Retina is the innermost layer of the eyeball comprising of nerve endings and blood vessels. The main function of retina is to receive light, convert it into neural signals and send these signals to the brain for visual recognition.

Eye Anatomy

Retina needs to be examined by the ophthalmologist regularly especially if you have certain systemic or local issues. Some of them are listed below.

High Myopia (Nearsightedness) –

If the refractive error is more than -6.0D , there are chances that retina is overly stretched and that can cause breaks, tears or detachment.

Symptoms to look for – Floaters and Flashes of light

Diabetes –

Diabetic retinopathy (DR) -If blood sugar is poorly controlled, the chance of damaging the blood vessels in the retina is higher. This damage cannot be reversed.                        Factors which can worsen DR are- Pregnancy, Hypertension, kidney disease, Obesity, Hyperlipidemia, smoking and anemia.                                                                          Progression of DR can be controlled by controlling the blood glucose levels. Annual retina check is required in Diabetic patients. Certain patients may require Laser treatment or surgery to avoid blindness caused by DR.

Hypertension –

Hypertensive retinopathy (HR)- Uncontrolled hypertension can also be the cause of damaged retinal blood vessels.

Occlusion of the blood vessels in the retina and serious detachment of the retina are also manifestations of HTN.

Premature Newborn –

All infants born at less than 36weeks or weighing less than 1500 g who have received supplemental oxygen should be screened for ROP.

Sickle Cell Anemia –

Sickle Cell Retinopathy- The abnormal shape and rigidity of the red blood cells can cause the blood vessels to get blocked and hence causing damage further on.

Retinal Examination –

Your Ophthalmologist will do a routine vision test and then instill some drops in the eyes to dilate the pupils to be able to visualize your retina appropriately. Fundoscopy test will be done after the dilatation of the pupils.

The vision will be slightly blur after the test till the effect of the drops wear off (approximately 2-3 hours).

ANTIBIOTIC RESISTANT H1N1 PNEUMONIA SPREAD THROUGH COMMUNITY

H1N1 induced pneumonia leads to heart condition, timely treatment saves life of 64-year-old

Doctors at Ruby Hall Clinic Hinjawadi help senior citizen come back to life

Pune, 17th June 2019: 64-year-old Kamakshi Chettiar* was visiting Pune from her hometown in Kerala. Over the course of the next few days, her health seemed to be deteriorating with a constant bout of fever and wet cough that kept her up at night. She soon started developing chest pain. “There were days when I just didn’t know what was happening to me. I was already a patient of rheumatoid arthritis and the onset of cough and fever began to bother me consistently. I realised something was just not right when the chest pain escalated” said Mrs. Chettiar.

She was immediately rushed to the emergency department of Ruby Hall Clinic Hinjawadi wherein reports suggested the presence of H1N1. “Swine flu had already began affecting her body and no sooner than later we began a course of antibiotics and antivirals to help stabilise her. Within a few days, the patient seemed to be improving and was shifted to the ward,” said Dr. Javed Shah, Consultant Physician, Ruby Hall Clinic Hinjawadi. Unfortunately this was not the end of her problems, but the beginning of new ones.

Mrs. Chettiar’s breathing condition started deteriorating so much so that she started developing a respiratory spasm and needed to be shifted to the ICU. A diagnostic CT scan showed the presence of a condition known as necrotising pneumonia, a rare complication of bacterial pneumonia, in which tissue death (necrosis) begins to occur in the lung due to reduction in the vascular supply. The lack of blood supply due to damaged blood vessels impairs the delivery of antibiotics to the infection, allowing for further progression of the infection.

“Since this patient’s case was so severe, fluid had begun to build up in the space between the lungs and the lung lining, a space called the pleural cavity. This could not simply be drained with an intercostal drainage tube, we therefore injected her with streptokinase to dissolve this blockage. A fluid culture test revealed the presence of an MRSA (methicillin-resistant staphylococcus aureus) that becomes resistant to many of the antibiotics,” commented Dr. Sudha Desai, ICU In Charge, Ruby Hall Clinic, Hinjawadi.

Over the course of the next few days, Mrs. Chettiar’s health began to improve gradually, but the difficulty in breathing persisted along with high blood pressure. A 2D ECHO suggested a rather shocking result — her heart had a low ejection fraction of just 30%, i.e the heart wasn’t pumping to full capacity. As diagnosed by Dr. Desai, the patient was suffering from a condition known as ‘Takotsubo cardiomyopathy’, a temporary heart condition that develops in response to severe infection. It’s also known as stress cardiomyopathy or broken heart syndrome. The main symptoms are sudden chest pain, shortness of breath or fainting – usually after having severe stress — which explained the symptoms she faced.

Dr. Sudheer Rai, COO, Ruby Hall Clinic, Hinjawadi concluded, “Over the next 3-4 weeks, the patient settled and her heart condition too improved with the correct medication. This is one of the most rare cases medically and we’re proud of our entire team here at Ruby Hall Clinic, Hinjawadi. More often that not, we have seen that community-borne viral infections in the elderly become the cause of mortality and morbidity. Though senior citizens become more prone to these conditions, good medical management can help discover the root cause of the issue and eliminate further risk to health. We urge people to stay alert to any changes in their health to enjoy the golden years of their life.”

* name changed to protect patient identity