Ophthalmology

Ophthalmology

Ophthalmology, or eye care, is a medical field dedicated to diagnosing and treating eye diseases. Ophthalmologist’s consultation, whereby visual acuity, visual field, eye pressure and retinas are controlled, is sometimes part of the general health check. Some of the most common eye problems and their treatment options are described below.

Different eye diseases and their treatment

Visual acuity loss is a very widespread problem in the Western world. Although nearsightedness (or myopia) and farsightedness (hyperopia or the need for reading glasses) are not classified as eye diseases, they both have a negative impact on life quality. Fortunately, thanks to new developments in medicine, it is possible to improve visual acuity by means of simple and safe laser operations. There are many different methods available, such as Lasik, Femtolasik and Smile. During the laser operation, the topmost layer of the eye or cornea is reshaped so that the light beams will refract at the right angle. This leads to the recovery of visual acuity. If the cornea is too thin or its shape makes it unsuitable for a laser operation, or if the loss of visual acuity is too extensive, an artificial lens could be placed in the eye. The artificial lens can later be removed, if need be. In addition to that, ophthalmologists take care of diseases and problems that require more complicated treatment or even surgical intervention.

Strabismus, also called crossed eyes, is a condition in which the cooperation between the eyes is lacking – the eyes can be crossed always or only in some situations. Strabismus can manifest at any age. In children below one year of age, episodic strabismus may be evident as the cooperation between the eyes has not yet fully developed. This is considered normal. However, if you notice that one eye is crossed all the time, an ophthalmologist should be consulted. The reasons for developing strabismus include lazy eye or amblyopia, but also deficient visual acuity, genetic predisposition, traumas, and weakness of eye muscles. In case of amblyopia, early discovery and treatment are crucial. In addition to noninvasive methods (glasses, covering the eye, adhesive tapes, eye exercises), surgical methods are also used in treatment, especially when weak eye muscles are the culprits.

Cataract is a common disease in elderly people, however, the reasons for developing it are unfortunately not exactly known. A healthy eye lens is transparent and directs light to the retina. In case of cataract, clumps start to form inside the lens liquid and the lens becomes cloudy. The disease may affect only one eye or both eyes. In some rare cases cataract may be congenital or may develop as a complication of certain diseases (for example, rheumatoid arthritis, atopic dermatitis, or diabetes). The main symptom of cataract is painless progressive loss of vision. When the disease has progressed and starts to disturb everyday life, lens replacement surgery could be performed. During this operation, the cloudy lens is removed and replaced with an artificial lens.

Glaucoma is a chronic disease in which the intraocular pressure is increased. Increased pressure in the eye may damage the optic nerve and the visual field. In this disease, the production, movement and drainage of the liquid is disturbed and this leads to an increase in intraocular pressure, which may damage the optic nerve, which, in its own turn, may lead to the contraction of the visual field. Quite often glaucoma is not noticed in the early stage because the visual field starts to narrow from the edges. If not treated, this disease may result in permanent blindness. In order to maintain satisfactory vision as long as possible, glaucoma patients should be assessed and studied regularly. For glaucoma, eye drops, laser treatment and surgical interventions are used.

Macular degeneration or yellow spot disease is a common eye disease and the leading reason for blindness. Macula (“yellow spot” in Latin) is a region in the retina rich in photoreceptors. Thanks to these receptors we perceive our environment sharply and see colors. Macular degeneration leads to gradual loss of visual acuity and/or decreased visual field. First alarm symptoms include distorted vision and reading difficulties. As it is not possible to treat the causes behind the disease, prevention and early diagnosis are crucial. Different procedures, such as laser treatment, may slow down or postpone loss of vision.

Stye and chalazion are eye diseases that are, fortunately, not dangerous, but may still disturb everyday life. Stye (also called hordeolum) is an acute purulent inflammation of a fat or sweat gland in the eyelid that develops as a result of a blocked gland, foreign body, or trauma. Stye can be painful and appear suddenly, however, quite often it will disappear by itself. Chalazion (also known as meibomian cyst) can often be a complication of an inflammation of a fat gland, when the drainage of pus is blocked for some reason. Chalazions are generally painless. The healing process can be accelerated by means of a small operation, whereby the abscess is opened and pus allowed to drain. In case of recurrent styes or chalazions, an ophthalmologist should be consulted.

Services:

    • Laser treatment for presbyopia

      7 clinics

      Femto 40+ is a new laser procedure that can be used to improve presbyopia, which is associated with aging of the eye and worsening ability to focus clearly on close objects. Femtolaser procedure offers a good opportunity to get rid of reading glasses. During the procedure, a femtolaser is used to change the shape of the cornea to significantly improve depth perception, so that the eye can see well without changing the lens shape. By changing the shape of the cornea, it is possible to increase depth perception up to 1.5 diopters without affecting vision quality, contrast sensitivity or twilight vision. By increasing depth perception, the dominant eye will have good far and intermediate vision, and the other eye good intermediate and near vision. This condition is called micro-monovision. As the vision acuity of both eyes to intermediate distances is the same, the brain can easily merge the images from the two eyes.

    • Laser eye surgery - ASA

      7 clinics

      Advanced Surface Ablation (ASA) or FLOW laser operation is a vision correction procedure suitable for correcting nearsightedness and astigmatism (cylinder glasses). During the procedure, a flap of about 8 mm in diameter of the outermost layer of the eye (epithelial layer) is removed using an excimer laser, followed by reshaping the underlying corneal tissue. As the removal of the epithelium causes a corneal “wound”, a contact lens must be worn for 3–5 days to protect the eye during the healing process. Due to high risk of inflammation, hormone eye drops should be used for at least one month after the ASA laser surgery. Recovery of good visual acuity takes about 2–3 weeks after the procedure.

    • Laser eye surgery - ASA - 2 eyes

      5 clinics

      Advanced Surface Ablation (ASA) or FLOW laser operation is a vision correction procedure suitable for correcting nearsightedness and astigmatism (cylinder glasses). During the procedure, a flap of about 8 mm in diameter of the outermost layer of the eye (epithelial layer) is removed using an excimer laser, followed by reshaping the underlying corneal tissue. As the removal of the epithelium causes a corneal “wound”, a contact lens must be worn for 3–5 days to protect the eye during the healing process. Due to high risk of inflammation, hormone eye drops should be used for at least one month after the ASA laser surgery. Recovery of good visual acuity takes about 2–3 weeks after the procedure.

    • Laser eye surgery - FemtoLasik

      22 clinics

      FemtoLasik laser eye surgery is a second-generation vision correction procedure suitable for treating nearsightedness (up to -9D), farsightedness (up to +4D) and astigmatism (up to -4D). The procedure starts with creating a tiny corneal flap. The top layer of the cornea is separated with the laser impulses of a femtolaser and folded back. After the corneal reshaping by a laser, the flap is gently repositioned. As the epithelium is not permanently removed during this procedure and thus there is no wound, recovery is faster and there is no need to use protective contact lenses. Recovery of good visual acuity takes only a couple of hours. The risk of inflammation is lower than in ASA procedure (it is necessary to use hormone eye drops only for two weeks).

    • Laser eye surgery - FemtoLasik - 2 eyes

      8 clinics

      FemtoLasik laser eye surgery is a second-generation vision correction procedure suitable for treating nearsightedness (up to -9D), farsightedness (up to +4D) and astigmatism (up to -4D). The procedure starts with creating a tiny corneal flap. The top layer of the cornea is separated with the laser impulses of a femtolaser and folded back. After the corneal reshaping by a laser, the flap is gently repositioned. As the epithelium is not permanently removed during this procedure and thus there is no wound, recovery is faster and there is no need to use protective contact lenses. Recovery of good visual acuity takes only a couple of hours. The risk of inflammation is also lower than in ASA procedure (it is necessary to use hormone eye drops only for two weeks).

    • Laser eye surgery - Lasik

      3 clinics

      Lasik laser eye surgery is a vision correction procedure for treating nearsightedness. The procedure starts with creating a tiny corneal flap mechanically by means of a microkeratome and folding it back. After the underlying corneal tissue has been reshaped, the flap is repositioned. As the epithelium is not permanently removed during this procedure and thus there is no wound, recovery is faster and there is no need to use protective contact lenses. Recovery of good visual acuity takes only a couple of hours. The risk of inflammation is also quite low (it is necessary to use hormone eye drops only for two weeks). Since it is not possible to cut an evenly thick corneal flap with a mechanical microkeratome and the centering accuracy is also not perfect, this procedure is not appropriate for treating astigmatism and farsightedness.

    • Laser eye surgery - Lasik - 2 eyes

      3 clinics

      Lasik laser eye surgery is a vision correction procedure for treating nearsightedness. The procedure starts with creating a tiny corneal flap mechanically by means of a microkeratome and folding it back. After the underlying corneal tissue has been reshaped, the flap is repositioned. As the epithelium is not permanently removed during this procedure and thus there is no wound, recovery is faster and there is no need to use protective contact lenses. Recovery of good visual acuity takes only a couple of hours. The risk of inflammation is also quite low.

    • Laser eye surgery - PRK

      17 clinics

      PRK (photorefractive keratectomy) is a vision correction procedure for treating nearsightedness, farsightedness and astigmatism. The procedure consists of two steps – removing the epithelial layer of the eye and reshaping the cornea. An alcoholic solution (LASEK) or a plastic blade (Epi-K) are used to remove the epithelium. In case the epithelium is removed by a laser, the procedure is called “no touch PRK”, also known as ASA laser surgery.

    • Laser eye surgery - PRK - 2 eyes

      4 clinics

      PRK (photorefractive keratectomy) is a vision correction procedure for treating nearsightedness, farsightedness and astigmatism. The procedure consists of two steps – removing the epithelial layer of the eye and reshaping the cornea. An alcoholic solution (LASEK) or a plastic blade (Epi-K) are used to remove the epithelium. In case the epithelium is removed by a laser, the procedure is called “no touch PRK”, also known as ASA laser surgery or Flow.

    • Laser eye surgery - PTK

      1 clinic

      PTK laser eye surgery (photo-therapeutic keratectomy) is a procedure whereby defective epithelial layer of the cornea is removed with a laser. The procedure is used, for example, to remove corneal scars, to smoothen the surface of the cornea, to treat corneal ulcers or to change the shape of the cornea, which was distorted after an accident or surgery. PTK laser surgery is expected to improve vision and general feeling of comfort in the eye.

    • Laser eye surgery Smile - 1 eye

      8 clinics

      Laser eye surgery SMILE (Small Incision Lenticule Extraction) is the newest tissue saving method to improve visual acuity. The main difference compared to PRK and LASIK procedures is that the cornea’s epithelium and nerves will stay intact, which ensures faster recovery after the surgery and reduces the risk of dry eye development. During the ReLex SMILE surgery, an incision is made and a lenticule is created inside the intact cornea using a femtolaser. The lenticule is then extracted through the same incision, which is only a couple of millimeters in width.

    • Laser eye surgery Smile - 2 eyes

      4 clinics

      Laser eye surgery SMILE (Small Incision Lenticule Extraction) is the newest tissue saving method to improve visual acuity. The main difference compared to PRK and LASIK procedures is that the cornea’s epithelium and nerves will stay intact, which ensures faster recovery after the surgery and reduces the risk of dry eye development. During the ReLex SMILE surgery, an incision is made and a lenticule is created inside the intact cornea using a femtolaser. The lenticule is then extracted through the same incision, which is only a couple of millimeters in width.

    • OCT scan

      19 clinics

      OCT scan or optical coherence tomography is a non-invasive imaging method, which makes it possible to assess the condition of the different layers of the retina. The OCT apparatus scans the light reflections of various tissue layers and takes cross-section pictures of the retina. Based on these scans, the eye doctor can identify damaged layers of the retina and visualize fine ocular structures. The procedure usually takes 5 minutes.

    • Intraocular pressure measurement

      20 clinics

      Intraocular pressure measurement or tonometry is a simple and fast procedure that is painless to the patient and very informative to the doctor. Regular measurement of the intraocular pressure allows an early detection of a serious disease named glaucoma. For people over 40, it is recommended to monitor intraocular pressure regularly even if there are no complaints.

    • Fundus photography - 1 eye

      17 clinics

      Fundus photography (retinal imaging) is a non-invasive and painless diagnostic method, which enables to visualize and evaluate the condition of the fundus of the eye. To make the fundus well visible, eye drops are used before the imaging to widen the patient’s pupils. Fundus images are taken with a special camera, attached to a microscope. After the procedure, vision may be blurred for a few hours because of the pupil-expanding eye drops used.  

    • Fundus photography - 2 eyes

      2 clinics

      Fundus photography (retinal imaging) is a non-invasive and painless diagnostic method, which enables to visualize and evaluate the condition of the fundus of the eye. To make the fundus well visible, eye drops are used before the imaging to widen the patient’s pupils. Fundus images are taken with a special camera, attached to a microscope. After the procedure, vision may be blurred for a few hours because of the pupil-expanding eye drops used. 

    • Fluorescein angiography (FAG)

      3 clinics

      Fluorescein angiography is a diagnostic method for assessing blood vessels and identifying pathologies by visualizing and examining the circulation of the retina of the eye with fluorescent dye. Fluorescent dye called fluorescein, which is injected in the patient’s vein and reaches the blood vessels of the retina through circulation, makes the capillary network visible. With preparations, the procedure takes about 1.5 hours.

    • Chalazion removal - 2 eyes

      2 clinics

      A chalazion, also known as a meibomian cyst, is a painless lump that develops on the inner lining of the upper or lower eyelid due to a blocked meibomian gland (tiny oil gland). Chalazion usually occurs because of recurring styes. A stye, also known as a hordeolum, is an infection of an oil gland in the eyelid. The chalazion often disappears by itself or after antibiotic treatment within one month. However, if it is big and persists for more than two months, incision and drainage may be recommended. Chalazion removal is performed under local anesthesia.

    • Laser iridotomy - eye

      3 clinics

      Laser iridotomy is one of the laser operations for the treatment of narrow- and closed-angle glaucoma. Glaucoma is an eye disease, which damages the eye’s optic nerve. The damage usually results from increased pressure in the eye and other factors promoting the disease. Laser iridotomy is performed under local anesthesia. During the procedure, patient’s eyelids are kept open with a special contact lens. A very small opening is made in the iris by means of laser pulses to create a connection between the posterior and anterior chambers. It improves the internal fluid circulation of the eye and lowers intraocular pressure.

    • Laser trabeculoplasty - 1 eye

      3 clinics

      Laser trabeculoplasty is the most common laser procedure for the treatment of open-angle glaucoma. Laser trabeculoplasty is performed using local anesthesia. During the procedure, patient’s eyelids are kept open with a special contact lens. The corner region of the anterior chamber is treated with laser pulses, leading to tissue contraction and opening of the adjacent trabecular meshwork. The procedure improves internal fluid drain and lowers intraocular pressure. The procedure is painless for the patient, only some flashes of light could be experienced during laser treatment.

    • ICL Surgery for astigmatism - 1 eye

      11 clinics

      ICL (Implantable Contact Lens) surgery is a procedure for improving visual acuity and an alternative to laser operations. The procedure involves implanting an IC lens behind the iris through a tiny incision. The IC lens is positioned between the iris and natural lens. For correcting astigmatism, during the IC lens insertion the doctor takes the cylinder axis into account. With ICL surgery it is possible to correct astigmatism up to +7D. The procedure is performed using local anesthesia and very good vision acuity is achieved immediately after the surgery. It usually takes 1–2 days to completely recover from the operation.

    • ICL Surgery for hyperopia - 1 eye

      9 clinics

      ICL (Implantable Contact Lens) surgery is a procedure for improving visual acuity and an alternative to laser operations. The procedure involves implanting an IC lens behind the iris through a tiny incision. The IC lens is positioned between the iris and natural lens. The ICL procedure can be used to correct hyperopia (farsightedness) from +1D to +12D. The procedure is performed using local anesthesia and very good vision acuity is achieved immediately after the surgery. It usually takes 1–2 days to completely recover from the operation.

    • ICL Surgery for myopia - 1 eye

      17 clinics

      ICL (Implantable Contact Lens) surgery is a procedure for improving visual acuity and an alternative to laser operations. The procedure involves implanting an IC lens behind the iris through a tiny incision. The IC lens is positioned between the iris and natural lens. The ICL procedure can be used to correct myopia (nearsightedness) from -1D to -20D. The procedure is performed using local anesthesia and very good vision acuity is achieved immediately after the surgery. It usually takes 1–2 days to completely recover from the operation.

    • Lens Surgery with monofocal lens - 2 eyes

      5 clinics

      Refractive lens exchange (lens replacement surgery) is a procedure for improving visual acuity for those people, for whom laser surgery is not suitable. It is performed under local anesthesia. During the procedure, the content of the eye lens is removed, but the surrounding lens capsule is retained. A new artificial lens is placed into the empty capsule. Ordinary artificial lenses or monofocal lenses deliver excellent vision at only one distance. Therefore, this operation does not allow to give up glasses completely. If a person has received artificial lenses for distance vision, he must use reading glasses to see objects near, and vice versa. If desired, there is a technique, where monofocal lenses with different refractive powers are implanted in each eye – for distance vision into one eye and for near vision into the other. This condition is called monovision. However, it must be taken into consideration that monovision disturbs cooperation between the eyes and may cause defects in visual-spatial ability.

    • Lens Surgery with monofocal lens- eye

      15 clinics

      Refractive lens exchange (lens replacement surgery) is a procedure for improving visual acuity for those people, for whom laser surgery is not suitable. It is performed under local anesthesia. During the procedure, the content of the eye lens is removed, but the surrounding lens capsule is retained. A new artificial lens is placed into the empty capsule. Ordinary artificial lenses or monofocal lenses deliver excellent vision at only one distance. Therefore, this operation does not allow to give up glasses completely. If a person has received artificial lenses for distance vision, he must use reading glasses to see objects near, and vice versa.

    • Lens Surgery with multifocal lens - 1 eye

      21 clinics

      Refractive multifocal lens exchange (lens replacement surgery) is a procedure for improving visual acuity for those people, for whom laser surgery is not suitable. It is performed under local anesthesia. During the procedure, the content of the eye lens is removed, but the surrounding lens capsule is retained. A new artificial lens is placed into the empty capsule. The multifocal artificial lens can correct vision both far away and up close, and many patients can live glasses-free life after the operation. Human’s eye lens ensures good vision by changing its shape, whereas multifocal lens does the same due to its special surface design. With bifocal lenses, it may be difficult to see objects clearly at an intermediate distance (e.g. computer screen distance), however, the newest trifocal lenses overcome this shortcoming, guaranteeing clear vision at intermediate-distance tasks, such as computer work or reading a newspaper, as well.

    • Lens Surgery with multifocal lens - 2 eyes

      3 clinics

      Refractive multifocal lens exchange (lens replacement surgery) is a procedure for improving visual acuity for those people, for whom laser surgery is not suitable. It is performed under local anesthesia. During the procedure, the content of the eye lens is removed, but the surrounding lens capsule is retained. A new artificial lens is placed into the empty capsule. The multifocal artificial lens can correct vision both far away and up close, and many patients can live glasses-free life after the operation. Human’s eye lens ensures good vision by changing its shape, whereas multifocal lens does the same due to its special surface design. With bifocal lenses, it may be difficult to see objects clearly at an intermediate distance (e.g. computer screen distance), however, the newest trifocal lenses overcome this shortcoming, guaranteeing clear vision at intermediate-distance tasks, such as computer work or reading a newspaper, as well.

    • Chalazion removal - 1 eye

      6 clinics

      A chalazion, also known as a meibomian cyst, is a painless lump that develops on the inner lining of the upper or lower eyelid due to a blocked meibomian gland (tiny oil gland). Chalazion usually occurs because of recurring styes. A stye, also known as a hordeolum, is an infection of an oil gland in the eyelid. The chalazion often disappears by itself or after antibiotic treatment within one month. However, if it is big and persists for more than two months, incision and drainage may be recommended. Chalazion removal is performed under local anesthesia.

    • Cataract surgery with monofocal lens - eye

      40 clinics

      A cataract is a clouding of the eye's natural lens. In cataract surgery, the lens inside your eye that has become cloudy is removed and replaced with an artificial lens to restore clear vision. Ordinary artificial lens or monofocal lens delivers excellent vision at only one distance. Therefore, this operation does not allow to give up glasses completely. If a person has received an artificial lens for distance vision, he must use reading glasses to see objects near, and vice versa.

    • Cataract surgery with monofocal lens - 2 eyes

      4 clinics

      A cataract is a clouding of the eye's natural lens. In cataract surgery, the lens inside your eye that has become cloudy is removed and replaced with an artificial lens to restore clear vision. Ordinary artificial lenses or monofocal lenses deliver excellent vision at only one distance. Therefore, this operation does not allow to give up glasses completely. If a person has received artificial lenses for distance vision, he must use reading glasses to see objects near, and vice versa. Optionally, there is a technique where monofocal lenses with different refractive powers are implanted in each eye. After that, one eye has good distance vision and the other eye has good near vision. This condition is called monovision. However, it must be taken into consideration, that monovision disturbs cooperation between the eyes and may cause defects in visual-spatial ability.

    • Cataract surgery with multifocal lens - eye

      20 clinics

      A cataract is a clouding of the eye’s natural lens. In cataract surgery, the lens inside your eye that has become cloudy is removed and replaced with an artificial lens to restore clear vision. The multifocal artificial lens can correct vision both far away and up close, and many patients can live glasses-free life after the operation. Human’s eye lens ensures good vision by changing its shape, whereas multifocal lens does the same due to its special surface design. With bifocal lenses, it may be difficult to see objects clearly at an intermediate distance (e.g. computer screen distance), however, the newest trifocal lenses overcome this shortcoming, guaranteeing clear vision at intermediate-distance tasks, such as computer work or reading a newspaper, as well.

    • Cataract surgery with multifocal lens - 2 eyes

      5 clinics

      A cataract is a clouding of the eye’s natural lens. In cataract surgery, the lens inside your eye that has become cloudy is removed and replaced with an artificial lens to restore clear vision. Multifocal artificial lenses can correct vision both far away and up close, and many patients can live glasses-free life after the operation. Human’s eye lens ensures good vision by changing its shape, whereas multifocal lens does the same due to its special surface design. With bifocal lenses, it may be difficult to see objects clearly at an intermediate distance (e.g. computer screen distance), however, the newest trifocal lenses overcome this shortcoming, guaranteeing clear vision at intermediate-distance tasks, such as computer work or reading a newspaper, as well.

    • Cataract surgery with multifocal toric lens - eye

      6 clinics

      A cataract is a clouding of the eye’s natural lens. In cataract surgery, the lens inside your eye that has become cloudy is removed and replaced with an artificial lens to restore clear vision. The shape of a multifocal toric artificial lens provides different focusing powers on the vertical and horizontal planes, guaranteeing good vision at all distances. Additionally, toric lenses can help to correct astigmatism, so that people with cylinder glasses with an optical power of more than one diopter can give up glasses.

    • Cataract surgery with Toric lens - eye

      20 clinics

      A cataract is a clouding of the eye's natural lens. In cataract surgery, the lens inside your eye that has become cloudy is removed and replaced with an artificial lens to restore clear vision. In addition to farsightedness and nearsightedness, monofocal toric lens can also correct astigmatism (cylinder glasses). At present this technology enables to correct astigmatism up to six diopters. As the lens is monofocal, good vision can be achieved at only one distance (far or near).

    • Cataract surgery with Toric lens - 2 eyes

      2 clinics

      A cataract is a clouding of the eye's natural lens. In cataract surgery, the lens inside your eye that has become cloudy is removed and replaced with an artificial lens to restore clear vision. In addition to farsightedness and nearsightedness, monofocal toric lens can also correct astigmatism (cylinder glasses). At present this technology enables to correct astigmatism up to six diopters. As the lens is monofocal, good vision can be achieved at only one distance (far or near). If desired, it is possible to implant lenses with different refractive powers – for distance vision into one eye and for near vision into the other. This condition is called monovision. However, it must be taken into consideration, that it disturbs cooperation between the eyes and may cause defects in visual-spatial ability.

    • Ophthalmologist’s consultation

      83 clinics

      An ophthalmologist or eye doctor is a physician who specializes in eye disease prevention, diagnosis and treatment. During the appointment, visual acuity is checked, retinas are examined and intraocular pressure is measured, according to the patient’s needs. The ophthalmologist also prescribes additional tests or analyses, if necessary, and chooses a suitable treatment method. If the sole purpose of the visit is to check visual acuity or get a prescription for new eyeglasses, then it is advisable to make an appointment with an optometrist.

    • Optometrist’s consultation

      16 clinics

      An optometrist is a healthcare professional who performs a primary examination of the eyes and visual acuity. It is easier to get an appointment time with an optometrist than with an ophthalmologist. If the sole purpose of the appointment is to control visual acuity or get a prescription for new glasses, then a visit to an optometrist is enough. The optometrist is competent to assess, whether the patient needs an additional consultation with an ophthalmologist.