10 Jul

Child Eye Care

A study conducted by Advanced Eye Hospital and published by Times of India in April 2013, reveals some surprising facts about the state of eye care in Navi Mumbai children…

The Study:Advanced Eye Hospital conducted a screening program for over 3500 school kids from ages 3 to 17 years. Our team screened the children in 5 schools over a period of two months.

Our Kids’ Eyes Need Help:The study revealed that about 22% of all kids screened had impaired vision. Refractive errors (near / far sightedness) were responsible for the decrease in vision of 96% of kids… which means that most of these kids could have normal vision if they were prescribed and urged to wear a simple pair of glasses. Rest 4% were comprised by more serious issues like squint and retinal problems.

Our Kids Fail To Get Proper Help:About 52% of the kids were not even aware that they had troubles with their vision. Of the remaining 48% kids who were aware that they needed glasses, 36% of these were still not using glasses. This shows that a huge majority of our kids are going around with defective vision and hence an incomplete physical, social, intellectual and emotional development… all this despite living in an advanced city like Navi Mumbai.

How We Are Responsible For The Situation:We enquired of these children as to why they did not wear their glasses. The kids came up with varying reasons like friends teasing, discomfort / headache due to glasses, cosmetic blemish, not informed their parents, hampers outdoor activities, monetary constraints, broken glasses and ignorance by the parents. What was most surprising was that 64% of these kids reported parents who had not given due importance to their kid’s complaints.

What are the common eye diseases in kids that one should be aware of?

Refractive errors mean that the shape of the eye doesn’t bend, light properly, so images appear blurred. Nearsightedness is the most common refractive error in school-age children; others include farsightedness and astigmatism:

Nearsightedness is poor distance vision, which is usually treated with glasses or contacts.

Farsightedness is poor near vision, which is usually treated with glasses or contacts.

Astigmatism is imperfect curvature of the front surface of the eye, which is usually treated with glasses if it causes blurred vision or discomfort.

Amblyopia (“lazy eye”) is poor vision in an eye that may appear to be normal. Two common causes are crossed eyes and a difference in the refractive error between the two eyes. If untreated, amblyopia can cause irreversible visual loss in the affected eye. (By then, the brain’s “programming” will ignore signals from that eye.) Amblyopia is best treated during the preschool years.
Strabismus is a misalignment of the eyes; they may turn in, out, up, or down. With early detection, vision can be restored by patching the properly aligned eye, which forces the misaligned one to work. Surgery or specially designed glasses also may help the eyes to align.
Retinopathy of prematurity is a disease that affects the eyes of premature babies.
Retinoblastoma is an eye cancer that usually appears in the first 3 years of life. The affected eye or eyes may have visual loss and whiteness in the pupil.
Cataracts can occur in new born babies. A cataract is a clouding of the eye’s lens. (Yes, Cataracts can occur in kids too! It’s not just a disease of the old.)
Glaucoma in infants is a rare condition that may be inherited. It is the result of incorrect or incomplete development of the eye drainage canals before birth and can be treated with medication and surgery.

But how would one know if something is wrong with one’s kid’s eyes?

Your child’s behaviour may often drop subtle hints that all is not well. Your child may have an eye problem if he shows any of the following signs:

constant eye rubbing
extreme light sensitivity
poor focusing
poor visual tracking (following an object)
abnormal alignment or movement of the eyes (after 6 months of age)
chronic redness of the eyes
chronic tearing of the eyes
a white pupil instead of black

In school-age children, watch for other signs such as:

inability to see objects at a distance
inability to read the blackboard
squinting
difficulty reading
sitting too close to the TV

31% of our population is under 15 years of age. Kids truly are the light of our future and this study is an eye opener on the state of child eye care in Navi Mumbai.

06 Jun

What is the right age for LASIK Surgery?

Disha, a 17 year old entered my room at Centre for Lasik Surgery within Advanced Eye Hospital and Institute Navi Mumbai and started complaining how she hates her glasses. Her friends tease her and she is not able to get the attention of the guy she likes because of her glasses. She came all alone for a consultation as she wanted me to convince her dad that she can undergo LASIK surgery and get rid of her glasses. Today’s youngsters demand and know more than we knew when we were their age.

On the other hand are the baby boomers who continue to redefine aging. As soon as Mr Sharma, a 60 year old gentleman, entered my room I was thinking he must have come for cataract opinion. But to my surprise he had come for a LASIK procedure opinion! He had craved for a glasses free life for years.

I thought to myself how even being an eye doctor I am getting into stereotypes!
So of course the broader question is what is the right age for LASIK surgery?
It is a question that needs an answer, and here we go!

Not before 18- Too young for LASIK!
Most Lasik surgeons tend to avoid LASIK surgery in children less than 18 years as eyes keep changing shape and size into early adulthood. A stable glass power for 1-2 years is also mandatory prior to LASIK laser surgery. We do make exceptions to this rule sometimes. Younger people who are resistant to traditional treatment may benefit from LASIK. For example LASIK can be a viable alternative in children with a condition called anisometropic Amblyopia (where one eye has a very high power and poor vision compared to the other) who are intolerant to spectacle and contact lenses.

What about after 40 -Reading glasses?
The second fluctuation in a person’s eye happens around the age of 40. Soon thereafter, many people start to need reading glasses due to a condition known as presbyopia. LASIK surgery cannot correct two different numbers in the same eye (one for distance and one for reading) but can help with monovision. Monovision is a laser eye surgery that leaves one eye corrected for near vision and the other eye corrected for distance vision. Additionally one needs to remember that reading numbers continue to increase with age. Hence what has been corrected today will stand corrected but future gain in numbers will reflect.

50’s – Too Old for LASIK?
Its never too late for a lasik surgery but we must remember a few things about aging and the eye. At older age, the lens inside the eye may undergo changes and a cataract formation can start. However I have seen some adults who did not have cataract even at the age of 70 or 80 years. It’s possible that a 70-year-old without cataracts or other eye illnesses is actually a better candidate for a lasik surgery than a 30-year-old. The lens has to be clear and the patient must understand that LASIK procedure will not prevent a cataract from developing in the future

Special Considerations before Lasik surgery in older age groups
As with any other patient population, some issues need to be considered:

Pre-existing eye disease: Prior to moving forward with any LASIK surgery, it is imperative to rule out any pre-existing retina and corneal conditions which can interfere with the outcomes. We also need to rule out a check out family for history of corneal disorders, diabetes and glaucoma.

Drug side effects: Some medications taken by older patients could pose a problem, for example Amiodarone is a drug taken for a heart condition. It can have some ocular side effects like photosensitivity, corneal microdeposits, hazy vision, and colored haloes around lights. Rare side effects include corneal ulceration, subcapsular lens opacities and nonarteritic ischemic optic neuropathy.
Person’s medical history and any prescription drugs need to be properly documented before even considering LASIK.

Cataract surgery: Those patients who have already started developing cataracts are better served with a cataract extraction followed by implantation of an IOL. These patients can always be evaluated for multifocal lens suitability. We all need to understand the real possibility of cataract formation months or years following the procedure. Previous LASIK surgery may make calculating a subsequent IOL power difficult. To address this problem, we often record a preoperative topography measurement prior to the LASIK procedure, and then keep this information on file. This baseline measurement taken before the surgery can be extremely helpful for the IOL calculation down the road when cataract surgery may be needed.

Finally a previous cataract surgery does not represent a contraindication for LASIK,
Age certainly influences one’s LASIK candidacy, but it by no means draws an absolute boundary. Don’t let your age hold you back! If you are interested in freedom from glasses – do start investigating, it is never too late to improve the quality of your life. Only thing needed is a detailed medical and ocular evaluation to ensure you qualify for Lasik.

07 May

Can Lasik surgery be done during pregnancy or early motherhood (breastfeeding)

Pregnancy is a wonderful period and particularly so as a woman becomes even more beautiful when she is pregnant. Often it is also the time when we slow down on our day to day activities. Some women take a break from work and concentrate on their and the growing child’s health. The free time makes some women want to utilize it better. Some of them who have been planning to get LASIK to get rid of the glasses and contact lenses think this is the perfect time. Their busy schedules never allowed them to get it done earlier and now their free time gives them ideas. “Let me get it done before baby is out and I get even busier”

These situations are common especially for me as cornea and lasik surgeon and I have to deal with these from time to time. I feel and understand the issues of these women who due to their hectic and busy lives have not been able to spare time for lasik surgery.

But pregnancy is certainly not the time for any form of eye surgery unless it is an absolute emergency!

During pregnancy due to hormonal alterations a lot of changes can happen in the eye for example glass power can change, corneal curvature undergoes changes and to add to that we cannot prescribe some medicines after lasik eye surgery due to their potential harmful effect on the growing baby. Hmmm.. Let me explain more:

Cornea curvature and eye power changes

An increase in corneal curvature and mild steepening can occur during pregnancy. These changes can also develop post pregnancy when mothers are breast feeding. But the good news is that corneal curvature is reversible upon cessation of breastfeeding.

Contact lens issues

Women who wear contact lenses should also be careful. Contact lens intolerance may occur during pregnancy as a result of a change in corneal curvature, increased corneal thickness or an altered tear film.

Changing glass numbers

Due to all these changes, the glass number may fluctuate during pregnancy or breastfeeding. In any case, it is recommended that one should wait several weeks after stopping breast feeding before taking a new glass number. Additionally, decreased or transient loss of accommodation may occur during pregnancy or within the postpartum period. What that means is that pregnant women or breast feeding mothers may experience a difficulty in reading.

Eye power stability as well as corneal curvature stability is important before planning LASIK surgery. Laser vision correction involved reshaping the corneal curvature but that is exactly what is not stable during pregnancy or breastfeeding. That is why planning a LASIK surgery during pregnancy or breast feeding period is not a good idea.

Now what is a good time for lasik

Good time to get assessed for suitability for LASIK is few weeks after stopping breast feeding. Good thing is that after LASIK surgery you can be back to your routines and work in 2-3 days.

Newer techniques- flapless and bladeless lasik?

Yes, newer techniques of laser vision correction such as Femto Lasik (bladeless lasik) and Smile Lasik (Flapless lasik) have enhanced the safety, applicability, accuracy of lasik surgery procedure and also shortened the recovery time considerably.

Last words:

Pregnancy and early infancy are precious times for the baby and the mother, just sit back, relax and enjoy this time with the baby We are not going anywhere. Once you are well settled into the motherhood and ready for spectacle removal surgery – do visit us. We will make sure that you experience not only the best in lasik but the best in class service.

Special Considerations before Lasik surgery in older age groups As with any other patient population, some issues need to be considered:

Special Considerations before Lasik surgery in older age groups
As with any other patient population, some issues need to be considered: