Saroj Speciality Eye Clinic

Good morning friends,

I am Dr. Harshvardhan Ghorpade and today I am going to speak to you about retinal disorders especially diabetic retinopathy. Now retina is the innermost layer of the eye. It is the light-sensitive layer, it is the layer where the image of the light is formed and then transmitted to the brain, any damage to this layer leads to blurred vision. The most important sensitive part of the retina is the macula and the centermost point is called the fovea. If there is any collection of fluid or blood or damage to this part of the retina, it leads to blurriness and even blindness of vision so there are various disorders that can affect the retina that could be infections, inflammations, retinal detachments, injuries and various other disorders which ultimately lead to blurred vision.

Specifically speaking if we talk about diabetic retinopathy, it is a disorder where diabetes leads to blockage and leakage of blood vessels in the retina. Now this blockage leads to hypoxia which means less oxygen supply which in turn leads to the formation of new blood vessels and these new blood vessels can break, rupture and bleed leading to blindness.

The other part is leakage. Leakages because the blood vessels become leaky due to blood sugar in the blood as a result of which fluid starts accumulating in the central area as I said the fovea and macula, this leads to initial blurred vision; however, for long time later it can lead to scarring and finally complete loss of vision at the center.

So the most important thing in diabetic retinopathy is screening, there is no symptom of diabeticretinopathy. The patient does not have any problem until it actually occurs and therefore patients with diabetes for more than five years and patients with congenital diabetes or juvenile diabetes from the first year itself need to be screened every year. If you find any changes in the retina then the patient may have to be screened every six months or even at three months because every small change has to be monitored. This monitoring can be done by various instruments like simple fundus camera or it can be done by lenses and most new instruments have now we use is the OCT, which is a scan of the retina and which gives us the idea of the thickness of the layers and if there is any leakage the layer thickness can increase.

When we come to know about any changes in the retina through all these apparatuses then we can definitely warn the patient and we can even do preliminary treatment. The early treatment can be done by simple laser machines which are an OPD based procedure, where we can block these blood vessels which are leaking and prevent further loss of vision because as the fluid starts accumulating it can come to the center of the retina, which is the most sensitive area.

However. if the bleeding is more we might even need surgery, this surgery is called vitrectomy. In vitrectomy what we do is we cut the central area of the jelly that is present in the eye and removes all the blood that is collected, this is followed by laser therapy to the areas which are leaking and then follow-up is needed.

There are other treatments also available in which if there is a mild swelling in the center we just give injections which stop the leakage, one or more injections may be required these are called anti-VEGF injections. example is Lucentis. Now once we treat the patient with injections, lasers or surgery we need to be sure that the patient is followed up because the diabetes is going to remain throughout their life and therefore retinopathy can come again at different parts which have not been treated.

The most common treatment for severe diabetic retinopathy is panretinal photocoagulation or PRP which means retinal laser is given to the entire retina in three steps. this results in coverage of the whole retina and therefore the chances of diabetic retinopathy affecting any of the parts are less; however, it can affect your night vision and peripheral vision which is a side effect of the therapy. Apart from this, we should be careful that during injections and operations, there should not be an infection because a diabetic patient is always prone to more infections, all this care has to be taken by the doctor as well as the patient because it's a combined effort in preventing blindness due to diabetic retinopathy.

Hence, I appeal to you that every time, any patient is detected with diabetes a yearly screening of the eyes is a must and follow-up treatment if required has to be done without any delay, even a delay of a few weeks can lead to permanent blurring of vision.

Thank you very much and I hope you enjoyed my video. If you want to know more about me please contact me on lybrate.com

Thank you
 

Hi,

I am Dr. Harshavardhan Ghorpade, Ophthalmologist. Today I am going to talk about various general eye care. So, what do we need to know about general eye care? We all know that eyes are the most important structure as far as vision is concerned. Because without vision nothing much left in life apart from blindness and darkness. First of all, coming to diet. We should have a very normal and healthy diet. Too much of fried and junk food can affect the health of the retina. It may not cause an immediate effect. But in old age, there is early degeneration of the retina which can lead to a poor vision specifically in the last 15-20 years of your life which you don't want. So, green and red vegetables, fresh fruits, nuts, almonds, apricot, and walnuts are very important ingredients in life. Remember every morning have milk, eggs, nuts, and fruits in your diet. You should also follow the meds policy. What are meds? Meds mean doing meditation, exercise, diet, and sleep. All of these are general things. By this, not only your eyes but also health will be good.

How do we take care of eyes in daily life? Every year you should have a general check-up specially when you are above 40, every 1-2 years. And if you are more than 50, every year eye check-up is a must. Especially, when you have a family history of glaucoma, diabetes, hypertension then we should check your eyes more regularly. Apart from this, if you have any blurring of vision, don't wait for a long time. Go to the Dr and show as early as possible. Get to know why your vision is a blur. Is it because of glass power or is it anything else going in your eyes. Because glass is not the only thing in the eye. There is cornea, retina, glaucoma, optic nerve, so many things are involved in giving perfect vision. And therefore, we need to look at all those factors. We should also look at various other aspects, for example, computer vision syndrome. All of us use a computer every day and we cannot avoid it. How do we take care?

First of all, have anti-glare glasses as it prevents too much light entering into your eyes which can cause irritation and redness of the eye. Nowadays the blue screen is also available which blocks the blue light. Apart from this, you should take a break every 20 minutes. Put your eyes away from the skin. Look somewhere else. You can also do eye exercises right, up, down, left which can help in relaxing your eyes muscles. Apart from this, you should use lubricating drops which are easily available over the counter. This can lead to the freshness of your eyes and can give you comfort, avoid redness and tiredness. You should keep your system at a little lower height so that the exposure of the eyes are less. Blink your eyes continuously and avoid sitting in front of the AC. You need to work for 40 years of your life and you need to have that kind of sustain.

When you read books, you should sit in front of the bright lights. Letters should not be very small and keep the book at a distance of 30 cms. Good sleep is the most important thing for overall health. Tired muscles and eyes can lead to the early formation of presbyopia which is early glasses at the age of 40. Going out in the sun is important for the growth of the eye. Sun is not only important for bones but also for eyes. UV rays are important for the growth of retina, especially in children. It is important to let them grow naturally. UV rays also help in the prevention of dryness of the eye. Good diet, sleep, avoiding laptops, computers, mobiles especially in kids are a must. Because not only eyes but also brain growth will be affected. a TV can be given to kids to watch for half an hour for the day. But that is not as bad as a mobile phone. So, ophthalmologists are there to get them corrected by laser treatment. It also has its limitation. So, to avoid all kind of complications, we should take care of our eyes. Lastly, I would like to talk about trauma care. Injuries are very common in all of us.

If you see that something is there in your job which can harm your eyes, you should have protective gare. Hard polycarbonate glasses are a must. People walking in front of cutting stones, even playing matches where a ball can hit you, we wish you to take good care of your eyes. Also, while swimming, we should never wear contact lenses. When you are sleeping, you should not wear lenses. If there is any injury, any foreign body, redness, discharge, don't do self-medications. Over the counter drugs is big No. Steroids can cause further damage. Go to a nearby ophthalmologist and ensure that the right diagnosis is made. Stay happy, take care of your eyes. And if you need any other information, please contact me through Lybrate.

Thank You!

Good morning friends.

I am Dr. Harshvardhan Ghorpade. Today I am going to speak to you about a very special type of disorder or disorders of the eyes which comes under the heading of oculoplastic and squint. Now what is oculoplasty? oculoplasty is plastic surgery or plastic disorders of the eye which means cosmetic disorders. These could be congenital which means they come during birth, acquired that come later on because of injuries or any other problem or weakness in the muscles or neurological or neuro-ophthalmic, which means because of disorders in the brain.

Now what are the different types of disorders that come under this heading, it could be droopy eyes, the eyelid droops down, it could be squinted eyes, the eyelids eyes go either out or in, it could be protruding eyes the eyes come out, it could be small eyes, large eyes, changes in the lids, the lids can go out, in, scar or can affect the inner layers or the outer layers of the eye by rubbing against them. So all these disorders ultimately can affect your vision, as well as the cosmetic problem, is always there, so how do we look at it?

First, we assess the patient, any patient who has any abnormality or difference between the two eyes. for example, if one eye is droopy, another eye is normal or both eyes are droopy or we need to assess. There are various causes of these disorders so we cannot just straight away go and treat the problem, first of all we should know what is the cause for example in myasthenia gravis which is a condition where there is weakness of the muscles because of a neurological problem, the eyes droop more in the evening and less in the morning this is because of tiredness of muscles this requires a totally different kind of approach we may even treat it without surgery, we can even just give medicines and control this disorder.

However if it's a congenital problem that is a problem since birth where the muscle of the eyelids are weak then of course we need to do a surgery and sometimes we need to do different types of surgeries, for example, a sling surgery or a levator resection, these are technical terms but they simply mean stranding of the eye muscles to get the lid back to its place.

There are other disorders like squinting. Now squinting is a problem which is very common, it's a taboo for children who go to school, people call them by various names so any child who is about to go to school has a cosmetic problem we need to correct them. There are various ways of correcting squinting. First of all, we need to know the cause. is it because of glass power or any retinal problem or a cornea problem or just the eye muscle problem? If eye muscle problem is there then we should consider the change of glasses initially or giving prism glasses which are special glasses which deviate the light; however, in larger squints, we may need to do a surgery. Sometimes even exercises are given to control the movement of the eye muscles which in turn strengthen the muscles and can lead to improvement of squint.

Surgeries are basically stranding surgeries where the muscles are positioned at different places. There are around six muscles which operate around the eyes which help you to move the eye in various directions, any weakness in these muscles can lead to squint so we need to assess which muscles are weak. There are various tests that we do first to find out what is the muscle involved and then after that we go and correct that muscle strength. Then we come to other problems like orbital, where orbit is basically the bony structure behind the eye, any problem in that can lead to protrusion of the eye, the eye comes out that can be because of thyroid and thyroid disorders are the most common cause of protrusion, hyperthyroidism per se and these can be corrected by medical therapy; however, sometimes we need to do radiotherapy or surgical correction to correct the protrusion.

Most important thing is to know the cause whether there is a tumor growing behind the eye or whether there is a blood vessel problem or muscle hypertrophy, so all this can be done by MRI scan and then after diagnosis is done by doing a few tests, we do the correction. Correction basically involves orbital reconstruction or orbital decompression, then there are other lid problems like eyelid going out or in because of scarring or old age all these need corrections because they can lead to tearing, watering, scarring of the cornea that is the black part of the eye and many other things can happen. These require cosmetic correction in such a way that we don't lead to any bad appearance of the patient at the end of the surgery,

Finally, there are problems of the nasolacrimal duct which is the duct which connects the eye to the nose. If there is an occlusion of that duct then it can lead to constant watering, in children is called congenital nasolacrimal duct obstruction and it's a very common surgery where we do what is known as DCR, where we connect the duct to the nose directly and bypass the occlusion; however, nowadays we do endonasal DCR, where endoscopy is used and we enter the nose and do the surgery in a reverse way which in turn leads to no scarring on the skin and cosmetically the patient is very good, the surgery is faster and bleeding is very less.

So all these various endoscopic surgeries and correcting surgery requires a very specific and very experienced eye plastic surgeon, basically oculoplastic surgeon and a squint surgeon both of them we have and we coordinate together all of us and finally give the best possible appearance to the patient, correcting his problem, going to the root of the problem and then getting him the happy face that he wants. At the same time, it also can affect vision so vision rehabilitation is also important at the end of surgery. amblyopia treatment that is lazy eye treatment and many other treatments video-based, software-based or surgical based can be done ultimately to give the best possible correction and happiness to the patient.

So I hope you all liked my video about oculoplastic and squint problems in children and adults and if you want to know more about it you can contact me on lybrate.com.

Thank you
 

Hi ALl,

I am Dr. Harshavardhan Ghorpade. Today I am going to talk to you about a very important condition in the eye that is childhood blindness and more importantly childhood low vision because of refractive errors. Now in children, there are many causes of blindness that could range from a simple refractive error that is powered glasses or cataract or glaucoma or optic nerve problems. So for children to be detected to have any kind of these conditions it is important to have a regular checkup with the ophthalmologist in the early ages. This is important because children do not complain of blindness especially if it is in only one eye. And they can see with the other eye so they neglect it. Even because they are small they cannot even tell their parents that they cannot see clearly. After the age of 5, of course, they start telling their parents but before that it is imperative for the parents to take their children to the doctor and get them examined because any of these conditions could be there and we could miss it out and later on it would be too late to improve the vision.

So usually we advise a checkup at around 1 to 2 years then the next checkup at around 3 to 4 years and last check up around 5 to 7 years before the child himself becomes smart enough to complain about vision problems. Now talking about refractive errors, they have powered glasses which come for children. If they come in one eye then that eye becomes weak or lazy and ultimately after the age of 8 that laziness cannot be removed very easily. Therefore children have to be checked for refractive errors especially in clinical programs that are conducted in schools or can be taken to an eye doctor for checkup. What happens in refractive errors? Because of refractive errors, the focusing of light does not go out to the retina of the child and the child is not able to see images clearly because the vision is blurred the images which are formed are blurred and the visual development of the child is affected and slowly that eye becomes lazy.

When both eyes are affected it is much easier to check or to understand the child’s problem. However, if only one eye is affected then he may not able to complain and even the parents may not notice that the child is not able to see. Now, what are the causes of refractive errors? The most common cause is hereditary because if the parents have glasses then the child is likely to have glasses. It is said that about 25% of children have some kind of a vision problem and most of them are because of powered glasses. Especially if the child is not eating properly if he has poor diet he has bad habits like watching mobile computer laptops for a long time and finally because his parents also have some kind of hereditary problems of minus power the child is likely to have glasses. In such conditions, it is very important to get the vision of the child tested. The other factors nowadays that we have found are less exposure to sunlight by children. So it is very important that you allow children to go out & play in the sun or walk in the sun to school. This helps to develop the vision of the child and avoids faster progress of power especially minus number.

Talking about plus number. Plus number is not very common in children however many children do have plus power which gets undetected because the child can use his accommodation to overcome it. However, if it is in one eye especially if it is more than plus 3 that eye is surely likely to become lazy over a period of time and the child is not able to use his vision especially after the age of 8. What is the treatment? The treatment is very important because if it improves the child’s vision before the age of 8 then long term his vision is going to remain fine and later after the age of 18 can get rid of the glasses using a laser or other procedure. The main treatment is of course glasses. When your glasses full time is important however if one eye is lazy we can cover the normal eye for 3 to 4 hours a day & allow the lesser eye to see everything with those glasses. This is called as patching therapy.

Patching therapy helps to improve the laziness of the eye and gets back the vision of the poor eye equivalent to the normal eye. This treatment is very important before the age of 8 because after the age of 8 this may not work. Finally, I would suggest that children do not wear contact lenses because even if glasses don’t look very good even if children in the school might tease them for glasses contact lense have long term poor effects like infection & dryness that can cause problems in children’s eyes. So, all in all, I would suggest a regular checkup a very healthy diet avoid mobile avoid laptop, ipads go out & play in the sun & get your eyes checked at regular intervals to avoid childhood blindness. Thank you very much. If you want to know more about it please contact me on Lybrate.com.

Thank you.

Hi all,

I am Dr. Harshavardhan and today I am going to speak to you about a condition in the eye called Glaucoma. 10th March is celebrated as World Glaucoma Day and we all should know what this condition means. Glaucoma is called the sneak thief of the eye. It means when Glaucoma comes no one comes to know and when the patient actually comes to us he has advanced Glaucoma. So the main thing about Glaucoma is that the pressure inside the eye slowly rises & because of that the optic nerve which transmits messages or light impulses from the eye to the brain is damaged. In Glaucoma the patient initially does not have any symptoms the vision is also good. The peripheral vision, however, starts shrinking and this cannot be detected by regular tests or regular optometrist. It has to be detected by an ophthalmic surgeon & with the help of a special test called perimetry pekimetry OCT etc. Now, what happens in Glaucoma? When the pressure rises the nerve starts getting damaged and the peripheral vision initially starts shrinking. So when the patient comes to us he may complaints of an accident happening to him because he could not see the car coming from the side. 

In that case, we usually check the pressure of the eye. The pressure is usually found to be high. We then look at the optic nerve. And there is damage happening there which is then captured on a fundus photograph. This is followed by tests perimetry pekimetry OCT to rule out or confirm Glaucoma. When this happens we need to check the patient and get his pressure down. How do we do that? We have options for drops surgeries and shell surgeries. Before that let me tell you that patient may sometimes complaint of heaviness in the eye sometimes may have complaints like blurring of vision or seeing haloes around the light. That happens when the pressure rises suddenly that especially in acute Glaucoma. However, most of the Glaucoma is slow and they are associated with patients above 40 age with diabetes with minus power and with a family history of Glaucoma. Sometimes blood pressure can also be a condition that can accompany Glaucoma. However, all these causes are not directly related and we need to check the patient every year. So my advise to all of you would be that after the age of 40 please get your eyes checked regularly. Please insist on checking on the eye pressure and looking at the optic nerve by opthalmologist and also if there is any doubt in your mind or in the mind of the ophthalmologist please get the special tests like perimetry & OCT done.

And in terms of the treatments that are available well initially, we treat with drops to control the pressure. However, if the number of drops is increasing or if the patient is not able to put drops because of his age & other limitations then we need to do a surgery to control the pressure. This surgery is safe and if done with the help of good hands and usually lasts for about 15 to 20 years however if the pressure does not come down with surgery then even repeat surgery may be required & sometimes a shunt has to be put. A shunt is nothing but a small tube which is inserted to drain the fluid from the eye & reduce the pressure. So all in all Glaucoma is a condition which cannot be detected by the patient himself & regular checkup is a must & if suspected must be treated as early as possible to prevent long time loss and complete blindness. Thank you very much and hope this video helps you. For more information, you can contact me on Lybrate.com.

Thank you!

Hello friends!

I am Dr. Harshavardhan Ghorpade . I am a cataract cornea and reflector surgeon. Today I am going to speak to you about a very common occurrence in everyday life that is eye trauma or eye injuries. There are three type of eye injuries, one it could be a small foreign body or a large foreign body, second it could be a chemical injury and third it could be a mechanical injury. Now talking about foreign bodies, they can happen anywhere while playing, while working specially or while travelling, specially while doing work. We see many people coming with foreign bodies which have small dust particles or metal particles or wood particles and they are left inside for a long time. The main thing to do in this is to show the doctor immediately. Why? Because of the foreign bodies stays there for a long time, it can lead to devastating eye infections leading to permanent blindness.

How does that happen? The foreign bodies stay on the black part of the eye that is a cornea, sends in germs into the eyes which ultimately affect the vision. So go to the doctor, get it removed and take proper antibiotic eye drops for the prescribed period of time and then things should be fine. The second thing I would suggest is to have the good protection of the eyes while dealing with such work or while travelling. So that includes special eyegear that are prescribed by the company or the doctors. The second type of injuries are chemical injuries. They can happen anywhere specially in the laboratories or in factories or even while playing diwali or holi games we can have fire crackers or the colours from holi which can lead to chemical injuries. They can also happen in the house while you are dealing with liquids like harpic or any other fluid that is used to clean the toilets or homes or detergents. So the best thing to do that you can do in such a case is to give a thorough eyewash.

An eyewash is the most important thing that anyone can do before even coming to the doctor. Remember the water has to be absolutely clean while doing such a thing and the eyewash may have to be given for almost ten to fifteen minutes. Just a two or three minute eyewash may not be enough and even then there could be particles of the chemical that can stay inside for a long time and that have to be removed by the doctor. So go to the eye doctor immediately and the doctor will immediately have a look at you, remove the foreign particles, give you further eyewash and give the prescribed medications. However if the injury is very severe for example acid or alkali burns in factories or in laboratories, then sometimes an immediate surgery is also required to cover the bare areas which have got injured, otherwise it can lead to infections or even damage to the eye permanently.

The most important thing again that I would suggest is to use protective eyegear while doing such things for example while playing holi or diwali you can use a plastic goggle, while working in the laboratory or factory you should use the prescribed glasses or frames that are given by the company doctors and while travelling you can use eyegear to protect your eyes. It makes the use difference definitely. The last type of injuries are mechanical injuries. They could be of two types, blunt injuries caused by say for a example a tennis or a cricket ball and penetrating injuries caused by a nail, a knife or even a pencil or e pen refill. I have seen such cases many times. So what happens to you, what do you do? You definitely don’t have to give an eyewash in this case because the water can enter the eye through the wound and cause further problems. So the best thing is to cover the eye with a eyepad or a eyepatch or a eyeshield which is available in any pharmacy and then rush to the doctor. Do not strain or caught any kind of pressure to the eye because the contents of the eye can come out. When you will go to the doctor they will examine you and decide whether it needs medical treatment if the injury is superficial but if it is deep, it will need surgery definitely because the surgery can close the wounds, put the parts of the eyes back into their place and also avoid infection because they give antibiotics through injections or tablets. Once that is done a thorough follow up is required because injuries can cause further complications in the long run that could be cataract, glaucoma or retinal problems. So the regular follow up to the doctor is a must. So that’s all about injuries in short and I hope you take the requisite precautions to protect your eyes all the time and remember to approach the doctor as early as possible. Any delay from your side can lead to devastating eye blinding complications. Thank you very much. Stay healthy. Stay fit. And if you want to contact me or know more about me please visit lybrate.com.

Thank you.

Good Morning friends!

I am Dr. Harshavardhan Ghorpade. Today I am going to speak to you about a very common condition that we all encounter and that is Conjunctivitis. Conjunctivitis is of two types, Infectious and Allergic. Infectious can be of two types, bacterial and viral. The Bacterial Conjunctivitis is usually seen in the rainy seasons while the viral conjunctivitis is commonly seen in the summer seasons. The commonest cause of the spread of this conjunctivitis is direct contact.

If you happen to encounter a person say in a swimming pool with infection or someone at home or office, you have to be aware, that it could be transmitted to you through contact. It can happen through direct contact or through indirect contact that is through towels, napkins or even at touch at the tap or the bolt of a door. Once you know that you have encountered this condition, then you need to go immediately to the eye doctor because the common symptoms are redness, watery discharge and a lot of swelling of the eyes. If you try to self medicate, there can be complications. So the best way is to go to the doctor. However even better than that is to avoid contact through such a person.

How do you do that? First, ask the person not to touch his eyes repeatedly. If he touches his eyes, then ask him to wash them thoroughly, at least twice with clean water and soap. At the same time you should avoid touching the places where the person may have contacted and clean them thoroughly. Apart from that the patient has to put regular antibiotic drops and other drops that are being prescribed. The viral conjunctivitis is more dangerous because it spreads very rapidly and it can spread into a family very quickly. Also it can lead to some complications like membranes in the eyes, and black spots or white spots appearing in front on the black part of the eye that is a cornea, which can lead to blurring of vision.

This complication needs to be treated with utmost care because it can lead to long term blurring of vision as well. So talking about the other types of conjunctivitis that is Allergic, it is commonly associated in peep patients who are allergic to certain things like dust, pollen grains or insects and mites that are seen on the mattresses. It can also happen to people who are allergic to certain medications or food types. The patient mainly comes with itching of the eyes and swollen eyes and the treatment involves total different approach as compared to an infectious conjunctivitis. So the best way is to go to the doctor, have a check, try to find out what type of conjunctivitis it is and then we can treat accordingly.

The allergic conjunctivitis can mainly be treated by anti inflammatory drops, lubricating drops as well as avoiding the allergens mainly dust and pollen grains. However it is not always possible and we may have to give long term treatment to such patients and as regards conjunctivitis I would also like to add one small note. Please do not use contact lenses when you have any kind of eye infection because they can definitely cause corneal or any type of other complications which can lead to blindness. So contact lenses never to be used during any kind of conjunctivitis and at the same time you should take good care of your contact lenses that includes cleaning them daily, not wearing them during sleep and using them only for the period for which they have been prescribed. For example, if they have been used to use for 8 hours, you should use them for 8 hours, if they have to be used for a month, they should be used for a month and not more than that and definitely

I would say monthly disposable lenses are a better option than using a yearly disposable lens. So that is all in short about two types of main conjunctivitis. Remember to avoid contact, wash your hands thoroughly and show the doctor as early as possible and please avoid self-medication. Thank you. Stay healthy. Stay fit. Thank you very much and to contact and know more about me go to lybrate.com.

Thank you!

Good morning friends.

I’m Dr. Harshavardhan Ghorpade from the department of visual sciences DOVS from Fortis hospital Vashi, Mumbai and Saroj Speciality Eye Clinic Vashi, New Mumbai. I have done my MS. FRCS and I m a cataract, cornea and a refractive eye surgeon practicing here in New Mumbai. You can get back to me on lybrate.com and know more about me.

Today I’m going to talk to you about very interesting topic about recent advances in corneal surgeries. Now first of all let me start by telling you what is cornea. The Cornea is the front surface of the eye, the black thing you see at the center of the eye. It is actually very transparent and the black color comes from behind i.e. from the iris. This transparent structure is responsible for most of our vision. The other organ or other part which is responsible for most of our vision is the lens that lies behind the iris. So the cornea helps us to focus light on the retina which then transmits it to the brain. If this cornea is opaque then the light will not be transmitted and you will not see clearly. As a result of which we need to do something about it and the most important thing is to do is to replace the cornea with another cornea which comes from a donor and, therefore, donation of eyes after death is a very important act because you helped the next person who is blind to see again. But you should remember that while doing a corneal surgery we only replacing the front part of the eye and not the entire eye. So, now talking about the recent advances corneal surgery we thought that only one cornea could be used per person but today we are doing microsurgery in the cornea as well we are dissenting the cornea into multiple parts and therefore one single eye can help three other eyes. How is that? So, we have three parts of the cornea: the front, the middle and the back. The front part is called Epithelium the middle is Trauma and the inner is Endothelium. Periphery to these are stem cells which are called as limbal stem cells. Now if you have one donation we can dissect the cornea into the front and the back part. The back part can be use for replacing the back part of a damaged cornea and this called as DSEK Descemet Stripping Endothelial Keratoplasty which is a surgery where the inner part is replaced. In other cases where you have the front part involved where there is opacity because of say infection then we removed only the front part of the cornea and it is called as DALK Deep Anterior Lamellar Keratoplasty where we use only the front part of the donated cornea and then use the back part to some other person. Now the third part of the cornea is the Limbal stem cells, these limbal stem cells are responsible for growing a new layer on the cornea. however if they are damaged e.g. in acid injuries or alkali injuries or any other chemical injury then they don’t grow and this front part of the cornea gets completely opaque now we need to replace these stem cells from where do we get them. We get them from the other eye if it is normal or we can take it from a donor may be a relative or a dead person. Once you get these stem cells they can then be implanted into the eye which called as stem cell transplant and then they grow back on the surface leading to clear and very crystal clear front surface of the eye. These stem cells are very much important for overall health of the cornea. So as I have discussed the various advances i have now helped us to donate cornea and makes you full use of it for three different persons; the front part, the back part and the stem cells. So what are you waiting for? Go to the eye bank and get yourself registered for eye donation and remember eye donation can only be made after death so you don’t have to worry. After that you make other person see and you will also see the world through them.

Thank you very much.

Good morning friends.

I’m Dr. Harshavardhan Ghorpade from Fortis hospital Vashi, department of visual sciences. And Saroj Speciality Eye Clinic Vashi. I have done my MS. FRCS and I m a cataract, cornea and a refractive eye surgeon. You can contact me and know more about me through lybrate.com.

Today I’m going to talk to you about one very important topic which is of interest to one and all i.e. cataract and refractive surgeries, the recent advances in these surgeries. Let me first start by telling you what is cataract surgery? In cataract surgery the procedure is to remove the opaque lens of the eye which is called a cataract and replaced it by a nice clean artificial lens so that a patient can see again. While refractive surgery is something where we do refractive correction i.e. correction of power of the glasses either by the laser or by a surgical procedure. Both the things can be combined to ultimately give clear vision to the patient. So let’s start by starting with the recent advances in the cataract surgery. Well today cataract surgery has been sophisticated by doing procedures using ultrasound phaco probe which is about 2.2mm in size and it can be lesser of up to 1.8mm as well. We can do microincision cataract surgery through these probes. As a result of which we don’t require any anesthesia, any stitch and any blood coming out during surgery. During surgery we enter the eye with a very small opening and with the help of this ultrasound probe the emulsify or break the cataract into small pieces and then it is absorbed into the system of the machine, this is then replaced by a very small foldable lens. The lenses are of various types. They are usually monofocal, multifocal, or cylindrical. When we use monofocal lens we try to give you correction for distance so that most of the vision is good without glasses. When we use multifocal lens which is necessary to be put in both the eyes we can give you distance as well as near vision and when we use a toric lens we try to correct your cylindrical power as well. So ultimately by doing cataract surgery we not only remove the cataract but we also correct the glasses power of the patient so the patient can see very well without being too much dependent on the glasses. Apart from the various types of lenses we have now different types of machines which do the surgery. As I said micro-incision surgery is possible by using phaco probe but nowadays we are using laser as well to do the surgeries. Laser was a common term used in public to know or to talk about phacosurgery but today actual laser can also be used to do the surgeries. Although it is very expensive as well as time consuming. So ultimately if we have a good surgeon or experience surgeon micro incision phaco surgery is the surgery of choice even today and with the various type of lenses that available we can get rid of glasses as well apart from removing cataract. Now coming to the refractive surgery. Refractive surgery means removal of power of glasses doing a procedure on the eyes, this is usually done on the surface of the eye using a laser. What we do over here is laser surface ablation of the cornea which can lead to removal of glasses without doing any type of incision any cut or any kind of trauma to the patient or lots of tissue. So this a bladeless procedure and the patient is absolutely comfortable during the procedure and he may have some discomfort in first three or four days but overall at the end of the week he is absolutely normal as he was before without his glasses. This is one of the recent advances of bladeless procedures in laser surgeries. The other advances that we are doing nowadays is in very high refractive power say a power of more than seventeen and eighteen we introduces a special lens which is called as ICL which is put inside the eye without removing the cataract. This lens is like a contact lenses that sits on the lens i.e. given to us by nature. As a result of which the power which is there say e.g. patient with minus eighteen end up with the power which is close to zero and he would be again not dependent on his thick glasses. So this is another advanced that is occurred so that we can correct even the higher refractive errors. So overall if you look at the cataract and the refractive surgeries today we are doing very good sort of very advanced sort of treatments to all our patients which start with the removal of cataract, putting a lens of different types, we can do laser procedure over it to get rid of glasses. We can also put intraocular contact lenses, called ICL, which helps in removal of numbers with high powers and so at the end of the day our patients seems very happy and satisfy with all these results that are coming with modern advancements in cataract and refractive surgeries.

I hope you have understood the topic and if you have any more queries you can get back to me on lybrate.com.