KERATOCONUS AND CORNEAL COLLAGEN CROSS-LINKING
FAQ's |
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The below FAQ's Includes queries asked by those travelling from abroad |
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There are
special queries that our patients from other parts of India
and from abroad raise.
We have tried to address most here. If
there is anything that we have missed or something more that
you would like to know from us kindly contact us.
We will try and make you comfortable doing this procedure
with us. |
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| Information on KERATOCONUS AND CORNEAL COLLAGEN CROSS-LINKING |
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| Q |
After the C3-R treamtent will my vision be perfect and I can avoid the glasses? |
| A |
There are 2 aspects to keratoconus treatment - first we need to stop progression for which there is only one treatment namely, C3R or crosslinking. Secondly, once the C3R is done, we look at the refractive error 3 months to 6 months after the treatment and see if there is any aid to improve vision. The options include : spectacles, RGP contact lenses, special keratoconus contact lenses, laser, ICL's etc.
This decision as to what is best suited from the above choices for your eyes can only be taken after we re evaluate you 3 to 6 months after the C3R is done. |
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| Q |
If not is there any other treatment can be done to make the vision perfect. I just want to get rid of glasses? |
| A |
We need to evaluate you 3 - 6 months after C3R is done. Also, this depends on the level of vision after the keratoconus stabilizes, that is the vision once stable that you should expect. Your visual expectation can be defined when you visit us.We have been able to reduce dependency or eliminate glasses with implantable contact lenses once the cornea shape stabilizes and the numbers do not change further. |
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| Q |
After the treatment how long I have to stay in India as I live abroad? |
| A |
Minimum 3 to 4 days after the C3R is done. |
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| Q |
What is C3R + Topolink treatment or C3R done with PRK? |
| A |
This is a treatment on the surface of your eye (cornea) to treat your powers or spectacle numbers as well as treat the keratocconus.
C3R is not going to help any spectacle correction, but only stabilize the progression of the abnormality viz. keratoconus.
In some cases, who have the possibility (you will know when Dr Anand Shroff, our corneal and refractive surgeon examines you), they are offered a dual treatment, one to correct their keratoconus, other to improve vision (if possibile) - PRK. |
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| Q |
I am working in IT and need to be in front of computer continuously. How long will it take for me to join office from the time of operation? |
| A |
You may expect to be unable to function on the PC at all for about 3-4 days and then in the first week, work with short intervals, but are able to work for long hours. You can safely resume work on Day 5. Some even join earlier depending on their comfort level. |
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| Q |
How long will the vision be blurred after operation? |
| A |
This is usually blurred on the first 2 days, however improves thereafter, such that most routine work can be done on Day 3. Specficially we say no driving for 7 days. |
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| Q |
How long will the eye be painful after the anaesthesia effect is over? |
| A |
This is very subjective, depending on the threshold of tolerance of the person. Usually the first day is 'tough', with fair amount of discomeort, but second day onwards improves. We also help you with painkillers and eye drops to tide over this period. |
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| Q |
As an IT professional
i have to continuously work in front of a computer so will
i be able to work on computers immediately after the treatment that
is after the first week after the removal of the bandage lenses? |
| A |
This depends from person to person.
We have had people recover well and back to their office and
computer usage after the first week, some take little longer.
Using your old glasses, one can sit comfortably for short
durations after 5-6 days but as days pass, it gets more comfortable
for you. You may have to start with shorter durations of compuetr
related activity, but with frequent reaks, this is manageable. |
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| Q |
What is your experience
with the 50 patients you have already treated in context
with safety, side effects? |
| A |
We have performed over 70
C3-R®*
treatments and still going on. None have had any complications.
Yes, they were all prepared for some days of discomfort as
informed. The treatment is very safe and in fact beneficial
for Keratoconus as it strengthens the cornea 300%. |
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| Q |
Has visual acuity
improved after the C3-R®* in patients[if any and in how many patients out of the total? |
| A |
The visual acuity improvement
is gradual, even taking upto 6 months or longer. This improvement
is not dramatic as in LASIK or laser eye surgery, because
the aim is not to improve visual acuity but to prevent further
deterioration. Our earliest cases have been done
in April 2007, hence it is still to early to comment on any
significant data. However, all patients have shown arrest
and no progress in the condition and some of our patients
have had upto 2 lines of improvement in visual acuity. Many
have shown actual improvement on their topography maps. |
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| Q |
How many days should
i take out from my schedule for the treatment to be done and
for the later checkups in all? |
| A |
We need to do one eye at a time.
As some are symptomatic for about a week, we prefer to do
the second eye when one is comfortable with the first treatment.
This can be spaced between 5-6 days apart. If they are from
out of Mumbai, then one plans accordingly.
The days to stay away from work are the first 5-7 days
post procedure as the bandage lens is removed on Day 4 and
it may take upto another 2 days to be symptom free.
You basically start using your old glasses. Contact
lenses can be worn after about 10-15 days.
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| Q |
I am unable to see from my left
eye if my right eye is closed, but when both eyes are open,
I can see perfectly fine, like a normal person. how is this
possible? |
| A |
We see from the
brain. If one eye is weak, then with both eyes open we are
seeing from the dominant eye as the brain learns to suppress
the image of the weaker eye.
When one shuts the good eye, it is only then
that one can make out the huge difference in the weak eye.
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| Q |
In this kind of a situation, what
effect does the desease have on his right eye? |
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If we are talking about keratoconus
specifically, due to which your left eye's (weaker) has poor
vision, then in most cases keratoconus does become bilateral.
But this is not like an infection where the other eye 'catches
it'. It is more the abnormality existing in one or both eyes.
If today there is no abnormality or keratoconus in the right
eye, it may stay that way, or it may show early signs and progress
to become worse like the left one.
A good eye examination with sensitive equipment like the Pentacam
- Topolyzer we use helps diagnose even early stages of this
disease to help keep it under control and not allow it to worsen. |
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| Q |
If there is no
discomfort in the daily life of the patient (except for a little
irritation) should he go for any kind of medical treatment at
this stage?
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| A |
This depends on the stage of
keratoconus one has, not symptoms as these are often misleading.
Unless a drastic change in the 'cone' takes place, patients
cannot appreciate any change even if the abnormality is leading
to a worse stage as these are usually minor changes in
numbers. One does need to be aware of any deterioration in
vision.
Basically, in keratoconus, having no treatment means always
living under a 'hanging sword'!
The new treatment called 'C3-R®* or Cross Linking' also has limitations that it cannot be
done on very thin cornea. Since this treatment has produced
remarkable results, one does not want to lose the opportunity
of missing it. If however, keratoconus is in early stages,
the patients not keen on any surgery, then he needs to be
very vigilant in his follow ups with the doctor and can
wait if the doctor allows it.
If the keratoconus is progressing, then it is better
to halt its progress with C3-R®* when one is fit, rather than wait to do a corneal transplant.
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| Q |
Can the patient use any eye drops
for the irritation? |
| A |
Yes, however, this may be coincidental
that he may be having an eye allergy at present. However, no
eye drops treat the keratoconus. |
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| Q |
How succesful is the cross linking
treatment and what will be the position of the patient's eye
after the procedure is done? |
| A |
There will be no change in position of the eye. The procedure
is done on the 'cornea' which is a transparent area just
covering the coloured part of the eye.
This treatment when done correctly has excellent results.
Till date (we have been doing this treatment since last
year) we have had no failures. All patients have stopped the
progress of the cone and many patients have had a 'flattening'
of the 'cone'. Dr Anand Shroff, our corneal expert does the
pre procedure check, procedures and post procedure checks
himself.
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| Q |
What is your best advise for a person
suffering from keratoconus and which is the best place to get
treatment done from? |
| A |
We offer
you the best eye services in the country combined with expertise
and longest experience (very important in such cases) in C3-R®*.
Ours is the only eye hospital in india to have recieved the
highest award for healthcare from the Joint Commission USA,
this makes us stand apart from the rest. For more details
about our Keratoconus Treatment, please click
here.
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| Q |
What are the dangers when you keep
your eyes open fixing UVA lights during 30 min as generally
one says that UV lights are generally very bad for us !? |
| A |
We use Riboflavin
which coats your cornea through and through its thickness.
The UV light is applied to this are and is absorbed in the
cornea itself. Its this combination which actually makes the
C3R successful in strengthening the weak crosslinks due to
keratoconus. Hence, no harm or damage occurs when this light
is applied to the eyes.
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| Q |
Can we lose color vision ? Could
our Retina (cones and rods) be damaged? |
| A |
Again, since
this light does not travel into the eye to the retina, the
retina is spared from any such incidents.
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| Q |
How long will I be required to
stay in Mumbai after the treatment as I live outside India?
When can I travel back? |
| A |
If planned well, you need no more
than 5 or 6 days for treatment of one eye or 10 days for both. |
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| Q |
Is the treatment done on weekends? |
| A |
Treatment days are usually as follows:
C3R only treatments - on Tuesdays and Thursdays; C3R with
Topolink laser treatments - on Wednesdays and Saturdays.
Not knowing what is neededed for your case, it is best to
plan this after your check up.
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| Q |
When can I start driving ? |
| A |
Usually after 15 days from day of
treatment, depending on your comfort level. |
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| Q |
I am a thyroid patient .Will that
have any effect ? |
| A |
C3R is a therapeutic procedure and
needs to be done in all cases of keratoconus. Systemic conditions
like Thyroid, Diabetes, do not interfere with the treatment
unless not in control. However, best to also inform your physician
regarding the same. |
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| Q |
Would I be required
to come to Mumbai for any future check ups? |
| A |
If in Mumbai, we would be happy
to examie as we would have your earlier records and would know
your improvement by comapring with earlier Topography maps.
However, many of our patients are from out of India and do the
follow ups with their local ophthalmologist. |
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| Q |
Are their any test/investigations
which are done before the treatment? Are they done on the same
day or I need to come a day before the appointment date for
these tests? |
| A |
The initial check up or tests
are done prior to the treatment date and these include the
following:
1. Exact refraction
2. IOP or Intra Ocular Pressure
3. Examination of the entire eye with Slit Lamp and a Retinal
check up
4. Specific tests like Topography maps, Pachymetry test |
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| Q |
Can I take up air
travel after this treatment? |
| A |
After the last follow up, you may
fly out of Mumbai |
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*
C3-R® is a registered trademark of Boxer Wachler
Vision Institute |
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