Squints can be cured by glasses and eye exercises and in certain cases surgery must be done at the earliest to rectify the misalignment.

When both the eyes of a person are not in alignment with each other it is known as squint or strabismus. Nearly 40% patients with squint can be cured by spectacles and/or eye exercises. However, a large majority require an operation. Squint operations are very safe and should be done at the earliest. Generally if the eyes are not aligned for more than 6 months in a child, irreversible damage to the three dimensional vision occurs, which is only partly reversible. Squint surgeries are performed successfully even in 4 month old children. If surgery is required it should be done in most cases within six months after the squint is noticed to avoid any irreversible damage to three dimensional vision.

What is squint (strabismus)?

Squint is a misalignment of the two eyes where both eyes are not looking in the same direction. This misalignment may be constant or may be present throughout the day or it may appear occasionally and the rest of the time the eyes may be straight; this is called as intermittent squint.

What causes squint?

The exact cause of squint is not known. Six muscles control the movement of each eye (see picture). Each of these muscles acts along with its counterpart in the other eye to keep both the eyes aligned properly. A loss of coordination between the muscles of the two eyes leads to misalignment. Sometimes a refractive error like hypermetropia (far sightedness) or an eye muscle paralysis may lead to deviation of the eye. Poor vision in an eye because of some other eye disease like cataract etc. may also cause the eye to deviate. Therefore it is important in all cases of squint, especially in children, to have a thorough eye checkup to rule out any other cause of loss of vision.

When to see a doctor?

Make an appointment for an eye exam if you notice any changes in your vision. If you develop sudden vision changes, such as double vision or flashes of light, sudden eye pain, or sudden headache, see your doctor right away.

Center for Refractive & Therapeutic surgical procedures.

The following excimer related procedures are commonly performed in this hospital.

• LASIK (MEL80-ZEISS) with SBK 90 (MORIA)
• PRK
• PTK (for corneal opacities, recurrent erosions, none healing abrasions)
• KERATOCONUS – For Diagonsis and treatment
  • SIRIUS system (Topography)
  • C3R (Collagen cross linking)
  • C3R plus (C3R combined with topoguided PRK in KC
  • Phakic IOLs (ICL, IPCL)

Lens Replacement surgery:

Carma Services cross linking Reratocom contact lens.

Lens replacement surgery is normally used to refer to one of three similar types of treatments: Refractive Lens Exchange (RLE), Implantable Contact Lenses (ICL) and Cataract Surgery, with each having alternative names and acronyms so it can be a little confusing.

BEST CANDIDATES

hyperopia, presbyopia, ineligibility for LASIK or phakic IOL

• Procedure time:about 15 minutes per eye
• Typical results:clear vision at all distances without glasses or contact lenses
• Recovery time:a few days to several weeks

Types Of Lens Replacement Surgery

1. Refractive Lens Exchange (RLE)

In general, when people talk about lens replacement surgery they are referring to some type of Refractive Lens Exchange (RLE), which is also known as Refractive Lens Replacement, Clear Lens Exchange (CLE) or Clear Lens Surgery. This is a treatment for patients suffering from presbyopia (long-sightedness normally occurring in middle and old age), hyperopia (farsightedness where objects nearby are not seen as clearly as objects in the distance) or those with a considerably thin cornea.

2. Cataract Surgery

Cataract surgery involves the same procedure as the refractive lens surgery described above, except that the lens that is removed is not clear but cloudy due to existence of cataracts. Patients have the same choice of monofocal, multifocal or trifocal lenses (see lens types below) giving them the option to also remove the need for reading glasses as well as correcting their cataracts.

3. Implantable Contact Lenses (ICL)

This type of lens surgery involves implanting contact lenses rather than removing and replacing the natural lens which occurs in lens replacement surgery.  This new phakic intraocular lens is placed on top of the natural lens and behind the iris (the exact positioning will depend on the lens chosen). As the natural lens is not removed this procedure can be reversed at a later date.

Is There Anything I Should Avoid After Surgery?

• To help make sure your recovery period is a successful one, there are a number of things you’ll need to avoid post-surgery to ensure this, including:
• Avoid swimming for a week after your surgery
• Refrain from contact sports for a month – non-contact sports (e.g. jogging or going to the gym) can be resumed the day after your surgery, but you should try not to overexert yourself as high blood pressure can hamper your recovery
• Avoid touching your eyes or letting any smoke, dust or sweat get into them for at least a month to help prevent any infections
• To reduce your risk of eye fatigue try not to watch television for too long and refrain from extended periods of computer work
• Avoid driving for a few days after your surgery (your surgeon will be able to advise when it’s safe for you to resume this)

Surgeries

The most common indications for a vitrectomy include:

• Diabetic vitreous hemorrhage
• Retinal detachment
• Epiretinal membrane
• Macular hole
• Proliferative vitreoretinopathy
• Endophthalmitis
• Intraocular foreign body removal
• Retrieval of lens nucleus following complicated cataract surgery

Advanced surgical treatment of vitreo retina disorders, such as PDR, macular hole, Retinal detachment inculdes postuiq vitrectomy, membrane peeling, SOL etc

Pediatric eyecare

A child should go for an eye checkup if the following symptoms are noticeable

• Crossed eyes.
• Keeps object close to his eyes.
• Not being able to see the blackboard at school.
• Things looking blurry or funny.
• Feeling an itching, burning or scratchy sensation in the eyes.
• Injury to the eye.
• One or both the parents wear glasses.

What are the Common Eye Diseases in children?

• Refractive errors
• Lazy eye disease
• Eye injuries
• Squinting of eyes
• Watering from the eyes
• Eye allergies

What is Lazy Eye Disease?

This is a common eye disease affecting nearly 5-10% of children. In this disease a child cannot see well from one or both eyes due to uncorrected refractive error or squint. Unfortunately, Lazy Eye Disease goes undetected as, children do not complain and parents do not realize it. Appropriate treatment at the correct time can restore good vision

What do I do if the child’s eyes go red?

• Do not put any eye drop especially the ones with Steroids.

Glaucoma is an eye disease that causes loss of sight by damaging a part of the eye called the optic nerve. This nerve sends information from your eyes to your brain. When glaucoma damages your optic nerve, you begin to lose patches of vision, usually side vision (peripheral vision). Over time, glaucoma may also damage straight ahead (central) vision. You may not notice a loss of side vision until you have lost a great deal of your sight. When checking for glaucoma, eye doctors usually look for damage to the optic nerve and any loss of side vision. They may also check your eye pressure. Glaucoma is often called the ‘silent killer’ because people usually do not notice any signs of the disease until they have already lost significant vision. Once lost, vision cannot be restored.

What are the three major signs that a person may have glaucoma?

• Optic nerve damage
• Vision loss (visual field loss)
• Increased eye pressure (elevated intraocular pressure)

Who is at Risk for Glaucoma?

These risk factors may increase your chance of having glaucoma:

• Age: The older you are, the greater your risk
• Race: African-Americans have glaucoma four to five times more often than others.
• African -Americans: are also likely to have glaucoma at a younger age
• Family history : If you have a parent, brother or sister with glaucoma, you are more likely to get glaucoma too. If you have glaucoma, your family members should get complete eye exams.

Medical history: Medical history: Diabetes, previous eye injuries, eye surgery or long-term steroid use anywhere in the body can increase your risk of glaucoma. Anyone can get glaucoma it affects one in 200 people until the age of 50. The rate increases to one in 10

• over the age of 80.

What is Cataract?

Cataract is clouding of the normally clear and transparent lens of the eye. It can be compared to a window that is frosted or yellowed.

The common symptoms of Cataract include:

• A painless blurring vision
• Glare or light sensitivity
• Poor night vision
• Double vision in one eye
• Needing brighter light to red
• Fading yellowing of colors

What causes Cataract?

The  most common types of cataract are related to aging of the eye.

How cataract treated?
Surgery is the only way a cataract can be removed. Surgery consists of removal of cataract & replacement with an artifical lens (IOL – Intra Ocular Lens of an appropiate power)

Modern cataract surgery performed at My Eye
Cataract surgery is performed under topical anesthesia i.e. few drops of anesthesia – NO INJEECTIONS

• The preferred surgical technique used in phaco emulsification ( cold phaco ) with foldable Intra Ocular Lens implantation.
• We at present use Infiniti Vision Systems from Alcon Incl. USA for Advanced Phaco.
• Cataract surgery lasts for about 15 – 20 minutes. You can choose from variety of IOLs. We use all types of IOls ranging from non-foldable to foldable and the latest presbyopia correcting IOLs ( Restor Acrysof Multifocal from Alcon, USA, Tecnis Multifocal Resume from AMO, USA) which reduces the spectacle dependence after operation.
• Drapes, knives – used by us are disposable and imported from USA/Japan.

WHAT IS THE DRY EYE ?

The Dry Eye is a tear film disorder due to reduced production or excessive evaporation of tears, which causes damages to the exposed ocular surface and is associated to a sensation of eye discomfort.

Excessive evaporation of tears (cause of 86% of Dry Eye cases) is induced by the obstruction or malfunction of the Meibomian glands that are located in the eyelids, and are responsible for producing the tears lipid layer.

When not working properly, the Meibomian gland does not produce enough oily components for the tear film, which consequently evaporates quicker. Insufficient or absent lipid layer, can cause tear evaporation up to 16 times faster.

• Over 300 million people worldwide suffer for the Dry Eye Syndrome.
• In Italy it involves 26% of adult population, but this syndrome mainly affects women over 40 years old (50%) and those in menopause (90%).

Risk factors

• Allergic conjunctivitis
• Hormonal imbalances – Menopause
• Use and abuse of eye cosmetics
• Use of contact lenses.
• Chronic blepharitis
• Age (especially after age 50)
• Prolonged use of video terminals
• Prolonged use of systemic drugs (i.e antihistamines, etc)
• Air pollution

Diagonsis

Dry eye diagonsis should always be made Opthalmologist with reliable tests, thus avoiding self diagonsis and treatment “over the counter”. The Opthalmologist will consisder a number of parameters and correct the therapy for each specific case.

The cure

There are several solutions for the dry eye problem, going from artificaltears (eyedrops) to a new generation of therapeutic treatments.

Diabetes Mellitus

Diabetic Mellitus is a condition which impairs the body’s ability to use and store sugar.

This can effect the vision by involving various parts of the eye causing DAIBETIc EYE DISEASE

which consists of:

1. Temporary blurring of vision – with each attack of hyperglycemia (increased blood sugar level)
2. Cataract – early clouding of the human crystalline lens, needing cataract surgery by phacoemulsification.
3. Glaucoma a condition of increased intraocular pressure needing lifeline medication/surgery.
4. Diabetic Retinopathy (DR) resulting from damage to the blood vessels of the retina. (It is the commonest and the most sight threatening complication of Diabetes).

How common is DR

1. Nearly 50-80% of all diabetics get DR sometimes in their lifetime.
2. The longer someone has diabetes, the more likely that he/she will get DR.
3. Poor control of blood sugar will cause early onset of DR.

How is the Treatment?

Timely treatment by Laser Photocoagulation of the retina is the only method to arrest the progress of the disease, in addition to good control of blood sugar, Blood pressure and smoking.

What can you do to protect your vision?

• Successful treatment of Diabetic Retinopathy depends not only on early detection through medical eye examination and treatment by an opthalmologist but also on the patients attitude and attention to medications and diet. It is important to remember that Diabetic Retinopathy may be present without any symptoms.
• Early detection of Diabetic Retinopathy is the best protection against loss of vision.
• It is a silent killer of sight.
• Blindness caused by Diabetic Retinopathy is irresversible in natural (i.e. sight lost is lost forever)
• Hence, early diagnostic by periodic dilated eye checking (eye year) is a must.
• Laser Photocoagulation of the retina is the only proved treatment for control.
• Stop smoking, Good control of Diabetes and Blood Pressure is a must.