41-year-old Rachana Jambla* lived in Turbhe, Navi Mumbai with her family andused to drive to work through eastern express highway daily. Gradually, she started experiencing headache, cloudy vision especially in morning hours. In ate evenings, she would face difficulty while driving as halos around lights would constantly disturb her. So, she medicated herself with nonspecific medication.
Gradually, she realised that is not getting any relief from these problems. Her family doctor then advised her to visit an eye doctor at Advanced Eye Hospital Institute (AEHI) located at Sanpada, Navi Mumbai based on the excellent reviews on Just dial.
A detailed eye check-up was conducted for Rachana. Visual acuity showed that her vision was reduced in the left eye while her right eye was normal. The intraocular pressure was just a little above the normal range in the left eye – 28mmHg.
Dr. Vinayak Damgude, a Cornea & Cataract specialist, examined her left eye under slit lamp and observed that there was corneal swelling. She also had peripheral anterior synechiae in the same eye. The eye was found to be normal. Dr. Vinayak diagnosed her condition as Chandler syndrome.
Then she was referred to Dr. Rajesh Mishra, a Glaucoma & Cataract surgeon, who examined her and observed that there were Peripheral anterior Synechiae in her left eye. In other words, the peripheral part of iris was stuck to the anterior chamber thereby blocking the normal flow of aqueous humor and increasing the eye pressure.
Dr. Rajesh Mishra prescribed her few eye drops to suppress the aqueous humour production and thereby lower the eye pressure.
Chandler syndrome: – Iridocorneal endothelial (ICE) syndrome is group of various rare ocular disorders such as progressive iris atrophy, the Cogan-Reese syndrome, and the Chandler syndrome. In Chandler syndrome, the interior layer of the cornea i.e. endothelium multiples and a cell layer develops and grows on the structures located inside the eye starting from the back of the endothelium, onto the iris and the angle. This layer undergoes contraction and, in the process, causes formation of peripheral anterior synechiae and leads to angle closure. Besides this, it impacts the functioning of the cornea. This causes corneal edema (swelling) which may progress if the intraocular pressure is not controlled.
Gradually, as Rachana’s intraocular pressure lowered, Dr. Vinayak decided to observe her for corneal edema. However, over the next few months her corneal edema progressively worsened. Dr. Damgude decided to perform a type of cornea transplantation called Endothelial keratoplasty (DSEK) on her affected eye. The aim was to replace the layer of cells and the damaged endothelium layer with a healthy new endothelium layer. DSEK and DMEK are two such endothelial keratoplasties which can help in such cases.
Endothelial keratoplasty is usually a fast recovery surgical procedure. This selective surgery keeps the stroma and epithelium layer intact. However, in complicated situations like Chandler’s syndrome sometimes a lot of caution is required due to the presence of peripheral anterior synechiae and potential risk of future high intraocular pressure.
During follow up sessions, her corneal layer was observed which showed that it was healing. Over few weeks, she showed drastic improvement in vision with minor refractive power. She was counselled to continue to be on regular follow-ups so that her eye pressure and corneal status can be monitored.
Eye problems in one eye including blurry vision, halos around lights along with constant headache can be a sign of a serious eye disease. Hence, early eye check-up is vital. Corneal disease affecting the corneal endothelium causes corneal swelling and can happen due to many causes like Fuch’s Endothelial dystrophy, after eye injury, chemical exposure to the eye, after previous eye surgeries etc. In these cases patients experience blurring of vision, haloes around the light and eye pain in advanced cases. Sometimes in conditions like Chandlers syndrome high pressure may hasten the damage to the corneal endothelium. It is imperative that in such cases eye pressure is controlled and monitored.
Dr. Vinayak A Damgude (MBBS, MS, Fellowship in Cornea) is a Cornea, Cataract Consultant and General Ophthalmologist at Advanced Eye Hospital near Vashi, Navi Mumbai. He is trained from the best institutions and has several years of performing cataract and cornea surgery. Further, apart from his clinical skills, his patients connect with him in the first consultation itself, which speaks volumes about his polite nature. Over his extensive years of practice, he has successfully treated a variety of patients for Cornea Retrieval, Penetrating Keratoplasty, Sutureless Autograft Pterygium surgery, keratoconus, AMG graft transplantation for Pterygium patients and operated thousands of cataracts patients with Phacoemulsification surgery. Consult Dr. Vinayak A Damgude by booking an appointment.
Dr. Rajesh Mishra (MBBS, MS, FAEH, and PGDHM) is a Glaucoma and Cataract surgeon at Advanced Eye Hospital near Vashi, Navi Mumbai. He is trained from the best institutions and has years of experience managing glaucoma patients. Besides his clinical skills, his patients love him for his communication skills. He is a patient listener and empathises with each and every one. He has successfully treated a variety of glaucoma patients, children and adults, as well as operated more than ten thousand cataracts and glaucoma. Consult Dr. Rajesh Mishra by booking an appointment.
About Advanced Eye Hospital and Institute:
Advanced Eye Hospital and Institute in Navi Mumbai is one of the best eye hospitals in Mumbai. Comprehensive eye check-up and the operation theatres are state-of-art and equipped with the best diagnostic and surgery machines. Personalised care, infection free modular operation theatres and beautiful ambience complement the cutting-edge eye care offered at AEHI. Besides treating patients from Kharghar, Nerul, Vashi and Panvel, patients from all over western India travel to AEHI for world class eye care management.