Cataract affects people over the age of 50, and most of them develop slowly over time. By the age of 65, about half of the population has a cataract by the age of 65. People over 75 years of age have at least one. It is a rare case where infants have cataracts. Cataracts are usually related to the mother’s history if she had measles, chickenpox, or another infectious disease during pregnancy, but sometimes they are inherited.
There are very few cases with serious cataract surgery complications, and as with any surgery, pain, infection, swelling & bleeding are evident. In most cases, medication or a follow-up procedure can successfully manage complications or side effects from the procedure. For a healthy and safe lifestyle post-surgery, please follow the instructions your surgeon has given you and report any unusual symptoms at the earliest.
There are multiple factors on which the cost depends. It varies from one doctor to another, depends on the procedure type and intraocular lens you & your surgeon decide is best for you. Most of the health insurance plans cover cataract surgery and ordinary intraocular lenses. Still, they do not cover the cost of premium IOLs, such as Presbyopia-correcting IOLs that simultaneously correct vision at near, intermediate and distant ranges.
Yes, there are different types of cataract surgery. The procedure/surgery differs depending upon multiple factors, which includes the health of the affected eye, the expertise of the surgeon, and the surgical equipment used.
If you face any problem with your sight and your vision seems to be unclear, it is time that you consult your Ophthalmologist. Depending on how bad is the cataract, the surgeon will suggest the procedure. Sometimes one may experience problematic vision problems such as glare and halos at night even before the specialist notices significant clouding of the lenses in eyes while examining a dilated eye. For a better vision, it is advisable to get a surgery at the earliest or at the time suggested by the specialist.
The need for glasses is likely to depend on the requirement post-surgery. The standard cataract surgery with intraocular lens (IOL) implantation requires you to wear reading glasses and possibly computer glasses or other special-purpose eyewear which depends on your visual needs. Other cataract surgery options reduce or even eliminate the need for glasses. In particular, the combination of laser cataract surgery and premium implantable lenses such as multifocal IOLs and accommodating IOLs can provide excellent outcomes that enable many people to be glasses-free for much of their day.
For the foreseeable future, cataract surgery seems to be the only viable treatment for cataracts. Some study suggests that a healthy diet may help prevent cataracts. Once cataracts appear, making few dietary & lifestyle changes will not reverse them. There are ongoing researches (which are in their early stages) to find an eye-drop that can prevent or cure cataracts. One cannot say if such a treatment (eye-drop) will be as effective as surgery to restore vision. Besides restoring vision that has been lost due to cataracts, cataract surgery can correct astigmatism, farsightedness, and nearsightedness.
Yes, cataract surgery can be performed after Laser eye surgery and also post any laser vision correction procedure, including LASIK, PRK, Epi-LASIK and LASEK. Any laser vision (including LASIK) correction alter the curvature of the front surface of the eye (cornea) hence you should provide your cataract surgeon with the records of your eye exams that were performed prior to your laser procedure.
In such a case where cataracts are present in both the eyes, the surgery is typically performed on one eye first followed by the second one a few days or a few weeks later. This approach will let the first eye to recover and the vision in that eye to stabilize. Once it is stabilized and healed the second surgery on the fellow eye is performed. With the modern cataract surgery being safe and effective, and the rate of cataract complications being low, some surgeons are planning on offering simultaneous (or sequential) bilateral cataract surgery (SBCS). In other words, cataract surgery performed on both eyes on the same day. But as of now, we do not offer cataract surgery for both the eyes at a time.
In case if one has Glaucoma, yes, it is possible to get cataract surgery done. In some cases, cataract surgery lowers the high eye pressure, in turn, reducing the number of medications one needs to manage their Glaucoma. It can also eliminate the need for Glaucoma medication altogether. Sometimes, your surgeon can perform a minimally invasive type of Glaucoma surgery along with the cataract procedure, to address both conditions at once. Consult your doctor for any queries before taking any decision.
LASIK (laser in situ keratomileusis) is a scientifically well-documented and well-established treatment of refractive errors and is the preferred treatment method by most eye specialists. This classic LASIK method has been developed significantly in recent years: into Femto-LASIK. In order to correct a vision disorder with laser treatment, it is necessary first to prepare a small round corneal flap. In the classic LASIK procedure, this corneal lamella is prepared with a microkeratome (a surgical precision instrument with an oscillating blade), in the Femto-LASIK procedure, however, the femtosecond laser prepares the flap-without any use of mechanical blades.
Flap preparation with Femto Laser
Smooth, even corneal flaps, thinner flaps, less tissue ablation
A safer, more precise & pain-free method, ‘gentle LASIK.’
Faster vision rehabilitation
No cut-related complications
Treatment of higher refractive errors
Lesser suction pressure & more gentle
Precise shape, location & possible for a smaller area to be cut
Flap preparation with Micro Keratome (Blade) Difficult to obtain perfectly shaped flap
Ore/One strain on the cornea due to a thicker flap
An unreliable method, deviations in the thickness of the flap
Unpleasant to painful
Increased strain in the eye due to the microblade
Cut related complication are possible
Treatment may not be possible
The femtosecond laser can produce a much more reliable, gentle and precise corneal flap than the microkeratome. A femtosecond laser can create a flap within 10 μm of the desired thickness, whereas the traditional keratome is only accurate within 20-40 μm. The laser creates a smooth and uniformly shaped corneal lamella. The centre of the flap is the same thickness as in the periphery. Cut related complications are thereby reduced to an absolute minimum-they are nonexistent. The high precision in the thickness of the flap is impossible with a microkeratome. Corneal flaps that are made with the microkeratome are thinner in the centre. This can cause a postponement of the following treatment to a later date. The Femtosecond laser works fast and pain-free. When the corneal lamella is being prepared, you will see a bright light. The so-called “blackout”, which usually occurs with the microkeratome, is virtually impossible. The moulded glass lens used to fixate the eye is much more pleasant than the previously used suction ring and also much less stressful for the cornea. Due to the gentle and blade-free treatment of the cornea, significantly faster vision rehabilitation is possible. The cornea remains free of damage because the cornea will absorb the tiny bubbles, induced by the femtosecond laser. The tissue heals very rapidly after the treatment. Temporary side effects, such as dry eyes are less frequent.
1. Personal, non-binding consultation
We determine what the best method of treatment is for your eyes, to examine your eyes, to make sure you are a suitable candidate for the treatment.
2. A thoroughly medical preliminary examination
The examination usually lasts about two hours of intensive ophthalmic preliminary examination and measurement of your eyes. Our specialists in ophthalmology and patient counsellors will explain every detail about the treatment before this preliminary examination you must not have worn soft contact lenses for at least two days (may differ in individuals) and hard contact lenses for two weeks. Please note that after the examination you will not be safe driving a vehicle-neither car nor motorcycle and bicycle. We, therefore, recommend that you take a cab or public transportation. At the examination, you will receive aftercare set for the days your treatment. The medication and content will be explained in detail by our staff.
3. On the day of the treatment
We recommend that you wear comfortable clothes on the day of treatment you can eat and regularly drink on the treatment day but please do not smoke for hygiene reasons, it is also crucial that you wash your face thoroughly prior to treatment, altogether remove makeup and avoid perfume/aftershave lotion in outpatient surgery, anaesthetic eye drops, no bandage and clean/ protective glasses are recommended. The duration of the laser eye treatment for both the eyes is a total of 25 minutes. You are not allowed to drive a vehicle after the procedure.
4. After the treatment
Please do not rub your eyes for one week
Artificial tears as required for three months or more
Antibiotic eye drops 4 X a day for one week
Return to work after 2-3 days
Resume sports activities after approximately ten days, swimming and sauna after almost one-month Post-operative follow-up examination: after 1 day – 1 week – 1 month or as per Doctor Recommendation you may be called frequently.
You may drive a vehicle again only with the doctor’s permission, generally after the 1week Post-operative examination.
An Optic nerve is the main nerve that transmits information from the eye to the brain. The term Glaucoma describes many related conditions that damage the optic nerve. It is usually (not always) associated with high pressure inside the eye. Glaucoma can cause blindness if left untreated.
The term used to describe high eye pressure is called Ocular hypertension. In ocular hypertension, the IOP is higher than normal and do not cause optic nerve damage or vision loss. But ocular hypertension is a risk factor for Glaucoma. It should be monitored closely.
The screening test that most people are familiar with is called the “puff test” that measures IOP. The gold standard for measuring eye pressure is called “Applanation Tonometry”. This test (Glaucoma test) involves an eye drop which is used to numb the surface of the eye. Then to measure IOP, a small probe rests gently on the cornea of the eye.
People who are above the age of 50 years, have a family member with Glaucoma, or who are diabetic, are at a higher risk for Glaucoma than others.
The risk of Glaucoma can be reduced by going for regular eye checkups and screening tests to detect it. Though it’s unclear whether Glaucoma can be prevented, the regular eye checkups can help prevent it in the early stages with proper medication.
Glaucoma has no signs of its presence/development in the eye until the patient has a vision loss. This is the very reason that one must regularly go for eye checkups. Through the tests, the doctor will be able to detect and treat IOP before it progresses in damaging the optic nerve, which results in vision loss.
The most common form of Glaucoma is the Primary Open-Angle Glaucoma (POAG). The other types are as follows: closed-angle, narrow-angle, normal-tension, congenital, pigmentary, and secondary.
If Glaucoma causes one’s vision loss, then it cannot be reversed. Regular eye checkups help discover Glaucoma early and begin glaucoma treatment before significant vision loss has occurred.
To reduce the intraocular pressure, doctors usually prescribe special Glaucoma eye drops. These eye drops can be used more than once a day, depending on the medication for your entire lifetime. Surgery is the next step if the eye-drops do not work. In certain cases, laser or surgery becomes the first option for Glaucoma treatment.
No, there is no pain as surgery is nearly painless.
You need to take an off on the day of the surgery so that post the procedure you can go and take rest. You can resume your work the next morning, and you will notice a considerable improvement in your vision on the following day, post OP. A clear vision may take a week or more.
The surgery will last for about 10 minutes. You will be at the laser centre for two hours and will need a driver to take you back home.
Rest as much as possible. The day your surgery is done, you are supposed to keep both eyes closed for the day and rest as much as possible. For three days you are advised to place the shield over your eye for additional protection. Swimming is strictly off the list of to-dos for a month post-surgery unless you wear watertight goggles. It is also advised to avoid hot tubs for a week and to keep taking medications on time as prescribed.
It depends on the patient. They can go for getting the procedure done for both the eyes at once or can opt for intervals. The surgery can be done two days or one week apart. If the next surgery is after a week, then you can wear a contact lens in the unoperated eye in the interim.
The pre-surgical exam into the laser’s computer helps the doctor to determine the amount of nearsightedness. The laser is accurate to the level of 25 microns (a human hair is 50 microns in diameter).
The most common side effects of these procedures are temporary light sensitivity and halos. There are chances of under-correction or over-correction. An enhancement may be necessary to attain the best correction for you.
You can discuss in detail about this during your comprehensive pre-surgical consultation.
In most cases, glasses are not required for a distant vision. However, some patients will require thinner lenses for fine-tuning. When you are in the age range of 40-45, and beyond, bifocals or “readers” are required for close vision; hence you will most likely need a reading glass. This natural process is known as ‘Presbyopia.’
LASIK was first performed (using a laser) in 1991 in Europe. It is based on the lamellar keratomileusis technique that has been used for over forty years.
One should be 18 years at least (recommended) for this surgery. There is no upper age limit for LASIK.
If you wear soft lenses daily, then it is advised that you should remove them at least 48 hours before your pre-surgical evaluation. If you wear contact lenses which have extended use, then you must leave them out for two weeks. The ones who wear rigid gas permeable lenses must leave them out for three weeks prior to the pre-surgical testing. You can wear your contacts again once you have your detailed exam done. You can continue to wear it right up to the night before surgery without affecting your result. The laser treatment will be based on the results of your exam.
No. The laser pulses from the laser treatment do not enter the inside of the eye, and it will not cause glaucoma or cataracts. If you develop glaucoma or cataracts later in life, these can be treated even if you had laser treatment.
People who have lupus, keratoconus, AIDS, rheumatoid arthritis, herpes simplex of the cornea (herpes elsewhere is of no consequence), autoimmune diseases, or anyone with unrealistic expectations cannot get this surgery done.
The eyelids are held open with a small lid holder.
A blinking light inside the laser will help you focus during the procedure.
Your vision will be dark once the flap is created. During the later stages, patients often say that they see someone working on a window above them or perhaps working on the surface of their glasses. The topical anaesthetic drops are used to numb the eye during the procedure. No stitches are needed since the two layers of the cornea are naturally “sticky” and will adhere to one another very well once the flap has been put back into position.
There are about ZERO cases of blindness post the Laser Vision Correctiontill date.
The latest technologies in LASIK include wavefront-guided LASIK, an aspheric correction which is a customized treatment or C-Lasik. Few newer ones include Bladeless (Femtosecond laser) assisted customized LASIK.
That will depend on what your doctor suggests. PRK/LASEK have slightly longer healing time & you may have to visit the clinic often during the treatment.
Patients who cannot undergo or are not suitable for (LASIK/PRK) laser treatment are given an alternate like ICL (Permanent Contact Lenses).
Before jumping to Macular Degeneration, let us read what the Macula is. The Macula is the central segment of the Retina, and it is accountable for most of our vision. It helps us in focusing, evaluating different shapes, distinguish between precise colouring and faces, etc. This is the section that controls our central vision. The Macula is a fragile, film-like membrane present our Retina’s core on which the picture of the object is projected. The rods and cones in our eye acquire these images and ship it to the brain in the structure of electrical signals through the optic nerve. When this membrane is healthy and working in its ideal condition, you can see the image of the object in excessive definition or its pure form.
Macular Degeneration is a condition in which Macula gets broken or starts to degrade. It results in abnormal vision, and in worst cases, leads to total blindness. In its early stage, Macular Degeneration no longer causes any full-size impact on our eyesight. Still, if the trouble continues, you can experience a complete loss of sight, blurred visions, foggy images, etc. Although this does not cause any impact on the peripheral vision as the concerning section is the central part of the Retina only.
In most cases, the reason for macular Degeneration is the age. People above 50-years face it the most, that is why this condition is often known as AMD or ‘Age-related Macular Degeneration’. Currently, there is no treatment for AMD. However, few treatments are limited to maintaining and enhancing a person’s eyesight for as long as possible.
Symptoms- The signs of the AMD are barely visible and mostly include blurred visions, lines and sentences appear to be curvy, you can have difficulty in reading in low light, being substantially sensitive to glares, etc. These symptoms would possibly seem as ordinary in the initial state of AMD. Still, in some cases, if left untreated, it continues to erode the Macula membrane resulting in more significant long term effects such as blindness.
There are two types of AMD- ‘dry’ and ‘wet’.
Dry AMD is the most common condition and constitutes the majority of the AMD cases. Dry AMD occurs when the Macula gets too thin, and the Retinal Pigment Epithelium Cells of the Retina die due to this. These two scenario leads to patches of lacking retinal cells leading to loss of central vision.
Wet AMD is a chronic condition, and in some instances lead to a complete loss of eyesight. This circumstance arises due to the excessive leak of fluid or blood from the blood vessels beneath the retinal membrane. This causes everlasting harm to the membrane that often leads to complete blindness in a short period.
The treatments available do not cure the condition but help in maintaining the remaining eyesight of the affected person for as long as possible. The treatment planned depends on the kind of AMD.
Drugs such as Ranibizumab (Lucentis), Aflibercept (Eylea) and Bevacizumab (Avastin) are most commonly used for the cure of AMD. These drugs are directly injected into the vitreous cavity of the eye. These drugs minimise the increase of blood vessels beneath the Retina, along with their leaks of fluids. Patients need to take these drugs regularly depending on the severity of AMD.
Photodynamic Therapy (PDT)- PDT is a specialised laser therapy that combines injection of a photosensitive drug called Verteporfin into the bloodstream which is followed by laser treatment. Both the injection and the laser treatment work together to seal the leaky blood vessels. They do not cause any damage to the other parts of the eye. A variant of wet AMD called ‘Idiopathic Polypoidal Choroidal Vasculopathy’, is commonly seen in Indians & Asians can be effectively treated with PDT. PDT may reduce the need for continuous treatment with injections for these patients.
Laser Photocoagulation – A Laser Photocoagulation seals the leaky blood vessels onto the Retina with a concentrated beam of high energy laser light directed onto it. This laser treatment may reduce the need for injections as a treatment to the problem.
An eye specialist/ ophthalmologist will determine an appropriate treatment for each case. There are no proven treatments for reversing Dry AMD. There are antioxidants, vitamins and minerals that help in slowing down the progress of AMD.
One can reduce the impact of the AMD by following the steps mentioned below:
Diabetic Retinopathy is usually seen in diabetic patients, and the leading cause behind this is diabetes. In Diabetic Retinopathy, the blood vessels of the light-sensitive tissue at the back of the, i.e., Retina get damaged. In its early stages, Diabetic Retinopathymay causes little or no problem with the vision.
Diabetic Retinopathy can be reduced and controlled by following a healthy diet, exercising regularly, quit smoking, regularly checking BP and cholesterol, and taking the prescribed medication, but it cannot be prevented. A regular eye checkup ensures the safety of your eyes.
In Retinal Detachment, the Retina pulls away, separates or detaches from its normal position of lining the inner back wall of the eye. Various reasons for this Detachment can be retinal tears, retinal holes, traction on the Retina from scar tissue on the retinal surface or in the vitreous gel. It has to be treated immediately if not results in a permanent loss of vision.
The symptoms of Retinal Detachment includes new floaters, flashing lights, a sudden increase in the number of floaters, (i.e., cobwebs, specks or strings) that float in your field of vision. In another symptom, a curtain appears over the field of vision. It starts at the periphery and gradually progresses towards the central part of the visual field. A Retinal Detachment is a medical emergency which and anyone who is experiencing such symptoms must see an ophthalmologist/eye specialist immediately.
A Retinal Detachment occurs for people over 40 years, but it can occur at any age, and it is more common in men compared to women. Retinal Detachment is likely to occur for people who had cataract surgery, who are nearsighted, family history of retinal Retinal Detachment, an eye injury, etc.
Rhegmatogenous Retinal Detachment: The most common type of detachment is the Rhegmatogenous Retinal Detachment which is caused by breaks or holes in the Retina called ‘retinal tears‘. A retinal tear lets in the fluid from the middle of the eyeto settle under the Retina. As the fluid builds up, the Retina gets pushed away from the layer beneath it. One of the most common causes of retinal tears is Posterior Vitreous Detachment (PVD) which is a normal part of ageing. In PVD the vitreous gel separates from the Retina. PVD is harmless usually, at times the vitreous gel can pull hard, resulting in a tear in the Retina. The Vitreous gel is strongly attached to the sides (periphery) of the Retina, and most of the tears occur in this region. The eye fluid that moves through the tear and accumulates under the Retina will make it (Retina) come off the back of the eye. Retinal tears aren’t the cause for Retinal Detachment often, but the retinal tears with symptoms (such as flashes or lights, floaters or other disturbances in vision) likely push the progress of the detachments. If one had recent cataract surgery or is nearsighted, then they are at a high risk of experiencing a Retinal Detachment.
Traction Retinal Detachment: Traction Retinal Detachment occurs when the growth of the scar tissue or other abnormal tissue on the surface of the Retina pulls it away from the layer beneath it. It doesn’t cause a break or tear in the Retina. A condition called Proliferative Retinopathy, frequently caused by diabetes is the leading cause of Traction Retinal Detachment.
Exudative Retinal Detachment: Exudative Retinal Detachment is caused when fluid or blood from the middle layer of tissue [that forms the eyeball (choroid)] flows/accumulates into space under the Retina. This fluid/blood separates the Retina from the layer beneath it and does not cause traction from the vitreous or tears in the Retina. Exudative Retinal Detachment is a complication caused by other conditions or diseases. These conditions include high blood pressure, severe Macular Degeneration, inflammation in the Retina or choroid, or eye tumours.
Your ophthalmologist may perform the treatments that cause little or no discomfort. Consult your eye specialist before taking up any decision. Your ophthalmologist will use a laser to make small burns around the retinal tear and scars it. It is this scarring that seals the Retina to the underlying tissue and helps prevent a Retinal Detachment.
The primary and effective way to prevent Retinal Detachment is to educate people to seek medical help if they suffer symptoms to that of a Posterior Vitreous Detachment. Laser therapy or cryotherapy can treat Retinal Detachment if retinal tears are detected early. The sooner, the better.
Retina and Vitreous – The Retina and Vitreous Section comprises physicians who specialise in the evaluation and treatment of Vitreoretinal disease and Retinal Detachment repairs. Expertise in the treatment of the following diagnoses is provided:
A Retina is vital for vision. It is a light-sensitive layer of tissue that lines the back of the eye, and it is covered with special cells called rods and cones. These rods and cones convert light into neural signals and send them to the brain. Hence you can see your surroundings. The Retinal Vascular Occlusion affects the eye, specifically the Retina.
The Retina requires a constant blood supply with enough oxygen and nutrients to keep the cells healthy. The Vascular System (which includes blood vessels called arteries & veins), transports blood throughout the body, including eyes. The blood flow helps remove waste the Retina produces. Sometimes a vessel carrying blood to or from the Retina develops a clot or is blocked. This blocking is called ‘Occlusion’.
The Occlusion causes fluids or the blood to build up and stops Retina from filtering light, and this leads to a sudden loss of vision. The position of blockage or the clot decides the severity of the vision loss.
The reason for Retinal Vascular Occlusion is unknown. The risk is high when veins become narrower in the eye besides the other factors that affect blood flow may be risky. The risk factors are:
There is no specific medication available for Retinal Artery Occlusion. People affected by this will have permanent changes in their vision.
To treat Retinal Artery Occlusion, the doctor may recommend medication such as blood thinners or injections into the eye.
The drugs used to treat Retinal Artery Occlusion include:
Antivascular Endothelial Growth Factor (anti-VEGF) drugs such as Aflibercept (Eylea) and Ranibizumab (Lucentis). These are injected into the eye
Corticosteroid drugs that are injected into the eye to control the swelling
Sometimes a laser is used to break down the blockage in the blood vessels. It helps to keep further damage at bay. If the other eye is at risk for the same problem, the doctor will develop a prevention plan.