Tell Me Why people get laser eye treatment

Gulf News

In part 2 of our Tell Me Why podcast episode, ophthalmologist Dr. Sandip Mitra explains to Maria Botros the differences between laser eye treatments and LASIK, and when each procedure is most appropriate. Laser and LASIK are actually different generations of laser correction, laser came first and LASIK is an advancement for it, says Dr. Mitra Dr. Mitra: Patients have to go through various investigations and meet certain requirements to qualify for laser treatment, it’s not for everybody As an ophthalmologist I think prevention is better than cure, says Dr. Mitra  Dr. Mitra: 90% of eye disease is preventable, treatable, and reversible   Read the full story here:   See more videos at https://gulfnews.com/videos Read more Gulf News stories here: https://bit.ly/2HLJ2km

Transcript

00:0090% of eye disease is preventable, treatable, and reversible.

00:07So we have a very, very coned down conditions where we say, no, we cannot do anything.

00:12But most today with the modern science, with technology, with genetic medulation, immunotherapy,

00:18cancer therapy, we can treat everything.

00:30So going back to a point that you mentioned within the conversation, but I want to touch

00:37up on it.

00:38You mentioned laser treatment.

00:40So first off, what is the difference between LASIK and laser?

00:44And when is it necessary?

00:46So as I told you, myopia is very common and is growing.

00:52Laser treatment is for correction of glasses.

00:55So for example, first of all, it's a cosmetic treatment.

01:01You can very well stay with your glasses and contact lenses.

01:04The reason you do laser is for two reasons.

01:07One, you want to get rid of glasses.

01:09You are fed up of glasses.

01:10Number two, you have problem with contact lenses.

01:13For example, you are in a profession where you don't need to show that you're wearing

01:17glasses like a presenter like you, for example.

01:21And you develop infection with contact lenses.

01:24So you want to get rid of contacts.

01:26The other half of people who, for example, they wear glasses, but they are not able to

01:31use good sunglasses, like for example, many sportspersons, some of the aviators, pilots,

01:37they need laser to get rid of their glasses.

01:42Laser and LASIK, they are actually different generations of laser correction.

01:47Laser came first.

01:48They were the first generation.

01:50They were back somewhere in 1990.

01:53It started somewhere in Europe and in the US.

01:59Later on, it became LASIK.

02:02Now LASIK is an advancement of laser.

02:04The process remains the same.

02:06What we do is we have a laser which corrects the number by changing the shape of the cornea,

02:12which is the front part of your eye.

02:14So if you are myopic, we just flatten the cornea.

02:18It corrects your number.

02:21If you are plus power, like hyperopic, we make the cornea more steeper.

02:24It corrects it.

02:25How we do it is the trick.

02:28If we have to make a flap and then lift the flap like a window and correct the numbers

02:35and the window falls back and you get the vision next day, it's called LASIK.

02:41So LASIK is a surgery where we make a flap, we make a cut, and then the laser works.

02:47On the other hand, if you don't make that flap and you correct it without making the

02:51flap, it's called laser.

02:53So laser was the old technique.

02:55It used to take longer for recovery.

02:57For example, you do laser, you take about a month to recover, whereas the LASIK, you

03:02recover next day, 24 hours.

03:05So that's the advantage of LASIK over laser.

03:09And when do you recommend it?

03:11So I mean, the question is very simple.

03:15Anybody who's coming to me to get rid of glasses, I would say, yeah, you're welcome.

03:20But there are some restrictions.

03:23The restrictions is, are you suitable for it or not?

03:25So we let that person go through various investigations, and then we look into it, okay, your eyes

03:32are suitable, it is going to be done without complications, and you don't run complication

03:38in future.

03:39Because if you are, for example, you are minus four, and I'm going to correct you, you have

03:44to have a proper thickness of cornea to correct that number.

03:48If you have a very thin cornea, you cannot correct.

03:51So there are prerequisites.

03:52I mean, not everyone can do it.

03:54Yes, no, no.

03:55It's not for everybody.

03:56Okay.

03:57But there are certain misconceptions around the whole procedure.

03:59I mean, I'm sure you've heard a lot of them.

04:01Can you maybe mention a few?

04:02Yeah, I mean, see, one of the things which people think that laser is very, very safe,

04:09you can do it anywhere.

04:12It has no problem.

04:14The answer is no.

04:15Any surgical intervention in your eyes, within the safe parameters, safe.

04:22If you deviate from any of the safe parameters, it's not safe.

04:26Driving car on zigzag is safe, so long as you follow the rules.

04:29Absolutely.

04:30If you take a Ferrari and drive rash, you're going to make with an accident.

04:35If you do not follow the instructions mentioned for each and every individual, you're bound

04:42to have problems.

04:43So the misconception comes from two things.

04:46One, there are people who think everything is safe, and then there are people in the

04:50other spectrum who think everything is bad.

04:53Both are wrong.

04:54It is neither very safe or neither very bad.

04:57It is safe.

04:58It is done within those parameters, as I mentioned.

05:02It has problems.

05:03So you need to go to a proper doctor for proper evaluation.

05:06And if it is safe, go for it.

05:08If it's not safe, choose other objects.

05:10Like, for example, you can stay with contacts.

05:12You can go for ICL, implantation of contact lens in the eye.

05:16So there are various other techniques which may work for you.

05:18Okay.

05:19Okay.

05:20I mean, it's important to know that anything in the medical field and in life is never

05:23100% perfect.

05:24Yeah.

05:25I mean, there's always, you know, pros and cons to everything.

05:30So could it be reversed, though?

05:32I mean, could I actually get this LASIK or laser treatment, and then down the line, my

05:37eyesight deteriorates again?

05:41So there are two things.

05:42Okay.

05:43Again, one is, is it reversible?

05:45The answer is no.

05:47So once you do it, you do it.

05:49But if you have a regression, for example, you had minus four, and let's say five years,

05:5510 years down the line, you get back minus one again back.

05:58So we do what is called enhancement.

06:01So we can retreat you.

06:03So we open the same window again and do the retreatment as possible.

06:06But then you will have to go through the same process of evaluation.

06:10So you have to have enough cornea left.

06:13You have to have the enough parameters, which are safety parameters.

06:17The shape should be okay.

06:18So if we see everything is okay, then we say, okay, you come, we can do the retreatment

06:23for you.

06:24But if retreatment is not possible, it's better to go back to glasses or contacts.

06:28Okay.

06:29And blindness is a topic that we mentioned in the beginning, but I want to go a bit more

06:35in depth into that because I think everyone fears it the most, especially if you've had

06:40your eyesight for the longest time.

06:43So is there any way for someone to reach a point where they genuinely cannot see and

06:49it can be rectified or is it then too late?

06:53So it's a tricky one, but I'm thinking, I don't know, I mean, is there any condition

06:59out there that can be salvaged?

07:01So you're right.

07:02You're right.

07:03You're right.

07:04Yes.

07:05Now, there can be blindness of different things.

07:06There can be blindness from birth, for example.

07:09The child is born totally blind.

07:12There are certain genetic modulation now available, which we can treat certain blindness in children

07:17as well.

07:18I'm not saying all types of blindness can be treated in children, but there are different

07:22types.

07:23So if the blindness is primarily because of a cataract in a child, for example, yes, we

07:28can operate the child and make the child see again.

07:31For example, if the child is born with some defect in the cornea, which is causing blindness,

07:36we can operate the cornea and give the new life to the child.

07:41Sometimes the children have, for example, squint, which can also cause partial blindness.

07:48We can correct that.

07:49Or amblyopia, like lazy eye, we can correct that.

07:52As an adult, some of the blindness are preventable.

07:56For example, glaucoma.

07:58Now glaucoma doesn't have any symptoms.

08:00So you actually don't know whether you suffer from glaucoma.

08:03So that's why if you have a history in your family, if your parents, your brother, your

08:08sister, somebody is diagnosed to have glaucoma, you must visit, even if you have no problem

08:13in your eyes.

08:14You must go and see an ophthalmologist, tell, OK, my parents have glaucoma.

08:18Can I have one?

08:19Can you check me?

08:20So what we do is we check your eye pressure.

08:22There's a threshold which we check.

08:25If your threshold is more than we say, yeah, your pressure is raised.

08:28Now you need additional tests.

08:30Those tests are, for example, we take pictures of the eye.

08:32We take pictures of the optic nerve.

08:34We do some field test.

08:36And then we say, OK, you are fine, you are safe.

08:38Or we say, no, you are doubtful zone, and you need to do close follow ups.

08:43Cataract can give blindness as well.

08:45If you don't treat cataract, cataract can mature, mature, mature, and you go blind.

08:50So these are preventable blindness, cataract.

08:53Correcting glasses, myopia, or uncorrected errors, these are preventable.

08:58But sometimes we fail.

09:00It's there.

09:01There are certain diseases which we cannot treat, but there are only very few of them.

09:0690% of eye disease is preventable, treatable, and reversible.

09:12So we have a very, very coned down conditions where we say, no, we cannot do anything.

09:18But most today with the modern science, with technology, with genetic medulation, immunotherapy,

09:23cancer therapy, we can treat everything.

09:26So it's not that we have lost hope.

09:29We have lots of hope.

09:30I'm happy to hear that.

09:31So in terms of prevention, it is preventable.

09:33But if it does reach blindness, it's not always rectifiable, is what you're saying.

09:38If your nerves are dead and there is no communication between your eye and the brain, absolutely

09:44dead nerve, can you do something for that?

09:48The answer is yes.

09:50Sometimes we have a new technique where we fit in cameras.

09:54So we have these microchip cameras which we can fit in the eye, and that will give you

09:59some vision.

10:00I'm not saying that you will get everything back, but you can see some shades, and some

10:04people can even move around with those cameras.

10:07These are microchip cameras which are fit in the retina, and in very advanced cases.

10:12But if your optic nerve is dead, can you transplant the eye?

10:15Answer is no.

10:16So far, we have not reached that point.

10:18Where there's eye transplants.

10:19Eye transplant, no, as a complete eye.

10:22But we do cornea transplant, we do retinal transplant, but not complete eye transplant.

10:26No.

10:27Are there any other technological advancements that you think are worth mentioning, especially

10:32when it comes to the eye?

10:33Because I know there have been quite a few in the field.

10:35Yeah.

10:36I mean, the most important thing nowadays is called the stem cells.

10:40So we are talking about that.

10:42We think that in future, we can have the stem cells, which will probably transplanting in

10:47the eye, and it might grow, and it might help in blind eyes.

10:52But that experiment is still going on.

10:55In some states, we have succeeded.

10:58In some, we are still waiting for research.

11:00So I don't know.

11:01I mean, medicine is today and tomorrow and then beyond.

11:04So I don't know what's going to happen.

11:05Yes.

11:06It's forever evolving.

11:07Yes.

11:08Okay.

11:09Dr. Mitra, we've taken so much of your time.

11:10But my last question is, what's your advice for everyone?

11:14If you were to give them the golden piece of advice when it comes to eyes, what would

11:18it be?

11:19Well, I think as an ophthalmologist, I think prevention is better than cure.

11:25You should not come to me when you are almost a dead fish to make you alive.

11:30So take care of your eyes.

11:32Eat healthy.

11:34Stay outdoors.

11:35I mean, the recommendation is two hours a day, you should stay in daylight.

11:39It really helps.

11:40Blue light actually helps your eyes.

11:42It's another thing.

11:44Good nutrition, good environment, and visit the doctor when you need.

11:48So checkups, periodic checkups, when it's required, you must do that.

11:53But stay healthy.

11:55Expose yourself to outdoor life and encourage your children to play out.

11:58I think that's the way how you can stay safe and you keep your eyes healthy.

12:03Yeah.

12:04Reducing the screen time.

12:05I think that is the most difficult thing to do with kids these days.

12:07Dr. Mitra, thank you so much.

12:08Thank you very much.

12:09Thanks for inviting me.

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