EYESIGHT
The truth about spectacles
Dr Mahipal Sachdev

THE human eye captures enormous quantity of information. Our eyes are more susceptible to disorders than any other sensory organ. Just think of all the things we wouldn’t be able to do if we didn’t have access to visual aids. In case a person suffers from refractive errors like myopia (shortsightedness), hypermetropia (longsightedness), astigmatism, etc, then the options with him are to either opt for spectacles, contact lenses or laser surgery/refractive surgery

The history

In the ancient cultures as far back as the Romans, there were no spectacles. However, ancient Chinese culture knew of glass that was used in the form of spectacles. Travellers’ tales have made China the original centre of glasses. The monks in the middle ages developed the “reading stones” that consisted mainly of rock crystal or semi-precious stones and it was ground into a hemisphere to magnify characters.

The first ground glasses were first made in a Venetian workshop and were intended for one eye (Monocle). Towards the end of 13th century the idea was born to frame two ground glasses using wood or horn, making them into a single unit. Roughly, around 1850 the spectacles took on the form in which we know them today.

Today 2.2 billion people worldwide wear spectacles. When it comes to correction of refractive errors, spectacles are the first and most popular option. Apart from many children and young people who are long-sighted or short sighted, the ability to see near objects in sharp focus starts to deteriorate with age. Roughly, by the age of 40 years, many individuals need reading glasses (also known as presbyopia). That means above 40 years, sooner or later every one will require visual aids to see clear for near vision.

On the one hand, while the percentage of shortsighted people is increasing rapidly, on the other hand, the increasing ageing of the population (due to better life expectancy) is resulting in an ever-growing number of spectacle-wearers. Taking a closer look at the types of spectacles that are normally prescribed today, we find that they have been broadly categorised into long-distance glasses, reading glasses, combined (bifocal or multi-focal glasses) and children’s glasses.

Children’s glasses

In children, the eye tests or “refraction” tests (to determine the power of glasses) can be made right from birth. If a child requires vision correction, there are options of being prescribed contact lenses or spectacles. Children’s glasses should never be tinted as they can distort the colours and allow less light to pass through. Simple coating is, however, sufficient. While choosing a frame for children, it’s advisable to do so together with the child. Allow the child to chose the frame for him or herself, so that he or she actually likes the glasses.

The spectacle lenses should be made up of polycarbonate instead of glass. Polycarbonate, though a plastic and prone to scratches, is very resistant to any impact or damage and thus will prevent any injury to the eye.

Bifocal or multi-focal lenses

These glasses represent a single pair of glasses for all distances. The traditional bifocal spectacles have an upper section for distance viewing and lower section for close-up viewing. However, the disadvantage is that the middle-distance range in unclear. Many professionals like teachers, accountants, architects and computer operators require clear vision for all the distances.

This led to the introduction of progressive spectacle lenses or commonly known as multifocal glasses. In these spectacles there is a gradual transition from the upper section of glasses for distance viewing to close-up viewing at the bottom. While this makes vision clear at distance, middle distance and near viewing, it takes time to get used to these multi-focal lenses. Sometimes people may find it difficult to adapt to the multi-focal lenses.

Spectacle frames

Thinner and more attractive lenses, lighter frames and better vision have been the goals that lens manufacturers have always strived to achieve. Frame styles have always been much more varied than lens types. Spectacles are made from materials like wood, leather, bone, ballen, horn, tortoise shell, rubber, ferrous metals, copper and its alloys, silver, gold, lead, tin, platinum, etc. The shapes of the frames haven’t changed dramatically over the ages. People still rely on the conventional rounds, rectangles and ovals to which minor changes are made every now and then. Rimless eye wear along with colourful lenses in titanium metal is the latest trend around the world.

Spectacle lens materials

There are basically three general categories of lens material : glass, plastic (CR 39) and polycarbonate. Glass lenses are scratch resistant but are easily breakable while polycarbo-nate lenses are strongest and lightest with a high degree of protection. This makes polycarbonate lenses the lens of choice for children. Hi-index lens materials make the lenses to be lighter and thinner in high prescriptions producing better-looking eyewear.

And as new brands and options enter the market, there are more styles and options to choose from than ever before. So, go ahead. Make a statement

The writer is Chairman and Medical Director, Centre for Sight, New Delhi. Email: msachdev@bol.net.in

A new painless technique to cure piles
Dr Pankaj Garg

PILES affect a large number of people. It is estimated that one-third of the population generally suffers from piles. Piles are more common in women during pregnancy and childbirth, and there is some evidence that piles run in families.

Constipation has been identified as the main cause. Pushing hard to pass stools puts a strain on the veins in the anal canal which eventually dilate and enlarge to form piles.

Piles is a distressing condition which in the initial stages causes itching and discomfort around the anal opening. As it progresses, it causes heavy or dragging sensation and occasionally pain as well. In most cases piles are associated with the passage of fresh blood with stools.

In the initial stages, a lot of treatment options are available such as high fibre diet, banding, selerotherapy, cryotherapy, infra-red coagulation, etc. These modalities provide good relief in the initial stages but do not help much in the later stages of the disease. In the advanced stage, only surgery provides long lasting relief.

Conventionally, the piles operation is done by the open method in which the bunch of dilated veins (piles) are dissected in the lower part of the anal canal and then tied off. The dissection results in a wound in the lower anal canal which takes time to heal. Since the lower part of the anal canal is highly sensitive to pain, the patient experiences agonizing pain for four -five post operative days. Therefore, the patient is kept admitted in the hospital for three-five days. Normally, the patient resumes work after two weeks when the wound is at least partially healed. The patient also needs to do hot water baths (Sitz bath) two-four times a day till the wound heals completely which usually takes four-six weeks.

But now a technique is available which provides a very good alternative. This technique is called Stapler technique or MIPH (Minimally Invasive Procedure for Piles). In this technique, the pile mass is not directly operated or dissected. Instead, the operation is done in the upper anal canal which is insensitive to pain. A disposable Stapler device is used which cuts the lining of the anal canal and sutures it back instantaneously. In the process, the blood supply to the pile mass is obliterated and this results in shrivelling and hence disappearance of piles.

Since this operation doesn’t create any wound, the patient needs no post-operative dressings and hot water baths (Sitz bath). As the lower sensitive anal canal is not cut during this procedure, the patient is absolutely pain-free right after the operation and can resume work next day. Moreover, the time taken for operation, (15-20 minutes) and the blood loss in the Stapler technique is comparatively much less.

In short, the Stapler operation for piles has following benefits:

• Less post-operative pain
• Shorter hospital stay
• Early resumption of work
• No need for post-operative dressing and hot water baths (Sitz baths)
• Much less healing time
• Less blood loss during the operation
• Shorter operating time

The writer is a Senior Consultant in the Department of Surgery, Fortis, Mohali

Hair care: watch your diet
Dr R. Vatsyayan

LONG before the invention of chemical-based shampoos and detergents, ayurvedic seers included hair care as an essential part of one’s daily routine. They emphasised that healthy hair grow from within the body and if we keep heredity considerations apart, diet and lifestyle are the most important factors which determine the quality and quantity of hair. Here are some important tips one should keep in mind while drawing a hair care programme:

lLike other body organs, our hair too need nutrition from inside. Our food should be wholesome, natural and fresh. Green vegetables, whole grains and smaller legumes with their higher protein contents, besides citrus and vitamin rich fruits and milk are an excellent choice for a good supply of nutrients to the hair.

lPersons looking for healthy hair should consume less of processed, refined and packed food items. Excessive use of fast food and over-consumption of eatables with preservatives, chemical dyes, and added flavours are increasingly seen as one of the major causes behind the graying of hair in most young people.

lOne should avoid using harsh products of chemical origin as they can harm the hair. If you wash your hair for more than three times a week, it is better to use a preparation that is gentle and contains some hair nourishing agent also. As a word of caution, make sure that any herbal product you buy over the counter should contain minimum chemicals. It is better to postpone dying of the hair for the first time. Once started, chemical dyes speedily change the colour of natural black hair into grey.

lLike all other systems of the body, stress adversely affects the quality and quantity of the hair. One should always try to manage one’s time and task to minimise stress. Practising relaxation techniques like yoga and meditation and getting adequate and good quality sleep can help in falling and graying of hair, resulting due to constant worrying and other tension-related conditions.

lFalling of hair should be treated according to the underlying reasons. Women may lose hair due to a number of reasons like after childbirth or abortion, during chronic pelvic infections, while taking oral contraceptives and around menopause. Hairfall is also reported in cases of chronic anaemia and after going through a regime of crash dieting.

lMassaging the scalp with coconut, sesame or mustard oil helps to stimulate and moisturise it. Amla, bhringraj and brahmi are famous herbs used for hair care. These can be processed in the above mentioned oils to be used to improve the health of the hair. Shikakai, henna, lemon juice, egg and curd are natural hair conditioners and “reetha”, a commonly available herb, not only removes the dust from the hair but also clears the minute secretions coming out of the scalp.