Monday 19 December 2016

Cataract – The Surgery

Once we know what a cataract is, let’s have a look at the Management Of Cataract

First and foremeost, there are no medicines which help resolve a cataract. Our prime responsibility is to spread awareness of this basic fact and protect gullible patients from Quackery and downright dangerous methods claimed to ‘cure’ the cataract.
Surgery performed by a trained Ophthalmologist in a sterile Operation Theatre is the Only safe, approved way to resolve a Cataract


REMOVE AND REPLACE – The basic principle of Cataract Surgery.

                                                                                                                                        
No matter what you do, no matter how hard you try, a scratched windshield needs to be replaced. This is exactly what we do in a Cataract Surgery. We REMOVE the aged/damaged lens; and REPLACE it with an artificial one.


The major strides in the evolution of Cataract Surgery have been first in the Method of Removal, and subsequently in the Implanted Artificial Lens.

    Coaching technique described
    in Sushrutha Samhita.



HISTORY

The first interventions for lens of the eye date back to 2000 B.C. in Egyptian empire and Indian Sciences. Back then, the procedure was limited to merely displacing the lens from its position within the eye itself – without any surgery – COUCHING. This would bring about a mild improvement in vision. The techniques used were understandably barbaric and rudimentary.

Then came a back and forth change as to whether to remove the lens with (intracapsular) or without (extracapsular) the entire Capsule.

The French ophthalmologist Jacques Daviel (1696–1762) was the first modern European physician to successfully extract cataracts from the eye. He performed the first EXTRACAPSULAR CATARACT EXTRACTION on April 8, 1747.
Albrech von Graefe (1828-1870), a tremendously important Ophthalmologist, died at the early age of 42. He gave a dissertation on 'modified linear extraction' among other significant papers at the 3rd International Congress of Ophthalmology, Paris. Ophthalmology developed tremendously through the application of the ophthalmoscope by von Graefe.

At the turn of the Century, a medical student told Sir Nicholas Ridley, that it was a pity that the cloudy lens extracted could not be replaced with a clear one. At that time, Sir Nicholas was a surgeon at Moorfield Eye Hospital and St Thomas' Hospital in London, specialising in Ophthalmology. Dissatisfied with the poor acuity and loss of binocular single vision following cataract extraction and the poor outcome, with the contact lenses then available, he had early in his career envisaged using an artificial lenticulus. He went on to pioneer ARTIFICIAL INTRAOCULAR LENS TRANSPLANTSURGERY for cataract patients.

In 1967, American Charles D. Kelman (1930-2004), an ophthalmologist pioneer in cataract surgery, introduced PHACOEMULSIFICATION after being inspired by his dentist's ultrasonic probe. This technique use ultrasonic waves to emulsifythe lens in order to remove the cataracts without a large incision. This new method of surgery decreased the need for an extended hospital stay and made the surgery less painful. The principle behind this has now been taken to cutting edge technology.

With the development in IOLs, the method of access to the catracted lens, removing it and Implanting the IOL developed further.



MICROSURGERY MADE COUCHING AND ICCE OBSOLETE

Most cataract extractions are now ExtraCapsular i.e. Surgeons leave the Posterior Capsule behind as a base for the artificial Intra Ocular Lens.

MICROSURGERY involves Extracpasular Lens Extraction and IOL Implantation.


Thanks to recent advances, the Size of Incision required is down from 6-10 mm to 2mm i.e. From an incision that went halfway round the eye, to barely the tip of a pen.

PHACOEMULSIFICATION

Microscopic surgery and Flodable lenses enabled the entire procedure to be accomplished through these tiny ports.




The IOL – to be discussed in subsequent blog post.

Majority of the cataract surgeries under VisionFoundation of India are performed via Phacoemulsification.
The Lens implanted is the Indian foldable lens.

So now that you know about Phaco, you can reassure prospective patient that :
  • ·       It is Bladeless – a very tiny incision is all that’s needed
  • ·       There are No Stitches – since the incision is small, it self-heals
  • ·       Post op care is simple and in a vast majority, uncomplicated
  • ·       A clear lens is implanted to restore optimum vision


So, what can you do now?

1.      Spread the Word!

By going through this blog, you’ve helped already! Next time you come across someone with possible problems with vision, do not hesitate to reassure them and refer them to us at - VISION FOUNDATION OF INDIA , 5, Babulnath Road, Mumbai 400 007, India. Tel: +91-22-23627777 / +91-22-23629999

2.     Donate!

Phaco Cataract Surgeries under Vision Foundation of India are presently   performed at just Rs. 1500 per eye!
For more details regarding donations, please log on to http://visionfoundationofindia.in/

3.     Join!

Join the movement as a Member/Volunteer/Brigadier. Whatever your skillset, VFI needs you. Find out how you can help. Drop us an email at eyecare@visionfoundationofindia.in

In Ophthalmology, Ignorance is not Bliss – it’s Blindness.


Next Blog Article : Preparing for Catarct Surgery

A VFI Youth Wing Initiative.

Monday 10 October 2016

Cataract – The Basics

Cataract of the eye is the leading cause of blindness in India and the world - Ironic, considering the fact that this blindness is reversible.
What we mean to say is that a majority of people facing visual impairment due to cataract are facing unnecessary physical, financial and emotional turmoil purely due to lack of awareness.
A plethora of reasons prevent them from seeking help at the right time.


                                                      

Without getting too technical, Here’s what You need to know to help break the chain of ignorance.



What is Cataract?


Cataract is the condition in which the natural human lens in the eye turns cloudy or opaque.




Why does cataract happen?

Cataract occurs due to degeneration of the normally transparent lens material or deposition of protein or pigments on it due to a variety of causes. Ageing is the most common cause.
Drugs, Tauma, Exposure to radiation, Diseases like diabetes, certain ophthalmic procedures all may result in cataract. It may well be present at birth too.



How does Cataract affect my vision?

Since the human lens is required to be clear in order for us to see well, the cataract causes dimness of vision and other similar symptoms – e.g. Glare

To get an idea of what a person with cataract sees - Imagine driving on a rainy day with your windshield fogged up, or looking through an unfocused camera.





How is Cataract treated?

Unfortunately, there is no oral or topical medication via which we can reverse the changes in the lens. What we do instead is, we Remove the natural lens and Replace it with an artificial one.
The method by which this surgery is done, and the quality of the artificial lens implanted are major factors to be considered. The Surgery has evolved from ICCE to Phacoemulsification to FemtoLaser. Lenses have evolved from glass to PMMA to a mind boggling array of present day foldable lenses. The details of each will be considered in subsequent newsletters.

Which method do we commonly use for Cataract surgery under VFI?

Majority of the cataract surgeries under Vision Foundation of India are performed via Phacoemulsification.
The Lens implanted is the Indian foldable lens.

Is this Phacoemulsification surgery safe?

Phacoemulsification is one of the safest and most performed surgery.
The patient doesn’t require any local anesthesia injection, any stitch, any eye patch or hospital admission. With over 90% success rate and minimal complications, this procedure has become the gold standard procedure for cataract removal.

What else do you need to know about the surgery to reassure a prospective patient?
Phaco Catarct Surgery under VFI requires no hospital stay.
The procedure involves an Intraoperative time of 30 minutes on an average.
The procedure is not associated with intense pain/discomfort – It’s Bladeless
Post operative care is simple and uncomplicated

So, what can you do to help?

1.      Spread the Word!

By going through this blog, you’ve helped already! Next time you come across someone with possible problems with vision, do not hesitate to reassure them and refer them to us at - VISION FOUNDATION OF INDIA , 5, Babulnath Road, Mumbai 400 007, India. Tel: +91-22-23627777 / +91-22-23629999

2.     Donate!

Phaco Cataract Surgeries under Vision Foundation of India are presently   performed at just Rs. 1500 per eye!
For more details regarding donations, please log on to http://visionfoundationofindia.in/

3.     Join!

Join the movement as a Member/Volunteer/Brigadier. Whatever your skillset, VFI needs you. Find out how you can help. Drop us an email at eyecare@visionfoundationofindia.in

In Ophthalmology, Ignorance is not Bliss – it’s Blindness.