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Retina Vitreous Services

Retina Clinic

Digital and highly sophisticated

Of late, there has been increasing awareness and demand for hi-tech and sophisticated retinal services in the community. The MEH&RC has established a world class exclusive Retina Clinic. Fundus evaluation is done by Indirect ophthalmoscope and 90D lens.

 

OTI B-Scan

The new OTI scan - 1000 is the most advanced ophthalmic ultrasound system both A & B available today. The ultra fast 12.5 NH1- B probe is the only one of its kind with automatic self calibration. Its scanning rate of 50 frames /second allows excellent visualization of low density structures in vitreous. It can generate a 3D image in less than two seconds.

Image Net 2000 

Image net 2000 is a state of the art digital imaging system for faster, more efficient capture, storage retrieval and analysis of all types of Ophthalmic Images.

Image net 2000 incorporates a full range enhancement program that can be of great help in precisely evaluating difficult pathologies.

FFA - Fundus Fluorescein Angiography done as OPD procedure.

 

Normal FFA

Abnormal FFA

 A good quality angiogram requires adequate pupillary dilatation.

The patient is seated in front of the fundus camera.

Fluorescein, usually 5ml pf 10% solution is drawn into a syringe.

A color and Red Free photograph is taken

   
   

   

Fluorescein is injected rapidly intravenously

Photographs are taken at approximately 1-second intervals, 5-25 sec FFA injection

After the transit phase has been photographed in one eye, control pictures are taken of the opposite eye. Late photographs may also be taken after 1 minute and occasionally 20 minutes, if leakage is anticipated.

The photographs in all quadrants are taken, analysed, reported and accordingly treatment advised.

Iridex Occulight Green Laser Unit

Our OPD is also equipped with Iridex Occulight Green Laser Unit for the photocoagulation procedures.

   

Photocoagulation also known as Light coagulation a treatment procedure introduced into Ophthalmology in the early 90s. Light from a suitable source is focused into the eye and converted into heat by tissues that selectively absorb the light. An immediate coagulation occurs in the choroids, retina which later results in a scar. Photocoagulation is similar to the manner in which paper can be burnt when sunlight is properly focused on it by means of a convex lens.

The Argon or Diode Laser Photocoagulator utilizes Mono-chromatic laser that exhibits coherence. The laser is generated in a tube and delivered into the patientís eye by means of an optical system. The advantage of the laser is that very small areas very close to the fovea - the region most vital for visual function is safely guarded.

     

Photocoagulation is advised after the doctor has completed a thorough examination of the patientís eye, studied the Fluorescein angiogram pictures and weighed the benefits to be derived by treatment compared to natural history of the disease. Treatment is done on an out - patient basis. You may need treatment for one or both the eyes . each eye may need one to five treatment sessions. The pupils will have to be maximally dilated prior to each treatment session. Each session will last about 20 minutes and your waiting period may be between 1 to 2 hours. If you are a Diabetic you can bring some snacks with you. So that you do not become hypoglycemic, any medication that you may be taking for your general systemic diseases  are to be continued during Photocoagulation treatment. You can have normal diet before and after treatment and you can bathe. Any mode of transport ( auto, bus, car, aeroplane) is permissible. You may watch movies or television after the treatment.

    

Post Laser

Laser Photocoagulation can be performed through the Indirect Ophthalmoscope with the patient lying down on the couch, or by seating the patient at the slit lamp. During treatment through the slit lamp delivery system, after instillation of drops to anaesthetize the surface of the eye, a contact lens will be placed on the eye through which the doctor looks in and treats the inside of the eye. You will be required to keep the eyes open and look in the direction in which you are requested to look. After completion of treatment the eye will be left open. Vision will be blurred for a couple of hours after the treatment and need not cause concern.

The main purpose of Photocoagulation is to arrest the progress of the disease at the stage at which it is being treated thereby preventing certain vision threatening complication that may ensue later. The vision usually remains the same and in certain limited conditions improves. It does not make you feel better or improve your symptoms like blackspots, floaters etc . In some instances where the disease process is progressing rapidly, Photocoagulation may not help in producing the desired effect.

Floaters And Flashes

What Are Floater?

You may sometimes see small specks on clouds moving in your field of vision. They are called floaters. You can often see them when looking at a plain back wall or blue sky.

Floaters are actually tiny clumps of gel or cells inside the vitreous, the clear jelly-like fluid that fills the inside of your eye.

While these objects look like they are in front of your eye , they are actually floating inside. What you see are the shadows they cast on the retina, the nerve layer at the back of the eye that senses light and allows you to see.

Floaters can have different shapes: little dots, circles, lines, clouds or cobwebs.

What Causes Floaters?

When people reach middle age, the vitreous gel may start to thicken or shrink, forming clumps or strands inside the eye. The vitreous gel pulls away from the back wall of the eye , causing a posterior detachment . It is a common cause of floaters.

Posterior vitreous detachment is more common for people who:

  • Are nearsighted;

  • Have undergone cataract operations;

  • Have had YAG laser surgery of the eye;

  • Have had inflammation inside the eye.

The appearance of floaters may be alarming, especially if they develop suddenly. You should see an ophthalmologist right away if you suddenly develop new floaters , especially if you are over 45 years of age.

Are Floater Ever Serious?

The retina can tear if the shrinking vitreous gel pulls away from the wall of the eye. This sometimes causes a small amount of bleeding in the eye that may appear as new floaters.

A torn retina is always a serious problem, since it can lead to a retinal detachment. You should see your ophthalmologist as soon as possible if:

  • Even one new floater appears suddenly;

  • You see sudden flashes of light.

If you notice other symptoms ,like the loss of side vision, you should return to ophthalmologist.

What Can Be Done About Floaters?

Because you need to know if your retina is torn, call your ophthalmologist if a new floater appears suddenly.

Floaters can get in the way of clear vision, which may be quite annoying, especially if you are trying to read. You can try moving your eyes, looking up and then down t move the floaters out of the way.

While some floaters may retain in your vision, many of them will fade over time and become less bothersome. Even if you have had some floaters for years, you should have an eye examination immediately if you notice new ones.

What Causes Flashing Lights?

When the vitreous gel rubs or pulls on the retina , you may see what look like flashing lights or lightning streaks. You may have experienced this same sensation if you have ever been hit in the eye and seen "stars".

The flashes of light can appear off and on for several weeks or months. As we grow older, it is more common tp experience flashes. If you notice the sudden appearance of light flashes , you should visit your ophthalmologist immediately to see if the retina has been torn.

Migraine

Some people experience flashes of light that appear as jagged lines or "heat waves" in both eyes, often lasting 10-20 minutes. These types of flashes are usually caused by a spasm of blood vessels in the brain, which is called migraine.

If a headache follows the flashes, it is called a migraine headache. However, jagged lines or "heat waves" can occur without a headache. In this case , the light flashes are called ophthalmic migraine, or migraine without headache.

How Are Your Eyes Examine?

When an ophthalmologist examines your eyes, your pupils will be dilated with eye drops. During this painless examination , your ophthalmologist will carefully observe your retina and vitreous. Because your eyes have been dilated, you may need to make arrangements for some one to drive you home afterwards.

Floaters and flashes of light become more common as we grow older. While not all floaters and flashes are serious, you should always have a medical eye examination by an ophthalmologist to make sure there has been no damage to your retina.

Diabetic Retinopathy

Magnitude of Diabetic Eye Disease In India

  • Increasing incidence of diabetes mellitus poses a major health problem in India. It was the 17th cause of blindness 20 years ago in India, but today it has ascended to the 6th position.

  • Diabetic patients are twice as likely to develop eye problems than non-diabetic patients.

  • 50 percent of diabetic patients develop some degree of diabetic eye disease.

  • The risk of blindness is 25 times higher in diabetic patients.

Diabetic Retinopathy Is Symptomless Until Late Stage. 
It Is You Who Has To Look For It.

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