JTS Medical Centre: Secure your vision

JTS Medical Centre provides a wide range of outpatient and wellness services, including an ophthalmology clinic, which offers state-of-the-art solutions for diabetic eye diseases and cataract.

Understanding Cataract and its management

Dr K R Sathish

MS., DOMS., Specialist Ophthalmologist

Any reduction in clarity of vision is a very concerning issue for all of us. One of the leading causes for this poor vision is Cataract. It causes more than half of all cases of blindness and a third of all cases of 'visual impairment' worldwide. However, it is practically a reversible blindness unlike Glaucoma, which is related to eye pressure.

A clear natural lens inside the eye is vital for focusing vision. When this lens gets clouded from any cause, it is referred to as Cataract. This word is essentially derived from a Latin word 'cataracta' that means 'waterfall'. It refers to the whitish appearance of the clouded lens behind the pupil. Even the term in Arabic translates to 'white water'.

Even though it is more often age-related, no age is exempt from developing Cataracts, including newborns. Risk factors include Diabetes, injury or surgery to the eyes, steroid medication and some skin diseases. Prolonged exposure to ultraviolet rays in sunlight, smoking tobacco and even consuming excess alcohol are other known causes of Cataract. Understanding these mechanisms helps in taking measures that can prevent cataract formation.

The symptoms include foggy blurred vision for distance or near, frequent change of specs, altered colour vision, ghost images or double vision, and glare disabilities, especially when driving at night thereby increasing the risks of falls, accidents and even depression. Symptoms vary according to the types, sites and degree of cataract. When the entire natural lens is opaque, it is referred to as a 'fully ripe' or mature stage. If not treated, it can lead to complications like inflammation and Glaucoma leading to blindness. Fortunately, Cataracts are easily diagnosed by simple examination of eyes that may require instilling eye drops to dilate the pupil.

In the early stages of cataract, symptoms may be partly improved by changing spectacles. No eye drops or oral medicines or even supplements can reverse the cataractous lens. The definitive treatment remains essentially surgical. With current technologies, the indication for surgery is based on the visual handicap of the person or to facilitate retinal care as in Diabetics or age-related macular degeneration. Awaiting the 'ripening' of cataract for surgery is now a thing of the bygone era.

The first cataract surgery performed in the world is credited to Sushruta, a Physician in India, who had done the procedure before 500BC. The technique has undergone great refinement over the ages. Currently, the worldwide gold standard technique is a day care procedure called Phacoemulsification.

Herein ultrasound energy is employed to liquefy the cataract in the eye and removed through a wound as small as two millimetres. The surgery is completed by implanting a clear artificial lens (IOL) of pre-calculated power in the place of the diseased natural lens. The choice of IOLs and its power helps to restore good vision within four to six weeks after surgery, even to the extent of being relatively specs-free for life. Like any surgery on the human body, cataract surgery too can have complications, some of which may be even sight-threatening but are fortunately very rare. Contrary to the general belief, Lasers in primary Cataract treatment can perform only two or three steps of the above surgery and is not an alternative to it. Technically, its precision is exemplary but is very expensive.

Demystifying diabetic eye diseases

Dr Chidamber B Srinivas

MBBS, DOMS, MS, Vitreo-Retinal Fellow (Melbourne, Australia)

Specialist Ophthalmologist

According to the 2019 IDF statistics, the UAE has one of the world's highest prevalence rates of diabetes at 16.3 per cent, approximately 40.7 per cent of adults (aged 20-79) with type 2 diabetes mellitus are unaware that they have the condition. Globally, approximately 95 million (35.4 per cent) diabetic patients have diabetic retinopathy (DR), of which a third have vision-threatening DR and 7.6 per cent macular edema. Global annual incidence of DR is 2.2 per cent to 12.7 per cent, and disease progression is 3.4 per cent to 12.3 per cent. In Ninety-five per cent of these cases, blindness can be prevented by timely medical intervention and screening for DR is the first most crucial step. You could have DR and not know about it. Often because at the early stage, symptoms are yet to manifest themselves.

If you notice any of the below symptoms it is advised to get oneself screened:

.    Seeing an increasing number of floaters

.    Having blurry vision

.    Seeing black or dark spots in your field of vision

.    Having poor night vision

.    Noticing colours appear faded or washed out

In majority of the cases, retinal changes can be identified even before visual symptoms present themselves, hence the importance of screening. Once DR is identified, preventing further damage is critical. This means:

1.    Strict control of blood sugars, having a HbA1c of 6 to 6.5 helps reversing the retinopathy.

2.    Timely intervention with Argon laser photo coagulation also decelerates the progression.

3.    In cases of Diabetic Maculopathy, using intravitreal injections of anti VEGF's reverse the maculopathy and helps maintain reading writing vision in most cases.

4.    In 12.3 per cent of cases where retinopathy progresses, it requires surgical intervention to prevent blindness.

It becomes very important to maintain timely periodic follow ups, as retinopathy can recur and further damage to vision can ensue. At JTS Medical Centre, we employ cutting edge technology and state-of-the-art facilities to screen and document DR, via OCT and OCT-A, Argon laser, VEGF's injections and digital visualisations.

JTS Medical Centre is located in Jumeirah 1 near Etihad Museum. To book an appointment, call 04-3799954

or visit www.jtsmedicalcentre.com

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