Detailed patient information about the procedures performed by Dr. Laavanyaa Somasundaram — cataract surgery, intravitreal injections, and retinal laser treatment.
The human lens inside the eye is normally crystal-clear. Light passes through it and focuses precisely on the retina, giving sharp vision. A cataract is a clouding or opacity that develops within this natural lens over time.
As the cataract progresses, the lens becomes increasingly opaque, scattering and blocking light so it can no longer focus clearly on the retina. The result is progressively blurred, dimmed, or glare-affected vision.
Good news: Cataract is one of the most treatable causes of blindness. Surgery is safe, quick (10–15 minutes), and the results are excellent when performed at the right time.
Phacoemulsification (phaco) is the gold-standard technique for modern cataract surgery. The cataract is broken up by ultrasound energy through a tiny self-sealing incision (~2.2 mm) and aspirated out, after which an artificial lens (IOL) is folded and inserted through the same incision.
Topical anaesthesia means that only anaesthetic eye drops are instilled into the eye before surgery. There is absolutely no needle injection around or behind the eye. The patient remains awake, comfortable, and cooperative throughout the procedure.
| Feature | Topical (drops only) | Needle injection |
|---|---|---|
| Pain from anaesthesia | None — just drops in the eye | Needle prick around the eye |
| Risk of needle injury | None | Small but real |
| Eye patch after surgery | Usually not needed | Often required |
| Vision recovery | Often same day or next day | 24–48 hrs minimum |
| Patient cooperation | Awake and comfortable | May feel pressure/anxiety |
Key advantage: With topical phacoemulsification, many patients are surprised to find they can see clearly within hours of surgery and need no eye patch at all.
After the cataractous lens is removed, it must be replaced by an artificial intraocular lens (IOL). Choosing the right IOL is one of the most important decisions in cataract surgery — it determines your vision quality for the rest of your life.
| IOL Type | Far Vision | Intermediate | Near Vision | Astigmatism Fix | Reading Glasses |
|---|---|---|---|---|---|
| Monofocal | ✓ Excellent | — | — | — | Yes, always |
| Toric | ✓ Excellent | — | — | ✓ Yes | Yes, for near |
| Multifocal | ✓ Good | ✓ Good | ✓ Good | Toric variant | Usually not |
| EDOF | ✓ Excellent | ✓ Excellent | Partial | Toric variant | Rarely, for fine print |
Corrects vision at one distance — typically distance (far) vision. You will still need reading glasses for near tasks. Most reliable, proven technology, most cost-effective option. Ideal for patients who are comfortable with glasses for reading.
A monofocal lens with a built-in astigmatism correction. Patients with significant corneal astigmatism who want to reduce dependence on distance glasses benefit most from this lens. Reading glasses are still required.
Uses concentric zones of different focal powers to provide vision at near, intermediate, and far. Many patients achieve spectacle-independence for most tasks. Best suited for motivated patients willing to adapt to the optics. Some patients notice halos around lights at night — this usually fades within weeks to months.
Rather than creating separate near/far zones, EDOF lenses extend the range of clear focus smoothly from far to intermediate. Fewer halos than multifocal, with excellent distance and computer vision. Most patients still need glasses for very fine near print (reading small text).
Dr. Laavanyaa's approach: The best IOL depends on your lifestyle, job, hobbies, and eye measurements. During your pre-operative assessment, she will discuss your daily visual needs and recommend the most suitable lens for you personally.
| Drop Type | Frequency | Duration | Purpose |
|---|---|---|---|
| Antibiotic | 4 times/day | 2 weeks | Prevent infection |
| Steroid | 4 times/day → taper | 4–6 weeks | Reduce inflammation |
| NSAID | 3–4 times/day | 4 weeks | Reduce inflammation & pain |
| Lubricant | 4–6 times/day | 3–6 months | Comfort & surface healing |
Seek urgent review if you notice: sudden pain, sudden decrease in vision, redness increasing after Day 3, flashes of light, or floating objects in vision after surgery.
If a monofocal IOL is used (which corrects only one distance), you will need reading glasses for near tasks. This is expected and normal — not a surgical failure.
Your spectacle prescription stabilises over 4–6 weeks after surgery. Do not get reading glasses before the 4–6 week review, as the power may still be settling.
With multifocal or EDOF IOLs, most patients can read, use computers, and see at distance without glasses. Some may still need glasses for very fine print or in low light.
Using reading glasses after a monofocal IOL is not a problem — many patients are delighted to have excellent distance vision (for driving, watching TV, outdoors) and simply wear glasses to read, just as they do for everyday life.
Schematic cross-section
Normal vs. cataractous lens
IOL types
Retinal fundus — as seen on examination
An intravitreal injection is the administration of a small volume of medication directly into the vitreous cavity — the gel-filled space inside the eye behind the lens. This delivers high concentrations of the drug exactly where it is needed: at the retina.
This approach bypasses the blood-eye barrier that prevents most oral or intravenous drugs from reaching the retina in effective concentrations.
The injection itself takes under 60 seconds. The entire clinic visit including preparation takes about 30–45 minutes. Most patients are pleasantly surprised by how manageable the procedure is.
Intravitreal injections are not a one-time treatment — most conditions require a series of injections followed by ongoing monitoring. Dr. Laavanyaa will tailor the frequency based on your OCT results and disease activity.
| Condition | Typical Loading Phase | Maintenance |
|---|---|---|
| Wet AMD | 3 monthly injections | Every 1–3 months (PRN/T&E) |
| DMO | 3–5 monthly injections | As needed based on OCT |
| BRVO/CRVO | 3 monthly injections | As needed |
| Myopic CNV | 1–3 injections | Often no further injections |
OCT imaging is performed at each visit to monitor fluid levels in the retina and guide treatment decisions.
Pan-Retinal Photocoagulation (PRP) is a laser treatment used for advanced diabetic retinopathy, particularly when new, abnormal blood vessels have formed on the retina (proliferative diabetic retinopathy) or in the drainage angle of the eye.
These fragile new vessels (neovascularisation) are prone to bleeding, causing vitreous haemorrhage and potentially retinal detachment. PRP laser destroys the oxygen-deprived peripheral retina, eliminating the signal that drives new vessel growth.
Goal: PRP does not restore lost vision, but it significantly reduces the risk of further vision loss from vitreous haemorrhage and traction retinal detachment. It is a sight-saving, not sight-restoring, procedure.
Focal laser targets individual leaking microaneurysms in the macula (the central retina responsible for fine detail vision). Grid laser applies a grid pattern of laser burns to areas of diffuse retinal oedema.
These techniques have largely been complemented by anti-VEGF injections for diabetic macular oedema, but laser remains useful for focal leaks and as a combined therapy to reduce injection frequency.
| Feature | Laser (Focal/Grid) | Anti-VEGF Injection |
|---|---|---|
| How given | Laser light through slit lamp | Fine needle into vitreous |
| Sessions needed | Often 1–2 sessions | Multiple (monthly) |
| Best for | Focal leaks, mild/moderate DMO | DMO with central involvement |
| Vision improvement | Stabilises, modest improvement | Often significant improvement |
Retinal tears and holes are weak spots in the retina through which fluid can seep underneath, causing the retina to detach. Retinal detachment is a serious emergency that can result in permanent vision loss.
Preventive laser barricade creates a ring of laser burns around the tear or hole. These burns form a scar that seals the retina to the underlying tissue, preventing fluid from entering and causing detachment.
Urgent warning: Sudden onset of many new floaters, flashes of light, or a curtain/shadow across vision should prompt same-day or next-day ophthalmology review. Treated early, a tear can be sealed with laser. Left untreated, it can progress to retinal detachment requiring major surgery.
Follow-up is scheduled 1–4 weeks after laser to confirm the reaction is satisfactory and the retina is sealed.
Call or WhatsApp Dr. Laavanyaa's clinic to discuss your specific condition and the best treatment plan for you.