Sai Deep Eye Clinic

Cataract Treatment in Vileparle and Santacruz

Cataract Diagnosis & Treatment

Uveitis Specialist In Mumbai

What is Uveitis?

The word uvea originated from ‘uva’ the Latin word for grape. Uvea is the middle layer of the eye behind the external layer sclera (the white of the eye) and in front of retina, the transparent layer at the back of the eye.

Uvea consists of three parts:

  • Iris is a coloured part of the visible portion of the eye that surrounds the pupil, an opening at the centre. It contains muscles that allow the pupil to become larger (after dilatation) and smaller (after constriction);
  • Ciliary body, which also contains muscles, secretes a transparent liquid within the eye; and
  • Choroid, which contains blood vessels and connective tissue, lies between the sclera and the retina.

Classification of Uveitis

According to standardisation of uveitis nomenclature (SUN), uveitis is classified into-
  • Anterior
  • Intermediate
  • Posterior
  • Panuveitis
Uveitis

Classification of Uveitis

According to standardisation of uveitis nomenclature (SUN), uveitis is classified into-

  • Anterior
  • Intermediate
  • Posterior
  • Panuveitis (Image)

Uveitis Signs And Symptoms

What Causes Uveitis?

Uveitis occurs due to certain infections in the body or due to disbalance of immune system caused by various not well understood external and internal factors. It is not always possible to pin point the cause of uveitis. Common causes of uveitis are listed below:
  • Infections (Bacterias, Viruses Fungus and protozoal
    • Tuberculosis, Syphilis, Leprosy, Toxoplasmosis, Leptospirosis, Brucellosis, Typhoid and Rikettsial
    • Herpes, Dengue, Chikungunya, cytomegalovirus (CMV), Mumps, HIV, H1N1, COVID
    • Candida, Ring worm, Tinea, Aspergillus, Histoplasma
  • Auto immune diseases
    • Ankylosing spondylitis, Rheumatoid arthritis, Psoriasis, SLE, Behcet’s syndrome, Sarcoidosis,VKH disease etc.,
Uveitis
Uveitis
Uveitis
Uveitis
  • Cancers can cause uveitis like conditions
    • Lymphomas, leukaemia, and secondries from other cancers in the body (like breast cancer, lung cancer or prostate cancer)
  • Trauma can cause uveitis in the same eye or even other eye
  • When the cause is unknown the uveitis is known as idiopathic

What causes Uveitis?

Uveitis occurs due to certain infections in the body or due to disbalance of immune system caused by various not well understood external and internal factors. It is not always possible to pin point the cause of uveitis. Common causes of uveitis are listed below:

  • Infections (Bacterias, Viruses Fungus and protozoal
    • Tuberculosis, Syphilis, Leprosy, Toxoplasmosis, Leptospirosis, Brucellosis, Typhoid and Rikettsial
    • Herpes, Dengue, Chikungunya, cytomegalovirus (CMV), Mumps, HIV, H1N1, COVID
    • Candida, Ring worm, Tinea, Aspergillus, Histoplasma
  • Auto immune diseases
    • Ankylosing spondylitis, Rheumatoid arthritis, Psoriasis, SLE, Behcet’s syndrome, Sarcoidosis,VKH disease etc.,
  • Cancers can cause uveitis like conditions
    • Lymphomas, leukaemia, and secondries from other cancers in the body (like breast cancer, lung cancer or prostate cancer)
  • Trauma can cause uveitis in the same eye or even other eye
  • When the cause is unknown the uveitis is known as idiopathic
Uveitis
Uveitis
Uveitis
Uveitis

Investigation of Uveitis

It is important to know the cause of the uveitis. Once it is identified uveitis can be treated successfully. Since most of the uveitis are due to disbalance of body’s immune system or due to certain infections in the body, work up of uveitis includes many investigations, which various scans for eye as well as body, lab tests from eye fluid or from body fluid like blood, sputum, urine etc.

Eye Investigation

Eye Tap

Eye fluid test is a procedure where a small needle goes into eye and aspirates fluid for certain lab tests tofind out the cause for uveitis.

Laboratory Test

Blood test

CBC, ESR, CRP, TPHA, RBS, HIV, HLA B 27, HLA B 5 1,ANA, ANCA

Urine Test

mantoux

Radiological Test

Treatment for Uveitis

NON-STEROIDAL ANTI-INFLAMMATORY DRUGS (NSAIDS)

  • Oral COX-2 inhibitors
  • Ophthalmic solutions

CORTICOSTEROIDS

  • Eye drops/ointment
  • Injections: External and Intraocular (inside the eye)

IMMUNOSUPPRESSION

  • Often act as alternatives to steroids for extended treatment

BIOLOGICS

  • Termed “biologics” due to their biological derivation, these drugs specifically..

Uveitis 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

draniruddha

Dr. Aniruddha Mahindrakar

Vitreo Retinal Surgeon

Uveitis Patient Reviews

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Karan Kothari

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Tan

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Sakshi Shetty

Frequently Asked Questions

WHAT IS UVEITIS?
Uveitis refers to the inflammation of the uvea, which comprises the pigmented layer of the eye, including the iris, choroid, and ciliary body.
WHAT ARE THE CAUSES OF UVEITIS?
Uveitis refers to the inflammation of the uvea, which comprises the pigmented layer of the eye, including the iris, choroid, and ciliary body.
WHAT ARE TREATMENT OPTIONS IN UVEITIS?
Possible treatments for uveitis include the use of eye drops, eye injections, oral medications, or systemic medications. In certain cases, systemic medications may require coordination with a pulmonologist or a rheumatologist.
WHAT ARE THE OCULAR TESTS FOR DIAGNOSIS OF UVEITIS?
If you are currently taking medication for a systemic illness, it is generally advised to continue taking your regular medication unless specifically instructed otherwise by your ophthalmologist. Your ophthalmologist will provide guidance regarding any adjustments or precautions related to your systemic medication in relation to your cataract surgery. It is important to follow their instructions to ensure the best possible outcome for your surgery and overall health.
WHAT ARE THE SYSTEMIC TESTS FOR DIAGNOSIS OF UVEITIS?
The systemic tests for diagnosing uveitis involve analyzing blood, urine, and conducting chest or hip bone X-rays.
WHAT IS DURATION OF TREATMENT IN UVEITIS?

The treatment duration for uveitis varies, lasting from a few months to years, depending on disease severity.

HOW FREQUENTLY I HAVE TO VISIT OPD AFTER TREATMENT?

The frequency of OPD visits after treatment depends on individual diagnosis, typically requiring personalized follow-up based on consultant advice.

CAN I GET UVEITIS AFTER FEVER?
Uveitis can indeed occur after a fever or infection, as reported in many cases, affecting ocular structures.
DO I NEED TO VISIT ANY OTHER SPECIALISTS?

Depending on your condition’s diagnosis, you may need to see a rheumatologist or a physician/chest physician.

WHAT ARE COMPLICATIONS OF UVEITIS?

Uveitis complications may include increased eye pressure, cataract development, and macular swelling (sensitive eye layer). Adherence to consultant instructions is crucial.

NON-STEROIDAL ANTI-INFLAMMATORY DRUGS (NSAIDS)

  • Oral COX-2 inhibitors
  • Ophthalmic solutions
  • Administered in the presence of mild inflammation
  • Prescribed to alleviate pain
  • Considered a prolonged substitute for corticosteroids
  • Not recommended for individuals with severe kidney disorders

 

CORTICOSTEROIDS
  • Eye drops/ointment
  • Injections: External and Intraocular (inside the eye)
  • Oral

Dosage, potency, and duration of eye drops are determined by a doctor based on inflammation level.

  • Do not self-administer.
  • Steroid eye drops can lead to high eye pressure (glaucoma), cataracts, and infection risk.

Injectable steroids may cause:

  • Cataracts
  • High eye pressure
  • Infection risk
  • Bleeding
  • Rarely, retinal detachment

Systemic corticosteroids can result in:

  • Acne
  • Blurred vision
  • Cataracts/glaucoma
  • Easy bruising
  • Increased appetite, weight gain
  • More body hair growth
  • Sleep disruption
  • Reduced infection resistance
  • Muscle weakness
  • Nervousness
  • Osteoporosis
  • Stomach irritation/bleeding
  • Mood swings
  • Swollen face
  • Water retention
  • Aggravated diabetes, high blood pressure

 

IMMUNOSUPPRESSION

  • Often act as alternatives to steroids for extended treatment
  • Typically prescribed in collaboration with a rheumatologist
  • Administered orally
  • Include Methotrexate, Azathioprine, Cyclosporine, Tacrolimus, Mycophenolate
  • Also available as injections, like Methotrexate
  • Essential to maintain regular check-ups with both an ophthalmologist and rheumatologist
  • Frequent blood tests required during this period
  • Possible side effects encompass hair loss, elevated liver enzymes, increased susceptibility to secondary cancers, and heightened risk of additional infections.

 

BIOLOGICS

  • Termed “biologics” due to their biological derivation, these drugs specifically target distinct components of the immune system. This focused approach helps mitigate potential risks linked to more traditional immune-modulating treatments.
  • Not suitable for patients with active tuberculosis (TB), chronic hepatitis B or C, or ongoing infections.
  • Pregnancy should be postponed for five months after the final biologic dose.
  • Patients should promptly consult a doctor in case of fever, sore throat, or bleeding from any part of the body.
  • Examples include Infliximab, Adalimumab, Rituximab, Tocilizumab, and Secukinumab.

 

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)

Dr. Aniruddha Mahindrakar

Dr. Aniruddha Mahindrakar, is a Vitreo retinal surgeon with around 18 years experience at Sai deep eye hospital and practicing in Andheri West, Mumbai Maharashtra. He is an alumnus of the prestigious Seth G S Medical college and trained by Dr S Natarajan, Aditya Jyot Eye Hospital, Mumbai. A member of the prestigious American society of retina specialist, He is amongst the 37 Honor Award Recipients from all over the world, recognised by the American Society of Retinal Specialists for his time and significant contributions to the scientific programs at the annual meeting at Boston, USA 2017. He has numerous other awards and presentations at national and international conferences.

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