Shabnam Khan, a 54-year old mother lived happily with her husband in Antop Hill, Wadala. She loved giving insights about designing to her daughter, a budding fashion designer, and stitched couple of dresses for her as well. She thoroughly enjoyed her life helping her daughter each and every day.
Over the last several years, she was finding it difficult to do simple things like threading the needle, and her vision was blurry. Occasionally she would get headaches and used to see halos around lights. But, she brushed off these symptoms as normal occurrence to people over the age of 50. Once, while stitching, she accidently pricked her finger with needle. She knew this was not an accident and has happened because the objects have become very blurry. Somehow, in the evening, she confessed these eye problems to her family.
After listening to Shabnam, without much delay, her husband searched for best eye hospital in near by area on internet. And, he learnt that R & R Eye Care Hospital in SION, has excellent reviews from happy and satisfied patients and decided to visit it the next day.When Shabnam visited R & R Eye Care Hospital, her assumption was busted that one eye doctor can treat all the eye problems. She was in awe of this hospital and learnt that it has 5 super specialist eye doctors.
Upon detailed eye examination, which began with Visual Acuity, it showed that vision loss was because of cloudy lens i.e. she had developed moderate cataract (Anterior capsular cataract along with Nuclear Sclerosis Grade II) mainly due to her age. She was then referred to Dr. Rajesh Mishra, a Cornea, Cataract & Lasik Surgeon. he evaluated her eyes and explained that the hazy vision in her eyes was because of the cloudy lens. She also had dry eyes which was adding to her symptoms of light sensitivity.
Cataract is the leading cause of blindness worldwide. It affects the lens of the eyes and is usually seen in people over the age of 40. The working of eye’s lens is similar to that of camera’s lens, which is to focus light properly so that image can be viewed clearly.
Dr. Rajesh advised her few eye drops and an ointment to relieve her from headache and light sensitivity. She further advised her to undergo cataract surgery and follow up after a week.
However, even several months later, Shabnam Khan did not turn up for the follow up until one day she actually fell in her living room due to poor vision. The following day, her daughter fixed an appointment for her with Dr. Rajesh Mishra.Again, she underwent the detailed eye check-up. Visual acuity test showed that her vision had dropped even further. She had developed an additional posterior subcapsular cataract (PSC). Lens has three layers in it – outer covering – ‘the capsule/bag’, innermost part – ‘the nucleus’ and the middle portion – ‘the cortex’. PSC occurs at the back of the capsule. In this type of the cataract, impact on visual acuity is most profound. Patients with PSC usually have a lot of other symptoms like light sensitivity, difficulty adjusting to different light conditions and poor vision in bright light.Dr. Rajesh again reiterated to Shabnam that she needs to undergo Phacoemulsification – a type of cataract surgery before her poor vision leads to other problems like falls leading to fractures. In a study it was found that 60% fractures in elderly are due to poor vision due to cataract.
Subsequently, Shabnam had an investigation for lens power calculation called as IOL Master as she decided to undergo cataract treatment. Dr. Rajesh evaluated the test results and chose the appropriate power of intraocular lens. Mrs. Khan opted for a multifocal lens (a lens which allow clear vision for near as well as far without glasses).In Phacoemulsification, a micro incision is made on the side of the cornea. A device emits ultrasonic energy on the cloudy lens that breaks the lens into small pieces, which are then removed by suction. After this, the cataract surgeon inserts a new artificial lens called as intraocular lens (IOL) and the procedure is called intraocular lens implantation.Mrs. Khan showed tremendous improvement in her vision post-surgery. She was thrilled to see clearly and not need glasses for both distance and near vision. She expressed gratitude towards Dr. Rajesh Mishra and everyone else at the eye hospital.Cataract surgery procedure is usually completed in 5-10 min. The whole process from admission for cataract surgery to discharge takes around 2 hours and so the patient does not require staying in the hospital. The recovery time for vision improvement is generally a few days. Patient is expected to observe some precautions for a few weeks after the cataract surgery so as not to develop any side effects or complications after the surgery. Most people can go back to work after cataract surgery in 3-4 days. The cost of the Cataract surgery usually depends on the surgeon experience & expertise, type of cataract surgery and the IOL chosen.
It is never an advantageous approach for cataract patients to allow the cataract to mature and then undergo the treatment for the same. If you find that you have blurry vision, it is better to get it assessed and get timely treatment as per the recommendations of your eye specialist.
About R & R Eye Hospital in SION is one of the most advanced centres where treatment is tailored to patient’s needs and lifestyle.
It has become very popular and trusted cataract surgery centre for the residents of Sion, Matunga, KingCircle, Mahim, Dharavi, Kurla, Chunnabhatti, Everad Nagar, BKC, Antop hill, Wadala and other parts of Mumbai.
Mrs. Shabnam Khan - 54 year old - Antop Hill- Tailor
Kavita Nadar works as a sales professional for a cosmetic company. She often gives presentation for various clients all over Mumbai. This 24-year-old woman who lived in Dharavi, used to wear contact lenses for her myopic eyes since many years.
However, increased workload, constant maintenance of contact lenses, experiences of dry eyes, and other daily inconveniences affected her lifestyle.Once during a coffee break in her office, she got to know that her office colleague’s daughter had undergone LASIK surgery the previous month from R & R Eye Care Hospital in Sion.
And the relieved mother informed that her daughter was extremely satisfied afterher Lasik. Her daughter has been so ecstatic with the whole experience that she has branded it as the best eye hospital in Sion.
Listening to such positive feedback about R & R eye doctors, all the staff members, and the fact that all eye care services from diagnostic, optometry, optical, out- patient and eye surgery were available under one roof was like music to Kavita’s ears. Promptly
Kavita booked an appointment with Dr. Rajesh Mishra at R & R Eye Care Hospital the following day.On the day of her visit, Kavita experienced the same warmth, professionalism yet friendliness, cleanliness at every corner; be it the initial registration or the comprehensive eye check-up.
During her eye check-up, a detailed examination was conducted through various tests to evaluate the health of the cornea, lens, iris (known as anterior segments) and the vitreous humor, retina, choroid, and optic nerve (posterior segments of the eye). Luckily for Kavita, all the tests were normal. A detailed pre lasik evaluation was carried out which included tests like corneal topography, IOL master, contrast sensitivity, muscle balance testing and dry eye analysis.
During consultation with Dr. Rajesh Mishra, Kavita bombarded her with a barrage of questions like, Is Lasik safe?, “Am I suitable for Laser eye surgery?”, Is Summer the right time for Lasik? etc. And Dr. Rajesh patiently answered all her questions and allayed her fears and doubts about LASIK. After learning about all the types of LASIK surgery, she opted for FEMTO-LASIK.
LASIK is the acronym for “Laser Assisted in Situ Keratomileusis” and is commonly known aslaser eye surgery or laser vision correction. The last decade has seen newer, better, safer and highly advanced laser vision correction procedures such as Bladeless Femto LASIK and Bladeless & Flapless ReLEx Smile LASIK. Femto Lasik is a two-stage procedure where a Femto second laser (first laser) is used to create a flap on the cornea. This corneal flap is then lifted so that an excimer laser shapes the exposed inner surface of cornea. No blade is used in this procedure and the whole procedure is done within few minutes. The recovery is faster than the other LASIK methods.
During the follow up session, Kavita came in with double excitement to meet Dr. Rajesh Mishra. She thanked him wholeheartedly and recited (like a thorough sales professional) one of the famous quotes of Jeff Bezos, Amazon’s Founder, “Your Brand Is What Other People Say About You When You’re Not In The Room”. And that was like receiving a reward! LASIK surgery is best way to get freedom from glasses and contact lenses! Many patients have concern about post-Lasik recovery which is understandable. Nevertheless, the only advice is that people should undergo a detailed pre lasik evaluation, should not get misguided by incomplete knowledge of vision correction procedures and seek advice only from the best eye doctors.
About R & R Eye Care Hospital at Sion. Centre for Lasik Surgery at R & R Eye Care Hospital is a state of art center for all those who want to get freedom from glasses and contact lenses. It is one of the most advanced centres for glass removal in SION - Mumbai.
Ms. Kavita Nadar - 25 year old - Dharavi- Sales Professional
Sheetal Vermani used to do a part time job in an advertising company. his ideas through graphic designing always use to break stereotypes and were always appreciated by his employer. Apart from this job, this young 21-year-old young lady was a huge cricket fan and lived in Shahu Nagar, Mahim.
Over period of time, prolonged use of computer left her eyes with blurry vision and she started experiencing constant headaches. On several occasions she experienced fatigue, nausea and drowiness as well. She took a few pain relief tablets from a general doctor and continued with her routine life.
Nevertheless, these symptoms would re-surface again and again. Once while with a friend, she confessed these eye problems.Her friend recommended her R & R Eye Care Hospital, which is 10 mins away from SION station and where his mother received the best treatment for cataract surgery. According to him it is the best eye hospital in SION, which treats all the eye problems and diseases under one roof.
At R & R Eye Care Hospital she underwent complete eye check-up, visual acuity test confirmed she had a refractive error –shortsightedness also called as myopia. So, she was recommended specatacles with accurate glass power. Her eye/ intraocular pressure was within normal range.
For the constant headache, drowsiness and nausea problems, he was referred to Dr. Riddhi Shah, an Ophthalmologist & Paediatric Squint Eye Surgeon. Dr. Riddhi noticed that the diameter of Sheetal’s pupil was 3mm and 5mm for right and left eye respectively which was not normal. Generally, pupils are of equal size. Retina and optic nerve evaluation was normal. A visual field analysis also showed changes suggestive of a neurologial abnormality. Therefore, she advised her to undergo a MRI scan keeping in mind her other symptoms as well.
And the scan delineated the cause of Sheetal’s constant headache, nausea and drowiness. There was a tumor in her brain close to the optic nerve! Luckily it was a type of benign tumor.A tumor in the brain can occur at any age. The brain and the remaining body communicate with each other through a network of nerves which carries messages to and fro. And there are some nerves that go directly from the brain to the eyes, ears, and other parts of the head. Hence, this explains Sheetal’s condition.
Dr. Riddhi, explained everything in detail to Sheetal and asked her to consult a neuro surgeon who would treat her further for the brian tumour. Sheetal follwed up a month after her brain surgery. Her other symptoms had completely disappeared and her vision was also good with her myopic glasses.It is important to know that very often the pathology/ disease lies in another part of the body but it can have impact on othis body parts like eyes. If Sheetal had not come for her eye check-up there would have been a delay in her diagnosis and often these kinds of delay are not good. So whenever anyone experiences headache, reduced vision, nausea etc a detailed eye check-up is mandatory.
Ms. Sheetal Vermani - 21 year old - Shahu Nagar, Mahim- Designer
45-year-old Shweta Singh lived in Matunga and worked as a senior accountant in an IT company in Bandra Kurla Complex. She was very meticulous at her job. Back home, she would always keep an eye on the variety of aromatic tea brands available in the market apart from pursuing classical singing.
In March 2017, as the fiscal year was about to end, the workload in her office just got heavier day after day. One afternoon,she ran into one office worker and tea from that office worker’s cup spilled over her right arm. More than the burning sensation of hot tea, this accident shook her because she could not see the cup of tea held by her colleague.
One week later, a trespasser saved her from a car accident. Manisha’s fear just got amplified since her eye check up from a nearby eye hospital showed that her vision and eye was not normal. Knowing this, for next couple of days, her husband insisted her to visit the best eye specialist in Matunga and get a thorough eye check-up.
Without delaying much, she pulled out her phone and learnt on internet that R & R Eye Care Hospital in SION has excellent reviews from happy patients. Besides, she learned that this eye hospital has 5 super specialist eye doctors. She didn’t realise that even in eye there are different super specialist doctors. For her one eye doctor could treat all the eye problems.
She visited R & R Eye Care Hospital and underwent a comprehensive eye check-up. Her eye pressure was detected to be high. She was directed and advised to meet Dr. Rajesh Mishra, an eye doctor specialising in Glaucoma surgery. Further, she told him that she experienced intermittent headache, redness in eyes and vomiting sensation. Upon patiently listening to her problems, Dr. Mishra revealed that it was due to her intraocular pressure (IOP), which when high, beyond the normal range of 12-22mmHg can cause all these eye symptoms. Dr Mishra did gonioscopy test on her eyes. Gonioscopy revealed narrow angles in both the eyes. He also noticed that there was already an existing damage to her optic nerve. Dr. Mishra made a diagnosis of for Primary Angle Closure Glaucoma! Now this came as a shocker for Shweta Singh, as the eye check-up from the earlier eye hospital did not reveal it and hence she was not informed of the same. Dr. Mishra advised her to undergo OCT scan for optic nerve and the visual field examination to quantify the optic nerve damage.
She became very nervous as well as curious so she asked Dr. Mishra how he detected the eye disease, what is Primary Angle Closure Glaucoma and what is the treatment for this eye condition ?In order of magnitude Glaucoma is next to cataract in causing blindness worldwide. However, the symptom of glaucoma is not as evident as cataract, hence glaucoma is often called as the ‘sneak thief of vision’.Dr. Rajesh told her that one of the tests called as Gonioscopy, helped him to evaluate the opening of the drainage system of the eye. This system drains the liquid of the eye (i.e. aqueous humor) from anterior chamber into the blood stream. And the junction of the flow is where the angle is formed by cornea and iris.Why Gonioscopy is needed:
Gonioscopy helps to understand the status of the angle. We can grade the extent to which the angle is open. Angle closure can block the flow of fluid from the inside of the eye to the outside into the bloodstream. This in turn causes pressure build up inside the eye. This directly affects the optic nerve, the function of which is to send visual impulse to the brain. Further, it also helps to check if there is any abnormal growth of blood vessels or any injury from previous eye trauma.In Primary Angle Closure Glaucoma, a part of or the whole drainage angle becomes closed, thus the aqueous humor within the eye cannot reach all or part of the trabecular meshwork which is a structure inside the angle. This explains Shweta’s case, wherein the narrow angles caused increase in her eye pressure. This high eye pressure over a period damaged the parts of her optic nerve. That impacted her peripheral vision, which caused her to miss the tea cup and the car.
Dr. Rajesh Mishra advised her to undergo Laser Peripheral Iridotomy as the treatment of Primary Angle Closure Glaucoma. In this treatment, the eye doctor makes a tiny hole in the iris with a laser beam. This hole acts as passage for the aqueous fluid to continue to drain into its normal outflow channels. Iridotomy is a first step in the treatment of angle closure glaucoma. It works until at least some part of the angle is open. If the angle completely closes then another glaucoma surgery, called trabeculectomy may be required.
The recovery is almost instantaneous after the laser procedure. Shweta was extremely happy as the headache and redness had vanished. She expressed her immense gratitude towards Dr. Rajesh Mishra for explaining and recommending her best and timely eye treatment for her glaucoma.
It is therefore, very pertinent to note that any eye doctor or the best eye hospitals must be able to identify eye diseases by conducting complete eye check-up. It is a normal practice at R & R Eye Care Hospital to do comprehensive eye check–up which comprises of determining the intraocular pressure, the functioning of drainage angle and condition of the optic nerve, and visual fields as and when needed.
Ms. Shweta Singh - 45 year old - Matunga- Librarian
Issac Devdoss, a 62-year-old retired Physics Professor often sat in his balcony to recite short stories for his granddaughter who plays around him. And looking at her carefreeness, his spine still gets chilling effect remembering the day when he realised something was wrong with his eyes and his left eye was almost completely dark. That day he stumbled and almost collapsed in a movie theatre when his eyes were unable to adjust to the darkened room.
Issac Devdoss, a sion resident, used to go to an optical shop every few years and get his reading glasses checked and made.He never bothered to go to an eye specialist as his eye sight was good and he never felt any problem. He used to exercise regularly, eat healthy food, and never wore spectacles other than for reading.
From the movie theatre, his son brought him to R & R Eye Care Hospital in SION, to get his eye evaluation done.Comprehensive eye check-up was done for him. Some of his eye tests included visual acuity test (measures how far a person can see), visual field analysis (checks the side vision) and Non-Contact Tonometry (which measures the eye pressure). Initial evaluation revealed that Issac’s left eye vision had reduced to finger counting at two metres and also his eye pressures were high.
He was then advised to see Dr. Rajesh Mishra, an eye specialist in Glaucoma surgery and treatment at R & R Eye Care Hospital. When Issac told about his eye problems, he immediately confessed to Dr. Mishra ‘Instead of visiting an optical shop, he should have consulted the best eye doctor in SION, especially when he started noticing signs of poor night vision’.After the detailed eye check-ups and Glaucoma tests, Dr. Mishra calmly asked him if he had a family history of glaucoma, to which he took a long pause and hesitantly gave an affirmative reply.
Issac did not have other risk factors which makes one more prone to get affected by glaucoma like: - Decrease in corneal thickness and rigidity - High degree of minus numbered glasses OR plus numbered glasses - History of injury to the eye - Use of steroids, either in the eye, orally or injected
However, genetics often play a role in determining not just our facial features and height but also our predisposition to some diseases like Glaucoma. This is what probably happened with Issac as well. Issac has a hereditary eye disease.Glaucoma is an eye disorder in which the optic nerve gets progressively damaged due to various reasons such as poor blood supply, imbalance in the intraocular pressure (pressure inside the eye), etc.
Patients who have a family history of glaucoma are at risk of developing it, especially as the age advances. Hence, early eye check –up of family members becomes all the more important.Primary open-angle glaucoma is the most common form of glaucoma. It accounts for about 80% of glaucoma cases. If primary open-angle glaucoma is a hereditary eye disorder running inyourfamily, then your chances of developing glaucoma sometime in your life are nine times higher than your peers.
As we see in Issac’s case, glaucoma gene runs in family. It draws our attention as a society, to take it seriously, discuss with all our family members and encourage them to get an eye check up early on.Glaucoma is an eye disease which steals our vision silently. Hence, the only way to catch this eye disease is to detect it as early as possible. To Know more about Glaucoma please do visit R & R Eye Care Hospital.
Mr. Issac Devdoss - 62 year old - Kamgar Nagar, Sion- Physics Professor
A 55-year-old retired Indian Army officer Lt. Rohit Sharma was following his lost passion of cooking after serving our country for decades. He always used to attempt making new food dishes and make his whole family go bananas over the eye pleasing decoration of the plate. At the time of lunch, he would always dry wipe each dish for about good ten times. And his family would brush off this obsessive habit of his, as his love for cleanliness.
One fine day, his fellow colleague from Bandra, met Lt. Rohit Sharma and his whole family for lunch. Eventually, he noticed dense white spot on Rohit’s eyes and asked him about the same. Hearing, Rohit’s casual response to his blurry vision, he recommended R & R Eye Care Hospital, which is also near SION.
After pondering over his colleague’s encounter with cataract and the best treatment for cataract that he received at R & R Eye Care Hospital, Rohit booked an appointment. He underwent a detailed eye check-up and consulted Dr. Rajesh Mishra, an eye doctor for Cataract and glaucoma surgery. He patiently listened to his eye problems of blurry vision, inability to see in dim light, and reduced contrast sensitivity.
Initial eye pressure check-up showed high pressures in both the eyes. After Dr. Mishra’s assessment he underwent Perimetry (visual field test) test along with Applanation Tonometry. Visual field test revealed that his central vision was preserved but peripheral vision was highly reduced.
Further, Gonioscopy test showed narrow angles in both the eyes. Eye fluid flows from posterior to anterior chamber and then leaves the eye through the angle. Narrowing of the angle can cause the eye fluid to build up in eye and this is what increased the eye pressure in Rohit’s eyes.Dr. Rajesh Mishra diagnosed the eye condition as Cataract with Glaucoma. Rohit was shocked to know that he was suffering from both Cataract and Glaucoma in both his eyes.Glaucoma is a group of eye diseases, which causes damage to the optic nerve and vision loss.Cataract is clouding of lens leading to decrease in vision.
Dr. Mishra further simplified it for him. Cataract has caused glaucoma in his eyes. Since his natural crystalline lens had become cloudy and swollen, it increased its size. The swelling of the lens was so much that it literally pushed the iris to bend. Forward bending of iris can compress and narrow the angles. Narrow angles, in turn, causes eye pressure to shoot up. This high eye pressure puts pressure on the optic nerve (whose function is to send visual impulse to the brain). This in turn causes slow damage to the fibres of optic nerve. In the initial stages peripheral vision gets reduced and in advanced stages even central vision can get damaged. Rohit was lucky that at least his central vision was preserved. Swollen lens leading to glaucoma is called Phacomorphic Glaucoma (‘Phaco’ means lens, ‘morphic’ means shape).
So, Dr. Mishra recommended him to undergo Cataract surgery (Phacoemulsification). This cataract surgery will replace the cloudy lens with a new artificial lens called as intraocular lens implant. Phacoemulsification surgery involves an ultrasonic device that breaks and removes the cloudy lens. Removal of the swollen lens reduces the pressure on the iridocorneal junction and hence widen the narrow angle. This ultimately lowers the eye pressure.He was happy to know that cataract surgery will cure both his eye conditions. Additionally he was relieved that Dr. Rajesh Mishra is a specialist for both Cataract and Glaucoma and so he won’t require a separate eye consultation with another eye doctor.
Before the cataract surgery, few blood tests were done to know his medical fitness as a part of routine pre-operative investigations. On the day of operation, all his reports were checked which were normal and he was operated for phacoemulsification.Lt. Rohit was very happy with his new normal vision and reduced eye pressure. And he happily testified that the overall experience in R & R Eye Care Hospital was excellent. It is indeed the best eye hospital in SION and Dr. Rajesh Mishra is one of the best eye surgeon for cataract and glaucoma in Mumbai.
Lt. Rohit Sharma - 55 year old - Bandra - Retired Indian Army Officer
61-year-old Prem Selvakumar, a Kamgar Nagar, Kurla native, was a happy librarian who worked diligently everyday as he was passionate about books.
But soon his work was becoming a burden as he used to experience grittiness, burning sensation and fluctuating vision in his eyes especially when he used to read and use computer. But, as a natural human tendency, he assumed these signs are due to fatigue. Finally when his symptoms worsened, his daughter insisted him to visit an eye doctor in near bye area for an eye check-up. She started searching on the internet and after reading numerous positive feedbacks and reviews from happy patients, she chose R & R Eye Care Hospital in SION.
Initial comprehensive eye check-up was done for him. The visual acuity test confirmed that although he had normal vision but it was fluctuating. he mentioned about the symptoms of irritable and gritty eyes. Dry eye evaluation was one for him. The Schirmer’s test score was 2 mm and 3 mm after 5 min for right and left eye respectively.
Schirmer’s test is a dry eye test where the moisture content in the eyes or production of tears is determined using paper strips. Paper strip is inserted under the lower eye lid into the eyes. When the test result is normal- the filter paper shows more than 10 mm of moisture in 5 minutes. For Prem the reading was too less and was indicative of dry eyes.
Prem was then referred to Dr. Rajesh Mishra, a Cornea and Cataract surgery eye doctor at R & R Eye Care Hospital. On probing about his ocular history, he informed that his family members have observed that his eyes are half closed whenever he is in deep sleep (an eye condition called – lagophthalmos). Additionally, Dr. Rajesh used a special stain to check the severity of his dry eyes. He noticed that the cornea in both his eyes showed extensive staining suggestive of severe dry eyes and that explained his symptoms as well. Dr. Rajesh diagnosed him with dry eye syndrome and mild lagophthalmos. He advised him some blood tests to rule out any auto-immune cause for the dry eyes.
Aqueous tear deficiency happens when its source – lacrimal gland secrets tears less than the optimal level. This low-level of tear secretion is mainly due to abnormal functioning of the lacrimal glands which can happen due to multiple reasons. Reduced tear production leads to dryness in the eyes along with irritability and grittiness.
Lagophthalmos is a type of Exposure-related Dry eye syndrome. This happens when your eyelids are not positioned properly or is not functioning optimally or it has some structural defect. Luckily in case of Prem it was mild and didn’t have much effect on his eyes.
Dr. Rajesh prescribed him a few tear substitute eye drops, eye ointments and anti-inflammatory eye drops. Prem followed for next couple of weeks. He also advised him to restrict computer and mobile activity to the bare minimum.
Gradually, Prem experienced huge relief from gritty eyes and he could read on the computer without any eye problem. However as a precaution he reduced the gadget use to prevent these symptoms form recurring.
It is not uncommon that hot season along with excessive computer and mobile use can lead to dry eye. Dry eye in turns causes gritty eyes, burning sensation, conjunctivitis and eye tiredness. There are many times when we self-treat to get relief from dry eyes. But, like Prem, it is important to understand that an eye check –up is important to ascertain the type and severity of dry eyes and treat accordingly.
Mr. Prem Kumar - 61 year old - Kamgar Nagar, Kurla- Librarian
I have been performing Lasik surgeries for more than a decade. I have experienced how it has been truly a life changing experience for so many of my patients. It gives me immense satisfaction to see the positive impact of Lasik surgery on people’s lives besides the fact that they get rid of their glasses and contact lenses.
I remember Yamini Yegurwar very distinctly. She used to live with her parents in Matunga Labour Camp, Mumbai. She was a shy under-confident girl. She was always a topper in her class and there was no obvious reason for her under confidence if I considered her academic success.
But personally she had always been bullied by cousins and friends since her childhood due to her thick glasses. She had a very high eye power in the range of -30D. Her glasses were really thick and unfortunately she could not tolerate contact lenses and hence could not wear them. After visiting multiple eye doctors and getting declined for Lasik from everywhere she landed at my consultation chamber at R & R Eye Care Hospital in SION.
We did a detailed pre Lasik evaluation for her with tests like corneal topography, corneal tomography, IOL master, contrast sensitivity, pupil diameter, muscle balance testing, and dry eye assessment. Subsequently, we evaluated the health of her cornea, retina and Optic nerve. Lucky for her that all the tests were normal. But then the big dilemma was can Lasik correct such high power.
And the answer to that was No! Lasik can only correct eye powers in the range of -10 to -12 D depending on corneal thickness and other parameters. Correction of eye power beyond that can lead to future complications after Lasik. So we needed to be creative with our solution for Yamini. Using advanced technologies to find the right solution yet keeping patient’s safety at forefront is extremely important.
I discussed my plan with Yamini and she was absolutely over joyed with the possibility of getting rid of her glasses. This entailed getting 3 different procedures done at different time points. In the first instance only a corneal flap was created which we can say is half the Lasik procedure. 6 weeks after that a phakic lens called ICL (Implantable contact lens) was inserted in her eyes. 3 months after this her residual number was -9D. We lifted the previously created flap and completed the lasik surgery by doing the laser ablation.
Next day she had a crystal clear vision and that too without any glasses. She would see with that clarity for the first time in her life. Over the next few weeks she started loving herself and regained her confidence. She changed her entire wardrobe, joined the gym and lost some weight. She started performing really well professionally and got a promotion within a few months itself. And to top the list she met her Mr. Right! I had the privilege of appreciating these changes in her life first hand. I sometimes feel blessed that God has given us the opportunity to make a difference beyond the medical treatment itself.
All the modern laser vision correction surgeries can be combined with other procedures like Phakic Lens (implantable contact lens), piggy back lens, cataract extraction etc. Very often Lasik and other advanced procedure like femto lasik, Relex smile have their limitations and cannot be the whole sole procedure for a person mostly due to safety concerns. But in those cases other surgeries come to our aid and we can still help people wanting to get rid of glasses. Often combining 2 or more procedures can provide solution in all different complicated cases.
Ms. Yamini Yegurwar - Matunga Labour Camp, Mumbai - Student
61-year-old Abhishek Tiwari lives in Chunnabhatti. He used to go to his field which is located adjoining to the railway premises with equal enthusiasm. His half acre land used to produce all types of leafy vegetables.
One sunny day, the weather was little windy due to which a small particle of wood scraped the outer surface of his eyes called the cornea. Cornea is a very sensitive structure and any injury on it can cause severe pain. Abhishek experienced a lot of pain, watering and redness in his eyes.
His daughter-in-law immediately took him to R & R Eye Care Hospital in SION. She was recommended this eye hospital by her friend and according to her it is the best eye hospital in Navi Mumbai.
Comprehensive eye check-up was done for him. It was noted that he had diminished vision, intense eye pain and redness. After the initial eye check-up he was referred to Dr. Rajesh Mishra.
Dr. Rajesh Mishra, an eye cornea specialist at R & R Eye Care Hospital, diagnosed Abhishek with corneal abrasion with an embedded wooden splinter. Dr. Rajesh removed the splinter from the patient’s cornea gently. Subsequently, he instilled an ointment in his eye and patched the eye for one night. During the subsequent follow-ups his injury gradually healed and he recovered normal vision.
In Abhishek’s eye the abrasion was deep and it injured not just the superficial epithelium but also the stromal layer. Injury caused by eye trauma affecting below the bowman’s layer and stromal layer of the cornea usually forms corneal scar. However, the scar formation on the Abhishek’s eyes, thankfully, was minimal and hence did not affect the vision.
During all the subsequent follow up sessions, Abhishek's cornea showed gradual significant improvement in his vision.
Thus, Abhishek was delighted with this new, normal vision and so his family expressed their gratitude towards Dr. Rajesh Mishra.
And, Yes! Eye trauma can cause corneal abrasions, corneal ulcers and subsequently corneal scar. It is commonly seen in farmers, drivers, bikers etc. who are normally exposed to external factors of eye trauma. Any injury or corneal infection can lead to corneal scar is not treated on time. To prevent corneal scar formation only an eye doctor should remove any foreign body from the cornea with appropriate instrument. Moreover, timely intervention by the eye specialist is important as well as critical in cases of eye injury.
Mr. Abhishek Tiwari - 61 year old - Chunnabhatti - Farmer
I was working for a MNC company in Bandra-Kurla Complex. I had to often required to visit various customers all over Mumbai. Over several months, I started experiencing intermittent hazy vision. Whenever I used to wake up in the morning, I used to have blurry vision. But as the day progressed, the haziness in my eyes used to go away. I found these signs very unusual.
I decided to finally consult an eye doctor. On the day of appointment, I underwent a complete eye check-up. The visual acuity test confirmed that vision was slightly reduced and my contrast sensitivity was also reduced. I was then referred for a Cornea and Cataract surgery eye doctor. Eye evaluation on slit lamp examination showed I had swelling on the cornea (the outermost surface of the eye) as well as there were some whitish superficial scars on it.
Doctor further advised Corneal Pachymetry. It revealed that my cornea had a swelling on it. Doctor further asked me if I had any family history of eye problems. I confirmed that my father also had some eye disease but wasn’t sure of the exact diagnosis. Doctor diagnosed me with Fuchs Endothelial Dystrophy. Fuch’s endothelial dystrophy is a progressive genetic eye disease wherein the cornea’s endothelium (innermost layer) is affected. Slowly the number of endothelial cells decrease in number causing the upper layers to swell. This in turn causes the cornea to become cloudy or hazy thus affecting vision.
Luckily, Fuchs dystrophy in my eyes was in its early stage. Had it reached in its advanced stage, I would experience eye pain and sensitivity to light and the vision would not have been clear. In advanced stages the only option is cornea transplantation. A corneal transplant procedure known as Penetrating Keratoplasty or Descemet’s stripping endothelial keratoplasty (DSEK) or Descemet’s membrane endothelial keratoplasty (DMEK) can be performed and have shown an excellent success rate, if a person loses vision in the concluding stages of the disease.
At an early stage, a patient may be given ointments and eye drops to minimize the uneasiness. Doctor prescribed me saline eye ointment at night so as to pull extra fluid from the cornea to help reduce the oedema of the cornea. This reduced the morning blurriness. Doctor further informed me that I may eventually need the cornea transplantation as and when the disease progresses and his corneal swelling becomes more persistent.
When someone experiences Intermittent or constant hazy vision, one must undergo an eye check up to detect the eye problem. Many eye problems can be healed through eye drops or sometimes surgery may be needed, depending on the type and severity of eye disease.
Mr. Sunil Yadav - 45 year old .
- Sion Resident
Lasik surgery has been around for than 2 decades and has been instrumental in giving freedom from glasses to over a million people worldwide. Naturally, some of them are now reaching a stage that their lens has developed a cataract and they need a cataract surgery.Misconception around LASIK surgery
For some reason, common perception in the public is that cataract surgery cannot be performed after previous Lasik surgery. That is a total misconception. There are definitely special considerations that we need to give during the cataract surgery. The calculations that are done for lens power calculation needs some modifications and corrections to be taken into account.
I was suffering from blurred vision for so many months inspite of undergoing a LASIK surgery 10 years ego. On proper examination I had developed a cataract and I needed a surgery to replace the cloudy lens with a clear lens. I was shocked and exclaimed that how I can develop a cataract. The Doctor explained me the following about LASIK procedure.
Lasik is a mechanical procedure and entails laser dependent reshaping of the cornea. It does not alter any other part of the eye. What that means is that anything and everything that can happen to the eye will happen in future. Age related changes like cataract etc will happen which is determined by genetics, age and other external factors like diabetes among other things. Anyone who has uncontrolled diabetes is at risk of developing diabetic changes in the retina and there won’t be any protection just because someone had done a Lasik surgery earlier.
Lasik surgery does not prevent treatment for any future eye problem. Be it a cataract surgery or treatment for glaucoma or any retinal diseases. In some of these treatments some correction factors are required during measurements.
During cataract surgery there are 2 considerations
Intra-ocular Lens (IOL) power calculation- this require some correction factors to be taken into account depending on the type of Lasik done in the past. Also the regular formulae that we use to calculate the IOL power cannot be used after previous Lasik surgery. This is a widely known fact among the eye doctors and any good experienced eye doctor will automatically take all these factors into consideration
The type of lens that is implanted is also given special consideration. Mostly monofocal lenses are preferred after previous Lasik procedure. Additionally depending on the spherical aberration of the patient’s cornea the asphericity of lens can be chosen to reduce the impact of patients pre-existing aberrations.
Surgical procedure can be done as a routine procedure keeping in mind that intraocular pressure after the procedure should be properly monitored and controlled
So in case of mine I was satisfied and had all my concerns allayed. A cataract surgery was performed on me. Doctor used special formulae for my IOL power calculation. I chose one of the best monofocal lens suitable for me. I got excellent results as was expected!
Lasik surgery is an excellent option for people who want to reduce dependence on their glasses or contact lenses. However one must know and understand that the normal aging changes will affect the eye irrespective of the previous Lasik. Lasik does not prevent any future eye treatment if required.
Ms. Anita - 52 year old - Matunga .
Lawyer by profession
I used to play football after office hours. Unfortunately, one evening during a match, football hit my eye and I immediately noticed a blurry vision. After this blunt trauma to my eyes, I was immediately taken to the hospital for an eye check-up.
My eye exam revealed thin sclera and blood inside my eye- hyphema. Additionally Tonometry showed high intraocular pressure (IOP) of 32mmHg. The normal range of intraocular pressure falls between 12-22mmHg.
Dr. Rajesh Mishra, an eye doctor specialising in Glaucoma treatment and Cataract surgery, examined me. Dr. Mishra confirmed the findings and prescribed me few eye drops to limit inflammation, reduce the intra ocular pressure and to reduce the pain.
I followed the instructions and instilled the prescribed eye drops for 2-3 weeks but didn’t follow up as was advised by Dr. Mishra. All was well for him till one day I had intense eye pain after 3 months. I was suddenly reminded that I forgot to visit my eye doctor for follow up sessions.
Next day, I booked an appointment with Dr. Rajesh Mishra. Upon my visit, Dr. Mishra, observed that the intraocular pressure had again shot up. He advised me to undergo OCT scan for optic nerve and the visual field examination. These tests along with Gonioscopy confirmed that I had developed Angle-closure glaucoma (closed-angle glaucoma) and showed cupping of the optic disc with moderate loss of peripheral vision. Glaucoma is a group of eye diseases, which cause progressive damage to the optic nerve and vision loss.
I was of course upset with meself for not following up diligently. I was also concerned what would be the best treatment for my eye condition given the signs and symptoms I showed. Dr. Rajesh Mishra initially gave me oral medicines and eye drops to control the eye pressure. Subsequently given the moderately advanced glaucoma, Dr. Mishra advised me to undergo Trabeculectomy with Ologen Implant as the treatment of angle-closure glaucoma.
In Trabeculectomy, a new drainage pathway is created under the conjunctiva by removing a small block of the clogged trabecular meshwork. This new pathway creates a ‘filtering bleb’. Fluid of the eye flows under the bleb and then passes into the blood stream. This alternative channel helps in lowering the intraocular pressure.
While performing trabeculectomy, Ologen implant is inserted under the conjunctiva that helps to maintain the height of the bleb ensuring proper drainage of fluid. Ologen Collagen implant is a porous and biodegradable glaucoma drainage device made from collagen.
Trabeculectomy with Ologen Implant is known to effectively reduce the eye pressure and assist in surgical wound healing. This surgery is performed especially in those when patients who have thin sclera.
Trabeculectomy surgery takes less than an hour and it does not require overnight stay at the eye hospital. The recovery time for this glaucoma surgery is quick and patient can get back to normal lifestyle in 3-4 weeks.
With passage of time, I regained normal eye pressure and my eye pain vanished. I thanked Dr. Rajesh Mishra for treating my eyes with utmost care and immense patience.