Having questions regarding your eye? The following will definetly help you

Brinzolamide and Brimonidine eye drops are anti glaucoma medication to control the eye pressure in glaucoma. Individually they can reduce the pressure by around 20%. How ever when used in combination its effect is lesser than the arithmetic sum of its individual efficacy. Both these drugs are considered second line medication as efficacy in terms of reducing the eye pressure is lesser than the first line drug. First line drugs for glaucoma are prostaglandin eye drops( Travaprost/ bimatoprost and Latanoprost) and beta blocker eye drops( Timolol). Prostaglandins can reduce the pressure upto 35% and beta blockers upto 25% when used independently. Hence first line drugs are preferred over second line drugs in the initial treatment of glaucoma unless there is a contraindication for the first line drug.

Antiglaucoma medications are used as a single medication or in combination depending on the amount of pressure required to be reduced in an individual patient. This depends on the initial eye pressure at diagnoses, age of the patient and the amount of optic nerve damage that has already happened.

Most of the multifocal and trifocal lenses work on diffractive technology. Here certain proportion of light from distance, intermediate and near are focussed simultaneously on the retina. In prepresbyopic aged patient( < 40 years), the normal crystalline lens changes its shape with the input received from the brain to focus on a particular distance. Hence at a time, it focusses 100 percent of light from distance or near or intermediate .This is not possible with artificial multifocal lens which cannot change its power to focus at a distance of interest at that particular time. Hence simultaneous focussing of multiple distances are done by diffractive multifocal technology. This allows only a part of the light to be focussed from a particular distance and light from multiple distance are focussed simultaneously. As a result the brightness of image and quality of vision ( contrast sensitivity is affected) in diffractive multifocal technology. Furthermore a small proportion of loss of light energy occurs in multifocal IOLs due to inherent property of diffractive multifocal lenses. This affects vision during dim illumination.

With few limitations in diffractive multifocal technology, it needs a perfectly functioning eye to give a good performance in multifocal IOLs. Any eye disease which limits quantity and quality of vision is a contraindication for multifocal IOL. Severe dry eye, irregular astigmatism, corneal opacity, large ange alpha and kappa, zonular weakness, any optic nerve disease including glaucoma and retinal diseases are medical contraindications for multifocal IOL.

Halos and glare associated with diffractive multifocal IOL can cause night driving problems. People who have to work in low illumination, drive frequently at night and looking for crisp vision are not suitable for multifocal IOL

Multifocal and trifocal IOLs are suitable for people who have a strong drive for not wearing glasses for reading as well as distance and vision and are willing to accept few limitations of the multifocal IOL. Hence eye surgeon does not suggest multifocal IOL to all the patients.

Squint ( deviation of the eye) is often associated with spectacle power. If inward deviation of the eye (esotropia) is associated with plus spectacle number ( hypermetropia), then squint is likely to be corrected by spectacle( accommodative esotropia). If outward deviation(exotropia) is associated with minus spectacle number then squint is likely to improve with the prescribed glasses. However the eye needs to be evaluated by the eye specialist to under what type of intermittent squint( occasional deviation of the eye). Certain types of squint improves with spectacle use. One needs to know whether it is a plus 3 spectacle number or minus 3 spectacle number and also whether it is inward or outward deviation of the eye. Furthermore complete orthoptic work up including assessment of AC/A ratio is required especially in inward deviation of the eye. Consult your eye specialist for detailed evaluation.