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CATARACT

1. Is cataract surgery effective?
Cataract removal is one of the most common operations performed today. It is also one of the safest and most effective. Cataract surgery has an overall success rate of 98 percent. Continuous innovations in cataract surgery allow cataract surgeons to treat greater numbers of patients while keeping costs down with no sacrifice in quality or patient care.

2. What happens before surgery?
A week or two before surgery, your eye care professional will do some tests. These may include tests to measure the curve of the cornea and the size and shape of the eye. For patients who will receive an IOL, this information helps your doctor choose the right type of IOL. Also, doctors may ask you not to eat or drink anything for few hours before your surgery.

3. What happens after surgery?
It’s normal to feel itching and mild discomfort for a while after cataract surgery. Some fluid discharge is also common, and your eye may be sensitive to light and touch. If you have discomfort, your eye care professional may suggest a pain reliever every 4-6 hours. After 1-2 days, even moderate discomfort should disappear. In most cases, healing will take about 6 weeks. After surgery, your doctor will schedule exams to check on your progress. For a few days after surgery, you may take eye drops or pills to help healing and control the pressure inside your eye. You will also need to wear an eye shield or eyeglasses to help protect the eye. Avoid rubbing or pressing on your eye. Problems after surgery are rare, but they can occur. These can include infection, bleeding, inflammation (pain, redness, swelling), loss of vision, or light flashes. With prompt medical attention, these problems usually can be treated successfully. When you are home, try not to bend or lift heavy objects. Bending increases pressure in the eye.

4. When will my vision be normal again?
You can quickly return 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 just received an IOL, you may notice that colors are very bright or have a blue tinge. Also, if you’ve been in bright sunlight, everything may be reddish for a few hours. If you see these color tinges, it is because your lens is clear and no longer cloudy. Within a few months after receiving an IOL, these colors should go away. And when you have healed, you will probably need new glasses.

5. What is an “after-cataract”?
Sometimes a part of the natural lens, called the capsule, that is not removed during cataract surgery (in order to give support to the IOL) becomes cloudy and may blurr your vision. This is called an after-cataract. An after-cataract can develop months or years later. Unlike a cataract, an after-cataract is commonly treated with a laser. In a technique called YAG laser capsulotomy, your doctor uses a laser beam to make a tiny hole in the lens to let light pass through. This is a painless outpatient procedure. In some cases it can be removed surgically also.

6. What can you do to protect your vision?
Although we don’t know how to protect against cataracts, people over the age of 60 are at risk for many vision problems. If you are age 60 or older, you should have an eye examination through dilated pupils at least every 2 years. This kind of exam allows your eye care professional to check for signs of age-related macular degeneration, glaucoma, cataracts, and other vision disorders.

7. Can a Cataract Return?
A cataract cannot return because all or part of the lens has been removed. However, in about half of all people who have extra capsular surgery or phacoemulsification, the lens capsule becomes cloudy. This cloudiness of the lens capsule, if it occurs, usually develops a year or more after surgery. It causes the same vision problems as a cataract does. The treatment for this condition is a procedure called YAG capsulotomy. The doctor uses a laser (light) beam to make a tiny hole in the capsule to let light pass. This surgery is painless and does not require a hospital stay. Most people see well after YAG capsulotomy, but, as with cataract surgery, complications can occur. Your doctor will discuss the risks with you.

8. Is Cataract Surgery Right for Me?
Most people who have a cataract recover from surgery with no problems and improved vision. In fact, serious complications are not common with modern cataract surgery. This type of surgery has a success rate of 95 percent in patients with otherwise healthy eyes. But no surgery is risk free. Although serious complications are not common, when they occur they could result in loss of vision. If you have a cataract in both eyes, experts say it is best to wait until your first eye heals before having surgery on the second eye. If the eye that has a cataract is your only working eye, you and your doctor should weigh very carefully the benefits and risks of cataract surgery. You will be able to make the right decision for yourself if you know the facts. Ask your doctor to explain anything you do not understand. There is no such thing as a “dumb” question when it comes to your health.

9. What are my Personal risks? 
Possible Complications: High pressure in the eye Infection inside the eye? Artificial lens damage or dislocation Drooping eyelid ? Retinal detachment severe bleeding inside the eye ? Swelling or clouding of the cornea Blindness

10. When is the right time to have a cataract removed?
The decision to have cataract surgery is one that you and your eye doctor make together. In younger people or those with diabetes, cataracts may develop more quickly.The decision is based on your degree of vision loss and your ability to function in daily life. In general, surgery is recommended if the results of your visual acuity test are 20/50 or worse, even with eyeglasses, but this figure isn’t set in stone. Just check whether, Can you see to do your job and drive safely? Can you read or watch television in comfort? Is it difficult to cook, shop, do yard work, climb stairs or take medications? How active are you? Does lack of vision affect your level of independence? Are you afraid you’ll trip or fall or bump into something? If the answers to these questions are negative, then you might be the candidate for Cataract Surgery.

11. What are the new ways to prevent and treat cataracts?
Most cataracts occur with age and can’t be avoided altogether. Regular eye exams remain the key to their early detection. You can take steps to help slow or prevent the development of cataracts:
” Don’t smoke. Smoking produces free radicals, increasing your risk of cataracts.
” Eat a balanced diet with plenty of fruits and vegetables.
” Limit alcohol. Excessive drinking may increase your risk of developing cataracts.
” Protect yourself from the sun. Ultraviolet light may contribute to the development of cataracts. It’s good to wear sunglasses when you are outdoors.
” Follow your treatment plan if you have diabetes or other medical conditions.

Researchers continue to explore new ways to prevent and treat cataracts. If you do have a cataract, your chances of fully restoring your vision with cataract surgery are excellent if you have no other eye diseases.

 

LASIK

12. What is Refractive Errors?

The cornea is a part of the eye that helps focus light to create an image on the retina. It works in much the same way that the lens of a camera focuses light to create an image on film. The bending and focusing of light is also known as Refraction. Usually the shape of the cornea and the eye are not perfect and the image on the retina is out-of-focus (blurred) or distorted. These imperfections in the focusing power of the eye are called Refractive errors.

13. What is Lasik?
Lasik is the acronym for “Laser In-Situ Keratomileusis”. It is a surgical procedure
that is capable of correcting a wide range of “Near-sightedness”, “Far-sightedness” & “Astigmatism” by the use of laser to reshape the “Cornea” without invading the adjacent cell layers. This correction procedure utilizes two devices i.e. the excimer laser and the microkeratome. The microkeratome, a precise instrument that is the “keystone” in the LASIK procedure, is a mechanical shaver that contains a sharp blade that moves back and forth at high speed. This shaver is placed in the guide tracks of the suction ring and is advanced across the cornea using gears at a controlled speed. This process creates a partial flap in the cornea of uniform thickness. The flap is created with a portion of the cornea left uncut to provide a hinge.

14. Why people do Lasik?
Lasik is the latest Refractive Surgery technique that can benefit a great number of people with Myopia, Hyperopia & Astimatism. Candidates who have a strong desire to reduce a lifetime dependence on glasses & contact lens can go for Lasik.

15. How safe is the Lasik procedure?
According to several large studies, there is approximately a 2% intra-operative and 3-5% post-operative complication rate. The rate of severe complications should be substantially less than 1%. It is important for patients to understand that LASIK is surgery, and a small incidence of complications is to be expected.

16. Are the result achieved from Lasik Permanent?
LASIK is a surgical procedure that permanently removes corneal tissue to reshape the eye in order to improve refraction. The physical results are permanent. However, you should be aware that since the eyes can still change with time and LASIK does not affect a number of visual conditions associated with age. For example, LASIK does not prevent presbyopia or affect this condition once it does occur.

17. What result I can expect from Lasik?
LASIK improves the uncorrected vision – one’s vision without wearing corrective lenses – in most patients who have the procedure. Over 90% of patients with low to moderate myopia will achieve 20/40 vision. Over half of all patients can expect to achieve 20/20 vision or better. However, there are no guarantees that you will have perfect vision, and patients with high myopia (more than -7D) and high hyperopia (more than +4D) should have a different set of expectations.

18. Can both eyes be treated simultaneously?
Both eyes can be treated at the same time. In as much as the procedures are generally safe, effective, and predictable a number of patients and surgeons will have both eyes done at one sitting. That being said, some surgeons/patients prefer to do only one eye at a time. This is safer as should their be some problem (which occasionally happens), with over or under correction, infection, epithelial ingrowths or many other rare but, possible complications then presumably only one eye would be damaged or lose best corrected visual acuity. However, if each eye is done separately then there are two appointments for treatment and two healing periods etc.

19. Can anyone have Lasik?
No. It is not for everyone. There are certain conditions under which LASIK is not recommended. It can be detected when you have your Preoperative examination & Corneal Map done. There are rare individuals who have some eye disease or other condition, which could worsen with LASIK. The most common contraindication to LASIK is a misunderstanding of what the procedure can and cannot do for you. It can usually correct near (myopia) or far (hyperopia) sightedness as well as astigmatism. It cannot however make 20-year-old eyes out of 50-year-old eyes – i.e. correct presbyopia (the need for reading glasses).

20. How long will I be out of work after having Lasik?
That depends on whether you have your eyes done one at a time or both together. You would have to be professionally examined to determine what is best for you. In any case, most people return to work and other normal activities within 3 – 7 days. This period may be longer if you develop any complications or if you have a medium to high initial correction (-5.00 diopters or above). It depends on your occupation. Certain jobs that require intense clarity of vision (dentistry and surgery, for example) may be difficult to perform for one or two days. Most patients can return to work the next day, assuming their vision is adequate for their job.

 

GLAUCOMA

21. What is acute Glaucoma?
In acute glaucoma the pressure in the eye rises rapidly. This is because the periphery of the iris and the front of the eye (cornea) come into contact so that aqueous is not able to reach the tiny drainage channels in the angle between them. This is sometimes called closed angle glaucoma. The sudden increase in eye pressure can be very painful. The affected eye becomes red, the sight deteriorates and may even black out. There may also be nausea and vomiting. In the early stages you may see misty rainbow colored rings around white lights.

22. Is Glaucoma a serious risk to sight?
The danger with chronic glaucoma is that your eye may seem perfectly normal. There is no pain and your eyesight will seem to be unchanged, but your vision is being damaged. The early loss in the field of vision is usually in the shape of an arc a little above and/or below the center when looking `straight ahead’. This blank area, if the glaucoma is untreated, spreads both outwards and inwards. The center of the field is last affected so that eventually it becomes like looking through a long tube, so-called `tunnel vision’. In time even this sight would be lost.

23. What causes increased IOP?
The eye creates a liquid known as aqueous humor. This fluid helps to bathe and nourish the inside of the eye. It also helps the eye hold its shape. The fluid flows out of the eye into a drainage system. A block in the drainage system from the eye may increase the intraocular pressure (IOP) of the eye.

24. Who is at risk?
Patients who may be at risk for developing glaucoma may have a history that includes:
– High intraocular pressure (IOP)
– A family history of glaucoma
– Severe nearsightedness (myopia)
– Diabetes
– Older than 45.
– Used steroids or cortisone for a long time.
– Had a previous eye injury.

 

DIBETIC RETINOPATHY

25. Who is at risk of developing Diabetic Retinopathy?
Every person with diabetes is at risk of developing diabetic retinopathy. The longer a person has diabetes the more likely the person is to develop diabetic retinopathy. Eye examination at the time of diagnosis of Diabetes and then as advised by the Doctor would reduce the risk of vision loss and blindness. Tight control of Diabetes can delay the development of Retinopathy.

26. Once diagnosed what is to be done?
After the diagnosis of Retinopathy is done, it is Categorized according to its severity. Fundus Fluoresceive Angiography is performed to exactly know the site of blockage and amount of leakage. And accordingly the laser treatment is advised.

But sometimes if Retinopathy is with vitreous hemorrhage or Tract ional Retinal detachment surgery may be required.

27. Will My Vision Improve After Laser Treatment?
Laser therapy can only stop the progression of the retinopathy. It cannot reverse the damage already done.

28. What Happens if the LASER Doesn’t Work?
While pan retinal photocoagulation is usually successful in halting the proliferative process, some patients progress despite laser treatment. Other patients may have bleeding into the vitreous of the eye. These eyes may require vitreous surgery. The main indications for vitrectomy are persistent vitreous hemorrhage and tractional retinal detachment. Vitrectomy surgery is a major eye operation. It involves removal of the vitreous from the eye. Frequently, the retina has to be reattached by surgically separating the scar tissue from the surface of the retina. Laser treatment is often applied at the time of vitrectomyvasectomy. In some cases, a gas bubble is left in the eye following surgery to keep the retina flat against the back of the eye.

29. Will Glasses Help?
The glasses that the patient was using earlier can be continued. Often time special vision aids need to be prescribed. Magnifiers and other devices can help.

30. Can vision loss from diabetic retinopathy be prevented?
Yes, Severe visual loss can be prevented if diabetic retinopathy is detected early And treated. By keeping blood glucose levels within the normal range, one can minimize the risk of visual loss. Take action before you notice any eye-problems.