Cornea Centre is located at Sector 22 (Opposite to the Parade Ground), Chandigarh, India and is easily approachable by rail, road and air from the National Capital New Delhi and other major towns/ Cities of the region. Nearest international airports are New Delhi and Amritsar.
Dr Ashok Sharma is best doctor for Corneal Grafting, best Doctor for Corneal Transplant, best doctor for corneal disorder.
Dr Ashok Sharma, M.S.(Ophthamology) PGI, Chandigarh, MBBS(IGMC) Shimla is dedicated to excellence and provide the best possible medical care. He has been a leader in the field of ophthalmology-a branch of medicine specializing in the anatomy, function and diseases of the eye for over 27 years. He is a pioneer Cornea Transplant Surgeon and has performed maximum number of corneal transplants in the region.
Dr Ashok Sharma is one of the best Eye Specialist in Chandigarh, best Ophthalmologist in chandigarh, best eye Surgeon in Chandigarh and has over 27 years of Experience in this field.
Corneal graft can be successful in children. We perform corneal transplants for children at Dr Ashok Sharma's Cornea Centre, Sector 22, Chandigarh. She had infantile glaucoma and corneal opacity and underwent corneal grafts in both eyes. She is enjoying good vision..
HOW SAFE ARE CONTACT LENSES?
Today contact lenses have advanced and are frequently used. Disposable Contact lenses are even healthier. These contact lenses are soft membranes. They are made from a "water-loving" spongy material that has the ability to absorb water, making the lens soft and flexible.
FEAR / MYTH: Lenses can get “lost” in the eye.
The human eye is covered from all sides and does not have any space to let any foreign body to get sucked inside. The lens would normally be on the centre of the eye(black/brown part) and may rarely get displaced on the white part of the eye. Eye Care Practitioners , today recommend a very simple method of wearing and removing contact lenses So, contact lenses never get lost in the eye.
HOW LONG IS THE CLEANING PROCEDURE?
Contact lenses today have reached a far stage of development and in the process the cleaning procedures have just got friendlier. Lenses, especially disposable ones, don’t need protein removers, as they are replaced every month, making the task very simple to follow. Also, these days single solution bottles make the lens cleaning even simpler. So, the contact lens user needs to spend only a few minutes everyday to keep the lenses clean
Set a regular day for throwing away your old lenses and replacing them with a new pair.
Associate throwing away your lenses to a favorite event, for example, watching your favourite show or another television program.
If you follow a four-week replacement schedule, you might be able to link throwing away your lenses to your pay-day.
Write your lens replacement date on your calendar. If you have an electronic calendar, such as Microsoft® Outlook® or a PDA (e.g., a Palm™ Pilot), program your calendar to remind you to follow your replacement schedule.
When you open up a new box of lenses, take a permanent marker and write your "fresh lens" day or date on the individual lens packages.
Be sure to write yourself a reminder to order new lenses on your last box. You may also be able to figure out when your lenses should run out, and have your Eye Care Professional arrange to automatically ship you fresh lenses before that date.
ASTIGMATISM OR CYLINDRICAL POWER
Refers to a state of the eye, wherein the rays of light coming from a distant target, cannot focus at a single point on the retina. In this situation special lenses of different curvature are required to focus the light onto the retina
HYPEROPIA OR LONG SIGHTEDNESS
Refers to a state of the eye, wherein the rays of light coming from a distant target, get focused at a point behind the retina. In this situation, plus powered glasses or contact lenses are necessary to focus this image onto the retina
MYOPIA OR SHORT SIGHTEDNESS
Refers to a state of the eye, wherein the rays of light coming from a distant target, get focused at a point in front of the retina. In this situation, minus powered glasses or contact lenses are necessary to focus this image onto the retina
The continuous production and drainage of tears is important to the eye's health. Tears keep the eye moist, help wounds heal and protect against infection. The tear film smoothes the surface of the cornea giving it a polished appearance and helping visual clarity.
Dry eye is very common, especially in women after the menopause.
Tears are made mostly by the lacrimal gland (in the upper outer part of the eye socket). Tears leave the eye either by evaporation or drainage. The tear drainage system runs from the inner corner of both eyelids and drains into the nose. Most commonly, dry eyes occur with increasing age due reduced production by the lacrimal gland. It can also occur due to eyelid problems such as blepharitis when the tear quality is poor. Dry eyes can occur in climates with dry air, as well as with the use of some drugs, including antihistamines, nasal decongestants, tranquillisers and anti-depressant drugs. People with connective tissue diseases such as rheumatoid arthritis; can also develop dry eye. Dry eye is sometimes a symptom of Sjögren's syndrome, a disease that attacks the body's lubricating glands, causing dry eyes and dry mouth.
SIGNS & SYMPTOMS
Patients with dry eye complain of chronic discomfort, usually described as a burning, gritty sensation. Some describe a scratchy or sandy feeling as if something is in the eye. Other symptoms include stinging, stringy discharge, heaviness, blurred vision or even watering (if the quality of the tears is poor). The eyes can become red and loose its shiny appearance. You might also see stringy mucus strands and filaments. The tear film on the lower eyelid maybe reduced. The tear break up time may be rapid.
DETECTION AND DIAGNOSIS
Adding a dye to the eye: fluorescein (orange) or rose bengal (red) may identify dry/damaged areas on the cornea. A Schirmer's test (the amount of moistening of a strip of blotting paper placed in contact with the inside of the lower eyelid) can measure the amount of tear production.
The best treatment is frequent lubricating drops or artificial tears. They are generally available over the counter as drops. Sterile ointments are sometimes used at night, but they can make the vision misty first thing in the morning. Each patient will prefer different drops, and will need them at different frequencies - from once daily right up to every 15 minutes. The drops are cheaper to buy than a prescription charge - but are available on prescription if necessary. Using humidifiers, wearing wrap around glasses when outside and avoiding outside windy and dry conditions may aid relief. For people with severe cases of dry eye, temporary or permanent closure of the tear drains may be helpful. Some people even use swimming goggle type of protection to reduce evaporation.
Severe Dry eye patients need occlusion of puncta with punctal plugs. Recent drug cyclosprain (0.05%) drops have been found to be beneficial in improving tear formation. Autologus serum drops are especially helpful in healing of micro epithelial defects. Patients undergoing treatment should be taken up for cataract surgery under proper counseling.
A corneal ulcer forms when the surface of the cornea is damaged or compromised. Ulcers may be sterile (no infecting organisms) or infectious. The term infiltrate is also commonly used along with ulcer. Infiltrate refers to an immune response causing an accumulation of inflammatory cells in an area of the body where they don't normally belong.
To distinguish whether or not an ulcer is infectious is an important distinction for the physician to make and determines the course of treatment. Bacterial ulcers tend to be extremely painful and are typically associated with a break in the epithelium, the superficial layer of the cornea. In some cases, the inflammatory response involves the anterior chamber along with the cornea. Certain types of bacteria, such as Pseudomonas, are extremely aggressive and can cause severe damage and even blindness within 24-48 hours if left untreated.
Sterile infiltrates on the other hand, cause little if any pain. They are often found near the peripheral edge of the cornea and are not necessarily accompanied by a break in the epithelial layer of the cornea.
There are many causes of corneal ulcers. Mot of our patients get corneal epithelial injury while working in fields and get corneal ulcer. These patients have injury with vegetative foreign body and develop fungal Corneal Ulcer. Contact lens wearers (especially soft) have an increased risk of ulcers if they do not adhere to strict regimens for the cleaning, handling, and disinfection of their lenses and cases. Soft contact lenses are designed to have very high water content and can easily absorb bacteria and infecting organisms if not cared for properly. Pseudomonas is a common cause of corneal ulcer seen in those who wear contacts.
Bacterial ulcers may be associated with diseases that compromise the corneal surface, creating a window of opportunity for organisms to infect the cornea. Equally important are Corneal Ulcers caused by fungus. These ulcers need early diagnosis, a prompt institution of treatment as drugs used to treat fungal ulcers do not penetrate deeper into the eye. Patients with severely dry eyes, difficulty blinking, or are unable to care for themselves, are also at risk. Other causes of ulcers include: herpes simplex viral infections, inflammatory diseases, corneal abrasions or injuries, and other systemic diseases.
SIGNS AND SYMPTOMS
The symptoms associated with corneal ulcers depend on whether they are infectious or sterile, as well as the aggressiveness of the infecting organism.
Severe pain (not in all cases)
White spot on the cornea, that depending on the severity of the ulcer, may not be visible with the naked eye
DETECTION AND DIAGNOSIS
Corneal ulcers are diagnosed with a careful examination using a slit lamp microscope. Special types of eye drops containing dye such as fluorescein may be instilled to highlight the ulcer, making it easier to detect.
If an infectious organism is suspected, the doctor performs corneal scraping and may order a culture. After numbing the eye with topical eye drops, cells are gently scraped from the corneal surface and tested to determine the infecting organism.
The course of treatment depends on whether the ulcer is sterile or infectious. Bacterial ulcers require aggressive treatment. In some cases, antibacterial eye drops are used every 15 minutes. Steroid medications are avoided in cases of infectious ulcers. Some patients with severe ulcers may require hospitalization for IV antibiotics and around-the-clock therapy. Sterile ulcers are typically treated by reducing the eye's inflammatory response with steroid drops, anti-inflammatory drops, and antibiotics. Sterile ulcers leading to impending or actual corneal perforations are treated with a corneal glue. Patients having large corneal perforations or infective corneal perforations are treated by Tectonic Penetrating Keratoplasty.
Keratoconus is a degenerative disease of the cornea that causes it to gradually thin andKeratoconus bulge into a cone-like shape. This shape prevents light from focusing precisely on the macula. As the disease progresses, the cone becomes more pronounced, causing vision to become blurred and distorted. Because of the cornea's irregular shape, patients with keratoconus are usually very nearsighted and have a high degree of astigmatism that is not correctable with glasses.
Keratoconus is sometimes an inherited problem that usually occurs in both eyes. The disease may occur in association with Vernal Catarrh (allergy), Down's Syndrome.
Signs and Symptoms
Blurred vision - even when wearing glasses and contact lenses
Glare at night
Frequent prescription changes in glasses and contact lenses
DETECTION AND DIAGNOSIS
Keratoconus is usually diagnosed when patients reach their 20's. For some, it may advance over several decades, for others, the progression may reach a certain point and stop.
Keratoconus is not usually visible to the naked eye until the later stages of the disease. In severe cases, the cone shape is visible to an observer when the patient looks down while the upper lid is lifted. When looking down, the lower lid is no longer shaped like an arc, but bows outward around the pointed cornea. This is called Munson's sign.
Special corneal testing called topography provides the doctor with detail about the cornea's shape and is used to detect and monitor the progression of the disease. A pachymeter may also be used to measure the thickness of the cornea.
The first line of treatment for patients with keratoconus is to fit rigid gas permeable (RGP) contact lenses. Because this type of contact is not flexible, it creates a smooth, evenly shaped surface to see through. However, because of the cornea's irregular shape, these lenses can be very challenging to fit. This process often requires a great deal of time and patience. In case the disease progresses, collagen cross linking with Topical Riboflavin Sensitization is performed. This is a new treatment modality and may stabilize Keratoconus in 70-80% cases.
When vision deteriorates to the point that contact lenses no longer provide satisfactory vision, corneal transplant may be necessary to replace the diseased cornea with a healthy one.
WHAT IS A CORNEA?
The cornea is the transport window at the front of the eye and it can become scarred by injury or go cloudy due to disease when the rest of the eye remains quite normal.
IS A CORNEAL GRAFT?
Corneal grafting, or keratoplasty, is carried out to replace the damaged cornea with a clear cornea. This is another example of 'spare part surgery' and the clear donor cornea has to be taken from a deceased person.
WHO NEEDS A CORNEAL GRAFT?
corneal graft is done:
• To improve vision
• To relieve pain from a problem within the cornea
• To seal a hole in the cornea
• To remove infection in the cornea
WHAT ARE THE RISKS OF SURGERY?
No surgery is free of complications. Fortunately, complications are rare. The most common possible problems are infection and graft rejection. These complications would require extra treatment if they occurred and may even lead to the need for another operation. In someone who has had a corneal graft operation, if there is a rapid change in their vision, the eye feels as if there is something in it or becomes sticky, they must seek immediate help.
WHAT TYPE OF ANAESTHETIC IS USED?
The corneal graft operation can be carried out under local anesthetic but is usually done with a general anesthetic. The operation takes a little bit more than an hour to complete. How long is the hospital stay? 3-4 days.
HOW LONG IS THE RECOVERY PERIOD?
You should notice an improvement in your vision within days of the operation but it is important to understand that the vision continues to gradually improve over many months. Your doctors may want to take out loose or tight stitches over the months. The best vision (with new glasses or contact lenses) is not usually achieved for up to a year (and occasionally longer).
WHAT CAN I EXPECT AFTER THE SURGERY?
After the operation you need to wear old glasses or an eye shield to protect the eye. You may feel that there is 'something in the eye' but it should not be painful. It may water a lot. We use many (about 16) very fine stitches for this type of operation.
WHAT ARE THE DO'S AND DON'TS AFTER SURGERY?
You need to avoid situations where the eye may be bumped, and also avoid heavy lifting. You will be asked to put drops in for many months (to prevent infection and rejection of the graft). You need to avoid swimming for at least a month and you may wish to take up to a month of work.