the iris (the colored membrane surrounding the pupil). The lens focuses light on the retina, the light-sensitive membrane at the back of the eye which converts light impulses into nerve signals to produce clear visual images. Clouding of the lens, much like smearing grease over the lens of a camera, can develop at any age but most often appears in people older than 42. Most cataracts are caused by a change in the chemical composition of the lens. In a small percentage of cases, the chemical changes are caused by a hereditary enzyme defect, trauma to the eye., diabetes, or use of certain drugs, such as the steroid prednisone. Precisely why cataracts occur with age is unknown, but ultraviolet radiation, particularly from the sun, is thought to play a major role in creating, the chemical change in the lens responsible for most cataracts. Experimental evidence suggests that UV radiation can cloud the lens by forming highly reactive chemical fragments called "free radicals." These, in turn. disrupt the delicate structure of the lens. The type of ultraviolet radiation from the sun called UVB-the kind that causes blistering sunburn and skin cancer-is thought to be a major factor because the lens absorbs these rays. Indeed, in a study of 838 Chesapeake Bay professional fishermen, Hugh Taylor, M.D., of Johns Hopkins Hospital in Baltimore, Md., found a strong association between ultraviolet radiation and cataract formation. Fishermen with the highest levels of ultraviolet radiation exposure had three times the risk of contracting cataracts compared with those with the least exposure. Those with cataracts had 20 percent more exposure to sunlight in every year of life. Taylor's studies suggest that cataracts can be prevented by avoiding sun exposure between 10 a.m. and 4 p.m., when sunlight is strongest, and by wearing a widebrimmed hat and sunglasses. (See "Shielding Your Eyes from the Sun" below). A cataract can develop so slowly that a person may not even know it's there. If the cataract is on the outer edge of the lens, no change in vision may be noticeable. Cloudiness near the center of the lens, however, usually interferes with clear sight. What are the symptoms of cataracts? Symptoms of developing cataracts include double or blurred vision, sensitivity to light and glare (such as bright sun or auto headlights), less vivid perception of color, and frequent changes in eye-glass prescriptions. As the cataract grows worse, stronger glasses no longer improve sight, although holding objects nearer to the eye may help reading and close-up work. The pupil, which normally appears black, may undergo noticeable color changes and appear to be yellowish or white. How are cataracts diagnosed? Cataracts are typically detected through a medical eye examination. The doctor can see the abnormal lens using a hand-held viewing instrument (ophthalmoscope). The usual test

for visual acuity, the letter eye chart, may not, however, reflect the true nature of visual loss, says the American Academy of Ophthalmology. Other tests-which measure glare sensitivity, contrast sensitivity, night vision, color vision, and side or central vision-help nail down the diagnosis. Because most cataracts associated with aging develop slowly, many patients may not notice their visual loss until it has become severe. Some cataracts remain small and never need treatment, others grow more quickly and progressively larger. Only when a cataract seriously interferes with normal activities is it time to consider surgery, doctors say. People who depend on their eyes for work, play and other activities may want their cataracts removed earlier than those whose needs are less demanding. What are the treatment options? During the diagnostic examination, an ophthalmologist will carefully measure the shape, size and general health of the eye to determine whether a lens implant will be effective. In the relatively small number of cases where it won't be, eye-glasses or contact lenses will improve vision after traditional cataract surgery. Glasses, while used for years, have drawbacks. Their extreme thickness makes them unattractive and heavy. Magnification and distortion of the visual image causes objects to appear closer and 25 percent larger than they are. Peripheral vision may be reduced. Contact lenses provide fairly good vision, but many elderly people have trouble inserting, removing and cleaning them. An implanted IOL is usually the best replacement. Because the implant is placed in or near the original position of the removed natural lens, vision is restored with good peripheral vision and depth perception yet with minimal magnification and distortion. Some experts estimate that about 88 of every 100 persons receiving IOLs will achieve 20/40 vision or better. (An individual with 20/40 vision can read letters on an eye chart from 20 feet away, while a person with normal 20/20 vision can read the chart from 40 feet away; 20/40 vision is good enough to get a driver's license in most states.) Among those who do not have other eye diseases, about 94 of 100 will achieve 20/40 vision. IOLs remain permanently in place, require no maintenance or handling, and are neither felt by the patient nor noticed by others. Eyeglasses with thin lenses for near or distant viewing may still be required, but thick glasses are not necessary. A doctor can determine the appropriate implant prescription with an ultrasound device that measures eye length and corneal curvature. These measurements are combined by computer to calculate the lens power required. What is the procedure for implantation of an IOL? The standard surgical procedure, which ranges in cost from $3,000 to $5,000, is performed in a hospital or doctor's office. Peering through an operating microscope, the surgeon makes a minute, curved incision in the cornea-the surface of the eye. Then the

clouded lens is cut loose with a thin needle and suctioned out, leaving intact the rear wall of the transparent capsule that encloses the lens. There are three types of surgery to remove lenses that have a cataract: 1. Extracapsular surgery. The eye surgeon removes the lens, leaving behind the back half of the capsule (the outer covering of the lens). 2. Phacoemulsification (pronounced FAY-co-ee-mul-sih-fih-CAY-shun). In this type of extracapsular surgery, the surgeon softens the lens with sound waves and removes it through a needle. The back half of the lens capsule is left behind. 3. Intracapsular surgery. The surgeon removes the entire lens, including the capsule. This method is rarely used. The surgeon enlarges the original incision, and the new lens-a clear hard plastic disc-is then slipped in behind the iris and up against the back wall of the capsule. Two tiny "c" shaped arms attached to the lens eventually become scarred into the side of the eye and hold the lens firmly in place. The incision is closed with 7 to 10 nearly invisible stitches of fine nylon or silk. In a newer method, an ultrasonic probe enters the cut in the cornea and high-speed vibrations break the lens into microscopic flecks that are then removed by suction. A folded flexible plastic lens one-quarter of an inch in diameter can be inserted through the cut with a scissors-like device called an injector and positioned behind the pupil against the capsule wall. Once in place, the injector is removed and the lens opens. Some manufacturers are also developing bifocal IOLS, which may eliminate the need in some patients for prescription glasses after surgery. The procedure to remove the natural lens and replace it with a synthetic one is done under a general or local anesthesia with injections made in muscles around the eye. Recovery takes several hours in the hospital; in a few cases, it may require an overnight stay. The patient wears a metal shield over the eye at night; wrap-around sunglasses are recommended during the day. What happens after the IOL procedure? Within a few days of the operation, most people are back at work. In several office visits during the first six to eight weeks after surgery, the doctor will check for infections or other complications and fit the patient for reading glasses. Vision is significantly improved in 95 to 98 percent of cases. However, results of the operation aren't always worry free. After the IOL implantation, a clouding of the lens capsule, known as a "secondary cataract," occurs in roughly 40 percent of cases. To restore vision, a pulsed yttrium, aluminum, garnet (YAG) laser is used to produce a hole non-thermally, by "optical breakdown." in the capsule to allow the normal passage of light rays back to the retina. This painless procedure takes a few

minutes; improvement usually is immediate. Other problems that may occur in a small percentage of patients include swelling of the cornea, glaucoma, and swelling of the retina, which distorts vision. At a time when more older Americans than ever before are looking forward to years of active life ahead of them, IOLs clearly offer hope and a better life. Why should I shield my eyes from the sun?...Prevention Headed for the ski slopes or beach? These pleasures can pose dangers to your eyes unless you take precautions against the sun's harmful rays. Ultraviolet radiation is invisible and cannot be felt, yet long-term exposure to it may be associated with development of cataracts. Short-term exposure to very intense ultraviolet light- such as you get on a ski slope-can produce photokeratitis, also called actinic keratopathy or snow blindness. There is even some evidence ultraviolet radiation may damage the eye's retina. By spring of 1990, a new voluntary labeling program developed by the Sunglass Association of America in cooperation with the Food and Drug Administration is expected to be in place to tell consumers how much UV protection they can expect from nonprescription sunglasses. (Prescription sunglasses already meet standards of protection against UV radiation and are not included in this labeling program.) The voluntary labeling program calls for manufacturers to attach a tag to sunglasses that specifies the level of protection from the two types of ultraviolet rays: the longer wavelength ultraviolet A (UVA) radiation and the shorter wavelength ultraviolet B (UVB) rays. The standards were developed in 1986 by the American National Standards Institute in New York City through consultation with eye-care professionals and educators, research scientists, industry, and military and other government agencies. The labeling standards are the only recognized statement on the properties and performance of sunglasses. The different categories describe minimum levels of protection and are designed to help consumers pick the best glasses for the types of activities they plan:

Cosmetic: For non-harsh sunlight and around-town uses such as shopping. These will block at least 70 percent of UVB, 20 percent of UVA, and less than 60 percent of visible light. General Purpose: For most outdoor activities such as boating, flying, hiking, picnicking, and beach outings. They also can be used for snow settings. They will block at least 95 percent of UVB, at least 60 percent of UVA, and from 60 to 92 percent of visible light. Special Purpose: For very bright environments such as tropical beaches and ski slopes and for activities like mountain climbing. They will block at least 99

percent of UVB and 60 percent of UVA, in addition to from 20 to 97 percent of visible light. The amount of visible light-glare blocked by sunglasses depends on the darkness of the lenses. The darker shades of special- purpose sunglasses are intended for a high level of brightness, while the lighter shades can be used for less bright situations-like skiing on a cloudy day. In addition, within the categories, look for the actual percentage of the sun's UV radiation that each particular model of glasses claims to block. The greater the blockage, the lower the risk of UV damage to the eye. Thomas Loomis, technical director of the Sunglass Association of America, offers this advice when buying non- prescription sunglasses: First, decide on the purpose, color and fashion you want. Once you've made a selection, hold the sunglasses up at arm's length and look through them at an object with a straight border, such as a window or door frame. Move the glasses slowly across the line. If it seems to wiggle, sway or curve, the lenses contain an optical defect and should be replaced with another pair. Since 8 percent of males and 3 percent of females have a vision color defect, be sure the glasses don't distort the colors of a traffic signal. Pay for the glasses, says Loomis, walk outside the store and conduct your own test. If they distort the colors, exchange them for another pair.

Cataracts At A Glance

Cataracts will affect most people if they live long enough. Symptoms of cataracts include double or blurred vision and sensitivity to light and glare. Cataracts can be diagnosed when the doctor examines the eyes with a viewing instrument. The ideal treatment for cataracts is surgical implantation of a new lens. Sunglasses can help to prevent cataracts.

This article is in part based in information from the U.S. Food and Drug Administration (FDA). Abnormal: Not normal. Deviating from the usual structure, position, condition, or behavior. In referring to a growth, abnormal may mean that it is cancerous or premalignant (likely to become cancer ). See the entire definition of Abnormal Actinic: Referring to the ultraviolet (UV) rays from sunlight and UV lamps. Sunburn is an actinic burn. An actinic keratosis is a skin lesion that is the consequence of chronic sun exposure. From the Greek "aktis" meaning "ray."

Aging: The process of becoming older, a process that is genetically determined and environmentally modulated. See the entire definition of Aging Aluminum: A naturally occurring element that makes up about 8% of the surface of the earth and is always found combined with other elements such as oxygen, silicon, and fluorine. Aluminum is is the most common metallic element in the earth's crust but has no clear biologic role. Everyone is exposed to low levels of aluminum from food, air, and water. Exposure to high levels of aluminum may result in respiratory problems (aluminosis). Inhalation of bauxite (aluminum ore) fumes may cause pulmonary fibrosis . Aluminum in the bloodstream may lead to neurological symptoms and may be fatal. See the entire definition of Aluminum Anesthesia: Loss of feeling or awareness. A general anesthetic puts the person to sleep. A local anesthetic causes loss of feeling in a part of the body such as a tooth or an area of skin without affecting consciousness. Regional anesthesia numbs a larger part of the body such as a leg or arm, also without affecting consciousness. The term "conduction anesthesia" encompasses both local and regional anesthetic techniques. Many surgical procedures can be done with conduction anesthesia without significant pain. In many situations, such as a C-section, conduction anesthesia is safer and therefore preferable to general anesthesia. However, there are also many types of surgery in which general anesthesia is clearly appropriate. Arms: An appendage in anatomy and in clinical trials. See: Arm. Blindness: Loss of useful sight. Blindness can be temporary or permanent. Damage to any portion of the eye, the optic nerve, or the area of the brain responsible for vision can lead to blindness. There are numerous (actually, innumerable) causes of blindness. The current politically correct terms for blindness include visually handicapped and visually challenged. See the entire definition of Blindness Blurred vision: Lack of sharpness of vision with, as a result, the inability to see fine detail. Blurred vision can occur when a person who wears corrective lens is without them. Blurred vision can also be an important clue to eye disease. Capsule: Capsule has many meanings in medicine including the following: 1. In medicine, a membranous structure that envelops an organ, a joint, tumor, or any other part of the body. It is usually made up of dense collagen-containing connective tissue. 2. In pharmacy, a solid dosage form in which the drug is enclosed in a hard or soft soluble container, usually of a form of gelatin. 3. In microbiology, a coat around a microbe, such as a bacterium or fungus.

See the entire definition of Capsule Cataract: A clouding of the lens of the eye. The normally clear aspirin-sized lens of the eye starts to become cloudy. The result is much like smearing grease over the lens of a camera. It impairs normal vision. See the entire definition of Cataract Cataract surgery: Removal of the clouded lens (the cataract ) in its entirety by surgery, usually followed by replacement of the lens with an intraocular lens (IOL) made of plastic, silicone, acrylic or other material. The operation typically takes about an hour, is done under local anesthetic only, and does not require hospitalization. See the entire definition of Cataract surgery Contrast: Short for "contrast media." Contrast media are X-ray dyes used to provide contrast, for example, between blood vessels and other tissue. Cornea: The clear front window of the eye that transmits and focuses light into the eye. See the entire definition of Cornea Corneal: Pertaining to the cornea, the clear front window of the eye that transmits and focuses light into the eye.

Cut: An area of severed skin. Wash a cut or scrape it with soap and water, and keep it clean and dry. Putting alcohol, hydrogen peroxide, or iodine into a wound can delay healing, and should be avoided. Seek medical care if you think you might need stitches, as delay can increase the rate of wound infection. If the cut results from a puncture wound through the shoe, there is a high risk of infection, and you should see your healthcare professional. Redness, swelling, increased pain, and pus draining from the wound also indicate an infection that requires professional care. Diabetes: Refers to diabetes mellitus or, less often, to diabetes insipidus . Diabetes mellitus and diabetes insipidus share the name "diabetes" because they are both conditions characterized by excessive urination (polyuria). See the entire definition of Diabetes Diagnosis: 1 The nature of a disease ; the identification of an illness. 2 A conclusion or decision reached by diagnosis. The diagnosis is rabies . 3 The identification of any problem. The diagnosis was a plugged IV. See the entire definition of Diagnosis

Enzyme: A protein (or protein-based molecule) that speeds up a chemical reaction in a living organism. An enzyme acts as catalyst for specific chemical reactions , converting a specific set of reactants (called substrates) into specific products. Without enzymes, life as we know it would not exist. See the entire definition of Enzyme Enzyme defect: A disorder resulting from a deficiency (or functional abnormality) of an enzyme. In 1902 Archibald Garrod first attributed a disease to an enzyme defect: an inborn error of metabolism. Today, newborns are routinely screened for certain enzyme defects such as PKU (phenylketonuria) and galactosemia, an error in the handling (metabolism) of the sugar galactose. Eye: The organ of sight. The eye has a number of components. These components include but are not limited to the cornea, iris, pupil, lens, retina, macula, optic nerve, choroid and vitreous. See the entire definition of Eye FDA: The Food and Drug Administration, an agency within the U.S. Public Health Service, which is a part of the Department of Health and Human Services. See the entire definition of FDA Feet: The plural of foot, both an anatomic structure and a unit of measure. See the entire definition of Feet Food and Drug Administration: The FDA, an agency within the U.S. Public Health Service, which is a part of the Department of Health and Human Services. See the entire definition of Food and Drug Administration Glaucoma : A common eye condition in which the fluid pressure inside the eyes rises because of slowed fluid drainage from the eye. If untreated, it may damage the optic nerve and other parts of the eye, causing the loss of vision or even blindness. See the entire definition of Glaucoma Health: As officially defined by the World Health Organization, a state of complete physical, mental, and social well-being, not merely the absence of disease or infirmity. Hospital: It may seem unnecessary to define a "hospital" since everyone knows the nature of a hospital. A hospital began as a charitable institution for the needy, aged, infirm, or young. See the entire definition of Hospital Implant: 1. To embed; to set in firmly. In embryology, the fertilized egg implants in the uterine lining 6 or 7 days after conception (fertilization). In medicine today, many things may be implanted. 2. That which is embedded. For example: lens implants, breast implants, cochlear implants, defibrillator implants, pacemaker implants, etc.

Implantation: The act of setting in firmly. See the entire definition of Implantation Incidence: The frequency with which something, such as a disease, appears in a particular population or area. In disease epidemiology, the incidence is the number of newly diagnosed cases during a specific time period. The incidence is distinct from the prevalence which refers to the number of cases alive on a certain date. See the entire definition of Incidence Incision: A cut. When making an incision, a surgeon is making a cut. Intraocular: In the eye. The intraocular pressure is the pressure within the eye. Intraocular lens: An artificial lens made of plastic, silicone, acrylic or other material that is implanted inside the eye during cataract surgery. Abbreviated IOL. See the entire definition of Intraocular lens Iris: The iris is the circular, colored curtain of the eye. Its opening forms the pupil. The iris helps regulate the amount of light that enters the eye. See the entire definition of Iris Laser: A powerful beam of light that can produce intense heat when focused at close range. Lasers are used in medicine in microsurgery, cauterization, for diagnostic purposes, etc. For example, lasers are employed in microsurgery to cut tissue and remove tissue. See the entire definition of Laser Lens: The transparent structure inside the eye that focuses light rays onto the retina (the nerve layer that lines the back of the eye, senses light and creates impulses that go through the optic nerve to the brain). The lens was named after the lentil bean because it resembled it in shape and size. See the entire definition of Lens Membrane: A very thin layer of tissue that covers a surface. Microscope: An optical instrument that augments the power of the eye to see small objects. The name microscope was coined by Johannes Faber (1574-1629) who in 1628 borrowed from the Greek to combined micro-, small with skopein, to view. Although the first microscopes were simple microscopes, most (if not all) optical microscopes today are compound microscopes. Microscopic: So small it cannot be seen without the aid of microscope. As opposed to macroscopic (large enough to be seen with naked eye). A tiny tumor is microscopic while a big tumor is macroscopic. See the entire definition of Microscopic

Nail: In medicine, there are two types of nails. One is just a plain old metal nail used to hold 2 or more pieces of bone together, for example, after a fracture. The other type of nail is the horny plate on the end of the finger or toe. Each nail anatomically has a body, lateral nail folds (on the sides), a lunula (the little moon-shaped feature at the base), and a proximal skin fold (at the base). See the entire definition of Nail Nerve: A bundle of fibers that uses chemical and electrical signals to transmit sensory and motor information from one body part to another. See: Nervous system. Operation: Although there are many meanings to the word "operation", in medicine it refers to a surgical procedure. See the entire definition of Operation Ophthalmologist: An eye doctor. A physician practicing ophthalmology. An ophthalmologist is an M.D. Ophthalmology: The art and science of eye medicine. Ophthalmoscope: A lighted instrument, one of the most important tools of the physician, used to examine the interior of the eye , including the lens , retina and optic nerve . See the entire definition of Ophthalmoscope Pain: An unpleasant sensation that can range from mild, localized discomfort to agony. Pain has both physical and emotional components. The physical part of pain results from nerve stimulation. Pain may be contained to a discrete area, as in an injury, or it can be more diffuse, as in disorders like fibromyalgia . Pain is mediated by specific nerve fibers that carry the pain impulses to the brain where their conscious appreciation may be modified by many factors. See the entire definition of Pain Peripheral: Situated away from the center, as opposed to centrally located. See the entire definition of Peripheral Peripheral vision: Side vision. The ability to see objects and movement outside of the direct line of vision. Peripheral vision is the work of the rods, nerve cells located largely outside the macula (the center) of the retina. The rods are also responsible for night vision and low-light vision but are insensitive to color. As opposed to central vision. Phacoemulsification: A procedure in which the lens clouded by a cataract is broken up by ultrasound, irrigated, and suctioned out. Most cataract surgery today is performed using phacoemulsification. Before the advent of this technique, people with cataracts could expect a 10-day hospital stay followed by a lengthy recovery. Today, it is an outpatient procedure. Instead of making a large incision in the eye and removing the lens, the ophthalmologist can make a tiny one and then insert an ultrasonic tip which, vibrating thousands of times a second, breaks up the cataracts without damaging the surrounding

tissue. The remains of the cataract are suctioned out. See the entire definition of Phacoemulsification Photokeratitis: A burn of the cornea (the clear front surface of the eye ) by ultraviolet B rays (UVB). Also called radiation keratitis or snowblindness. See the entire definition of Photokeratitis Prescription: A physician's order for the preparation and administration of a drug or device for a patient. A prescription has several parts. They include the superscription or heading with the symbol "R" or "Rx", which stands for the word recipe (meaning, in Latin, to take); the inscription, which contains the names and quantities of the ingredients; the subscription or directions for compounding the drug; and the signature which is often preceded by the sign "s" standing for signa (Latin for mark), giving the directions to be marked on the container. Probe: (1) In surgery, a probe is a slender flexible rod with a blunt end used to explore, for example, an opening to see where it goes. (2) In molecular genetics, a probe is a labeled bit of DNA or RNA used to find its complementary sequence or locate a particular clone like homing in on a needle in a haystack. See the entire definition of Probe Pupil: The opening of the iris. The pupil may appear to open (dilate) and close (constrict) but it is really the iris that is the prime mover; the pupil is merely the absence of iris. The pupil determines how much light is let into the eye. Both pupils are usually of equal size. If they are not, that is termed anisocoria (from "a-", not + "iso", equal + "kore", pupil = not equal pupils). See the entire definition of Pupil Radiation: 1. Rays of energy. Gamma rays and X-rays are two of the types of energy waves often used in medicine. 2. The use of energy waves to diagnose or treat disease. See also: Irradiation. Retina: The retina is the nerve layer that lines the back of the eye, senses light, and creates impulses that travel through the optic nerve to the brain. There is a small area, called the macula, in the retina that contains special light-sensitive cells. The macula allows us to see fine details clearly. See the entire definition of Retina Secondary cataract: See: Cataract, secondary. Sensitivity: 1. In psychology, the quality of being sensitive. As, for example, sensitivity training, training in small groups to develop a sensitive awareness and understanding of oneself and of ones relationships with others. 2. In disease epidemiology, the ability of a system to detect epidemics and other changes in disease occurrence. 3. In screening for a disease, the proportion of persons with the disease who are correctly identified by a

screening test. 4. In the definition of a disease, the proportion of persons with the disease who are correctly identified by defined criteria. Skin: The skin is the body's outer covering. It protects us against heat and light, injury, and infection. It regulates body temperature and stores water, fat, and vitamin D. Weighing about 6 pounds, the skin is the body's largest organ. It is made up of two main layers; the outer epidermis and the inner dermis. See the entire definition of Skin Steroid: A general class of chemical substances that are structurally related to one another and share the same chemical skeleton (a tetracyclic cyclopenta[a]phenanthrene skeleton). See the entire definition of Steroid Sunburn: Sunburn is an inflammation of the skin that develops in response to exposure to ultraviolet (UV) radiation from the sun or from tanning beds and booths that emit UV radiation . Sunburn is manifested by reddened, painful skin that may develop blisters. See the entire definition of Sunburn Surgeon: A physician who treats disease, injury, or deformity by operative or manual methods. A medical doctor specialized in the removal of organs, masses and tumors and in doing other procedures using a knife (scalpel). The definition of a "surgeon" has begun to blur in recent years as surgeons have begun to minimize the cutting, employ new technologies that are "minimally invasive," use scopes, etc. See the entire definition of Surgeon Surgery: The word "surgery" has multiple meanings. It is the branch of medicine concerned with diseases and conditions which require or are amenable to operative procedures. Surgery is the work done by a surgeon. By analogy, the work of an editor wielding his pen as a scalpel is s form of surgery. A surgery in England (and some other countries) is a physician's or dentist's office. See the entire definition of Surgery Trauma: Any injury , whether physically or emotionally inflicted. "Trauma" has both a medical and a psychiatric definition. Medically, "trauma" refers to a serious or critical bodily injury, wound, or shock . This definition is often associated with trauma medicine practiced in emergency rooms and represents a popular view of the term. In psychiatry , "trauma" has assumed a different meaning and refers to an experience that is emotionally painful, distressful, or shocking, which often results in lasting mental and physical effects. See the entire definition of Trauma Ultrasound : High-frequency sound waves. Ultrasound waves can be bounced off of tissues using special devices. The echoes are then converted into a picture called a

sonogram. Ultrasound imaging, referred to as ultrasonography, allows physicians and patients to get an inside view of soft tissues and body cavities, without using invasive techniques. Ultrasound is often used to examine a fetus during pregnancy. There is no convincing evidence for any danger from ultrasound during pregnancy. See the entire definition of Ultrasound Ultraviolet A: One of the three types of invisible light rays (together with ultraviolet B and ultraviolet C) given off by the sun. See the entire definition of Ultraviolet A Ultraviolet B: One of the three types of invisible light rays (together with ultraviolet A and ultraviolet C) given off by the sun. See the entire definition of Ultraviolet B Ultraviolet radiation: Invisible rays that are part of the energy that comes from the sun. Ultraviolet radiation can burn the skin and cause skin cancer . See the entire definition of Ultraviolet radiation UV radiation: Ultraviolet radiation. Invisible rays that are part of the energy that comes from the sun, can burn the skin, and cause skin cancer . UV radiation is made up of three types of rays -- ultraviolet A (UVA), ultraviolet B (UVB), and ultraviolet C (UVC). See the entire definition of UV radiation Visual acuity: The clarity or clearness of the vision, a measure of how well a person sees. The ability to distinguish details and shapes of objects; also called central vision. See the entire definition of Visual acuity Vital: Necessary to maintain life. Breathing is a vital function. Voluntary: Done in accordance with the conscious will of the individual. The opposite of involuntary. See the entire definition of Voluntary Yttrium: A rare elemental metal. A radioactive form of yttrium is used in radiation therapy and some types of immunotherapy.