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Eye Care: Facts About Opthalmology

opthomology in India

What does opthalmology treatment mean?

Ophthalmology pertains to the branch of medicine/surgery dealing with the study and management of eyes and the orbit. In addition to it, the term ocular is also used interchangeably with it. The commonest form of an ophthalmic disease is the disability to read or see correctly for which spectacles are used. However an ophthalmologist has much more to offer since the ocular pathologies are quite vast. MedcureIndia acquaints its readers with all about it in the coming lines.

Causes of ophthalmic diseases:

A host of environmental and genetic factors cumulatively lead to infections/trauma/tumors of the eye.

  • Inflammation of the eye membranes is caused by bacterial/viral or fungal infections e.g scleritis, conjunctivitis. Corneal ulcers may also occur because of the same.
  • Allergy to dust/pollen/certain medications may also lead to swelling and inflammation of the membranes.
  • Trauma during road traffic accidents/punches/fist fights/stabbing usually lead to strabismus (squint), abrasions, lacerations and even orbital fractures.
  • Extremely high diabetes, hypertension, migraine may lead to damage of the retinal epithelium and rupture of retinal blood vessels causing retinopathy.
  • Genetically determined diseases such as sjogren’s disease, night blindness may manifest immediately after birth or later in life. While the former is related to dry eyes known as xeropthalmia, the latter relates to damage to retinal rods and cones causing difficulty in perceiving some colors.
  • A cloudy and frosty accumulation of mass in the lens causes blurred vision leading to cataract.

   

A raised intraocular pressure causes damage to the ocular nerve leading to a partial or total loss of vision. This is termed as glaucoma.

Signs & symptoms of ophthalmic diseases:

·       Inflammatory diseases mostly encounter redness, dryness, swelling and itching in the membranes.

·       Refractive errors lead to partial or total blurring of vision.

·       Complete loss of vision maybe seen in retinopathies, cataract and glaucoma

·       Failure to recognize green and red colors occurs in color blind individuals

·       Night blindness causes blurred vision during nocturnal hours.

·       A raised intraocular pressure is seen in glaucoma and retinopathies.

Diagnostic tests for ophthalmic diseases:

  • Refraction/vision/snellen test:  Most routinely used examination to help prescribe spectacles of a certain degree. Works by making a patient read letters and numbers from a distance and judging his or her ability to read them without any eye strain.
  • Visual field testing: These are done to test the vertical and horizontal range of vision. Blind spots may occur over the lens or retina leading to blurred vision and diminishing its range. The ophthalmologist asks the patient to close one eye and then describe a far object with the other open eye. All the central and peripheral parts of the object are asked to describe. Used in cataracts and glaucoma cases.
  • Opthalmoscopy/fundoscopy:It is done with the help of an opthalmoscope/fundoscope. Used  routinely to examine conjunctiva, sclera, iris and pupil.
  • Tonometry: It is method employed to study the intraocular pressure in glaucoma cases. They give readings in millimeters per mercury Hg, normal reading being 10 to 21 mmHg. Readings above 30 indicate serious condition and calls for immediate action.

Types of opthalmic disorders:

For the ease of understanding, we study the ophthalmic diseases according to the anatomical sites as follows:

 

Involving conjunctiva: It is a clear, transparent and thin membrane covering the front portion of the eye and inner portion of the eyelids. It keeps the ocular environment moist and free of germs.

  • Conjunctivitis mostly occurs due bacterial/fungal/viral infections, foreign body invasion or trauma to the eye.
  • It may be allergic or infectious in nature depending upon the degree of inflammation, redness and soreness.
  • Involving sclera: The white portion of the eye is known as sclera.
  • Very rarely it may show scleritis with swelling of the eye due to infections.
  • It may appear pale or yellow during jaundice due to leakage of bile in the ocular spaces.

 

Involving iris and pupil: The colored part of the eye is known as iris which acts like the shutter of a camera regulating the amount of light passing through the pupil. Pupil is the centre of the iris, the opening through which light is enabled to enter the eye. Pupil has the ability to expand or contract as per the intensity of light.

  • Iritis may occur due to uncontrolled bacterial and fungal infections in the eye.
  • Melanin pigment containing cells in the iris may also abnormally increase in number causing melanoma of eye.
  • Anisocoria is a term used when pupil of the both eyes are of unequal size. If no abnormality exists in the vision, it is considered as a normal condition.
  • Coloboma refers to a long tubular like shape of pupil, causing changes in the reception of intensity of light.
  • Aneurysm of an ophthalmic artery or vein and Horner’s syndrome may lead to pupil shrinkage.
  • Pupillary dilation is seen with pituitary gland tumors.

 

Involving cornea, lens and retina: A thin membrane covering the pupil is the cornea. Lens lies behind the iris while retina forma the innermost layer of the inside of the eye. It is because of the retina that we are able to visualize properly.

  • Keratitis pertains to bacterial inflammation of the cornea whereas keratoconus refers to gradual thinning of it.
  • Herpes simplex virus HSV 1 causes viral infection of cornea known as ocular herpes.
  • Fuch’s dystrophy occurs as a result of gradual deterioration of corneal endothelium due to old age.
  • Retinitis pigmentosa occurs as a genetic disorder leading to death of retinal rods and cones.
  • A genetically inherited disease in which retinal cones and rods fail to perceive certain colors leads to color blindness.
  • Thinning of rods and cones may also cause night blindness i.e nyctalopia
  • Macular degeneration is an age related retinal disease leading to its total disintegration.
  • Diabetic retinal damage occurs in high diabetics due raised intraocular pressure leading to spots on retina. Eventually all retinal damages if untreated  lead to vision loss.
  • Cataract occurs due to a clouding near or at the lens of the eye either due to coagulation of corneal proteins in the lens or excessive ocular pressure due to chronic medications. It leads to blurred vision, frequent headaches and extreme strain on the eye.

 

Involving optic nerve: Optic neuritis refers to inflammation of optic nerve, mostly seen in multiple sclerosis cases. Glaucoma occurs as a result of severely raised  intra-ocular pressure leading to compression of the nerve.

 

Refractive errors: The phenomenon in which the shape of the eye fails to bend light correctly to form an image leading to its blurring is known as a refractive error. In myopia/near sightedness, close objects appear clear, distant ones appear blurred. In contrast to it, in hyperopia the distant objects appear clear whereas the closer ones blurry. Both the disorders are inherited and may appear anytime between child hood to adulthood. Due to aging, the lens looses its ability to flex or bend the light rays falling on it. This condition is known as presbyopia. Astigmatism refers to the abnormal curvature of the cornea leading to insufficient flexing of light and thus poor image perception.

Treatment of ophthalmic disorders:.

·       Dryness, swelling/inflammation, redness, itching are mostly corrected by medications in the form of drops, gels and tubes.

·       Refractive errors are corrected by using spectacles and contact lenses. However wearing these 24x7 becomes quite cumbersome for a few individuals. Thus many resort to lasik eye surgeries i.e laser in situ keratomileusis eye surgeries which use lasers for the permanent correction. It permanently reshapes the cornea allowing sufficient light to fall on the lens and thus enables un blurred perception of image at retina. It is an out-patient department procedure these days, with minimal pain, no stitches/scars involvement and a 90 percent success chance. However dry eyes and the need to wear glasses while reading at times maybe encountered in a few cases.

 Surgical correction:

  1. Cataract: Total blurring of vision, difficulty in gauging colors and extreme eye straining are symptoms that call for a surgical approach. Any of the following two approaches can be chosen:
  2. Phaco-emulsification: It makes use of ultrasound waves to break the lens and thus remove the coagulated parts. The patient can go home the same day.
  3. Extracapsular surgery: In this procedure, a long incision is made in the cornea and cloudy part of the lens is removed. An artificial lens is then placed to enhance vision. The patient may or may not be discharged the same day.
  4. Glaucoma: It is a totally painless/strain less disease involving the optic nerve. The only sign is a raised intraocular pressure; which the ophthalmologist examines. Reconstruction of the optic nerve is the last resort if eye drops and medications fail to reduce the ocular pressure. Laser surgery can also be done to optimize the eye pressure.
  5. Macular degeneration: It is mostly encountered in the old age with the only symptom being almost nil vision which calls for an immediate surgical intervention. There are three surgical methods to treat this condition. These are:
  6. Laser photocoagulation:  It is a bloodless procedure which aims at sealing the retinal blood vessels using laser technology.
  7. Photodynamic therapy with visodyne: It is totally similar to laser photocoagulation process, except that in addition to it a dye is injected into the eye for tracing the course of the blood vessels. The dye used is called visodyne, hence the name.
  8. Anti VEGF therapy: Vasculo-endothelial growth factor VEGF is responsible for the growth and development of blood vessels. In cases of macular diseases of retina, VEGF looses its potential of growing healthy blood vessels and in turn results in the formation of weaker ones. As a result there is a continuous leakage of blood in the retinal tissues. To prevent this, anti-vegf injection is given in the eye.
  9. Diabetic retinopathy: In a procedure called vitrectomy, the vitreous gel and blood leaking in the retina are removed through a corneal approach. As a result of this cleaning, light rays can pass now through the lens and reach the retina, thus improving the vision.

Complications & risk factors associated with ophthalmic diseases:

  • A universal complication associated with eye disorders is old age and the inability to heal.
  • Pre-existing high blood pressure, hyperthyroidism and diabetes are other risk factors which may cause an eye disorder or may aggravate an already existing one.
  • Excessive UV radiation, chronic trauma, smoking/alcohol, raised intraocular pressure are other risk factors.

Success Rate of ophthalmologic disorder treatment:

Laser surgeries done to correct the refractive disorders are 80 percent successful leaving behind only a small percentage of population needing reading glasses again. Surgical approaches used for cataract have 99 percent success chance restoring the normal vision. However, surgical approaches used for glaucoma and diabetic retinopathy are only 64 percent successful in getting the vision back to normal.

Why MedcureIndia?

We at MedcureIndia take utmost care of our clients; considering how valuable their lives are for us too. We aim at directing our customers to the excellent institutes offering top class opthalmic services at affordable rates, assuring the best treatment outcomes.