arrowSpectacle Number


Our eye is like an egg. The length of the normal eyeball is 24 mm. Those who have perfect length of eyeball are fortunate to see things without glasses. But many people have either shorter or longer eyeballs constitutionally.
If the eye eyeball is not of perfect size and shape, the rays of light don’t fall perfectly on visually sensitive retina. Hence objects are seen blurred. In case of longer eyeball, it is called myopia and if eyeball is shorter it is called hypermetropia.
Some people have this abnormality only in one axis of spherical eyeball, which is called astigmatism.
Almost everyone progressively reduces the ability to see near things clearly, and need near glasses. But purchasing them without checking the eyes is dangerous.
The number doesn’t come because of too much reading, studying, or computer use, or because of watching television. Rather those people, who do lot of such eye work, need their existing number while other people like housewives or farmers can afford to go without using glasses.
Constant use of glasses doesn’t reduce the number neither prevents its progress. Spectacle is an aid not the treatment.
Frequent check up of spectacle number is necessary, as it tends to change.
Though it looks very simple to check spectacle number and prescribe glasses, in this era of computer, where constant intensive eye work is involved, it’s very very important to find suitable and perfect spectacle number. It’s not only important to see things clearly, but they should be seen comfortably also.
Various innovative ideas have to be found while prescribing glasses, depending upon person’s age, computer distance, and his work style and neck problem. We give tailor made design of glasses to spectacle shop people depending upon patients job requirement.
Apart from prescribing glasses, it is also important to know how to use the glasses, how to adjust with the new glasses, how much should be the height of lenses, the distance between centre of 2 glasses, material of the glasses etc. Special care needs to be taken while prescribing glasses.
At many places, this job of spectacle number checking is not given due importance and left for the ophthalmic assistant.
This leads to incurable headaches, eye aches and various discomforts. Nothing is found in CT and MRI.
We have saved many of our patients from all these expensive investigations and cured them of their so called migraines and headaches, because we believe that no work is small or unimportant and giving comfortable vision is equally important as performing the operation, which is our prime job.

arrowLazy Eye, Amblyopia


When a child has less vision in one eye than the other, because of some eye problem in that eye, that eye becomes lazy. It is called amblyopia. That means, the eye with less vision develops squint and does not improve even if the cause for less vision is removed or corrected.
There is need for special treatment and exercise to overcome this problem. The reason for this is not exactly known, but it is supposed to be because of laziness of brain cells. If brain cells of visual area don’t get proper visual stimulus during the developing age, they become lazy and don’t get excited, even after removal of the cause for visual problem. But another issue is of rivalry between two eyes, as the better other eyes dominates over the visually weak eye, which leads it to become lazy.
Some of the reasons for lazy eye or visual blunting in a child are -
» Uncorrected refractive error or spectacle number in one eye.
» Undetected, unequal spect number in both eyes.
» Untreated cataract in one eye.
» corneal opacity in one eye.
» Ptosis (drooping eyelid) covering half of the eye.
The treatment for lazy eye −
» Correcting the cause of visual blunting.
» Temporary, periodic patching of better eye under strict medical supervision.
» Some exercises for weak eye.
We have developed special therapy for such children. It has helped many children.

arrowConjunctivitis or Sore Eyes


It is a very common disease of eye but neglected and often complicated because of wrong treatment.
It presents with mild to severe redness, pain, swelling, watering of one or both eyes. It may present with sudden severe foreign body sensation though there is no foreign body in eye.
Though it is presented with red eye, all red eyes are not always conjunctivitis. So, it is necessary to get the eyes checked to confirm the diagnosis.
But many times, patients take some medicines from chemist or family doctor, which is often steroid. Use of steroid eye drops in acute stage of conjunctivitis can cause vision threatening complications.
Conjunctivitis can be bacterial or viral. The treatment depends upon the cause and severity.
The routine care to be taken at home for the conjunctivitis patient -
» Wash the eyes frequently with plain water.
» Avoid touching the eyes, use tissue paper to clean the eyes.
» Keep the napkin, hanky and soap separate to avoid transfer of infection to other family members.
» Apply ice to the affected eye or eyes.
» Taking pain killer during acute stage may help.
» Use goggles to avoid spread of infection.

arrowGlaucoma


Just like our blood pressure, we have certain eye pressure. Glaucoma is the eye disease where this eye pressure is increased. This increased eye pressure slowly leads to damage of the optic nerve (nerve of vision). This causes reduction in visual field. Visual field is the ability of the person to see sideways while fixing at the front object. Slowly this ability to see sideways decreases till even the central vision also goes and person becomes blind.

This damage to the sight is because of damage to the nerve. Hence it is permanent and cannot be reversed. But it is possible to prevent the visual loss by diagnosing it in time.
How will the patient know that he or she is likely to have glaucoma?
It’s really difficult. Glaucoma can damage the eye sight without symptoms and patients knowledge.
There are two types of glaucoma.

» Closed angle glaucoma- here, sometimes patient gets redness and pain the eye, and he may rush to a doctor.
» Open angle glaucoma-this may never show any symptoms. Eye pressure may keep on increasing slowly without patient’s knowledge till he goes blind.

Then how one can deal with this silent killer of vision?
Usually, glaucoma occurs after the age of 35 yrs. So every person above the age of 35 yrs should get his or her eyes checked regularly, once in a year from the expert ophthalmologist. With the help of various equipments we can check the eye pressure. We can directly visualise the optic nerve and find out its damage. Thus we can suspect the glaucoma early before visual damage. If glaucoma is suspected, perimetry or field-testing can be done to support the diagnosis.

Following persons should be more careful and get their eyes checked at least yearly, even if there are no symptoms.

» Person above 35yrs of age
» Person having family history of glaucoma
» High hypermetrope (those with high plus number glasses)
» High myopics

Secondary Glaucoma
This occurs because of certain diseases of other parts of the eye , like advanced cataract, untreated diabetic retinopathy, excessive use of steroids eye drops, tumour of the eye etc.

Management
We control the eye pressure and prevent the visual loss with the help of antiglaucoma eye drops. Skilful use of drops and strong motivation of the patient to use them have protected the vision of many of our patients for years and they don’t need the surgery. But in some patients, medicines don’t work. In such cases, we perform bypass operation to reduce the eye pressure permanently.

IMPORTANT
» Glaucoma is silent killer of the eye and visit to the ophthalmologist only can prevent vision damage.
» Once the vision damage occurs because of glaucoma, it cannot be reversed. Hence prevention is best cure.
If eye is blind and painful because of advanced glaucoma we reduce the pain by cryo surgery

arrowDiabetic Retinopathy


Retina is the backside layer of the eye on which the image of the object we see falls. In diabetes, because of microangiopathy, retina of the eye doesn’t get enough oxygen. The tiny blood vessels of retina get blocked or dilated. This leads to bleeding and leakages on retina. This leads to visual damage.

To deal with this shortage of oxygen, the body tries to build new blood vessels on retina. But these vessels are fragile. They tend to break and bleed inside the eye. This can also lead to sudden or slow vision loss.

When all these things are happening on retina, patient may not have any symptom. He may have normal vision. If these problems are on peripheral retina, visual loss is slower. But if it affects the central part of retina that is (macula), vision loss may be faster, severe and more permanent.

All this process is called diabetic retinopathy.
The damage to retina caused by diabetes is permanent and without symptom. Hence, like glaucoma, diabetic retinopathy is also called silent killer of the eye.

The only way to deal with this problem is prevention. Every diabetic patient, irrespective of visual problem, should visit the expert ophthalmologist and get his or her retina checked.

During examination, we can directly visualise the retina with various instruments and diagnose the retinopathy at early stage before it causes vision damage.

The treatment of diabetic retinopathy is mainly laser treatment.

Laser Treatment For Diabetes
We treat diabetic retinopathy with green laser. It is done in sitting position. It is absolutely painless. It works like welding at leaking blood vessels. It also helps to improve the oxygen supply of functioning retina. It prevents complications of diabetic retinopathy and blindness. Depending upon the severity of retinopathy, multiple sittings for laser may be needed.

Prevention of diabetic retinopathy
Following care should be taken by diabetics to prevent retinopathy and blindness
» Smooth control of diabetes
» Smooth control of blood pressure
» Antioxidant medicines
» Vit C supplement like lemon juice
» Control of cholesterol
» Regular eye check up

arrowLasik Operation


Those who need glasses are always curious and interested about Lasik operation. Here are some of the facts about Lasik operation.
» It is best done between the age of 18 and 35 years.
» The spectacle number has to be fixed for last 1 year.
» Use of contact lenses has to be stopped 1 month before surgery.
» Eye should be free of any infection. Especially viral keratitis has to be ruled out.
» Corneal thickness has to be sufficient, else the higher number may recur.
» Aim should be to remove the dependence from the spectacles.
» Patients with spherical number–3 to –9 and +2 to+4 and cylindrical number up to +3or –3 are ideal candidates for surgery.

If any of the above criteria is not being fulfilled, extensive discussion about risk and benefit with the operating surgeon on scientific basis needs to be done.

Who are wrong candidates?
» Cornel infection cases
» Those with very high spectacle number
» Persons above 35 years, diabetics, thyroid patients, pregnant ladies.
» Very small spectacle number.
» Those who don’t want near number as well.

Patients whose spectacle number changes frequently.
Lasik operation is done on the cornea that is the most important focusing lens of the eye and is vital for vision. Operation involves peeling of the layer of cornea and reshaping the it’s bed with laser energy. Technically it is really very quick and easy.
The peeled part is just replaced, which heals naturally. (In other words, it is left to heal with the hope that person has normal healing power.)
Lasik operation is really a boon to the mankind provided it is done on a right candidate.

arrowEye Emergencies


Proper first aid treatment can save the vision in many cases of eye injuries.
Following things can be done in different emergency situations
If a foreign body enters into the eye one can wash the eye with plain water. But avoid rubbing the eye as rubbing causes the particle go deeper layer and causes more scaring afterwards. Attempt to remove particle with nail or needle should be avoided. If particle keeps hurting, it is better to visit the ophthalmologist who will remove it under the microscope so that excess damage to eye doesn’t occur.
If acid or alkali enters into the eye, washing the eye with lot of water helps.
In industry, it is advisable to keep a packed bottle of normal saline which is easily available in chemist shop. If chemical enters in the eye, this bottle is opened and poured on the open eye of the patient till one reaches an ophthalmologist.
In case of injury with sharp object and bleeding, one should avoid any pressure on eye. Applying sterile eye-pad gently on the eye till one reaches the ophthalmologist is advisable.
One sided severe headache, brow pain associated with eye pain could be because of a possibility of acute attack of glaucoma (increased eye pressure) or acute iridocyclitis. It has to be treated at the earliest, else it can cause permanent vision damage.
In case of any sudden pain, injury, trauma, strictly no medicine should be introduced in the eye without ophthalmologist’s advice. Especially introduction of steroid eye-drops, without proper eye examination and diagnosis can worsen the situation.

arrowComputer Eye Care


Nowadays, youngsters have to work extensively on computers. Problems which I have encountered in extensive computer users are
» Eye strain
» Redness of eyes
» Headache
» Dryness of eyes
» Frequent infections of eyes.
Indirect bad effects of computer due to lack of exercise and faulty diet and work stress
» Severe nutritional deficiency
» Cardiac problems due to high cholesterol
» Joint problems
» Diabetes
» Hypertension
» Nervousness
» Tiredness
» Acidity
None of the problem is actually created by computer and computer itself is harmless. It does not cause any permanent effect on eyes or body.
If few precautions are taken while using computer, one can have perfect eye and general health.
What care need to be taken while working on computer?
» Keep comfortable distance from screen, may be 15 to 20 inches
» Adjust the screen light, so that it matches the room light.
» Avoid the direct blow of a/c on face.
» Use proper number glasses.
» Persons above 40 yrs age may need progressive glasses, or separate special computer glasses.
» Blink frequently, cautiously as constant looking at computer can cause dryness of eyes.
» 20/20 rule − Look at the distance object for 20 seconds after every 20 minutes, which gives relaxation to eye muscles and prevent headaches and eye strain.
» Take a break of 5 min. from computer work after every hour of work if possible.
Having taken all these precaution meticulously, one should not get any eye problem.
If one keeps getting eye problems in spite of all this care, he/she should meet the ophthalmologist; get thorough eye examination and special counselling done.
We have special program of power point presentation for corporates in which we teach about taking care of eyes for computer users and it also includes specially designed exercises and diet tips for busy corporates.