Interesting Retina Facts you Didn’t Know

best retina specialist in Kolkata

Retina is a tissue present inside your eyeballs that lines the backside of the eyeballs. It converts the incoming light into nerve signals, and that is how you can see objects clearly under different conditions such as under the sunlight or starlight. It helps in differentiating between the light wavelengths so that you can see colours. Not only that, Retina also gives you the precision to see and detect minute objects including a strand of human hair or speck of dust a few metres away.

Retina is a part of the brain; to be precise, it is a part of the Central Nervous System (CNS). During the embryonic developmental stage in vertebrates, the Retina and the Optic Nerve develop as an outgrowth of the developing brain.

Source: https://www.sciencedaily.com/terms/retina.htm

Here, we have explored interesting facts about the design, working and all related facts about the Retina:

The Retina

  • Similar to the other structures in the Central Nervous System, the shape of the retina is like a plate. It is about a quarter millimetres in thickness. Similar to the layers of cake, the Retina also consists of three layers of nerve-cell bodies. These bodies are separated by two layers that contain the synapses made by the axons and the dendrites of these cells.

Source: http://hubel.med.harvard.edu/book/b8.htm

  • Retina consists of sensory neurones and the intricate neural circuits. The sensory neurones respond to light while the intricate neural circuits perform the primary stages of image processing. Finally, an electrical message travels through the optic nerve to your brain and further processes your visual perception.
  • The photoreceptors or the sensory cells lie at the back of the retina. The light rays need to pass through the entire retina before it reaches the pigment molecules and excites them. This is so because the membranes of the photoreceptors containing the pigments must be in touch with the Epithelial Layer of the Eye. This layer provides a steady stream of Retinal or Vitamin A, one of the vital molecules.
  • After these Retinal molecules are exposed to light, they undergo a conformational change and are recycled back into the pigment epithelium. This tissue is located behind the retina. It is very dark as its cells contain melanin granules. These granules absorb stray photons thus preventing them from creating a reflection on the photoreceptors, which might make the images appear blurred. These melanin granules also safeguard the cells from overexposure to light radiation.

Source: http://webvision.med.utah.edu/wp-content/uploads/2011/01/2003-01Kolb.pdf

The Design of Retina

  • The Retina of all vertebrate contains two types of photoreceptors. These are the rods and the cones. Rods are used for low-light vision and Cones for daylight and any bright-coloured vision. The Retinas of frogs, fishes, turtle and bird contain at least 3-5 different types of cones. And that is why they have a very good colour vision. On the other hand, the Retinas of most of the mammals predominantly consist of rods.
  • The Retinas of most of the mammals contain two types of cones: the green-sensitive ones and the others are blue-sensitive cones. However, primates have one extra type of cones in their eyes. These cones are red-sensitive cones. With the cone vision of your eye, you can see images starting from the grey shades of dawn to the eye-dazzling brightness of noon when the sun is the brightest.
  • The cone photoreceptors can adapt to the surrounding brightness, and the circuitry in the retina further regulates the eye’s response to the brightness. Similar to the cone photoreceptors, the rod photoreceptors and the neural circuitry (to which they are connected) can adapt to the low intensity of light.

Anatomy and Physiology of the Retina

  • The brightest and the most brilliant colour vision are experienced by the eye when the light directly falls on the small dimple on the Retina, also known as the Macula or the Fovea Centralis. This region has a high presence of cones which are smaller and tightly packed compared to any other region on the Retina.
  • Your eyes receive data from a field that ranges up to 200 degrees. The visual acuity over most of that range is very poor.  In order to form high-resolution images, the light needs to fall on the Fovea. This limits your acute vision angle to about 15 degrees. In low light, the Fovea constitutes a second blind spot as because it is only the cones that have low light sensitivity. So, during night. If you want to get the maximum visual acuity, shift the vision slightly to one side by at least 4 to 12 degrees. In this way, the light will fall on some rods.

Source: http://hyperphysics.phy-astr.gsu.edu/hbase/vision/retina.html

  • The diameter of the Anatomic Macula or Area Centralis is about 4.5–6 mm. These are centred on the fovea and are located between the superior and inferior temporal arcades. The macula or the fovea centralis is located about 3 mm temporal to the optic disc. It has a diameter of about 1.5 mm.

Source: https://www.libreriauniverso.it/pdf/9783642120404.pdf

  • The Fovea is the central part of the macula. It is formed by a central depression of about 0.35 mm wide. Clinically, one can recognise the area by the foveal reflex. If it is lost, then it indicates an early macular disease.
  • The peripheral retina constitutes the rest of the retina which is outside the temporal retinal arteries. If considered anatomically, the peripheral retina contains only a layer of ganglion cells.
  • Each adult human retina consists of 3.5 million Retinal Pigment Epithelium (RPE) cells.
  • The human retina constitutes about 4 to 5 million cones and about 77 to 107 million rods.
  • Each photoreceptor cell in your eye contains an outer segment (photopigment), the inner segment (mitochondria, endoplasmatic reticulum), a nucleus, an inner fibre, and the synaptic terminal.
  • The ganglion cell layer and the photoreceptor layer are connected by the Interneurons in the inner nuclear retinal layer. These interneurons contain the bipolar, horizontal, amacrine, and the inner plexiform cells. These cells constitute the complex neuroretinal circuits that help in processing the photoreceptor signal and then transmit that information to the ganglion cells. In other words, the photoreceptor cell is directly connected to the ganglion cell through bipolar cells. The rods and cones provide input to these bipolar cells.
  • The visual information is transmitted by the ganglion cells from the retina to your brain. The ganglion perikarya are the largest retinal neurones. These are located in the ganglion cell layer. Their axons run in on the inner surface of the retina in a separate layer and are collected at the optic disk. From there, they exit the eye as the optic nerve.

Source: https://www.libreriauniverso.it/pdf/9783642120404.pdf

Retinal Diseases

A healthy Retina is essential for good vision. Retinal disorders affect the vital tissues of the eye, thus affecting your vision. It can even cause blindness. Common Retinal disorders include:

  • Macular Degeneration: Age-related macular degeneration (AMD) is cased when the Macula of your Retina is damaged. People suffering from AMD lose their central vision. You won’t be able to see fine details. Your peripheral or side vision remains normal. AMD is of two types:

Dry AMD

This type of AMD is very common. About 80% of the people who suffer from AMD suffer from the dry form. When parts of your macula get thinner with age, tiny clumps of protein called drusen grow on them. With this, you slowly lose your central vision. There is no way to treat dry AMD.

Wet AMD

This is less common; however is a serious one. When there is an abnormal growth of blood vessels under the retina, the condition is called Wet AMD. Blood or other fluid often leaks from these vessels that cause scarring of the macula. Compared to dry AMD, you tend to lose vision faster with wet AMD.

People often do not realise they are suffering from AMD until their vision gets extremely blurred.

Source: https://www.aao.org/eye-health/diseases/amd-macular-degeneration

  • Diabetic Retinopathy
    People with diabetes suffer from this eye disease.  High blood sugar levels often damage the blood vessels in the retina. This causes the blood vessels to swell and leak. They even close, thereby completely stopping blood flow. Many times, abnormal new blood vessels grow on the retina.  These changes too can cause vision loss.

Source: https://www.aao.org/eye-health/diseases/what-is-diabetic-retinopathy

  • Retinal Vein Occlusion
    The veins that carry blood away from the retina get blocked causing Retinal Vein Occlusion. Retinal vein occlusion is often caused when the arteries harden, thus, causing blood clots.

Blockage of smaller veins in the retina often occurs in places where the retinal arteries have thickened. This puts excess pressure on the retinal vein. Several factors can cause Retinal Vein Occlusion. This includes:

  • Atherosclerosis
  • High blood pressure (hypertension)
  • Diabetes
  • Other eye conditions, such as macular edema, glaucoma, and vitreous haemorrhage

The risk of Retinal Vein Occlusion increases with age, and thus, older adults are vulnerable to retinal vein occlusion.

Source: https://medlineplus.gov/ency/article/007330.htm

  • Retinal Tear or Detachment
    Often it happens that the vitreous moves away from the retina without causing any serious problem.  However, sometimes it pulls so hard that it tears the retina. Fluid tends to pass through this retinal tear, thus lifting it off the back of the eye similar to the way you peel wallpaper off the wall. This is known as retinal detachment. As the retina gets detached from the eye, your vision becomes blurry. This is a very serious problem that results in blindness unless you undergo a detached retina surgery.

Source: https://www.aao.org/eye-health/diseases/detached-torn-retina

  • Retinitis Pigmentosa
    This is a group of eye problems that affect your retina. Retinitis Pigmentosa affects the way your retina responds to light, thus making it difficult for you to see clearly. People suffering from Retinitis Pigmentosa may slowly lose their vision over time. However, people do not become completely blind.

Source: https://www.aao.org/eye-health/diseases/what-is-retinitis-pigmentosa

  • Macular Hole
    People suffering from this condition often notice a sudden decrease in vision in one eye. Macular hole often occurs due to Vitreous shrinkage and/or separation. This condition is caused by a number of other conditions such as:
  • Diabetic eye disease
  • Macular pucker
  • High amounts of nearsightedness
  • A detached retina
  • Best’s disease (this is an inherited condition that causes macular damage)
  • Eye injury
  • Source: http://www.allaboutvision.com/conditions/macular-holes.htm

  • Epiretinal Membrane (ERM)

This condition is commonly known as cellophane maculopathy or macular puckers. In this condition semitranslucent, avascular (having few or no blood vessels), fibrocellular membranes develop on the inner surface of the retina. They cause minimal symptoms and can be diagnosed only after close observation. However, in a number of other cases, they also cause painless loss of vision and metamorphopsia or distortion of vision. Generally, ERMs give symptoms when it affects the macula or the central portion of the retina. The macula is the part that helps us to identify fine detail, helps in reading and recognising faces. So, distortion of vision is more evident when ERM affect eyes.

Most of the patients suffering from ERMs do not experience any symptoms. After close examination of the retina or during a dilated retinal exam the eye specialist detects the condition. Retinal imaging such as with ocular coherence tomography (OCT) is also used for identifying ERM.  In these cases, patients usually have a normal or a near-normal vision. However, this condition can get worse with time causing great visual distortion. Defect on the surface layer of the retina causing the glial cells to migrate there and start growing on the retinal surface can give rise to this condition. This extra growth appears like cellophane and may contract with time, thus causing traction and macular puckers and poor vision quality.

Source: https://www.asrs.org/patients/retinal-diseases/19/epiretinal-membranes

This is why it is crucial visits ophthalmologists or retina specialists regularly. They can examine your eyes closely and determine the early symptoms of any retinal problem.

Wondering where to get the best retina specialist in Kolkata? We are here to help you. Book an appointment with us today at http://www.dishaeye.org/appointment.

How Stress Affects Your Eyes?

How Stress Affects Your Eyes

Stress negatively impacts your overall wellbeing. Too much stress can cause problems such as depression, heart ailments, high blood pressure, resulting in other serious conditions. But do you know that too much stress can also impact your vision? Yes, stress can affect your vision in many ways. Let’s take a look:

1. Central Serous Retinopathy

Central serous retinopathy (CSR) affects the Macula which is the central area of Retina. In this condition, excessive fluid gets accumulated underneath your Macula, thus causing distorted and blurred vision. Whenever you look at any object, it will appear smaller or distorted. In most of the cases, Central Serous Retinopathy gets better with time and without any treatment and it doesn’t cause any long-term changes in your vision. However, in many people, the condition might recur. If it is a recurring problem, in that case, chances are high that your vision might get permanently affected. This condition is also known as Central Serous Chorioretinopathy. If you are under high stress, your body releases stress hormone into your blood called Cortisol. This helps your body to cope with stress. Although Cortisol is essential for your body but a high level of Cortisol in your bloodstream causes problems. This includes vision related problems (CSR), immune suppression (reduce your body’s ability to fight diseases and infection) and increases the fragility of your blood vessels.

2. Blepharospasm

This condition is also known as eyelid twitching. Usually, Blepharospasm is caused by high level of stress. In this condition, the constant spasms make your eyelid twitch uncontrollably. This might irritate or frustrate you. In most of the cases, other observers won’t be able to see the twitching movement in your eyelids. With time, the twitching gradually lessens and usually doesn’t need any treatment. However, if this continues for longer time period, then the doctor might recommend injecting Botox near your eyelids. This helps in preventing muscle twitching. High stress, lack of sleep along with caffeine consumption may trigger this condition.

3. Nystagmus

This is a vision condition where your eye makes an uncontrolled movement. These movements are repetitive. Such frequent movements often cause reduced vision and a reduced depth perception. Such issues can affect your balance and coordination. In this eye condition, your eye moves either up or down, side to side, or in a circular way. And as a result, your eyes cannot see objects steadily. People suffering from Nystagmus often nod or hold their heads in unusual positions to see clearly.
Fatigue and stress is one of the triggers of nystagmus and often make the condition worse. It is not possible to cure this condition with any treatment but using eyeglasses can improve your vision to some extent. In extreme cases, the eye surgeon may manipulate the muscles that are controlling your eye movement for reducing the symptoms.

Source: https://www.aoa.org/patients-and-public/eye-and-vision-problems/glossary-of-eye-and-vision-conditions/nystagmus?sso=y

4. Dry Eyes

When you are stressed, your body increases and thickens the blood flow in your stream in order to protect you from the negative effects of stress. When the blood flow increases, your heart too works harder than usual for circulating the blood. In such case, blood circulation to the extremities in your body, such as your brain, skin and eyes is decreased. As a result, your eyes become dry and irritated. In a study published in Pakistan Journal Of Medical Science in 2015, the researchers studied the relation between psychosomatic conditions such as stress, anxiety, and depression and Dry Eye Disease (DED). The study involving 121 people concluded that people with stress, anxiety, and depression are prone to Dry Eye Disease compared to those who do not suffer from those psychosomatic conditions.

Source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4485284/

5. Blurred vision

Blurred vision

Stress affects your body and manifests itself in a number of ways. Blurred vision is a secondary symptom of stress and when you experience vision problem, it creates more stress, thus aggravating the situation. When you experience stress, your body reacts to it as if it is facing something dangerous, causing your pupils to dilate. As a result, more light enters the eye so that you can assess the situation in a better way. However, too much light results in poor vision and blurriness. A study published in the journal called Optometry in 2010 found that patients suffering from Post-Traumatic Stress Disorder (PTSD) often suffer from blurred vision. PTSD is a condition linked to an unpleasant memory that causes a severe emotional response in you causing stress and other psychological and physical symptoms.

Source: https://www.ncbi.nlm.nih.gov/pubmed/20435270
http://allabouteyes.com/home/stressed-stress-affects-eyes/

6. Functional/Hysterical Vision Loss

Hysterical vision loss is different from malingering. It affects you outside your conscious awareness. Based on the Freudian concept, Hysteria can be defined as a conversion disorder which is caused by an extreme psychological conflict. Such conflicts often manifest itself in form of physical symptoms. Stress is one of the leading causes of such conversion reaction causing trauma and fear. This problem is characterised by poor visual acuity, reduced hyperopic refractive status, stereopsis, and emmetropia. Even using corrective lenses often doesn’t help in improving your distance visual acuity.

Source: https://www.reviewofoptometry.com/article/when-stress-strains-vision

7. Photophobia

This condition is also known as light sensitivity. Under this, you will experience intolerance of light. From an incandescent light to the normal sunlight, any and all light sources can cause discomfort so that you will feel like squinting or closing your eyes. This condition is accompanied by headaches. People suffering from light sensitivity are bothered by bright light. However, in extreme cases, any source of light will cause irritation in your eyes. This is not a disease but actually a symptom of other conditions such as Corneal Abrasion, any infection or inflammation of eyes, Uveitis, and other Central Nervous System disorders (such as meningitis). This condition can also be caused by detached retina and irritation caused by contact lenses. Stress can further aggravate this condition, making it worse.

Source:

https://www.aao.org/eyenet/article/photophobia-looking-causes-solutions?novemberdecember-2005
http://www.allaboutvision.com/conditions/lightsensitive.htm

Most of the eye conditions caused by stress are temporary. However, if such symptoms are persistent, then get in touch with an eye specialist immediately.

Here is how we can help you!

At Disha, you can get in touch with our expert eye specialists who can help in treating your eye problems and enjoy a better vision. Get in touch with our experts today. Book an appointment with us at http://www.dishaeye.org/appointment.

25 Data-Backed Eye Care Tips

Disha Eye Hospital

It is very important to take good care of your eyes. Poor vision makes it difficult for you to carry on your day-to-day activities. It would be difficult for you to read, write, drive, or cook. Fortunately, you can easily avoid a number of eye problems and eye diseases if they are diagnosed early and if you maintain the basic eye care routine.

You can do a lot to ensure that you enjoy a healthy vision throughout your life. Here are a few tips for you:

Lifestyle Tips to Maintain Healthy Eyesight

1.  Conduct a dilated eye exam

dilated eye exam

You might think that your vision is fine and you do not need to go for any eye check-up. But, how to make sure that your eyes are alright? That’s why you need to visit your eye care specialist and undergo a comprehensive dilated eye exam. There are a number of eye diseases such as Diabetic Eye Disease, Glaucoma, and Age-related Macular Degeneration that do not have early warning signs. With a dilated eye exam, your eye specialist can easily detect these diseases when in their early stages. During this exam, the eye specialist will give you eye drops for dilating or widening the pupil. In this way, more light can enter your eye, and the eye specialist can get a good look at the back of the eyes and determine if there are any signs of damage or disease or not. An eye specialist is the only one to determine whether your eyes are healthy or not. Moreover, when it comes to vision problems, many people do not realise that it can be corrected using glasses or contact lenses. For identifying these issues, you need to visit the doctor.

2. Be Aware of the eye health history of you family

Eye conditions are often hereditary; which means you can acquire them from your ancestors. To prevent the onset of any eye disease it essential to know the eye health history of your family. Talk to your family and see if there is anyone who has been diagnosed with an eye disease or condition. This information will help understand whether you are at greater risk of an eye disease or not.

3. Eat well

A diet rich in essential vitamins and nutrients is essential, for maintaining good eyesight. A diet rich in fruits and vegetables, particularly green leafy ones is extremely beneficial for your eyes. Fish is also considered good for eyesight as they contain high levels of Omeg-3 fatty acids.

4. Maintain a healthy weight

If you are overweight or obese, you are at greater risk of getting diabetes and other health conditions. This also affects your vision. For instance, diabetes gives you a condition called Diabetic Eye Disease. Talk to a nutritionist today if you are unable to keep a check on your weight.

5. Always wear protective eye gear

protective eye gear

If you are into sports or your work involves heavy physical and mechanical activities (for instance if you work in the construction fields) then always ensure that you are wearing protective eyewear. Use protective gears such as goggles, safety glasses, safety shields, and eye guards. These are specially designed to protect your eyes. Most of the manufacturers use polycarbonate for making protective eyewear lenses. This is 10 times stronger than any other plastic material.

6. Quit smoking

Smoking is harmful to your eyes and the rest of your body. Smoking increases the risk of developing conditions such as Cataract, Age-related Macular Degeneration, and optic nerve damage. These conditions can lead to blindness.

7. Protect your eyes from Sun damage

Sunglasses are not just fashion accessories, but they do one of the most important jobs- they protect your eyes from UV damage from the sun. When purchasing one, check whether it blocks 99% to 100% of both UV-A and UV-B rays or not.

8. Let your eyes rest for a while

Spending a long time in front of computer or smartphones can damage your eyes. If you are focusing a lot on the computer screen, sometimes you forget to blink, and your eyes get fatigued. Follow the 20-20-20 rule. Every 20 minutes, look away from your computer screen to a place about 20 feet in front of you. Look for 20 seconds. This helps reduce eyestrain.
9. Clean your hands before putting contact lenses
This helps to avoid the risk of infection. Ensure that you have disinfected the contact lenses and have replaced them appropriately.

Source: https://www.nei.nih.gov/sites/default/files/health-pdfs/tipsforeyehealth.pdf

Food for Eye

How Nutrients boost Vision?

10. The Age-Related Eye Disease Study (AREDS) conducted by the National Eye Institute’s (NEI) in 2001 found that proper intake of nutrients and taking nutritional supplements can reduce the risk of getting advanced Age-related Macular Degeneration (AMD). In this study, the formulation that was used contained vitamins C and E, Zinc, Beta-Carotene, and copper. The study found that those who took that formulation were 25% less likely to develop advanced AMD.

11. In 2006, the NEI conducted a second study, AREDS2, in order to improve the original AREDS formulation. Researchers used lutein and zeaxanthin instead of beta-carotene this time. The study AREDS2 concluded that the formulation improved the ocular health of the participants. The formulation included Vitamin E (400 IU), Vitamin C (500 mg), zeaxanthin (2 mg), lutein (10 mg.), zinc (80 mg) and copper (2 mg).

12. Since the study, this formulation has been adopted by many optometrists around the world for reducing the risk of AMD and keeping the eye healthy.

13. Zeaxanthin and lutein are primary macular pigments that are mainly found in the Fovea of your eye. The Fovea protects your eyes from harmful rays and filters high-energy blue wavelengths of light, thus protecting and maintaining the healthy cells. If you do not take proper nutrients, then the levels of macular pigment decrease. Taking Lutein and Zeaxanthin supplements increase the levels of macular pigment and protect your eyes against diseases. Zeaxanthin supplements also help in improving visual processing speed. This study was conducted by the University of Georgia Vision Sciences Laboratory. It measured how high levels of dietary zeaxanthin influences the processing speed (the speed at which your eyes and brain communicate for identifying process and for responding to any stimuli). The study found significant improvement in the reaction time of the participant. Apart from that, omega-3 fatty acid GLA is also beneficial for treating dry eye.

Source: http://www.visionmonday.com/CMSDocuments/2014/10/cover_story_VM102014.pdf

What to Eat?

Eating more fruits and vegetables help protect your eyes against disease. It is recommended to eat food rich in certain vitamins and minerals to keep your eyes healthy. These vitamins and minerals are known as antioxidants that keep our cells and tissues healthy.

Source: https://www.health.ny.gov/publications/0911.pdf

Five great foods for your Eyes

14. Carrots

carrots for eye

Carrots and other orange-coloured fruits and vegetables are great for your eyes. They contain Beta-carotene which is a type of Vitamin A which protects your Retina and keeps your vision strong.

15. Green Leafy Veggies

From Spinach to Kale, all green leafy veggies are packed with Lutein and Zeaxanthin, the antioxidants that keep your eyes healthy by lowering the risk of developing macular degeneration and cataracts.
Lutein and zeaxanthin are antioxidants that are present in the eye. Having green leafy vegetables ensures that your eyes are never short of these antioxidants. These two components also help in reducing the risk of chronic eye diseases such as Cataract and AMD.

Source: http://www.aoa.org/patients-and-public/caring-for-your-vision/diet-and-nutrition/lutein?sso=y

16. Eggs

If you throw away the yolk of the egg, then stop doing that. It’s because the yolk contains lutein and zeaxanthin and zinc. Having eggs thus helps reduce your risk of developing macular degeneration.

Source: https://www.ncbi.nlm.nih.gov/pubmed/11594942

17. Citrus fruit and berries

Citrus fruits (lemon) and berries are powerhouses of vitamin C, an essential component that reduce the risk of developing conditions such as macular degeneration and cataract.

Source:

http://www.aoa.org/patients-and-public/caring-for-your-vision/diet-and-nutrition/vitamin-c?sso=y
https://www.ncbi.nlm.nih.gov/pubmed/11864861

18. Almonds

Rich in vitamin E, Almonds slow down your risk of developing macular degeneration. Vitamin E, found in nuts, sweet potatoes and fortified cereals protect eye cells from damage by safeguarding them against harmful free radicals. These free radicals break down your healthy eye tissue. And when this happens, your risk of developing Age-related Macular Degeneration (AMD) and cataract increases. More than 25 million people across the globe suffer from AMD. http://www.aoa.org/patients-and-public/caring-for-your-vision/diet-and-nutrition/vitamin-e?sso=y

19. Fatty fish

Fatty fishes such as Salmon, Tuna, Mackerel, and Trout are a rich source of DHA, a fatty acid found in your retina. Low levels of DHA can cause dry eye syndrome.

Source: https://www.ncbi.nlm.nih.gov/pubmed/16210721

Take Care of your Eyes at the workplace

protect eyes at the workplace

Increased use of computers in the workplace has its hazards. People who work for long hours in front of the computer usually have a high level of physical health complaints that includes ocular discomfort and strain. Visual discomfort if ignored can result in serious eye-related problems.

People who work in front of PCs and laptops for long hours often suffer from a complex of eye related problem. This is known as “computer vision syndrome” or CVS. Eye problems that are caused by working a long time in front of the computer come under CVS. How can you avoid or prevent discomfort caused by CVS?

Here are the ways:

20. Have proper ergonomically designed chairs that are properly adjusted with your computer. This helps in decreasing the visual demands of the work you are doing and.

21. The display of your computer matters for your visual performance. Adjust the screen brightness and contrast to maintain a balance with room lighting. Lowering the brightness of the screen will reduce issues related to image stability, thus lessening the burden on your eyes.

22. Clean the computer screen regularly. Remove dust and dirt that affects the screen visibility.

23. The colour of the characters of your computer screen also affects the ease of visibility. The way your eyes focus on the screen is affected by the colours. Monochrome displays have been found to provide more legible images. This is highly recommended for people who are into word processing or data entry job. Computers with a negative contrast display (dark characters on a light background) or with positive contrast displays (light characters on a dark background) are always better than green or yellow, red, and blue.

24. Adjust your workstation to increase your comfort level. For instance, proper viewing distance and angles can help maintain your posture, eventually improving the way you view the computer screen. Determine the appropriate distance of the computer screen from your eyes. See if you can comfortably read the letters on the screen from that position. Usually, a viewing distance of 20 to 28 inches is usually recommended.

25. The direction of your gaze also affects the focusing ability of your eyes. It’s because when your eyes are placed much higher or below the optimal level of looking at the computer screen, the focusing mechanism of your eyes has to work hard. So, the direction of your gaze is important. Usually, a downward gaze of 15 degree helps in reducing the stress on your eyes. This means that the top of your computer screen should be below the horizontal eye level. And also, it should be tilted back slightly away from you.

Source: http://www.aoa.org/Documents/optometrists/effects-of-computer-use.pdf

Taking care of your eyes is beneficial for your overall health. People who have vision problems have greater risk of injuries due to falls
How can we Help You?

Disha Eye Hospital has a team of expert eye specialists dedicated to promoting healthy vision, thus improving your quality of life. We are committed to our promise of helping you in protecting your vision by providing comprehensive eye care services thus, assisting you in preventing any disability resulting from poor vision or vision loss.

For any queries related to eye health or for booking an appointment with our expert eye specialists, visit http://www.dishaeye.org/appointment.

16 Common Eye Disorders

glaucoma treatment in Kolkata

Eye is one of the most complex organs of the human body and eyesight is among the most valuable assets that we have. It’s because of the eye that we could see and experience the world around us. However, common eye disorders can cause great inconvenience and in severe cases, cause vision loss. And that is why it’s so important to take care of our eyes.

Many of the eye disorders have early symptoms, and many don’t. People often fail to identify these symptoms and tend to ignore them initially. But an early diagnosis can help you save the most precious gift of vision that you have.

Here we have discussed 16 common eye disorders and their symptoms to help you in early detection:

1. Glaucoma

Glaucoma is caused when the pressure inside your eyes increase, thus damaging your optic nerves. People often inherit this eye condition, and it usually affects them later in their life.

The pressure inside your eye is known as intraocular pressure. An increased intraocular pressure damages the optic nerve that transmits images to your brain. If not detected early, Glaucoma causes permanent vision loss. If you go without treatment, you will lose your vision within a year or two.

You do not experience pain, and it’s very difficult to detect the early symptoms of Glaucoma. However, if you experience any of the following symptoms, consult an eye specialist immediately:

  • Redness of eye
  • Seeing halos around lights
  • Nausea or vomiting
  • Vision loss
  • Eye that looks hazy (especially in infants)
  • Pain in the Eye
  • Tunnel vision

Detecting glaucoma early is one of the reasons why you should have a complete eye check-up every 1-2 years. If you want to undergo Glaucoma Treatment in Kolkata, then book an appointment with our eye specialist today. Disha Eye Hospital is one of the leading eye hospitals in Kolkata. Visit http://www.dishaeye.org/contact-us today.

Source: http://www.webmd.com/eye-health/glaucoma-eyes#1-2

2. Astigmatism

In simple words, Astigmatism is the condition when your eyes are not completely round. All of us have this condition up to a certain degree, but that doesn’t interfere with our vision. However, in some people, this condition is a bit severe. In such cases, the light that falls on the eye doesn’t bend properly causing blurry or wavy vision. This condition can be easily treated with a simple eye surgery or by using glasses and contact lenses.

People are mostly born with this condition; however, eye injury, disease, or any eye surgery can also cause Astigmatism. Look for these common symptoms to detect Astigmatism:

  • Blurry vision
  • Eye fatigue or eye strain

Source: http://www.webmd.com/eye-health/astigmatism-eyes

3. Cataract

It’s the condition when the natural lens of your eyes, located behind the Iris and the Pupil, becomes cloudy. People over 40 are susceptible to this condition. And this is also one of the most common causes of blindness in the world. The types of Cataract include:

  • Subcapsular cataract: it occurs at the back of the eye lens. People with diabetes are at a greater risk of developing it.
  • Nuclear cataract: it affects the nucleus of the lens. This type of cataract is associated with ageing.
  • Cortical cataract: this is characterised by white, wedge-like opacities starting in the periphery of the eye lens and move towards the centre. It mainly occurs in the lens cortex surrounding the central nucleus.

Source: http://www.allaboutvision.com/conditions/cataracts.htm

Check for these early signs of Cataract:

  • Cloudy vision
  • Double vision
  • Problem with glare at night (glare from light sources) and daytime.
  • Unclear vision with glasses and contact lenses

Source: http://www.webmd.com/eye-health/cataracts/what-are-cataracts#1-3

4. Corneal Abrasion

It happens quite often when dirt or sand gets trapped in your eye. As you rub your eyes to get rid of it, the dust particle causes a scratch on your eye. This condition is called Corneal Abrasion. You experience pain in your eye and a burning or stinging sensation.
The symptoms are:

  • you feel like you have sand or dirt stuck in your eye
  • Pain in eye, especially when you open or close it
  • Redness of eyes and teary eyes
  • Light sensitivity
  • Blurred vision

Rubbing your eyes too hard, poking it with nails or other objects, wearing dirty contact lenses can cause Corneal Abrasion.

5. Dry Eyes

This is a very common condition and occurs when the tears cannot lubricate your eyes properly. There are a number of reasons for inadequate production of tears. For instance, dry eyes may occur if the tear production is not enough.

This condition is very uncomfortable. You will experience stinging or burning sensation in eyes.

Signs and symptoms include:

  • A stinging or burning sensation in the eyes
  • Scratchiness in your eyes
  • A sensation that there is something in your eyes
  • Difficulty in wearing contact lenses
  • Mucus formation in or around the eyes
  • Light sensitivity
  • Redness on eye
  • Blurred vision
  • Eye fatigue
  • Difficulty in night-time vision especially while driving
  • Watery eyes, (body’s response to the irritation of your eyes)

Source: http://www.mayoclinic.org/diseases-conditions/dry-eyes/basics/definition/con-20024129

6. Subconjunctival Haemorrhage

This condition occurs when a tiny blood vessel breaks just below the conjunctiva of your eye. The conjunctiva cannot absorb blood. This causes the blood to be trapped underneath it.

A subconjunctival haemorrhage often occurs without causing any serious harm to your eyes. A strong sneeze or a bout of a cough can even cause haemorrhage of blood vessels in your eyes. The initial symptoms might worry you, but this condition is usually harmless condition and disappears within a week or two.

  • The most obvious sign of a subconjunctival haemorrhage is a red patch on the white part of your eyes.
  • It doesn’t hamper your vision and causes no pain or discharge. However, you might experience a slight discomfort or a scratchy feeling on the surface of your eye.
  • If you experience recurrent subconjunctival haemorrhages, then talk to the doctor immediately.

Source: http://www.mayoclinic.org/diseases-conditions/subconjunctival-hemorrhage/home/ovc-20231436

7. Retinal Detachment

This is a serious eye condition. It occurs when your retina located at the back of your eye detaches from the tissue around it. The Retina processes light and a damaged Retina may cause permanent vision loss if it isn’t treated right away.

You are at risk if you are severely nearsighted or have a family history of retinal detachment.

A detached retina doesn’t hurt and often has no warning symptoms. However, you might notice the following changes:

  • Seeing lots of floaters (small floating thread-like structures in front of your eyes)
  • Flashes of light
  • A poor peripheral or side vision
  • The doctor may suggest Laser, Cryopexy or Pneumatic Retinopexy for treating the damaged Retina.

Source: http://www.webmd.com/eye-health/eye-health-retinal-detachment#1-2

8. Diabetic Retinopathy

The high blood sugar levels damage the blood vessels present in the retina. These blood vessels swell or leak and stop blood from passing through. This can cause vision loss.

There are two stages of Diabetic Retinopathy:

  • NPDR (non-proliferative diabetic retinopathy)
  • Here, the tiny blood vessels leak causing swelling of Retina.
  • PDR (proliferative diabetic retinopathy)

This is a more advanced stage and happens when the new blood vessels grow in the retina. This is called neovascularization. These new vessels often bleed and block your vision.

The symptoms of Diabetic Retinopathy include

  • seeing too many floaters
  • a blurred vision
  • washed out colours
  • poor night vision
  • changes in vision from blurry to clear
  • seeing dark areas in the field of vision

Source: https://www.aao.org/eye-health/diseases/what-is-diabetic-retinopathy

9. Age-Related Macular Degeneration (AMD)

This is the deterioration of the macula, the central area of the retina that controls visual acuity.

Symptoms of Age-related Macular Degeneration include:

  • Loss of visual acuity
  • Loss of contrast sensitivity
  • Seeing images distorted in the centre

AMD is of two types, Dry AMD and Wet AMD. Dry AMD is more common and is the initial stage of the condition while Wet AMD is typically worse and is a much-advanced stage of the condition.

Source: http://www.nhs.uk/Conditions/Macular-degeneration/Pages/Symptoms.aspx

10. Uveitis

Uveitis is a broad term and covers a number of eye problems. The condition mainly affects the Uvea, a part of your eye. It encompasses eye inflammation and swelling that destroys the tissues in your eye causing poor vision or blindness.

Types of Uveitis include:

  • Anterior uveitis: this affects the front part of your eye.
  • Intermediate uveitis: this affects the ciliary body.
  • Posterior uveitis: this affects the back of your eye.

The warning signs include:

  • Redness of eye
  • Pain
  • Blurry vision
  • Light sensitivity
  • Seeing floaters in your vision

Source: http://www.webmd.com/eye-health/uveitis-inflammation-eye#1-5

11. Hyphema

Hyphema is the condition when blood gets accumulated in the front part of your eye. The blood mainly collects between the Cornea and the Iris. This condition occurs when an injury (such as a sharp blow) tears the blood vessels. The less harmful case of the broken blood vessel is called subconjunctival haemorrhage while Hyphema is very painful and can also cause serious vision and eye problems such as Glaucoma or Corneal damage.
Symptoms of Hyphema include:

  • bleeding in the front of the eye
  • sensitivity to light
  • pain in the eye
  • blurry or blocked vision

Source: https://www.aao.org/eye-health/diseases/what-is-hyphema

12. Central Retinal Vascular Occlusion (CRVO)

The retina of your eye contains one main artery and one main vein. When the vein of the retina is blocked, the condition is called Central Retinal Vein Occlusion (CRVO).

With a blocked vein, the blood and fluid spill out into the retina causing swelling of the macula, thus affecting your central vision.

Symptoms of CRVO include:

  • Vision loss or blurry vision (in one part or all of the eye)
  • Gradual worsening of vision (over several hours or days)
  • Complete loss of vision
  • Seeing floaters, dark spots or lines in your vision.
  • Pain and pressure in the affected eye

Source: https://www.aao.org/eye-health/diseases/what-is-central-retinal-vein-occlusion

13. Scleritis

This is a painful condition where the white part of the eye (called Sclera) swells. The tissues of the sclera constitute the protective outer layer of your eye. It makes up 83% of your eye’s surface.

In most of all cases, scleritis is associated with other autoimmune disorder such as rheumatoid arthritis. The two types of scleritis are Anterior and Posterior Scleritis.

The symptoms include:

Severe pain and tenderness in the eye.
This pain often extends to other regions of the face such as the jaw, face, or part of head at the affected side.
Blurred vision and tearing
Extreme sensitivity to light
Partial or complete loss of vision (in some cases)

Source: https://www.aao.org/eye-health/diseases/what-is-scleritis

14. Hypertensive Retinopathy

This condition is caused by extremely high blood pressure levels. High blood pressure results in swelling of the blood vessels in the Retina, causing them to narrow down, thus blocking blood flow to the retina.
You won’t experience any major symptoms until the condition has aggravated. Possible symptoms include:

Swelling of the eye
reduced vision
bursting of a blood vessel
double vision along with headaches

Source: http://www.healthline.com/health/hypertensive-retinopathy#overview1

15. Strabismus

If your eyes are not aligned properly, and both the eyes look at different direction, this condition is called Strabismus or crossed eyes. Some are born with it (Congenital Strabismus); however, adults may also develop this due to the problem in the nervous that controls your eyes.
This condition leads to double vision, problems in peripheral vision. Surgery is an option for correcting this condition.

Source: http://www.webmd.com/eye-health/strabismus

16. Corneal Ulcer

This is an open sore in the Cornea and is mainly caused by viral, fungal or bacterial infection, dryness of eye, scratches or tear in the Cornea. People who wear contact lenses are at greater risk of developing Corneal Ulcer.

Symptoms of Corneal Ulcer include:

  • Redness of eye and pain
  • Pus or thick discharge from eye
  • Blurred vision
  • Swollen eyelids
  • White round spot on the cornea

Source: http://www.webmd.com/eye-health/corneal-ulcer

How we May Help You?

From two decades, Dish Eye Hospital has been a leading name in providing quality treatment at affordable prices. Our experienced and qualified team of Eye specialists are among the best teams in Kolkata and have been relentlessly serving the people. Reach to our specialist for any eye-related issue.

30 Facts About Myopia

Facts About Myopia

You are having difficulty in seeing a distant object clearly; but you can easily read a newspaper up close. Is that the case with you? If yes, then chances are high that you are Myopic or Nearsighted.

According to a report published in 2016 in the journal called Ophthalmology, the number of people affected by nearsightedness is increasing rapidly. And by 2050, about half the population of the world (about 5 million people) is expected to suffer from this condition. Researchers mainly blame the rapid change in lifestyle involving increased usage of smartphones, laptops and decreased outdoor activities for the situation.

Source: http://www.aaojournal.org/article/S0161-6420%2816%2900025-7/fulltext

Before we delve into the details of Myopia, let’s first find out how the eye works.

How do Your Eyes work?

When light falls on your eyes, it passes through the Cornea of your eye and into the lens. The lens then focuses it onto the retina at the back of your eye and creates the image which is then transmitted to the brain. This is how you can see the world clearly. However, for producing a clear image, the cornea must have an even curve, and the eye also needs to be at the right length.

In Myopic people, the eye is a bit long from the front to back. This means when you look at any distant object, the light rays won’t focus on your retina, but in front of it. As a result, a blurry image is formed which is transmitted to the brain, making the distant object appear blurry for you.

Source: https://nei.nih.gov/health/errors/myopia

Signs and Symptom of Myopia

1. Myopia or Nearsightedness starts developing during the childhood between ages 6 and 12. The eyeballs continue to grow in teenagers so, if the child or teen is suffering from Myopia, it tends to worsen quickly during this age.

2. The prime symptom of nearsightedness is difficulty in seeing distant objects or a blurred vision when you look at distant images or objects. If you can see closely held objects clearly or read books without struggling to see things compared to distant objects, then you have a myopic vision. You might face problems in clearly seeing images or words on notice boards, TVs, and movie screen. As a result, this can cause poor work performance or drop in performance at school and carrying out other tasks (driving or playing sports).

3. If you see that your child squints or frown while viewing distant objects, complaints of headaches and holds books and other objects close to his or her face, then he or she might be suffering from Myopia.
4.Children who are nearsighted may move closer to TV screens or show lack of interest in sports and other outdoor activities as it requires a clear distance vision.

5. If your child is having difficulty in seeing distant objects clearly, take him to the eye specialist. An early diagnosis and treatment of nearsightedness are important. It’s because, without better visual skills, your child might face trouble doing school work and other activities that require seeing distant things.

Source: http://www.webmd.com/eye-health/tc/nearsightedness-myopia-topic-overview#1

Causes and Risk Factors of Myopia

6. After you focus on closely held objects for longer periods, the focusing muscles in the eyes or the Ciliary muscles lock up. As a result, your eyes become elongated. When your eyes are overly elongated, nearsightedness occurs.

Source: http://www.preventmyopia.org/

7. Myopia can be hereditary. This means, if both parents are Myopic, then chances are high that their children are at a greater risk of developing nearsightedness.

Source: http://www.allaboutvision.com/parents/myopia-causes.htm

8. In a study conducted by Kathryn Rose, researcher of Visual disorders at the University of Sydney’s Faculty of Health Sciences says that deficiency of sunlight can also cause myopia in children. Another study conducted by the University of Western Australia also found that the lack of outdoor time is also a risk factor and contributes to the development of nearsightedness.

Source:
http://edition.cnn.com/2011/HEALTH/06/01/myopia.causes/
http://www.abc.net.au/news/2016-09-06/wa-researchers-investigating-myopia-epidemic-east-asia/7819418

9. People who read a lot are also at the risk of developing nearsightedness.

Source: http://www.mayoclinic.org/diseases-conditions/nearsightedness/basics/risk-factors/con-20027548

10. According to Professor Ian Morgan, a researcher at Australian National University in Canberra, when children spend more time in front of computers or doing activities such as reading books, and watching television or reading books, they become nearsighted.

Source: http://www.preventmyopia.org/

11. According to a study conducted by the researchers at Complutense University in Spain about 31.3% of first-year students were nearsighted. On the other hand, the rate of nearsightedness in final year students was 49%. As per the Research author Dr Rafaela Garrido, students usually spend a long time doing intensive near work with their eyes. People who use computer or microscope are also doing intense work with their eyes. This puts the eye under severe stress, causing nearsightedness.

Source: http://www.preventmyopia.org/

How to Diagnose Myopia?

12. The eye specialist may use several procedures to measure how your eyes focus light and for determining the power of optical lenses that might be needed to correct the problematic vision.

13. The eye specialist will ask you to identify the letters printed on the chart. This test is for measuring your visual acuity, which is usually represented as a fraction such as 20/20. The top number of the fraction represents the standard distance at which your test has been performed (for instance, 20 feet). The bottom number of the fraction is the smallest letter size that you have read. If you have a 20/40 visual acuity, then you will have to get within 20 feet for identifying a letter or letters that a person with normal vision can see clearly at 40 feet. Normal distance for visual acuity is 20/20; however, people might also have 20/15 vision which is of course, better.

14. The eye specialist might also use a phoropter. The eye specialist or an optometrist will place several lenses in front of your eyes. They will measure how your eyes focus light using a Retinoscope. The eye specialist might also use an automated machine for evaluating the focusing power of your eye. The power is then refined according to the response of your eyes for determining the lenses that will help you get the clearest vision.

15. Many eye specialist use eye drops before conducting these tests. However, they may also conduct this test without using any eye drops. They do this for determining how your eyes will respond under normal vision conditions. The eyes drops are used for temporarily keep your eyes from changing focus while testing.

16. The information thus obtained from the test, along with the results of other tests, your optometrist will decide whether you have myopia or not. The optometrist will also determine the power of lens correction that is required for a clear vision.

Source: http://www.aoa.org/patients-and-public/eye-and-vision-problems/glossary-of-eye-and-vision-conditions/myopia?sso=y

Treatment of Myopia

The eye specialist may suggest a number of ways for treating myopic vision. They include:

17. Using Eyeglasses: This is the primary choice for correcting myopic vision for a number of people suffering from myopia. Depending on the amount of myopia, the doctor might ask you to wear glasses only for performing certain activities such as driving a car or while watching a movie. In case you are very nearsighted, then you might need to wear glasses all the time.

18. Usually, the doctor will prescribe a single-vision lens to give you clear vision at all distances. However, if you are over 40 years of age or if the patient is a child or an adult whose myopia is due to the stress caused by near-vision work, the eye specialist might suggest a bifocal or a progressive addition lens. These lenses are multifocal and provide different powers throughout the lens to help you get a clear vision at all distances.

19. Using Contact Lenses: Some people with nearsightedness use contact lenses that offer a clearer vision. Compared to an eyeglass, contact lenses offer much wider field. However, since you will be wearing contact lenses directly on the eyes, it’s extremely important to take proper care of the lenses for ensuring your eye health.

20. Laser processes: Your doctor might also suggest Laser processes such as LASIK (Laser in-situ Keratomileusis) or PRK (photorefractive keratectomy) as possible treatment options for persons suffering from nearsightedness. A laser beam is used to reshape your Cornea by removing a small part of your eye tissue. However, the amount of myopia that these processes can correct depends on the amount of corneal tissue that can be safely removed from your eyes.

  • In LASIK the eye surgeon removes tissue from the inner layers of the Cornea. For doing this, the surgeon lifts a section of the outer corneal surface, folds it back to expose the inner tissue. After that, using a laser the eye surgeon removes a certain amount of corneal tissue that is required for reshaping your eye. After that, the flap is then placed back in position. LASIK eye surgery is performed in all leading hospitals in India. If you want to undergo LASIK eye surgery in Kolkata or if you want to know about LASIK eye surgery cost, then contact us today at http://www.dishaeye.org/contact-us.
  • In the case of PRK, the doctor uses the laser for removing a thin layer of tissue from the surface of the cornea for changing its shape and refocus light that enters your eye.

21. Ortho-k or CRT: This is yet another option for treating myopia. This process is also known as Corneal Refractive Therapy (CRT). This is a nonsurgical procedure where you have to wear a series of specially designed contact lenses that will gradually reshape the curve of your cornea. The lenses placed on the Cornea puts pressure on it, eventually flattening it to the desired level. This changes the way light (entering your eye) is focused. In this process, you have to wear contact lenses only for a limited period and then remove it. If you have moderate myopia, you can temporarily obtain clear vision for your daily activities.

22. Other procedures: If your eyes are highly nearsighted or if your corneas are too thin for laser procedures, then you might need surgical processes for correcting Myopia. An optometrist may implant small lenses in your eyes. These lenses are in accordance to the optical correction desired. This implant is usually placed in front of the natural lens of your eye.

23. Vision therapy (for people having stress-related myopia): Vision therapy is also an option for people who have blurred distance vision due to spasm of the muscles that controls the focus of the eyes. Your eye specialist might suggest various eye exercises for improving the poor focusing ability of your eye thus, regaining clear distance vision.

Source: http://www.aoa.org/patients-and-public/eye-and-vision-problems/glossary-of-eye-and-vision-conditions/myopia?sso=y

How to Prevent Nearsightedness?

Nearsightedness can be easily prevented by bringing a few changes in your lifestyle.

24. Get your eye checked regularly. Even if you see well, follow this routine regularly.

25. Certain health conditions, such as high blood pressure and diabetes can affect your vision. Try to control these conditions by following a healthy lifestyle.

26. Protect your eyes from harmful UV rays. Always wear sunglasses when outside.

27. Eat healthily. Include plenty of fruits and leafy greens vegetables in your diet. Eat fish that are high in omega-3 fatty acids.

28. Quit smoking. This adversely affects your eye health as well.

29. Use right corrective lenses for optimising your vision.

30. Do not put much strain o eyes. Look away from the computer or the book you are reading every few minutes.

Source: http://www.mayoclinic.org/diseases-conditions/nearsightedness/basics/lifestyle-home-remedies/con-20027548

How can we help you?

For over a decade, Disha Eye Hospitals is committed to protect and preserve the most precious gift that we have- the gift of vision. We strive to remain the best by providing excellent services and by creating a continuum of care for everyone. Our specialists and experts specialise in preserving and restoring your vision at every stage of care. Schedule an appointment with our specialists today for comprehensive eye care.

31 Facts on LASIK Surgery

Facts on LASIK Surgery

Using glasses or contact lenses forever seems a hassle. Everyone wants to get rid of them and enjoy clearer vision. LASIK is the most common surgical procedure for vision correction. If you are considering LASIK, then check these facts about the surgery first:

About LASIK

Fact 1:

Laser in-situ Keratomileusis or LASIK is the popular surgery for treating vision problems such as farsightedness, nearsightedness, and astigmatism.

Fact 2:

This vision correction surgery reshapes your cornea and the transparent front part of your eye so that the light that travels through your eye focuses on your retina, thus helping you see clearly.

Fact 3:

For near-sighted people, an eye surgeon uses LASIK surgery to flatten their too-steep cornea. In the case of farsighted people, the surgeon aims for a steeper cornea. LASIK is used to correct astigmatism by smoothing your irregular cornea giving it a normal shape.

Source: http://www.allaboutvision.com/visionsurgery/

Fact 4:

LASIK surgery was made possible due to the efforts of Spanish ophthalmologist Jose Barraquer. In 1950, he developed the keratome knife for performing keratomileusis or cutting the flap of the cornea for vision correction.

Source: http://www.physics.rutgers.edu/~pchandra/physics397/Project_Paper.pdf

Fact 5:

In 1980, researcher R. Srinivasan concluded that an ultraviolet excimer laser could be used on living tissues without causing any damage. Since this discovery, LASIK surgery has evolved a lot and has been widely used to improve the vision of millions of people all over the world.

Source: http://www.physics.rutgers.edu/~pchandra/physics397/Project_Paper.pdf

How does LASIK surgery work?

Fact 6:

At first, the ophthalmologist will apply numbing drops in your eye by pulling down your bottom eyelid. It takes a few seconds for the drops to work. The effect lasts for 10 to 15 minutes. A device is used to hold your eye lid open. This device is specially used during LASIK eye surgery. You won’t feel any pain.

Source: http://www.lasik.com/articles/lasik-eye-surgery-how-does-it-work/

Fact 7:

During the surgery, the doctor uses an instrument called a microkeratome or femtosecond laser for cutting a thin flap in your cornea. The flap is then painlessly peeled back. Your vision is blurred during this time. The doctor uses another laser for reshaping and correcting the underlying corneal tissue so that it can properly focus light onto your retina. Once the cornea is reshaped and corrected, the flap is put back in place, and the surgery is complete.

Fact 8:

The laser used for LASIK surgery is highly specialised; it uses a cool ultraviolet light beam for removing the microscopic amounts of tissue from the cornea and reshape it. For nearsighted people, the surgeon uses the laser to flatten the cornea while for farsighted people, the cornea is made steeper. For correcting astigmatism, the eye surgeon also uses Excimer lasers for smoothing the irregular cornea, giving it a normal shape.

Fact 9:

LASIK is a painless procedure. No bandages and stitches are required for it. The entire process takes hardly a few minutes.

Advantages of LASIK

Fact 10:

LASIK has a 96% success rate. The majority of the patients who have undergone LASIK surgery agreed to have an improved vision. Your vision improves immediately after the surgery or a day after the surgery.

Source: http://www.webmd.com/eye-health/lasik-laser-eye-surgery#1

Fact 11:

You can make further adjustments for correcting your vision if it changes with age. You can do this even if you had LASIK surgery years ago.

Source: http://www.webmd.com/eye-health/lasik-laser-eye-surgery#1

Fact 12:

Most of the people achieve 20/20 vision after a LASIK surgery. A very small percentage of people require a LASIK enhancement procedure, a few months after the primary LASIK surgery for achieving visual acuity.

Source: http://www.allaboutvision.com/visionsurgery/lasik.htm

Fact 13:

After the surgery, you might experience problems with the corneal flap. This might need further treatment.

Fact 14:

Some people might also experience minor side effects after surgery. However, these problems disappear with time. These side effects include hazy vision; dryness of the eye, difficulty with night vision; scratchiness, halos or starbursts around lights and halos; light sensitivity; small pink or red patches on the white portion of the eye; mild discomfort or pain in the eye.

Source: https://www.aao.org/eye-health/treatments/lasik

Fact 15:

Some people (a very small percentage) might also need a second surgery. This is known as an enhancement. An enhancement helps in achieving the desired vision correction. This is more common in people who were more farsighted, nearsighted, or had higher astigmatism before they underwent LASIK surgery. In other words, people whose vision required more intensive correction might need to undergo retreatment.

Source: https://www.aao.org/eye-health/treatments/lasik

Fact 16:

A few number of people experience discomfort after LASIK eye surgery. This usually continues till the first 24 to 48 hours. These include –

  • Under corrections: If too little tissue is removed, then you won’t get the desired clarity in vision. This problem is common in people who are myopic.
  • Overcorrection: If too much tissue is removed from your eye with the laser, then you will experience vision problems. Compared to under corrections, overcorrections are a bit tough to fix.
  • Halos, Glares, and Double Vision: After the surgery, you may have problems in your night vision. You might also notice halos around bright lights, glare or have double vision. Even if you have a good visual result under standard testing conditions, your vision may be reduced in dim light (during dusk or in fog).
  • Flap Problem: Since the corneal flap is folded back or removed from the front of your eye during surgery, it can also cause complications. This includes inflammation, excessive tears, and infection. Moreover, the epithelium (the outermost tissue layer of the cornea) may experience abnormal growth underneath the corneal flap during the healing process.

Source: http://www.mayoclinic.org/tests-procedures/lasik-eye-surgery/basics/risks/prc-20019041

Fact 17:

Certain health conditions can increase the risks associated with LASIK surgery. The eye surgeon may not recommend LASIK surgery if you have the following conditions:

* Persistent dryness of eye
* Eye conditions such as glaucoma, keratoconus, uveitis, cataract, herpes simplex (that affects eyes), keratitis, lid disorder or any other eye injury.
* Unstable vision due to pregnancy, age, medications, hormonal changes, breastfeeding, etc.
* Autoimmune disorder such as rheumatoid arthritis
* Immunodeficiency conditions caused by HIV or other immunosuppressive medications.

Fact 18:

The doctors may not advise you to undergo LASIK surgery if you have very thin cornea or very large pupil, a fair overall vision; have a job that might be affected if you undergo surgery, age-related changes in eye causing presbyopia (less clear vision); and if you participated in sports which is associated with blows to your face (such as boxing).

Can you consider LASIK?

Fact 19:

If you are thinking of going for a LASIK eye surgery, first choose a good LASIK surgeon who will help you determine whether it’s right for you to undergo LASIK eye surgery or not. Your surgeon will first examine your eyes. He or she will first determine your eye health and see what kind of vision correction you need. He or she will then determine how much laser ablation or corneal tissue removal is required. Your surgeon might also inquire whether you have any specific health conditions or not (for determining whether you are fit for undergoing a LASIK surgery or not).

Fact 20:

If the doctor doesn’t find it suitable to perform LASIK, then you can also try (if your doctor considers its feasible) other laser eye surgeries such as epi-LASIK, LASEK, and PRK (this is a process similar to LASIK eye surgery but without the flap). Your doctor may also prescribe other non-laser vision correction procedures. Your surgeon will check your prescriptions and your eye structure to determine which procedure is best for you.

Fact 21:

LASIK is an outpatient procedure. This means you do not have to stay at the hospital overnight. The surgeon uses a computer for adjusting the laser. He or she will ask to look at a light for a while as the laser will send pulses of light to reshape your cornea.

How Should Patients prepare for LASIK?

Fact 22:

You will meet your eye surgeon before the LASIK eye surgery is performed. The surgeon will discuss and explain what you can expect during and after the procedure. The surgeon will also go through your medical history. He/she will examine your eyes. The most likely tests that a surgeon might conduct before the surgery are measuring your corneal thickness, corneal mapping, refraction, pupil dilation, and air pressure. Once the initial evaluation is over, you can ask the surgeon any questions you may have. Following this, you can schedule an appointment for the procedure.

Fact 23:

If you wear rigid gas permeable contact lenses, then you must stop wearing those 3 weeks before your eye examination for LASIK surgery. You should stop wearing any contact lenses at least three days before the evaluation. Do not forget to show your eyeglasses to the surgeon so that he or she can review your prescription.

Fact 24:

Eat a light meal on the scheduled day of your procedure and before you go to the doctor and take all of your prescribed medications. Avoid wearing eye makeup or attaching any heavy hair accessories which might interfere with the position of your head when under the laser. In case you do not feel well in the morning before your surgery, immediately let the doctor know. This will help you determine whether the procedure can be done or needs to be postponed or not.

Healing and What to Expect after LASIK

Fact 25:

Immediately after the LASIK surgery, you might feel itching and burning sensation in your eyes, and they may become watery. You might also experience blurred vision. You might experience a little pain. However, you will recover your vision quickly.

Fact 26:

The surgeon might give you medication for pain or eyedrops to make your eyes comfortable for several hours after the surgery is over. Your eye doctor may also ask you to wear a shield over your eyes until it heals completely.

Fact 27:

Right after the surgery, you will be able to see, but your vision won’t be clear initially. It might take about two to three months after the procedure for your eyes to heal completely and for stabilising your vision. Your chances for improved vision depend highly on the quality of vision you had before surgery.

Fact 28:

Once your surgery is over, you will have a follow-up with your eye doctor a day or two after the surgery. Your doctor will review how your eye is healing after the surgery and whether there are any complications or not. It’s better to plan for follow-up appointments during the first six months after surgery.

Fact 29:

After a few weeks of the surgery, you can start using cosmetics around your eyes. If you are into sports or other strenuous activities, you might need to wait for several weeks before resuming those activities.

Fact 30:

You may feel a temporary dryness of the eye. Your doctor will prescribe you drops to prevent infection and inflammation. The doctor might also prescribe eye-drops to keep your eyes moist. The drops might cause slight burning sensation in your eyes or also blur your vision when you use them.

Fact 31:

Your eyes heal rapidly after LASIK eye surgery. Most of the patients notice an improvement in vision within a few days.

Do not hesitate to ask the doctor about your post-operative eye routine and ensure that you follow each of them ardently.

Patients’ Guide to Living with Glaucoma

Patients' Guide to Living with Glaucoma

Glaucoma

The ability to see the beautiful world around you is one of the greatest gifts that life has to offer. However, many unfortunate people lose this gift when affected by Glaucoma, an eye disease that gradually takes away the vision.

Glaucoma does not show any symptoms during the preliminary stages. It affects the optic nerves located at the back of your eye and gradually destroys it. The damage is caused due to an increase in the pressure inside the eyes as the flow and drainage of aqueous humour are blocked. In other cases, Glaucoma is also caused by the poor supply of blood to the optic nerve fibers in the eyes;  which could be due to defect or problem in the structure of the nerve itself.

How Lifestyle Affects Glaucoma?
glucoma vision
Eye health and lifestyle choices share a deep relationship. Patients suffering from Glaucoma should know this connection. Certain changes in  lifestyle can dramatically improve your ocular health. Apart from taking medications and undergoing treatment, these lifestyle changes can help you to combat this deadly disease often known as the silent thief of sight:

  • Exercise for lowering eye pressure
  • There are certain exercises that help in reducing the Intraocular Pressure or IOP (the pressure inside the eye). The eye pressure increases during the first 5 minutes of exercising, but after that it decreases. Aerobics are considered good for decreasing eye pressure, thus keeping your eyes healthy. Exercises such as brisk walking, bicycling, swimming, jogging and gym conditioning three times a week drops the IOP substantially. Regular exercise improves the blood flow to the retina and the optic nerve.

  • Obesity and Glaucoma
  • According to research, obesity is also closely linked to Glaucoma. A study conducted by Professor Michael Belkin and Dr Zohar Habot-Wilner, Goldschleger Eye Institute at the Sheba Medical Centre, found that excess weight creates pulmonary problems and as a result, the blood vessels in the eyes are affected which leads to loss of vision. They reviewed more than 20 studies involving thousands of patients all over the world and came to this conclusion.

  • Alcohol Consumption and Eye pressure
  • Alcohol consumption can lower eye pressure for a short period, but experts suggest that daily alcohol consumption can cause higher eye pressure. Therefore, it is important to let your ophthalmologist know whether you are consuming alcohol or not because it will affect your readings during check-ups.

  • Caffeine increases eye pressure
  • Drinking coffee increases eye pressure. Moderate amount of coffee is fine, but excessive caffeine intake should be avoided by Glaucoma patients. According to the data from the Blue Mountains Eye Study, patients with open-angle Glaucoma who regularly drank coffee had significantly higher mean IOP than those who didn’t drink coffee.

    Source:

    http://glaucomatoday.com/pdfs/0904_01.pdf
    https://www.glaucomafoundation.org/news_detail.php?id=154
    http://www.dailymail.co.uk/health/article-372725/Obesity-lead-blindness.html
    https://www.aao.org/eye-health/ask-ophthalmologist-q/alcohol-eye-pressure
    http://www.glaucoma.org/glaucoma/do-lifestyle-choices-affect-glaucoma.php

Impact of Diet on Glaucoma

Everything you eat affects your overall health. A study by Spanish Society of Ophthalmology in 2014 found that eating the right food can help reduce the risk of Glaucoma. It also helps in preventing the disease and maintains healthy eyesight for long run.
http://www.foxnews.com/health/2014/09/10/foods-to-help-reduce-glaucoma-risk.html

The Spanish study examined the diets of people as noted in two American Ophthalmological studies, and in one study from Rotterdam. As per this study, the food rich in Retinol (a type of vitamin A) such as cheese, milk, liver and butter helps to eliminate the risk of Glaucoma.
The researchers also found that higher consumption of  green leafy vegetables such as cabbage, carrots, fruits and fruit juices help in reducing the risk of Glaucoma. Orange-coloured fruits such as apricots and peaches are also quite beneficial in preventing the  disease.

The study also   recommends foods rich in antioxidants such as green tea, dark chocolate and black tea for patients having Glaucoma. However, they also maintained that Glaucoma patients should also consume little or no caffeine, as that increase intraocular pressure and thus, worsen the disease.

Here are a few super foods that are beneficial for lowering the risk of Glaucoma and maintaining overall eye health:

  1. Spinach
  2. Spinach is excellent for the eye as it’s rich in lutein, carotenoid, a compound that is found in colourful fruits and vegetables. It protects cells from damage.

  3. Walnuts
  4. Among nuts, this is the best source of omega-3 fatty acids. In small amounts, these fatty acids can be converted to EPA or eicosapentaenoic acid. This is an important omega-3 fatty acid which is very useful for the eyes, apart from DHA. These are full of antioxidants and vitamin E that help in preventing inflammation and maintaining cardiovascular health. Walnuts also help in lowering C-reactive protein, an indicator of inflammation in the body. Consuming walnuts can cut your risk of cardiac problems to 50%.

  5. Salmon
  6. Cold-water fishes like salmon, mackerel, herring and albacore tuna are best for the back of the eyes. These fishes contain DHA (docosahexaenoic acid), an important omega-3 fatty acid that concentrates in the retina and may prevent plaque.

  7. Berries
  8. Berries, especially blackberries, blueberries, strawberries, cherries, mulberries and even grapes are excellent foods for protecting cardiovascular health, which makes them equally beneficial for the health of the eyes too. Berries are great for lowering high blood pressure which increases the risk for Glaucoma and other eye diseases. Blueberries and blackberries also contain anthocyanins, containing dark purple pigments, which helps in fighting inflammation and improves blood flow.  These pigments also help in preventing artery blockages and thus, maintain a supply of oxygen to the retina.

  9. Orange Bell Peppers
  10. Orange bell peppers are the best dietary source of zeaxanthin, a type of carotenoid that accumulates in the back of the eye. The higher the level of lutein and zeaxanthin, the lower the risk for eye diseases. Orange bell peppers also contain vitamin C. Other orange coloured foods such as goji berries, squash, pumpkin, sweet potatoes and carrots are also beneficial for eye health.

  11. Avocados
  12. Avocados are the best food for the eyes. This is one of the most nutrient-rich fruits. This fruit is rich in lutein which  helps in prevention of eye diseases such as Glaucoma and macular degeneration. Avocados are also a great source of important eye nutrients such as Vitamin C, beta-carotene, vitamin B6 and vitamin E.

    Source:
    http://www.foxnews.com/health/2014/09/10/foods-to-help-reduce-glaucoma-risk.html
    http://www.aarp.org/health/conditions-treatments/info-01-2011/10_foods_to_help_prevent_eye_disease.html

Living With Glaucoma

Do not let Glaucoma stop you from enjoying life. Even if you are diagnosed with Glaucoma, continue with what you were doing before the disease affected you.

  • What to do when your vision begins to change?
  • People with Glaucoma have low vision. In other words, you might have problems doing routine things even if you are using glasses. Glaucoma can cause loss of contrast sensitivity, which leads to problems with glare, and reduce visual acuity. Consult your doctor immediately if you experience these symptoms.

  • Cooperate with your doctor
  • If you have been newly diagnosed with Glaucoma, have your eye pressure checked frequently until it is under control. Even if your eye pressure is at a safe level, see your doctor several times a year for frequent checkups.

    Source: https://www.glaucoma.org/GRF_Understanding_Glaucoma_EN.pdf

Other Health-related Issues Increasing the Risk of Glaucoma

Antihypertensive drugs at bedtime

There are a number of elderly patients who consume antihypertensive drugs. However, lowering blood pressure at night can lead to a hypotensive crisis. In other words, the blood pressure can dip too low to support ocular perfusion.

Sleep apnea

Moderate to severe obstructive sleep apnea can increase the risk of glaucoma development and increase the chances of its progression. Patients address sleep apnea by using a Continuous Positive Airway Pressure machine at night. Although, CPAP is an effective non-surgical treatment for sleep apnea, yet a few studies have shown that CPAP therapy can increase IOP, especially at night. So it’s important to consult your doctor before going for CPAP therapy.

Migraines

Migraines can increase the risk of Glaucoma progression in patients who are suffering from normal-tension glaucoma. So, it’s essential to consult both a neurosurgeon and an eye specialist for effectively treating this condition.

Marijuana

Accrding to research, it has been found that smoking marijuana  lowers IOP in both normal people and people suffering from Glaucoma.  However,  it should be kept in mind that it  lasts for only 3 or 4 hours. So, it is not advisable for Glaucoma patients to try Marijuana. Apart from that,  since marijuana lowers the blood pressure, it can be harmful to the optic nerves (in glaucoma patients) by affecting the blood flow. The American Glaucoma Society, in a position statement on Glaucoma mentioned that, “Although marijuana can lower the intraocular pressure, its side effects and short duration of action, coupled with a lack of evidence that its use alters the course of Glaucoma, preclude recommending this drug in any form for the treatment of Glaucoma at present.”

Source:
https://www.reviewofophthalmology.com/article/taking-control-lifestyle-choices-and-glaucoma
http://www.americanglaucomasociety.net/professionals/policy_statements/marijuana_glaucoma

How to Manage Glaucoma

Here is how you can manage Glaucoma and lead a healthy lifestyle:

  • Do not forget to take your medications regularly. Make them a part of your daily routine. If you keep on forgetting, use an alarm clock or a smartphone to remind you about your medicine timings.
  • Research and find out the possible side effects of the medicines. If your side effects are severe, then the medicines may not be right for you. In such cases, inform your doctor at the earliest.
  • If you are not getting any results after using the medicine, let your doctor know. The doctor can help you to find out the reason behind your medications not working for you (may be due to change in daily routine or dietary routine). The doctor is the right person to solve such problems by changing the type or timing of your medications.
  • Keep a thorough record of each medicine that you are taking. Note down the name and the dosage. Write down the number of times it should be taken every day. Carry it in your purse or wallet, or keep it in places where you can see it every day.
  • Before you leave the doctor’s office, always schedule your next check-up. Put it on your calendar so that you do not forget.
  • Keep your eyes clean and free of irritants. If you are a woman, be careful about eye cosmetics. Try using non-allergenic brands.
  • Never rub your eyes. Few Glaucoma medications might make them feel itchy or blurry but avoid rubbing them.
  • If you have had eye surgery, wear goggles when going out. Wear protective glasses when playing sports or doing some yard work.
  • Take care of your body. A good general health is as important as taking care of your eyes.
  • Eat healthy foods, exercise, quit smoking, avoid caffeine, and maintain a healthy weight. Be sure to check with your doctor before you start any strenuous exercise program.

Living with Glaucoma has an emotional and psychological aspect as well. Living with a chronic, vision-threatening health condition is not easy. You might feel worried, depressed, and anxious when you are first diagnosed with Glaucoma. Research and learn more about the disease, and you’ll find that there are a number of ways that can help you to manage Glaucoma. Even if you lose a part of your vision, you still can enjoy and continue to lead an active and healthy life.

Source: https://www.glaucoma.org/GRF_Understanding_Glaucoma_EN.pdf

Diabetic Retinopathy Guide

Diabetic Retinopathy, as the word implies, is a medical condition which causes progressive damage to the retina; mainly to the patients who have diabetes. When left untreated, the severity of Diabetic Retinopathy can eventually lead to blindness.

Diabetic patients have sugar (glucose) imbalance in their body as the metabolic disease interferes with insulin production. Later stages of diabetes cause damage to major organs of the body and eye is one of the first organs to get affected.

Analysts predict that the number of Americans affected by Diabetic Retinopathy is going to double up over the course of time. Hispanic Americans getting affected by this case are expected to reach up to 5.3 million by 2050.

Symptoms

Much like Macular Edema, self-diagnosis of Diabetic Retinopathy is very rare as you never know the onset of this eye complication. In most cases, patients are left clueless until severity and significant damages start to occur. Some of the common symptoms of Diabetic Retinopathy include:

  • Loss of central vision – You can diagnose Diabetic Retinopathy if you start losing sight or suffer poor vision while doing activities like reading and driving.
  • Colour Blindness – It is very common for a person to suffer from colour blindness when Diabetic Retinopathy prevails.
  • Night Blindness – If you start developing the inability to see during night-time, you might as well consider it to be the first effects of Diabetic Retinopathy.
  • Black Spots & Holes – One of the most dreadful initial effects of Diabetic Retinopathy is developing black structures that interfere with vision. To see it from the sufferer’s perspective, it would look something like –

diabetic vision

Stages

Diabetic Retinopathy is classified into 2 stages; NPDR (Non-proliferative Diabetic Retinopathy) and PDR (Proliferative Diabetic Retinopathy).

  • Stage 1 (NPDR)

During the early stages of Diabetic Retinopathy, the effects are indeed mild. In the 1st stage, blood vessels in the retina start to weaken and bulge out from their walls. This effect is also known as microaneurysm. These weakened blood vessels then release fluid into the retina which causes the macula to swell. NPDR is barely noticeable and doctors use fundus photography to confirm the onset of stage 1.

non-proliferative diabetic retinopathy

With time, the discharged fluid can fill up the macular region which leads to distorted vision which is not the same in both eyes. During NPDR, 10% of patients stand a high chance of developing vision loss.

  • Stage 2 (PDR)

When Diabetic Retinopathy enters stage 2, the disease gets more advanced. The early-on changes in PDR include growing of fragile blood vessels in the retina and vitreous. This phenomenon is also called neovascularization.

diabetic retinopathy

Then there are micro-disruptions in these fragile blood vessels which cause them to leak blood at the back of the eye which eventually interferes with vision. The retina eventually detaches due to the formation of scar tissue and development of glaucoma. This episode is followed by an extreme pain in the eye which eventually leads to blindness.

Causes

Although Diabetic Retinopathy usually occurs in patients who are already suffering from diabetes, other factors also contribute to the risk of developing this disease. Such factors include:

  • Pregnancy – As pregnant women are prone to develop gestational diabetics, therefore there’s a high chance that diabetes might cause Diabetic Retinopathy.
  • Race – Although researchers haven’t come up with specific reasons as to why certain groups of races get affected by Diabetic Retinopathy the most, White, African and Hispanic Americans hold the highest rate of the severity of this medical condition.
  • Other Medical Conditions –Apart from diabetes, other medical conditions such as high cholesterol and high blood pressure also trigger the risk of Diabetic Retinopathy.

Diagnosis

Doctors usually diagnose Diabetic Retinopathy through a comprehensive eye examination. To diagnose the retina and macula, doctors go through a rigorous set of evaluations including:

-Patient History

Before starting with all the diagnosis, doctors generally go through the patient’s medical history to determine the cause of vision difficulties. In this step, the doctor determines whether it’s actually diabetes or other medical condition that is hampering eye health.

-Measurement of Visual acuity

Doctors also perform measurement of visual acuity to determine the loss of central vision. In case of minor central vision loss, the doctor might even prescribe eyeglasses for refraction of the eye lenses.

-Retinal Photography

To get a clearer picture of the status of retina, doctors conduct retinal photography for severely affected patients.

-Evaluating Ocular Structures

Further diagnosis of Diabetic Retinopathy involves the doctor evaluating the retina by dilating the pupil. The doctor might even conduct measurements for eye pressure to determine the severity of Diabetic Retinopathy.

Research

Fundoscopic imaging and analyses

Fundoscopic imaging is one of the most favoured tools (diagnostics) by doctors to sort out Diabetic Retinopathy. Doctors take images of the retina to figure out abnormalities that are triggered by Diabetic Retinopathy. Doctors also use colour fundus photography to stage Diabetic Retinopathy.

To develop the further treatment plan, doctors access Fluorescein Angiography to take note of the abnormal growth of blood vessels. Now, computer-aided diagnosis has taken a massive leap of progress which involves the analysis of fundoscopic images to be automated. This computer automated diagnosis has several benefits including accuracy and time efficiency.

Blood Pressure Control

Controlling blood pressure is one rare measure that doctors take to cater prevention of Diabetic Retinopathy. According to a Cochrane study http://www.cochrane.org/CD006127/EYES_blood-pressure-control-for-diabetic-retinopathy, controlling or reducing blood pressure has helped prevent Diabetic Retinopathy up to 5 years for patients who already have diabetes.

However, there is no evidence of blood pressure control slowing down the progression of Diabetic Retinopathy or preservation of the clarity of the vision.

Stem Cell Therapy

Stem cell therapy for Diabetic Retinopathy is under clinical trials as of now. According to the analogy of clinical trials, doctors can use the patient’s bone marrow to derive stem cells and inject them into the degenerated areas for regenerating the vascular system.

For further information, read https://www.ncbi.nlm.nih.gov/pubmed/26454200.

C-Peptide

As C-peptide (aka Connecting Peptide) has shown promising results in treating vascular degeneration, Cebix (read http://www.xconomy.com/san-diego/2015/02/23/cebix-shuts-down-following-mid-stage-trial-of-c-peptide-drug/#) organised a program of $50 million to complete the Phase llb trail in 2014. The trial showed no difference between placebo and C-peptide which caused the company to shut down the program entirely.

Light Treatment

In 2016, Noctura (http://noctura.com/) developed a medical device which the patients can use as a sleeping mask to treat Diabetic Retinopathy. As per the clinical trials, the mask emits green light on the eyelids which supposedly stops the retina’s rod cells to adapt dark light. This, in turn, reduces oxygen requirement which has a counter effect on the formation of blood vessels.

Treatment

As of now, there are 3 major treatments for Diabetic Retinopathy which aid in restoring vision. Having said that, there’s no single solution for the complete cure of Diabetic Retinopathy till date.

Monitoring the symptoms vigilantly and getting optimal glycemic control is the best way to prevent the onset and delay further development of Diabetic Retinopathy. Here are the 3 main treatments:

1. Laser Photocoagulation

For treating Diabetic Retinopathy, doctors adapt Laser Photocoagulation into two usages. First, Laser Photocoagulation can be used to control neovascularization via panretinal coagulation and secondly for treating macular edema.

  • Panretinal Photocoagulation

Panretinal Photocoagulation aka scatter laser treatment is designed for treating PDR (Proliferative Diabetic Retinopathy). The process involves reducing the oxygen demand in the retina by creating 1,600 to 2,000 burns.

Before the ophthalmologist begins with the procedure, the physician numbs the eye by anaesthetic drops and dilates the pupil. The doctor may choose between pattern scan laser or a single spot laser.

From the patient’s perspective, you will see flashes of light during the procedure. This is accompanied by a stinging-like sensation. After the laser surgery, vision remains blurry for the rest of the day and the patients might suffer from a mild headache later on. Given the effectiveness of Panretinal Photocoagulation, this laser surgery involves several side effects too including reduced night and colour vision.

  • Laser Photocoagulation for macular edema

To treat macular edema with Laser Photocoagulation, doctors create a modified grid; a C-shaped pattern at the posterior pole with low-intensity burns. Clearing macular edemas helps in reducing the risk of vision. Read https://www.ncbi.nlm.nih.gov/pubmed/2866759.

2. Vitrectomy

Apart from laser surgery, Vitrectomy surgery is another treatment that doctors prefer; especially in the case where the vitreous contains lots of blood. To restore vision with vitrectomy, surgeons remove the blurry vitreous and replace it with a saline solution.

Vitrectomy doesn’t require special numbness and can be done under local anaesthesia. The surgery involved the doctoring making a tiny incision in the white portion of the eye to remove the vitreous. The doctor uses the same incision as a gateway to insert the saline solution.

The after-effects of the surgery include redness in the eye and sensitivity. In usual cases, patients are required to wear an eye patch for a couple of days. The doctor also prescribes medicated eye drop for prevention of infection.

3. Medication

Intravitreal anti-VEGF

Multiple doses of anti-VEGF intravitreal injection combined with Modified Grid Laser Photocoagulation works well for treating diabetic macular edema.

Intravitreal triamcinolone acetonide

Steroid preparation including Triamcinolone has lasting benefits in treating macular edema. The steroid is injected in the vitreous cavity which reduces the swelling of the retina that results in increased visual acuity.

In most patients, the effects of this steroid last for a time period of 3 months. This, in turn, necessitates repetition of the dosage to maintain the consistency of benefits.

Prevention

Management and prevention of the onset of Diabetic Retinopathy (especially Proliferative Diabetic Retinopathy) entirely depends upon the management of diabetes. However, the patients can take several measures to prevent PDR. Some of these measures include:

  • Cholesterol and Blood Pressure Control

Diabetics with abnormal lipid metabolism and high blood pressure are vulnerable to get affected by Diabetic Retinopathy. As these factors can trigger the development of vascular changes at an alarming rate, Doctors recommend diabetics to maintain a normal BP and manage serum lipid levels by undergoing regulated medications.

  • Blood Sugar Control

It is always best to maintain a healthy lifestyle by doing physical activity on a regular basis and maintaining a healthy diet. Diabetics are often advised to consult a diabetic specialist for undergoing the best-suited hypoglycemic medications.

  • Quitting Tobacco

Smoking leads to abnormal blood sugar levels which create the risk of developing atherosclerosis. Similarly, hazardous habits like alcohol consumption and illicit drug abuse are a strict no for diabetics to prevent Diabetic Retinopathy.

  • Eye Examination

It is often recommended that a diabetic should visit a specialist for ensuring the working of hypoglycemic medication. Visiting an eye specialist every once in a while in 3 months is helpful to come up with diagnostics of vascular changes.

Alternatives to medication

As discussed earlier, there’s no definite cure to Diabetes or Diabetic Retinopathy. However, there are several herbal supplements which have seemed to work well for patients in the past. Some of these supplements that help in delaying the onset of Diabetic Retinopathy include:

  • Butcher’s broom

Butcher’s broom

  • Pycnogenol (Pine bark)

Pine bark

  • Bilberry

Bilberry

  • Grape Seed Extract

Grape Seed Extract

  • Gingko Biloba

Gingko Biloba

Communities

As the percentage of diabetics suffering from Diabetic Retinopathy is increasing, several communities encourage patients to share up for creating a positive perception. Also, such communities provide information and make the patients aware of the available treatment options. Some of these communities include:

Macular Society: https://healthunlocked.com/macularsociety?utm_campaign=diabetic-retinopathy&utm_medium=syndicated&utm_source=nhs.uk&utm_term=web_part_id_20
Diabetes Research & Wellness Foundation:
https://healthunlocked.com/drwfdiabetes/about

23 Quick Facts on Diabetic Retinopathy

Diabetic Retinopathy

Almost everyone having diabetes is vulnerable to the risk of vision loss known as Diabetic Retinopathy, which is also one of the most common long term complications of diabetes.

Here are some interesting facts about Diabetic Retinopathy.

#Fact 1
Diabetic Retinopathy is so prevalent that around 93 million adults are affected by it on a global scale. Both Type 1 and Type 2 diabetics stand a high risk for the onset of Diabetic Retinopathy.

#Fact 2
As diabetes triggers Diabetic Retinopathy, the underlying cause is high blood sugar levels and high blood pressure. Other risk factors include abnormal serum lipid levels and consumption of tobacco and alcohol.

#Fact 3
A significant percentage of diabetics have uncontrolled cholesterol and hypertension which increase the prevalence of Diabetic Retinopathy. Almost all patients suffering from advanced diabetic kidney disease have Diabetic Retinopathy or suffer from it later on.

#Fact 4
According to a recently conducted survey, almost 63% of Indians are not even aware that diabetes has a hazardous effect on the eye apart from other body parts. 92% of diabetics underwent retinal analysis after having their vision affected. Read more info at http://economictimes.indiatimes.com/magazines/panache/63-indians-not-aware-that-diabetes-can-spoil-retina-too-survey/articleshow/56096193.cms.

#Fact 5
In India, 52.2% male smokers have been diagnosed of developing Diabetic Retinopathy.

#Fact 6
In a study of 7,000 diabetics in 41 countries, 80% of Diabetic Retinopathy sufferers face difficulties while doing everyday chores like, driving, going to work, reading, etc. The study even holds that Diabetic Retinopathy patients face several “barriers” that prevent them from accessing diagnosis, timely screening and treatment. Read for further info: https://www.statnews.com/2017/02/14/living-longer-living-better-aging/

#Fact 7
Diabetic Retinopathy is not the only vision complication of diabetes as there are other conditions as well including glaucoma, cataract and diabetic macular edema. Irrespective of the type, all of these medical conditions cause severe vision loss and eventually lead to blindness.

#Fact 8
According to a study conducted by the University of Michigan, Telemedicine stands a high chance of serving as a medical tool for screening patients of Diabetic Retinopathy.

#Fact 9
As the early symptoms of Diabetic Retinopathy are very subtle, the cases involving patients having early-on diagnostics are very rare (and rare would be an understatement here).

#Fact 10
Although there’s no absolute cure to Diabetic Retinopathy, diagnosis and treatment during the initial stages help maintain vision.

#Fact 11
There is no such rule of thumb that an optometrist (O.D) or ophthalmologist (M.D) has to examine the diabetics, as all eye specialists and physicians can identify Diabetic Retinopathy.

#Fact 12
A patient can opt for either one or several combinations of treatments for curing Diabetic Retinopathy. For example, a patient might need some extra medication after having gone through surgery.

#Fact 13
Diabetic Retinopathy is not the only eye complication triggered by diabetes as patients are likely to develop double vision caused by the paralysis of the eye muscles. Fortunately, this effect is temporary in usual cases.

#Fact 14
Although maintaining a tight blood glucose control reduces the risk of development of Diabetic Retinopathy, it cannot be prevented entirely. Doctors claim that maintaining glucose control delays the jeopardy of vision loss. Read more at http://www.healthcommunities.com/diabetes-complications/diabetic-retinopathy-facts.sht.

#Fact 15
The countries that contribute to almost 75% of global epidemic of     diabetes are the ones having low and middle income. Western Pacific and South East Asia are accounted for more than half the number of adults who get affected by diabetes and Diabetic Retinopathy eventually.

#Fact 16
Countries including India, Bangladesh, China and Indonesia represent 45% of the global epidemic of diabetes. Eastern Mediterranean holds the highest number of prevalence of diabetes and Diabetic Retinopathy which accounts for 14% of the population. Read more at http://www.iapb.org/vision-2020/what-is-avoidable-blindness/diabetic-retinopathy.

#Fact 17
In Africa, almost two-thirds of the people having diabetes and Diabetic Retinopathy remain undiagnosed. Studies show that Africa will be affected the most by diabetes and Diabetic Retinopathy by 2040. Get more info at http://www.iapb.org/vision-2020/what-is-avoidable-blindness/diabetic-retinopathy#_edn3.

#Fact 18
In total, 1 in 3 people who are currently living with diabetes are reported to have some degree of Diabetic Retinopathy. Likewise, 1 in 10 people stand a high chance of developing vision-threatening form of Diabetic Retinopathy.

#Fact 19
The International Council of Ophthalmology provides educational and supportive role for ophthalmologists to get a better understanding of diabetes and Diabetic Retinopathy. Currently, the firm has issued new “Guidelines for Diabetic Eye Care.” Get further information at http://www.iapb.org/news/ico-launches-2017-guidelines-diabetic-eye-care.

#Fact 20
The Centre of Eye Research Australia, Global Health and the University of Melbourne School of Population have collaborated to develop the Online Self Directed Diabetic Retinopathy. Now the course is available in different languages including Spanish, Mandarin, Urdu, Portuguese and French. Check out http://drgrading.iehu.unimelb.edu.au/cera/index.asp.

#Fact 21
As of 2011 report, there were 11,000 Ophthalmologists in India and the number of diabetics undergoing screening per day was 18. China has the maximum number of Ophthalmologists at 28,340 and only 11 diabetic patients were screened per day. http://www.iapb.org/sites/iapb.org/file/ICO%20Diabetic%20Eye%20Care%20Workforce%20Challenges_Prof.%20Hugh%20Taylor_0.pdf.

#Fact 22
The Commonwealth Eye Health Consortium is focused on addressing the epidemic of diabetes across the Commonwealth nations. CEHC consists of 11 leading research facilities which support a network of training campaigns in the UK and Africa for building a strong and a well-informed Diabetic Retinopathy team. Read more at http://cehc.lshtm.ac.uk/dr-links/.

#Fact 23
Major programs have been organised to provide support, treatment and relief from Diabetic Retinopathy. In a program supported by Bayer, IDF (International Diabetes Federation), IAPB (International Agency for the Prevention of Blindness) and IFA (International Federation on Ageing) have collaborated in an attempt to subside the devastating consequences of DR. Read more at http://drbarometer.com/.

Eyecare Guidelines For Holi

Eyecare Guidelines For Holi festival

Everyone in India looks forward to celebrate the festival of colours, Holi.  Every one gears up to celebrate the riot of colors and make it an enchanting experience with the gulal, rang pichkaris, song & dance and a sumptuous meal.

Earlier Holi was played with colors made of plant and flower extracts. But over the years, chemicals and other toxic substances have slowly replaced natural colors. Apart from causing irritation to the eyes, these synthetic colors might also lead to temporary blindness and permanent blindness in certain cases.This colourful festival can only be a better day of fun and frolic when we play it with safety measures.

Some probable damages caused to the eyes during Holi and their solutions are as follows:

1 ) Photo Phobia: If toxic colors get into your eyes, they turn red, burn and swell up sometimes resulting in photo phobia.
Solution:  Wash your eyes time and again in water at normal temperature. If that does not solve the problem, visit your nearby eye specialist immediately.

2) Retinal Detachment: If your eyes are hit by balloons full of colour, your eye balls may get severely damaged or it may lead to retinal detachment.
Solution:  Don’t try to wash your eyes as it may cause infection. Keep your eyes closed and visit your nearby eye hospital.

3) Corneal Abrasion: The granular particles, which make the colours shine brightly are actually quite toxic and can cause damage to the cornea in the form of a corneal abrasion. A person who gets a corneal abrasion will have severe pain and watering and if not treated by an en expert may develop an ulcer or infection.Solution: Gently rinse your eye with clean water or a sterile saline solution. But do not rub the eye while rinsing it.
Solution: Gently rinse your eye with clean water or a sterile saline solution. But do not rub the eye while rinsing it.

The precautionary measures to be taken during Holi to safeguard your eyes are as follows:

Cover Your Eyes: The first step is to protect your eyes. If someone smears colour on your face, the first thing you should do is close your eyes.Better is to cover your eyes with your palms.

Apply a Good Cream:  Apply a cold cream around your eyes to avoid getting any colour in your eye. The cold cream acts a shield from the Holi colours.

Wearing Contact Lenses: First and foremost, avoid wearing contact lenses while playing Holi. If you cannot do without it, then make sure you avoid getting colour into your eye. If colour does get into your eye, discard the lenses and wash your eyes with clean water.

Shade Your Eyes: The next best eye care tip for Holi is to wear a pair of sunglasses while playing Holi. This will protect your eyes from the colour as well as coloured water.

Avoid Rubbing: If colour gets into your eyes, the first thing you should do is rinse your eyes. If there is any irritation avoid rubbing the eye at any cost. Rubbing the eye will aggravate the situation.

Coconut oil protection: Before you play Holi, rub natural coconut oil around your eye. Just like cream, coconut oil will also avoid the colour from entering your eye. This is one of the best eye care tips to follow when playing Holi.

Natural colours made from home-based products are a much better and safer option to play Holi. These can be easily made and offers a safer option as compared to the synthetic colours. Haldi mixed with besan or flour can give a yellow colour and work as a face-mask at the same time. White petals of Palash flower can be used to obtain a saffron colour. Beetroot soaked in water provides a bright magenta colour. Henna powder, gulmohar and hibiscus flowers, etc can also be used to make different colours.

Article written By

Dr. Aditya Pradhan
Dr.Aditya Pradhan MBBS, MS, Fellowship in Cornea
Consultant in the Dept. of Cataract & Cornea