Topical anaesthesia

Cataract surgery with ‘eye-drop anaesthesia’

No injection, No pain, No eyepad.

What is cataract surgery with ‘eye-drop anaesthesia’?

Since the 1980’s, cataract surgery has required the injection of an anesthetic near the eye. Now advances in surgical techniques and technology have made it possible to perform the surgery using eyedrops alone to make the eye numb.

What are the main advantages of not injecting the anaesthetic?

1. The pain of an injection near the eye is avoided.

2. Potential common complications associated with the injection such as injury to blood vessels around the eye, injury to eye muscles or lid muscles are avoided.

3. The rare but potentially serious complications such as perforation of the eye, injury to the optic nerve, misdirected injection into a blood vessel are also avoided.

Is it safe for patients with heart disease?

Yes, it is safer for patients who have irregular heartbeats as the pain and anxiety of the injection can alter the heart rhythm in such patients. We monitor the heart rate and ecg and oxygenation of the patient throughout the procedure and we find that there are very few changes during the surgery with eye drop anaesthesia.

Do the patient’s eyes move during the operation?

Yes, the patients can move their eyes during the operation. The surgeon however is operating with two instruments and can stabilize the eye during the operation.

Can I speak during the operation if I am uncomfortable?

Yes, you can tell us immediately if you have any problem. In fact your surgeon will talk to you throughout the surgery and tell you what you will feel next.

Why is a pad not applied at the end of surgery with eye drop anaesthesia?

Since the eye muscles are not immobilised, the recovery from anaesthesia is immediate. So there is no need to apply a pad on your way home, all you need is a pair of sun glasses.
More importantly, you can start using anti-infectives and anti-inflammatory eye-drops early in the post-operative period. This helps prevent complications and improves surgical outcomes.

Are all doctors operating by this method?

A survey of members of the American Society of Cataract and Refractive Surgeons revealed that the surgeons using eye-drop anaesthesia had increased from 45% in 1999 to 70% in 2008. At Oculus Eye Hospital 99% cataract surgeries are done with eye drop anaesthesia.

Dr. Jagruti Desai
Oculus Eye Hospital
Tel. 26202369, 9819983158 

What is a cataract?

What is a cataract? Why did I get a cataract?

The human eye has a lens which focuses light on to the retina. A cataract is an opacity of this lens. It scatters the light going into the eye and blurs vision.

There are different types of cataract.

CORTICAL This type of cataract causes increasing blurring of vision and patients generally come to us in time.

POSTERIOR SUBCAPSULAR This type of cataract causes glare from headlights and difficulty seeing in bright light.

NUCLEAR SCLEROSIS This type of cataract causes a decrease in the reading glasses number and patients can actually read better for some time. It then causes difficulty in differentiating colours and a decrease in contrast. Patients can still see things with high contrast like the letters on our reading charts. As the patients do not have serious visual disturbances, they tend to come to us late and the cataract becomes ‘hard’ and the surgery challenging.

We do not know yet what exactly causes these cataracts.

Age is the most common cause. Lens proteins denature and degrade over time. This process is accelerated by diseases such as diabetes and hypertension.

Environmental factors such as toxins, radiation and ultraviolet light also hasten the process.

Injury to the eye and steroids eyedrops or systemic steroids are also known causes of cataract.

-Dr. Jagruti Desai
Oculus Eye Hospital,
Tel. 26202369, 9819983158 

How do I keep my eyes healthy?

How do I keep my eyes healthy?

Healthy lifestyle 

• Healthy lifestyle with regular moderate exercise .
• Healthy diet consisting of good proteins, healthy fats with omega-3 fatty acids and high fibre carbohydrates .
• Antioxidants and Vitamins from a wide variety of fruits and vegetables are particularly necessary to keep eyes healthy.

 

Regular eye check-ups 

• Eye  doctors  all  over  the  world  recommend  a  baseline  eye  disease  screening  at age 40. 
• Many conditions like glaucoma, macular degeneration, diabetic retinopathy become more common with age.
• When you come for your eye check-up,we assess your risk of getting any of these diseases and devise a check-up plan personalized for you.

 

Education and knowledge 

• We give you informative articles about your eye  condition so that you can understand and  help us with your treatment .
• We provide general eye care information for you and your family.

 

 

Dr. Jagruti Desai,

M.S. Ophthalmology

Warding off injuries due to firecrackers

Bursting firecrackers is one of the major causes of eye injuries. Here are a few precautions one can take, to celebrate a safe and injury free Diwali

General Precautions to be taken:

• Keep first aid and buckets of water handy. In the event of fire, extinguish flame by pouring water from the buckets. 

• Sparkles considered by many as the safest firework for children, burn at very high temperatures and can easily ignite clothing. 
• Never ignite aerial fireworks (like rockets) if there is any overhead obstruction present like trees and wires.
• Don’t keep your face close to the cracker while trying to light it.

If you suffer a skin burn :

•  Apply a cool cloth or cool running water.

•  Don’t use ice — the extreme cold temperature can lead to more injury.

     See a doctor.

 

    IF YOU SUFFER AN EYE INJURY

• Don’t press the eye with the palm or hand, lest the injury may get compounded.

• Don’t tie a cloth across the eye firmly. This can cause undue pressure on the eye. Protect the eye with a cup of a shield. An ice-cream cup can be an excellent device to cover the eye. The same can be fixed with cello tape.

• Do not delay medical attention even for seemingly mild injuries. “Mildly” damaged areas can worsen and end in serious vision loss, even blindness, that might not have happened if treatment had occurred immediately.
• Stay calm, do not panic; keep the person as calm as possible.
• Do not rub the eye. If any eye tissue is torn, rubbing might push out the eye’s contents and cause more damage. Trying to rub the eye is an automatic response to pain, but pressure will only do more harm. Take the child’s hand from his or her face.
• Do not attempt to rinse out the eye. This can be even more damaging than rubbing.
• Avoid giving aspirin or ibuprofen (or other non-steroidal anti-inflammatory drugs, called “N-SAIDS”) to try to reduce the pain. They thin the blood and might increase bleeding. Acetaminophen is the over-the-counter drug of choice. Unfortunately, non-prescription painkillers will not be of much help. It is better to by-pass the drugstore or medicine cabinet and get to the emergency room right away.
• Do not apply ointment or any medication. It is probably not sterile. Also, ointments make the eye area slippery. This could slow the doctor’s examination at a time when every second counts.

We wish everyone a happy and safe Diwali.

Oculus is the latin word for eye

OCULUS is the latin word for eye

While oculus is not in common use in English, words derived from it such as ‘ocular’ are, primarily in medical and optical fields. Also the terms Oculus dexter (right eye ), Oculus Sinister(left eye ), and Oculus Uterque (both eyes) are used in ophthalmology, usually abbreviated OD, OS and OU respectively.

In archaeology, the word oculus (circular window) is used most commonly as the name of the round opening in the top of the dome of the Pantheon in Rome, Italy.                                               

The saying ‘Eyes are the window to the soul’ is true in more ways than one. Ophthalmologists can detect many health problems by looking into the eye.                                           

Cataract Surgery at Oculus.

CATARACT SURGERY  at  OCULUS  

Advanced techniques and technology 

All cataract surgeries are done by phacoemulsification with premium foldable  lens implants. The latest microscope, phacoemulsification system and other equipment assure precision and safety.

All surgeries are done with eye-drop anesthesia. It is totally painless with no injection. The patient goes home wearing dark glasses after the operation. No eye pad is required.

Special attention to anxious patients 

Many patients are unusually anxious about their surgery. We take special care of  them by a detailed explanation about what will happen during the surgery.

On the day of surgery our expert anesthetist doctor takes care of them with medicines and counseling. As a result all our patients tell us that their experience of the surgery was great.

Vision correction customized to patients needs

Different people have different vision requirements in their daily life. Reading, going out, driving , computer use , house work varies with your lifestyle. We take a detailed history of your needs and advise you about the right lens implant for you – unifocal, multifocal or toric. We also try and give you the best possible unaided vision (without glasses). Most of our patients need to wear spectacles only 10% of the day.

Transparency

We maintain the highest ethical standards in everything we do.We will try to communicate to you all aspects of your surgery and what we can achieve for you. We will show your relatives your eye surgery as it is being done on a screen. After your surgery, in the critical post-operative period you are free to call Dr. Jagruti Desai any time of the day or night.

Is it a good idea to use eye drops suggested by a chemist?

In India, when someone has a red eye, they often go to a chemist and request him to give them an eye drop. Chemists tend to handout steroid drops. Now steroid drops are indicated only in a small percentage of red eye cases. Their use in conditions like corneal ulcer or a foreign body in the eye can considerably worsen the situation. Prolonged use can cause glaucoma which is a sight –threatening condition.

Decongestant eye drops relieve redness and discomfort by constricting the superficial blood vessels of the eyes. But what consumers don’t know is that this is a temporary solution – the more you use these products, the more sensitive and redder your eyes will be.

Some eyewash also may relieve redness and soothe the eyes for a few hours, but their long term usefulness is questionable. The truth is your eyes don’t have to be cleaned with eyewashes. Simple irritation caused by smog, strong light, bathing in sea or bathing in chlorinated water is often self-limiting and natural tears do a better job of eliminating these problems.

If you have conjunctivitis, you need specific antibiotic drops and lubricant drops according to the type of infection.

Another bad effect of self medication is that it may mask symptoms of other diseases like glaucoma that is sometimes characterized by a vague discomfort – the kind of feeling you could mistake for tired eyes. In this case, eye drops won’t solve the problem. You have to see an ophthalmologist for a correct diagnosis and treatment.

Comprehensive eye check-up at Oculus Eye Hospital

This is what we will do when you come to us for a routine eye check-up.

Besides treating the complaints you have at present, we will advise you about how to take care of your eyes.

I will  examine the anterior parts of your eyes with a microscope called the slit-lamp. We will then do your vision test and eye glasses check-up. After that, we will dilate your pupil with eye drops so that i can see inside your eye and check your retina and optic nerve. You will not be able to see clearly for about 5-6 hours because of this. We also put some anaesthetic eye drops and check your eye pressure.

We record the  details of all your eye problems until now, health problems like diabetes or hypertension and whether you have any hereditary eye diseases in your family. We also inquire about your profession and whether you are putting any undue stress on your eyes.

Based on your age, the condition of your eye and your history, I will evaluate your risk of having certain eye problems which are common in the Indian population and will advise when you need your next check-up. Please see us at the recommended time and help us keep your eyes healthy for life.

-Dr. Jagruti Desai

Why you need an eye checkup, if you are diabetic?

People with DIABETES are advised to have their eyes checked frequently .

Do you know why ?

If you have diabetes , you are more likely to develop cataract and glaucoma. You also need to be aware of a condition called DIABETIC RETINOPATHY. Diabetes weakens the blood vessels in your body. In the eye , we can directly see the blood vessels in your retina and detect early signs of damage like small haemorrhages and exudates.This can worsen to a condition called proliferativediabetic retinopathy which is very difficult to treat and can lead to blindness.

The wise thing to do is have regular check-ups so that this is detected in the early stages. If it is detected early, it can easily be kept under control with laser therapy.

Your physician would also like to know whether you have retinopathy as it gives him valuable information about the condition of your blood vessels.

Prevent Computer Vision Syndrome

As more and more people all over the world use computers for long hours , many people are discovering that it causes problems like red eyes, tiredness etc.

What are the symptoms of computer vision syndrome?

Eye strain, dry, irritated eyes, blurred vision and difficulty refocusing  .It can also cause headaches, fatigue and neck and shoulder discomfort.

Why does it happen?

There are two main components of the syndrome

1) The eyes use muscles to accommodate – to focus on near objects. Our cavemen ancestors used their eyes more for distance – to hunt, to detect danger. It is only in recent history that we have so much near work – reading, desk work, computer work. The ciliary muscles were not made for such prolonged contraction and get fatigued.

We have more difficulty trying to focus on the letters on the computer screens which are made up of fuzzy-edged pixels than printed material whose letters have sharp contrast.

Young people who have a very small eye no. may be able to do all other work without glasses but may find difficulty in computer work.

As we approach the age of 40, the ciliary muscles start weakening – that’s when everybody needs reading glasses. We need computer glasses as well.

2)  The other component of CVS is dry eye. Normally we blink 16-20 times per minute. This blinking spreads tears over the front of the eyes and keeps them comfortable. When we are staring at the computer the blink rate can go as low as 6-8 times per minute. This causes dry spots and the gritty sensation.

Prevent

# To relax the muscles of accommodation, follow the 20-20-20 rule.
Every 20 minutes, look at an object 20 feet away for 20 seconds.

# Blink more often, consciously.

# Check your vision. Close each eye in turn and look at a clock or a calendar about 20 feet away.Ifthere is any difference in clarity between the two eyes you probably need to wear glasses.

# Check that the level of the computer monitor is below your eye level so that you have to look down. This is better as the eyes do not get dry very soon.

# Flax seeds (they are known as ‘alsi’ in hindi) can help treat dry eyes .Roast one teaspoon, chew them properly and drink 2 glasses of water – everyday.
Treat

If you still have symptoms after following these rules, you need to see us. We will do special tests to assess the CVS and treat the condition.

The consultation for CVS will include

* A complete eye exam.

* Prescription of computer glasses.

* Test for tear film quality and treatment with eye drops if necessary.

* Advise about exercises and workstation ergonomics.