A refractive error is a condition in which a clear image fails to focus on the retina due to variations in optics of eye (cornea, lens or length of the eyeball). The variations are determined by our genetic/chromosome pattern like any other organ of the body.

There are three different types of refractive errors / Spectacles Power namely, myopia, hypermetropia and astigmatism.

• Myopia or short-sightedness is a condition wherein the image is focussed in front of the retina. The person is unable to see distant objects clearly.
• Hypermetropia or far-sightedness is a condition when the image get focussed behind the retina. The person is unable to see near objects clearly.
• Astigmatism or cylindrical error is the condition when due to irregular curvature of the cornea, a point focus of image is not formed at the retina. objects at most distances appear blurred to such people. It can be of simple, compound and mixed type depending on where and how the image is formed in relation to retina.

Refractive errors occur due to a combination of genetic and environmental factors.

Refractive errors / Spectacles power can be overcome by either using temporary aids like glasses / contact lenses or removed permanently by undergoing a refractive surgical procedure-LASIK/PRK/SMILE/Phakic ICL/RLE.

The option of any of above depends on the age, refractive error ,eye condition and PERSONAL CHOICE.

• Age Criteria- contact lens and LASIK is not an option for children. They should wear spectacles as they are safe and maintenance free. As the child grows older and is able to handle contact lens say around 14 or 15 years of age, they can star wearing soft contact lens .The option of LASIK is after 18yrs age as the refractive error becomes stable by this time.
• If contact lens do not suit you or cumbersome to handle, LASIK/PRK is a good option .It is a safe day care procedure and gives long lasting solution. .There are certain parameters in eye which need to be examined upon prior to opting for LASIK eg-corneal thickness, curvature, tear film, retina etc. The ophthalmologist will examine your eyes in detail and guide you accordingly.

The choice of refractive procedure is based on the power of glasses, eye parameters and age of patient. There is a strict selection criteria for each procedure and we examine your eyes thoroughly before deciding on same. We examine your eyes in detail to decide what option would be best for your eyes. Broad guideline to help you understand the refractive options for various spectacles power:

• -1 to -8 myopia (normal cornea):Lasik standard/ customized or wavefront guided .If the cornea thickness is adequate, we can sometimes correct upto -10 also but prefer phakic ICL for high numbers) .(for detailed info: Click Here)
• -1 to-8 (borderline thin cornea): Ultra Thin Flap Lasik/ PRK-Surface Ablation/ Epi Lasik
• +2 to +6 hyperopia (normal cornea) : Lasik
• 1 to 6 astigmatism- Lasik
• -8 to -20 (any type of cornea): Phakic ICL-Implantable Collamer Lens-Phakic Intraocular Lens (for detailed info: Click Here)
• -20 to-30 pathological myopia / +10 or more hyperopia (age >40yrs)/ : CLE-Clear Lens Extraction/Refractive Lens Exchange
• Presbyopia (near vision problem in elderly) : Supracor Presbyopic LASIK (for detailed info: Click Here ) Monovision Lasik

All refractive procedures are walkin -walk out day care procedures. One is expected to rest for a day and can resume routine work from next day. Majority of refractive error is restored soon after while the fine vision may take few days to settle. One can safely resume work in few days.

There is a strict selection criteria for each procedure and we examine your eyes thoroughly before deciding on same. Once the eyes are decided to be suitable for a certain procedure, its very safe. Few incidence of complications (like any surgical procedure) can be managed well.

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Clear Lens Extraction (CLE), also called Refractive Lens Exchange (RLE), is the removal of natural lens of the Eye with Intraocular Lens placement as a Refractive procedure. This procedure is done for people having very high glasses number where Lasik or Phakic Implanatble Collamer Lens (ICL) is not possible. The Natural Lens of the Eye is replaced by an Intraocular Lens to correct and neutralize high Spectacles number. The process resembles that of Cataract Surgery; however in Cataract Surgery the Lens is clouded, whereas in this Surgery, the Removed Lens is clear.

Who is an eligible candidate for RLE?
RLE is usually reserved for patients with high myopia and high hyperopia (12 to 30 diopters ) that is not easily managed by other Refractive procedures, such as laser in situ keratomileusis ( LASIK / PRK ) or Implantable phakic Intraocular Lens (ICL). The advanced premium Intraocular Lenses like Toric IOL can correct astigmatism along with myopia and hyperopia. Similarly Multifocal and Accomadative IOLs can correct presbyopia (near vision problem after 40) and distant vision simultaneously.

What is the procedure?
RLE is performed as any other Cataract Procedure under Local anaesthetic Eye Drops. The Natural Lens matter is aspirated and replaced with Refractive Intraocular Lens. It is done as a day Care Surgery.

What are the advantages of this procedure?
A through checkup of the retina periphery is a must before planning the Surgery specially for high myopia. Prophylactic retinal laser needs to be done for any hole or break detected. This is done to prevent the remote possibility of retinal detachment. There no such concerns for patients with high hyperopia. Rest of the risks & complications remain same as that of Cataract Surgery.

What are the risks and complications?
A through checkup of the retina periphery is a must before planning the Surgery specially for high myopia. Prophylactic retinal laser needs to be done for any hole or break detected. This is done to prevent the remote possibility of retinal detachment. There no such concerns for patients with high hyperopia. Rest of the risks & complications remain same as that of Cataract Surgery.