In today’s medical world, equipment-based diagnostics and therapeutics play a major role, while the clinical skills of doctors although important, are fast dwindling due to overdependence on these equipment. The other important factor is medicolegal issues, due to which diagnostics and proof of disease have become an inseparable part of medical practice, making the use of modern technology all the more imperative.
So, what do we have in Ophthalmology today?
- First and foremost, the existing surgeries have all become even less invasive with the advent of suture less micro incision options in Cataract and Vitrectomy.
- Secondly, use of laser-based machines is on the rise with the advent of Femtosecond Laser which has applications in refractive surgeries like Femtolasik and Smile, corneal procedures like transplants, rings and inlays, and finally in Cataract surgery as well. We have bladeless laser procedures like Transprk for correcting higher errors with less tissue loss. We also have high-end lenses giving trifocal vision and correcting Corneal Astigmatism, as well as implantable contact lenses for very high refractive errors giving spectacle independence. For diseases like Keratoconus, customised crosslinking of the cornea give hope and avoid transplants.
Talking about transplants, today we can use a single donated Cornea for two patients, due to the advent of Corneal Lamellar Surgeries like Dalk, Dsaek and Dmek. Limbal Stem Cell surgeries for clearing Corneal Opacification and reconstructing the Ocular surface has evolved into Clet and Slet surgeries, as well as nerve transplant procedures. For patients that have a very poor prognosis for the above procedures, we have high quality artificial Corneas, bio engineered Corneas and retinal Implants (Bionic Eye). As for the latest inventions, we are talking of applying the Crispr Technology in genetic diseases of the eye like Congenital Optic Atrophy, giving hope to thousands of patients.
As for the diagnostic aspects, we have high-quality retinal and optic nerve scans in the form of OCT and angioOCT, Glaucoma Visual Field Progression monitoring through perimetry, high-quality Topographers for mapping the Cornea before and after refractive surgery, and accurate IOL power calculators for cataract surgery in the form of Optical Biometers.
For Glaucoma patients, there are new stents and valves which control eye pressure in patients with a slim ray of hope. In Retinal surgeries, we have newer 27G Vitrectomy Cutters, lasers and anti-VEGF Injections for controlling Diabetic Eye Disease and age-related bleeds.
For Oculoplasty and squint patients, newer approaches and equipment are used to deal with trauma, complex injuries, congenital anomalies, eye movement disorders, Neuro-Ophthalmic diseases, complex tumors and complicated squints.
In pediatric diseases and sports ophthalmology, today there are software available to improve visual acuity in lazy eyes and other equipment to improve dynamic visual acuity for sports persons. Finally, in rehabilitation there are electronic devices as Low Vision Aids, Intraocular Telescopes and artificial eyes and lenses for cosmetic improvement.
All in all, Ophthalmology is at the brink of a revolution and we are happy to be a part of it, as we increase our armamentarium in delivering the best and safest patient eye care that was ever possible!
Dr Harshvardhan Ghorpade,
Cornea, Cataract and Refractive Surgeon,
Department of Visual Sciences,
Hiranandani Hospital Vashi-A Fortis Network Hospital