Our process starts with a detailed recording of Case history – Details about the patients general health, medications, his work environment and vision problems he may be experiencing. Any patient who walks in at Anand eye hospital with any kind of problem has to undergo a comprehensive eye check-up to help the doctor understand the patient’s total eye anatomy and history and solve the case with more clarity and confidence. We are equipped with the latest technologies for an accurate and comprehensive eye checkup to ensure the best for the patient.
Vision tests
Using a visual acuity chart and a reading card, our eye specialist will assess the patient’s ability to see small details clearly at both near and far distances. Any refractive errors will be detected and corrective measures will be suggested using a combination of lenses. Eye specialist will systematically change the lens combination until a clear focus is obtained.
Eye movement
Using a number of tests, the eye doctor will evaluate how well your eyes align or coordinate when working together and individually.
Slit lamp examination
The front portion of the eye is examined in detail using a special instrument called slit lamp.
Intraocular pressure measurement
It is a process to measure the pressure in the eye and is an important test in detecting glaucoma
Dilated examination
Will be administered dilating drops to see the back portion of the eye (retina) using the indirect ophthalmoscope and 90D.
Other tests may be undertaken to evaluate your ability to change focus, see colour correctly, or perceive depth correctly.
Understanding Cataract
Cataract is the Opacification of the Natural Lens inside the eye.
The lens that is responsible for normal vision gets naturally clouded due to a change in structure of the protein which makes up the lens of the eye impairing eyesight. This ‘clouding’ occurs in the area of the eye that is normally clear, preventing light rays from passing through the lens to the the retina that is situated in the back of eye and normally responsible for reflecting the light providing vision. The outcome of a clouding of the natural intraocular crystalline lens that prevents this focus of the light towards the eye and reflecting onto the retina is cataract. Some symptoms include blurry vision, seeing double/multiple images, increased sensitivity to light/colours and impaired night vision. This clouding is often neglected in cases where symptoms go unnoticed and even lead to permanent blindness.
The Cause of cataracts
- Aging
- Long-term exposure to sunlight
- Cigarette Smoking
- Steroids medication taken in any form for long duration
- Eye Injury
- Congenital Cataract
How do people know when they have a cataract?
- Blurry distance vision, especially outdoors.
- Print appearing faced and lacking in contrast.
- Colors appearing faded or changed in hue. Blue may appear to be green and yellow may look white.
- Worsening of vision in dim light and an increasing need for more light to see clearly.
- Only on ophthalmologist can detect a person’s initial condition of cataracts.
How are cataracts treated?
- There are no medications to prevent or cure cataracts.
- Surgery is the only effective cure and it is safe.
Cataract ( Phaco) Surgery a simple explanation
- A 2 to 3 mm incision /opening is made at the cornea
- A special probe is passed through the 2 to 3 mm opening
- Cataractous lens is broken down into small fragments and sucked out of the eye.
- The cataractous lens is replaced by an artificial intra ocular lens (IOL).
- The incision / opening will heal by its own. No need for Stitches.
How Can I choose the Right Lens for me?
Aspheric Lens
Enjoy the clarity distant vision with Aspheric IOL.
- Aspheric lens improves the contrast sensitivity and good night vision.
- Gives improved vision then a normal lens.
Toric Lens
Toric lens correct the pre existing corneal astigmatism there by reducing the possibility of spectacle wear for distant vision post operatively.
Multifocal Lens
- These IOLs provide clear vision for all distances hence almost 90% of the day-to day activities can be performed without the need for additional glasses.
- Rarely the patient may experience glare during nights post operatively but usually gets adapted within a few months.
Steps to Get Ready for Before Cataract Surgery
Comprehensive Eye Checkup
Counselling
Optical Biometry (AL-Scan) Intra Ocular lens power calculation
ECG
Blood Test
Physician Opinion
Consent Sign
Medication before Surgery
Fix Date for Surgery
Can you compromise on cataract treatment?
Today Cataract surgery is performed with greater precision and quality than ever before, restoring vision. A complete and accurate vision is necessary for our life.
So don’t compromise on cataract/package treatment.
Refractive Surgery
Refractive surgery is a way to correct the errors and impairments caused to the eye due to its poor refractive ability thus enabling the focus light correctly on the retina to be able to see more clearly.
Photorefractive keratectomy
Photorefractive keratectomy (PRK) is a procedure intended to correct a person’s vision using laser to surgically remove the corneal stroma and correct refractive errors such as myopia ,hypermetropia and astigmatism. It can correct Myopia up to -8 diopter (D), astigmatism up to 6 D, and hyperopia up to 5 D.
The first step of PRK requires removal of the superficial corneal epithelium down to Bowman’s layer which in layman’s terms is to change the shape of the cornea permanently. The excimer laser then ablates the stroma, thereby remodelling the corneal surface. The goal of PRK is to improve your vision and reduce dependancy on eyeglasses or contact lenses.
LASIK
Laser Assisted Insitu Keratomileusis
The ophthalmologist uses a laser to change the shape of your cornea. This laser eye surgery improves the way light rays are focused on the retina. LASIK is used to treat myopia (nearsightedness), hyperopia (farsightedness) and astigmatism.
The goal of LASIK is to correct your refractive error to improve your vision.
Femotosecond Laser or bladeless LASIK
Femtosecond laser is a precise ,cutting edge tool that can make corneal surgery accurate and safe. A one of a kind in lasers that emits optical pulses in the domain of femtoseconds ie very short durations – ultrashort pulses. Two types of lasers are used in the procedure that focus the energy on a limited time scale in a single laser pulse achieving multiple light projected emissions. One ensures making a corneal flap with the femtosecond laser as a first step followed by excimer laser correction below the flap as the next step. It can correct up to -8 diopter (D), astigmatism up to 4 D, and hyperopia up to 5 D.
A unique advantage of this technology as seen in industry standards of quality control is to reduce the thermal damage to the material when used. Achieving an effective pulse emission is a short time span ensures a directed to the focal point target with minimal heat dissipation to the surrounding area reducing any post operational hazards.
SMILE
Small incision lenticule extraction (SMILE) is a relatively new refractive procedure designed to treat refractive errors such as myopia, hyperopia, presbyopia, and astigmatism. An FDA approved laser vision correction procedure dedicated to treat near sightedness with up to 3D of astigmatism.The procedure involves using a femtosecond laser to create a corneal lenticule which is extracted as a whole through a small incision without the use of an excimer laser.The SMILE procedure seems to be a promising alternative to LASIK in some cases due to its minimally invasive technique and promising outcomes.
What are Phakic Intraocular Lenses?
Phakic lenses, are lenses made of Collamar, Hydrophillic Acrylic or silicone that are implanted into the eye permanently to reduce a person’s need for glasses or contact lenses particularly in cases of near sightedness. Another technology advancement, Phakic lenses expand the range of refractive surgeries to cover higher degrees of myopia, hyperopia and astigmatism which was not possible earlier. The term Phakic means “ having a lens”, involves implanting the lens into the eye without removing the eye’s natural lens. The principal indication for use of phakic IOLs is the correction of myopia or myopic astigmatism beyond the range of LASIK correction (ie, generally for myopic errors of -8.00 D or greater).
Diabetic retinopathy and Anti VEGF
Diabetes cause damage to blood vessels in the retina and is a leading vascular associated cause of blindness throughout the world. These blood vessels can swell and leak or can even close, stopping blood from passing through. In some cases as an abnormality, new blood vessels grow on the retina.This damage, a long standing consequence of diabetes mellitus is called diabetic retinopathy. It can lead to poor vision and if left untreated can cause blindness and remains to occupy a significant position in the socio economic cost for healthcare systems worldwide.
Predominantly a disease of the retina, but due to this leak of blood in an asymptotic and irregular fashion -vacular and ischemic changes can be found in other parts of the eye aggravating the damage. In recent years anti VEGF – have emerged as front runners in treatment for diabetic retinopathy by stunting and slowing the production of new blood vessels. VEGF- Vascular endothelial growth factor is a protein produced by cells in your body and produces new blood vessels when your body needs them. In conditions like Diabetes mellitus, this overgrowth of blood vessels can obstruct the functionality of the eyes progressing from low vision to blindness if left unattended. Anti VEGF are a group of biomaterials injected into the eye over a cycle prescribed by the doctor to slow the growth of these blood vessels and control the leakage of blood. It is an invasive procedure and can have side effects.
VEGF is an important factor in the development of Diabetic retinopathy. Anti- VEGF medicines such as Avastin, Lucentis prevents damage to the retinal light receptors and loss of central vision. These medicines are effective in preventing further central vision loss in up to 90% of treated eyes.
What is Glaucoma?
Glaucoma “ a silent thief of sight” is an eye disease where the eyes optic nerve is damaged. It is one of the leading causes of blindness. Once Vision is lost, It Cannot be regained.
The visual field test produces a computer printout of the light thresholds that the patient’s eyes were able to perceive and process .The darkest areas of the test indicate a complete loss of vision in that area. The lighter the area, the more vision the patient has in that part of the eye. Visual field testing can help the eye care provider help detect early signs glaucoma. Some symptoms of a glaucoma attack include severe headache, nausea, eye pain with sudden episodes of blurred eyesight. You tend to vomit more often and start to see halo’s or rings under bright light.
Risk Factors
- Genetic Factors : Family History
- Aging : Above 40
- Eye Trauma
- Severe Myopia
- Ocular Surgery
- Migraine Headache
- Prolonged Use of Corticosteroid
Types of Glaucoma
There are two main types of Glaucoma
- Primary open angle glaucoma : The intra ocular eye pressure rises because the correct amount of fluid can’t drain out of the eye
- Primary Angle closure Glaucoma : Acute angle closure glaucoma completely blocks your canals. It stops fluid from flowing through them, kind of like a piece of paper sliding over a sink drain.
Symptoms of Glaucoma
- Mild Pain in the eyes
- Headache
- Increased IOP – More than 21mmhg
- Loss of Peripheral / Side Vision
- Reduced Vision at night
- Pain and Redness in Eyes
- Blurred / Decreased Vision
- Nausea
- Vomitting
Glaucoma Evaluation
History Collection
Tonometry – To Measure IOP
Pachy – To Measure Central corneal Thickness
Slit Lamp- Examination
Visual Field Test- To Detect Loss of Side/ Peripheral vision
Fundus Photography – To Monitor the Disc Changes
OCT- To Access the thickness of nerve fiber layer
Management of Glaucoma
Management measures mainly include
Medical Management – Eye Drops
Management measures mainly include
Surgical management – Trabeculectomy
Refractive Errors
- Refractive errors are the most common eye disorders and not a disease.
- A refractive error means that the shape of the human eyes do not refract the light rays correctly on the retina resulting blurred vision.
Common symptom of Refractive Error
- Rubbing of eye
- Head Tilt posture to see the object
- Shrinking the eye to see object
- Eye become lazy
- Going closer to see TV
Emmetropia
A person with Normal Vision , Can Focuses the light on the retina, It converts the light into the image that you see .
Ametropia
A person with refractive error , Their eyes are unable to focus the light on the retina (i.e., light rays focus either in front of or behind the retina) . This results in Blurring of vision
Types of refractive Error
There are four most common types :
- Myopia (Short-Sight)
- Hyperopia (Long-Sight)
- Astigmatism
- Presbyopia
Myopia
When our eyeball are longer than normal, the rays are focused before the retina.
Symptoms of Myopia
Close objects look clear, but distant objects are blurry.
Treatment
- Myopia Corrected by Minus power spectacles.
Hyperopia
When our eyes are slightly narrow ,the rays get focussed behind the retina
Symptoms of Hyperopia
- Distant objects look clear, while nearby objects look blurry.
- In extreme cases, objects are blurry at any distance.
Treatment
- Myopia Corrected by Plus Power Spectacles
Astigmatism
In astigmatism, light rays do not refract (or bend) properly as they enter the front of the eye. Vision is blurry at near and far because light rays either fall short of the retina or behind it.
Symptoms of Astigmatism
- Both Distance and Near Vision are unclear slightly.
Treatment
- Astigmatism Corrected by Cylinder Power ( Both Plus and Minus Lenses).
Presbyopia
Above 40 yrs ,Near by Objects are generally appear blurred .
Dry Eye Syndrome
Our eyes need tears to stay healthy and comfortable. If it does not produce enough tears then that condition is called Dry Eyes.
What are the symptoms of dry eye?
- Burning Sensation
- Scratchy feeling
- Dryness sensation
- Red eyes
- Heavy eyes
- Fatigued eyes
- Blurry eyes
- Photophobia
What are the cuases of Dry Eyes?
- Prolonged contact lens users
- Arthririts
- Sun exposure
- Dry environment
- Smoking
- Hormonal Factors
- Prolonged Screen Time
- After LASIK Eye surgery
HOW TO CURE MY DRY EYES ???
- Eye drops
- Limit screen Time
- Warm compress
- Eye massage
- Clean Eyes
- Better sleeping
- Drink water
- Humidifier
- Avoid Smoking
Can I do anything to prevent or protect my eyes from dryness? Yes – We must adhere to the 20-20-20 rule
Every 20 Minutes Of Screen time….Take a 20 Seconds Break….
and focus your eyes on something at least 20 feet away….
Optical Services
- Dispensing of Single Vision Lenses, Bifocal Lenses and Progressive Addition Lenses.
- Dispensing of Glass or Plastic Lenses
- Dispensing lenses with tint, anti reflection coating, hard coat
- Dispensing of frames and reading glasses
- Dispensing of high index lenses for higher powers
Value Added Services
- Optical services are available in the ground floor near the reception area
- We have good collection all varieties of frames for all categories
- Finished spectacles are sent by courier to out station patients.
Retina Services
What is Retina?
In order to enjoy this colourful world, the light from the object passes through the cornea ,lens and focuses in the light sensitive layer of the retina. This light is transmitted to the brain by the optic nerve and perceived as an image.
Common Symptoms of Retinal Diseases
- Seeing floating
- Blurred or distorted vision in which straight lines can look wavy
- Defects in the side vision
- Vision loss
- Dark or empty areas in your vision
Risk factors for retinal diseases
- Ageing
- Smoking
- Obesity
- Uncontrolled Diabetes
- Kidney Disease
- Increased Cholesterol
- Low haemoglobin
Most Common types of Retinal Diseases
- Retinal tear
- Retinal Detachment
- Diabetic Retinopathy
- Epiretinal membrane
- Macular hole
- Age Related Macular degeneration
- Retinitis pigmentosa
Are you aware of Diabetic Retinopathy ?
Diabetic retinopathy and Anti VEGF
Diabetes cause damage to blood vessels in the retina and is a leading vascular associated cause of blindness throughout the world. These blood vessels can swell and leak or can even close, stopping blood from passing through. In some cases as an abnormality, new blood vessels grow on the retina.This damage, a long standing consequence of diabetes mellitus is called diabetic retinopathy. It can lead to poor vision and if left untreated can cause blindness and remains to occupy a significant position in the socio economic cost for healthcare systems worldwide.
Predominantly a disease of the retina, but due to this leak of blood in an asymptotic and irregular fashion -vacular and ischemic changes can be found in other parts of the eye aggravating the damage. In recent years anti VEGF – have emerged as front runners in treatment for diabetic retinopathy by stunting and slowing the production of new blood vessels. VEGF- Vascular endothelial growth factor is a protein produced by cells in your body and produces new blood vessels when your body needs them. In conditions like Diabetes mellitus, this overgrowth of blood vessels can obstruct the functionality of the eyes progressing from low vision to blindness if left unattended. Anti VEGF are a group of biomaterials injected into the eye over a cycle prescribed by the doctor to slow the growth of these blood vessels and control the leakage of blood. It is an invasive procedure and can have side effects.
VEGF is an important factor in the development of Diabetic retinopathy. Anti- VEGF medicines such as Avastin, Lucentis prevents damage to the retinal light receptors and loss of central vision. These medicines are effective in preventing further central vision loss in up to 90% of treated eyes.
Diagnosis for retinal diseases
Vision Test
Colour Vision
Slit Lamp Examination
Fundus Photo
Treated by – Medical Management
Laser Treatment
Intra Vitreal Injection
Retina – Vitreous Surgery
