Refractive error

Diabetic Retinopathy

  • What is diabetic retinopathy?

    Diabetic retinopathy is an eye problem that can be caused by Diabetes Mellitus. Retinopathy occurs when diabetes damages the tiny blood vessels in the retina. The weakened blood vessels may leak fluid and blood.

  • Who are at risk for developing diabetic retinopathy?

    Those with poorly controlled blood sugar levels are at a high risk of developing diabetic retinopathy. In addition, high blood pressure, high cholesterol, anemia, kidney disease and pregnancy can all place a patient at greater risk of suffering from diabetic eye disease.

  • How frequently should I get my eye examined?

    If you have diabetes, you should get a yearly examination by your ophthalmologist. Once you develop diabetic retinopathy, the frequency of these follow up visits is decided based on the severity of the disease.

  • What are the symptoms of diabetic retinopathy?

    There may be no symptoms in the early stages, especially when the central portion of the retina is not involved. As the retinopathy progresses, you may have:

    • Blurred vision.
    • Floaters, which can look like black spots, little threads, or cobwebs.
    • Bleeding in the eye causing sudden loss of vision.
    • Temporary or permanent loss of vision.

  • What is laser treatment? Will I regain my vision after laser treatment?

    The aim of this treatment is to protect central vision. It will not restore lost vision, but it can prevent further deterioration, which is why early Diabetic Retinopathy diagnosis through periodic eye examination is important. Laser Photocoagulation involves tiny burns to seal the capillaries. This may lead to small spots in your field of vision, however these spots generally fade and disappear with time.

  • What are Anti VEGF agents, and what is their role in managing diabetic retinopathy?

    Anti VEGF agents (Lucentis, Avastin, Macugen) are emerging as the new modality of treatment for various stages of Diabetic Retinopathy. These agents are injected into the eye (intravitreal injection) and are commonly used in Diabetic Maculopathy and Proliferative Diabetic Retinopathy. They may also be used as an adjunct before surgery for Diabetic Vitreous Hemorrhage and Retinal Detachments.

Glaucoma

  • What is Glaucoma?

    Glaucoma is characterized by progressive damage to the optic nerve of the eye, the most common cause being increased pressure in the eye. It is the leading cause of irreversible blindness worldwide. At first, patients lose side (peripheral) vision. But if the disease is not treated, vision loss may worsen, leading to total blindness over time.

  • Who does glaucoma affect?

    People above the age of 40 years need to undergo routine eye examinations to rule out glaucoma. Those with a family history of glaucoma, diabetes, systemic hypertension, thyroid disorders and myopia are at a higher risk of developing glaucoma.

  • How is it treated?

    Most of the glaucomas require treatment and follow-up life long, and the damage that occurs is irreversible. Most commonly your doctor will prescribe eyedrops to decrease the intraocular pressure in your eye. These drops usually need to be used lifelong much like the drugs that you may use for your diabetes or hypertension You may also need laser treatment or surgery. In adults, treatment can't bring back vision that has been lost, but it can keep your vision from getting worse. Treatment aims to stop more damage to the optic nerve by lowering the pressure in the eyes.

Cataract

  • What is cataract?

    Cataract is the clouding (Opacification) of the natural lens, at an early stage, a change in glass power could be a quick solution. However as the disorder grows, vision gets progressively worse.

  • What are the causes of cataract?

    Ageing is the most common cause of cataract. Every person gets it sooner or later, especially people over 50yrs of age. Other causes include diabetes, injury, usage of certain medications, and secondary to other eye diseases such as uveitis and glaucoma.

    • Cataract is usually painless, accompanied by gradual blurring of vision.
    • Double vision or seeing multiple images.
    • Trouble seeing under poor light conditions and sometimes even in excessive sunlight.
    • Sensitivity to glare – which can make night driving difficult.
    • Difficulty in distance vision as well as in reading.

  • When should you opt for surgery?

    This is a decision that depends largely on the patient himself. When the cataract begins to affect vision to a degree that it hampers daily activities such as reading and driving, surgery should be considered.

  • What is Phacoemulsification?

    Phacoemulsification at present is the universally accepted standard of care for cataract surgery. In this process, ultrasound energy is utilized to break up the cataract (emulsify) into microscopic fragments which are taken out of the eye.

  • What are the options in Intra-ocular Lenses (IOLs)?

    Majority of IOLs implanted are mono-focal, meaning they can focus light rays from one particular distance only. In these cases, distance objects are clear and one requires glasses only for reading. IOLs can be rigid or foldable. Foldable lenses require smaller wounds to insert.

  • What are Multifocal IOLs?

    Multifocal IOLs have many different segments inbuilt onto the same lens, which allows for clear distance as well as near vision without spectacles for most activities.

  • What about Toric IOLs?

    Mono-focal IOLs essentially only correct the spherical refractive error. Patients suffering from pre-existing astigmatism will need spectacle correction for distance vision as well as near vision. Toric IOLs eliminate the need for glasses for distance vision. With recent developments, multi-focal IOLs have been introduced, enabling correction for distance, near and cylindrical error.

  • What are Accommodative IOLs such as Crystalens HD?

    Accommodative IOLs are lenses that mimic the natural eye at a young age. At present, the only accommodative IOLs available provide good intermediate vision (such as for reading text on a computer screen), but most patients will require glasses for reading from near.

  • What are the pre-op requirements?

    • Patients need to be in reasonably good general health. Diabetes, hypertension, cardiac problems need to be controlled and cared for before surgery.
    • Patients need to undergo detailed check-up of the eye and a dilated examination of the retina.
    • Patients need to get their eyes scanned to determine the curvature and length of their eyes in order to decide the model and power of the intra-ocular lens to be implanted.

  • Can I take my routine medications on the day of surgery?

    You can take all the medications prescribed by your general physician on the day of surgery. However, diabetics need to skip their diabetic medications and Insulin on the morning of the surgery unless specifically instructed by your doctor. Do not forget to take your morning dose of anti-hypertensive medications. Normally, blood thinning medications such as Aspirin and Clopidogrel are generally stopped 3-5 days prior to surgery. Please ask your physician regarding this.

Retinal Detachment

Retinal Detachment is the separation the retina from its supporting layers.

If not promptly treated, retinal detachment can cause permanent vision loss.

  • Who is at risk for retinal detachment?

    A retinal detachment can occur at any age, but it is more common in people over 40 years. It affects men more than women.

    • Retinal Detachment is more likely to occur in:
      • Patients who are extremely nearsighted (high myopia).
      • Patients who have had a retinal detachment in the other eye.
      • Patients who have a family history of retinal detachment.
      • Patients who have had an eye injury.

  • What are the alarming symptoms of retinal tear and detachment?

    • Bright flashes of light, especially in peripheral vision.
    • Sudden blurred vision.
    • Floaters (cobwebs / specks) in your field of vision.
    • Shadow or blindness in a part of the visual field of one eye.

  • How soon should I consult my doctor?

    Whenever you experience symptoms such as floaters of flashes, consult your doctor without delay. The vision that you can hope to regain after surgery for detachment decreases the longer the retina is detached.

Amblyopia

  • What is Amblyopia?

    Commonly known as “lazy eye”, it is the loss of one’s ability to see details. It is one of the leading causes of vision problem in children.

  • What are the symptoms?

    Some of the symptoms include

    • Eyes that turn in or out.
    • Eyes that do not appear to work together.
    • Inability to judge depth correctly.
    • Poor Vision.

  • Can vision be completely restored in the child?

    If treated early, children usually recover almost normal vision, although they may continue to experience problems with depth perception.

Contact lens

  • What are contact lens?

    Are used to correct various disorders such as myopia (nearsightedness), hyperopia (farsightedness), astigmatism. They are used instead of spectacles.

  • How do I get contact lenses?

    Contact lenses are prescribed by your doctor. You will have to undergo a simple eye exam which determines the type of lens, size and material best suited for you.

  • What are the different types of lenses?
    • Soft Contact Lenses
    • Made of soft, flexible plastics, soft contact lenses are more comfortable on the eyes as they allow oxygen to pass through to the cornea.

    • Rigid Gas Permeable Contact Lenses (RGP)
    • RGP contact lenses are more durable and provide crisper vision. They are also less expensive as they last longer than soft contact lenses.

    • Disposable Contact Lenses
    • These contact lenses are designed for single use. A brand new pair of lenses is used each day and discarded.

  • What if my eyes become red or irritated?

    Your doctor must be informed immediately as any redness or irritation in the eye should be taken seriously. The wearer must take the lens out, rinse and disinfect them and switch back to glasses right away.

Computer Vision Syndrome

Staring at a computer monitor for hours on end has become a part of the modern workday. And inevitably, all of that staring can put a real strain on your eyes.

In addition, working adults aren't the only ones vulnerable to computer vision syndrome. Kids who stare at portable video games or who use computers throughout the day at school also can experience eye problems related to computer use, especially if the lighting and computer position are less than ideal.

  • What Symptoms Are Part of Computer Vision Syndrome?

    There's no evidence that computer vision syndrome causes any long-term damage to the eyes -- for example, cataracts. However, regular computer use can be the source of significant eyestrain and discomfort.If you have computer vision syndrome, you may experience some or all of these symptoms:

    • Blurred vision
    • Double vision
    • Dry, red eyes
    • Eye irritation
    • Headaches
    • Neck or back pain

Squint

  • What is squint?

    Squint (or strabismus) is misalignment of the eyes, due to which both eyes do not look in the same direction. This misalignment may be constant, or it may appear only sometimes. It is a common condition among children. It may also occur in adults.

  • What causes squint?

    The exact cause of squint is not really known. Loss of coordination between the muscles leads to misalignment. This misalignment may be the same in all directions of gaze, or in some conditions the misalignment may be more in one direction of gaze.

    Sometimes a refractive error hypermetropia (long sight) or poor vision in the eye because of some other eye disease (such as cataract) may also cause the eye to deviate. Therefore, it is important in all the cases of squint, especially in children, to have a thorough eye check up to rule out any other cause of loss of vision.

  • What are the symptoms of squint?

    In a child, the parents may notice the deviation of eyes. It is important to remember that the eyes of a new born are rarely aligned at birth. Most establish alignment at 3-4 weeks of age. Therefore, squint in any child who is more than one month old must be taken seriously and should be evaluated by an ophthalmologist.

  • How is squint diagnosed?

    The squint is diagnosed by the ophthalmologist. A few special tests confirm the disorder.