AWARD

Most unexpected award ... I received yesterday at the annual general body meeting of the Poona Ophthalmological Society held here at Pune at Hotel Le Meridien.
It was for maximum number of interesting case presentations. ..

Great feeling ... and Satisfaction...

Need for Oculoplasty

Is there a need for an oculoplasty surgeon? Well to admit frankly, my personal experience is that the plastic or neurosurgeon or even the maxillofacial surgeron is reluctant to touch the eye ball or surrounding areas. My personal experience especially when managing serious conditions like orbital fractures is that the non ophthalmic surgeon is very comfortable when the ophthalmic surgeon is around.

The eye is a small organ in a small space with many structures all around. The importance of the eyes cannot be understated. The nose and the ears are not as important as the eyes. One argument in my favour is the way the nerves from the brain are organized. There are 12 cranial nerves, of which about 4 nerves are dedicated for supplying the eyes. The optic nerve can be considered the most important and is deeply interlinked with structures in the brain. The other nerves the 3rd, 4th and 6th nerve supply the muscles  of the eyes. In other words, of the 12 cranial nerves, 4 are exclusive to the eyes.

Need I say more about the importance of the eyes. Hence I do understand the importance of oculoplasty ... more in not creating new problems for the patient and also to ensure none of the important visual functions are disturbed...

Oculoplasty is here to stay and will be established soon...

PTOSIS SURGERY

Ptosis surgery is not only functional, it has definite cosmetic implications. Even if one does ptosis surgery in a child, there is a high likelihood that the parents will point out any asymmetry if present. Hence it is of great importance that one plans the cosmetic goal when one plans to lift the lid. The results of surgery are always good in all cases, but getting the angle, the contour and equal lid lift is of great importance. 

Most of the times, the patient is explained clearly about the goals of surgery, so they end up cooperating well for the surgery and the results are great. 

Even adjustable ptosis surgery is possible. I have performed it for a patient where the surgery had not worked 4 times and he came to me for the 5th time to get everything corrected. 

Ptosis is definitely correctable and gives excellent results if the preoperative planning is perfect. 

ADJUSTABLE SQUINT SURGERY

Getting perfect results in any form of surgery is always a challenge. More so in case of squint, where the results are there for all to see. In such cases especially in adults, it is easier to perform adjustable squint surgery.

At the end of the day or the next day, the patient is called back to the clinic and based on the need, the muscle position is perfectly adjusted. This gives optimum results and the best outcome possible.
I have done this for many cases referred to me after one squint surgery and have got good results.
For the patient it is never unpleasant, they feel good with the correction and can actually see the good outcome.

CHILDREN AND THEIR EYES

DID YOU KNOW ?

Amblyopia or lazy eye can be treated even upto 17 years of age. This is what the latest research has to tell us. This comes from the PEDIG ( pediatric eye disease investigator group)..

I thought I should give it a try. Previously the thought was that vision could not be improved in cases of amblyopia beyond 7-8 years of age.

I wish to share 2 cases with you. One was a 11 year old boy, very intelligent and well behaved. His parents were shocked when it was discovered that he had a vision of 6/60 in one eye. They came to me and the refraction was +2.00. He was prescribed glasses and patching. He improved to 6/12 and could read a few letters on the 6/9 line as well. In other words he was out of the definition of amblyopia. Of course the credit goes to the young lad as he was sincere in the patching and serious about improvement in vision.

My second interesting patient was a 23 year old girl with squint ( convergent ). She had a vision of 6/36 in the left eye which was the squinting eye. She was again advised intense patching and within 2 weeks her vision had improved to 6/12. For her and her family it was very reassuring. She had been indoors for two weeks and taken a break from her work to ensure that her eyesight improves.

I used to counsel them well, with positive reinforcement of the benefits of patching and use of near exercises. 

My message is
1. try patching even in the older age group.
2. intense counselling
3. positive reinforcement of benefits
4. show them the response in a week's time, which will spur them to perform better...

This will be our contribution towards the elimination of preventable visual impairment.

HAPPY HOLI

HOLI is the festival of colours...
It signifies the victory of good over evil... the Holika dahan and the colours are a celebration of life 
given to us by mother nature. 

But the eyes have to be taken care of during Holi. 
1. some of the colors have harmful chemicals and cause abrasions on the surface of the eye ( cornea) and this may lead to severe burning.
2. It is best to wash the eyes, do not rub the eyes, and consult an eye doctor immediately. 
3. The gulal is better than the other colors. 
4. The reds and orange colors are safer, the green and silver are the bad culprits, which can cause severe stinging.

So take care and celebrate HOLI