What is CATARACT ?
Cataract can rob your eyesight. Cataract is responsible for 81% of the blindness in India. Advancing age is the most common cause of cataract. It is the clouding of the normally clear lens of the eye. It obstructs light leading to a blurred image. Just as the lens of the camera focuses light on the film inside the eye’s natural lens works to focus light on the retina. With the addition of new cells, the inner cells of the lens get compressed and turns opaque. So when light passes through the lens, it diffuses and gets scattered o the retina

HOW DO PATIENTS WITH CATARACT SEE THIS WORLD?
Vision appers cloudy, fuzzy and foggy without pain. They may need brighter light to read May frequently change their eye glasses
May see images in double or multiples.
May glare from lamp or the sun.
May have problems driving at night.
May have a short term improvement of near vision.
Colours look washed out.

WHAT SHOULD BE DONE?
Invariably, the accepted treatment of cataract is surgery.

EXTRA CAPSULAR CATARACT EXTRACTION WITH PC IOL
In this method, the clouded lens is removed in one piece through 10 mm incision. Then an IOL is placed in the eye. Sutures are needed to secure the incision.
Recovery of vision takes 6 weeks.

PHACOEMLSIFICATION
It is microincision surgery which safely and swiftly restores vision to millions of people world over. The lens is removed after emulsification through a 2.8 mm incision. This is a sutureless surgery where the recovery is fast.

WHEN SHOULD I GET OPERATED FOR CATARCT?
When your day to day activities like driving, reading, becomes difficult But please do not wait till it ripes as it will lead to vision threatening complications.
AM I AT RISK ? Yes you are
If you are over 50 Years
If you are exposed to unprotected sunlight and UV Radiation for a long time
If you suffer from diabetes
If you have sustained an injury to the eye.
If you are on long term medication like corticosteroids

HOW DO I BENEFIT FROM PHACOSURGERY?
It is microincision surgery which safely and swiftly restores vision to millions of people world over. The lens is removed after emulsification through a 2.8 mm incision. This is a sutureless surgery where the recovery is fast.

WILL MY EYE ACCEPT THE INTROCULAR LENS?
The intraocular l May 8, 2008 aterial and are time tested. So, there is no question of rejection.

WILL I NEED GMay 8, 2008need it to fine-tune your vision. These are normal glasses and not those thick spectacles as in the past.

IS PHACO SURGERY COSTLY?
Just compare, the disadvantages of conventional surgery, anaesthesia, inability to attend work, slow visual recovery etc., you will appreciate that the marginal increase in cost of surgery is more than compensated. Indeed, your deserve the best.
For more information contact your eye doctor.

GLAUCOMA

1. What is Glaucoma?

Glaucoma is an eye disorder marked by increased pressure within the eye. It's one of the leading causes of blindness in India. Unfortunately, there are no discernible symptoms in the early stages of the disease, and glaucoma-induced damage to your eye is irreversible. The positive news is that there are simple diagnostic tests which, if performed regularly, can detect the disease in it's early stages when serious vision loss is preventable.

2. How is it caused?

Normally, a clear fluid called aqueous humor flows through your inner eye, bathing it constantly and nourishing the surrounding tissues. With glaucoma, the fluid drains too slowly, causing pressure inside the eye to rise. The pressure, in turn, affects the optic nerve, which is like an electronic cable carrying messages to your brain- messages that normally result in sharp, clear vision. If the entire nerve is destroyed, blindness is the end result.

3. Is a person with family history of glaucoma likely to develop Glaucoma?

Yes, since it is a risk factor for glaucoma.

4. How does one find out whether he or she is having Glaucoma?

A periodical check up by an ophthalmologist is the best way to detect Glaucoma.

5. Doctor, if a patient is labelled a Glaucoma suspect, what precaution should the patient take?

The patient should not become apprehensive, should follow the physician's advice, and have periodic eye check up.

6. What are the risk factors for developing Glaucoma?

The risk factors for developing primary open angle glaucoma are

• Family history of Glaucoma
• Myopia
• Old age
• Cardiovascular Disease
• Endocrine Disease

7. What is Normal Tension Glaucoma?

It is a condition in which the pressure remains normal but the patient develops visual field defects and disc cupping.

8. What are the predisposing causes for Intermittent [subacute] Angle Closure Glaucoma?
The attack may be precipitated by watching television in a dark room, adopting a prone or semiprone position to sew or read. Emotional stress may be a precipitating factor.

9. What is lens induced Glaucoma?

There are a variety of lens induced glaucomas.
Phacomorphic Glaucoma: A swollen lens causes increased pupillary block and secondary angle closure.
Dislocated Lens: A dislocated lens causes increased pupillary block and secondary angle closure.
Phacolytic Glaucomas: Lens protein leaks from an intact cataract and obstructs the trabecular meshwork.
Lens Particle Glaucomas: Lens material liberated by trauma or surgery obstructs the outflow channels. Phacoanaphylaxis: Sensitization to lens protein produces granulomatous inflammation and secondary glaucoma.

10. Controlling glaucoma is up to you

To safeguard vision, anyone over 40 should undergo a comprehensive eye examination every year. This especially applies if other risk factors are present such as high blood pressure, diabetes or a family history of glaucoma. If you have been diagnosed with glaucoma, you must follow instructions meticulously with regards to your medication. It must become a central part of your daily routine if it is to be effective. You should never stop taking your medication without talking to your ophthalmologist or optometrist. Also, if you are seeing other physicians for any reason, tell them about your eye medications. Finally, because the effects of glaucoma may worsen (or improve) without your being aware of the change, follow your eye doctor's recommendations on regular check-ups to monitor your progress.

11. Glaucoma and high blood pressure. Are they related?

Glaucoma is not generally related to high blood pressure, however, any patient on high blood pressure medication should inform their ophthalmologist and family doctor of all medications they are currently taking. Certain drugs taken for glaucoma can interact with those taken for other conditions.

DIABETIC RETINOPATHY

1. What is Diabetic Retinopathy?

Diabetic retinopathy is a complication of diabetes that is caused by the blood vessels of the eye. The retina is a nerve layer at the back of the eye that senses light and helps to send images to your brain. When blood vessels in the retina are damaged, they may leak fluid or blood , and grow fragile, brush-like branches and scar tissue . This can blur or distort the images that the retina sends to the brain, and may lead to blindness if left untreated.

2. What are the symptoms of Diabetic Retinopathy?

Initially, there are usually no symptoms in background retinopathy, although gradual blurring of vision may occur if macular edema is present. As diabetic retinopathy progresses and bleeding occurs, your sight may become hazy, spotty or even disappear altogether. While there is no pain, proliferative retinopathy is a severe form of the disease and requires immediate medical attention. Pregnancy and high blood pressure may aggravate diabetic retinopathy.

3. Doctor, I am a 40 year old male detected to have diabetes 5 years back. I do not have any visual problem. My blood sugar level is not under good control. Do I need a Eye Check up?

Yes, you should have an eye check up by your ophthalmologist immediately even though you do not have any visual problem. You should be examined in detail for

• Cataract
• Glaucoma
• Retinopathy
• Vitreous Haemorrhage
• Optic Neuropathy
• Cranial Nerve Involvement

The effect of uncontrolled diabetes on the eye is extremely variable. Some diabetics never show any sign of disease in the eye. But in many diabetics, the disease progresses until massive bleeding, scarring or retinal detachment has damaged the eyes and make any recovery of sight impossible.

4. Doctor, do all diabetic patients need retinal laser treatment?

No, not necessarily, when diabetic retinopathy is diagnosed the patient's age, life style and the degree of damage to the retina are considered before starting treatment.

5. Can you explain to us about Retinal Laser Treatment?

There are two types of laser treatment:

1. Macular laser which focuses on the central part of the eye when it becomes swollen and has macular     oedema. Most patients who need macular laser treatment will need more than one sitting to get rid of the     oedema. The goal of laser treatment for macular oedema is to stabilize the vision.
2. Panretinal laser treatment is indicated for eyes which have proliferative disease with neovascularization.     Here the laser is focused on the peripheral portions of the retina and is more extensive than macular laser     treatment.
3. Laser treatments are performed as out-patient procedure.

6. What are the symptoms of Retinal Disorders?

• Small objects floating in front of the eye.
• Flashes of light in front of the eye.
  
• Straight lines appearing curved.
  
• Hazy Vision.
  
• Sudden loss of vision - like a curtain falling in front of the eye.

CONTACT LENS

1. What are Contact lenses?

Contact lenses are small, very thin optical discs that are designed to rest on the cornea. They are held in place by a layer of tears present between the contact lens and cornea. They are used most frequently to correct errors of refraction like myopia (short sight), hypermetropia (long sight) astigmatism( cylinder power) and presbyopia.

2. Can I go in for contact lenses?

Yes- You Can!

1. If you prefer the way you look without glasses or find glasses too cumbersome and awkward
2. If you lead an active life style
3. If you have a defect in the cornea-keratoconus
4. If you suffer from “dry eyes”
5. If you want to change your eye color
6. If you have a totally damaged eye and want to hide the defect
7. If you have a non-healing ulcer on the cornea
8. If you have undergone cataract surgery without IOL implantation
9. If you cannot afford LASIK- Laser correction for refractive errors

3. Are there any contra-indications for wearing contact lenses?

Contact lenses are not for everyone- it is better to avoid lenses if you suffer from one of the following

1. People with frequent eye infections
2. Severe eye allergies
3. Dusty & dirty working environment

4. What are the different varieties in contact lenses? How do I choose the best one for my eyes?

There are several types of contact lenses designed to fit the most common vision conditions

1. Hard
2. Semi soft (RGP/AIR lens)
3. Soft lenses a) Daily wear b) Extended wear
4. Disposable contact lenses
5. Cosmetic lenses
6. Toric lenses
7. Bandage contact lens

Consult your Ophthalmologist for details and to help you choose the best lens for your eyes.

5. What are semi soft or RGP contact lenses?

Semi-soft lenses are made of slightly flexible plastic that allows oxygen to pass through to the eyes. The advantage with these lenses is the vision which may be sharper than with soft contact lens. They are especially useful in astigmatism, keratoconus and post-refractive surgery. They are easy to put on and care for. Semi soft lenses are durable (1-2 years) and are available in various tints and even as bifocals.

6. I have normal vision. Can I use contact lenses to change my eye color?
Yes- You Can!

You have colored cosmetic lenses both with power and as ‘plano’ (without any power)
Colored lenses are used to enhance the person’s appearance. In the past coloured contact lenses were used only by actors and stage artists to dramatically alter their appearance. In today’s world coloured contact lenses are becoming a part of our daily “beauty routine” There are more than 126 colors being sold and you can now ‘mix-and-match’ your eye color with your moods and outfit!

7. My eye doctor says that I have a high cylinder power-can I wear soft lenses to correct my vision?

Yes- You can with the help of toric lenses.

Toric lenses are available as both as soft and semisoft lenses and are used to correct astigmatism. With the advent of corneal topography, the fitting of lenses for astigmatism has become easier. In the past, patients were prescribed glasses or RGP lenses to correct astigmatism. The advances in soft lens technology, design and manufacturing techniques have enabled practitioners to offer a new, comfortable option without sacrificing clear vision.

8. I am over forty years of age and need glasses for reading-can I switch to contact lenses?

Yes- You Can. You are the right candidate for bifocal contact lenses.
Bifocal Contact lens are now available as both soft & RGP lenses. They work on one of the following principles- Simultaneous or alternating vision

9. What are the safety precautions for contact lens Wearers?

1. Have an eye examination as frequently as recommended by your eye care professional.
2. Use lenses prescribed by licensed eye care practitioners.
3. Never swap contact lens with other persons. It can lead to serious eye infections resulting in permanent eye damage and other problems.
4. Don’t wear lenses longer than prescribed.
5. Don’t sleep with lenses unless otherwise directed.
6. If eye becomes red or irritated, remove the lenses immediately and consult your doctor.
7. Replace lens as recommended by your eye care professional.

10.What is topography assisted contact lens fitting?

Topography assisted contact lens fitting is the ‘ no-touch’ technique of contact lens fitting wherein the computer topography is used to simulate the contact lens fit on the eye and helps in deciding the lens parameters. The contact lens can be ordered directly from these data without the patient undergoing any trial

1. Will there be any pain during the procedure?

The surgery is nearly painless. We usually don't prescribe drugs for pain.

2. How much time off from work do I need to take?

The day of surgery, you need to go home and rest. The next morning the vision starts improving and most of the patients may be able to resume their normal activities within a week.

3. How long does the surgery take?

You will be in the surgical suite for about twenty minutes. Plan on being at the Laser center for about an hour or two. You will need a driver to take you home.

4. What are the post-operative restrictions? After the procedure, you are requested to keep both eyes closed for 2 hours and rest as much as possible. Every night for a week, you will place the shield over your eye for additional protection. Do not rub your eyes for few days. You are advised to take head bath after a week. Swimming is not recommended for a month following the laser procedure unless you wear watertight goggles. Avoid hot tubs for one week. You will use antibiotic drops for one week and other medicines as prescribed for a month or more use.

5. Are both eyes corrected at the same time ?

We allow each patient to make his or her own decision. Your options are:
simultaneously or separately.

6. How does the Doctor know how much surgery to do ?

The Doctor programs the amount of near sightedness or farsightedness determined from your pre-surgical exam into the laser's computer. The laser is accurate to the level of 0.25 microns! (A human hair is 50 microns in diameter)

7. What are the side effects of LASIK?

The most common side effects are temporary light sensitivity and haloes. Under correction or over correction may occur, and an enhancement may be necessary to attain your best correction. Dry eye and related problems have been experienced in some patients. A more detailed discussion of these issues will take place during your comprehensive pre-surgical consultation.

8. Can I go blind following laser vision correction procedure?

There have been no serious complications of laser in our hands.

9. Will I ever use glasses again?

Usually not for distance vision, although some patients may still require thinner glasses for fine-tuning. When your are in the age range where bifocals or "reading glasses" are normally required for close vision (Usually 40-45 and beyond) you will most likely need glasses for reading.

10. How old do I have to be for LASIK ?

18 years is the minimum age we recommend. There is no upper age limit.

11. I am currently wearing contact lenses. Do I need to do something about it?

Yes! Remove your lenses at least one week prior to your pre-surgical evaluation if you are on daily wear soft lenses. If you have using extended wear lenses, your must leave them out two weeks. Patients who wear rigid gas permeable lenses must not use them for three weeks prior to the pre-surgical testing.

12. Does the laser affect the inside of my eye?

No, The pulses of the laser do not enter the eye at all. The laser treatment will not cause glaucoma or cataracts. Cataracts and glaucoma can develop if some drugs are used for a long term without supervision or proper follow up. These conditions can be treated, as though you had not had the laser treatment.

13. Who is not a candidate?

Anyone with lupus, rheumatoid arthritis, keratoconus, dry eye, herpes simplex of the cornea (herpes elsewhere is of no consequence), AIDS, auto-immune disease, or anyone with unrealistic expectations.

14. How can I hold my eye still for the treatment?

There is a blinking light inside the laser that you focus on during the procedure

15. How will I keep my eye open during the treatment?

We hold your lids open with a small lid holder.

16. Will I see everything the doctor is doing the treatment?

When the flap is created, your vision will be dark. You won't see this step of the procedure. During later steps you will see a red light. You need to see the red-light through out the procedure when the laser is applied.

17. Will there be any injections or any stitches ?

We use topical anesthetic drops to numb your eye during the procedure. No stitches are necessary because the two layers of the cornea are naturally "sticky" and will adhere to one another very well once the flap has been put back into position.

18. I am interested! What is my next step?

Call your Doctor for fixing up the appointment.
The pre-surgical testing is the next step and takes about an hour and a half. This is the ideal time to have all of your questions answered by one of our doctors.