Articles on ophthalmology

Most Important Questions Regarding Spectacle Removal Surgery (Lasik)

Dr. Vishal Arora, Ophthalmologist
1. WHAT IS LASIK? HOW IS IT PERFORMED?LASIK or laser-assisted in situ keratomileusis is procedure commonly used for removal of spectacle number (Glasses) of the patient. The surgery is done on the cornea which is the outermost clear part of the eye. A flap is created as a part of the process followed by laser delivery on the cornea to remove the glass number. The flap is positioned back at the end of the procedure. 2. WHAT OCULAR CONDITIONS OR DISORDERS CAN BE EFFECTIVELY TREATED BY LASIK?LASIK is most commonly performed for Myopia (Negative spectacle power) and its variants like High Myopia, Myopic astigmatism (patients with cylindrical glass power), Anisometropia (difference in glass power of both eyes).LASIK can also be done for Hypermetropia (Positive spectacle power), Off  late it has been increasingly done for presbyopia(Age related positive power beyond 40 years of age.)3. HOW SAFE IS THIS PROCEDURE ? WHAT ARE THE SUCCESS RATES WITH LASIK TREATMENT FOR REFRACTIVE  ERRORS?LASIK is one of the most evolved procedures in ophthalmology today. It has been more than 20 years since first procedure was done. It’s SAFE and EFFECTIVE in patients who want to get rid of their glasses. (http://www.ncbi.nlm.nih.gov/pubmed/21946784)4. HOW DO YOU DECIDE WHETHER A PARTICULAR PATIENT IS FIT FOR LASIK OR LENS?I follow a very strict criteria for my patients undergoing LASIK (I reject 4 out of 10 cases)The criteria are Expectation: the expectations of the patient should be realisticStability: the glass number should be stable over a period of 6 months to 1 yearCorneal Thickness:the corneal thickness should be adequate so that the procedure can be done safely. The cornea should be disease free.Retina: Patients with retinal diseases need treatment for the same before proceeding for LASIKIn patients who don’t  have adequate corneal thickness a procedure called ICL is done in which a thin lens is implanted in front of the natural lens.5. WHAT SHOULD A PATIENT EXPECT BEFORE AND AFTER LASIK SURGERY?The expectation of the patient before the procedure should be realistic. Most patients who wish that their number should never come back should consider that it took 20 + years for the number to develop and expecting the doctor to predict that it will not come is unrealistic. But if the number has remained stable and all above mentioned criteria are met there is less than 1 % chance that it will come back.After LASIK one can resume normal activities from day 1. Eye rubbing and swimming should be avoided for at least one month.6. WHAT ARE THE POSSIBLE COMPLICATIONS OR RISKS ASSOCIATED WITH LASIK SURGERY?LASIK is one of the safest and most rewarding surgery. The patient starts seeing from day 1 post surgery. Dry eye is most common and can be controlled with eye drops. Other complications like Regression of number, Ectasia can also occur.

"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.   

Why Is My Child Getting Recurrent Eye Lid Infections?

Dr. Manoj Rai Mehta, Ophthalmologist
Recurrent lid infections can be disturbing to the children as well as the parents.  From a small stye to a full blown cellulitis of the lid with pus formation (suppuration) can occur.  Associated pain, fever and redness of eyes can keep child away from school as well as play.Infection is acquired through contaminated hands that take bacteria to the eye lids in normal course when the lids are touched or scratching of itchy lids.  It is, of utmost importance, to teach hand hygiene and hand sanitation to children.Its a reality that infections spread faster during rainy season.  The bacteria survive relatively longer on moist surfaces and warm temperatures.  Humid rainy season provides that opportunity.  Infection may be spread by touching door nobs, school desks, sharing toys, pencils, other objects or even by the handlers and care givers.A popular myth is that recurrence occurs seven times.  There is no substance in this view.  Some people put overnight saliva on the lids which is an extremely insanitary and horrendous practice, please do not even think of it.  Saliva carries many bacteria and may aggravate the infection.A small fraction of children with recurrent infections of eye and elsewhere turn out to be pre- Diabetic or Diabetic as well, especially if there is a family history of Diabetes.Please take opinion of your eye surgeon as systemic antibiotics are required in most cases.  The infection is generally at the root of an eye lash or a gland.  Associated conjunctivitis may require topical drops as well. Dry cold/warm fomentation as an adjunct helps.   Vital Message:  Good Hand Hygiene (sanitise hands regularly)Good Local Hygiene (rinse eyes in running water before and after going off to sleep)

Healthy Eyes

Dr. Hemant Patel, Ophthalmologist
Eyes are the windows to the beautiful world around us. Therefore, healthy eyes are a part of a happy life. They enable us to enjoy our beautiful world. There are few simple steps by which you can make sure that you have healthy eyes and clear sight in your golden years. 1. Healthy DietYou can help maintain good eye health and potentially prevent some troubling eye conditions by having food rich in vitamins & antioxidants. Studies have shown that antioxidants and nutrients that are linked to a lower risk of common eye conditions include lutein, omega-3 fatty acids, vitamins C and E, which are plentiful in following food items:• Carrots, green leafy vegetables such as spinach and kale• Nuts, beans, eggs and other non-meat proteins such as soy• Dark pigment fruits such as blueberries, blackberries, strawberries, cherries and grapes• Citrus fruits and juices• Cold-water fish like salmon, tuna and other oily fish 2. Quit SmokingSmoking is injurious to the entire body. It causes eye damage by producing oxidative stress to eye tissues & makes you susceptible to developing macular degeneration, hasten the progress of development of cataracts and can cause optic nerve damage.3. Protect your eyesIt is important to protect our eyes from hazardous things around us. Most prevalent things around us are pollution and ultraviolet rays of sun. Wear protective glasses to prevent exposure to dust, smoke and UV radiation. Have your AC vent direct away from your eye to prevent dryness & direct wind exposure. 4. Follow proper eyecare guidelinesDo follow eye care practices at your work place. If you are using computers or other digital instruments then follow the 20-20-20 rule: Simply rest your eyes every 20 minutes by looking 20 feet in front of you for 20 seconds. This will prevent blurring of vision, dry eyes & headaches. If your workplace is too hot or has exposure to flying particles then do use protective wear.Don't self-medicate your eyes. Don't use medications available over the counter. Don't use drops available for 'REGULAR USE'. Nature has provided us with tears as a protective mechanism, so don't put drops without any indication. 5. See your Eye Specialist regularlyIt is the best way to maintain the health of your eyes. It is not necessary to have unhealthy eyes to visit an eye specialist. Have routine yearly eye check-ups to diagnose any developing disorders. Have regular vision checkups, even if you are having clear sight, especially people having Diabetes, Hypertension, Dyslipidemia & a Family History of eye diseases. 6. Take care of your overall healthExercise also helps to maintain a healthy weight. Being overweight increases your risk of developing diabetes and other systemic diseases, increasing chances of having major eye diseases.

Cataract

Dr. Rajesh Babubhai Shah, Ophthalmologist
 Practice ManaCATARACTSWhat Are Cataracts?Cataract SymptomsWho Is at Risk for Cataracts?Cataract CausesCataract DiagnosisCataract TreatmentCataract SurgeryIOL Implants: Lens Replacement and Cataract SurgeryCataract Vision SimulatorCataract Pictures and Videos: What Do Cataracts Look Like?IOL Implants: Lens Replacement and Cataract SurgeryWritten by: Kierstan BoydReviewed by: Elizabeth Yeu MDMar. 01, 2016Before intraocular lenses (IOLs) were developed, people had to wear very thick eyeglasses or special contact lenses to be able to see after cataract surgery. Now, with cataract lens replacement, several types of IOL implants are available to help people enjoy improved vision. Discuss these options with your Eye M.D. to determine the IOL that best suits your vision needs and lifestyle.Cataract lens replacement: How IOLs workLike your eye's natural lens, an IOL focuses light that comes into your eye through the cornea and pupil onto the retina, the sensitive tissue at the back of the eye that relays images through the optic nerve to the brain. Most IOLs are made of a flexible, foldable material and are about one-third of the size of a dime. Like the lenses of prescription eyeglasses, your IOL will contain the appropriate prescription to give you the best vision possible. Read below to learn about how IOL types correct specific vision problems.Which lens option is right for you?Before surgery your eyes are measured to determine your IOL prescription, and you and your Eye M.D. will compare options to decide which IOL type is best for you, depending in part on how you feel about wearing glasses for reading and near vision.The type of IOL implanted will affect how you see when not wearing eyeglasses. Glasses may still be needed by some people for some activities.If you have astigmatism, your Eye M.D. will discuss toric IOLs and related treatment options with you.In certain cases, cost may be a deciding factor for you if you have the option of selecting special premium lOLs that may reduce your need for glasses.Intraocular lens (IOL) typesMonofocal lensThis common IOL type has been used for several decades.Monofocals are set to provide best corrected vision at near, intermediate or far distances.Most people who choose monofocals have their IOLs set for distance vision and use reading glasses for near activities. On the other hand, a person whose IOLs were set to correct near vision would need glasses to see distant objects clearly.Some who choose monofocals decide to have the IOL for one eye set for distance vision, and the other set for near vision, a strategy called "monovision." The brain adapts and synthesizes the information from both eyes to provide vision at intermediate distances. Often this reduces the need for reading glasses. People who regularly use computers, PDAs or other digital devices may find this especially useful. Individuals considering monovision may be able to try this technique with contact lenses first to see how well they can adapt to monovision. Those who require crisp, detailed vision may decide monovision is not for them. People with appropriate vision prescriptions may find that monovision allows them see well at most distances with little or no need for eyeglasses.Presbyopia is a condition that affects everyone at some point after age 40, when the eye's lens becomes less flexible and makes near vision more difficult, especially in low light. Since presbyopia makes it difficult to see near objects clearly, even people without cataracts need reading glasses or an equivalent form of vision correction.Multifocal or accommodative lensesThese newer IOL types reduce or eliminate the need for glasses or contact lenses.In the multifocal type, a series of focal zones or rings is designed into the IOL. Depending on where incoming light focuses through the zones, the person may be able to see both near and distant objects clearly.The design of the accommodative lens allows certain eye muscles to move the IOL forward and backward, changing the focus much as it would with a natural lens, allowing near and distance vision.The ability to read and perform other tasks without glasses varies from person to person but is generally best when multifocal or accommodative IOLs are placed in both eyes.It usually takes 6 to 12 weeks after surgery on the second eye for the brain to adapt and vision improvement to be complete with either of these IOL types.Considerations with multifocal or accommodative IOLsFor many people, these IOL types reduce but do not eliminate the need for glasses or contact lenses. For example, a person can read without glasses, but the words appear less clear than with glasses.Each person's success with these IOLs may depend on the size of his/her pupils and other eye health factors. People with astigmatism can ask their Eye M.D. about toric IOLs and related treatments.Side effects such as glare or halos around lights, or decreased sharpness of vision (contrast sensitivity) may occur, especially at night or in dim light. Most people adapt to and are not bothered by these effects, but those who frequently drive at night or need to focus on close-up work may be more satisfied with monofocal IOLs.Toric IOL for astigmatismThis is a monofocal IOL with astigmatism correction built into the lens.Astigmatism: This eye condition distorts or blurs the ability to see both near and distant objects. With astigmatism the cornea (the clear front window of the eye) is not round and smooth (like a basketball), but instead is curved like a football. People with significant degrees of astigmatism are usually most satisfied with toric IOLs.People who want to reduce (or possibly eliminate) the need for eyeglasses may opt for an additional treatment called limbal relaxing incisions, which may be done at the same time as cataract surgery or separately. These small incisions allow the cornea's shape to be rounder or more symmetrical.Protective IOL filtersIOLs include filters to protect the eye's retina from exposure to UV and other potentially damaging light radiation. The Eye M.D. selects the filters that will provide appropriate protection for the patient's specific needs.Other important cataract lens replacement considerationsIn some cases, after healing completely from the cataract lens surgery, some people may need further correction to achieve the best vision possible. Their ophthalmologist may recommend additional surgery to exchange an IOL for another type, implant an additional IOL, or make limbal relaxing incisions in the cornea. Other laser refractive surgery may be recommended in some cases.People who have had refractive surgery such as LASIK need to be carefully evaluated before getting IOLs because the ability to calculate the correct IOL prescription (PDF 650K) may be affected by the previous refractive surgery.Additional cataract information resourcesIf you're interested in learning more about cataract from the ophthalmologist's perspective, follow the link below to read American Academy of Ophthalmology practice guidelines for clinicians.American Academy of Ophthalmology Preferred Practice Pattern: Cataract in the Adult EyePreviousCataract SurgeryNextCataract Vision SimulatorRelated Ask an Ophthalmologist AnswersDid my six-month glutathione deficiency cause my cataracts?MAY 01, 2016Why has my near vision gotten worse since my cataract surgery two weeks ago?APR 26, 2016Are penicillin and clindamycin used in the antibiotic eye drops prescribed after cataract surgery?APR 21, 2016Which precautions should a diabetic patient take after cataract surgery?OCT 05, 2015Posterior Capsulotomy and TASSAUG 31, 2015Leer en Español:Reemplazo de Lente y La Cirugía de las CataratasSelect LanguageAfrikaansAlbanianAmharicArabicArmenianAzerbaijaniBasqueBelarusianBengaliBosnianBulgarianCatalanCebuanoChichewaChinese (Simplified)Chinese (Traditional)CorsicanCroatianCzechDanishDutchEsperantoEstonianFilipinoFinnishFrenchFrisianGalicianGeorgianGermanGreekGujaratiHaitian CreoleHausaHawaiianHebrewHindiHmongHungarianIcelandicIgboIndonesianIrishItalianJapaneseJavaneseKannadaKazakhKhmerKoreanKurdish (Kurmanji)KyrgyzLaoLatinLatvianLithuanianLuxembourgishMacedonianMalagasyMalayMalayalamMalteseMaoriMarathiMongolianMyanmar (Burmese)NepaliNorwegianPashtoPersianPolishPortuguesePunjabiRomanianRussianSamoanScots GaelicSerbianSesothoShonaSindhiSinhalaSlovakSlovenianSomaliSpanishSundaneseSwahiliSwedishTajikTamilTeluguThaiTurkishUkrainianUrduUzbekVietnameseWelshXhosaYiddishYorubaZuluPowered by TranslateFind an OphthalmologistAdvanced SearchAsk an OphthalmologistBrowse AnswersFREE NEWSLETTERGet ophthalmologist-reviewed tips and information about eye health and preserving your vision.Privacy PolicyRELATEDPet Fish Fitted with Fake Eye in Rare ProcedureJUN 30, 2016Firework Blinds Teenager, Severs HandJUN 29, 2016Ethnicity and Eye Disease: A Risk Reminder for Asian-, African- and Latino-AmericansAPR 26, 2016Vitamin See: Foods Rich in Vitamin C Help Curb CataractsMAR 28, 2016Los Alimentos Ricos en Vitamina C Ayudan a Controlar el Desarrollo de CataratasMAR 28, 2016Follow The Academy Professionals:        Public & Patients:   Contact UsAbout the AcademyJobs at the AcademyFinancial Relationships with IndustryMedical DisclaimerPrivacy PolicyTerms of ServiceFor AdvertisersFor MediaOphthalmology Job Center© American Academy of Ophthalmology 2016OUR SITESEyeWikiInternational Society of Refractive SurgeryMuseum of Vision

How Can I Pass a Test for Colour Blindness?

Dr. Manoj Rai Mehta, Ophthalmologist
It comes as a total surprise to many people when they are found to have a deficiency or defect in colour recognition.  The frequent protestations are- I am perfectly healthy, I have had no eye problem ever, I can drive normally and have had no difficulty in my daily work so far!  The list is endless.Colour perception is unique to primates and most developed in Humans.  We are able to differentiate between various wavelengths in the visual spectrum and have given them specific names as well. The rainbow spells our classification violet, indigo, blue, green, yellow, orange and red (VIBGYOR). There are innumerable hues in between the different colours that we perceive and enjoy the beauty of nature.  We do not perceive wavelengths outside the visual spectrum.Light and Dark perception is universal in animal kingdom.  While vision is a complex psycho-optical function, it starts at the retina of the eye from special cells that receive light and process it. They are called photo receptors and are characterised by unique shapes- Rods ( for light perception) and Cones (for colour perception).  There are cones are specific to each primary colour-Red, Green, Blue primarily.Defect in the function of cones related to a specific colour create colour deficiency or defect popularly called 'Colour Blindness'. Colour Blindness is a genetically transmitted character and is linked to female chromosome in a recessive way.  Women carry the defect but it is the males who are affected.  Rarely a woman can also be affected but the probability is very low. A man found to have colour blindness may have male cousins from mother's side affected as well.There is no problem in routine functions as colour identification is a learnt behaviour. They identify but do not perceive the way a normal person does. It is unmasked while doing complex tasks requiring matching of colours and hues and sorting coloured objects.  A person may never be diagnosed of colour deficiency, though defects are easier to catch.No person can 'learn' or 'practice' to pass a colour deficiency test.  The most commonly used screening test is ISHIHARA charts that come in a booklet.  Many people try to remember page number or practice a numeral that is seen to a normal person, well it is of little use.  a doctor will check pages randomly and the patterns are different in different books. Test are carried out at multiple levels and increasing sensitivity beyond the charts for specific jobs and fluke chance may not favour again.There are so many jobs that do not have colour vision as a mandatory physical fitness parameter. There is no reason for despair as you can choose a profession and achieve great heights by putting in hard work.   

Refractive Errors In Children

Dr. Brijinder Singh Rana, Ophthalmologist
Refractive error is the most common cause of visual impairment in children. Visual impairment can have a significant impact on a child’s life in terms of education and development. It is important that effective strategies be developed to eliminate this easily treated cause of visual impairment.Children with such errorsFind difficulty in reading, writing and have difficulty to see distanceEye strain while reading for long or shrink eyes to see at a distanceMay have squint (crossed eyes)May hold book close while readingIn addition to the above condition,Child may rub the eyes or blink frequentlyHeadache in forehead regionRecurrent swelling in the eyelidsCorrection using the spectacles is the best option available .Though children may initially refuse to accept glasses, They will become fond of them once they realize they can see better with them on. The power of glasses may change depending on the growth of eyeballs. An eye checkup and change of glasses if necessary, has to be done once six months for children less than 5 years of age and once a year thereafter.Making a child wear glasses regularly is the duty and responsibility of the parents. Failure to wear glasses in childhood will retard the development of vision in that eye. Children older than 15 years can use contact lenses, if they don’t want spectacles. Those over 18 years of age with stable power have option of going in for lasik.“HELP YOUR CHILD SEE THE WORLD BETTER.WEARING GLASSES IS NOT A STIGMA”

Spectacle Numbers Rising Like Inflation? Stop Committing These Mistakes Today

Dr. Vivek kumar jain, Ophthalmologist
It is a regular day and you have a same routine to follow except that in the evening you have an appointment with your ophthalmologist. Your annual check-up was not due, but lately you have started noticing that you have frequent headaches. Even wearing your glasses all the time does not ease the pain, so much so that sometimes you have to strain to see things clearly. The doctor tells you that your spectacle number has increased and you need a new pair of glasses. But you just changed your glasses few months back for the same reason!This might be happening because of grave mistakes that you might be committing unknowingly on a daily basis. Identify these errors and stop them today!● Outdoor time- It is important for children as well as adults to spend quality time in outdoor activities in which there is a necessity to focus on distant objects like riding a bike, playing football, tennis etc.● Limit indoor activities, like watching television, playing cards, and surfing oncomputer, as much as possible because these strain your eyes due to theconstant close distance that limits your eye movements.● Avoid using tablets, laptops, iPad, etc., in darkness, as the eyes have tostrain much more while adjusting to the darkness.● Do not read in a moving vehicle because it stresses out your eyes faster.● If you have spectacles, make it a habit of wearing them on daily basis, as not wearing glasses also exerts strain on your eyes when you have to focus on objects, both near and far.● If you are using lenses instead of spectacles, do not wear them for prolonged duration, as they may cause dryness and can be very harmful.● If your job requires you to work on computer screens for long hours, take breaks at regular intervals, do eye exercises in between, you can even put up a transparent shield on the computer screen so that your eyes are not exposed to direct UV rays from the screen or you can even wear glasses with no number to prevent the same. Remember 20-20 rule for computer users.● Finally, a healthy diet is a key to almost all human health issues; the same holds true for healthy eyes too. Have a diet that is rich in beta-carotene,like carrots, mangoes, papayas, as it helps the retina to work smoothly.Green leafy vegetables, like spinach, kale, collard, etc., are rich sources of antioxidants, such as lutein and zeaxanthin, which are good for eyes. Eggs,whole grains, citrus fruits and berries, nut and legumes are good sources of vitamins that have positive effects on eyes.So make these few changes in your lifestyle that will assist you in maintaining optimum health of your eyes and also prevent your spectacle numbers from inflating like the stock market figure you are staring at.

The 5 Myths About Eye Testing in Children

Dr. Siddharth Kesarwani, Ophthalmologist
Myth 1. All Children are born with normal eyes and all eye diseases start later in life.Truth: This is what most parents assume. Most Children are born with normal eyes. However some babies have problems in one or both eyes right at birth and unless detected in time, are likely to affect vision. All babies should get eye screening immediately following birth.Myth 2. Children should get eye checkups only when they complain of eye strain or headache or inabilty to see.Truth: Most small children with eye problems never complain of any symptoms. Infact they can appear to be leading a normal life inspite of having poor vision in one or both eyes. They need to be routinely checked at 1 year, 3 years and 5 years to detect any issues with vision and eye development.Myth 3. My child does not know how to read. How will the doctor test his eyes?Truth: Children off all ages right from infancy  can undergo a detailed eye check up. There are many different ways of testing vision in small children who cannot read.Myth 4. Me and my spouse do not have any eye problems, so our child doesn't need any eye testTruth: All children irrespective of positive family history of eye diseases need periodic eye check ups. Although it is true that children whose parents have eye problems have a higher risk of having the same problem, but, ant child can have the same eye problem.Myth 5: Eye testing is painful for the child and child wont co-operate.Truth: Pediatric ophthalmologists are trained to handle children delicately and will ensure that the experience is pleasant for the child. The pediatric eye clinics have a child friendly waiting area and play area where the child feels comfortable.

Choose the Right Refractive Procedure for Your Eyes (And, Get Rid of Those Glasses!)

Dr. Manoj Rai Mehta, Ophthalmologist
It becomes confusing for a patient to select a "Refractive Procedure" that is safe for his or her eyes.  It is important to know that "LASIK" is not the only procedure  that is available to get rid of the glasses. There is a wide selection of procedures available with distinct advantages and disadvantages and it becomes imperative for a patient to weigh the pros and cons and then reach a conclusion.Procedures that are carried out on the "Cornea" of the eye, carry out correction by changing the curvature of the cornea and thus, change the refractive power.  Before the surgery inputs required are as follows:1) Cycloplegic Refraction, slit lamp examination of cornea, tear film function 2) Complete retinal check up; Indirect ophthalmoscopy and Central retinal evaluation by +90 D lens3) Corneal Topography (OCT/Orbscan/Pentacam) and Corneal Thickness graphs. Both front and back surface of the corneas need to be evaluated.4) Wave Front analysis for correction of aberrations   LASIK/LASEK/PRK/Lenticule removal can be carried out depending upon the parameters and patient safety. Profession, need to drive at night, age are taken into consideration and a discussion should happen between the doctor and the patient. Guardians of a patient are often a part of this discussion.Mechanical flap/ Femto Second flap/ Flap free procedures should be discussed for their merits and demerits and financial implications as well.  Minimum amount of tissue loss should take place during the procedure.  Safety measures during surgery especially tracker mechanisms should be discussed and elaborated upon.(Corrective lens over the existing natural lens) ICL/IPCL: In this a special lens is put over the existing lens behind the iris mostly for correction.  When the power is very high or the corneas relatively thin the procedure is indicated. A report on shape of the is required to find enough space for the lens. Clear lens removal with an IOL implant can also be carried out in certain situations. One procedure in one eye and another for the other can also be recommended if need be.    Select a safe procedure and be safe!