LASIK

LASIK is laser vision correction of refractive errors like Myopia, Hypermetropia and Astigmatism using Excimer Laser. Corneal tissue is selectively removed to aid better focusing. Normal activity can be resumed after a 48 hour rest period. This procedure reduces dependency on spectacles or contact lenses by altering the shape of the cornea.

Types of Laser corrections

Traditional LASIK uses a a microkeratome, a cutting tool with a metal blade, which cuts a hinged flap in the cornea. This is folded back and the excimer laser then removes some exposed tissue. The flap is then replaced to reshape the cornea.

The IntraLase LASIK, or bladeless LASIK, uses two different lasers for the whole procedure and eliminates the cutting tool. A special infrared laser creates the flap for the excimer laser to remove tissue. This eliminates vision threatening scars or abnormal corneal surfaces that results in astigmatism which may sometimes be caused by the oscillating blade.

Intralase Bladeless LASIK now at Uma Eye Clinic

Uma Eye Clinic has always aimed at bringing the latest technology to deliver the best eye care to the public. The Clinic offers the latest technology in laser surgery the IntraLase. This procedure enhances safety and produces better results.

LASIK Laser surgery

  • Is painless and done under topical anaesthesia
  • Is over in less than 15 minutes
  • Can be customized to suit individual patient's eyes
  • Can be done on both eyes simultaneously or separately
  • Restore vision instantly
  • Has an over 95% 6/6 vision restoration success rate

The LASIK Guide

You can under go LASIK procedure if you are :-
  • Over 18 years of age
  • Not pregnant or nursing
  • Not taking certain prescription drugs like Accutane or oral prednisone
  • Have healthy eyes with a stable prescription for the past one year
  • In good general health and do not suffer from diabetes, rheumatoid arthritis, lupus, glaucoma, herpes infections of the eye, or cataracts
  • Not suffering from presbyopia (near and distance vision problems)

IntraLase is the technology behind LASIK success

IntraLase delivers crucial advantages including biomechanical superiority, excellent visual acuity and unmatched safety. IntraLase has become an integral part of advanced LASIK offering:

Biomechanically Superior Flap Creation

The success of a refractive procedure depends on maintaining the integrity of the corneal biomechanics. IntraLase delivers unmatched control over flap diameter, depth, centration and morphology which offer

  • Controlled flap structure
  • Uniform flap thickness
  • Rapid visual recovery
  • Better quality of vision

Safer LASIK

The femtosecond laser in the IntraLase replaces the blade commonly used for flap creation making it safer. It offers 100% greater accuracy than a microkeratome in flap thickness. This is crucial for the success of LASIK.

Innovative shaped Corneal Incisions

IntraLase enables precise creation of uniquely shaped corneal incisions leading to better corneal transplants and delivering faster healing and improved visual recovery.

Faster Visual Acuity

Eyes treated with IntraLase have clinically better visual acuities through a one month post operation period when compared to surface treatment

Cataract

The clouding of the natural crystalline lens is called cataract. It occurs in old age in everyone. Cataract can also occur in children or adolescents. Patients with diabetes mellitus, may develop cataract earlier in their life.

How is cataract treated?

Till date, the only definitive treatment for cataract is surgery

When should cataract be removed?

Cataract needs to be operated upon and removed when it hampers the patient's visual requirements. It is not necessary to wait for the cataract to become "ripe" or mature to be removed as in earlier times.

At Uma Eye Clinic, phacoemulsification, the latest surgery for cataract is performed for cataract removal. The cataract is removed through a very small incision by phacoemulsification in which ultrasonic aspiration of the cataract is done. The surgery is done without any injections and no suture is applied at the end of the surgery. For this surgery, we use the latest SIGNATURE PHACOEMULSIFICAITON MACHINE WITH ELLIPSE TECHNOLOGY. A foldable intraocular lens is implanted through this small incision at the end of surgery. Multifocal intraocular lenses, when implanted eliminate the need for glasses for both distance and near vision. The patient can go home immediately after surgery and no pad is applied to the eyes after surgery.

Total cataract refractive solutions in Uma Eye Clinic

Uma Eye Clinic offers the latest in phaco surgery where the surgery is done with an incision as small as 2.1 mm with the COLD PHACO SURGERY where the amount of heat being delivered to the eye is significantly reduced thus preventing any damage to the eye. State of the art intraocular lenses like as Multifocal intraocular lenses, Toric intraocular lenses, Aberration free, aspheric, aspheric – with – blue – light filtering intraocular lenses are implanted which eliminate the need to wear glasses. In addition, presbyopic lens exchange surgery to eliminate need to wear cataract glasses is also done in Uma Eye Clinic.

How does cataract affect vision?

The amount of cloudiness of the lens determines the loss of vision. The various symptoms of cataract include

  • blurred vision
  • glare in the presence of bright light
  • image distortion

Symptoms of Cataract

  • Symptoms
  • Cloudy or blurry vision
  • Lights appear too bright or glare causes problems
  • Colours seem faded
  • Poor night vision
  • Double or multiple vision
  • Frequent changes in glasses

Total Refractive Solutions

Uma Eye Clinic offers a whole new concept in refractive error treatment. If you are tired of your bespectacled face then Uma Eye Clinic offers you the best option for total freedom from glasses.

Refractive errors in people under 40 are most commonly corrected with

  • Spectacles
  • Contact lenses
  • LASIK- laser correction
  • Phakic Intra Ocular Lens Implantation- implantation of high powered lens inside the eye
  • People over 40 years develop presbyopia, an inability to read fine print. Then contact lens and LASIK become unsuitable.

PRELEX (Presbyopic Lens Exchange)

We offer PRELEX a simple surgical option to grant freedom from glasses. This procedure removes the lens inside the eye and replaces it with a multifocal lens like Restor to restore perfect near and distant vision. Sovereign Phacoemulsification System, one of the best Phacoemulsification technologies in the world is used. This surgery is possible even in the case of cataracts. The latest technology solution for every refractive need in the hands of experienced surgeons presents near perfect results.

The advantage of See Smarter- Total Refractive Solutions Package

  • Bausch and Lomb Zyoptix Z-100 LASIK Centre. (First in ASIA)
  • Zeiss IOL Master for perfect Intra Ocular Lens Power calculation (First in South India)
  • Sovereign Phaco Emulsification System
  • Phakic Intra Ocular Lens Implantation.
  • PRELEX – Presbyopic Lens Exchange.
  • Variety of Multifocal Lens options including the Restor Lenses
  • If you suffer from Presbyopia or are going in formultifocal IOL implantation cataract surgery PRELEX is the ideal alternative.

Implantable Contact Lenses (ICLs)

ICLs are also known as Phakic IOLs. These lenses are similar to the intraocular lenses used during cataract surgery to replace the natural lens. During ICL surgery however the ICL is inserted through a small incision in the cornea and placed behind the iris in front of the natural lens which works with the implanted lens to correct vision. This is suitable for patients who are not suitable for laser vision correction. This is a virtually pain free procedure with a 95% success rate.

The procedure

ICL surgery is an outpatient procedure which lasts less than 30 minutes. Recovery time is relatively short and there is mild discomfort. Improved vision is noticed generally on the same day as the surgery and the patients heal fully within a month.

  • Suitable candidates for ICL procedures
  • Are between 21 and 45 years of age
  • Have mild, moderate or severe myopia
  • Have minor or no occurrence of astigmatism
  • Have an unchanging vision correction prescription for at least 6 months
  • Are not pregnant or nursing mothers
  • Are not suitable for LASIK

The benefits of ICL

The greatest benefit is that ICL corrects severe myopia and hyperopia, improves the quality of life and affords greater convenience in day to day activities. Its reversibility is another advantage. It is a procedure that rarely leads to complications.

It is the perfect solution for convenient vision correction.

Glaucoma

Glaucoma is a slow build up of the intraocular pressure within the eyeball. This is usually between 12 and 18 millimetres of mercury. But in the case of glaucoma the pressure gradually rises damaging the optic nerve resulting in progressive loss of vision. The progression is so slow that it is often not realized at the onset. Unlike cataract the vision loss in glaucoma is permanent and can never be restored. This makes it vital for regular eye check up with an ophthalmologist for early diagnosis.

Who gets Glaucoma?

Anyone over 40, with a family history of glaucoma, diabetics, abnormally high IOP (intraocular pressure), nearsighted, previous eye injury or regular or long-term use of steroids/cortisone are succumb to getting glaucoma. Since it cannot be cured, anyone suffering from these risk factors should get regular eye check-ups so that the disease can be detected and treated before it progresses further.

What are the symptoms?

There are no symptoms at first. Glaucoma develops slowly over time and the first symptom of this loss of eye sight is tunnel vision. There is a gradual loss of vision from the periphery towards the centre as the disease progresses leading to blindness as the optic nerve once damaged cannot be reversed.

What is the importance of IOP?

Intraocular pressure (IOP) is the certain pressure which is maintained in the eye by fluids. Doctors can easily measure IOP using a tonometry test and can use it in the diagnosis and treatment of glaucoma. Controlling IOP is a major goal of glaucoma therapy as it helps the optic nerve from being at a lower risk of being damaged and thus preserving vision.

Causes of high IOP:

Aqueous humor is a specific fluid which nourishes the different parts of the eye, is present in the front of the eye flowing out of the eye through various paths and chambers. The clogging of these paths results in a pressure buildup due to the aqueous humor being trapped and thus resulting in high IOP which is a major risk factor for glaucoma.

How is glaucoma treated?

The unfortunate factor is that there is no cure for glaucoma but it can be treated effectively when diagnosed at an early stage. Lowering IOP which is the primary effect of most glaucoma medications is the first step towards the treatment of glaucoma. Medications like prostaglandin analogues, beta blockers, alpha agonists, carbonic anhydrase inhibitors and miotics are the types of medication prescribed by most doctors which will gradually reduce the IOP rage to a desirable range and control it over time. Surgery will usually be recommended by the eye doctor if the treatment with one or more medications is unsuccessful.

Medication has to be used life long as glaucoma is a chronic disease but it will effectively help to manage and lower IOP thus helping patients to lead a normal and active life.

How does glaucoma develop?

There is a fluid inside the eye called aqueous humour which is responsible for maintaining the shape of the eye. Pressure may increase in the eye when the passage through which the fluid passes out of the eye is either

  • Narrow or closed altogether (Narrow angle glaucoma)
  • The passage is structurally open but is malfunctioning i.e. clogged (Primary open angle glaucoma)

How is glaucoma diagnosed?

At Uma Eye Clinic, we have a full fledged glaucoma clinic equipped with sophisticated instruments. As part of eye examination, eye pressure is routinely measured in the clinic by using the applanation tonometer which is the most accurate. For patients who have or suspected to have glaucoma we do the following tests.

  • Gonioscopy – study of the angle of the eye with goniolenses like the Zeiss four mirror.
  • Ultrasonic pachymeter for measuring corneal thickness
  • Fundus photography for taking serial photographs of the optic nerve
  • Ocular Response Analyzer for obtaining certain intrinsic measurements of the eye specific to glaucoma
  • Visual Field Test – to study the loss of side vision which occurs in persons with glaucoma
  • Optical Coherence Tomography – in which serial imaging of the optic nerve head is done

Corneal Grafting

Cornea is the outer layer of the eye which helps focus and transmit light through the lens onto the retina. When the cornea is damaged beyond repair transplanting a donated cornea becomes a necessity. The cornea harvested after the donor?s death is screened for infectious diseases before grating.

Causes for damage

  • Congenital abnormalities
  • Childhood infections like measles
  • Severe trauma
  • Degenerative diseases due to exposure to harsh light

Types of corneal grafts

Partial thickness or Lamella grafts are used to treat conditions of the cornea where the damage is mostly restricted to the front surface of the cornea and only the front part of the cornea is replaced.

Full thickness or penetrating grafts are more commonly used and result in the whole of the cornea being replaced.

The procedure

The surgery is performed after the mandatory urine, blood and in some cases ECG rule out any complication. In the hour long operation the central piece of the cornea is cut and removed. This is replaced by the donor cornea which has been treated with an antibiotic solution.

The fine stitches will stay in place for up to 2 years and it will take at least a year to heal completely. The eye is covered with an eye pad and protective plastic eye shield post surgery. This is removed a day after the surgery and normal activities can be resumed as soon as possible. The patient returns home in a few days.

Post operation

  • Eyesight is blurred immediately after surgery
  • Eye may water and be sensitive to light
  • Sight will fluctuate due to the healing process
  • Cornea shape may change and necessitate glasses after a few months
  • There is absolutely no change in the physical appearance of the eye

Do's and Don'ts after the operation

  • Do not rub or touch the eye
  • Apply prescribed medication strictly according to schedule
  • Avoid smoky and dusty rooms, which can cause irritation.
  • Wear sunglasses if the eye is light sensitive
  • Do not play contact sports and swimming in particular. Ask the doctor if you are unclear which sports you should avoid
  • You will need at least 2-4 weeks off work, but again this will be discussed with you on an individual basis.
  • Avoid driving until the doctor tells you otherwise
  • Stick to your follow up appointments to check for other problems lind cataract retinal detachment
  • Return to the hospital immediately if you have
    • Increased pain
    • Increased redness
    • Increased watering or discharge
    • Further reduction in the vision

Diabetic Retinopathy

Diabetes and Eye

India is tipped to be the diabetes capital of the world by 2020. Diabetes mellitus affects various organs in the body including the eye. The changes in the eye due to diabetes are called diabetic retinopathy. Uma Eye Clinic has been providing Diabetic Eye Care Services for more than two decades. The Clinic has got a dedicated Vitreoretinal Surgeon who has been trained in world class institutes to handle patients with Diabetic Eye Diseases.

How does diabetes affect vision?

In diabetes mellitus, if the sugar level is not maintained under control with treatment, the blood vessels in the retina become structurally weak and leaky. This results in fluid accumulation in the retina or bleeding inside the eye. In advanced stages, there can be retinal detachment too. However, there are no symptoms in the early stage of the disease. The patient may notice slight reduction in vision or distortion of images. Many a time changes in the retina are diagnosed on routine examination. If left undetected, diabetic retinopathy can cause severe retinal damage and irreversible loss of vision.

How is diabetic retinopathy treated?

All diabetics should have periodical eye check up to find out if diabetic retinopathy has developed. Detection and grading is done on dilated retinal examination. Uma Eye Clinic offers comprehensive facilities to diagnose and treat diabetic retinopathy. The facilities to diagnose diabetic retinopathy available at Uma Eye Clinic are

  • Slit Lamp Biomicroscopy.
  • Indirect Ophthalmoscopy.
  • Fundus photography
  • Fundus Flourescein Angiography
  • Optical Coherence Tomography

Diabetic retinopathy can be treated with laser, intra vitreal injections or surgery. Uma Eye Clinic is equipped with state of the art Argon Laser Photocoagulation machine, Accurus Vitrectomy machine for retinal surgeries. Uma Eye Clinic offers suture less Vitrectomy surgeries for vitreous hemorrhage / retinal detachment due to diabetes retinopathy

If I am a diabetic what should I do to protect my eyes from diabetic retinopathy?

  • Keep your sugar under good control
  • Have periodical eye check up (at least once in a year) – Remember the involvement of eye is related to both the severity and duration of diabetes mellitus. So, longer you have diabetes, your eyes may get affected even if your sugar is under control.
  • Follow the doctor's advise regarding the various modes of treatment and follow up

Retina and Vitrous Disorders

Retina is the light receptive screen of the eye (akin to the screen in the camera) that sends visual messages to the brain through the optic nerve. When the retina is lifted or pulled from it normal position it gets detached. This interferes with the reception of light by the retina. If this is not treated immediately, this could result in permanent blindness. Retinal detachments are caused by a host of conditions in the eye,

  • Rhegmatogenous detachment – caused by retinal tears or breaks (dehiscence in the retina)
  • Tractional detachment – caused by tractional bands (due to fibrous tissue growth on the surface of retina)
  • Exudative detachment – caused by injury to or inflammation in the eye (when the retina is lifted by fluid accumulation behind it)

Of these Rhegmatogenous detachment is the most common type.

The vitreous is a gel like substance filling the eye behind the lens and in front of the retina. It is an optically clear viscous medium. The vitreous can be become opaque due to bleeding in the eye due to injury/ diabetes mellitus etc.

Retinal detachment can occur if you

  • Are over 40 years of age
  • Are myopic (especially high myopia)
  • Had a retinal detachment in one eye
  • Have a family history of retinal detachment
  • Have other eye diseases like retinoschisis, uveitis, lattice degeneration, retinal breaks etc
  • Had an eye injury
  • Untreated vitreous hemorrhage, diabetic retinopathy etc.

Symptoms of retinal detachment/ vitreous diseases you should look out for

  • Sudden appearance or increase in "Floaters" – black cobweb like little specks in the field of vision
  • Flashes of light
  • Appearance of a curtain over the field of vision
  • Sudden or gradual drop in vision

Treatment for retinal detachment / vitreous diseases

Uma Eye Clinic is fully equipped for the management of disorders of retina and vitreous with very experienced vitreo – retinal surgeon providing all the available treatment options. Uma Eye Clinic also has a – state – of – art machines and Operation Theater exclusively dedicated to treating vitreo – retinal conditions.

Diagnosis of retina and vitreous diseases is done with

  • Indirect Ophthalmoscopy
  • B – Scan ultrasound
  • Optical Coherence Tomography

Treatment of retina and vitreous diseases is done with

  • Laser indirect ophthalmoscopy – for retina breaks in which the hole or break in the retina is sealed with laser
  • Cryopexy – which freezes the area around the hole to reattach the retina
  • Pnuemoretinopexy – where air is injected into the vitreous to push the retina to its normal position
  • Scleral buckling – where a buckle is attached to outside of the eye to gently push the wall of the eye against the detached retina
  • Vitrectomy – is performed with the state of the art Accurus machine in which the vitreous is removed partly or totally through a small incision in the sclera, gas is injected into the eye to push the retina to its normal position

Over 90% of retinal detachment can be successfully treated with good visual outcome achieved when the patient presents early in the course of disease. It is vital to report to the eye specialist at the first instance of noticing floaters, flashes or curtain in the field of vision.

Squint and Oculomotor Disorders

Ocular motility is tested when patients complain of double vision or if neurologic disease is suspected. A visual assessment of the eyes tests for deviations that resulting from strabismus, extraocular muscle dysfunction, or palsy of the cranial nerves innervating the extraocular muscles. Saccadic dysfunction results in poor ability of the eyes to 'jump' from place to place. This will inhibit reading and other skills. This is tested by making the patient move his/ her eye quickly to targets at the far right, left, top and bottom.

The 'follow my finger' test makes the patient follow the examiner's finger as it traces an imaginary 'double H' which touches upon the eight fields of gaze. Inferior, superior, lateral and medial rectus muscles and the superior and inferior oblique muscles are tested.

Squint (Strabismus)

The eyes in a newborn are generally not aligned. Alignment is established only between 3-4 weeks. If misalignment persists in a baby over month old then it should be evaluated.

This condition where the eyes are misaligned and the two eyes look out in different directions is called Squint or Strabismus. This can either be permanent or occasional with eyes straight at other times. It is common in children and may also occur in adults.

It is caused by a lack of coordination between the six muscles that control the movement of each eye leading to misalignment. This may be the same in all directions or may be pronounced in one direction. This may be caused by refractive error, long sight or poor vision in one eye due to various eye diseases.

In case of squint a thorough examination of the eyes is necessary especially in children. An ophthalmologist will establish the nature and cause of squint after evaluation and suggest corrective measures.

The treatment will revolve around

  • Preservation or restoration of vision
  • Straightening of the eyes
  • Restoration of binocular vision

If there is a refractive error then that is treated first. If the squint is an Accommodative Squint this would be all that is required for correction. The eyes are checked for ambylopia and treated. The parents are involved in this procedure as their cooperation is vital for the success of the treatment. The squint is then treated surgically by strengthening or weakening the relevant muscles to restore balance and coordination.

It is essential to correct squint at an early age to avoid amblyopia. If it is not corrected by 10 years squint leads to ambylopia resulting in severe eye strain, headaches and abnormal head posture. Squint will never correct by itself. The earlier the treatment the better the result.

Contact Lenses

These thin plastid discs correct, improve all types of defective vision. They are also used for bandaging the eye after surgery and for cosmetic purposes to change the colour of the eye. They come as Rigid and soft lenses with varying levels of oxygen permeability- the greater the permeability the better.

Types of contact lenses

Rigid Gas Permeable (RGP) : enses are semi-rigid lenses made usually from acrylate and fluorosilicon, a plastic which allow oxygen through to the eye. They are clinically the best as they allow maximum oxygen to reach the cornea being smaller in size. They are easy to care for, durable and give good clarity of vision. They can be prescribed for all types of vision correction, including high astigmatism, bifocals, post surgery (RK, PRK,& Lasic), therapeutic, and cosmetic for all age groups. In certain cases these lenses are also prescribed for myopia control.

Soft lenses : Soft lenses are made from water-absorbing plastics, which make them pliable and membrane-like for maximum comfort. They are ideal for sports as they cannot be easily dislodged from the eye.

New silicon based soft lenses allow maximum oxygen to the cornea, enabling overnight continuous wear safely for a month. With modern manufacturing techniques, soft lenses can be made to correct all types of refractive errors and many types of lifestyles. Soft lenses are available in toric (to correct astigmatism), bifocal, weekly disposable, monthly disposable, daily disposable, extended wear and cosmetic to cover corneal scars, as well as to change the colour of one's eyes for fashion.

Irrespective of the type all lenses accumulate deposits from the secretions of the eye and the environment. All soft lenses are contaminated within 24 hours, when not in the eye, due to the water contained in the material. This makes contact lens care of vital importance.

Contaminated lens can cause

  • Recurrent infections
  • Red eyes
  • Papillae (pimples) on the inner lining of the upper eye lids
  • Reduced vision
  • Contact lens care
  • Lens should be kept clean, disinfected and hydrated
  • Hypoallergenic solutions formulate for sensitive eyes
  • Clean daily by rubbing in the palm of the hand with a surfactant cleaner
  • Protein cleaning should be done once a week

Frequent Replacement Lens

Build up of contaminants over a period of time, from three months onwards, is inevitable. A new system called Frequent Replacement has been introduced. Lenses are replaced on a Daily, Weekly, Monthly or Quarterly (once in three months) basis. Frequent infections are eliminated and the eye gets more oxygen. Vision and comfort are greatly enhanced and simple cleaning systems like multipurpose solutions can be used.

We offer the Holistic approach

At Uma Eye Clinic we lay great emphasis on proper guidance in the use of contact lens. We take the time to educate the patients on proper handling, cleaning and disinfection of their lenses.