Eye Treatment

Eye Treatment

  •  LASIK (Laser) Surgery
  •  Vitrectomy
  •  Cataract Surgery
  •  Corneal Surgery
  •  Muscle Surgery
  •  Glaucoma surgery
 

Introduction Of Eye

Conjunctiva - This clear membrane covers the white portion of your eye, or the sclera.

Function It produces mucus and tears to lubricate your eyes and keeps microbes out of your eyes. If this thin membrane becomes inflamed or swollen, it’s called-conjunctivitis,

Sclera - The sclera is more commonly known as the whites of your eyes. This fibrous layer contains collagen contain. As sheath covering of optics nerve behind function protect inner component

Cornea - Your cornea is a clear covering that rests over your pupil, iris, and anterior chamber function transmit and focuses light into eyes dieses of cornea

Astigmatism, Corneal abrasions, Keratitis, Keratoconus, Pterygium.

Iris - The iris is the coloured portion of your eye. It is made up of a fibrovascular tissue called the stroma. The stroma connects to a muscle that allows your pupils to contract and dilate function regulate the amount of light

Pupil - Your pupil is the black circle in the centre of your iris. It regulates how much light enters your eye. Interestingly, the pupil appears black because this tissue absorbs most of the light that passes through it.

Anterior Chamber - The anterior chamber rests behind your cornea but in front of your lens and iris. It holds the aqueous humour and allows it to drain properly from your eyes into your bloodstream.

Aqueous Humour - This thick fluid rests in the anterior chamber and provides nutrients to these two parts of your eyes. The liquid must drain regularly, and your body replaces it.

Lens - This part of your eye is a transparent structure inside your eye. It can curve both inward and outward. Like the cornea, your lens refracts light. The lens is held in place by a fibrous membrane called the zonule of Zinn or the suspensory ligaments of the lens.

If the lens has an irregular curve to its disease called- astigmatism. If lens becomes opaque or cloudy and impairs vision.in disease called-cataract

Retina - The retina is the light sensitive nerve tissue in the eye that converts images from the eye’s optical system into electrical impulses that are sent along the optic nerve to the brain, to interpret as vision include two types of cells: rods and cones.

Cones - function under light vision

Rods - function under night vision

Macula - It is the “yellow spot” in the small (3 °) central area of the retina surrounding the fovea. It is the area of acute central vision (used for reading and discriminating fine detail and colour). Within this area is the largest concentration of cones

​Fovea - The fovea is the central pit in the macula that produces the sharpest vision. It contains a high concentration of cones within the macula and no retinal blood vessels.

Vitreous Humour (Chamber) - is the transparent, colourless gelatinous mass that fills rear two-thirds of the eyeball, between the lens and the retina. It has to be clear so light can pass through it and it has to be there or eye would collapse.

Optic Nerve - The Optic Nerve is the largest sensory nerve of the eye. It carries impulses for sight from the retina to the brain.

Extra - ocular muscle

Rectus muscle - responsible for straight, upward, lower, medial and lateral movement

Oblique muscle - There are two Oblique muscles that are responsible for angled movement

 

Laser eye surgery is a procedure that involves the use of a laser to reshape the surface of the eye. This is done to improve or correct near-sightedness, far-sightedness and astigmatism.

Lasik surgery the correct the vision problems:

Near sightedness (myopia). When your eyeball is slightly longer than normal or when the cornea curves too sharply, light rays focus in front of the retina and blur distant vision. You can see objects that are close fairly clearly, but not those that are far away.

Farsightedness (hyperopia). When you have a shorter than average eyeball or a cornea that is too flat, light focuses behind the retina instead of on it. This makes near vision, and sometimes distant vision, blurry.

Astigmatism. When the cornea curves or flattens unevenly, the result is astigmatism, which disrupts focus of near and distant vision.

If you're considering LASIK surgery, you probably already wear glasses or contact lenses. Your eye doctor will talk with you about whether LASIK surgery or another similar refractive procedure is an optional that will work for you.

Condition treated with lasik

Laser eye surgery can be used to treat a range of conditions, including:

  •  Diabetes eye diseases
  •  Some cases of age-related macular degeneration
  •  Some cases of glaucoma
  •  Retinal tears
  •  Retinopathy in premature babies
  •  Cataracts

Laser eye surgery can also correct vision problems due to a misshapen cornea, People with poor vision have a cornea that is not the correct shape to focus light on the back of the eye. This causes blurred vision.

Laser eye surgery can be used to reshape the cornea and restore vision. There are many types of laser eye surgery

LASIK procedure

There are three essential steps to a LASIK procedure:

  •  A mechanical surgical tool called a microkeratome or a femtosecond laser is used to create a thin, circular flap in the cornea.
  •  The surgeon then folds back this hinged flap to access the underlying cornea (called the stoma).
  •  An excimer laser is used to reshape the corneal stroma.

This highly specialised laser uses a cool UV light beam to remove microscopic amounts of tissue from the cornea to reshape it so it more accurately focuses light on the retina for improved vision.

The corneal flap is laid back in place, where it adheres to the corneal stroma without stitches.

Surgery not recommended if:
  •  Are younger than 18
  •  Are pregnant women
  •  You Take certain medications
  •  You Have a lot of recent changes to your vision prescription
  •  You Have eye conditions such as glaucoma or very dry eyes
  •  You Have other health issues such as diabetes, lupus or rheumatoid arthritis

Vitrectomy is a surgical procedure undertaken by a specialist where the vitreous humour gel that fills the eye cavity is removed to provide better access to the retina.

Vitrectomy surgeries involve the removal and replacement of some or all of the vitreous humour or fluid from the eye. The procedure is considered very successful and is often done as part of other eye surgeries.

Why would you need a vitrectomy?

Common reasons for a vitrectomy surgery, and other surgeries associated with it include:

  •  Bleeding inside of the eye
  •  Eye infections
  •  Major eye trauma or injury
  •  Problems after cataract (cloudy lens) surgery
  •  Vitreous floaters or tiny bits of tissue in the vitreous fluid
  •  Damaged retinal tissue or scar tissue on the retina
  •  Injury from a dislodged, misplaced, or infected intraocular lens (IOL)
  •  Detached retina -where the retina becomes loose and moves around the eye
  •  Trauma or injury -during cornea, cataract, or glaucoma surgery
  •  Diabetic retinopathy- retina has been damaged by long periods of uncontrolled diabetic
  •  Macular degeneration
  •  Tear, or defect in the macula or central tissue of the retina
  •  Swelling of eyes or central retinal tissue

Some other problems vitrectomy can treat include:

  •  Damaged blood vessels in your retina
  •  Infections inside your eye
  •  Serious eye injuries
  •  Wrinkles in your retina (macular pucker)

Procedure of vitrectomy

  •  The eye is anesthetized or numbed and dilated.
  •  Then eye is cleaned with an antiseptic solution and draped with a sterile covering.
  •  An eyelid speculum is used to keep the eye open, and a protective covering is placed over the eye not being operated on.
  •  The surgeon makes a small incision or cut, in the outer membrane of the eyes
  •  The surgeon uses forceps to open the cut.
  •  The surgeon inserts a microscope, as well as a fiber-optic light to be able to see the eye.
  •  The surgeon uses a vitrector or vitrectomy probe to cut the vitreous gel, and a suction tool to remove broken down fluid.

Depending on the individual case the surgeon will then:

Use forceps, scissors, and cutters to peel back scar tissue from the retina

Insert a silicone-tipped needle to drain infected, cloudy, or bloody fluid

Use a laser probe, to treat abnormal blood vessels, clots, and seal off retinal injuries, such as tears or holes

The surgeon fills the eye with a vitreous substitute similar to saline solution, silicon oil, or a gas or air bubble.

An antibiotic ointment will be applied to the eye to prevent infection and the eye will be covered.

The individual may need to lay face down for a while to be monitored, and instructions will be given, depending on what other procedures are done on the eye.

In general, the full recovery process for vitrectomy surgeries takes between 4 to 6 weeks.

This procedure done to treat the cataract

What is cataract: clouding of lense of the eyes

Symptom of cataract:

Cloudy, fuzzy, foggy, or filmy vision.

Changes in the way you see colours.

Problems driving at night because of glare from car headlights.

Problems with glare from lamps or the sun.

Frequent changes in your glass’s prescription (increasing short sightedness).

Double vision

Difficulty in carry out normal activities

What causes cataracts?

Cataracts are caused by a build-up of protein in the eye, and usually develop because of old age.

Result of eye injuries or following eye surgery for other problems.

Present from birth: childhood cataracts can be a major cause of blindness.

Types of cataracts

Subcapsular cataract - occurs at the back of the lens. more chance with People has diabetes or those taking high doses of steroid medications.

Nuclear cataract - forms deep in the central zone (nucleus) of the lens. usually are associated with aging.

Cortical cataract - that start in the periphery of the lens to the centre in a spoke-like fashion. This type of cataract occurs in the lens cortex, which is the part of the lens that surround central nucleus

What is cataract surgery?

Cataract surgery is a procedure to remove the lens of your eye and, in most cases, replace it with an artificial lens.

Cataract surgery is performed by an eye doctor (ophthalmologist) on an outpatient basis, which means you don't have to stay in the hospital after the surgery. Cataract surgery is very common and is generally a safe procedure.

When surgery needed?

It used to be that cataract surgery was only performed when the cataract had matured and was causing vision loss. But now a day’s cataract removed in the early stages of development, When it is causing subtle changes to vision, such as loss of colour perception, glare and loss of contrast, but not necessarily severe sight loss.

Although it’s never too late to have a cataract removed, it is better to have cataracts removed while they are immature, as this reduces the length of surgery and the recovery time. Earlier removal also means that you avoid the significant visual impairment associated with very mature cataracts

If a cataract makes it difficult for your eye doctor to examine the back of your eye to monitor or treat other eye problems, such as age-related macular degeneration or diabetic retinopathy then surgeon suggest cataract surgery

When very young children develop cataract, cataract surgery may be performed without implanting an IOL. This is because their eyes are still growing and connections to and within the brain are still developing. The child is provided with appropriate glasses and an ophthalmologist monitors their progress and decides when to implant an IOL at a second surgical procedure.

Three different type of surgery

  •  Phacoemulsification
  •  Extracapsular cataract surgery
  •  Intracapsular cataract surgery

Phacoemulsification; In this most modern method, cataract surgery can usually be performed in less than 30 minutes and usually requires only minimal sedation. Numbing eyedrops or an injection around the eye is used and, in general, no stitches are used to close wound.

The standard cataract surgical procedure is performed in a hospital or in an outpatient surgery centre. There is no overnight stay at the facility.

In this procedure numbing the eye with drops or an injection, surgeon, with the use of an operating microscope, will make a very small incision in the surface of the eye in or near the cornea

A thin ultrasound probe, is inserted into the eye and uses high-ultrasonic vibrations to break up the clouded lens. These tiny fragmented pieces are then suctioned out of the eye using the same ultrasound probe.

Once the cataract is removed, an artificial lens is placed into the thin capsular bag that the cataract previously occupied. This lens is essential to help your eye focus after surgery.

Extracapsular cataract surgery: This procedure is used mainly for very advanced cataracts in which the lens is too dense to dissolve into fragments or when phacoemulsification is impossible. This technique requires a larger incision so that the cataract can be removed in one piece without being fragmented inside the eye. An artificial lens is placed in the same capsular bag as with the phacoemulsification technique.

This surgical technique requires a various number of sutures to close the larger wound, and visual recovery is often slower. Extracapsular cataract extraction usually requires an injection of numbing medication around the eye and an eye patch after surgery.

Intracapsular cataract surgery; This method is rarely used. This surgical technique requires an even larger wound than extracapsular surgery, and the surgeon removes the entire lens together with the surrounding capsule. This technique requires the intraocular lens to be placed in a different location, in front of the iris.

What is the cornea?

Your eye has a number of layers. The cornea is the transparent (clear), dome-shaped outer layer in front of the black pupil and coloured iris. Sometimes the cornea can become diseased, causing it to become less clear. This affects your vision.

How does the cornea become diseased?

There are many causes for the cornea becoming diseased.

Three common causes are

Keratoconus - A condition where the cornea becomes cone-shaped, causing blurred vision.

Endothelial decompensation - A condition that causes the cornea to become swollen and cloudy.

Scarring - injury that causes inflammation Cross-section of the eye.

Infection: Bacterial, fungal and viral infections are common causes of corneal damage.

Age: Aging processes can affect the clarity and health of the cornea.

Cataract and intraocular lens implant surgery: Bullous keratopathy occurs in a very small percentage of patients following these procedures.

Symptoms of corneal disease

Pain, Blurred Vision, Tearing, Redness, Extreme Sensitivity to Light, Discharge

What is cornea transplant?

A cornea transplant (keratoplasty) is a surgical procedure to replace part of your cornea with corneal tissue from a donor. Your cornea is the transparent, dome-shaped surface of your eye that accounts for a large part of your eye's focusing power.

A cornea transplant can restore vision, reduce pain and improve the appearance of a damaged or diseased cornea.

Most cornea transplant procedures are successful. But cornea transplant carries a small risk of complications, such as rejection of the donor cornea.

Why cornea transplant needs - A number of conditions can be treated as like;

  •  A cornea that bulges outward (keratoconus)
  •  Fuchs' dystrophy
  •  Thinning of the cornea
  •  Cornea scarring, caused by infection or injury
  •  Clouding of the cornea
  •  Swelling of the cornea
  •  Corneal ulcers, including those caused by infection
  •  Complications caused by previous eye surgery

Procedure for corneal transplant

In cornea transplant surgery you'll be given a sedative to help you relax and a local anesthetic to numb your eye. You won't be asleep during the surgery, but you shouldn't feel any pain.

During the most common type of cornea transplant (penetrating keratoplasty), your surgeon cuts through the entire thickness of the abnormal or diseased cornea to remove a small button-sized disk of corneal tissue. An instrument t(trephine) is used to make this precise circular cut.

The donor cornea, cut to fit, is placed in the opening. Your surgeon then uses a fine thread to stitch the new cornea into place. The stitches may be removed at a later visit when you see your eye doctor.

In some cases, if people aren't eligible for a cornea transplant from a donor cornea, doctors may insert an artificial cornea (keratoprosthesis).

During a full-thickness cornea transplant (penetrating keratoplasty), a circular disk-shaped portion of your cornea is removed and replaced with a similarly sized portion of cornea from a donor. For the purpose of illustration, only the lower portions of the eyes are shown in this picture.

Eye muscle repair surgery is a procedure that corrects a muscle imbalance in the eyes. The muscle imbalance causes the eyes to cross inward or outward. This condition is known as strabismus.

Strabismus is a failure of the two eyes to maintain proper alignment and work together as a team. Strabismus can be constant or intermittent. The misalignment also might always affect the same eye (unilateral strabismus), or the two eyes may take turns being misaligned (alternating strabismus).

People with strabismus have eyes that don’t line up properly. As a result, the eyes look in different directions. It’s important to treat strabismus as early as possible to avoid lifelong vision problems. In fact, vision loss could become a permanent disability if treatment isn’t received promptly.

Eye muscle repair surgery helps realign the eyes so that both point in the same direction. This procedure is most often performed on children with strabismus, but it may also be done to help adults with eye muscle problems.

Causes and risk factors

Whilst the causes of strabismus are not completely understood it is known that abnormalities in the muscles and nerves surrounding the eyes are both contributing factors.

A person can be born with strabismus or develop it during infancy or childhood, or later in life. It can also occur as a result of injury to the eye or head trauma.

Sometimes strabismus can be a sign of a more serious eye disease or other health problem, and should always be thoroughly investigated by an eye specialist as soon as possible.

Symptoms

The symptoms of strabismus may be constant or intermittent, and include;

Crossed eyes, Double vision, Uncoordinated eye movements, Vision loss, Loss of depth perception.

Strabismus can be difficult to detect in children, particularly if the size of the turn is small and not cosmetically noticeable. If a child is showing any signs of strabismus, they should be examined by an eye specialist immediately.

Procedure

Depending on the problem, one or both eyes may need surgery.

After the anaesthesia has taken effect, the eye surgeon makes a small surgical cut in the clear tissue covering the white of the eye. This tissue is called the conjunctiva. Then the surgeon will locate one or more of the eye muscles that needs surgery. Sometimes the surgery strengthens the muscle, and sometimes it weakens it.

To strengthen a muscle, a section of the muscle or tendon may be removed to make it shorter. This step in the surgery is called a resection.

To weaken a muscle, it is reattached to a point farther toward the back of the eye. This step is called a recession.

The surgery for adults is similar. In most cases, adults are awake, but are given medicine to numb the area and help them relax.

When the procedure is done on adults, an adjustable stitch is used on the weakened muscle so that minor changes can be made later that day or the next day. This technique often has a very good outcome.

Glaucoma is an eye disease that can damage your optic nerve. The optic nerve supplies visual information to your brain from your eyes.

Type Open angle glaucoma

  •  Peripheral vision is gradually lost. This nearly always affects both eyes.
  •  In advanced stages, the patient has tunnel vision.
  •  Narrow-angle glaucoma, Or closed angle glaucoma

Medical emergency with following symptoms of closed angle glaucoma

  •  Eye pain, usually severe.
  •  Blurred vision.
  •  Eye pain is often accompanied by nausea and sometimes vomiting.
  •  Lights appear to have extra halo-like glows around them.
  •  Red eyes.
  •  Sudden, unexpected vision problems, especially when lighting is poor.
  •  seeing coloured rings around lights

Developmental glaucoma may be present from birth; sometime injury or underlying conditions

Secondary glaucoma is caused by a separate illness or condition

BAKI

Risk factor of glaucoma:

  •  Family history of glaucoma
  •  Hereditary predisposition to glaucoma
  •  Underlying conditions like diabetes or high blood pressure
  •  Regular use of certain medications, including steroids
  •  Eye injury or trauma
  •  Thin corneas (the clear layer in front of your pupils)
  •  Extreme near sightedness

What Causes Glaucoma?

The back of your eye continuously makes a clear fluid called aqueous humor. As this fluid is made, it fills the front part of your eye. Then, it leaves your eye through channels in your cornea and iris. If these channels are blocked or partially obstructed, the natural pressure in your eye, which is called the intraocular pressure (IOP), may increase. As your IOP increases, your optic nerve may become damaged. As damage to your nerve progresses, you may begin losing sight in your eye.

What causes the pressure in your eye to increase isn’t always known. However, doctors believe one or more of these factors may play a role:

  •  Dilating eye drops
  •  Blocked or restricted drainage in your eye
  •  Medications, such as corticosteroids
  •  Poor or reduced blood flow to your optic nerve
  •  High or elevated blood pressure

Surgery for glaucoma

Trabeculoplasty – a laser beam is used to unblock clogged drainage canals, making it easier for the fluid inside the eye to drain out.

Filtering surgery (viscocanalostomy) – this may be carried out if nothing else works, including laser surgery. Channels within the eye are opened up to improve fluid drainage.

Drainage implant (aqueous shunt implant) – this option is sometimes used for children or those with secondary glaucoma. A small silicone tube is inserted into the eye to help it drain out fluids better.

 
Procedure Cost Range in India (USD) Days in India Required Medical Test
0 Glaucoma $700 - $930   Tonometry, Ophthalmoscopy, Perimetry, Gonioscopy, Pachymetry
Cataract Surgery with lens   Hospital – 0 Outside – 7 India - 7 Biometry tests, Corneal topography, Optical coherence tomography, Blood pressure measurements
Corneal Transplant $1000 - $2200 Hospital – 2 Outside – 18 India - 20  
Vitrectomy   Hospital – 1 Outside – 7 India - 8  
Retinal detachment $1400 - Hospital – 1 Outside – 7 India - 8 Retinal examination, Ultrasound imaging
Laser Surgery $500 - Hospital – 0 Outside – 5 India - 5  
Muscle Surgery   Hospital – 1 Outside – 7 India - 8