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LAZY EYE

 Lazy eye (Amblyopia) is a condition where vision in one or both eyes are low inspite of the eye being normal in structure. The reason for lazy eye can be  1. Large difference in power between both eyes.  2. Presence of squint  3. Undetected and uncorrected glass power in childhood  4. Presence of cataract or other opacity in one eye in early childhood. Amblyopia starts in childhood and so regular eye check up in children is essential to detect and correct it. If refractive errors (glass power) are detected early and corrected with appropriate glasses in childhood, then lazy eye can be prevented. Once lazy eye sets in the window for treatment and correction is mostly upto age of 12 years, beyond which it becomes permanent. The principle of treatment of amblyopia is stimulation of the lazy eye by forcing it to work, by occluding the normal eye for a fixed number of hours per day. Before initiating the occlusion therapy the underlying cause whether it be refractive errors or squint or c

Eye care during Exams

 Examination season is again around the corner, students preparing for 10th, 12th and various entrance exams are in a feverish pitch of activity. So, a few suggestions on how to take care of eyes during this period are certainly in order. Sleep deficiency: A minimum of 7 hours of sleep is essential to maintain good health for the eyes as well as the whole body and mind, sleep deficiency leads to eye problems like recurrent styles (eye boils), which causes pain and swelling of the eyelid and results in loss of study time. Pro tip: Plan and manage study time to get enough sleep. Dietary deficiency: Students tend to skip meals or depend on fast foods, nutritional deficiencies tend to cause fatigue and loss of concentration and again affects the eyes with blepharitis, dry eyes and eyelid infections # eat balanced healthy meals at regular intervals. Foods rich in vitamins A, D,E, B complex, minerals and Omega 3 are essential for students preparing for exams. Dehydration: Due to the intensit

Post anesthetic blindness

Mrs. A underwent surgery under GA, she was under sedatives and painkillers for next 2 days and it was only on the 3rd post operative day that she realised that her vision was very blurred and she had more pain around her eyes and in her head that in the operated area. Her Ophthalmic examination revealed a picture of an acute angle closure glaucoma. Obviously being under GA she hadn't experienced the pain of the acute angle closure which is comparable to the pain of a MI. The hypothesis was that Mrs. A being a hypermetrope with shallow anterior chamber and occludable angles had gone into acute angle closure due to the effect of some anti cholinergic agent administered as part of the GA medications. Being positioned in prone position for prolonged period can impinge the iris lens diaphragm against the angle triggering an acute angle closure  Just asking the patients if their glasses are plus or minus power and if plus getting a gonioscopy done, and if angles are occludable getting a

DIABETIC END ORGAN DAMAGE

  1. The first 10 years of diabetes are the most important.  2. Complications of diabetes usually start after 10 years of onset of diabetes.  3. First to be affected are eyes and it leads to blindness.  4. Kidneys, joints, feet, skin, heart, brain are also affected leading to stroke heart attack etc.  5. Most important and effective way to control sugar level is EXERCISE EXERCISE EXERCISE.  6. without exercise medicine and dieting are not effective.  7. Every year the diabetic person should get checked for any organ damage and not wait till blindness or stroke or heart attack occurs  8. Your optimal blood sugar level should be decided by your level of organ damage.  9. MAIN AIM OF ANY DIABETES TREATMENT SHOULD BE TO PREVENT ORGAN DAMAGE AND NOT TO ACHIEVE ANY MAGIC NUMBER OF BLOOD SUGAR LEVEL.  These are just guidelines.  1. If you are a person who is already walking but sugar is not controlled then increase walking by  2km or 30 mins or 2400 steps till the sugar reaches normal level.

BLACK FUNGUS IN INDIA - WHAT WE DONT KNOW

  1. 99% of the mucormycosis (black fungus) cases reported worldwide occurred in India. 2. The factors attributed for black fungus infection, viz. High blood sugar, steroid usage, contaminated oxygen, ICU equipment etc. are same all over the world 3. Then why did India see 99% of the cases? 4. Are we seeing a variant or subspecies of mucor specific to India.? 5. The mortality and morbidity of cases in India was out of proportion with worldwide statistics. 6. Is the standard drug Amphotericin B not effective against Indian mucor infection? 7. A genetic analysis of Indian mucor and comparison with other specimens from across the world will be helpful If another wave of mucormycosis occurs we can be better prepared. https://journals.asm.org/doi/10.1128/mbio.00473-22#.YkXFE_4zBEE.twitter

How can I get rid of glasses

 Procedures for removal of glasses (Refractive surgery) are generally classified as cosmetic procedures.  But are they truly cosmetic or curative? Take the case of a person with high glass power, the first action on waking up in the morning is groping around for the glasses, a person with minus power can atleast see the time on the alarm clock by the bedside, but persons with plus glass power can neither see the alarm clock nor the wall clock clearly. The extreme situation would be that of the person who reaches for glasses even to see dreams with clarity. So in a nutshell spectacle dependency has direct effect on functionality and hence quality of life and freedom from spectacles is more curative than cosmetic. The options that are available for achieving freedom from glasses are LASER based and LENS based surgical procedures. LASIK has become a household term, not only in families with girls of marriageable age but also as a requirement for jobs which specify clear vision without gla

When should my cataract be operated?

Many patients are baffled by the conflicting opinions of eye doctors. The reason being the different methods of cataract surgery and the confidence levels of different eye surgeons. In the olden days cataract used to be removed in - toto through a large cut on the eyeball and the cataract was required to mature into one solid mass for this.  The modern technique is to use a micro puncture into the eyeball to extract the gel like soft immature cataract using an ultrasonic device called phacoemuslification. So why should one prefer the second method? It is because it requires only a micro puncture and not a large cut on the eyeball because of which healing and recovery are very quick. This reduces the number of days of rest and loss of activity from the traditional 40 days to 4 days. Further the new method is ideal for diabetics and people with cardiac problems who are on blood thinner tablets, as phacoemuslification can be done without injection and so blood thinner tablets need not be