Acknowledgment We would like to thank, Our professor of Kiit School of Management,, Mr. Biswajit Das, for his support, Encouragement & for his esteemed guidance. We would also like to show our gratitude towards Dr. Bikas Chandra Mohanta( L V Prasad Eye Hospital) for paving the right path for the Kiitians. Lastly, We would thank The Almighty for blessing us with our abilities. CONTENTS Preface……………………………….. LV Prasad Eye Institute…………….. Introduction …………………………. Services……………………………….. Research……………………………..
Education…………………………….. ICARE……………………………….. LASIK……………………………….. Arvind Eye Hospital…………………. Conclusion…………………………… Bibliography…………………………. Preface During the first year of MBA in Kiit School of Management ,this is a major project which is included in the course curriculum. The topic of our project reports on the Difference in Services provided between L V Prasad Eye Hospital & Arvind Eye Hospital. A complete task of starting from concept analysis to preparation of the entire Project by various methodology has been done nder the guidance of Professor. Biswajit Das ( Course Instructor). The unique services provided by the hospitals has collaboration with World Health Organization and assures the society for prevention of blindness ratio. Every care has been taken while preparing this project report. Clinical Services Cataract • Small incision cataract surgery • Phacoemulsification : Phacoemulsification refers to modern cataract surgery in which the eye’s internal lens isemulsified with an ultrasonic handpiece and aspirated from the eye.
Aspirated fluids are replaced with irrigation of balanced salt solution, thus maintaining the anterior chamber, as well as cooling the handpiece. [pic] • YAG Capsulotomy : A yttrium aluminum garnet (YAG) capsulotomy isan outpatientlaser surgery performed by an ophthalmologist on a patient who has previously had cataract surgery — the removal a cloudy lens from the eye. Corea • Corneal Transplantation : Also known as corneal grafting, is a surgical procedure where a damaged or diseased cornea is replaced by donated corneal tissue in its entirety. Infections and Ulcers: The cornea is the clear (transparent) tissue at the front of the eye. A corneal ulcer is an erosion or open sore in the outer layer of the cornea. It is often caused by infection. • Amniotic membrance transplantation : Amniotic membrane transplantation has been used for reconstruction of the corneal surface in the setting of persistent epithelial defects, partial limbal stem cell deficiency, bullous keratopathy and corneoscleral ulcers. Contact Lenses Soft Contact Lens: Soft contact lenses are made of a highly flexible gel material that contains water. Soft lenses do permit oxygen to reach the eye. [pic] A pair of contact lenses, positioned with the concave side facing upward • Rigid Gas Permeable contact Lens: Rigid gas permeable contact lenses, also called RGP or GP contact lenses, are made from a firm plastic material and contain no water. Unlike hard lenses, RGP lenses permit oxygen to pass directly through he lens to the eye so that it may “breathe. ” Because they transmit oxygen these lenses are referred to as gas permeable. • Cosmetic Contact lens: A cosmetic contact lens is designed to change the appearance of the eye. Retina Vitreous • Diabetic Retinopathy: Caused by complications of diabetes mellitus, which can eventually lead to blindness. • Infammations and infections • Neuro-ophthalmology: Specializing in diseases affecting vision that originate from the nervous system. Ophthalmic Plastic surgery,orbit & ocular oncology Orbit and reconstruction surgery is extremely important in the restoration of normality for patients who have suffered disease, illness or injury to the eye • Functional and cosmetic eye plastic surgery • Botox is Scientific research led doctors to the discovery that botulinum toxin could be medically useful because of its effects on paralyzing — or relaxing — abnormally tight muscles. NTPC centre for Sight Enhancement & Rehabilitation • Optical & Non-optical devices • Training in orientation ,mobility and daily living skills
Marium Hyman Children’s Eye care centre • Pediatric Cataract • Pediatric Eye tumors • Pediatric Retinal diseases • Squint Education & Training LVPEI is a World Health Organization Collaborating Centre in developing human resources for blindness prevention and providing training to eye care professionals from all over the world. The Institute strives to provide the highest quality of training and education through a committed faculty, complemented with the most advanced technological and methodological tools.
The Institute, since its inception has trained more than 10,000 students from India and abroad in various training programs for eye care personnel at all levels. Education At LVPEI • Ophthalmology • The Bausch & Lomb School of Optometry • Eye Care Professionals Training Programs: [pic] Education At LVPEI Has Three Main Objectives To upgrade the skills of practicing ophthalmologists To provide opportunities to keep abreast of developments in the field of vision science and its application To equip new entrants to the field with the appropriate skills and knowledge
International Applicants They train all international applications who intent to pursue fellowship at the institute, in addition to other requirements mentioned in individual training and study program. Technical & Training Facilities The L V Prasad Eye Institute is a tertiary eye care center, which serves every major area of eye health. At LVPEI a trainee can acquire the widest kind of experience in eye health, eye surgical procedures, technical training, rehabilitation and low vision program and other ancillary activities. The Institute has an excellent infrastructure with 45 examination rooms, nine dedicated operating rooms, and supporting diagnostic and therapeutic services. It also has several specialized centers for different facets of eye care. • The Institute has dedicated laboratories for microbiology, molecular genetics, pathology, and serology, and a surgical wet laboratory. • There is a dedicated center for pediatric eye care – the Jasti V Ramanamma Children’s Eye Care Centre. • Vision Rehabilitation Centres are model centers for rehabilitation of people with low vision across the globe. The International Centre for Advancement of Eye Care (ICARE) at our Kismatpur campus provides community eye care for underserved urban areas All these opportunities combine to give fellows and trainees excellent hands-on experience and the confidence that comes with such experience to mould them into world class professionals. Honours & Awards- LVPEI The Only Eye Institute In India With Four Bhatnagar Awardees L V Prasad Eye Institute (LVPEI) is the only eye institute in India with four Bhatnagar Awardees on its rolls.
Director of Research at LVPEI, Padmashri Dr D Balasubramanian, received the Shanti Swarup Bhatnagar Prize in Chemical Sciences in 1981. Dr Anil K Mandal, Head, Jasti V Ramanamma Children’s Eye Care Centre, was awarded the Bhatnagar Prize in Medical Sciences in 2003 for his research in glaucoma in adults and children. Dr Mandal was the first ophthalmologist ever to receive this award. Dr Virender Singh Sangwan, Associate Director, and Head, Cornea and Anterior Segment and Ocular Immunology and Uveitis Services, received the award in 2006 in recognition of his work in stem cell transplantation.
Dr Santosh G Honavar, Associate Director and Head, Ophthalmic and Facial Plastic Surgery, Orbit and Ocular Oncology, received the Bhatnagar Prize in 2009 for his work on retinoblastoma. Eye Disabilities What Are Refractive Errors? The eye functions like a camera. Light rays entering the eye are focused by the cornea and the lens of the eye onto the light sensitive retina at the back of the eye. The retina then transmits a clear image, or photo, to the brain. In people with refractive error the light rays do not get focused on to the retina and therefore, blurred images are formed.
Myopia And Treatment Options Definition of Myopia – It is commonly known as near-sightedness or short-sightedness, refers to a condition where the patient is unable to see distant Hyperopia Hyperopia refers to the condition known commonly as long-sightedness, wherein the patient has difficulty seeing objects or reading at close distances without the aid of glasses. Lasik LASIK Surgery LASIK (or Laser-Assisted In-Situ Keratomileusis) is the most modern surgical procedure for correcting vision problems like myopia, hyperopia, and astigmatism.
This is an advanced laser vision correction technique in which the curvature of the cornea is reshaped using a laser that is capable of removing tissues with precision up to a micron level. For this procedure patients should be at least 18 years of age and the refraction (spectacles power) should be stable (unchanged) for at least a year. Persons who typically opt for LASIK are those who find spectacles visually unacceptable, those who are intolerant to lenses, those who would like to participate in outdoor sports or opt for professions demanding excellent uncorrected vision.
However, though doctors strive to make the refractive error zero after LASIK, this may not always be possible. Objective of LASIK:- The main purpose of surgery is to offer sufficient good vision to patients so that they are not dependent upon glasses most of the time. Some of the possible side effects of LASIK are undercorrection, overcorrection, glare, halos, and reduced contrast sensitivity. Therefore patients must have a detailed eye examination before surgery, followed by a realistic discussion with the surgeon on the expected outcome of surgery. Defects Or Aberrations That Can Be Corrected With LASIK
Myopia or short-sightedness occurs when light rays are focused in front of the retina causing blurred vision, particularly when viewing distant objects. Objects that are near may be seen clearly, but not those that are far away. Myopia is often hereditary, usually due to an abnormally large eyeball or steeply curved cornea. Because the eyeball grows with age, myopia tends to progress, usually stabilizing by the time the person is 20 years old. Hyperopia or far-sightedness is the opposite condition of myopia, where the light rays converge at a point beyond the retina.
Initially objects that are near seem blurred, though distance vision remains clear. However, with age, objects at all distances become blurred. Astigmatism is an irregularity in the shape of the normally spherical cornea. The cornea is shaped like an egg or the back of a spoon, causing distortion of both distant and near vision. Why would One Be Interested In LASIK? • If the person do not want to wear spectacles or contact lenses. • If he feels visually and socially restricted by spectacles or contact lenses. • If the person want to participate in certain outdoor sports here using spectacles or contact lenses may be a problem. • If the person to join certain professions wherein excellent uncorrected visual acuity is a prerequisite. Who Can Undergo A Laser Correction Procedure? • Patient must be above 18 years old. • Patient should not have any ocular surface abnormality such as dry eyes. • Patient’s cornea should have adequate thickness for it to be operated upon. Before The Laser Procedure… The patient undergoes a normal eye examination after which the ophthalmologist may suggest a vision corrective procedure.
Thereafter, information about the patient’s eye structure and function – including corneal thickness, corneal curvature, optical aberrations etc. – will be ascertained. All this is done at LVPEI using state-of-the-art diagnostic equipment. The eye test reports are studied by the ophthalmologist before making a final decision, in consultation with the patient. After Laser Surgery Once surgery is over your eye will be covered with a shield after the administration of some drops and ointment. You can return home immediately. The patient may experience pain for the first 24 to 36 hours, for which you will have to take oral analgesics.
The patient will have to come for follow up visits from the very next day onwards. The concerned doctor will schedule the check-ups as necessary. The usual routine followed after Laser Surgery is :- • First check-up in the morning after surgery • Seven days from the date of surgery • One month from the date of surgery • Three months from the date of surgery • One year from the date of surgery The patient undergoes special diagnostic tests at each visit to the Institute aimed at assessing your visual acuity. It is important that you visit the doctor as scheduled on every appointment.
You will be advised to use eye drops or other medication during the post-operative period. LASIK Possible Side-Effects Laser surgery is very safe and effective. But in some patients there could be side effects. Some are as follows: Undercorrection/overcorrection: Undercorrection may sometimes be planned intentionally or may occur as an unintentional effect. As a result, the eye remains short sighted even after the surgery. If the degree of residual myopia is significant, the eye may be retreated at a later date. Overcorrection can occur very rarely.
Glare/halo effect: We may feel some sensitivity to light at night or in bright sunlight. Sometimes in dim light, it may see a faded ghost image around the sharp bright image. This will pass after the first few days or weeks. Flap complications: Sometimes the anterior corneal flap that is made in LASIK may not be complete if the keratome stops mid-way because of suction loss. In this situation the flap is repositioned and ablation is deferred. The surgery is re-attempted after three months. In rare instances, the flap may tear or become detached. Corneal ecstasia :
Can occur if the corneal thickness is less to begin with, or if the cornea is thinned more than it can withstand with the lasers. Therefore, persons having inadequate corneal thickness are not suitable candidates for LASIK. Alternatives To LASIK :- For patients where the corneal thickness is not sufficient for doctors to perform LASIK, there are other alternatives. Generally LASIK is not performed if the thickness is less than 470µm for spherical errors and less than 490µm for cylindrical errors. In such cases the options are: Photorefractive kertectomy (PRK)
This was the most popular laser procedure for correcting refractive errors before the advent of LASIK. Here the laser is applied to the corneal surface. Since the epithelium (surface layer of the cornea) is removed, this leads to greater activation of inflammatory mediators and better healing. The problems of excessive healing or haze (scar) can decrease the clarity of vision, and regression or refractive error returning due to the addition of tissue. Haze and regressions are more if the error is high. Generally PRK is recommended for cases up to 6. 0 diopters.
The problems encountered in the early post-operative period with PRK are more painful (because of epithelial defects), and delay visual rehabilitation as it takes 3-4 days for the epithelium to heal. Early visual recovery, more comfort, practically no haze and very little regression (not in all cases) are the advantage of LASIK over PRK. PRK is preferred in cases with borderline corneal thickness where LASIK might be risky. Excessive ultraviolet exposure is a risk factor as it might cause haze after PRK. After surgery, to minimize haze surgeons use ointments.
L V Prasad Eye Institute is one of the few places in India that offers this procedure, and the results have been very encouraging. Phakic intraocular lens The Phakic IOL technique is recommended for patients with moderate to severe myopia, i. e. , very high refractive powers (near-sightedness). It is used safely and effectively for the acutely near-sighted who are tired of wearing thick glasses and are not suited for the customized LASIK procedure, because they have low corneal thickness or flat corneas. Phakic IOL does not change the natural appearance of the face and does not require any special care or maintenance.
Clear lens extraction (Refractive lens exchange) with negative intraocular lens implantation This option is not considered for individuals with myopia as literature has suggested increased incidence of retinal detachment after removal of the lens. Though the incidence of retinal detachment is less in the case of hyperopia, this procedure is not recommended in young people with hyperopia since they stand the risk of posterior capsular opacification. Refractive lens exchange with multifocal or monofocal intraocular lens is recommended for high hyperopes over +5 D after the eye of 40 years. [pic][pic]