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Karthik Netralaya

Institute of Ophthalmology Private Limited

Retina is the light-sensitive layer of tissue located in the back of the eye. Nutrients and oxygen are richly supplied to it by the retinal blood vessels and an underlying network of blood vessels, called Choroid. The choroid gives the characteristic red color to the retina when examined and also is cause for the red eye defect seen in photographs.

diabetic retinopathy, vitrectomy surgery karthik netralaya, best eye hospital, karthik netralaya
diabetic retinopathy, vitrectomy surgery karthik netralaya, best eye hospital, karthik netralaya

 Vitreo Retina

Much like film in a camera, images come through the eye's lens and cornea and are focused on the retina. The retina then converts these images to electric signals and sends them to the brain.

Examining the retina

 

A retinal examination also called as ophthalmoscopy or funduscopy. It allows the retinal specialist to evaluate the back of your eye, including your retina, optic disk and the underlying layer of blood vessels that nourish the retina (choroid).

 

For a through retinal examination the pupils must be dilated using eye drops. The eyedrops used for dilation cause your pupils to widen, allowing in more light and giving your doctor a better view of the back of your eye.

 

 

  • The dilating eye drops may cause eye allergy in some individuals. Kindly specify to the doctor or optometrist if you have encountered such problems in the past.
  • The eye drops take time to act and may need to be repeated depending on the response.
  • The retinal examination usually takes less than 10 minutes, but it may take several hours for the effects of the dilating drops to wear off. Your vision will likely be blurry, and you may have trouble focusing on near objects.
  • If the light bothers you, you may need to wear dark glasses (or sunglasses) for a short time.
  • You may be uncomfortable driving with dilated pupils, so make sure you have transportation after your exam.
  • Depending on what you need to see at work, you might need to wear reading glasses or remove glasses that correct for nearsightedness until the effects of the eye drops wear off.
diabetic retinopathy, vitrectomy surgery karthik netralaya, best eye hospital, karthik netralaya

 

After administering eye drops and giving them time to work, your eye doctor may use one or more of these techniques to view the back of your eye:

 

• Indirect examination (indirect ophthalmoscopy). During this exam, you might be asked to recline in a chair or sit up. Your eye doctor examines the inside of the eye with the aid of a condensing lens and a bright light mounted on his or her forehead. This exam lets your eye doctor see the retina and other structures inside your eye in great detail and in three dimensions.

 

• Slit-lamp exam. In this exam your doctor shines the beam from a slit lamp through a special lens into your eyes. The slit lamp reveals a more-detailed view of the back of your eye. Sometimes eye-drops aren't necessary to dilate your eyes before this kind of exams.

 

• Direct examination. Your eye doctor uses a direct ophthalmoscope to shine a circle of light through your pupil and to see the back of your eye. Sometimes eye-drops aren't necessary to dilate your eyes before this kind of exams.

 

Who should get a dilated retinal examination?

 

The following are some of the indications for frequent dilated eye examination:

  • Diabetes
  • High blood pressure
  • Recent onset of sudden of progressive vision loss
  • Family history of retinal detachment
  • High spectacle powers
  • Recent onset of flashes or floaters in the vision.
  • Distortion in size and shape of objects.
  • Everyone at the age of 40 years
  • On drugs for Rheumatic problems.
  • Injury to the eye

 

Diabetic eye diseases

 

Diabetes is a condition that is caused due to a poor uptake of Glucose into the cells either because of decreased production or an increased resistance to insulin. Diabetes can increase the possibility of eye diseases needing periodic evaluation and treatment.

 

Diabetes and Glaucoma

 

People with diabetes are 40% more likely to suffer from glaucoma . This risk also increases with age.

 

Glaucoma occurs when pressure builds up in the eye. In most cases, the pressure causes drainage of the aqueous humor to slow down so that it builds up in the anterior chamber. Gradually because of the increased eye pressure the optic nerve gets damaged.

 

There are several treatments for glaucoma. Some need just eye drops which have to be used for lifetime while others may need surgery to reduce/ control pressure in the eye.

diabetic retinopathy, vitrectomy surgery karthik netralaya, best eye hospital, karthik netralaya

 

Cataracts

 

Diabetics have approximately 60% more likely chance to develop Cataract, and at an earlier age which progress faster. With cataracts, the eye's clear lens clouds, blocking light from falling onto the retina.

 

To help deal with mild cataracts, you may need to wear sunglasses more often and use glare-control lenses in your glasses. For cataracts that interfere with vision surgery for removing the cataract and placing an intra-ocular lens in its place. In people with diabetes, retinopathy can get worse after removal of the lens and hence needs it to be treated before treatment.

 

diabetic retinopathy, vitrectomy surgery karthik netralaya, best eye hospital, karthik netralaya

Diabetic Retinopathy

 

Diabetic retinopathy is a general term for all disorders of the retina caused by diabetes. There are two major stages of retinopathy: non-proliferative and proliferative.

 

 

 

 

 

 

 

 

 

 

 

 

 

  • Proliferative Retinopathy

In some people, retinopathy progresses after several years to a more serious form called proliferative retinopathy. In this form, the blood vessels are so damaged they close off. In response, new blood vessels start growing in the retina. These new vessels are weak and can leak blood, blocking vision, which is a condition called vitreous hemorrhage. The new blood vessels can also cause scar tissue to grow. After the scar tissue shrinks, it can distort the retina or pull it out of place, a condition called retinal detachment.

 

Your retina can be badly damaged before you notice any change in vision. Most people with non-proliferative retinopathy have no symptoms. Even with proliferative retinopathy, the more dangerous form, people sometimes have no symptoms until it is too late to treat them. For this reason, you should have your eyes examined regularly by an eye care professional.

  • Non-proliferative retinopathy

In nonproliferative retinopathy, the most common form of retinopathy, capillaries in the back of the eye balloon and form         pouches called Microaneurysms. Non-proliferative retinopathy can move through three stages (mild, moderate, and severe), as more and more blood vessels become blocked.

 

Although retinopathy does not usually cause vision loss at this stage, the blood vessels become leaky. When the macula swells with fluid, a condition called macula edema, vision blurs and can be lost entirely. Although nonproliferative retinopathy usually does not require treatment, macular edema must be treated, but fortunately treatment is usually effective at stopping and sometimes reversing vision loss.

diabetic retinopathy, vitrectomy surgery karthik netralaya, best eye hospital, karthik netralaya

 

Am I at risk for retinopathy?

 

Several factors influence whether you get retinopathy:

• blood sugar control

• blood pressure levels

• how long you have had diabetes

• genes

 

The longer you've had diabetes, the more likely you are to have retinopathy. Almost everyone with type 1 diabetes will eventually have nonproliferative retinopathy. And most people with type 2 diabetes will also get it. But the retinopathy that destroys vision, proliferative retinopathy, is far less common.

 

People who keep their blood sugar levels closer to normal are less likely to have retinopathy or to have milder forms.

 

diabetic retinopathy, vitrectomy surgery karthik netralaya, best eye hospital, karthik netralaya

Vision with diabetic retinopathy

Symptoms and Detection:

 

Many times, patients report no symptoms in the early stage of Diabetic Retinopathy. Patients experience following symptoms in the advance stage of this eye condition:

 

• Fluctuating vision

• Eye floaters and spots

• Development of a scotoma or shadow in your field of view

• Blurry and/or distorted vision

• Corneal abnormalities such as slow healing of wounds due to corneal abrasions

• Double vision

• Eye pain

• Near vision problems unrelated to presbyopia

• Cataracts

 

The irregular growth of new blood vessels gives rise to serious complications such as retinal detachment, vitreous hemorrhage, glaucoma and blindness. Usually, this disease affects both eyes.

 

How is it treated?

 

Huge strides have been made in the treatment of diabetic retinopathy. Treatments such as scatter photocoagulation, focal photocoagulation, and vitrectomy prevent blindness in most people. The sooner retinopathy is diagnosed, the more likely these treatments will be successful. The best results occur when sight is still normal.

 

  • In photocoagulation, the eye care professional makes tiny burns on the retina with a special laser. These burns seal the blood vessels and stop them from growing and leaking.

 

  • In scatter photocoagulation (also called panretinal photocoagulation), the eye care professional makes hundreds of burns in a polka-dot pattern on two or more occasions. Scatter photocoagulation reduces the risk of blindness from vitreous hemorrhage or detachment of the retina, but it only works before bleeding or detachment has progressed very far. This treatment is also used for some kinds of glaucoma.

 

Side effects of scatter photocoagulation are usually minor. They include several days of blurred vision after each treatment and possible loss of side (peripheral) vision.

 

  • In focal photocoagulation, the eye care professional aims the laser precisely at leaking blood vessels in the macula. This procedure does not cure blurry vision caused by macular edema. But it does keep it from getting worse.

 

  • When the retina has already detached or a lot of blood has leaked into the eye, photocoagulation is no longer useful. The next option is vitrectomy, which is surgery to remove scar tissue and cloudy fluid from inside the eye. The earlier the operation occurs, the more likely it is to be successful. When the goal of the operation is to remove blood from the eye, it usually works. Reattaching a retina to the eye is much harder and works in only about half the cases.

Retinal Detachment And Vitrectomy Surgery At Karthik Netralaya Bangalore

 

Vitreo Retinal Surgeries with Advanced 'Alcon Constellation Vision System' at Karthik Netralaya

 

Vitreo Retinal surgery does not refer to one specific type of surgery. It refers to any surgical procedure that treats eye problems involving the retina, macula, and vitreous fluid. These vision disorders include macular degeneration, retinal detachment, and diabetic retinopathy. Vitreo Retinal surgery can treat a detached retina, which happens due to a retinal tear. A retina may detach gradually or suddenly. Symptoms of retinal detachment may include flashes of light and spots that obstruct vision. Retinal detachment can occur due to an injury. It may also occur when the vitreous fluid pulls on the retina. A patient with a detached retina has a better chance of regaining lost vision if it is treated immediately.

Surgically managed retinal disorders:

• Advanced diabetic retinal diseases

• Vitreous haemorrhage

• Epiretinal membranes

• Diabetic macular edema

• Macular Holes

• Vitrectomy

Alcon Constellation microincisional Vitrectomy system was acquired at Karthik Netralaya for saving retinal surgeries with an ultra tiny self-sealing stitch-less pinhole entries. 13, 15, 27 Gauge Needle size instrumentation, ultra high speed cutting rates, brilliant endoillumination etc make major retinal surgeries quicker & safer.

 

Features of this state of the art equipment include:

 

ULTRAVIT® High Speed Vitrectomy Probes

• Deliver 7500 cuts per minute

• Micro incision vitrectomy surgery capable of sub 0.5 mm incision surgeries for safer, faster and more comfortable recuperating.

 

Duty Cycle Control

• Ability to modify duty cycle ensuring high safety levels when operating close to the retina.

 

Integrated Pressurized Infusion

• Monitor the pressure inside the eye, maintained by the fluid inflow to fluid removed. IOP compensation feature provides control of infusion pressure which maintains a stable IOP and improving surgical safety.

diabetic retinopathy, vitrectomy surgery karthik netralaya, best eye hospital

The CONSTELLATION® Vision System delivers an exceptional level of performance through its advanced technologies.

Illumination / Light

• Delivers state of the art illumination for visualizing tissues.

• ENGAUGE Radio Frequency Identification Device Technology (RFID) - recognizes probe gauge sizes automatically and adjusts light intensity, minimizing the harm to ocular tissue from over exposure to high intensity light, thereby improving surgical outcomes.

• CONSTELLATION® Xenon Illuminator provides long-lasting brightness, for better illumination of tissue and visualization.

diabetic retinopathy, vitrectomy surgery karthik netralaya, best eye hospital
diabetic retinopathy, vitrectomy surgery karthik netralaya, best eye hospital

ALCON® MIVS® procedure

Standard 20-gauge procedure

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KARTHIK NETRALAYA

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