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Ophthalmology

Clinical focus
BROAD AREA OF WORK

  • Routine treatments rendered
  • In the OPD, procedures like visual acuity testing, tonometry, syringing, slitlamp examination,  indirect slit lamp biomicroscopy , Gonioscopy, direct & indirect ophthalmoscopy , A-Scan, B-Scan, Keratometry , Contact lens fitting, low vision aids, refractions are routinely practiced.
  • Surgical procedures such as extra capsular cataract extraction, small incision cataract surgery, phaco emulsification, optical keratoplasty,  therapeutic keratoplasty, triple procedure,  trabeculectomy, phaco trab, I & C of Chalazion, SFIOL, vitrectomy are regularly performed.

SPECIALITY TREATMENTS
UVEA CLINIC 

The Uvea Clinic extends its services towards patients with ocular inflammatory diseases which includes uveitis. Although statistically, uveitis cases form only a small percentage of the total number of cases examined daily at the outpatient department, the magnitude and severity of ocular damage they can cause is extremely high. The new patients and the review patients are examined. Fundus fluorescein angiography, Optical coherence tomography and B scan are performed whenever required. A laboratory work up and radiological investigations are also done for all patients

Orbit Clinic

  • Orbit and Oculoplasty is a newly emerging sub-speciality in the field of Ophthalmology. The focus of the Orbit and Oculoplasty services is on the evaluation and management of Orbital and adnexal disorders. 
  • The Orbit and Oculoplasty services also deal with the management of orbital infections and inflammations with joint consultation with General physicians and ENT surgeons.
  • Patients with Thyroid Eye Disease are regularly being referred from the department of Endocrinology for thorough evaluation and management.
  • Blunt trauma and polytrauma needing intervention and orbital fracture reduction is intervened with multi OMFS co-ordination disciplinary approach.
  • Nasolacrimal duct obstructions both congenial and acquired are treated both conservatively & surgically.
  • Surgical management for ptosis, entropion, ectropion eyelid reconstruction are being performed.
Cataract and Refractive Surgeries

  • Cataract being a major cause of blindness in India, the Department of Ophthalmology, SRIHER is doing its part in the eradication of blindness adopting 3 districts under NPCB program. The procedures that are being done are extracapsular cataract extraction, small incision cataract surgery with rigid IOL implantation and phacoemulsification with foldable lens implantation. Both coaxial and Bimanual phacoemulsification are done. Foldable lenses that are implanted include both unifocal and multifocal lenses.
    A number of screening camps are held and patients who are found to require cataract surgery are operated in the New Block under the District Blindness Control Scheme.
  • Astigmatic Keratotomies and Limbal Relaxing incisions are routinely being done in the quest for restoration of normal vision.                                                                    
  • Corneal blindness is the second leading cause of blindness in the developing world. Common causes of corneal blindness include trauma, infections and hereditary disorders. In the Cornea Clinic we manage the following conditions:                 
1.Microbial Keratitis – We have a full fledged microbiology and pathology back up where all the samples are processed. Appropriate treatment is started depending upon the micro reports.
2.Trauma - All open globe injuries are taken care of round the clock. With a multi disciplinary approach.
3.Penetrating and Lamellar Keratoplasty.
4. Contact Lens services.

We also have an Eye Bank which is affiliated to the Ramayama International Eye Bank, L V Prasad Eye Institute, Hyderabad. Donor eyes are retrieved by Enucleation / In situ excision. They are preserved in
M K (McKarey Kaufman) medium and are utilized for lamellar and Penetrating Keratoplasty. The Eye Bank also helps in creating awareness about eye donation to the public.  

Patient being evaluated in Cornea Clinic using TOPCON slit lamp

RETINA CLINIC 

Eye being the index of systemic problems both for the young and the old, retinal examination becomes important in the complete examination of the eye. Blindness due to Diabetes is a major cause for irreversible blindness in old age. 8% of urban and 2% of rural population are diabetics. Diabetes, Hypertension, Renal diseases, Collagen vascular diseases, all affect the retina resulting in decreased vision. The Retina Clinic is equipped with state of the art Digital camera for documentation of retinal disesases and for Fundus Fluoresein Angiography. Retinal Lasers which is the mainstay in the management of Diabetic Retinopathy are being done. 

VITRIEO RETINAL SURGERIES:

  • Patients with Rhegmatogenous detachments macular hole, advanced diabetic retinopathy, macular tractures are being treated success fully by experts in speciality. 
GLAUCOMA CLINIC 

  • Glaucoma is an important, often undiagnosed cause of visual impairment.   In our clinic patients are screened for this important disease by various investigations including Tonometry, Gonioscopy, Perimetry,  Fundus examination & OCT. 
NEURO OPHTHALMOLOGY CLINIC 

  • The Neurophthalmology clinic deals with the evaluation and management of patients with ophthalmic manifestations of neurological diseases. These include Optic Neuritis, Papilloedema, Oculomotor palsies and diplopia.
  • The Neurophthalmological work up includes documentation of patient’s vision, colour vision, assessment of pupillary reaction, fundus examination and evaluation of visual fields by Humphrey’s field analyzer. Patients with diplopia are followed up with diplopia charting by Hess Screen. 
CULOPLASTY CLINIC 

  • Cosmetic surgery such as Brow lifts both internal and external is also done. 
  • Enucleation or Evisceration with orbital implants is performed when indicated. 
  • Patients who have undergone orbital implants are being fitted with either prefabricated prosthesis or custom made prosthesis with excellent results.
  • Baggy eyelids and droopy eyebrows can give rise to a tired appearance. When severe, these may even lead to impaired vision. Baggy eyelids and droopy eyebrows can be corrected by what is known as Aesthetic eyelid surgery with multi disciplinary team effort.
Broad area of work:
Routine treatments rendered:

In the OPD, procedures like visual acuity testing, refraction, keratometry, tonometry, syringing, slitlamp examination,  indirect slit lamp biomicroscopy, Gonioscopy, direct & indirect ophthalmoscopy are routinely practised. Complete ophthalmic evaluation is done and speciality evaluation is done as required.

Speciality Treatment:
Cataract and Refractive Surgeries:

Cataract being a major cause of blindness in India, the Department of Ophthalmology, SRIHER is doing its part in the eradication of blindness. The procedures that are being done are extracapsular cataract extraction, small incision cataract surgery with rigid IOL implantation and phacoemulsification with foldable lens implantation. Both coaxial and bimanual phacoemulsification are done. Foldable lenses that are implanted include both monofocal and multifocal lenses.
A number of screening camps are held and patients who are found to require cataract surgery are operated in the New Block under the District Blindness Control Scheme.
Astigmatic Keratotomies and Limbal Relaxing incisions are routinely being done in the quest for restoration of normal vision.

Cornea Clinic :

Corneal blindness is the second leading cause of blindness in the developing world. Common causes of corneal blindness include trauma, infections and hereditary disorders. In the Cornea Clinic we manage the following conditions:            
  1. Microbial Keratitis – We have a full fledged microbiology and pathology back up where all the samples are processed. Appropriate treatment is started depending upon the micro reports.
  2. Trauma - All open globe injuries are taken care of round the clock. Wherever needed consultation from other specialities are sought.
  3. Penetrating and Lamellar Keratoplasty.
  4. Contact Lens services.
We also have an Eye Bank which is affiliated to the Ramayama International Eye Bank, L V Prasad Eye Institute, Hyderabad. Donor eyes are retrieved by Enucleation / In situ excision. Cornea is prepared under laminar flow hood under sterile conditions and preserved in M K (McKarey Kaufman) medium and are utilized for lamellar and Penetrating Keratoplasty. The Eye Bank also helps in creating awareness about eye donation to the public. Patient being evaluated in Cornea Clinic using TOPCON slit lamp and specular microscope.
 
Retina Clinic :
Eye being the index of systemic problems both for the young and the old, retinal examination becomes important in the complete examination of the eye. Blindness due to Diabetes is a major cause for irreversible blindness in old age. 8% of urban and 2% of rural population are diabetics. Diabetes, Hypertension, Renal diseases, Collagen vascular diseases, all affect the retina resulting in decreased vision. The Retina Clinic is equipped with state of the art Digital camera for documentation of retinal diseases and for Fundus Fluoresein Angiography. Retinal Lasers which is the mainstay in the management of Diabetic Retinopathy are being done.
Patients with Rhegmatogenous detachments are operated. The procedures that are commonly done are explants or explants with encirclage, pars plana vitrectomy with silicone oil, silicone oil removal, endolaser, intravitreal injections and so on.

Uvea Clinic:
The Uvea Clinic extends its services towards patients with ocular inflammatory diseases which includes uveitis. Although statistically, uveitis cases form only a small percentage of the total number of cases examined daily at the outpatient department, the magnitude and severity of ocular damage they can cause is extremely high. The new patients and the review patients are examined. Fundus fluorescein angiography, Optical coherence tomography and B scan are performed whenever required. A laboratory work up and radiological investigations are also done for patients as required. Treatment including intravitreal injections is available.

Glaucoma Clinic:
Glaucoma is an important, often undiagnosed cause of visual impairment.   In our clinic patients are screened for this important disease by various investigations including Tonometry, Gonioscopy, Perimetry,  Fundus examination & OCT.  Perimetry shows functional glaucomatous damage whereas OCT of the RNFL shows anatomical glaucomatous damage.
Glaucoma treatment is done with medications, laser or surgery as needed. All glaucoma medications including the latest Rho-Kinase inhibitors are utilized where necessary. YAG laser peripheral iridotomy is done for angle closure glaucoma. Trabeculectomy surgery is done with or without cataract surgery as required. 

Neuro Ophthalmology Clinic:
The Neurophthalmology clinic deals with the evaluation and management of patients with ophthalmic manifestations of neurological diseases. These include Optic Neuritis, Papilloedema, Oculomotor palsies and diplopia.
The Neurophthalmological work up includes documentation of patient’s vision, colour vision, assessment of pupillary reaction, fundus examination and evaluation of visual fields by Humphrey’s field analyzer. Patients with diplopia are followed up with diplopia charting by Hess Screen. 

Orbit Clinic:
Orbit and Oculoplasty is a newly emerging sub-speciality in the field of Ophthalmology. The focus of the Orbit and Oculoplasty services is on the evaluation and management of Orbital and adnexal disorders. The blemish created by lid abnormalities and socket deformities are corrected.
The Orbit and Oculoplasty services also deal with the management of orbital infections and inflammations with joint consultation with General physicians and ENT surgeons.
Patients with Thyroid Eye Disease are regularly being referred from the department of Endocrinology for thorough evaluation and management.
Blunt trauma and polytrauma needing intervention and orbital fracture reduction is intervened with OMFS co-ordination.

Oculoplasty Clinic:
Surgical correction of Ectropion(outward turning of eyelid), Entropion(inward turning of eyelid) and Ptosis(drooping of eyelid) are regularly being performed. Cosmetic surgery such as Brow lifts both internal and external is also done. Enucleation or Evisceration with orbital implants is performed when indicated. Patients who have undergone orbital implants are being fitted with either prefabricated prosthesis or custom made prosthesis with excellent results.
Baggy eyelids and droopy eyebrows can give rise to a tired appearance.When severe,these may even lead to impaired vision.Baggy eyelids and droopy eyebrows can be corrected by what is known as Aesthetic eyelid surgery.