Macular Degeneration

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Rushabh Eye Hospital

The Eye...

The eye is like a camera. When you take a picture the lens in the front of the camera allows light through and focuses that light on the film that covers the back inside wall of the camera. When the light hits the film, a picture is taken.

The eye works in much the same way. The front parts of the eye (cornea, pupil and lens) are clear and allow light to pass through. The light is then focused on a thin layer of tissue called retina, which covers the back inside wall of the eye.


The Retina...

The retina is like the film in a camera. It is the seeing tissue of the eye. When the focused light hits the retina, a picture is taken. Messages about these pictures are sent to the brain through the optic nerve (the nerve of the eye), and this is how we see.

                                Light getting focused on normal retina


The retina has two parts: the peripheral retina and the central macula.
Macula lies in the central part of the retina. This is the only part of the retina capable of producing sharp and crisp image. Sharp and crisp image enables us to read, write, watch Television and drive.

                             Central part of retina (fovea/macula)


What Is Age related Macular Degeneration...

Age-related macular degeneration (ARMD) is the most common cause of irreversible vision loss in people over age of 60 years. Aging causes the cells in the macula to become less efficient.

There are two main types of macular degeneration, "dry" and "wet," which are discussed in the next section.

Dry type of Age related Macular degeneration...

The round deposits called drusen (degenerated material) appear beneath the retina . A few small drusen cause no decrease in vision. However, if many large drusen develop, vision may be decreased.

The dry type of macular degeneration presents with a slow, progressive loss of vision. In this type the vision remains stable and good for a longer period of time.

Macular degeneration at later stage

Drusen

.

 Wet type of Age related Macular degeneration :

In this type, abnormal blood vessels grow beneath the macula, they leak and bleed.
The "wet" form of macular degeneration can cause more severe visual loss. Vision may suddenly become distorted or blurred.


Causes of Macular degeneration :

Genetic, Age, Smoking may play a role.


Symptoms of Macular degeneration:

1. Initially patient may complain of seeing wavy or crooked lines or images.

2. Later on patient may have loss of central part of vision (may be slow with dry type and sudden in wet type of Age related macular degeneration).

3. Difficulty in reading, writing,watching TV.


How to diagnose Age related Macular degeneration :

AMD is diagnosed by:

1. A through eye examination.

2. Specialized test like FFA (Fluorescein Angiography) and OCT (Ocular Coherence Tomography) .

Eye Examinations:

Today's advances in medicine mean that more and more old people will be able to maintain good vision as they age. Since many serious eye conditions are treatable when detected at an early age, it is important to have periodic eye examinations, especially as one approach the sixth decade of life.


Specialized tests :

• Fundus Flurescein Angiogram: A special dye is injected in to the veins of the arm and when the dye is passing into the circulation of the eye, pictures are taken with the special camera.By examining the images captured by the cameras, the eye surgeon can determined the size and the location of the abnormal blood vessels in the retina.

• Ocular Coherence Tomography: To detect the swelling and bleeding blood vessels below retina.

Treatment for ARMD:
 Wet ARMD, is caused by leaking blood vessels, it needs to be sealed. It can be done by:

•     laser
•     Intra vitreal injections of Avastin or lucentis.

1. Laser: Earlier the recommendation was ARGON laser treatment or PDT

(Photo dynamic therapy) which did not give desired results.


2. The recent treatment is with special injections like Avastin / Lucentis.

These injections are antii-VEGF drugs that block the trouble-causing VEGF, reducing the growth of abnormal blood vessels and slowing their leakage.

The recent development of anti-VEGF medications have become a
path breaking advance in the treatment of wet AMD.Bevacizumab (Avastin) and Ranibizumab (Lucentis) are two very useful drugs. Most patients will retain the vision they have and some will regain some of the lost vision after these treatments.

Injection Lucentis/ Injection Avastin is injected as once every 6 to 8 weeks till the patients improve. Then the patients are evaluated after 3 months.The above doses generally take care of the acute need of treatment and no further injections are required, unless the condition changes over time.

The follow ups are simple and can be done by a local eye surgeon if not residing in our city. These procedures will help in restoring the sight.

Tips for AMD patients :

•  Making a few simple lifestyle changes will have positive effect on the quality of vision.
•  To make reading easier : Use bright focus light, e.g. focus light.
•  Shine the light on your reading material. Wear your reading glasses.
•  Incorporate dark leafy vegetables in your diet.
•  Stop smoking.
•  Monitor your vision daily with an AMSLER’S GRID. This is used to screen for macular degeneration.

How to perform Amsler’s Test:

•  Wear your reading glasses.
  
•  Hold the chart approximately 14-16 inches in bright light .
  
•  Cover one eye.
  
•  Look at center dot.
  
•  Note irregularities (wavy, size, gray. fuzzy).
  
•  Repeat the test with your other eye.
  
•  Contact ophthalmologist if you see any irregularities or notice any changes.

Normal Amsler Grid

                          
                                                                                 
                                                                            Grid seen by patients with ARMD

Have any queries please feel free to leave a comment subsequent response is assured.


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Diabetes And The Eye

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Rushabh Eye Hospital

Diabetes cannot be prevented in spite of lifestyle changes & healthier living but we can certainly prevent visionloss due to diabetic retinopathy.High levels of blood sugar can lead to early Cataract development and or can lead to a condition known as Diabetic Retinopathy.

Diabetic Retinopathy:

Nine out of ten people with diabetes will over a period of time eventually develops a complication that affects the eyes known as diabetic Retinopathy. This affects the retinal blood vessels and can lead to blindness, however if diagnosed and treated early much of this vision loss can be prevented.

How does diabetic retinopathy damage the retina...

Diabetic retinopathy occurs when diabetes damages the tiny blood vessels in the retina. At this point, most people do not notice any changes in their vision.Some people develop a condition called Macular Edema. It occurs when the blood vessels leak fluid and Blood onto the Macula(The central part of retina that lets us see in details). The fluid makes the Macula swell,thus blurring the vision.

Normal Retina

Diabetic Retinopathy

Bleeding on Retina

As these disease progresses, it enters its advanced or proliferative stage. Fragile, new blood vessels grow along retina and the clear, gel like vitreous that fills the inside of the eye.Without timely treatment, these new blood vessels can bleed, cloud vision and destroy the retina

Symptoms:

Diabetic retinopathy often has no early warning signs. At some point, through patient may have Macular edema. It blurs vision, making it hard to do things like read and drive.

                                                                                                                      Vision due to Diabetic Retinopathy

As new blood vessels form on retina, they bleed in viterous(clear jelly inside the eye) and blur vision. In extreme cases a person will only be able to tell light from dark in that eye. It may take the blood anywhere from a few days to months to clear.

Diagnosis:

Detailed eye examination and by doing specialized tests like Fluroescein Angiography and OCT (Optical Coherence Tomography). Angiography and OCT decide the stage and treatment of diabetic retinopathy.




Facility at Rushabh Eye Hospital:

Retinal Laser:

Digital Fluroescein Angiography:

                                                                                                                            Digital Fluroescein Angiography

In this test, a special dye is injected & pictures are then taken as dye passes through the blood vessels in the retina. This test is done to find out stage of diabetic retinopathy (to find the leaking blood vessels) and decide further line of treatment. Rushabh Eye Hospital & Laser Center has latest Digital Angiography.

Optical Coherence Tomography(OCT):

OCT can measure retinal thickness precisely and repeatedly.

Zeiss Tomography

It can measure minute changes, making it ideal for follow ups in retinal diseases, such as diabetes.Rushabh Eye Hospital & Laser Center is equipped with most advanced Zeiss-OCT system.

How is diabetic retinopathy treated...

The treatment for diabetic retinopathy include

1. Laser Treatment
2. Special Injections like Inj.Avastin
3. Surgery(Vitrectomy).

These are very effective in reducing vision loss from the disease. In fact, even people with advanced retinopathy have a 90% chance of keeping their vision when they get treatment before the retina is severely damaged.

Laser Treatment:

One of the most important and is one of the most widely used techniques.In early or non-prolifeartive stages the laser is used to seal leaking areas from the blood vessels. This is called as Focal Laser Therapy.

Vitrectomy:

A vitrectomy is performed if there is a long standing non absorbing vitreous hemorrhage(blood inside the eye).


Steps to prevent loss of vision in diabetics :

• It has been proved that better control of blood sugar levels slows the onset and progression of retinopathy and lessens the need for laser treatment or surgery.
• Co-existing high pressure can pressure can  speed up diabetic changes in the eye, so blood pressure also should be kept under control.
  
• Stop smoking:Smoking causes narrowing of blood vessels, which can aggrevate the diabetic changes in the eye.

Have regular eye checkups:

All patients with diabetes should have an thorough eye examination through dilated pupils at leats once a year. If patient has severe retinopathy, he/she may need to have a eye examination more often.


Have any queries please feel free to leave a comment subsequent response is assured. 

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LASIK Surgery - Laser Vision Correction

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Rushabh Eye Hospital

What is Lasik...

Lasik is a procedure that improves visionby changing the shape of cornea with laser and is a very effective treatment for a wide range of vision problems.

Why do people choose to have Lasik Surgery...

• Life simplification and independence: No longer having to deal with glasses or contact lenses.
• Performance: Ability to perform better in sports-related activities like cricket,football,squash.
• Ability to see when it counts: Certain professions like army, navy, airforce and railways require normal vision without glasses.
• Safety: With contact lens infections on the rise having clear vision Lasik is a favourable option.

What results can a person hope to achieve..

Lasik has proven overwhelmingly successful in reducing dependence on glasses and contact lenses.Clinical studies show that most LASIK patients(with mild to moderate prescriptions) have the potential to achieve 6/6 vision or near N/6 vision.Generally, this means they no longer need or have reduced their dependence on glasses or contacts to drive, play sports, watch movies and TV, or participate in careers requiring excellent vision.

Who is a good candidate for Lasik...

Lasik can treat very broad range of nearsightedness, farsightedness and astigmatism.The best way to determine who is a good candidate is with a thorough eye examination.

• Candidates must be 18 years or age of older.
• In good general health, and have good eye health with no diseases such as cataracts or glaucoma.

How long will the Lasik procedure take...

The Lasik laser vision correction procedure usually takes less than 15 minutes in the operating room. The actual laser time is approximately 1 minute.

Does the Lasik procedure hurt...

There is almost no pain involved with Lasik, but many patients find the procedure to be slightly uncomfortable. Anesthetic drops are used to numb procedure, the eye may feel a foreign body sensation or slight irritation for a few hours, like a grain or sand in your eye, but most patients are very comfortable shortly thereafter.

How is Lasik Done...

• After putting anestthetic eye drop, a partial thickness corneal flap is made with a microkeratome.

Flap Creation

•  Lasik is applied on the corneal bed.It corrects vision by reshaping cornea so that light rays focus precisely on the retina.

Laser Application

• 
  
  
  Flap is reduced back after completion of laser.Eye drops are put & patient goes home.
  
  
  
  

                                                                           

                                                                                  Flap Repositioning

What is the recovery process like...

Most Lasik patients usually see quite well the day following their procedure and may be able to resume most of their normal daily activities.

Are there any risks assosiated with Lasik...

Some temporary complications include conditions such as dryness, night glare, under or over-correction. The risks of surgery should be discussed fully with the doctor prior to the procedure. Additionally, proper post-opertive care helps to identify and address any potential healing complications.

Custom Lasik:

In custom Lasik a new standard for laser vision correction is achieved ,providing a precise& accurate level of measurement and correction never before possible. This new level of measurement is 25 times more precise and provides better vision than is possible with glasses or contact lenses.

Why Lasik Surgery at Rushabh Eye Hospital & Laser Center...

• 
  
  
  Eligibility criteria are strictly followed.
  
  
  
  
• 
  
  
  Each patient undergoes a thorough pre-Lasik evaluation.
  
  
  
  

The Lasik is done on US FDA approved VISX STAR-S4 excimer(http://www.visx.com/).

Have any quiries please feel free to leave a comment subsequent response is assured.

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Cataract

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Rushabh Eye Hospital

Today, Cataract Surgery is the most common & successfully performed surgical procedure in India.

What is Cataract...

Cataract is not caused by eye strain or reading too much, but is a result of aeging, injury, steroid use, exposure to UV light, smoking & diabetes.Almost every person develops cataract changes as the eye ages. It is a normal process of eye ageing.

Just behind the pupil of the eye is the lens. This focuses the light entering the pupil to make a clear image in the retina. The retina changes the image into a nerve impulse so that the brain can "see" it.Usually the lens of the eye is crystal clear so that light passes through it easily.
If any cloudiness develops in the lens then it starts to block the light passing through and the patient begins to get blurred vision.
This clouding of lens is called CATARACT. When the blurring gets worse it is better to have the cloudy lens removed by an operation and replaced by a clear artificial lens.

Symptoms of Cataract

1. Cloudy, fuzzy, foggy or filmy vision. Making daily activities like reading difficulty.
2. Colours appear dull and faded.
3. Problems driving at night because headlights seem too bright.
4. Problems with glare from lamps or the sun.

The only treatment option available for Cataract today is surgery.
Cataract surgery can be very safely performed in patients with Diabetes and or Glaucoma.

Surgical line of treatment: Phacoemulsification

The most advanced Cataract Surgery called phacoemulsification is a safe and straight forward process.It is performed without sutures through a micro incision in the eye and takes 7 to 15 minutes.

No discomfort is experienced during & none or minimal after the procedure. These are the benefits of the surgery today.

                                                      

Baush & Lomb Stellaris Phacoemulsification Systems

In Phaco surgery, a small ultrasonic probe is inserted into the eye.This probe breaks(emulsifies) the cloudy lens into tiny pieces and gently wash it out. This Cataractous lens is then replaced with a clear man-made lens.The new lens is inserted in the eye and it opens up like a flower. No stitches are used and the incision is self healing. Phaco requires a small incision of only 2.6 millimeters or less.
This technique is the most successful method of restoring vision following cataract surgery.

Advantages of "No Stitch" Phaco Surgery:

1. Does not require stitches.
2. Very Short Healing time up to 4-5 days only.
3. Chances of infection are minimal.

Types of IOL (Intra Ocular Lens):

Once the Cataract is removed, a permanent, artificial lens, called an intraocular lens or IOL is implanted.
There are two types of IOL available; non-foldable & foldable.

1. Non-foldable IOL:  Are made of a hard plastic material, are bigger in size & bigger incision is needed to insert them.
2. Foldable Lenses IOL: Are made of soft acrylic material. Patients who undergo Cataract surgery now also have option for 'upgrades' for intraocular lenses that have never been available in past. Foldable Lenses(IOL): Are either Monofocal or Multifocal

• 
  
         Monofocal IOL: Are designed to provide patients with enchanced distance vision but typically patients still require the use of glasses for near vision. A monofocal lens implant can fix your vision for one distance only. The implant can not change shape like your original lens. Thus, the patient has no ability to focus in or out and the patient will often be dependent on progressive bifocals for near vision
  
  
  
  
  
• 
  
        Multifocal IOL:  Are designed to provide patients who have a strong desire for greater independence from glasses  with multifunctional vision. A multifocal intraocular lens has both distance and near focal points. 80% of patients who get these lenses will never need glasses for any activity. Of those 20% of patients who need glasses for certain activities, 95% say that they would still get the bifocal lens because it gives them good vision for most activities at distance or near.
  
  
  
  
  
  

Post Cataract Care:

You will be permitted to go home within 2 hours after cataract surgery. The eye drops are started after the dressing in the evening or next morning.

1. Ther is no diet restriction.
2. Playing with children is to be avoided for a few days.
3. Do not rub the eye with hand or handkerchief.Use only tissues which can be used and thrown away. This prevents infection.
4. Head bath is permitted after 3 days of surgery.
5. The eyes should be kept clean after surgery, they should be wiped with cotton dipped in boiled and cooled water.
6. Hands should be washed with soap and water before putting the eye drops.
7. All activities at home are allowed after 2 days, including reading, writing, watching TV, cooking and taking an evening walk in non crowded areas.

Why at Rushabh...     


 Rushabh is a multispeciality eye hospital & offers the best services in eye care,services offered are:

• Cataract Services: By Phacoemulsification with Stelaris Baush & Lomb state of art machine foldable lens implantation.
• Corneal Services: The facility offers corneal transplantation
  
• Glaucoma Services: The Center is equipped with instruments like gonioscope, application tonometer, pachymeter(for central thickness) and state of art Humpry's visual fields analyzer-HFA 450 I with facility for blue on yellow perimeter.(This detects Glaucoma at very early stage.)
• Retinal Services: The hospital has facilities of Retinal angiography, OCT and retinal Lasers to detect and treat conditions like diabetic retinopathy, age related degeneration and other retinal vascular conditions at early stage.
• The Center is also equipped with following Lasers:

                  a. Yag Laser
                   b. Green Laser
                    c. Excimer Laser

 The center has VISX-STAR 4 Excimer laser system with B & L Topographer and Wave scan system for customized Lasik procedures.   The machine can safely remove spectacle numbers from +4.0 to -14.0 and is also capable of  treating high cylindrical numbers(astigmatism)

VISX-STAR 4

        VISX-STAR Excimer is a US-FDA approved machine for Lasik Surgery and is one of   the  most  modern machine and is first of its kind in Mumbai.

Have any queries please feel free to leave a comment subsequent response is assured.


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Eye Care In Children

Rushabh Eye Hospital

Vision is a gift to be cherished. Maintaining good vision and taking care of eyes is a relatively simple task.We help you to learn the art of taking care of your childs eyes and ensuring perfect sight for greater part of their lives.

What are common eye problems in childhood...

1. About 20% of children will have some spectacle number.
2. Some may have squint or crossing of the eye.
3. Child may have Amblyopia or Lazy eye.
4. May have congenital catarct or glaucoma.

All these makes periodic eye examination a must for a child.

When should a child undergo 1st eye examination...

One is recommended to get his child complete eye examination before the age of 5 years or early if any problem is noticed. While in school yearly evaluation is recommended.

How can a person know that their child has some vision problems or spectacle number...

If your answer is "YES" to any three of the following questions, your child needs a thorough eye examination.
Does your child -

1. Hold objects very close to his/her eyes.
2. Complains of headache after reading or watching TV.
3. Complains a blood vision while reading on school board.
4. Have difficulty comprehending what he/she has read.
5. Excessively rubs his/her eyes, blinks, squints after close work
6. Becomes tired after reading.
7. Have difficulty copying from textbook.
8. Have an eye that turns in or out.
9. Has red or watery eyes off and on.
10. Goes very near to TV while watching programs.

Few good tips for eye care in children-

1. Children should have a good posture while studying and reading adequate light.
2. Children should watch TV at a distance of atleast 6 feet or more(excessive TV watching or playing games on computer will lead to eye strain but will not spoil eye sight or induce spectacle number)
3. A good sleep of atleast 8 hours is a must for every child.
4. Children should take a well balanced diet, rich in natural vitamin A like carrot, spinach, papaya, milk etc. However, keep in mind no foods/ vitamins can revert back any refractive error.
5. To avoid eye strain small frequent breaks after an hour of studying are necessary.
6. Keep the child away from pointed objects, chemicals, cosmetics, medicines etc.
7. Children shouldnot rub or touch their eyes often as this could introduce infection.
8. No eye drop should be instilled in eyes without consulting the eye specialist.

Have any quiries please feel free to leave a comment subsequent response is assured.

For any further details please follow the link:

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Eye Care In Adults

Rushabh Eye Hospital

Periodic examinations with an eye care professional, atleast once a year are an essentail part of good preventive eye care; since most eye health problems have no early noticeable symptoms and can be diagnosed only through an eye check up. However, a few precautions can be taken to protect and maintain the heath of your eyes.

1. Protect your eyes from UltraViolet radiation

The suns rays are a boon, but over exposure to the sun's rays can cause earlier onset of cataracts,age related macular degeneration & conjunctival growths & pigmentation. The eyes can be protected from the sun's rays by wearing the right sun glasses which ensure U.V protection

2. Wear protective Eyewear

Every year, thousands of people suffer accidental eye injuries. Most eye injuries can be prevented by wearing proper eye protection. It is advisable to wear proper protective eyewear on the job, while doing potentially hazardous task at home such as putting nails on wall or working with chemicals and while playing sports with high risk of eye injury such as basketball, tennis, cricket. When fitted properly, eye protectors can reduce the risk of significant eye injuries by 90%.

3. Have a balanced diet

For your bodies overall good health, a proper well balanced diet is essential. The foods we eat provide us with a wide variety of vitamins amd minerals necessary for normal cell growth and repair.Nutritional imbalances in the circulatory system can affect the eyes. Vitamins and minerals found in fruits and green leafy vegetables have been shown to be good for our health and vision.

4. Avoid eyes strain while reading

To avoid eyes strain when reading, keep reading material at the best distance. Make sure that their is good light on your reading material and good room light as well. A light postioned behind and over one's shoulder works well for reading.Good posture while reading helps reduce eyestrain.Try to avoid reading while lying on your back, stomach or side. Also looking up from time to time from your reading can help your eyes relaxed.

5. Protecting your eyes from infections

Eye infection can be prevented by maintaining good hygiene. Hands must be washed as frequently as possible care must be taken during monsoon when eye infections are very common.Eye medication should be used only on the advice of the eye specialist and shouldnot be taken from any person not qualified to do so.

Have any quiries please feel free to leave a comment subsequent response is assured.

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Eye Care Facts and Myths

Rushabh Eye Hospital

There are numerous myths that have been told over generations and have generally come to be accepted as the truth. But when these misconceptions regarding eye care come in your way of living life as you want it, it is necessary to know the truth.

See how much you know about your eyes:

1. A computerized eye check up is all that I ever need...
 Answer:False

The most popular belief is that a computer is able to check your eyes. The only thing the computer can check is glass numbers. There are other important things that need to be looked at besides the glassnumber like your eye pressure, anterior segment(the front part of the eye), the retina, the visual field etc. Only a qualified eye surgeon can asses the health of your eye.

2. Reading in Dim light will hurt your eyes...
Answer: False

Using the eyes in dim light doesnot damage them. It wasn't too long ago that all night time reading and sewing was done by candle light or with gas or kerosene lamps. Everyone should use good lighting.
This makes reading easier and prevents eye fatigue.

3. Using computers will not damage your eyes...
Answer:True

Using computers or video display terminals will not harm your eyes. However,eyes strain or fatigue may develop with prolonged periods of close work or reading. Taking a break, and looking up or accross the room at frequent intervals usually relieves the strain. If your vision blurs or your eyes get tired easily you should have your eyes examined by an ophthalmologist.

4. Eating carrots will improve your your vision...
Answer: False

It is true that carrots are rich in vitamin A, which is essential for sight; however,many other foods also contain vitamin A. Only a small amount is necessary for vision. A well balanced diet, with or without carrots,provides all the nutrients necessary for good vision.Excessive doses of vitamin A,D or E may even be harmful.

5. Diabetes does not affect the eye...
Answer: False

Diabetic eye disease is the 2nd most common cause of treatable blindness after cataract. Diabetes affects the back portion of the eye called retina & goes through 3 stages before vision gets affected dramatically.Having a regular eye check up is the only way diabetic changes can be detected in the eye.

Have any quiries please feel free to leave a comment subsequent response is assured.

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10 Eye Saving Tips For Every Computer User

Rushabh Eye Hospital

Do you know that prolonged exposure to computer can lead to:
           
                1. Dry Eyes
                2.Itching
                3. Iritation
                4. Watery Sensation in eyes.

These problems are commonly addressed as Computer Vision Syndrome(C.V.S); which is very common problem with every user due to prolonged exposure or usage of computers, the altered life style and change in their work environment.

So are you a prolonged computer user?If  Yes:

Then there are 10 significant steps one can follow:

Step 1. Eyes to monitor- the Ideal distance:
Your computer monitor should be straight in front of you ideally at a distance of more than 25 inches from your eyes.

Step 2. Monitor Location:
The ideal viewing area of the monitor is 6 inches, below the horizontal eye level.

Step 3. Font color selection:
Preferably work with fonts of darker shades on light background & vice versa.

Step 4. Anti-glare screen:
Attach an anti-glare screen in front of the monitor which will decerease the amount of light reflected from the screen.

Step 5. Document holder:
Use a screen mounted document holder,positioned between keyboard & monitor screen almost at the same distance & height as that of the monitor.

Step 6. Light effect:
Use suspended lights from ceiling & windows with shades, blinds or curtains. Avoid light hitting directly on eyes.

Step 7. Sitting posture:
Use chairs with armrests which are able to provide, support while typing, position of head slightly titled downwards & height of the chair adjusted appropriately so that the feet rest flat on floor.

Step 8. A.C. distance:
Avoid sitting at a location with direct blow of air on eyes from a blower or an A.C. or for a long period in a room with low humidity.

Step 9. 20-20-20 rule:
Take a short breaks for your eyes every 20 minutes between your work for 20 seconds than look at objects that are at least 20 feet away.

Step 10. Eye exercise:
Close your eyes & slowly roll your eyeballs clockwise & anticlockwise.Repeat it for three times.

Have any quiries please feel free to leave a comment subsequent response is assured.
For any further details please follow the link:

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