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Cornea and Glaucoma Clinic


Cornea & External Disease Services

The Cornea Services at Patiala Eye Hospital & Lasik Laser Centre, Patiala is dedicated to the medical and surgical treatment of problems involving the cornea and ocular surface.

The clinic caters to the following Cornea & External eye diseases:
1. Corneal Infections
2. Eye allergies or corneal complications arising from other forms of ocular surgery
3. Ocular surface trauma
4. Ocular surface disorders like blepharitis, meibomitis, conjunctival and scleral diseases
5. Refractive errors (nearsightedness, farsightedness and astigmatism)
6. Conjunctivitis (red eye)
7. Dry eye syndrome
8. Ectatic corneal diseases like keratoconus, keratoglobus and pellucid marginal degeneration
9. Pterygium
10. Corneal dystrophies and degeneration

Surgical Procedures
1. Corneal Transplantation: Penetrating keratoplasty, Lamellar keratoplasty, Endothelial keratoplasty(DSAEK)
2. Keratoprosthesis (Artificial cornea)
3. Scleral grafting
4. Corneal, limbal, and amniotic membrane transplants for ocular surface reconstruction in severe ocular surface disease
5. Tissue adhesive application to seal corneal perforation
6. C3R (Corneal Collagen-Cross Linkage with Riboflavin) for Keratoconus.

Other Facilities
1. Specular Microscopy- Study of the corneal endothelium (cells that maintain corneal clarity)
2. Pachymetry- Measurement of corneal thickness
3. Corneal Topography - Mapping of the cornea
4. Aberrometry- Measurement of the aberrations in the eye
5. Specialized contact lens fitting


What is Glaucoma?

Glaucoma is a disease of the major nerve of vision, called the optic nerve. The optic nerve receives light from the retina and transmits impulses to the brain that we perceive as vision. Glaucoma is characterized by a particular pattern of progressive damage to the optic nerve that generally begins with a subtle loss of side vision (peripheral vision). If glaucoma is not diagnosed and treated, it can progress to loss of central vision and blindness.

Glaucoma is usually, but not always, associated with elevated pressure in the eye (intraocular pressure). Generally, it is this elevated eye pressure that leads to damage of the eye (optic) nerve. In some cases, glaucoma may occur in the presence of normal eye pressure. This form of glaucoma is believed to be caused by poor regulation of blood flow to the optic nerve.

What causes glaucoma?

Elevated pressure in the eye is the main factor leading to glaucomatous damage to the eye (optic) nerve. The eye is firm and round, like a basketball. Its tone and shape are maintained by a pressure within the eye (the intraocular pressure), which normally ranges between 10 and 21 mm (millimeters) of mercury. When the pressure is too low, the eye becomes softer, while a too high pressure causes the eye to become harder. It turns out that the optic nerve is the most susceptible part of the eye to high pressure because the delicate fibers in this nerve are easily damage.

What are the risk factors?


Glaucoma is often called "the sneak thief of sight." This is because, as already mentioned, in most cases, the intraocular pressure can build up and destroy sight without causing obvious symptoms.

The major risk factors include:
Age over 45 years
Family history of glaucoma
Black racial ancestry
History of elevated intraocular pressure
Nearsightedness (high degree of myopia), which is the inability to see distant objects clearly
History of injury to the eye
Use of steroids, either in the eye or systemically (orally or injected)
Farsightedness (hyperopia), which is seeing distant objects better than close ones (Farsighted people may have narrow filtering angles, which predispose them to acute (sudden) attacks of closed-angle glaucoma.)

Symptoms of Primary Open-Angle Glaucoma

There are typically no early warning signs or symptoms of open-angle glaucoma. It develops slowly and sometimes without noticeable sight loss for many years. Most people who have open-angle glaucoma feel fine and do not notice a change in their vision at first because the initial loss of vision is of side or peripheral vision, and the visual acuity or sharpness of vision is maintained until late in the disease. By the time a patient is aware of vision loss, the disease is usually quite advanced. Vision loss from glaucoma is not reversible with treatment, even with surgery.

Because open-angle glaucoma has few warning signs or symptoms before damage has occurred, it is important to see a doctor for regular eye examinations. If glaucoma is detected during an eye exam, your eye doctor can prescribe a preventative treatment to help protect your vision.

Symptoms of Angle-Closure Glaucoma

Hazy or blurred vision
The appearance of rainbow-colored circles around bright lights
Severe eye and head pain
Nausea or vomiting (accompanying severe eye pain)
Sudden sight loss

If you are diagnosed with glaucoma, it is important to set a regular schedule of examinations with your eye doctor to monitor your condition and make sure that your prescribed treatment is effectively maintaining a safe eye pressure.

Examination of glaucoma

The following tests make up a glaucoma examination:

1. Medical and ocular history
2. Visual acuity testing
3. Refraction to measure the glasses or lens correction
4. Tonometry testing for IOP
5. Slit lamp biomicroscope examination is the "stethoscope" of the eye doctor. This high-quality optical device allows the doctor to view the eyes in stereo under high magnification while the patient places their chin on a rest and their forehead against a bar to maintain consistent positioning.
6. Gonioscopy to examine the aqueous humor outflow channels
7. Peripheral visual field testing
8. Optic nerve head photography is taken by high-quality cameras and recorded, usually digitally. This allows precise comparison from year to year, permitting analysis of subtle anatomical changes over time.
9. Optic nerve head topography creates a precise digital image of the nerve thickness around the optic nerve to within 1/1000 of a millimeter. Subtle loss of nerve thickness indicates the progression of glaucoma.

What is tonometry?

Tonometry is a method of measuring the pressure in the eye. Tonometry is used to determine the pressure in the eye by measuring the tone or firmness of its surface.

Is glaucoma curable?

Mode of treatment includes eye drops, medicines, laser or surgery. These do not cure the disease but treat the condition by preventing further damage. Hence the importance of early detection. It is a condition that needs long term follow-up, mostly life long. The treatment is modified based on time to time evaluation of the disease status.

What is the treatment for glaucoma?

The treatment is aimed to keep eye pressure in normal range. For any individual the normal or "target pressure" is different, which is decided by the eye surgeon after studying the reports of all above mentioned tests. The lowering of eye pressure is achieved by eye drops or medicines alone or in combination with laser procedure. If the eye pressure is not controlled by above, surgery is required. The modality of treatment is decided by factors like type & stage of glaucoma, damage already done at the time of presentation, response to prior treatment, patients ability to put medication regularly etc.

What is the role of laser in glaucoma?

Laser surgery may be effective for some types of glaucoma. In open angle variety, trabeculoplasty is done where the drainage angles are treated by laser to increase the outflow of aquous fluid and lower eye pressure. In narrow angle glaucoma, a hole is made in the iris –peripheral iridotomy, to restore the flow of aquous fluid to drainage angles.

What is the surgery done for glaucoma?

It is a microscopic filtering surgery-trabeculectomy where a small drainage channel is created for the fluid to leave the eye and thus lower the eye pressure. It is done under local anesthesia.

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* Enter your information - Patiala Eye Hospital & Lasik Laser Centre was established in 1995 by Dr. Dr. Sukhdip Singh Boparai's. The hospital has now expanded and is housed in a central location of Royal City Patiala, Punjab. Now Our hospital "A Centre for Complete Eye Care Under One Roof" is the Biggest Eye Hospital in Punjab.