Sutureless vitrectomy for management of retinal diseases
- Dedicated retinal OPD
- Screening for diabetic retinopathy and age related macular degeneration with sophisticated diagnostic devices
Zeiss Visulas 532 Green Retinal Laser
(USFDA approved ophthalmic laser system) It is a precise all integrated workstation with par focus zoom system delivering homogenous sharply
defined retinal spot with utmost accuracy without heat related effects on the cornea.
Diabetic Retinopathy (DMRP)
Diabetic Retinopathy is today one of the leading causes of Preventable Blindness in India.
One-Third of patients with type-2 have retinopathy at diagnosis, increasing to two-third within 20 years. What is it?
- Disorder of retinal blood vessels.
- Increased incidence with longer duration & poor blood sugar control.
- Associated factors like Hypertension, anemia, Nephropathy increase risk of DMRP
In the quest of controlling blood sugar levels, damage to vision many times goes unnoticed. However, if detected and diagnosed early, blindness due to Diabetic Retinopathy can be prevented. All it requires is a regular complete fundus examination.
Forms of Diabetic Retinopathy
Background Retinopathy is an early stage of diabetic retinopathy and progresses slowly over the years. The retina usually shows evidence of tiny blood spots and fatty deposits. The majority of patients may show a gradual blurring of vision which can often go unnoticed. In some patients, blood vessels leak at the macula, the part of the retina responsible for central vision, causing loss of vision, due to macular edema.
Proliferative Retinopathy Develops from the background retinopathy and is responsible for most of the visual loss in diabetes left untreated. Bleeding occurs due to rupture of abnormal blood vessels. The patient may see few floating spots or complete loss of sight. Though there is no pain, this severe form of diabetic retinopathy requires immediate medical attention. Fibrous scar tissue may pull on retina causing retinal detachment.
A special photographic process using a hightech, high resolution fundus camera is very helpful in detecting effects of diabetic retinopathy. This is known as fundus flourescein angiography (FFA) and will sometimes be recommended by your ophthalmologist. The procedure involves injection of dye through the arm into the blood stream. As the dye is carried to the eye, photographs of the retina are taken showing areas of leakage or poor blood flow.
- It shows areas of leakage or poor blood flow.
- Demarcates the area requiring laser photocoagulation.
- Analyses status post photocoagulation & determines the necessity and extent of re treatment if required.
Control of blood sugar and blood pressure are important but progression of retinopathy may occur despite all medical efforts. If diabetic retinopathy is detected early, photocoagulation by laser may stop continued damage Even in advanced stages of the disease, it can reduce the chance that a patient will have severe visual loss.
Laser treatment is used to seal the abnormal leaking blood vessels. This Procedure focuses a powerful beam of laser light onto the damaged retina to from tiny scars inside the eye. The scars reduces abnormal vessels growth and cause existing ones to shrink and close. Laser treatments are usually carried in an outpatient setting. They do not require special preparation or admission to hospital.
Laser cannot be used successfully in all patients. Advanced cases with vitreous bleeding into the eye and scar tissue formation require a procedure called vitrectomy together with other sophisticated surgical procedures.
- DMRP often has no early warning signs.
- Don′t Wait For Symptoms!
- Successful treatment of DMRP depends on early detection.
- Newly diagnosed Diabetics should undergo an eye checkup.
- All Known Diabetics are advised to undergo a comprehensive dilated eye examination at least once a year.
- Strict control of diabetes & elevated blood pressure & cholesterol reduces risk of vision loss.
DIVYAJYOT EYE CARE provides the facility of detection and follow up of Diabetic Retinopathy with sophisticated investigative modalities including Fundus Angiography and photography.
Macular Degeneration A Closer Look
Macular degeneration is a deterioration or breakdown of the macula. The macula is a small area in the retina at the back of the eye that allows you to see fine details clearly and perform activities such as reading and driving. When the macula does not function correctly. Your central vision can be affected by blurring, dark areas or distortion. Macular degeneration affects your ability to see near and far, and can make some activities ¬ like threading a needle or reading ¬ difficult or impossible.
Although macular degeneration reduces vision in the central part of the retina, it usually does not affect the eye′s side, or peripheral, vision. For example, you could see the outline of a clock but not be able to tell what time it is.
Macular degeneration alone does not result in total blindness. Even in more advanced cases, people continue to have some useful vision and are often able to take care of themselves.
In many cases, macular degeneration′s impact on your vision can be minimal.
Many older people develop macular degeneration as a part of the body′s natural aging process. There are different kinds of macular problems, but the most common is age-related macular degeneration (AMD). Exactly why it develops is not known and no treatment has been uniformly effective. Macular degeneration is the leading cause of severe vision loss in Caucasians over 65. The two most common types of AMD are “dry” (atrophic) and “wet” (exudative):
1. “DRY” macular Deneration (Atrophic)
Most people have the “dry” form of AMD. It is caused by aging and thinning of the tissues of the macula. Vision loss is usually gradual.
2. “WET” macular Degneration (Exudative)
The “wet” form of macular degeneration accounts for about 10% of all AMD cases. It results when abnormal blood vessels from underneath the retina at the back of the eye. These new blood vessels leak fluid or blood and blur central vision. Vision loss may be rapid and severe.
Deposits under the retina called drusen are a common feature of macular degeneration. Drusen alone usually do not cause vision loss, but when they increase in size or number, this generally indicates an increased risk of developing advanced AMD. People at risk for developing advanced AMD, or abnormal blood vessels under the macula in one eye (“wet” form).
Macular degeneration can cause different symptoms in different people. The Condition may be hardly noticeable in its early stages. Sometimes only one eye loses vision while the other eye continues to see well for many years. But when both eyes are affected, the loss of central vision may be noticed more quickly.
Following are some common ways vision loss is detected:
- Words on page look blurred;
- A dark or empty area appears in the center of vision;
- Straight lines look distorted, as in the following diagram.
Many people do not realize that they have a macular problem until blurred vision becomes obvious. Your ophthalmologist (Eye M.D.) can detect early of AMD during a medical eye examination that includes the following
- A simple vision test in which you look at a chart that resembles graph paper (Amsler grid);
- Viewing the macula with an ophthalmoscope;
- Taking special photographs of the eye called fluorescein angiography to find abnormal blood vessels under the retina.
Although the exact causes of macular degeneration are not fully understood, antioxidant vitamins and zinc may reduce the impact of AMD in some people.
A large scientific study found that people at risk for developing advanced stages of AMD lowered their risk by about 25% when treated with a high ¬ dose combination of vitamin C, vitamin E, beta carotene and Zine. Among those who have either no AMD or very early AMD, the Supplements did not appear to provide an apparent benefit.
It is very important to remember that vitamin supplements are not a cure for AMD, or will they restore vision that you may have already lost form the disease. However, specific amounts of their supplements do play a key role in helping some people at high risk for advanced AMD to maintain their vision. You should speak with your ophthalmologist to determine if you are at risk for developing advanced AMD, and to learn if supplements are recommended for you.
Laser sugery, PDT and Anti-Vegf treatments
Certain types of “wet” macular degeneration can be treated with laser surgery, a brief outpatient procedure that uses a focused beam of light to slow or stop leaking blood vessels that damage the macula. A treatment called photodynamic therapy (PDT) uses a combination of a special drug and laser treatment to slow or stop leaking blood vessels.
Another form of treatment targets a specific chemical in your body that is critical in causing abnormal blood vessels to grow under the retina. That chemical is called vascular endothelial growth of abnormal blood vessels and slowing their leakage.
These procedures may preserve more sight Overall, though they are not cures that restore vision to normal. Despite advanced medical treatment, many people with macular degeneration still experience vision loss.
Adapting to Low Vision
To help you adapt to lower vision levels, your ophthalmologist can prescribe optical devices or refer you to a low-vision specialist or center. A wide range of support services and rehabilitation programs are also available to help people with macular degeneration maintain a satisfying lifestyle. Because side vision is very useful. Often, people can continue with many of their favorite activities by using low-vision optical devices such as magnifying devices, closed-circuit television, large-print reading materials and talking or computerized devices.
Testing your Vision with the Amsler Grid
You can check your vision daily by using an Amsler grid like the one pictured here. You may find changes in your vision that you wouldn′t notice otherwise. Putting the gird on the front of your refrigerator is a good way to remember to look at it each other.
To use the grid
- Wear your reading glasses and hold this grid 13-15 inches away from your face in good light.
- Cover one eye
- Look directly at the center dot with the uncovered eye.
- While looking directly at the center dot, note whether all lines of the grid are straight or if any areas are distorted, blurred or dark.
- Repeat this procedure with the other eye.
- If any area of the grid looks wavy, blurred or dark, contact your ophthalmologist immediately