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PROBABLE CAUSES SYMPTOMS SOME COMPLEX EYE DISEASES TREATMENT
 
SUCCESS RATE OF CORNEA TRANSPLANT    
   

There are numerous eye problems which can be complex, This may be because of one or more of the following reasons :

  • Many Eye problems are not detected even as these develop slowly And are noticed when manifested in terms of pain, discomfort or deterioration of Vision
  • Complexity comes in because the symptoms are vague and easily attributable to a cause. Some of the problems are not easily treatable and may appear again & again after some periods of treatment.
  • Some Eye problems may be complex as these may appear subsequent To some body disease and/or treatment or surgery.
  • Accident, injuries, professional hazards, virus, UV rays are other reasons which may an eye problem complex in nature.
  • Several times some eye problems are congenital and are because of Genetics disorders.
  • Cornea is the most essential for good vision. The outermost tissue of cornea functions like a window that controls lights into the eye.
  • It also filters some of the most damaging ultraviolet (UV) lights , some wave length in sun lights.
  • Shape, design, health, nature of Cornea, and changes in this, determines the final vision.

 
 
 
 
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PROBABLE CAUSES
Some of the probable causes are summarized below :
  • Injury , abrasion, or accident
  • Chemical burns
  • Congenital or Genetics
  • Abnormal growth or change
  • Microbial Infections.
  • Ocular Herpes / Herpes Zoster
  • Corneal Dystrophies ( Over 20 types )
  • Keratoconus.
  • Malnutrition ( Vit A deficiency )

Cornea becomes cloudy due to disease, injury or infection. A damaged Cornea distorts light as it enters the eye thereby leading to decrease of eyesight. This type of visual impairment is called corneal blindness. Hence any change in cornea, for whatever reasons it may be, can cause problems including astigmatism , nearsightness, and many other disease.

The cornea and ocular surface can be severely damaged by a number of problems, including:

  • Chemical, mechanical and thermal injuries
  • Corneal infections
  • Diseases such as Stevens-Johnson syndrome and pemphigoid
  • Chronic infections or inflammations
  • Malnutrition (Vitamin A deficiency)
  • New tissue growths such as pterygium and tumors
  • Neurotrophic conditions (due to damage to the eye's sensory nerves)
  • Rare hereditary conditions such as aniridia (congenital absence of the iris)

 
 
 
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Corneal Opacity
 
 
 
SYMPTOMS

There could be several symptoms visible or invisible. There could be some or more of the following. These may subside on medication but recure time & again

  • Unbearable pain, occasional or Continual
  • Discharge
  • Burning of Eyes
  • Corneal opacities or Dystrophy.
  • Decrease in Vision
  • Others with varying conditions of visions.
  • Corneal Blindness
  • Neurotrophic Condition.
  • Aniridia ( Congential )
  • Dry Eye Syndrome.
 
 
 
 
 

Some of the above symptoms & complex eye problem are briefly in the next section :


SOME COMPLEX EYE DISEASES

Surya Eye caters to all Complex eye problems including the following. Many of the Complex Eye Problems pertain to Cornea. It is therefore important to understand as to which problems affect the cornea.
The cornea copes very well with minor injuries or abrasions. If dirt scratches the highly sensitive cornea, epithelial cells slide over quickly and patch the injury before infection occurs and vision is affected.
But if the scratch penetrates the cornea more deeply, the healing process will take longer, resulting in greater pain, blurred vision, tearing, redness, and extreme sensitivity to light. These symptoms require professional treatment. Some of the more serious problems that affect the cornea are:

DRY EYE SYNDROME :
Decreased tear production can result in burning, stinging, itching, foreign body sensation, dryness, soreness, heaviness of the lids, light sensitivity, and/or ocular fatigue. Occasionally there may be episodes of excessive tearing due to dryness, causing severe irritation of the eyes.
Symptoms often are worse at the end of the day and can be aggravated by certain activities (e.g., reading, watching television, or working on the computer) and certain environments (e.g., airplane cabins, air conditioners, smoky rooms.)

CORNEAL EDEMA :
Corneal edema means that the surface layer of the eye, the cornea, is swollen. It can cause mild to severe irritation and decreased vision. Causes include surgery (including cataract surgery), trauma, and corneal dystrophy. Treatment with eye drops may help. Patients with advanced corneal edema may require surgery, such as a corneal transplant.

SKIN CANCER OF EYE :
Just like on the skin, there are many types of cancers that can affect the eye. The most common is similar to a common skin cancer and develops on the surface of the eye.
It is typically treated with surgical removal of the cancer to prevent it from affecting your vision or spreading to other parts of the body. Occasionally, eye drops can be helpful. While this type of cancer does not usually grow back, patients will need to be monitored for recurrence following removal.

RECURRENT EROSION SYNDROME :
Loosening of the surface layer of the cornea can cause mild to severe pain, depending on the amount of damage. The pain usually develops during the night or upon waking in the morning, and can recur.
Traumas to the eye or certain cornea dystrophies predispose people to these painful episodes. Recurrent erosions often respond to treatment with eye drops and ointments. If not, they may be treatable with anterior stromal micropuncture, diamond burr polishing of the cornea, or with laser surgery.

CORNEAL DYSTROPHY :
Corneal dystrophies are inherited non-inflammatory diseases that affect both eyes. There are several types of corneal dystrophy. Some corneal dystrophies, such anterior basement membrane dystrophy, affect the front surface of the cornea.
Dystrophies that affect the front layer of the cornea can cause painful episodes, decreased vision, or both. Some dystrophies affect the body of the cornea, such as granular or macular lattice dystrophy. These dystrophies can also cause decreased vision, painful episodes, or both.
Dystrophies that affect the back surface of the cornea, such as Fuchs' dystrophy, can lead to corneal edema (see below). Treatment options include eye drops, eye ointments and surgery. Surgical options include removing the surface layer of the cornea with a diamond burr or excimer laser, phototherapeutic keratectomy (PK), and corneal transplantation.

PTERYGIUM :
img A pterygium is a wedge-shaped scar tissue growth on the surface of the cornea caused by sun exposure. Pterygia can cause redness and inflammation of the eye. If pterygia become large, they can cause decreased vision.
Occasionally, an inflamed pterygium may respond to eye drops. When vision becomes affected or the pterygium grows quickly, surgery to remove it is often recommended. At Corneal Associates, we remove pterygia on an outpatient basis.

MICROBIAL INFECTION :
img When the cornea is damaged, such as after a foreign object has penetrated the tissue, bacteria or fungi can pass into the cornea, causing a deep infection and inflammation. This condition may cause severe pain, reduce visual clarity, produce a corneal discharge, and perhaps erode the cornea.
As a general rule, the deeper the corneal infection, the more severe the symptoms and complications. It should be noted that microbial infections, although relatively infrequent, are the most serious complication of contact lens wear.
Minor corneal infections are commonly treated with anti-bacterial or anti-fungal eye drops. If the problem is more severe, a person may receive more intensive antibiotic treatment to eliminate the infection and may need to take steroid eye drops to reduce inflammation. Frequent visits to an eye care professional may be necessary for several months to eliminate the problem.

OCULAR HERPES :

img Herpes of the eye is a recurrent viral infection that affects an estimated 400,000 Americans with herpes.
Although ocular herpes can result from the sexually transmitted herpes simplex II virus, it is usually caused by herpes simplex virus I (HSV I), the virus responsible for cold sores. In about 12 percent of those with ocular herpes, both eyes are involved.

Treatment
Ocular herpes produces a relatively painful sore on the surface of the cornea. Prompt treatment with anti-viral drugs helps to stop the herpes virus from multiplying and destroying epithelial cells. In time, the infection may also spread into the stroma, causing thebody's immune system to attack and destroy stromal cells.
This more severe infection, called herpes simplex stromal keratitis, is harder to treat and can scar the cornea, causing vision loss. It may also produce an infection of the inside of the eye.

Control & Recurrence
Like other herpetic infections, herpes of the eye remains a controllable, but incurable, problem. For those who lose vision to ocular herpes, it usually results from recurrent attacks that lead to severe stromal keratitis. Studies indicate that after a person has had an initial outbreak of ocular herpes, he or she has better than a 50 percent chance of having a recurrence of the disease.
This second outbreak could come weeks or decades after the initial attack. In one large study, researchers found that recurrence rates were 10 percent after one year, 23 percent at two years, and 63 percent at 20 years.
Some factors associated with recurrence include fever, stress, sunlight, and trauma. Anyone with ocular herpes should avoid using over-the-counter steroid eye drops. Steroids cause the virus to multiply and the infection to worsen.

Causes
Ocular Herpes is generally described as Herpes Zoster (Shingles) and This infection is produced by the varicella-zoster virus, the same virus that causes chicken pox. After an initial outbreak of chicken pox (often during childhood), the virus remains dormant within the nerve cells of the central nervous system.
But in some people, the varicella-zoster virus will reactivate at some time during their lives. When this occurs, the virus travels down long nerve fibers and infects some part of the body, producing a blistering rash (shingles), fever, painful inflammations of the affected nerve fibers, and a general feeling of malaise.


Spred
Varicella-zoster virus may travel to the head and neck, perhaps involving an eye, part of the nose, mouth, cheek, and forehead. In about 40 percent of those with shingles in this area, the virus infects the cornea. These zoster-related corneal lesions will usually clear up on their own.
But without early anti-viral treatment, a person runs the risk of the virus infecting cells deep within the tissue, causing inflammation and scarring of the cornea. The disease may also cause decreased corneal sensitivity. For many, this decreased sensitivity will be permanent.


Who May Have ?
Although shingles can occur in anyone exposed to the varicella-zoster virus, several studies have established two general risk factorsfor the disease: (1) advanced age and (2) a weakened immune system.
Studies show that people over age 80 have a five times greater chance of having shingles than adults between the ages of 20 and 40. Unlike herpes simplex I, the varicella-zoster virus does not usually flare up more than once in adults with normally functioning immune systems.

KERATOCONUS :
This is a type of corneal bystrophy Keratoconus stems from one of several causes: (1) an inherited corneal abnormality. About 7 percent of those with the condition have a family history of keratoconus; (2) an eye injury, i.e., excessive eye rubbing or wearing hard contact lenses for many years; (3) certain eye diseases, such as retinitis pigmentosa, retinopathy of prematurity, vernal keratoconjunctivitis; or (4) systemic diseases, such as Leber's congenital amaurosis, Ehlers-Danlos Syndrome, Down's syndrome, osteogenesis imperfecta, and Addison's disease. Keratoconus usually occurs during puberty, or shortly thereafter. At first, people can correct their vision with eyeglasses.


Keratoconus Cornea

But as the astigmatism worsens, they must rely on specially fitted contact lenses to reduce the distortion and provide better vision. Finding a comfortable contact lens can be an extremely frustrating and difficult process. However, it is crucial because a poorly fitting lens could further damage the cornea and make wearing a contact lens intolerable.
In most cases, the cornea will stabilize after a few years without ever causing severe vision problems. But in about 10 to 20 percent of people with keratoconus, the cornea will eventually become too scarred or will not tolerate a contact lens. If either of these problems occur, a person will probably need to replace the diseased tissue with a donor cornea, called a corneal transplant.

LATTICE DYSTROPHY :
lattice dystrophy       Although lattice dystrophy can occur at any time in life, the condition usually arises in children between the ages of 2 and 7. It is characterized by an accumulation of abnormal protein fibers (amyloid) throughout the middle and anterior stroma. However, the disease is NOT related to amyloidosis, a serious systemic disease.
Lattice dystrophy gets its name from the amyloid deposits, which during an eye examination can appear as clear, comma-shaped dots and branching filaments that overlap each other in the stroma, creating a lattice effect. Over time, the lattice lines will grow opaque and involve more of the stroma.
They will also gradually coalesce, giving the cornea a slight cloudiness that may also reduce vision somewhat.

   
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TREATMENT
 

Surya Complex Eye Problems Clinic is well equipped with relevant advanced Ophthalmic instruments, facilities and competent consultants for excellent diagnosis and treatment. The treatment comprises of effective eye check-up, diagnostic tests and necessary medication and or surgical measures depending upon the medical history, type of problem and other related aspects. The treatment may require :

  • Pachymetry- Measurement of corneal thickness
  • Corneal Topography - Mapping of the cornea
  • Specialized contact lens fitting
CORNEAL TRANSPLANT

In extreme case of Corneal blindness or Visual Impairement the Ophthalmologist has to carefully the various pros & cons and second opinion may also be songht : The cornea becomes cloudy due to disease, injury or infection.
A damaged cornea distorts light as it enters the eye thereby leading to decrease of eye sight. This kind of visual impairment is called corneal blindness. This is the only type of visual impairment that can be treated by corneal transplantation. Corneal problems can afflict anyone at any age.
A corneal transplant involves replacing a diseased or scarred cornea with a clear, healthy donor cornea. For many individuals, a corneal transplant may be the only hope for vision restoration, and may be necessary when the cornea is cloudy or damaged due to disease, injury, accident, malnutrition or hereditary conditions. Cornea Transplant- A clear central area allows light transmission.

Success Rate of Cornea Transplant :

Corneal transplants are one of the most common and most successful of all transplants. The procedure may be successful in up to 90 percent of some cases. However, the success depends on a number of factors- recipientís eye condition and corneal disease, donor cornea quality and the surgical technique and skill.
The first year after a transplant is the most crucial, because most complications, if they occur, will occur within the first year of the transplant. The more common complications include increased eye pressure which can cause damage to the eye nerve (glaucoma) and corneal graft rejection & infection.

 
   
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