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Corneal Arcus or Arcus Senilis : Causes, Symptoms, Diagnosis, and Treatment - Mumbaieyecare
Corneal Arcus
Corneal Arcus or Arcus senilis appears as a white, gray, or blue ring or arc around the cornea of the eye. The condition is usually seen in older adults but can affect people of all ages, even appearing at birth. Arcus senilis is generally harmless, and an involutional change modified by genetic factors. However, arcus is sometimes indicative of hyperlipidoproteinemia (involving low-density lipoproteins) with elevated serum cholesterol, especially in patients under 40 years of the age.

Causes of corneal arcus
Arcus is a deposition of lipid in the peripheral corneal stroma. Cholesterol and triglycerides are two types of fats in your blood. Some of the lipids in your blood come from foods you eat, such as meat and dairy products. Your liver produces the rest. Lipid deposition starts at the inferior and superior poles of the cornea and in the late stages encircle the entire circumstances. Arcus senilis is more common in men than in women. In people under age 40, arcus senilis is often due to an inherited condition and in rare cases, children are born with arcus senilis ( arcus juvenilis).

Arcus senilis can also appear in people with Schnyder central crystalline dystrophy. This rare, inherited condition causes cholesterol crystals to deposit on the cornea.

A person with arcus senilis may develop:

A white, gray, or blue circle around the cornea of the eye.
The circle or arc will have a sharp outer border but a blurred inner border.
If someone has an arc, the lines could grow to form a complete circle in front of the iris.
The presence of corneal arcus in patients younger than 40 year-old warrants evaluation for systemic lipid abnormalities.
Unilateral arcus is a rare condition associated with contra lateral artery disease or ocular hypotony. Usually it is an asymptomatic condition and does not affect your vision.

Eye examination performed by eye doctor can diagnose arcus senilis. A slit lamp microscope is a very helpful tool to evaluate eye thoroughly. A special eye drop is used to widen the pupil of the patient. Once the eye drops works, ophthalmologist can inspect all parts of the eye with back of the eye as well for any disease. In arcus, thickness of the vessels increases due to fat deposition. Surgeon has to look for signs of atherosclerosis also, which is a condition where arteries become clogged with fatty substances.

A blood test will determine whether someone has high cholesterol. If they do, they may be prescribed medicine or advised on a suitable diet and exercise program to lower the cholesterol in their blood.

How corneal arcus is managed?
The good news is, you don’t need to treat arcus senilis. It typically affects both eyes, but in some cases only one eye has a grayish arc around the cornea, which may be a sign of poor blood circulation.

Eating healthy foods and exercising regularly are some good ways to keep your eyes healthy. We recommend wearing sunglasses with 100% UV protection when outdoors and safety goggles when doing hazardous tasks as well.

If arcus senilis is a sign of high cholesterol, a doctor may recommend a diet that is low in saturated fats and high in fruit, vegetables, and fiber.

If lipid levels are not controlled by diet and exercise are not enough, several medications can help lower your lipid levels:

Statin drugs block a substance your liver uses to make cholesterol. These drugs include atorvastatin, fluvastatin, pravastatin and rosuvastatin.
Bile acid binding resins force your liver to use more cholesterol to produce digestive substances called bile acids. This leaves less cholesterol in your blood. These drugs include cholestyramine, colesevelam and colestipol.
Cholesterol absorption inhibitors like ezetimibe reduce your body’s absorption of cholesterol.
Drugs may be used to lower triglyceride levels:
Fibrates reduce production of lipids in your liver and increase the removal of triglycerides from your blood.
Niacin reduces the production of lipids by your liver.
Increased exercise and quitting smoking can also help.
Possible complications
Arcus senilis alone is not known to have any complications unless it is a sign of high cholesterol. High levels of cholesterol in a person’s blood can cause significant problems, such as coronary artery disease or cardiovascular disease.

Arcus senilis may sometimes appear as a white ring around the iris due to calcium deposits on the circumference of the cornea, where the white section of your eye (the sclera) and the colored part (the iris) meet (called the limbus). When the deposits consist of calcium, the limbus appears milky and may indicate tissue damage that needs correction.

The blue (or sometimes gray) ring around the iris often is associated with high cholesterol and triglycerides. In turn, this may be an indicator of heart condition that yor are more prone to heart attacks and strokes. When this condition appears in people younger than 60 years old, regular blood tests are normally recommended to monitor elevated lipid levels.

In few other cases, when corneas become opaque, due to genetic mutation it could be from a lowered high-density lipoprotein (HDL) cholesterol level. This condition can result in other eye problems. Principally, this opacification may be related to deficient levels of lecithin cholesterol acyl transferase (LCAT). LCAT is an enzymatic protein responsible for converting free cholesterol into cholesteryl ester.

Cholesterol ester, is then separated into the nucleus of the lipoproteins to produce a synthetic high-density lipoprotein (HDL) chain. This reaction is forced one way, since the deposits are removed from the exterior. So the enzyme is attached to both HDLs and low-density lipoproteins (LDLs) in blood plasma.

This process can result in the manifestation of fish eyes, and it is actually called “fish eye disease.” Corneal opacification can also result from mutations in another HDL protein, the adenosine triphosphate-binding protein ABCA1.

Just because you are younger than 40 and have arcus does not mean you absolutely have elevated lipid levels, but at a very minimum, it is recommended that you have them checked.

Unilateral corneal arcus may be associated with vascular or inflammatory etiologies.

Important Reminder: This information is only intended to provide guidance, not a definitive medical advice. Please consult eye doctor about your specific condition. Only a trained, experienced board certified eye doctor can determine an accurate diagnosis and proper treatment.

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PRK and EPI - LASIK Surgery In Delhi
What is PRK?

PRK ( photorefractive keratectomy ) is a type of laser vision correction procedure to correct the refractive errors that is… myopia, hypermetropia and astigmatism. PRK was one of the earliest laser eye surgery vision correction procedures and has been performed longer than LASIK which has become more popular than PRK now. Similar to LASIK and other types of LVC procedures corneal reshaping is done using an EXCIMER LASER thus allowing the light rays to properly focus on the retina and achieving a clear vision without spectacles.

In both the techniques the laser used is same and corneal reshaping is also the same but the difference lies in the FIRST step. In LASIK in the first step a flap is made either using a microkeratome or a laser , the thickness of the flap varies between 90 to 130 microns and after the procedure is over this flap is repositioned back. In PRK the flap is not made, instead most superficial layer of the cornea called epithelium ( only 45 to 50 microns thick ) is scrapped /removed to expose the deeper corneal layers which is then treated with excimer laser to reshape the cornea. The epithelium regrows and repairs itself within a span of 3 to 4 days 1after the surgery. So PRK is a flapless technique and since the flap is not made, the tissue saved adds to the residual corneal stromal bed thickness thus making PRK a very safe procedure in terms of long term corneal biomechanical stability.

Who are the best candidates for PRK?…in other words what are the indications for PRK
Patients having relatively thin corneas where lasikcan not be done. In patients with thinner corneas making a flap ( in the first step of lasik ) may weaken the cornea later on thus it is better to avoid lasik in these patients and PRK is a preferred procedure.
All those patients who are into contact sports etc , here a possible later trauma to the flap is theoretically avoided.

Because there is no flap made here in this technique unlike lasik ( flap consists of both epithelium and the deeper corneal tissues ) more corneal thickness is available for treatment and also more corneal tissue is left behind, benefitting thin corneas, resulting in safety.
Since there is no flap there are no flap complications which may occur in blade lasik

PRK recovery is slower than lasik. Though one is able to see clearly within a week’s time it takes at least 4 to 6 weeks before the final visual recovery takes place. It is because it takes a few days for the new epithelial cells to grow and fully cover the surface of the eye.
Postoperative recovery period is more painfulas compared to lasik
Slightly more risk of eye infection in postoperative period, however it is minimised with the usage of proper antibiotic eye drops.
There is a minimal risk of postoperative corneal haze postoperatively, however it is minimised with the concurrent use of an intraoperative drug called mitomycin-c.

How is PRK performed?
During PRK, a central approx. 8 to 9 mm area of the uppermost layer of cornea called the epithelium is removed either mechanically or using an alcoholic solution. This is followed by usage of excimer laser rays which very precisely reshape the corneal curvature. This is done by removing corneal tissue in microns the amount of which is proportional to number of glasses in diopters. A drug called mitomycin-c may be applied for few seconds to some patients if indicated to prevent postoperative haze. A soft contact lens called bandage lens is applied for about 3 to 4 days to promote healing and minimize pain and later on removed.

What is the recovery process with PRK?
Patients are advised to rest for a short while after which one can go home. some body must accompany to drive you back home. Post operative antibiotics and anti- inflammatory drugs are applied and prescribed to minimize post operative pain and discomfort and to accelerate healing process.

Patients are followed up the very next day, then on the 4th day to remove the bandage contact lens. Frequent follow ups are required to monitor the progress and to avoid any post op complications.

It takes a bit longer in PRK to recover fully, sometimes to the tune of 10 to 12 weeks. Till then one is very comfortable in carrying out the routine activities. One is able to drive within a week or two. It is important to protect the eyes from direct sunlight ( u v rays ) and one should wear a good UV protecting sunglasses.

The results obtained after PRK are quite similar to LASIK with most of the patients achieving 6/6 vision unaided postoperatively. Glasses are required to read when one crosses the 45 years age barrier due to a natural process called presbyopia.

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Diabetic Retinopathy Treatment From Retina Specialist in Mumbai - Dr. Jatin Ashar
Diabetic Retinopathy Treatment In Ghatkopar
Diabetic retinopathy is a form of eye disease caused by chronically high or variable blood sugar that is associated with diabetes. If left untreated, diabetic retinopathy can lead to vision loss and blindness. The condition develops slowly throughout many years; therefore, it is essential to undergo regular eye tests when you have Diabetes. Retinopathy is basically impaired blood vessels in the retina which is the thin inner light-sensitive layer situated in the back of the eyes. In some cases, these vessels will swell up (macular oedema) and leak fluid into the rear of the eye. In other cases, abnormal blood vessels will grow on the surface of the retina.

Diabetic retinopathy occurs in three stages:
Background retinopathy - Background retinopathy is said to occur if you have developed microaneurysms on your retina. Microaneurysms are when there is a swelling of the capillaries (very small blood vessels) that feed the retina. It is an early warning sign that your diabetes has lead to some damage of the small blood vessels of your retina.
Diabetic maculopathy - The macula is the part of the eye that helps to provide us with our central vision. Diabetic maculopathy is when the macula sustains some form of damage. One such cause of macular damage is from diabetic macular oedema whereby blood vessels near to the macula leak fluid or protein onto the macula.
Proliferative retinopathy - If a significant number of blood vessels on the retina become damaged, your body will respond by releasing a growth hormone known as Vascular Endothelial Cell Growth Factor (VEGF). The growth hormone stimulates the growth of new blood vessels. However, these new blood vessels are particularly weak and prone to leaking. Proliferative retinopathy is the body’s attempt to save its retina but it can often lead scarring of the retina and can cause the retina to detach, leading to blindness.
You might not have any signs of diabetic retinopathy until it becomes serious. When you do have symptoms, you might notice:

Loss of central vision, which is used when you read or drive
Not being able to see colors
Blurry vision
Holes or black spots in your vision
Floaters, or small spots in your vision caused by bleeding
Poor night vision
Risk factors
Anyone who has diabetes can develop diabetic retinopathy. Risk of developing the eye condition can increase as a result of:

Duration of diabetes — the longer you have diabetes, the greater your risk of developing diabetic retinopathy
Poor control of your blood sugar level
High blood pressure
High cholesterol
Tobacco use
Being African-American, Hispanic or Native American
Treatment of diabetic retinopathy depends on the extent of the disease.

Eye Injections - Eye Medications called vascular endothelial growth factor (VEGF) inhibitors can be used to help stop the growth of new blood vessels and improve vision. Most people who receive these injections will need to get them for at least three months. Over time, some people may need to get them less often or may no longer need them at all, but others will need to continue in order to protect their vision.
Focal laser surgery - This surgery attempts to stop or reduce the leaking of blood or fluid into the eye by burning and sealing the damaged blood vessels.
Photocoagulation - This is usually done in your doctor’s office as an outpatient procedure during a single session. The procedure may or may not restore your vision to normal, but it should prevent your condition from worsening.
Scatter laser surgery - This surgery uses lasers to burn the damaged blood vessels so that they shrink. This procedure may require more than one application, and your vision may be blurry for a day or more after each session. You may also experience loss of peripheral vision or night vision after the procedure.
Vitrectomy - This surgery is done under general anesthesia and involves making a tiny incision in the eye to remove blood from the vitreous fluid, as well as any scar tissue that may cause retinal detachment.
Diabetic retinopathy involves the abnormal growth of blood vessels in the retina. Complications can lead to serious vision problems:

Vitreous hemorrhage - The new blood vessels may bleed into the clear, jelly-like substance that fills the center of your eye. If the amount of bleeding is small, you might see only a few dark spots (floaters). In more-severe cases, blood can fill the vitreous cavity and completely block your vision. Vitreous hemorrhage by itself usually doesn't cause permanent vision loss. The blood often clears from the eye within a few weeks or months. Unless your retina is damaged, your vision may return to its previous clarity.
Retinal detachment - The abnormal blood vessels associated with diabetic retinopathy stimulate the growth of scar tissue, which can pull the retina away from the back of the eye. This may cause spots floating in your vision, flashes of light or severe vision loss.
Glaucoma - New blood vessels may grow in the front part of your eye and interfere with the normal flow of fluid out of the eye, causing pressure in the eye to build up (glaucoma). This pressure can damage the nerve that carries images from your eye to your brain (optic nerve).
Blindness - Eventually, diabetic retinopathy, glaucoma or both can lead to complete vision loss.
To schedule an appointment with our experts for Diabetic Retinopathy Treatment In Ghatkopar, please call us at +91 8451045935, +91-8451045934 or visit our clinic at Address.

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Sport Injury Treatment in Delhi by Pain Specialist Doctor in Delhi - Dr. Amod Manocha
Sports Injuries Prevention

Overuse and trauma are two common factors responsible for sports injuries. Both intrinsic (such as age, fitness level, muscle strength etc) and extrinsic factors (such as equipment, environment, type of activity etc) play a role in injuries.

Prevention of injuries may involve changing of training schedule, gear, training, practicing environment and style and many other factors. Primary prevention deals with prevention of an injury whereas secondary prevention is about prevention of re occurrence of injury. As "Prevention is better than cure," here are some tips that can help you prevent sports injuries. Whilst most of these may seem like common knowledge, you would be surprised by how many injuries can be avoided by following these tips.

Tip 1: Understand the importance of physical conditioning and know your limits
This factor is often overlooked by amateurs who easily succumb to temptation and overindulge. It is easy to get carried away when you return to sports after a long time. Knowing ones limits, gradually increasing the intensity and duration of training can help in injury prevention. Regular exercise is an effective way to energize your body and keep fit. On the other hand aggressive training beyond ones capabilities and the resulting overuse, fatigue, poor judgment makes injuries more likely.

Be mindful of old injuries and listen to your body. Warning signs such as joint pain, tenderness, and swelling are reasons to re-evaluate your technique and routine.

Tip 2: Invest in the right sporting gear
This includes every essential bit of equipment required for playing a particular sport, starting from the right shoes to the protective equipment such as helmets, gloves, protective pads etc. Right gear not only protects you from injuries but can also enhance your performance.

Tip 3: Warm and stretch your muscles
Warmed up muscles are less prone to injuries and overlooking warm-up sessions can cost one dearly. Warm up raises the core body temperature and gears up the body for the intended exercise. It helps by increasing the blood flow to muscles improving the muscle efficiency, range of motion and stretching the muscles being used in particular sports. Stretching to the point of tension (not pain) helps to reduce stiffness and improve flexibility, thereby reducing the chances of injury.

Warm up may be general or specific to the intended sport. The right exercises would vary depending on the sports. Starting the sport at a slow pace can be helpful. If you closely observe your sporting idols, you will always see them warm up prior to any game.

Tip 4: Use the right technique and follow the rules of the game
Correct techniques to play a sport are defined to minimize the chances of injuries and maximize your performance. The same can be said about the rules of the game. Incorrect overzealous manoeuvre can predispose one to injuries and hence the importance of concentrating on the precise technique. One example which I can quote as I commonly see this in my clinic is back injuries due to incorrect dead lift technique. Often that temptation to add the extra 5kgs compromises the technique predisposing one to injuries.

Selecting the appropriate surface for sports is equally important especially for repetitive activities such as running, jumping where the impact force on the body is magnified by 3- 12 times. Impact force on hard surfaces is much higher increasing the injury chances.

Tip 5: Cool down
Cooling down is another injury prevention technique that helps to return the heart rate, breathing, and blood pressure to the pre-training levels. It can also help to limit the post exercise muscle soreness and flush out toxins produced during the training.

Tip 6: Adequate recovery
Adequate recovery is essential no only for avoiding injuries but also for the full training effect. Inadequate recovery can lead to tiredness, lethargy, mental fatigue and impaired performance. Adequate recovery includes warm down sessions, re stand sleep, psychological and nutritional advices.

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Our team published a very important review on Multisystem Inflammatory Syndrome in Children | Dr. Sidharth Kumar Sethi
Our Team Published A Very Important Review On ‘Multisystem Inflammatory Syndrome In Children
Our team published a very important review on ‘Multisystem Inflammatory Syndrome in Children with COVID- A Pediatric Nephrologist’s Perspective’ in journal ‘Clinical Kidney Journal’. This review is very important for all physicians, Pediatricians and Nephrologists taking care of children with COVID and AKI.

About Dr.
Dr. Sidharth Kumar Sethi
Kidney & Urology Institute
He was trained as a Fellow (International Pediatric Nephrology Association Fellowship) and Senior Resident in Pediatric Nephrology at All India Institute of Medical Sciences and Division of Pediatric Nephrology and Transplant Immunology, Cedars Sinai Medical Centre, Los Angeles, California. He has been actively involved in the care of children with all kinds of complex renal disorders, including nephrotic syndrome, tubular disorders, urinary tract infections, hypertension, chronic kidney disease, and renal transplantation. He has been a part of 8-member writing committee for the guidelines of Steroid Sensitive Nephrotic Syndrome and Expert committee involved in the formulation of guidelines of Pediatric Renal Disorders including Steroid Resistant Nephrotic Syndrome and urinary tract infections. He has more than 30 indexed publications in Pediatric Nephrology and chapters in reputed textbooks including Essential Pediatrics (Editors O.P. Ghai) and “Pediatric Nephrology” (Editors A Bagga, RN Srivastava). He is a part of Editorial Board of “World Journal of Nephrology” and “eAJKD- Web version of American Journal of Kidney Diseases”. He is a reviewer for Pediatric Nephrology related content for various Pediatric and Nephrology journals.

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Skin Treatment in Vasundhara, Skin Care Treatment in Vasundhara at Twachaaclinic
Skin Treatment in Vasundhara
Acne (Pimples)/ Rosacea
Acne is one of the most common skin conditions worldwide today. The myths surrounding the subject make it hard to separate the facts from the fiction. We understand the huge impact that acne can have on your life, causing embarrassment, affecting self-esteem and personal relationships – in short, it really gets you down.

Pigmentory Disorders (Blemishes, Freckles Etc.)
Hyper pigmentation indicate an increased amount of melanin, leading to darker color of the skin. This includes melasma, freckles, lentigenes, post inflammatory pigmentation and many others. We can guide you to reduce these unsightly blemishes through continuous skin care and a range of treatment options available with us.

Wrinkles/ Sagging Skin
In this era of cosmetic dermatology you can easily get years off your face by losing those ugly wrinkles. We provide you with the most advance treatment options to smoothen your skin and look young again.

Stretch Marks
Stretch marks are often the result from rapid weight gain or loss, rapid growth or can be caused by hormonal changes due to puberty, pregnancy, muscle building or hormone replacement therapy. We can reduce your stretch marks with the help of Microdermabrasion, Peels, Fractional Laser and Dermaroller.

Eczema/Skin Allergy/ Urticaria
Rashes, hives, itching – the suffering is always underestimated. We at Twachaa Clinic understand you and your allergies can help you live symptom free. Over and above medications we provide facility for allergy testing and immunotherapy.

This disease, characterised by thick red scaly lesions over body and scalp, has a lot of psychological impact. A range of treatment options are available depending on multiple factors like age, severity, distribution, medical illness etc.

Vitiligo commonly known as leukoderma is one of the most dreaded skin disease though it is really harmless. There are many myths about this disease like it is contagious and it cannot be corrected. With so much advancement in medical science, it is possible to get your pigment back either by medical or surgical treatment in most of the cases.

Tinea (Fungal Infection)
Tinea, once easily treatable, has now becoming resistant due to self medications and incomplete treatment. It now demands treatment in expert hands.

Warts / Tags/ Moles/ Cyst
These can be removed using radio frequency surgery.

Pediatric Skin Conditions
All pediatric skin diseases will be addressed at Twachaa skin clinic like diaper rash, cradle cap, eczema, skin infections, birth marks etc.

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Best Otology Doctor in Delhi, India | Dr.(Prof.) Ameet Kishore
Ear (Otology) Doctor In Delhi, India
Your ear problems need advice from an expert. You can now consult to the Best Otology Doctor In India for any issue related to Otology. A right advice after a complete diagnosisfrom an experienced professional can help you to achieve the necessary relief with the hearing issues. An experienced and qualified specialist is now available in your city.

A tympanoplasty is an operation that is aimed to remove infection from your ear and close a hole in your eardrum. The aim of thisoperation is to prevent repeated ear infections and if repair certain types of hearing losses. With the perfect diagnosis from Best Octology Doctor in India you can gain your hearing back. With the availability of modern equipment and state-of-the-art facilities, our staff will extend you the best service.

A stapedotomy (or stapedectomy) is an operation to help improve hearing in those patients who suffer from a condition called otosclerosis. In this delicate operation a part of the fixed stapes bone is removed and replaced with an artificial piston. Performed by Best Otology Doctor In India to enhance the transmission of sound to the internal ear, stapedectomy treats dynamic hearing loss brought on by otosclerosis, a condition in which bone solidifies around the base of the stapes.

An ossiculoplasty is an operation to help improve hearing in those patients where hearing loss is due to damage to the ossicles (tiny hearing bones) following chronic ear infection. In this operation we may either use your own residual ossicle or an artificial ossicle to achieve the desired result. In a few sorts of ear surgery that incorporates an ossicular chain repair, the surgical approach is through the ear canal (outside sound-related channel) and this is called an endaural approach.

A mastoidectomy is an operation that is aimed to remove any pocket of dead skin and infection in your ear and mastoid bone (ear bone) and thus stop ear discharge. The infection in the ear can spread to the temporal / mastoid bone. Your ENT specialist may need to evacuate parts of the temporal bone if this happens. This can cause hearing loss. You can expect some hearing distress from a radical and modified radical mastoidectomy. This operation isn't as common as it used to be. These days the expert Ear Surgeon can reconstruct the defects caused by the disease or the surgery at the same time as the primary operation. Antibiotics ordinarily treat infections, yet surgery is an alternative if antibiotics are not effective.

We provide to all aspects of ENT surgeries and ENT treatments, from the very elementary to the most exceptional, with the association of our ENT Specialist, Consultants, Onco-Surgeons, Plastic Surgeons, therapists, practitioners, rehabilitators, and assistance staff. Guided by the extensive knowledge, excellent expertise, and clear vision, we are providingthe best ENT health care in the Capital city.

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Best ENT Doctor in India, ENT Specialist in India - Dr. Ameet Kishore
Best ENT Doctor in india - Dr. Ameet Kishore

Dr (Prof) Ameet Kishore is a graduate of the AFMC (Pune) and was awarded the medal for ENT. He obtained his higher surgical training in ENT Surgery in the UK and attained Fellowships of the Royal College of Surgeons of Edinburgh as well as the Royal College of Physicians and Surgeons of Glasgow.

He has received special training and experience in Microscopic Ear surgery, Neuro-Otology, Cochlear Implants, Endoscopic Sinus Surgery and in Paediatric ENT at various centres in UK, Europe and USA.

He was trained at the National Centre for Cochlear Implantation (UK) since 1995 and thus has extensive experience in management of deafness and in cochlear implantation. He set up and is the lead surgeon for the cochlear and hearing implant programme (for children and adults) at Apollo Hospitals. He has over 1800 cochlear implant recipients in this programme.

His team is particularly experienced in management of complex cochlear situations and is the only active programme in North India for Auditory Brainstem Implantation.

This programme also provides Bone Anchored Hearing Aids (BAHA), Bonebridge and Vibrant Soundbridge middle ear implants as options for patients with hearing loss.

Dr Kishore has large experience in endoscopic nasal and sinus surgical procedures like Functional Endoscopic Sinus Surgery (FESS) and Balloon Sinuplasty. Also performs advanced endoscopic procedures such as orbital decompression, optic nerve decompression, dacryocystorhinostomy (DCR), endoscopic closure of CSF leaks and endoscopic pituitary tumour surgery.

He was trained at the Royal Hospital for Sick Children, Glasgow in the Paediatric ENT, and is competent in the management of the child with common ENT problems as well as complex conditions that affect the paediatric ear, nose, throat and airway.

Is experienced in the management of conditions and lumps of the head and neck, salivary and thyroid gland. Well versed in microlaryngeal surgery and phonosurgical techniques for hoarseness.

He held the post of Consultant and Sr Lecturer at the Glasgow Royal Infirmary University Hospital for a number of years before returning to India, having spent over 15 years overseas.

His academic profile includes 6 book chapters, over 30 articles in peer reviewed journals and numerous presentations at National and International Conferences.

With over 25 years of ENT experience, he is Sr Consultant in ENT & Neurotology at Indraprastha Apollo Hospital, New Delhi and the Founder Director & Lead Consultant of Adventis ENT, Head Neck & Cochlear Implant Clincs.

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Treatment For Corneal Dystrophies in Ghatkopar - Mumbaieyecare
Corneal Dystrophy

Corneal distrophies are a group of rare and genetic diseases affecting the cornea. It runs in a families and may be present asymptomatic. They affect both the eyes and other parts of the families are not involved. Main cause of corneal dystrophies is foreign material build up in the cornea and that results in clouding of cornea and visual impairment.

The cornea is made up of five distinct layers:
The Epithelium - the outermost, protective layer of the cornea.
The Bowman's membrane - this second layer is extremely tough and difficult to penetrate further protecting the eye
The Stroma - the thickest layer of the cornea, consisting of water, collagen fibers and other connective tissue components that give the cornea its strength, elasticity and clarity.
Descemet's Layer - a thin, strong inner layer that also acts as a protective layer.
The Endothelium - the innermost layer consisting of specialized cells that pump excess water out of the cornea
Types of corneal dystrophies:
There are 20 different types of corneal distrophies but are groped in 3 main categories:

Anterior or superficial corneal dystrophies. These affect the outermost layers of the cornea: the epithelium and Bowman’s membrane.
Stromal corneal dystrophies affect the stroma, which is the middle and thickest layer of the cornea.
Posterior corneal dystrophies affect the innermost parts of the cornea: the endothelium and the Descemet membrane. The most common posterior corneal dystrophy is Fuchs’ dystrophy.
Symptoms of Corneal distrophies:
Symptoms like watery eyes, dry eyes, corneal erosions, Blurry vision, halos around light, light sensitivity and difficulty in seeing at night often overlaps with diseases like glaucoma and cataract. Two differentiating symptoms are pain and a feeling of something in the eye occurs in the corneal distrophies. As the condition worsens vision becomes poor and irregularities in the cornea may lead to fluctuating vision.

Who is at risk for corneal dystropies?
People having family history of the disease are at more risk than others. Corneal dystrophies can appear at any age. Men and women are equally affected by most corneal dystrophies, except for Fuchs’ dystrophy. Fuchs’ affects women more frequently than men.

What are my treatment choices?
Treatment for corneal dystrophies may vary from eye drops to corneal transplant and depends on:

The type of dystrophy
The severity of symptoms
In few cases, people with corneal dystrophy may have repeated corneal erosion. This condition may be treated with antibiotics, lubricating eye drops, ointments, or special soft contact lenses that protect the cornea. If erosion continues, other treatment options may include the use of laser therapy or a technique for scraping the cornea.

In severe cases, a corneal transplant (called keratoplasty) may be necessary. The damaged or unhealthy corneal tissue is removed and clear donor cornea tissue is put in its place. For endothelial dystrophies, such as Fuchs’ dystrophy, a partial cornea transplant (or endothelial keratoplasty) is used.

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Smile Eye Surgery in Delhi - Lasikdelhi
Smile Eye Surgery
SMILE is an advanced surgery for enhancing vision and is less invasive as compared to LASIK. It is a one-step procedure and provides enhanced and clear vision

What is the procedure of SMILE surgery?
SMILE, also known as Small Incision Lenticule Extraction which is significantly less invasive than LASIK surgery but provides the results like this surgery. Through a focused, computer-guided LASER, the surgeon makes a small incision on the cornea. With the help of this incision, a small corneal tissue is removed which results in reshaping of the cornea. With the help of highly-focused light, the surgery is done with high precision.

The procedure ends within a minute and the patient starts feeling better within 24 hours after surgery.

What are the benefits of SMILE?
Minimally Invasive Procedure:
As compared to PRK and LASIK surgery, the SMILE is less invasive. During the LASIK surgery, a corneal flap of 20 mm is created while in PRK, an incision of 8-mm is created. In the SMILE, the vision is corrected by creating only a 3 mm incision.

No formation of flap:
Although LASIK surgery is a highly safe procedure complication may arise in a few patients because of the flap creation. SMILE does not cause flap formation and thus, is safer, as compared to LASIK.

Odorless Procedure:
Due to the corneal ablations in LASIK surgery through excimer laser, the patient may smell an odor. As SMILE does not use an excimer laser, the procedure is completely free from the odor.

Fast recovery:
As the SMILE procedure is minimally invasive, the patient may recover fast and the vision is enhanced within a day after surgery. The results of the SMILE procedure are like that of LASIK surgery.

Fewer complications:
The patients undergoing SMILE procedure have fewer chances of complications as compared to LASIK surgery. There is less risk of halos or glare complications and have less incidence of dry eye syndrome.

Who are good candidates for the SMILE procedure?
SMILE procedure is effective in those patients who do not meet the criteria for LASIK surgery. These candidates include patients with a thin cornea, suffering from dry eye syndrome, and are involved in contact sports.

What is the difference between LASIK and SMILE?
Both procedures are used to correct the eye vision and to remove the spectacles and contact lenses. However, SMILE is safer as compared to LASIK surgery. The recovery period in the SMILE procedure is also less as compared to LASIK. SMILE surgery is less invasive and there is no creation of a flap in SMILE procedure.

SMILE is developed by using the traditional system of vision correction with the advancement in reducing the side effects. Experienced ophthalmologists should do SMILE surgery.

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