PRIMARY EYE CHECK UP
A primary eye check up and optometry check up includes additional check up of meibomian gland disease (MGD), dry eyes (leading to eye strain, stickiness, redness), extra ocular motility (to look for diabetic vasculopathy related muscle paresis), pupil examination (optic neuropathy and glaucoma), gonioscopy in a diabetic patient. This is followed by pupil dilatation with specific drops.. Patient will have blurred vision for 4-5 hours after the eye drop instillation.
Detailed check up by Retina specialist
Consultation will happen with diabetic eye specialist, who does meticulous eye examination of the cornea surface, cataract (diabetic cataracts are mainly epinuclear, cortical, PSC cataract, which can have sticky stubborn nature and requires appropriate planning preoperatively).
A detailed fundus examination with 78D lens and indirect ophthalmoscope(funduscopy) is done to meticulously examine the retina for diabetic macular edema and small tiny Neovascular blood vessels (NVE) which can lead to sudden bleeding and loss of vision if not detected and treated in early stage. Meticulous optic nerve head examination to look for glaucoma (glaucoma is a blinding preventable disease seen more commonly in diabetic patients)
The patient is categorized into either diagnosis of proliferative diabetic retinopathy(PDR), non proliferative diabetic retinopathy(NPDR) or no evidence of diabetic retinopathy. Patient may be asked to do various eye related investigations in case necessary.
All investigations under one roof
All the investigation A-Z are available under one roof at Asian eye hospital including zeiss optical coherence tomography(OCT)/ Zeiss fundus fluorescein angiography (FFA) fundus camera , Zeiss Humphreys visual field test, Pentacam, Iol master. This makes it very convenient for the patient.
BENEFITS OF CATARACT SURGERY...
1. How Is Cataract Detected?
A cataract may be detected by your optometrist or family doctor. It is important that a thorough eye examination is performed by your optometrist or eye specialist to ensure that there are no other causes for your blurry vision.
2. How Fast Does A Cataract Develop?
How fast a cataract develops varies among individuals and may even vary between eyes. In younger people and people with diabetes cataracts may progress rapidly over a few months. However, most age-related cataracts progress gradually over a period of years.
3. When Should A Person With A Cataract Have Surgery?
Cataract surgery is usually considered when loss of vision begins to interfere with daily activities or affect your quality of life. Based on the specific symptoms, a patient and his/her surgeon should decide together when surgery is appropriate. Their is no effect of immaturity/maturity or weather on result of cataract surgery.
4. How Is A Cataract Treated?
During the early stages of a cataract, a change in glasses may improve the clarity of vision, though this is usually temporary. When cataracts begin to interfere with daily activities, surgical removal is the only effective treatment.
5. Is Cataract Surgery Permanent?
Yes. It is not possible to get another cataract once it has been removed. However, approximately 10% of patients may become aware of a gradual blurring of vision some months or even years after the surgery due to thickening of the lens capsule that supports your artificial lens. If this occurs, clear vision is usually restored by a simple laser treatment, called a capsulotomy, which can be performed during a short visit to the clinic.
6. Will I Need Glasses After The Surgery?
Most patients will require glasses for fine visual tasks although some patients can get by without them for certain activities.The design of IOL decides your need for spectacles after the surgery. Newer advanced IOL (Toric, Multifical and Accomodative) can treat cataract and get rid of most of spectacle power too.
7. What If I Have Other Eye Diseases– Will Cataract Surgery Help?
There are many diseases which can affect and limit the eye’s visual improvement following cataract surgery. These can be diagnosed before the operation and your eye specialist will discuss the impact of any such problems with you.
Does The Operation Hurt?
No. An anaesthetic is applied before surgery so that there is no pain, but some people experience slight discomfort after the surgery. The anaesthetic stops the eye from moving during the operation and your eyelids are held open by a spring, so all you have to do is lie still for the surgery. You cannot see what is happening during the operation.
Can Problems Occur After Surgery?
Cataract surgery is very safe and has a high success rate. However it is important to understand that complications can occur during or after the surgery. If you experience even the slightest problem after surgery, please contact your surgeon immediately.
TREATMENT OF DIABETIC RETINOPATHY
NETRA JYOTI KENDRA AGRA eye hospital is a reputed, state of the art hospital located in heart of city approachable to any person in the city of AGRA. The hospital has all possible equipments in eye care under one roof from OCT, Retinal Angiography(FFA), Retinal Green laser , lasik laser machine, best Phacoemulsification micro-incision cataract surgery .
Diabetes Retinopathy Eduaction and Diagnosis :
Diabetic retinopathy is a major cause of avoidable blindness or visual impairment in society. One must be wondering how a person can get blind when such advanced technology and doctors are available in today’s era. What we need to understand is sometimes the disease doesn’t give us enough indications and time to treat it and hence we need to attack the disease proactively before it damages our eyes.
What happens in diabetic retinopathy is that patient doesn’t realize any symptoms or signs until advanced stage of proliferative diabetic retinopathy is reached. At this stage there can be severe bleeding and ‘pull’ on the delicate retina(traction) causing permanent irreversible damage to the vision. To cut short diabetic retinopathy can permanently damage your vision without any warning signs. This can only be prevented if a proficient doctor meticulously checks the retina of patient and diagnose the retinopathy in early stage. Along with the treatment of diabetic retinopathy, good systemic control of blood sugar levels, HTN , cholesterol, CRP is very important, since this is root cause of diabetic retinopathy, which is also ensured at NJK Agra Charitable eye clinic.
Keeping in mind above things, the clinic will also educate the patient about frequency of retinal check ups required depending upon duration of diabetes mellitus or stage of retinopathy incase in casr of DR, the symptoms patients is required to be aware of etc.
If the patient has diabetic retinopathy , educating the patient about the stage of disease, role of treatment like Antivegf intravitreal injections , retinal green laser therapy, motivating to take care of DM will be done here. In addition , guidance about systematic blood sugar level monitoring , counselling about customized diabetic diet, stress management (stress is the most common and ignored cause of fluctuating sugar levels), will also be provided to the patient.
Cataract Evaluation and Guidance :
Diabetic Cataract Management
In case an eye surgery is required then patient goes through detailed counselling where the patient is educated about the surgery, pre and post operative eye care, and all the small and big queries are answered to the patients satisfaction.Specific intraocular lenses are advised to diabetic patients depending on various factors.(multifocal IOL are avoided with DR , hydrophilic IOL are also best avoided in any diabetic patients)
Pre – operative consideration for diabetic Patients
We also have a diabetes (blood sugar) control team in the same premises which ensures blood sugar control of patients prior to surgery only through diet and lifestyle planning. On the day of surgery patient is asked to come fasting and a diabetic breakfast is served at our hospital to avoid any sugar hike on the day of surgery.
Intra – operative consideration for diabetic Patients
Netra Jyoti Kendra eye hospital is equipped with state of the art modular operation theatre with HEPA filter, maintaining highest standards of sterile precautions. Sterile precautions during surgery in any diabetic patients becomes very important as these patients are more prone to infections. Infection rate is also controlled through micro incision cataract surgery at Netra Jyoti Kendra eye hospital.
Treatment of Diabetic Retinopathy
Coming to the treatment of diabetic retinopathy I believe a holistic approach is necessary where the root cause of problem is tackled sincerely.; which is mainly long term uncontrolled sugar levels in the past, high blood pressure, anemia, raised CRP is also catered along with eye problem. The treatment of diabetic retinopathy is in the form of intravitreal anti vegf or ozurdex injections to reduce the retinal swelling in diabetic macular edema and Retinal green laser to prevent complications like bleeding within the eye (vitreous hemorrhage) or tractional retina detachment.
In addition to this, strict monitoring of other systemic problem like raised blood pressure, anemia (low hemoglobin), hypercholesterolemia, raised C reactive protein, glycosylated hemoglobin(HbA1c) is done.
The aim of SDEC is to cater to all the above issues through a dedicated team under the guidance of Dr. PRADEEP SANE
LASIK SERVICES
Advanced LASIK vision correction has changed the life of many by giving them freedom from glasses and contact lenses ..
A Laser procedure which is SAFE, PROVEN, TRUSTED. A way to “change your life” and get rid of your glasses. Laser vision correction has enabled millions of people worldwide to enjoy a new found freedom-Living there lives without the inconvenience of glasses or contact lenses.
Lasik At NJK AGRA Eye Hospital And Laser Institute:-
- Completely “SAFE” and “PAINLESS”
- optimal results
Why Should You Consider Laser Eye Surgery?
Lasik Imagine seeing clearly from the moment you open your eyes in the morning! Once you have vision correction you will see and experience all freedom that life has to offer. Laser refractive eye surgery will truly change your life. Whether you are farsighted, near sighted or have astigmatism, Laser eye surgery can eliminate your dependence on glasses or contact lenses. Once you have a vision correction procedure your natural vision will be restored.Gaining the freedom and security you want is actually quite easy. Laser vision correction is a pain free procedure that takes only few minutes and is approximately 60 seconds of laser time per eye in most cases.
Lasik Procedure
Lasik is an acronym for laser in-situ-keratomileusis. Lasik is a gold standard in refractive surgery. The procedure which is painless, safe, and with a faster recovery of vision which makes it a very popular procedure for laser vision correction. Post qualifying the eyes with a pre Lasik evaluation and informed consent for the procedure, the patient is prepared before the procedure with anesthetic and antibiotic eye drops, making the eye numb and sterile for the laser procedure. A Microkeratome or a Femtosecond laser is used to create a thin corneal flap which remains hinged through the procedure.
GLAUCOMA
Glaucoma Awareness , Education and Screening :
Glaucoma screening is a must after age of 40, because glaucoma is the leading cause of preventable blindness world wide. It is called as the silent thief of vision because patient never realizes or notice any difficulty in vision until about 70 % of irreversible vision loss has already occurred. What is required is thorough clinical evaluation of optic nerve and measurement of intraocular pressures (IOP) to do appropriate glaucoma screening. We educate and screen patients for glaucoma here. Regular follow ups of patients will help the doctor and patient as a team to manage and cure any kind of eye diseases.
CORNEA SERVICES
The Cornea departments in NETRA JYOTI KENDRA AGRA offer cutting edge technologies at affordable cost to the patients. At NETRA JYOTI KENDRA AGRA we work as a team to keep abreast of the latest in Ophthalmology and motivate each other to deliver high standards of patient care.
NETRA JYOTI KENDRA AGRA
The cornea is the transparent front part of the eye that covers the iris, pupil, and anterior chamber. The cornea, with the anterior chamber and lens, refracts light, with the cornea accounting for approximately two-thirds of the eye’s total optical power. Various disorders affecting the cornea can lead to pain, irritation, reduced vision, and sometimes blindness.
The most common corneal disorders are the following :-
- Corneal abrasion – a medical condition involving the loss of the surface epithelial layer of the eye’s cornea as a result of trauma to the surface of the eye.
- Corneal dystrophy – a condition in which one or more parts of the cornea lose their normal clarity due to a build up of cloudy material.
- Corneal ulcer – an inflammatory or infective condition of the cornea involving disruption of its epithelial layer with involvement of the corneal stroma.
- Corneal neovascularization – excessive ingrowth of blood vessels from the limbal vascular plexus into the cornea, caused by deprivation of oxygen from the air.
- Fuchs’ dystrophy – cloudy morning vision.
- Keratitis – inflammation of the cornea.
- Keratoconus – a degenerative disease, where the cornea thins and changes shape.
Treatment options for all of them are now available. They include corneal transplant, lamellar corneal surgery and stem cell transplant and therapy, where the diseased cornea is removed and replaced with a natural cornea procured from a donor eye (eye donated after death). Artificial cornea is also available now, for cases where multiple corneal transplants have failed. Other than corneal surgery for corneal diseases, we conduct refractive surgery for reduction of refractive error (glass number) and phakic intraocular lens implant surgery to correct myopia.
PEDIATRIC OPHTHALMOLOGY AND SQUINT SERVICES
At we NETRA JYOTI KENDRA AGRA provide treatment for an extensive range of pediatric eye problems such as sight-threatening conditions like pediatric glaucoma, cataract and congenital opacities of the cornea.
We also have comprehensive services in:-
- The management of squint, double vision and other disorders of eye alignment and movement, both in children and adults
- The management of amblyopia or lazy eyes
- Refraction in young children using eyedrops (cycloplegic refraction) for those who have difficulty getting a good refraction.
- General eye problems such as eye sore, allergic conjunctivitis and lumps on the eyelids (stye and chalazion).
- Providing pediatric ophthalmology consultation to doctors in the pediatric departments.
Pediatric ophthalmology is a sub-speciality of ophthalmology concerned with eye diseases, visual development, and vision care in children. Pediatric ophthalmologists are specially trained to manage the following disorders:
- Infections (Conjunctivitis).
- Strabismus or Squint is a misalignment of the eyes
- Amblyopia or Lazy eye occurs when the vision of one eye is significantly better than the other eye and the brain begins to rely on better eye and ignore the weaker one.
- Blocked tear ducts.
- Ptosis- Drooping or falling of upper eye lid
- Retinopathy of prematurity often seen in premature babies
- Nystagmus
- Visual inattention
- Pediatric cataracts
- Pediatric glaucoma
- Abnormal vision development
- Genetic disorders often cause eye problems for affected children.
- Congenital malformations affecting vision or the tear drainage duct system
- Orbital tumours
- Refractive errors such as myopia (near-sightedness), hyperopia (far-sightedness) and astigmatism can often be corrected with prescriptions for glasses or contacts.
- Accommodative insufficiency
- Convergence insufficiency and asthenopia
- Evaluation of visual issues in education, including dyslexia and attention deficit disorder.
What is Squint?
Squint or strabismus is a misalignment of the eyes so that the eyes do not point in the same direction. Squint can itself lead to amblyopia or lazy eye. More importantly squint if present since childhood can itself lead to loss of three dimensional vision or depth perception (stereopsis). Many cases can be treated with glasses. Orthoptic exercises are useful in some cases. Prism trials can be used as a temporary or permanent measure. Squint can itself lead to cosmetic disfigurement, in addition in children there is a risk of amblyopia.
Under such circumstances, it is important that one corrects the squint early. In addition there is a beneficial effect of correction of squint even in older adults as there is improvement in binocular vision. The simplicity and ease of surgery means some patients start work the next day after surgery. The results are very good with a proper clinical assessment and surgery.
The most common types of squint
Esotropia (convergent squint) : Convergent squint can be corrected many a times by glasses. Early correction is recommended especially in the convergent squints as there is a higher risk of amblyopia and loss of binocularity.
Exotropia (divergent) : Divergent squint can again be corrected with glasses, but more commonly needs surgery. Vertical squints are tackled especially in cases of superior oblique muscle palsy or Brown Syndrome and need proper planning, surgery is however easy to perform.
Nystagmus can also be considered as a form of squint and indications for surgery include head posture or need for dampening the nystagmus. Newer surgeries for this condition give successful outcomes.
What are the signs and symptoms of a squint (strabismus)?
- One of the eyes does not look straight ahead, but veers.
- Infants (newborns) may go cross-eyed, especially if they are tired. This does not mean they have a squint. Concerned parents should check with their doctor.
- If you notice that your child has one eye closed, or turns his/her head when looking at you, this could be a sign of double vision, and a squint is possible. Check with your doctor.
What are the causes of a squint (strabismus)?
- Congenital or Heriditory. In the majority of cases, people are either born with strabismus or develop it during their first six months after birth.
- Due to some Refractive Errors [If the Child has a Spectacles] as the child may turn the affected eye inward in order to get a better focus.
- Associated Neurological Conditions [ Brain Disorders]
- Viral infections, such as Measles
What are the treatment options for a squint (strabismus)?
A diagnosed squint needs prompt treatment, otherwise there is a serious risk of complications, such as amblyopia (lazy eye). The younger the patient is, the more effective treatment is likely to be.
Glasses – if the child is found to hypermetropia (long-sightedness), they will be prescribed glasses which usually solve the squint.
Eye patch – this is worn over the good eye to get other eye, the one with the squint, to work better.
Orthoptic Exercises -The doctor may also prescribe eye drops, and get the patient to do specific eye exercises.
Surgey – surgery is only used when other treatments have not been effective.can restore binocular vision, as well as realign the eyes. The surgeon moves the muscle that connects to the eye to a new position – sometimes both eyes need to be operated on to get the right balance. The simplicity and ease of surgery means some patients start work the next day after surgery.The results are very good with proper clinical assessment and surgery.
WHAT IS OCULOPLASTY?
Oculoplasty is reconstructive and cosmetic eye-plastic surgery to correct eye problems like Tumours, a watering eye, a disfigured eye, or a pure cosmetic enhancement.
Oculoplasty deals with all the structures surrounding the eyeball to preserve eye sight and also improve the normal facial appearance.
Eye and facial plastic surgery can change your life by enhancing your features, restoring normalcy, rejuvenating your appearance, and most importantly, boosting your self-esteem!
Why should an eye surgeon do Plastic Surgery?
Oculoplastic surgeons first train as ophthalmologists, when they learn in details about the eye. During further higher training, they start to handle plastic surgery. They have the best knowledge about the eye and its surrounding; as eye surgeons, they are also ready to handle the most delicate of structures. These include repair of droopy eyelids, repair of tear duct obstructions, orbital fracture repairs, and removal of tumours in and around the eyes. This combination of skills makes the Oculoplastic surgeons the best to do plastic surgery around the eye.
Oculoplastic surgery is the cosmetic, corrective, and reconstructive surgery of the eye. It manages and repairs problems primarily related to the tissues or structures surrounding the eye, rather than the eyeball itself. These structures include the eyelids, the tear ducts, and the orbit (bony socket surrounding the eye).
Blepharoplasty, also known as an eyelift, removes excess skin and fat in the upper eyelids and excess fat in the lower lids. The procedure can also be done on just the upper or lower eyelids. It may be accompanied by an eyebrow lift and cheek lift as well. This procedure is done for cosmetic beautification.
Services Are Available :
- Eyelids
- Orbit
- Lacrimal Disorders
- Trauma
Eyelids
Eyelids normally have a single row of eyelashes on the upper (average 150 lashes) and lower lids (average 75 lids), pointing outwards away from the eye. The spectrum of eyelid problems includes eyelid malposition, lid lacerations, and finally, inflammatory, benign and malignant conditions
Droopy Eyelid (Ptosis):
Ptosis is drooping of the upper lid. It can occur as a result of birth defect, injury, muscle disorder, nerve disorder, or simply due to aging. It gives a sleepy appearance, and can even obstruct vision if severe. Ptosis may also cause excessive forehead wrinkling, abnormal head posture such as chin elevation, and eye fatigue. In children below 8 years of age, severe droop might obstruct development of vision leading to a lazy (amblyopic) eye thus reducing vision. In adults, droopy eyelid is mainly a cosmetic concern. Surgery can correct this problem by repairing the muscle that lifts the eyelid. Several surgical options are available, and the type of surgery used depends upon the severity of the droop. After evaluation, your specialist will decide which surgery best suits your need. Health insurance will cover the costs of ptosis surgery, if it was acquired later in life. Any congenital deformity (present since birth) is not covered by insurance.
Entropion :
Entropion is in-turning of the eyelid.The eyelashes rub on the eye and cause pain and watering; treatment is by surgery
Ectropion is turning outwards of the eyelid margin, causing redness and watering