Ophthalmology

What is Cataract?

Cataract is the clouding of the natural lens of the eye, which lies behind the iris and the pupil. The disorder causes blurred vision or total loss of vision in people especially above 40 years of age. The disorder develops slowly due to protein build-up in the eye and may affect one or both eyes. Cataract may occur due to age factor or due to trauma to the eye (after an accident). It may also occur after birth or after an eye surgery, as a side-effect. The three types of cataracts are subcapsular cataract, nuclear cataract, and cortical cataract.

Subcapsular cataract affects the back of the lens. Nuclear cataract starts from the nucleus of the eye, i.e. the deep central zone of the lens. And, cortical cataract is categorized by white wedge-like patches (opaque) that start from the edge of the lens and extend towards the center of the eye.

Symptoms

The symptoms are not fixed for cataract and maybe related to other eye problems. Most common symptoms of cataract are:

  • Blurred or cloudy vision.
  • Faded eye color or reduced eye color.
  • Difficulty in night vision.
  • Double vision or multiple image formation in one eye.
  • Frequent eyeglass number change.
  • Any source of light may appear too bright.
Causes

Medically, the reason for cataract forming is not clear, but researchers have identified a few possible causes, which are:

  • Age: Lens degrades with age, and the process is accelerated due to diseases and infection.
  • Trauma or fatal accident which left the eye injured or affected.
  • Radiation: Exposure to UV radiations from sunlight, or X-rays etc. Radiations from microwave have also been found to affect eyes.
  • Diseases like diabetes, hypertension, obesity, etc. which affect different body organs.
  • Smoking and alcohol consumption.
  • Prolonged use of corticosteroid medications.
  • Statin medicines used to reduce cholesterol.
  • An eye injury or inflammation.
  • Infection after a surgery.
  • Hormone replacement therapy.
  • High myopia.
  • Family history or genetic disorder.
  • Deficiency of Vitamin C.
Risks

The following are some risks associated with the disease:

  • Bleeding.
  • Inflammation.
  • Drooping eye.
  • Dislocation of the artificial lens.
  • Infection.
  • Loss of vision.
  • Glaucoma.
  • Retinal detachment.
Prevention

There are no proven methods that prevent cataract. However, following are a few ways that can prove helpful in preventing cataract:

  • Quit smoking.
  • Eat healthy.
  • Use sunglasses.
  • Use steroid medicines, only when necessary.
How is it diagnosed?

Starting of cataract is visible and can be confirmed through a comprehensive eye test which includes:

  • Visual sharpness test
  • Dilated retinal/eye exam
  •  Tonometry
How is it treated?

The following treatment methods can be used to treat cataract:

 Lenses

When the symptoms have just begun to develop; glasses, bifocals, lens, etc. are recommended to improve vision.

Surgery

When the condition worsens further affecting daily life, surgery is the only solution. During surgery, the surgeons remove clouded and dysfunctioning lens and replace it with a new plastic intraocular lens (IOL).

What is a Squint?

A Squint, or strabismus is a medical condition in which the eyes do not align properly. They do not look in the same direction at the same time. The disorder occurs due to poor eye muscle control. Other reasons are, improper balance of eye muscles, faulty nerve signals to the eye muscles, and focusing faults (usually long sight). Due to these complications, eyeballs may converge or diverge, thus obstructing proper functioning of the eye. The disorder can affect at any age (adult or baby). A child may be born with a squint or develop the condition right after birth. In case, the child develops the condition 6-7 weeks after birth, it is necessary to consult a doctor (eye specialist) and get them tested. Children with squints may also have poor vision in the affected eye. The sooner the treatment and care starts, the better the results.

Symptoms

Symptoms of squint are often difficult to detect. People often mistake unusual look of the eyes as squint. Children may often complain about vision problems. In case the problem is squint, a specialist should be consulted. The common symptoms could include:

  • Blurred vision.
  • Lazy eye (amblyopia) can develop: A condition where brain ignores signals.
Causes

The major causes of squint are either a nerve injury or dysfunctioning of the muscles controlling the eyes. Though the cause of squint is not clear, a person is more likely to develop it. The possible causes are:

  • Congenital squint – a family history of squint.
  • Long sight – develops as the eyes ‘over-focus’ in order to see clearly.
  • Childhood illnesses – develops following an illness such as measles or chickenpox.
  • Nerve damage – a difficult delivery of a baby or illness damaging a nerve.
Risks

The main risks of the disease include:

  • Double vision errors.
  • Retinal detachment.
  • Blurred vision.
  • Infection after the surgery.
Prevention

In order to prevent the occurrence of the disease, one should take care of the following things:

  • Closing the eyes and resting after each set of 4 repetitions.
  • Moving the eyes as far up and to the right.
  • Finding a point in the vision to focus on and count one breath.
How is it diagnosed?
  • Retina and optic nerve test
  • Light test
  • Reading or matching pictures and letters
  • Looking at visual targets at varying distances with one eye closed alternately
How is it treated?

Squints if treated on time without delay, are easier to correct. Treatment is effective for young children. At TX Hospitals, there are several treatment types available, which include:

 Vision glasses

They should be worn regularly to correct vision problems (refractive errors).

Eye exercises

These exercises should be done to bring back eye coordination.

Medications

Botulinum toxin injections are given into the eye muscles which allow eyes to realign by weakening the muscles.

Corrective surgery

It is also known as strabismus surgery. It usually involves tightening or moving of one or more of the outside eye muscles, which helps to move the eyes and changes their position.

 What is Uveitis?

Uveitis is known as the inflammation of the uvea. Uvea is the middle layer of the tissue present in the eyewall. The main cause of uveitis may be an autoimmune disease or an infection. Uveitis can lead to permanent vision loss and requires proper medical attention.

Symptoms

Symptoms of uveitis include:

  • Eye pain
  • Blurred vision
  • Decreased vision
  • Light sensitivity
  • Eye redness
Causes

In some cases, the cause of the inflammation isn’t clear. General causes of uveitis include:

  • Eye injury
  • Autoimmune disorder
  •  Inflammatory disorder
  •  Cat-scratch disease
  • Lymphoma
Risks

Individuals with changes in genes may get uveitis. Moreover, a current study demonstrates a direct relationship amongst uveitis and cigarette smoking.

Prevention

Uveitis can be prevented if you:

  • Recognise symptoms early
  • Eat a balanced diet
  • Reduce infection exposure
  • Avoid stress
  • Protect yourself from trauma
How is it diagnosed?

To diagnose uveitis, the specialist(ophthalmologist) will assess the patient’s medical history and perform various eye tests:

  • Angiography
  •  Examination of fluid from the eye
  •  Blood tests
How is it treated?

The objective of the treatment is to minimize the inflammation in the eye. The procedure of treatment is chosen according to the cause or symptoms of uveitis. 

 Medications

Medications to Reduce Inflammation: Your specialist may use oral medications like corticosteroid to control the inflammation in the uvea.

Antibiotics: Your specialist may use antiviral or antibiotics to fight the bacteria if the patient’s condition is caused by an infection.

Surgery

Vitrectomy: In this surgery, the specialist removes a vitreous part of the patient’s eye to reduce the inflammation.

Implanting a device: In this procedure, a device is implanted into the eye of the patient which slowly releases corticosteroid medication for 2-3 years. This procedure helps to control the inflammation in the eye but may have possible side effects like glaucoma and cataract.

 What is Glaucoma?

Glaucoma is a group of eye disorders which cause damage to the optic nerve. The optic nerve connects the eye to the brain and transmits images. This optic nerve is damaged when intraocular pressure inside the eye becomes higher than normal. This condition is also called ocular hypertension or high eye pressure. The disorder is an inherited condition and worsens over time leading to permanent vision loss. A timely treatment and detection can protect the eye against serious vision loss and permanent blindness.

Two main types of glaucoma are open angle glaucoma (OAG) and narrow angle glaucoma (NAG). OAG refers to cases where the watery fluid built-up inside the eye can access the drainage angle to form its path out of the eye. NAG refers to a condition where the watery fluid cannot access the drainage path.

Symptoms

Most people do not develop early symptoms of glaucoma. However, the only first sign is a peripheral loss of angled or side vision. For an early detection, in case any symptoms of vision difficulty, complete eye check up with a specialist on regular basis is advised. The symptoms that should not be ignored or are grouped as early signals are:

  • Difficulty in seeing.
  • Peripheral or partial vision loss.
  • Redness in the eyes.
  • Hazy eyes particularly for infants.
  • Nausea and vomiting.
  • Eye pain.
  • Narrowed tunnel vision.
Causes

Glaucoma occurs due to pressure build-up inside the eye because of obstruction in the path of liquid movement in front part of the eye. The fluid called aqueous humor, moves within the eye through a mesh like structure. In case of any obstruction inside this channel, pressure builds up leading to glaucoma. Probable causes of the disease include:

  • Infection.
  •  Injury.
  • locked blood vessels of eye.
  • Eye inflammation.
Risks

The main risk factors are:

  • Origin.
  • Age above 40.
  • An inherited factor or genetics.
  • Diabetes and poor vision.
  • Under steroid medications.
  • Trauma or injury to eye.
Prevention

To prevent the occurrence of this disease, there are certain things one should take care of:

  •  Regular eye health.
  • Safe exercise.
  • Taking prescribed eye drops.
  • Wearing eye protection.
How is it diagnosed?

In case the patient complains of eye pain or redness in the eye, which is persistent and leads to sudden loss of vision, the doctor may ask him to undergo:

  •  Tonometry test
  •  Complete eye checkup
How is it treated?

Depending on severity and complexity of the disease, doctors may recommend further course of action/ medication. At Medanta, our doctor may prescribe:

Eye drops

They help reduce pressure build up by increasing the liquid flow or outflow. However, side- effects may include itching, redness, allergy, blurred vision, etc.

Laser surgery

As it opens the fluid blockage, it is effective for people suffering from open angle glaucoma. The procedure helps to open the drainage (Trabeculoplasty) by creating a hole for fluid flow (Iridotomy) and treating mid affected layer of the eye to reduce fluid pressure (Cyclophotocoagulation).

 Cornea Conditions and Refractive Errors

Refractive surgery care at TX Hospitals uses cutting edge technology – CONTOURA VISION LASIK– which provides precise and accurate laser removal of glasses. This LASIK technology is USA FDA approved, causes minimum corneal tissue loss, and is among the best in the world. At the same time, the cornea team at TX Hospitals performs complex corneal surgeries including corneal transplants.

Retinal Disorders

Retina is like the film of the camera where the image is formed & gets transmitted to the brain for processing. A damaged retina, like with aging (like Age related macular degeneration or ARMD) can lead to significant visual disturbances many of which may become permanent if not treated on time. Diabetes is a growing health problem, and it affects the retina causing Diabetic Retinopathy which is one of the leading causes of blindness. Often in some eyes, there may be bleeding inside the eye called vitreous hemorrhage, or the retina may be displaced from its position called retinal detachment.

Pediatric Eye Conditions

The eyes of children are different from adults and require specialized treatment. At TX Hospitals, we have dedicated child friendly facility which is managed by experts with specialized training in this field. The important diseases handled by our experts are retinopathy of prematurity, pediatric cataract, pediatric glaucoma and congenital ocular disorders.