Cornea and Contact Lens Services

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Cornea

Cornea is the window of the eye through which light rays fall on the Retina, Cornea can be affected by a wide range of conditions like malnutrition, infection, injuries and degeneration. In India infection and injuries are the main cause of corneal related blindness. This department is managing all types of anterior segment inflammations, infections, injuries and ocular surface diseases. It is well equipped with latest technology like Optovue Avanti Anterior Segment OCT, Corneal Topography, Specular Microscopy, Pachymetry, etc.

We are performing various Anterior Segment Micro Surgeries, including Corneal Grafting, surgical repair of the injured eyes and Ocular Surface Surgeries. A well equipped Refractive Surgery Unit, Contact Lens Clinic and Eye Collection Centre are attached to this department.

What is Cornea –

The cornea is the front, clear & transparent avascular and outermost layer of the eye that acts as a window that lets light into a room, the cornea lets light into the eye. It also focuses the light passing through it to make images clear and sharp.

Parts of Cornea:

  • Epithelium
  • Bowman’s membrane
  • Stroma
  • Descemet’s membrane
  • Endothelium

Anatomy of Cornea

Common corneal diseases:

Cornea & Contact Lens Services
  • Corneal ulcers (corneal infections – Bacterial, viral , fungal etc)
  • Corneal degenerations & corneal dystrophies
  • Corneal scars (white spot In cornea)
  • Corneal ectasias (Keratoconus etc)

Corneal problems can occur in anyone regardless of age. Sometimes due to disease, injury or infection the cornea becomes white & altered shape & curvature. A damaged cornea, like a frosted windowpane, distorts light as it enters the eye which leads to blurred images of the seen object.

When should one consult corneal surgeon-

  • Pain, redness, itching, watering & persistent foreign body sensation
  • Excessive tearing or less tears
  • Currently using any systemic medications for Diabetes mellitus, thyroid, neurological problems - Depression, Hypertension, Parkinsonism, Obsessive compulsive neurosis, connective tissue disorders etc.
  • Alleged history of fall of foreign body, iron piece, glass piece, dust, insect etc
  • Injury with glass piece, plant leaf or stem.
  • Fire cracker injury or chemical injuries such as acid injuries – common household cleaning agents, Laboratory acids, Car battery explosions & alkaline injuries with Lime, cement, etc.
  • Defective vision due to white spot over black of the eye (cornea)

Facilities available:

  • RTVue-CAM system (Optovue, Inc.) (OCT) RTVue-CAM system, which has higher resolution and imaging speed that can be used to evaluate corneal dystrophies, Keratoconus, Lasik flap thickness measurement , to assess level of impact of corneal foreign bodies , corneal injuries.
Cornea & Contact Lens Services
Cornea & Contact Lens Services
Cornea & Contact Lens Services

Corneal Topography SHIN NIPPON CT -1000 –

  • Important modality to assess corneal shape & curvature(Diagnosing & monitoring progress of keratoconus disease.), to measure corneal aberrations, useful guide in fitting contact lens etc.
  • Tomey Ultrasonic Pachymeter - An excellent instrument to measure corneal thickness in various corneal quadrants especially in Pre op evaluation of LASIK patients, Corneal Dystrophies , Keratoconus etc
  • Specular Microscopy – Useful equipment to know the density (Cell Count) and Morphology of Endothelial Cells of Cornea. Thus helpful in diagnosing Endothelial Dystrophies – Fuchs, Posterior Polymorphous Dystrophy, etc.
  • Microbiological & Histopathological evaluation of corneal & ocular surface diseases.- Corneal scraping and sending the pus to Lab for identifying the causative organism for ulcer Excision biopsy of ocular surface mass lesions & Histopathological evaluation of these disorders.
Cornea & Contact Lens Services
Cornea & Contact Lens Services
Cornea & Contact Lens Services
Cornea & Contact Lens Services
Cornea & Contact Lens Services
Cornea & Contact Lens Services

Contact Lens Clinic

Contact lens clinic of Modern Eye Hospital & Research centre, examines, prescribes, and fit patients with contact lenses. We educate patients with clear guidelines regarding use of contact lens, their hygiene & timely replacement of new lens.

Contact lenses are prescribed for three broad categories of patients:

  • For routine use in patients with myopia, hyperopia and, astigmatism,.
  • For patients with ectatic disorders or eye conditions such as keratoconus, &Pellucid marginal degeneration with customized ROSE – K contact lens.
  • For post-surgical use in patients with
    • Aphakia
    • Post LASIK,& photo refractive .keratectomy (PRK),
    • Post corneal transplant or penetrating keratoplasty.
  • Post corneal tear repair

Toric lenses for astigmatism, cosmetic contact lenses, prosthetic tinted lenses, and bandage contact lenses are prescribed and fitted here. We also offer monthly & quarterly disposable lens..

Cornea & Contact Lens Services
Cornea & Contact Lens Services
Cornea & Contact Lens Services
Cornea & Contact Lens Services

Rose - K Lens

Cornea & Contact Lens Services

 

 

Three Lens Designs

(Rose K2, Rose K2 IC, Rose K2 Post Graft)

To fit all corneal shapes and one simple systematic approach to fitting

Fitting Set

The Rose K lens is available in fitting set up to 25 lenses. (boston material non uv.) with various base curve range and flexible edge lift system.

Aberration control aspheric optics providing outstanding acuity, reduced flare and glare and minimal lens mass. Reverse geometry fitting curves provide better fit and comfort (Rose K2 IC & Rose K2 Post Graft)

Advanced fitting options include

  • Toric peripheral curves
  • Asymmetric corneal technology or ACT
  • Front, back & Bi Toric designs
Cornea & Contact Lens Services

Extensive diameter and base curve range

Fits all corneal shapes, sizes and stages of keratoconus because of the unique design that changes as the base curve steepens. Therefore Rose K lens can be used to fit all types of Keratoconus, i.e., Niple, Oval, & Globus Cones, Pellucid Marginal Degeneration, Post Keratoplasty patients.

Surgeries

The department offers recent advances in the field of corneal surgery which include:

Penetrating Keratoplasty / Corneal Transplantation in a corneal transplant, the cloudy or warped cornea is replaced with a healthy cornea. If the new cornea heals without problems, there will be tremendous improvement in vision Optical & therapeutic Keratoplasty with anterior segment reconstruction, Combined with Intra ocular Lens implantation.

Lamellar corneal surgeries: Including

  • Deep Anterior Lamellar Keratoplasty (DALK)
  • DSAEK

Patch Grafts : Crescentic, Circular – Full thickness and Lamellar

Ocular surface reconstruction surgeries -

  • Amniotic Membrane grafting.
  • Pterygium surgery with Conjunctival Limbal Auto Graft etc.
  • Ocular surface tumour excision with AMG etc.
  • Double Pterygium, Postop Pterygium Excision with Auto Graft and AMG
  • CDK, Postop CDK Debridement with AMG
  • PUK, Postop Conjunctival resection with Multilayered AMG
  • Limbal Dermoid, Post Excision with AMG
Cornea & Contact Lens Services
Cornea & Contact Lens Services
Cornea & Contact Lens Services
Cornea & Contact Lens Services
Cornea & Contact Lens Services
Cornea & Contact Lens Services

Trauma care – Repair of Conjunctival & Corneal Lacerations, Traumatic Cataracts, Rupture globe, Fire Cracker Injuries, Chemical Injuries etc, are being managed with an excellent Operation Theatre & advanced equipment.

Collagen Cross Linking for Keratoconus, Pellucid Marginal Degeneration & Post LASIK Ectasia.

Cornea & Contact Lens Services

Conventional CXL Machine

Cornea & Contact Lens Services

Accelerated CXL Machine

Collagen Cross Linking (CXL /C3R) with Riboflavin

C3R is performed by exposing the eye to UV A radiation of 3mW/cm2 for 30 min, by simultaneous installation of Riboflavin drops that releases oxygen radicals which in turn induce covalent bonds between collagen fibres and thus increases the stiffness of the cornea.

Indications

  • Progressive Keratoconus
  • Post Refractive Surgery Ectasias
  • Pellucid marginal degeneration

Exclusion criterion

  • Corneal thickness less than 400 microns
  • Pregnancy and immunocompromise patients
  • Diabetes, Herpetic Keratitis

C3R alone or in combination with Intacs or Rose K lens allows improved vision & comfort to patients, C3R is a simple, safe and effective procedure in the management of progressive ectatic disorders of of the cornea.

Patient education

Dry Eye

Normally, glands in your eyelids manufacture tears which are washed across your eye every time you blink. When your eye produces too few tears, or when the tears drain too quickly from the eye, the resulting condition is called "Dry Eye".

What to look for?

Your eyes may burn or feel itchy, gritty, red, and dry. In some cases, the eyelids may stick together upon awakening in the morning. Difficulty in wearing contact lens, hay fever or sinus problems, and recurring infection may also be associated with dry eye condition. During your first visit, you will probable be given Schirmer tear strip paper test, in which a small strip of paper is placed inside the lower eyelid to determine if you have normal tear production.

What to Do?

Dry eye may be related to a number of causes and if left untreated, may lead to eye conditions including corneal infections and ulcers, conjunctivitis, chalazion and pterygium. The common first treatment for dry eye is eye drops known as "Artificial Tears". Artificial tears bring relief to many people, but they are not a permanent solution to the dry eye. Advanced techniques have been developed which in many cases, can dramatically improve the dry eye condition. These procedures are relatively simple and can be performed on an outpatient basis, without requiring a hospital stay. If you believe you may have dry eye, we urge you to make an appointment with our office for an evaluation.

Who is affected?

As we age, our eyes produce fewer tears -60% fewer at age 65 than at age 18, in fact. Thus older adults often suffer from dry eye, as do pregnant and menopausal women. However, dry eye is a relatively common condition which can and does affect people of all ages and backgrounds.

Causes of Dry Eye

Among the common causes of dry eye are irregularities in the blinking process. Interestingly, both those who blink infrequently and those who blink constantly may experience an imbalance of tears in their eyes. Dry eye may also be caused by medications such as antihistamines, decongestants and heart medications. There are some studies which link Vitamin A deficiency to dry eye syndrome. Overexposure to sun, wind, smog ,air conditioners, smoke or aerosols such as hair spray may aggravate or initiate a dry eye condition in some people. Finally, an overly-large punctum or drainage canal in the eye may let your tears drain away too quickly.

What to Do?

Computer Vision Syndrome, also referred to as Digital Eye Strain, describes a group of eye and vision-related problems that result from prolonged computer, tablet, e-reader and cell phone use. Many individuals experience eye discomfort and vision problems when viewing digital screens for extended periods. The level of discomfort appears to increase with the amount of digital screen use.

To help alleviate digital eye strain, follow the 20-20-20 rule; take a 20-second break to view something 20 feet away every 20 minutes.

Ocular Allergies

Eye Allergies

An eye allergy is an allergic response to allergens in your environment that cause symptoms such as swollen, itchy eyes. These allergens may be seasonal or they may be found in common substances , cosmetics, to which many people react year-round . An eye allergy can be either an immediate or delayed reaction. The name for an eye allergic reaction is allergic conjunctivitis. Seasonal allergic conjunctivitis is typically caused by pollen released into the air by flowers, grasses and weeds. Symptoms are most severe when the pollen counts are highest, during the spring months and late summer through fall months. Perennial allergic conjunctivitis produces symptoms year-round because the allergens that trigger pace are always present . Dust mites and pet dander cause most cases of this type of ocular allergic response. Other common allergens causing perennial allergic conjunctivitis are mold, air, pollutants, smoke, and cosmetics

What Causes Allergic Conjunctivitis?

When your are exposed to a substance that your body considers "foreign," such as pollen, dust , or pet dander, cells in your eyes called mast cells are alerted. These cells in turn release a number of chemical substances that cause the symptoms of allergic conjunctivitis.

What Are The Signs And Symptoms Of Allergic Conjunctivitis?

Itching is the most common symptom of allergic conjunctivitis. Burning, redness and watering of the eyes are other common symptoms of allergic conjunctivitis . You may also experience swelling, puffiness and /or throbbing, dry, gritty eyes. Some people with allergic conjunctivitis may also be unusually sensitive to light. The conjunctiva of the eye is a thin lining on the inside of the eyelid that extends over the white part of the eye. The conjunctiva and the eyelid usually act as a natural barrier to a wide range of foreign invaders including bacteria and viruses.

Cornea & Contact Lens Services

The conjunctiva is the part of the eye that becomes inflamed during an ocular allergic reaction. Allergic conjunctivitis is not only frustrating and painful but can also become a significant inconvenience. For example, eye allergies can interrupt your ability to concentrate, cause fatigue, and , in some severe cases, prevent you from driving a car because you simply can't see well enough. You may also feel uncomfortable about your appearance if your symptoms are particularly severe.

Treatment of Allergic Conjunctivitis

How can I minimize the effects of allergic conjunctivitis?

The best way to minimize the effects of allergic conjunctivitis , including irritation, is to control your exposure to allergens by taking such simple measures as:

  • Washing your hands, face, and hair frequently to rid them of allergens.
  • Using air filters indoors and vacuuming regularly.
  • Avoiding the outdoors when the pollen counts are high.
  • Closing windows and doors to keep allergens out.

If you have itchy eyes, try to avoid touching or rubbing them because you may introduce the allergen directly into your eyes and aggravate your condition. Aggravating your condition may result in further damage to your eyes and/ or to the development of more serious eye problems. Instead , apply a cool compress to your eyelids, or try using an over-the- counter (OTC, or nonprescription) artificial tears product.

What is corneal ulcer / corneal infection

Corneal ulcer is infiltration of cornea with overlying epithelial defect caused due to various infectious agents like Bacteria, fungi, viruses.

Who are more prone to get corneal ulcers?

Patients who meet with eye trauma, severe dry eye, contact lens users, toxic medications in eye & Diabetics.

How do we treat corneal ulcers

Topical Antibiotic eyedrops either commercially available or fortified antibiotic preperations / anti fungal agentsalong with cycloplegic agents to relieve the patient from pain & infection.

Surgical treatment-

We treat large corneal ulcers unresponsive to medical treatment or perforated corneal ulcers with therapeutic keratoplasty or tectonic corneal grafting.

What is KERATOCONUS -

It is a progressive thinning of cornea with bulging of cornea forwards leading to altered shape & curvature & progressive defective vision i.e myopic astigmatism, which in advanced stages may not improve with high power glasses or even with contact lens.

Treatment options - C3R & Corneal transplantation(PKP & Deep Anterior lamellar keratoplasty)

Corneal Dystrophies-

It is a group of genetically inherited diseases corneal disease characterized by progressive whitening of cornea & painful eye with decreased vision in both eyes Treatment options – Corneal transplantation – penetrating keratoplasty, Lamellar keratoplasty _

  • DALK - Deep Anterior lamellar keratoplasty
  • DSAEK (Descemets stripping automated endothelaial keratoplasty)

What is corneal transplant?

Corneal transplantation is a procedure in which diseased cornea is replaced by a healthy cornea which if taken up well without any complications can lead to pain relief and visual improvement to the patient.

Since the cornea was one of the first parts of the body to be transplanted, corneal transplants remain one of the most common, and most successful, of all transplants within hours of death The healthy corneal tissue used for transplantation is supplied by an Eye Bank Or Eye collection centre.Eye Banks works round the clock to collect, evaluate, and store donated corneas. The corneas are collected from human donors. Stringent tests are done to ensure the safety of the person receiving the cornea. The Eye Bank verifies the donor's medical history and cause of death, and performs blood tests to ensure that the donor did not have any contagious disease, such as AIDS or hepatitis.

Cornea & Contact Lens Services
Cornea & Contact Lens Services