Why Some People Are Not Suitable For Lasik?

Nov6

Why No Lasik For Me? As a Lasik surgeon, I have to answer this question many times. Just a few months back, Samarth came to Advanced Eye Hospital for his eye check-up and Lasik evaluation. He had just turned 18 and he was basically looking forward to being 18 so that he will get the permission from his parents to get rid of his glasses. And on top of his own desire, he had an additional requirement. He was planning to get admission into merchant Navy and as a perquisite to that he needed to be glass free. At the Eye hospital, a detailed pre-Lasik evaluation was carried out which included eye number and eye pressure check, corneal mapping (Corneal Topography), corneal thickness, eye length, muscle balance, dry eyes status, health of cornea (Specular Microscopy), retina and optic nerve checking. All his tests were normal other than his corneal topography. His topography was suggestive of a forme fruste keratoconus. This basically means that there is a disease in cornea which is not manifesting itself fully at that stage but under certain conditions can become a full-blown disease. When Lasik or any other corneal based Laser procedure is carried out on the cornea, it becomes weaker. So, if cornea is weak to begin with then doing Lasik can harm it in the long run and cause keratoconus to become fully manifest. Cornea can develop a disease called post-LASIK ectasia. Even though modern surgeries like ReLEx smile is better suited for thin corneas but in situations like these where there is a pre-existing disease it is better to avoid any surgery on the cornea.

No eye doctor will advice the patient to take that kind of risk. So unfortunately, I had to advise him against Lasik. He was however suitable for ICL (Implantable contact Lens). He went through ICL surgery, got freedom from glasses and also secured the admission into Merchant navy. Sometimes when one door closes, other opens up!

This story brings an important question, what makes some people unsuitable for Lasik?

Age- People with age less than 18 are usually advised to wait to get their Lasik done
Unstable glass power- LASIK is best done when eye power has been stable for atleast one year. What one needs to understand is that LASIK removes the eye power as per the current eye power. If eye power is not stable and is bound to increase in future, then even after a previous Lasik, eye power will increase. To prevent that from happening we postpone the surgery to future years and plan once the eye power is stable.
Thin corneas- In Lasik surgery, laser is used to change the curvature of the cornea and this whole process makes cornea thinner by some amount which is dependent on patients’ eye power. So, if a patient already has thin corneas then the procedure may not be safe.
Abnormal corneal maps- Corneal topography gives us the maps of the cornea. It ensures that there is no underlying sub-clinical corneal abnormality such as Keratoconus or suspect Keratoconus which can become a full-blown disease after Lasik surgery. So, if topography maps show any abnormality, we have to decline the procedure.
Advanced Glaucoma- A patient who is a known case of glaucoma controlled on two to three medications and has advanced visual field defects or gets detected during Pre-LASIK evaluation. In either scenario we avoid performing Lasik on these eyes to reduce interference with glaucoma management.
Squint or gross eye muscle abnormality- Anybody who is at risk of developing squint based on pre-operative evaluation may be advised to defer the LASIK surgery. In some cases, we go ahead with LASIK knowing that patient may require a squint correction after LASIK surgery.
Severe Dry eye- People who are already suffering from severe dry eyes and produce lesser quantity or poor quality of tears are also advised to defer LASIK surgery. If the condition improves and we rule out any permanent reason for severe dryness, then LASIK can be done in future.
Uncontrolled Diabetes or autoimmune diseases- these diseases can interfere with proper healing after LASIK and in fact increase the risk of corneal meting and infections. In these conditions we usually defer any form of non-urgent eye surgery.

Long term safety is paramount and should be kept in perspective before planning any Lasik. A detailed pre-Lasik evaluation reveals all the subtle and obvious features pointing towards future risks. Additionally, pre-Lasik evaluation helps us in deciding the most suitable options among the many different types of procedures like wavefront guided Lasik, contoura Lasik, Femto Lasik, Smile Lasik and surface ablation like PRK.

If you have been advised against Lasik, please do not get disheartened. ICL implantation and Refractive lens exchange are some of the other options which can be explored.

About Advanced Eye Hospital and Institute:

Advanced Eye Hospital and Institute in Navi Mumbai is one of the best eye hospitals in Mumbai. Eye check-up rooms and the operation theatres are state-of-art and equipped with the best diagnostic and eye surgery machines. Team of Eye doctors are very experienced and trained from the best institutions in the world. Personalised care, infection free modular operation theatres and beautiful ambience compliment the cutting-edge eye care offered at AEHI. Besides treating patients from Kharghar, Nerul, Seawoods, Sanpada, Belapur, Vashi, Ghansoli, Airoli and Panvel, patients from all over western India travel to AEHI for world class eye care management.

Best Lasik surgeon Navi Mumbai — Dr Vandana Jain – Lasik Surgeon expert

About Dr. Vandana Jain

Dr. Vandana Jain is an experienced eye doctor dealing with cornea, cataract, and laser vision correction procedures. She has been performing all kinds of cornea, cataract, and Lasik surgeries for more than 15 years. She is a sought-after eye doctor and admired by her patients for her skills and friendly nature. She is very meticulous in her work and believes in giving her best to each and everyone.

Can ICL be done after previous Lasik

Sep22

Can someone get eye power again after previous Lasik? Can Lasik be done again? Is it safe to repeat Lasik? Are there other options? People who are planning to get Lasik done, often ask me these questions. So, there are two kinds of situations- One where the numbers were so high that it cannot be completely removed with Lasik safely and hence the patient and Lasik surgeon collectively decide to leave some residual eye power. Second situation is where the number was completely removed but later after many years there was a recurrence of eye power.

Radha was one such patient who had an extremely high eye power and her eye power was not completely removed during her previous Lasik. She got it done almost a decade ago, when she was just 18, somewhere in North India. Now she is close to thirty and a mother of two. Her eye power had increased over the years and she needed to wear a -5D in both her eyes. She was unable to see without her glasses and hence was dependent on them. She came to me to get a repeat Lasik done. She underwent series of eye tests as part of detailed Pre Lasik evaluation. Unfortunately, her corneal thickness was not sufficient, and she was not suitable for a repeat Lasik. But all the other eye parameters were normal. After initial disappointment, she was delighted that she can still get rid of her glasses. I gave her the option of Implantable Contact lenses (ICL). These are tiny lenses which are inserted inside the eye and rests in front of the natural lens inside the eye. These are not visible to anyone and becomes part of the eye. Millions of people have undergone ICL world over with great results. The parameters of Radha’s eyes were suitable for ICL. She of course had a series of questions related to ICL which I happily addressed. Here is the brief of our discussion

After how long will I be able to see after ICL?

After ICL surgery, vision improvement is almost instantaneous. However, initially slight haziness may be experienced which improves gradually over a period of few days

What precautions are needed after ICL and what about recovery period?

Just like Lasik, some minor precautions are needed after ICL. To prevent the risk of infection, person must be careful while bathing for a week to ten days. No eye makeup, swimming, and hot spa etc are allowed for 2 weeks. Heavy workout should be deferred for 2-3 weeks. Excessive digital strain on eyes should be prevented for a week.

Can I drive and go out after the surgery?

A person can drive and go out as soon as they feel comfortable which can be next day as well.

What are the risks and side effects after ICL?

Just like any other eye surgery, there is a risk of infection. To prevent that from happening one has to take care and follow all the post-surgery instructions. There is a small risk of high eye pressure which in most circumstances can be managed with medicines. There is also a small risk of cataract formation. This usually happens due to sizing issues or occasionally when surgery is performed by a novice surgeon. If cataract is significant, then cataract surgery needs to be performed. If it is minor and due to sizing issues, then ICL can be removed from the eye to prevent the risk of further progression of cataract.

What is I am not happy with ICL?

That is a rare situation that someone is not happy with ICL but in that rare event, ICL can be removed from the eye.

Will anyone get to know that I have a ICL lens inside my eye, will it reflect in my photographs?

No one gets to know by looking at your face or your photographs that you have a ICL inside your eye. ICL mostly does not give any reflections in photographs.

Radha had a Lasik eye surgery done when she was not very mature and didn’t ask any questions. Now, she wanted to make sure that she takes an informed decision. After getting a satisfactory reply to all her questions, Radha scheduled her ICL surgery. She underwent ICL procedure one by one in both her eyes. Today she is glass free and has to no longer save her glasses from her two munchkins!

So, ICL or IPCL can be a great addition to Lasik for a lot of people-

People who are not suitable for any of the types of Lasik like Contoura Lasik, Femtolasik, Smile Lasik
People whose eye powers are very high and cannot be completely removed with Lasik
People have a recurrence of eye power after previous Lasik and Lasik cannot be repeated

I have been doing ICL for the last 14 years and that has given me even enough confidence to continue to recommend it to my patients.

About Advanced Eye Hospital and Institute:

About Dr. Vandana Jain

Is ICL a good alternative to Lasik?

Sep8

Sushmita used to wear thick glasses. She started wearing glasses when she was in 5^th standard. Over years her eye powers increased, and the thickness of her glasses increased. More often than not it was a source of embarrassment and low self-esteem for her! So, when she was introduced to contact lenses in college, she took to it rapidly. So much so that the only time she would remove her contact lenses was when she was sleeping. However, much to her disappointment, in less than a decade she started developing side effects of excessive contact lens use. Often her eye doctor would instruct her to discontinue contact lenses before she was allowed to resume it again. During those times she would hide inside her house for the fear of people noticing her thick glasses. It became a vicious cycle where as soon as she resumed contact lens wear her eyes would start developing some or the other problem like dry eyes, eye allergies, and sometimes corneal infiltrates (corneal infection). Finally, she was advised to stop the contact lens wear altogether and explore alternatives. This is when she contacted me at Advanced Eye Hospital in Sanpada, Navi Mumbai.

At the eye hospital, a battery of tests were performed like corneal topography, corneal thickness, dry eyes test, muscle balance teats, specular microscopy( endothelial cell count of cornea) and AC depth (depth of the front of the eye). Also, we ascertained the health of her retina, drainage angles and optic nerve, among others. After a detailed eye testing, it was clear that she was not a suitable candidate for Lasik or any of the other types of Lasik Like Femto Lasik, Smile Lasik, and PRK. The reason for that was her high power of -15D along with her thin cornea.

However, her AC depth, specular counts and other parameters were good. This was really a blessing in disguise for her given that she really needed to get rid of her glasses and not suffer the misery of contact lenses. I explained to her in detail about phakic IOL’s (Implantable contact lenses) which were a great option for her. After having performed ICL implantations in people for more than 15 years, I felt comfortable in advising Sushmita to consider it.

So, what exactly is ICL and why it is a great alternative to Lasik-

Implantable Contact Lenses (ICL) are tiny thin lenses which can be inserted inside the eye to get rid of eye power.
ICL’S become part of the eye and do not need wearing or removal like regular contact lenses
ICL’s are positioned in front of the natural lens inside the eye and require a quick surgery to be inserted inside the eye.
Unlike Lasik, it does not induce any thinning of the cornea and hence it is a great option for people with higher eye powers
Since it does not alter the corneal curvature or thickness, the quality of vision in patients with higher power is superior than Lasik
Unlike Lasik, corneal nerves are not affected, so the possibility of dry eyes is also less
Unlike Lasik, ICL is a reversible procedure and these lenses can be easily removed from the eye through a minor eye surgery.
Not everyone is suitable for ICL and it has its own suitability criteria

It is paramount that anyone wanting to get rid of glasses and is looking for an alternative to Lasik, give a serious consideration to ICL. But just like Lasik, a detailed pre-ICL evaluation is mandatory. So, after discussing in detail about ICL, she opted for the ICL surgery.

She underwent ICL surgery in both her eyes in rapid succession. She has been one of my happiest patients. At the end of the day there is no substitute for the joy and convenience that great options like ICL bring out for patients like Sushmita.

About Advanced Eye Hospital and Institute:

About Dr. Vandana Jain

What Is The Cost Of Lasik?

Aug26

Aparna had come to consult me for Lasik. We did a detailed pre-Lasik evaluation for her. All her parameters were normal, and she was suitable for all the different types of Lasik right from Lasik to Femtolasik to Smile Lasik. I explained everything to her, and she was very happy to know that she can finally get rid of her glasses. The comforts and pleasures of life without the burden of glasses is something only someone with glasses can understand! Her happiness was palpable. She wanted nothing but the best for her eye and she decided to go for SMILE Lasik. Soon after, she met my surgery counselor who explained her everything else including the cost of various types of Lasik. After getting the information related to the cost of various types of Lasik, she came back to me and expressed that that the cost is more than she expected! I empathized with her and explained to her the difference between the cost and the value!

So really what is the cost of LASIK? First of all, is this even the right question to ask? Is Lasik surgery which you get done on your precious eyes a commodity? Can you trade a good surgeon, a good hospital, a good machine with slightly higher cost to another one (lower on all these parameters) just because the cost is low? This is a question that troubles me personally as a Lasik surgeon. I would like to believe that when it comes to your eye health and safety, one would go for the best and not compromise just on some differences in the cost of the procedure!

I know many of you face this dilemma when deciding the right place and the right cost of the procedure. So, how do you decide? Let us understand some of the parameters which can help you decide the value you get in different situations!

Knowledge and experience of the Lasik surgeon– These according to me should be non-negotiable. You must ensure of this even before you visit your Lasik surgeon by doing an online search, reading patient reviews, and checking the surgeon’s profile. You can also judge this after your interactions with your Lasik surgeon. Whether he/she answered all your queries to your satisfaction. Also, particularly important is your own comfort with that hospital and the doctor. Before and after the Lasik laser you would be interacting with that eye hospital and the eye doctor many times. So, you must make sure that you feel confident and comfortable with the eye doctor who would be performing your Lasik.
Lasik surgery machines– It is especially important to understand which all different types of Lasik surgery the centre is offering. All the different types of Lasik like Conventional Lasik, wave front guided Lasik, topography guided Lasik (Contoura Lasik), Femtolasik, smile Lasik, require a different machine. You should not restrict your options just because that centre does not have the option to do the more advanced type of Lasik like SMILE Lasik etc
Location of Surgery– If the eye centre or the eye hospital does not have their own machines and the surgeon will be taking you to another centre, then you should enquire about the other Lasik Centre. If the surgeon is not involved in managing that another centre, then he has no control on their safety protocols and condition of the machines.
Cost of Lasik– Finally assuming everything else is equal, cost becomes an important parameter. Again, we need to compare apples to apples and not otherwise. Let us take the example of SMILE Lasik. Now the cost of Smile Lasik cannot be compared to Femto Lasik or Contoura Lasik. The technology is more advanced, the machine is more expensive, and the software licence required for the cost of the procedure is expensive.

So if Aparna will have to make a decision about her procedure, she needs to first find a surgeon who is good, eye hospital which is well equipped and have an option to do SMILE Lasik in that location itself and not somewhere else. If still cost of SMILE Lasik remains a limitation for her then she can always choose to go for Lasik or FemtoLasik. However, it is really time that we make our decisions based on the value we derive from getting a safe and effective Lasik and not just the cost of the procedure!

About Advanced Eye Hospital and Institute:

Advanced Eye Hospital

About Dr. Vandana Jain

Delay In Treatment For Fear Of Corona Infection Led To Worsening After Lasik

Aug12

Sunidhi Menon, a 29-year-old, IT professional underwent Lasik surgery in Surat in the month of February. She was extremely happy after her Lasik and did not need her clunky glasses anymore. World was suddenly more beautiful, and she felt so liberated. I can relate to that feeling! A month after her surgery, lock-down was being announced. She immediately decided to go back to her parents’ home in Navi Mumbai. She somehow managed to reach Navi Mumbai after a lot of difficulty. Being a computer professional she was sending 10-12 hours on laptop every day. Things were going great for her. One day accidentally her fingernail hit her right eye while she was rubbing her eyes. Her eye was painful for some time. She instilled the lubricating eye drops and slept through the day. To her respite, her irritation had settled down and she went on with her daily life and schedules. Slowly she started noticing a mild blurring of vision in her right eye. She ascribed it to her excessive computer work. She took a teleconsult with the doctor in Surat, who recommended her to visit a local eye doctor and get her eyes evaluated. She kept postponing that for the fear of Corona pandemic. 2 months later when she closed her left eye, she realized that her right eye vision had deteriorated even further. Finally, after doing an online search for a good Lasik specialist near her, she landed for a consult with me at Advanced Eye Hospital in Sanpada.

She went through a detailed eye check-up. The vision in her right eye had reduced to almost 50% of normal. Besides that, there was a distortion of her vision as well which could not be corrected even with glasses. I examined her and realized that she had developed an epithelial ingrowth in her right eye. This is the growth of excessive cells under the Lasik flap and this rarely encroaches on the centre of the cornea as well. Large epithelial ingrowths can cause not just reduction of the vision but also distortion of the remaining vision. She was basically functioning due to her left eye. We immediately advised her to undergo a small procedure to remove the epithelial in-growth. She got very upset and started questioning her decision to have undergone Lasik.

I can understand the agony that she was facing given the need for an additional procedure. I re-assured her. Finally, after some amount of counselling, she decided to get the procedure done. Her procedure was performed under all safety guidelines and was uneventful, and we removed the full in-growth. She was advised some eye drops and given a schedule for follow-up to ensure the proper recovery.

Now this incident brings home a particularly important point. Can we allow the fear of one problem aggravate another? We are all worried about the corona pandemic and taking utmost precautions so that we and our loved ones are safe. If everyone will develop the attitude like Sunidhi then doctors should be the first one to sit at home and not expose themselves to any risk! Rather than realizing that problem aggravated due to her delay in seeking the treatment, she started blaming the Lasik itself. In her case probably her fingernail injury led to the development of epithelial ingrowth which slowly progressed while she sat at home due to the fear of Corona virus.

I think we all need to realize that not doing anything is surely not the solution for a lot of eye problems. Even though teleconsultation is a great option for getting opinion for many eye problems but in some cases a physical visit is required to ascertain the actual eye problem. I have already written about it in more detail here.

Patients like Sunidhi teach an important lesson to each one of us. No health problem is a small problem and should not be ignored. To begin with teleconsult is a great option and in many cases that would be enough to get the right advice and treatment. Sometimes your doctor will advice you to consult in person. That is the time when not doing anything can aggravate a minor eye problem to a more serious one! Take all precautions with face mask, hand sanitization, social distancing and choose an eye hospital where all safety precautions are being implemented.

About Advanced Eye Hospital and Institute:

Dr Vandana Jain – Lasik Surgeon expert

About Dr. Vandana Jain

Taking care of your eyes in Monsoon season

Jul23

Reema contacted me over a teleconsult. Her eyes were swollen, and the pain was excruciating. She started experiencing these symptoms over the last one day. She had not even stepped out of the house due to the lockdown and was working from home. Over the video consult, I realized that she had developed a stye, which is a kind of infection in the glands of the lids. Due to this infection, lids become painful and swollen. On further probing she did mention her recent tendency to rub her eyes to relax the tired eyes after hours of working on her laptop. Monsoon season along with her newly acquired habit of eye rubbing probably predisposed to it.

Obviously, monsoons are the most wonderful time of the year. For all age groups it has something magical to offer. This season is all about thundering clouds, falling rain drops, freshness and greenery all around, and of course croaking frogs. This year the magic of monsoon is even more, as due to lock-down, we are working from home and we don’t have to brace ourselves for the raincoats, traffic jams, water puddles, and whole host of inconveniences that come along with it.

Monsoons are also associated with its host of health issues for a lot of people. Our eyes are also vulnerable to a host of eye infections and conditions during monsoons:

Pink Eye

Seasonal changes predispose people to certain viral infections of the eyes. Pink eye or conjunctivitis is one of them. Watering of eyes, redness, discharge, foreign body sensation, swelling of the eyelids, sensitivity to light are all signs and symptoms of conjunctivitis or pink eye. It is important to not self-medicate. We have had patients who unknowingly bought steroid eye drops from the pharmacy and ended up worsening their conjunctivitis to a dangerous complication called corneal ulcer.

conjunctivitis

Stye

You can develop an infection of the glands of your eye lids which is called a Stye. It is a red lump on your eyelid that looks like a boil. It can lead to watering, pain, and often diffuse swelling of your eyelid. You can apply a warm napkin on your closed eyelid for 10 minutes a day and repeat it 3-4 times a day. If it does not improve after 2-3 days, visit your eye doctor.

Dry Eyes

Though it seems like a paradox, exposure to drafts of cold wind and opening your eyes directly onto raindrops can wash out the natural tear film that protects your eyes. Use protective glasses when you are exposed to strong winds to prevent drying out of the eyes. And do not allow raindrops to fall into your eyes directly. Using too much laptop or mobiles can add to this

Corneal Ulcers

Viruses, bacteria and fungus are active in this moist weather. They can cause a sore on the outermost transparent layer of the eye called the cornea. This can get extremely dangerous if not treated appropriately in time. Do not hesitate to consult your eye specialist if you suffer from eye pain, yellowish discharge and blurry vision.

Corneal Ulcer

Here are some more tips to help you take care of your eyes this monsoon.

Wash your hands especially before you touch your eyes. Avoid rubbing your eyes or even touching your eyes.
If a family member is suffering from an eye infection, do remember to keep his/her towels, napkins and pillow covers separate. Ask the family member to use disposable tissues instead of towels to wipe their eyes. Wash your hands after administering eye drops.
Prevent kids from jumping in puddles and waterlogged areas.
Do not share eye makeup. If you have an eye infection, replace the old makeup after you have been cured of it. Always use good brands for eye makeup.
Avoid opening your eyes directly under rainwater. Though rainwater per se is clean, that which slides off buildings or has absorbed atmospheric pollutants can harm your eyes.
Avoid the use of over-the-counter eye drops. They may contain steroids which may be harmful if used without the supervision of an eye specialist.
Use sunglasses with UV protection whenever you are outdoors, even if it is a cloudy day.
If you are a contact lens user, do not use your contact lenses when you have an eye infection. After you have recovered, do remember to clean your lens thoroughly before you put it back in your eyes. Do not share your contact lens case or solution with others.

Let us all enjoy the beautiful monsoon weather amidst lush greenery along with a hot cup of tea and pakoras! Enjoy getting wet as well but not at the cost of the health of your eyes! Simple precautions will ensure happy and healthy eyes!

About Advanced Eye Hospital and Institute:

Advanced Eye Hospital and Institute in Navi Mumbai is one of the best eye hospitals in Mumbai. Eye check-up rooms and the operation theatres are state-of-art and equipped with the best diagnostic and surgery machines. Personalized care, infection free modular operation theatres and beautiful ambiance compliment the cutting-edge eye care offered at AEHI. It is one the eye hospitals where all the protocols are implemented to ensure safety of everyone from corona infection. All different super-specialist eye doctors like cataract, cornea, retina, glaucoma, lid surgeon, kids eye specialist, are present under the same roof. Besides treating patients from Kharghar, Nerul, Seawoods, Sanpada, Belapur, Vashi, Ghansoli, Airoli and Panvel, patients from all over western India travel to AEHI for world class eye care management.

About Dr. Vandana Jain

Dr. Vandana Jain is an experienced eye surgeon dealing with cornea, cataract, and laser vision correction procedures. She has been performing all kinds of cornea, cataract, and Lasik surgeries for more than 15 years. She is a sought-after surgeon and admired by her patients for her skills and friendly nature. She is very meticulous in her work and believes in giving her best to each and everyone

Eye Problems In Work From Home Scenario During Corona Lockdown

Jul16

Abraham was experiencing an increasing discomfort in and around his eyes. Initially he was experiencing this eye discomfort at the end of the day. Gradually the duration, intensity and the episodes of eye discomfort became more pronounced. It started interfering with his work and he found it increasingly difficult to work and was often lagging on his deliverables. That is when he decided to contact me and consulted me through a teleconsult. He is just 32 years old and never needed glasses and had a wonderful eyesight. And this was one of the reasons that he was surprised why of all the people he was having such a bad eye discomfort. On being asked to give a detailed account of his eye discomfort, he mentioned that he experiences eye pain, his eyes turn red, his head hurts and often he is unable to maintain focus on his screen and his vision turns blurred. In the second half of his workday he needed to take frequent breaks to reduce the discomfort. He was quite distraught by the eye problems that he was facing. He was an overachiever and hated to be lagging on his work due to his eyes.

I am sure a lot of us can relate to this story. Abraham is not alone. These days most of the patients who consult me are having similar eye issues. Due to the lock-down and work from home scenario, the distinction between workday and leisure day has blurred. Most people are working more than 10-12 hours a day given that they are saving time not travelling. And to add to this, even the entertainment involves use of additional gadgets. So really, on an average most people are interacting with some or the other screen for more than 12-15 hours a day.

Let’s try to understand what happens to our eyes when we are glued to laptops, mobiles, and tablets for long hours.

Our Eyes develop what is called “Digital Eye Strain”
We experience one or all of the following symptoms
- Eye pain
- Redness
- Irritable eye
- Headache
- Pain around eyes
- Blurred vision
- Difficulty to focus on a near object
- Difficulty in changing focus from one object to another at a different distance
- Grittiness/ foreign body sensation
- Dryness in the eye
Eye discomfort is severe especially if the engagement with screens is without proper consistent breaks
Even Anti-glare glasses are of no use
Lubricating eye drops give temporary relief
Break from digital tools reduce the intensity of the eye symptoms temporarily

I have heard these things so many times that I feel that my response to such problems is sort of narrated.

Let us be honest- we all need to have a life beyond the gadgets. I know that many of you must be thinking, if not gadgets then what? Given the lockdown we cannot freely step out and indulge in other social activities. I get it and understand that the current situation is not necessarily the best time to reduce the use of gadgets. So truly, what is the solution to all these eye problems?

Reduce the amount of uninterrupted time with these screens- Take a short break after every 15-20 minutes.
Blink frequently- normally a person blinks 12-14 times per minute and this drops to 4-5 times when we are using gadgets. So, this means we need to consciously blink.
Adopt a proper posture while you are using these gadgets. Do not lie down or sit on a bed while you are working on your laptop or mobile
Ensure that you are wearing your prescription eyeglasses if you have any while you are working on these gadgets
Do not use excessive air conditioning and do not keep the temperature too low- Air conditioning use reduces the atmospheric humidity and that can enhance the eye dryness
Drink enough water
Use lubricating eye drops depending on your eye symptoms
You can use anti-glare glasses if your laptop/desktop already does not have an inbuilt glare protection. Blue light blocking glasses do not have much role here
Manage the contrast on your screen and the lightning conditions around you. Screen contrast should be just optimal. The light around you should not directly fall on your face or on the screen that you are using.
Keep a strict division of your workday and personal time and wind up your work by the decided time.
Rather than messaging your friends, call them up and have a conversation. That will be good for not just your relationship but will also reduce your screen time
Find alternative means of entertainment such as cards or board games with your family
Wear your masks and go out for walks in open spaces (Avoid any crowded places while walking)
Eat healthy nutritious food and sleep well
If none of this works then pay a visit to your eye doctor to rule out other eye diseases

To be honest, it is all about managing our lifestyle and leading a healthy well-balanced life. It is to a large extent in our own control. Let us all be more deliberate about what we do and how that may be impacting our eyes and overall health!

About Advanced Eye Hospital and Institute:

Advanced Eye Hospital and Institute in Navi Mumbai is one of the best eye hospitals in Mumbai. Eye check-up rooms and the operation theatres are state-of-art and equipped with the best diagnostic and surgery machines. Personalised care, infection free modular operation theatres and beautiful ambiance compliment the cutting-edge eye care offered at AEHI. It is one the eye hospitals where all the protocols are implemented to ensure safety of everyone from corona infection. All different super-specialist eye doctors like cataract, cornea, retina, glaucoma, lid surgeon, kids eye specialist, are present under the same roof. Besides treating patients from Kharghar, Nerul, Seawoods, Sanpada, Belapur, Vashi, Ghansoli, Airoli and Panvel, patients from all over western India travel to AEHI for world class eye care management.

About Dr. Vandana Jain

Delaying Eye Surgery In Times Of Corona Pandemic

Jul10

Mohan is an educated well-read 65-year-old gentleman. He can strike an intelligent conversation with anyone irrespective of the age or the background. I still remember the first time he had come for his eye check-up, a few years ago, he chatted with me regarding mechanism of vision and involvement of brain. I was very impressed by the depth and breadth of his knowledge. Without fail every year he would come for his eye check-up. On his last visit I noticed that the lens inside the eye was cataractous and was slightly swollen and was compressing the angles of the eye. I gave him the option to do a laser-based procedure called YAG PI or to go for early cataract surgery to prevent development of high pressure in his eye. He decided to go ahead with the surgery after a month as he had some urgent matter to settle.

Soon after Corona pandemic took hold and lockdown was announced. Luckily for him no adverse event occurred, and he restricted himself to his home on the earnest request of his children. After a month he developed an episode of pain and redness in the affected eye. He contacted me through a tele-consult. I realized that the lens may be pressing on the angle and his eye pressure may have shot up. I prescribed a few drops to reduce the eye pressure but asked him to come to the hospital for an immediate assessment. After a few days, his pain and redness settled down and he decided to postpone the visit to the hospital and carried on with his regular activities. One day he realized that the vision in that eye has dropped significantly. He again took a tele-consult with me. This time I insisted again and requested him to come to the hospital. Finally, after a lot of urging, he came to the hospital. Under all precautions, we performed a detailed eye check-up. His cataract had increased, and the angles of the eye were completely blocked, cornea (the front transparent part of the eye) was slightly oedematous and the nerve of the eye was also damaged. So, basically the delay in performing the surgery led to high pressure which caused the damage to the cornea and the nerve of the eye. We immediately prescribed medicines to reduce the eye pressure. Post that a combined cataract and glaucoma surgery was performed. Unfortunately for him there was a permanent reduction of vision in that eye due to an irreversible damage to the nerve of the eye.

Episodes like this are painful not just for the patients but for doctors alike! We could have prevented this from happening. I wished he had paid more heed to my advice! I can understand that the fear of the corona pandemic is causing many people to delay their treatments. And I think to some extent this mind set may be correct. We all need to reduce the unnecessary interaction with hospitals especially the ones where Corona patients are also being treated. I have written earlier about how to choose the right eye hospital for your eye treatment. Please read it here

It is important for us to understand that often seemingly minor health issues may lead to long standing problems. It is a good idea that even for minor persisting issues, we all get the opinion from the right doctor. A lot of issues can be sorted through tele-consults. As a first step if we fear going to the hospital, we can just do a tele-consult with our eye doctor. If the eye doctor is unable to conclusively ascertain the problem, he/she may ask you to come for an in-person evaluation. Seldom you may be advised an eye surgery as well.

I personally feel that if an eye surgery is required then it is better to discuss with your eye doctor in more detail about the pros and cons of doing it now versus after a few months. But the question is, Will the situation improve after a few months?

I have done some eye surgeries during this time and with the precautions and protocols we follow, none of my patients, my staff or me personally have developed any problem at all. We all have been safe and healthy. In fact some of my patients have commented that it was the perfect time for them as there was no crowding, no waiting in the hospital, doctor had more time, staff was more patient and caring, their children had more time to take care of them and they could adhere to precautions better as they were not actively venturing out of the house. Yes, sometimes even the dark clouds have silver lining in them!

If you really need to plan an eye surgery like cataract surgery, retinal detachment, injections for retinal oedema, glaucoma lasers etc, here are some of the things to know and understand-

Ascertain that your eye doctor and the staff at the eye hospital are following strict protocols, to ensure safety
There is no over crowding in any area of the eye hospital
Avoid hospitals where Covid positive patients are admitted
Go for day care eye surgery, where you are out of the hospital soon after completing your eye surgery.
Ensure that you are also adhering to all the precautions like good quality face mask, hand sanitization, and social distancing.

If we all adhere to the right protocols and take precautions, then none of us need to postpone essential surgeries. For all we know, it may be a prefect time to get rid of your eye problems and get a new vision!

About Advanced Eye Hospital and Institute:

Advanced Eye Hospital and Institute in Navi Mumbai is one of the best eye hospitals in Mumbai. Eye check-up rooms and the operation theatres are state-of-art and equipped with the best diagnostic and surgery machines. Personalised care, infection free modular operation theatres and beautiful ambience compliment the cutting-edge eye care offered at AEHI. It is one the eye hospitals where all the protocols are implemented to ensure safety of everyone from corona infection. All different super-specialist eye doctors like cataract, cornea, retina, glaucoma, lid surgeon, kids eye specialist, are present under the same roof. Besides treating patients from Kharghar, Nerul, Seawoods, Sanpada, Belapur, Vashi, Ghansoli, Airoli and Panvel, patients from all over western India travel to AEHI for world class eye care management.

About Dr. Vandana Jain

Dr Vandana Jain – Lasik Surgeon expert

Role Of Telemedicine For Eye Problems In Corona Affected World

Jun30

World is seeing something completely unprecedented. With the ongoing Corona Pandemic, and restricted mobility, many things have changed. Children learning from home with online classes, adults working from home and seniors consulting their doctors from home using Telemedicine. All this had been unprecedented! But as the wise men say” Change is the Only Constant”. As a practising Eye Doctor, I have embraced teleconsultation Technology. For me, the purpose is straight forward. I want to be available to my patients.

I frequently get worried calls from my patients and how they are unable to travel for the fear of contracting the corona virus infection. Sometimes it is the fear and sometimes it is the lockdown in their areas. Nevertheless, I think telemedicine is a great boon in times like this. So, the big question is- what kind of eye problems are amenable to Video based teleconsultation.

Follow-up Eye consultations–
1. Often eye doctors call their patients for follow-ups after prescribing initial treatment for various eye problems like eye irritation, dryness, eye strain, headaches, redness, itching etc. The aim here is to ensure that patient is symptomatically better and modify treatment, should the evaluation demand that. These kinds of patients can easily follow up with their doctors via teleophthalmology. In most cases review is possible through just a video-based consultation
1. Follow-ups after surgery- After surgeries like cataract surgery and Lasik surgery, doctors ask their patients to follow up at regular intervals. Unless it was a complicated case, most of these patients can follow up via tele-consult in the initial period.

First time Eye Problems– Issues like eye redness, irritation, stickiness, itching, eye strain etc are suitable for tele-consult. These days a lot of people including children are glued to screens for long hours and this leads to myriad of eye problems. The advantage of teleconsult is that doctors can judge the problems and often give the right advice and prescribe the appropriate treatment. And even if doctor does not feel comfortable prescribing after the teleconsult, at least as a patient you get to know that you really need to get your eyes examined in person by the eye doctor. So indirectly teleconsult is a good triage for deciding which patient is suitable for treatment via teleconsult and which patient needs to physically come to the hospital and get examined in person

Now this also brings home the question- which kinds of eye problems may not be suitable for tele-consult.

Sudden vision loss– most of the time sudden vision loss is a medical/ surgical emergency and needs a detailed examination by the doctor so that appropriate treatment can be started within the right and in most cases limited time window.
Eye Injury– Injury to the eye by blunt or sharp objects have a propensity to cause severe damage to the eye. These also needs to be diagnosed and treated at the earliest.
Sterilization liquid splash in the eye– Sterilizers are made of chemicals which can cause severe damage to the surface of the eye. Often, we need to diagnose the severity and treat accordingly. Very rarely emergency surgery may be required
Vision related problems– Vision related problems like reduced vision, double vision etc needs an in-person check-up with the eye doctor. Change of glasses, progression of cataract, diabetic retinopathy or any other retina problem- all these can be evaluated by using some examination and diagnostic tools.
Headache, dizziness along with reduced vision– There are several eye related causes for these. The actual reason can be ascertained only after in person examination.

So, a lot of eye problems are amenable to tele-consult. The biggest advantage is that teleconsultation is not constrained by time, place, or availability. It is a great option for people who live in remote places or those who need a second opinion from the super specialist eye doctors. In most cases, it is easy to get an immediate teleconsultation with an eye doctor. Even in worst possible cases, one gets to know that they need to physically go to their eye doctors.

About Advanced Eye Hospital and Institute:

About Dr. Vandana Jain

Taking Care Of Your Childs Eyes In Times Of Corona Lockdown

May9

Life has changed a lot due to the corona virus Pandemic. And this is no less true for school children who are forced to take online classes. With new changes comes new behaviours and often new challenges. I as a practising Eye doctor have been getting incessant calls from anxious mothers about the concerns of safety for their children’s eyes. My child is experiencing more headaches, my child’s eyes are red, my child is unable to see clearly by evening, my child is rubbing the eyes all the time! These and many more have been the concerns of doting mothers. So, what has changed compared to before. For children a lot, I guess! Suddenly from sitting in classes with friends, they are sitting at home with computers and laptops and taking online classes. The amount of time they are spending with different gadgets has gone up disproportionately. Besides their online classes, they are doing homework on computers and then probably also spending some time playing with mobile phones since right now they do not have the freedom to step out and play with their friends.

Is this the reason for the symptoms that children are experiencing these days? To be honest the answer to that is yes, majority of symptoms are probably because of the large amount of time that children are spending on computers, laptops, and mobile phones. Tiredness of eyes, temporary weak vision, dry, irritated eyes, light sensitivity & muscular problems are some of the common conditions caused by excessive computer use and are collectively known as Computer Vision Syndrome.

Staring at a monitor for long hours is like doing continuous push-ups of the focusing muscles, leading to burning & tired eyes. A dry environment & dehydration are two other culprits at the workstation that can worsen the problem. Also, children often forget to blink when they are looking at the computer screen.

Common symptoms include:

Eyestrain
Headaches
Blurred vision
Dry eyes
Neck and shoulder pain.

These symptoms may be caused by:

Poor lighting in the surrounding
Glare on the computer screen
Improper viewing distances
Poor seating posture
Uncorrected vision problems
Not using prescription glasses
Excessive amounts of time staring at the screen
Incomplete and insufficient blinking
Pre-existing eye allergies
Combination of these factors

So, what can be done to take care of the child’s eyes while they cannot avoid using computer for their school classes

Location of computer screen – The computer screen should be 15 to 20 degrees below eye level (about 4 or 5 inches) as measured from the center of the screen and 20 to 28 inches away from the eyes.
Lighting – Position the computer screen to avoid glare, particularly from overhead lighting or windows. Use blinds or drapes on windows.
Seating position – child should be using a chair table and not bed while using laptops etc. Chairs should be comfortably padded and conform to the body.
Rest breaks – To prevent eyestrain, child should rest their eyes in between. They can close their eyes when only discussions are going on and they do not need to actively look at the screen. Intermittently children should look at a distant object to change the focus of their vision from a nearby screen to a distant object.
Blinking – To minimize chances of developing dry eye children should consciously blink in between. Blinking keeps the front surface of your eye moist.

Lubricating eye drops– If nothing else works then lubricating eye drops can be used intermittently

Additionally, if a child has glasses, they should be wearing it while looking at the screen. If you notice excessive headaches even after following these steps, then your child may have a change of eye power and a visit to an eye doctor may help in that case. Parents need to monitor and educate children on healthy practises while using gadgets to prevent these side effects of using too much technology.

About Advanced Eye Hospital and Institute:

About Dr. Vandana Jain

Expert Lasik Surgeon

Dr Vandana Jain, Cornea and Lasik Surgeon, Mumbai, India

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