Overview
The Department of Ophthalmology at RAIGAD Hospital brings to you some of the most experienced Ophthalmologists who consistently deliver state of the art care. Each service offering is designed to further our lifelong tradition of being a centre of excellence in everything we do. Here you will find a multi specialty group of surgical, research, and clinical consultants working in an integrated setting to provide the highest-quality for close to a patients. We are equipped with the latest diagnostic and surgical facilities to deliver the comprehensive best of practices care from simple routine eye examinations to the most complex surgical cases.
The multidisciplinary expertise and managed care protocols implemented ensure care of not just primary disorders of the eye but also eye problems related to other systemic diseases like diabetes, thyroid disorders, autoimmune conditions, stroke etc.
Comprehensive Ophthalmology Care
This division of our department provides the most basic care for your eyes. We offer a full complement of services one might need. These include: Screening and treatment for common eye diseases (e.g., cataract, glaucoma, diabetes-related eye problems, , hypertension, thyroid) Spectacle and Contact Lens prescriptions Evaluation of patients who may have visual loss or complaints but do not know the diagnosis.
It serves as the entry point for patients needing specific additional medical or surgical services. Once evaluated comprehensively, each patient is advised a highly individualized treatment plan to ensure optimum compliance with his/her personal and professional requirements. With us, you will find specialists who are pioneers in their field not just by what they treat, but also how they treat you. Within them exists a self-sufficient referral network. Each doctor is capable of handling a multitude of cases and offers that extra expertise to deal with what very few can claim mastery over.
FACILITIES
Enabled by our continuous commitment to quality health care, we have behind us years of experience which helps us even today to make a positive difference in lives of patients. This hallmark of care at RAIGAD Hospital extends to each and every aspect of the whole spectrum of care services we offer.
Our state of the art digitalized OT Complex has been researched developed and installed to deliver the highest level of patient safety and comfort.
The highlights of our OT complex are amongst the many firsts in the country:
Compliance with international guidelines in relevant infection control and engineering measures.
Cutting edge state of the art equipments
Highest level of patient safety and comfort
Medical Guided Airflow Ventilation for ultra clean, three directional airflow to create a clearly defined sterile zone, wider and more energy efficient than conventional cross flow systems
High efficiency Particulate Air-filters giving 99.97%filtration efficiency @3 micron particles.
High air change rates within the sterile zone to achieve particle dilution (dilution of bacteria dispersed by surgical personnel and adjacent areas.
CDC airflow to predict results of a particular ventilation with respect to airflow pattern, air velocity, temperature and bacterial contamination
All systems meet air quality standards of particle, bacteria and fungus counts.
As part of our Quality System CFD(Computational Fluid Dynamics) analysis conducted in house is core part of our airflow design.
Integrated camera with LED lamps to capture crystal clear live images for simultaneous web telecasting of procedures.
PACS allows operating surgeons to view any investigational detail during the course of surgery.
Audio-visual Conferencing facility for research, demonstration and specialist opinion from centers of excellence across the globe.
On site Pathology Laboratory for viewing frozen sections.
Gas terminal units incorporate a double protection system to seal off possible gas leakages.
Excellent resistance by way of insulation against fire and UV rays.
Wall facades designed to be anticorrosive, anti fungal, anti impact, noncombustible and highly durable
Permanently antistatic homogenous vinyl flooring
Emergency Services
Chemical contact with eye or face
Severe eye, head or face injury
Sudden loss of all or part of your vision
Bulging eye
Painful eye
Onset of flashing lights, floaters, or a noticeable increase in the amount of flashes and floaters
Appearance of a “veil”, or curtain across the field of vision
Sudden changes in pupil size
Eye that is sensitive to light
Foreign body in the eye
Double vision
Post-operative patients with pain in or around the eye, infectious discharge, increased redness, or decreased vision (in either eye)
Sports Injuries
These and many other conditions, for blunt, penetrating, chemical, and other eye injuries. are treated 24-hour-a-day by our Consultants. Our specialised Emergency Department is well equipped to address the patient’s complete needs during these episodes of acute care.
For Queries, Contact our Emergency Medical Services at 02148-
INDICATION AND TREATMENT
Cornea, Cataract and Other Diseases of the Anterior Segment
Our Consultants are dedicated to providing excellence in patient care across the complete spectrum of medical and surgical problems involving the cornea, lens,ocular surface, and other structures involving the anterior segment of the eye (ciliary body, choroid, iris)
The specialists are trained to deal with the simplest of cases to the more complex ones, often received as referrals from other eye care centers. The specific conditions treated include:
Allergic Conjunctivitis
Blepharitis
Varieties of Chronic Conjunctivitis
Episcleritis
Corneal edema (swelling)
Cataracts
Secondary and Complex Cataracts
Keratoconus
Corneal dystrophies (including Fuchs’ dystrophy)
Corneal trauma
Corneal scarring
Corneal infection such as microbial keratitis or corneal ulcer
Corneal erosions
Pterygium
Dry eye syndrome (Sjogren’s Syndrome)
Tumors and Degeneration of the Iris
Glaucoma Care
Glaucoma is a disease that often goes undetected till the advanced stages of the disease. Often asymptomatic other than gradual visual loss, the disease can lead to irreversible optic nerve damage And blindness may gradually set in. It is often known as “The Silent Thief of Vision “for this very reason.
The Glaucoma Care Division offers comprehensive consultations and long-term follow-up care for all forms of glaucoma and its complications, including medical, laser, and surgical treatment. Our services treat the complete range of glaucoma related conditions, including:
open-angle glaucoma
angle-closure glaucoma
Secondary glaucoma
Exfoliation glaucoma (Pseudoexfoliation Syndrome)
Glaucoma associated with retinal diseases
Glaucoma secondary to eye trauma
Juvenile onset glaucoma
Neovascular glaucoma
childhood glaucoma
Not every patient is necessarily a candidate for surgery. In fact, our physicians first consider all non surgical options. For patients who have surgery in the operating room; they can expect exceptional, personalized care from our staff.
Each patient is evaluated to determine if he/she is best suited to medical or surgical line of treatment. The various state of the art diagnostic facilities which enable to reach the ideal patient treatment option include:
Automated perimetry
Color vision testing
Visual Field Testing
Pachymetry to measure corneal thickness, an important risk factor
Intraocular pressure measurement ( Applanation Tonometry)
Frequency Doubling Perimetry
Heidelberg retinal Tomography (HRT II)
Optical Coherence Tomography ( OCT)
Optic Disc and Fundus Photography
Glaucoma that is resistant to medical treatment can be treated surgically. Glaucoma surgical services performed include:
Combined phacoemulsification (small incision cataract surgery), intraocular lens implantation, and trabeculectomy (glaucoma surgery)
Trabeculectomy
Glaucoma implant surgery (tube or shunt surgery)
Goniotomy (for specific childhood glaucomas)
Glaucoma laser services include:
Cyclophotocoagulation
Laser iridectomy
Laser trabeculoplasty
Neuro-Ophthalmology
Neuro- Ophthalmology is a subspecialty of Ophthalmology and Neurology dedicated to managing disorders of the eye caused by or associated secondarily with diseases of the brain, brain tumor, trauma etc. We bring together sub specialists from multiple disciplines (Neurologists and Neurosurgeons) to provide treatment option to evaluate and treat individuals to deliver complete care Each patient is thoroughly evaluated by way of
Testing of visual acuity
Color vision testing
Evaluation of the eye movements and ocular alignment
Visual field testing using kinetic perimetry, static perimetry, or both.
VER Testing
Selected patients may also undergo a variety of other diagnostic tests, including CT scanning and MRI.
Our service treats the complete range of spinal conditions, including
Optic nerve disorders, such as optic neuritis,
Ischemic optic neuropathy
optic neuropathies
Visual field defects related to stroke or MS
Double vision from ocular motor nerve palsies
Myasthenia gravis
Thyroid eye disease
Orbital tumors
Blepharospasm and other involuntary facial movements
Pupillary abnormalities (e.g., anisocoria).
vision loss and eye movement abnormalities resulting from brain tumors, strokes, multiple sclerosis, head trauma, or neurodegenerative conditions.
Disorders of the optic chiasm (i.e. pituitary tumors)
Papilledema
Double vision
Supranuclear disorders of eye movement (i.e., progressive supranuclear palsy)
Transient vision loss (Amaurosis fugax)
Nystagmus
Migraine
Temporal arteritis or giant cell arteritis
Vitreo-Retinal Disorders
A healthy Vitreous Humor is crucial to normal eyesight because light entering your eye is transmitted through the Vitreous Humor to the retina. (The retina then transmits these impulses to your optic nerve, which carries them to your brain.)
The Vitreo-Retinal Disorders Service provides a full spectrum of medical and surgical management of diseases affecting the posterior segment of the globe. We have the most modern Retina LASER Machine, Digital Fundus Camera (for Fundus Fluorescein Angiography [FFA]) and Spectral Domain OCT (Optical Coherence Tomography) which help in the Diagnosis and Treatment of various Retinal Disorders.
We have the latest Vitrectomy machine for Retinal Surgery; which enables High Speed Vitrectomy and Sutureless Vitrectomy
We provide the state of the art infrastructure, unsurpassed range of treatment options and multidisciplinary expertise to treat cases from the simplest yet oft missed to the most complex referred from hospitals far and wide ranging from
Diabetic Retinopathy
Age related macular degeneration (AMD)
Branch Retinal vein occlusion (BRVO)
Central Retinal vein occlusion (CRVO)
Macular Hole and Macular Pucker
Tumors of the Retina such as Retinoblastoma
Tumors of the Choroid such as Choroidal melanoma, Choroidal metastasis, Choroidal hemangioma
Choroidal neovascularization (CNV)
Retinal detachment and Retinal Holes
Retinitis pigmentosa and various Hereditary Retinal Dystrophies
Ocular Trauma
Intraocular Foreign Body (IOFB) Removal
Posterior Vitreous Detachment
Retinopathy of Prematurity (ROP): Screening and Treatment
Complications of Anterior Segment Surgery such as Nucleus Drop and Dislocated Intraocular Lens (IOL)
Scleral Fixated Intraocular Lens (IOL) Implantation for Aphakia due to various problems
Intraocular infections such as Endophthalmitis and Panophthalmitis
Posterior Uveitis and Various types of Chorioretinitis and Choroiditis
Eales’ Disease and various types of Retinal Vasculitis
PAEDIATRIC OPTHALMOLOGY
Pediatric Ophthalmology RAIGAD HOSPITAL Children Eye Clinic
Children are not mini adults. Their health issues are highly specific and require specialized treatments from specialized experts. A Pediatric Ophthalmologist is an expert in evaluation, diagnosis and treatment of all eye problems in children. The process of assessing a child involves special charts and equipment apart from the knack making the child feel comfortable to go through an eye test. The visual system is immature until the age of 7 years and most of the modalities of treating vision threatening eye conditions are best done prior to this age. At every level, while treating the young ones, one needs to ensure that the due attention is paid not only to their current eye problem, but also that equal emphasis is placed on their rehabilitation and monitoring. This ensures optimum return of productivity during their adult years.
WE TREAT:
Squint (Cross eyed)
Refractive Errors-
Long-sightedness (Hypermetropia)
Shortsightedness (Myopia)
Astigmatism
Lazy eye (Amblyopia)
Droopy eyelid (Ptosis)
Childhood Cataracts
Childhood Glaucoma
Childhood Orbital conditions (Proptosis)
Retinopathy of Prematurity (ROP)
Eye problems related to learning disabilities and neurologically challenged children
Genetic eye conditions
Blocked tear ducts (NLD Obstruction)
Corneal transplant in children
Artificial eyes and contact lenses
Low vision aids (Telescopes, Magnifying Glasses)
Commonest eye problems in children:
1. SQUINT
It occurs when one eye is straight and the other is turned away.
Why treat
It is not only a cosmetic problem.
It can lead to permanently reduced vision in the squinting eye (lazy eye). There is a common myth that the squint will go away by itself, which is untrue.
When to treat
The earlier the treatment is commenced the better is the final outcome.
The child should be evaluated as soon as the squint is noticed (even at the birth).
Treatment
Glasses
Patching
Botulinum toxin injection (Botox) – This is the new treatment for squints now available at our hospital
Fusion exercise
Surgery
2. REFRACTIVE ERRORS
It is defined as reduced vision due to the optics of the eye being out of focus. It affects 10-12% of children.
When to treat
Treatment is recommended as early as possible or else it can lead to permanently reduced vision (lazy eye) in the child.
Children with a refractive error in one eye only will never complain of reduced vision due to presence of good vision in the other eye. Since this can only be detected on a vision test, it is ideally recommended that all children should have a routine eye test before starting school (4 years).
Children with parents or other close family members using glasses since childhood have a higher chance of needing glasses themselves.
Treatment
Glasses
Contact Lenses
3. LAZY EYE (AMBLYOPIA)
It is defined as poorly developed vision in one eye due to Lack of Stimulation of that eye at an early age. It affects 1-3.5% of children.
Lack of stimulation may be due to
Uncorrected refractive error
Squint
Droopy eyelid
Cloudy eye (corneal opacity)
Cataract
When to treat
Treatment with conventional means is usually effective only till the age of 7-8 years, thus commencing treatment early is vital for a good final outcome of vision.
It is a SILENT condition and can be detected by an eye examination.
Treatment
Glasses
Contact Lenses
4. DROOPY EYELID (PTOSIS)
It can be complete or partial
Why treat
It is not only a cosmetic problem. It can cause permanently reduced vision (lazy eye) if the lid obstructs the vision. Children with a droopy eyelid have a high tendency of needing glasses (refractive error) and should be checked for it.
When to treat
Early assessment (1-2 years) for glasses is recommended. Surgery for a complete droopy eyelid is planned early in life.
5. WATERY / STICKY EYE IN NEWBORN
It usually occurs due to a blocked tear duct (Nasolacrimal duct). It is essential to rule out other rare causes of watering at that age (like glaucoma)
When to treat
90% of blocked tear ducts spontaneously recover by one year of age. Surgery is planned if not recovered after 1 year of age
Treatment
Message
Surgery (Probing)
6. CHILDHOOD CATARACT
It is defined as clouding of the lens of the eye. It is responsible for 10% of blindness in children.
What are the causes of cataracts in children?
Congenital (Idiopathic)
Metabolic diseases (e.g. galactosaemia)
Infections (e.g. Rubelia)
Steroid intake
When to treat
As early as possible. Cataracts that are present by birth are best treated before 6 weeks of age.
Treatment
Cataract surgery
7. CHILDHOOD GLAUCOMA
It is a rare condition in children, wherein, the eye pressures are increased which results in large eyes, optic nerve damage, watering and clouding of cornea. It is a potentially blinding condition.
Treatment
Eye drops (anti-glaucoma medication)
Glaucoma surgery
8. RETINOPATHY OF PRE-MATURITY (ROP)
It is defined as abnormal vessel formation in the retina (nerve layer at the back of the eye) occurring in preterm babies (lesser than 34 weeks or lesser than 1.5 kg birth weight)
When to treat
These children need to have a dilated eye examination at 4-6 weeks after birth. They may then need only monitoring every few weeks or laser treatment depending on the severity of the ROP. All preterm children have a higher incidence of squints and refractive errors and should have a routine eye examination before starting school (4 years).
Treatment
Laser treatment
Surgery
Facilities and equipment available at the Children’s eye clinic at P. D. Hinduja Hospital
Trained Pediatric ophthalmologist who has an exclusive pediatric practice
Fully fledged orthoptic assessment team for children
Special vision assessment charts for children
Binocular vision assessment chart for children
Air puff and Perkins tonometer to measure eye pressure in children
Synaptophore
Portable slit lamp
Facility to examine a child under sedation or anaesthesia on an OPD basis
EMG guided Boutulinum toxin treatment for squints in children
Contact lenses for children
Specialist consultants in all sub specialties in ophthalmology like cornea, retina, oculoplasty and glaucoma
Complete medical support – Pediatric department, pediatric neurology department and pediatric surgery department
Low vision aids (Telescopes, Magnifying Glasses)