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How the eye works!

on July 05, 2021

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Laser treatment of the Retina : a brief history!

" When, according to Greek mythology, Prometheus gave man the gift of fire (an act for which he was severery punished by the gods) it was one of the most important steps in the history of mankind." The use of HEAT in the history of medicine goes back to antiquity. Heat and fire were used to sterilise wounds and stop bleeding since ancient times. The use of heat in ophthalmology also has quite an interesting history. Jules Gonin Jules Gonin, a French ophthalmologist was the first to use a heat cautery to treat retinal detachment for the first time. A metal filament was heated on a flame and inserted into the eye to cauterise the retinal break. (For a non medico : Consider this procedure similar to a soldering iron. When you solder a metal, it melts and gets attached to another metal with which you intend to attach it. A heat cautery would do a somewhat similar thing! It would attach the detached retina back to its original position.) In those days this was quite a revolu

Age related Macular Degeneration : from Antiquity to Modernity

Part 1 Age Related Macular Degeneration : From antiquity to modernity Tracing the journey of treatment for this blinding condition ( ref : Wikimedia commons) by Dr Chinmay Nakhwa The evolution of eye treatments has had an interesting history. It was in the late 19th century when Howe first photographed the human retina and documented it ( This has had many controversial claims). Since then diagnosing diseases of the retina and treating them has been quite an enigma among eye doctors. Age related eye problems of the retina ( AMD : Age related macular degeneration ) were first classified by Sir Stewart Duke-Elder as “ Senile degeneration of the retina”. In this condition , fine blood vessels grew under the central retina. Being fragile, these vessels ruptured easily, causing a sudden and irreversible drop in the patient's vision. This was responsible for up to 20% cases of blindness in people beyond 65 years of age, in those days. Many treatments including steroid injection

Age Related macular degeneration : Era of Anti Vegf

Part 2 Age related macular Degeneration: The era of intravitreal Pharmacotherapy A commentary about current practice patterns…. by Dr Chinmay Nakhwa Laser and PDT destroyed retinal tissue and caused a lot of collateral damage, eventually leading to a large “ blind Spot” for the patient. The limitations of macular laser treatment and photodynamic therapy created a need for development of drugs which had a more physiological effect on the treatment of macular degeneration. The idea for development of intraocular drugs actually came from the treatment for cancer. A class of drugs called “ Anti VEGF “ were being developed for the treatment of colon cancer. It was presumed that these drugs will reduce the blood supply to the cancer cells and hence kill them. It was serendipitously noticed that a few patients who were given intravenous anti VEGFs had betterment of their macular degeneration too. Ophthalmologists then began experimentally injecting these drugs into the eye of the patien

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How the eye works!

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