Why does the number of glasses increase?

Why does the number of glasses increase?

                                          By : Prof. Dr. S.P.S. Grewal

With a lot of research happening in the field of medicine, especially vision research, there is hope for solutions to many conditions hitherto considered beyond management. Short sightedness of myopia or an increase in the number of glasses is a focus of current research. Though genetic inheritance pattern of myopia is well recognized, new studies attempt to understand the environmental effects on the progression of myopia.

Data presented from the RESC (refractive Error study in school children) study, a global study carried out in 11 countries across world, has tried to throw interesting light on the prevalence of poor vision due to refractive error like myopia or hyperopia in children and the factors affecting them.  

It is believed that outdoor activities like plying sport have a positive role to play. Interestingly, a decrease in near work and increase in outdoor activities reduced the odd of increase in number by three times. Distance viewing that relaxes the eye muscles, narrowing of pupil with light and exposure to natural light also play a role in preventing an increase in number.

For lower number, a partial use of glasses may lead to more progression of myopia than constant use of glasses. Excessive near work from too close a distance is also associated with greater chance of increase in number. It was show that study intensive societies have a higher incidence of myopia.

The study found the incidence of myopia to be 7.4 per cent in a northern Indian urban upper-class population, 4.1 per cent in a south Indian rural population and 20 per cent in the Gaungzhou province of china.

The social impact of refractive error was also highlighted. There were several barriers to children not using correction for myopia. These included lack of awareness, cost constraints and the lack of usage. The study also highlighted the high incidence of uncorrected refractive error in the school going age group of 10 to 12 Years. Out of all the children requiring glasses, only 22 per cant were wearing correct prescription glasses, 7 per cant were under corrected and 71 per cant were not wearing them at all, The younger the child the greater are the chances of him/her being under corrected or not corrected at all.

Almost 6-18 per cent of school going children in age group of 10 to 14 years, across the world need glasses and this is quite a disturbing figure. The onus falls on the parents to ensure that their school going children have a proper cyclopegic refraction. The study also noted that educated parents frequently considered the prospect of their child’s missing out study time because of blurred vision as unacceptable.

The number of one’s glasses may increase at any time in life. There are more myths, than facts, surrounding the progression of myopia. The good news is that the scientific evidences are on way to demystify the myths. ***

Prof. Dr. S.P.S. Grewal
Grewal Eye Institute
SCO 166, Sector 9-C, Madhya Marg
CHANDIGARH - 160 014 (India)
Ph : +91-17-2747118, 5056901, 5056969
Fax : +91-172-274843
Mail : drgrewal@gmail.com
Website : http://www.gei.co.in/

Ignorance: A barrier to Treatment

Ignorance: A barrier to treatment

                                                 By : Prof. Dr. S.P.S. Grewal

We generally believe that a QUICK recovery from disease needs an accurate diagnosis and good management from the doctor. How ever a good doctor is only half the story and patient factors are equally important. And the one parameter that patient are usually not aware of is, Ignorance. Ignorance of disease, that patients of treatment options, Ignorance of risks and even Ignorance of precautions and restrictions.

Often eye drop are prescribed but they are not explained how to instill them. Eye drops have the desired effect only if they are instilled properly. There are several examples in which ignorance deters patients from accepting the best treatment.

‘Progressive or bifocal glasses do not suit me’ is a common refrain of presbyopic patients, a few days after they get a new pair of glasses. Patients are not aware or have not been informed of the training process they have to go through in older to be able to use the new glasses.

I recently had a chance to treat a patient with uncontrolled diabetic eye disease. The angiography test and laser was performed on him. I counseled him on the significance of controlling the blood sugar and was controlled. While thanking me he commented that it was so easy since he knew what to do. It was lack of knowledge about role of diet, drug and exercise that prevented him from controlling diabetes initially.

Similarly if you are aware of the side-effects of a drug, you can identify serious side effects at the earliest and report to the doctor. Often of appearance of some of the know side effects the tablets or drop drops are discontinued without informing the doctor. as the patient is bot aware of the side effects.

Spring catarrh or seasonal allergy of the eye is common in kids. Many parents will report back saying that the redness appears if the medicine is stopped. Probably they were not educated in detail about the time frame for which the medicine was to be used and the deleterious effects of repeated interruptions in treatment.

Glaucoma (kala motia) is another disease where patient education goes a long way in preserving vision. Many patients are not aware that the treatment and monitoring of glaucoma is to be continued for their entire life, and that vision can only be preserved and not restored.

Ignorance of the disease and treatment process also results in one searching for alternatives that do not exist. Education is also critical for setting realistic expectations from the treatment. I feel the level of compliance among the citizens of Chandigarh very high. It needs to be reinforced, by the treating physician or surgeon, with more emphasis on patient education. ***


Prof. Dr. S.P.S. Grewal
Grewal Eye Institute
SCO 166, Sector 9-C, Madhya Marg
CHANDIGARH - 160 014 (India)
Ph : +91-17-2747118, 5056901, 5056969
Fax : +91-172-274843
Mail : drgrewal@gmail.com
Website : http://www.gei.co.in/

Spark in your eyes !

Spark in your eyes !

By : Dr. Prof. S.P.S. Grewal

Many of you would be surprised to know that our eyes actually run on electricity! The light waves from all the objects that we look at fall on the retina and get converted into electrical impulses that are transmitted to our brain which in turn processes the electrical impulses into an understandable view.

Retinal Electrophysiology, a study of various electrical currents generated inside our eyes, enables us to record these electrical impulses. As an expert electrician finds the expert fault by testing the various circuits, a Retinalelecto-physiologist, by performing various tests, can diagnose a problem in patients with poor vision. You get a graph for the eyes, just like the ECG.

ERG (Electroretinogram) is an indispensable tool that gives a clear assessment of the retinal function. ERG is an electrical potential generated by the retina in response to a brief flash of light. When the retina is suddenly illuminated, all of its cells are simultaneously activated and generate current. A part of this current escapes the eye through the corneas (front part of the eye). However, this current is extremely small and requires a special instrument to be recorded as ERG. The amount of generated is proportional to the functional status of the retina.

The standard ERG is the whole response evoked from the entire retina. It is not able to pick up the isolated problem localised to themacula (the central part of retina), which is the most important part of the visual function, but constitutes only1% of the total retinal surface area. Here Multifocal ERG comes to our rescue. Specialised equipments are used to measure the reaction of several areas of the retina in a single recording. This is really helpful in diseases of themacula with small or no morphological changes in the retina.

Multifocal ERG not only gives information regarding central loss of function in maculopathies, but also gives a detailed description of extent of the lesion, which is useful in case of patients with diseases such as diabetic eye disease, optic neuritis, retinal detachment, glaucoma, and multiple sclerosis.

Electrophysiolgy (used to determine presence of retinal function) is also quite useful in confirming the diagnosis of specific diseases and evaluating the progression of Age Relatedmacular Degeneration (AMD), Electrophysiology can be used for early detection of toxic retinopathies (side effect of drugs on the eyes). Electrophysiology is a useful tool that helps assess visual functions in infants, children, and uncooperative patients. All such modern tools and techniques can add a spark to your eyes. ***

Prof. Dr. S.P.S. Grewal

Grewal Eye Institute

SCO 166, Sector 9-C, Madhya Marg

CHANDIGARH - 160 014 (India)

Ph : +91-17-2747118, 5056901, 5056969

Fax : +91-172-274843

Mail : drgrewal@gmail.com

Website : www.gei.co.in