Sunetra Eye Hospital

Now you can lose your glasses…on purpose!!

Remember how your life changed when you had to get glasses? Now you can change it back and see naturally again. All this is possible now thanks to laser vision correction. We know you need more information to make an informed decision: so we would like to answer some of the question you may have while considering this procedure.

WHAT IS LASIK?

Laser Assisted Stromal In-situ Keratomileusis [Lasik] is a method of re-shaping the external surface of the eye [the cornea] to correct low moderate and high degrees of near sightedness,astigmatism and far-sightedness, During the treatment, an instrument called the microkeratome creates a corneal flap to make it a painless procedure. The computerized Excimer laser then uses a cool beam of light to gently reshape the cornea so as to alter its curvature to the desired extent. The flap when replaced onthe new corneal curvature allows images to be sharply focused on the retina. The goal is to eliminate or greatly reduce the dependence on glasses of contact lenses.

WHO IS A CANDIDATE?

The treatment is for patients who have a refractive error and meet certain visual and medical criteria. In addition the best candidates tend to be those who are dissatisfied with their contact lense or glasses and are motivated to make a change, whether it is due to occupational or lifestyle reasons. However, only a thorought examination by our LASIK team can evaluate whether or not you are medically suited for LASIK.

IS LASIK SAFE?

Yes.When chossing this method to improve your vision safety should be your first corcern. It’s ours too.

Using advanced surgical techniques of Phacomulsification. The removal of the cataract is a safe and straightforward process. It is performed without sutures through a micro incision in the eye and takes 7 to 15 minutes.

No discomfort is experienced during & none or minimal after the procedure. These are the benefits of the surgery today.

What Method is used?

The best way to treat your cataract is to remove the cloudy lens and replace it with a new, clear artificial lens. This can be accomplished two ways. The first technique, called extracapsular cataract extraction (ECCE) involves removing the cloudy lens in one piece. This technique requires a large incision of 10 to 12 millimeters in length. This was the older method, requiring rest and care upto a month in most cases.

The second technique is the latest advance in cataract removal. It’s called phacoemulsification, or phaco. In phaco surgery, a small ultrasonic probe is inserted into the eye. This probe breaks (emulsifies) the cloudy lens into tiny pieces and gently washed out This lens is then replaced with a clear man-made one. The new lens is inserted and it opens up like a flower when inside. No stitches are used and the incision is self healing. Phaco requires a small incision of only 2.6 millimeters or less.
See a video of Phaco

This technique is the most successful method of restoring your vision following cataract surgery.

Whichever technique is used to remove your cataract, anesthesia will be a necessary part of the procedure. Two types of anesthesia, local or topical, are used in most cataract cases.

Anesthesia

Local anesthesia eliminates any sensation of pain and prevents movement of the eye during surgery. Topical anesthesia OR Eye Drop Anaesthesia is administered by placing drops on your eye. It eliminates any sensation of pain but does not prevent your eye from moving around. Both types of anesthesia leave you fully awake and aware during the operation. The type of anesthesia that the surgeon will choose for you will depend on the technique your surgeon chooses and the condition of your eye.

YAG laser
The YAG (yttrium aluminum garnet) laser produces infrared light impulses which create tiny openings in the targeted tissue through photodisruption. These short bursts of energy are used to treat secondary cataracts and the iris, and some retinal problems in the back of the eye.
Posterior capsulotomy
The procedure used to clear cloudy vision caused by secondary cataracts is called a posterior capsulotomy or laser posterior capsulotomy. YAG laser treatment offers the patient many benefits over traditional surgical procedures including:

* Virtually pain-free treatment
* No risk of infection
* Performed on an outpatient basis
* Only takes a few minutes and cost is reduced
* Faster healing with less trauma to the eye
With a YAG laser capsulotomy the patient sits in a chair with their head in a support that looks just like a regular eye examination station. The doctor focus’ the YAG laser onto the cloudy posterior capsule using a special aiming beam.

The laser beam passes through the clear cornea and lens implant. As the beam reaches its focal point on the cloudy capsule, the energy becomes highly concentrated causing disruption of the tissue and creating a tiny opening.
As the laser is activated a click may be heard. Multiple applications of the laser are usually required to create a new window in the cloudy capsule. The procedure only takes a few minutes and the patient is able to leave shortly after completion. In most cases pain medication is not necessary; occasionally however, some patients may require aspirin or Tylenol®. Good vision returns quickly.

A series of applications of the laser creates a window in the posterior capsule restoring good vision

THE WORD KERATOCONUS IS FORMED BY TWO GREEK WORDS: KERATO, MEANING CORNEA, AND KONOUS, MEANING CONE. KERATOCONOUS IS A CONDITION IN WHICH THE SHAPE OF THE CORNEA, WHICH IS USUALLY ROUND, IS DISTORTED, DEVELOPING A CONE-SHAPED BULGE, RESULTING IN HARM TO VISION, PROGRESSION OF THE CONDITION DEPENDS ON THE PATIENT’S AGE AT THE TIME OF THE ONSET. THE EARLIER THE ONSET, THE FASTER KERATOCONOUS PROGRESSES. THE CONDITION IS ALWAYS BILATERAL AND ASYMMETRIC- MEANING THAT IT AFFECTS BOTH EYES, HOWEVER ONE EYE MAY BE MORE AFFECTED THAN THE OTHER.

WHAT CAUSES KERATOCONOUS?

KERATOCONOUS IS AN INHERITED CONDITION THAT SOMETIMES SKIPS GENERATIONS. ITS ONSET IS USUALLY DURING PUBERTY AND OFTEN RELATED TO ALLERGIES(HIGH FEVER, ASTHMA AND ECZEMA). THE CORNEA IS A BIT MORE ELASTIC THAN NORMAL AND TENDS TO ALTER IN SHAPE AND THIN OUT BECOMING CONE SHAPED. RUBBING THE EYES CAN AGGRAVATE THE CONDITION.

HOW IS KERATOCONOUS TREATED?

1. EYEGLASSES IN THE EARLY STAGES.
2. RIGID CONTACT LENSES: WHEN GLASSES DO NOT WORK.
3. C3R – CORNEAL COLLEGAN CROSS LINKING WITH RIBOFLAVIN- INCREASES THE STRENGTH OF THE CORNEA TO PREVENT PROGRESS.
4. INTRACORNEAL RINGS (INTACS AND FERRARA): WHEN THERE IS INTOLERANCE TO CONTACT LENSES AND WHEN THE CONDITION CONTINUES TO PROGRESS.
5. CORNEAL TRANSPLANT: IN ADVANCED STAGES- EITHER A PARTIAL THICKNESS(DEEP ANTERIOR LAMELLAR OR DALK) OR FULL THICKNESS(PENETRATING OR PK)

Your eyes are a window to detection of many systemic conditions. The eyes are the only place in the body where blood vessels and nerves can be viewed directly. A few examples of diseases that can manifest in the eyes:

1. Diabetes
2. High Blood Pressure
3. High Cholesterol
4. Signs of a stroke
5. Brain Tumors
6. Multiple Sclerosis
7. Thyroid Dysfunction
8. Arthritis
9. Sjogren’s Syndrome
10. Leukemia
11. Malignant Melanoma
12. Nutritional Deficiencies

1. Wear safety eye wear when appropriate to protect your eyes from sight threatening injury.
2. Wear ultraviolet protecting sunglasses and a hat outdoors. Ultraviolet radiation is a risk factor for conditions such as macular degeneration and cataracts.
3. Exercise regularly. Set a goal of moderate-intensity physical activity for 30 minutes five days a week. Studies tell us individuals who exercise regularly can reduce their risk of macular degeneration by up to 70%.
4. Follow your physician’s instructions in controlling systemic diseases, such as diabetes and high blood pressure. These diseases affect eye health at a greater rate when they are not properly controlled.
5. Discontinue smoking habits. Smoking has a negative effect on eye health and can worsen eye diseases such as macular degeneration and dry eye.
6. Eat a healthy diet rich in fruits, vegetables and anti-oxidants. Anti-oxidants can help slow progression of eye diseases such as macular degeneration.
7. Drink 64 ounces of water each day. This is especially important for those individuals with dry eyes.
8. Keep your glasses and/or contact lens prescription current. Injuries are less likely to occur when vision is at its best.
9. Change contact lenses at the prescribed replacement interval and comply with instructions for contact lens hygiene.
10. Have your eyes examined every year or at the frequency recommended by your optometrist. The key to good vision and health is prevention.

1. WHAT ARE CONTACT LENSES AND HOW DO THEY ACT?

CONTACT LENSES ARE MATERIALS MADE OF BIOPOLYMERS WHICH ACT ONCE PLACED ON THE BLACK OF THE EYE CALLED “CORNEA”. THEY ACT DUE TO THEIR OWN PHYSICS AND PHYSIOLOGICAL INTERACTION WITH TEARFILM AND CORNEA.

2. WHAT ARE THE BASIC PRECAUTION CONTACT LENS WEARER SHOULD TAKE CARE?

THE BASIC NECESSITY IN WEARING CONTACT LENSES IS THE HYGIENE. HANDS SHOULD BE CLEAN AND NAILS TRIMMED. WASH YOUR HANDS BEFORE INSERTION OR REMOVAL OR CONTACT LENSES, WITH SOAP AND WATER.

NEVER LET YOUR LENSES DRY.

THE MOST IMPORTANT COMPONENT OF SOFT CONTACT LENSES IS WATER. HENCE DO NOT WASTE TIME ON REMOVAL OF LENSES FROM CASE. AFTER GENTLE CLEANSING INSERT IT QUICKLY INTO THE  EYE.

DO NOT INTERCHANGE YOUR LENS WITH THAT OF THE OPPOSITE EYE. ALWAYS FOLLOW A FIXED SCHEDULE “RIGHT FIRST” BOTH FOR REMOVAL AND INSERTION. AFTER FINISHING WITH RIGHT EYE CLOSE THE RIGHT LENS CASE, THEN GO FOR LEFT.

3. WHAT IS RIGHT TECHNIQUE OF WEARING CONTACT LENSES?

THE BEST TECHNIQUE IS TO PLACE THE LENS DIRECTLY ON THE  CORNEA. YOU NEED NOT HAVE TO FIX THE LENS ON THE CORNEA. AS IT MAKES CONTACT WITH THE CORNEA,  TEARS WILL ATTRACT AND PULL THE LENS ON TO IT. TAKE CARE NOT TO WEAR THE LENS WRONG SIDE UP. TO KNOW THE WRONG SIDE THERE ARE SIMPLE TESTS.

HOLD THE LENS ON YOUR FINGER TIP. IT SHOULD LOOK LIKE A CUP AND NOT SAUCER. IF YOU LOOK FROM ABOVE YOU WILL FIND THAT THE DIAMETER OF LENS IS MORE AS COMPARED TO THE SIZE YOU ARE USED TO. GENTLY PUSH THE EDGE OF THE LENS WITH INDEX FINGERL IT SHOULD ROLL IN AND NOT FLOWER OUT.

SOME DO’S AND DON’TS

DO’S

• IDEALLY CHANGE YOUR CONTACT LENSES ANNUALLY.
• CLEAN YOUR LENS CASE EVERY MONTH WITH A SOFT TOOTHBRUSH.
• ALWAYS CARRY YOUR LENS CASE FILLED WITH FRESH SOLUTION IN IT, WHEREVER YOU GO.
• APPLY EYE AND FACIAL MAKEUP BEFORE WEARING CONTACT LENSES REMOVE THEM BEFORE REMOVING MAKEUP.
• REPORT IMMEDIATELY IF YOU HAVE REDNESS OF EYES, SENSITIVITY TO LIGHT, BLURRING OF VISION OR PAIN IN THE EYES.

DONT’S

• DO NOT SLEEP WITH CONTACT LENSES ON.
• DO NOT WASH YOUR CONTACT LENSES WITH TAP WATER.
• DO NOT WEAR YOUR LENSES CONTINUOUSLY FOR MORE THAN 12 HOURS.
• DO NOT WEAR CONTACT LENSES IF YOU HAVE AN EYE INFECTION.
• DO NOT RUB YOUR EYES WHILE YOU ARE WEARING CONTACT LENSES.

CONTACT LENS CARE PRODUCTS

SOLUTIONS: WHY TO USE?

SOLUTIONS FOR CONTACT LENSES ARE LIKE AIR TO US. THEY GIVE THEM FRESHNESS, KEEP THEM CLEAN AND PREVENT INFECTION. SO USAGE OF PROPER SOLUTIONS IN THE  LIGHT TECHNIQUE IS OF AT MOST IMPORTANCE.

WHICH TO CHOOSE?

THERE ARE MANY COMPANIES WHICH ARE PRODUCING MULTIPURPOSE SOLUTIONS. THE  ONE WHICH SUITS YOUR EYES IS THE BEST CHOICE. TO TEST THIS, YOU CAN START WITH DIFFERENT SOLUTIONS IN THE  BEGINNING. USE SMALLER BOTTLES INITIALLY. GO FOR THE ONE WHICH YOU ARE MOST COMFORTABLE WITH.

HOW TO USE?

AFTER OVERNIGHT STORAGE OF LENSES IN THE CASE, CLEAN EACH LENS WITH FRESH SOLUTION BEFORE WEARING IT. ALSO, AFTER REMOVAL FROM THE  EYES CLEAN THEM BEFORE STORING THEM. IT IS  A BEST TO DO WITH YOU, YOUR LENS CASE FILLED WITH FRESH SOLUTION, WHEREVER YOU GO. CHANGE STORAGE SOLUTION EVERYDAY. IF YOU DO NOT USE YOUR CONTACT LENSES REGULARLY, CHANGE THE SOLUTION AT LEAST ONCE IN 3 DAYS.

HOW LONG CAN A BOTTLE OF SOLUTION BE USED?

USE IF 6 MONTHS FROM THE DAY YOU OPEN THE SEAL. EVEN IF SOME SOLUTION IS LEFT BEHIND AT THE END OF 6 MONTHS, PLEASE DISCARD IT.

SPECIAL INSTRUCTIONS

• ALWAYS KEEP THE BOTTLE COVERED WITH LID.
• DO NOT TOUCH THE NOZZLE OF THE BOTTLE.
• DO NOT REUSE SOLUTIONS.
• BEWARE OF DUPLICATES WHEN BUYING SOLUTIONS.

ENZYME TABLETS

WHY TO USE?

THE MOMENT A CONTACT LENS IS PUT ON THE EYE IT IS BATHED IN BODY FLUIDS; THAT IS TEARS, WHICH CONTAINS MATERIALS WHICH CAN GET DEPOSITED ON TO THE LENS. THESE DEPOSITS IN TURN ACT AS A SOURCE OF INFECTION AND IRRITATION IN THE EYE, AS WELL AS DECREASE THE COMFORT, QUALITY AND LIFE OF YOUR CONTACT LENSES.

WHEN TO USE?

USE OF ENZYME  TABLETS OR “DEPROTEINIZATION” DEPENDS MAINLY ON THE AMOUNT OF PROTEINS, ONE DEPOSITS. IN OTHER WORDS, IT VARIES WITH EVERY INDIVIDUAL. HENCE THE DURATION AND FREQUENCY WILL BE GUIDED BY CLINIC ON YOU FOLLOW UP VISIT.

Just like hay fever and skin rashes, eye allergies develop when the body’s immune system becomes sensitized and overreacts to something that is ordinarily harmless. an allergic reaction can occur whenever that “something” – called an allergen – comes into with your eyes. The allergen causes certain  cells in the eye to release chemicals that cause blood vessels in the eyes to swell, and the eyes to becom itchy, red and watery.

pollen,dust mites and molds, pet hair and dander and smoke are the most common allergens.

Diabetic mellitus is a condition which affects millions of Indians. It impairs the body’s ability to use and store sugar. Elevated blood sugar levels and excessive thirst and urination are the indicators of diabetes. It can affect vision by causing damage to the blood vessels all or a higher incidence of cataract and glaucoma.  changes are also seen in blood vessels all over the body.

What Is Diabetic Retinopathy?

It is an advance stage of the diabetic disease process in which the blood vessels in the retina are damaged and leak fluid or blood. The longer a person has diabetes, the more the risk of developing diabetic retinopathy. People with type 1 diabetes( diabetes since childhood) are more likely to develop diabetic retinopathy at a youger age.

What Are The Symptoms Of Diabetic Retinopathy?

Early diabetic retinopathy usually has no symptoms. Gradual blurring of vision may occur if fluid leaks in the central part of the  retina(the macula). In diabetic retinopathy(proleferative stage) new abnormal blood vessels begin growing on the surface of the retina or the optic nerve. These vessels have weak walls and leak blood out into the retina and vitreous(jelly that fills most of the eye). Presence of blood in the path of light entering the eye blocks v vision.

How is diabetic retinopathy diagnosed?

A complete eye examination is required for the detection of diabetic retinopathy. We perform a painless examination of the retina of the eye using  an instrument called the indirect ophthalmoscope after dialating the pupils.  If diabetic retinopathy is found, a special test called Fluorescein angiography may be performed where a dye is injected in the vein and photographs of the retina are taken.

How is diabetic retinopathy treated?

In early cases only regular follow up may be necessary.More advanced cases require treatment to control the damage of diabetic retinopathy and improve sight. Laser photocogulation involves the focusing a powerful beam of laser light on the damaged retina to seal leaking retinal blood vessels and stop abnormal blood vessel growth.

Vitrectomy- In the event of the patient presenting with very advanced diabetic retionopathy, a micro surgical procedure known as vitrectomy is recommended. Blood -filled vitreous gel of the eye is replaced with a clear solution to aid in restoring vision.Sometimes the retina may also be detached.Vitroctomy surgery is then performed to re attach the retina.

How to prevent visual loss in diabetes?

Prevention of diabetic retinopathy and accompanying visual loss is a team effort involving the patient and our team of diabetic eye specialists.Early detection of diabitic retinopathy is the best protection against loss of vision.Diabetics must have their retinas examined atleast once a year.Our diabetic clinic is designed towards providing regular preventive care as well as follow-up for patients with established daibetic retinopathy.