What is a Cataract?

A cataract occurs when an opaque or cloudy area develops in the normally clear lens (responsible for the focusing mechanism) of the eye. This cloudy area scatters and blocks the light as it passes through the lens, preventing a clear image from reaching the retina (light-sensitive tissue at the back of the eye). clouded vision caused by cataracts is often described as seeing through a frosty or foggy window. When the cloudy vision interferes with daily activities such as reading or driving a car, undergoing surgery is recommended to remove the Cataract.

Dr. Vishakha Jibhakate & Dr. Yogesh Jibhakate are the specialists at Indrakshi Eye care who does cataract surgery.

Cataract ( Motibindu ) Treatment

Cataract ( Motibindu ) Surgery

Modern cataract or lens replacement surgery is one of most successful surgeries known. It is effective in restoring vision to most patients. The surgeon makes a tiny incision on the side of the cornea, removes the eye’s clouded natural lens after dissolving it (using a procedure known as Phacoemulsification) and then replaces it with an artificial ‘Intraocular Lens’ (IOL). Because the incision is very small, stitches are not required and the eye heals quickly, allowing the patient to return to routine lifestyle within a week. Modern cataract surgery is a safe outpatient procedure that barely takes about 10 minutes. Newer advancements such as whitestar phaco (cold phaco) and microincisional phaco emulsification (MICS) have increased its safety even further.

What Is An IOL?

An Intraocular Lens (IOL) is the replacement lens that is surgically implanted in the eye to replace the existing natural clouded lens during cataract surgery.

Oertli Phaco Machine used in Cataract Surgeries at Indrakshi Eye care.

Types Of IOL

The design of IOL decides your need for spectacles after the surgery. Newer advanced IOL (Toric, Multifical and Accomodative) can treat cataract and get rid of spectacle power too.

Monofocal IOL

A standard mono-focal IOL has one point of focus, which is usually distance vision. If you choose standard IOLs, you will generally need glasses for near activities like reading. On the other hand, if your mono-focal IOLs are focused on near vision, you would need glasses to see distant objects clearly.

Optical Biometer for Lens Power Calculation.

Toric IOL

Astigmatism means that your eye is shaped more like and egg than a round ball. This irregular shape causes blurry vision.20% cataract cases have astigmatism, which requires them to wear cylindrical powered glasses after the cataract surgery with monofocal lenses. The toric lens is a special form of a single vision cataract lens that has astigmatism correction built right into the lens implant. If you like the idea of a single vision intraocular lens and have astigmatism, then a toric lens would be a great choice for you. A toric lens that corrects your astigmatism inside the eye does a better job of correcting your vision than a pair of glasses that sit out away from your face.

Multifocal IOL

As against monofocal IOL, which focuses at only single distance; A multi-focal IOL contains multiple zones that focus light at a variety of distances, allowing you to see a continuous range of vision without glasses. This results in excellent visual acuity of close up and far away objects. Many patients report the ability to read small print and see distances, both without glasses. This lens can however, produce rings or halos around bright lights and may make it difficult to see in low light situations, such as driving at night. While most patients adapt to this effect over a period of several months.

GLAUCOMA SERVICES

Glaucoma is the leading causes of irreversible blindness worldwide. In India alone, it affects around 12 million people; India is projected to become the world capital of glaucoma by 2020. The sight loss caused by glaucoma is progressive and, unlike cataract, is irreversible. Fortunately, early diagnosis and treatment can prevent blindness.Glaucoma is a disease of the nerve for vision (optic nerve) caused by increased pressure in the eye.95% patients with glaucoma do not have any symptoms. Glaucoma is a silent disease that cannot be detected or felt by the patient since central vision remains unaffected till the late stages of the disease. Hence it is rightly called as the ‘sneak thief of sight’. It is usually detected during a routine eye checkup.

Dr. Amar Bhaskare is the specialist from Nagpur who comes to Indrakshi Eye Care to treat Glaucoma.

The department is equipped with state-of the art diagnostics and imaging facilities that includes computerized visual field testing, Optic Nerve imaging, Spectral domain OCT Pachymetry. The team is dedicated to the care and treatment of Glaucoma patients.

Types of Glaucoma

• I. Primary Glaucoma
• II. Secondary Glaucoma

Open angle & angle closure glaucoma are the common forms of the disease. The treatment of Glaucoma depends on the severity of the disease and early detection of the disease. Rarely there can be acute rise in intraocular pressure resulting in emergency. Laser treatment to reduce the intra ocular pressure. Glaucoma can be treated & controlled but cannot be cured completely and if not treated can result in blindness.

Post op photo of Trabeculectomy.

Who are at the risks of developing glaucoma?

• Anyone above the age of 40yrs
• Hypertension
• Family history of glaucoma
• Patients on long term steroid medications
• Patients with chronic eye diseases.

Glaucoma management includes careful clinical evaluation assisted with advanced imaging devices and visual field analyzers. Treatment includes medical (eye drops), Laser and surgical intervention. This treatment depends on the stage of the disease at the time of diagnosis. Appropriate and early detection can avoid blindness. Trabaculectomy is the most commonly performed surgery for glaucoma. YAG Laser iridotomy helps in treating angle closure glaucoma. The final action of treatment is to allow the patient to lead an independent and fully functional lifestyle.

The Department is equipped with

• Humphrey Visual Field Analyzer
• Retinal Nerve fiber layer Analyzer
• Optical Coherence tomography (OCT)
• Ultrasound Pachymetry
• Anterior Segment OCT
• I care Tonometer
• Non contact Tonometer
• Applanation Tonometer
• Nd YAG Laser

Perimeter

Visual Fields with Perimeter

Diagnostic Facility

Tonometry

The technique of measurement of pressure within the eye (intra ocular pressure IOP/IOT) is called tonometry. This is very important since IOP is one of the indicators of Glaucoma. Tonometry is recommended in everyone over the age of 40, family history of glaucoma. This technique can be performed with either Applanation or non-contact Tonometer.

Ophthalmoscopy

Ophthalmoscopy is used to examine the inside of the eye, especially the optic nerve this helps the doctor to assess the condition of the optic nerve

Humphrey Visual Field Analyzer

During this test, you will be asked to look straight ahead and then indicate when a stationary light appears in the field of vision. This helps draw a “map” of your field of vision. This is a non invasive computerized test which takes about 10-20 minutes to perform and gives information regarding optic nerve damage due to glaucoma.

Glaucoma and Optic Nerve Head Digital Photograph

During the tests a detailed photo of the Optic Nerve is taken and documented. This helps in assessing the progress of the disease.

Optical Coherence Tomography (OCT)

Optical coherence tomography is a new, noninvasive, noncontact, imaging technology capable of early detection of glaucoma through its ability to evaluate the nerve cells damaged in glaucoma.

Medical Treatment

Glaucoma is usually controlled with eye drops taken daily which prevent damage to the optic nerve by lowering eye pressure, either by slowing the production of aqueous fluid within the eye or by improving the flow out of the eye

Laser Treatment

YAG LASER IRIDOTOMY

Yag laser iridotomy is performed almost exclusively for patients with narrow angle glaucoma, or acute angle closure glaucoma. Yag laser iridotomy involves making a tiny opening in the iris with a laser, which allows fluid to drain freely. The laser peripheral iridotomy procedure is usually completed as a brief outpatient procedure. Prior to the procedure, the pupil is often constricted with an eye drop medication known as pilocarpine. The procedure itself is completed with the patient seated at the laser, and requires no sedation. Usually, a lens is placed on the eye after topical anesthetic drops are applied to better control the laser beam. The entire procedure only takes a few minutes. The lens is then removed from the eye and vision will quickly return to normal. After the procedure, your eye surgeon may recommended anti-inflammatory eye drop medications for the next few days. A post-op visit will be scheduled

What is Squint?

Squint or strabismus is a misalignment of the eyes so that the eyes do not point in the same direction. Squint can itself lead to amblyopia or lazy eye. More importantly squint if present since childhood can itself lead to loss of three dimensional vision or depth perception (stereopsis). Many cases can be treated with glasses. Orthoptic exercises are useful in some cases. Prism trials can be used as a temporary or permanent measure. Squint can itself lead to cosmetic disfigurement, in addition in children there is a risk of amblyopia.

Dr. Shikha Yadav is the Specialist at Indrakshi Eye care who does surgeries of squint.

Under such circumstances, it is important that one corrects the squint early. In addition there is a beneficial effect of correction of squint even in older adults as there is improvement in binocular vision. The simplicity and ease of surgery means some patients start work the next day after surgery. The results are very good with a proper clinical assessment and surgery.

The most common types of squint

Esotropia (convergent squint) :

Convergent squint can be corrected many a times by glasses. Early correction is recommended especially in the convergent squints as there is a higher risk of amblyopia and loss of binocularity.

Exotropia (divergent) :

Divergent squint can again be corrected with glasses, but more commonly needs surgery.

Vertical squints are tackled especially in cases of superior oblique muscle palsy or Brown Syndrome and need proper planning, surgery is however easy to perform.

Nystagmus can also be considered as a form of squint and indications for surgery include head posture or need for dampening the nystagmus. Newer surgeries for this condition give successful outcomes.

What are the signs and symptoms of a squint (strabismus)?

• 1. One of the eyes does not look straight ahead, but veers.
• 2. Infants (newborns) may go cross-eyed, especially if they are tired. This does not mean they have a squint. Concerned parents should check with their doctor.
• 3. If you notice that your child has one eye closed, or turns his/her head when looking at you, this could be a sign of double vision, and a squint is possible. Check with your doctor.

What are the causes of a squint (strabismus)?

• 1. Congenital or Heriditory. In the majority of cases, people are either born with strabismus or develop it during their first six months after birth.
• 2. Due to some Refractive Errors [If the Child has a Spectacles] as the child may turn the affected eye inward in order to get a better focus.
• 3. Associated Neurological Conditions [ Brain Disorders]
• 4. Viral infections, such as Measles

What are the treatment options for a squint (strabismus)?

A diagnosed squint needs prompt treatment, otherwise there is a serious risk of complications, such as amblyopia (lazy eye). The younger the patient is, the more effective treatment is likely to be.

Glasses - if the child is found to hypermetropia (long-sightedness), they will be prescribed glasses which usually solve the squint.

Eye patch - this is worn over the good eye to get other eye, the one with the squint, to work better.

Orthoptic Exercises -The doctor may also prescribe eye drops, and get the patient to do specific eye exercises.

Botulinum toxin injection (Botulinum) - this is injected into a muscle on the surface the eye. The doctor may recommend this treatment if no underlying cause can be identified, and if signs and symptoms come on suddenly. The injected muscle is weakened temporarily, which often helps the eyes to align properly.

Surgey - surgery is only used when other treatments have not been effective.can restore binocular vision, as well as realign the eyes. The surgeon moves the muscle that connects to the eye to a new position - sometimes both eyes need to be operated on to get the right balance.

Oculoplastic surgeries are the surgeries of the eyelids and structures around the eyes. Dr. Gunjan Rathi Kelkar is an ophthalmologist specialised in these complex surgeries. She has recieved speciality training in Oculoplasty, Orbit, Ocular Oncology and Aesthetics. She has multiple publications to her name. Dr. Gunjan has successfully managed 12000+ oculoplasty patients and has done around 2500 oculoplastic surgeries. She practices in Nagpur and is attached to more than 15 reputed hospitals across Central India and Mumbai providing high quality speciality eye care services .

Dr. Gunjan Rathi is the Specialist from Nagpur who does all the surgeries of Oculoplasty at Indrakshi Eye Care.

What is retina in our eye?

The Retina in our eye, is a nerve tissue that lies at the back of the eye and is responsible for the sense of the light, and creates an impulse or series of impulse that travels through the optic nerve to our brain. Retina is the most important part of the eye and is responsible for the vision to happen. Due to its importance in the eye, any damage to the retina can result in permanent damage to the eye and complete vision loss.

Dr. Pritam Bawankar is the Specialist from Nagpur who comes to Indrakshi Eye Care to do Surgeries of Retina.

What are the types of diseases associated with Retina and their symptoms?

Age-Related Macular Degeneration (AMD):

Age-Related Macular Degeneration or AMD, often occurs at the later stage of life and is related to a central vision loss in eye. Almost 3% of the world population have this condition and lose their vision partially or completely.

Topcon NCT and Keratometer

The symptoms can include blurry vision, warped central lines, and difficulty in focusing on a single point. In some severe cases blind spots can also appear making it difficult for the person to clearly see things. Fortunately, there are treatments for AMD which may include blocking the growth of unhealthy blood vessels or giving oral nutritional supplements and anti oxidants..

Pre & Post operative maculer hole.

Retinal Detachment:

Retinal Detachment is a major problem and should be not considered lightly. When too much fluid accumulates at the back of the eye this can result in causing separation of the retina. There are also other risk factors which can increase the chances of Retinal Detachment over a period of time:

• Extreme nearsightedness ( High myopia )

• Previous retinal detachment in the other eye

• Genetic predisposition

• Previous complicated cataract surgery

• The presence of other eye disorders

• Eye injury

Reticare Machine

If you are experiencing an increased presence of floaters over a period of time, or the sudden development of a curtain like structure in your field of vision, this can be an indication of retinal detachment. It is highly recommended that you visit an eye doctor immediately. An early, intervention can reduce the chances of permanent vision loss.

High tech Green Laser machine used at Indrakshi Eye care to treat Retina patients.

Retinitis Pigmentosa:

This type of disease is normally associated with heredity and genetics. In Retinitis Pigmentosa, there is a gradual loss of vision over a period of time as rods and cones die and cause retinal degeneration. Leber’s congenital amaurosis, Usher syndrome, Bardet-Biedel syndrome, rod-cone disease, and Refsum disease are some examples of conditions that are classified as retinitis pigmentosa.

LASIK AND REFRACTIVE SERVICES

Everyone deserves clear sight without the aid of glasses or contact lenses. We offer the ideal solutions- LASIK Surgery and Implantable Contact Lens (ICL) surgery.

LASIK surgery alters the shape of the surface of the cornea so that the light rays bend in such a manner as to focus on the retina perfectly. LASIK, a form of refractive surgery, corrects vision and eliminates your dependency on glasses or contact lenses. Laser in-situ keratomileusis (LASIK) corrects myopia, hyperopia, or astigmatism.

Dr. Yogesh Jibhakate is the Specialist at Indrakshi Eye care who does Refractive Surgeries.

ICL Surgery is the latest technology in Refractive Error Correction. As the name suggests a contact lens is implanted in the eye in front of the natural lens. A detailed screening is performed to assess the patient for the surgery which is carried out only when all parameters are met.

Benefits of ICL Surgery

• Latest Technology

• Suitable for all, even those with very high powered glasses

• Reversible procedure

• Lens can be removed when cataract surgery becomes necessary

• Performed by Ophthalmologist with International Certification

Corneal diseases can cause clouding and distortion of vision, and eventually blindness. There are many types of corneal diseases and infections such as bacterial, fungal and viral infections related to contact lenses, abrasions from trauma, and inflammation, all of which need early treatment for preservation of vision.

Indrakshi Eye care network provides avenues for development of newer treatment modalities in collaboration with the industry and develop innovative surgical technologies to bring best possible eye care to the patients. Research forms an integral part of the Corneal Services at Indrakshi Eye Care.

Dr. Shikha Yadav is the Specialist at Indrakshi Eye care who does surgeries of Cornea.

Indrakshi Eye Care, Bhandara is the first NABH Accredited Eye care center in entire Bhandara district, which has experts available for all types of Eye complications like, Cataract, Cornea, Glaucoma, Retina, Squint & Oculoplasty.

The latest techniques in Corneal Transplantation like Lamellar Keratoplasty (Deep Anterior Lamellar Keratoplasty and Endothelial Keratoplasty) are performed with good quality tissues. Penetrating keratoplasty can be done for patients who are not suitable for above procedure. Corneal collagen cross linking, which strengthens cornea and prevents further damage is done to treat Keratoconus.

Indrakshi Eye care is empanelled with MJPJAY (Mahatma Jyotiba Phule Jan Arogya Yojna). Infact Indrakshi Eyecare is the only Eye hospital in Bhandara to have MJPJAY empanelment.

Under MJPJAY scheme thousands of patients have been treated FREE OF COST. And many of needy and poor patients are still being treated free of cost at Indrakshi Eye care.

Indrakshi Eye care is empanelled with many of Reputed Private Insurance companies so that patients will get hassle free, cashless treatment at Indrakshi Eye care, Bhandara.about-contain

There are many more Empanelments which are widely used accorss the country which are mentioned below. Apart from these there are many of other reputed companies that Indrakshi Eye Care is empaneled with like, United India Parekh, Ericson, Spurthi, Happy Insurance, Cigna TTA, Grand Health, Health India, Medi Assist, Paramount, Raksha TPA etc.