Articles on eye drop

Common Eye Investigations Explained!

Dr. Quresh Maskati, Ophthalmologist
Pachymetry: Measurement of the thickness of the cornea – a test done to determine if your cornea is suitable for LASIK or collagen cross linkage procedure in patients with keratoconus or conical corneaKeratometry: Measurement of corneal curvature, usually done in the centre of the cornea. This measurement is handy to add to other measurements to calculate amount of LASIK laser required to bring your spectacle number to zero; also one of the measurements required to calculate the Intra-ocular lens power suitable for your eye in case you have a cataract.AS-OCT: Anterior Segment Optical Coherence Tomography. Something like a CT scan of the front portion of the eye. Comes in handy for a variety of diseases of the cornea and anterior segmentUBM – Ultra Biomicroscopy: This is an ophthalmic ultrasound using a special probe, to view in detail structures in the anterior segment, up to and including the crystalline lens of the eye and an inserted IOL. Also useful to examine the angle of the eye (UBM Gonioscopy) to find out if it is narrow, closed or open. This may influence decision making about glaucoma surgery in some cases.B-scan: An ultrasound test to examine structures in the back of the eye, especially if the view of the back of the eye is hampered due to opacities in the normally clear media, such as a cataract or haemorrhage in the posterior compartment(vitreous haemorrhage), so that ophthalmoscopy examination is not possible. Also useful in lesions of the extraocular muscles and any space occupying lesions in the orbit, outside the eye.A-scan: Also called A scan biometry. In this the examiner determines the front to back measurement of the eye using ultrasound. He then feeds in the keratometry reading obtained from the keratometer. An inbuilt computer in the A- scan biometry machine, using one of several complex formulae, then calculate the power of the intra-ocular lens implant required for your eyeOCT: Exactly like the AS-OCT talked about earlier; it gives you colour coded pictures of the back of the eye including individual layers of the retina. Therefore , if there is bleeding into the back of the eye or fluid collection in the retina, the OCT can tell you in which layer of the retina or whether it is just in front of or just behind the retina. It can also measure retinal thickness .This is helpful in planning treatment  in conditions like diabetic macular oedema or monitoring efficacy of intravitreal injections given for wet age related macular degeneration.Corneal Topography: This gives you several ‘maps’ of the cornea; an invaluable tool in assessing suitability of the cornea for LASIK and useful in detection of keratoconus and in fitting of contact lenses. It provides information on the curvature of the cornea at various points of the cornea, the ‘power’ of the cornea etc.Aberrometry: This is often used by the LASIK surgeon in patients unhappy after a successful LASIK – it detects minute flaws called “higher order aberrations” in your eye’s optical system which prevents you from enjoying ‘super’ vision after LASIK. Some LASIK machines which are “wave-front guided” routinely use data from aberrometers to fine tune the LASIK treatment to reduce these aberrations post LASIK surgery.Visual Field Analysis:  Mechanical devices that measured your field of vision were called perimeters. They have been largely replaced by Visual Field Analysers (VFA). These have inbuilt computers for storing and analysing your visual fields. They can compare fields done over a period and analyse whether the patient’s field is worsening or remaining the same. The routine test is a little cumbersome and requires your co-operation, lasting around 30-40 minutes, though for simple screening faster tests are available in the same machine. VFA is ordered in cases of glaucoma both for diagnosis and for judging efficacy of treatment. They are also invaluable in some neurological disorders causing drop in vision like in stroke etc.Fluorescein Fundus Angiography (FFA): In this test a dye, fluorescein Sodium is injected into the vein of your forearm. It takes around 10 seconds for the dye to spread into your retinal vasculature. This can be viewed by the observer using an ophthalmoscope, though more commonly, a digital camera called a fundus camera is used to take multiple photos of the retina shortly after dye injection.Depending on the areas of perfusion (dye seen) or non-perfusion (dye not seen) or leakage of dye from the vessels into the retina, decisions are made in cases of diabetic retinopathy, age-related macular degeneration etc. about whether to do laser or give some injections or treat with medications .HRT/GDX : These are fancy names for computer software in which images of the optic disc and retina are analysed. Accurate measurements are made of optic  nerve size, cup/disc ratio, retinal nerve fibre thickness. This is a useful adjunct to diagnose glaucoma and monitor its progression.Electro-retinography (ERG):  This test is used to find out the function of the retina. This comes in useful when the retina appears normal on ophthalmoscopy but patient has poor vision and also when the retina is not clearly seen due to media opacities. If the ERG is poor or absent, the eye surgeon may decide that the visual prognosis is poor and further surgery to clear the media opacities like a corneal transplant for corneal opacities or a cataract extraction for a mature cataract is not warranted.M-ERG or Multifocal ERG. This is the newest version of the ERG. In this a colour map is generated with the area of maximum cone function (macula) showing a steep elevation while the area with no cones (optic nerve ) showing up as flat and blue in colour. In diseases like macular degeneration, the central hill is considerably flattened, making diagnosis a ‘no-brainer’.Visual Evoked Potential (VEP):  In this test, either a very bright light (Flash VEP) or a checker board pattern is shone into the patient’s eye. The time taken for this to be perceived by the visual area of the brain (situated at the back of the head) and the intensity of the signal is recorded by sensitive electrodes placed at the back of the scalp. This measures the integrity of the visual pathway from the eye right up to the brain. In conditions like optic neuritis, where the optic nerve which carries signals from the eye to the brain is inflamed, the VEP will be reduced. On the other hand, a patient who is feigning blindness will have a normal VEP.Can a person who has undergone one or more of these tests donate their eyes?None of these tests is life threatening. However, it is proved that every patient who undergoes any of these tests will die some day, maybe months, years or decades later! If a patient were to die due to natural or accidental causes years after any of these tests were performed, the author does recommend donation of the eyes!

Primary Eye Care in 7 Emergency Situations

Dr. Manoj Rai Mehta, Ophthalmologist
Many People learn Basic Life Saving skills to save lives and render primary care to the sufferers in emergency situations.  Similarly, there can be "sight saving situations" where timely action can restrict damage and give sufficient time safely to reach a higher centre for further management.1. Sputtering of hot cooking oil into the eyes while frying.Rinse eyes immediately in running cold water or simply dip your head in a bucket full of water to bring down the temperature as soon as possible.  Apply cool patch/ice pack around the lids.  Instil only lubricating drops (if available), gently patch the eyes with a sterile eye pad or clean handkerchief and take the patient to an eye surgeon. 2. Squirting of glue in the eyes.This is not an infrequent occurring with people trying to squeeze tubes that have a blocked nozzle. Immediate action should be to rinse eyes in running water.  Luke warm water around 40 degrees is somewhat more effective.  Put an ointment (lubricant or antibiotic) in the eye, gently cover the eye and take the patient to an eye surgeon.3. Chemical Injury to the eyes (domestic).Diluted Hydrochloric Acid, phenols, diluted caustic soda are some of the common corrosive chemicals found in homes for cleaning purposes.  They are acidic or alkaline in nature. Accidental exposure is not uncommon.  Immediate action is again washing off of the chemical to dilute its damaging effect.  Wash should continue for several minutes before a patient is taken to a medical facility.  lubricating drops, gels, ointments or antibiotic ointment may be applied for relief.Carry the bottle or the container in which the chemical was stored, with a label, in case the exact nature of chemical is not known, it will help the treating doctor in carrying out specific treatment.4. Foreign Body (FB) in the eye (domestic)Foreign bodies of different kinds fall into eyes under various circumstances such as- dusting, blowing dust with a vacuum cleaner, using a screwdriver on rusted components, hammering a nail, splicing cables, cutting wires, gardening or simply going for a ride.  Do not rub the eyes or put pressure as the FB can go deeper into the cornea.  Rinse in running water for a while, cover the eye with a suitable patch and take the patient to a facility.  One can use lubricating drops or antibiotic drops on the way.  No ointment, please.   5.  Soap solution, shampoo, chlorine in water or face creams in the eyesThis is a common issue especially with young children and all it requires is thorough rinsing followed by a lubricating eye drop and some cool compresses.  Creams can be very irritating as they adhere to the cornea and take a while to get washed off.  Chlorine in the swimming pools can also cause a lot of irritation especially on the days when tipping is done.  Preservative free lubricating drops, cold compresses provide relief.    6. Blunt trauma around the eyesAccidental injuries from window panes, friendly boxing or grappling amongst children are also a frequent occurrence.  Apply gentle pressure on the bones to prevent swelling around the eyes and apply a cold patch with pressure.  Take the opinion of a doctor in due course.  At times a blue haematoma may occur after a few days.  Please take an opinion as some blunt traumas around the eyes can lead to retinal oedema (Berlin's Oedema) that needs to be tackled timely to prevent a loss of visual acuity. 7. Penetrating InjuriesPenetrating injuries are seen with pencil tips, pen tips, compass used in geometry, knives, scissors, sewing needles, screwdrivers etc. Do not try to examine the eye forcefully, prise the lids, put pressure on the eye or even touch it. All these actions can result in disastrous outcomes!  Prevent the child from pressing or touching the eye by firmly holding in lap. Patch the eye gently with a clean handkerchief or a sterile pad and reach a facility at the earliest.You may keep a special first aid kit ready with disposable sterile eye pads, clean bandages, one-inch plaster tape, scissors, preservative free lubricating gel drops and gel tubes, antibiotic eye ointment, antibiotic eye drops etc.  A plastic bottle with a bent tube at the opening may be useful for gentle irrigation of the eyes with water.  It is equally important to reduce the risk of injuries at home by keeping potentially harmful chemicals out of reach of children and supervise them when they are using sharp instruments.  Safety always Saves.   

For Your Eyes only...

Dr. Geetanjali Jha, Homeopath
EYE FLU OR CONJUNCTIVITIS.Eye flu or Conjunctivitis is very common during the monsoons. Conjunctivitis is an inflammation of the white part (conjunctiva) of the eyes. Due to inflammation, the blood vessels in the conjunctiva become enlarged, thus giving a red or pink appearance to the eyes.It is a painful condition, sometimes conjugated with the rise in temperature.There are 3 types of conjunctivitis –1) Viral –  Caused by the same virus that is responsible for common cold. It is highly contagious and spreads from person to person. The virus is air born.2) Bacterial – Caused by various types of bacteria. This is also contagious but more easily treated with the help of eye drops and care.3) Allergic –  This is a non–contagious type, as the allergens are unique to each individual. People who have allergic conjunctivitis are generally sensitive to pollen, grass, hay, dust and mites.The most occurring type during monsoon is Bacterial and Viral conjunctivitis.Symptoms and signs –Burning and irritation on eyes.Stinging of eyes.Excessive lacrimation or dryness.Sensitivity to light.Redness of conjunctiva.In later stage, there may be pus-like discharge from eyes.High temperature may be found due to inflammation.Symptoms of a common cold may be found.Myths and facts about conjunctivitis –The biggest myth is that conjunctivitis can be caused by looking into an infected person’s eyes. People, no disease spreads by mere looking. It is just a normal person suffering from eye flu, not Medusa who will turn you into stone. Conjunctivitis is air and contact borne disease.You can contract infection if you are in a swimming pool that is not clean or someone who is already infected with eye flu is also using the same pool. It is a good idea to avoid public pools during monsoons.You will not be infected if you go to a crowded market.Prevention-Do not wear contact lenses if you are suffering from eye flu.Avoid shaking hands, or sharing edibles or drinking cups with an infected person. Towels and handkerchiefs must not be shared either.It is best if the person suffering from eye flu is kept in quarantine , the infection recedes in 3 days to 1 week.If you have visited the market, handled currency notes, or shaken hands with an infected person, wash your hands vigorously for 20 seconds with soap before you touch your face and eyes and before you use your hands to touch your food.Wash eyes with cool water 3-4 times a day during the conjunctivitis season.Homoeopathic prevention Take a clean phial with a dropper, fill it with Rose-water (or distilled water) , add 1 drop of Euphrasia Q and 1 drop of Camphora Q . (1 drop each for 10 ml of rose water or distilled water) Shake the bottle. Use this as an eye drop. Make sure to have separate bottles for each family member. This eye drop can also be used if a person already has eye flu.Homoeopathic medicines for eye flu – Belladonna – The first and foremost remedy for inflammation. It is mostly indicated when there is a complete loss of lachrymation along with other symptoms. A rise in temperature is also seen.Euphrasia – When eyelids appear as if injected or ulcerated and there is excoriating discharge from the eyes. There is extreme photophobia. The patient cannot even bear the little artificial light.Graphites – Intense burning and lachrymation . There may be cracking and bleeding of the eyelids. Ulceration may be found.Home management –Keeping clean and hygienic prevents secondary infection and helps the present infection to go cure soon.Washing eyes with cool water, or applying ice packs at regular intervals. If the patient is uncomfortable with a cold application, steam fomentation may be helpful.Avoid going out of home to prevent further infection.Fight the urge to rub eyes, if there is irritation , use the eye drop mentioned above.Increase the amount of Vitamin C in your diet.Yoga for eye flu –Do at least 10 ujjai breaths, followed by 5 – 10 minutes of naadi shodhan. This process clears the energy channels and boosts vitality which helps you to fight infection more strongly.Bhrastrika pranayam also helps in getting rid of infection soon.*Warning- Self-medication , though sounds easy, may or may not work, because believe it or not, Homoeopaths go through 5.5 years of thorough study and training and only then they are eligible to prescribe medicines. One cannot hope to master that art by merely reading a few blogs or books. SO..in all fairness, the medicines here are tried and tested, but it would not be right to say that this blog is a substitute for a clinic visit. This knowledge may although, help you to rule out different possibilities.

Eye Care in the Monsoon

Dr. Hasanain Shikari, Ophthalmologist
After the heat of the summer, the monsoon is a welcome relief. Yet, the rains bring with them a host of bacteria, viruses and allergens, many of which disturb our delicate eye equilibrium. Let us identify the main eye-related complaints and then establish some easy tips to maintain your eye health this monsoon.Conjunctivitis, also known as pink eye, is the inflammation of the outermost layer of the white part of the eye and the inner surface of the eyelid. This can be caused by irritants like dirt, bacterial or viral infections or may be allergic.Eye Allergies are also known as allergic conjunctivitis.  These are non-infectious and may be seasonal. It leads to red, watery or itchy eyes.Stye (Sty) is usually recognized as a “pimple” on the eyelid. Its an inflamed swelling on the edge of the eyelid and is usually due to bacterial infection.Personal hygiene is important. Prevention is better than cure!Some Eye Care Tips- Keep your eyes clean. Do not rub your eyes with dirty hands, or rather, do not rub your eyes at all.- Maintain hygiene. Wash your hands frequently. Wash your eyes with cold water 2-3 times a day.- Do not share personal items like towels with anyone.- Wear sunglasses to protect your eyes, especially while traveling.- Avoid getting wet in the rain or swimming in the monsoon. This can aggravate existing eye inflammation.- Eat healthy foods. This should include fresh fruits and vegetables. Anti-oxidants will boost your immune system.- Do not self-medicate or use medications given by pharmacists.Go for an eye check-up to an eye specialist if you have symptoms.Healthy diet, healthy body

5 Easy Ways to Reduce the Redness of the Eyes

Dr. Manoj Rai Mehta, Ophthalmologist
Redness of eyes is an important clinical sign of many underlying clinical problems that can be grouped under the following heads:InfectionsAllergiesImmunoinflammationsForeign Bodies on the surface of the eyeDry Eye Disease, Ocular fatigueThe increase in the pressure of the eyes etc.Needless to say that the Primary Cause of redness needs to be addressed in order to reduce the redness of the eyes.   However, there are a few tips that can give additional relief to a patient and also increase the effect of other medications and sometimes reduce the frequency as well.Clean eyes in running tap water or filtered water. It should be cool, not cold. Temperature around 20 degrees is most comforting.Use shades when going out in the open. Ultra Violet light absorbing glasses are most suitable.  Polarised lenses may be used to reduce glare in the case of glare intolerance.  Full face helmets while riding two wheeler vehicles is recommended.  Keep the air con going for a minute before you enter a car and pull up all the windows while riding.  Always wash air con condenser tubes under pressure every morning when a car is being cleaned.    Cold compresses help soothe eyes. The cool  patch may be put over the eyes after cleaning them in running water.  Cucumber slices may be placed over the eyes or ice cubes in small polythene bags may be used instead.  Avoid ice cubes wrapped in cloth as it increases swelling due to hypotonic water entering the eyelids.  Some people like to keep a moist tissue paper over the face with eyes closed and an even clean cloth soaked in water with a few drops of Eu de cologne for cooling.    Environmental Management. This accounts for half the part of managing a patient.  The ambient temperature of 24 to 26 D Celsius and a relative humidity of around 62% gives a comfortable environment and reduces redness. Avoid direct flow of air to the eyes as it increases evaporation losses. Avoid use of room fresheners sprays, mosquito repellent fumes and smoke, carpet cleaning shampoos etc in the presence of people having red eyes.  Vacuum cleaning along with air exchanges is important to reduce chemical and particle load.Lubricating Eye DropsOnly "Preservative Free" lubricating drops may be used and they are available OTC.  Astringent, blanching drops may not be used without doctor's approval as they can cause a rebound increase in redness of the eyes.  Keep the eye drops on the door side in a refrigerator.Always discuss the primary disease thoroughly with your doctor before taking any liberty of using any of these tips.

Glue-Coma or Glaw-Coma? What Is This Glaucoma?

Dr. Aravind P. M., Ophthalmologist
6-12 March is World Glaucoma Week and it is observed around the world to increase awareness about this silent disease of vision. Let us know a little more about this condition.How do I pronounce ‘Glaucoma’?The word is pronounced “glaw (rhymes with claw and flaw) – koma (as in coma)”Is it one disease? Actually Glaucoma is a group of eye diseases which have one thing in common - increasing eye pressure and progressive damage to the optic nerve.What is this Eye pressure? Is it the same as Blood Pressure? The eye also maintains its pressure. It varies between 10 and 20 mmHg in most eyes. It is different from Blood Pressure.What is the Optic nerve? The optic nerve transmits images from the eye to the brain just like your TV cable. And we know how damage to your cable can result in poor picture quality.Can I get Glaucoma? Glaucoma can affect any person regardless of age, gender, economic status, and personal habits. Some risk factors increase the possibility of developing glaucoma. These are-People who wear high minus or plus spectacle power - High Myopia and HypermetropiaPeople who are on oral steroid medication or steroid dropsThose who have suffered an eye injury (especially with balls or shuttlecocks)Anybody with a close family member diagnosed with glaucomaHow is Glaucoma diagnosed?Glaucoma is detected by specific tests done by your eye doctor. The most common test is recording the eye pressure. It can be done painlessly with specific pressure recording devices.We usually record eye pressure for all patients who come for an eye examination(We may not do it for children who find it difficult to cooperate or if one has an eye infection)The other common test is a fundus exam. The eye doctor uses an ophthalmoscope to shine light inside your eye and examines the optic nerve.  Dilatation of the pupil with drops may be necessary to further examine the eye in detail.A more specific test is the computerised Visual Field test done to locate the areas of visual loss due to GlaucomaAn advanced test called OCT may also be needed to obtain more detailed information about the status of the optic nerve.I get my eye power checked regularly in an Optical shop. Will I be safe from Glaucoma?Optical shops check only your eye power and spectacles. They do not screen you for Glaucoma or any other eye disease. Only a qualified ophthalmologist should screen you for Glaucoma.What does Glaucoma cause? Why is it a silent thief?Imagine yourself driving your vehicle on the road looking straight ahead. If a big water tanker drives up by the side to overtake you and you don't notice it till it comes really close - wouldn't you be startled? Well, what saves your skin most times is your peripheral vision which lets you notice people, vehicles or obstacles even without turning your head. Glaucoma affects this peripheral vision and slowly destroys it without your knowledge. Glaucoma doesn't cause pain, redness, watering or blurring of your central vision until the very last stages of the disease. Treatment of the disease at its end stage is not only very difficult but also at times, futile.My relative suffered from Glaucoma once and she had pain, a red eye, and headache with nausea. How do you say it is without any symptom?As told previously, Glaucoma is a group of diseases. One form can manifest with intense pain and headache. Such symptoms force an individual to seek a doctor early. So the concern is for the painless form of Glaucoma which needs timely diagnosis and management.Is Glaucoma treatable? Will I lose my sight completely if I have it?Glaucoma is a treatable condition. Now a number of excellent pressure-controlling eye drops are available which can halt the progress of the disease. Some other forms of treatment like LASERs and surgery may also benefit certain individuals with Glaucoma. If diagnosed early and treated promptly Glaucoma can be treated effectively and vision preserved

How Do I Behave When I Am Undergoing Cataract Surgery?

Dr. Manoj Rai Mehta, Ophthalmologist
Cataract Surgery nowadays is usually performed under 'topical anaesthesia' that involves instillation of drops of the anaesthetic agent on the eye surface.  The patient retains the power to close the lids and move the eyeball during surgery, feel no pain but touch and pressure sensations are unaffected.  A peribulbar block anaesthesia may be used at times on surgeon's discretion that involves an injection of anaesthetic agent around the eyeball with a short needle.  This takes away lid and eye movements to a large extent but some control may remain with the patient.     Operating Surgeon expects the patient to follow the instructions for a smooth surgery.  It is important to have a surgical counselling session with the doctor to understand the procedure and expected sounds/conversation during the operative procedure.  The sequence of events should be understood and played in your mind while you move through the surgical suite.You should be wearing loose, comfortable hospital pyjama suit.  Do not hesitate to change it if it is tight around your neck.  Some hospitals have the policy to allow you to wear your own loose clothes and give you a hospital gown over them.  Please ensure you are not wearing tight fitting clothes and your neck is free.  Ladies to tie their hair in a ponytail with a band or a soft bun with no clips or claspsSit quietly in the pre-operative area and use the washrooms before going to the OR.  You may take sips of water if your mouth feels dry but do not hydrate yourself too much.You may be given a cap and eye marked for surgery.  The antiseptic solution will be painted around the eye.  Let the solution dry and do not touch your eye. OR assistant will help you lie down on the OT table with a rubber ring under the head to prevent rolling from side to side. You should be comfortable and be able to breathe rhythmically while lying down.  Ask for a head raise if neck extension is hurting you and get the ring adjusted to your comfort and if it is hard for you to ask for a softer ring.When you are comfortable allow the staff to put monitoring devices which could be a pulse oxygen meter alone or additional cardiac electrodes.  Breath rhythmically and try to relax.Sterile Drapes will be placed around your head and an adhesive eye drape on the eye to be operated upon.  Please maintain your head in a position as required and adjusted by the surgeon.  Do not move your head or lower your chin.  The surgeon works under a microscope and any movement shifts the focus and obstructs in smooth surgery.There will be several sounds in the OR that you should ignore-beep of monitors, hum of air circulation unit, trolley wheels, the doctor would be giving instructions to staff and asking for instruments etc.  Try to keep your attention focused towards surgery only.Coughing and snorting during surgery can create complications, always ask the surgeon to stop the surgery if you feel like doing so.  Do not try to suppress a cough or sneeze by holding breath.  Do not bear down or move.Follow instructions of a surgeon and do not start a conversation. Answer only when a question is directed towards you.  The surgeon may ask you to look in a particular direction.  You have to follow the command by moving your eyes and not head unless the specific instruction is made. The first touch of the instrument will increase your confidence.  Do not wince, squeeze your lids or make a jerky movement if you feel some pain.  Inform the doctor, who will reinforce anaesthesia.Cataract Surgery machines also produce different types of sounds during different phases of surgery and also have synthesised verbal outputs.  Do not get distracted by the same.You will see movements in front of the eye during surgery and also perceive vibrations.  Light intensity will increase towards the end of surgery.  A calm patient who is having a regular rhythmic breathing and a regular normal pulse rate makes a surgeon's job easy.(In case of specific problems additional monitoring and specialised anaesthetic cover may be required which the operating surgeon will discuss before hand).               

7 Golden Rules for Healthy Eyes & Sight

Dr. Manoj Rai Mehta, Ophthalmologist
7 Good Office Habits Read and Write while sitting in a comfortable chair with a straight back and neck and a lumbar support if required.  Your hip and knee joints should bend at 90 degrees.There should be adequate direct light falling onto your books and papers coming from the front or right to left (when writing/reading in scripts that move left to right).  This prevents shadows falling on the text to be read or written.No light should be coming towards the eyes directly as it causes glare and makes it difficult to read and write.  The room should have diffuse background light and focused light at the work table.Working distance should be generally kept between 30 and 50 centimetresTop end of the computer or laptop screen should be in the line of your eyes while you are sitting erect in your seat.  you should not be looking up or down.  The ergonomic arrangement is important.There should not be any reflections on the computer or laptop screen.  No windows or light bulbs in the background, please.  Wall with matt finish paint in the background is most appropriate. Take regular breaks from near work.  Reach into an open space with fresh air; walk 20 paces, take 20 large breaths, blink completely 20 times and look beyond 20 feet.  Thus refresh yourself and get back to work. Lubricant eye drops may be used, preferably preservative free.      7 Good General HabitsRegular daily routine with adequate hours of sleep.  Sleep in a darkened room, light filtering through eyelids does not give  a restful sleep.Rinse your eyes in running water or filtered water before going off to sleep a dafter getting up in the morning.  Wash your hands thoroughly and use cup your hand to hold water and dip an eye into it and open lids.  Repeat a couple times with each eye for effective cleansing.Do not use "surma" or "kajal" on the inner side of the lid margin.  Never share kohl pencils or any makeup items that are used around eyes.Balanced diet that provides sufficient daily requirement of Vitamin A is important.  The daily requirement varies at different stages of life.  Supplementation may be required if dietary insufficiency is detected.  Food items rich in Vitamin A are - sweet potatoes, carrots, dark green leafy vegetables, tomatoes, dried apricots, tropical fruits (such as Mango), fish, liver meat etc.Avoid using eye drops from a bottle 15 days after opening and discard them when not required.  Do not try to store them in the refrigerator for future use.  Keep eye drops away from makeup area where talcum powder, perfumes etc are kept.  Keep the bottle cover on and do not touch the opening of the dropper.  Always discard first few drop of medicine when you start instilling eye drops from a bottle the next day.Remove your contact lenses immediately in case of redness, glare, frank discharge, excessive watering from the eyes, smarting or pain.  Do not ignore these signsIn case a foreign body falls in an eye, do not rub the eye or try to remove with a piece of cloth, cover it with a clean cotton pad or a sterile eye pad and report to an eye surgeon.   

"Oh God! I Have Been Diagnosed with Cataract!"

Dr. Manoj Rai Mehta, Ophthalmologist
When a patient is diagnosed to have cataract the following questions pop up immediately:Is it unusual at this age?Can it be cured with medication of any sort?Is the surgery a must?  What if I do not get operated?How long can the surgery be avoided?  Cataract is the commonest cause of gradual, painless, progressive diminution of vision in middle-aged and old people.  The reaction of a patient varies from utter shock, disbelief to acceptance and discussion of further treatment.Why Me?     While cataract is known to occur at all ages and even congenitally, it is the senile, age-related, a cataract that is the commonest in prevalence.  People get cataract at different ages depending upon familial trends and associated systemic illnesses and exposure to certain light frequencies.  Diabetes (and other metabolic afflictions), steroid intake and exposure to Ultra Violet light cause early cataract formation.  Trauma to the eye also causes cataract formation. Why does vision decrease?The normally transparent crystalline lens of the eye becomes translucent and some areas turn opaque, thus causing scattering of light as well as a blockage.  Location of opaque areas also matters as central changes affect vision much earlier than those in the periphery.  Opaque areas close to the nodal point of the lens will affect vision profoundly even if small in size.Is there a medical cure available?In spite of tall claims no medical treatment has been established scientifically beyond doubt till now. Anecdotal claims do not satisfy scientific hypothesis.  Use of antioxidants may retard the progression of cataract as a general anti ageing effect.  Avoid using eye drops of unknown composition and dubious sources in the name of magical cures!  They may cause more harm than benefit.What is the "Right Time" for surgery?It depends on upon the lifestyle, profession and visual needs of a patient.  It is ordinarily an elective surgery and a patient should discuss all the elements of procedure and care with the surgeon and decide on the timing of surgery.  Surgery is aimed at improving "quality of life".  Glare, difficulty in driving and reading are some of the things that can affect the quality of life of a person and surgery is expected to alleviate them.  A driver, an IT professional, an avid golfer may choose to undergo surgery at an earlier stage than a person who does not drive and read much.Gone are the days when patients used to wait for the cataract to mature! Surgery time is decided after a mutual discussion on outcomes and QOL targets.  Surgery should not be postponed for long in case of advanced cataracts as they turn harder with time and surgery becomes more challenging. There are situations when surgery can not be postponed such as a swollen lens causing a rise in pressure or a leaky lens causing inflammation.Cataract surgery is one of the most gratifying surgical procedures and safest as well.  Do not get scared, discuss the goals of surgery and take a cool decision.