Author: savio

Glaucoma

What is Glaucoma?

An increase in pressure of the eye with weakening of the optic nerve can cause damage to the optic nerve.

This eye condition is called Glaucoma.

Let’s understand what happens internally in the eye when affected with glaucoma. In every eye, a clear fluid (aqueous humor) is present in the front portion of the eye. This is circulated to maintain constant healthy eye pressure. Some fluid drains out of the eye through a tubular meshwork on a regular basis. In a glaucoma affected eye due to blockage in this meshwork, the drainage of the fluid gets affected and thereby increases the ocular pressure. When this is not treated or controlled, continuous increase in the intra ocular pressure may result in damage to the optic nerve fibers, which results in irreversible vision loss.

Glaucoma is one of the commonest causes of irreversible blindness worldwide. It is better known as the “silent thief of sight” as it silently causes damage before it is known and the symptoms surface when Glaucoma is severe. It usually occurs in both the eyes, but could be severe in one eye only.

Types of Glaucoma:

  • Open angle glaucoma: It is most commonly known type of glaucoma wherein the drainage channels are blocked although the drainage angle between the iris and the cornea are open. In early stage the vision could be normal and symptoms are not well defined.
  • Acute Closed or Narrow Angle glaucoma: A narrow angle between the iris and the cornea results in poor drainage of the eye fluid causing sudden build in pressure in the eye. This type is less commonly known.
  • Normal tension glaucoma: Although the eye pressure is below normal, vision is impaired and optic nerve is damaged.
  • Secondary glaucoma: This category is associated with other eye disorders like acute cataract, tumor, injury or inflammation in the eye.
  • Congenital glaucoma: In this category glaucoma that is present at birth is known as congenital glaucoma.

Other known Causes:

  • Eye infection
  • Corrective eye surgery
  • Inflammation

Symptoms:

  • Peripheral field vision loss (as in case of Chronic Open-Angle Glaucoma) – Blind spots appear less noticeable until optic nerve gets severely damaged.
  • Tunnel Vision- Peripheral vision could progress to Tunnel Vision. Vision gets narrowed gradually (like looking through a tunnel).
  • Blurred Vision, Halos, Dilated Pupil, Severe Pain and redness in the eye, Headache, Nausea (as in acute Closed or Narrow Angle Glaucoma)
  • Frequent rubbing, squint, tearing and sensitivity to light (as in congenital glaucoma)

Prevention: Glaucoma once diagnosed can be only controlled not reversed. Poor visual fields or visual field loss can lead to accidents in the elderly; hence the following steps may help to prevent this condition.

  • Early detection followed by effective treatment.
  • Beware of medications which indicate warning note on glaucoma e g. decongestants
  • Maintain active lifestyle with healthy diet and weight.
  • Avoid smoking

Risk factors:

  • Drugs used for other ailments like cold, bladder problems etc.
  • Genetics or Hereditary in nature
  • Side effects of steroid e g. Asthma
  • Eye trauma
  • Result of another eye problem undetected.

·       Ethnicity- narrow angles glaucoma more common in certain races (e g. Asians, Eskimos).

  • Thin cornea (less than .5mm)
  • Nearsightedness or farsightedness.
  • Older age group
  • Other health problems like migraines, diabetes and low blood pressure.

Treatment:             

Diagnosis: The common screenings for glaucoma includes tests such as:

  • Tonometry (to measure internal eye pressure or IOP)
  • Ophthalmoscopy(dilated eye exam to inspect the optic nerve)
  • Perimetry(visual field test)
  • Gonioscopy (to identity the drainage angle between the cornea and the iris)
  • Pachymetry (measure the thickness of the cornea)
  • Nerve fiber analysis (for thickness measurement of the nerve fibre)
  • Visual field test (to test side or peripheral vision)

The treatment options are:

  • Medications Eye drops and pills are prescribed to reduce the eye pressure. It helps in reducing the production of aqueous humor and improves drainage of the fluid of the eye.
  • Laser treatment: High energy laser beam is used to drain the fluid.
    • Laser trabeculoplasty
    • Laser iridotomy
    • Selective Laser Trabeculoplasty (SLT)
    • Argon Laser Trabeculoplasty (ALT)
  • Filtering surgery:
  • Trabeculectomy is mainly the gold standard of treatment. It is sometimes combined with cataract surgery
  • Operative surgery:
  • Microinvasive glaucoma surgery (MIGS)
  • Glaucoma drainage implants

Appropriate diagnostic techniques, follow-up examinations and the treatment depend on the nature and severity of glaucoma on the affected eye. The damage to the optic nerve at various intraocular pressures varies from person to person. In order to control progression of glaucoma, medication needs to be consistently followed as per prescription.

Vision researchers are working on stem cells and other treatments like vaccine, optic nerve regeneration and smart contact lenses to provide solution for treating glaucoma.

Effective diagnosis is very crucial in the treatment at the right time.

Let’s tackle the ‘silent thief of sight’ …let’s not get caught unawares.

 

Eye Trauma

Eye Trauma occurs when an injury or damage is caused by direct blow to the eye. It could damage the surrounding area of the eye like the bone structure or tissues surrounding the eye. Multiple damage could occur to several parts of the eye at the same time. A severe trauma could cause blindness or can resurface in the form of cataract, glaucoma or retinal detachment after some period. Eye trauma are most common in children, people working in hazardous conditions, certain sports etc.

Types of eye trauma:

The most common types are as listed below:

  • Corneal Abrasions (when a scratch or injury occurs to the cornea)
  • Chemical Injury or a chemical burns ( mainly injury caused by chemicals)
  • Hyphema (blood in the anterior chamber of the eye)
  • Fractures of the Orbit (the bony eye socket that surrounds the eye)
  • Penetrating Injuries with embedded Foreign Bodies
  • Eyelid lacerations (cuts to the eyelid)
  • Black eye (bruising of surrounding eye tissues)
  • Thermal Injury
  • Traumaticiritis (inflammation of the iris of the eye due to eye trauma)

Symptoms:

  • Bruising (black eyes)
  • Bruises to the eyelid and other surrounding areas
  • Eye redness and swelling
  • Bleeding between the cornea and iris, or area near the eye.
  • Retinal detachment
  • Blurred or cloudy vision
  • Double vision or decreased vision
  • Headache
  • Pain in the eye
  • Changes in the shape of iris or pupil

 

Treatment:

The treatment depends on the severity of the injury. Minor eye traumas may just be fine with medications while others may require surgery depending on the case. Surgery could be performed with advanced microsurgical techniques. Continued follow up on the eye condition would be required. The treatment emphasizes mainly to protect vision, arrest infection and ensure speedy recovery.

Prevention:

Use of eye protective eyewear while undergoing activities that could likely cause damage to the eye like certain sports, welding or working in hazardous conditions like working with toxic chemicals that could affect the eye.

Common Tips in case of Eye Trauma

  • In any case of any type of eye trauma, avoid rubbing of the eyes.
  • Attempt should not be made to remove the penetrating particle by oneself. Entry of any foreign particle could scratch the cornea and cause infection and irritation.
  • Not to apply any kind of pressure to the eye.
  • Little children should be supervised while playing and sharp edged toys should be avoided.
  • Avoid using cotton swabs or any material to take foreign particle directly from the eye by oneself.
  • In case of any chemical injury, water flush may help.
  • Proper implementation of first aid according to the type of eye trauma helps in the treatment.
  • Do not touch the eye with unclean hands.

Eye injuries are mostly unexpected and accidental. Understanding the sensitivity of your eyes due care and precautions helps to safe guard them. Any type of eye trauma is a medical emergency and immediate medical attention must be given.

Every eye trauma poses a unique situation and may not be identical. Sometimes eye trauma may seem small but the internal damage could be severe and any delay could further worsen the condition.

Corneal Abrasion

Cornea is a highly innervated protective covering over the iris and the pupil. Any scratch on the eye’s cornea epithelium is called a corneal abrasion. It normally occurs when corneal surface is scraped away due to external physical forces like eye injury, stoke by paper pieces, make up applicators or finger nails etc. This could cause damage on the cornea when hit by force. The blinking reflex protects the eye from injuries but sometimes accidently injuries do occur. Cornea is very sensitive and any scrapping or scratch could be very painful as they have more nerve endings that transmit pain. Corneal abrasion is not contagious. Mild corneal abrasions do not affect vision but in case the abrasion is deep it could impair vision.

Symptoms:

  • Pain in the eye while opening or closing and discomfort.
  • Sensitivity to light.
  • Blurred vision.
  • Loss of vision.

Causes:

  • Eye Trauma or Injury.
  • Chemical burns.
  • Presence of foreign particle.
  • Misuse of contact lenses.
  • Aggressive rubbing.
  • Corneal dry out due to lack of sufficient protection during surgery.

Diagnosis:

The evaluation of injured eye is conducted through examination with the help of opthalmoscope, slit lamp microscope and fluorescein instillation. The vision is also checked. The symptoms and causes are discussed during the examination to understand the extent of the abrasion.

Treatment:

Depending on the size and severity of the damage on the cornea the duration of healing varies and sometimes corneal abrasions can cause recurring irritations. In case of advanced corneal abrasion issues surgical line of treatment is performed. Generally medication is prescribed to reduce the pain. Usually mild abrasions are expected to heal within a day or two or longer depending on the healing. In case the scar is too deep and if it impairs vision corneal transplant may also be required.

Studies suggest eye patching does not have significant outcome in the treatment process for corneal incision hence mostly avoided. In case you have any allergies or past eye medication you need to inform in order to avoid any adverse reaction with certain medications. Contact lenses wearers need to discontinue lenses until healing is complete. Eye makeup should not be used till complete healing. Avoid rubbing or any kind of experiment to remove the foreign particle by oneself.

The most common treatments for corneal abrasion are:

  • Eye drops: Eye drops are normally prescribed to keep the eye lubricated.
  • Bandage contact lenses: Bandage contact lenses with antibiotic and mild steroidare used to facilitate healing.
  • Others: Micro-puncture of the epithelium /Removal of the damaged epithelium.

Prevention: Corneal abrasions are preventable.

  • Do not rub your eyes in case you experience any discomfort or irritation.
  • Use of protective eye wear: Certain jobs, sports etc have high risk factor for corneal abrasion. Hence protective eye wear must be utilized for eye safety.
  • Beware while playing with pets like cats, dogs as it could unintentionally scratch the eye while playing.
  • Contact lenses: Precautions and directions to be followed while fixing or removal of contact lenses. Practice excellent hygienewhile using contact lenses.
  • Environmental precautions: Avoid dusty environment. Use sufficient eye protective measures.
  • Do not touch the eye with unclean hands, cotton swabs or any other material to remove any foreign body.
  • Ensure infants have their finger nails trimmed.

In case you experience any symptoms, do get in touch with us.

Children and Adults with Non Age-Related Cataracts

Normally cataracts are seen more frequently in adults due to advancing age. Some cataracts are seen in children and adults are non age-related.

Non age-related cataracts could be either unilateral or bilateral. (Unilateral cataract is when it affects one eye and bilateral cataracts are when both the eyes are affected).

Types of non age- related cataracts are:

  • Congenital cataracts:

Congenital cataracts are cataracts that occur at birth. It could be hereditary or genetic. Congenital cataracts if untreated can cause permanent vision loss.The exact causes of cataracts are still unknown in most of the cases. Cataract surgery is most effective in the first month after birth.

  • Other diseases and medication:
    • Previous eye surgery can cause cataracts earlier.
    • Metabolic disorders likeDiabetes and Galactosaemia – Those suffering from Diabeteshave high blood sugar which makes the lens of the eye swell and obstructs vision. Further posterior subcapsular cataracts and post operative inflammation are common in those having diabetes.
    • Excessive use of steroids
    • Ocular inflammation
  • Traumatic cataracts:

Traumatic cataracts occur when the eye gets damaged due to trauma, accidents, punch causing corneal abrasions and orbital fractures.

Signs of cataracts in children:

  • Inability to look directly.
  • Inability to see smaller toys or objects.
  • Glares make the child to squid or cover the eyes.
  • Strabismus (unable to focus on the same point at the same time).
  • White spot in the pupil.

Problems due to cataract in children:

  • Eye wiggling (nystagmus)
  • Amblyopia (lazy vision)
  • Strabismus
  • Glaucoma (high eye pressure)

Treatment:

The first few months of an infant after birth is most critical stage in the development of vision. The deformities in the visual cortical connections can give rise to lazy eye (amblyopia) in children.

Early eye check up after birth helps in diagnosing Pediatric vision issues and enables children to get treatment and correction. Eye examinations with tests can detect cataract in children. Not all pediatric cataracts require surgery as vision develops normally nevertheless cataract surgery with general anesthesia is normally conducted wherein the natural lens are replaced with IOL on case to case basis .In some glasses or contact lens are prescribed.Post operative follow up and preoperative evaluation are essential. The kind of Pediatric cataract determines the urgency of the treatment. Long term follow up is essential for Pediatric cataracts than compared to adults.

Ensure children have adequate protection of eyeswith UV protected sun glasses while outin the sun.Pregnant women are advisable to take precautions against infectious diseases.

In case your child is a new born infant pre-screening eye test after birth isof paramount importance. Moreover tiny babies can’t say if they can see well or not.

In case of older children or adults any symptoms of cataract or difficulties in vision, do consult us early fordiagnosis and appropriate choice for treatment. With advances in treatment, your child can have an enhanced visual outcomeand safe treatment.

 

At Home before Cataract Surgery

Your decision to undergo cataract surgery is the major step towards your visual improvement and cataract treatment goal. Normally at home one has best opportunity to have a well focused preparation before surgery.

The journey to better vision begins…… right from the pre-operative office visit through consultation till ultimately your vision goal is obtained. We assure our support in this endeavor.

Preparation for cataract surgery:

Instructions before cataract surgery:

  • Eye care
    • The eye is required to be kept clean and infection free.
    • Instructions regarding the instillation of eye drops are to be followed.
    • Advisable to maintain a gap of 5 minutes between two types of eye drops on instillation.
    • Contact lens in the affected eye is needed to be removed before the surgery to prevent infection.
    • The contact lens removal duration also depends on the type of contact lens used.
  • Rest
    • Avoid straining the eye.
    • Unprotected UV rays to be avoided. Use UV protected sunglasses while out in the sun.
    • Take ample rest before surgery.
  • Diet
    • Have healthy and wholesome diet.
  • Relaxation
    • Keep yourself stress free and without anxiety.
  • Medications:
    • Follow medications as instructed.
  • General Hygiene
    • Follow general hygiene in handling eye drops. Hands to be washed well before and after application.
  • Transportation arrangement: To and fro travel arrangements to be made being an outpatient procedure.

On the day of cataract surgery:

  • Ensure medicines are continued as instructed and medicines which need to be stopped are discontinued. Do not stop any medication without advice.
  • Maintain required hygiene conditions favorable for the surgery.
  • Fasting before surgery- You may be asked to avoid any solid food 3 hrs before the surgery/ liquid foods 2 hrs before surgery unless instructed otherwise.
  • Avoid smoking or alcohol.
  • Carry all medication details and reports.
  • In case of contact lenses, they should not be worn on the day of cataract surgery.
  • Having head bath in the morning of the day of the surgery is advisable.
  • Avoid eye makeup especially on surgery day.
  • Ensure arrangement is made for relative / by stander to accompany you for the surgery.
  • In case of diabetic patients, the instructions need to be followed accordingly.
  • Use comfortable clothing on surgery day.
  • Ensure you reach the hospital in time.
  • Normally tropical anesthetic eye drops are administered, do inform in case you have any allergies to anesthetic drops or any medicine in particular.
  • In case you are affected by other eye conditions like Glaucoma or previous eye surgery, kindly follow instructions as recommended.

Proper understanding and follow up of pre- operative instructions streamlines the process of your treatment and helps you to make the best of your time at home before the cataract surgery. You could refer to the printed copy of the pre-operative instructions for guidelines and cross reference. Nevertheless in case of any further queries, do contact us. We would be glad to assist you.

At the Surgical Facility

Steps to be taken (at home) before reaching the surgical facility:

  • Medications for eye: Eye drops as prescribed which need to be started before reaching the surgical facility to be followed as advised. These are usually dilating eye drops to ensure that the pupil is dilated for the surgery. These may be repeated after admission.
  • Other medications: Medications for Diabetes, Thyroid and high blood pressure etc. should be taken in the morning as usual, with your light breakfast.Oral antibiotics may also be started the day before surgery.
  • By stander: You are advised to be accompanied with a family member/friend from your home till you reach back home after the surgery is completed.
  • Travel arrangement: Ensure appropriate arrangement is made to travel back home. It is not advisable to drive back by yourself as your operated eye is protected by a shield and vision would need time and rest to restore back.
  • Fasting:If the surgery is under general anesthesia (as in case for children) then overnight fasting as instructed to be followed. Otherwise a light breakfast is recommended.
  • Physical preparation for the surgery: Ensure you are free from illness on the surgery day. In case you happen to have any other discomfort, cold, cough fever or high BP. Kindly report the same to the nurse/ doctor.
  • Mental preparation for the surgery: Although cataract surgery is the most common procedure, for most people cataract surgery may be is their first eye surgery. In case of adults it is quite possible that some do have a phobia for operations due to past experiences of other surgeries. In case of any such issue, do inform us to ensure that we help you relax before surgery. At Shroff Eye Hospital, we encourage you to be well prepared not only physically but also mentally through various consultations including our counseling session. Moreover your meeting with our operating surgeon would have already helped you gain confidence for the surgery.

Finally, you need to reach the surgical facility in time with all relevant documents.

Steps before the cataract surgery at the surgical centre:

Irrespective of the type of cataract surgery to be performed, Noted below are the common processes that follow prior to surgery:

  • You would be greeted and welcomed by our nurse at the time of admission.
  • She would escort you to your day bed and orient you to the room facility and other details like the emergency bell, rest room area etc.
  • You would be given a change of clothes for the surgery.
  • The nurse would review your medical history. You would be asked a few questions regarding your medications etc.
  • Your vital parameters such as Pulse, Blood Pressure, Oxygen saturation would be checked and noted before the surgery. This is to ensure parameters are within the normal level.
  • Diabetic patients may require to be tested with a spot test for blood glucose level to check control of blood sugar.
  • Dilating drops for cataract surgery will be continued as required.
  • A skin test is done for checking any allergy / sensitivity towards the anesthetic agent.

With the continuous support from our entire team, you could be assured of best care at the surgical facility before the operation.

Deciding when to have a Cataract Surgery

After completion of your initial eye examination and consultation with us, we guide you in your decision on when you need to have a cataract surgery. Cataract surgery being an elective procedure, the time for the procedure is mutually discussed; however the final decision lies with you.

Difficult to take a decision?

  • Our painless surgical procedures and extensive use of advanced technology helps in faster post operative recovery.
  • Understanding the symptoms, risks and treatment of cataract helps in taking the decision for cataract surgery.
  • With a wide array of intraocular lenses to choose from, it could be a difficult decision. Our advise during consultation helps you to make the right choice depends on your need, life style and eye condition.
  • With the expertise of our well experienced surgeons you could have an enhanced surgical experience.

A common myth regarding cataracts is that cataracts need to be mature enough for surgery. This may not be required with the latest advances in cataract surgery. Moreover cataracts are likely to harden as stages advance leading to more complications during surgical removal and also higher risk of other issues like glaucoma or other age related complications etc.

Symptoms and Indication:

Deterioration of vision may not always be an indicator for cataract surgery. For example: Although vision may be 20/20 still cataract surgery may be required. Some for work conditions that require fine vision, even glare could affect their vision.eg. Pilot, Drivers etc. Nevertheless any symptoms of cataract like blurred vision, halos or glare etc. should not be ignored. Intervention and treatment at right time is important.

Decreased vision and quality of life:

Cataracts disrupt your quality of life. Cataracts need treatment anyway; the only treatment being a surgery. There is no advantage of postponing treatment because delay can worsen the cataract. Moreover as age progresses other aliments like diabetes or heart related issues could make surgery complicated and risky. The risks of accidents would be much higher without treatment. Furthermore you are restrained from doing the work that you want to do because of the decrease in vision. In case of cataracts that cannot be operated upon or those that do not need immediate surgical intervention, our surgeon and other option would advise other options and the roadmap of treatment.

If both the eyes require surgery, it is advisable to maintain a time gap between the surgeries before proceeding with the second eye. Usually a week’s gap is acceptable. This is to avoid infection and giving time to the first eye to heal comfortably. During your consultation you could get your doubts clarified in order to have a proper understanding of your treatment process.

Get rid of glasses: Decrease in vision is often corrected with corrective glasses. Today, cataract surgery can aid in getting rid of glasses as well. According to the type of lens used, one can opt for lenses which give you an advantage of being able to see near, intermediate and distant vision clearly, without need of glasses. These are multifocal or accommodative lenses. This enables you to get rid of cataract as well as be least dependent on glasses.

As the symptoms and eye conditions differ from each eye, the treatment options and guidance from eye specialists is vital.

Consultation at the right time would help you to take the right decision on your cataract surgery.

First few Months after Cataract Surgery

The first few months after cataract surgery is the time to witness a major healing process in the operated eye. Although the healing time varies from person to person and eye to eye the healing in small incision cataract surgeries is faster compared to older techniques. When you have observed the precautions and instructions as mentioned you will begin to notice the changes in your overall visual condition improving day by day. It is in this adjustment period that the brain takes to adjust gradually with your new lens in stages.

What could be expected within the first several days of cataract surgery?

  • Considerable improvement in vision.
  • Ability to resume normal activities most of them from day 1.
  • Gradual and steady decrease in the mild eye discomfort.
  • Mild Floaters in some cases.
  • Discharge from the operated eye at times.
  • Minor discomfort is normal on the first day.
  • Mild light sensitivity would wane off.

Points to note:

  • Make your follow up visit as discussed.
  • Continue with eye drops and other general instructions as discussed. Cataract Surgery alters the focus for the operated eye. Your old spectacle cannot be used and you would require new spectacle depending on the IOL.
  • Avoid rubbing the eye and ensure eye is protected with eye shield.
  • Any abnormal or unusual side effects need to be reported immediately like bleeding, nausea or persistent pain without any improvement.

What could be expected within the 1st month of cataract surgery?

  • In case your eyes require glasses after surgery, it would be prescribed only after vision gets stabilized. The power of the new glasses depends on the type of IOL selected (normally after 3-4 weeks). Some may not need glasses at all. You would be informed about the appointment for the measurement for glasses.

What happens at the first post-operative visit?

  • Eye pressure tested. In case higher side, medicated would be prescribed.
  • Dosage of medicines (eye drops) would be reduced as required.

What happens at the final post-operative visit?

  • At the final post-operative visit, your vision would be tested. Measurements to be taken to see if glasses are fine, in case you need them. Next visit would be advised to you after a specific gap time. It is advisable to have a yearly eye check up even in case you don’t face any issues.

Precautions to be taken:

  • It may take around 3 months for most people to recover completely from a cataract surgery. You would notice clarity in fine details more vividly by then.
  • PCO (secondary cataract) and Retinal detachment. It is relatively rare and not be ignored. Do report if you have pain or discomfort, blurring after cataract surgery.

In case you are advised cataract surgery for the second eye, the time schedule would be intimated to you as per the healing of the first operated eye. Normally one month gap is maintained to avoid infection. Overall vision can be judged when both the operated eyes are back to the new vision pattern.

The healing transformation from cataract surgery is a journey from blurred vision to better vision and with us you will experience the power of enhanced vision. Shroff Eye Hospital extends all support to ensure that you have a speedy recovery in the best possible manner.

 

Immediately after Cataract Surgery

At the hospital after surgery:

  • Post cataract surgery you would be seen by the surgeon before you leave the hospitalHe will answer any queries that you may have. You will be discharged from the hospital soon after the instructions are completed and with your caretaker as you are not allowed to leave by yourself alone.
  • The nurse will brief you regarding all post operative care and instructions at time of discharge.
  • Generally there is very little discomfort following surgery. However, if you do experience some mild pain, you may take the any pain-killers suitable to you.

At home after surgery:

SPECIFIC POST OPERATIVE INSTRUCTIONS

CLEANING YOUR EYE

  • For the first week following surgery you should protect the eye from injury. Do not rub or put pressure on the eye.
  • Take small pieces of cotton wool and place them in a bowl containing water. Boil for 10 minutes and keep the bowl covered. After washing your hands with soap, take a small piece of the sterilized cotton wool from the bowl. Squeeze out the excess water. Clean the discharge around the lids without applying pressure on the eye.

PUTTING EYE DROPS

  • Retract the lower lid and instill one drop of the prescribed eye drop into the eye. Gently close the eye just once and keep it closed after putting the eye drops. If you blink after instilling eye drops, they will reach the throat causing a sore throat and headache. Eye drops should be used as per the prescription. Ensure that your do not touch the dropper and that dropper does not touch the eye while instilling. This is to avoid infection.
  • Do not apply drop by yourself on your eye.

PROTECTING YOUR EYES

  • Put on protective eye wear provided by us throughout the day and continue to do so for one week outdoors
  • Wipe tears or eye drops which have over flown below the margin of the dark glasses. Do not touch the eye.
  • At night you will be instructed how to use a protective eye shield over the operated eye
  • Before going to sleep, cover the eye with the shield provided to you with sticking plaster.This is to be used for a week post surgery.
  • Do not place cotton wool between the shield and the eye.
  • Do not sleep on the operated side for one week.
  • For the first 5 days from the time of operation, take a bath below the neck. Hair can be washed after 5 days.

ACTIVITIES

  • Avoid strenuous activities.
  • Do not lift any objects heavier than 10 kg for about 15 days after the surgery.
  • Do not bend with your head below waist level for about 10 days after the surgery.
  • You may start reading and watching TV after 2 days.
  • Many people return to light work immediately after surgery, but please discuss your needs with your doctor during your post operative visit (next day).
  • Ask your surgeon about any specific activities you may have in mind as in leaving town, driving, yoga, walks, gym etc.

FOLLOW UP VISITS

You would be required to come for a post operative check up as advised upon discharge. Please make sure that you call and confirm the appointment 2 days earlier.

If you have any further questions regarding your surgery or post operative treatment kindly speak our Nurse who will coordinate with your surgeon to answer your queries.

 

Initial Exam by an Ophthalmologist (for cataract)

Cataracts can be detected and treated at an early stage. In some cases the clouding could be advanced and can be visible to even the naked eye, but in most of the cases, changes in the eye may not be visible without and internal eye examination by an ophthalmologist. In some case the symptoms are not major. Is it advisable to wait for recovery without a proper eye examination and treatment?

Regular eye examinations are important and the cost of the examination varies according to the tests conducted.

Why is an initial examination for cataract necessary?

  • To confirm the presence of cataract.
  • Rule out other eye illnesses which have symptoms similar to that of cataract.
  • Understand the stage of cataract and finalize on the treatment options.

Preparation for an effective initial eye examination:

  • During the eye examination the eye needs to be dilated for an accurate diagnosis.
  • Tests are normally conducted before and after dilation. You need to inform the optometrist if you have allergy to any medicines/ eye drops.
  • Understand the symptoms of cataract or other major illnesses if any and discuss them during the consultation.
  • Avoid self driving after eye dilation, as vision is blurred for a few hours.
  • Discontinue use of contact lenses, if using any, at least 24 hours prior to the examination.

Comprehensive Eye Examination

Comprehensive Eye Examination is conducted by both Optometrist and Ophthalmologist to determine the type, location and stage of the cataract.

Examination by Optometrist 

Detailed history and physical examination of the eyes are reviewed.

  • Visual Acuity Test– The impairment in the vision is detected by reading the Snellen eye chart with variation in the size of letters and is read from various distances.
  • Refraction Test- It determines the need for changes in your eyeglass or contact lens prescription.
  • Tonometry test for Glaucoma screening– This is a standard test to measure fluid pressure (Intra Ocular Pressure) inside the eye. It is commonly known as the ‘Puff Test’. This test helps to exclude Glaucoma (condition with raised eye pressure) before the cataract surgery.
  • Pupil Dilation: The pupils are widened using dilating drops and a retinal examination is performed.

 

Examination with Ophthalmologist 

  • Slit Lamp examination: The slit lamp has a special microscope for an eye examination. The structure in front and back of the eye including the cornea, iris, sclera, conjunctiva, lens, retina and optic nerve and the spaces in between are illuminated using a slit lamp to investigate minute abnormalities. A camera on the slit lamp stores the images as required. The examination takes few minutes and is painless. Special preparation is not required for the test. The thin beam of high intensity light on the eye gets a clear view of the internal parts of the eye. The examination is performed under dilation using eye drops. Based on the examination the further treatment is done.
  • Fundus Examination for retina: The fundus is part of the retina at the posterior part of your eye. In the fundus examination the pupil is dilated to increase the size of your pupil. The observation of the vitreous, optic nerve, blood vessels, macula and retina is then recorded. Here the retina is checked using an ophthalmoscope.

To avoid complication and have a successful cataract surgery the initial examination plays an important role in the diagnosis and treatment process.

Our ophthalmologist will guide you to the most suitable treatment and choice of lens based on the initial examination.