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Apr27
Glaucoma Treatment In Ghatkopar, Mumbai From Glaucoma Specialist - Dr. Jatin Ashar
Glaucoma Treatment In Ghatkopar
Glaucoma is Cluster of eye diseases, resulting in optic nerve damage. Main function of optic nerve is to carry images from the retina, which is the specialized light sensing tissue, to the brain for interpretation so we can visualize it. In many cases, we do not know exactly what causes glaucoma. However, increased eye pressure is the most common risk factor for developing the disease. The pressure comes when the clear fluid in the eye, called the aqueous humor, does not drain properly.

This fluid normally helps to nourish the eye, and flows in and out of the eye through a mesh-like channel. In people with high eye pressure, the fluid does not drain properly and pressure builds up in the eye.

Due to this eye pressure delicate nerve fibers of the optic nerve are damaged. Once these nerve fibers are damaged, blind spots develop in the field of vision. It’s a permanent loss, once nerve damage and visual loss occur. Most people don't notice these blind areas until much of the optic nerve damage has already occurred. Glaucoma is a leading cause of blindness in the world, especially in older people.

What are symptoms of Glaucoma?
Open-angle glaucoma is asymptomatic. It develops slowly and sometimes without noticeable sight loss for many years. Most people who have open-angle glaucoma feel fine because the initial loss of vision is of side or peripheral vision, and the visual acuity or sharpness of vision is maintained.

As open-angle glaucoma has few warning signs or symptoms before damage has occurred, it is recommended to see a doctor for regular eye examinations. In open-angle glaucoma, the angles in your eye are normal, but the eye’s drainage canals become clogged over time, causing an increase in internal eye pressure and subsequent damage to the optic nerve.

In Angle-closure glaucoma (also called narrow angle glaucoma) the angle is closed, causing increased eye pressure, which leads to optic nerve damage, and possible vision loss. There is an acute attack of angle closure leading to noticeable symptoms and damage occurs quickly. If you experience any of these symptoms, seek immediate care from an ophthalmologist.

Hazy or blurred vision
The appearance of rainbow-colored circles around bright lights
Severe eye and head pain
Sudden vision loss
Nausea or vomiting (accompanying severe eye pain)
Congenital glaucoma is glaucoma occurring in children, whether from birth or at a very early age. This usually happens from a physical defect in the eye that doesn’t allow it to function normally, but it can also come from some other medical issue.

Pigmentary glaucoma, or pigment dispersion, blocks the drain of your eye with tiny granules of the eye’s pigment, or the iris, after circulating through the fluid at the front of your eye.

Secondary glaucoma – Glaucoma with associated conditions like tumor, diabetes, an advanced cataract, or inflammation.


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Apr27
Cornea Specialist and Eye Specialist In Ghatkopar, Mumbai - Dr. Jatin Ashar
Eye Specialist In Ghatkopar East and West
Dr. Jatin Ashar




Soft-spoken, compassionate and an intellectual man, Dr. Ashar trained at the prestigious ‘All India Institute of Medical Sciences’, New Delhi; one of Asia’s best! After his post-graduation, he completed his fellowship in Cornea and Anterior Segment from the world renowned L. V. Prasad Eye Institute. Later on, he was appointed as the main cornea consultant at the ‘New Tertiary Care Center’ at the same institute.

Specialties: Cataract, Cornea, Lasik and Refractive Surgery Specialist

Remarkable sensitivity to patients' needs and providing the warmth of compassionate healing makes us stand apart. Technology is mandatory for high standards of care and Mumbai Eye Care understands that. We use only the latest technology and best in the class equipment throughout the hospital.

His areas of expertise are Lamellar Keratoplasty, Pediatric Keratoplasties and Laser LASIK Surgery. He has gifted sight to many who could not see due to corneal pathologies by performing Corneal Transplantation.

His knowledge and proficiency has positioned MEC amongst the ‘Best Eye Care Centres’ providing quality eye care with new technology, latest surgical techniques and most advanced machines catering to variety of eye diseases under one roof.

Areas of expertise:
Dr. Jatin is one of the best eye doctors & eye surgeons in Ghatkopar, Mumbai area. He has expertise in performing complex cataract surgeries and also in phacoemulsification and bladeless cataract surgeries.

He has a vast experience in using multifocal lenses such as trifocal and bifocal lenses and also performed cataract surgeries in children at Mumbai eye care hospital in Ghatkopar.

Dr. Jatin specializes in cornea transplant surgeries and he has performed a very high number of cornea surgeries such as full-thickness cornea surgery or penetrating keratoplasty, layer by layer cornea transplants such as Deep anterior lamellar keratoplasty (DALK) and the latest type of cornea surgery that is sutureless cornea transplant or Descemet’s membrane endothelial keratoplasty (DMEK) and launched state of the art eye clinic for cornea surgeries in Ghatkopar.

He also trains other doctors from India and abroad in performing cornea transplant surgeries and also has a very high success rate of cornea transplant surgery.

Dr. Jatis is a medical director of an eye bank at Thane and an eye clinic at Ghatkopar and he is among the top cornea eye surgeon doctors in India.

Dr. Jatin performed many laser vision correction surgeries for spectacle/ glass number removal such as LASIK, LASEK, PRK, PTK, SMILE and also launched a state of the art eye hospital for LASIK in Ghatkopar. His patients say that he is among the best eye doctor for LASIK.

For patients who cannot undergo LASIK, he also is an expert at performing ICL, IPCL surgery.

Awards and Achievements:
Dr. Ashar has many feathers in his cap; to list a few –

Youngest Indian surgeon to be invited at the ‘American Academy of Ophthalmology’
Credited with numerous awards, invited faculty at most conferences
Publications in international journals and conferences,
Performed numerous complex cataract surgeries,
Execute corneal transplants even in infants as young as 1 month old,
Carry-Out many refractive surgeries such as LASIK, PRK, and ICL,
Among top few surgeons trained in performing ‘Lamellar Keratoplasties’,
Received ‘Achievement Award’ from American Academy of Ophthalmology,
‘International Ophthalmologists Education Award’ from American Academy of Ophthalmology


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Dec18
World Class Eyecare Centre, Prizma Eyecare Hospital
Good news for the residents of Surat. Dr Nirav Shah, leading Ophthalmologist of Surat, Gujarat has started another super speciality Eye Hospital - Prizma Eyecare Hospital at Golden Square, Besides Sargam Shopping Centre, Parle Point, Surat.

Prizma Eye Care Hospital, a state of art Eye Care Centre with most competent and experienced team of doctors lead by eminent ophthalmologist of South Gujarat, Dr Nirav Shah offers best eye care solutions in Surat. Their eye specialist consultants team is dedicated to protecting, preserving and restoring vision through their more than 18 years of work experience, world-class eye care and state of art instruments set up. The best ophthalmic team of S.Gujarat is made up of cataract and laser refractive surgery expert Dr Nirav Shah, Glaucoma expert Dr Manan Jariwala, Medical Retina Expert Dr.Heli Shah and general Opthalmologist Dr Fatema Shayer.

Prizma hospital strives to provide comprehensive super speciality eye care services under one roof through cutting edge technology and personalised compassionate care.

In Surat, Prizma Eyecare Hospitals is a recognized name in patient care. It was incepted in the year 2016. They are one of the well-known Hospitals in Parle Point. Backed with a vision to offer the best in patient care and equipped with technologically advanced healthcare facilities, they are one of the upcoming names in the healthcare industry. Location of the hospital is easily accessible by various means of transport. This hospital is also located near krishi mangal hall chiramik point - Athwa Gates, Below Barbeque Nation - Parle Point. A team of well-trained medical staff, non-medical staff and experienced clinical technicians work round-the-clock to offer various services. Their professional services mark them among one of the best hospitals in Surat. A team of doctors on board, including specialists are equipped with the knowledge and expertise for handling various types of medical cases.

Prizma Eye Care Hospital Offers Best Eye Care Solutions in Surat. They are committed to provide clinical excellence with cost effective treatment.

The services offerred by Prizma Eye Care Hospital includes

Cataract Care
Refractive Care
Glaucoma care
Retina Care
Cornea Care
Pediatric Eye Care
Oculoplasty Care

Prizma Eye Care Hospital Offers Best Eye Care Solutions in Surat. Team of experienced doctors, latest equipments and high end technology makes them different from others. For any concern regarding your eye care you can contact them at http://www.prizmaeyecare.com/

Follow them on https://www.youtube.com/channel/UCoMjvmQ2PXmbq4Dh4nSqFoQ

https://www.facebook.com/prizmaeyecare/ Eye Specialists & Doctors


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Jun24
Bhargava R, Kumar P, Prakash A, Chaudhary KP. Estimation of mean ND: Yag laser capsulotomy energy levels for membranous and fibrous posterior capsular opacification. Nepal J Ophthalmol. 2012 Jan-Jun;4(1):108-13. doi: 10.3126/nepjoph.v4i1.5861. PubMed PMID
Abstract
INTRODUCTION:
Posterior capsule opacification (PCO) is a visually-disabling complication of cataract surgery.
OBJECTIVE:
To estimate energy levels for capsulotomy in various subtypes of PCO (membranous, fibrous and fibro-membranous).
MATERIALS AND METHODS:
A total of 215 patients with PCO were randomly selected and evaluated for Nd: Yag laser capsulotomy, after a quiet post-operative course of 3 months.The ocular area was arbitrarily divided into three zones: YAG zone (3mm), Optical zone (6mm) and the peripheral zone (12mm). A colour code was assigned to the subtype of PCO in these zones: fibrous green and membranous blue. The type of PCO in each quadrant of YAG zone was estimated in percentage.
RESULTS:
The statistic mean values of initial energy levels were 1.80 mJ for membranous PCO, 3.17 mJ for fibrous PCO and 2.73 mJ for fibro-membranous PCO. The mean summated energy levels for membranous PCO was 22.80 mJ for membranous PCO, 80.06 mJ for fibrous PCO and 80.48 mJ for fibro-membranous type.
CONCLUSION:
Colour coding is extremely helpful for quantification of the type of PCO and in deciding the initial energy level necessary to create capsulotomy. Fibro-membranous PCO required more summated energy despite a lower starting energy. Therefore, we recommend firing the initial shot in fibrous portion in case of fibrous-membranous type of PCO.


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Jun24
Bhargava R, Kumar P, Phogat H, Chaudhary KP. Neodymium-yttrium aluminium garnet laser capsulotomy energy levels for posterior capsule opacification. J Ophthalmic Vis Res. 2015 Jan-Mar;10(1):37-42. doi: 10.4103/2008-322X.156101. PubMed PMID: 26005551; PubM
Abstract
PURPOSE:
To study factors affecting laser energy levels required for neodymium: yttrium aluminium garnet (Nd: YAG) laser capsulotomy and to evaluate whether any correlation exists between applied laser energy levels and complications.
METHODS:
The present study examined 474 consecutive patients for a number of factors including age, type of posterior capsule opacification (PCO), material and fixation of intraocular lens (IOL) and complication rates, versus energy levels used for Nd: YAG laser capsulotomy.
RESULTS:
Mean patient age was 55.6 ± 8.7 years and mean follow up period was 22.9 ± 4.5 months. IOL biomaterial (KW ANOVA; P = 0.173) and patient's age (P = 0.246) did not significantly influence total laser energy requirement for capsulotomy. However, total laser energy levels were significantly higher (KW ANOVA; P < 0.001) with fibro-membranous and fibrous subtypes of PCO. Complications such as IOL pitting, intraocular pressure (IOP) elevation, uveitis, retinal detachment (RD) and cystoid macular edema (CME) were significantly more common when higher energy levels was used. The mean total energy in patients with RD was 77.7 ± 17.7 mJ as compared to 43.4 ± 26.9 mJ in the rest of the cohort. RD was more common in patients with higher axial length [n = 7 (63%)] (P < 0.001).
CONCLUSION:
Type of PCO significantly influenced laser energy levels required for capsulotomy, whereas IOL biomaterial and fixation did not. Complications such as IOL pitting, uveitis, IOP elevation, RD and CME was significantly more common when total laser energy was higher. It is recommended that the lowest possible single pulse laser energy be used for capsulotomy to minimize complications.
KEYWORDS:
Intraocular Lens; Laser Capsulotomy; Posterior Capsule Opacification


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Jun24
Bhargava R, Kumar P, Sharma SK, Sharma S, Mehra N, Mishra A. Peeling and aspiration of elschnig pearls! An effective alternative to Nd:YAG laser capsulotomy! Indian J Ophthalmol. 2013 Sep;61(9):518-20. doi: 10.4103/0301-4738.119449. PubMed PMID: 24104714;
Abstract
To evaluate the efficacy of peeling and aspiration of Elschnig pearls. Retrospective study in a medical college hospital. Records of 217 eyes which underwent surgical peeling and aspiration for membranous PCO between 2006 and 2009, was reviewed. Peeling and aspiration was fashioned with a blunt tipped 20G cannula after stabilizing anterior chamber with anterior chamber maintainer. Post-operative vision and complications were analyzed. Mc Nemar and Chi square tests. The mean age was 56.84 years. 85.71% patients achieved best corrected visual acuity (BCVA) of 20/20 at 3 m. Recurrence of pearls, uveitis and cystoid macular edema were the most common causes of reduced vision. Peeling and aspiration of pearls seem to be a viable alternative to Neodymium yttrium garner aluminium (Nd: YAG) laser capsulotomy for membranous PCO.


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Jun24
Bhargava R, Kumar P, Sharma SK, Kaur A. A randomized controlled trial of peeling and aspiration of Elschnig pearls and neodymium: yttrium-aluminium-garnet laser capsulotomy. Int J Ophthalmol. 2015 Jun 18;8(3):590-6. doi: 10.3980/j.issn.2222-3959.2015.03.2
Abstract
AIM:
To compare surgical peeling and aspiration and neodymium yttrium garnet laser capsulotomy for pearl form of posterior capsule opacification (PCO).
METHODS:
A prospective, randomized, double blind, study was done at Rotary Eye Hospital, Maranda, Palampur, India, Santosh Medical College Hospital, Ghaziabad, India and Laser Eye Clinic, Noida India. Consecutive patients with pearl form of PCO following surgery, phacoemulsification, manual small incision cataract surgery and conventional extracapsular cataract extraction (ECCE) for age related cataract, were randomized to have peeling and aspiration or neodymium yttrium garnet laser capsulotomy. Corrected distance visual acuity (CDVA), intra-operative and post-operative complications were compared.
RESULTS:
A total of 634 patients participated in the study, and 314 (49.5%) patients were randomized to surgical peeling and aspiration group and 320 (50.5%) to the Nd:YAG laser group. The mean pre-procedural logMAR CDVA in peeling and neodymium: yttrium-aluminium-garnet (Nd:YAG) laser group was 0.80±0.25 and 0.86±0.22, respectively. The mean final CDVA in peeling group (0.22±0.23) was comparable to Nd:YAG group (0.24±0.28; t test, P=0.240). There was a significant improvement in vision after both the procedures (P<0.001). A slightly higher percentage of patients in Nd:YAG laser group (283/88.3%) than in peeling group (262/83.4%) had a CDVA of 0.5 (20/63) or better at 9mo (P<0.001). On the contrary, patients having CDVA worse than 1.00 (20/200) was also significantly higher in Nd:YAG laser group as compared to peeling group (25/7.7% vs 15/4.7%, respectively). On application of ANCOVA, there was less than 0.001% risk that PCO thickness and total laser energy had no effect on rate of complications in Nd:YAG laser group and less than 0.001 % risk that PCO thickness had no effect on complications in peeling group respectively. Sum of square analysis suggests that in the Nd:YAG laser group, thick PCO had a stronger impact on complications (Fischer test probability, Pr<0.0001) than thin PCO and total laser energy (Fischer test probability, Pr<0.002), respectively; similarly, in peeling group, thick PCO and preoperative vision had a stronger effect on complications than thin PCO, respectively (Fischer test probability, Pr<0.001).The rate of complications like uveitis (P=0.527) and cystoid macular edema (P=0.068), did not differ significantly between both the groups. However, intraocular pressure spikes (P=0.046) and retinal detachment (P<0.001) were significantly higher in Nd:YAG laser group as compared to peeling group. Retinal detachment was more common in patients having degenerative myopia (7/87.5%, P<0.001). Recurrence of pearls was the most common cause of reduction of vision in the peeling group (24/7.6%, P<0.001).
CONCLUSION:
There is no alternative to Nd:YAG laser capsulotomy for fibrous subtype of PCO. For pearl form of PCO, both techniques are comparable with regard to visual outcomes. Nd:YAG laser capsulotomy has a higher incidence of IOP spikes and retinal detachment whereas recurrence of pearls may occur after successful peeling and aspiration. When posterior capsulotomy is needed in patients with retinal degenerations, retinopathies and pre-existing retinal breaks, the clinician should be cautious about increased risks of possible complications of Nd:YAG laser capsulotomy.
KEYWORDS:
Elschnig pearls; capsulotomy; neodymium: yttrium-aluminium-garnet; posterior capsule


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Jun24
Kumar P, Bhargava R, Kumar M, Ranjan S, Kumar M, Verma P. The correlation of routine tear function tests and conjunctival impression cytology in dry eye syndrome. Korean J Ophthalmol. 2014 Apr;28(2):122-9. doi: 10.3341/kjo.2014.28.2.122. Epub 2014 Mar 14.
Abstract
PURPOSE:
To establish the strength of the association between routine tear function tests and conjunctival impression cytology (CIC) and to determine whether they simulate the morphological and cytological changes that occur on the ocular surface in dry eye. What are the sensitivity, specificity and positive predictive values of these tests when CIC is considered the gold standard?
METHODS:
The tear film profile included tear film break up time (TBUT), Schirmer's-1, Rose Bengal scores (RBS), and impression cytology. CIC samples were obtained from the inferior bulbar conjunctiva and stained with periodic acid-Schiff and counter stained with hematoxylin and eosin.
RESULTS:
The mean Schirmer's value was 11.66 ± 5.90 in patients and 17.17 ± 2.97 in controls (p < 0.001). The mean TBUT in participants was 8.88 ± 3.54 and 13.53 ± 2.12 in controls (p < 0.001). Patients had a mean goblet cell density (GCD) of 490 ± 213, while the value for controls was 1,462 ± 661 (p < 0.001). Abnormal CIC was observed in 46.7% cases of dry eye and in 32.8% of controls. The correlation coefficient (L) for Schirmer's was 0.2 and 0.24 for participants and controls, respectively, while TBUT values were 0.26 and 0.38, RBS were 0.5 and 0.5, and GCD was 0.8 and 0.6 in cases and controls, respectively.
CONCLUSIONS:
GCD, RBS, and TBUT were better predictors of morphological and cytological changes in the conjunctiva than Schirmer's in dry eye syndrome. The sensitivity of tear function tests in diagnosing dry eye was TBUT > Schirmer's > RBS, and the specificity was Schirmer's > TBUT > RBS in decreasing order when CIC was considered the gold standard.
KEYWORDS:
Conjunctiva; Goblet cells; Tears


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Jun24
Bhargava R, Kumar P, Kaur A, Kumar M, Mishra A. The diagnostic value and accuracy of conjunctival impression cytology, dry eye symptomatology, and routine tear function tests in computer users. J Lab Physicians. 2014 Jul;6(2):102-8. doi: 10.4103/0974-2727
Abstract
AIMS AND OBJECTIVES:
To compare the diagnostic value and accuracy of dry eye scoring system (DESS), conjunctival impression cytology (CIC), tear film breakup time (TBUT), and Schirmer's test in computer users.
METHODS:
A case-control study was done at two referral eye centers. Eyes of 344 computer users were compared to 371 eyes of age and sex matched controls. Dry eye questionnaire (DESS) was administered to both groups and they further underwent measurement of TBUT, Schirmer's, and CIC. Correlation analysis was performed between DESS, CIC, TBUT, and Schirmer's test scores. A Pearson's coefficient of the linear expression (R (2)) of 0.5 or more was statistically significant.
RESULTS:
The mean age in cases (26.05 ± 4.06 years) was comparable to controls (25.67 ± 3.65 years) (P = 0.465). The mean symptom score in computer users was significantly higher as compared to controls (P < 0.001). Mean TBUT, Schirmer's test values, and goblet cell density were significantly reduced in computer users (P < 0.001). TBUT, Schirmer's, and CIC were abnormal in 48.5%, 29.1%, and 38.4% symptomatic computer users respectively as compared to 8%, 6.7%, and 7.3% symptomatic controls respectively. On correlation analysis, there was a significant (inverse) association of dry eye symptoms (DESS) with TBUT and CIC scores (R (2) > 0.5), in contrast to Schirmer's scores (R(2) < 0.5). Duration of computer usage had a significant effect on dry eye symptoms severity, TBUT, and CIC scores as compared to Schirmer's test.
CONCLUSION:
DESS should be used in combination with TBUT and CIC for dry eye evaluation in computer users.
KEYWORDS:
Computer vision syndrome; conjunctival impression cytology; dry eye scoring system; tear function tests


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Jun24
Bhargava R, Kumar P, Kumar M, Mehra N, Mishra A. A randomized controlled trial of omega-3 fatty acids in dry eye syndrome. Int J Ophthalmol. 2013 Dec 18;6(6):811-6. doi: 10.3980/j.issn.2222-3959.2013.06.13. eCollection 2013. PubMed PMID: 24392330; PubMed
Abstract
AIM:
To evaluate the role of dietary supplementation of omega-3 fatty acids in dry eye syndrome.
METHODS:
A prospective, interventional, placebo controlled, double blind randomized trial was done at two referral eye centers. Two hundred and sixty-four eyes of patients with dry eye were randomized to receive one capsule (500mg) two times a day containing 325mg EPA and 175mg DHA for 3 months (omega-3 group). The omega-3 group was compared to a group of patients (n=254) who received a placebo (placebo group). There were 4 patient visits (at baseline, 1 month, 2 months and 3 months). On each visit, recording of corrected distance visual acuity (CDVA), slit lamp examination and questionnaire based symptom evaluation and scoring was done. A symptomatic score of 0-6 was mild, 6.1-12 moderate and 12.1-18 severe dry eye. Response to intervention was monitored by routine tear function tests like Schirmer I test, tear film break-up time (TBUT), Rose Bengal staining and most notably, conjunctival impression cytology.
RESULTS:
Sixty-five percent of patients in the omega-3 group and 33% of patients in placebo group had significant improvement in symptoms at 3 months (P=0.005). There was a significant change in both Schirmer's test value and TBUT values in the omega-3 group (P<0.001), both comparisons. However, there was a larger drift in TBUT values in omega-3 than the placebo group, in comparison to Schirmer's test values. The mean TBUT score was 2.54±2.34 in the omega-3 group and 0.13±0.16 in placebo group, respectively. The mean reduction in symptom score in omega-3 group was 2.02±0.96 as compared to 0.48±0.22 in placebo group (P<0.001). Despite a slight increase mean score, the Schirmer scores did not correlate well with symptomatic improvement.
CONCLUSION:
Omega-3 fatty acids have a definite role for dry eye syndrome. The benefit seems to be more marked in conditions such as blepharitis and meibomian gland disease. The role of omega fatty acids in tear production and secretion needs further evaluation.
KEYWORDS:
conjunctival impression cytology; dry eye syndrome; meibomian gland disease; omega-3 fatty acids


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