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Opthalmology

Ophthalmology is a branch of medicine that deals with the anatomy, physiology and diseases of the eye. At Wockhardt hospital we are equipped with the modern diagnostic and surgical facilities to deliver the comprehensive best of practices care from simple routine eye examinations to surgeries of complicated cases.

 Our department provides the most basic care for your eyes. We offer a full complement of services one might need. These include: Screening and treatment for common eye diseases (e.g., cataract, glaucoma, diabetes-related eye problem and many others. We have a team of extremely competent ophthalmic surgeons of repute.

The Department of Ophthalmology at Wockhardt hospital strives to offer the best to its patients and has been at the forefront of delivering specialized eye care services for various disorders. Once evaluated comprehensively, each patient is advised a highly individualized treatment plan to ensure optimum compliance with his/her personal and professional requirements. Our Consultants are dedicated to providing excellence in patient care across the complete spectrum of medical and surgical eye problems.

We specialise in offering treatment for the following ophthalmic disorders:

  • Refractive procedures (vision correction procedures),
  • Cataract,
  • Glaucoma,
  • Vitreo Retinal services and  Uvea diseases,
  • Cornea diseases and surgery,
  • Squint correction ,
  • Paediatric Ophthalmology,
  • Neuro-Ophthalmology,
  • Oculoplasty
  • Opticals and Vision Aids, Contact Lens and Comprehensive Eye Check-up.
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FAQs

What is glaucoma?

Glaucoma is a disease that often goes undetected many a times till the advanced stages of the disease. Glaucoma is one of the leading causes of blindness. Glaucoma occurs when the pressure inside the eye rises high enough to damage the optic nerve. Uncontolled eye pressure gradually leads to loss of vision which is not recoverable. The high eye pressure associated with glaucoma is caused by blockages in the eye’s fluid drains. People at the greatest risk include those who are over the age of 60, diabetic, near-sighted or who have a family history of glaucoma.

What are the types of glaucoma?
  • open-angle glaucoma
  • angle-closure glaucoma
  • Glaucoma associated with retinal diseases
  • Glaucoma secondary to eye trauma
  • Juvenile onset glaucoma
  • Neovascular glaucoma
  • childhood glaucoma
What are some diagnostic tests for glaucoma?
  • Automated perimetry
  • Pachymetry to measure corneal thickness, an important risk factor
  • Intraocular pressure measurement ( Applanation Tonometry)
  • Frequency Doubling Perimetry
  • Heidelberg retinal Tomography (HRT II)
  • Optical Coherence Tomography ( OCT)
  • Optic Disc and Fundus Photography
What is the treatment for glaucoma?

With any type of glaucoma, periodic examinations are very important to prevent vision loss The treatment for glaucoma depends upon the nature and severity of each case. In general, glaucoma cannot be cured, but it can be controlling intraocular pressure.Eye drops, pills, laser procedures, and surgical operations are used to stop or slow down further damage from occurring. With any type of glaucoma, regular eye examinations are very important to detect progression and to prevent vision loss,even after surgery.

  • Medical Intervention
  • Glaucoma is often treated with eye drops taken regularly few times a day, sometimes in combination with pills. These medications will alter the circulation of eye fluid and lower eye pressure, either by decreasing the production of fluid within the eye, or by increasing the flow leaving out the drainage angle/out of eye.

  • Surgical Intervention
  • When operative surgery is needed to treat glaucoma, doctor will use a microscope and specialized instruments to create a new bypass drainage channel for the eye fluid to leave the eye. The new channel helps to lower the eye pressure. Surgery will be recommended if there is progression of visual fields or uncontrollable eye pressure and also to prevent loss of vision and/or further progression of optic nerve damage.

  • Laser Surgery
  • Laser surgery is also effective for glaucoma treatment.

    • Trabeculoplasty is laser treatment to enhance the eye drain age function to control eye pressure within the eye when treating open-angle glaucoma.
    • Iridotomy is laser treatment to create tiny holes in the iris to improve the flow of eye fluid to the drain when treating narrow angle glaucoma.
What is Neuro-Ophthalmology?

Neuro- Ophthalmology is a subspecialty of Ophthalmology and Neurology dedicated to managing disorders of the eye caused by or associated secondarily with diseases of the brain, brain tumour, trauma etc.

What are some conditions treated in neuroopthalmolgy?
  • Optic nerve disorders, such as optic neuritis
  • Ischemic optic neuropathy
  • optic neuropathies
  • Visual field defects related to stroke or MS
  • Double vision from ocular motor nerve palsies
  • Myasthenia gravis
  • Thyroid eye disease
  • Orbital tumours
  • Blepharospasm and other involuntary facial movements
  • Disorders of the optic chiasm (i.e. pituitary tumours)
  • Nystagmus
What is cataract?

A cataract is a cloudy area in the normally clear lens of the eye. Cataracts are caused by a chemical change in the eye, and cause blurred or distorted vision. People at a risk for developing cataracts are over 55 years old, have had eye injuries or disease, have a family history of cataracts, smoke cigarettes or use certain medications.

What are the symptoms of cataract?
  • There is no pain associated with the condition, but there are several symptoms that indicate failing vision due to cataracts. These include:
  • Blurred/hazy vision
  • Spots in front of the eye(s)
  • Sensitivity to glare
  • A feeling of “film” over the eye(s)
  • A temporary improvement in near vision
What is phacoemulsification?

Cataract surgery removes the natural cloudy lens from the eyes and replaces with artificial lens. Phaco means lens and Emulsifying means to break into pieces.Today, phacoemulsification is performed as an outpatient basis, under local anaesthesia or "eye drop" anaesthesia. The surgery entails the removal of the natural cataractous lens which is opaque and replacing it with an artificial clear lens, called an Intraocular lens (IOL). The most popular technique for cataract surgery is Phacoemulsification ("phaco" meaning lens and "emulsify" means to break into pieces). Cataract surgery is customized, we make the surgery personalised as per each individual eye needsTo offer the best possible vision without glasses following surgery.

What are the different types of intraocular lenses?

It is an artificial lens that is implanted during cataract surgery. It is made up of acrylic material and can be folded and inserted into the eye. Once inside the eye, the IOL unfolds to its original size and shape.

  • Aspherical lenses ensure aberration free image which gives better vision and enhances contrast sensitivity, thus better night vision and under low light conditions.
  • Square Edges: These lenses have square edges have square edges which prevent the lens capsule from thickening, thus reducing the chances of after cataract formulation.
  • Monofocal IOL: Distant vision becomes clear but has to wear spectacles for near vision. These are standard IOLs implanted in the eye after cataract surgery for correction of distance vision only.
  • Toric IOL: It corrects conical astigmatism so it improves quality of vision in patient with high astigmatism (Cylinder power). These are monofocal IOLs implanted in patients with pre-existing astigmatism and cataract. Provides spectacle free vision even when patients has astigmatism before surgery. Most commonly used is the Toric IOL
  • Multifocal IOL: It improves distant intermediate & near vision.
  • Specialized IOLs. Patients are totally free of glasses for distance, intermediate and near vision for all routine purposes..
What is dry eye?
  • Irritated, scratchy, dry, uncomfortable or red eyes
  • A burning sensation or feeling of something foreign in your eyes
  • Blurred vision
What is the cornea?

The cornea, the transparent front "window of the eye", is responsible for about two thirds of the focusing power of the eye. The cornea's refractive power is actually greater than that of the eye's lens. The cornea receives its nutrients through surrounding areas the tear film. A normal, healthy cornea is transparent, thus devoid of blood vessels and opacities. Corneal tissue can get damaged by disease or trauma.

What is keratoconus?

Keratoconus is a progressive eye disease in which the normally round cornea thins in centre and begins to bulge into a cone-like shape. This cone shape deflects light as it enters the eye on its way to the light-sensitive retina, causing distorted vision.

If keratoconus left untreated can result in severe corneal thinning, bulging and scarring of the cornea (corneal hydrops) making the patient blind. The scarred cornea would eventually require a corneal transplant procedure.

What are the SIGNS & SYMPTOMS?
  • Frequent changing of glasses or contact lens prescriptions. Blurring and distortion of vision.
  • Glare and sensitivity to light especially during night Irritation.
  • Scarring of the cornea.
What is the retina?

The retina is like the film in a camera. It is the seeing tissue of the eye. When the focused light hits the retina, a picture is created and sent to the brain through the optic nerve (the nerve of the eye), thus giving us vision.

What is age related macular degeneration?

The disease affects the part of the retina called the macula, which is responsible for central vision. Vision loss from AMD typically occurs gradually and can affect both eyes at different rates. Even though macular degeneration can cause visual impairment, the disease usually does not cause peripheral (side) vision loss or lead to total blindness. The two common types of macular degeneration are "dry" and "wet." "Dry form": The most common form of macular degeneration is caused by aging and thinning of the tissues of the macula.

Treatment includes intravitreal injection, photodynamic therapy, and rarely laser photocoagulation.

What are the symptoms of the disease?

Blurred or fuzzy vision, Colour perception fades or changes, Straight lines, such as sentences on a page or telephone poles, appear wavy or distorted are some symptoms.

What are the causes of macular degeneration?

The causes of macular degeneration are not completely understood. Some scientists believe heredity may play a part, as well as UV light exposure, nutrition, and cigarette smoking. Studies are ongoing.

What is DIABETIC RETINOPATHY?

The cells in persons with diabetes mellitus have difficulty using and storing sugar properly. When blood sugar gets too high, it can damage the blood vessels in the eyes. This damage may lead to diabetic retinopathy. There are two TYPES OF DIABETIC RETINOPATHY Background or nonproliferative diabetic retinopathy -

What is the treatment of DIABETIC RETINOPATHY?

Good control of diabetes with intensive management and control of blood sugar will delay, and possibly prevent, both the development and progression of diabetic retinopathy. Patients with diabetic retinopathy frequently need to have special photographs of the retina taken. This series of photos is called fluorescein angiography.

  • Laser photocoagulation is one of the most common treatments for diabetic retinopathy
  • Vitrectomy surgery is performed for patients with very advanced proliferative diabetic retinopathy or retinal detachment.
  • Pharmacotherapy: Increasingly, a variety of medications are being used to treat the manifestations of background and proliferative diabetic retinopathy. These involve intravitreal injections of small amounts of medication into the eye.
What are FLASHES & FLOATERS in the eye?

Some people may occasionally see small specks or clouds moving in your field of vision. These are called floaters. Floaters are actually tiny clumps of gel or cells inside the vitreous , the clear jelly-like fluid that fills the inside of the eye. While these objects look like they are in front of the eye, they are actually floating inside. When people reach middle age, the vitreous gel may start to thicken or shrink, forming clumps or strands inside the eye.

What is a retinal detachment?
  • As the vitreous gel in the back of the eye starts to liquefy, it can separate from the retina, a condition called vitreous detachment. If the vitreous gel adheres too firmly to the retina, a retinal tear can occur with a vitreous detachment.
  • A retinal detachment occurs when fluid leaks through the tear and separates the retina from the back of the eye. Patients with a retinal tear or detachment often, but not always, have flashes and floaters as their first symptoms. This occurs as the vitreous gel detaches from the back of the eye.
  • Laser treatment can be used to treat this condition. It is a highly focused and concentrated beam of light that is usually performed to decrease leakage in the retina, treat abnormal blood vessel growth, or create a beneficial scarring effect that can help prevent a retinal detachment.
What is FUNDUS FLUORESCEIN ANGIOGRAPHY (FFA)?

Fundus Fluorescein angiography is a clinical test to look at blood circulation in the retina at the back of the eye. It is used to diagnose retinal conditions caused by diabetes, age-related macular degeneration, and other retina abnormalities.

What is OPTICAL COHERENCE TOMOGRAPHY (OCT)?
  • It gives a cross sections magnified slices of various structures of the eye, giving a better insight in the treatment of the eye disease.
  • A retinal Optical Coherence Tomography, “OCT” for short is a non-invasive technology used for imaging the retina , the multi-layered sensory tissue lining the back of the eye, is revolutionizing the early detection and treatment of eye conditions such as macular holes , pre-retinal membranes , macular swelling and even optic nerve damage.
What is a VITRECTOMY?

It is sophisticated microsurgical technique in which the vitreous gel is removed from inside the eye with a small, specialized cutting device with the help of an operating microscope to look into the eye, and microsurgical instruments.

The vitreous gel is then replaced with a clear saline fluid. Vitrectomy is performed for many conditions including retinal detachment, diabetic retinopathy, macular pucker or hole, haemorrhage or infection inside the eye, and ocular trauma. Vitrectomy is usually performed under local anaesthesia.

WHAT IS SQUINT?

Technically known as Strabismus, Squint is a condition where the two eyes are misaligned. That is both eyes do not appear to be looking in the same direction. One eye may be looking at an object and the other eye may be turned in or out or up or down.

Squints are more commonly seen in children. The condition affects 2% of children under 3 years and 3% of children and young adults.

What are common Refractive errors?

Refractive errors occur when the shape of the eye prevents light from focusing directly on the retina.

The most common types of refractive errors are myopia, hyperopia, presbyopia, and astigmatism.

  • Myopia (near-sightedness) is a condition where objects up close appear clearly, while objects far away appear blurry.
  • Hyperopia (farsightedness) is a common type of refractive error where distant objects may be seen more clearly than objects that are near.
  • Astigmatism is a condition in which the eye does not focus light evenly onto the retina, the light-sensitive tissue at the back of the eye
  • Presbyopia is an age-related condition in which the ability to focus up close becomes more difficult.

Eyeglasses or contact lenses are the simplest and safest way to correct refractive errors. Your eye care professional can prescribe appropriate lenses to correct your refractive error and give you optimal vision. Refractive Surgery aims to change the shape of the cornea permanently.

What is Lasik surgery?

LASIK is a surgical procedure that uses a laser to correct nearsightedness, farsightedness, and/or astigmatism. In LASIK, a thin flap in the cornea is created using either a microkeratome blade or a femtosecond laser.

  • It is a daycare procedure which is painless, safe, and with fast recovery of vision. It the most popular procedure for laser vision correction.
  • The patient is prepared before the procedure with anesthetic and antibiotic eye drops, making the eye numb and sterile for the laser procedure.
  • A Microkeratome or a Femtosecond laser handpiece-is used to create a thin corneal flap which remains hinged through the procedure.
  • The corneal flap is lifted and the inner layers of the cornea are "Lasered" with a excimer laser to reshape the inner layer of the cornea assisted by an active eye tracking system , tracking eye movements and directing the laser accordingly. The laser algorithms or treatment plans are computer calculated and driven to give an accurate outcome.
  • The flap is then replaced without the need for stitches, the entire LASIK procedure thus finishes within few minutes.
What is Colour Blindness?

Colour blindness, also known as colour vision deficiency, is the decreased ability to see colour or differences in colour. The most common cause of colour blindness is an inherited fault in the development of one or more of the three sets of colour sensing cones in the eye.

Diagnosis is done by the test consists of a number of coloured plates, called Ishihara plates, each of which contains a circle of dots appearing randomized in colour and size.

What are some Eye Infections?

Eye infections occur when harmful microorganism’s bacteria, fungi and viruses that invade any part of the eyeball or surrounding area. This includes the clear front surface of the eye (cornea) and the thin, moist membrane lining the outer eye and inner eyelids (conjunctiva).

Other infection can include a stye or chalazion. When infection invades the eye's tear glands, inflammatory conditions such as dacryostenosis and uveitis can result.

Common symptoms include:

  • Pain, itching, or sensation of a foreign body in the eye.
  • photosensitivity (aversion to bright light)
  • Redness or small red lines in the white of the eye.
  • Discharge of yellow pus that may be crusty on waking up - a possible sign of bacterial infection.
  • Tearing
What are some Tips of Eye Care?
  • Eat Healthy foods to prevent nutritional decencies
  • Quit Smoking
  • Wear Sunglasses
  • Use Safety Eyewear
  • Look Away From the Computer Screen to prevent eye strain
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