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Dr Agarwals Eye Hospital - Arera Colony, Bhopal

E-2/66 Arerra Colony, 10 No. market, Arera Colony, Bhopal - 462016

agarwalhospitals@gmail.com9594904661

For Dr Agarwals Eye Hospital

Glaucoma Shunt Surgery

What Is Glaucoma Shunt Surgery?

Glaucoma shunt surgery, also known as glaucoma tube shunt surgery, is an advanced surgical technique used to manage high eye pressure that does not respond to medications or previous glaucoma procedures.

In this surgery, the ophthalmologist implants a tiny, flexible tube (a shunt or drainage device) into the eye’s white part (sclera). The tube diverts excess fluid to a small plate placed under the conjunctiva, where it is absorbed into surrounding tissues. This creates a new pathway for fluid drainage and helps maintain stable eye pressure levels. Glaucoma tube shunt surgery is particularly beneficial for patients with complicated glaucoma types or those whose previous surgeries, such as trabeculectomy, have not been successful.

Why Is Glaucoma Tube Shunt Surgery Needed?

Doctors recommend glaucoma tube shunt surgery when standard treatments are no longer effective in controlling intraocular pressure. It is considered when other surgical options are not suitable or have failed.

Common reasons include:

  • Persistent high IOP despite maximum use of eye drops or laser therapy
  • Advanced glaucoma with risk of optic nerve damage
  • Complex cases, such as neovascular or congenital glaucoma
  • Previous failed trabeculectomy or scarring that blocks normal drainage pathways

By providing an alternative route for fluid to exit, a tube shunt for glaucoma helps protect vision and prevent progressive vision loss.

Glaucoma Shunt Surgery Steps Explained

The glaucoma shunt surgery procedure is usually completed within 45-60 minutes in a hospital or eye surgery centre. It is performed under local or general anaesthesia, depending on patient preference and medical condition.

Here’s how glaucoma tube shunt surgery is done:

  • The eye is numbed using anaesthetic drops or injections.
  • A small incision is made in the white part of the eye (sclera).
  • The surgeon places a small tube implant inside the eye to allow fluid drainage.
  • The other end of the tube connects to a reservoir plate, which is secured under the conjunctiva.
  • The fluid drains from the eye into this plate, where it is naturally absorbed.

This procedure effectively reduces IOP by bypassing the eye’s natural drainage system, offering long-term control for patients with uncontrolled glaucoma.

What to Expect During Glaucoma Shunt Surgery

Pre-Surgery Preparation

Before surgery, patients undergo comprehensive tests, including eye pressure measurement, visual field analysis, and optic nerve imaging. These eye tests before glaucoma shunt surgery help determine disease severity and plan the best approach.

Doctors may adjust medications or advise stopping blood-thinning drugs before surgery as part of glaucoma shunt pre-op instructions.

During the Surgery

During the glaucoma shunt procedure, patients are awake but pain-free due to local anaesthesia. The surgeon carefully implants the glaucoma drainage device to ensure proper positioning and flow control. The process is smooth and precise, minimising trauma to the surrounding eye tissues.

Recovery After Glaucoma Shunt Surgery

Post-Surgery Instructions

Following surgery, patients must follow proper aftercare for tube shunt surgery. Doctors usually prescribe anti-inflammatory and antibiotic glaucoma shunt eye drops to prevent infection and reduce inflammation.

Patients should:

  • Avoid rubbing or pressing the operated eye
  • Wear an eye shield at night for protection
  • Avoid strenuous activities or swimming until cleared by the doctor
  • Attend all follow-up appointments for monitoring

Good glaucoma shunt recovery care ensures the surgery’s long-term success.

Glaucoma Shunt Surgery Recovery Time

The glaucoma shunt surgery recovery time varies for each patient, but typically takes 4-6 weeks for complete healing. Blurred vision and mild redness are common during the first few days. 

Most people resume daily activities within two weeks, though close monitoring continues for several months to ensure stable pressure and healing. Consistent follow-up care is crucial since healing after tube shunt surgery determines how well the implant functions over time.

Complications of Glaucoma Shunt Surgery

While generally safe, glaucoma shunt surgery can occasionally lead to side effects or complications, which are usually manageable with timely care.

Possible glaucoma shunt surgery complications include:

  • Temporary redness, irritation, or discomfort
  • Mild bleeding or infection
  • Over-drainage, leading to low eye pressure
  • Tube blockage or scarring at the drainage site
  • Cataract formation over time

These tube shunt surgery side effects are uncommon, and serious complications are rare when performed by experienced ophthalmic surgeons. Regular check-ups help detect and address any issues early.

Benefits of Glaucoma Tube Shunt Surgery

The benefits of glaucoma shunt surgery are substantial for patients with uncontrolled or complex glaucoma.

Key advantages include:

  • Long-term control of intraocular pressure
  • Reduced dependency on multiple glaucoma medications
  • Protection of the optic nerve from further damage
  • Improved quality of life through stable vision
  • Effective management when other surgeries have failed

Because it offers sustained pressure reduction, the effectiveness of tube shunt surgery makes it a valuable option for preventing progressive glaucoma damage.

How to Prepare for Glaucoma Shunt Surgery

Proper preparation for glaucoma shunt surgery ensures a smoother recovery and optimal outcomes.

Patients should:

  • Share their full medical history and medications with the ophthalmologist
  • Stop taking blood-thinning medicines if advised
  • Arrange transportation after surgery, as driving immediately after is not recommended
  • Follow any fasting instructions before the operation

This pre-op glaucoma checklist helps the surgical team plan effectively and reduce risks during the procedure.

Conclusion: Is Glaucoma Shunt Surgery Right for You?

Glaucoma shunt surgery is a proven and safe treatment for patients whose eye pressure remains high despite other treatments. Although it does not restore lost vision, it helps prevent further optic nerve damage by effectively lowering intraocular pressure.For many patients, this surgery provides lasting relief, reduced reliance on medications, and a better quality of life. Consulting an ophthalmologist is the best way to determine whether glaucoma tube shunt surgery is the right option based on your condition and eye health.


Laser Trabeculoplasty for Glaucoma Treatment

What Is Laser Trabeculoplasty?

Laser trabeculoplasty is a specialised glaucoma laser treatment designed to lower eye pressure in patients with open-angle glaucoma. During this trabeculoplasty surgery, a focused laser beam is applied to the trabecular meshwork, the eye’s natural drainage system. 

This helps improve the outflow of aqueous fluid, reducing the pressure inside the eye. The laser does not create a hole or cut. Instead, it stimulates biological changes that enhance drainage and maintain healthy eye pressure levels.

Types of Laser Trabeculoplasty

Argon Laser Trabeculoplasty (ALT)

Argon laser trabeculoplasty (ALT) uses a thermal laser to create tiny, precise burns on the trabecular meshwork. These small burns cause the tissue to contract, opening nearby drainage channels and allowing fluid to flow out more efficiently. 

ALT is highly effective in lowering eye pressure during ALT glaucoma treatment. This is particularly the case in patients with primary open-angle glaucoma or secondary forms such as pseudoexfoliation or pigmentary glaucoma.

Selective Laser Trabeculoplasty (SLT)

Selective laser trabeculoplasty (SLT) is a more advanced technique that uses low-energy laser pulses to target only pigmented cells in the trabecular meshwork. The surrounding tissue remains unaffected, making the SLT glaucoma procedure gentler and repeatable if needed.  Because it causes minimal thermal damage, SLT is often preferred for its safety profile and long-term effectiveness. It is widely considered a first-line glaucoma treatment for patients who do not tolerate or respond well to eye drops.

How Does Laser Trabeculoplasty Work for Glaucoma?

In laser trabeculoplasty glaucoma procedures, the laser energy interacts with the trabecular meshwork to improve the outflow of aqueous fluid. Enhancing the eye’s natural drainage system helps lower intraocular pressure, the leading risk factor for glaucoma-related vision loss. 

This improved outflow prevents further optic nerve damage and maintains stable vision. Unlike traditional glaucoma surgery options, the procedure is quick, requires no incisions, and can be done in a clinic setting.

Benefits of Laser Trabeculoplasty Over Other Treatments

The benefits of laser trabeculoplasty are numerous, making it a preferred option for many patients.

  • It is a non-invasive procedure performed under topical anaesthesia, eliminating the need for surgical cuts.
  • Patients experience minimal discomfort and a quick recovery.
  • It can reduce dependency on glaucoma drops, improving treatment compliance.
  • In some cases, it delays or prevents the need for more invasive glaucoma surgeries.

Both ALT and SLT have excellent safety profiles, but ALT vs SLT studies show that SLT offers better repeatability and lower risk of tissue damage.

Who Is a Candidate for Laser Trabeculoplasty?

Candidates for laser trabeculoplasty include individuals diagnosed with open-angle glaucoma, pseudoexfoliation glaucoma, or pigmentary glaucoma. It is also recommended for patients whose intraocular pressure remains high despite using medications or for those who wish to reduce their dependence on multiple eye drops. 

Patients with narrow or closed angles are typically not suitable candidates. An ophthalmologist will perform a detailed assessment to determine eligibility and choose between ALT or SLT based on the individual’s eye condition.

What to Expect During a Laser Trabeculoplasty Procedure

Pre-Procedure Preparation

Before the laser trabeculoplasty procedure, the doctor performs a thorough glaucoma exam to measure intraocular pressure and examine the angle of the eye using gonioscopy. Medications may be reviewed to ensure they are compatible with the laser treatment. Some patients are given pressure-lowering drops before the procedure to minimise temporary spikes after treatment.

During the Procedure

During laser trabeculoplasty steps, the eye is numbed with anaesthetic drops, and a special contact lens is placed to help focus the laser. The ophthalmologist applies laser pulses to the trabecular meshwork, typically 50 to 100 spots in total. 

The ALT procedure or SLT procedure usually takes 10-20 minutes. Patients may feel mild pressure or light flashes, but no significant pain.

Recovery and Aftercare Following Laser Trabeculoplasty

Post-Surgery Care and Instructions

During laser trabeculoplasty aftercare, patients may receive anti-inflammatory eye drops to reduce swelling and irritation. Vision may appear slightly blurred or hazy for a few hours after the procedure. It is essential to attend follow-up visits to monitor intraocular pressure and assess treatment success.

Returning to Normal Activities

The laser trabeculoplasty recovery time is typically short. Most patients resume their normal routines within one to two days. Heavy exercise and eye rubbing should be avoided immediately after treatment.

Potential Risks and Complications of Laser Trabeculoplasty

Though generally safe, laser trabeculoplasty risks include mild inflammation, temporary increases in intraocular pressure, or light sensitivity. Rarely, the procedure may need to be repeated if eye pressure rises again. The risk of serious complications is significantly lower compared to surgical glaucoma procedures, making it a safe first-line or adjunctive treatment option.

Argon vs. Selective Laser Trabeculoplasty: Which Is Right for You?

When comparing argon vs selective laser trabeculoplasty, both techniques aim to lower eye pressure, but they differ in mechanism and long-term outcomes. ALT uses heat to create small burns, whereas SLT selectively targets pigmented cells. 

SLT is generally preferred due to its reduced tissue damage, fewer side effects, and ability to be repeated safely. However, ALT may still be effective for specific patients or in settings where SLT is unavailable. Your ophthalmologist will decide based on eye type, previous treatments, and overall glaucoma status.

Conclusion: Is Laser Trabeculoplasty the Right Choice?

Laser trabeculoplasty glaucoma treatment offers a safe, quick, and effective way to control intraocular pressure and prevent vision loss. 

Whether through argon laser trabeculoplasty or selective laser trabeculoplasty, the procedure helps maintain long-term eye health without surgery. It’s ideal for patients seeking a non-invasive solution with minimal downtime. Consulting an experienced ophthalmologist is essential to determine if ALT or SLT suits your specific needs and to establish an appropriate follow-up plan for sustained results.

YAG Peripheral Iridotomy (YAG PI)

What Is YAG Peripheral Iridotomy (YAG PI)?

YAG Peripheral Iridotomy (YAG PI) is a type of glaucoma laser treatment performed to prevent or treat angle-closure glaucoma. It uses a highly focused YAG laser to make a microscopic hole near the edge of the iris, the coloured part of the eye. This small passage allows trapped aqueous fluid to move from the back chamber to the front of the eye, equalising pressure and keeping the drainage angle open.

The YAG laser peripheral iridotomy procedure is non-invasive, takes only a few minutes, and is typically painless. It is an effective way to prevent vision-threatening complications without the need for traditional surgery.

Why Is YAG PI Laser Treatment Needed?

YAG PI laser treatment is recommended when a patient is at risk of developing or already has angle-closure glaucoma. In this condition, the iris blocks the fluid drainage system, causing a sudden rise in pressure. The YAG PI eye surgery prevents such blockages by providing an alternate pathway for fluid flow.

Key reasons for performing YAG laser peripheral iridotomy include:

Prevention of angle-closure attacks



How Does YAG PI Eye Surgery Work?

YAG PI eye surgery is a precise and controlled laser trabeculoplasty procedure that targets the iris. Here’s how it works:

  •  Anaesthetic drops are applied to numb the eye and ensure comfort.
  • A special contact lens is placed on the eye to focus the YAG laser.
  • The laser creates a tiny hole in the peripheral iris, usually in the upper part, where it’s less visible.
  • This new channel allows aqueous fluid to move freely between chambers, relieving pressure and preventing further blockages.

The YAG PI laser treatment restores the eye’s natural fluid balance, reducing the risk of optic nerve damage and glaucoma progression.

What to Expect During YAG Laser Peripheral Iridotomy

Pre-Procedure Preparation

Before the YAG PI laser procedure, your ophthalmologist will perform a comprehensive eye examination. This will include intraocular pressure measurement and gonioscopy (a test to view the eye’s drainage angle).

You may be prescribed eye drops to constrict the pupil and lower pressure before treatment. Proper YAG PI laser preparation ensures accuracy and safety during the procedure.

During the Procedure

The YAG laser peripheral iridotomy procedure is typically completed within 5-10 minutes. The patient remains seated at a slit lamp microscope during a standard eye examination. 

After applying numbing drops, the ophthalmologist uses the laser to create the microscopic opening. Most patients describe the process as painless, with only slight pressure or flashing light sensations.

Recovery and Aftercare Following YAG PI Laser Treatment

Post-Treatment Instructions

After the procedure, patients may experience mild irritation, redness, or light sensitivity. Anti-inflammatory eye drops are prescribed to reduce swelling and aid healing. 

These are part of standard YAG PI aftercare and help prevent temporary pressure fluctuations. Vision usually stabilises within a few hours.

Returning to Normal Activities

The YAG PI recovery time is short. Most individuals can resume their regular routines, including reading and light work, within a day. 

However, it is important to avoid rubbing the eyes or engaging in strenuous activities immediately after treatment. Regular follow-up visits are essential to ensure the iridotomy remains open and effective.

Risks and Complications of YAG PI Laser

While the YAG PI laser is very safe, some mild side effects can occur. These include temporary increases in eye pressure, redness, glare, halos, or mild discomfort. In rare cases, the opening may close and require a repeat treatment.

Common YAG PI laser risks include:

  • Temporary pressure spike shortly after the procedure
  • Mild inflammation or redness
  • Light sensitivity or glare
  • Closure of the iridotomy hole, requiring another laser session

Serious complications such as bleeding or permanent vision problems are extremely rare

  Benefits of YAG PI Over Other Treatments

The benefits of YAG PI make it one of the most effective and widely recommended preventive glaucoma treatments.

  • Quick and outpatient-based: The procedure takes less than 10 minutes and requires no hospital stay.
  • Minimally invasive: No incisions or stitches are involved.
  • Prevents acute angle-closure glaucoma: Reduces the risk of sudden increases in eye pressure.
  • Reduces dependency on medications or surgery: Many patients experience long-term control without additional interventions.

When comparing YAG PI vs surgical iridectomy, the laser version is preferred for its precision, comfort, and faster recovery.

Who Should Consider YAG PI Eye Surgery?

Candidates for YAG PI eye surgery include individuals at risk of developing angle-closure glaucoma or those already experiencing early signs. It is particularly beneficial for:

  • Patients with narrow angles identified during routine eye exams
  • Those with a history of angle-closure symptoms, such as pain, blurred vision, or seeing halos
  • Individuals with a family history of glaucoma
  • High-risk eyes, including hyperopic (farsighted) patients and those with thick lenses

Your ophthalmologist will determine suitability after a detailed examination and discussion of treatment options.

Conclusion: Is YAG Peripheral Iridotomy the Right Choice?

YAG Peripheral Iridotomy (YAG PI) is a safe, efficient, and effective laser treatment to prevent glaucoma-related vision loss. It improves fluid circulation, lowers intraocular pressure, and protects the optic nerve from irreversible damage. 

For patients at risk of angle-closure glaucoma, YAG PI laser treatment offers an excellent preventive solution that is quick, painless, and minimally invasive. Consulting an experienced ophthalmologist can help determine whether YAG PI eye surgery is the best option for your eye health.

Minimally Invasive Glaucoma Surgery (MIGS)

What Is Minimally Invasive Glaucoma Surgery (MIGS)?

Minimally Invasive Glaucoma Surgery is a group of surgical techniques designed to control glaucoma with smaller incisions, less tissue disruption, and faster recovery. 

Unlike conventional filtering surgeries, MIGS surgery uses advanced devices to improve fluid drainage from the eye. As a form of minimally invasive eye surgery, it focuses on lowering pressure while preserving natural eye structures whenever possible.

How Does MIGS Work to Treat Glaucoma?

MIGS treatment involves using specialised micro-instruments or tiny stents inserted through tiny openings in the eye. These create new drainage pathways or enhance existing ones, allowing fluid to exit more efficiently. 

This supports long-term glaucoma pressure management and prevents damage to the optic nerve. By reducing reliance on drops, eye surgery for glaucoma through MIGS provides patients with an effective, targeted, and safe alternative.

Benefits of Minimally Invasive Glaucoma Surgery (MIGS) Over Traditional Methods

The benefits of MIGS include smaller incisions, quicker healing, and fewer complications. Unlike conventional surgery, which often carries a higher risk of scarring or infection, MIGS vs traditional glaucoma surgery offers a gentler approach.

Patients experience reduced discomfort, shorter recovery times, and a lower chance of side effects. These advantages of MIGS make it a preferred choice for many glaucoma patients who need surgical care.

Who Is a Good Candidate for MIGS?

Candidates for MIGS are typically those with early to moderate stages of glaucoma. Patients who have tried medications or laser therapies without sufficient control may be ideal. 

Glaucoma candidates include adults who still have functional outflow pathways and wish to reduce dependence on drops. The best candidates for MIGS are those needing surgical intervention with minimal disruption to their daily lives.

Types of Minimally Invasive Glaucoma Surgery Procedures

  • Stent-BasedMIGSProcedures

Glaucoma stent surgery utilises tiny implants, such as the iStent procedure or Hydrus microstent, to create permanent channels for fluid drainage. These stents are placed inside the eye’s natural drainage system, lowering pressure safely and effectively. They are particularly helpful when combined with cataract surgery, offering long-term relief with minimal additional risk.

  • Trabecular BypassMIGS

Trabecular meshwork surgery involves bypassing the natural resistance within the eye’s drainage system. With a MIGS trabecular bypass, fluid flows directly into Schlemm’s canal, significantly reducing pressure. This option is often recommended for patients where traditional drops or laser therapy have failed, but surgery must remain minimally invasive.

What to Expect During a MIGS Procedure

  • Pre-Surgery Preparation forMIGS

Before MIGS preparation, patients undergo detailed examinations, including eye pressure checks, gonioscopy, and a review of their medical history. Current medications are assessed, and the target intraocular pressure is discussed. 

Patients may be advised to adjust certain drops or avoid specific drugs before the procedure. Clear planning ensures the MIGS surgery preparation stage is safe and smooth.

  • During theMIGSProcedure

The MIGS surgery steps are straightforward. Under local anaesthesia, a surgeon makes a very small incision at the corneal edge. 

Using advanced micro-instruments, a stent or bypass device is inserted. The MIGS surgical procedure usually takes less than 30 minutes, and patients typically return home the same day. 

Recovery and Aftercare After Minimally Invasive Glaucoma Surgery

MIGS recovery is generally faster than with conventional surgery. Most patients notice less discomfort and return to daily activities sooner. The MIGS healing process involves close follow-up to monitor intraocular pressure and eye stability. The overall recovery time after MIGS is often just a few weeks, depending on the individual.

The MIGS healing process involves close follow-up to monitor intraocular pressure and eye stability. The overall recovery time after MIGS is often just a few weeks, depending on the individual.

  • Post-Surgery Care and Instructions

MIGS aftercare includes using prescribed eye drops to prevent infection or inflammation. Patients should avoid strenuous activities, heavy lifting, or swimming during the first few weeks. Following all post-surgery instructions for MIGS helps ensure successful outcomes and minimises complications.

  • When to Return to Normal Activities

Most patients resume normal routines within a week. Light office work is often safe after a few days, while exercise may need to be avoided for two to three weeks. 

MIGS activity restrictions are temporary, and patients typically return to their normal life routine quickly. Returning to normal life after MIGS is faster compared to traditional glaucoma surgeries.

Potential Risks and Complications of MIGS

Although considered safe, MIGS procedures carry risks, including minor bleeding, inflammation, or temporary fluctuations in eye pressure. Rarely, devices may move or additional surgery may be required. Compared with traditional methods, MIGS complications are far less frequent. The overall risks of minimally invasive glaucoma surgery remain low, and outcomes are generally excellent when proper care and follow-up are provided.

Why Choose MIGS for Glaucoma Treatment?

There are many reasons to consider choosing MIGS. It offers quick recovery, minimal discomfort, and effective pressure control with fewer risks. 

As part of modern glaucoma management, MIGS advantages are well-suited for patients who seek reliable results with minimal downtime. For many, MIGS for eye health is the ideal way to strike a balance between safety and success, highlighting the core benefits of MIGS for patients with glaucoma.

Conclusion: Is Minimally Invasive Glaucoma Surgery Right for You?

Minimally Invasive Glaucoma Surgery represents an important step in advancing glaucoma care. It offers patients effective pressure reduction with reduced risks and quicker recovery compared with older methods. 

The decision to undergo MIGS depends on the stage of glaucoma, overall health, and the results of previous treatments. Patients should consult their ophthalmologist to decide whether MIGS is the best choice among today’s glaucoma surgery options.

Central Serous Retinopathy (CSR)

Causes of Central Serous Chorioretinopathy

The exact cause of CSR is not fully understood, but several factors contribute to its development

1. Stress:

High stress levels can lead to increased cortisol production, which may trigger CSR.

2. Steroid Use:

The use of corticosteroids, either oral or topical, is a significant risk factor.

3. High Blood Pressure:

Hypertension affects blood flow to the retina, increasing the risk of fluid buildup.

4. Sleep Issues:

Poor sleep patterns and insufficient rest can worsen stress, contributing to CSR.

5. Unhealthy Diet:

Diets high in processed foods, salt, or sugar can lead to inflammation, affecting eye health.

Foods to Avoid with Central Serous Retinopathy

To manage CSR and reduce worsening symptoms, it’s essential to avoid foods that can trigger inflammation or elevate cortisol levels:

  • Processed Foods: Avoid snacks high in preservatives like chips and packaged goods.
  • Sugary Foods and Drinks: Limit candy, sodas, and high-sugar items that cause inflammation.
  • High-Salt Foods: Reduce salty snacks, canned soups, and processed meats that contribute to fluid retention.
  • Caffeine: Minimize coffee, tea, and energy drinks that can increase stress and cortisol levels.
  • Alcohol: Limit alcohol consumption as it impairs overall eye health and recovery.

Best Foods for Central Serous Retinopathy

A nutrient-rich diet promotes eye health, reduces inflammation, and supports faster recovery from CSR. Include the following foods:

  • Leafy Green Vegetables: Spinach, kale, and collard greens are rich in lutein and zeaxanthin, essential for eye health.
  • Omega-3 Fatty Acids: Found in salmon, walnuts, and chia seeds, they reduce inflammation and support retinal health.
  • Vitamin C-Rich Foods: Oranges, strawberries, and bell peppers boost eye tissue repair and immunity.
  • Vitamin A Sources: Sweet potatoes, carrots, and pumpkin support the retina’s function.
  • Hydrating Foods: Cucumbers, watermelon, and water-rich foods help maintain hydration.
  • Whole Grains: Brown rice, oats, and quinoa regulate blood sugar levels, reducing stress on the eyes.

Treatment Options for Central Serous Retinopathy

1. CSR Eye Treatment Naturally

  • Reduce Stress: Engage in relaxation techniques like meditation, yoga, or deep breathing exercises.
  • Improve Sleep Hygiene: Establish a consistent sleep routine to lower cortisol levels.
  • Adopt a Healthy Diet: Consume anti-inflammatory foods that support retinal health.

2. CSR Eye Treatment – Medical Options

  • CSR Laser Treatment: This treatment, also known as photodynamic therapy, can help seal leaky blood vessels.
  • CSR Eye Surgery: In chronic cases, specialized retinal surgery may be required.
  • Medications: Some patients may benefit from anti-VEGF injections to control fluid leakage.

When to See an Eye Specialist

If you experience persistent blurry vision, distorted shapes, or dark spots in your central vision, visit your nearest eye hospital for a thorough examination. Early diagnosis and timely intervention can prevent complications.

Conclusion

Proper diet and lifestyle changes play a crucial role in managing Central Serous Retinopathy (CSR). Whether opting for CSR eye treatment naturally or considering CSR laser treatment, maintaining good eye health and reducing stress are key to preventing recurrences. If you notice persistent symptoms, seek medical attention for timely intervention and appropriate CSR treatment.

Hyperopia

Symptoms of Hyperopia (Farsightedness)

Hyperopia can cause several symptoms, especially during activities that require close vision. These include:

  • Blurred Near Vision: Difficulty focusing on nearby objects, such as reading text or working on computers.
  • Eye Strain (Asthenopia): Eye fatigue after performing near-vision tasks for extended periods.
  • Headache: Persistent headache, often around the eyes or forehead, after activities requiring close focus.
  • Difficulty Focusing: Trouble switching focus from distant to near objects.
  • Squinting: A tendency to squint when viewing close objects to achieve better focus.
  • General Fatigue: A feeling of tiredness after performing visually demanding tasks.

If these symptoms are persistent or worsen over time, it’s advisable to seek medical evaluation for hyperopia correction.

When to See a Doctor for Hyperopia

Seeking medical advice is essential when hyperopia symptoms begin to impact your daily activities. Common situations where you should consider seeing a doctor include:

  • Persistent blurred vision when reading or working on close-up tasks
  • Ongoing eye strain or discomfort  
  • Frequent headache, especially after near-vision tasks
  • Difficulty focusing on objects close to you
  • A noticeable decline in vision that affects work, reading, or driving

Children showing signs of hyperopia, such as holding reading material far from their eyes or complaining of difficulty reading or writing tasks in school, should also be evaluated by an eye specialist.

Causes of Hyperopia

Hyperopia is primarily caused by structural issues within the eye. The most common causes include:

  • Shorter Eyeball: A shorter-than-average eyeball prevents light from focusing directly on the retina, leading to farsightedness.
  • Flat or Under-curved Cornea: An inadequately curved cornea can reduce the eye’s ability to refract light effectively, contributing to hypermetropia.
  • Thin or Weak Lens: The eye’s natural lens may lack sufficient power to bend light rays correctly.
  • Genetic Factors: Hyperopia often runs in families, indicating a genetic predisposition.
  • Developmental Issues: In children, hyperopia is common due to underdeveloped eyes, but many grow out of the condition as their eyes mature. 
  • Age-related Changes: Age-related changes, such as presbyopia, can exacerbate the symptoms of hyperopia as the lens becomes less flexible over time.

Understanding these causes is essential to identify the right treatment approach, whether through corrective lenses or refractive surgery.

Hyperopia Treatment Options

Modern advancements in ophthalmology have made treating hyperopia more effective and accessible. Here are the leading options:

1.    Corrective Lenses for Hyperopia

Corrective lenses, including eyeglasses and contact lenses, are commonly used to treat mild to moderate hyperopia.

  • Eyeglasses: Eyeglasses with convex lenses help bend light inward so that it focuses correctly on the retina. This is one of the most accessible options for farsighted correction and provides immediate results.
  • Contact Lenses: Contact lenses offer a wider field of view and sit directly on the eye, providing more natural vision correction. Soft and rigid gas-permeable options are available based on individual needs.
  • Corrective Lens for Hyperopia: Convex corrective lenses work by increasing the eye’s focusing power, making them highly effective in improving close-up vision.

While corrective lenses provide immediate relief, they do not offer a permanent cure for hypermetropia. For those seeking long-term solutions, surgical interventions may be more appropriate.

2. Refractive Surgery

Refractive surgery is an increasingly popular option for patients seeking permanent hyperopia correction. The following procedures are widely used:

  • LASIK (Laser-Assisted In Situ Keratomileusis): A laser reshapes the cornea, allowing light to focus directly on the retina. It is suitable for patients with mild to moderate hyperopia.
  • SMILE (Small Incision Lenticule Extraction): A minimally invasive procedure that reshapes the cornea through a small incision. Ideal for patients with specific refractive needs or thin corneas.
  • SMILE Pro: An advanced version of the SMILE procedure, SMILE Pro offers enhanced precision, faster recovery, and a broader range of applications for refractive errors.

PRK (Photorefractive Keratectomy): A laser removes the corneal surface layer to reshape the eye. PRK is often recommended for those with high hyperopia or patients not eligible for LASIK

3. Implantable Contact Lenses (ICLs)

For severe cases of hyperopia correction, implantable contact lenses are an effective solution. ICLs are surgically placed between the natural lens and the iris, offering long-term vision correction. This option is beneficial for patients who are not candidates for LASIK or other refractive surgeries.

4. Multifocal and Hypermetropia Lenses

  • Multifocal Lenses: These lenses address both distance and near vision issues, making them ideal for patients with coexisting presbyopia.
  • Refractive Lens Exchange (RLE): Also known as Clear Lens Extraction,here the natural lens is replaced with an artificial intraocular lens, offering a long-term solution for older patients or those with severe hyperopia.

5. Orthokeratology (Ortho-K)

Ortho-K is a non-surgical procedure that involves wearing specially designed gas-permeable contact lenses overnight to reshape the cornea temporarily. When the lenses are removed in the morning, patients experience clearer vision throughout the day without needing corrective eyewear.

Emerging Innovations in Hyperopia Correction

Emerging technologies continue to expand the options for farsightedness treatment. These include:

  • Wavefront-guided LASIK: This advanced version of LASIK customizes treatment based on the unique shape of the patient’s eye, ensuring improved accuracy and results.
  • Femtosecond Laser Technology: Used in procedures like SMILE and LASIK, this technology provides precise, minimally invasive corneal reshaping.
  • Biocompatible Lenses: Researchers are working on lenses that seamlessly integrate with the eye, offering long-term comfort and vision correction.

Can Hyperopia Be Cured Permanently?

For many patients, surgical procedures such as LASIK, SMILE Pro, and SMILE offer a permanent cure for hypermetropia. However, it’s essential to remember that age-related vision changes, such as presbyopia, may require additional interventions later in life.

Managing Hyperopia: Lifestyle Tips

Maintaining good eye health is crucial, even after receiving treatment for hyperopia. Consider the following tips:

  • Regular Eye Exams: Annual check-ups help monitor vision changes and ensure timely intervention.
  • The 20-20-20 Rule: Every 20 minutes, take a 20-second break and focus on something 20 feet away to reduce eye strain while working with computer.
  • Wear Protective Eyewear: Protect your eyes from harmful UV rays to prevent long-term damage.
  • Balanced Diet: Include foods rich in omega-3 fatty acids, vitamins A and C, and antioxidants to promote overall eye health.

What Are the Complications of Hyperopia

  • Chronic Eye Strain: Prolonged difficulty in focusing on close objects can lead to ongoing eye fatigue and discomfort.
  • Frequent Headaches: Straining to maintain focus during near-vision tasks can trigger persistent headaches.
  • Poor Academic or Work Performance: In children and adults, untreated hyperopia can affect reading, writing, and overall productivity.
  • Crossed Eyes (Strabismus): In severe cases, especially in children, hyperopia may lead to misaligned eyes due to the extra effort needed to focus.
  • Amblyopia (Lazy Eye): If one eye is more affected by hyperopia than the other, the brain may start ignoring signals from the weaker eye, leading to amblyopia.
  • Reduced Quality of Life: Blurry near vision and related symptoms can interfere with everyday activities, such as reading, using digital devices, or performing detailed tasks.



Stye Eye Treatment

What is a Stye?

A stye, medically known as a hordeolum, is a localized bacterial infection of the oil glands in the eyelid. It typically manifests as a red, swollen lump that can either appear externally (on the edge of the eyelid) or internally (inside the eyelid). Though styes are not contagious, they’re often caused by a common bacterium called Staphylococcus aureus.

Types of Styes

There are two main types of styes, categorized based on their location:

1.External Stye:

This is the most common type and develops on the outer edge of the eyelid. It originates from an infected hair follicle or an oil gland near the eyelashes.

2.Internal Stye:

This occurs inside the eyelid when an oil-producing gland (meibomian gland) becomes blocked and infected. Internal styes can be more painful and may take longer to heal.

How Common Are Styes?

Styes are very common and can affect individuals of all ages. They are more frequent in people who:

  • Have a history of blepharitis , eye lid margin scaling and crusting (chronic eyelid inflammation).
  • Suffer from skin conditions like rosacea or seborrheic dermatitis.
  • Frequently rub their eyes, introducing bacteria from their hands to the eyelids.
  • Experience hormonal changes that increase oil gland activity.

What Are the Risk Factors for Developing a Stye?

Several factors can increase the likelihood of developing a stye:

  • Poor hygiene:Not washing hands before touching the eyes.
  • Makeup use:Using old or contaminated eye makeup and not removing it before bed.
  • Chronic conditions:Skin disorders like acne, rosacea, or seborrheic dermatitis make styes more likely.
  • Hormonal changes:Increased oil production during puberty or pregnancy can clog the glands.
  • Weakened immune system:Illness, stress, or lack of sleep can make you more prone to infections.
  • Uncorrected refractive Errorsand eye rubbing

How Is a Stye Diagnosed?

A stye is typically diagnosed based on its appearance. Your doctor will:

  1. Perform a visual examination: The doctor will inspect the affected eyelid for swelling, redness, and tenderness.
  2. Check for blocked glands: If needed, they may gently press the bump to assess fluid buildup.
  3. Assess recurring infections: If you frequently develop styes, an eye specialist may evaluate underlying conditions like blepharitis or meibomian gland dysfunction.

In rare cases, if the stye does not heal with treatment, a biopsy may be recommended to rule out other eyelid conditions.

How Do You Get Rid of a Stye?

Most styes heal on their own within a week, but you can speed up recovery with the following treatments:

  1. Apply Warm Compresses: Soak a clean cloth in warm water and place it on the affected eye for 10-15 minutes, 3-4 times a day. This helps drain the stye naturally.
  2. Avoid Makeup and Contact Lenses: These can further irritate the stye and delay healing.
  3. Use Over-the-Counter Ointments: Antibacterial stye ointments can help reduce infection and inflammation.
  4. Take Pain Relievers: If necessary, ibuprofen or acetaminophen can help manage pain and swelling with your doctor’s recommendation.
  5. Let It Drain Naturally: Never pop or squeeze a stye, as it can spread the infection and cause complications.

When Should I See a Doctor?

While most styes resolve without medical intervention, you should seek medical help if:

  • The stye does not improve within 5 to 7 days.
  • There is excessive swelling, redness, or severe pain.
  • Vision becomes blurred or obstructed.
  • The infection spreads to other parts of the eye or face.
  • You experience frequent or recurring styes.

Your doctor may prescribe antibiotics or, in severe cases, perform a minor procedure to drain the stye.

What are the Common Symptoms:

  • A painful red bump near the eyelash line.
  • Swelling of the affected eyelid.
  • Tenderness and sensitivity to touch.
  • Watery eyes or crusting around the eyelid.

Best Stye Treatment Options

1.Stye Medicine

If home remedies do not provide relief, stye medicine can be a great alternative. Over-the-counter antibiotic ointments or prescription medications help in faster healing.

2.Medicine for Stye in Eye

Some eye stye treatment medicines come in the form of eye drops or oral antibiotics, particularly for persistent infections.

3.Internal Stye Treatment

An internal stye treatment is required when the stye forms inside the eyelid, often needing stronger medication or minor procedures to drain the infection.

4.Homeopathic Stye Treatment

Many prefer homeopathic stye treatment as a natural remedy. Homeopathic solutions help reduce swelling and discomfort while supporting the body’s immune response.

5.Cure for Eye Stye

Combining good hygiene, warm compresses, and stye treatment medicine can significantly speed up recovery. For severe cases, professional medical help is necessary.

Eye Stye Prevention: Tips to Keep Styes Away

  • Avoid rubbing your eyes frequently.
  • Use clean towels and pillowcases.
  • Never share eye makeup or eye care products.
  • Stay hydrated and maintain a balanced diet.
  • Wear appropriate corrective glasses.
  •  Wash your face and remove any face make up completely before going to bed.

Expert Care for Lasting Relief

With our advanced treatments and expert ophthalmologists, at Dr Agarwals Eye Hospital we offer personalised solutions to help you recover quickly and prevent future occurrences.

Whether you need effective medication, minor procedures, or guidance on home remedies, our specialists ensure you receive the best eye care tailored to your needs. Don’t let a stye affect your vision and comfort—trust the experts at Dr Agarwals Eye Hospital for safe and effective stye treatment.

Don’t let stye overshadow your days. Take charge of your eye health today and enjoy the clarity and comfort you deserve.

Refractive Surgery

How Does Refractive Surgery Work?

Refractive surgery involves altering the way light is focused on the retina by modifying the eye’s shape. Different surgical techniques are available depending on the patient’s condition, including laser-based procedures like LASIK, PRK, and SMILE, as well as lens-based procedures such as Implantable Collamer Lens (ICL) implantation and refractive lens exchange. Each technique uses cutting-edge technology to ensure precision, reduce healing time, and maximize vision correction. The choice of surgery depends on the patient’s eye condition, prescription, and corneal thickness. Consulting with an experienced ophthalmologist will help determine the best approach for each individual seeking vision correction surgery.

Who is a Good Candidate for Refractive Surgery?

Not everyone is an ideal candidate for refractive correction surgery. To be eligible, a patient must meet the following criteria:

  • Must be at least 18 years old (preferably 21+ for stable vision)
  • Have a stable prescription for at least one year
  • Have a healthy cornea with sufficient thickness
  • Be free from severe eye conditions like keratoconus, glaucoma, or advanced dry eye syndrome
  • Not be pregnant or nursing, as hormonal changes can affect vision
  • Have realistic expectations about the outcomes of the procedure

If you meet these criteria and want to explore options for clear vision without glasses, refractive surgery may be the right choice for you.

Types of Refractive Eye Surgery

Refractive surgery consists of different techniques that cater to various vision correction needs. The most common procedures include:

PRK (Photorefractive Keratectomy) – Benefits & Procedure

PRK is one of the earliest forms of eye refractive surgery. It involves removing the thin outer layer of the cornea (epithelium) and then reshaping the corneal tissue using an excimer laser. Benefits of PRK include suitability for patients with thin corneas, no risk of corneal flap complications, and ideal correction for individuals with active lifestyles. While PRK has a slightly longer recovery period compared to LASIK, it is still a highly effective option for vision correction surgery, particularly for individuals with irregular corneal surfaces.

LASIK Surgery – Flap-Based Eye Correction

LASIK (Laser-Assisted In Situ Keratomileusis) is the most popular form of refractive surgery. It involves creating a thin corneal flap using a microkeratome or femtosecond laser, reshaping the underlying tissue with an excimer laser, and repositioning the flap. Advantages of LASIK include quick recovery time with minimal discomfort, immediate improvement in vision, and a high success rate with long-term stability.

Refractive Lenticule Extraction – ReLEx SMILE / FLEX

SMILE (Small Incision Lenticule Extraction) and FLEX (Femtosecond Lenticule Extraction) are minimally invasive laser procedures that involve removing a tiny lenticule from the cornea. Key benefits of these procedures include no flap creation, reducing the risk of flap-related issues, faster healing and lower risk of dry eye syndrome, and suitability for individuals with high myopia. SMILE is particularly beneficial for individuals looking for a flapless, minimally invasive procedure with fast recovery and minimal postoperative discomfort.

Lens-Based Refractive Surgeries

For patients who are not candidates for laser-based procedures, lens-based surgeries offer an alternative.

Implantable Collamer Lens (ICL) – An Alternative to LASIK

ICL surgery involves implanting a biocompatible lens inside the eye, providing permanent vision correction without reshaping the cornea. It is ideal for patients with thin corneas or extreme refractive errors, individuals seeking a reversible procedure, and those with dry eye concerns. ICL is gaining popularity as an excellent alternative to LASIK, offering superior vision quality and reversibility if needed.

Refractive Lens Exchange – Best for Presbyopia & High Refractive Errors

Refractive Lens Exchange (RLE) replaces the natural lens with an artificial intraocular lens (IOL), correcting vision while also preventing cataract formation in the future. It is especially beneficial for:

  • Older individuals experiencing presbyopia
  • Those with extreme hyperopia

Benefits & Risks of Refractive Surgery

Benefits

  • Permanent correction of vision
  • Improved quality of life with reduced dependency on glasses and contact lenses
  • High success rate with rapid recovery
  • Customizable solutions for different eye conditions

Risks

  • Temporary discomfort and dry eyes post-surgery
  • Potential for glare, halos, or night vision disturbances
  • Rare complications like under-correction, over-correction, or flap-related issues

Refractive Surgery Recovery & Post-Procedure Care

Post-surgical care is crucial for optimal recovery and best results. Here are key aftercare tips:

  • Avoid rubbing the eyes for at least two weeks
  • Use prescribed eye drops to prevent dryness and infection
  • Wear protective eyewear, especially in bright environments
  • Avoid swimming and heavy physical activity for a few weeks
  • Attend follow-up checkups to monitor healing

Cost of Refractive Surgery in India

The cost of refractive surgery in India varies based on the procedure, clinic location, and surgeon expertise. On average:

  • LASIK: ₹25,000 – ₹60,000 per eye
  • PRK: ₹20,000 – ₹50,000 per eye
  • SMILE: ₹60,000 – ₹1,00,000 per eye
  • ICL: ₹80,000 – ₹1,50,000 per eye
  • RLE: ₹80,000 – ₹2,00,000 per eye

Many eye hospitals offer EMI options and insurance coverage for specific procedures.

Myopia

Symptoms of Myopia

Recognizing the symptoms of myopia early can help in timely intervention and management. Some common myopia symptoms include:

1. Blurred Vision:

Difficulty seeing distant objects clearly, such as road signs or blackboards.

2. Eye Strain:

Frequent squinting or straining to see far-off objects.

3. Headaches:

Persistent headaches due to prolonged eye strain.

4. Frequent Eye Rubbing:

Often a sign of discomfort or fatigue.

5. Difficulty Seeing at Night:

Also known as night myopia, it can make driving at night challenging.

6. Sitting Close to Screens:

Children with myopia may sit closer to the television or hold books and tablets very close.

If you notice any of these nearsightedness symptoms, it is essential to visit an eye specialist for an accurate diagnosis and corrective measures.

Causes of Myopia

Understanding the causes of myopia can help reduce its progression and prevent severe complications. The following factors contribute to the development of myopia:

  • Genetic Factors

If one or both parents have myopia, there is a higher risk of developing the condition.

  • Environmental Factors

Increased screen time and prolonged close-up work, such as reading or using digital devices, contribute to early onset and progression.

  • Lack of Outdoor Activity

Studies show that spending less time outdoors and limited exposure to natural light can increase the risk of developing myopia.

  • Elongated Eyeball

Myopia occurs when the eyeball grows too long, causing light to focus in front of the retina rather than on it.

  • Abnormal Curvature of the Cornea

A cornea that is overly curved or thick can also result in myopia.

By identifying these causes early, you can take preventive steps and minimize the risk of myopia disease.

Types of Myopia

  • Simple Myopia:

The most common form, where the refractive error is mild to moderate and manageable with glasses or contact lenses.

  • High Myopia:

A severe form of myopia where the refractive error exceeds -6.00 diopters, increasing the risk of complications like retinal detachment and glaucoma.

  • Pathological Myopia (Degenerative Myopia):

A progressive condition that can lead to vision-threatening complications if not managed properly.

  • Night Myopia:

A condition where vision becomes blurry in low-light conditions due to a loss of focus.

Diagnosis of Myopia

Diagnosing myopia involves a comprehensive eye examination. Here are some common diagnostic methods:

  • Visual Acuity Test

The patient reads letters on a chart at a distance to measure clarity of vision.

  • Retinoscopy

A light is shone into the eye to observe how it reflects off the retina, helping determine the refractive error.

  • Refraction Test

This test uses a phoropter to identify the exact prescription for corrective lenses.

  • Corneal Topography

Measures the curvature of the cornea to detect any irregularities that may be causing myopia.

These tests provide a detailed understanding of the severity and type of myopia, guiding the appropriate treatment plan.

Treatment Options for Myopia

Managing myopia involves a combination of corrective measures, lifestyle changes, and advanced treatments.

1. Eyeglasses and Contact Lenses

The most common and immediate solution, eyeglasses and contact lenses correct the refractive error, enabling clear vision.

2. Orthokeratology (Ortho-K)

Special gas-permeable contact lenses worn overnight temporarily reshape the cornea, providing clear vision during the day.

3. Medicated Eye Drops (Atropine)

Low-dose atropine drops have been shown to slow the progression of myopia in children.

4. Laser Refractive Surgery

Procedures like LASIK and SMILE reshape the cornea, correcting myopia and reducing dependence on glasses or contacts.

5. Implantable Contact Lenses (ICL)

For individuals with severe myopia, ICLs provide a long-term solution without the need for corneal reshaping.

6. Vision Therapy

Exercises designed to improve focusing ability and eye coordination, particularly for children experiencing early signs of myopia.

How to Prevent Myopia Progression

While some risk factors like genetics cannot be controlled, you can adopt the following measures to slow down the progression of myopia:

  • Encourage Outdoor Activities

Spending at least 2 hours outdoors daily has been shown to reduce the risk of developing myopia.

  • Follow the 20-20-20 Rule:

Every 20 minutes, look at something 20 feet away for 20 seconds to reduce eye strain.

  • Limit Screen Time:

Set boundaries on the use of digital devices and ensure proper posture and lighting during use.

  • Maintain Proper Nutrition:

A balanced diet rich in vitamins A, C, and E, along with zinc and omega-3 fatty acids, supports overall eye health.

  • Regular Eye Exams:

Early detection and intervention through annual eye checkups can help manage myopia effectively.

Complications of Untreated Myopia

Without proper treatment, myopia disease can lead to several complications, including:

  • Retinal Detachment

The risk increases with severe myopia, potentially leading to permanent vision loss.

  • Glaucoma

Increased intraocular pressure can cause damage to the optic nerve, leading to vision impairment.

  • Cataracts

Myopic individuals are at a higher risk of developing cataracts at an earlier age.

  • Macular Degeneration

High myopia can lead to degenerative changes in the macula, resulting in central vision loss.

Recognizing these risks highlights the importance of early diagnosis and proper treatment.

What are the Types of Refractive Surgeries Available for Myopia?

1. LASIK (Laser-Assisted In-Situ Keratomileusis)

  • Overview: The most popular refractive surgery, LASIK reshapes the cornea using a laser to correct mild to moderate myopia.
  • How it works: A flap is created on the surface of the cornea, which is then lifted to allow the laser to reshape the underlying tissue. The flap is repositioned after the procedure.
  • Benefits: Quick recovery and minimal discomfort.

2. SMILE (Small Incision Lenticule Extraction)

  • Overview: A minimally invasive laser surgery suitable for patients with moderate to high myopia.
  • How it works: The surgeon uses a femtosecond laser to create a small lenticule (thin disc of tissue) within the cornea, which is removed through a small incision.
  • Benefits: Less invasive than LASIK, with reduced dry eye symptoms and faster healing.

3. PRK (Photorefractive Keratectomy)

  • Overview: Ideal for patients with thin corneas or those not eligible for LASIK.
  • How it works: The outer layer of the cornea (epithelium) is removed, and a laser reshapes the corneal tissue to correct the refractive error. The epithelium regenerates naturally after the procedure.
  • Benefits: No corneal flap is created, making it suitable for individuals with corneal irregularities.

4. ICL (Implantable Collamer Lenses)

  • Overview: An excellent option for individuals with high myopia or those not suitable for corneal reshaping surgeries.
  • How it works: A biocompatible lens is implanted inside the eye, between the natural lens and the iris, to correct vision.
  • Benefits: Reversible procedure, suitable for high refractive errors.

5. LASEK (Laser-Assisted Sub-Epithelial Keratectomy)

  • Overview: A variation of PRK where the epithelium is loosened with alcohol before laser treatment.
  • How it works: The epithelial layer is lifted and repositioned after the cornea is reshaped by the laser.
  • Benefits: Suitable for thin or irregular corneas, with less discomfort compared to PRK.

6. Refractive Lens Exchange (RLE)

  • Overview: Typically recommended for patients with high myopia and presbyopia.
  • How it works: Similar to cataract surgery, the natural lens is removed and replaced with an artificial intraocular lens (IOL) that corrects myopia.
  • Benefits: Corrects both refractive errors and age-related vision loss.

7. SMILE PRO (Small Incision Lenticule Extraction – PRO Version)

1.Overview:

The latest and more advanced version of the SMILE procedure, typically recommended for individuals with moderate to high myopia or astigmatism.

2.How it works:

A femtosecond laser creates a precise lenticule (thin disc of corneal tissue) within the cornea. A small incision is made, and the lenticule is removed, reshaping the cornea to correct the refractive error.

3.Benefits:

  • Minimally invasive procedure (within 9 seconds) with no need for a corneal flap.
  • Reduced risk of dry eye and faster recovery compared to LASIK.
  • High precision for correcting moderate to high refractive errors.

Each of these surgeries has specific indications, risks, and benefits. Consulting a specialist at Dr Agarwals Eye Hospital can help determine which procedure is best suited for your individual case.

Robotic Cataract

Key Benefits of Robotic Cataract Surgery

Bladeless Accuracy with Advanced Technology

Image-guided femtosecond lasers ensure every incision and lens breakup is done with ultra-precise, computer-controlled accuracy. This minimizes error, reduces trauma to the eye, and enhances surgical consistency.

Custom Mapping for Every Eye

Advanced imaging systems create a 3D map of the eye, allowing for fully personalized treatment. This ensures that every step of the procedure is tailored to the patient’s unique eye anatomy — especially beneficial in cases with astigmatism.

Faster Recovery & Minimal Risk

Robotic precision results in less tissue disturbance, reduced inflammation, and faster healing. The risk of complications such as infection or delayed vision improvement is reduced, making it a preferred choice for those seeking safer outcomes.

Who Should Consider Robotic Cataract Surgery?

Here’s a quick checklist to see if you’re an ideal candidate:

✅ Over 45 with blurred or cloudy vision due to cataracts

✅ Diagnosed with astigmatism and want correction during surgery

✅ Looking for a faster recovery and minimally invasive option

✅ Prefer advanced, bladeless technology for better visual outcomes

✅ Interested in treatment by an Experienced LACS Specialist

Robot Cataract Procedure at Dr. Agarwal’s Eye Hospital

Here’s how the procedure works at our centers:

Step 1: Laser Mapping & Planning

A 3D scan of your eye is taken to guide the laser. This mapping allows the surgeon to plan precise incisions and determine the exact placement of the intraocular lens (IOL).

Step 2: Lens Fragmentation with Laser

The femtosecond laser softens and breaks the cataract into smaller pieces, making removal easier and safer — with minimal ultrasound energy used.

Step 3: Intraocular Lens Placement

After cataract removal, a high-quality intraocular lens (IOL) is implanted for clear, enhanced vision— often reducing or eliminating the need for glasses.

Black Fungus Treatment & Diagnosis

Clinical testing and workup 

Black fungus diagnosis test include:

  • Endoscopic examination of the nose

This is a black fungus diagnosis test includes a thin flexible tube with a tiny camera and light, called an endoscope is inserted into the nose. This allows the doctor to look at the nose and sinus passages. 

  • A biopsy of a swab taken from the nose 

A swab is inserted into the nostril of the patient and rotated in place to obtain a sample of the tissue. This is then sent for examination under a microscope by a trained microbiologist. This examination can show the presence of the mold. 

  • CT / MRI scan 

A CT or MRI scan may also be used to indicate certain changes that can indicate mucormycosis infection. This along with the clinical findings can help clinch the diagnosis. 

Time is of utmost importance in the treatment of Mucormycosis and the investigative processes take no more than one day to produce reports.

  • Black Fungus Treatment

The process of black fungal disease treatment is teamwork involving an ENT (Ear, nose, throat) specialist, ophthalmologist, neurologist and radiologist. If black fungal disease is suspected, the patient should receive medical attention at the earliest. Mucormycosis treatment at home should not be attempted without medical advice. Treatment for black fungus post diagnosis should happen at a medical center with advanced facilities. 

For black fungal infection treatment, the ENT surgeon has to aggressively debride the necrotic or dead tissue from the nose and the sinus. In case, the eye is involved, then the fungal material from around the eye also has to be removed. 

In other cases, where advanced black fungus treatment is required, the entire orbit or the space around the eye is also involved, the eye has to be removed in a process called orbital exenteration. 

Be it the eye or upper jaw, these can be replaced with appropriate artificial substitutes or prostheses. While prosthetic replacement of the missing facial structures can commence once the patient stabilizes after surgery, it is important to reassure patients about the availability of such interventions instead of leaving them to panic with the sudden unforeseen loss, augmenting a post-Covid stress disorder which is already a reality.

Along with the surgery, treatment for black fungus will also include the administration of antifungal medication. The most commonly used medication is Amphotericin B. Initially, this medicine is infused intravenously and if the patient shows improvement, they can be shifted to oral antifungal medication. 

Doctors will also treat the underlying risk factors that are associated with mucormycosis infection.  

Black fungus treatment in advanced cases can lead to loss of the upper jaw and sometimes even the eye. Patients would need to come to terms with the loss of function due to a missing jaw — difficulty with chewing, swallowing, facial aesthetics, and loss of self-esteem.

Be it the eye or upper jaw, these can be replaced with appropriate artificial substitutes or prostheses. While prosthetic replacement of the missing facial structures can commence once the patient stabilizes after surgery, it is important to reassure patients about the availability of such interventions instead of leaving them to panic with the sudden unforeseen loss, augmenting a post-Covid stress disorder which is already a reality.

Mucormycosis (Black Fungus)

What is Black Fungus (Mucormycosis)? Black fungus, scientifically known as mucormycosis, is a rare but...

Learn more about Mucormycosis (Black Fungus)


Laser Cataract Surgery

How Does Laser Cataract Surgery Work?

Laser cataract surgery involves a high-precision laser to perform key steps in cataract removal. The procedure includes:

  • Corneal Incision: The femtosecond laser creates a precise, bladeless incision in the cornea.
  • Capsulotomy: The laser accurately removes the cloudy cataract-affected lens capsule.
  • Lens Fragmentation: The cataract is broken down into smaller pieces using laser energy, making removal easier.
  • Intraocular Lens Implantation: A premium intraocular lens (IOL) is implanted to restore clear vision.

This advanced approach leads to higher success rates, faster recovery, and reduced risks compared to traditional cataract surgery.

Laser vs. Traditional Cataract Surgery – Which is Better?

When comparing laser cataract surgery to traditional cataract surgery, the key differences include:

  • Precision: Laser-assisted procedures offer more accuracy in incision and lens fragmentation.
  • Less Trauma: Femtosecond laser reduces stress on the eye, leading to faster healing.
  • Bladeless Technology: No surgical blades are used, minimizing complications.
  • Customization: The procedure is tailored to each patient’s eye condition for optimal results.

Given these advantages, many patients prefer laser cataract surgery for its safety and effectiveness.

Who is an Ideal Candidate for Laser Cataract Surgery?

Laser cataract surgery is suitable for:

  • Patients with age-related cataracts affecting vision.
  • Individuals seeking bladeless laser cataract surgery for enhanced safety.
  • Those with astigmatism who require precise corneal correction.
  • People looking for advanced cataract surgery with premium IOL options.

Your ophthalmologist will assess your eligibility based on eye health and personal preferences.

Benefits of Laser Cataract Surgery for Clear Vision

Choosing laser cataract surgery comes with multiple benefits:

  • Greater Accuracy: Laser incisions are precise, improving overall outcomes.
  • Reduced Recovery Time: The procedure minimizes stress on the eye, allowing for a quicker return to daily activities.
  • Minimized Risks: A controlled, bladeless process lowers the risk of complications.
  • Astigmatism Correction: Helps in achieving better post-surgical vision.
  • Improved Success Rate: Studies indicate a higher success rate of laser cataract surgery compared to traditional methods.

Types of Laser Cataract Surgery

There are different approaches to laser treatment for cataracts, including:

  1. Femtosecond Laser Cataract Surgery: Uses a high-speed laser for incision, capsulotomy, and lens fragmentation.
  2. Bladeless Laser Cataract Surgery: A no-blade approach ensuring precision and reduced complications.
  3. Cataract Laser Treatment Procedure with Premium IOLs: Enhances visual outcomes with advanced lens options such as multifocal and toric IOLs.

Recovery After Laser Cataract Surgery – What to Expect?

Recovery from laser cataract surgery is generally smooth and quick. Patients can expect:

  • Improved vision within 24 to 48 hours post-surgery.
  • Minimal discomfort and faster healing.
  • A return to normal activities within a few days.
  • Clearer vision over the next few weeks as the eye fully adjusts.

Following post-surgery care, such as using prescribed eye drops and avoiding strenuous activities, ensures a successful recovery.

Laser Cataract Surgery Side Effects

While laser cataract surgery procedure is highly safe, some patients may experience:

  • Mild discomfort or light sensitivity.
  • Temporary blurred vision as the eye heals.
  • Dry eyes, which can be managed with lubricating drops.

Serious complications are rare, and our specialists at Dr Agarwals Eye Hospital ensure the highest standards of care to minimize risks.

Why Choose Dr Agarwals Eye Hospital for Laser Cataract Surgery?

Dr Agarwals Eye Hospital is a leader in laser cataract surgery in India, offering:

  • Advanced femtosecond laser cataract surgery technology.
  • Highly experienced surgeons specializing in bladeless cataract removal.
  • Comprehensive pre-operative and post-operative care.
  • Customized treatment plans to suit individual patient needs.


Lasik Surgery

Which Type of Eye Conditions Does LASIK Treat?

LASIK surgery is suitable for various vision conditions, including:

Nearsightedness (Myopia)

People with myopia have difficulty seeing distant objects clearly. LASIK surgery for eyes corrects this condition by reshaping the cornea to allow light to focus properly.

Farsightedness (Hyperopia)

Individuals with hyperopia struggle to see close objects. Laser eye surgery adjusts the corneal shape to enhance near vision.

Astigmatism

Astigmatism occurs due to an irregularly shaped cornea, causing blurred vision. LASIK surgery smooths out these irregularities, ensuring sharper vision.

How to Prepare for LASIK Surgery

Preparation is crucial for a successful LASIK eye surgery procedure. Here’s what to do:

  • Stop wearing contact lenses for at least two weeks before surgery to allow your cornea to return to its natural shape.
  • Schedule a comprehensive eye exam to ensure you are a suitable candidate for laser surgery.
  • Avoid applying eye makeup or creams on the day of surgery to minimize infection risk.
  • Follow your doctor’s instructions regarding medication and pre-surgery care.

LASIK Surgery Procedure

The LASIK eye surgery procedure is quick and typically completed within 30 minutes. Here’s how it works:

  • Numbing drops are applied to prevent discomfort.
  • A thin corneal flap is created using a femtosecond laser or microkeratome.
  • The cornea is reshaped using an excimer laser, correcting refractive errors.
  • The flap is repositioned, allowing natural healing to occur.

Most patients notice improved vision within a few hours after the surgery.

 LASIK Surgery Side Effects

While What You Need to Know Like any medical procedure, laser eye surgery has potential side effects, though they are usually temporary.

Dry Eyes:

  • Temporary dryness is common after LASIK surgery, but eye drops help alleviate discomfort.

Glare and Halos:

  • Some patients experience glare or halos around lights, especially at night, but these effects fade within a few weeks.

Fluctuating Vision:

  • Vision may take a few days or weeks to stabilize completely after LASIK eye surgery.

 Who is Not Recommended for LASIK Surgery?

While LASIK surgery for eyes is highly effective, some individuals may not be suitable candidates, including:

  • People with thin corneas – A thin cornea may not support the necessary reshaping.
  • Patients with severe dry eyes – Existing dryness can worsen after surgery.
  • Individuals with unstable vision – If your prescription changes frequently, LASIK may not be suitable.
  • People with certain medical conditions – Autoimmune diseases can affect healing post-surgery.

 LASIK Surgery Recovery Time

Recovery from LASIK eye surgery is typically fast. Here’s what to expect:

  • First 24 hours – Mild discomfort, blurry vision, and sensitivity to light.
  • 1 week – Significant vision improvement, but avoid strenuous activities.
  • 1 month – Vision stabilizes, and most restrictions are lifted.
  • 3-6 months – Full recovery, with optimal vision results.

 Risks of LASIK Surgery

Although LASIK surgery is generally safe, it’s important to be aware of potential risks:

  • Under-correction or over-correction – Some patients may still need glasses after surgery.
  • Infection or inflammation – Rare but possible side effects.
  • Night vision disturbances – Halos, glare, or starbursts around lights.
  • Flap complications – Issues related to the corneal flap created during surgery.

 LASIK surgery is a highly effective solution for those seeking to correct refractive errors and reduce dependence on glasses or contacts. Understanding the LASIK surgery procedure, potential LASIK surgery side effects, and LASIK surgery recovery time can help you make an informed decision. If you’re considering laser eye surgery, consult an experienced ophthalmologist to determine whether it’s the right choice for you.

Photorefractive Keratectomy (PRK)

Who is a Candidate for PRK Surgery?

PRK eye surgery is ideal for:

  • Individuals with thin corneas who may not be eligible for LASIK.
  • Patients with mild to moderate myopia, hyperopia, or astigmatism.
  • Those experiencing chronic dry eyes, as PRK causes less post-surgical dryness compared to LASIK.
  • Individuals involved in contact sports or professions where corneal flap-related complications from LASIK could be a concern.
  • People who want a long-term solution for vision correction without undergoing LASIK.

PRK Eye Surgery Procedure

PRK laser surgery involves three main steps:

  • Removal of the Epithelium

– The thin outer layer of the cornea (epithelium) is gently removed using a laser or alcohol solution.

  • Reshaping the Cornea

– An excimer laser is used to reshape the corneal surface, correcting refractive errors.

  • Healing & Recovery

– A special bandage contact lens is placed on the eye to promote healing and reduce discomfort. The epithelium naturally regenerates within a few days.

The procedure is quick, taking approximately 15 minutes per eye, and is performed under topical anesthesia to ensure a pain-free experience.

PRK vs. LASIK: Which is Better?

While both PRK eye surgery and LASIK offer effective vision correction, there are key differences:

  • Corneal Thickness:

PRK is preferred for patients with thin corneas, as it does not require creating a corneal flap like LASIK.

  • Healing Time:

PRK has a slightly longer recovery period since the epithelium needs to regenerate, whereas LASIK offers immediate visual improvement.

  • Dry Eye Risk:

PRK has a lower risk of post-surgery dry eyes compared to LASIK.

  • Suitability for Active Lifestyles:

PRK is recommended for athletes and military personnel due to the absence of a corneal flap, reducing the risk of flap-related complications.

Ultimately, the choice between PRK and LASIK depends on individual eye health, lifestyle, and personal preference.

PRK Eye Surgery Recovery & Healing Time

Recovery after PRK eye surgery typically follows these stages:

  • First 3-5 Days:

The epithelium regenerates, and mild discomfort, light sensitivity, and blurry vision may occur.

  • First Week:

The bandage contact lens is removed by the doctor, and vision gradually starts improving.

  • 1-3 Weeks:

Clearer vision develops as the eyes heal.

  • 3-6 Months:

Full vision stabilization occurs, with results being long-lasting.

Patients should follow post-operative care instructions, including using prescribed eye drops, avoiding bright lights, and refraining from rubbing their eyes for optimal healing.

What Are the Risk Factors of PRK Eye Surgery?

While PRK eye surgery is generally safe, some potential risks include:

  • Temporary Discomfort:

Mild irritation and light sensitivity are common in the first few days.

  • Delayed Vision Clarity:

Unlike LASIK, visual improvement takes a few weeks.

  • Haze Formation:

Some patients may experience corneal haze, which is treatable with medicated eye drops.

  • Dry Eyes:

Though less severe than LASIK, some dryness may occur during the healing phase.

Following proper post-operative care minimizes these risks and ensures the best possible results.

PRK Eye Surgery Cost in India

The cost of PRK eye surgery in India varies based on several factors, including:

  • The hospital and surgeon’s expertise.
  • The technology and laser system used.
  • Pre-operative evaluations and post-operative care.

On average, PRK surgery costs between ₹30,000 to ₹60,000 per eye in India. Dr Agarwals Eye Hospital offers affordable and high-quality PRK treatment with advanced technology and experienced specialists.

Trans PRK Surgery – An Advanced No-Touch PRK Procedure

Trans PRK (Transepithelial Photorefractive Keratectomy) is an innovative, no-touch laser eye surgery technique that eliminates the need for alcohol or mechanical removal of the epithelium. Instead, the excimer laser removes the epithelium and reshapes the cornea in a single step, enhancing precision and reducing healing time. This method ensures greater comfort and faster recovery for patients.

PRK Surgery vs. Other Vision Correction Procedures

PRK is often compared to other vision correction procedures, such as:

  • SMILE (Small Incision Lenticule Extraction)

 Suitable for high myopia, but PRK is better for patients with thinner corneas.

  • ICL (Implantable Collamer Lens)

 A good alternative for those unsuitable for laser surgery.

  • Refractive Lens Exchange (RLE):

Recommended for older individuals with presbyopia.

Each procedure has unique advantages, and the choice depends on the patient’s eye condition and lifestyle needs.

Why Choose Dr Agarwals Eye Hospital for PRK Treatment?

Dr Agarwals Eye Hospital is a trusted name in eye care, offering:

  • Advanced PRK laser eye surgery with advanced technology.
  • Highly experienced ophthalmologists specializing in laser vision correction.
  • Comprehensive pre-surgery assessments and personalized treatment plans.
  • Affordable pricing and easy financing options.
  • Dedicated post-operative care for optimal results.
Implantable Collamer Lens (ICL)

How Does ICL Surgery Work?

ICL eye surgery involves the insertion of a thin, flexible, and biocompatible collamer lens between the natural lens and iris. The procedure is quick, taking about 20-30 minutes per eye, and does not involve corneal removal. Steps include:

  • Pre-operative Assessment

– The surgeon evaluates eye health and measures parameters to select the right lens power.

  • Anesthetic Eye Drops

– Used to numb the eyes, ensuring a pain-free experience.

  • Small Incision

– A micro-incision is made to insert the lens.

  • Lens Implantation

– The ICL lens is placed inside the eye and positioned correctly.

  • Healing and Recovery

– The incision heals naturally without the need for stitches.

Who is a Good Candidate for ICL Surgery?

ICL surgery is suitable for:

  • Individuals aged between 21-45 years with stable vision.
  • Those with high myopia (-3D to -20D) or hyperopia (+3D to +10D).
  • Patients with thin corneas, making them ineligible for LASIK or PRK.
  • Individuals seeking reversible vision correction without removing corneal tissue.
  • Those with dry eye concerns, as ICL surgery does not cause post-surgical dryness.

ICL Surgery Age Limit & Suitability

ICL surgery is best suited for individuals between 21 to 45 years of age. It is essential for the patient’s vision to be stable for at least one year before surgery. Younger patients may still have changing refractive errors, while older patients might have presbyopia or other age-related eye conditions that may not make them ideal candidates for ICL. Consulting an eye specialist can help determine whether ICL surgery is the right option based on individual eye health.

Benefits of ICL Surgery

  • Permanent Vision Correction

– Provides long-term clarity without affecting corneal structure.

  • High-Definition Vision

– Offers sharper and more natural visual outcomes.

  • No Dry Eyes

–Unlike LASIK, ICL surgery does not induce dry eye syndrome.

  • Removable Lens

– The lens can be removed or replaced if required.

  • UV Protection

– The collamer material in the lens protects the eyes from UV rays.

  • Quick Recovery

– Most patients experience improved vision within 24-48 hours.

Why Choose ICL Over LASIK?

While LASIK is a well-known laser vision correction procedure, ICL eye surgery offers key advantages:

  • No Corneal Flap Creation

– Reduces risks associated with corneal thinning.

  • Ideal for High Refractive Errors

– Works better for individuals with severe myopia.

  • Reversible Procedure

– Unlike LASIK, the implantable contact lens can be removed.

  • Safe for Thin Corneas

– People with thin corneas who cannot undergo LASIK can opt for ICL.

ICL Surgery Before and After – What to Expect?

Before Surgery

  • Comprehensive eye evaluation and lens power selection.
  • Pre-surgery instructions, including temporary discontinuation of contact lenses.

After Surgery

  • Immediate vision improvement within 24-48 hours.
  • Minimal discomfort and quick recovery after ICL surgery.
  • Follow-up visits to monitor eye health and vision progress.

ICL Surgery Procedure & Recovery

Step-by-Step ICL Surgery Process

  1. Initial Consultation & Eye Measurements – Detailed eye tests are conducted.
  2. Surgical Preparation – Anesthetic drops are applied.
  3. Lens Implantation – The ICL lens is inserted through a small incision.
  4. Post-Surgery Care – Eye drops are prescribed to aid healing.
  5. Follow-Up Appointments – Vision improvement is monitored.

Recovery Time After ICL Surgery

  • First 24 Hours – Mild discomfort, sensitivity to light, and hazy vision may occur.
  • Within 48 Hours – Significant vision improvement is noticeable.
  • 1 Week to 1 Month – Full stabilization and adaptation to the new lens.

ICL Surgery Cost & Factors Affecting Pricing

How Much Does ICL Surgery Cost?

The ICL surgery cost varies based on multiple factors, including:

  • Hospital location and infrastructure.
  • The surgeon’s expertise.
  • The type of ICL lens used.

On average, ICL eye surgery cost in India ranges from ₹1,00,000 to ₹1,80,000 per eye. However, prices may vary depending on individual cases and requirements. Visit your doctor or consult your doctor for more details and personalized cost estimation.

Potential Risks & Side Effects of ICL Surgery

While ICL surgery is highly safe, potential risks include:

  • Glare and Halos

– Some patients may experience night vision disturbances.

  • Increased Eye Pressure

– Rare but manageable with medication.

  • Cataract Formation

– Long-term monitoring is essential to prevent lens-induced cataracts.

Common Disadvantages of ICL Surgery

  • Higher Cost

– Compared to LASIK and PRK, ICL is more expensive.

  • Surgical Risks

– Although rare, complications like infection or incorrect lens positioning may occur.

  • Not Suitable for Presbyopia

– People above 45 years may need reading glasses post-surgery.

Possible Problems After ICL Surgery

Although rare, some patients may experience:

  • Lens Rotation

– Requires repositioning by a doctor.

  • Intraocular Pressure Fluctuations

– Managed with medications.

  • Night Vision Issues

– Improves as the eyes adapt to the lens.

Is ICL Surgery Safe?

Yes, ICL surgery is FDA-approved and has a long history of successful vision correction. The biocompatible lens does not cause adverse reactions and is designed to last a lifetime.

ICL Surgery vs. Other Eye Treatments

  • ICL vs. LASIK

– ICL is better for high myopia, while LASIK is faster and less expensive.

ICL vs. PRK

 PRK is suitable for mild vision correction, while ICL is preferred for high refractive errors.

Why Choose Dr Agarwals Eye Hospital for ICL Surgery?

Dr Agarwals Eye Hospital is a leading provider of ICL surgery in India, offering:

  • Advanced Technology

– Advanced diagnostic tools and surgical techniques.

  • Expert Surgeons

– Experienced ophthalmologists specializing in vision correction.

  • Personalized Treatment

– Customized ICL lens selection for each patient.

  • Affordable Pricing

– Competitive costs with financing options.

  • Comprehensive Post-Surgery Care

– Follow-ups to ensure long-term success.

Eyelid & Eye Socket Correction (Oculoplasty)

What Conditions May Require Oculoplastic Treatment?

Several medical and cosmetic conditions may necessitate oculoplastic surgery. Some of the most common conditions include:

1. Eyelid Ptosis

Ptosis, or droopy eyelids, occurs when the upper eyelid sags over the eye, potentially obstructing vision. This condition can be congenital (present at birth) or acquired due to aging, muscle weakness, or neurological disorders. Oculoplastic surgery corrects ptosis by tightening the eyelid muscles and improving both function and appearance.

2. Entropion and Ectropion

  • Entropion is a condition where the eyelid turns inward, causing irritation and discomfort as the eyelashes rub against the cornea.
  • Ectropion is the outward turning of the eyelid, which can lead to dryness, tearing, and exposure-related issues. Both conditions can be effectively treated with oculoplasty surgery to restore eyelid positioning and protect the eye from damage.

3. Thyroid Eye Disease

Thyroid eye disease (TED) is an autoimmune disorder associated with thyroid dysfunction, leading to bulging eyes, double vision, eyelid retraction, and swelling. Oculoplastic surgeons perform corrective procedures to alleviate discomfort, reposition the eyes, and improve overall aesthetics.

4. Eye Tumors

Benign and malignant tumors around the eyes can affect vision, eye movement, and facial symmetry. Oculoplastic surgery is used to remove tumors while preserving function and ensuring minimal cosmetic impact.

5. Cosmetic Conditions

Oculoplasty is widely sought for cosmetic enhancements such as reducing under-eye bags, removing excess skin from droopy eyelids (blepharoplasty), and rejuvenating the eye area with minimally invasive treatments like Botox and dermal fillers.

6. Congenital Deformities & Traumatic Injuries

Birth defects and injuries affecting the eyelids, tear ducts, or orbital structures can impact both vision and facial appearance. Oculoplastic surgeons specialize in reconstructive procedures that restore normal anatomy and function.

Treatment Modalities in Oculoplasty

Oculoplasty includes various treatment techniques tailored to each condition. Some of the most common procedures are:

1. Blepharoplasty

Blepharoplasty is a popular eyelid surgery performed to remove excess skin, fat, and muscle from the eyelids. It improves vision in cases of severe drooping and enhances the cosmetic appearance of the eyes.

2. Botox Treatment

Botox injections are used for both medical and cosmetic purposes. They help in reducing wrinkles, treating eyelid spasms, and managing conditions like hemifacial spasms and blepharospasm.

3. Dermal Fillers

Dermal fillers restore lost volume around the eyes, reducing dark circles and sunken appearances. They are a non-surgical option for facial rejuvenation.

Why is Oculoplasty Important for Eye Health and Aesthetics?

Oculoplasty is not just about aesthetics—it is essential for maintaining eye health, comfort, and function. Many conditions treated through oculoplastic surgery can cause vision impairment, eye discomfort, and functional limitations if left untreated. Furthermore, aesthetic procedures help individuals regain confidence by addressing age-related concerns, congenital deformities, and trauma-related disfigurements.

Oculoplasty surgery improves not only appearance but also functionality. Eyelid abnormalities, orbital fractures, and tear duct blockages can lead to chronic irritation and vision obstruction. By undergoing oculoplastic procedures, patients can experience relief from discomfort, prevent long-term damage, and enhance their overall quality of life. Additionally, individuals seeking cosmetic enhancements such as eye plastic surgery, Botox, or dermal fillers can achieve a more youthful and refreshed appearance with minimal downtime.

Oculoplasty Surgery: What to Expect Before, During, and After

Before Surgery

  • Comprehensive eye examination to assess the condition.
  • Discussion of treatment options, risks, and expected outcomes.
  • Pre-surgical instructions, including medication adjustments and dietary restrictions.
  • Lab tests and imaging may be required to evaluate the underlying structures.
  • Smoking cessation is advised before surgery to enhance healing.

During Surgery

  • Local or general anesthesia is administered based on the procedure.
  • Precision surgical techniques are used to correct the identified condition.
  • The procedure duration varies depending on complexity.
  • Minimal incisions are made to reduce scarring and enhance recovery.

After Surgery

  • Recovery time typically ranges from a few days to weeks.
  • Mild swelling, bruising, and discomfort may occur initially.
  • Post-operative care instructions must be followed to ensure optimal healing.
  • Vision and eyelid function improve progressively over weeks.
  • Regular follow-ups with the oculoplastic surgeon ensure a smooth recovery.

Recovery and Aftercare Following Oculoplasty Treatment

Recovery after oculoplastic surgery depends on the type of procedure performed. General guidelines include:

  • Keeping the operated area clean and avoiding strenuous activities.
  • Using prescribed eye drops or ointments to prevent infections.
  • Avoiding rubbing or touching the eyes.
  • Sleeping with the head elevated to minimize swelling.
  • Following up with the surgeon for post-operative assessments.
  • Any unusual symptoms such as severe pain, vision loss, or excessive swelling should be reported immediately.

Risks and Complications of Oculoplasty: What You Should Know

While oculoplastic surgery is generally safe, some risks include:

  • Infection and bleeding.
  • Scarring or asymmetry in eyelid positioning.
  • Temporary or permanent vision changes (rare).
  • Allergic reactions to anesthesia.
  • Dry eyes or excessive tearing post-surgery.
  • Delayed healing in individuals with underlying medical conditions. A skilled oculoplastic surgeon minimizes these risks through advanced surgical techniques and thorough patient evaluations.

Why Choose Dr Agarwals Eye Hospital for Oculoplasty Surgery?

Dr Agarwals Eye Hospital is a trusted name in ophthalmic care, offering world-class oculoplastic treatments performed by experienced specialists. Here’s why patients prefer us:

  • Expert Oculoplastic Surgeons: Our team comprises highly trained oculoplasty specialists with extensive experience.
  • Advanced Facilities: Equipped with the latest technology for precise and effective treatments.
  • Personalized Care: Each patient receives a customized treatment plan tailored to their specific needs.
  • Comprehensive Services: From medical treatments to cosmetic enhancements, we offer a full range of oculoplastic procedures.
  • Affordable Oculoplasty Surgery Cost: We provide transparent pricing with high-quality care.
  • Advanced Post-Surgical Care: Our follow-up services ensure a smooth and comfortable recovery experience.

Whether you need corrective eye plastic surgery, Botox treatment, or dermal fillers, Dr Agarwals Eye Hospital ensures the highest standard of care in oculoplasty procedures.

Neuro Ophthalmology

Neuro Ophthalmology – When should you visit your eye doctor?

Neuro Ophthalmic issues are quite a concern for doctors; for if not treated on time, it could result in Optic Nerve atrophy (death of the optic nerve).

Some of the most common signs of Optic Nerve Dysfunction include:

  • Reduced visual activity all of a sudden
  • Double vision and headaches
  • A less reactive pupil (pupil is the central part of eyeball that allows light to pass through)
  • Impairment of colour vision (especially inability to identify red & green colours)
  • Difficulty in seeing light (Photophobia)
  • Visual Field Defects (visibility coverage)

Neuro Ophthalmic Conditions – And here come the ‘scary’ words

It’s quite natural that you’ll hear a lot of medical jargons in your doctor’s office. However, your doctor will try and explain the details, so you understand the illness/condition well and proceed with the available treatment options. Here are a few common conditions pertaining to neuro ophthalmology:

Optic Neuritis:

 This is a condition that involves inflammation of the optic nerve. An inflammation could occur due to various reasons – starting from an infection to an autoimmune disorder.

Papilloedema: 

In this case, the optic disc (the circular area where the optic nerve connects to the retina, at the back of the eye) swells up due to an excessive pressure from inside the skull may be due to a tumor for instance.

Nutritional Optic Neuropathy: 

Here the damage to the optic nerve is caused by certain toxic substances found in tobacco & alcohol. This could also occur due to lack of nutrients and deficiency of vitamin B-complex and folic acid.

Diabetic Neuropathy: 

In this, the optic nerve is damaged due to the excessive blood sugar or diabetes. As the disease progresses, the blood supply to the retina gets cut-off, leading to vision loss.

Although each of them attacks the optic nerve in a different way, the final outcome is eventually the death of the optic nerve, if left untreated.

Neuro Ophthalmology Treatments – Pills or prayers?

Your eye specialist will ideally be able to pick up an optic nerve issue during an eye examination. A brain CT scan or an MRI is then typically done to assess whether there is associated damage in the brain as well. While some conditions can be treated with oral medications and injectables, others might require a surgery. Some of the common treatment options would be:

Optic Neuritis: 

Antibiotics and corticosteroids are used to flush out the infection or suppress the immune disorders from causing further damage.

Papilloedema: 

Medications are used to reduce the pressure inside the skull. Might require a brain surgery if the increased pressure is due to a tumorous growth.

Nutritional Optic Neuropathy: 

Lifestyle changes are recommended and vitamin injectables are prescribed.

Diabetic Retinopathy

Since the underlying cause is diabetes, it is essential to treat the diabetes before it further damages the nerve and other blood vessels.

If not detected on time, there’s a good chance for complete loss of vision.

Written by: Dr. Preetha Rajasekaran – Consultant Ophthalmologist, Porur

Glued IOL

What are the Indications of Glued IOL?

Glued IOL surgery is recommended for patients who experience one or more of the following conditions:

Aphakia

  • – The absence of a natural lens due to cataract removal, trauma, or congenital reasons.

Inadequate Capsular Support

  • – Cases where the natural support structure (capsular bag) is insufficient for standard IOL placement.

Subluxated or Dislocated Lens

  • – When an intraocular lens becomes displaced due to trauma, previous surgeries, or connective tissue disorders.

Zonular Weakness

  • – Conditions such as Marfan’s syndrome or pseudoexfoliation syndrome, where the natural support of the lens is compromised.

Post-Vitreoretinal Surgery Cases

  • – When patients have undergone complex retinal procedures affecting lens stability.

By using a glued IOL technique, ophthalmic surgeons can provide a stable and secure alternative for vision correction, eliminating the need for anterior chamber or iris-claw IOLs, which may have higher complication rates.

An Insight into Different Intraocular Lens Types

Intraocular lenses (IOLs) are artificial lenses implanted in the eye to restore vision following cataract removal or lens extraction. Various types of IOLs are available, each designed to meet specific vision needs:

1. Monofocal IOLs

Monofocal intraocular lenses are the most commonly used IOLs, offering clear vision at a fixed distance (either near, intermediate, or far). Patients receiving monofocal IOLs may still require glasses for tasks such as reading or computer work.

2. Multifocal IOLs

Multifocal IOLs are designed to provide clear vision at multiple distances, reducing dependency on glasses. These lenses are ideal for individuals who wish to have a greater range of focus without additional visual aids. However, they may cause minor side effects such as glare and halos in low-light conditions.

3. Toric IOLs

Toric IOLs are specifically designed for patients with astigmatism. These lenses correct corneal irregularities, providing sharp and distortion-free vision.

4. Extended Depth of Focus (EDOF) IOLs

EDOF lenses offer an extended range of vision, reducing dependency on glasses for intermediate and near tasks. These lenses provide smoother transitions between distances compared to multifocal IOLs.

5. Accommodative IOLs

Accommodative IOLs mimic the natural focusing ability of the eye’s crystalline lens, allowing dynamic focusing at different distances.

6. Cataracts in Both Eyes

Patients with cataracts in both eyes often require IOL implantation to restore vision. Depending on their lifestyle and vision needs, they may opt for monofocal, multifocal, or toric lenses for improved clarity and focus.

7. Macular Degeneration and IOLs

For individuals suffering from macular degeneration, specific IOLs can be used to improve central vision, reducing the blurriness associated with this condition. These specialized lenses enhance contrast and image sharpness, providing better vision for daily activities.

8. Budget-Friendly IOL Options

For those on a limited budget, there are IOLs that are mostly covered by insurance plans. While these lenses may not offer advanced features like multifocal or toric correction, they provide significant visual improvement at an affordable cost.

9. Multifocal IOLs for Presbyopia

If you are suffering from age-related farsightedness or presbyopia, multifocal IOLs are a great option. These lenses allow patients to see at different distances without requiring additional glasses, making everyday activities more convenient.

10. IOLs for Contact Lens Independence

If you want to free yourself of contact lenses and glasses, premium IOL options such as multifocal, EDOF, and accommodative lenses can provide excellent visual outcomes.

11. Visual Capability and IOL Selection

If both your eyes have good visual capability, selecting the right IOL is crucial to ensure a balanced vision. Consulting an eye specialist helps in determining the most suitable option based on lifestyle and vision goals.

12. Depth Perception and Night Vision Considerations

Some settings of multifocal IOLs may cause issues like depth perception and problems with night vision. Patients need to be aware of these potential challenges when selecting a multifocal lens and should discuss their lifestyle needs with an ophthalmologist.

13. Toric IOLs for Astigmatism

Toric lenses contain specific peripheral indicators that help with accurate astigmatism correction. These lenses provide better clarity and reduce dependence on corrective eyewear.

14. Cataract Surgery and Toric IOLs

Toric lenses do not raise the risk of complications that arise from cataract surgery, such as eye inflammation or light sensitivity. They are considered a safe option for patients requiring astigmatism correction along with cataract removal.

15. Risks of Misaligned Toric IOLs

It is imperative to keep in mind that a misaligned toric IOL can result in hazy vision that is difficult to rectify with glasses. Ensuring precise placement during surgery is essential for optimal results.

16. Phakic Lenses

Phakic IOLs are implanted without removing the natural lens, making them ideal for individuals with high refractive errors who are not suitable for laser vision correction. These lenses provide excellent visual outcomes for patients with severe myopia or hyperopia.

Risks and Complications of Glued IOL Surgery

Although glued IOL surgery is a safe and effective procedure, some potential risks include:

Intraocular Pressure Fluctuations:

  • Post-operative intraocular pressure changes can occur, requiring medical intervention.

Inflammation:

  • Mild to moderate inflammation is common but can be controlled with prescribed medications.

Corneal Edema:

  • Swelling in the cornea may cause temporary vision disturbances.

Retinal Detachment:

  • A rare but serious complication that requires prompt surgical intervention.

Suture-Related Issues:

  • Some patients may experience irritation or foreign body sensation due to residual suture exposure.

Step-by-Step Glued IOL Surgery Procedure

Glued IOL surgery is an advanced technique used to implant an intraocular lens (IOL) when the natural support structures in the eye are inadequate. This procedure involves securing the IOL to the sclera using fibrin glue, ensuring stability and long-term vision correction. Below is a detailed step-by-step guide to the glued IOL surgery process:

1. Pre-Surgical Preparation

  • A thorough eye examination is conducted to assess the patient’s condition and determine the need for glued IOL implantation.
  • The patient is advised on pre-operative precautions, including avoiding blood-thinning medications and fasting if necessary.
  • Anesthesia (local or general) is administered to ensure patient comfort during the procedure.

2. Creation of Scleral Flaps

  • The surgeon creates two partial-thickness scleral flaps (approximately 2.5mm in size) on opposite sides of the eye.
  • These flaps provide an anchor point for the IOL haptics and ensure proper fixation.

3. Vitrectomy (if required)

  • If the patient has residual lens matter or vitreous obstruction, a vitrectomy is performed to clear the visual pathway.
  • This step ensures that the IOL can be placed securely without interference from remaining lens fragments.

4. IOL Preparation and Positioning

  • The IOL is carefully selected based on the patient’s refractive needs and ocular anatomy.
  • The haptics (lens arms) of the IOL are externalized using microforceps through sclerotomies made under the scleral flaps.
  • Proper positioning of the IOL ensures long-term stability and optimal visual outcomes.

5. Fixation Using Fibrin Glue

  • A small amount of fibrin glue is applied under the scleral flaps to secure the IOL haptics.
  • The glue ensures strong adhesion, minimizing the risk of lens movement or dislocation.
  • Unlike traditional suture-based fixation, fibrin glue reduces inflammation and speeds up healing.

6. Closure of Scleral Flaps and Conjunctiva

  • The scleral flaps are repositioned over the haptic ends and sealed with additional fibrin glue.
  • The conjunctiva (the outer layer of the eye) is gently closed to provide further protection and enhance healing.

7. Post-Surgical Eye Care

  • Antibiotic and anti-inflammatory eye drops are prescribed to prevent infection and reduce swelling.
  • The patient is monitored for intraocular pressure changes and other post-operative complications.
  • A follow-up schedule is provided to ensure proper healing and assess vision improvement.

What are the advantages of Glued IOL?

Glued IOL offers several benefits over traditional IOL implantation methods, making it an effective solution for patients with inadequate capsular support. These advantages include:

The IOL is placed in the normal anatomical position

  • Unlike anterior chamber IOLs, which sit in front of the iris, glued IOLs are positioned within the posterior chamber, ensuring a more natural placement.
  • This enhances comfort and provides better visual outcomes compared to alternative fixation techniques.

The stability of the IOL is good

  • The use of fibrin glue ensures that the IOL remains securely attached to the sclera, minimizing the risk of dislocation or lens movement.
  • Patients experience long-term stability, reducing the need for additional surgical interventions.

This procedure brings the eye back to 90% normal

  • By securely implanting the lens, glued IOL helps restore near-normal visual function.
  • The technique eliminates common complications associated with aphakia, such as glare, halos, and unstable vision.
  • Patients regain a significant portion of their visual clarity, improving daily activities and overall quality of life.

Why is Glued IOL a Revolutionary Solution for Lens Implantation?

Glued IOL has transformed the approach to intraocular lens implantation, especially for cases where conventional techniques fail. Here’s why it is considered revolutionary:

Overcomes Capsular Deficiencies:

  • Traditional IOL implantation requires an intact capsular bag, but glued IOL provides a solution for patients with capsular damage, zonular instability, or lens dislocation.

Minimally Invasive and Sutureless:

  • The fibrin glue technique avoids sutures, reducing inflammation, irritation, and recovery time.

Long-Term Stability:

  • Unlike anterior chamber IOLs or iris-claw IOLs, glued IOLs are scleral-fixated, ensuring better long-term positioning and functionality.

Lower Risk of Secondary Complications:

  • Traditional methods sometimes lead to complications such as increased intraocular pressure or endothelial cell loss. Glued IOL minimizes these risks while offering better aesthetic and functional outcomes.

Ideal for Complex Cases:

  • Patients with trauma-related lens loss, pediatric aphakia, or post-vitrectomy conditions benefit greatly from this technique.

Risks and Complications Associated with Glued IOL

While glued IOL is a highly effective procedure, like any surgery, it has potential risks and complications. These include:

Post-Operative Inflammation:

  • Mild to moderate inflammation is common but can be managed with medication.

IOL Dislocation or Tilt:

  • If not properly positioned, the IOL may shift, leading to visual disturbances.

Scleral Thinning or Erosion:

  • In rare cases, long-term pressure from the lens may lead to scleral complications.

Retinal Detachment:

  • Though uncommon, patients with prior retinal conditions should be monitored closely.

Glaucoma or Increased Intraocular Pressure (IOP):

  • Some patients may experience elevated IOP, requiring medical management.

Corneal Edema:

  • Swelling of the cornea can occur but typically resolves with proper post-operative care.

Post-Surgery Care and Recovery After Glued IOL Implantation

Proper post-surgical care ensures a smooth recovery and optimal results after glued IOL implantation. Here are key recovery steps:

Use of Medications:

  • Patients must follow a strict regimen of antibiotic and anti-inflammatory eye drops to prevent infection and reduce swelling.

Avoid Rubbing the Eyes:

  • Any pressure on the eyes can lead to IOL displacement or delayed healing.

Restricted Physical Activities:

  • Patients should avoid lifting heavy objects, bending over, or engaging in strenuous activities for at least a few weeks.

Follow-Up Appointments:

  • Regular check-ups help monitor healing progress and detect any complications early.

Protective Measures:

  • Wearing sunglasses or protective eyewear can prevent accidental injury and reduce light sensitivity.

Symptom Monitoring:

  • Patients should report any unusual pain, vision loss, excessive redness, or sudden floaters immediately.

Why Choose Dr Agarwals Eye Hospital for Glued IOL?

Dr Agarwals Eye Hospital is a leader in advanced eye care and offers world-class expertise in glued IOL implantation. Here’s why patients trust our institution:

Highly Experienced Specialists:

  • Our team of ophthalmic surgeons has extensive experience in complex IOL implantation procedures.

Latest Technology:

  • We use the latest advancements in ophthalmic surgery to ensure precision and safety.

Customized Treatment Plans:

  • Each patient receives personalized care tailored to their specific condition and vision needs.

Comprehensive Post-Surgical Support:

  • From recovery monitoring to rehabilitation, we provide thorough aftercare to ensure the best outcomes.

Affordable and Transparent Pricing:

  • We offer competitive pricing with flexible options, making glued IOL surgery accessible to a wider range of patients.

Proven Track Record:

  • Thousands of successful glued IOL procedures performed with high patient satisfaction and long-term results.
CAIRS Eye Surgery

One day, imagine experiencing a clear eyesight that you haven’t had in years. These days, a lot of people with eye diseases like keratoconus or corneal ectasia can actually achieve this because of breakthroughs in eye surgery. A notable example of this is the CAIRS eye surgery. If you or a loved one is thinking about having this operation done, we’ll walk you through everything you need to know, making sure you understand every step and feel confident.

How Does CAIRS Treatment Procedure Work?

With keratoconus, a progressive eye disease, vision becomes distorted as the cornea thins and attains cone-shaped. In order to stabilise and restructure the cornea, corneal ring segments are implanted during the CAIRS operation. The below four points will guide you about thorough rundown of the CAIRS treatment process:

1. Indications

CAIRS is often recommended for patients with:

  • Progressive Keratoconus.
  • Other corneal ectasias that do not respond well to conservative therapies, such as rigid contact lenses.
  • Patients who are not good candidates for corneal collagen cross-linking or other surgical procedures.

2. Preoperative Assessment

Before the surgical treatment, a comprehensive eye examination is performed as follows,

  • Corneal Topography is used to map the corneal shape and assess the extent of the ectasia.
  • Pachymetry is used to determine corneal thickness.
  • Ocular History and Visual Acuity Testing are used to determine the influence on vision and set a baseline.
  • The purpose of the contraindications evaluation is to ensure that no conditions, such as active infection or extensive corneal scarring, preclude surgical intervention.

3. CAIRS Procedure

Anaesthesia

  • The surgical procedure is usually done under local anaesthesia with topical anesthetic drops.

Creation of Stromal Tunnel

  • A femtosecond laser or a mechanical microkeratome is utilised to create a precise tunnel through the corneal stroma. This tunnel is where the corneal segments will be inserted.
  • The depth and length of the tunnel are carefully estimated using preoperative measurements.

Preparation of Allogenic Segments

  • CAIRS corneal segments are created from the donor corneal tissue. These segments are formed into little rings or arcs that offer structural support for the cornea.
  • To assure its suitability for implantation, allogenic tissue is treated and sterilised.

Insertion of Segments

  • The allogenic corneal ring segments are carefully placed in the stromal tunnel.
  • The positioning is critical for producing the desired effect on corneal shape and stability. The severity and asymmetry of the keratoconus determine whether one or two segments are inserted.

Final Adjustments and Healing

  • Following insertion, the segments are adjusted to ensure optimum alignment and positioning.
  • Antibiotic and anti-inflammatory drops are given to help prevent infection and inflammation.

4. Postoperative Care

  • Patients are carefully monitored following surgery, with regular follow-up sessions.
  • They are given a regimen of antibiotic and anti-inflammatory eye drops.
  • Visual acuity and corneal topography are examined on a regular basis to ensure the procedure’s success and detect any problems at the earliest.

Benefits of CAIRS for Keratoconus

The CAIRS technique has many benefits for individuals with keratoconus, making it a viable choice for managing this degenerative eye disease. Here are the main benefits of CAIRS for keratoconus: 

1. Stabilisation of Corneal Shape

  • CAIRS gives structural support to the cornea, slowing the course of keratoconus by preventing additional thinning and bulging.
  • The use of allogenic segments can result in long-term stabilisation of the corneal shape, eliminating the need for future invasive treatments.

2. Improvement in Vision

  • By reshaping and stabilising the cornea, CAIRS can considerably reduce irregular astigmatism, a prominent source of visual distortion in keratoconus patients.
  • Many patients report better visual acuity as the corneal shape becomes more regular, resulting in clearer and sharper eyesight.

3. Minimally Invasive Procedure

  • CAIRS is less invasive than standard corneal transplantation (penetrating or deep anterior lamellar keratoplasty), which requires more intensive surgery and a longer recovery time.
  • It often has a quicker recovery period than more invasive surgical treatments, allowing patients to resume their regular activities sooner.

4. Compatibility with Other Treatments

  • CAIRS can be used in conjunction with corneal collagen cross-linking (CXL), which strengthens the corneal collagen fibres. The combination can improve stability and vision.
  • It can be adjusted to specific patient demands by adjusting the number and location of the ring segments based on keratoconus severity and asymmetry.

5. Use of Donor Tissue

  • The use of allogenic (donor) corneal tissue segments assures greater biocompatibility and lowers the likelihood of adverse responses when compared to synthetic implants.
  • Donor tissue blends seamlessly with the patient’s cornea, facilitating natural healing and lowering the risk of rejection or extrusion.

6. Potential for Delay or Avoidance of Transplantation

  • By stabilising the cornea early in the disease process, CAIRS can postpone or even eliminate the need for corneal transplantation, a more complicated and hazardous treatment.
  • Delaying or postponing transplantation can also save money in the long run, lowering the patient’s overall healthcare burden.

7. Customizability

The technique can be customised to the patient’s individual corneal shape and degree of ectasia. Surgeons can modify the number, size, and positioning of the segments to produce the best results.

Who Is Required to Do This CAIRS Procedure?

The CAIRS procedure should be conducted by a highly skilled eye surgeon with a medical degree and ophthalmology residency. Ideally, the surgeon should have extra fellowship training in cornea and refractive surgery, which allows for specialised competence in treating corneal illnesses and executing advanced corneal procedures. They must be board-certified in ophthalmology and have extensive experience diagnosing and managing keratoconus, as well as knowledge of corneal surgical methods, particularly those using intrastromal implants. 

Experience with modern equipment such as femtosecond lasers or mechanical microkeratomes is also required. To guarantee comprehensive patient care, the surgeon should participate in ongoing education to stay up to date on the newest breakthroughs, join relevant professional organisations, and collaborate with a multidisciplinary team of experts. To achieve the best results, effective communication skills are required while meeting with patients, explaining the operation, and giving detailed postoperative care.

Will I See Better After Having CAIRS Surgery?

Many individuals see significant improvements in their vision after CAIRS surgery, while the level of improvement varies depending on the severity of the keratoconus, prior eyesight, and corneal features. It can decrease irregular astigmatism and increase visual acuity, resulting in crisper and sharper vision. Patients frequently report better eyesight, with fewer distortions and glare. The surgeon’s precision in segment placement, adherence to postoperative care recommendations, and corneal health all contribute to the surgery’s outcome. While CAIRS primarily tries to stabilise the cornea and slow disease progression, many patients still require corrective lenses, albeit less strong ones. It is critical to set reasonable expectations and explore possible outcomes with the surgeon. 

Is CAIRS the Only Option Left to Improve My Sight, or Are There Other Treatments?

CAIRS is one of various methods for improving eyesight in people with keratoconus and other corneal ectatic conditions. Other eye treatments include glasses and contact lenses, which can correct vision in the early stages; rigid gas permeable (RGP) and scleral lenses, which provide a more consistent refractive surface for moderate to advanced keratoconus; and corneal collagen cross-linking (CXL), which strengthens the corneal collagen fibres and slows disease progression. Furthermore, Intacs (intrastromal corneal ring segments) are synthetic implants used to reshape and stabilise the cornea, similar to CAIRS but with plastic segments instead of donated tissue. The severity of the condition, corneal characteristics, and unique patient demands all influence treatment decisions, which frequently necessitate a consultation with a trained ophthalmologist to establish the best strategy.

How Much Does CAIRS Surgery Cost?

In India, the cost of CAIRS varies based on the patient’s eye features and the type of corneal problem being treated. The severity of keratoconus, as well as the particular corneal shape and thickness, can all have an impact on the procedure’s difficulty and cost. Furthermore, the geographic location, surgeon expertise, and kind of medical facility all have an important impact in deciding the final keratoconus surgery cost. A full consultation with an experienced ophthalmologist is required to provide an accurate cost estimate based on your specific needs and corneal health.

Who Developed the CAIRS Procedure?

Dr. Soosan Jacob, a distinguished ophthalmologist and pioneer in corneal and refractive surgery at Dr Agarwals Eye Hospital, created the CAIRS procedure. Dr. Soosan Jacob is well-known for her unique contributions to ophthalmology, which have helped advance numerous surgical approaches for treating difficult corneal problems. Her CAIRS method, which uses allogenic tissue to stabilise and restructure the cornea, is a revolutionary strategy for treating keratoconus and other corneal ectatic problems.

Verified by: Dr. T. Senthil Kumar MBBS MS (Ophthal) (Gold Medallist) FICO

Reference:

  • Jacob S, Agarwal A, Awwad ST, Mazzotta C, Parashar P, Jambulingam S. Customised corneal allogenic intrastromal ring segments (CAIRS) for keratoconus with decentered asymmetric cone. Indian Journal of Ophthalmology/Indian Journal of Ophthalmology. https://pubmed.ncbi.nlm.nih.gov/37991313/
Advanced Corneal Transplant (PDEK)

How is the penetrating keratoplasty surgery performed?

The penetrating keratoplasty surgery is usually performed under local anaesthesia. Through a small corneal incision (opening), the endothelium is removed from the patient’s eye and a disc of donor endothelium is inserted in the patient’s eye which is placed in position with the help of an air bubble.

A few stitches may be taken which will be removed 3-4 weeks after the surgery. Once keratoplasty surgery is over, the patient needs to lie down flat for a few hours for proper attachment of the graft. The air bubble usually gets absorbed in 48 hours but may take longer. 

What are the indications of Penetrating Keratoplasty (PDEK)?

  • Fuch’s endothelial dystrophy
  • Pseudophakic bullous keratopathy
  • Aphakic bullous keratopathy
  • ICE syndrome

Endothelial dysfunction secondary to glaucoma

What are the advantages over full thickness penetrating Keratoplasty?

  • Few sutures required as compared to penetrating keratoplasty.
  • Suture induced astigmatism is avoided
  • Suture related complications are avoided
  • Greater stability
  • Faster visual rehabilitation
  • The graft can be obtained from any age group of the donated eyes
  • Chances of rejection are less

 What are the complications of Penetrating Keratoplasty (PDEK)?

  • Graft detachment/ dislocation
  • Recurrent epithelial erosions
  • Cataract formation
  • Glaucoma
  • Graft rejection
  • Graft failure 

What is corneal graft rejection?

The donor eye is genetically different from the patient’s body, due to which the patient’s body tries to fight against it. This is called corneal graft rejection.  

What are the symptoms of corneal graft rejection?

The symptoms are: Redness, Sensitivity to light, Vision drop, Pain (RSVP). Along with sticky discharge and foreign body sensation.

Report to your Ophthalmologist as soon as possible if any of the above symptoms show up post-surgery.

How do I prevent graft rejection?

  • In order to prevent rejection, a list of anti-rejection medications will be prescribed by your doctor, which should be used religiously.
  • You should have an adequate supply of eyedrops at home so that a single dose is not missed.
  • Do not stop any medication without consulting your Ophthalmologist.
  • In case any of the above symptoms of rejection occur, meet your Ophthalmologist immediately. It can often be reversed if anti-rejection medications are started promptly. It should also be noted that rejection can occur at anytime in the years to come.
  • Review regularly to check for vision, intraocular pressure, graft condition and retinal assessment.

What are the risk factors for rejection?

What is graft failure?

When the corneal graft rejection has not been promptly treated or does not respond to anti- rejection medication, graft failure has occurred. The only way of managing graft failure is by replacing the graft. In addition, there are three types of graft rejection: acute, hyperacute, and chronic rejection.

Written by:Dr. Preethi Naveen – Training Committee Chair – Dr. Agarwals Clinical Board

Pneumatic Retinopexy (PR)

Who is a Suitable Candidate for Pneumatic Retinopexy?

Not all retinal detachments can be treated with pneumatic retinopexy. This procedure is suitable for:

  • Patients with a single small retinal tear or break that is located in the upper portion of the retina.
  • Individuals without proliferative vitreoretinopathy (PVR), which is a condition where scar tissue forms on the retina and complicates reattachment.
  • Those with minimal fluid accumulation under the retina, as excessive fluid may prevent successful reattachment.
  • Patients who can follow strict post-operative positioning to ensure that the gas bubble remains in the correct place for effective healing.

Patients with multiple retinal tears, large detachments, or severe vitreoretinal scarring may require alternative treatments like scleral buckle surgery or vitrectomy.

Step-by-Step Pneumatic Retinopexy Procedure

The pneumatic retinopexy procedure consists of the following steps:

  • Administration of Anesthesia:

The eye is numbed using local anesthesia to ensure a painless experience.

  • Gas Bubble Injection:

A small amount of gas (such as SF6 or C3F8) is injected into the vitreous cavity of the eye. This bubble expands and applies pressure against the detached retina.

  • Sealing the Retinal Tear:

The surgeon uses laser photocoagulation or cryotherapy to create a scar that prevents the tear from reopening.

  • Post-Procedure Positioning:

The patient is instructed to maintain a specific head position for several days, ensuring that the gas bubble remains in contact with the retinal tear to facilitate healing.

  • Gradual Absorption of the Bubble:

Over time, the gas bubble dissolves, and the eye’s natural fluids replace it, maintaining the retina’s position.

What are the Key Benefits of Pneumatic Retinopexy?

  • Minimally invasive procedure with no need for large incisions.
  • Performed in an outpatient setting, eliminating hospital stays.
  • Faster recovery time compared to traditional retinal surgeries.
  • Lower risk of complications such as infection and excessive bleeding.
  • Preservation of the eye’s natural anatomy, minimizing structural changes.
  • Effective for selected retinal detachments, particularly in early-stage cases.

Risks and Complications of Pneumatic Retinopexy

While PR is a relatively safe procedure, potential risks include:

  • Incomplete retinal reattachment, requiring additional procedures.
  • Increased intraocular pressure (IOP), which can lead to glaucoma.
  • Gas bubble-related vision impairment, affecting sight until the bubble dissolves.
  • Cataract development, particularly in older patients.
  • Infection or inflammation inside the eye.
  • Recurrent retinal detachment, necessitating further surgical intervention.

Recovery Time and Postoperative Care Tips

Recovery from pneumatic retinopexy requires patience and strict adherence to post-operative instructions. Key aspects of the recovery process include:

  • Maintaining Proper Head Positioning:

Patients must keep their head in a specific position for up to a week to ensure the gas bubble remains in place.

  • Avoiding Air Travel and High Altitudes:

The gas bubble expands at higher altitudes, potentially leading to dangerous increases in eye pressure.

  • Using Prescribed Eye Drops:

Medications help prevent infection and reduce inflammation.

  • Attending Regular Follow-Up Appointments:

The ophthalmologist will monitor the retina’s healing process and detect any complications early.

  • Gradual Vision Improvement:

Vision may be blurred initially, but it improves as the gas bubble dissolves over a period of 2 to 8 weeks.

Success Rate and Effectiveness of Pneumatic Retinopexy

The success rate of PR varies depending on the severity of the detachment and the patient’s adherence to post-operative care. Studies indicate that pneumatic retinopexy successfully reattaches the retina in 70-80% of cases. If PR is unsuccessful, additional surgical interventions such as vitrectomy or scleral buckling may be required.

Alternative Treatments for Retinal Detachment

For more complex cases of retinal detachment, alternative treatments include:

  • Scleral Buckling:

A silicone band is placed around the eye to reposition the retina.

  • Vitrectomy:

The vitreous gel is removed and replaced with gas or silicone oil to stabilize the retina.

  • Laser Photocoagulation:

Laser treatment is used to seal small retinal tears before detachment occurs.

Why Choose Dr Agarwals Eye Hospital for Pneumatic Retinopexy?

Dr Agarwals Eye Hospital is renowned for its excellence in retinal care, offering:

  • Highly skilled retinal specialists with extensive experience in PR.
  • Advanced diagnostic and surgical technology ensuring precision and safety.
  • Personalized patient care, post-operative monitoring, and follow-up consultations.
  • High patient satisfaction and successful treatment outcomes.
Cornea Transplantation

When is a Corneal Transplant (Keratoplasty) Needed?

A corneal transplant is required when the cornea becomes so damaged that it no longer functions properly. Common conditions that may necessitate a transplant include:

  • Keratoconus

– A progressive thinning of the cornea that causes it to bulge into a cone shape.

  • Corneal Scarring

– Due to infections, trauma, or chemical burns.

  • Fuchs’ Dystrophy

– A condition where the inner layer of the cornea deteriorates, leading to swelling and vision loss.

  • Corneal Ulcers

– Severe infections or ulcers that leave the cornea damaged.

  • Previous Failed Corneal Transplant

– Some patients may require a repeat transplant if the initial one fails.

  • Hereditary Eye Conditions

– Some genetic disorders can affect corneal health.

Who Performs Corneal Transplant Surgery?

Corneal transplant surgery is performed by an ophthalmologist specializing in corneal diseases and surgeries. These highly trained eye surgeons carefully assess each patient’s condition and determine the best type of transplant procedure.

What is the Procedure of Cornea Transplant (Keratoplasty)?

Corneal transplant surgery is a delicate procedure that follows these steps:

  • Pre-Surgical Assessment:

The patient undergoes a detailed eye examination, including corneal measurements and imaging.

  • Anesthesia Administration:

The procedure is usually performed under local or general anesthesia.

  • Removal of the Damaged Cornea:

The surgeon carefully removes the affected portion of the cornea using precision instruments.

  • Donor Cornea Placement:

The healthy donor cornea is prepared and positioned in place.

  • Suturing or Fixation:

The new cornea is secured using fine stitches or a laser-based attachment, depending on the technique used.

  • Post-Operative Care:

Medications and follow-up visits ensure the success of the transplant and prevent rejection.

What are the Types of Cornea Transplantation?

There are several types of corneal transplant procedures, each suited for different conditions:

  • Penetrating Keratoplasty (PK):

A full-thickness transplant where the entire cornea is replaced.

  • Deep Anterior Lamellar Keratoplasty (DALK):

Only the outer layers of the cornea are replaced, preserving the inner layers.

  • Endothelial Keratoplasty (DSAEK/DMEK):

A selective replacement of the cornea’s innermost layer, often used for conditions like Fuchs’ dystrophy.

  • Artificial Cornea Transplant (Keratoprosthesis):

Used in cases where donor corneas are not an option.

Risk Factors of Cornea Transplantation

While corneal transplant surgery has a high success rate, some risks include:

  • Rejection of the Donor Cornea

– The immune system may attack the transplanted tissue.

  • Infection

– Post-surgical infections can occur if proper care is not taken.

  • Increased Intraocular Pressure (Glaucoma)

– A possible complication leading to optic nerve damage.

  • Astigmatism

– Irregular curvature of the cornea, sometimes requiring glasses or contact lenses.

  • Swelling or Cloudiness

– Can affect vision post-surgery.

How to Prepare for a Cornea Transplant?

Patients undergoing corneal transplant surgery should follow these steps:

  • Undergo a comprehensive eye examination.
  • Discuss medications with their doctor, as some may need to be stopped before surgery.
  • Arrange for someone to assist them post-surgery.
  • Follow pre-operative fasting instructions if required.

What to Expect After Cornea Transplant Surgery?

Recovery from cornea transplant surgery varies by individual and procedure type. Some general expectations include:

  • Initial Healing Period:

Vision may be blurry for a few weeks as the eye adjusts.

  • Use of Eye Drops and Medications:

Steroid eye drops help prevent rejection.

  • Avoiding Strenuous Activities:

Activities such as heavy lifting and rubbing the eyes should be avoided.

  • Regular Follow-Up Visits:

Monitoring is crucial to detect any complications early.

How to Take Care of Your Eyes After a Cornea Transplant?

To ensure a successful recovery, patients should:

  • Follow the prescribed medication schedule.
  • Protect their eyes from dust, wind, and bright sunlight.
  • Avoid swimming and exposure to contaminated water.
  • Wear protective glasses to prevent accidental injury.
  • Report any sudden pain, redness, or vision changes immediately.

What Are the Alternatives to Cornea Transplant?

For some patients, alternative treatments may be considered before opting for corneal transplant surgery:

  • Corneal Cross-Linking:

Strengthens the cornea in keratoconus patients to slow progression.

  • Specialty Contact Lenses:

Scleral lenses can help improve vision in certain corneal conditions.

  • Laser Treatments:

Procedures like PTK (Phototherapeutic Keratectomy) can remove superficial corneal scars.

  • Artificial Cornea (Keratoprosthesis):

For severe cases where donor transplants are not viable.

Why Choose Dr Agarwals Eye Hospital for Cornea Transplant Surgery?

Dr Agarwals Eye Hospital is a leader in corneal transplantation and keratoplasty procedures, offering:

  • Expert Corneal Surgeons:

Highly trained specialists with years of experience.

  • Advanced Facilities:

Advanced diagnostic and surgical technology.

  • Comprehensive Patient Care:

From pre-surgical counseling to post-operative recovery.

  • High Success Rates:

Thousands of successful corneal transplants performed.

  • Affordable and Transparent Pricing:

Competitive pricing with accessible treatment plans.

Cornea transplantation (keratoplasty) is a life-changing procedure that restores vision and improves quality of life. With advanced surgical techniques and expert care, patients can expect a successful outcome and long-term visual improvement. If you or a loved one is considering a cornea transplant, consult an experienced ophthalmologist to explore the best options available.

Pinhole Pupilloplasty

Principle

A pinhole or a small aperture is created, thereby allowing passage of rays of light from the central aperture and blocking the rays emanating from the peripheral irregular cornea, so that the impact of higher order aberrations caused by irregular corneal astigmatism can be minimized. Another mechanism is the Stiles-Crawford effect of the first kind, according to which, an equal intensity of light entering near the centre of the pupil produces a

greater photoreceptor response compared with the light entering the eye near the edge of the pupil. Therefore, when the pupil narrows, more focused light enters the eye through the narrow aperture, producing a greater photoreceptor response.

 Procedure

  • Under peribulbar anaesthesia ,4 mL lidocaine hydrochloride (Xylocaine 2.0%) and 2 mL bupivacaine hydrochloride 0.5% (Sensorcaine)
  • 2 paracenteses are created and a 10-0 polypropylene suture attached to the long arm of the needle is introduced into the anterior chamber.
  • The anterior chamber can be maintained with an ophthalmic viscosurgical device or with fluid infusion with the help of an anterior chamber
  • maintainer or a trocar anterior chamber maintainer.
  • An end-opening forceps is introduced through the paracentesis, and the proximal iris leaflet is held. The suture needle is passed through the
  • proximal iris tissue.
  • A 26-gauge needle is introduced from the paracentesis from the opposite quadrant and passed through the distal iris leaflet after being held with end-opening forceps. Next, the tip of the 10-0 needle is then passed through the barrel of the 26-gauge needle, which is then pulled out of the paracentesis. The 10-0 needle exits the anterior chamber along with the 26-gauge needle.
  • A Sinskey hook is passed through the paracentesis, and a loop of suture is withdrawn from the eye. The suture end is passed through the loop 4 times. Both the suture ends are pulled and the loop slides inside the eye, approximating the iris tissue edges. The suture ends are then cut with micro scissors and the procedure is repeated in the other quadrant to achieve a pupil of desired configuration and to decrease the pupil to pinhole size.

 Indications

  • Functional or Optical:

Symptomatic iris defects (Congenital, Acquired, Iatrogenic, Traumatic)

  • Oppositional angle closure or PAS:

To break PAS and angle apposition angle closure glaucoma whether primary, post trauma, plateau iris

syndrome, Urrets-Zavalia syndrome or long-standing silicone oil in the anterior chamber.

  • Cosmesis:

PPP can be done for cosmetic indication, especially in large colobomas.

  • Penetrating Keratoplasty:

In cases of floppy iris that is expected to adhere to the peripheral edge of graft causing peripheral anterior synechiae,

pupilloplasty is performed to tighten the iris preventing it from causing synechial adhesions that would increase the risk of angle closure and graft failure.

 Advantages

 Disadvantages

  • Limited dilation- to examine the posterior segment – (In cases of retinal detachment, it is possible to YAG the iris and undo procedure if needed).
  • Chances of touching crystalline lens during procedure and risk of cataract formation – So preferably done in pseudophakic eyes.

 Written by: Dr. Soundari S – Regional Head – Clinical Services, Chennai

Paediatric Ophthalmology

Paediatric Ophthalmology – Problems affecting our little people

Research shows that 1 out of 6 kids has vision related issues. Some of the most common issues affecting the little ones include:

Eye diseases in newborns include:

It is essential to address and rectify the issues in newborns as soon as possible. If not treated within the first six months of the child’s birth, there’s a good possibility that the child gets visually impaired for the rest of his/her life. The reason being, the optic nerve connecting the eyes to the brain is still developing and if any prevalent disease is not treated on time, there could be a permanent disconnect between the eyes and brain, eventually leading to total blindness.

 Paediatric Ophthalmology – Let’s nip it in the bud!

Routine comprehensive eye checks should be an essential part of your child’s healthcare regime. While problems like squint or drooping of eyelids can be easily noticed, finding issues related to lazy eye & refractive errors could be quite a challenge to the parents. Especially because most kids do not report the problem to their parents for often they lack the ability to understand that there’s been a change in their visual skills. It, therefore, becomes the primary responsibility of parents to notice any change in their kids’ behavioural pattern like watching TV from a close distance or excessively straining to read from a book or performing badly at school all of a sudden.

If any of these ring a bell, then it’s time to meet a paediatric ophthalmologist and clarify on your kid’s eye health.

 Paediatric Ophthalmology – Saving the vision of our tomorrow

Paediatric Ophthalmology is taken quite seriously at Dr. Agarwal’s Eye Hospitals with expert consultants & surgeons working round-the-clock to make sure, the vision of our future generation is well protected. Children with squint and lazy eye issues are initially treated by prescribing glasses and suggesting eye exercises. In fact, Dr. Agarwal’s was one of the first hospitals to introduce the concept of eye yoga as a treatment mechanism. Parents of children born from a wedlock between relatives or with both of them wearing glasses due to refractive errors are advised to bring their kids for an evaluation, right from 3-4 years of age.

Mucormycosis (Black Fungus)

Black Fungus (Mucormycosis) Symptoms in the Eye

Early detection of black fungus in eyes is essential to prevent vision loss or severe complications. Symptoms may include:

1. Swelling and Redness Around the Eye

Mucormycosis can cause inflammation around the affected eye, leading to visible swelling and redness.

2. Blurred or Double Vision

Patients may experience black fungus symptoms such as blurry or double vision due to the infection spreading into the eye socket.

3. Eye Pain and Sensitivity to Light

Eye discomfort, along with increased sensitivity to bright light, is another key indicator.

4. Dark Patches Around the Nose and Eyes

A distinctive sign of black fungus infection is the presence of darkened skin patches near the eyes and nasal area, caused by dead tissue.

5. Partial or Complete Vision Loss

In severe cases, the fungal infection may damage the optic nerve, leading to irreversible vision loss if left untreated.

Causes of Mucormycosis or Black Fungus

Understanding the causes of mucormycosis can help in early prevention and treatment. The primary causes include:

1. Weakened Immune System

Individuals with compromised immunity, such as those undergoing chemotherapy or organ transplants, are at a higher risk of developing mucormycosis disease.

2. Uncontrolled Diabetes

Diabetes, particularly uncontrolled blood sugar levels, creates an environment where fungi thrive, increasing the chances of infection.

3. Prolonged Use of Steroids

The excessive use of steroids, often prescribed for severe respiratory illnesses, can lead to black fungus infection due to immune suppression.

4. Exposure to Mold Spores

Molds responsible for mucormycosis are present in soil, decaying plants, and dust. Inhaling these spores can result in fungal infections in vulnerable individuals.

5. Contaminated Oxygen Support Equipment

During the COVID-19 pandemic, cases of black fungus were linked to unclean oxygen cylinders, humidifiers, and medical equipment.

Symptoms & Causes

Black Fungus Symptoms & Causes

Mucormycosis is caused by exposure to mucor mold which is commonly found in soil, plants, manure,...

LEARN MORE

Risk Factors of Black Fungus Infection

Certain individuals are more prone to developing mucormycosis. Risk factors for black fungus infection include:

  • Diabetes and high blood sugar levels
  • Extended steroid use (especially during COVID-19 treatment)
  • Cancer or undergoing chemotherapy
  • Organ transplants or weakened immunity
  • Poor hygiene and environmental exposure

How to Prevent Black Fungus (Mucormycosis)?

While mucormycosis is a severe condition, preventive measures can reduce the risk:

  • Maintain proper hygiene: Keep nasal passages clean and avoid dusty environments.
  • Monitor blood sugar levels: Diabetic patients should manage their glucose levels effectively.
  • Use steroids cautiously: Only take steroids as prescribed by healthcare professionals.
  • Avoid prolonged exposure to moldy environments: Stay away from damp or decaying surroundings.
  • Strengthen immunity: A balanced diet, regular exercise, and adequate sleep support immune health.

Types of Mucormycosis or Black Fungus

There are different types of mucormycosis, classified based on the affected area of the body:

1. Rhinocerebral Mucormycosis (Sinus and Brain)

This form affects the sinuses and brain, often spreading from the nasal cavity. Symptoms include severe facial pain, headache, nasal congestion, and blackened nasal tissue.

2. Pulmonary Mucormycosis (Lungs)

Common in individuals with lung disease or those undergoing chemotherapy, this type presents with fever, chest pain, and difficulty breathing.

3. Cutaneous Mucormycosis (Skin and Wound Infections)

Affects the skin following surgery, burns, or injuries, causing redness, swelling, and painful ulcerations.

4. Gastrointestinal Mucormycosis

This type occurs in the digestive tract and is often found in premature infants or individuals with malnutrition.

5. Disseminated Mucormycosis

The most severe form, where the infection spreads throughout the bloodstream, affecting multiple organs, including the brain.

When to See a Doctor for Black Fungus (Mucormycosis) Disease?

Seek medical attention if you experience:

  • Persistent facial pain or swelling
  • Black patches around the nose or eyes
  • Difficulty breathing or chest pain
  • Sudden vision changes or eye swelling
  • Unexplained headaches and fever

Early diagnosis is crucial in managing mucormycosis treatment effectively and preventing life-threatening complications. Mucormycosis is a severe fungal infection that requires immediate attention. Early detection, proper hygiene, and timely medical intervention can help prevent its devastating effects. If you notice any black fungus symptoms, consult a healthcare provider immediately.

Treatment of Black Fungus (Mucormycosis)

The treatment of black fungus mucormycosis involves antifungal medications and, in some cases, surgical procedures to remove infected tissue. Common treatment options include:

  • Amphotericin B: A strong antifungal drug administered intravenously.
  • Posaconazole or Isavuconazole: Oral antifungal medications used for long-term treatment.
  • Surgical Removal of Affected Tissue: In severe cases, surgical debridement is necessary to prevent the spread of infection.

Black Fungus Treatment & Diagnosis

Black fungus diagnosis is challenging because the symptoms are common to several other conditions It s diagnosis hence involves a...

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Dry Eye Treatment

Why Does Eyes Need Moisture?

Adequate quality and quantity of tears in the eyes is essential for smooth feeling and functioning of the eyes.

The dry eye syndrome is the change in quality or quantity of the three layers of the tear film – Oily (exterior), water/aqueous layer (middle) and protein (inner).

What are the Common Causes of Dry Eye?

Commonest cause of dry eyes are the air conditioners. The artificial air and temperature change caused by the air conditioners can cause changes and effect the largest organ of the body- the skin to the immune system, to the most delicate organ the eyes. The extreme loss of humidity and resultant dryness in the air around us especially in low temperature settings in AC, causes more evaporation from the watery layer of tear film , causing evaporative dry eyes and subsequently, long term exposure to such AC can also alter the lipid production from glands in the eyelids causing both change in quality and quantity of tear film and hence dry eyes. 

The tears have antimicrobial functions and in dry eyes, when there is no adequate lubrication, the eyes are also more vulnerable to inflammation and infections which could lead to decrease in vision.

The other important causes of dry eye disease are:

  • Prolonged staring/usage of computer/mobile phones (Computer Vision Syndrome).
  • The natural aging process, especially menopause problems and hence women are more affected by dry eyes .
  • Certain medical conditions including diabetes, thyroid disorders and Vitamin A deficiency
  • Side effects of certain drugs like antihistamines can also be a cause of dry eye.
  • Laser eye surgery, though symptoms of dry eyes related to this procedure are usually temporary.
  • Tear gland damage from inflammation or radiation
  • Diseases that affect your ability to make tears, like Sjogren’s syndrome, rheumatoid arthritis, and collagen vascular diseases
  • Problems that don’t allow your eyelids to close the way they should.
  • Air pollution -people in metros like New Delhi, Mumbai, Kolkata and Chennai are  few times more likely to be diagnosed with dry eye syndrome than the other towns with relatively little air pollution. 

 Major symptoms of dry eye disease:

Symptoms of dry eyes and dry eye syndrome can be Burning ,dryness ,grittiness, Itchiness, Aching sensations, Heaviness , watering from the eyes and blurred vision. The reading speed can slow down for dry eyes and the rate decreases as the severity increases.

 Tips & Treatment to Prevent Symptoms of Dry Eye Syndrome:

  • Try to minimize and decrease the number of hours of using air-conditioned rooms, setting of AC temperature around 23 degree C and above is recommended.
  • Avoid sitting with your face facing air conditioners, thereby preventing eyes from being directly exposed to air from air-conditioners.
  • Place a small open bowl of fresh water in the corner of the room you sit with the air conditioner to maintain the humidity of the room, thereby preventing dry skin and dry eyes. So far, this has proven to be one of the best dry eye remedies.
  • Another dry eyes home remedy is to drink enough liquids can also help prevent dry eye syndrome.
  • Frequent conscious blinking when using computer or mobile phones which will help in the appropriate distribution of tear film. 
  • Have a traditional 7 – 8 hours of sleep, which will give adequate rest to the eyes.
  • Consider wearing sunglasses or protective eye wear.
  • Reach out to your eye doctor to diagnose the cause of your dry eyes, and follow recommendations and prescriptions from the Eye doctor on eye medications like lubricants, and /or antibiotics and/or anti-inflammatory eye drops and other in-office procedures which could help your body create and secrete more tears and better quality of tears and to decrease eye irritation and inflammation.

If precautionary methods are not followed to prevent symptoms of dry eye syndrome, people will also develop eye infections. In the case of untreated, dry eyes, as the severity and duration of dry eyes increase, patients might develop damage to the corneal surface (abrasion), corneal ulcer and serious vision problems.

Prevention is better than cure. Get your eyes checked for dry eyes syndrome and get them treated appropriately.

Retinal Laser Photocoagulation

Types and benefits of Retina Laser

According to the type of retinal disorder, laser therapy is provided in different ways.

Proliferative Diabetic Retinopathy (PDR)

  • Proliferative diabetic retinopathy is a form of advanced or end-stage diabetic retinopathy. Due to the long duration of diabetes and uncontrolled blood sugar levels, the retinal blood vessels undergo changes which happen in stages, ultimately leading to PDR. PDR is a vision-threatening disorder. When timely treatment is not provided, it can cause complications like bleeding within the eyes from the abnormal vessels and/or can retinal detachment
  • Retinal laser therapy is helpful in PDR as it decreases the risk of such complications. The doctor performs pan-retinal photocoagulation (PRP) to treat PDR.
  • The retina is a 360-degree structure that is responsible for vision. The central retina is called as macula and is the chief zone responsible for fine vision. During proliferative diabetic retinopathy, the doctor applies laser therapy to the poorly vascular retinal areas sparing the macula.  Proliferative diabetic retinopathy therapy is provided in three to four sessions since the almost 360-degree retina is slowly covered with laser spots. The formation of abnormal blood vessels and undue complications are prevented by this procedure. 

Diabetic Macular Edema (DME)

DME is abnormal fluid collection leading to swelling at the level of the macula, causing vision loss. Retinal laser photocoagulation is beneficial in some cases of DME. Here, minimal laser spots are given targeting the leaky macular blood vessels to reduce the swelling.

Retinal Vein Occlusion (RVO)

In RVO, the entire retinal vessel or a part of the retinal vessel gets blocked due to various reasons leading to abnormal blood flow to the part of the retina supplied by the vessel. Here, Retinal laser therapy is useful, similar to PRP in PDR, as explained before.

Retinal Tears, Holes and Lattice Degeneration

Retinal tears, holes and lattice degenerations (areas of retinal thinning) occur in almost 10% of the normal population and are more common among myopes. If not treated, there is always a risk of developing retinal detachment through the breaks.

The doctor, in such cases, can delimit the retinal breaks with two to three rows of laser spots around the breaks, thus causing dense adhesion in the surrounding retina and thereby decreasing the risk of retinal detachment. It is mandatory to screen and laser such lesions prior to LASIK and cataract surgeries.

Central Serous Chorioretinopathy (CSC) and Choroidal Neovascularization

Both the conditions lead to areas of leak at the macular level, causing fluid collection and vision loss. Based on the specialist’s decision, in some cases, retinal laser therapy targeting the leaky areas is beneficial.

Patient preparation

The laser procedure is performed only after providing topical anaesthesia. Eye drops would be used prior to the procedure to minimize pain. The procedure is relatively painless. The patient might feel a mild pricking sensation during the therapy. The entire procedure might take place for five to twenty minutes, depending on the patient’s disease. 

After the procedure

The patient might feel mild glare and visual discomfort for a day or two. He or She will be advised to use antibiotic and lubricant eye drops for 3 to 5 days, depending on the type and duration of the procedure. Extensive PRP in diabetic retinopathy can lead to a decrease in contrast sensitivity and colour vision.

Types and method

There are two methods by which laser therapy can be performed: Contact and Non-Contact methods. In the contact procedure, a lens with a lubricating gel will be placed over the patient’s eyes, and laser therapy would be delivered in sitting position.

In the non-contact method, the patient is made to lie down, and laser therapy is delivered. Sometimes the doctor might apply minimal pressure around the patient’s eyes with a handheld instrument.

Conclusion

Retinal laser photocoagulation is a relatively safe, fast and a painless procedure.

Written by: Dr. Dheepak Sundar – Consultant Ophthalmologist, Velachery

Scleral Buckle

Why is Scleral Buckle Needed?

Scleral buckle surgery is required when the retina detaches from its underlying support layers, leading to vision loss. If not treated in time, a retinal detachment can cause irreversible damage, leading to permanent blindness. This surgery is particularly beneficial for patients who experience:

  • Retinal tears or holes

that allow fluid to seep underneath, causing the retina to lift off.

  • Rhegmatogenous retinal detachment

 the most common type of detachment caused by age-related changes in the vitreous gel inside the eye.

  • Trauma-induced retinal detachment

 which can occur due to direct impact on the eye, sports injuries, or accidents.

  • High myopia (severe nearsightedness)

 which increases the risk of retinal detachment due to the elongation of the eyeball.

  • Previous eye surgeries

where complications may have led to retinal instability.

By reinforcing the eye’s structure and supporting the retina’s position, scleral buckling prevents further detachment and helps maintain vision stability.

Benefits of the Scleral Buckle Surgery

Scleral buckle surgery has several advantages that make it a preferred option for treating retinal detachment:

  • High success rate

in reattaching the retina and restoring vision.

  • Long-term stability

 as the buckle remains permanently in place without interfering with daily activities.

  • Preservation of natural eye structures

 since the procedure does not remove the vitreous gel, unlike vitrectomy.

  • Compatibility with other retinal treatments

such as laser photocoagulation or cryotherapy, to enhance retinal attachment.

  • Minimized risk of cataract formation

 which is a common side effect of vitrectomy-based retinal surgeries.

Preparation Before the Procedure

Before undergoing scleral buckle surgery, a comprehensive preoperative assessment is necessary. The preparation includes:

  • A complete eye examination - to determine the extent of retinal detachment and assess the health of the retina.
  • Retinal imaging tests - such as optical coherence tomography (OCT) and fundus photography, to visualize the detachment in detail.
  • Reviewing medical history - to identify any underlying conditions that could affect surgery or healing.
  • Stopping blood-thinning medications - such as aspirin or anticoagulants, if advised by the doctor to prevent excessive bleeding.
  • Fasting guidelines - if the procedure will be performed under general anesthesia.

Scleral Buckle Treatment Procedure

The scleral buckle surgery is performed in several steps:

  • Administration of anesthesia: The patient receives local or general anesthesia to ensure comfort during the procedure.
  • Small incisions on the sclera: The surgeon makes precise incisions in the white part of the eye to create space for the buckle placement.
  • Placement of the scleral buckle: A flexible silicone band is positioned around the eye to support the retina’s reattachment.
  • Draining subretinal fluid: If necessary, excess fluid beneath the retina is drained to allow better adherence.
  • Cryotherapy or laser treatment: Retinal tears are sealed using a freezing technique (cryotherapy) or laser photocoagulation to reinforce the attachment.
  • Closing the incisions: The surgeon carefully sutures the incisions, and an antibiotic ointment is applied to prevent infection.

Precautions and Care After the Procedure

Proper post-operative care is essential to ensure a successful recovery. Patients should:

  • Use prescribed eye drops - to reduce inflammation and prevent infection.
  • Avoid strenuous activities and heavy lifting - for at least a few weeks to prevent stress on the eye.
  • Wear an eye shield at night - to prevent accidental rubbing.
  • Adhere to head positioning guidelines - if recommended, to help fluid drainage and healing.
  • Attend follow-up visits - to monitor progress and detect any complications early.

Result of Scleral Buckle Treatment

Most patients notice an improvement in vision within a few weeks. However, some may require additional treatments, such as vitrectomy, if complications arise. With proper care, scleral buckle surgery successfully prevents further detachment and stabilizes vision.

Types of Retinal Detachments Treated with Scleral Buckle

Scleral buckle surgery is effective for various types of retinal detachments, including:

  • Rhegmatogenous detachment - caused by retinal tears and fluid accumulation.
  • Tractional detachment - due to scar tissue pulling on the retina, often seen in diabetic retinopathy.
  • Exudative detachment - resulting from fluid leakage beneath the retina due to inflammation or tumors.

Scleral Buckle vs. Vitrectomy – Which is Better?

Scleral buckle and vitrectomy serve different purposes:

  • Scleral buckle is ideal for simpler retinal detachments

particularly in younger patients, as it preserves the vitreous gel.

  • Vitrectomy is better suited for complex cases

such as those involving severe traction or multiple retinal breaks.

Risks and Complications of Scleral Buckle Surgery

While highly effective, scleral buckle surgery carries some risks, including:

  • Infection
  • Increased intraocular pressure (glaucoma)
  • Double vision
  • Bleeding inside the eye
  • Need for additional surgery in rare cases

Success Rate and Long-Term Outcomes of Scleral Buckle Surgery

The surgery has an 80-90% success rate, with most patients experiencing stabilized vision and reduced risk of recurrence. Regular eye check-ups help maintain long-term retinal health.

Why Choose Dr Agarwals Eye Hospital for Scleral Buckle Surgery?

Dr Agarwals Eye Hospital is a best choice due to:

  • Expert retinal specialists
  • Advanced surgical technology
  • Personalized patient care and follow-up
  • High surgical success rates

 

 

Retina Repair Surgery (Vitrectomy)

Why is Vitrectomy Performed?

Vitrectomy surgery is performed to address several eye conditions, including:

  • Retinal detachment:

A condition where the retina separates from the underlying layer, causing vision loss if not treated immediately.

  • Diabetic retinopathy:

A diabetes-related eye condition that can cause blood vessels to leak into the vitreous, leading to vision impairment.

  • Macular hole:

A small break in the macula, the central part of the retina responsible for sharp vision.

  • Vitreous hemorrhage:

Bleeding into the vitreous cavity, which can occur due to trauma, diabetic eye disease, or retinal tears.

  • Epiretinal membrane:

A thin layer of scar tissue that forms on the retina, distorting vision.

  • Eye injuries:

Trauma to the eye that results in vitreous or retinal damage requiring surgical intervention.

Vitrectomy is often recommended when these conditions significantly impact a person’s ability to see clearly or if they pose a risk of permanent vision loss.

Who Needs Vitrectomy Surgery?

Patients experiencing vision impairment due to vitreous or retinal diseases may require vitrectomy eye surgery. A thorough examination by an eye specialist will determine the need for this procedure. Some of the signs that may indicate a need for vitrectomy include:

  • Sudden or gradual vision loss
  • Blurred vision that does not improve with glasses
  • The presence of floaters or flashes of light
  • Distorted or wavy vision
  • Difficulty reading or recognizing faces
  • Shadows or dark spots in the field of vision

In some cases, vitrectomy is performed as part of a combination surgery, such as cataract removal or retinal repair, to ensure optimal vision restoration.

Types of Vitrectomies

There are different types of vitrectomy procedures, including:

  • Pars plana vitrectomy (PPV eye surgery):

The most common method, performed for conditions affecting the retina and vitreous. This procedure is done through tiny incisions in the sclera (white part of the eye) using specialized instruments.

  • Anterior vitrectomy:

Performed when vitreous gel moves into the front part of the eye, usually after cataract surgery. It helps clear the visual pathway and prevent complications.

  • Core vitrectomy:

A partial vitrectomy focused on removing the central portion of the vitreous gel.

  • Total vitrectomy:

A complete removal of the vitreous gel to address severe conditions affecting the entire vitreous body.

Each type of vitrectomy is selected based on the specific eye condition and the overall treatment goals.

Common Indications of a Vitrectomy

Vitrectomy is recommended when vision is significantly impaired due to:

  • Severe eye infections (endophthalmitis)
  • Retained lens fragments after cataract surgery
  • Trauma-related eye conditions leading to vitreous damage
  • Floaters impacting daily activities and quality of life
  • Scar tissue formation on the retina (proliferative vitreoretinopathy)

A comprehensive eye examination, including imaging tests such as optical coherence tomography (OCT) and fluorescein angiography, helps determine whether vitrectomy is necessary.

Step-by-Step Vitrectomy Procedure

1.Preoperative preparation:

The eye is numbed using local or general anesthesia to ensure patient comfort.

2.Creating access:

Small incisions are made in the sclera to insert surgical instruments.

3.Removing the vitreous:

The vitreous gel is carefully removed using a vitrectomy probe.

4.Repairing the retina:

If necessary, additional procedures like laser therapy or membrane peeling are performed.

5.Replacing the vitreous:

The removed vitreous is replaced with a saline solution, gas bubble, or silicone oil to maintain eye shape.

6.Closing the incisions:

The tiny incisions are self-healing, but in some cases, sutures may be used.

Recovery and Aftercare Following Vitrectomy Surgery

Post-surgery recovery includes:

  • Using prescribed eye drops to prevent infection and inflammation.
  • Wearing an eye shield to protect the operated eye.
  • Avoiding strenuous activities, heavy lifting, and bending over.
  • Keeping the head in a specific position if a gas bubble is used to support the retina.
  • Regular follow-up visits to monitor healing and vision improvement.

The vitrectomy before and after results show significant improvement in vision when proper aftercare is followed.

What are the Risks of Vitrectomy?

Vitrectomy surgery, like any procedure, has risks, including:

  • Infection:

Rare but possible, requiring prompt medical attention.

  • Increased eye pressure:

Can lead to glaucoma if left untreated.

  • Cataract formation:

A common side effect, often requiring cataract surgery later.

  • Retinal detachment:

Occurs in some cases and may require further surgery.

  • Bleeding inside the eye:

Can delay visual recovery.

Potential Risks and Complications of Vitrectomy

Although vitrectomy has a high success rate, potential complications include:

  • Swelling and discomfort
  • Prolonged recovery in certain cases
  • Need for additional surgeries in rare cases
  • Temporary or permanent vision changes

Vitrectomy vs. Other Eye Surgeries: What’s the Difference?

Unlike cataract surgery or LASIK, vitrectomy surgery focuses on treating retinal conditions rather than improving refractive errors. It is a specialized procedure designed for repairing severe eye conditions.

Why Choose Dr Agarwals Eye Hospital for Vitrectomy?

Dr Agarwals Eye Hospital is a leading provider of vitrectomy treatment in India, offering:

  • Expert retinal surgeons with years of experience
  • Advanced technology and advanced surgical facilities
  • Comprehensive post-operative care and patient education
  • High success rates and personalized treatment plans
Contoura Lasik

THE SCIENCE BEHIND THE TECHNOLOGY

The success of Contoura Vision lies in its precision. Unlike conventional LASIK procedures that use standard measurements, Contoura Vision employs a sophisticated diagnostic technique known as topography-guided mapping. This involves creating a 3D map of the cornea’s imperfections, capturing even the most minute irregularities. With this highly detailed map, the laser can target specific imperfections with unparalleled accuracy.

By customizing the laser treatment to the unique topography of each patient’s cornea, Contoura Vision not only corrects refractive errors but also addresses higher-order aberrations that can significantly impact vision quality. This level of precision results in sharper, clearer vision, often surpassing what glasses and contact lenses can offer.

BENEFITS OF THE PROCEDURE

Contoura Vision offers a plethora of benefits that have made it a preferred choice for many seeking vision correction:

1. Sharper Vision:

Contoura Vision often provides patients with a vision that surpasses what they could achieve with glasses or contact lenses.

2. Customization:

Each procedure is tailored to the individual, addressing their unique corneal irregularities for optimal results.

3. Quick and Painless:

The procedure is quick, usually lasting only a few minutes, and patients typically experience minimal discomfort.

1. Fast Recovery:

Most patients notice improved vision within a day or two, and many can return to their normal activities shortly after the surgery.

2. Reduced Dependence on Glasses:

Many patients find that they no longer need glasses or contact lenses for daily activities after Contoura Vision.

3. Long-Lasting Results:

Contoura Vision results are generally stable over the long term,offering lasting benefits.

HIGHLIGHTS OF CONTOURA VISION PROCEDURE

  • No pain
  • No cut
  • No stitches
  • No hospitalization
  • Quick recovery

CONTOURA VISION VS. TRADITIONAL LASIK

1. Precision:

Contoura Vision’s topography-guided mapping system provides a level of precision that traditional LASIK cannot match.

2. Visual Quality:

Contoura Vision often results in better visual quality, particularly in lowlight conditions and for those with higher-order aberrations.

3. Customization:

Traditional LASIK uses standardized treatments, while Contoura Vision tailors the procedure to each patient’s unique corneal topography.

4. Reduced Side Effects:

Contoura Vision has been associated with fewer side effects such as glare and halos compared to traditional LASIK.

CONTOURA VISION PROCEDURE – PROCESS

Contoura Eye surgery is increasingly becoming a popular vision correction treatment option for people all around the country. It is a quick, painless same-day surgery, helping you gain excellent vision in 15 to 20 minutes.

Pre-Operative Eye Exam

A comprehensive preliminary assessment is performed, including a clinical examination and corneal topography (Pentacam), to determine the patient’s eligibility and safety for the Contoura LASIK surgery. If any retinal defects (such as thinning/hole/tear) are discovered during the evaluation, they are treated with a barrage laser first, and then Contoura is performed after 1 to 4 weeks.

During the Procedure

On the day of surgery, the topolyser collects the patient’s topographic imagery, which is then sent to the treatment planning station to develop the personalized treatment profile. The laser will adjust your vision by accurately reshaping your cornea based on up to 22,000 elevation points, guided by your individualized topography profile.

Post Procedure

After 30 minutes, the patient is free to exit the hospital. Eye drops are used to prevent infection and aid in the healing process. The patient is evaluated the day following the procedure and one week and one month after that.

WHY CHOOSE CONTOURA

  • US FDA-Approved
  • Excellent night vision
  • Quick results
  • Walk-in and Walk-out spectacles free

If you’re tired of the limitations of glasses and contact lenses and dream of experiencing the world with clarity and freedom, Contoura Vision could be the solution you’ve been waiting for—a future where perfect vision is no longer a distant dream but a reality

Cryopexy

What are the retinal diseases which can be treated with cryotherapy?

Retinal tears to prevent retinal detachment, to seal leaking blood vessels, to slow or stop the growth of abnormal blood vessels caused by diabetic retinopathy

How does cryopexy help in treating retinal disorders?

 This treatment creates a scar around retinal tears, around the abnormal blood vessels in order to stop the progression of the abnormal growth.

What are the precautions to be taken before the procedure?

It is an outpatient procedure. There are no special preparations for this procedure. You should eat normally and take all your regular medicines before you come in for the procedure

How is cryotherapy performed?

Cryopexy is administered with local anaesthesia to prevent pain. During the process, your ophthalmologist will use an indirect ophthalmoscope to view the inside of your eye through the pupil while gently pushing on the outside of the eye with the small metal probe to find the exact place for treatment. Once the appropriate treatment location is found, your doctor will activate the probe to deliver the freezing gas, which rapidly freezes the targeted tissue. As the tissue heals, it forms a scar.

Retina Injection Therapy (Anti-VEGF)

What are anti VEGF Agents

Anti Vascular endothelial Growth factor (anti VEGF) agents a group of medications which block the activity of VEGF and thus mitigate the abnormal effects of VEGF

How have anti VEGF treatment influenced the management of various eye conditions

Anti VEGF agents when administered under appropriate conditions act at molecular level countering the action of VEGF and thereby reducing the morbidity.

Many diseases which were considered untreatable earlier like age related macular degeneration are rendered treatable, enabling patients maintain quality vision and subsequent improvement in quality of life

Ocular manifestation of systemic diseases with diabetes hypertension are also now treated with anti VEGF agents, with quality vision being restored and maintained.

How do I choose the type of anti VEGF agent

  • The doctor examining you will prescribe the appropriate agents as per the disease process and systemic illness. Active bleeding or fluid leak at the back of the eye called macula warrants urgent treatment. The doctor will perform appropriate scans to confirm, quantify and monitor the progress of the disease. Vision is measured and is one of the yardsticks for monitoring response to treatment

How is the anti-VEGF agent administered

Antibiotic drops are prescribed for usage after injection in the eye. 

What are the anti-VEGF agents available for treatment?

  • Bevacizumab
  • Ranibizumab
  • Aflibercept
  • Brolucizumab

Written by: Dr. Mohanraj – Consultant Ophthalmologist, Coimbatore

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