Ophthalmology

The Department of Ophthalmology at our hospital provides comprehensive and specialized medical and surgical care for all types of eye diseases in both adult and pediatric patients. Eye disorders can be diagnosed and treated at Amrita, including cataract, glaucoma, strabismus and amblyopia, retinal diseases including Retinopathy of Prematurity, Cornea and external diseases including  refractive disorders and keratoplasty [corneal transplant], neuro ophthalmology, uveal and lachrymal drainage disorders. Our facility is fully equipped with the latest and most advanced technology to ensure accurate diagnosis and effective treatment of all eye conditions.   Our whole team is dedicated to provide vision in an accessible and affordable manner to all in a patient friendly empathetic manner. We are a recognized centre for cornea retrieval and transplantation. 

PEDIATRIC OPHTHALMOLOGY  

The pediatric ophthalmology service at Amrita Hospitals is a dedicated  facility offering expert diagnosis and treatment of ophthalmic problems in children of different age groups. The most common childhood eye diseases treated at our clinic are: 

• Refractive errors 
• Squint 
• Amblyopia
• Childhood cataract 
• Genetic eye disease 
• Congenital glaucoma 

The clinic makes all efforts to enhance the residual vision in children with visual impairment by providing either optical or non-optical Low Vision Aids (LVA). 

Services Offered 

CATARACT  

We utilize the latest surgical techniques and the most advanced Intraocular lenses to provide excellent outcomes after cataract surgery. 

 We are equipped with the state-of-the-art equipment for diagnostics and surgeries and facilities to make the surgical experience very pleasant and comfortable for the patient.  A meticulous eye examination with slit lamp along with diagnostic tools like Auto refractometer, non-contact tonometer, A scan, B scan are the services provided with indefinite care and precision. Opening up opaque membranes that sometimes form after cataract surgery can be done in the clinic with our Nd – YAG Laser. 

 Our hospital has the latest modular operation theatres with laminar flow technology and are equipped with a world class Zeiss ARTEVO 800 3D microscope with surgical recording system and Whitestar signature pro phacoemulsification machine.  We have a variety of IOLs which include aspheric monofocal, multifical, trifocal, EDOF, toric and 3-pc IOLs. After a through work up by our team, the doctor decides the best IOL for the patient for an optimal outcome.  

GLAUCOMA SERVICE 

The team of experienced eye specialists at Amrita Hospitals is dedicated to providing world-class glaucoma treatment and care including Lasers, medicines and surgery. Glaucoma is often asymptomatic, and people may lose their vision without knowing it. Regular eye exams are an important way to detect the disease. 

Glaucoma filtering surgeries -trabeculotomies, trabeculectomies and aqueous drainage implants - are routinely performed in our state-of-the-art modern operation theaters.  

CORNEA 

We have an advanced department of corneal services where a team of well-trained and experienced surgeons offer management of complex corneal and anterior segment diseases. Since a significant number of ocular problems can have other systemic associations, we believe in a multidisciplinary team approach. We work in close conjunction with the microbiologists, rheumatologists and physicians to provide holistic care to the patient. We provide state-of-the-art medical and surgical treatment for the following diseases of the cornea: 

•        Corneal ulcer
•        Corneal edema
•        Ectatic diseases of the cornea – keratoconus, pellucid marginal degeneration,       terriens marginal degeneration, post LASIK-ectasia
•        Corneal inflammations
•        Corneal scars and dystrophies
•        Corneal cancers
•        Dry eye
•        Ocular allergy
•        Trauma 

OCULAR SURFACE SERVICE 

Ocular surface comprises of the tear film, cornea, conjunctiva and the eyelids and diseases affecting these are collectively termed as “ocular surface diseases”. These diseases usually start as minor irritation and dry eyes but if left undetected and untreated can progress to corneal blindness in some cases. Chuna (lime) injury to the eye, Steven Jhonson Syndrome, Ocular Cicatricial Pemphigoid, Sjogren syndrome and Ocular Surface Squamous Neoplasias (OSSN) are some of the diseases, which can have a blinding sequalae. Early diagnosis and prompt medical and surgical intervention in the initial phase of disease itself can alter the natural course of the disease and prevent the visual morbidity associated with the condition. 

RETINA SERVICE 

The retina service offers the highest level of care available in the areas of retinal and vitreous disorders. We provide specialized diagnostic testing and treatment for retinal conditions of all types. The most commonly managed disorders are age-related macular degeneration, diabetic retinopathy, retinal vein occlusions, vitreous hemorrhage, retinopathy of prematurity and retinal detachments. 

Retinal surgeries being performed include: 

• Pars plana vitrectomy 
• Complicated procedures for retinal detachment, proliferative diabetic retinopathy 
• Intraocular foreign body removal 
• Intravitreal injections 

UVEA SERVICES 

Ocular inflammation may occur as a part of systemic disease or involve only the eye. It needs thorough evaluation including blood tests and imaging and interdepartmental referrals with rheumatologist, orthopedicians, dermatologists and other physicians . At our multispeciality hospital it is possible to provide them comprehensive evaluation in consultation with other specialists for expert management. 

PEDIATRIC OPHTHALMOLOGY AND SQUINT SERVICE 

Children can be afflicted by many eye diseases.  The eye problems in children need different diagnostic and treatment modalities and protocols than adults. 

Children suspected/ found with disorders related to Cornea, Retina, Uvea, Orbit & Glaucoma are referred to the respective specialty clinics at the hospital. 

Routinely performed procedures by the pediatric ophthalmology service include: 

• Cataract surgeries for congenital cataracts under general anesthesia 
• Squint correction surgery under anaesthesia appropriate for age (general/local) 
• Examination under anaesthesia (EUA) for children who need detailed evaluation 
• Surgery for nystagmus.  

Squint surgeries are performed for squints at all ages, either strengthening procedures or weakening procedure on the extra ocular muscles after a thorough assessment  

NEURO-OPHTHALMOLOGY  

Neuro-ophthalmology is the ophthalmic subspecialty that deals with eye diseases and issues caused by different neurological disorders involving the optic nerves, visual pathways and eye movements.  

The Neuro-ophthalmology clinic treats patients with symptoms of vision loss, double vision, drooping of eyes, visual field defects, headache, eyelid and facial disorders. 

It also evaluates and treats patients with ophthalmic manifestations of various neurological diseases like brain tumors, cranial nerve palsies, stroke and Myasthenia Gravis. 

OCULOPLASTY AND ORBITAL SURGERY 

Ophthalmic plastic surgery is a specialized branch of ophthalmology that deals with reshaping the area in and around the eye. It is concerned specifically with the eyelids, the orbit (the bone around the eye), and the lacrimal system (the tear duct system). 

Our oculoplastic surgeons treat patients with conditions such as 

• Ptosis (eyelid drooping), 
• Eyelid malposition (entropion, ectropion) 
• Eyelid lesions (benign and malignant) 
• Blepharospasm 
• Periocular injuries 
• Orbital fractures 
• Orbital tumors 
• Periocular tumor removal and lid reconstruction
• Tearing disorders 
• Thyroid eye disease 
• Eye removal 
• Brow lifting 
• Blepharoplasty 
• BOTOX® and other injectable treatments   

OCULAR ONCOLOGY 

Ocular oncology, or eye cancer, is a cancer that forms in tissues in and around the eye. Our objective is to save the life of the patients and also to salvage the eye and preserve vision if possible. 

Eye cancer can occur in the newborn, in children and in adult. There are a variety of tumors that can exist in the eye’s tissues. The Ocular Oncology Service manages: 

• Tumors of the eyelids 
• Conjunctiva 
• Cornea 
• Orbit   Intraocular structures, like 
• Iris 
• Ciliary body 
• Choroid Retina 
• Optic disc 

The Ocular Oncology Service uses cutting-edge treatments and explores the newest treatment techniques, including those used to deliver radiotherapy and chemotherapy to the eye with minimal side effects. The specialists also collaborate with radiation oncologists, pediatric oncologists, and neurosurgeons to improve therapies  

CONTACT LENS  

We provide the latest in cosmetic and therapeutic contact lens technology for all age groups. These range from simple soft and rigid gas-permeable contact lenses to specialized hard lenses for keratoconus, semi-scleral and scleral lenses. After a thorough work our expert team of ophthalmologist and optometrist decide about the type of contact lenses that would be best for the patient.  

LOW VISION AIDS  

The Low Vision Service offers patients the opportunity to make the best possible use of their remaining vision through a comprehensive rehabilitative process. 

EYE EMERGENCY 

Emergency eye care facility is available 24X7 at our hospital. You must seek emergency service if you have any of the following symptom. 

• Sudden vision loss 
• Severe Pain in or around the eye 
• Eye Infections 
• Cuts and lacerations to the eye 
• Adverse reactions to contact lenses 
• Sports-related eye injuries 
• Chemical exposure to the eyes 

CATARACT SURGERY;

Phacoemulsification [Microincision Cataract Surgery] is done for our cataract patients after a thorough cataract evaluation for all types of cataract including Senile [most common], Complicated, Paediatric, Traumatic and congenital cataracts. We have state of the art latest equipment including IOL Master 700, Specular Microscope, [OCT]Optical Coherence Tomography to assess each cataract thoroughly.

Our experienced surgeons operate in a sophisticated modular operation theatre with laminar flow systems to ensure highest standards of sterility. The OT is equipped with high end Zeiss ARTEVO 800 3D microscope with wide-angle viewing system with surgical recording system. 

After phacoemulsification we implant intraocular lenses best suited for each eye keeping in mind their astigmatism, ocular illnesses and visual needs , choosing a multifocal, Toric, Toric Multifocal, Extended Depth IOLS or monofocal IOL - give the best IOL suited for the patient’s eye. For the subluxated & dislocated lenses we use capsular tension rings or scleral fixated Intraocular as per need of the case.

GLAUCOMA

We have the full armamentarium for glaucoma diagnosis and management.

Each patient of suspected or diagnosed glaucoma is examined and investigated using Goldman applanation tonometry, Gonioscopy, Visual fields, OCT including OCT angiography, Pachymetry and Ultrasound Biomicroscopy.  The clinic is equipped with state-of-the-art fundus imaging system (CLARUS 700 Ultra widefield) and handheld fundus camera (VISUSCOUT 100) for disc imaging in adult and pediatric cases. Visual fields are charted with the latest version of Humphrey Field Analyzer (Humphrey Field Analyzer model HFA3 850). Very early cases of glaucoma are diagnosed with the help of Optical Coherence Tomography, using Zeiss Cirrus 6000 OCT.

Medical, Laser and surgical treatment is available for management of glaucoma in all ages. Yag Laser (VISULAS YAGIII) is used YAG Laser Iridotomy – initial treatment for most with angle closure glaucoma. Our team performs various Glaucoma surgeries including Trabeculectomy, Glaucoma Implant, Trabeculotomy and Goniotomy.

CORNEA

We provide all types of corneal procedures in our department ranging from simple superficial keratectomies, cyanoacrylate glue application and tenons patch grafts to more complex corneal transplants (keratoplasty) and artificial corneas (keratoprosthesis). A corneal transplant surgery involves excision of the diseased cornea (either total or partial) and replacement with a healthy donor cornea (complete or partial). After a through workup our experts decide what type of corneal transplant is needed. Types of corneal transplant surgeries available in our institute are as follows:

• Full thickness or penetrating keratoplasty (PKP)– The entire thickness of diseased cornea is replaced by a healthy donor.
• Anterior lamellar keratoplasty (ALK/DALK) – only the anterior layers of the affected cornea are replaced.
• Posterior lamellar keratoplasty (DSEK/DMEK) – only the posterior layers of the cornea are selectively replaced.

OCULAR SURFACE 

 Our team of experts are well trained and well equipped in managing these cases. We provide advanced ocular reconstruction surgeries as mentioned below:

•        Conjunctival auto grafts
•        Amniotic membrane grafting
•        Limbal stem cell transplantation (SLET) – New stem cells are obtained from the other healthy eye or from a living or deceased.
•        Mucous membrane grafting
•        Keratoprosthesis – This is a type of artificial corneal transplantation done in cases where traditional corneal transplantation is unlikely to be successful
•       Corneal cancer treatment after a thorough evaluation our experts decide for topical chemotherapy alone with interferon α2b, 5-fluorouracil and mitomicin C or a wide excision biopsy and double freeze-thaw cryotherapy in conjunction with perioperative topical chemotherapy.

Early detection of a retinal disorder is important for vision preservation. Our retina service offers state of the art diagnostic and therapeutic facilities.

For the diagnosis of retinal and uveal disease we use the advanced digital Fundus imaging system (CLARUS 700 Ultra widefield), Hand held fundus camera (VISUSCOUT 100), Optical Coherence Tomography (OCT and OCT angiography), Ultrasound B scan with UBM.

Retinal diseases are treated with Laser Indirect Ophthalmoscope (LIO),PDT Laser, TTT Laser, VISULAS Retinal Green Laser (532 nm), etc.

Retinopathy of prematurity screening is done for preterm neonates to diagnose and treat them at the right time.

Our experienced surgical retina doctors operate in a sophisticated modular operation theatre with laminar flow systems to ensure highest standards of sterility. The OT is equipped with high end Zeiss ARTEVO 800 3D microscope with wide-angle viewing system with surgical recording system , Digital Recording System, Vitrectomy System endolaser and cryopexy systems.

SQUINT 

We assess and treat all types of squints [ also called Strabismus ] in all ages, including Paralytic and restrictive squints. We assess these patients using the Synaptophore, Prism bar, Hess charting and Diplopia charting and advise them surgery, exercise or Prisms and glasses. We assess binocularity and treat patients with muscle imbalance giving them specialized exercises.