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Before going for the Trek & Treat Campaign (Eye Health Screening Camp in remote areas of Nepal) I had some idea about what I would be seeing in those remote villages of Nepal. I was already aware of the fact that many remote places of Nepal are still deprived of basic health care services. I knew that the things we keep hearing on radio and televisions about people dying without getting a mere ORS solutions (Jeevan Jal) is still prevalent in many of such rural areas of Nepal. I also knew that there are many people whose blindness that can be prevented are still living their life in darkness. I always knew that there are people in those remote areas who does not have enough money to come to the city for their treatment. But is knowing things just enough?? Can we do something better than just knowing things? Hopefully we can !!

Let me tell you our journey of the first Trek & Treat Campaign. After 5 hours of hiking from RARA Lake we reached Khatyad, a remote village of Mugu District. The only means of transportation were the mules and there were no signs of proper health care centers around. We were trekking from RARA to Khaptad and Khatyad was on our way of the trekking route. We were prepared with our basic screening instruments and medicines to carry out our first screening camp at Khatyad and it was during our screening camp that I really felt upset about the health care system of our country about which I already knew before. We saw a 28 days old child who had injury in her left eye and needed immediate surgical intervention. Though the treatment of such cases are usually done at free of cost, the parents did not have enough money even to travel to the city. Sadly, the child passed away the next day without proper treatment facility in the village. Knowing things and seeing things were now completely two different things for me. After what I experienced being in that village for a couple of days made me realize that if I do not take things seriously now and work harder to solve this problem (at least the problem of eye health care service from my side) then I would be no different than other people who just know things but do nothing.

We now have dreamt of making Trek & Treat a nationwide health care campaign to reach those people who needs us. To make this happen we need help from everyone around us. Some of us here are Optometrists, Ophthalmologists, Physiotherapists, Cardiologists, Writers, Photographers, Content Creators, Bloggers, Drivers, etc, etc. If we can all just spare about couple of days from our busy schedule and work together to help those in need then we can indeed make places like Khatyad a better place with better facilities.

Changes come from ourselves. Please be the change and lead others to make the change.

Optometrist & OrthoKeratology Practitioner with passion for Music, Singing, Songwriting, Photography & Travelling. I am also a founder of Lubhu Eye Care and is associated with SEED Contact Lens (a Japanese Contact Lens Manufacturing Company)

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Health&Sports

Top 5 things to do while living in Kathmandu Valley

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Photo by WeRoad on Unsplash

Kathmandu, being the city of temples amuses much of the tourist just by its sheer beauty. The culturally rich capital of Nepal is nothing short of spectacular when witnessed for the first time. Some by choice other by necessity, the capital is house for thousands of people. For those who have been here for a while, those historic temples and squares start to look usual.

Living in the capital might have its perks but once in while break from this monotonic life is more than just necessity. If you been living here and ran out of the things to do inside the classic valley and seeking for something adventurous and challenging then these can be your next weekend plan.
Plus visitnepal2020 is on its way and we got to build internal tourism as well.

5. Cyclicing to Nagarkot:

Approximately 30 km from the valley Nagarkot has become the go to location for many tourists and valley residents for spending some quality time. Though readily available bus ride to the location had made it more convenient and acc

essible, for the more daring youths, cycling trip has its own fun. The elevation change is about 800m on 30 km length which is fairly challenging. Typically a days trip is enough to reach and get back to the valley. But to those who want more than just tiring ride, spending a night over and getting back with the memories of sunrise and sunset imprinted is just as worth it.

4. Himalayan white water rafting:

The fresh water rivers and tributaries of Nepal are not only famous for hydropower. These rivers hold totally different significance for traveller and adventurers. The white water rafting is one of the must do task for everyone. Not so far from the capital, one can have a days tour to few days experience of the thrill. All the arrangement can be found within the capital and one can simply jump in for a day or two and enjoy the power of the ride and win over the rivers. Typically Bhotekoshi and Trishuli river are easily accessible by kathmandu dwellers.

Link: http://www.himalayanriverfun.com/

3. Wall climbing in Thamel:

Not all of us has the whole day for spare but that shouldn’t be discouraging you to get in on some adrenaline rush. Astrek Wall Climbing, Thamel is the tallest wall climbing in the whole country and its so close to the city that it is impossible to miss. No prior experience requirements so one can simply jump in and have a completely safe and fun climbing. Team of experts are there for guiding and the place offers other accommodations too.

Link: https://astrekclimbing.com/

2. Dhulikhel Zipline:

Just 3 km from kathmandu, the zipline is possibly the easiest choice on the list. 1100 meter flight with wings spread like a bird, this is the closest on can come to flying. Handled by the team of experts this place offers both single and couple zipline services so if your significant other is as crazy as you then this can be your next adventure together.

Link: https://world-wideadventure.com/

Photo Courtesy: World Wide Adventure Pvt Ltd

1. Bungee Jump and Canyoning:

Hands down, this is the best thing to do if you are an adrenaline junkie with a busy schedule. Jumping from the Bhote Kosi suspension bridge into the open air with straps holding on to you and your life isn’t anything less than pure crazy and courageous act. Though the description itself sounds thrilling, the real tradeoff in this bravery is the epic sense of flight one can get from it. Nothing quite like it. Completely safe and easily accessible as the main office is in ktm and all the transport and accommodation arrangement are done here, bungee jumping or canyon swing whatever it is, you gotta try at least once. The Last resort offers other services too which are equally amazing.

Link: https://www.thelastresort.com.np/home/

(Kmagz, is in no way connected to the company that offers the services and is not paid for mentioning them. So it do not bear any responsibilities for their actions.)
Continue Reading

Health&Sports

Myopia Management & OrthoKeratology

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on

If you are wearing glasses, you surely do remember your first visit to your eye doctor. Many of you might have been prescribed spectacles or contact lenses as a remedy to the refractive correction (Glass Prescription). As a small kid, I remember my eye care professional prescribing me a -0.75 refractive correction (lens power) when I was around 11 years old.  By the time I was 20 years old, my refractive correction was -2.75.  I always used to wonder and ask myself why my refractive correction was increasing even though I was wearing spectacles as prescribed by my eye care professional.  Could this -2.00 Diopter of increase in power have been controlled?  Is there any way we can help children of 4 to 5 years, already having -1.00 Diopter of correction, stop them from becoming high Myopic (>-6.00 D) when they grow? Should we really worry about myopia control in children? What are the risk factors that comes after having a high myopia?

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We have to be asking all these questions now and try getting the answers.  One of the reasons of Myopia progression is due to the elongation of the eyeball with its increase in axial length.  Myopia control wizards (Optometrists) have been trying their best to control this phenomenon of increasing the axial length of the eye ball to control the Myopia progression. Controlling Myopia does not just improve the patient’s quality of life but it also prevents vision threatening conditions like retinal detachments and retinal maculopathy.  Now, the question arises how do we control this normal phenomenon of the elongation of the eyeball? Luckily for us, many researchers has already found a way to control this phenomenon by various methods.

  1. Simply get out of your room and play outside:  Sounds simple yet very effective. If you want your children, brothers or sisters to be less vulnerable to refractive error, then send them outside to play. Though the exact reason for this is not known yet, many researchers have found out that spending just about 10 to 12 hours a week outside the room and indulging in outdoor activities helps to reduce myopia progression in Children.Hence, taking kids out of their digital gadgets and spending time outdoors can be beneficial in reducing Myopia progression.
  2. Low Dose Atropine: A low dose atropine of 0.01% is considered to be really helpful in controlling the progression of Myopia. The ATOM & LAMP trials study has shown that low dose atropine of 0.01% & 0.05% is more effective than 1% atropine with much less side effects and rebound effect. 2, 3
  3. Multifocal Contact Lens: The use of center distance design Multifocal Contact Lenses helps to reduce the elongation of the eye ball by creating a myopic defocus in the periphery of the retina. With normal spectacle and contact lenses, hyperopic defocus is created in the peripheral retina which makes the peripheral retina to elongate in order to focus the light rays into the retina. The center distance multifocal lenses has high add in the periphery which corrects this hyperopic defocus and pushes the light rays in front of the retina creating a myopic defocus which helps to control the elongation of the axial length of the eye ball.
  4. OrthoK Lenses: The OrthoK lenses corrects the Myopia by flattening the center of the cornea without the need of surgery. As in LASIK surgery, the OrthoK lenses helps to flatten the central corneal area which corrects the Myopia. The peripheral cornea creates a myopic defocus that helps to control the Myopia progression as well. The OrthoK lenses are the gold standard treatment for myopia control and is also one of the options for myopia correction.

Why should we worry about Myopia Progression?

Myopia progression today has become a topic of discussion for many of the eye health care practitioners. It is estimated that by the year 2050 about half of the world’s population will become myopic. So, if something is not done to control this progression, we will be seeing rise in more and more myopic patients in the days to come. But why should we actually worry about Myopia Progression?

With this digital age, children today spend most of their time in their electronic devices which is turning them into an early Myopes. We are now getting myopic cases more than ever. It is common to find more than -1 Diopter of Myopia in children of 5 to 6 years. If this is not corrected and controlled, these children are bound to become high Myopic at the age of 18. With high Myopia comes the high risk of many eye health conditions like Cataract, Glaucoma, Retinal Detachment & Maculopathy.

The only goal of Myopia Control & Orthokeratology is to stop these children from progressing from -1 Diopter to -6 or -7 Diopters.  If we can start Myopia Control now, the Myopia progression can be controlled by more than 50% and these children can be saved from the risk factors of high Myopia.

Conclusion:

We are treating Myopia as a refractive error but now it’s time to take myopia as a disease and start treating it and help those children from progressing their myopia to become high Myopic. If you are a parent, brother or sister of a young myopic child, then please do start talking about myopia control with your eye health care professionals. Pediatric Ophthalmologists along with Optometrists who practices Myopia Control can stop the progression of Myopia. Refractionists and Ophthalmic Assistants can help you find if your children has any refractive errors and will refer you to the Myopia Control practitioner.

 


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References:

      1. Wu PCChen CTLin KK, et al. Myopia Prevention and Outdoor Light Intensity in a School-Based Cluster Randomized Trial. Available from: https://www.ncbi.nlm.nih.gov/pubmed/29371008
      1. Li FFYam JC. Low-Concentration Atropine Eye Drops for Myopia Progression. Available from: https://www.ncbi.nlm.nih.gov/pubmed/31478936
      1. Yam JCJiang Y, et al. Low-Concentration Atropine for Myopia Progression (LAMP) Study: A Randomized, Double-Blinded, Placebo-Controlled Trial of 0.05%, 0.025%, and 0.01% Atropine Eye Drops in Myopia Control. Available from: https://www.ncbi.nlm.nih.gov/pubmed/30514630
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Health&Sports

Things to know before buying a Soft Contact Lens

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When we get a prescription for refractive correction we start thinking about spectacles. Spectacles has become a very good means of correcting refractive error but sometimes we do want to break free from the glasses and enjoy our coffee without the fog, enjoy rain without the blur & enjoy the dance floor without worrying about the glasses. There are various other options that we can choose if we are fed up with the spectacles. The very first option that I, as an Optometrist suggest to my patients are Contact Lenses. But before buying Contact Lenses we should always know about these wonderful invention and the way to handle it.

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Should I buy Contact Lenses Online?

We find a lot of online stores selling contact Lenses these days but is it a right way to get your contact lenses? If I was an owner of an online store I might have said, “Contact Lenses are just like spectacles you can buy anywhere you want if you have the prescription” but being an Optometrist I know the risk of buying contact lenses without proper fitting and evaluation of your eye health conditions. Buying your contact lenses is fine if the seller can arrange an eye examination from an eye health care practitioner who is authorized to dispense contact lenses but it can lead to serious complications if you buy those contact lenses without consulting with a contact lens practitioner.

How long can I wear a Contact Lens?

If you can understand how long you can stay underwater without oxygen then you will get your answer of how long a contact lens can be worn. This is just an analogy but when the Contact lens sits in front of your eye ( the Cornea ), the time that it can be worn depends upon how much oxygen can be passed into the cornea through the contact lens. This is determined by the property of the contact lens material called Oxygen permeability (Dk). When contact lenses are made with the material having certain Dk the amount of oxygen that will go through that contact lens will now be dependent upon the thickness of the contact lens which will be termed as oxygen transmissibility (Dk/t). So every material with which the contact lens is made has a Dk value.

Now the actual question of how long a contact lens can be worn will be dependent upon the dk/t value of the lens.

For Daily Wear modality lenses ( lens that are worn on day for 10 to 14 hours ), the Dk/t value according to Holden & Mertz criteria is 24 x 10-9

For Extended Wear Modality lenses ( lens that are worn overnight while sleeping ) the Dk/t value according to Holden & Mertz criteria is 87 x 10-9  

Another thing to know in order to understand how long you can wear a contact lens is to know the replacement schedule of the contact lens. This means when you should dispose your lenses.

There are currently four contact lens replacement schedule:

  1.  Daily Disposable Contact Lens
  2.  Biweekly Disposable Contact Lens
  3.  Monthly Disposable Contact Lens
  4.  Yearly Disposable Contact Lens

The daily disposable lenses are worn and disposed every day. So you can wear a fresh pair of lenses every day. This type of contact lens usually come in a 30 or 32 piece lens in a box. Some of the Contact lens also comes in a small eco pack of 4 to 8 piece lens in a box. These lenses are the most recommended contact lens to wear because of very less chance of infections and other complications because every day the lenses are disposed and a new one is worn. Because these lenses are daily disposable you will not need any lens care solution to clean these every day. Simply dispose it and use a new pair of lens. Do Not wear the same daily disposable lenses more than 1 day.

The biweekly disposable lenses are worn and disposed in every two weeks. That means you store these lenses in a lens storing case for 2 weeks and get a new pair after 2 weeks. The lenses are worn each day for 8 to 14 hours depending upon the contact lens material and removed and stored in a lens case after cleaning. The lenses should be cleaned with a lens care solution every day before wearing and after removing during the 2 weeks period time of wearing. These lenses will come in a 6 piece lens pack. That means when you buy one box of biweekly disposable lens you will have 6 lenses to wear and each lens can be worn for 2 weeks. Do Not wear the same biweekly disposable lenses for more than 2 weeks.

The monthly disposable lenses are worn and disposed in every one month. Similar to biweekly you should clean these lenses every day with lens care solution for the period of one month and dispose it at the end of the month and wear a new one. The lenses are worn each day for 8 to 14 hours depending upon the contact lens material and removed and stored in a lens case after cleaning. These lenses will also come in a 6 piece lens pack and you can wear each lens for 1 month.  Do not wear the same monthly disposable lenses for more than 1 month.

Yearly disposable lenses are not prescribed in western and developed countries now a days because of high chances of infection and complications than other disposable lenses. They usually come in a pair and the same lens is worn for a year. Similar to monthly and biweekly these lenses should be cleaned every day with a lens care solution. These lenses are not usually recommended to wear.

In short, while buying a contact lens you should know which replacement schedule contact lens you need ( daily, biweekly, monthly or yearly) and when to dispose it. Before buying any lenses make sure you have a detailed eye examination and after buying the lenses make sure you are taught how to correctly insert and remove the lenses with proper maintenance and lens handling.

Summary:

Contact Lenses are great alternative for your spectacles. There are daily disposables, biweekly disposables, monthly disposables and yearly disposables contact lens currently in market. Make sure to choose the right one with the help of your Optometrist. Don’t buy any contact lens without consulting with an Optometrist and make sure you are taught the proper way of lens care and maintenance. A good Optometrist will always help you to make you comfortable with your contact lens.

( Only Soft Contact Lens is discussed in this article. There are many other contact lens which are used as specialty contact lenses )


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