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Category Archives: Eye care

New Age Solutions for Cataract Provide Better Vision

Dr Mahipal Sachdev

Posing as a major healthcare challenge, India is a home of over 80 Lakh blind people in the country. The definition of blindness, which was changed earlier in 2016 by the Indian Government, identifies a blind person as someone who has less than 3/60 vision in better eye is understood to be blind.

One of the major factors causing loss of vision world over is cataract, which accounts to approximately 62% of blindness in India. Although government efforts are aiming towards restoring sight, a major focus on spreading awareness on quality of vision post-surgery is much needed.

I have been treating more than 200 cataract patients every month. In a world governed by screens and social media, we are glued to our digital devices day in and out. Thus impeccable intermediate vision has become a priority for younger and older generations alike. Fortunately today, cataract is easily treatable and advanced ophthalmology solutions such as extended range of vision lenses are available to enable patients lead highly active lifestyles with good quality of life even post cataract surgery.

With the growing desires of leading an independent, active life, vision loss due to cataract at any age comes as a big impediment to hopes of people. The eye ailment is not preventable but is treatable through intraocular lenses (IOLs), which are used to replace the natural eye lenses. However, with modern advancement in IOLs, patients have more than one alternative.

Post-surgery quality of vision is an important aspect that determines the quality of life. With monofocal IOLs, spectacles become a necessity. Even with progressive glasses, eyes take time to adjust while shifting from near to distance vision. This aberration is little but not completely corrected with multifocal lenses. However, the new extended range-of-vision lenses give impeccable clarity and contrast of vision, and reduce dependency on spectacles. The night vision through these lenses is uninterrupted with reduced incidence of halos or glares, quite common in the more popular multifocal lenses. The new lens also caters to distant, near and intermediate vision with seamless transition.

Although usually considered as an age related disease but cataract is not restricted to older population now.  Factors like diabetes, long-term use of steroid medicines, prolonged exposure to indoor pollution and even ultraviolet rays can lead to cataract at young and old age.

Today, cataract surgery is considerably a straightforward day care procedure, with vision being restored to patients within hours of surgery. The surgery today is possible to be done with just eye drop anesthesia, with no eye pad or stitches. Patients return home and can resume daily activities the same day. Post-surgery, careful post-operative care ensures a safe and speedy recovery.

Is wellknown opthamologist and chairman of Centre for Sight, New Delhi.

MACULAR EDEMA

Dr. Shashank Rai Gupta

Macular edema occurs when the retina’s ability to absorb fluid is overwhelmed by the fluid leaking into it. If more rain falls on the lawn than it can handle, you get puddles of water. In the retina, blisters of fluid form and swell the retina—this is macular edema. Factors likely to cause macular edema include conditions that:

  • Cause more fluid to leak from blood vessels (diabetes and high blood pressure)
  • Increase inflammation in the eye (surgery, inflammatory diseases)
  • Are associated with the growth of abnormal blood vessels (wet age-related macular degeneration)

Symptoms

Macular edema refers to an abnormal blister of fluid in the layers of the macula.The swollen retina distorts images—making it more difficult to see clearly. The more widespread, thicker, and severe the swelling becomes, the more likely one will notice visual symptoms of blur, distortion, and difficulty reading.

If untreated, chronic macular edema can lead to irreversible damage of the macula and permanent vision loss. Macular edema is typically caused by increased leakage from damaged retinal blood vessels or growth of abnormal blood vessels in the deep retina. New vessels (neovascularization or NV) do not have normal “tight junctions” and almost always result in abnormal leakage of fluid (serum from the bloodstream) into the retina.

RISK FACTORS

Macular edema is not a disease, but is the result of one.

Macular edema can be caused by many factors including

  • Metabolic conditions (diabetes)
  • Blood vessel diseases (vein occlusion/blockage)
  • Aging (macular degeneration)
  • Hereditary diseases (retinitis pigmentosa)
  • Traction on the macula (macular hole, macular pucker, and vitreomacular traction)
  • Inflammatory conditions (
  • Toxicity
  • conditions (eye tumors)
  • Trauma
  • Surgical causes (following eye surgery)
  • Unknown causes

Diagnostic testing

Fluorescein angiography and optical coherence tomography (OCT; Figure ) are 2 common tests to evaluate macular edema. Based on the appearance of fluid on these tests, macular edema may be widespread, localized, or be made up of many small blisters surrounding the center of the macula—a common form called cystoid macular edema.

Treatment and prognosis

The most effective treatment strategies for macular edema address the underlying cause (diabetes, blood vessel occlusion, neovascularization, inflammation, etc), as well as an excess of fluid leaking from abnormal blood vessels in and around the macula.

Eye drops,medication, laser, and surgery can be effective in many diseases, but the mainstay of treatment is intravitreal injections (IVI). If macular edema is localized then Focal laser can be done.

The IVI is an day care procedure performed under topical anesthesia in which medication is placed inside the eye by a very small needle. The injection genrally causes little to no pain. IVI should be performed by a trained retina specialist with meticulous monitoring of treatment efficacy and detection of rare but potentially serious complications. IVI is now considered one of the most commonly performed medical procedures.

 Is Founder Chairman of Delhi Eye Care. He is specialist in Vitreo-Retina, Uveitis & Diabetic Eye Care. He is visiting consultant at Sunetra Eye & Laser Centre, Ghaziabad, Narang Eye Institute, Model Town, New Delhi, Dr. Aggarwal’s Clinic, New Delhi and Apollo Spectra, Karol Bagh.

 

How Should Your Diet Look Like After LASIK

Does your morning ritual consist of turning off the alarm and spending the next few minutes looking for your glasses? How many times have you wished for a perfect eyesight and have considered LASIK surgery to fulfill that wish? If you are seriously considering LASIK, it is important to remember that the main surgery and preventive measures aren’t the only things that will assure the success of the procedure; what you eat before and after the surgery also plays a big role.

A person is as healthy as the food he eats. This is a common saying and it also holds true when you get your eyes operated upon. Eating certain kinds of food will speed up healing and enable a quick recovery, while consuming others will arrest the healing process. They may even cause complications post surgery and you may risk impairing your vision. Let us look at a list of food  items and nutrients you must include in your diet and the foods you must certainly avoid after  the LASIK surgery.

What to Include

Your diet should consist of food products that are rich in the following nutrients.

Proteins

The amino acids in proteins help in healing the wounds and regenerating tissue. You can consume proteins through fish, poultry, lentils, low-fat diary products, nuts and beans. It is normal for the eyes to get a little dry after the surgery. This can be tackled by increasing the intake of Omega-3 fatty acids that are found in cold water fish. They improve the oily layer of the tear film preventing eye dryness. You can take omega-3 in pill form for several weeks to a month before and several months after surgery. Additionally, it is also excellent for improving eyesight. Flax seed oil is a good alternate to the fish oil for vegetarians.

Vitamins

Vitamin A and C have wound healing properties, therefore you must increase their intake. They can either be taken through pills or through food rich in them. Include dark, leafy, green vegetables, carrots, citrus fruits, sweet potatoes, tomatoes and sweet bell peppers.

Carbohydrates

Carbohydrates that are high in fiber help in healing after the surgery. Moreover, they help in improving eyesight and fighting eye diseases. Consume fruits, legumes,vegetables, beans and whole grains. Keep snacking on carrots during the healing period.

Fats

Consuming good fats in moderation helps in improving and boosting the response of the immune system. This is extremely important for quick healing. Foods like olive oil, seeds, avocados and nuts must be incorporated in the diet.

What to Avoid :

 If you love the following, then you must gather a lot of will-power to avoid them for a couple of weeks after the surgery if you wish to go through a smooth, complication-free recovery period.

Trans-Fat Rich Food

While the good fats must be included, bad fats such as trans-fat rich foods must be strictly avoided altogether after LASIK surgery. They will hinder with the repairing process and increase the chances of being prone to eye disorders. You must keep fried food and margarine away for a few weeks.

Salts and Spices

Including too much salt or spices in your diet post surgery multiplies the chances of eye complications. Food items like tacos, hot dogs and processed food increase the risk of osteoporosis and make your bones really weak. This has serious implications on the eyes. Thus you should stay away from all those foods which speed up osteoporosis if you have undergone the LASIK surgery. Foods high in salt and spices can cause impaired eyesight, which might be difficult to recover from. Avoid caffeine, red meat and smoking. All these delay the recovery process and prevent you from achieving the optimal results from the surgery.

Confectionaries and Bakeries

This will be bad news for those with a sweet tooth. You should not even look at sugary items like confectionaries, candies, bakeries and chocolates for a minimum of 3 months after your surgery. Anything with excess sugar is bad for your eyes, so it is advised to keep the sugar at some distance after the surgery.

Subtracting these from your dietary chat for few months may seem a hard prospect, but it will serve you well ten out of ten times.

 Author Bio: 

Aaron Barriga is attached with Insight Vision Center, Fresno, California.

 

Newest Advances In Vision Correction Surgery

Dr. Alkesh Chaudhary

What is vision problem

In our countries thousands of Indians have vision problems due to refractive errors. In India, as many as 550 million people, almost half of India’s population estimated to be suffering from vision problems and correction. Fortunately, the majority of these issues can be addressed with prescription eyewear or laser vision correction. People wanting to get rid of eyeglasses can immensely benefit from the latest technology without having to experience any side-effect or discomfort.”

The most common vision or refractive errors are nearsightedness, farsightedness and astigmatism. All of these are caused by light not bending — or refracting — correctly as it hits the eye. Nearsighted individuals have difficulty seeing objects far away. Farsighted individuals have difficulty seeing objects up close. Those with astigmatism have football-shaped eyes, which causes objects to appear blurry.

Most children have clear distance and up-close vision. Starting in adolescence, some develop a refractive error and need corrective lenses. The prescription for these lenses may change often from adolescence into early adulthood. In adulthood the prescription stabilizes and varies little thereafter.

As many people enter middle age, they develop a condition called presbyopia. This is caused by the natural lens of the eye becoming inflexible, which affects the ability to see up close.

Vision is Corrected

Glasses are the oldest method of refractive vision correction and have been around for hundreds of years. Contact lenses have been available since the 1950s. Both glasses and contacts change how light focuses on the retina, which corrects the refractive error and improves vision. Reading glasses help those with presbyopia see up close.

Since the 1990s, a laser vision correction method called LASIK (laser assisted in situ keratomileusis) has been available as a third option to correct refractive vision problems. LASIK reduces or eliminates refractive errors by changing the structure of the cornea, which is located on the front surface of the eye. This restores visual function.

LASIK is a two-step process. First, the doctor uses a laser to create a flap in the eye’s cornea to preserve the skin of the eye called the epithelium. In the second step, the doctor uses another laser to etch an individual’s own corrective lens prescription on the cornea below the flap. The flap is then put back in place.

No stitches are used in LASIK, and healing is fast for the majority of patients. In fact, many are able to return to work the next day. Numbing drops are used, so patients experience very little discomfort. While side effects and complications may occur, they are rare and usually temporary.

Patients with presbyopia may benefit from monovision LASIK. Monovision corrects one eye’s distance refractive error, while the other eye is left mildly nearsighted for near vision.

Advantages of lasik

Glasses and contact lenses only improve the symptoms of refractive errors. LASIK reshapes the surface of the eye, therefore addressing the structural cause of blurry vision due to refractive errors. This allows the eye to focus without the use of glasses or contacts. LASIK addresses the cause of refractive errors, not just the symptoms. Each person’s eyes are different. Always consult with a trusted, experienced ophthalmologist to determine which vision correction solution is best for you.

latest advancement in the field of vision correction surgery

Tremendous advances have been made in refractive surgery for vision correction, and technology continues to be refined, making more options available for more and more people who want to reduce or eliminate their need for glasses or contact lenses.

Refractive eye surgery uses non-thermal lasers to shape the cornea—the “window” that focuses light on the surface of the eye. The laser removes microscopic bits of tissue to flatten the cornea (to correct nearsightedness), steepen the cornea (to correct farsightedness), or smooth out irregularities (to correct astigmatism). Reshaping the cornea allows more focused light to enter the eye, which provides clearer vision.

LASIK and photorefractive keratectomy (PRK) are two of the most common types of laser vision correction. In LASIK, surgeons make a thin corneal flap and then focus an excimer laser on the exposed cornea to remove tissue before replacing the flap.

But one should be aware that LASIK cannot correct presbyopia, the age-related loss of close-up focusing power. Some patient may not fit for LASIK procedure, then there is a new way that is called ICL (IMPLANTABLE CONTACT LENSES).

What is ICL

The ICL (Implantable Contact Lens) is a state-of-art refractive error solution that is ideal for anyone who has the need or desire for removal of power with high quality of vision correction. ICL or Implantable Contact Lens, as the name suggests, is a kind of lens which is implanted into the eye and does not require frequent removal like a normal contact lens. This phakic intraocular lens has numerous advantages including its correction of the widest range of myopia (near sightedness), hyperopia (far sightedness) and astigmatism (cylindrical power).

When ICL is needed

Not everyone is a candidate for LASIK surgery. People with extremely thin corneas, for instance, those prone to dry eye syndrome or those who have extreme prescription correction needs may not get the vision correction results they seek. But there are significant technological developments in other aspects of eye surgery that can help these and other patients.

One of the newest technologies available actually has its roots in the treatment of an old condition: cataracts. A cataract happens when the natural lens we are born with get clouded over, affecting the clarity of our vision and our impressions of light and color.  In cataract surgery, tiny incisions are made near the edge of the cornea, allowing the surgeon to remove the clouded lens and insert a new, clear lens, called an intraocular lens (IOL). The lens takes over where your old lens was, refracting light back toward the retina. Your sight improves immediately, because the clouded lens is gone.

For a long time, the only lenses used in cataract surgery were monovision lenses – in other words, “single vision,” or lenses that simply focused on one focal point, that being distance. This meant that after surgery, people still needed corrective lenses – eyeglasses or contacts – for their near vision. But the development of multifocal lenses – lenses which improve vision at all distances – actually made it possible for cataract patients to leave their surgeries needing no further vision correction at all. It was the equivalent of having a prescription contact lens implanted in your eye instead of wearing it on the outside.

Now, these implantable contact lenses (ICL) are available to people who do not have cataracts, but want to improve their vision. Instead of altering the outer surface of the eye, as in LASIK surgery, implantable contact lenses correct a patient’s vision from inside the eye. No change takes place on the cornea.

Is a renowned ophthalmologist based in Delhi. He is founder Director of M.D. Eye Care and Laser, Greater Kailash, New Delhi.He was also associated with the Moolchand Hospital in New Delhi for 10 years from 1996 to 2006 as a Honorary Consultant, and continues to visit the Saket City Hospital in Similar Capacity.