It is the common name for “strabismus” where the Eyes are not aligned in the same direction. The Squinting Eye may turn in (converge), turn out (diverge) or sometimes turn up or down. These can be present all or only part of the time, in one or alternating between two Eyes.

Dr. parul sharma

Divergent SquintRight eye-before surgery

Dr. parul sharma

Straight eyes after surgery

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Left Eye divergent Squint before Surgery

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Left Eye straight after Surgery

Our eyes have a natural alear lens that helps to focus light on retina. It is located just behind the iris, thecoloured (brown, blue or green) part of the eye. In focusing(accommodation), for various distances ,the lens changes shape. It becomes more convex(curved) when you look at nearby objects and flatter for distant objects.

Cataract may develop at any age - right from birth to old age - but is most commonly seen in elderly.

Cataract is usually due to aging process, but, may occureat a younger age also. Although researchers are learning more about cataracts, no one knowsfor sure what causes them in old age. There can be other reasonsbesides age to cause cataract , e.g. eye diseases like uveitis, general diseases like diabetes, heredity, injury,radiation, infections, trauma and steroid intake.

The most common symptoms are:

  • Cloudy or blurry vision
  • Problems with light, headlights that seem too bright at night, glare from lamps or the sun, or a halo or haze around lights
  • Colours seem faded
  • Double or multiple visions
  • Frequent changes in eye glasses or contact lenses

In early cataract one may not notice any changes in vision. Most Cataract tends to grow slowly, so vision worsens gradually.

A comprehensive eye examination usually includes:

Visual acuity test/ Refraction : This test measures how well you can see at various distances and if you can improve with change in glasses prescription.

Pupil dilation: The pupil is widened with eye-drops to allow us to see more of the lens & retina and to look for other eye problems.

Tonometry: This is a standard test to measure eye pressure. Some patients have high eye pressure leading to glaucoma .

Biometry: Ultrasonic or Optical measurement of the eye to calculate the power of intra ocular lens to be implanted.

Other eye and general test may be required to establish complete diagnosis and fitness for cataract surgery.

The first thing a person must do on experiencing any of these symptoms is to consult an Eye Surgeon for a thorough eye examination. Answers to the following questions should be sought:

  • Do I have cataract?
  • Do I have any other eye disease?
  • What is the cause of cataract in my eye?
  • What are the treatment modalities available?
  • What treatment would be most suitable for me?
  • What is the expected outcome of the surgery in my case?
    • What are the risks involved and possible complications?
    • How long can I wait before I get operated?
    • What does the surgery involve in terms of time and expenditure?

Surgery is the only definitive treatment. Whenever the patient feels his vision hasdecreased to a level where it interferes with his daily activities hecan get operated upon (waiting for cataract to mature is an old concept suitable for the surgery of that era). However, in certain cases where there areassociated complications or potential risks of complications, anearly (even urgent) operation may be required - here the advice ofyour Consulting Eye Surgeon should be followed. The operations done for cataract are the following (the list includesonly established standard procedures):

  • Phacoemulsification with foldable IOL MicroIncision Cataract Surgery (MICS)
  • Femto Assisted Bladeless Cataract surgery (FLACS) with foldable IOL
  • Small Incision Cataract Surgery (SICS) with IOL

MICS Phacoemulsification:

  • It is a no stitch, no injection and no bandage micro incision cataract surgery. A very small cut/incision (only 2.2 mm) is made into the clear part of the eye (Cornea) and the hard core(nucleus) of the lens is converted into small pieces & soft pulp using high frequency ultra sonic waves (NOT Laser) and sucked out. Then a foldablelens (IOL) is injected through the small incision and positioned intothe capsular bag.
  • The main advantages of this operation are early rehabilitation and decreased occurrence of astigmatism (cylindrical power in glasses).
  • All these operations are done under local (injection) or topical (eyedrops) anaesthesia that makes the eye numb and the patientalthough conscious does not feel any pain.The preferred method of giving anaesthesia is topical or eye drops anaesthesia. This not only helps in avoiding the painful injections and the eye bandage, but also reduces the risk associated with injection anaesthesia (e.g., retro-bulbar haemorrhage, globe perforations, etc.)
  • The general anaesthesia or sedation is used only in children and uncooperative patients.

Femto Laser Assissted Cataract Surgery (FLACS)

  • A Femtosecond is one millionth of a nanosecond and is a measurement used in laser technology. The femtosecond laser in cataract surgery is used to make corneal incisions (instead of microkeratome blade), opening of capsule of lens (instead of a needle to make capsulorhexis), pre chopping & fragmentation of cataract. The rest of surgery wherein cataractous lens is emulsified, cortex cleaning & lens insertion remains the same as in MICS Phacoemulsification surgery.Although it is called a BLADELESS surgery it does not mean that there is no cut on cornea. The femto laser advantage is that it can be used with varied specifications, which gives the surgeon more control, precision and increases the SAFETY FACTOR.

Read More Here - https://eyecaregurgaon.com/Intraocular-gurgaon.html

The Opaque cataractory lens is removed by surgery and replaced by a clear intraocular lens(IOL). These IOLs are of different type and customised as per your eye problems and life style requirements.

To know more about type of IOLs, Click Here https://eyecaregurgaon.com/Intraocular-gurgaon.php

Before surgery, a detailed eye examination is done including Biometry (measurements of eye to decide on the power of intraocular lens). Other tests-BP, blood sugar, viral marker screening, urine R/M, ECG have to be done.

Most people after a cataract surgery can go home in few hours . It's normalto feel itching, sticky eyelids, and mild discomfort for a while after thesurgery and on day one. You will be instructed to put eye drops and most of routine daily activities can be resumed from the very next day. There are no diet restrictions and no lifestyle changes are required. The post op visits are next day in opd, then after a week and then at end of third week wherein we give final spectacles prescription. Some outstation patients may choose to go back early after the first opd visit and follow up locally.

After the surgery, you can read and watch TV etc from the next day itself, but yourvision may be blurry. It takes few days for vision to stabilise. The vision is restored after the final spectacles prescription at 2 or 3 weeks time.

Cataract surgery is a relatively safe day care surgery due to advanced technology with gratifying visual results. But like any surgery in body ,there is an inherent small risk of predicted or non predicted complications. Problems after cataract surgery are uncommon, but they may occur sometime despite best technique & aseptic precautions. These can include infection, higher eye pressure ,inflammation, haziness of the cornea, swelling in macular area of retina and rarely retinal detachment of the retina. We also have to keep in mind that the surgeon, surgical technique and the quality of the IOL are not the only factors that decide the result of cataract surgery. It also depends on the pre existing condition of the eye, the cornea, retina status and the presence of systemic diseases like diabetes, hypertension, infections, etc. The quality of the operation theatres, use of disposable instruments, ancillary and backup facilities, training of the support staff, etc. also have a significant influence on the success of the surgery. Ensuring good quality in all these areas leads to an increase in the surgical cost for the patient, but it must be understood that our eyes are worth a lot more.

None . There is no prevention or medical treatment .The only solution is surgery wherein the opaque lens is removed and replaced with a clear customised intra ocular lens .

Cost of cataract surgery depends on the type of intraocular lens (monofocal/ Toric/Multifocal/Trifocal /EDOFs ) and the technique of cataract surgery which is either MICS phaco or FLACS -Femto laser assisted cataract surgery . The total cost varies from 40k to 85k

If you or your parent has been diagnosed with cataract , then this article written by me is for you. It will address Myths, Facts & Recent Advances about Cataract treatment

Myths & Facts and Recent Advancment about Cataract Treatment

Myth: Cataract is an old age problem

Fact: Most cataracts are senile but can occur at any age. They can also be congenital or caused by steroid intake, injury, diabetes or eye inflammations.

Myth: Cataract can be prevented by medicines, diet, eye drops, eye exercise or yoga/Cataract can be cured by eyedrops, diet or yoga.

Fact: There is NO PREVENTION for cataract. There is NO MEDICAL CURE for cataract and the only definitive treatment is surgery.Some early cataracts may naturally never progress and may require no treatment if not causing a problem in vision. Hence non progressive early cataracts do not require surgery specially if there eye sight is ok.

Myth: Cataract surgery should be delayed and done only when it matures or ripens.

Fact: This is an old era concept which is not true now as the technique of cataract surgery has completely changed. Best time to get surgery done is when you start having early visual problems in your day to day life. There is no point delaying the surgery too much as the ultrasonic system works faster and is safer on softer cataracts then hard mature ones.

Myth: Cataract can be removed with lasers without incision.

Fact: There is no surgery possible without an incision as one has to enter the eye to operate. Cataract,which is opacity or clouding of natural lens, is removed by ultrasonic fragmentation into tiny pieces by phaco probe and sucked out through a small incision(2.2mm). Injectable foldable intraocular lens is then implanted in the eye to restore good vision. Femto laser –bladeless technique of operating cataract does intial few steps ( creates incisions, circular opening of anterior capsule and partial nucleus fragments ),which is followed by routine phacoemulsification with foldable intraocular lens insertion.Hence,laser assists in few steps of phaco surgery but does not completely replace it.

Myth: Cataract surgery-both femto laser assisted and phacoemulsification is painful and recovery time is long.

Fact:The complete surgery takes around 15mins on table and is done as a day care surgery.Usually,we do the surgery under local anesthetic eye drops as a result of which there is no injection,no pad and bandage.Patient is allowed day to day routine activities from next day itself and most people resume work in few days.

Myth: Spectacles are never required after cataract surgery.

Fact:We aim to decrease spectacles dependence after cataract surgery but this may not happen in all eyes for various reasons. Monofocal intraocular lens work well for distance but you have to wear reading glasses. Toric Intraocular lens correct astigmatism and patients still have to wear reading glasses. Multifocal /Trifocal intraocular lens can give freedom from both distance and near glasses after cataract surgery or decrease dependence on them. But not all eyes are fit for multifocal /trifocal lens,there is a selection criteria which the doctor needs to decide after examining your eyes.

Myth: Cataract can reoccur or regrow.

Fact:Cataract never regrows as the opaque lens is permanently removed in surgery leaving behind the posterior capsule on which the intraocular lens is placed. Sometimes after surgery this capsule becomes cloudyand can be treated by a quick laser procedure in OPD.

Myth: Safed motia-bind and kala moti -bind are related to each other .

Fact:These two conditions are not related to each other.Safed motiabind is Cataract-cloudiness or opacity in lens of the eye and causes blurring of vision and or glare.The treatment is surgery and vision can be fully restored if retina etcare healthy. Kala motiabind is Glaucoma wherein the eye pressures become high and slowly damage the optic nerve.For many years patient would not know as the vision decreases slowly from periphery of vision. The damage of optic nerve affecting the vision are irreversible if detected late and hence early detection is must.The treatment for glaucoma is either medical-eye drops ,laser or surgery to keep the eye pressure under control.

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Hope this helps in clarifying your doubts .Wish you healthy vision. Dr Parul Maheshwari Sharma