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Asian Eye Clinic : Speciality Diabetic Eye Clinic

Asian Eye Clinics is an initiative started under the aegis of "Asian Eye Foundation". The aim of Asian Eye Clinics is to breach the gap between the needy patients having specific eye problems and the expert eye doctors. These patients need to be diagnosed appropriately referred to specialist expert if needed and treated with proficiency and expertise. The main focus of Asian eye clinic is going to diabetic retinopathy and glaucoma screening . These two diseases are the leading cause of preventable blindness in India and world.

Purpose Of Asian Eye Clinic

There are numerous kind of patients in society . Few are aware of their health issues, but either they have half knowledge about it or unnecessarily know too many things which may be misguiding. Such half knowledge unnecessarily increase the apprehension in patients and make thenm feel more sick and demotivated. On the other side, majority of patients even today are completely unaware of signs and symptoms of even basic eye problems , which may push them unnecessarily into complicated health issues. This gap between the needy and expert can be breached by bringing the primary eye clinics like Asian eye clinic to the doorsteps of the patients.

Scope And Facility at Asian Eye Clinic

The clinic will be well equipped to diagnose any kind of eye problem accurately. A complete eye check-up including Vision, Refraction, Intra Ocular Pressure check, retinal check-up, optic never evaluation will be carried out here. Patients having an eye disease, which requires investigations and surgery will be directed to tertiary center ASIAN EYE HOSPITAL. Asian eye hospital is internationally reputed, state of the art hospital located in heart of city approachable to any person in the city of Pune. The hospital has all possible equipments in eye care under one roof from OCT, Retinal Angiography(FFA), Retinal Green laser , SMILE and lasik laser machine, best Phacoemulsification micro-incision cataract surgery set up and Indias first zepto cataract etc.

Diabetes Retinopathy Eduaction and Diagnosis

Diabetic retinopathy is a major cause of avoidable blindness or visual impairment in society. One must be wondering how a person can get blind when such advanced technology and doctors are available in today’s era. What we need to understand is sometimes the disease doesn’t give us enough indications and time to treat it and hence we need to attack the disease proactively before it damages our eyes.

What happens in diabetic retinopathy is that patient doesn’t realize any symptoms or signs until advanced stage of proliferative diabetic retinopathy is reached. At this stage there can be severe bleeding and ‘pull’ on the delicate retina(traction) causing permanent irreversible damage to the vision. To cut short diabetic retinopathy can permanently damage your vision without any warning signs. This can only be prevented if a proficient doctor meticulously checks the retina of patient and diagnose the retinopathy in early stage. Along with the treatment of diabetic retinopathy, good systemic control of blood sugar levels, HTN , cholesterol, CRP is very important, since this is root cause of diabetic retinopathy, which is also ensured at Asian eye clinic.

Keeping in mind above things, the clinic will also educate the patient about frequency of retinal check ups required depending upon duration of diabetes mellitus or stage of retinopathy incase in casr of DR, the symptoms patients is required to be aware of etc.

If the patient has diabetic retinopathy , educating the patient about the stage of disease, role of treatment like Antivegf intravitreal injections , retinal green laser therapy, motivating to take care of DM will be done here. In addition , guidance about systematic blood sugar level monitoring , counselling about customized diabetic diet, stress management (stress is the most common and ignored cause of fluctuating sugar levels), will also be provided to the patient.

Cataract Evaluation and Guidance

Cataract evaluation and guiding patient for appropriately planning their surgery will be done here. The procedure of cataract surgery is explained including preoperative and postoperative care to be taken . Information about various intraocular lenses(IOL)is provided and patients are helped to choose the best suitable IOL considering all the aspects of ones eye. This will help patient to understand every aspect of cataract surgery , discuss with family members and take an informed decision.

Glaucoma Awareness , Education and Screening

Glaucoma screening is a must after age of 40, because glaucoma is the leading cause of preventable blindness world wide. It is called as the silent thief of vision because patient never realizes or notice any difficulty in vision until about 70 % of irreversible vision loss has already occurred. What is required is thorough clinical evaluation of optic nerve and measurement of intraocular pressures (IOP) to do appropriate glaucoma screening. We educate and screen patients for glaucoma here.
Regular follow ups of patients will help the doctor and patient as a team to manage and cure any kind of eye diseases.

Speciality Diabetes Eye Care Centre (SDECC)

All of us are aware that India is infamously known as the diabetes capital in the entire world. Being a diabetic eye disease specialist, I have realized that the missing link in the treatment of any diabetes related with health issue is; the lack of knowledge about the disease itself and unawareness about the complications and consequences it can have upon one’s body organs.
Even if few patients have basic knowledge about the disease, they don’t have the clarity on how to tackle the disease, in order to prevent the complications .

Peeping into the mind of a Diabetes Patient

Lack of clear knowledge about the disease, makes one apprehensive of many things like how do I ensure sugar control? Will I have to always refrain from the food I like? will I die because of diabetes? Will I become blind because of diabetes? All these negative stream of thoughts increases stress resulting in fluctuation of blood sugar levels.
I believe that, educating these patients appropriately in time and in a hopeful manner is the need of hour, which will naturally motivate them to follow the lifestyle modifications required to prevent various diabetes related complications.

What is Speciality Diabetes Eye Clinic

Diabetes can affect every part of eye right from eyelid margin anteriorly to optic nerve posteriorly. A routine eye checkup done for non diabetic patient may not be sufficient for a diabetic patient. This is why the idea of specialty diabetic eye clinic emerged to give due importance and attention deserved by these patients.

What’s special about SDEC?

Once The diabetic patients walking into Asian eye hospital is identified, a detailed registration form is filled including parameters like

  • Hemoglobin %age (Hb)
  • Fasting blood sugars(FBS)
  • Post Prandial Blood sugars (PPBS)
  • HbA1c (glycosylated hemoglobin percentage which gives us an idea of average blood sugar control in last 3 months)
  • Blood Pressure(BP)
  • Diabetic Nephropathy status
  • Alternative therapies and lifestyle modification etc. is filled.

Primary eye check up

A primary eye check up and optometry check up includes additional check up of meibomian gland disease (MGD), dry eyes (leading to eye strain, stickiness, redness), extra ocular motility (to look for diabetic vasculopathy related muscle paresis), pupil examination (optic neuropathy and glaucoma), gonioscopy in a diabetic patient. This is followed by pupil dilatation with specific drops.. Patient will have blurred vision for 4-5 hours after the eye drop instillation.

Detailed check up by Retina specialist

Consultation will happen with diabetic eye specialist, who does meticulous eye examination of the cornea surface, cataract (diabetic cataracts are mainly epinuclear, cortical, PSC cataract, which can have sticky stubborn nature and requires appropriate planning preoperatively).

A detailed fundus examination with 78D lens and indirect ophthalmoscope(funduscopy) is done to meticulously examine the retina for diabetic macular edema and small tiny Neovascular blood vessels (NVE) which can lead to sudden bleeding and loss of vision if not detected and treated in early stage. Meticulous optic nerve head examination to look for glaucoma (glaucoma is a blinding preventable disease seen more commonly in diabetic patients)

The patient is categorized into either diagnosis of proliferative diabetic retinopathy(PDR), non proliferative diabetic retinopathy(NPDR) or no evidence of diabetic retinopathy. Patient may be asked to do various eye related investigations in case necessary.

All investigations under one roof

All the investigation A-Z are available under one roof at Asian eye hospital including zeiss optical coherence tomography(OCT)/ Zeiss fundus fluorescein angiography (FFA) fundus camera , Zeiss Humphreys visual field test, Pentacam, Iol master. This makes it very convenient for the patient.

Diabetic Cataract Management

In case an eye surgery is required then patient goes through detailed counselling where the patient is educated about the surgery, pre and post operative eye care, and all the small and big queries are answered to the patients satisfaction.Specific intraocular lenses are advised to diabetic patients depending on various factors.(multifocal IOL are avoided with DR , hydrophilic IOL are also best avoided in any diabetic patients)

Pre - operative consideration for diabetic Patients

We also have a diabetes (blood sugar) control team in the same premises which ensures blood sugar control of patients prior to surgery only through diet and lifestyle planning. On the day of surgery patient is asked to come fasting and a diabetic breakfast is served at our hospital to avoid any sugar hike on the day of surgery.

Intra - operative consideration for diabetic Patients

Asian eye hospital is equipped with state of the art modular operation theatre with HEPA filter, maintaining highest standards of sterile precautions. Sterile precautions during surgery in any diabetic patients becomes very important as these patients are more prone to infections. Infection rate is also controlled through micro incision cataract surgery at Asian eye hospital.

Treatment of Diabetic Retinopathy

Coming to the treatment of diabetic retinopathy I believe a holistic approach is necessary where the root cause of problem is tackled sincerely.; which is mainly long term uncontrolled sugar levels in the past, high blood pressure, anemia, raised CRP is also catered along with eye problem. The treatment of diabetic retinopathy is in the form of intravitreal anti vegf or ozurdex injections to reduce the retinal swelling in diabetic macular edema and Retinal green laser to prevent complications like bleeding within the eye (vitreous hemorrhage) or tractional retina detachment.

In addition to this, strict monitoring of other systemic problem like raised blood pressure, anemia (low hemoglobin), hypercholesterolemia, raised C reactive protein, glycosylated hemoglobin(HbA1c) is done.

In addition to this, strict monitoring of other systemic problem like raised blood pressure, anemia (low hemoglobin), hypercholesterolemia, raised C reactive protein, glycosylated hemoglobin(HbA1c) is done.

The aim of SDEC is to cater to all the above issues through a dedicated team under the guidance of Dr. Shrutika Kankariya.