EYESIGHT
Plastic surgery around eyes for better appearance
Dr Mahipal S. Sachdev

Eyes are windows to the soul and are considered to be the most important feature of our face. Over a period time, their beauty is marred by aging, creases and eyebags. This is all the more true in modern times, where average life-span has increased and people are more conscious of their looks.

Moreover, a youthful appearance induces confidence and makes way for a more positive personality. The aesthetic aspect of ophthalmology deals with rejuvenation and enhancement of facial features with the help of various surgical and non-surgical methods. Some of the procedures include Botox injections, which is a simple non-surgical treatment for wrinkles around eyes, forehead, crowlines, etc.

With aging, one may start noticing periocular hollows and folds which occur due to the loss of tone and sagging of tissues around the eyes. For this, natural fillers like Restylane are injected with an ultra-fine needle in the problem areas.This procedure is simple and convenient, and the results are visible immediately.

Almost everyone develops sagging around one’s eyes which develops due to loose excess skin or weak muscles. Also bags may develop under the eyes with age, though young people too may have this problem. The procedure called blepharoplasty is performed for such a condition.

Incision in the eyelid is small and is hidden in the natural eyelid skin crease. Fat from one part of the body can be added or removed from the periocular region in certain cases to enhance the appearance, depending upon the requirement.

The ophthalmic plastic surgery helps correct abnormal eyelid positions (droopy eyelids) which may be there since birth in some children or develop later on in adults. Problems related to excessive watering from the eyes may be because of blockade of the tear draining system of the eye and these can be effectively treated with simple surgery.

Those who suffer a paralysis attack often have difficulty in eyelid closure, which can also be dealt with effectively. Orbit — the bony cavity in which the eyeball resides — often gets affected by infections, especially in diabetics, and is also a seat of various kinds of tumours which may be benign or malignant and become manifest usually by a bulging or increased prominence of the eye ball. The eye may be the first organ to get affected in certain conditions like thyroid dysfunction. A timely intervention by a trained ophthalmic plastic surgeon may help avoid complications.

Trauma may range from a minor laceration of the eyelid to a major fracture of the orbital bones. Proper and timely repair and reconstruction of eyelid injuries is important as the type of primary intervention that a patient receives has a bearing on subsequent scarring and deformities that may develop later. Oncology and ophthalmic plastic surgery are intimately linked.

The incidence of cancers like sebaceous gland carcinoma and basal cell carcinomas in and around the eye is on the rise as we see more and more people now entering their seventh or eighth decades of life. A proper surgical intervention in association with a medical/radiation oncologist ensures a longer life and a better quality of life for these patients. Furthermore, cosmetic fitting of a natural looking artificial prosthesis is also possible and is of utmost importance in restoring the self-esteem in a person who has had to suffer the loss of one of his eyes.

With Laser refractive, plastic, reconstructive and aesthetic eye surgery, more and more people , young and old, now have the opportunity to improve their vision and appearance.

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

Buying running shoes and jeans
Rahul Verghese

Inseam, hip and waist measures are critical in buying a pair of jeans once the decisions on brand, style and price have been taken. A trial room and mirror helps.

Fitting, size, cushioning and arch support are key to the choice of a running shoe, and often override brand, price and style. All new shoes feel great, but an inappropriate shoe leads to problems, sometimes, over the years. It’s important to know whether you are flat- footed or have a high or a normal arch, and also to understand if you over- pronate or under-pronate “Ouch — what was that?”

OK — let me try and explain: When you run — the outer part of your heel strikes the ground first. The middle part of your foot then begins to make contact with the ground, while it rolls inwards by around 4-5 degrees at the arch (or pronates). This is the body’s means of natural shock absorption. The entire foot is in contact with the ground for a fraction of a second before the ball of the foot (the part just next to the five toes) kicks off — with the help of the toes. And we have lift-off!

So, to get you to appreciate your feet for the first time in your life, a trial room and a mirror won’t help. You had just taken them for granted and bought footwear based on style and the price for the most part, and fit too right? Pretty much like I used to until seven years ago.

You wouldn’t build a house without getting the foundations right. So, why do it with your body?

Here are some simple ways to understand your feet better.

The wet test:

Wet both your feet, step onto a sheet of paper, and view the wet pattern.

If the imprint shows your whole foot — then you, like me, are flat-footed and you, perhaps, overpronate. This means that when your foot hits the ground your arch collapses a bit more than needed (over-pronates) and you need a shoe that has a much firmer middle — a stability shoe, or if you are severely over-pronating or are a heavier runner, over 75-kg — than a motion-control shoe.

If you see some of your foot and a curved arch — a normal arch — the best shoes are those that provide stability.

A thin line connecting your heel to the ball of your feet and your toes means you have a high arch (the foot most probably supinates or turns outwards) and need a shoe with a soft middle, to absorb the shock of every foot strike.

The old shoe test:

Flip your old running shoes over (or if you don’t have one, examine the soles of your old shoes that you use for work, or for walking).

If the inside of the sole is more worn out, then you are most likely flat-footed and overpronate. If the outer sides of your soles are worn out, you are likely high-arched and under- pronate (or supinate)

The walk test:

Walk towards a full length mirror and then away from it, and observe your feet motion. Also, just watch other people jogging or walking in the park or on a treadmill and see if the inners of their shoes are getting most of the wear — as then you can tell, they are overpronating or under pronating. About 80 per cent of the population has structural problems in the feet which cause abnormal walking pattern

Basic shopping tips:

Feet swell during the day — shop around in the afternoon/ evening.

If you are running longer distances — 10 km or more — then definitely buy a size larger than normal, to allow for foot expansion. You should be able to stick in a finger between your heel and the shoe. Don’t ever fall for the sales talk — it will loosen out! While that could be the case for a leather shoe, that’s the wrong answer for a running shoe purchaser to hear.

Most of us, strange as it may sound, have one foot longer that the other — so measure the shoe size of each foot and try out the shoe size for the bigger foot.

Wear socks during the try-out. Visit multiple stores, try multiple brands and models, ask questions and learn more, before you buy.

This will be your most important investment, as otherwise, problems with arches often travel up the skeletal system to the ankles, shins, knees, hips and, finally, the lower back.

Do not assume that the most expensive shoe is the best for you — many in the Rs 2,500-4,000 range could be just right for you.

So, just like you would never buy a 40-inch waist DKNY jeans just because they are the latest, don’t end up buying the latest and most expensive Nike or Reebok shoes and assume that they are the best for you.

Animal magic: how pets prevent illness 

Dog owners tend to have lower cholesterol and lower blood pressure, as dogs can reduce the risk of spikes in blood pressure due to stress or tension.

In some cases, the emotional support offered by an animal is greater than that offered by a human. For older people in particular, an animal can fulfil "the need to be needed".

Owning a pet can improve a person's chances of survival after a life-threatening illness, by helping to lower blood pressure. Pets can also help speed up rehabilitation following a stroke.

Children with pets have higher levels of self-esteem and function better emotionally than those without, studies have shown. Some teachers have introduced pets into the classroom and children with learning disabilities and behavioural disorders such as autism, for example, show immediate benefits from animal-assisted therapy.

Children who live with a cat or dog in their first years have a lower incidence of hay fever and asthma and are less likely to develop animal-related allergies, or to suffer a bout of gastroenteritis.

— The Independent