FAQ's
About Diabetic Retinopathy
What is Diabetic Retinopathy?
Diabetic Retinopathy is essentially a disease process, which affects the blood vessels of the retina. It is also an indicator of the status of blood vessels elsewhere in the body e.g. kidney, heart, etc.
What happens to the retina in diabetes?
The pathological change in diabetes leads to the lack of blood supply or ischaemia of the retina and hypoxia of retinal tissues. Long standing hypoxia leads to new vessel formation. These new vessels are fragile and bleed very easily. Excessive bleeding in the eye leads to vitreous hemorrhage, and loss of vision.
In some areas there is swelling of the vessel wall and leakage of the fluid leading to retinal edema. Involvement of macula, the central portion of the retina leads to severe drop in vision. Scar tissue can also grow from ruptured blood vessels, which will contract and pull retina, detaching it with resultant loss of vision.
How to prevent?
- Good control of diabetes by medication and diet.
- Control of associated disorder like hypertension.
- Regular ophthalmic check up.
- Immediate treatment of your eye problem once advised.
About Corneal Graft Operations
How long does it take for the operation?
The operation usually takes about one hour. The surgery is done under local anesthesia when a prolonged surgical time is anticipated in complicated cases or when patients have general health problems. You can get admitted on the day of surgery and will need to stay in the hospital for only 1 day thereafter.
What is it like afterwards?
You will have the operated eye patched for about a day or two after surgery. For the initial few days you may feel some irritation in the eye due to the fine stitches applied. For the first two or three months you must avoid situations where the eye might be bumped. You are also advised not to bend and lift heavy weights. You should be able to return to work after a month.
Are there complications?
Fortunately, complications are rare, but the eye can occasionally become infected and rarely the graft may be rejected. These developments may require extra treatment and may even lead to another operation.
What is sight afterwards?
The final visual improvement depends on structures behind the cornea being normal. You should notice visual improvement within days of the operation but it is important for you to realize that the vision can go on gradually improving over a period of many months. The prevalence of corneal blindness in India is 2 million at present and the number is increasing by 20,000 every year. The number of surgeries performed is only 8000 to 10,000 per year, creating a wide gap between demand and supply. Therefore, patients who have undergone Penetrating Keratoplasty and have been able to regain vision should spread the message of eye donation. They should also encourage people with corneal blindness to undergo Keratoplasty and help in improving their quality of life.
About Glaucoma
What is Glaucoma?
Glaucoma is a disease of the optic nerve head caused by the increase of the fluid pressure in the eye.
How does it happen?
The Fluid, which is secreted into the eye, is being constantly drained out of the eye. This maintains a constant intraocular pressure. When this circulation gets blocked, it results in the fluid accumulating inside the eyeball. As the fluid builds up it begins to exert pressure inside the eye. Abnormally high levels of IOP can damage delicate visual structures like the optic nerve head, which can lead to gradual loss of visual field and finally to blindness if left untreated. This phenomenon is known as glaucoma.
About Excimer Photorefractive Keratectomy
Will my vision improve immediately?
You should be able to see a few days after surgery. But your vision may be blurred for close work or reading fine print, for one to three months after the procedure, as your eye undergoes a period of long sightedness before stabilization. Double vision may develop. Use of a contact lens on the untreated eye may be necessary.
What are the possible side effects?
Common side effects include glare, foreign body sensation and light sensitivity as the epithelium grows back over the cornea in the first two to three days. You may also have a corneal haze (clouding of the corneal tissues), which usually occurs two to four weeks after laser treatment. But this usually disappears with time.
Will I need to wear lenses or spectacles after the procedure?
PRK treatment is designed to allow you to discontinue wearing lenses. But if you have higher refractive errors, or are over 40 years of age, you may need to wear corrective lenses after the treatment for driving or near work.
Can both eyes be treated at the same time?
PRK is performed on one eye at a time. At present, the interval between the two procedures will be determined by the condition of your first treated eye and by your ophthalmologist- it is usually between 3 and 4 months.
How often must I come for follow up appointments?
You will be asked to come for a follow up examination the next day and your ophthalmologist will prescribe medication to help promote your eye's healing process. Normally, the epithelium heals itself over the first two to three days after the procedure, although in a small number of patients this takes a longer time. The medication may need to be continued for up to 5 months. Depending on the condition of your eye, you will have to come for several follow up examinations during the first month, three months, six months, one year, 18 months and up to the second year after the PRK procedure.
Who is a suitable candidate for the procedure (PRK)
- You must be at least 21 years old.
- You must be mildly to moderately myopic (short-sighted).
- Your vision must have been stable over the past one year.
- You have had no previous serious eye diseases.
- You have had no connective tissue diseases e.g., rheumatoid arthritis.
- If you are wearing contact lens, it should be avoided for one month before the procedure.
If you meet the above criteria and are interested in having the procedure, discuss your decision with your ophthalmologist. Your ophthalmologist may decide to perform an in depth pre-procedural examination to determine if you meet all of the criteria and in order to gauge the overall health of the eye.
About Cataract
What is Cataract?
Cataract is opacity in the lens of the eye. The normal lens is transparent and allows light to reach the retina. When it becomes opaque (Cataract) light does not reach the retina and the patient is unable to see clearly.
Why does cataract form?
Cataract is the most common cause of blindness in our country. The causes of formation of cataract are not fully known.
- It is an aging problem.
- Ultraviolet light exposure.
- Deficiency of protein and vitamins.
When does cataract require removal?
Apart from the mature cataracts, even immature cataracts need to be removed if it hampers with the patient's visual requirements. There is no necessity to wait for the cataract to ripen as in earlier times.
Are they too expensive?
Just compare the disadvantages of traditional surgery, anesthesia, inability to attend work / business for some days, poor vision etc. You will yourself appreciate that the marginal increase in cost of surgery is more than compensated.
Will I need glasses after surgery?
Very often not. You may need to wear glasses only to fine-tune your vision. These are normal glasses and not those "thick" spectacles as in the past. Phaco and small incision cataract surgery is probably a great leap forward in the field of ophthalmic surgery.
What is after Cataract?
In about 25% of the patient who undergo cataract surgery, thickening of the posterior capsule of the original lens occurs causing mild blurring of vision. This can occur anytime between 3 months to 5 years after surgery. The treatment for this is very simple.
We do what is called Laser Treatment for these patients. The 'Yag Laser' is used to make a small opening in the thickened capsule behind the IOL. It is a painless, outpatient procedure.