Apollo Health Blog
Imagine you wake up to clear view of the world. Imagine you are set free from depending on Glasses and
Contact Lenses. Imagine you can see the world as sharp and clear from the time you wake up to the time you go to bed.
Conductive Keratoplasty (CK) or Near Vision CK is the preferred choice for Refractive Surgery by all the eye surgeons for patients above 40 years of age. It is done to correct Presbyopia by reshaping the cornea with the help of Radio Frequency energy instead of a Laser or Scalpel.
What is Presbyopia ?
As we age, our eyes lose their ability to focus on near points. Reading, seeing the time on a watch, identifying the object near you or working on a computer becomes difficult. This usually begins to occur when we cross 40 years of age. It happens to everyone. Besides Reading Glasses, Conductive Keratoplasty is the only treatment available to correct Presbyopia.
Why CK ?
Near Vision CK procedure is specifically for people over 40 years of age, who want freedom from Reading Glasses or Contact Lenses.
When a patient has gone through a LASIK Surgery or has implanted multi-focal / accommodating Intra Ocular Lenses (IOLs) during Cataract Surgery and still requires Reading and Distance Glasses, then CK treatment can be rendered to cure the problem.
The procedure takes only a few minutes
It is a safe and minimally invasive procedure which done without cutting and removing of eye tissues.
CK is the first US Food and Drug Administration (FDA) approved vision technology for patients with �Aging Eyes�i.e. Presbyopia.
CK is certified by the US Federal Aviation Administration (FAA) as a vision correction procedure for Pilots who want to reduce/eliminate their dependency on Glasses or Contact Lenses.
CK is the only safest and most effective procedure to obtain a FAA protocol for Refractive error correction.
Good Candidacy For Near VIsion CK
- You are a good candidate for Near Vision CK if you are tired of your Reading Glasses
- Have difficulty in reading the newspaper or identifying other objects which are close to you.
- Are at least 40 years of age
- Have had good distance vision for most of your life
- Have no health issues affecting you eyes
- Are not pregnant or nursing.
STEP-I: Topical or �Eye Drop� anesthesia is applied to numb the eye and to ensure a painless procedure.
STEP-II: A circular treatment pattern is imprinted on the cornea using �rinse away ink� to guide the doctor�s treatment.
STEP-III:Using a probe, which is thinner than the strand of human hair, Radio waves are applied in a circular pattern to shrink a small area of collagen in the cornea.
STEP-IV: The circular treatment patterns will act like a belt tightening around the cornea by increasing its overall curvature to improve near vision.
After The Procedure
Before you go home, our staff will give you personalized aftercare instructions and eye drops.
After the procedure, you will experience watering of the eyes for a certain time. This is a natural process, but please do not rub your eyes.
Follow up Care
After the surgery, we recommend you see us as advised. This way you can help us properly monitor the success of your treatment.
CK After Cataract Surgery
CK is the most attractive alternative for low postoperative hyperopia in a Cataract patient after Multi-focal or accommodating IOLs implantation. It is less invasive and traumatic than bringing patients back for another Intraocular procedure.
CK After Lasik Surgery
It is also an alternative for over and under corrections following LASIK surgery or other excimer Laser treatment. 98% of Patients could see J5 (magazine-and newspaper-size print) in the eye that was treated by Near Vision CK. 87% of patients could see 20/20 in the distance and also read phone book-size prints (significantly smaller than a news print)
There are NO reported serious, sight-threatening or unanticipated safety events.
The kidneys play an important role in the body: they filter the blood, removing waste products and excess salt and water. If the kidneys become diseased, they fail in their task, leaving the blood polluted.
Finding out that you have early kidney disease can alert you that your kidneys are in danger. It is important to take steps to protect your kidneys before the problem advances.
What are the symptoms of KIDNEY DISEASE?
People who develop kidney disease usually have no symptoms early on, although the condition puts them at risk of developing more serious kidney disease.
Symptoms like swelling of lower limbs, face swelling, difficulty in breathing, loss of appetite, nausea, vomiting, decrease in hemoglobin level and bone disease develop at very late stages of kidney disease.
How to diagnose KIDNEY DISEASE?
Urine tests for protein called albumin are recommended once per year in people with diabetes and hypertension, staring at the time of diagnosis. If there is albumin more than 30mg/day in urine or urine albumin creatinine ratio more than 30mg/g of creatinine, it means you may have kidney disease.
Blood chemistry abnormalities like rise in creatinine and blood urea develop at late stages of kidney disease.
What re the risk factors for KIDNEY DISEASE?
- Having elevated blood sugar levels
- Being overweight or obese
- Having a diabetes – related vision problem
(Diabetic retinopathy) or nerve damage
- Having a family history of kidney disease
PREVENTION AND TREATMENT OF KIDNEY DISEASE
Consult kidney specialist (Nephrologist) before starting treatment
- Limit the amount of salt you eat
- If you smoke, quit smoking
- Lose weight if you are overweight
- Keeping blood sugars close to normal (Target blood glucose levels before each meal 80 to 120mg/dl and HbA1C of 7percent of less)
- Manage high blood pressure (blood pressure reading below 130/80 is recommended)
- Use Angiotensin converting enzyme inhibitor (abbreviated ACE inhibitor) or a related drug known as an angiotensin receptor blocker (ARB) to control blood pressure and proteinuria.
- Avoid pain killers (like Ibuprofen, Diclofenac, and Nimesulide – NSAIDS).
- Inform your family doctor that you are having kidney disease.
- Diet as per your doctor’s advice.
KIDNEY DISEASE COMPLICATIONS
The key complication of kidney disease is more advanced kidney disease, called chronic kidney disease. Chronic kidney disease can, in turn, progress even further, eventually leading to total kidney failure and the need for dialysis (Hemodialysis or peritoneal dialysis) or kidney transplantation.
Dr.Dilip M. Babu M.D., D.M. (Nephrology)
Consultant Nephrologist and Transplant Physician, Apollo Hospitals, Hyderguda
Due to inadequate reporting and data, an accurate estimation of the burden of kidney disease in India is not possible at present. In some small studies, the prevalence (Number of existing patients) of chronic kidney disease is about 0.79 %. This does not include patients with ESRD (End stage renal disease) and AKI (Acute kidney injury). If these disorders were added, the prevalence would be closer to 1 %.
Based on the current population of India which is 1.27 billion – the number of people with kidney disease would be 12.7 million. If you think this a huge number, remember this is just the tip of the iceberg and the actual numbers would be much greater than this.
Common causes of kidney disease in India, which can be extrapolated to Andhra Pradesh and Telangana include:
Diabetic Kidney Disease – 31%
Chronic Glomerulonephritis – 14%
Hypertension – 13%
Tubulointerstitial Disease – 7%
Obstructiion (Stones, Prostate, etc) – 3.5 %
Genetic Diseases – 2.5%
Unknown Causes – 17%
Of particular interest, in Srikakulam and Prakasham districts in North Eastern Andhra Pradesh, the prevalence of kidney disease is much higher than the rest of the country. The exclusive use of groundwater for drinking was postulated as a cause for this but this myth has be busted after chemical analysis of the water revealed no excess of toxic minerals.
The mystery of the unimaginably high prevalence of kidney disease of 24 to 37 % in Uddanum in Srikakulam district continues….
Dr. V. Ravi Andrews,
Department of Nephrology,
Apollo Health City, Hyderabad
Dryness of the eye is a common clinical entity. This can result from a variety of conditions; hence proper assessment is essential to manage this condition. The ocular surface clinic at Apollo Hospitals specializes in the management of this condition.
Excessive use of computers can result in ocular fatigue and other symptoms. Complete evaluation of the eye, along with modifications in working habits are required to manage this condition.
Uveitis is swelling of the uvea, the middle layer of the eye. It is usually an autoimmune problem though in some patients it may be due to infections such as herpes, toxoplasmosis or tuberculosis. It may be a one-time event or may occur repeatedly.
Untreated uveitis is a serious condition that may scar the retina cause glaucoma or cataract. Management requires detailed examination of the eye, appropriate investigations and accurate diagnosis. Each case requires a different management approach tailored to the specific features of that case.
HIV infection causes the immune system of the body to become weak. This can result in various blinding infections in the eye. Proper examination allows diagnosis and appropriate management, sometimes in consultation with our physicians. Absolute confidentiality is maintained at each step.
Cataract or clouding of the natural crystalline lens can be corrected surgically by removing the cataract and replacing the same with an intraocular lens (IOL) implant. Ultrasound A Scan and keratotomy tests are used for accurate IOL power calculation.
The cataract is removed with phacoemulsification, a technique wherein ultrasonic energy is used to break and emulsify the cataract followed by removal. All this performed through an incision size of just 2.75mm. Our phaco machine, AMO Sovereign,with new white star technology allows cold phaco (minimal build up of heat during cataract surgery
That is much safer for the eye compared to conventional phaco machines. IOL selection is customized for each individual to ensure best visual outcome. The surgery is painless and patients can return home
Stones are a common problem affecting the urinary tract. They commonly occur in the kidney or the ureter (the tube that conducts urine from the kidneys to the bladder) but can occur at other sites such as the bladder or urethra (tube through which we pass urine from the bladder).
These stones are ‘real’ stones just like the stones one sees in nature! Patients with stones commonly present with pain, blood in the urine, burning sensation in urine or fever. Rarely there may be no symptoms and the stone is identified incidentally on imaging done for some other problem. Confirmation of diagnosis may require various combinations of ultrasonography, X-rays, IVU (intravenous urogram) or CT scan.
Small stones may be managed by medication alone. Larger stones or those causing swelling in the kidney or infection need to be treated, sometimes urgently. Removal of stones can be accomplished by ESWL (extracorporeal shock wave lithotripsy), keyhole removal (PCNL), removal by ureteroscopy (URS) or rarely by laparoscopy. Small stones are well suited to ESWL which is non invasive although some patients may require the placement of a small tube in the kidney called a stent. Larger stones are best removed by PCNL or URS. A recent addition to the armamentarium for stone treatment has been the Holmium Laser Lithotripsy and Flexible Ureteroscopy. Holmium Laser offers the option of a delivery mechanism that is extremely precise and powerful, yet very slim (the smallest diameter laser fibers are 200microns in size) and flexible thus allowing it to be used through the flexible ureteroscope. Use of these technologies makes RIRS (retrograde intrarenal surgery) and mini-PERC (slim keyhole) stone removal feasible.
Large and complex stones (such as staghorn stones) can be removed by minimally invasive methods and have a large experience with the removal of such stones in normal or even congenitally malformed kidneys such as horseshoe kidneys or malrotated kidneys.
Dr Sanjay Sinha, MS,DNB,M.CH,MAMS
Urologist & Transplant Surgeon,
Apollo Hospitals, Hyderguda
Glaucoma is a disease that damages the eye’s optic nerve and can result in vision loss or blindness. However, with early detection and treatment, is only option against serious vision loss.
There are two types of Glaucoma:
1. Open-angle glaucoma (wide-angle glaucoma) – The is the most common type of glaucoma. Eye appears normal, the fluid passes too slowly through the drain as a result fluid builds up’s and presuure increases. If the pressure inside the eye rises to a level that may damage the optic nerve. When the optic nerve is damaged from increased pressure, open-angle glaucoma-and vision loss—may result. That’s why controlling pressure inside the eye is important.
There are no warning signs or symptoms for open-angle glaucoma, with regular eye checks & tests it can be deducted & treated.
2. Angle-closure glaucoma (narrow-angle glaucoma) – The drain i.e the iris gets blocked so the fluid doesnt pass through sufficiently resulting in vision loss. the vision is not total loss in this case.
Symptoms of angle-closure glaucoma may include headaches, eye pain, nausea, rainbows around lights at night, and very blurred vision.
Retinal is the light sensitive layer of the eye. Any disease affecting this layer results in visual disturbance. A complete evaluation of the retina is necessary during routine examination to identify any silent retinal problems. Proper evaluation of the retina is performed using indirect ophthalmoscopy and 78D lens.
Retinal holes or Tears
These problems increase the risk of retinal detachment and hence often require laser treatment or cryotherapy to seal them.
Other common conditions affecting the retina include Diabetic Retinopathy, occlusion of retinal blood vessels, bleeding inside the eye and age related muscular degeneration.
The photographs are taken to document treatment. Patients can also keep a copy of this photograph for their records.
Fundus Fluorescein Angiography
The procedure is performed to identify the disease, know its extent and to plan treatment.
Green Diode (Iris Medical) or Argon Laser
This helps in treatment of various retinal diseases including retinal holes and diabetic retinopathy. Both slit-lamp delivery mode and the Laser Indirect Ophthalmoscopic Delivery System are available to ensure optimal treatment of all cases.
Surgical Intervention is necessary if the retina shifts from its normal position or if bleeding inside the eye persists fro long duration. The AMO Gemini, a newer generation Vitrectomy System, with the Iris Medical Green Diode Endolaser helps perform safe surgery to ensure optimal visual recovery.
Apollo Eye Institutes
A refractive error is a very common eye disorder. It occurs when the eye cannot clearly focus the images from the outside world. The result of refractive errors is blurred vision, which is sometimes so severe that it causes visual impairment.
The four most common refractive errors are:
- Myopia (nearsightedness): distance objects appear blurry, while near objects appear clear
- Hyperopia (farsightedness):distance objects appear clear, while near objects appear blurry
- Astigmatism: distorted vision
- Presbyopia: means aging eye – is an age related eye problemin which patients start developing this problem around the age of 40 years.
The main cause of refractive errors if Blurred Vision, in some cases even double vision, glare, etc, etc.
Glasses or contact lenses can usually correct refractive errors. Laser eye surgery can also be done if required.
A patient having Chronic Kidney Disease or End Stage Renal Disease is advised to undergo kidney transplantation. The advantage of transplant over dialysis is kidney transplantation is better in terms of quality of life, longevity of the patient and also cost in the long run
What is kidney Transplantation?
A kidney transplantation is surgically transferring a functioning kidney from a person (called the donor) to another person whose kidneys are not working (called the recipient) is called renal transplantation. Transplant of Kidney from a live donor is called live renal transplantation and kidneys taken from a dead person (who is certified brain dead) is called cadaveric renal transplantation*
Kidney Donor Charasteristics:
- Should have normal kidney functions, no proteinuria and no focus of severe infections in the Genito-urinary tract
- Should have a compatible blood group with the recipient as in blood transfusion
- Should be between 25-60 years of age
- Should have no Hypertension, Diabetes , significant cardiac disease or Lung disease, multiple kidney stones, disseminated cancer
- No Viral infections –HbsAg, HIV,HCV,CMV should be negative
- Should be mentally and physically fit and willing to donate the kidney Donation.