Dr. Sunita Lulla Gur

I am Dr Sunita Lulla Gur, senior consultant eye specialist in Sarita Vihar. Today, I will speak about the topic LASIK.

What do you mean by LASIK?

Lasik is a surgery which stands for Laser-Assisted in Situ Keratomileusis.

Why this surgery is done?

This surgery is done basically to correct the vision and eye power like- near sightedness, far sightedness, astigmatism. LOt many times we do get questions from many people like "I am eligible for LASIK or not?". So just for the short brief I will take you to the journey of LASIK. 

As it is one of a cosmetic surgery, I would say but there are other advantages that why one can go for LASIK is;

• It corrects the power
• It gives good vision
• It improves the contarst

These are the advantages which is why one can go ahead with the LASIK surgery.

Sometimes people think that at what age a person can have LASIK surgery?

So the criteria for the LASIK surgery is that;

• The age should be more than 18 years.
• Your power should be stablized for atleast 1 year
• Your cornea should be fit to under take the LASIK surgery.
• Another criteria is that the females who are pregnant should not undeergo LASIK at that time.

These are the main 4 selections for the LASIK. Again depending on the number, LASIK can be done from 0.5 to -10 also. Nowadays there are many technologies coming and lot of advances have been done . We are now doing in high powers also. Again we have to select the candidate properly for successfull outcome of LASIK.

The success rate of LASIK is usually 93-95%. Initially the success rate was less and the reasons for improving its success rate is that the selection criteria has improved. Our protocols have improved over the period of time.

There are different types of LASIK which are been done, those are,

• C-LASIK  - We make a superficially thin flap and the reshaping of the cornea is done as per the number and a person can see a good image after that. When the re shaping is done then the rays which comes focus properly on the retina. So it does the work how we do in practical correction. Here the microkeratome blade where the flap is removed and after that the reshaping of the cornea is done by the laser.
• I-LASIK - It is bladeless LASIK surgery where the flap which is being removed is done by the laser itself and no blade is used. The advantage of this is that it can be done in thin cornea also. So, if the person is having thin cornea as per the criteria which we set, then I-LASIK can be done in these type of cases.
• Contoura vision LASIK - This is an advanced surgery which has come in which the computerized topography is done and which is attached to LASIK which can pick up the minor abrasion which are present in the cornea so that it can correct the vision to its fullest. So sometimes we do have patients who are completely satisfied with the change in their vision. It also reduces the chances of dryness which is there after LASIK surgery.

So, when we plan for LASIK, there are certain criteria for the selection as I have explained. But for the successfull result,

• You have to follow the advices that are been given by the doctor.
• You should not put any water in the eyes after LASIK surgery.
• You should not rub your eyes.
• You should use the eye drops as suggested by the doctor.

Follow the protocol atleast for one month.

The precautions are;

• Water should not go inside the eyes.
• Avoid swimming atleast for 3 months.
• Avoid going to gym atleast for 1-3 months.

Otherwise, you can go to the office next day. Initially you may feel discomfort but you can see the improvement in the vision the very next day. Every season is suitable for LASIK sugery and rest it depends on the fitness of a person for the surgery.

If you want to contact for any LASIK appointment, you can do it through Lybrate.

Thank you
 

Glaucoma is a group of diseases that causes damage to your eye's optic nerve and gets worse over time. The optic nerve is a bundle of millions of nerve fibres which carry visual impulse from the retina at the back of eye to the brain. The increased Eye pressure, called intraocular pressure, can damage the optic nerve and fasten the natural nerve fibre loss. Since nerve cells can't regenerate this damage is permanent and irreversible.

Without treatment, glaucoma can cause total permanent blindness within a few years. Because most people with glaucoma have no early symptoms or pain from this increased pressure, it is important to see your eye doctor regularly so that glaucoma can be diagnosed early and treated before significant functional visual loss occurs.

If you are over age 40 and have a family history of glaucoma, you should have a complete eye exam with an eye doctor every one to two years. If you have any risk factors, you may need to visit your eye doctor more frequently.

What Are the Symptoms of Glaucoma?

For most people, there are usually few or no symptoms of glaucoma. The first sign of glaucoma is often the loss of peripheral or side vision, which can go unnoticed until late in the disease. This is why glaucoma is often called the "Sneak Thief of Vision" or "Silent Thief of Eye Sight".

If you have any of the following symptoms, seek immediate medical care:

1. Seeing halos around lights
2. Vision loss
3. Redness in the eye
4. Eye that looks hazy (particularly in infants)
5. Nausea or vomiting
6. Pain in the eye
7. Narrowing of vision (tunnel vision)

Risk Factors

There are several risk factors, which may lead to glaucoma, such as

1. Age of the individual
2. Ethnicity- African, Caribbean, Hispanics and Asians are at higher risk
3. Increased eye pressure or IOP History of glaucoma in family or relatives
4. Presence of Myopia or Hyperopia
5. Previous eye injuries
6. Use of steroids- as injections, tablets, eye or ear drops or ointments or protein supplements for muscle building in gyms or inhalers
7. Previous history of anemia
8. Individuals conditions affecting blood flow like hypertension, diabetes or high blood sugar, migraine etc are also at risk.

Treatment-

The treatment for glaucoma relies on the nature and seriousness of every case. Generally, glaucoma cannot be totally cured, but it can be controlled. Eye drops, pills, laser strategies, and means of surgery are utilized to maintain and prevent further harm from happening. Talk to your eye doctor to find out if you are at risk of developing glaucoma. If you wish to discuss about any specific problem, you can consult an Ophthalmologist.

Vision is one of our most important senses. Reduced vision that triggers the need for corrective glasses is one of the most common disorders associated with the eyes. Crossed eyes are another such common disorder that affects the eyes. In medical terms it is also known as Strabismus. This condition is a result of miscommunication between the brain and the eye muscles that result in misalignment of the eyes. It is largely a hereditary condition and should not be confused with a lazy eye syndrome.

In fact one of the condition causing lazy eyes! Crossed eyes can cause double vision and disorientation. Your depth perception may also be affected. It also causes eye strains and headaches that affect the quality of your life. This condition is seen mostly in children. If not treated in time, it can continue into the adult years as well. The development of crossed eyes in adults who have not suffered from this condition as children is usually a sign of a serious condition such as a stroke.

Some symptoms characteristic of this condition are:

1. Independent movement of eye balls
2. Tilting the head to a side
3. Squinting Varied points of reflection in each eye
4. Frequently bumping into things as a result of impaired depth perception

Treatment for this condition can be surgical as well as non surgical.

Non surgical treatment aims at strengthening the eye muscles and treating the visual system as a whole. The aim is to not allow the eye to become lazy or amblyopic. If the squint is due to refractive error then corrective glasses are prescribed which need to be worn regularly.

In some case lazy eye requires patching whe re it is worn over the strong eye. In some cases glasses and patching both are advised. Medication may also be injected into the eye to relax the eye in cases were paralysis is the reason for squint. If you wish to discuss about any specific problem, you can consult an Ophthalmologist.

Most individuals suffer from eye problems sometime in their entire life span. Since our eyes are one of the most important assets and sense organs, periodic check ups are recommended to prevent serious eye problems. Here is a list of 5 primary eye diseases, their causes and care:

Conjunctivitis: This disease is commonly called pink eye. It involves swelling of the conjunctiva lines inside the eyelids which cover the sclera of the eyes as well.

Causes: May occur because of factors like viruses, bacteria and Irritant substances such as shampoo, smoke, dirt, chlorine in swimming pools. Dust, pollens or similar allergies may cause this disease in sensitive people. Infectious conjunctivitis can be transmitted from person to another.This can be prevented from transmission by frequent hand wash and cleaning the common use materials like TV remote, mobiles and laptop keyboards. Avoid shaking hands with other people when affected and also abstain from using contact lenses.This disorder may be treated with eye drops, pills or ointments

Vascular: The diseases can be caused in patients with uncontrolled diabetes, hypertension and other systemic diseases, macular degeneration etc. It can be treated with anti-VEGF injections for further progression and loss of vision.

Glaucoma: In case of this disease, the optic nerve of the eye is damaged and can lead to loss of vision over time.

Causes:  Occurs due to poor pressure control modalities within the eyes . The extra pressure destroys the optic nerve. Permanent blindness is caused if the disease is not controlled and treated. Eye drops, laser surgery, and microsurgery are methods for curing glaucoma.

Ocular Migraine: This temporary disease causes loss of vision in one eye and generally does not last for more than an hour. This might happen after a migraine headache.

Causes: Mainly caused due to health-related issues than from eye problems. Also occurs from regular migraines. temporary blurred vision is related to spasms caused in the blood vessels of the retina. This disorder can be cured by using aspirin, epilepsy drugs and blood-pressure medication known as beta blockers.

Retinal vascular occlusion: This disease affects the retina and lowers the supply of oxygen-rich blood.

Causes: Factors such as atherosclerosis, blood clots and blockage in arteries, diabetes, high blood pressure, obesity or smoking lead to this disease. The blood flow to the retina is restricted. Medicines like blood thinners, eye injects such as vascular endothelial growth can cure this disorder.

Ophthalmoplegia: Paralysis of the eye muscles occurs. Can occur in more than one of the eye muscles.

Causes: Happens due to interruption of messages sent to the eye from the brain. Caused from muscle disorders. Also caused from migraines, thyroid problems, stroke, etc. Special eye patches and eyewear are used for treating this disorder, for relieving double vision.

So one should go for regular eye check ups to keep all these diseases away to prevent serious visual loss. If you wish to discuss about any specific problem, you can consult an ophthalmologist.

A simple, uncomplicated cataract surgery should not take much time to perform. The best part about a cataract surgery is that most people see almost immediate results and improved vision. However, full recovery can take awhile. Each person heals at a different speed but ideally, your eyes should heal completely in a month. Here are a few tips to help speed up this process and avoid infections and eye injuries:

1. Take it easy: Just because the surgery takes a short time is no reason to underestimate its importance. Do not drive on the first day and as far as possible avoid driving for the next few days as well. Do not put any extra pressure on your eyes by bending, lifting weights etc. Try to avoid excessive sneezing and coughing. One should go for regular follow up as advised by your doctor. Use post op medication for a duration as advised by your treating surgeon. Do not use post op medications on your own whenever you have problem.
2. Protect your eyes: Wearing sunglasses is a good idea after a cataract surgery. This will protect your delicate eyes against dust, wind etc. Avoid using community swimming pools and hot tubs immediately after such a surgery to lower the risk of infections. Avoid rubbing your eyes aggressively. For the first week, keep your face out of the shower so as to avoid feeling the need to press or rub your eyes as well as to protect them from bacteria in the water.
3. Lubricate: Your eyes may feel dry and scratchy after a cataract surgery. This is normal and not something to worry about. Your doctor will prescribe eye drops to be taken after the surgery. Use these regularly. Once this is over you may need additional artificial tears or lubricating eye drops. However, do not take these drops without first consulting your doctor. If your eyes are sensitive to the preservatives in bottled eye drops, look for single use ampoules. Ensure that you always wash your hands well before administering the eye drops.
4. Keep the eye clean: Though washing your face is avoidable, you must still keep the eye clean. Use cotton and a sterile saline wash for the first few days. You can later replace the saline with cool boiled water. You should rush to the Ophthalmologist if you develop any sudden onset of pain, watering, redness or blurry vision in the operated eye . Seeing sudden flashes of light or floaters in your vision should also not be ignored.

A simple, uncomplicated cataract surgery should not take much time to perform. The best part about a cataract surgery is that most people see almost immediate results and improved vision. However, full recovery can take awhile. Each person heals at a different speed but ideally, your eyes should heal completely in a month.

Causes, prevention, and treatments for Cataract

I am Dr. Sunita Lulla Gur, a senior eye specialist at Accuvision Eye Centre and AcuVision center. It has been long that people wonder, why we see less with ageing. Of which, ageing is itself a problem of many disease, or may be degenerative changes which are taking place in a body, of one, cataract is an important thing that happens. Now let’s see what is cataract. Now when we see the complete structure of the eye, this is the cornea; then you have a natural lens, which is situated over here, and then we have the retina. So whenever the degeneration, normally when we see, the lens, which is more clear, okay? Now, what happens , with ageing, this degeneration of the proteins which are there in the lens, and it leads to opacification.

Now when we look into this, this is opacification of the lens which is happening. Now because of this opacification, what happens is, the natural clarity of the lens is lost, and then we see through this haze which is there. So this reduces, or leads to the diminishing of vision, or blurred vision. So, this condition is called as cataract. Now cataract can be of many types, and depending on the stage, your vision will be affected. Sometimes what happens in early cataracts, you will have little bit blurred vision, but you can cope up with your daily day to day life. There are different types of cataract; age-related, in children also we have seen, which is since birth and which is called as congenital cataract.

Traumatic cataract, it means, whenever there is injury to the eye, then it can lead to traumatic cataract. Or sometimes, drugs; there are some kind of drugs which can cause cataract, like if you are on, long term on steroids, or other drugs, then it can lead to cataract formation. So keeping that in mind, you should always have your regular eye check up, once you are at the age of 40 or 50 years old. In Indian scenario, as we are a tropical country, too much of sunlight and UV radiation, the chances of cataract formation in Indian scenario is much higher than the counterpart in American scenario which we have seen. Now coming to, when should I get the cataract surgery one? Now when we say that you have cataract, one should not panic, because it is a normal ageing process which is happening; and surgery is the only treatment option available, as there are no drops or drugs or oral medication available to prevent it. Yes the role of anti-oxidants and good healthy diet is definitely there, to prevent early onset of cataract, okay? Now coming to the treatment or the preventive part.

Now how can you prevent cataract? As I already said, it is an ageing process, nothing can be done, but still, get a regular eye check up, have a healthy diet, including greens, reds, and yellow vegetables in your diet. Take some, well, you can include some almonds, and walnuts in your diet. These are all antioxidants which can delay the degenerative process. Now another thing is, as I said, there are no drops etc, so there is no need to put any drops for that. Sometimes people do take over-the-counter drops, many say that these are the drops which will be able to reduce the cataract, but then nothing happens. Now when can one get the surgery done? Now we have seen that surgically, it is one of the safest procedures to get done.

Nowadays with technology, so many good machines are available, the evaluation protocols have improved, what are seeing. So nowadays we do laser surgery, microincision surgery which is the key-hole surgery, through a, very small incision, that is made; and then cataract is emulsified and removed. Now, because we make a very micro hole surgery or a very small hole surgery, the wound healing is very fast. Now the techniques which are available to remove cataract is, one is laser, where we make a very small laser cut over here, where no blade is used, and a small phaco emulsification, for objects like the tip of this pen, if you see, it is entered, and whole of this cataract which is there, is emulsified. The cataract which is there is emulsified, and intraocular lens is implanted, and then the wound healing occurs, and the next day, or within 2 to 3 days, you are back to your normal work.

You have to take some precautions, which we will explain to you later. So this process is called as laser technique. Then we have another technique which is microincision, which is a very small key hole that is done, around 1.8-2 mm, through which the probe goes inside, it emulsifies the cataract, the cleaning is done and then the lens is implanted. The 3rd technique is phacoemulsification, where again, the incision size is slightly more than the microincision hole, but still it can be moved, through a small incision and the wound healing is faster. So, well, what was happening in the initial days, we were making incisions of this size, to this size, but now the incisions are hardly around 1.5 to 3.5 mm, which helps in healing process. It does not induce any number, and again the intraocular lens which is implanted, it is implanted as according to your eye power, so that most of the time, it will help you to get rid of glasses for distance, but for reading, you will require some glasses, for reading.

There are different types of intraocular lenses to be implanted, depending on the need of the patient, the profession of the patient; after discussion with the doctor, one can decide, what kind of lenses one can go for. Now, after care treatment of cataract if we look, it is not very hard. Only, well, some precautions you have to take, like no water should go inside the eyes, no rubbing of eyes. These are the two main precautions to be done. Otherwise you can carry forward your daily routine as you were doing before. Regarding what can be done, after, as in, preventive, if we say, there are many patients who come an ask me, “Doctor, how can I prevent cataract?” , so I say to them, that as I cannot prevent cataract in my eyes, how can I suggest? But still, as I already said, good eating habits.

Smoking is again, one of the causes of cataract early. So do not smoke, or if you are smoking, quit smoking or reduce it. Third, again, if you are on UV exposure lights too much, like working in sunlight, always wear protective glasses, so that the UV radiation does not fall directly in your eyes, and then the amount of cataract can be reduced. If you all do not take any steroids on your own, always consult a doctor before you start steroids. So these are the precautionary things which can prevent cataract, from happening. And once you develop, you should be seen by an ophthalmologist. Get your eyes checked and then decide with your doctor that when you should get your surgery done.

Thank you. For further details, if you want to know, you can, contact me. I am Dr Sunita at Accuvision Eye Centre and you can book your appointments to Lybrate.com or call to Lybrate and also, you can visit the website. Thank You.

Your eyes are an important part of your health. There are many things you can do to keep them healthy and make sure you are seeing your best. Follow these simple steps for maintaining healthy eyes well into your golden years.

• Regular checkup: Get your eyes regularly checked once a year after the age of 40 years as it helps to detect age-related ocular changes like macular degeneration (the part of the retina that processes light deteriorates), cataracts (the lens of your eye becomes cloudy) and glaucoma (pressure in the eye damages the optic nerve). 
• Eat Well: Eat healthy diet, include food rich in Vitamin C, Vitamin E, Lutein, Zinc, etc. which includes all green, yellow and red vegetables, fruits and fish as it is rich in omega-3 fatty acid. All these food prevents early degeneration in eyes and also delays the onset of cataract. To get them, fill your plate with:
  • Green leafy vegetables like spinach, kale, and collards
  • Salmon, tuna, and other oily fish
  • Eggs, nuts, beans, and other nonmeat protein sources
  • Oranges and other citrus fruits or juices
  • Oysters and pork

A well-balanced diet also helps you stay at a healthy weight. That lowers your odds of obesity and related diseases like type 2 diabetes, which is the leading cause of blindness in adults.

• First Eye Exam: Children should have their first eye exam between the ages of 6 and 12 months as it is important to detect visual problems as it is vital to ensure your child has the visual skills that that will have the ability to learn in school.
• Healthy Lifestyle: Maintain a healthy lifestyle to prevent any eye damage due to diabetes, hypertension, etc.  
• Quit Smoking: Quit smoking or don’t start as it is known that smoking increases the rate of macular degeneration and early cataract formation. It makes you more likely to get cataracts, damage to your optic nerve, and macular degeneration. If you've tried to kick the habit before only to start again, keep at it. The more times you try to quit, the more likely you are to succeed. Ask your doctor for help.
• Wear Sunglasses: Always wear your corrected prescription as advised by your doctor Wear sunglasses/shades whenever you go out in sunlight as you need to protect your eyes from harmful UV radiation from the sun. The right pair of shades will help protect your eyes from the sun's ultraviolet (UV) rays. Too much UV exposure boosts your chances of cataracts and macular degeneration. Choose a pair that blocks 99% to 100% of UVA and UVB rays.
• Use Safety Eyewear: Use safety glasses while playing games like hockey, racquet ball to prevent eye injury. If you use hazardous or airborne materials on the job or at home, wear safety glasses or protective goggles. Look Away From the Computer Screen: Staring at a computer or phone screen for too long can cause:
  • Eyestrain
  • Blurry vision
  • Trouble focusing at a distance
  • Dry eyes
  • Headaches
  • Neck, back, and shoulder pain
• Follow the Rule: If you are an avid screen reader/computer user follow the rule of 20/20/20 i.e. look at 20 feet distance, after every 20 minutes for 20 second. This will help your eyes to take rest and also improve the blinking rate for lubrication. 
• To protect your eyes:
  • Make sure your glasses or contacts prescription is up to date and good for looking at a computer screen.
  • If your eye strain won’t go away, talk to your doctor about computer glasses.
  • Try to avoid glare from windows and lights. Use an anti-glare screen if needed.
  • If your eyes are dry, blink more.
  • Drink plenty of water to prevent dryness in your eyes. 
  • Wash your hands regularly and avoid touching eyes as much as possible to prevent eye infections and lumps (stye) in the lids. 
  • Don’t use any self-medication as some drops may contain steroid, and after long use of it can lead to cataract, glaucoma and infection in the eye. If you wish to discuss about any specific problem, you can consult a ophthalmologist.

LASIK or Laser-Assisted in-situ Keratomileusis is a kind of eye surgery used for correcting certain vision problems as well as reducing or doing away with the need for corrective lenses or eyeglasses. It is a widely used refractive surgery that alters the shape of your cornea, the transparent tissue on the frontal portion of the eye. The fundamental aim of this surgery is to refract (bend) light rays in order to make them focus on the retina with improved precision, thus creating a sharper and clearer vision.

You can go for a LASIK eye surgery if you are experiencing any of these problems:

1. Myopia or Nearsightedness: It is a condition wherein you enjoy a clearer vision while looking at objects that are close to you. However, distant objects would appear blurred.
2. Hypermetropia or Farsightedness: Here, you may experience blurred vision while focusing on objects which are near to you but tend to enjoy better clarity in vision while viewing objects which are placed at a distance.
3. Astigmatism: It is a condition disrupting focus of both the distant and close (near) vision.

Learn About The Different Tyoes Of Lasik-

1. C-Lasik- C-Lasik or Customized Lasik is gaining ground as the latest and the most effective tool for restoring the quality of one’s vision. It uses a Wave front Guided customized ablation to render personalized treatment to each individual. While the surgical procedure stays the same, C-Lasik, also known as “Eagles’ Eye Vision” can provide the perfect shape to the eye surface, helping one to focus accurately. C-Lasik means that laser eye treatment is now unique to each eye. With C-Lasik, treatment is designed specifically to treat your individual vision errors. It improves the quality of your vision. Each C-Lasik assessment involves an extra diagnostic (screening) process to let the surgeon understand your vision better and select the most suitable treatment for you.
2. iLasik- iLasik is the first vision rectifying procedure that is fully customized, done with the use of a laser. It is used to rectify myopia till a measure of 10 diopters, hypermetropia up to +5 diopters and astigmatism, till -5 dioptersafter evaluation of cornea. iLASIK is different from normal LASIK surgery because it recognises that every eye is different. Using 3D mapping technology, the characteristics along with the uniqueness of each eye is recognised. Then using this information, a blueprint is developed so that the lasers can target the right areas. High-frequency pulses are used to create a corneal flap which is lifted so that another laser can repair your eyes. iLasik is the only procedure that has the technology to personalize treatment to individual vision needs. In fact, wavefront measurements are 25 times more precise than those taken with conventional methods used for eyeglasses and contacts.
3. Contoura Vision LASIK- Contoura Vision is the most advanced technology available for laser vision correction when it comes to accuracy and precision. This diagnostic technology is able to meticulously identify and record irregularities in the cornea’s curvature as well as its optics. During the procedure, this information is combined with the patient’s corrective eyewear prescription to dramatically improve vision for those suffering from nearsightedness (myopia) and astigmatism. While standard LASIK surgery has been helping individuals enhance correct visual refractive errors for many years, Contoura Vision takes the treatment a step further by offering even greater degrees of enhanced vision quality. Potential benefits of this technique can also include a reduced “glare” at night and even an increase in reading speed. If you wish to discuss about any specific problem, you can consult an ophthalmologist.