Laser iridotomy for Glaucoma

If you are having headache/ heaviness in morning/ watering eyes, these are symptoms of glaucoma & you will have higher eye pressure during the period of headache but by the time you visit the doctor, pressure will be normal

This is very early stage glaucoma & all the test for glaucoma will be normal as no damage to optic nerve has occurred 

Glaucoma eye drops will relieve you of your symptoms but glaucoma will keep on progressing 

You need to undergo laser iridotomy which will increase the size of aqueous outflow pathway & cure your glaucoma forever. You need to do it at very early stage when eye pressure are normal. Once pressure is high, more than 3/4 th of the angle is already closed & will need to put eye drops for the rest of your life

Regular Eye check up

 During childhood, vision should be checked to detect refractive error at an early stage so that we can prevent amblyopia by wearing corrective glasses.

During the presbyopia age, (around 40 years) , you need to get your eyes checked with doctor & not optician for early detection of glaucoma

If you have diabetes/ hypertension, you need to check every year as it can have effect on the eyes as well

Macular Hole surgery

 It is a delicate surgery of the macula which requires removal of internal limiting membrane of retina( internal sheet of layer on retina) & injection of gas at the end. Patients need to follow prone position for atleast 3-4 days after surgery, moving around only for toilet & eating. Rest of the time maintaining prone position is crucial for the success of the surgery. Those who can’t sleep in prone position, we need to inject silicone oil which needs to be removed after 3-4 months. 

Visual recovery depends on how early surgery was performed after macular hole development- early surgery leads to better outcomes

Glaucoma & how it takes away your sight

 Glaucoma is nothing but pressure of the eye( similar to blood pressure) & high pressure ( normal 10-20) can damage the optic nerve slowly & silently without you realising as central vision is preserved till the end. You can save yourself from damages by doing regular eye check up after the age of 35 years with qualified Ophthalmologist.some people get symptom of early morning headaches/ heaviness ( narrow angle glaucoma) & it can be better treated at early stage with laser iridotomy which is OPD procedure & can be done in both eyes at the same time. It doesn’t require injection/ patch, no need to go to operation theatre also. It is done with laser on slit lamp in sitting position & patient can go home immediately & resume normal work. This laser will help to stop further progress of the disease. If after doing laser iridotomy, eye pressures are high, you will need to put anti Glaucoma drops for the rest of  your life. It is advisable to undergo glaucoma surgery ( Trabeculectomy with Mitomycin) at the time of undergoing cataract surgery so that you don’t need to put eye drops for the rest of your life. You will need to do eye pressure check up & perimetry test to assess the progress of the disease. Surgery for glaucoma is covered under insurance. It is also covered under Ayushman Bharat scheme & Mahatma Jyotiba Phule Jan arogya yojna

How insurance company troubles patient

 I am an ophthalmologist & deal with cataract surgery patients day in & day out. For cashless treatment under insurance for cataract surgery which is planned, insurance company doesn’t give full & final approval before surgery. They give initial approval of 10,000/- for e.g. for surgery package of 50,000/-. & final approval comes only after performing the surgery & submitting discharge card with lens sticker. This creates a situation where hospital needs to take deposit of 40,000// before doing the surgery & refund the amount once final approval comes. Sometime patient is unaware of limit in his policy & how much final approval will come & may have to pay the difference amount of full approval doesn’t come after surgery. Many patients do not want to spend out of pocket & want to go for a package which will be approved by insurance company & they do not mind going for a lower package but insurance company doesn’t give any clarity before the operation & many are having corporate policy, unaware about cataract package limit in their policy as they don’t have any policy documents except for the mediclaim card. This is seer harassment to patients even for a planned surgery with fixed packages & no hidden cost. I think IRDAI will look in the matter to streamline the process

How poor patients are being fleeced under the guise of charity

 I came across Tara Netralaya in mumbai projecting them as charitable organisations where all treatment & surgery are being done for free. Patient doesn’t have to pay for any check up or operation except for the cost of the lens. They have a pharmacy of their own where patients are directed & asked to buy lenses from there as per the MRP so that patients feel that they are not paying anything to the hospital for surgery & everything is free for them. As I am an eye doctor, I know the cost of all the lenses & what MRP written on the lenses mean. I will share an example of Indian hydrophilic foldable lens which is available in the market for Rs 300/- with an MRP written on the box as 6000/-. Same with Indian hydrophobic foldable lens available to doctors at Rs 1000/- with an MRP written on the box as 15000/-. Same with Indian multifocal lens available for Rs 6000/- with an MRP written on it as 35000/-. Now you get the idea how these people cheat poor patients & donors under the guise of charity. There is no harm in doing business but should not fool poor patients under the banner of charitable eye hospital where everything is being done for free & also fool the donors & take lot of money as donations as well. Such organisations should be exposed for fooling poor patients