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What is LASIK?

Laser Assisted In-situ Keratomileusis or LASIK, is an outpatient procedure used to treat myopia (near sight), hyperopia (far sight) and astigmatism. In LASIK, your ophthalmic specialist uses a microsurgical instrument and a specialized Excimer laser beam is used to reshape the cornea. Reshaping your cornea alters the focusing power of the eye, allowing you to become less dependent on glasses or contact lenses. In most people, LASIK allows you to do without them entirely.

Why should you consider LASIK?

For many years, the only way people could correct their vision was to wear spectacles. Over the last forty years, contact lenses have become increasingly popular as their design and availability has improved.
More recently, LASIK has been a major breakthrough among vision correction techniques. With its outstanding results, LASIK has rapidly gained acceptance as a realistic alternative and enabled millions of people worldwide to enjoy a new found freedom living their lives without the inconvenience of glasses or contact lenses.

How does LASIK work?

The Cornea provides two thirds of the eye's focusing power. Altering its shape changes the power of the eye. LASIK flattens the cornea to correct myopia (near sight) and steepens the cornea for hyperopia (far sight). The reshaping process can also be used to correct astigmatism at the same time.
The specialist creates an ultra thin corneal flap, using a highly specialized instrument called a microkeratome. The Excimer Laser is then used to reshape the cornea under the flap. The flap is replaced and adheres firmly and fully without the need for stitches. With the flap in place, the eye recovers quickly and vision is rapidly restored with minimal discomfort.
Our technology:
Our experienced specialists, after exhaustive research, have decided on the MEL 80 Excimer Laser, manufactured by Carl Zeiss, Germany, renowned for their innovative and cutting edge equipment. The MEL 80 incorporates the latest WAVEFRONT technology for diagnosis and treatment, allowing CUSTOMISED treatment for all. With its industry leading parameters in speed, laser spot size and tracking, the MEL 80 sets new standards in delivering accurate and consistent visual results.

Who is suitable for LASIK?
You may consider this procedure if you:

  • Are over 20 years old and have had a stable prescription for at least 1 year
  • Have healthy eyes with no diseases (e.g. cataract, glaucoma)
  • Are in good general health
  • Are not pregnant nor planning pregnancy in the immediate future

What happens after LASIK?

  • Vision: Visual recovery is rapid after this procedure and most people will see well within a day or two.
  • Pain: The procedure and recovery is painless
  • Time off: You will be able to come in for treatment over the weekend and return to work without taking time off from work.
  • Restrictions: There are very few restrictions during recovery. Antibiotic and anti-inflammatory drops have to be instilled for about a week after surgery.
  • Enhancement: Most people attain the clear vision they hoped for after one treatment. In the rare event of regression or if the desired correction is not achieved by your first procedure, then your consultant may recommend an enhancement, which is an easier procedure.

Risks, complications and side effects:

Like any procedure on the body, LASIK has risks and complications that should be carefully considered. Sight threatening risks are extremely rare and should not be a cause for concern. Most complications are minor and can be treated without any loss of vision. Some people experience temporary side effects after LASIK that disappear in time.
If you have been waiting for a safe alternative to set you free from your spectacles and contact lenses, then LASIK may be your answer.

Other Refractive Procedures

LASEK / EPILASIK: This procedure also incorporates excimer laser to change the focusing power of the cornea. This procedure is recommended for cases with thinner corneas.ICL (Implantable Collamer Lens) Implants: Introduction of a thin collamer lens inside the eye. This is indicated in patients with very high refractive errors with excellent results.

  • Cornea Transplantation Surgery

Cornea Transplantation is one of medicine's big success stories. For patients, it's little short of a miracle-a one-hour operation that can restore that most precious of senses, our sight. It is one of the most commonly performed transplant operations and with modern surgical techniques and drugs the success rate is very good.

Why do people need transplants?
The transparent cornea tissue is very thin and when damaged by injury or disease it can become cloudy or lose its natural shape, both of which can lead to blindness or limited sight.
Among older people, age-related or inherited conditions.

People in their 20s and 30s, Keratoconus (in which the cornea becomes progressively thinner).
To treat painful diseases or trauma.

Infections: In rare cases, a cornea transplant might be needed if there's an infection in the cornea that does not respond to antibiotics and keeps returning.
To treat corneal blindness because of trauma or disease

How does cornea and tissue donation work?
Cornea and tissue donation is only considered after a patient has died. One donor can restore the sight of two people through a cornea transplant. Donated corneas are stored in Corneal Transplant Service Eye Banks and can be kept for up to four weeks.

About the Surgery:

  • A new cornea can be transplanted in as little as an hour
  • First, a disc of damaged corneal tissue is removed
  • This is then replaced by a disc of healthy tissue taken from a donated cornea, and the graft is stitched in place with super-fine sutures
  • The patient will wear an eye-patch for a day or two and will have to use steroid drops but the transplanted cornea will gradually clear, restoring sight

What happens to donated eye tissue?

Corneal tissue can be stored in a special eye bank for up to four weeks before transplant, which helps ensure that donated corneas are available for emergency use as well as for planned operations.
The urgent need for more donors:
Sadly many corneas that could be donated go to waste because people have not registered or told their loved ones of their wish to donate. About 2,000 people become donors each year, but there remains a shortage of corneal tissue for transplant and many more patients could benefit from this life-changing operation if donation increased.
Manipal Eye Care provides the facility for Eye donation. To become a future donor, just walk into Manipal Eye Care Out Patient Department, and pledge your eyes.

Squint Eye Surgery

What is squint or strabismus?
Six muscles control the movement of each eye. Each of these muscles acts along with its counterpart in the other eye to keep both the eyes aligned properly. A loss of coordination between the muscles of the two eyes leads to misalignment. Squint is a misalignment of the two eyes where both eyes are not looking in the same direction. This misalignment may be constant or may be present throughout the day or it may appear occasionally and the rest of the time the eyes may be straight; this is called as intermittent squint.

What causes squint?
The exact cause of squint is not known. The reason could be:

  • Congenital squint: Congenital squint means that the child is born with a squint, or it develops within the first six months of age
  • Refractive errors: Squints are sometimes caused by the eye's inability to focus on the light that passes through the lens. This is known as a refractive error. Types of refractive errors include:
  • short-sightedness (myopia) - a sight problem that affects your ability to see distant objects
  • Long-sightedness (hyperopia) - a sight problem that affects your ability to see close-up objects
  • astigmatism - where the cornea at the front of the eye is unevenly curved, which causes blurred vision
  • Other: Most squints are congenital or refractive, but there are some that can occasionally be results of:
  • Childhood illnesses, for example viral infections such as measles
  • Genetic conditions, such as Noonan syndrome
  • a brain condition, such as hydrocephalus, where there is a build-up of fluid in the brain
  • eye problems, such as abnormal development of the muscles that move the eye, or a problem with the retina (the layer of light-sensitive nerve cells at the back of the eye)
  • having a family history of squints or lazy eye (amblyopia)
  • being born early (prematurely) or with a low birth weight

What is 3D vision?

When both the eyes have good vision and are aligned properly, they focus on the same object, and sends picture of the same object, from different angles. These two images reach the brain where they are fused to form a single 3D or three- dimensional picture, known as a 3D vision. This gets affected in children with squint.
What are the problems faced by a patient with squint?
When the eyes are not aligned properly, each of the eyes is focusing on a different object and sends signal to the brain. These two different images reaching the brain lead to various problems that are different in children and adults.

In children it can cause loss of depth perception (3D vision) and lazy Eye Disease (poor development of vision in the squinting eye).
An adult can't ignore the image from either eye, and therefore they can have double vision. This can be very annoying and may interfere with work. Loss of 3D vision and cosmetic deformity are also causes of concern.

What are the symptoms of squint?

In a child, the parents may notice the deviation of eyes. It is important to remember that the eyes of a newborn are rarely aligned at birth. Most establish alignment at 3-4 weeks of age. Therefore squint in any child who is more than one month old must be evaluated. Adults noticing double vision, or misalignment of the eyes should get themselves checked up too.

What are the treatment options?

Early treatment can help save the vision.
Children rarely outgrow a true squint. If treatment is delayed after the age of eight, the child will see with only one eye even after the squint is corrected by surgery. This is because until the age of eight both the eyes develop and work together. When there is a squint only one eye works. If the squint is operated upon after the age of eight, only a cosmetic result can be achieved as the eyes are already developed by then.

  • Glasses: If the child has a significant refractive error, glasses are a must. In some cases wearing glasses may correct squint. In other cases, wearing glasses help the eyes to see clearly. This clear vision is very important for the prevention of amblyopia, and also for maintaining the alignment of the eyes after they have been corrected by surgery. Remember surgery cannot replace the need for glasses
  • Patching Therapy: In some children, squints cause the affected eye to become 'lazy' and stop working properly. Patching of the 'good' the eye will make the lazy eye work harder, which in turn will improve vision.
  • Surgery: Treatment of squint generally requires eye muscle surgery. The best way to determine whether straightening of the eyes is possible and appropriate is to ask your doctor.

What preventive measures can be followed?

  • Avoid marriages between blood relations.
  • Treat all eye defects among children as early as possible.
  • Convergence exercises help to coordinate the eye movements.
  • Pediatric ophthalmologists are specially trained to manage the following disorders:
  • Squint or Strabismus: Squint is a misalignment of the two eyes where both eyes are not looking in the same direction. This misalignment may be constant or may be present throughout the day or it may appear occasionally and the rest of the time the eyes may be straight; this is called as intermittent squint.
  • Amblyopia: A child with strabismus also has a chance of developing Amblyopia. Amblyopia occurs when the pathways that carry vision messages from the eye to the brain are not strong enough; As a result, the brain favors the other eye. The condition is also known as lazy eye. Amblyopia happens to be the most common cause of vision problem in Children.

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