ARMD

ARMD is a condition which generally affects older adults and leads to vision loss in the center of the visual field (the macula) because of damage to the retina. This condition is considered as the major cause of blindness and visual impairment in older adults (>50 years). Macular degeneration can make it difficult or impossible to read or recognize faces, although enough peripheral vision remains to allow other activities of daily life.

Signs and symptoms

Signs and symptoms of macular degeneration include:

  • Drusen
  • Pigmentary alterations
  • Hemorrhages in the eye, hard exudates
  • Atrophy
  • Decreasing visual acuity
  • Blurred vision
  • Central scotomas
  • Distored vision
  • Trouble discerning colors, especially dark ones
  • Slow recovery of visual function after exposure to bright light
  • A loss in contrast sensitivity

Causes

Most common causes of ARMD are:

  • Aging - Approximately 10% of patients 66 to 74 years of age have more chances of macular degeneration
  • Family history
  • Macular degeneration gene
  • Hypertension
  • Fat intake
  • Obesity
  • Diabetes
  • Cardiovascular diseases
  • Cholesterol
  • Oxidative stress
  • Smoking

Treatment

There is no permanent cure for ARMD. In some cases ARMD may be active and then slow down or even stop progressing for many years. The aim is to keep a check on progression of the disease and take measures to improve functional capability of the patient.

Condition - Cataract

A cataract is a clouding that develops in the crystalline lens of the eye or in its envelope (lens capsule), varying in degree from slight to complete opacity and obstructing the passage of light.

Early in the development, the power of the lens may be increased, causing near-sightedness (myopia), and the gradual yellowing and opacification of the lens may reduce the perception of blue colors.

Cataracts typically progress slowly to cause vision loss, and are potentially blinding if untreated. The condition usually affects both eyes, but almost always one eye is affected earlier than the other.

Treatment

There are both surgical and nonsurgical treatment options. Non-surgical treatment is administered with the help of eye drops that are said to control the clouding. Whereas for surgical treatment, below are the options:

  • Phacoemulsification & foldable lens implantation surgery under eye drops anaesthesia
    • no injection; no stitch; no bandage surgery
    • virtually painless
    • rapid recovery
  • Bi-manual micro-incision phacoemulsification (phakonit)
  • Refractive cataract surgery
  • Small incision cataract surgery (SICS)
  • Paediatric cataract surgery
Condition - Diabetic Retinopathy

It is evident that diabetes can damage your eyes. Diabetic Retinopathy is a disease, referring to the damage of small blood vessels in your retina, the back part of eye. Diabetes also increases your risk of having glaucoma, cataracts, and other eye problems.

The retina is the layer of tissue at the back of the inner eye. It changes light and images that enter the eye into nerve signals that are sent to the brain. There are two stages of diabetic retinopathy:

  • Nonproliferative develops first
  • Proliferative is more advanced and severe

Signs and Symptoms

Most often, diabetic retinopathy has no symptoms until the damage to your eyes is severe.

  • Blurred vision or slow vision loss over time
  • Floaters
  • Shadows or missing areas of vision
  • Problem seeing at night

Causes

The major causes of diabetic retinopathy are:

  • Suffering from diabetes for a longer period of time
  • Improper management of diabetes
  • Cataracts
  • Glaucoma

Treatment

Laser surgery is used to prevent a bleed in the eye and it also helps in reducing the edema. However, it is not found successful in restoring vision lost due to the retinal damage. To avoid this, laser surgery should be appropriately timed.

  • Periocular or Intraocular injection of steroids can also help reduce swelling of the retina (macular oedema).
  • Advanced cases with non-resolving bleed in the eye or retinal detachment require advanced microsurgery. Today with highly advanced technology, good visual results can be achieved in a large number of advanced cases also.
Condition - Glaucoma

It refers to a group of eye conditions that sometimes lead to the damage of the optic nerve. This nerve plays a crucial role in transmitting visual information from the eye to the brain. In most cases, damage to the optic nerve is primarily caused due to increased pressure in the eye, known as Intraocular Pressure (IOP). Mainly, there are four types of glaucoma:

  • Open-angle glaucoma
  • Angle-closure (acute) glaucoma
  • Congenital glaucoma
  • Secondary glaucoma

Signs and Symptoms

The signs and symptoms depend on the type of glaucoma one has:

OPEN-ANGLE GLAUCOMA

  • Most people have no symptoms
  • Once vision loss occurs, the damage is already severe
  • There is a slow loss of side (peripheral) vision (also called tunnel vision)
  • Advanced glaucoma can lead to blindness

ANGLE-CLOSURE GLAUCOMA

  • Symptoms may come and go at first, or steadily become worse
  • Sudden, severe pain in one eye
  • Decreased or cloudy vision, often called "steamy" vision
  • Nausea and vomiting
  • Rainbow-like halos around lights
  • Red eye
  • Eye feels swollen

CONGENITAL GLAUCOMA

  • Symptoms are generally noticed when the child is a few months old
  • Cloudiness of the front of the eye
  • Enlargement of one eye or both eyes
  • Red eye
  • Sensitivity to light
  • Tearing

Causes
  • Open-angle glaucoma is the most common type of glaucoma and its cause is not known. This type of glaucoma generally runs in families.
  • Angle-closure glaucoma is an emergency. This is completely different from open-angle and slowly damages vision. Its causes are dilating eye drops and certain medications.
  • Congenital glaucoma is generally found in babies and caused by abnormal eye development.
  • Secondary glaucoma is caused by eye diseases such as uveitis, systemic diseases, and trauma.

Treatment

The best treatment of glaucoma is to keep eye pressure near normal range which stops further damage. Doctors suggest eye drops, laser or surgery.

  • Laser Surgery is found to be effective in treating some types of glaucoma. In open angle variety, trabeculoplasty is done where the drainage angles are treated by laser to increase the outflow of aqueous fluid and lower the eye pressure. In narrow angle glaucoma, a hole is made in the iris - peripheral iridotomy, to restore the flow of aqueous fluid to drainage angles.
  • The surgery used for treating glaucoma is called microscopic filtering surgery – trabeculectomy. During the surgery, a small drainage channel is created for the exit of fluid which helps in lowering the eye pressure. It is done under local anaesthesia and the patient needs to be in the hospital for a couple of hours only.
  • We at Max Eye Care, advise all our patients to maintain the glaucoma file comprising of periodic check-ups, as the future treatment depends on closely monitoring the changes occurring in your eye. The key to prevent blindness happening due to glaucoma is regular treatment and follow-up.
Condition - Keratoconus – C3R

This is a disease of the eye where the central mirror like structure, called Cornea, become weak, leading to progressive thinning and stretching which gradually progresses. Gradually, the Cornea bulges forwards, leading to an irregular cone shape. This causes distortion and blurring of the image formed by the cornea. Usually the disease is bilateral, though the severity may vary between the two eyes. Keratoconus affects about 1 in 7000 people. The cause is not known though genetic predisposition is present.

Symptoms

It may present as frequent change in spectacles power. When the disease progresses, vision deteriorate and may not improve with spectacles. It also causes distortion in vision with multiple images, glare and sensitivity to light.

Treatment
  • Rigid Gas Permeable Contact Lenses: Early Keratoconus can be managed by giving rigid gas permeable contact lens to the patient, which corrects the irregularity of the cornea and provide better quality of vision. In advanced keratoconus, these lenses may not fit the eye optimally and become difficult to wear.
  • Rose K Contact Lens/Scleral Boston Contact Lens: Theses are special custom made contact lenses which give better fit and superior vision quality. These are ordered after taking various measurements of cornea.
  • C3R (Corneal Collagen Cross Linking wit Riboflavin): This is the only treatment to stop the progression of Keratoconus. It is based on collagen cross- linking with ultra-violet A (UVA, 365 nm) and Riboflavin (Vitamin B2, a photo sensitizing agent). This increase in corneal strength has shown to arrest the progression of Keratoconus in almost all cases and it can reverse the Keratoconus changes by 20 to 30 percent.
  • Cornea Transplant: This is a surgical treatment, which is reserved for advance cases of Keratoconus, where the vision cannot be improved with glasses or contact lenses. Here the central portion of the cornea is removed and replaced with a donor cornea of similar size. Since there is high possibility of complications and graft rejection, this surgery is done for selected cases.
  • Intacs: These are acrylic rings inserted in the corneal stroma to decrease corneal irregularity in cases of Keratoconus. They can improve uncorrected vision without contact lenses. These can also be combined with C3R.
Condition - Phakic Implantable Collamer Lens
Correction of High Spectacle Power

The ICL is an intraocular lens (IOL) used to correct spectacle power (refractive errors-myopia, hyperopia, astigmatism). The phakic ICL is placed inside the eye between iris and the natural lens.

Benefits
  • High Quality of Vision and stable vision in long term
  • Day care procedure with quick recovery time
  • Correct wider range of myopia (-4.0 to -20 d) & astigmatism (1 to 4d)
  • Biocompatible – Biologically quite in eye due to Collamer copolymer composition
  • Small Incision/ Foldability & fast recovery
  • Removable – Does not permanently alter the eye’s structure of shape. One of the important advantages of the ICL is that while it can permanently correct your vision, in the unlikely event that an ICL patient experiences negative side effects after surgery, the lens can be removed and/or replaced if necessary. Also, concerns involving the cornea typically do not apply to the Visian ICL, as no natural tissue is removed or changes (reshaped) in any way during implantation
  • Ideal for patients where Lasik was refused, for example due to thin cornea or very high numbers

Clinical trial patients reported over 99 percent vision satisfaction

Condition - Squint

Squint (Strabismus) is a disease of eye that generally affects children. It refers to the misalignment of the two eyes so that both the eyes are not looking in the same direction. This misalignment may be constant, being present throughout the day or it may appear sometimes and the rest of the time the eyes may be straight.

Signs and Symptoms

The most common signs are:

  • Deviation of eyes
  • Double vision
  • Misalignment of eyes

Causes of Squint

The exact cause of squint is not known. The movement of each eye is controlled by six muscles. Each of these muscles act 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.

Treatment

The objectives of treatment are to restore vision, straighten the eyes, and restore binocular vision.

  • Squint surgery is a day care surgery and is done to treat squint. During surgery, one or more muscles are weakened or strengthened (by moving their attachment backward or forward) to make the eye straight. The procedure is done under local anaesthesia in adults and general anaesthesia in children.
  • It is extremely rare that more than one operation is needed. Sometimes the squint is too large and hence a two-stage surgery is planned. The world over average is 2.3 operations to achieve ideal correction of squint.