Ophthalmic Surgeries

    
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Ophthalmology

Cataract Eye Surgery

Cataract is launching of natural lens and is a commonly suffered eye sight problem. Light rays are unable to pass through cloudy lens to form on image on retina resulting in poor vision.

This can cause difficulties in performing daily activates like reading, driving and watching things from distance.

Most common reasons for development of cataract are

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AGENING > 60 YERS

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EXPOSURE TO UV RAYS

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DRUG INDUCED EG. STEROID USE

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DRALELTIS

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INJURY

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DEVELOPMENTAL

Treatment

Treatment

Cataract cannot be corrected with glasses or medication. Surgery is the definitive treatment. Various surgical options are available depending on the severity of cataract and patient’s lifestyle.

In cataract surgery the cloudy lens is removed from the patients lens bag and replaced with an artificial one. At RNH Hospital, we perform cataract surgery by taking a microunioun (2mm) and phacoemulsifying the nucleus .it is an incredibly delicate procedure requiring lots of skill

There are numerous types of IOL (Intraocular lens) option that we use to replace the original one.

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Monofocal lens

It is a lens beneficial for distance version and will require the patient to wear spectacles for computer work and reading.

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Premium monofocal IOL

It’s a aspheric lens with high definition providing both quantity as well as great quality of vision. It has good contrast and light sensitivity and gives great picture quality. Yet the patient has to wear glasses after surgery because it still is a monofocal lens .

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Multifocal Lens

for most day to day activities this lens provides comfortable vision for both distance and near without the need for corrective glasses. Some patients may experience halos and glare during night driving.

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Newer Multifocal IOL

These lenses provide extended depth of focus and provide good vision for distance reading and intermediate work ( complete work ).

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Newer Multifocal IOL

These lenses provide extended depth of focus and provide good vision for distance reading and intermediate work ( complete work ).

LASIK AND REFRACTIVE SURGERY

LASIK AND REFRACTIVE SURGERY

To correct myopia, hypermetropia and Astigmatism

To understand lasik we need to first understand how our eyes work.

Cornea bends the rays of light inwards and this light then gets fine focused by the lens to fall on retina from where optic nerve takes all the signals to the train .If the eye ball is longer or shorter than normally a person needs to wear glasses or contact lenses to help focus the light on the retina. We cannot change the length of the eyeball but we can surely remove glasses by working on cornea or on the lens. The process by which shape of the cornea is remodeled is called LASIK.

LASEK

Cornea has 5 layers and to perform a spectacle removal surgery we need to remove the top layer and laser the underlying tissue.

Cornea has 5 layers and to perform a spectacle removal surgery we need to remove the top layer and laser the underlying tissue.

In PRK, the thin outer layer of the cornea is removed and discarded. Underlying corneal tissue is reshaped using excimer laser, new epithelium grows back over the corneal surface within a few days after surgery. When epithelium is lifted using a surgical instrument called trephine preserving and replacing it at the end of the procedure it is called LASEK.

Trans PRK

Trans PRK

Is a new one step incision free procedure.

The same laser beam removes the epithelium and also treats the underlying corneal tissue. Clear contact lens is used to reduce discomfort during the healing of the epithelium.

Advantages of Trans PRK

  • No incision or flap created in the cornea.
  • No touch - all laser.
  • Removes epithelium more preciously and early than manual PRK.
  • Wound surface – usually smaller, so it heals quickly.
  • Epithilium and stroma can be removed at the same time with great accuracy.
  • Overall treatment time is shortened..

Advantages of Trans PRK

This compact excimer laser from the technology leader has 500Hz Repetition rate , 0.34 mm laser spot and 5D eye tracking system. The Schwind Amaris 500E is a fast and efficient precise eye laser system for refractive and therapeutic corneal surgery.

Schwind Sirius 2 in 1 topography and pachymetry gives exact corneal thickness and wave front data in a single step.

  • At least 18 year of age.
  • Have healthy eyes that are free from any eye disease or corneal abnormalities leg scar, infection.
  • All other parameters in the eye being reasonably normal.
  • Normal pre operative refractive surgery tests.
  • Should not have any connective tissue disease (Rheumatoid arthritis ) , autoimmune (SLE) and AIDS.
  • Should not be pregnant or nursing mother.

Procedure :

Please remember that of you are a contact lens wearer, you have to discontinue your contact lenses at least 2 weeks prior to your Lasik appointment ( as the contact lens can alter the shape of the cornea ) during this period you can wear spectacles.

As part of Lasik workup, your eyes will be dilated for retina examination which will cause your vision to be slightly blurred and you may not be in a position self drive.

Treatment is planned as per persons needs, age and glass power to give precise results.

  • Anesthetic drops are installed on the eye
  • Your eyes will be positioned under the laser and lid speculum is used to keep the eyelid open
  • Based on the type and refractive procedure, surgeon will create the flap or the bed for the refractive procedure.
  • You will be asked to look at the target light for a short while as the laser sends pulses of light to your cornea
  • You will also hear a sound while the laser is operating. Lasik will be performed on each eye separately at the same setting.
  • After the procedure is done, the surgeon will take a look at your eyes on the slit lamp
  • Post lasix instruction will be given
  • After resting for a short period of time, you will be able to go home.

Follow up

Patient will be received on the next day following the procedure. in lasix bcl is removed on the 1st post operative day and hans prk is removed after 4-5 days.

  • Meld to moderate tearing is expected after the procedure
  • A sense of foreign body sensation and creations are common
  • Small red spots on the white surface of the eye occasionally appear.
  • Sensitivity to bright light (corneal haze on the day of the procedure).
  • Investigation of eye drops as per instructions
  • Do not touch or rub the eyes
  • Do not take head bath on splash water in to the eye for swipes
  • Do not clean the eye on the day of surgery
  • Do not clean the eye on the day of surgery
  • Do not use eye cosmetics for one month
  • Avoid exercise for 1 week
  • Avoid self driving for 1 week
  • There is a possibility that you may still need spectacles or contact lenses to attain good vision following treatment
  • Patient may have light sensitivity, halos, dryness and glare after treatment
  • Very rarely severe complications during or after corneal refractive surgery ( eg. flap problems, infections) can result and may need extensive treatment.

Spectacles and contact lenses are the most common method of correcting refractive errors. The other option to correct your vision is ICL (Implantable contact lens)

Glucoma treatment

Glucoma treatment

Of all the conditions prevailing in human eye, glucoma is the most threatening one. It is also known as kala motia or as a silent thief of vision. Clinically it is a slow manifesting disease distinguished by damage to the optic nerve caused due to loss of retinal gnaglion cells.

Common symptoms

  • Slow degradation of side vision
  • Headache accompanied by redness and pain in the eyes
  • Rapidly changing glass prescription
  • Reduced vision in low light conditions or at night
  • Seeing colorful halo rings after coming in to the light from darkness
  • Any one can have this decease, but few people are more susceptible to it
  • Age > 40 years.
  • A having travlling,mygraneand hypertension
  • A having travlling,mygraneand hypertension

Types of glucoma

primary open angle glaucoma

Angle closure glaucoma

Secondary glaucoma

Reverse shoulder Replacement

Traumatic glaucoma

Reverse shoulder Replacement

Psudoexfocal glaucoma

Glaucoma Treatment.

The damage done by glaucoma cannot be reversed. However timely intervention can prevent further progress. Treatment aims at covery iop, so that no more damage can take place, using medicaton, laser and surgery.

  • OCCULAR SURFACE AND DRY EYE DISORDER
  • CONTACT LENSES
  • SIMPLE SQUINT PROCEDURES
  • ENDOSCOPIC DCR
  • OCCULOPLASTY