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.

Numbing the Eye

With modern surgical techniques, cataract surgery is quite painless and without stitches. The process begins with the dilation of the eyes.

Dilation: In this process, dilating drops are instilled to enlarge the pupil and expose the cataract. Once the eye is dilated, it blurs your vision for some time thereafter it restores back to normal.

After dilation, the eyes are numbed to begin the surgical process.

Before numbing:

Before the surgery, a patch test is done to determine any sensitivity or allergy to the anesthetic agent being used.

 What is numbing the eye?

Numbing is the process in which pain is eliminated in the eye before the surgery by anesthetizing the eye with the use of anesthetics. It could be in the form or topical eye drops, ointments or injections.

In the earlier days numbing was done by general anesthesia. This further progressed to injection behind the eyeball. Nowadays most common method of numbing in a cataract surgery is by using topical anesthetic eye drops in most of all cases. In certain cases anesthetic injection is given if essential. Numbing may sting for a few seconds. Only the eye would be numb and you would be awake during the entire surgery. After the eye is numb, an eyelid holder is placed on the affected eye to prevent blinking during the surgical period. If the cataract surgery is under general anesthesia (as in case for children) overnight fasting as instructed to be followed.

Advantages of Numbing through Topical anesthetic eye drops:

  • Easy to administer
  • For Painless surgery
  • Facilitates stillness during surgery and minimizes discomfort.
  • Block the pain signals at the nerve ending in our eyes, thus enabling us to withstand pain without realizing it.
  • Quick recovery
  • Eliminates risk and side effects associated with injection.

What to expect when your eyes are numbed?

The eyes are kept open during the entire surgery with the help of an eye lid holder. This does not hurt, but feels like a gentle stretching of the eyelids. The numbing eye drops take away the sensation of wanting to close the eyes or the blink reflex. Hence, it is quite comfortable to keep the eyes open without feeling the urge to blink, though the surgery.

Ensure that you are still and refrain from any head movement for successful instillation of the topical anesthetic eye drops. In case you have cough or other illnesses that could cause movement during surgery need to be intimated. If fasting is advised or restriction to a particular food is advised, kindly follow as instructed. After initial stinging sensation you begin to face painlessness and lack of sensation till the numbing effect wanes off. Topical anesthetic eye drops are administered in the affected eye as per the requirement. Some medicines may interact with certain topical anesthetic eye drops. The cataract surgery is performed under a close observation on your vitals with an anesthetist stand by for additional support if needed.

Do inform our anesthetist for any of the below conditions.

  • General Health reasons: In case of any health problems, infectious diseases, past operations, serious illnesses.
  • Dental conditions: False teeth, caps, loose teeth or other dental   problems.
  • Any medical problems needing regular treatment.
  • In case of intake of any herbal/ayurvedic medicines.
  • Allergies or intolerances of any type especially to medicines.

Am I a candidate for Topical anesthetic eye drops?

Those who suffer from chronic pain and alcoholics may have varied doses for Topical anesthetic eye drops and in certain cases it would not be administered.

Before your cataract surgery, the type of anesthesia to be administered is usually pre-determined. Pro Paracaine eye drops are commonly administered topical anesthetic eye drops. The choice of anesthetic depends mainly on the surgical procedure adopted, your eye condition and general health.

 

Anesthesia during Cataract Surgery

Anesthesia is an integral part of many surgeries. It was also an essential part of cataract surgeries done in earlier times. However, today Cataract surgery has metamorphosed greatly. From using General anesthesia and keeping patients in the hospital for several days, the surgery changed to using local anesthesia in the form of injections, and today it has so evolved that we perform most cataract surgeries under topical anesthesia (just using eye drops).

Modern cataract surgeries with advanced laser treatments have resulted in faster surgeries with smaller incisions, thereby involving the least need of anesthesia. Presently, during cataract surgery topical eye drops are administered by most skilled surgeons. However other kinds of anesthesia are also used in some cases, only if it is essential.

Let us understand more about this.

Major goals for administration of anesthesia for successful cataract surgery:

  • To avoid pain during the surgery.
  • To restrict movements of the eye during the surgery as required.
  • Maintain safety of patient and optimize surgical outcome.
  • To regulate the intraocular pressure.
  • To facilitate quick recovery.

     Selection of right anesthetic for cataract surgery depends on:

  • The type of surgery performed.
  • Patient’s health condition.
  • The surgeon’s expertise.
  • The time taken for surgery etc.

   Kinds of anesthesia for cataract surgery depend on:

  • Age of the patient and tolerance.
  • The type of cataract surgery.
  • Ocular co-morbidity like corneal opacity etc.

     Types of anesthesia:

  • Regional or Local anesthesia: It may be administrated with a sedative followed by a tiny injection generally on the top and underneath the eye. This is done to prevent blinking and restrict eye movements during the surgery. Intracameral Lidocaine / Lignocaine (local) is used commonly and Pro Paracaine eye drops are used as the anesthesia eye drops (topical) .
  • General anesthesia: Health condition should be supportive and intake of food or drink should be avoided as instructed by the Doctor. Continuous monitoring of the progress on the blood pressure, heart beat rate and breathing are done during the procedure by an General anesthesia is mainly reserved for Pediatric patients and some adult patients (when uncooperative). Vomiting, drowsiness, nausea after general anesthesia is rare but gradually wanes off.
  • Techniques in general anesthesia for cataract surgery:

Blocks:

  • Peribulbar blocks- In this type a needle is inserted close to the eyeball for administering a local anesthetic agent like Lignocaine.
  • Retrobulbar blocks- In this type a needle is inserted behind the eyeball for administering a local anesthetic agent like Lignocaine.

(Hyaluronidase for ophthalmic blocks is used at times to enhance the speed of action of the local anesthetic)

  • Topical anesthesia– This is mainly administered as eye drops to block the afferent nerves of the cornea and the conjunctiva. It is most suitable for clear corneal incisions. It is advantageous in shorter surgeries and has fewer side effects. This type of anesthesia helps you to experience the benefit the cataract surgery at a faster rate and is the type of safe anesthesia used at Shroff Eye, Mumbai.

Risks: Modern anesthesia is generally safe, although not completely risk free. The risk factor varies according to the anesthetic used alongside other factors. Few of them are noted below but are rare and mostly associated with block- type anesthesia.

  • Globe perforation.
  • Damage to optic nerve.
  • Retrobulbar hemorrhage.
  • Ocular muscle injury.

Considerations:

  • Any problems encountered by you during any previous surgeries or allergy to drugs etc. should be informed to the doctor before the procedure.
  • Other prescription medications being taken should also be discussed prior to surgery to avoid any drug interactions.
  • Your co-operation to remain calm and anxiety free during the cataract surgical process will help you immensely.

At Shroff Eye, we manage your cataract surgery in the safest and most helpful way for you and allow you to return home with a pleasant surgical experience.

How Smoking Affects the Eye

How often our eyes catch the random statutory warning “Smoking is injurious to health” and yet many times unbaffled by the parlance, we smoke. What cigarette smoke can do to your eyes is even more harmful than what we assume. Along with the lungs and other organs, your eyes too bear the blunt. Knowingly or unknowingly we share responsibility of ruining ourselves just for momentary delight. Eye being the most vital sense organ and your window to the world, let not smoke lead your sight to blindness!

Why is smoking harmful for your eyes?

  • Age-related Macular Degeneration: Smoking is major risk factor for AMD. Smoking can cause types of Age related Macular Degeneration (AMD) and the progression is accelerated due to smoking. It ultimately blurs the central part of your field of vision and can cause vision loss making it difficult to see minute details. AMD can occur with or without smoking, even then when one smokes the chances increase two to three fold than non smokers.
  • Cataracts: As you already know Cataracts are a part of aging and most commonly found with advancing age. Smoking gives cataracts an invite prematurely thereby letting the turmoil of vision issues to encounter early unnecessarily.
  • Diabetic retinopathy: Smoking damages the blood vessels in the eye and makes you insulin resistant causing diabetic retinopathy, a damage to the eye’s retina.
  • Ischemic Optic Neuropathy: Smoking damages the optic nerve as the blood flow gets decreased experiencing a sudden vision loss in most cases.

Researchers have linked how smoking could cause Dry Eyes (insufficient tear production), Tobacco Amblyopia (lazy eye), Glaucoma, Thyroid Eye Disease, Graves disease, Uveitis (inflammation inside the eye). Tobacco smoking decreases the circulation and oxygen flow to the eye resulting in impairing vision in many ways. Eye disorders caused due to smoking if left untreated could cause permanent blindness. Smokers experience the defect of the colour fields. Smoking lets thousands of toxic chemicals enter the blood stream impairs not your vision but creates a disastrous body and mind damage.

Smoking and children:

  • Smoking during pregnancy could cause serious harm to the fetus as toxins are passed on through the placenta to the fetus. An increased risk to strabismus (cross eyes) in children and premature birth could occur.
  • Children are usually innocent victims of second hand smoke as they may be too young to really understand the actual harm it can cause. Are we sparing our innocent little’s ones from the devastating second hand smoke? How passive smokers are exposed to the risk like the actual smokers becoming a victim has no bounds. Moreover when you smoke, your child may also pick up to smoke.

Quit smoking and benefit!

  • You could reverse or halt progression of eye diseases depending of severity and other factors. Do get eyes checked regularly.
  • Find ways to overcome or reduce exposure to environmental tobacco smoke. (Passively or actively).
  • An encouragement for others to refrain from tobacco smoke by setting an example.
  • Also you save financially.

If you have never smoked, better refrain.

If you are a smoker, there is better choice than a life in darkness.

On this ‘WORLD NO TOBACCO DAY’, let’s surge ahead with determination towards a smoke free and healthy life!

For consultation and details, get in touch with Shroff Eye Hospital (Bandra/Marine Lines)

(Call on 022 6692100 or mail to info@shroffeye.org)

Presbyopia

What is Presbyopia?

When you look at a nearby object your lens curvature changes accordingly and alters the focusing power forming an image. But aging causes a refractive error wherein the ciliary muscle fibres around the lens of the eye lose its flexibility. Further the lens capacity to reshape gets rigid and causes difficulties in changing the focus from far and near vision known as Presbyopia (age related long sight) or aging eye condition. The exact causes are under research and debate.

Sometimes one gets imperative to change presbyopic prescriptions for glasses quite often.

Spectacle independence and presbyopic correction has now become an enhanced vision experience with better refractive satisfaction owing to advancement in ophthalmology and wide array of options.

What are the causes?

One of the major risk factor causing presbyopia is increasing age and it normally occurs around 40 yrs although diabetes, multiple sclerosis or cardiovascular disease can have an early onset prematurely.

What are the symptoms?

You begin to experience difficulty to read small print or sometimes see with blurred vision at normal reading distance, headaches and strain in the eyes to read small print. Normally the need to hold the reading material at one arm length to read is another common symptom. It needs to be identified if these symptoms are due to presbyopia or some other reason.

How is Presbyopia Diagnosed?

Presbyopia is diagnosed through a comprehensive eye examination including the Visual acuity exam, Refraction test and Slit lamp exam according to the suitability of your eye.

What are the Treatment options?

Reading glasses, eye glasses with bifocal lens having variable focusing power and multifocal contact lens are the simplest options. Other common options are surgeries either to enable clear vision at all distances by using presbyopia correcting IOL’s (Intraocular lenses) or to maintain near vision for one eye and distance vision for the other eye using monovision lenses.

What are the commonly available surgical options for Presbyopia correction?

  • Laser Assisted Stromal In-situ Keratomileusis (LASIK) – This is a wavefront guided refractive surgery by excimer lasers where the correction is done by reshaping the cornea by creating a flap. It is a customized procedure wherein one eye is reserved for near vision and the other for distance vision enabling you to make the best use of monovision. It is a safe, painless and effective procedure.
  • Lens implant– IOLs are implanted according to the suitability of your eye and life style requirement.
  • Refractive lens exchange (Clear Lens Exchange)This procedure is advisable if you have high refractive error. It takes care of near and distant vision as well as cataract occurrence. Here the natural lens is removed and replaced by intraocularlens which provides multifocal vision. The concept is similar to a cataract surgery to remove the cataract but here it’s for refractive purpose. It is suitable in case you are suffering from dry eyes or have thin cornea.

Presbyopia is not a disease but an inevitable part of aging.

It has no cure but it is correctable.

Hence prudent to have a timely eye check up in case you find any of the presbyopic symptoms affect your vision.

Some procedures are undergoing research and trials while some are more frequent and effectively conducted.

To avoid presbyopia complications do get in touch with us for a comprehensive eye examination and obtain the best treatment suitable for your eyes.

Posterior Capsule Opacity

What is Posterior Capsule Opacity?

Let’s imagine an analogue of an egg wherein eggshell as lens capsule with its egg white plus egg yolk as natural lens. If the anterior or front portion of the egg is carefully cut through incisions to extract the egg white and yolk then the back portion or posterior end is retained intact.

In a similar manner during a cataract surgery your natural lens are removed from the anterior position of the lens capsule and further implanted with IOL. The posterior position of the lens capsule is kept purposely kept intact to hold the IOL in its position. The opacity or blurring of the posterior capsule which holds the lens is called Posterior Capsule Opacity. This could occur as the outer cells of the natural lens remain in the membrane and grows on the capsule making it progressively thick and opaque. It is commonly known as ‘secondary cataract’ or ‘after cataract.

The commonly known two forms are fibrous and pearl or a combination of both. Posterior Capsule Opacity is a known complication after a cataract surgery. Some symptoms are pretty similar to that of cataract and apparently you may feel like the re-occurrence of cataract.

Symptoms:

  • Vision becomes hazy and blurred.
  • Glares occur.
  • Difficulty in reading small print.
  • Gradual decrease in vision.

Causes:

  • Use of surgical techniques– Single piece lenses are used extensively compared to three piece lenses. The variation in sizes and certain surgical techniques can cause Posterior capsule opacity.
  • Intraocular lens optic edge designs– Comparatively Square and sharp edge designs in IOL aids In preventing Posterior Capsule Opacity as it arrests the movement of lens cells migrating behind the lens.
  • Intraocular lens materials- The biocompatibility of IOL materials usually made of silicone or acrylic polymers. Depending on the type of material the cell inflammation can increase or decrease leading to Posterior capsule opacity.
  • Other causes include the Use of therapeutic agents, Patients age, Inflammation in the eye after surgery, Duration of time since the surgery.

Diagnosis:

During a routine eye exam your eye pupils would be dilated to detect Posterior Capsule Opacity along with OCT (optical coherence tomography)). It could become severe if you have diabetes or uveitis. Risk factors are modifiable through surgical techniques. Based on the diagnosis you would be advised necessary treatment.

Treatment:

YAG laser capsulotomy: This is a safest, painless and effective outpatient procedure to restore vision. It is painless since the capsule bag does not have any nerves in it. Ensure that you remain still during the procedure which lasts for few minutes. In this procedure a small opening is created by using laser. Further the laser removes the affected portion of the posterior capsule from your line of sight. During this process no incision are made. Normally when laser is fired you may hear a clicking sound with a few light flashes. Owing to the absence of incisions the risks are minimal. Nevertheless in rare cases Retinal detachment (the retina loses connection with the inner back of the eye), movement of the lens implant or retina may develop swelling etc. are rare complications in YAG laser capsulotomy.

You are advised rest at the hospital for few hours to ensure that eye pressure is under control and to instill eye medication.

After undergoing YAG laser capsulotomy, your vision is expected to be normal after a day. You could resume normal activities quite immediately.

In case you experience no improvement in vision or any other discomfort like pain etc., do get in touch with us at the earliest.

New advances in IOL technology and surgical techniques, vision researchers are investigating on solutions to combat Posterior Capsule Opacity and optimize visual outcome.

Astigmatism

What is Astigmatism?

Astigmatism is a common refractive error or vision condition mainly caused due to irregular shape in the eye lens or cornea. If caused to cornea wherein the cornea gets irregular shape it is called corneal astigmatism and if caused due to the lens it is called lenticular astigmatism.

Normally when light enters the eye it bends (refracts) uniformly forming a clear image. In case of an eye with astigmatism only a part of the object gets focused at time as light gets refracted to multiple areas of the retina. This makes it difficult to see causing blurring in vision.

It is also referred to as a ‘cylindrical number’

What are the causes?

It could be hereditary, due to eye injury, eye surgery causing scarring in the cornea or other eye conditions such as keratoconus where the structure of the cornea changes from a normal shape to a cone shape. Some are born with astigmatism while some have it along with other refractive errors like nearsightedness (myopia) or farsightedness (hyperopia). The exact cause is still unknown.

What are the symptoms?

The common symptoms are as noted below.

  • Blurred vision
  • Fatique
  • Headaches
  • Squinting
  • Eye irritation

These symptoms could be a cause for some other illnesses too.

How is Astigmatism diagnosed?

A comprehensive eye examination including tests in Visual acuity, Streak Retinoscopy, Keratometry, Refraction, Corneal topography helps to diagnose Astigmatism.

What are the correction options?

There are various corrections options where the main focus is to reshape your cornea.

The common correction options are as noted below.

  • Spectacles – Traditionally spectacles according to the prescriptions with the desired lens are used to correct astigmatism. These are best when surgery is not advisable. A cylindrical number corrects astigmatism.
  • Contact Lens – SoftToriclenses or gas permeable rigid contact lenses for high astigmatism are used to maintain the shape of the lens to correct astigmatism. Great care need to be taken in usage and maintaining them hygienically. Toric = astigmatism
  • Refractive Surgery – In case you are the right candidate for refractive surgery then Astigmatism could be corrected by vision correction procedures. Some of the common procedures are listed below.
  • Laser-assisted in situ keratomileusis (LASIK) – In this procedure the corneal flap is created using a microkeratome or a Femtosecond laser (bladeless LASIK). The shape of the anterior corneal surface is changed using excimer laser. It is a safe, quick and painless procedure if found suitable for your eyes.
  • Photorefractive keratectomy (PRK) – During this procedure, the laser is used to reshape the cornea and change its curvature. It is an old procedure compared to LASIK and is currently used only when the cornea has had previous eye surgery, scars etc and not commonly as a primary line of management.

Astigmatism is correctable not preventable. It may worsen gradually if unattended. It may get unnoticed in children if they are not subject to regular eye checkups.

Blurred vision is a common symptom both in cataract as well as Astigmatism. Both are correctable and treatable in a single procedure.

Enhance your vision to permanent correction and spectacle free life.

If you notice any vision problems do get in touch with us for an eye check up and get the best correction suitable for your eyes.