Retinal Detachment

What is a retinal detachment?

A retinal detachment is a separation of the retina from its attachments to its underlying tissue within the eye. Most retinal detachments are a result of a retinal break, hole, or tear. These retinal breaks may occur when the vitreous gel pulls loose or separates from its attachment to the retina, usually in the peripheral parts of the retina. The vitreous is a clear gel that fills 2/3 of the inside of the eye and occupies the space in front of the retina. As the vitreous gel pulls loose, it will sometimes exert traction on the retina, and if the retina is weak, the retina will tear. Most retinal breaks are not a result of injury. Retinal tears are sometimes accompanied by bleeding if a retinal blood vessel is included in the tear.

Once the retina has torn, liquid from the vitreous gel can then pass through the tear and accumulate behind the retina. The build-up of fluid behind the retina is what separates (detaches) the retina from the back of the eye. As more of the liquid vitreous collects behind the retina, the extent of the retinal detachment can progress and involve the entire retina, leading to a total retinal detachment. A retinal detachment almost always affects only one eye. The second eye, however, must be checked thoroughly for any signs of predisposing factors that may lead to detachment in the future.

What are the signs and symptoms of a retinal detachment?

Flashing lights and floaters may be the initial symptoms of a retinal detachment or of a retinal tear that precedes the detachment itself. Anyone who is beginning to experience these symptoms should see an eye doctor (ophthalmologist) for a retinal exam. In the exam, drops are used to dilate the patient's pupils to make a more detailed exam easier. The symptoms of flashing lights and floaters may often be unassociated with a tear or detachment and can merely result from a separation of the vitreous gel from the retina. This condition is called a posterior vitreous detachment (PVD). Although a PVD occurs commonly, there are no tears associated with the condition most of the time.

The flashing lights are caused by the vitreous gel pulling on the retina or a looseness of the vitreous, which allows the vitreous gel to bump against the retina. The lights are often described as resembling brief lightning streaks in the outside edges (periphery) of the eye. The floaters are caused by condensations (small solidifications) in the vitreous gel and frequently are described by patients as spots, strands, or little flies. There is no safe treatment to make the floaters disappear. Floaters are usually not associated with tears of the retina.

If the patient experiences a shadow or curtain that affects any part of the vision, this can indicate that a retinal tear has progressed to a detached retina. In this situation, one should immediately consult an eye doctor since time can be critical. The goal for the ophthalmologist is to make the diagnosis and treat the retinal tear or detachment before the central macular area of the retina detaches.

What are the risk factors for developing a retinal detachment?

Studies have shown that the incidence of retinal detachments caused by tears in the retina is fairly low, affecting approximately one in 10,000 people each year. Many retinal tears do not progress to retinal detachment. Nevertheless, many risk factors for developing retinal detachments are recognized, including certain diseases of the eyes (discussed below), cataract surgery, and trauma to the eye. Retinal detachments can occur at any age. They occur most commonly in younger adults (25 to 50 years of age) who are highly nearsighted (myopic) and in older people following cataract surgery.

Which diseases of the eyes predispose to the development of a retinal detachment?

Lattice degeneration of the retina is a type of thinning of the outside edges of the retina, which occurs in 6%-8% of the general population. The lattice degeneration, so-called because the thinned retina resembles the crisscross pattern of a lattice, often contains small holes. Lattice degeneration is more common in patients with nearsightedness (myopia). This tendency to lattice degeneration occurs because myopic eyes are larger than normal eyes and, therefore, the peripheral retina is stretched more thinly. Fortunately, only about 1% of patients with lattice degeneration go on to develop a retinal detachment.

High myopia (greater than 5 or 6 diopters of nearsightedness) increases the risk of a retinal detachment. In fact, the risk increases to 2.4% as compared to a 0.06% risk for a normal eye at age 60. (Diopters are units of measurement that indicate the power of the lens to focus rays of light.) Cataract surgery or other operations of the eye can further increase this risk in patients with high myopia.

Patients taking certain eye drops have an increased risk of developing a retinal detachment. Pilocarpine (Polocarp 2 or 4%), which for many years has been a mainstay of therapy for glaucoma, has long been associated with retinal detachment. Moreover, by constricting the pupil, pilocarpine makes the diagnostic exam of the peripheral retina more difficult, possibly leading to a delay in the diagnosis.

Patients with chronic inflammation of the eye (uveitis) are at increased risk of developing retinal detachment.

How does cataract surgery lead to a retinal detachment?
Cataract surgery, especially if the operation has complications, increases the risk of a retinal detachment.

What other factors are associated with a retinal detachment?

Blunt trauma, as from a tennis ball or fist, or a penetrating injury by a sharp object to the eye can lead to a retinal detachment.
A family history of a detached retina that is non-traumatic in nature seems to indicate a genetic (inherited) tendency for developing retinal detachments.

In as many as 5% of patients with a non-traumatic retinal detachment of one eye, a detachment subsequently occurs in the other eye. Accordingly, the second eye of a patient with a retinal detachment must be examined thoroughly and followed closely, both by the patient and the ophthalmologist.

Diabetes can lead to a type of retinal detachment that is caused by pulling on the retina (traction) alone, without a tear. Because of abnormal blood vessels and scar tissue on the retinal surface in some patients with diabetes, the retina can be lifted off (detached) from the back of the eye. In addition, the blood vessels may bleed into the vitreous gel. This detachment may involve either the periphery or central area of the retina.

Why is it mandatory to treat a retinal detachment?

A tear or hole of the retina that leads to a peripheral retinal detachment causes the loss of side (peripheral) vision. Almost all of these patients will progress to a full retinal detachment and loss of all vision if the problem is not repaired. The dark shadow or curtain obscuring a portion of the vision, either from the side, above, or below, almost invariably will advance to the loss of all useful vision. Spontaneous reattachment of the retina is rare.

Early diagnosis and repair are urgent since visual improvement is much greater when the retina is repaired before the macula or central area is detached. The surgical repair of a retinal detachment is usually successful in reattaching the retina, although more than one procedure may be necessary. Once the retina is reattached, vision usually improves and then stabilizes. Successful reattachment does not always result in normal vision. The ability to read after successful surgery will depend on whether or not the macula (central part of the retina) was detached and the extent of time that it was detached.

How are detached retinas repaired?

Retinal holes or tears can be treated with laser therapy or cryotherapy (freezing) to prevent their progression to a full-scale detachment. Many factors determine which holes or tears need to be treated. These factors include the type and location of the defects, whether pulling on the retina (traction) or bleeding is involved, and the presence of any of the other risk factors discussed above. Three types of eye surgery are done for actual retinal detachment: scleral buckling, pneumatic retinopexy, and vitrectomy.

Scleral buckling

A scleral buckle, which is made of silicone, plastic, or sponge, is then sewn to the outer wall of the eye (the sclera). The buckle is like a tight cinch or belt around the eye. This application compresses the eye so that the hole or tear in the retina is pushed against the outer scleral wall of the eye, which has been indented by the buckle. The buckle may be left in place permanently. It usually is not visible because the buckle is located half way around the back of the eye (posteriorly) and is covered by the conjunctiva (the clear outer covering of the eye), which is carefully sewn (sutured) over it. Compressing the eye with the buckle also reduces any possible later pulling (traction) by the vitreous on the retina.

A small slit in the sclera allows the surgeon to drain some of the fluid that has passed through and behind the retina. Removal of this fluid allows the retina to flatten in place against the back wall of the eye. A gas or air bubble may be placed into the vitreous cavity to help keep the hole or tear in proper position against the scleral buckle until the scarring has taken place. This procedure may require special positioning of the patient's head (such as looking down) so that the bubble can rise and better seal the break in the retina. The patient may have to walk, eat, and sleep with the head facing down for two to four weeks to achieve the desired result.


Pneumatic retinopexy

Laser or cryotherapy is used to seal the hole or tear. The surgeon then injects a gas bubble directly inside the vitreous cavity of the eye to push the detached retina against the back outer wall of the eye (sclera). The gas bubble initially expands and then disappears over two to six weeks. Proper positioning of the head in the postoperative time period is crucial for success. Although this treatment is inappropriate for the repair of many retinal detachments, it is simpler and much less costly than scleral buckling. Furthermore, if pneumatic retinopexy is unsuccessful, scleral buckling still can be performed.

Vitrectomy

Certain complicated or severe retinal detachments may require a more complicated operation called a vitrectomy. These detachments include those that are caused by the growth of abnormal blood vessels on the retina or in the vitreous, as occurs in advanced diabetes. Vitrectomy also is used with giant retinal tears, vitreous hemorrhage (blood in the vitreous cavity that obscures the surgeon's view of the retina), extensive tractional retinal detachments (pulling from scar tissue), membranes (extra tissue) on the retina, or severe infections in the eye (endophthalmitis). Vitrectomy surgery is performed in the hospital under general or local anesthesia. Small openings are made through the sclera to allow positioning of a fiberoptic light, a cutting source (specialized scissors), and a delicate forceps. The vitreous gel of the eye is removed and replaced with a gas to refill the eye and reposition the retina. The gas eventually is absorbed and is replaced by the eye's own natural fluid. A scleral buckle is usually also performed with the vitrectomy.


What are the results of surgery for a retinal detachment?

The surgical repair of retinal detachments is successful in about 80% of patients with a single procedure. With additional surgery, over 90% of retinas are reattached successfully. Several months may pass, however, before vision returns to its final level. The final outcome for vision depends on several factors. For example, if the macula was detached, central vision rarely will return to normal. Even if the macula was not detached, some vision may still be lost, although most will be regained. New holes, tears, or pulling may develop, leading to new retinal detachments. If a gas or air bubble was inserted in the eye during surgery, maintaining proper positioning of the head is also important in determining the final outcome. Close follow-up by an ophthalmologist, therefore, is required. Long-term studies have shown that even after preventive treatment of a retinal hole or tear, 5% to 9% of patients may develop new breaks in the retina, which could lead to a retinal detachment. Overall, however, repair of retinal detachments has made great strides in the past 20 years with the restoration of useful vision to many thousands of patients

Who is at risk for AMD?

The greatest risk factor is age. Although AMD may occur during middle age, studies show that people over age 60 are clearly at greater risk than other age groups. For instance, a large study found that people in middle-age have about a 2 percent risk of getting AMD, but this risk increased to nearly 30 percent in those over age 75.

Other risk factors include :
Smoking. Smoking may increase the risk of AMD.
Obesity. Research studies suggest a link between obesity and the progression of early and intermediate stage AMD to advanced AMD.
Race. Whites are much more likely to lose vision from AMD than African Americans.
Family history. Those with immediate family members who have AMD are at a higher risk of developing the disease.
Gender. Women appear to be at greater risk than men.

Can my lifestyle make a difference?

Your lifestyle can play a role in reducing your risk of developing AMD.
Eat a healthy diet high in green leafy vegetables and fish.
Don't smoke.
Maintain normal blood pressure.
Watch your weight.
Exercise.

What are the symptoms?

Both dry and wet AMD cause no pain.
For dry AMD: the most common early sign is blurred vision. As fewer cells in the macula are able to function, people will see details less clearly in front of them, such as faces or words in a book. Often this blurred vision will go away in brighter light. If the loss of these light-sensing cells becomes great, people may see a small—but growing—blind spot in the middle of their field of vision.

For wet AMD: the classic early symptom is that straight lines appear crooked. This results when fluid from the leaking blood vessels gathers and lifts the macula, distorting vision. A small blind spot may also appear in wet AMD, resulting in loss of one's central vision.

How is AMD detected?

AMD is detected during a comprehensive eye exam that includes:

1. Visual acuity test. This eye chart test measures how well you see at various distances.

2. Dilated eye exam. Drops are placed in your eyes to widen, or dilate, the pupils. Your ophthalmologist uses a special magnifying lens to examine your retina and optic nerve for signs of AMD and other eye problems. After the exam, your close-up vision may remain blurred for several hours.

3. Tonometry. An instrument measures the pressure inside the eye. Numbing drops may be applied to your eye for this test.

4. Fluorescein angiogram. In this test, a special dye is injected into your arm. Pictures are taken as the dye passes through the blood vessels in your retina. The test allows your eye care professional to identify any leaking blood vessels and recommend treatment

5 Optical coherence tomography (OCT) A breakthrough technology to study swelling and distortion of anatomical layers in your retina. Provides invaluable information in managing AMD patients.

During an eye exam, you may be asked to look at an Amsler grid. The pattern of the grid resembles a checkerboard. You will cover one eye and stare at a black dot in the center of the grid. While staring at the dot, you may notice that the straight lines in the pattern appear wavy. You may notice that some of the lines are missing. These may be signs of AMD.

How is wet AMD treated?

Wet AMD can be treated with laser surgery, photodynamic therapy, and injections into the eye. None of these treatments is a cure for wet AMD. The disease and loss of vision may progress despite treatment.

1. Laser surgery. This procedure uses a laser to destroy the fragile, leaky blood vessels. A high energy beam of light is aimed directly onto the new blood vessels and destroys them, preventing further loss of vision. However, laser treatment may also destroy some surrounding healthy tissue and some vision. Only a small percentage of people with wet AMD can be treated with laser surgery. Laser surgery is more effective if the leaky blood vessels have developed away from the fovea, the central part of the macula. Laser surgery is performed in a doctor's office or eye clinic.
The risk of new blood vessels developing after laser treatment is high. Repeated treatments may be necessary. In some cases, vision loss may progress despite repeated treatments.

2. Photodynamic therapy. A drug called verteporfin is injected into your arm. It travels throughout the body, including the new blood vessels in your eye. The drug tends to "stick" to the surface of new blood vessels. Next, a light is shined into your eye for about 90 seconds. The light activates the drug. The activated drug destroys the new blood vessels and leads to a slower rate of vision decline. Unlike laser surgery, this drug does not destroy surrounding healthy tissue. Because the drug is activated by light, you must avoid exposing your skin or eyes to direct sunlight or bright indoor light for five days after treatment.

Photodynamic therapy is relatively painless. It takes about 20 minutes and can be performed in a doctor's office.
Photodynamic therapy slows the rate of vision loss. It does not stop vision loss or restore vision in eyes already damaged by advanced AMD. Treatment results often are temporary. You may need to be treated again.

3. Injections. Wet AMD can now be treated with new drugs (e.g. Avastin, Lucentis and Macugen) that are injected into the eye (anti-VEGF therapy). Abnormally high levels of a specific growth factor occur in eyes with wet AMD and promote the growth of abnormal new blood vessels. This drug treatment blocks the effects of the growth factor.

You will need multiple injections that may be given as often as monthly. The eye is numbed before each injection. After the injection, you will remain in the doctor's office for a while and your eye will be monitored. This drug treatment can help slow down vision loss from AMD and in some cases improve sight.

How is dry AMD treated?

Once dry AMD reaches the advanced stage, no form of treatment can prevent vision loss. However, treatment can delay and possibly prevent intermediate AMD from progressing to the advanced stage, in which vision loss occurs.
The National Eye Institute's Age-Related Eye Disease Study (AREDS) found that taking a specific high-dose formulation of antioxidants and zinc significantly reduces the risk of advanced AMD and its associated vision loss. Slowing AMD's progression from the intermediate stage to the advanced stage will save the vision of many people.

Age-related eye disease study (AREDS)

What is the dosage of the AREDS formulation?
The specific daily amounts of antioxidants and zinc used by the study researchers were 500 milligrams of vitamin C, 400 International Units of vitamin E, 15 milligrams of beta-carotene (often labeled as equivalent to 25,000 International Units of vitamin A), 80 milligrams of zinc as zin
xide, and two milligrams of copper as cupric oxide. Copper was added to the AREDS formulation containing zinc to prevent copper deficiency anemia, a condition associated with high levels of zinc intake.

Who should take the AREDS formulation?
People who are at high risk for developing advanced AMD should consider taking the formulation. You are at high risk for developing advanced AMD if you have either:
1. Intermediate AMD in one or both eyes.
OR
2. Advanced AMD (dry or wet) in one eye but not the other eye.

Your eye care professional can tell you if you have AMD, its stage, and your risk for developing the advanced form.
The AREDS formulation is not a cure for AMD. It will not restore vision already lost from the disease. However, it may delay the onset of advanced AMD. It may help people who are at high risk for developing advanced AMD keep their vision.

How can I take care of my vision now that I have AMD?

Dry AMD. If you have dry AMD, you should have a comprehensive dilated eye exam at least once a year. Your eye care professional can monitor your condition and check for other eye diseases. Also, if you have intermediate AMD in one or both eyes, or advanced AMD in one eye only, your doctor may suggest that you take the AREDS formulation containing the high levels of antioxidants and zinc.
Because dry AMD can turn into wet AMD at any time, you should get an Amsler grid from your eye care professional. Use the grid every day to evaluate your vision for signs of wet AMD. This quick test works best for people who still have good central vision. Check each eye separately. Cover one eye and look at the grid. Then cover your other eye and look at the grid. If you detect any changes in the appearance of this grid or in your everyday vision while reading the newspaper or watching television, get a comprehensive dilated eye exam.

Wet AMD. If you have wet AMD and your doctor advises treatment, do not wait. After laser surgery or photodynamic therapy, you will need frequent eye exams to detect any recurrence of leaking blood vessels. Studies show that people who smoke have a greater risk of recurrence than those who don't. In addition, check your vision at home with the Amsler grid. If you detect any changes, schedule an eye exam immediately.

Contact Lens Clinic

Contact Lens

Contact lens are small, thin, curved transparent discs that are worn in apposition with the cornea. They may be corrective (in place of glasses), cosmetic, or therapeutic lens.

Contacts provide a safe and effective way to correct vision when used with care and proper supervision as only your eye specialist or your optometrist can decide whether you are a suitable candidate for contact lens use.

They can offer a good alternative to eyeglasses. They are optically superior to glasses as they move with the eye and hence do not cause peripheral distortions which are seen commonly in high powered spectacles.

Contact lenses enhances the vision of the the wearer by reducing spectacle aberrations and increasing the visual field, thus giving a natural vision

 

Standard Contact lenses : These lenses are available as spherical lenses and toric lenses which can be used everyday for about 8 hours and should be replaced every year.
Disposable contact lenses : These latest generation lenses are available as spherical and toric contact lenses which can be disposed as either quarterly, monthly, fortnightly, weekly or on a daily basis.

Lasik Treatment in Latur, Maharashtra

Cosmetic contact lenses : As the name suggests, these lenses are worn to enhance cosmetic appearance by changing the eye color.

Bifocal contact lenses : These lenses correct presbyopia by correcting both distance vision and near vision by a single pair of contact lenses.

Semi soft contact lenses : When a person is intolerent to soft contact lenses due to allergy or under correction of high astigmatism, he will be adviced to wear semi soft contact lenses.

Dibetic Retinopathy

Diabetic

Diabetic retinopathy, the most common diabetic eye disease, occurs when blood vessels in the retina change. Sometimes these vessels swell and leak fluid or even close off completely. In other cases, abnormal new blood vessels grow on the surface of the retina.

The retina is a thin layer of light-sensitive tissue that lines the back of the eye. Light rays are focused onto the retina, where they are transmitted to the brain and interpreted as the images you see. The macula is a very small area at the center of the retina. It is the macula that is responsible for your pinpoint vision, allowing you to read, sew or recognize a face. The surrounding part of the retina, called the peripheral retina, is responsible for your side—or peripheral—vision.

Diabetic retinopathy usually affects both eyes. People who have diabetic retinopathy often don't notice changes in their vision in the disease's early stages. But as it progresses, diabetic retinopathy usually causes vision loss that in many cases cannot be reversed.

Diabetic eye problems

There are two types of diabetic retinopathy:

Background or nonproliferative diabetic retinopathy (NPDR)
Nonproliferative diabetic retinopathy (NPDR) is the earliest stage of diabetic retinopathy. With this condition, damaged blood vessels in the retina begin to leak extra fluid and small amounts of blood into the eye. Sometimes, deposits of cholesterol or other fats from the blood may leak into the retina.

NPDR can cause changes in the eye, including:

  •  Microaneurysms: small bulges in blood vessels of the retina that often leak fluid.
  •  Retinal hemorrhages: tiny spots of blood that leak into the retina.
  •  Hard exudates: deposits of cholesterol or other fats from the blood that have leaked into the retina.
  •  Macular edema: swelling or thickening of the macula caused by fluid leaking from the retina's blood vessels. The macula doesn't function properly when it is swollen. Macular edema is the most common cause of vision loss in diabetes.
  • Macular ischemia: small blood vessels (capillaries) close. Your vision blurs because the macula no longer receives enough blood to work properly.

Many people with diabetes have mild NPDR, which usually does not affect their vision. However, if their vision is affected, it is the result of macular edema and macular ischemia.


Proliferative diabetic retinopathy (PDR)
Proliferative diabetic retinopathy (PDR) mainly occurs when many of the blood vessels in the retina close, preventing enough blood flow. In an attempt to supply blood to the area where the original vessels closed, the retina responds by growing new blood vessels. This is called neovascularization. However, these new blood vessels are abnormal and do not supply the retina with proper blood flow. The new vessels are also often accompanied by scar tissue that may cause the retina to wrinkle or detach.


PDR may cause more severe vision loss than NPDR because it can affect both central and peripheral vision. PDR affects vision in the following ways:

Vitreous hemorrhage: delicate new blood vessels bleed into the vitreous — the gel in the center of the eye — preventing light rays from reaching the retina. If the vitreous hemorrhage is small, you may see a few new, dark floaters. A very large hemorrhage might block out all vision, allowing you to perceive only light and dark. Vitreous hemorrhage alone does not cause permanent vision loss. When the blood clears, your vision may return to its former level unless the macula has been damaged.

Traction retinal detachment: scar tissue from neovascularization shrinks, causing the retina to wrinkle and pull from its normal position. Macular wrinkling can distort your vision. More severe vision loss can occur if the macula or large areas of the retina are detached.

Neovascular glaucoma: if a number of retinal vessels are closed, neovascularization can occur in the iris (the colored part of the eye). In this condition, the new blood vessels may block the normal flow of fluid out of the eye. Pressure builds up in the eye, a particularly severe condition that causes damage to the optic nerve.

Cataract Surgery

cataract

Cataract Surgery

What is a cataract?
A cataract is a clouding of the lens in the eye that affects vision. Most cataracts are related to aging. Cataracts are very common in older people. By age 80, more than half of all Americans either have a cataract or have had cataract surgery.

A cataract can occur in either or both eyes. It cannot spread from one eye to the other.

What is the lens?

The lens is a clear part of the eye that helps to focus light, or an image, on the retina. The retina is the light-sensitive tissue at the back of the eye.

In a normal eye, light passes through the transparent lens to the retina. Once it reaches the retina, light is changed into nerve signals that are sent to the brain.

The lens must be clear for the retina to receive a sharp image. If the lens is cloudy from a cataract, the image you see will be blurred.

Are there other types of cataract?
Yes. Although most cataracts are related to aging, there are other types of cataract:

Secondary cataract. Cataracts can form after surgery for other eye problems, such as glaucoma. Cataracts also can develop in people who have other health problems, such as diabetes. Cataracts are sometimes linked to steroid use.
Traumatic cataract. Cataracts can develop after an eye injury, sometimes years later.
Congenital cataract. Some babies are born with cataracts or develop them in childhood, often in both eyes. These cataracts may be so small that they do not affect vision. If they do, the lenses may need to be removed.
Radiation cataract. Cataracts can develop after exposure to some types of radiation.

Causes and Risk Factors

What causes cataracts?
The lens lies behind the iris and the pupil. It works much like a camera lens. It focuses light onto the retina at the back of the eye, where an image is recorded. The lens also adjusts the eye's focus, letting us see things clearly both up close and far away. The lens is made of mostly water and protein. The protein is arranged in a precise way that keeps the lens clear and lets light pass through it.

But as we age, some of the protein may clump together and start to cloud a small area of the lens. This is a cataract. Over time, the cataract may grow larger and cloud more of the lens, making it harder to see.

Researchers suspect that there are several causes of cataract, such as smoking and diabetes. Or, it may be that the protein in the lens just changes from the wear and tear it takes over the years.

How can cataracts affect my vision?


Age-related cataracts can affect your vision in two ways:

Clumps of protein reduce the sharpness of the image reaching the retina.
The lens consists mostly of water and protein. When the protein clumps up, it clouds the lens and reduces the light that reaches the retina. The clouding may become severe enough to cause blurred vision. Most age-related cataracts develop from protein clumpings.
When a cataract is small, the cloudiness affects only a small part of the lens. You may not notice any changes in your vision. Cataracts tend to "grow" slowly, so vision gets worse gradually. Over time, the cloudy area in the lens may get larger, and the cataract may increase in size. Seeing may become more difficult. Your vision may get duller or blurrier.
The clear lens slowly changes to a yellowish/brownish color, adding a brownish tint to vision.
As the clear lens slowly colors with age, your vision gradually may acquire a brownish shade. At first, the amount of tinting may be small and may not cause a vision problem. Over time, increased tinting may make it more difficult to read and perform other routine activities. This gradual change in the amount of tinting does not affect the sharpness of the image transmitted to the retina.
If you have advanced lens discoloration, you may not be able to identify blues and purples. You may be wearing what you believe to be a pair of black socks, only to find out from friends that you are wearing purple socks.


When are you most likely to have a cataract?
The term "age-related" is a little misleading. You don't have to be a senior citizen to get this type of cataract. In fact, people can have an age-related cataract in their 40s and 50s. But during middle age, most cataracts are small and do not affect vision. It is after age 60 that most cataracts steal vision.

Who is at risk for cataract?
The risk of cataract increases as you get older. Other risk factors for cataract include:

  • Certain diseases such as diabetes.
  • Personal behavior such as smoking and alcohol use.
  • The environment such as prolonged exposure to sunlight.

 

What can I do to protect my vision?
Wearing sunglasses and a hat with a brim to block ultraviolet sunlight may help to delay cataract. If you smoke, stop. Researchers also believe good nutrition can help reduce the risk of age-related cataract. They recommend eating green leafy vegetables, fruit, and other foods with antioxidants.

If you are age 60 or older, you should have a comprehensive dilated eye exam at least once every two years. In addition to cataract, your eye care professional can check for signs of age-related macular degeneration, glaucoma, and other vision disorders. Early treatment for many eye diseases may save your sight.

Symptoms and Detection
What are the symptoms of a cataract?
The most common symptoms of a cataract are:

  • Cloudy or blurry vision.
  • Colors seem faded.
  • Glare. Headlights, lamps, or sunlight may appear too bright. A halo may appear around lights.
  • Poor night vision.
  • Double vision or multiple images in one eye. (This symptom may clear as the cataract gets larger.)

Frequent prescription changes in your eyeglasses or contact lenses.
These symptoms also can be a sign of other eye problems. If you have any of these symptoms, check with your eye care professional.

How is a cataract detected?
Cataract is detected through a comprehensive eye exam that includes:

Visual acuity test. This eye chart test measures how well you see at various distances.
Dilated eye exam. Drops are placed in your eyes to widen, or dilate, the pupils. Your eye care professional uses a special magnifying lens to examine your retina and optic nerve for signs of damage and other eye problems. After the exam, your close-up vision may remain blurred for several hours.
Tonometry. An instrument measures the pressure inside the eye. Numbing drops may be applied to your eye for this test.
Your eye care professional also may do other tests to learn more about the structure and health of your eye.

Treatment

cataract op
How is a cataract treated?
The symptoms of early cataract may be improved with new eyeglasses, brighter lighting, anti-glare sunglasses, or magnifying lenses. If these measures do not help, surgery is the only effective treatment. Surgery involves removing the cloudy lens and replacing it with an artificial lens.

A cataract needs to be removed only when vision loss interferes with your everyday activities, such as driving, reading, or watching TV. You and your eye care professional can make this decision together. Once you understand the benefits and risks of surgery, you can make an informed decision about whether cataract surgery is right for you. In most cases, delaying cataract surgery will not cause long-term damage to your eye or make the surgery more difficult. You do not have to rush into surgery.

 

Sometimes a cataract should be removed even if it does not cause problems with your vision. For example, a cataract should be removed if it prevents examination or treatment of another eye problem, such as age-related macular degeneration or diabetic retinopathy. If your eye care professional finds a cataract, you may not need cataract surgery for several years. In fact, you might never need cataract surgery. By having your vision tested regularly, you and your eye care professional can discuss if and when you might need treatment.

If you choose surgery, your eye care professional may refer you to a specialist to remove the cataract.

If you have cataracts in both eyes that require surgery, the surgery will be performed on each eye at separate times, usually four to eight weeks apart.

Many people who need cataract surgery also have other eye conditions, such as age-related macular degeneration or glaucoma. If you have other eye conditions in addition to cataract, talk with your doctor. Learn about the risks, benefits, alternatives, and expected results of cataract surgery.

What are the different types of cataract surgery?
There are two types of cataract surgery. Your doctor can explain the differences and help determine which is better for you:

Phacoemulsification, or phaco.

A small incision is made on the side of the cornea, the clear, dome-shaped surface that covers the front of the eye. Your doctor inserts a tiny probe into the eye. This device emits ultrasound waves that soften and break up the lens so that it can be removed by suction. Most cataract surgery today is done by phacoemulsification, also called "small incision cataract surgery."
Extracapsular surgery. Your doctor makes a longer incision on the side of the cornea and removes the cloudy core of the lens in one piece. The rest of the lens is removed by suction.
After the natural lens has been removed, it often is replaced by an artificial lens, called an intraocular lens (IOL). An IOL is a clear, plastic lens that requires no care and becomes a permanent part of your eye. Light is focused clearly by the IOL onto the retina, improving your vision. You will not feel or see the new lens.

Some people cannot have an IOL. They may have another eye disease or have problems during surgery. For these patients, a soft contact lens, or glasses that provide high magnification, may be suggested.

What are the risks of cataract surgery?
As with any surgery, cataract surgery poses risks, such as infection and bleeding. Before cataract surgery, your doctor may ask you to temporarily stop taking certain medications that increase the risk of bleeding during surgery. After surgery, you must keep your eye clean, wash your hands before touching your eye, and use the prescribed medications to help minimize the risk of infection. Serious infection can result in loss of vision.

Cataract surgery slightly increases your risk of retinal detachment. Other eye disorders, such as high myopia (nearsightedness), can further increase your risk of retinal detachment after cataract surgery. One sign of a retinal detachment is a sudden increase in flashes or floaters. Floaters are little "cobwebs" or specks that seem to float about in your field of vision. If you notice a sudden increase in floaters or flashes, see an eye care professional immediately. A retinal detachment is a medical emergency. If necessary, go to an emergency service or hospital. Your eye must be examined by an eye surgeon as soon as possible. A retinal detachment causes no pain. Early treatment for retinal detachment often can prevent permanent loss of vision. The sooner you get treatment, the more likely you will regain good vision. Even if you are treated promptly, some vision may be lost.

Talk to your eye care professional about these risks. Make sure cataract surgery is right for you.

Is cataract surgery effective?
Cataract removal is one of the most common operations performed in the United States. It also is one of the safest and most effective types of surgery. In about 90 percent of cases, people who have cataract surgery have better vision afterward.

What happens before surgery?
A week or two before surgery, your doctor will do some tests. These tests may include measuring the curve of the cornea and the size and shape of your eye. This information helps your doctor choose the right type of IOL.

You may be asked not to eat or drink anything 12 hours before your surgery.

What happens during surgery?
At the hospital or eye clinic, drops will be put into your eye to dilate the pupil. The area around your eye will be washed and cleansed.

The operation usually lasts less than one hour and is almost painless. Many people choose to stay awake during surgery. Others may need to be put to sleep for a short time.

If you are awake, you will have an anesthetic to numb the nerves in and around your eye.

After the operation, a patch may be placed over your eye. You will rest for a while. Your medical team will watch for any problems, such as bleeding. Most people who have cataract surgery can go home the same day. You will need someone to drive you home.

What happens after surgery?
Itching and mild discomfort are normal after cataract surgery. Some fluid discharge is also common. Your eye may be sensitive to light and touch. If you have discomfort, your doctor can suggest treatment. After one or two days, moderate discomfort should disappear.

For a few days after surgery, your doctor may ask you to use eyedrops to help healing and decrease the risk of infection. Ask your doctor about how to use your eyedrops, how often to use them, and what effects they can have. You will need to wear an eye shield or eyeglasses to help protect your eye. Avoid rubbing or pressing on your eye.

When you are home, try not to bend from the waist to pick up objects on the floor. Do not lift any heavy objects. You can walk, climb stairs, and do light household chores.

In most cases, healing will be complete within eight weeks. Your doctor will schedule exams to check on your progress.

Can problems develop after surgery?
Problems after surgery are rare, but they can occur. These problems can include infection, bleeding, inflammation (pain, redness, swelling), loss of vision, double vision, and high or low eye pressure. With prompt medical attention, these problems can usually be treated successfully.

Sometimes the eye tissue that encloses the IOL becomes cloudy and may blur your vision. This condition is called an after-cataract. An after-cataract can develop months or years after cataract surgery.

An after-cataract is treated with a laser. Your doctor uses a laser to make a tiny hole in the eye tissue behind the lens to let light pass through. This outpatient procedure is called a YAG laser capsulotomy. It is painless and rarely results in increased eye pressure or other eye problems. As a precaution, your doctor may give you eyedrops to lower your eye pressure before or after the procedure.

When will my vision be normal again?
You can return quickly to many everyday activities, but your vision may be blurry. The healing eye needs time to adjust so that it can focus properly with the other eye, especially if the other eye has a cataract. Ask your doctor when you can resume driving.

If you received an IOL, you may notice that colors are very bright. The IOL is clear, unlike your natural lens that may have had a yellowish/brownish tint. Within a few months after receiving an IOL, you will become used to improved color vision. Also, when your eye heals, you may need new glasses or contact lenses.

 


News & Notices

Ophthalmologist Required

Shri Venkatesh Eye Institute is one of the leading eye hospitals in Marathwada region since last 29 years. We are inviting applications for Full Time Ophthalmologist (MD/MS/DNB/DO) and Long term fellowship holders in subject of Cornea, Glaucoma, Pediatric Ophthalmology and Oculoplasty as consultants. Salary structure is based on qualification/skill and is the best in industry with excellent personal growth and profit sharing option for promising candidates. Please apply with detailed resume to Dr. Pravin Patil This email address is being protected from spambots. You need JavaScript enabled to view it. Shri Venkatesh Eye Institute Shamnagar (East), Ambajogai Road, Latur - 413531, Maharashtra. Phone: (02382) 228204 / 228205 Mobile: 9766322030 http://www.venkatesheye.com

World Sight Day

World Sight Day (WSD) is an annual day of awareness held on the second Thursday of October, to focus global attention on blindness and vision impairment. World Sight Day 2015 is on 8 October 2015.

Visiting Consultants

Dr. Nitin Deshpande Glaucoma Surgeon 3rd Wednesday of every month Dr. Harish Pathak Oculoplasty Surgeon 3rd Friday of every month Dr. Jatin Ashar Cornea Surgeon 3rd Sunday of every month Dr. Prashant Murhe-Patil Paediatric Ophthalmologist 4th Sunday of every month