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An Interview With Dr. Arup Kumar Das

Dr. Arup Kumar Das

Chief Medical Officer and Senior Ophthalmologist

Siliguri Greater Lions Eye Hospital

MBBS, MS(Silchar)

Specialization: General Ophthalmology, Cataract,

Oculoplasty, Trauma Care

Sir, first of all congratulations on Siliguri Greater Lions Eye Hospital becoming the first eye hospital in North Bengal to have been honored with NABH accreditation.

Before we start with any further questions can you please explain why NABH is so important today?

NABH or National Accreditation Of Board Of Hospitals & Healthcare Providers certification reflects the relentless efforts that a healthcare institution have undertaken to improve the quality standards in terms of excellence in treatment and patient safety at their hospital or healthcare facility. NABH is the apex constituent board of Quality Council of India, set up to establish and operate accreditation programme for healthcare organizations. The principle objective of NABH is enhancing health system & promoting continuous quality improvement and patient safety to build trust within our patients and set global benchmarks for progress of health industry.

So, can we call the hospital now COVID Safe?

Many ask us this question, whether precautions alone can promise zero infection. COVID Safe explains our preparedness to combat COVID keeping it at bay and yet continue to provide best treatment in a safe eye care space. To ensure this in addition to the NABH norms of quality and safety standards we are also following all WHO, All India Ophthalmic Society and ICMR rules and regulations to keep our hospital premises safe.

How would you suggest one could keep themselves and their eye healthy during these COVID times?

COVID has made us realize how less we can contest in the hands of the massive design of cosmos. Hence, the best way to keep yourself safe is align yourself with this natural process. Yoga can work miracle in keeping your physical and mental health intact and in conduit to nature. Being preventive and keeping your immunity strong are the only ways one can safeguard their health during these times. With our time spent outdoor or with friends reduced considerable we also need to find new methods of engagement. We have seen there has been considerable rise in hours spent by any person on television and mobile phone; also with this new culture of work from home your mental space has been constricted to home and to your laptop. But, watching any electronic screen for more than 6 hrs continuously can cause serious implications on your eye and mental health. In the medical field we call it 20:20:20 rule, that is after every 20 minutes of continuous engagement on an electronic screen one must look 20 feets away, better if you can look out of the window and completely disengage for atleast 20 seconds. Especially, in case of children make sure you do not help them make a habit of mobile phones or your daily soap just to make your life easy. Children below the age of 5 should not at all have a habit of mobile phones. Use this time more as an opportunity to bond better with your child, with other family members. We have almost forgotten how we ourselves grew up without any help of mobile phone. Our parents helped us engage with life fully and did not tried to give up on their responsibilities replacing it with an easier choice of a mobile phone. I believe they were far better teachers who told us bedtime stories, bestowed storybooks upon us, we played quiz with them and with our siblings and discussed our heart out on all subjects never seeing them tired or taking our curiosity as worry. We need a similar and a more responsible parenting today.

Especially, in North Bengal, Darjeeling and Sikkim there is a culture of indoor games like Carom, Chess, Ludo, Puzzle games. We are people known to have always encouraged art, philosophy at our home. Why not try again to shape your forgotten hobby. Write a poem, sketch something, start a diary not to write your everyday activities but to illustrate your idea of life and what according to you is your learning from it. Why not use this time to learn an art form from the internet, probably a new language. You can learn embroidery, painting, cooking or even learning to start a business of your own. I have a very close friend living in Delhi. Though a Bengali, he is born and brought up in Delhi and never got a chance to learn Bengali language. During the 2-month lock down he at the age of 47 learnt Bengali Font and writing it watching through Youtube.

Isn’t it wonderful! Being positive, having a fertile mind is the key to have a strong immunity to combat the surreal environment in which we are today.

Moving forward what are the problems in eye, which are synonymous to old age?

One thing we must know and address clearly is that all the problems discussed here can happen at any age and one must not ignore an eye condition based on its prevalence at a certain age. Older age may bring more susceptibility making you more prone to certain eye conditions but the need for eye care is constant irrespective of age and sex.

What Are The Common Causes of Vision Loss in Elderly Patients?

Considering ageing starts from your 40s, you probably would notice your vision changing and hence would require special caring to avoid the catching eye ailments with age. Perhaps you need glasses to see up close or you have more trouble adjusting to glare or distinguishing some colors. These changes are a normal part of aging. These changes alone cannot stop you from enjoying an active lifestyle or stop you from maintaining your physical involvement. But with your age, risk of developing age-related eye conditions increases. Especially, your vulnerability to acquire cataract eye increases with almost everyone developing a cataract eye at some point of their life. With India having the second highest population of people with diabetes, chances of Diabetic retinopathy have also increased many fold in past few years. People above the age of 40 are more susceptible to Diabetic Retinopathy and requires thorough retinopathy management to avoid visual impairment.

Cataract Is A Much Talked About Subject Today. But Can It Be Treated?

Cataract is a natural clouding of the lens in the eye. It can also occur at any age to anyone but it happens more with increasing age. In a country like India cataract still remains the most major cause of avoidable blindness which with timely intervention can be avoided.

However, Cataract occurrence itself is completely natural and is treatable only through surgical removal of cataract lens and replacing it with artificial intra ocular lens.

Many people complain that their vision has improved but were diagnosed with Cataract?

Yes, many times during the initial development of the Cataract the densing of the Lens causes near vision of the person improve, but subsequent deterioration of the distant vision is evident. Hence, the patient becomes ambiguous of his situation.

When we should know that the Cataract is mature enough to proceed for the Surgery?

The need to wait till the cataract is mature is a criteria of the past. Today, with recent advancements the medical fraternity encourages to complete your Cataract surgery immediately after diagnosis as soon as your Cataract reaches an operable stage.

Why can’t we wait till the Cataract matures? Are there any risks?

The maturity of Cataract determines many things including increased blurring or densing of the lens. A fully matured or a hyper matured cataract is also sometimes called Morgagnion Cataract. If ignored there have been many cases when the lens capsule ruptures causing Glaucoma in later stages. In any case, one should not wait till the cataract matures as it affects the inner structure of the eye. With the increase in hardening of the lens, it becomes voluminous and very dense. As a result, the surrounding tissues may also become unhealthy, which in turn makes surgery more difficult.

Aren’t there any eye drop to avoid Cataract to occur in the first place?

The only cure to Cataract is surgery. Though we respect alternative medicines but Cataract is a natural occurrence and cannot be cured or avoided by any kind of eye drop, or oral medicines or glasses. So, one must come out of their ignorance which prevents them to access treatment in time.

This is very different from what we have believed since long. Are there any other beliefs associated to Cataract?

Most often people believe Cataract operation should not be conducted in summers. It is associated to the discomforts that people witness due to their inability to take bath or keep themselves clean during the summer heat. But, today Cataract operation is so simplified that you are discharged on the same day. Can continue with your daily routine with little precautions including bathing.

Secondly, we often find parents blamed for their child’s cataract condition. Cataract can happen to anyone irrespective of his or her age.

Does Cataract even happens to a newborn?

Yes, cataract condition in a newborn child is called Congenital Cataract. Many times Cataract has been also seen developing in the early 5 years of a child. This condition is called developmental Cataract. It is a rare condition but Cataract in Children is a reality and is completely curable with surgery.

Speaking about children. How different is child eye care from adults?

Unlike adults, children haven’t seen the world yet and hence are unable to judge or explain if what they are suffering from is different from what normally we understand visual clarity is. Hence, it is the responsibility of the parent to be extremely sensitive, observing to understand if their child is suffering with any visual impairment. More than 80% of all visual impairment in children are avoidable and treatable if diagnosed early. Especially the first 7 years of a child are very crucial to opt out any chances of Amblyopia to ensure your child enjoys a healthy vision life long.

Lastly, we hear a lot about machine operated Cataract surgery, also know as Phaco surgery. What exactly is that? Does the machine do the surgery?

A Phaco machine only increases the precision of the surgery, aides the Doctor with more stability and hence reduces the risks of any error in a Cataract surgery. Let me explain in detail. Earlier, in traditional Cataract surgery also known as SICS, the Cataract Lens was extracted out using a special surgical knife which worked as a scalpel to incise into the lens capsule and scalp out the clouded lens. This process needed a bigger incision, and cutting of the Cataract to scalp it out which many times risked the tissues around the lens capsule.

The new Phaco machine uses sound waves coming through the fine Phaco probe(needle) to emulsify or dissolve the Cataract lens and then carefully sucking it out of the lens capsule. This makes the entire process lot more safer, incision smaller and puts lot lesser pressure on the eye tissue to take any damage making recovery 10 times faster. We have the most advanced Centurion Phaco machine in the entire region to help our patients have a safe cataract surgery.

Any last tips for our readers to keep their eyes healthy?

Like, health care in eye care also you need to undergo routine check-up twice a year. If your age is below 40 atleast undergo eye check-up one a year. Take proper sleep and more importantly timely sleep. There is no fixed sleeping hours and it varies person to person. If your body asks of 6 hours of proper rest then provide it with the same. Wash your eyes frequently and give them warm compress using the palms of your hands atleast after waking up and before going to bed. Practice the 20:20:20 rule as discussed before and try to keep yourself tension free always.

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