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What Is Refractive
Surgery?
It is the surgery, which is done to correct the
refractive errors like Myopia, Hypermetropia, Astigmatism or Presbyopia.
Why Do We Get
Refractive Errors?
Refractive errors are due to changes in the length or
curvature of the eyeball. It may be:
- Myopia (near-sightedness) when the patient can see for near
but not for far. This is corrected by minus powered glasses or contact lenses.
- Hypermetropia (long sightedness): The patient requires a
plus power for correction both for far and near vision.
- Astigmatism: (Cylindrical): In this, the light is focused
only in one meridian. The corrective spectacles or lenses are usually required
for constant use.
When Do We Get Refractive Errors?
Usually refractive errors arise during school years, between
6-18 years. In a rare case, one may be born with an error.
How Are Refractive
Errors Treated?
Refractive errors may be treated with Spectacles, Contact
lenses or Refractive surgery.
What Are The Surgeries
Available To Remove Spectacles Or Contact Lenses?
- Laser Vision Correction: LASIK
- Implantable Collamer Lens (ICL)/ Phakic IOL
- Phaco with Multifocal IOL
What Is Lasik?
LASIK (Laser Assisted In-Situ Keratomileusis) is a surgical
procedure that can benefit patients with near-sightedness, farsightedness, and
astigmatism by reducing dependence on spectacles and contact lenses. The
procedure involves permanently reshaping the cornea (the transparent part of
the eye in front) with Excimer laser.
How Is Lasik Done?
During LASIK, the eye surgeon creates a thin surface flap of
the cornea, exposing the underlying tissues (stromal bed) to which the Excimer
laser beam is applied to reshape the cornea and change its power. Once the laser
ablation is completed, the surgeon gently replaces the corneal surface flap.
What Are The Risks And
Side Effects Of The Procedure?
LASIK is a relatively safe procedure with very low chances of
complications. Most of the complications are minor and include over or under
correction, temporary development of red spots over the eye, dry eyes,
decreased contrast sensitivity and glare. The patients are carefully screened
before the surgery to exclude patients who have more than normal chances of
developing complications.
Am I A Candidate For LASIK?
Yes you are if
- You are above 19 years of age
- Your refractive error (power of glasses) has been stable for
6 months
- The power of your glasses is:
1.Myopia more than -1.5D
2.Hypermetropia more than +1D
3.Astigmatism more than +/- 1D
How Do I Know Lasik Is
Safe For Me?
All potential LASIK candidates are screened for risk factors
and suitability for the procedure. The LASIK work-up entails a thorough eye
examination especially the cornea for corneal thickness (Pachymetry) and
corneal shape (Topography), the eye pressure and the retina. Patients who are
found unfit are then counseled for other modalities such as PRK, ICL etc.
What Happens During
The Procedure?
The lasik eye surgery procedure is typically performed under
topical (eye drop) anesthesia. During the surgery you will be asked to lie down
on the operating table and focus on a light above. The entire LASIK procedure
lasts only 20 minutes and the laser delivery itself takes less than a minute.
You can return home a few hours after the surgery and go back to work after one
to three days.
How To Prepare For The
Procedure?
You will be asked to undergo a few tests for evaluation of
your fitness for the procedure which requires a period of one week. Also:
- Discontinue using contact lenses 1 to 2 weeks before the
investigations
- Inform your doctor about medical problems and allergies
- Arrange for someone to drive you home on the day of surgery.
Bring along a pair of dark glasses for use after the procedure.
What Is Wavefront Or Customized Lasik?
CustomVue LASIK is a new innovation in LASIK surgery which
allows the procedure to be customised to each particular patient. While routine
LASIK corrects the refractive error Wavefront LASIK also attempts to correct
finer irregularities in the eye. Correction of these finer irregularities means
a better quality of vision with reduced symptoms of glare, haloes, ghost images
and improved contrast sensitivity.
What
Is An Implantable Collamer Lens?
Implantable Collamer lens is a special lens that is inserted
into the eye to correct the refractive error. This eliminates the need for
spectacles and contact lenses and unlike contact lenses, does not require to be
applied and removed.
How Is ICL Different From A Contact Lens?
The ICL is made from CollamerT, a hydrophilic, collagen
copolymer. This is a highly specialised material which ensures that the lens is
thin enough and inert enough to not create any disturbance to the other
structures of the eye. Since it is placed inside the eye, this is a onetime
procedure and there is no daily application and removal, no need for any
special care as it is with contact lenses.
Who are the candidates for ICL?
You are a candidate for ICL if
- You are above 19 years of age
- Your refractive error (power of glasses) has been stable for
6 months.
- The power of your glasses is
1. Myopia more than -3D upto 20D
2. Hypermetropia more than +2D to + 10D
3. Astigmatism upto + 4D
- Or, even if you are unfit for LASIK due to abnormal corneal
curvature or thin cornea.
How Does One Prepare For The Procedure?
First a complete evaluation is done to determine suitability.
Once the patient has been found suitable, a preparatory Laser iridotomy needs
to be done. The actual procedure of ICL insertion can be then scheduled after
one week.
What Does Laser
Iridotomy Entail?
In this, a small opening is created in the iris by using YAG
laser. This is an OPD procedure and takes 10-15mins. Eyedrops are then
prescribed for a week. This procedure should be done at least 1 week before the
ICL implantation.
Is The Procedure Of
ICL Implantation Painful?
No, it is not. This procedure is done in the operation
theatre, under topical anaesthesia. Eye drops are applied to anaesthetise the
eye, a micro-incision is made in the cornea and then the lens is inserted. The
procedure takes around 10 minutes.
Are Both Eyes Done
Together?
Usually both eyes are not done on the same day. There is a
gap of one or two days or even more depending on the patient.
Is ICL, A Risky Procedure?
We take a lot of precautions to ensure that it is not risky.
The ICL is custom made for the patient taking all the specific parameters into
consideration. It is made of very fine quality, ensuring that it doesn't cause
irritation to any of the other parts of the eye. Iridotmy is done in all cases
to prevent pupillary block and glaucoma. In the remote case of the ICL not
suiting or causing reaction in the eye, it can be taken out very easily.
What Is Cataract
(Safed Motiabind)?
Cataract is a clouding of the natural lens of the eye. This
prevents the passage of the light and makes everything look blurred and hazy.
Who Gets Cataract?
Cataract is usually a disease of old age, but anyone can get
it, especially after trauma or along with some other disease. Sometimes
children may be born with a cataract (congenital cataract) or it may present in
adolescence or early adulthood (developmental cataract).
What Are The Symptoms Of Cataract?
Cataract can lead to decreased vision, glare, double vision,
altered colour perception, haloes around lights and decreased contrast
sensitivity. Cataract rarely causes pain or redness unless there is a
complication.
Is Cataract Treatable?
Yes, Cataract is treatable by surgery. There is no known
medical treatment for cataract.
When Should Cataract Be Treated?
In the early stages, the vision can be improved by a change
in glasses. Anytime the patient feels that glasses are no longer adequate and
feels hampered in their activities, surgery can be undertaken. Maturity of
cataract is NOT a criterion. One should not wait for it to "ripen"!!
Does Waiting Too Long
Cause Any Problem?
Yes, the longer we wait, the cataract becomes mature and
hardens. This makes the surgery more difficult later on. Also mature cataract
can lead to secondary conditions like glaucoma, inflammation etc.
What Are The Surgical
Options?
Surgical Options are: Extra capsular Cataract Extraction
(ECCE) or Phacoemulsification (Without Stitches) known as cataract surgery.
What Is
Phacoemulsification?
Phacoemulsification or Phaco is the most advanced technique
of cataract extraction. In this method, the procedure is performed through a
very small incision (2-3mm). The instrument uses ultrasound vibrations to break
the cataract into small pieces and with the help of vacuum all the pieces of
the cataract are sucked out. A new lens, which is an intra-ocular lens (IOLs)
is inserted into the eye. The surgery is completed without any stitches. This
minimal incision allows faster and safer healing, hastening the return to
normal activity.
What Are The
Post-Operative Care Is Required?
Since this is a sutureless operation, there are very few
restrictions after the surgery. There is no need for bandages, green shades,
dark glasses etc. There are no restrictions on bathing, eating and other
activities. Eye drops are prescribed which need to be applied for 4-6 weeks.
What Is Intra Ocular
Lens (IOL)?
Intraocular lenses (IOLs) are different from contact lenses.
During Phaco surgery, the IOL of appropriate power fitted inside the eye. The
foldable IOLs can be inserted through very small. These are made of high
quality material. They unfold in the eye and are permanent and Lifelong.
What Are The Types Of IOLs?
- Non-Foldable & Foldable
- Aberration Free Aspheric IOL Foldable.
- Multifocal IOLs: Lens for both distance & near
- Toric IOLs: To correct preexisting cylindrical number
Is The Procedure
Painful?
No, most of the cases can be done under topical anaesthesia.
In this, eye drops are instilled to anaesthetise the eye and the procedure is
done. Sometimes, if the patient is unable to co-operate or the cataract is
mature/hard an injection might be needed to anaesthetise the eye.
What Are The
Advantages Of Phacoemulsification?
Since this is a minimally invasive surgery, the healing is
very fast and thus there is almost immediate rehabilitation. There are no
stitches, so no pain or irritation. There are no restrictions and the patient
can quickly return to a normal life.
Vitro Retinal Services
At Artemis:
Digital Fluorescein Angiography, Green Laser Retinal Photocoagulation,
Laser Indirect Ophthalmoscopy, Retinal Detachment Surgery, Vitreoretinal
Surgery, Diabetic Retina Care, Diabetic Retinopathy
I Have Diabetes, How
Does It Affect My Eyes?
People with diabetes may suffer from various eye related
complications of diabetes which can cause severe vision loss or even blindness.
Diabetic eye disease includes:
- Diabetic retinopathy – This is most important eye
complication of diabetes and results due to damage to the blood vessels in the
retina.
- Cataract - Clouding of the eye's lens which occurs at an
earlier age in diabetic patients.
- Glaucoma - Increase in fluid pressure inside the eye that
damages the optic nerve causing loss of vision. A person with diabetes is twice
as likely to get glaucoma as other adults.
What Is Diabetic
Retinopathy?
Diabetic retinopathy is a complication of diabetes that
results from damage to the blood vessels of the light-sensitive tissue at the
back of the eye (retina). If untreated, it may lead to blindness but if
diagnosed and treated promptly, blindness is usually preventable.
Who Is At Risk For
Diabetic Retinopathy?
All people with diabetes (both type 1 and type 2) are at risk
for diabetic retinopathy. The risk is highest if the person has poorly
controlled blood sugar, high blood pressure, high cholesterol, pregnancy or
habit of smoking.
Up to 45% of adults diagnosed with diabetes have some degree
of diabetic retinopathy and the longer you have diabetes, the more likely you
are to have it.
What are the stages of diabetic retinopathy and how does it
cause visual loss?
Nonproliferative diabetic retinopathy (NPDR) is the earliest
stage and the most common type of diabetic retinopathy. During this stage, the
blood vessels become weak and balloon like (microaneurysms). As the disease progresses,
some of the blood vessels become leaky or get blocked depriving the retina of
important nourishment.
Damaged blood vessels can leak fluid into the most essential
central part of the retina (macula) causing it to swell, blurring vision. This
condition called macular edema can occur at any stage of diabetic retinopathy,
although it is more likely to occur as the disease progresses.
PDR:
Proliferative Retinopathy (PDR) is the advanced stage when
abnormal fragile blood vessels start forming on the retina. These fragile
vessels can bleed inside the eye (vitreous hemorrhage) and even pull the retina
out of its normal position (Tractional retinal detachment) causing severe
vision loss.
What Are The Symptoms Of Diabetic Retinopathy?
Symptoms are unusual in the early stages of the disease and
often appear in the late stages without warning signs. It is therefore
important NOT to wait for symptoms for an eye exam. A comprehensive eye test is
a MUST for all diabetic patients at least once a year.
Later in the disease, diabetic retinopathy symptoms may
include
- spots floating in vision,
- blurred vision,
- dark streaks or a red film that blocks the vision,
- poor night vision
- vision loss.
I Have Diabetes. What
Should I Do?
Early detection of diabetic retinopathy is the key to prevent
severe vision loss. If you have diabetes, see your eye doctor for an yearly
dilated eye exam even if there are no symptoms. Your doctor may ask for more
frequent checkups in case of you have more advanced disease. If you become pregnant,
you may require additional eye exams throughout your pregnancy. Contact your
eye doctor immediately if you have sudden vision changes or your vision becomes
blurry, spotty or hazy.
What To Expect During A Test For Diabetic Retinopathy?
Diabetic retinopathy is best diagnosed with a dilated eye
exam. During the exam, your eye doctor will first dilate your pupils with eye
drops which may cause blurring of your close-up vision for several hours. Make
sure you have somebody to take you back home as you won’t be able to drive for
a few hours. Your eye doctor uses a special magnifying lens to examine the
inside of your eye for signs of damage. If your eye doctor finds features of
retinopathy, he or she may suggest Fluorescein Angiography for further evaluation.
What Is Fluorescein
Angiography?
Normal
Angiography:
It is a test to pinpoint blood vessels that are closed,
broken down or leaking fluid. In this test, a special dye is injected into your
arm and multiple digital
Angiography with severe diabetic changes
photographs of your retina are taken. The test allows your
eye doctor to plan further management of your disease.
My Doctor Tells Me
That I Need Laser Treatment. What Does It Mean?
Laser treatment is required when the eye has macular edema or
PDR. You will be asked to sit facing the laser machine and a special lens is
applied to your eye. During the procedure, you may see flashes of light. The
laser procedure causes only minimal discomfort and is over in 10 to 15 minutes.
After Laser Will My
Vision Be Restored?
Laser treatment stabilizes vision and reduces the risk of
vision loss by 50 percent. It may not be able to restore vision completely,
hence the need for screening and early treatment.
What Are The Types Of Laser Treatment?
•Focal laser spots
•For macular edema the laser treatment involves placing few
hundred small laser burns around the macula. More than one treatment may be
required to control the leakage
•For PDR 1,000 to 2,000 laser burns are applied in the retina
away from the macula. Two or more sessions may be required due to the large
number of spots
What Are The Side
Effects Of Laser Treatment?
Side effects of laser treatment can include some loss of your
side vision and reduction of color and night vision but it can save the rest of
your sight.
What Is Anti-VEGE
Therapy For Diabetic Retinopathy?
VEGF is a protein in the eye which has been found to play a
central role in the development of diabetic retinopathy. Anti-VEGF therapy
refers to the use of drugs to specifically inhibit this protein to control
diabetic retinopathy. Few drugs such as bevacizumab, pegaptanib and ranibizumab
are now available which can be used for this purpose. These drugs need to be
given as an injection in the center of the eye (intravitreal injection). In some
patients, the injections may need to be repeated at regular intervals.
When Is Surgery
Required For Patients With Diabetic Eye Disease?
Surgery may be required in advanced cases with vitreous
hemorrhage and/or tractional retinal detachment.
How Do I Prevent
Diabetic Retinopathy?
•Monitor and control your blood sugar tightly. Keeping blood
sugar levels close to normal slows the progression of disease and reduces the
need for laser or surgery.
•Keep your blood pressure and cholesterol under control.
•Stop smoking or the use of other forms of tobacco.
•Yearly dilated eye exams are absolutely essential as early
warning signs are typically absent. You can have the most severe forms of DR
and still have no symptoms.
•Contact your eye doctor immediately if you notice sudden
vision changes or your vision becomes blurry, spotty or hazy.
Oculoplasty:
•Ptosis ( Drooping eyelid)
•Dacryo-cysto Rhinostomy ( DCR)
•Eyelid malpositions ( Entropion, Ectropion)
Orbital Surgery:
•Repair of blow-out fractures of the orbit
•Orbitotomy: for biopsy/tumour removal
•Decompression of orbit for Thyroid Eye Disease
Discover Comprehensive Eye Care at Artemis Hospitals, Gurugram!
At Artemis Hospitals, we understand the importance of clear vision and exceptional eye health. Our team of renowned ophthalmologists and dedicated eye specialists is committed to providing comprehensive eye care services that cater to your unique needs.
From routine eye tests to advanced cataract surgeries, our state-of-the-art eye hospital is equipped with cutting-edge technology to deliver precise diagnoses and effective treatments. Whether you're seeking preventive care or require specialized interventions, our experts provide personalized solutions to ensure optimal eye health.
Cataract, a common vision problem, can significantly impact your daily life. Rest assured, our skilled surgeons perform advanced cataract surgeries with utmost precision, using the latest techniques and premium intraocular lenses. Regain crystal-clear vision and enhance your quality of life with our exceptional cataract surgery services.
Team Of Specialists:
