Introduction
ReLEx SMILE and Lasik surgery are effective methods for correcting the eyesight. Both procedures allow the patients to get rid of glasses and contact lenses. There are certain differences between these procedures.

Lasik Eye Surgery
Lasik eye surgery is one of the preferred surgical interventions for treating myopia, hyperopia, and astigmatism. Lasik stands for Laser-Assisted In-situ Keratomileusis. The Lasik eye surgery is safe and effective in managing the eyesight. The surgery lasts for 15-20 minutes, and the patient needs a day to stabilize after the surgery. During the Lasik eye surgery, the doctor creates and lifts a corneal flap, reshapes the corneal tissue, and put the flap back into its original position. Lasik does not cause pain in the eye, and the patient experiences vision correction immediately after the surgery. With sufficient post-operative care, post-operative complications are quite rare.

RELEX SMILE
ReLEx SMILE is a minimally invasive eye surgery to correct myopia, hyperopia, and astigmatism. It is a flapless procedure. ReLEx SMILE stands for Refractive Lenticule Extraction and Small incision lenticule extraction. It is the most recent, advanced, and novel surgery for vision correction. Carl Zeiss Meditec had developed this procedure. The SMILE was previously called Femtosecond lenticular extraction. The surgery is bladeless and stitch-less, and the patient does not experience any pain. It makes use of the femtosecond laser to prepare a 3D map of the eye tissues. This increases the accuracy, safety, and outcome of the procedure.

Difference Between LASIK AND RELEX SMILE
Lasik Eye surgery is currently the trending option for correcting vision problems, while ReLEx SMILE is a novel and advanced procedure. There are differences between both procedures. Some of these differences are:

Procedural difference: Both ReLEx SMILE and Lasik consists of two steps. However, there are certain basic procedural differences. The degree of incision in Lasik is 270 degrees, while in ReLEx SMILE, it is 90 degrees. Lasik comprises creating and lifting the flap on the upper surface of the cornea and reshaping the tissues of the lower layer. The surgeons create a flap because it is highly uncomfortable for the patient if the surgery is done on the first layer due to its high sensitivity. The surgeon reshapes the cornea with the help of an excimer laser.

Unlike a flap formation in Lasik surgery, the ReLEx SMILE comprises the creation of an intrastromal lenticule. For creating the lenticule, the doctor makes two cuts, i.e., posterior refractive cut and anterior cap cut. To get access to this lenticule, the doctor creates a small opening. In the next step, the doctor reshapes the cornea by dissecting and removing the lenticule. ReLEx SMILE provides excellent outcomes due to the use of the wavefront-optimization technique.

Different types of Laser: There is a difference in the type of laser used in ReLEx SMILE and Lasik surgery. ReLEx SMILE only uses a femtosecond laser by Carl Zeiss Meditec, which provides a highly detailed eye mapping. Lasik uses various types of excimer laser or the microkeratome. In some cases, the doctors may also use a femtosecond laser in Lasik.

Recovery time: Recovery time for Lasik and ReLEx SMILE is different for different activities. As the ReLEx SMILE has no cuts and there is no flap formation, the patients with this surgery resume normal activities such as swimming or playing outdoor games within 1-2 days after the procedure. Patient with Lasik surgery requires at least 15 days to a month to resume normal activities. The visual recovery in Lasik surgery is better as compared to ReLEx SMILE. People with Lasik surgery are like to get more comfortable with reading books or working on computer screens earlier in comparison to a patient with ReLEx SMILE procedure.

Scope of treatment: Both Lasik and ReLEx SMILE procedures are safe and effective in treating various eyesight conditions. However, Lasik surgery has a wider scope in treating ocular conditions as compared to ReLEx SMILE. Lasik surgery corrects myopia, hyperopia, and astigmatism. The efficacy of ReLEx SMILE is limited to the correction of myopia and myopic astigmatism. Its efficacy in other conditions is under trial. Lasik surgery may not be an option for people with a thin cornea, while ReLEx SMILE is effective in such cases.

The cost involved: There is a cost difference between the two procedures. ReLEx SMILE is costlier as compared to the Lasik surgery.

Conclusion
ReLEx SMILE and Lasik surgery are safe if performed by the trained surgeons. Some of the basic differences between the two include procedure, types of laser used, cost, and the recovery period.

Voice And Throat (Laryngology) Surgery In Delhi
Video Laryngoscopy Bronchoscopy
Endoscopic evaluation of the larynx (voice box) , trachea ( main wind pipe) and bronchi ( lower airways). This is often required for the diagnosis and treatment of hoarseness, noisy breathing and breathing difficulty.

Micro laryngeal surgery
Surgery of the larynx ( voice box) is carried out under the magnification of an operation microscope. This is use to diagnose and treat a number of conditions that affect the larynx and voice. Often a laser is used for precision.

Phonosurgery
This is a series of surgical procedures carried out on the vocal cords under endoscopy or microscopy to improve the quality of voice in a patient with hoarseness.

Tonsillectomy
Tonsillectomy is an operation where the tonsils are removed. It is usually performed in someone who has recurrent sore throats due to tonsillitis or because they interfere with breathing and swallowing.

Dry Eyes Treatment In Ghatkopar
A dry eye is an uncomfortable and painful condition. It can be understood as an inadequate production of tears leading to dryness of eyes. Dry eyes make you more susceptible to bacterial infections and trauma due to reduced lubrication over the cornea. As tear film is very thin, reading, writing and watching becomes very uncomfortable.

Role of tears
Blinking makes your eyes moist every time and keeps the corneal surface smooth and clean. Tear film contains a combination of oil, water and mucous. Outermost layer is made up of oil as it prevents tear from drying. Second layer (water) comes from lacrimal gland and made up of mostly water as main content. Water washes away any dirt and unwanted particles from the eye to keep it clean. Inner most layer is made up of mucus and formed in conjunctiva, due to this layer tears don’t stick to eyes. In general we see with any irritant, our eyes protective response is to produce tears but in few local and system medical conditions, tear formation is reduced and that hampers with the vision.

Why do I get dry eye condition?
We produce tears all the time, not only when we are emotional but with every blink. Dry eye can be because of various reasons:

Altered composition of tears or tears dry up too fast – imbalance is oil, water and mucous content may result in dry eyes.
Inflammation or trauma to the eye (lacrimal gland, conjunctiva) – dry eyes may result as a consequence to damaged tear producing apparatus.
Medical conditions for less production of tears – autoimmune diseases like lupus, scleroderma, rheumatoid arthritis, Parkinsons disease.
Vitamin A deficiency may result in poor eye health
Disease like diabetes or radiation exposure also affects eye status.
Hormonal imbalance like pregnancy or menopause also reduces tear production.
Drugs like Antihistamins, antidepressants may result in dry eyes.
Corneal nerve desensitivity caused by contact lens or nerve damage by laser eye surgery.
As an aging process.
Other medical conditions can lead to dry eyes, such as the following:

Keratoconjuctivitis - It refers to the inflammation of the surface of your eye, called the cornea or the conjunctiva
Keratitis is another condition that’s caused by irritation or swelling of your cornea when your eyes are dry for too long
Keratoconjuctivitis Sicca – This term is used to describe an autoimmune condition when you aren’t able to produce enough tears and develop an infection or inflammation.
How do I know that I have dry eyes condition?
Symptoms experienced by patients suffering from dry eyes are:

Fatigued and heavy eyes
Sore and itchy eyes
Burning and dryness sensation
Red eyes with blurred vision
Difficulty in wearing contact lenses
Difficulty in night driving
Sensitivity to light and stringy mucous around the eyes
Eyelids sticking together when waking up after sleep
Double vision
How diagnosis is made?
Ophthalmologist conducts a thorough eye examination and certain tests to reach to a final conclusion and design the treatment plan.

Detailed Medical and drug history of systemic diseases may help in diagnosis.
History of trauma and family occurrence can be related to present condition.
Schirmer test – this test is performed to see the volume of your tears, blotting strips of paper are placed under your lower eyelids. After five minutes your doctor measures the amount of strip soaked by your tears.
Phenol red thread test - In this test, a thread filled with pH-sensitive dye (tears change the dye color) is placed over the lower eyelid, wetted with tears for 15 seconds and then measured for tear volume.
Special dyes are used for your eye doctor to check the evaporation of your tears. As tear composition has oil content in it, so if it is reduced, it may lead to quick drying of your tears.
Tear osmolarity test can be done to measure the composition of particles and water in your tears.
Special Tear markers for dry eye disease like matrix metalloproteinase-9 or lactoferrin.
What are my treatment options?
Treatment is purely based on the cause as it may range from behavior modifications to medical procedures.

Behavior modifications like adjustment of your computer screens below eye level, taking short breaks between long tasks. Avoid harsh environments like dry winds, driving without protective eyeglasses; Sunglasses are must on sunny days.
Artificial tears – ophthalmologists prescribe you artificial tears, their composition is just like natural tears. If you are using more than six times a day, preservative free tears are also available in the market.
Treating local factors - warm compresses to the eyes, eyelid cleaners and massaging your eyelids.
Medication to reduce inflammation and infection to the eyes
Tear-stimulating drugs. Drugs called cholinergics (pilocarpine, cevimeline) help increase tear production. These drugs are available as pills, gel or eyedrops
Eye inserts that work like artificial tears. If you have moderate to severe dry eye symptoms and artificial tears don't help, another option may be a tiny eye insert that looks like a clear grain of rice.
Unblocking oil glands - improves the composition of the tears.
Punctal plugs – removal punctal plugs are tiny silicon plugs used to block the tear ducts to prevent tear loss. Punctal occlusion can be done by cautery.
Surgery – sometimes problems like incomplete blinking is treated with surgical procedure by oculoplastic surgeon (specialist in eyelid problems).
Lipiflow - This medical device uses heat and pressure to unclog blocked glands on your eyelids.
Salivary gland transplantation – It is a surgical procedure that is occasionally considered in persistent and severe cases that have not responded to other treatments.
Light therapy - Using intense pulsed light therapy followed by massage.
Prevention
As an aging process, tears production will eventually go down, but still precautions may help to avoid dry eyes discomfort.

Add humidifier to your room in winters
At high altitudes or extreme winters, take care of your eyes as dry winds may be traumatic to your eyes and tear producing apparatus.
If you are a person spending more time on computer or phone, take short brakes during your tasks as your eyes get tired by long focus and radiation exposure.
Use sunglasses while going outdoors
Use of ointments instead of drops
Frequent washing of your eyes also serves a natural way for eye moisture and cleaning.
Mild soap use to reduce the irritation.
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.

To schedule an appointment with our experts for Dry Eye Treatment in Ghatkopar, please call us at +91 8451045935, +91-8451045934 or visit our clinic at Address.

For more information = https://www.mumbaieyecare.com

Testing for and diagnosing nephrotic syndrome in children

Testing For And Diagnosing Nephrotic Syndrome In Children
Nephrotic syndrome explained:
Nephrotic syndrome is a condition which affects the kidneys and the miniscule filtering system within it, called the nephrons. There is damage to these structures as a result of various reasons, and mostly in children the cause remains unknown, also known as idiopathic nephrotic syndrome. As a result of this damage, the kidney starts to filter less of the substances that it usually helps our body get rid of, and it also starts to filter in excess certain substances which are useful to the body. Therefore an affected child usually presents with certain characteristic symptoms, including, swelling of the tissues, especially in the face and abdomen.

Diagnosing the condition:
It is when a child presents with this characteristic symptom of swelling in most areas of the body, that your doctor/pediatrician will suspect nephrotic syndrome. It is very important that the diagnosis is made correctly, because only then can prompt treatment be started in order to effectively manage the condition. Nephrotic syndrome is a condition which can be accurately diagnosed using a few tests, because the condition has some telltale signs which can easily be detected.

The investigations used to diagnose nephrotic syndrome:
The diagnostic tests which are carried out when a doctor suspects nephrotic syndrome in your child include:

Urine test – to look for the levels of protein in the urine, because nephrotic syndrome results in increased leakage of protein form the kidney and high levels of protein in the urine. The urine is also tested under the microscope in order to look for signs of inflammation of the kidney and kidney damage, which may indicate the type of nephrotic syndrome your child is suffering from.
Blood test – in order to look for the level of protein in the blood, because the increased leakage of protein in the urine, will result in reduced levels of protein in the blood, which is the reason why the child develops swelling within the body tissues.
Renal biopsy – Children usually do not require kidney biopsy at the onset. Which is a test where a small sample of kidney tissue is drawn out using a needle, and viewed under a microscope, in order to see the changes which have occurred in the kidney tissue. Some children may require additional immunosuppression if they frequently relapse or are steroid dependent.
Nephrotic syndrome can present in two forms. The first known as Minimal Change Disease is the most common form to affect children, and is a form that doesn’t show a lot of damage or change in the urine test, and even in the biopsy, there will not be any identifiable damage to the filtering system of the kidney. The second form known as Focal Glomerular Sclerosis, is a more aggressive form of the disease, and shows extensive damage in the urine test as well as renal biopsy.

On certain occasions, if your child is very symptomatic, your doctor will begin treatment straight away without waiting for the tests to confirm which form of nephrotic syndrome your child is suffering from. The treatment for nephrotic syndrome is a course of steroids, which are administered daily, till your child becomes symptom free. Once the treatment has commenced if it is minimal change disease, it will respond well to the treatment and immediate signs of improvement can be seen in your child. But if it Focal Glomerular Sclerosis, then it will not respond well to treatment with steroids.

For more information = http://www.pediatricnephrologyindia.com/

Age Related Macular Degeneration

Human eye has various important parts like Cornea, Pupil, Iris, Lens and Retina. The macula is located in the center of the retina, the light-sensitive tissue at the back of the eye. The retina instantly converts light, or an image, into electrical impulses. The retina then sends these impulses, or nerve signals, to the brain. When the cells of the macula deteriorate, images are not received correctly. In early stages, macular degeneration does not affect vision. Later, if the disease progresses, people experience wavy or blurred vision, and, if the condition continues to worsen, central vision may be completely lost. People with very advanced macular degeneration are considered legally blind. Macular Degeneration is the leading cause of vision loss, more than cataracts and glaucoma combined.

Macular degeneration is classified as:
Dry Age related Macular Degeneration
Wet Age related Macular Degeneration.
Pathophysiology
The dry form is more common than the wet form, with about 85 to 90 percent of AMD patients diagnosed with dry AMD. The less common wet AMD usually leads to more serious vision loss.

Dry AMD causes changes of the retinal pigment epithelium, typically visible as dark pinpoint areas. The retinal pigment epithelium plays a critical role in keeping the cones and rods healthy and functioning well. Accumulation of waste products from the rods and cones can result in drusen, which appear as yellow spots. Areas of chorioretinal atrophy (referred to as geographic atrophy) occur in more advanced cases of dry AMD. There is no elevated macular scar (disciform scar), edema, hemorrhage, or exudation.

Dry AMD has three stages, all of which may occur in one or both eyes:

Early AMD - People with early AMD have either several small drusen or a few medium-sized drusen. At this stage, there are no symptoms and no vision loss.
Intermediate AMD - People with intermediate AMD have either many medium-sized drusen or one or more large drusen. Some people see a blurred spot in the center of their vision. More light may be needed for reading and other tasks.
Advanced AMD - In addition to drusen, people with advanced dry AMD have a breakdown of light-sensitive cells and supporting tissue in the central retinal area. This breakdown can cause a blurred spot in the center of your vision. Over time, the blurred spot may get bigger and darker, taking more of your central vision. You may have difficulty reading or recognizing faces until they are very close to you.
Wet AMD occurs when new abnormal blood vessels develop under the retina in a process called choroidal neovascularization (abnormal new vessel formation). Localized macular edema or hemorrhage may elevate an area of the macula or cause a localized retinal pigment epithelial detachment. Eventually, untreated neovascularization causes a disciform scar under the macula.

Symptoms
Dry macular degeneration symptoms usually develop gradually and without pain. They may include:

Visual distortions, such as straight lines seeming bent
Reduced central vision in one or both eyes
The need for brighter light when reading or doing close work
Increased difficulty adapting to low light levels, such as when entering a dimly lit restaurant
Increased blurriness of printed words
Decreased intensity or brightness of colors
Difficulty recognizing faces
What causes macular degeneration?
Though macular degeneration is associated with aging, there is genetic component to the disease. A strong association between development of AMD and presence of a variant of a gene known as complement factor H (CFH) is observed. This gene deficiency is associated with almost half of all potentially blinding cases of macular degeneration.

Other investigators have found that variants of another gene, complement factor B, may be involved in development of AMD.

Specific variants of one or both of these genes, which play a role in the body's immune responses, have been found in 74 percent of AMD patients who were studied. Other complement factors also may be associated with an increased risk of macular degeneration.

Oxygen-deprived cells in the retina produce a type of protein called vascular endothelial growth factor (VEGF), which triggers the growth of new blood vessels in the retina.

The normal function of VEGF is to create new blood vessels during embryonic development, after an injury or to bypass blocked blood vessels. But too much VEGF in the eye causes the development of unwanted blood vessels in the retina that easily break open and bleed, damaging the macula and surrounding retina.

Risk Factors
The biggest risk factor for Macular Degeneration is age. Your risk increases as you age, and the disease is most likely to occur in those 55 and older.

Other risk factors include:

Genetics – People with a family history of AMD are at a higher risk.
Race – Caucasians are more likely to develop the disease than African-Americans or Hispanics/Latinos.
Smoking – Smoking doubles the risk of AMD.
Diagnosis
AMD is detected during a comprehensive eye exam that includes:

Visual acuity test - This eye chart test measures how well you see at various distances.
Dilated eye exam - Drops are placed in your eyes to widen the pupils. Your eye care professional uses a special magnifying lens to examine your retina and optic nerve for signs of AMD and other eye problems. After the exam, your close-up vision may remain blurred for several hours.
Tonometry - An instrument measures the pressure inside the eye. Numbing drops may be applied to your eye for this test.
Both forms of age - related macular degeneration (AMD) are diagnosed by funduscopic examination. Visual changes can often be detected with an Amsler grid.
Color photography and fluorescein angiography are done when findings suggest wet AMD. Angiography shows and characterizes subretinal choroidal neovascular membranes and can delineate areas of geographic atrophy. Optical coherence tomography (OCT) aids in identifying intraretinal and subretinal fluid and can help assess response to treatment.
What Treatments Are Available for Macular Degeneration?
There’s no cure for macular degeneration. Treatment may slow it down or keep you from losing too much of your vision. Your options might include:

Lifestyle changes - like dieting, exercise, avoiding smoking, and protecting your eyes from ultraviolet light.
Anti-angiogenesis drugs - These medications – aflibercept (Eylea), bevacizumab (Avastin), pegaptanib (Macugen), and ranibizumab (Lucentis) -- block the creation of blood vessels and leaking from the vessels in your eye that cause wet macular degeneration. Many people who’ve taken these drugs got back vision that was lost. You might need to have this treatment multiple times.
Laser therapy - High-energy laser light can destroy abnormal blood vessels growing in your eye.
Photodynamic laser therapy - Your doctor injects a light-sensitive drug verteporfin (Visudyne) into your bloodstream, and it’s absorbed by the abnormal blood vessels. Your doctor then shines a laser into your eye to trigger the medication to damage those blood vessels.
Low vision aids - These are the devices that have special lenses or electronic systems to create larger images of nearby things. They help people who have vision loss from macular degeneration make the most of their remaining vision.
Submacular surgery - This removes abnormal blood vessels or blood.
Retinal translocation - A procedure to destroy abnormal blood vessels under the center of your macula, where your doctor can’t use a laser beam safely. In this procedure, your doctor rotates the center of your macula away from the abnormal blood vessels to a healthy area of your retina. This keeps you from having scar tissue and more damage to your retina. Then, your doctor uses a laser to treat the abnormal blood vessels.