The Cornea and Anterior Segment unit at RamSudha eye hospital has been treating patients from Vijayapur and other surrounding places. It specializes in the treatment of the entire range of corneal disorders and infections. Apart from cataract surgery and corneal transplants, clinicians in this service handle a range of other ocular complications, from infections on the surface of the eye and eyelids to trauma care.
The cornea is the front, outermost layer of the eye. Just as a window lets light into a room, the cornea lets light into the eye. It also focuses the light passing through it to make images clear and sharp. Corneal problems can occur in anyone regardless of age. Sometimes due to disease, injury or infection the cornea becomes cloudy or warped. A damaged cornea, like a frosted or misshapen windowpane, distorts light as it enters the eye. This not only causes distortion in vision, it may also cause pain. When there is no other remedy, doctors advise a corneal transplant. In this procedure an ophthalmologist surgically replaces the diseased cornea with a healthy one to restore clear vision. Keratoplasty is of 2 types, Full-thickness and Partial-thickness lamellar. Full thickness Penetrating Keratoplasty gives satisfactory results but requires a lot of care after surgery. Stitch removal starts after 5-6 months and visual rehabilitation takes between 6 months to 1 year. Strict follow-up is required for first 6 months. Rejection and infection needs to be guarded against. Glasses or contact lenses are required after stitches removal for visual improvement. Deep lamellar Keratoplasty is a recent method of corneal grafting where the superficial corneal layers are only replaced, and the endothelium of the patient is retained. The rejection rate of DLK is lesser than conventional full-thickness keratoplasty and success rate is higher. Decemet’s stripping automated endothelial keratoplasty (DSAEK) is suture less & quick alternative for the penetrating keratoplasty for endothelial diseases
Keratoconus is a disease where the cornea becomes thinner than normal, and subsequently starts bulging forwards. This causes a blurring of visual images and is a known progressive condition. It is a disease of youngsters, starts in the second decade and is commoner with childhood eye allergy and rubbing habit. It causes frequent change of glasses with increase in cylindrical power. The currently available procedure to halt the progression of keratoconus is Collagen cross linking with riboflavin. We can even put special Implantable contact lenses called Toric ICL to improve vision further in these cases. For advanced Keratoconus, we can perform Deep Lamellar Keratoplasty or Penetrating Keratoplasty.
The contact lens department at RamSudha eye hospital is well equipped to cater the requirements of all eye conditions. We provide basic and various speciality contact lenses. The basic contact lenses like Spherical soft lenses and Toric lenses are available which can be given in patient’s who wish to avoid glasses due to cosmetic purpose or due to the profession itself. The prosthetic Contact lenses, which can be used in patient’s who have corneal scarring(white spot) or abnormalities like loss of iris, large/ irregular pupil can be given these lenses which will mask the scars/other deformities at the same time will reduce glare and photophobia.
A ‘dry eye’ is a condition where patients suffer from irritation and discomfort in the eye because of the decreased quantity of tears or increased evaporation of tears from the eye. The symptoms are non-specific and can range from a tired or itching eye to diminished vision in severe cases. A clinical examination can help diagnose a condition of ‘dry eyes’ but, to be more definitive, diagnostic tests are required. As part of our ocular surface service, patients with dry eyes undergo a detailed examination to assess the severity of the problem and other complications. Some patients may have extensive ocular surface damage. The treatment includes use of preservative-free artificial tears, autologous serum and topical immunosuppresive treatment. Dry eyes can also be a manifestation of systemic diseases like rheumatoid arthiritis. A blood examination could help identify the disease, which can then be jointly treated by the ophthalmologist and rheumatologist. Patients suffering from ocular discomfort and dysfunction, or damaged stem cells in the eye, resulting in scarring and new blood vessel formation, have a very unstable ocular surface. For some cases, stem cell transplantation can provide a solution.
Patients with severe ocular surface damage are advised to undergo limbal stem cell transplantation for the restoration of the ocular surface and the improvement of visual acuity.
A corneal ulcer is an open sore in the cornea. It is usually produced by an infection, commonly bacterial, fungal or viral. The ulcer can either be located in the centre of the cornea and greatly affect the vision or be placed in the periphery and not affect it so much. It causes pain, redness and watering in the eye which can be quite severe. Ulcers frequently require 2-3 months of intensive treatment with eye drops and / or tablets and heal by corneal scarring. If visual loss occurs, this may require corneal grafting later in future. If medical treatment fails; intense suppuration, pus formation ,often ensues, and the cornea can eventually perforate. Hence non healing ulcers may require therapeutic corneal grafting to save the eye.
Injury to the cornea is potentially blinding, and may be minor such as a small superficial foreign body or major, such as acid / alkali burns or penetrating injury. Emergency treatment is mandatory in any kind of injury to the eye. Investigations available in our centre: Corneal topography: Carl Zeiss ATLAS WASCA aberrometry VISANTE ANTERIOR SEGMENT OCT Specular microscopy Ultrasound pachymetry