SEPTEMBER 2012
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Guest Columns

Football AND VISION: The ASTIGMATISM Connection

By DR. ARUN C. GULANI

Astigmatism (uh-STIG-muh-tiz-um) is a common imperfection in the curvature of your eye.

Like a camera, the eye has a cornea (viewfinder) and a lens. Astigmatism occurs when this cornea (Corneal Astigmatism) or the lens (Lenticular Astigmatism), inside your eye, has a slightly different surface curvature in one direction from the other.

People with astigmatism often have blurred vision, which can be associated with fatigue, eyestrain and distorted vision. In most cases, astigmatism is present from birth. It can also develop after an eye surgery, disease or injury.

In the majority of cases, the shape of the cornea decides vision. Nearsighted corneas are steep or more curved, farsighted corneas are flatter and astigmatic corneas are shaped like an American football (oval) as opposed to being shaped like a basketball (spherical).

Astigmatism may therefore occur in combination with other refractive errors such as nearsightedness (Myopia) or Farsightedness (Hyperopia) and even Presbyopia (after 40 reading glasses).

Astigmatism can be diagnosed during your routine eye exam in most cases but advanced diagnostic technologies like Focused Keratometry, Corneal topography (very much like the earth’s land topography or shape), 3-dimensional tomography and refraction (glasses or contact lens prescriptions) can further detail the specifics toward measurement, type of astigmatism and treatment modalities. These technologies also help rule out any pathology such as Keratoconus that may be associated with astigmatism.

Except for Greek artist El Greco’s success with his paintings (which today we understand resulted from his astigmatism), most people I have seen with astigmatism usually suffer in their work and life. So, I would suggest that you do seek correction.

The treatment for astigmatism can be divided into non-surgical; using glasses or Toric contact lenses (contact lenses with built-in astigmatism correction) and surgical, using advanced Lasik techniques and also lens-based techniques.

I like to further divide surgical options into:

    1. Patients with no cataracts (young patients) who can avail of all forms of advanced Lasik surgeries.
    2. Patients with cataracts who can take advantage (refer to August article in Khaasbaat: “Congratulations you have cataracts!) during cataract surgery and have special Toric lens implanted to correct astigmatism and cataracts both.
    3. Patients can also have combination Lasik + cataract surgery: In cases of previous cataract surgery with residual astigmatism, patients can have Lasik surgery while patients with previous Lasik surgery with astigmatism can during their cataract surgery have Toric lens implant. Also, in some cases of high astigmatism, they can plan for staged cataract and Lasik surgery, both in sequence.

The final aim is always to have vision without any glasses.

In summary then, astigmatism is a visual handicap that can adversely affect life’s functions and, in most cases, is treatable with modern technologies. Even patients with previous surgery, i.e., Lasik or cataract surgery and even radial keratotomy surgery can have advanced laser surgery to reach their goals of vision without glasses.

So, make sure your cornea is basketball shaped to enjoy the upcoming football season.

Arun C. Gulani, M.D., M.S., is director and chief surgeon of Gulani Vision Institute in Jacksonville. He can be reached at gulanivision@gulani.com or visit www.gulanivision.com


AWARENESS

We are glad to welcome back guest columnist Namrata Amin, who was diagnosed with ovarian cancer last year.

By NAMRATA AMIN

Life takes us to unexpected places . . . and then we learn new ways. I was rushing as usual and life pulled its brakes . . . I tripped and broke my self (mind, body and soul) but then God helped me stand up again.

Yesterday is a beautiful reflection, today is a new beginning, and tomorrow is a limitless possibility. Life isn't about finding yourself but is about creating yourself. Lots of prayers from one and all helped me through this struggle. Love and care flowed my way. As we know, lot of things in life are easier said than done so it took a while to bring myself here and write to all of you.

I want to reach out to not just all the women but men as well. Ovarian cancer is usually diagnosed in the later stages due to lack of symptoms. Symptoms of ovarian cancer are not specific to the disease, and they often mimic those of many other more-common conditions, including digestive and bladder problems. When ovarian cancer symptoms are present, they tend to be persistent and worsen with time. Signs and symptoms of ovarian cancer may include:


Abdominal pressure, fullness, swelling or bloating;
Pelvic discomfort or pain;
Persistent indigestion, gas or nausea;
Changes in bowel habits, such as constipation;
Changes in bladder habits, including a frequent need to urinate;
Loss of appetite or quickly feeling full;
Increased abdominal girth or clothes fitting tighter around your waist;
A persistent lack of energy;
Low back pain.
(Source: American Cancer Society)


Make an appointment with your physician if you have any signs or symptoms that worry you. If you have a family history of ovarian cancer or breast cancer, talk to your doctor about the risk of ovarian cancer. A pap test is useful to detect cervical cancer but not ovarian cancer. Currently, there is no effective screening test for ovarian cancer. While women with ovarian cancer often have an elevated level of CA 125, an elevated CA 125 doesn't always mean you have ovarian cancer. Some women with ovarian cancer never have an elevated CA 125.

Pay attention to your body and address any concerns in a timely fashion. I would have never known about my ovarian cancer if I had not asked my physician to do a pelvic ultrasound. My doctor gave me information on certain vitamins when I told him that I was getting a little tired and joked that I was getting older. But I remained persistent in having the blood test and ultrasound done to find the correct diagnosis.

Also, please don't miss yearly checkups. If you are high risk, you can request an exam every six months. University of South Florida has a clinic where they will test high risk females for early diagnosis. Look for a clinic near you.

Namrata Amin can be reached at aminnamrata@gmail.com

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