Take Care Of Your Eyes

Dr Kapil Midha. Ophthalmologist. Gurgaon: How Protein In Teardrops Annihilates Harmful Bacte...

2012-01-31T13:34:00.000+05:30

Dr Kapil Midha. Ophthalmologist. Gurgaon: How Protein In Teardrops Annihilates Harmful Bacte...: How Protein In Teardrops Annihilates Harmful Bacteria

Dr Kapil Midha. Ophthalmologist. Gurgaon: Use Colorblind Assistant to Identify Whatever Colo...

2012-01-30T11:57:00.000+05:30

Dr Kapil Midha. Ophthalmologist. Gurgaon: Use Colorblind Assistant to Identify Whatever Colo...: A useful tool for the color blind. Use Colorblind Assistant to Identify Whatever Color Your Cursor is Pointing At

Feviquick in eye. Corneal Foreign Body

2012-01-28T19:08:00.000+05:30

Feviquick removal from the cornea of the right eye in a young male adult.

Dr Kapil Midha. Ophthalmologist. Gurgaon: Early Success in a Human Embryonic Stem Cell Trial...

2012-01-25T17:42:00.000+05:30

Dr Kapil Midha. Ophthalmologist. Gurgaon: Early Success in a Human Embryonic Stem Cell Trial...: Early Success in a Human Embryonic Stem Cell Trial to Treat Blindness | Healthland | TIME.com

Dr Kapil Midha. Ophthalmologist. Gurgaon: Age-related Macular Degeneration Vision Simulator

2012-01-23T14:37:00.000+05:30

Dr Kapil Midha. Ophthalmologist. Gurgaon: Age-related Macular Degeneration Vision Simulator: A very descriptive vision simulator showing how the patient with macular degeneration sees. Macula is the most sensitive part of the retina,...

Herpetic Stromal Keratitis.

2012-01-18T18:45:00.000+05:30

Herpetic Stromal Keratitis in the left eye of a 40yr old patient with eptithelial bullae.

The same patient after 3 days of antiviral and anti inflammatory therapy.

The same patient after 5 days of treatment. He is clearly much better.

traumatic cataract

2012-01-11T14:26:00.000+05:30

traumatic cataract right eye in a young male adult. he gave history of blunt injury with a small wooden stick 10yr back and less vision in his re for the last several years.

diabetic retinopathy in a middle aged lady

2012-01-11T14:24:00.000+05:30

diabetic retinopathy in both eyes. the patient had severe loss of vision.

Medical myths | BMJ

2012-01-10T13:37:00.000+05:30

Reading in dimlight is definitely not recemmended but it will not ruin your eyes . This and other medical myths dethroned at this address:

Medical myths | BMJ

Contact lenses-FAQ's

2012-01-05T13:03:00.000+05:30

Some common queries about contact lenses.Contact Lens Users and those who wish to wear contact lenses but are not sure whether they should, usually ask the following questions. I hope these answers will help all of you.

Are contact lenses safe.Contact lenses have proved their safety and effectiveness in millions of people all over the world. However, you must see an eye care professional to ensure that they are good for you. If you follow the simple guidelines of handling and wearing the lenses, they will continue to be safe. Regular follow up with your eye care practitioner is however important.

Do Contact Lenses Have Any Beneficial Effect On Progression Of Refractive Error.The main role of contact lenses in cases of refractive errors is to provide good vision , without having to wear glasses. Soft contact lenses as such have no role in slowing the progression of Myopia[near sightedness].

For How Long Can One Wear Contact Lenses At A Stretch.As a general rule, you can wear contact lenses during your waking hours. You should take them off before going to bed. Their is however some variability, depending upon the profession and lifestyle. Stay well within your comfort range. There is no competition here. The moment your eyes start feeling uncomfortable or tired it is better to remove your lenses. Your eye care practitioner is the best person to guide you in this regard.

Can I sleep with my lenses on.Again as a general rule no.These days with advent of revolutionary lens materials with very high oxygen permeability, lens wear is extremely safe, however it is not advisable to sleep with your lenses on and it is not needed also. It is true that in certain indications , lenses are prescribed for extended wear but for routine contact lens wear it is neither needed nor advisable to sleep with the lenses on the eye.

What about the cylinder in my prescription. Can lenses correct astigmatism.Yes. Both oxygen permeable rigid lenses, and Toric soft contact lenses can correct astigmatism.Toric soft contact lenses now provide excellent vision and full comfort.

But is’nt lens care very cumbersome.No, as a matter of fact it is quite easy. With the availability of latest lens care solutions , lens care has become a matter of couple of minutes every day. What is important is that it has to be done as per your eye care practitioner’s recommendations.

I have to work a lot on Computers. Are contact lenses good for me.It depends. Generally, wearing lenses does’nt cause any problems during working on the computer. However, while watching the monitor one tends to blink a little less , which may make the soft lenses a bit dry and uncomfortable. So try to blink frequently, and give your self regular rest breaks. Some lubricating drops are also available which can help soft lens users during computer work.

What about cosmetics and eye make up. Won’t the lenses get spoilt.It is best to avoid any make up touching the soft contact lenses, or the lenses may get stained and spoilt. If you wish to wear eye make up, make sure that it is water based and applied only to outer side of the lids. And always remember: The lenses go in first , and come out first. Always insert the lenses with clean hands before applying make and similarly always remove them first before removing make up.

I play a lot of sports. Are lenses good for me.Contact lenses are generally excellent vision correction option for sportspersons. They not only provide a wider vision field , but also do away with the hazard of injuries associated with broken glasses or frames. With contact lenses you can even wear protective goggles while playing.

For further information you may contact me at the following address.
Dr Kapil Midha
MS[Ophthalmology]
Midha Eye Centre
New Railway Road{opp Fire Station]
Gurgaon—122001 {Haryana}
PH: 0124-2328346

Eye-Popping: The Unclean Things We Do To Contact Lenses « AARP

2012-01-01T13:40:00.000+05:30

A very useful article on safe wearing of contact lenses.

Eye-Popping: The Unclean Things We Do To Contact Lenses « AARP

papilloedema in a young male

2011-12-29T13:09:00.000+05:30

optic disc swelling both eyes in a young male adult who presented with blurring of vision, video made through a 90D lens on the slit lamp using a digital imaging system

Highly Myopic Optic Disc

2011-12-28T12:58:00.000+05:30

Optic disc of left eye of a 20yr old boy with high myopia. This picture is taken through a 90D lens. The right eye also had high myopia.

coarse punctate keratitis

2011-12-23T18:31:00.000+05:30

coarse punctate keratitis in both eyes of a middle aged lady.

Corneal Foreign Body[cyanoacrylate glue]

2011-12-21T13:10:00.000+05:30

Corneal Foreign Body.{Cynoacrylate Glue-(FeviQuick) Stuck on the Cornea}

This is not an ucommon thing to happen. Cynoacrylate Glue is used commonly in the home and industry and it does fall in the eye at times.

Fortunately , as the cornea is always wet so the glue quickly polymerises and sticks only superficially and most of the times can be easily removed by the eye physician using a Q tip. Sometimes a superficial corneal abrasion may require patching.

In some cases the eyelids may get glued together and the lashes may have to be snipped off to free them.

Ant stuck in conjuntiva

2011-12-21T12:58:00.000+05:30

An ant got stuck in the conjunctiva of right eye of a 20yr old girl. It was gently removed after putting local anesthetic eye drops. The body could be removed with a Q tip but the head was tightly stuck and had to be removed with a sterile forceps.

conjunctival tear

2011-12-14T18:52:00.001+05:30

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conjunctival tears in a young adult male, was injured by an iron rod accidentally while driving a scooter

conjunctival tear in a small child

2011-12-14T18:46:00.001+05:30

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conjunctival tear in upper bulbar conjunctiva in a 5yr old child, was hit with a toy while playing.

subretinal macular hge

2011-12-14T18:06:00.000+05:30

subretinal macular hge le in a young adult male, presented with sudden decrease of central vision.

Squint[also known as strabismus]

2011-12-14T14:02:00.000+05:30

Strabismus{Squint}

Strabismus{Squint}, What is it? And how to know whether your child has it or not?Many times parents come to the doctor with the doubt, that there child may be having squint. Sometimes they are right and other times they are not.

Small children , many times have skin folds on the inner side of the eyes where the eye meets the nose [epicanthus] and many times the bridge of the nose is also wide, so when the child looks towards one side it appears that the other eye has gone very inwards. This condition is called pseudo squint.

The important sign for squint is that if one eye is straight and the other eye is turned in or out then probably the child has squint.

Squint can either be convergent[crossed eyes] or divergent[wandering eyes].If you see your child's eyes cross or see one eye wander to the side after three months of age, even if it happens only once in a while or if your child often keeps one eye closed or looks with his head tilted /turned to one side, see an eye specialist.
Squint-Can it harm the vision of my child?The important thing to remember is that if you suspect that your child may have squint, you must see and eye specialist. You can’t just let it be.

For normal binocular vision , both eyes must look in the same direction at the same time. If one eye squints in or out, it gives a different picture. Once the brain receives two different pictures from two eyes , it blocks the picture from the weaker eye.

This is called suppression.

If both eyes are not aligned properly when the child is still young , the brain will always ignore the weaker picture and one eye will suffer from vision loss called Amblyopia. Once Amblyopia develops, it is very difficult to treat and often becomes permanent.

In addition to this, there is another important reason for getting the childs eyes examined if parents suspect squint. Rarely, serious eye diseases may present as squint and only an eye specialist can look for them. So if the child has squint, one must see an eye specialist.
Managing Strabismus?The primary focus of treatment is to try to achieve normal vision in both the eyes and to achieve this focus , the treatment must be started as soon as possible.

As described above, in certain types of squint , one eye may become amblyopic. Amblyopia can be treated .

The way to do is to make the weak eye do more work. For this , the child may have to wear glasses and the better eye may have to be patched for certain period of time{Occlusion Therapy}.

Occlusion therapy, is difficult but very important when indicated.

It should be started early, esp before the age of 5 to 6yrs. The older the child becomes, it becomes more difficult to treat amblyopia. The child resents occlusion as the weaker eye sees less and the parents find it very hard to stay motivated and continue with it but it is very beneficial in improving vision in the weaker eye .Certain types of strabismus can be corrected by glasses, but some would require surgical correction. Surgery is usually done after treating amblyopia if any. Surgery is done on the external muscles of the eyeball to try and straighten the eye.Either one or both eyes may be operated. Sometimes a single operation may not be completely successful and may have to be repeated.
To Summarise:
The most important part of treatment in strabismus is to achieve normal vision in both the eyes. So occlusion therapy may have to be continued for many months or even a few years. Sometimes, the period of occlusion may be reduced as the child becomes older. This treatment is carefully monitored by the eye doctor. When the child is about 7 to 8yrs old the vision in the weak eye will be almost as good as it can get with occlusion.
Remember:Amblyopia must be treated as early as possible to achieve good vision in the weaker eye.
So ,if you suspect wandering or crossed eyes in your child, or you have a doubt that the child doesn't see well always see an eye doctor.
Please note:The above information is very general and is provided to stress the need for consulting the eye doctor in case you suspect squint in your childs eyes. For more information , you are welcome to consult me.

Glaucoma FAQ's

2011-12-12T12:43:00.000+05:30

Glaucoma{Kala Motia}-What you should know about it.
Glaucoma is like a silent stealer of vision. Like a thief it works quietly and by the time we know, in many patients some vision is already lost.

What is Glaucoma?Our eye balls contain a fluid called aqueous humour. This fluid is continuously being produced and drained from inside the eye and a fine balance is maintained. This fluid helps in providing shape to the eye and also nourishment to various ocular tissues esp the lens and cornea which do not get any blood supply. The pressure of this fluid inside the eye is called Intra ocular pressure{IOP}. It mostly recalls blood pressure to the minds of the patients, which is of course the pressure of blood inside the walls of the arteries.

Like blood pressure, there is a safe range of Intraocular Pressure usually between 10 to 20mm Hg. The ocular tissues remain healthy at this range of IOP.

However, sometimes and in some patients
there occurs a disregulation between the production and drainage of the aqueous. Mostly , it is the drainage channels that are obstructed or blocked and the IOP rises. When IOP rises beyond a critical level and for more than a certain length of time, it starts causing damage to the Optic Nerve and the retina. Optic nerve is very sensitive to abnormal IOP and when it is affected ,vision too is affected.
The thief has struck.

Is There Only One Type Of Glaucoma?The type of glaucoma I have alluded to in the above Para is the commonest. It is called as Primary Open Angle Glaucoma, and this is the one on which our discussion will remain focused for the sake of simplicity. Here we are trying to over simplify a highly complex subject.

However, this is not the only type of glaucoma. Glaucoma may be classified, broadly as Congenital{Developmental} or Acquired and Primary or Secondary.

Congenital glaucoma is a rare and sight threatening disease manifesting in infants and small children which requires difficult surgical management.
Secondary glaucomas are those conditions that occur as a complication of some ocular or systemic condition.

Primary Acquired Glaucomas are the ones on which this discussion will focus, and they are mainly of two types:
Primary Open Angle Glaucoma and Primary Narrow Angle Glaucoma.
Primary Narrow Angle Glaucoma{also ka angle closure glaucoma or ACG]: we can also call it glaucoma associated with acute attack of pain. This type of Glaucoma is less common than the Open Angle type and usually manifests after the age of 60yrs.Certain patients with shallow ant chamber and narrow angle are prone to it.
Hypermetropes are more susceptible. Under certain circumstances, the already narrow angle of the ant chamber from which the aqueous drains, close suddenly. This leads to an acute rise of IOP and an attack of ACG.
During this attack the patient suffers from acute eye pain and headache along with sharp loss of Vision in the affected eye. The pain is so severe that it is unbearable.

This is when the patient is usually rushed to the Eye Specialist and ACG is diagnosed.

The pressure is reduced by medical treatment and pressure lowering agents and the attack can usually be resolved. But the patient requires surgery to prevent further such attacks.

This surgery can be minor{Laser iridectomy} or major [Trabeculectomy] depending upon the status ot the eye.The above picture shows a patient's eye where a trabeculectomy has been done.

Repeated and unattended attacks of ACG can cause severe visual loss and can ultimately lead to a painful blind eye.

Primary Open Angle Glaucoma{POAG}: This is our main focus of our discussion here. As is self evident , in POAG the angle of the anterior chamber is open, however the trabecular mesh, through which the aqueous drains out from the eye is probably sclerosed and offers resistance to drainage.

POAG also normally affects elderly patients and is more common than the angle closure variety. Both affect both the eyes.

The patient with POAG doesn’ t feel pain as the pressure rise inside the eye is slow and insidious.

In fact initially the patient is unaware of thedisease. In this respect it resembles other chronic diseases like diabetes and hypertension.

Patients with family members suffering from Glaucoma have a higher chance of developing it themselves.

Sometimes frequent change of glasses esp for near-give an indication that something may be wrong.

Early POAG is usually picked up by the eye doctor, during routine eye check up when he sees the optic nerve of the eye and checks the pressure of the eye using a special instrument called tonometer.

What Happens if POAG is left untreated:
Abnormally high levels of IOP slowly start damaging the Optic Nerve and the retina. The size of the Optic Nerve cup increases and corresponding defects in the visual field start appearing. Initially the patient doesn't notice these defects in the visual field but slowly he starts becoming aware of them.
Still untreated, the damage to the optic nerve and retina progresses and finally the optic nerve may become atrophied and all vision may be lost.

Is there a treatment for POAG:
Fortunately, there is a very effective medical treatment available for this type of Glaucoma. During the last decade there has been a revolution in the treatment options available for this type of glaucoma and much more eyes are getting their vision saved by medical treatment alone.

The important point to remember about glaucoma: The vision lost is lost for ever. So every moment is precious. Once glaucoma is diagnosed the treatment is usually life long.

There are some cases of severe POAG where medical treatment is not fully effective and those patients have to undergo glaucoma surgery.

How is Glaucoma diagnosed.
Let us discuss, some of the important methods of diagnosing glaucoma.

IOP: The pressure inside the eye is a very important indicator about the health of the optic nerve. It is measured by a special instrument called tonometer. Safe IOP level is usually between 10mm to 20mm of Hg, but this is not a absolute statement because individual variations occur. However, IOP levels more than 20mm of Hg make us suspicious and more careful.

The Optic Nerve: The optic nerve of the eye is directly visible to the ophthalmologist , by using a instrument called Ophthalmoscope. Any glaucoma damage to the optic nerve can therefore be seen and assessed.

The visual fields: Using a special instrument called Perimeter, the defects produced in the visual field by raised IOP can be documented.
Gonioscopy: This test is done to see the angle of the ant chamber and its anomalies.The above picture shows the ant chamber angle as seen by a gonioscope.

There are various other tests and new and better tests are continuously being developed for eg: OCT & Nerve Fibre Layer Analyser.
However, once diagnosed the treatment as suggested by the Ophthalmologist should by started immediately and followed religiously to preserve vision.

Regular follow up must be maintained to monitor the efficacy of the treatment.

If Glaucoma is a silent disease what must one do to diagnose it early and save vision:
· Regular eye check ups are the answer, esp after the age of 40yrs. This is the best defense against glaucoma.
· If there is a family history of glaucoma , then regular eye check ups are even more important.
· If you are suffering from other chronic diseases like hypertension and diabetes,
· If you are requiring a frequent change of glasses esp for near

· In all the above cases we become more suspicious, but the bottom line is that regular yearly check up after the age of 40yrs can be sight saving.

I hope the above information will prove useful. May no one get glaucoma, but all wishes are not granted and people do get it. However, one must know that if diagnosed early and treated properly ,you can still enjoy a life time of good vision.
Kindly Note:
The above information is provided in good faith , and as a service, for the general information of public. This is not an alternative to consultation with the Ophthalmologist.

Extensive pterygium

2011-12-08T11:25:00.000+05:30

Extensive Pterygium left eye in an elderly male, transgressing the visual axis .

Computer Vision Syndrome.

2011-12-06T13:03:00.000+05:30

Prevent Eye Strain While Using Your PC.
Some Practical Tips.

Computer Vision Syndrome, is now being recognized as a important and increasingly common eye problem faced by the computer user . This is also true for avid Television watchers. As the computer is fast becoming an indispensable part of our daily life, more and more people are complaining of eye strain after working on their PCs.

Common symptoms of Computer Vision Syndrome: You may notice a variety of symptoms , including tired and aching eyes, with heaviness of the forehead, there may be eye irritation with burning sensation in the eyes and sometimes even red watery eyes. There may even be difficulty in focusing often accompanied by headache.

How to Prevent This Problem:

It is advisable to get an eye check done by an eye specialist to look for any eye problem and correct it . For eg –many times a small refractive error may be causing these annoying symptoms and using proper glasses may be all that is required.

While working on your PC take Periodic Rest Breaks. Don’t stare at the monitor continuously for long period of time—to prevent eye fatigue. A blank screen saver usually helps, so does getting up to get your glass of water, or your cup of coffee yourself, rather than getting it delivered to you on the PC Table.

Blink your eyes frequently, so that they stay lubricated with the natural tears and do not become dry. Infrequent blinking while working on a computer is a common cause of dry eye related symptoms, like burning and irritation.

Place the monitor at or slightly below eye level, and the copy holder as close to the screen as possible, so that you don’t have to turn your head frequently. The illumination in the room , should be such, that the glare , and reflections from the monitor are reduced.

For Computer Users Who Use Glasses For Near—Usually , people over the age of 40yrs , need glasses for near. Since the monitor is placed usually farther away from the reading distance, special glasses may sometimes be required for viewing the monitor comfortably.Progressive lenses are a good option in such cases. Your eye specialist can examine your eyes thoroughly and prescribe you these glasses if required
.

Dr Kapil Midha

MS
Ophthalmologist.

oblique insertion of optic disc

2011-12-03T14:04:00.001+05:30

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Oblquely inserted optic disc in the right eye of the same young myopic lady. see the sharp angle of disc insertion.

conjunctival foreign body.

2011-12-01T13:58:00.000+05:30

traumatic macular scar

2011-11-29T13:08:00.000+05:30

macular scar left eye in young adult male. he was injured by cricket ball several years back,

Failed Keratoplasty

2011-11-29T12:04:00.000+05:30

Failed Corneal Graft in the Right Eye of an elderly lady. The patient presented with no light perception and high Intraocular pressure. She gave the history of corneal grafting done 5yrs ago.

New Treatment for ARMD

2011-11-22T10:55:00.000+05:30

New treatment available for Age Related Macular Degeneration. ARMD is a disease of the elderly which produces significant loss of central vision. Ten years from now there was no effective treatment available for this disease. Now however, we have effective treatments in the form of VEGF inhibitors such as Lucentis which can be injected inside the eye and save the patients vision. This new drug should give further options to the ophthalmologist in the fight against ARMD.

Press Announcements FDA approves Eylea for eye disorder in older people

Central Serous Retinopathy

2011-11-16T14:17:00.001+05:30

This young male patient presented with painless decrease in vision in his right eye and the presence of a central haze over what ever object he sees. The Macula shows this picture, you can see the macular swelling and also the shimmering ring reflex around the macula.

Matchstick corneal burns

2011-11-15T14:36:00.000+05:30

A 40yr old man, presented with this picture in the left. A burnt matchstick end jumped and fell in his eyes when he was lighting his cigaratte. You can see the superficial corneal burns and the blackish powder stuck on the cornea. The corneal foreign body was gently removed under local anesthetic drops and a pad and patch applied for a few hrs. The patient was prescribed antibiotic and lubricant drops for a week.

Spectacles-some useful information

2011-11-15T12:12:00.000+05:30

General Information About Glasses.When you get a prescription for glasses, it is useful if you know about the various lenses available so that you can make a good choice.Glass vs Plastic: The main advantages of a plastic lenses are that they are much lighter and do not break. So they are more comfortable esp in cases of higher powers and much safer for children. Actually, for children a special type of plastic lens material called Polycarbonate is preferred which is almost shatter proof. The disadvantages of Plastic are that they get scratched more easily than glass even when hard coat is applied and they are generally more expensive. Anti glare coating can be applied both on glass and plastic lenses. Both materials can be made photochromic, but photochromic plastics are quite expensive.
Generally, the trend is more towards plastic lenses these days because of their comfort and safety. Rimless glasses can only be made with plastic lenses, but affordability is an important
PhotoChromatic Lenses: These lenses have been around for many years. They change colour and become dark when exposed to sunlight and return back to normal indoors. So they serve the dual purpose of Sunglasses and Prescription lenses. However they do reduce the light a little , even indoors and it is a good idea to have a separate pair of white lenses for indoor work. I usually advice my patients not to go for PhotoChromics in their Bifocals.
AntiReflection Coating{Anti Glare Lenses}: This is special coating applied on the lenses. It is useful as it cuts the glare esp of on coming headlights while
driving at night. To some extent it may be useful for computer work also.
Glasses For Children: A few tips when you are buying glasses for children.
· Go for good quality plastic frames. Metal frames can be unsafe. Frames should be well fitting and should not sag down on the nose.
· Plastic Lenses are much safer than glass for children. Poly carbonate is even better as it is almost shatter proof.
Bifocals:After the age of 40yrs, most of us will need separate glasses for near work. This condition is called Presbyopia.
Presbyopia is not a disease but just an aging change when the lens of the eye becomes less elastic and its power of instant zoom, decreases.
What are the choices for Presbyopia:Separate Glasses for near and distance.– Not a great choice as every time you need to look up from reading you have to take off your reading glasses.
Bifocals and their types;
Kryptok Bifocals are the ones most commonly used and the most affordable. The are not cosmetically very pleasing but they serve the purpose of bifocals.
Flat Topped Bifocals{also k a D Bifocals}: They are cosmetically better and also more expensive. In my opinion they are also easier to adjust to as all bifocals need an adjustment curve, where in the user learns to adjust his eyes and chin to see through the near and distance segments.
Progressives: They are the best option for presbyopes. Progressives are good because they provide an intermediate zone in addition to the near and distance and so , the transition from distance to near should be smooth and effortless and it should be ideal for computer work also. This is true , if the lenses are of high quality and fitted well. Other wise progressives can have a high degree of peripheral distortion and negate all these benefits.
I hope this general information will help you in making a better choice about your glasses.

Old healed uveitis with thick post synechiae

2011-11-05T19:31:00.001+05:30

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A Young Adult Female Patient with this picture in the right eye. A thick post synechiae at 6-0Clock position and adjoining complicated cataract. The macula showed the appearance of cystoid degen. The patient had a severe lenticular myopic astigmatism with the best corrected vision of 6/18.

traumatic optic neuropathy

2011-11-02T19:04:00.001+05:30

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Traumatic optic atrophy and mac hole in a young male left eye. You can see the macular hole and a very pale optic disc. The patient gave a history of head injury in a traffic accident one year back. The vision was severely compromised and he had only light perception in this eye.

Moderate Ptosis and Cataract

2011-11-02T18:54:00.001+05:30

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Moderate Ptosis and near mature Cataract of right eye in a 55yr old diabetic patient.

CSR

2011-11-02T11:40:00.001+05:30

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Macular Swelling in the left eye of a young adult male. He complains of a central black spot in his vision. The patient requires an OCT of the retina to further investigate.

Lacrimal abcess

2011-11-01T19:43:00.000+05:30

Lacrimal abcess left eye in a 10yr old child.

firecracker injury-corneal edema with folds in descemets memb

2011-10-29T11:39:00.001+05:30

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firecracker injury right eye in a young adult male, you can clearly see the corneal swelling and folds in the descemets membrane. the vision is drastically reduced.

Firecracker Burns

2011-10-28T18:20:00.000+05:30

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Firecracker burns in the right eye of a nine year old child who was burning firecrackers. You can see numerous soot particles stuck on the eye, which were gently removed after putting local anesthetic eye drops.

Here is another patient, again a young child playing with firecrackers.

firecracker burns left eye with multiple corneal foreign bodies

firecracker burns right eye with multiple corneal foreign bodies.

Atheromatous Corneal Ulcer

2011-10-25T18:44:00.000+05:30

Band Keratopathy with Atheromatous Corneal Ulcer in the Right Eye of an elderly lady . The next picture is , the same eye with a bandage contact lens.

zonular cataract

2011-10-22T14:33:00.000+05:30

Zonular cataracts in both eyes of a young teenage girl. These are possibly congenital. The patients vision was unaffected and she was unaware of it.

Corneal Foreign Body

2011-10-21T12:05:00.000+05:30

Corneal foreign body left eye in a young adult male, who got it while doing welding work. The foreign body removal is shown using a bent tip disposable needle and the rust is being scraped off.

World-first drug could cut need for cataract surgery | Adelaide Now

2011-10-18T20:03:00.000+05:30

This will be an amazing discovery if it works.

World-first drug could cut need for cataract surgery | Adelaide Now

Let us watch a short video of cataract in both the eyes of an elderly lady. you can see the spokes of a mainly cortical cataract and also the examn of the retina by a 90D lens on the slit lamp.

coarse puntate keratitis

2011-10-18T11:08:00.001+05:30

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Coarse Punctate Keratitis in the right eye of a young adult male patient.

Keep You Eyes Healthy

2011-10-17T14:09:00.000+05:30

Some Tips On How to keep your eyes healthy and sparkling.Protect Your EyesKeep your eyes well protected from dust, smoke and pollution. This is esp important while driving two wheelers. Young fellows ,come to me with itchy umcomfortable eyes. They drive latest, powerful bikes but do not use any protective glasses. The roads are highly polluted, full of smoke, dust and vehicular exhaust. Our eyes are just not designed to take this kind of insult.
So my advice is : Drive your mo-bikes and scooters but use effective eye protection. Good Sunglasses and also a helmet with a visor. Double pollution needs double protection .Those who drive a car with windows open are also exposed to pollution and need eye protection too and those who drive with windows closed and AC on, should protect their eyes from the direct blast of AC blowers. Air conditioning dries up the atmosphere and leads to dry and gritty eyes.
Do not touch your eyes, Do not rub your eyes!At least as much as possible. People who touch and rub their eyes often get more frequent eye infections. The reason is not hard to find. Through out the day, we are handling all sorts of things and it is not possible to thoroughly was our hands every time. Our eyes are delicate structures and even the slightest contact with unclean hands or cloth should be avoided. I have frequently seen patients, wiping their face and nose with their hankerchief and then use it to rub their eyes. This is a very wrong thing to do.
Rubbing the eyes in fact makes things worse. It irritates the lid and conjunctiva and makes the eyes more red and watery. The more you rub the more it waters and a vicious cycle is started. Some people rub so vigorously, that they even rub the conjunctiva, as if they are trying to catch fish inside the eye, we actually have a name for this condition, we call it ‘ mucous fishing syndrome’.
Do not splash water inside the eyes.I know this statement sounds contrary to what is normally believed and preached. Almost everyone believes that washing your eyes with clean and fresh water is good. So I will explain this statement. God has provided us with tears to keep our eyes soft, smooth and clean and their composition is such that the surface of our eyes feel very comfortable. So if , external dirt and grime doesn't get inside the eyes , splashing water inside the eyes is not required. Still, you may gently wash your eyes with fresh and clean water once a day but make sure that the water is clean. Ordinary tap water is perhaps not that clean and some times too much chlorinated. But, please do not vigorously splash water inside the eye for it can hurt and harm the eye. It is OK to splash water with your eyes closed for it cleans your eyelids nicely. For, similar reasons please do not go for swimming without your swimming goggles.
My Eyes Feel Tired and Gritty Evening ,What should I do:Check the following,
Do you drive a lot in your line of work-use eye protection.
Are you exposed to a lot of pollutants-again use adequate eye protection.
Do you smoke-avoid it as much as you can. Excessive smoking can cause dry and gritty eyes.
Do you get adequate sleep. Sleeplessness can also cause tired eyes.
Do you watch lot of TV or work a lot on computers—read the next few lines.

Computer Work Related Eye Strain[also k a computer vision syndrome]:Can you imagine a life without computers and TV. We live in a highly visual world and spend a lot of time watching TV or working on computers. This produces stress on our eyes in several ways. Continuously gazing on computer monitor makes our eyes rough and dry and also strains the internal muscles of the eye. This results in uncomfortable eyes that feel gritty and give a burning sensation and also eye ache and headache.
What is the solution to this vexing problem?
People who work on computer for leisure can cut down but not those who do it for their profession. So here a few suggestions that usually work quite well:
Uncorrected refractive errors increase the strain on eyes, so if you have even a small error of refraction you should get it checked and use specs while working on your PC or laptop.
Try to take as much rest as possible. I know it is easier said than done ,but try not to look at the monitor unnecessarily. So no fancy screen savers. Have a blank screen saver instead. There is rule called the 20.20.20 rule, which recommends 20sec break after 20mts work and asks you to look 20ft away so as to relax the internal [ciliary] eye muscles. It is a good rule if you can follow it.
The height of the computer screen should be at or slightly below eye level. Never above eye level.
The lighting in the room should be proper to avoid unnecessary reflections and glare.
Your chair should be ergonomic to avoid unnecessary stress on your neck and back muscles.
Important note for parents:I see many children who present with dry eye symptoms and on asking I find most of them are watching lots of TV , mainly cartoons. Kindly, restrict TV viewing to not more than 1hr a day. It is not yet proven that excess TV viewing increases myopia, but there is a suspicion that it does to some extent. It definitely produces tired , dry and uncomfortable eyes more so in children

Please Do Not SelfMedicate:Ophthalmolgy is a difficult science. Even a red eye may have several causes, each requiring a specific treatment. You are expert in your own field, similarly the eye specialist is specially trained for several years in treating eye diseases. Do not experiment on your eyes and do not let any chemist do so. Eye drops contain powerful medicines and are not to be played with. If you have any eye problem , please consult an Ophthalmologist and keep your eyes safe.

Some fallacies and Some Truths:
Is eating carrots good for the eyes?Carrots contain vit A which is essential for the eyes. However ,many other foods contain vit A and any well balanced diet gives adequate amount of vit A to the body. So definitely carrots are good but it can not replace a well balanced diet, which will provide all nutrients and vitamins. Indian, diet consisting of Dal, roti, Rice, Vegetables, Fruits, milk and curd etc is quite well balanced.
No amount of carrots will reduce your child’s refractive error if he has it. Ref Error esp Myopia tend to increase up to the age of 18 yrs and stabilizes around the age of 20yrs. This is the reason that LASIK surgery for removal of glasses is advised after the age of 18yrs.

uveitis with pupillary exudates

2011-10-16T11:33:00.001+05:30

Anterior Uveitis of right eye in a middle aged female. You can see the pupillary exudates.

Superficial Punctate Keratitis

2011-10-14T13:38:00.000+05:30

Superficial Punctate Keratitis in the right eye of a young lady. She habitually keeps her eyes a bit open during sleep. The patient was prescribed lubricants and advised proper eye protection and dramatically improved within a week.

FireCracker Safety for eyes

2011-10-12T12:37:00.000+05:30

Keep Your Eyes Safe This Diwali. Prevent FireCracker Injuries.
Diwali is the festival of lights and firecrackers. One of the most beautiful festivals in the whole world. However, on this festive night many people suffer from firecracker injury in their eyes and the eye emergencies in all the hospitals are busy.

Firecracker eye injuries can be very serious, and can even lead to blindness in the affected eye. So keep yourself and your children safe by following a few rules:
· Always light firecrackers in an open space and light them from a safe distance and away from inflammable materials , never in your hand.
· Never try to relight firecrackers , if they have failed to function the first time.
· Always use protective goggles while lighting firecrackers, never light them with naked eyes. This is most important.
· Never let your children light firecrackers unsupervised.
· All crackers are potentially dangerous, even sparklers. However, those crackers that go off at high speed like rockets are more dangerous.
What should one do in case of cracker eye injury.
Cracker injury can be a burn injury with many conjunctival and corneal foreign bodies, or a blunt trauma because of high impact or both.The eyeball itself can be damaged and there can be bleeding inside the eye. The point to stress is that firecracker injuries can cause loss of eye and eyesight. Once there is a cracker injury there is only one thing to do and that is to seek professional eye care. Self management has no role.

Here are some of the things to do while you are going to the doctor:
· Ask if the person is seeing well with the affected eye, and if he can open the eye. Good vision means, the severity is less, but if vision is highly decreased or if the patient says that he can’t see then things are very serious.
· Do not put any drops or ointment in the eye.
· Do not put pressure on the eye. Do not allow the patient to rub the injured eye at any cost. You can give the patient protective goggles to put on or you can gently apply an eye pad [available at chemists] and tape it to the forehead and cheek.
Should I wash the eyes with water:This is commonly asked question, so I am specifically writing about it.
If the eye ball is intact and the eye has suffered only burns, then washing gently can be a good idea, however in case of impact injury the eyeball may also be damaged. Since, you can’t tell whether it is or not,
it is better not to wash the eyes. Just seek professional care, as soon as possible.
Also Remember:
Bow and arrow injuries have claimed the eyes of many sweet and lovely children and continue to do so. Please do not allow your children to play with bow and arrow.
Have a very Happy and Prosperous Diwali..

Dr Kapil K. Midha
MB,BS; MS
Consultant Eye Surgeon

decentred IOL

2011-10-09T13:55:00.000+05:30

Decentred Post Chamber IOl seen in a young adult male, who has bilateral pseudophakos. He gave the history of cataract surgery in both eyes approx 15yrs back when he was in his early teens.

Multiple Corneal Abrasions

2011-10-04T12:05:00.000+05:30

Multiple Corneal Abrasions in left eye of a young male. He accidentally injured himself with a walking stick while walking his dog. A couple of days of patching with antibiotic eye ointment healed his cornea.

Pterygium Surgery

2011-09-30T12:44:00.001+05:30

Pterygium excision and conjunctival autograft.

Pterygium is fleshy growth of conjunctiva invading the cornea. It can progress and distort the cornea and decrease the vision. The modern treatment for this condition is excision of the Pterygium and Conjuntival Autograft. This is the first post operative day picture of this procedure done in a 50yr old male patient who had a large fleshy pterygium.

Burnt Matchstick Corneal Burns

2011-09-25T11:51:00.001+05:30

This is the picture of Left Eye of a young adult male. A Burnt Matchstick accidentally touched his eye. Luckily for the patient, he improved with treatment.

Astronauts risk blurred vision after months in space

2011-09-23T11:55:00.000+05:30

Space Travel is not all that safe for the eyes and vision. The microgravity conditions in space produce increase cerebro spinal fluid pressure in the head and may cause Optic Disc Swelling which can reduce vision. Read this article to find out more.

Astronauts risk blurred vision after months in space

Fingernail injury of cornea

2011-09-19T13:37:00.001+05:30

A small 3yr old child presented with this picture in the left eye. He said that he hurt his eye with his own finger while playing. You can see a central corneal epithelial defect. The child's eye was patched and he was OK the next day. He is now on lubricant eye drops to prevent recurrence.

central chorioretinitis

2011-09-19T12:15:00.000+05:30

Healed central chorioretinitis in the left eye of an 11yr old boy.

Hypopyon corneal ulcer

2011-09-19T11:18:00.001+05:30

Hypopyon Corneal Ulcer in the left eye of an elderly aphakic lady

Severe Uveitis

2011-09-11T13:21:00.001+05:30

Uveitis.

Severe Uveitis in the right eye of a adult male. You can see the condition of the eye on presentation. The patient had severe loss of vision and only counted fingers near to face. After appropriate treatment was started the eye and the vision improved as you can see in the subsequent pictures.

zonular cataract

2011-09-08T11:37:00.001+05:30

Zonular CAtaract in both eyes of a young adult female patient.

Phylecten

2011-09-08T11:14:00.001+05:30

Phylecten in the upper bulbar conjunctiva, in the right eye of a young adult male.

Cataract Surgery-a cure for insomnia?

2011-09-07T19:24:00.000+05:30

Aging eyes linked to sleepless nights, new study shows

This is an interesting study,according to which the aging eye lens decreases blue light transmission and produces insomnia. Cataract surgery should therefore have an additional benefit in curing sleeplessness!

Herpetic Corneal Ulcer

2011-08-27T13:47:00.001+05:30

This patient-a young male adult, came with the picture you see below; in his right eye. A clinical diagnosis of herpetic geographical corneal ulcer was made and the patient was started on antiviral and supportive therapy. There was dramatic improvement in his condition after one week of therapy as you can see in the second picture.

Herpetic Corneal Ulcer

Geographical Corneal Ulcer before treatment.

After treatment with antiviral therapy.

Study focuses on relationship between glaucoma and diabetes, hypertension

2011-08-18T12:27:00.000+05:30

Patients with diseases like Diabetes and Hypertension have a greater risk of developing Glaucoma. Therefore regular eye examn are highly recommended.

Study focuses on relationship between glaucoma and diabetes, hypertension

Bats navigate with visual map, additional unknown cues

2011-08-17T13:02:00.000+05:30

Blind as a bat is definitely a wrong expression. Read this article to find out more:

Bats navigate with visual map, additional unknown cues

Potential new eye tumor treatment discovered

2011-08-08T11:13:00.000+05:30

New research may promise better treatment for this dreaded childhood tumor of the eye.

Potential new eye tumor treatment discovered

Chemical burns of the eye

2011-08-06T10:13:00.001+05:30

A young male adult industrial worker. Chemical burns in left eye due to acetone falling in the eye .

Historic first images of rod photoreceptors in the living human eye

2011-08-01T19:28:00.000+05:30

Historic first images of rod photoreceptors in the living human eye
Rods and Cones are the nerve cells in the human retina. Cones are responsible for fine central vision and are more concentrated in the central retina, ie the macula and the fovea. Rods are responsible for night vision and are much more numerous. Actually visualizing these photoreceptors can have far reaching benefits in early diagnosis and treatment of retinal disease.

Contact Lens displaced in eye.

2011-07-30T12:36:00.000+05:30

contact lens displaced in the eye of a young adult female. It was hiding in the upper fornix and we gently removed it. It came out quite easily as you can see.

Disciform Keratitis.

2011-07-29T12:07:00.000+05:30

A young lady presented with this picture in her right eye. There is central stromal corneal edema and the corneal sensations were reduced. We made a clinical diagnosis of herpetic disciform keratitis and started her on antiviral and antiinflammatory medications. The patient has improved markedly.

BBC News - How dark winters meant bigger human brains and eyeballs

2011-07-27T13:49:00.001+05:30

A very interesting article on evolution of human eyes and vision.

BBC News - How dark winters meant bigger human brains and eyeballs

A gallery of biotech devices that could give you superpowers right now

2011-07-22T12:49:00.001+05:30

From retinal implants, to implantation telescopes in the eye-there are a host of new innovations in medical science. For a preview , have a peek at this link.
A gallery of biotech devices that could give you superpowers right now

Monroe or Einstein: Check If You Need Glasses at Your Computer

2011-07-21T10:45:00.001+05:30

This is very interesting. Check out this link and be amazed!
Monroe or Einstein: Check If You Need Glasses at Your Computer

Interesting Eye Facts

2011-07-18T12:41:00.001+05:30

Pupils of Cats are slit like and not round like humans. There is however a species of Cats called Manul, which is found in regions of central asia , which has round pupils.

check out this link.
http://www.arkinspace.com/2011/04/manul-cat-that-time-forgot.html

Gallery - Award-winning photographer looks into our eyes - Image 1 - New Scientist

2011-07-16T13:38:00.001+05:30

Excellent pictures of eye conditions here:

Gallery - Award-winning photographer looks into our eyes - Image 1 - New Scientist

Eye Injury with a pencil point.

2011-07-12T14:22:00.001+05:30

This young boy got injured in school -in his left eye , by a pencil point. You can see the triangular corneal stromal laceration. Fortunately, there was no penetrating eye injury.

Conjuctival foreign body

2011-07-12T14:20:00.001+05:30

Ant Chamber IOl

2011-07-12T14:18:00.010+05:30

An adult female patient -operated for traumatic cataract during her childhood. A well positioned AC IOl of modern design. The patient enjoys very good vision in this eye.

Rigid Gas Permeable Contact Lens

2011-07-12T14:15:00.001+05:30

An adult female , wearing Rigid Gas Permeable contact lenses.

Ant Chamber IOl

2011-07-12T14:14:00.001+05:30

An elderly patient. AC IOl in his left eye. This is an old 4 loop design.

conjuctival tear

2011-07-12T14:11:00.001+05:30

Traumatic conjuctival tear in the left eye of a young adult male.

Allergic dermatitis of eyelids

2011-07-12T14:10:00.001+05:30

This young adult male patient was using some ayurvedic eye drop and presented with this picture of allergic dermatitis of both lower lids.

Post Chamber IOL in Ant Chamber

2011-07-12T14:07:00.001+05:30

This 12 yr old child was operated for traumatic cataract when very small. You can see that the Post Chamber IOl has displaced into the ant chamber. The post capsule has been cut with yag laser.

Geographical corneal ulcer

2011-07-12T14:02:00.001+05:30

Herpetic Geographical Corneal ulcer in a young male patient.

Corneal Ulcer

2011-07-12T13:56:00.001+05:30

Corneal ulcer in the left eye of a young adult female. She recieved injury in her eye by some vegetative matter approx 2 wks back , while working in the field.

Eyewire Today | Hand-held Smartphone Device Developed at MIT Could Detect Cataracts at the Earliest Stages

2011-07-08T12:27:00.000+05:30

This is very interesting and potentially very useful.

Eyewire Today | Hand-held Smartphone Device Developed at MIT Could Detect Cataracts at the Earliest Stages

How Do I Prevent Eyestrain at My Computer?

2011-07-06T12:05:00.000+05:30

Prevent Eye Strain while working on the computer. Read on to find out more; esp about the 20-20-20 rule.
How Do I Prevent Eyestrain at My Computer?

Bionic specs may soon allow the blind to see - The Times of India

2011-07-06T11:12:00.000+05:30

A very interesting article that brings hope for the visually disabled.

Bionic specs may soon allow the blind to see - The Times of India

Hyperspectral Sensors - The Flying Eyes that See the Invisible - Popular Mechanics

2011-06-30T18:07:00.000+05:30

Seeing beyond the limits of human vision.
This is pretty futurustic. Human eyes see a very limited spectrum and this cutting edge Hyperspectral Sensors see much beyond. They are already being used in UAVs and can have many exciting applications.
Hyperspectral Sensors - The Flying Eyes that See the Invisible - Popular Mechanics

Heredomacular degeneration

2011-06-21T14:01:00.000+05:30

Heredomacular degeneration in botheyes of a young adult male. You can see the oval ,greyish, lesions with a metallic sheen in the macular region in both the eyes.

BBC News - 'White glow' in babies' eyes a possible cancer warning

2011-06-10T13:14:00.000+05:30

BBC News - 'White glow' in babies' eyes a possible cancer warning: "- Sent using Google Toolbar"

This is an excellent article. Retinoblastoma is a tumour of the retina of the eye and presents in early childhood. Delay in diagnosis can be catastrophic. The babies who get this disease have a white glow in their eyes also ka cat's eye reflex and alert parents can observe it. Early diagnosis can help in saving the patient's eye.

Shield Ulcer in Vernal Keratoconjunctivitis

2011-05-27T17:34:00.002+05:30

This young adult male patient presented with this picture in the left eye. He was suffering from severe vernal keratoconjunctivitis in both the eyes. Right eye had a smaller ulcer. VKC is a seasonal allergic condition of the eye and sometimes causes this type of corneal ulcers.

Ant Chamber IOL

2011-05-26T19:26:00.000+05:30

This is the picture of the left eye of a young adult. He was operated for eye injury during childhood. You can see the corneal scar and the ant chamber IOL . The patient enjoys good vision in this eye.

Einstein was right!

2011-05-21T14:16:00.001+05:30

Even though this is not related to eye and ophthalmology, it is so interesting.

in reference to: Epic Discovery: New Galaxy Observations Proves Dark Energy Dominates the Universe (view on Google Sidewiki)

conjuctival foreign body producing corneal abrasion

2011-04-26T19:00:00.000+05:30

The wing of an insect stuck in the upper lid conjunctiva of the left eye of a young male patient, and producing an abrasion on the upper corneal limbus.
The foreign body was gently removed under slit lamp magnification, and the corneal abrasion healed up fast.

wing of an insect stuck in the upper lid conjunctiva

upper limbal corneal abrasion.

Optic Atrophy

2011-04-26T13:33:00.001+05:30

Optic Atrophy in the left eye of an elderly aphakic lady.

spikelet of wheat, stuck in the punctum of the eye.

2011-04-15T12:23:00.001+05:30

Spikelet of wheat got stuck in the lower punctum of the right eye, of a 8yr old girl while playing. It was gently removed under topical anaesthesia using a forceps and the child was relieved of her symptoms. This is the picture of that spikelet protruding from the punctum.

Lasik

2011-03-29T10:57:00.001+05:30

An excellent article on Lasik, from American Academy of Ophthalmology.

in reference to: LASIK - Laser Eye Surgery (view on Google Sidewiki)

silicon oil in Ant Chamber of the eye.

2011-03-23T14:14:00.001+05:30

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silicon oil in ant chamber of the right eye of an aphakic middle aged high myope male patient, who underwent surgery for complicated retinal detachement several years ago.

HSV Keratitis with corneal thinning.

2011-03-21T12:00:00.001+05:30

Age-related macular degeneration.

2011-03-19T17:40:00.001+05:30

AMD is increasingly becoming a major cause of visual disability. The causes include : increase in age, diet and smoking. Read this article for useful information about this silent disease which is visually disabling.
Take a healthy diet, avoid smoking and go for regular eye checkups.

in reference to: BBC News - UK rise in age-related macular degeneration predicted (view on Google Sidewiki)

Central Serous Retinopathy.

2011-03-15T19:20:00.000+05:30

This is the fundus video of the right eye of a young adult male patient who came with the complaint of sudden decrease in vision in this eye for the last one wk. The vision was 6/60 with no imp with glasses or pinhole. Here you can see the swollen macular region clearly . He needs an OCT test for further evaluation of the condition.

Asteroid Hyalosis

2011-03-10T17:56:00.000+05:30