Sai Deep Eye Clinic

Cataract Treatment in Vileparle and Santacruz

Cataract Diagnosis & Treatment

Keratoconus Specialist In Mumbai

What Is Keratoconus Treatment?

Keratoconus is an ocular condition characterized by the gradual weakening and protrusion of the central cornea, assuming a conical form. This condition leads to notable visual complications such as blurred and distorted sight, heightened sensitivity to light, and more. In its initial phases, corrective lenses can offer treatment, while advanced stages necessitate corneal transplantation to reinstate visual acuity.
Keratoconus is a relatively uncommon disorder, with estimated occurrence rates ranging from 4 out of 100,000 individuals to 600 out of 100,000. This prevalence is roughly equivalent among both males and females. Typically originating during puberty, Keratoconus advances well into the mid-30s and commonly manifests in both eyes, although the speed of progression and the onset may differ between each eye.
In cases of Keratoconus, the cornea undergoes thinning and takes on an irregular conical shape, leading to impaired vision. Within the cornea, the central layer holds the greatest thickness and primarily comprises water and collagen, a protein. Collagen is responsible for providing strength and flexibility to the cornea, which functions optimally to focus light and ensure clear vision.
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Keratoconus Symptom Checker

Keratoconus Symptom Checker

Causes of Keratoconus

In spite of our extensive familiarity with this persistent ailment, the reasons behind it remain largely mysterious. The cornea protrudes in a conical shape due to the deterioration of collagen fibrils.

Recent studies indicate that an irregularity in enzyme levels can lead to this condition, rendering the cornea more prone to oxidative harm from free radicals. Consequently, the cornea becomes feeble and protrudes outward. Keratoconus emerges from a reduction in these enzymes and protective antioxidants within the cornea.

causes of keratoconus

Risk Factors

Certain Factors That Raise The Likelihood Of An Individual Being Impacted Are:
  • Genetic predisposition—likelihood of developing Keratoconus rises if any of your relatives have been afflicted.
  • Excessive exposure to ultraviolet radiation
  • Ill-fitting contact lenses
  • Eye allergies and persistent eye rubbing are linked to the development of keratoconus. Chronic rubbing of the eyes might also contribute to the advancement of the condition.
  • Specific conditions such as retinitis pigmentosa, atopic ailments, and disorders related to connective tissue.
  • Trisomy 21

Diagnosis of Keratoconus

In order to diagnose Keratoconus, we will assess your medical and familial background and perform an ocular examination. Additionally, various tests will be conducted to gather further information about the curvature and resilience of your cornea.
Keratoconus

Eye Refraction

Our team of optometrists with specialized training will utilize specific equipment to assess and determine the precise combination of lenses required to provide you with the clearest and sharpest vision possible.
Slit-lamp examination

Slit-Lamp Examination

Using a low-powered microscope, a vertical ray of light is directed onto the surface of your eye to observe it. The examiner assesses the contour of your cornea and examines for any other possible eye issues, such as allergies, that are closely linked to keratoconus.
Computerized corneal mapping

Computerized Corneal Mapping (Corneal Topography)

Cutting-edge diagnostic procedures, including optical coherence tomography and corneal topography, capture visuals of your cornea to generate a comprehensive map detailing its surface contours and assess its thickness. Moreover, we possess state-of-the-art tools that aid in gauging the resilience of your cornea.

Advanced Diagnostics

advance diagnostics

Corneal topography

Corneal topography is a method employed to observe and measure alterations impacting the durability and soundness of your eye’s cornea. At Sai deep Eye Clinic, your cornea will receive a thorough assessment utilizing the most up-to-date topography technology at our disposal.
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Pentacam

Operates based on the concept of a rotating Scheimpflug camera system designed for analyzing the front part of the eye. An innovative instrument used to gauge the topography and height of both the front and back surfaces of the cornea, along with its thickness – essentially, the cutting-edge tool for identifying and tracking the advancement of your condition.
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Schwind Sirius Topographer and Planning System

It incorporates a fusion of dual rotating Scheimpflug cameras and a Placido disk, enabling comprehensive examination of the contour and altitude of both the front and rear surfaces of the cornea, as well as complete corneal thickness measurement. Moreover, an integrated software assists in strategizing your laser surgery, guided by the details from your corneal map.
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Corvis ST

Thorough biomechanical assessment and identification of Keratoconus. Aids in evaluating intraocular pressure and the overall structural robustness of the eye.

Treatment of Keratoconus

Keratoconus may manifest in varying phases, and tailored treatment protocols are required for each stage of the condition. In the initial stages of the disease, visual correction can be achieved using eyeglasses and contact lenses.
With the advancement of keratoconus, addressing the heightened irregularity of the corneal surface necessitates more advanced lens designs. As the condition develops further, the cornea gradually thins and protrudes, leading to the requirement of rigid gas permeable contact lenses for corrective purposes.
During this phase, a Cross Linking procedure is typically recommended to enhance the resilience of your cornea.
contact lens

Contact Lenses

Our optometrists with specialized training will conduct a trial to determine the most suitable type of contact lens that fits comfortably on your eye.
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Collagen Cross-Linking

Collagen Cross Linking is a procedure to stop the progression of Keratoconus which involves removing the skin (epithelium) from the surface of the cornea either manually…

WhatsApp Image 2023-08-08 at 13.57.42Topography-guided photorefractive keratectomy

Laser Procedures in Keratoconus

Topography-guided photorefractive keratectomy (TPRK) employs a personalized excimer laser procedure directed by a topographic map.
INTACS

INTACS

INTACS refer to implantable intracorneal ring segments (ICRS), with INTACS being the proprietary term for slim, semi-circular plastic rings placed within the middle layer of the cornea.
Corneal Transplant Surgery

Corneal Transplant Surgery & Visual Rehabilitation

Keratoconus necessitates a corneal transplant in cases where the patient’s cornea is exceptionally thin or their vision remains significantly impaired despite the inability to correct it with rigid contact lenses.

Facilities & Machines

Keratoconus Doctors

Frame 1

Dr. Nitin
Balakrishnan

 Cataract & Refractive Surgeon

Frame 2

Dr. Nikhil Nitin Balakrishnan

Cataract & Refractive Surgeon
Frame-3

Dr. Pavitra Patel Balakrishnan

Cataract & Refractive Surgeon

Frequently Asked Questions

Is Keratoconus a serious eye condition?
Yes, keratoconus is considered a serious eye condition. It’s a progressive disorder that causes the cornea to weaken and change shape, leading to distorted vision. If left untreated, it can significantly impact a person’s quality of life and their ability to perform everyday tasks.
Is Keratoconus present since birth?
No, keratoconus is not present since birth. It usually develops during the teenage years or early adulthood and progressively worsens over time.
How common is Keratoconus?
Keratoconus is relatively rare, occurring in about 1 in 2000 individuals. It is more commonly diagnosed during adolescence or early adulthood.
If I have keratoconus, what is the likelihood that my sibling might also develop the condition?
If you have keratoconus, the likelihood of your sibling developing the condition is generally around 6-8%, but this can vary based on factors like genetics and family history.
Is there a chance that I could pass on keratoconus to my children?
Keratoconus can have a genetic component, so there is a possibility of passing on a genetic predisposition to your children. However, it’s not a guaranteed transfer, and the risk varies based on various factors.
When does Keratoconus stop progressing?
Generally, keratoconus tends to slow down or stabilize in your 30s, but this can vary for each individual.
Does Keratoconus affect both eyes?
Yes, in approximately 90% of keratoconus cases the disease will manifest itself in both eyes. The rate of progression and the timing of the onset of the disease however is typically different for each eye.
Is Keratoconus transmitted via sexual intercourse?
No, Keratoconus is not transmitted through sexual intercourse or any form of direct contact. While there’s a genetic predisposition associated with the condition, it’s not caused by or spread through sexual activity.
Can specific dietary habits help prevent the development of Keratoconus?
While no specific dietary habits can guarantee the prevention of keratoconus, maintaining a healthy and balanced diet rich in essential nutrients may contribute to overall eye health.
Do adverse environmental conditions have the potential to lead to keratoconus?
Adverse environmental conditions are not generally considered a direct cause of keratoconus. However, factors like chronic eye rubbing, poorly fitted contact lenses, and excessive exposure to ultraviolet (UV) light could potentially contribute to the progression of keratoconus in individuals who are genetically predisposed.

Keratoconus Patient Reviews

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Contact Lenses

Soft Lenses

Soft contact lenses have a restricted function in managing Keratoconus, as they conform to the uneven corneal surface, adopting its irregularities without creating a fluid cushion. Consequently, there’s no enhancement in the refractive surface compared to the original cornea.

However, specific thicker soft lenses are crafted to retain a somewhat rigid form, potentially generating a liquid lens effect. These designs are tailored for Keratoconus and prove beneficial in managing mild to moderate instances of the condition.

RGP Contact Lenses

Rigid Gas Permeable lenses conceal the uneven cornea beneath and act as the eye’s fresh refractive interface, while the tear film occupies the gap between the eye’s front and the rear of the contact lens. The term “Rigid” characterizes the lens type, while “Gas Permeable” depicts the lens material. A variety of distinct RGP lens designs are available.

Collagen cross-linking

Collagen Cross Linking is a procedure to stop the progression of Keratoconus which involves removing the skin (epithelium) from the surface of the cornea either manually or by a Laser and custom-made riboflavin eye drops are applied to the cornea every 2 mins for 30 mins. The eye is then exposed to UVA light.Following the procedure, an eye patch is worn for a period of 1-3 days, and an antibiotic solution is administered to the treated eye four times daily until the eye’s surface has completed the healing process.
It’s important to recognize that the collagen cross-linking procedure doesn’t provide a cure for Keratoconus. It doesn’t assist in rectifying the irregularities of the keratoconic cornea. To address this, Collagen Cross Linking is frequently paired with either a Laser Procedure or INTACS, preceding it.
The objective of Collagen Cross Linking is to decelerate or halt the progression of the condition, preventing further deterioration of vision and the necessity for corneal transplantation.
However, following the treatment, the use of glasses and contact lenses remains crucial, with occasional adjustments to the prescription.
Customized Collagen Cross Linking is akin to the standard procedure, but it focuses solely on the Keratoconic cone rather than the entire cornea.

Laser Procedures in Keratoconus

Following the laser ablation, the Cross Linking process takes place, succeeded by the placement of a soothing soft contact lens. This contact lens is usually taken out on the third day after the operation.

It’s crucial to comprehend that TPRK is primarily conducted to minimize irregular astigmatism, and its main focus is not always on enhancing distant vision. There are instances where the procedure may enhance your BCVA and/or overall visual quality. The surgical objective is to enhance the corneal curvature, thereby elevating visual quality when using glasses or contact lenses.

The TPRK procedure is most appropriate for individuals experiencing early to moderate keratoconus, possessing a preoperative thinnest pachymetry of 450 μm (following epithelial debridement), or an anticipated postoperative thinnest pachymetry of at least 400 μm.

INTACS

In cases of Keratoconus, the weakened cornea loses its natural shape, causing incoming light rays to be inadequately focused, leading to reduced image clarity. The exclusive patented design of Intacs aims to reshape the corneal structure, restoring a more natural dome-like configuration and enhancing vision. These implants operate by reducing the cornea’s arc length, which in turn flattens the central area and contributes to improved curvature and visual sharpness. Upon insertion into the keratoconic cornea, they reshape the cornea, altering the cone’s shape and position.

The introduction of INTACS serves to remodel and strengthen the cornea, promoting a more uniform corneal surface in cases of keratoconus, resulting in enhanced vision. Nonetheless, depending on the extent of keratoconus severity, corrective measures such as glasses or contact lenses may still be necessary for optimal visual outcomes. The recovery period after INTACS is typically brief when compared to corneal transplantation. As with any procedure, there are potential risks, including visual symptoms like blurred vision, glare, nighttime vision issues, halos, and the possibility of infection.

Corneal Transplant Surgery & Visual Rehabilitation

Keratoconus necessitates a corneal transplant in cases where the patient’s cornea is exceptionally thin or their vision remains significantly impaired despite the inability to correct it with rigid contact lenses. This could be due to factors like scarring, corneal steepening, or intolerance to such lenses. Generally, the corneal transplant procedure is conducted on an outpatient basis, allowing you to depart from the hospital or facility within a few hours following the completion of the surgery.

Dr. Nitin Balakrishnan

Dr. Nitin Balakrishnan, Medical Director and Chief of the Cataract & Refractive department at Sai Deep Eye Clinic & Crystal Vision Laser Centre has been in practice for more than 30 years.
He has undergone training in phakoemulsification from international stalwarts in the field, like Dr. David Chang of the United States Of America and Dr. Vittorio Piccardo Of Italy.
He specialises in Laser Vision Corneal Refractive Surgery, and is a member of the expert group of Contoura Lasik Surgeons Of Asia Pacific.
He Has been on the faculty and has presentationsin various National & International Conferences.
He has Been involved in Live surgeries in many Cataract & Refractive Meetings and has Published in various peer reviewed publications.
He was Awarded gold medals for exemplary service in Ophthalmology by IIRSI and by the UKSOS.
HE believes in continuously updating his practise with the latest techniques and has always been amongst the earliest adopters of cutting edge technology.

He Heads the Department of Ophthalmology at Nanavati Superspeciality Hospital Mumbai

  • Member of the American Society of Cataract & Refractive Surgeons
  • Member of All India Ophthalmology Association
  • Member of Indian Intraocular Implant Society
  • Member of Maharashtra Ophthalmology Society & Bombay Ophthalmologist’s Association
Dr. Nikhil Nitin Balakrishnan

Dr. Nikhil Nitin Balakrishnan is a proficient Cataract & Refractive Surgeon at Sai Deep Eye Clinic & Crystal Vision Laser Centre.

He has undergone training in Cataract and Refractive Surgery from the world renowned Narayana Nethralaya Bengaluru. He is a very competent clinician and a surgeon par excellence.

He is competent in both Manual and Femtosecond assisted Cataract Surgery (FLACS). He takes special interest in planning of premium IOL’s like Multifocal, TORIC and cataract in Complex Corneas such as Post Refractive Surgery eyes. He is proficient in the diagnosis and management of Keratoconus with newer treatment modalities such as Collagen Cross Linking (CXL), Topography guided treatments with Cross Linking (TPRK +CXL) and Intra Corneal Ring Segments (ICRS).

Dry Eye Disease, its newer investigation and treatment modalities are other domains he is skilled in. He has thorough knowledge and experience in the usage and interpretation of imaging tools including state of the art Topographers, Aberrometers, Biometers, OCT’s etc. He is an accomplished Translational and Research Clinician and has multiple publications on Cataract, Keratoconus, Refractive surgery in various National and International peer reviewed Journals. He has numerous Paper and Video presentationsin various National & International Conferences for which he has won many accolades.

Dr. Pavitra Patel Balakrishnan

Dr. Pavitra Patel Balakrishnan completed her basic medical education (MBBS) from JNMC, Wardha in 2013. She completed her Masters in Ophthalmology from the same college in 2017. She finished her long termfellowship in Cataract and Refractive Surgery from world renowned Narayana Nethralaya, Bengaluru. To add to her armamentarium, she did an observership in cornea from Cornea Eye hospital, Vadodara, Gujarat. At present, she is a prolific Cataract & Refractive Surgeon at Sai Deep Eye Clinic & Crystal Vision Laser Centre.

She is proficient in both Manual and Laser Assisted Cataract Surgery and takes keen interest in planning Complex IOL power calculations.Her area of expertise includesdiagnosis and treatment modalities of Dry eye, and Keratoconus. She has worked extensively on the latest Refractive Surgery Module- Contoura. She has a number of national and international research publications and has been acclaimed with many awards at national and international podiums.

She is a member of various State, National and International Ophthalmic bodies such as • Member of the European Society of Cataract & Refractive Surgeons (ESCRS) • Member of Asia Pacific Association of Cataract & Refractive Surgeons (APACRS) • Member of All India Ophthalmology Society (AIOS) • Member of Women Ophthalmological Society (WOS) • Member of Young Ophthalmologists Society of India (YOSI) • Member of Indian Intraocular Implant Society (IIRSI) • Member of Indian Society of Cornea &Keratorefractive Surgeons (ISCKRS) • Member of All Gujarat Ophthalmological Society (AGOS)

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