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Cornea & Contact Lens Services


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 departments managing all types of anterior segment inflammations, infections, injuries and ocular surface diseases. It is well equipped like topography, specular microscopy and pachymeter. We are performing various anterior segment micro surgeries, including corneal grafting, surgical repair of the injured eyes and pterygium surgeries. A well equipped Refractive Surgery Unit, Contact Lens Clinic and Eye Collection Centre are attached to this department.

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.

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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.

 

About Tears

Tears are very complex liquid produced by glands located behind the upper eyelids. In the normal eye , the blinking movement of the lids takes this material and forms watery layer over the exposed part of your eye. This watery layer renews itself with each blink. The film of tears which coat your eye is actually composed of three separate layers. The outer most layer called the lipid, is oily to minimize evaporation, the middle or aqueous layer, contains many; substances including Vitamin A , and the antibacterial agents lysozyme and lactoferrin, the mucin layer, which is directly next to the surface of the eye acts as a lubricating coat and binds lysozyme and other substances that protect the eye from infection.

How Tears Work

The eye produces about 400 drops of tears per day. These flow across the eye and drain into small openings called the upper and lower puncta. From the punctum, the tears drain through a canal, into the tear sac and finally into the nasal passage. For many people, restricting or closing of one or both these openings improves the dry eye condition.

The Tear Test

To determine if closure or restriction of the punctum may be appropriate for you, we often perform an implant tear test. In addition we may wish to determine the quality of the watery portion of your tears. An implant about the size of a grain of rice is inserted in the tear drainage canals. The procedure is relatively simple and painless. Once in place, these implants act like stoppers in a sink so that tears on the surface of the eye are prevented from draining away. To measure the quality of your tears we may take tear samples with a small circle of absorbed paper or sampling tube. If we find the symptoms of red, itchy, burning eyes disappeared with the implants in place, you and your consultant will come to conclusion that permanent punctum plugs are alternate methods to close or restrict the punctum would be appropriate

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.

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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. 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 allergies 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.

Pachymeter Keratometer

Pachymeter

Keratometer

Corneal Topographer

Contact Lenses

The Contact Lens Service, working with the staff of the Cornea & Anterior Segment Service, offers a full range of therapeutic contact lens services, including those for patients with corneal surface disorders, keratoconus, corneal leukoma, albinism, and aniridia. Contact lens evaluation and fitting for infants and children is routinely available

Rose - K Lens


Rose - K Lens

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


Fitting SetThe 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

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.

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.

Collagen Cross Linking Collagen Cross Linking Collagen Cross Linking

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.

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