In most cases, RK has proven to be safe and effective for mild degrees of myopia.
What is astigmatic keratotomy (AK) surgery?
Astigmatic keratotomy (AK) is a surgical procedure, similar to radial keratotomy (RK), which is used to correct astigmatism (an irregularly shaped cornea which causes blurring). Instead of using a radial pattern of incisions, the surgeon makes the incisions in a curved pattern when performing AK surgery.
What is automated lamellar keratoplasty (ALK) surgery?
Automated lamellar keratoplasty, or ALK, is a surgical procedure that is mainly used for hyperopia (farsightedness) and severe cases of myopia (nearsightedness). A person with hyperopia has shorter-than-normal eyes, causing objects up close to look blurry.
How is ALK surgery performed?
Although each procedure varies slightly, in general, ALK surgery for myopia involves the surgeon cutting a flap across the front of the cornea with a microkeratome (surgical instrument). The flap is folded to the side and a thin slice of tissue is removed from the surface of the cornea. The removal of tissue flattens the central cornea, or optical zone, reducing refraction. The flap is then put back in place, where it adheres without sutures.
During ALK surgery for hyperopia, the surgeon makes a deeper incision into the cornea with the microkeratome (a surgical instrument) to create a flap. The internal pressure in the eye causes the corneal surface to stretch and bulge. The bulging cornea improves the optical power, correcting the hyperopia. The flap is then put back in place, where it adheres without sutures.
Possible side effects of ALK surgery:
The following are the most common side effects and complications. Each individual may experience side effects differently. Side effects may include:
* astigmatism (blurring caused by an irregularly shaped cornea)
* overcorrection or undercorrection
* inability to wear contact lenses after the procedure
* loss of the corneal flap, requiring a corneal graft
* scarring
* infection
* vision loss
* glare
What is laser thermal keratoplasty (LTK)?
Laser thermal keratoplasty, or LTK, applies heat from a laser to the periphery of the cornea to shrink the collagen fibers, and reshapes the cornea. When the tissue is treated thermally, it contracts the tissue and causes the central cornea to steepen. You must be ages 40 or older to qualify for this procedure.
What is conductive keratoplasty (CK)?
Conductive keratoplasty, or CK, uses heat from low-level, radio frequency waves, rather than laser or scalpel, to shrink the collagen and change the shape of the cornea. A probe that is smaller than a strand of hair is used to apply the radio waves around the outer cornea. This creates a constrictive band that that increases the curve of the cornea and improves vision.
What is an intracorneal ring (Intacs)?
Intracorneal rings, or Intacs, is a micro-thin intracorneal ring that is implanted into the cornea. Intacs produces a reshaping of the curvature of the cornea, thus improving vision. Intacs are only available in the US for low degrees of myopia.
How to prepare for refractive eye surgery:
Most refractive eye surgeries are performed on an outpatient basis, with most procedures lasting less than one hour in duration. In preparation for surgery, you may be asked to:
* arrange for someone to drop you off and pick you up again after surgery.
* not wear your contact lenses for a period of time before surgery, to prevent corneal warpage.
* not wear eye make-up for a couple of days before surgery.
What to expect during surgery:
Although each procedure varies slightly, in general, refractive eye surgery involves minimal discomfort. The eye is usually numbed with eye drops prior to surgery. While in surgery, you may also:
* stay awake during the procedure.
* your eye may be kept open with an eye speculum (a spring-like device between the eyelids).
Specific events that occur during surgery vary depending on the type of surgery performed.
Recovering from surgery:
Recovery times vary depending on the surgery, but can last anywhere from a couple of days to a couple of months. The following are some common symptoms following surgery. However, each individual may experience symptoms differently. Symptoms following surgery may include:
* sensitivity to light
* blurry vision
* minor discomfort
* dry eyes
Monday, July 28, 2008
Eye Surgery for Refractive Errors
Surgery for correcting or improving refractive errors:
Clear vision depends on how well the cornea and lens permit light rays to fall onto the retina. Light rays must be refracted (bent) to focus on the retina. The retina is the light-sensitive nerve layer that lines the back of the eye, which creates impulses from the light rays that are sent through the optic nerve to the brain.
If the cornea or eye shape is abnormal, vision can become blurry because light does not fall properly on the retina. Called a refractive error, an abnormal cornea shape can often be corrected by refractive eye surgery, which, in turn, corrects the vision problem. Refractive errors can include myopia (nearsightedness), hyperopia (farsightedness), astigmatism (an irregularly shaped cornea which causes blurring), and presbyopia (similar to hyperopia, a condition which causes the lens to harden).
The goal of most refractive eye surgeries is to reduce or eliminate a person's dependency on eyeglasses or contact lenses. Refractive eye surgery is not for everyone. One type of surgery may be more suitable for one person than another. Always consult your physician for a diagnosis and to discuss which type of surgery, if any, may be appropriate for you.
There are several types of corrective surgical procedures for refractive errors, including, but not limited to:
* laser in-situ keratomileusis (LASIK) surgery/wavefront-guided LASIK
* photorefractive keratectomy (PRK)
* radial keratotomy (RK)
* astigmatic keratotomy (AK)
* automated lamellar keratoplasty (ALK)
* laser thermal keratoplasty (LTK)
* conductive keratoplasty (CK)
* intracorneal ring (Intacs)
What is LASIK surgery?
LASIK, or laser in-situ keratomileusis, surgery is used to correct nearsightedness. When a person is nearsighted (myopic), his or her eye is too long or the cornea is too steep, resulting in too much focusing power. The light rays entering the eye come in focus before hitting the retina, resulting in blurry vision when looking in the distance. The procedure, which should be performed by a skilled eye surgeon, involves reshaping the cornea using an excimer laser. LASIK is replacing many of the other refractive eye surgery techniques.
A promising new technology, called wavefront-guided LASIK, provides an advanced method for measuring optical distortions in the eye. The Eye Surgery Education Council states that physicians can now use this technology as a roadmap to evaluate the eye by measuring how light is distorted as it passes into the eye and then is reflected back. This creates an optical map of the eye, highlighting individual imperfections. In addition, the wavefront technology allows the surgeon to tailor the laser beam settings for a more precise procedure. This provides a patient sharper, better quality vision as well as a reduction in nighttime vision difficulties.
How is LASIK surgery performed?
Although each procedure varies slightly, in general, LASIK surgery involves using a computer-controlled excimer laser (a cold, ultraviolet laser) and a microkeratome (a surgical instrument). With these instruments, the surgeon cuts a flap in the center of the cornea to remove a thin layer of tissue. By removing the tissue, the cornea flattens, reducing the myopia. The flap, which is replaced without using sutures, adheres back to the cornea within minutes.
Recovery after LASIK surgery:
In most cases, recovery from LASIK surgery is fast and involves minimal discomfort. Mild pain relievers may be recommended by your surgeon to relieve discomfort during the first day after surgery. Patients typically take eyedrops for a week after the procedure.
Possible side effects of LASIK surgery:
Generally, LASIK has a high success rate. However, side effects do occur. The following are the most common side effects and complications. Each individual may experience side effects differently. Side effects may include:
* dry eyes (during the healing process)
* eye discomfort (mostly during the first 24 hours following surgery)
* irregular astigmatism, which can decrease the corrected vision (astigmatism means blurring caused by an irregularly shaped cornea)
* corneal haze or glare
* overcorrected or undercorrected vision
* inability to wear contact lenses in the future
* loss of the corneal flap, requiring a corneal graft
* scarring
* infection
* vision loss
Benefits of LASIK surgery:
For most candidates, LASIK surgery usually involves little pain and recovery is rapid. Other benefits may include:
* LASIK can correct a wide range of myopia, up to 15 diopters (unit of measurement of the refractive power of a lens).
* LASIK can be repeated to correct the vision further.
* The eyes stabilize between three and six months after LASIK surgery.
* The eye is not weakened, because only one flap is cut into the cornea.
* LASIK usually causes little or no scarring of the cornea.
* Post-operative care is usually limited to using eye drops for a week after surgery.
What is photorefractive keratectomy (PRK) surgery?
Photorefractive keratectomy, or PRK, uses the same excimer laser used in LASIK surgery and is performed to reshape the cornea in an attempt to correct mild to moderate myopia (nearsightedness). According to the US Food and Drug Administration (FDA), PRK has a 95 percent success rate. Only about 15 percent of patients need glasses, occasionally, following surgery.
How is PRK surgery performed?
Although each procedure varies slightly, in general, PRK surgery involves an excimer laser beam reshaping the cornea by removing microscopic amounts of tissue from the outer surface. The procedure, which generally only takes a few minutes, uses a computer which maps the eye's surface and calculates the required corneal change.
Possible side effects of PRK surgery:
Generally, PRK surgery has a high success rate. However, side effects do occur. Because the corneal surface is cut, it takes several weeks to heal. In addition, there is some eye discomfort following the surgery that may last for several weeks. The following are the most common side effects and complications. Each individual may experience side effects differently. Side effects may include:
* mild corneal haze (following surgery)
* glare or halos around light (this side effect may be present for months following the procedure)
Who is a potential candidate for LASIK or PRK eye surgery?
According to the US Food and Drug Administration (FDA), potential candidates for corrective laser eye surgery must meet the following criteria. However, it is advised that potential candidates consult his/her physician before undergoing any type of corrective eye surgery. The criteria include:
* The candidate must be at least 21 years old if being treated with the Summit laser (one brand of excimer lasers), or 18 years old if being treated with the VISX laser (another brand of excimer lasers). This age requirement is necessary to ensure the eyes have finished growing.
* The candidate must have mild to moderate nearsightedness (myopia).
* The candidate must be free of eye disease, problems with the retina, or scarring of the cornea.
* The candidate must have the financial ability to pay for this costly surgery, since insurance may not cover the procedure.
* The candidate must be aware of all the side effects, risks, and benefits of the surgery. Candidates should also be aware of the alternative treatment options available.
What is radial keratotomy (RK) surgery?
Radial keratotomy surgery, or RK, is a procedure also used to correct myopia (nearsightedness). The procedure involves making microscopic, radial incisions (keratotomies) in the cornea to alter the curvature of the cornea, thus, correcting light refraction. Hundreds of thousands of people who qualified for this type of surgery have undergone the procedure successfully since its introduction to the US in 1978.
How is RK surgery performed?
Although each procedure varies slightly, in general, RK surgery involves an eye surgeon cutting (with a calibrated diamond scalpel) radial or spoke-like incisions into the cornea outside of the center of the cornea (also called the optical zone, which is the area where a person sees through). Due to pressure inside the eye, the incisions cause the center, or optical zone, of the cornea to flatten, reducing refraction.
Possible side effects of RK surgery:
One main side effect of RK surgery is the excessive amount of time it takes for the cornea to heal. In some cases, healing may take weeks. The following are the most common side effects and complications. Each individual may experience side effects differently. Side effects may include:
* a weakened cornea that can rupture
* increased risk of infection
* difficulty in fitting contact lenses, if needed
* discomfort
* glare around lights
* fluctuating vision during the first few months
* cataracts (a change in the structure of the crystalline lens that causes blurred vision)
* loss of vision
Clear vision depends on how well the cornea and lens permit light rays to fall onto the retina. Light rays must be refracted (bent) to focus on the retina. The retina is the light-sensitive nerve layer that lines the back of the eye, which creates impulses from the light rays that are sent through the optic nerve to the brain.
If the cornea or eye shape is abnormal, vision can become blurry because light does not fall properly on the retina. Called a refractive error, an abnormal cornea shape can often be corrected by refractive eye surgery, which, in turn, corrects the vision problem. Refractive errors can include myopia (nearsightedness), hyperopia (farsightedness), astigmatism (an irregularly shaped cornea which causes blurring), and presbyopia (similar to hyperopia, a condition which causes the lens to harden).
The goal of most refractive eye surgeries is to reduce or eliminate a person's dependency on eyeglasses or contact lenses. Refractive eye surgery is not for everyone. One type of surgery may be more suitable for one person than another. Always consult your physician for a diagnosis and to discuss which type of surgery, if any, may be appropriate for you.
There are several types of corrective surgical procedures for refractive errors, including, but not limited to:
* laser in-situ keratomileusis (LASIK) surgery/wavefront-guided LASIK
* photorefractive keratectomy (PRK)
* radial keratotomy (RK)
* astigmatic keratotomy (AK)
* automated lamellar keratoplasty (ALK)
* laser thermal keratoplasty (LTK)
* conductive keratoplasty (CK)
* intracorneal ring (Intacs)
What is LASIK surgery?
LASIK, or laser in-situ keratomileusis, surgery is used to correct nearsightedness. When a person is nearsighted (myopic), his or her eye is too long or the cornea is too steep, resulting in too much focusing power. The light rays entering the eye come in focus before hitting the retina, resulting in blurry vision when looking in the distance. The procedure, which should be performed by a skilled eye surgeon, involves reshaping the cornea using an excimer laser. LASIK is replacing many of the other refractive eye surgery techniques.
A promising new technology, called wavefront-guided LASIK, provides an advanced method for measuring optical distortions in the eye. The Eye Surgery Education Council states that physicians can now use this technology as a roadmap to evaluate the eye by measuring how light is distorted as it passes into the eye and then is reflected back. This creates an optical map of the eye, highlighting individual imperfections. In addition, the wavefront technology allows the surgeon to tailor the laser beam settings for a more precise procedure. This provides a patient sharper, better quality vision as well as a reduction in nighttime vision difficulties.
How is LASIK surgery performed?
Although each procedure varies slightly, in general, LASIK surgery involves using a computer-controlled excimer laser (a cold, ultraviolet laser) and a microkeratome (a surgical instrument). With these instruments, the surgeon cuts a flap in the center of the cornea to remove a thin layer of tissue. By removing the tissue, the cornea flattens, reducing the myopia. The flap, which is replaced without using sutures, adheres back to the cornea within minutes.
Recovery after LASIK surgery:
In most cases, recovery from LASIK surgery is fast and involves minimal discomfort. Mild pain relievers may be recommended by your surgeon to relieve discomfort during the first day after surgery. Patients typically take eyedrops for a week after the procedure.
Possible side effects of LASIK surgery:
Generally, LASIK has a high success rate. However, side effects do occur. The following are the most common side effects and complications. Each individual may experience side effects differently. Side effects may include:
* dry eyes (during the healing process)
* eye discomfort (mostly during the first 24 hours following surgery)
* irregular astigmatism, which can decrease the corrected vision (astigmatism means blurring caused by an irregularly shaped cornea)
* corneal haze or glare
* overcorrected or undercorrected vision
* inability to wear contact lenses in the future
* loss of the corneal flap, requiring a corneal graft
* scarring
* infection
* vision loss
Benefits of LASIK surgery:
For most candidates, LASIK surgery usually involves little pain and recovery is rapid. Other benefits may include:
* LASIK can correct a wide range of myopia, up to 15 diopters (unit of measurement of the refractive power of a lens).
* LASIK can be repeated to correct the vision further.
* The eyes stabilize between three and six months after LASIK surgery.
* The eye is not weakened, because only one flap is cut into the cornea.
* LASIK usually causes little or no scarring of the cornea.
* Post-operative care is usually limited to using eye drops for a week after surgery.
What is photorefractive keratectomy (PRK) surgery?
Photorefractive keratectomy, or PRK, uses the same excimer laser used in LASIK surgery and is performed to reshape the cornea in an attempt to correct mild to moderate myopia (nearsightedness). According to the US Food and Drug Administration (FDA), PRK has a 95 percent success rate. Only about 15 percent of patients need glasses, occasionally, following surgery.
How is PRK surgery performed?
Although each procedure varies slightly, in general, PRK surgery involves an excimer laser beam reshaping the cornea by removing microscopic amounts of tissue from the outer surface. The procedure, which generally only takes a few minutes, uses a computer which maps the eye's surface and calculates the required corneal change.
Possible side effects of PRK surgery:
Generally, PRK surgery has a high success rate. However, side effects do occur. Because the corneal surface is cut, it takes several weeks to heal. In addition, there is some eye discomfort following the surgery that may last for several weeks. The following are the most common side effects and complications. Each individual may experience side effects differently. Side effects may include:
* mild corneal haze (following surgery)
* glare or halos around light (this side effect may be present for months following the procedure)
Who is a potential candidate for LASIK or PRK eye surgery?
According to the US Food and Drug Administration (FDA), potential candidates for corrective laser eye surgery must meet the following criteria. However, it is advised that potential candidates consult his/her physician before undergoing any type of corrective eye surgery. The criteria include:
* The candidate must be at least 21 years old if being treated with the Summit laser (one brand of excimer lasers), or 18 years old if being treated with the VISX laser (another brand of excimer lasers). This age requirement is necessary to ensure the eyes have finished growing.
* The candidate must have mild to moderate nearsightedness (myopia).
* The candidate must be free of eye disease, problems with the retina, or scarring of the cornea.
* The candidate must have the financial ability to pay for this costly surgery, since insurance may not cover the procedure.
* The candidate must be aware of all the side effects, risks, and benefits of the surgery. Candidates should also be aware of the alternative treatment options available.
What is radial keratotomy (RK) surgery?
Radial keratotomy surgery, or RK, is a procedure also used to correct myopia (nearsightedness). The procedure involves making microscopic, radial incisions (keratotomies) in the cornea to alter the curvature of the cornea, thus, correcting light refraction. Hundreds of thousands of people who qualified for this type of surgery have undergone the procedure successfully since its introduction to the US in 1978.
How is RK surgery performed?
Although each procedure varies slightly, in general, RK surgery involves an eye surgeon cutting (with a calibrated diamond scalpel) radial or spoke-like incisions into the cornea outside of the center of the cornea (also called the optical zone, which is the area where a person sees through). Due to pressure inside the eye, the incisions cause the center, or optical zone, of the cornea to flatten, reducing refraction.
Possible side effects of RK surgery:
One main side effect of RK surgery is the excessive amount of time it takes for the cornea to heal. In some cases, healing may take weeks. The following are the most common side effects and complications. Each individual may experience side effects differently. Side effects may include:
* a weakened cornea that can rupture
* increased risk of infection
* difficulty in fitting contact lenses, if needed
* discomfort
* glare around lights
* fluctuating vision during the first few months
* cataracts (a change in the structure of the crystalline lens that causes blurred vision)
* loss of vision
Friday, July 25, 2008
LASIK eye surgery in india
Dr. Arun Gulani, founder of the Gulani Vision Institute, Jacksonville, Florida, is a world renowned expert in LASIK eye surgery. Here he offers some insight and emphasizes that complications from the surgery occur most often when the necessary groundwork before surgery isn't covered both by the patient and or the surgeon.
We are all aware of the national trial and FDA hearing of patients who have had less than optimum outcomes from Lasik eye surgery. And, you have probably seen the commercials, heard the ads, and seen great results on your best friend. Now, you are ready to schedule your Lasik surgery.
Hold on. First of all, it is essential to cut through the hype of Lasik surgery the promises, the embellishments, the deals and learn exactly what it is, what it promises, how to know if you are a good candidate and, most importantly, how to choose the best surgeon for you.
LASIK eye surgery involves the use of the very precise Excimer Laser (cuts ¼th of a micron at every pulse), which re-shapes the cornea (clear front window) of the eye according to the glasses prescription of the patient. The surgery is done in minutes, with the patient awake, active, and participating; only numbing drops are used in the patient's eyes. This method provides the quickest healing and fastest results. Visual recovery is extremely fast, and most patients gain driving recovery by the day after the surgery.
Unfortunately, these are the very reasons that this surgery has a tendency to become a commodity, and in many places, is enough to mislead the patients.
Dr. Gulani has invented Lasik surgical instruments, published Lasik protocols, and teaches Lasik complication management to eye surgeons all over the world. He has recently introduced a new super-specialty in Lasik called Corneoplastique™ by which many of the Lasik complications can be corrected back to excellent vision.
Nevertheless he says - Prevention is the way to go!
Dr. Gulani has summarized three basic reasons for poor outcomes as a result of Lasik surgery:
1. Lack of patient education and expectations
2. Cookie-cutter surgery by Lasik surgeons who deem “One size fits all”
3. Poor pre-operative technological analysis of the patient's eye anatomy, vision, and stability.
The most important step in Lasik Surgery is choosing the best surgeon. “This is your responsibility as a patient,” says Dr. Gulani.
Dr. Gulani's seven rules to consider when choosing a Lasik surgeon:
1. Besides visiting the surgeon's website: do use an internet search, type in the doctor's name, and see what comes up. Do you find only a website and other paid advertising claims? Or do you find interviews, published articles, and third party confirmations of the doctor's status?
2. If your surgeon says that they are the one of the best or that they teach other Lasik surgeons, ask for evidence. Are they first in the world, country, state, or just in their own city? (In order from most prestigious to least prestigious). Do they teach at local dinner meetings that they host or are they invited to teach nationally at prestigious events?
3. Meet with the surgeon and get a feel for the integrity and involvement of the surgeon in educating you and answering your every question.
4. Make sure that your surgeon will see you before surgery, perform your surgery, and meet with you after your surgery
5. Find out if your surgeon performs the full spectrum of Laser Vision Surgery (remember Lasik is just one of many Laser Vision techniques). This is important so they can offer what is truly best for you rather than suggesting the only surgery they know how to perform.
6. Do not fall for flashy computer screens and equipment in the office. Make sure that you understand all that is going on and insist on asking the surgeon to explain in layman terms.
7. When you meet with your surgeon, do ask about possible side-effects and complications. Ask if in the rare event that you do end up having a complication can they handle it? If the answer is yes, then ask for evidence.
Due diligence on part of the patient, experienced selection of individualized surgery by the surgeon, and effective use of modern technology together can raise the bar on safety and predictability in LASIK, one of the most successful surgical breakthroughs of modern times.
We are all aware of the national trial and FDA hearing of patients who have had less than optimum outcomes from Lasik eye surgery. And, you have probably seen the commercials, heard the ads, and seen great results on your best friend. Now, you are ready to schedule your Lasik surgery.
Hold on. First of all, it is essential to cut through the hype of Lasik surgery the promises, the embellishments, the deals and learn exactly what it is, what it promises, how to know if you are a good candidate and, most importantly, how to choose the best surgeon for you.
LASIK eye surgery involves the use of the very precise Excimer Laser (cuts ¼th of a micron at every pulse), which re-shapes the cornea (clear front window) of the eye according to the glasses prescription of the patient. The surgery is done in minutes, with the patient awake, active, and participating; only numbing drops are used in the patient's eyes. This method provides the quickest healing and fastest results. Visual recovery is extremely fast, and most patients gain driving recovery by the day after the surgery.
Unfortunately, these are the very reasons that this surgery has a tendency to become a commodity, and in many places, is enough to mislead the patients.
Dr. Gulani has invented Lasik surgical instruments, published Lasik protocols, and teaches Lasik complication management to eye surgeons all over the world. He has recently introduced a new super-specialty in Lasik called Corneoplastique™ by which many of the Lasik complications can be corrected back to excellent vision.
Nevertheless he says - Prevention is the way to go!
Dr. Gulani has summarized three basic reasons for poor outcomes as a result of Lasik surgery:
1. Lack of patient education and expectations
2. Cookie-cutter surgery by Lasik surgeons who deem “One size fits all”
3. Poor pre-operative technological analysis of the patient's eye anatomy, vision, and stability.
The most important step in Lasik Surgery is choosing the best surgeon. “This is your responsibility as a patient,” says Dr. Gulani.
Dr. Gulani's seven rules to consider when choosing a Lasik surgeon:
1. Besides visiting the surgeon's website: do use an internet search, type in the doctor's name, and see what comes up. Do you find only a website and other paid advertising claims? Or do you find interviews, published articles, and third party confirmations of the doctor's status?
2. If your surgeon says that they are the one of the best or that they teach other Lasik surgeons, ask for evidence. Are they first in the world, country, state, or just in their own city? (In order from most prestigious to least prestigious). Do they teach at local dinner meetings that they host or are they invited to teach nationally at prestigious events?
3. Meet with the surgeon and get a feel for the integrity and involvement of the surgeon in educating you and answering your every question.
4. Make sure that your surgeon will see you before surgery, perform your surgery, and meet with you after your surgery
5. Find out if your surgeon performs the full spectrum of Laser Vision Surgery (remember Lasik is just one of many Laser Vision techniques). This is important so they can offer what is truly best for you rather than suggesting the only surgery they know how to perform.
6. Do not fall for flashy computer screens and equipment in the office. Make sure that you understand all that is going on and insist on asking the surgeon to explain in layman terms.
7. When you meet with your surgeon, do ask about possible side-effects and complications. Ask if in the rare event that you do end up having a complication can they handle it? If the answer is yes, then ask for evidence.
Due diligence on part of the patient, experienced selection of individualized surgery by the surgeon, and effective use of modern technology together can raise the bar on safety and predictability in LASIK, one of the most successful surgical breakthroughs of modern times.
Squint
When we look straight ahead at a far object our eyes are parallel to each-other, and when we look at a near object then the line or axis of eye point towards the object of regard. In squint this relationship of two eyes is disturbed. Also known as “strabismus”, squint is a condition where the eyes are not aligned in the same direction. The squinting eye may turn in (converge), turn out (diverge) or sometimes turn up or down. These can be present all or only part of the time, in one or alternating between two eyes.
What causes squint?
It can arise because of an incorrect balance of the muscles that move the eyes ,faulty nerve signals to muscles, refractive errors, childhood illnesses, etc.
Is squint only a cosmetic problem?
Squint is not just a cosmetic problem. It is always associated with certain degree of functional defect which make it important to treat squint as early as possible. It can be associated with decreased vision (amblyopia or lazy eye) or double vision (diplopia). Loss of binocular vision (ability to use two eyes together) can lead to loss of fine depth perception (stereopsis) and peripheral visual field.
What is Amblyopia?
Amblyopia or lazy eye means decrease in vision occurring in the eye due to abnormal or lack of coordination between two eyes. This decrease is over and obove what is caused by refractive error or any other physical problem in the eye. It can be treated before the age of about 9 years by occlusion therapy.
How is squint assessed?
It is assessed by various orthoptics tests, the aim of which is to:
*
Establish the amount and type of squint
*
Assess how well can the child /adult see
*
Detect presence of refractive errors (refraction)
*
Test for binocular vision
*
Retina examination including fixation pattern
*
Investigate for the cause of squint
Childhood Squint
Squint can present at any age. The cause is not always known, but if squint is suspected, then the baby should be seen for accurate assessment at the earliest opportunity. Sometimes a “pseudo or false squint” may be present due to wide gap between the eyes , flat nose bridge etc. where the eyes appear to be misaligned but do not actually have squint. Newborn child may have a certain degree of misalignment of the eyes which usually disappears by about 6 months of age but if it persists beyond 6 months then the child should be immediately examined by an eye surgeon.
What are the causes of childhood squint?
The cause of squint in children is varied:
*
Congenital squint: these children are born with a squint, though it may not be obvious for few weeks. A strong family history could be present. In all children the vision and need for spectacles has to be assessed.
*
Long sightedness or hypermetropia: as the child cannot focus well for near, he has to put extra effort to focus. The over focusing produces double vision. To avoid this double vision, the image in one eye is suppressed unconsciously and in turn the child avoids using that eye. If left untreated not only does the eye deviates but also becomes a lazy eye (amblyopia)
*
Childhood illnesses: Squint may also develop following viral fever, measles, meningitis etc
*
Injury: to the nerves supplying eye muscles can lead to squint.
*
Hereditary
What is the treatment for childhood squint? Spectacles or Surgery?
The child is thoroughly assessed to establish the type of squint. It is very important to note the vision and fixation pattern in both eyes. Treatment varies according to the type of squint and can be in the form of spectacles, occlusion, eye-drops (rarely) or surgery.
Some squints, especially those that arise from hypermetropia (long sightedness) respond well to treatment with wearing of spectacles. The child will be seen from time to time to note the change in spectacle power and degree of squint till he grows up. Any residual squint not corrected by spectacle can than be corrected by surgery.
Convergent Squint in a 5 years old girl
Almost completely corrected by glasses (Bifocal - parents were shocked at the idea of bifocal but correction of squint relieved them)
Amblyopia / Lazy eye: This is treated by patching / Occluding the good eye. The weaker eye is encouraged to work harder with visual activities such as coloring and reading while patch is on. It should be noted that amblyopia can be treated only before the age of about 9 years after which the visual system of the eye becomes fixed and fails to respond to occlusion therapy.
Surgery: Sometimes this is the only choice to straighten the eye. If done at appropriate time results can be very good and 3 D vision can develop. One or both the eyes may have to be operated and one or more operations sometimes may be required to achieve perfect functional results (cosmetic correction is usually easier to obtain).
Adult Squint
When an adult presents with squint it is not only imperative to establish the type and amount of squint but also to establish and treat the cause of squint. There are two main types: non-paralytic or paralytic squint. The non-paralytic variety either persisted from childhood or is a local eye muscle imbalance. Any adult presenting with sudden onset of paralytic squint has to be investigated in detail for the cause, which could be medical, e.g. hypertension, diabetes mellitus or surgical e.g. brain lesion. Majority of these kinds corrects on their own within 6 months and surgery is only required in cases where squint persists.
What happens in squint surgery?
There are six muscles attached to the outside of each eyeball, which move the eye in various directions. During surgery one or more (commonly two) muscles are weakened or strengthened (by moving their attachment backward or forward) to make the eye straight. The procedure is done under local anesthesia in adults and general anesthesia in children.
Will more than one surgery be required?
It is not uncommon for more than one operation to be necessary. This does not mean that something has gone wrong but that fine-tuning is needed to obtain the best straight alignment. 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.
What happens after the operation?
It is a day care surgery with no hospitalization (unless general anesthesia is used). The eye pad is removed the next day and eye drops are instilled for a couple of weeks. Since it is an external surgery there is no effect on the vision. Most of the times external stitches are absorbable and do not have to be removed. The person can join back his office in a couple of days although a certain amount of redness and irritation continues for a few days.
What causes squint?
It can arise because of an incorrect balance of the muscles that move the eyes ,faulty nerve signals to muscles, refractive errors, childhood illnesses, etc.
Is squint only a cosmetic problem?
Squint is not just a cosmetic problem. It is always associated with certain degree of functional defect which make it important to treat squint as early as possible. It can be associated with decreased vision (amblyopia or lazy eye) or double vision (diplopia). Loss of binocular vision (ability to use two eyes together) can lead to loss of fine depth perception (stereopsis) and peripheral visual field.
What is Amblyopia?
Amblyopia or lazy eye means decrease in vision occurring in the eye due to abnormal or lack of coordination between two eyes. This decrease is over and obove what is caused by refractive error or any other physical problem in the eye. It can be treated before the age of about 9 years by occlusion therapy.
How is squint assessed?
It is assessed by various orthoptics tests, the aim of which is to:
*
Establish the amount and type of squint
*
Assess how well can the child /adult see
*
Detect presence of refractive errors (refraction)
*
Test for binocular vision
*
Retina examination including fixation pattern
*
Investigate for the cause of squint
Childhood Squint
Squint can present at any age. The cause is not always known, but if squint is suspected, then the baby should be seen for accurate assessment at the earliest opportunity. Sometimes a “pseudo or false squint” may be present due to wide gap between the eyes , flat nose bridge etc. where the eyes appear to be misaligned but do not actually have squint. Newborn child may have a certain degree of misalignment of the eyes which usually disappears by about 6 months of age but if it persists beyond 6 months then the child should be immediately examined by an eye surgeon.
What are the causes of childhood squint?
The cause of squint in children is varied:
*
Congenital squint: these children are born with a squint, though it may not be obvious for few weeks. A strong family history could be present. In all children the vision and need for spectacles has to be assessed.
*
Long sightedness or hypermetropia: as the child cannot focus well for near, he has to put extra effort to focus. The over focusing produces double vision. To avoid this double vision, the image in one eye is suppressed unconsciously and in turn the child avoids using that eye. If left untreated not only does the eye deviates but also becomes a lazy eye (amblyopia)
*
Childhood illnesses: Squint may also develop following viral fever, measles, meningitis etc
*
Injury: to the nerves supplying eye muscles can lead to squint.
*
Hereditary
What is the treatment for childhood squint? Spectacles or Surgery?
The child is thoroughly assessed to establish the type of squint. It is very important to note the vision and fixation pattern in both eyes. Treatment varies according to the type of squint and can be in the form of spectacles, occlusion, eye-drops (rarely) or surgery.
Some squints, especially those that arise from hypermetropia (long sightedness) respond well to treatment with wearing of spectacles. The child will be seen from time to time to note the change in spectacle power and degree of squint till he grows up. Any residual squint not corrected by spectacle can than be corrected by surgery.
Convergent Squint in a 5 years old girl
Almost completely corrected by glasses (Bifocal - parents were shocked at the idea of bifocal but correction of squint relieved them)
Amblyopia / Lazy eye: This is treated by patching / Occluding the good eye. The weaker eye is encouraged to work harder with visual activities such as coloring and reading while patch is on. It should be noted that amblyopia can be treated only before the age of about 9 years after which the visual system of the eye becomes fixed and fails to respond to occlusion therapy.
Surgery: Sometimes this is the only choice to straighten the eye. If done at appropriate time results can be very good and 3 D vision can develop. One or both the eyes may have to be operated and one or more operations sometimes may be required to achieve perfect functional results (cosmetic correction is usually easier to obtain).
Adult Squint
When an adult presents with squint it is not only imperative to establish the type and amount of squint but also to establish and treat the cause of squint. There are two main types: non-paralytic or paralytic squint. The non-paralytic variety either persisted from childhood or is a local eye muscle imbalance. Any adult presenting with sudden onset of paralytic squint has to be investigated in detail for the cause, which could be medical, e.g. hypertension, diabetes mellitus or surgical e.g. brain lesion. Majority of these kinds corrects on their own within 6 months and surgery is only required in cases where squint persists.
What happens in squint surgery?
There are six muscles attached to the outside of each eyeball, which move the eye in various directions. During surgery one or more (commonly two) muscles are weakened or strengthened (by moving their attachment backward or forward) to make the eye straight. The procedure is done under local anesthesia in adults and general anesthesia in children.
Will more than one surgery be required?
It is not uncommon for more than one operation to be necessary. This does not mean that something has gone wrong but that fine-tuning is needed to obtain the best straight alignment. 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.
What happens after the operation?
It is a day care surgery with no hospitalization (unless general anesthesia is used). The eye pad is removed the next day and eye drops are instilled for a couple of weeks. Since it is an external surgery there is no effect on the vision. Most of the times external stitches are absorbable and do not have to be removed. The person can join back his office in a couple of days although a certain amount of redness and irritation continues for a few days.
Who may need cataract surgery?
A cataract is a clouding of the normally clear, natural crystalline lens in the eye. This clouding is due to the aging process, but can also be caused by eye trauma, diabetes, some medications or be hereditary. Whatever the cause, cataracts typically result in blurred or fuzzy vision and sensitivity to light.
Cataract formation occurs at different rates and can affect one or both eyes at the same time. Fortunately, with modern medical technology, cataracts can be effectively treated through the use of microsurgical techniques. In fact, cataract surgery is one of the most successful surgical procedures performed today - about 95% of all cataract surgery results in an improvement in vision.
The best way to treat a cataract is to remove the cloudy lens and replace it with a new, clear artificial lens. This can be accomplished in two ways. The first technique is called "extracapsular extraction" (ECCE) and involves removing the cloudy lens in one piece. This technique requires a relatively large incision of 10-12 mm in length. The second technique is the latest advance in cataract removal. It is called "phacoemulsification" or "phaco" for short.
In phaco surgery, a small ultrasonic probe is inserted into the eye. This probe breaks (emulsifies) the cloudy lens into tiny pieces. These pieces are then removed by suction from the eye. Phaco requires a small incision of only 3.2 mm or less.
In the event that you require cataract surgery, your surgeon will determine which method is most appropriate for your condition.
Cataract formation occurs at different rates and can affect one or both eyes at the same time. Fortunately, with modern medical technology, cataracts can be effectively treated through the use of microsurgical techniques. In fact, cataract surgery is one of the most successful surgical procedures performed today - about 95% of all cataract surgery results in an improvement in vision.
The best way to treat a cataract is to remove the cloudy lens and replace it with a new, clear artificial lens. This can be accomplished in two ways. The first technique is called "extracapsular extraction" (ECCE) and involves removing the cloudy lens in one piece. This technique requires a relatively large incision of 10-12 mm in length. The second technique is the latest advance in cataract removal. It is called "phacoemulsification" or "phaco" for short.
In phaco surgery, a small ultrasonic probe is inserted into the eye. This probe breaks (emulsifies) the cloudy lens into tiny pieces. These pieces are then removed by suction from the eye. Phaco requires a small incision of only 3.2 mm or less.
In the event that you require cataract surgery, your surgeon will determine which method is most appropriate for your condition.
Thursday, July 10, 2008
Eye Surgery in India
With the rising economy and increase of per capita income, the Indian Medical sector is at a rise. Medical tourism is India is a rising concept which is slowly and gradually getting very popular in the West. Patients are travelling from all over the world, specially developed countries, to India to get medical treatment. Why ? The advantages include five-star facilities, high quality doctors, very low costs (almost 1/3rd as compared to the developed countries and in most cases, even lower) and finally, a great tourist destination.
A recent study by McKinsey estimated that India's medical tourism industry could yield as much as $2.2 billion in annual revenue by 2012. Airport pick-up & drop, visa assistance, interpreter services, sight seeing, arranging forex services - hospitals are here to service the patients from the west in full energy.
Eye surgery in India is one of the highly growing sectors in medical tourism. Several hospitals and clinics are now fully equipped to handle the inflow of patients from the West with latest technology, highly trained doctors and of course, customized treatment for every patient.
A recent study by McKinsey estimated that India's medical tourism industry could yield as much as $2.2 billion in annual revenue by 2012. Airport pick-up & drop, visa assistance, interpreter services, sight seeing, arranging forex services - hospitals are here to service the patients from the west in full energy.
Eye surgery in India is one of the highly growing sectors in medical tourism. Several hospitals and clinics are now fully equipped to handle the inflow of patients from the West with latest technology, highly trained doctors and of course, customized treatment for every patient.
Monday, July 7, 2008
Refractive Errors
The eye is like a camera. In a camera, light passes through a lens system back onto the film. The cornea and lens are at the front of the eye (anterior chamber) and are similar to a camera's lens system. The retina is located at the back of the eye (posterior chamber) and is similar to the camera's film. In the normal eye, light rays of an image pass through the cornea and the lens and are focussed directly on the retina to produce a clear image.
Myopia (Nearsightedness)
In a myopic eye, the light rays are passed through the cornea and lens but the point at which they converge (focus) is in front of the retina, not on the retina. This configuration allows clear images of near objects but not those that are far away. Non- surgical treatment options for myopia include glasses and contact lenses. Surgical treatment options include ALK, clear lens extraction, LASEK, LASIK, LASEK, phakic IOL and RK. While there are numerous surgical options available, not all individuals are good candidates for specific procedures. Patients should review these options in depth with their physicians prior to making any final decisions.
Hyperopia (Farsightedness)
In a hyperopic eye, the light rays do not converge or focus by the time they reach the retina. Hyperopic patients can focus on more distant objects, but not images that are close at hand. Non-surgical treatment options include glasses and contact lenses. Surgical treatment options include clear lens extraction, CK, LASIK, LTK, phakic IOL, and PRK. While there are numerous surgical options available, not all individuals are good candidates for specific procedures. Patients should review these options in depth with their physicians prior to making any final decisions.
Astigmatism
With astigmatism, the rays of light do not converge into a single point but form a line on the retina. There are various types of astigmatism included regular, mixed and irregular astigmatism. Currently, excimer lasers in the US are approved for treatment of regular and mixed astigmatism. Recent advances in technology now allow for the therapeutic treatment of induced irregular astigmatism. In the future, this application may be expanded to include all types of irregular astigmatism. Patients who believe they have astigmatism should discuss this subject in further detail with their physician to gain a better understanding of the mechanisms in their case.
Presbyopia
Presbyopia affects people as they enter their 40s. Caused by changes within the eye's crystalline lens as one ages, presbyopia affects everyone, and eventually everyone will need to wear reading glasses or bifocals. Presbyopia is not affected by the laser treatment.
Myopia (Nearsightedness)
In a myopic eye, the light rays are passed through the cornea and lens but the point at which they converge (focus) is in front of the retina, not on the retina. This configuration allows clear images of near objects but not those that are far away. Non- surgical treatment options for myopia include glasses and contact lenses. Surgical treatment options include ALK, clear lens extraction, LASEK, LASIK, LASEK, phakic IOL and RK. While there are numerous surgical options available, not all individuals are good candidates for specific procedures. Patients should review these options in depth with their physicians prior to making any final decisions.
Hyperopia (Farsightedness)
In a hyperopic eye, the light rays do not converge or focus by the time they reach the retina. Hyperopic patients can focus on more distant objects, but not images that are close at hand. Non-surgical treatment options include glasses and contact lenses. Surgical treatment options include clear lens extraction, CK, LASIK, LTK, phakic IOL, and PRK. While there are numerous surgical options available, not all individuals are good candidates for specific procedures. Patients should review these options in depth with their physicians prior to making any final decisions.
Astigmatism
With astigmatism, the rays of light do not converge into a single point but form a line on the retina. There are various types of astigmatism included regular, mixed and irregular astigmatism. Currently, excimer lasers in the US are approved for treatment of regular and mixed astigmatism. Recent advances in technology now allow for the therapeutic treatment of induced irregular astigmatism. In the future, this application may be expanded to include all types of irregular astigmatism. Patients who believe they have astigmatism should discuss this subject in further detail with their physician to gain a better understanding of the mechanisms in their case.
Presbyopia
Presbyopia affects people as they enter their 40s. Caused by changes within the eye's crystalline lens as one ages, presbyopia affects everyone, and eventually everyone will need to wear reading glasses or bifocals. Presbyopia is not affected by the laser treatment.
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