First for the country from Maastricht University, Netherlands
Our own City’s Doctor Dr. Rohit Shetty has made Bengaluru proud by successfully defending his doctoral thesis work, a Ph.D on Tears & Keratoconus. He is the first in the country to earn a Ph.D in Medicine and the only Indian to have achieved it from the University of Maastricht, Netherlands. It is the immense passion to contribute towards the betterment of humanity that inspired him to take up this unique path breaking Research conducted on tears which help predict and prevent the one among progressivedisease of the eye, Keratoconus.
Ophthalmologists Dr. Rohit Shetty, Vice Chairman of Narayana Nethralaya, as a part of his research and thesis has done an extensive study of tear samples&he has discovered that, many new things can be decoded from a few tear drops. In his early practice, he had several young distressed patients visiting him with hazy vision and frequent headaches from trying to focus. Keratoconus (derived from a Greek word: Kerato which meant Horn or Cornea and Konos meaning cone) was severely affecting the way they saw the world, making simple tasks, like driving, watching TV or reading a book difficult.
What are the findings & Purpose of Ph.D?
1) Finding Genetic Cause (We found two novel genes)
2) Tears as a source of Information about this disease
3) New Therapeutic agents (drugs) for prevention & treatment
4) Extensive work on finding the right treatment
5) Work on Allergy in children which comes as a factor in development of this disease
Symptoms of Keratoconus
1) Frequent change of glasses (3-5 times a year)
2) Not happy with the glasses
3) Scattering of Images
4) Slow loss of Visual fields
5) More dryness, leading to rubbing of eyes
6) Seen in the age group of 10 to 35 years.
7) Seen more in females
8) Seen more during Pregnancy
Importance of this Disease
1) High visual disability in age group of 10 to 35 years
2) High in females
3) Loss of productivity in early age
4) Mostly among urban population
5) 45 to 60 % of transplants are due to Keratoconus
Importance of the research in the future of Keratoconus
1) Genetic testing
2) Preventive Medication
3) Work Style modification
What is Keratoconus?
Keratoconus is a condition in which the cornea, which is the front surface of the eye starts bulging outwards abnormally, and it does not allow the light to be properly focused on the retina blurring the vision. It cannot be corrected with eye glasses or even in the late stages with contact lenses.
It is a genetic disease in many cases and sometimes it is also seen in patients or in children who develop allergy, prompting them to rub their eyes, aggravating the issue. “The year 2007 saw more than 50 patients with the disorder in our clinic alone. The numbers have increased to 8 to 10 patients per day now. It is most common among youth less than 35 years of age, most of them from urban area. It was observed that only 1 % of them were diagnosed with genetic disorder and the remaining 99 % were allergies due to excessive exposure to Computer Screens, electronic gadgets and addiction to smartphones which all led to dry eyes” says Dr. Shetty.
With a focus on conducting early diagnosis to prevent vision loss, Dr. Shetty began his research in 2004. Titled “Understanding the clinical immunological and Genetic Molecular Mechanisms of Keratoconus”, he collaborated with Maastricht University, Netherlands in 2013 and worked with Prof Rudy Nuits. The research bagged him the prestigious Col. Rangachary Award at the All India Ophthalmological conference in February 2015, the highest research award for Research in Ophthalmology.
In the initial stages, it is best treated conservatively by giving contact lenses. There are some other surgical procedures too. However, there are different types of contact lenses but, normally gas permeable lenses are preferred. Now a days, there are special Keratoconus lenses called as scleral lenses that are available. They fit the cornea very well, giving good quality of Vision.
“When contact lenses were invented around 1888, the treatment of Keratoconus became one of the first practical applications. French physicians manufactured glass that improved vision by compressing the cornea into more regular shape. Since these treatment options did not halt the disease process, several cases needed more advanced methods, which led to corneal transplantation for a Keratoconus patient. Doctors have achieved large breakthroughs with treatments like C3R and Intacs. Cornea transplant is the last resort for patients who reach the last stages of Keratoconus. 45 % of the transplants in the world is due to Keratoconus. To prevent the progress of disease of Keratoconus, it is always imperative and important to treat it as soon as it is detected, so as to prevent its progress and make it stable. The main reason behind such high numbers of Keratoconus cases is lack of awareness,” Dr. Shetty observes.
“When we tell someone what we have diabetes, they may not understand all the implications but, they recognize the name and have some idea about it. But, when we talk to someone who has Keratoconus, they would not have the faintest idea of what we are talking about. I have participated in outreach programmes that were dedicated to both finding a cure for Keratoconus and providing treatment for the financially needy patients. However, not enough is done to raise awareness of the condition in India” regrets Dr. Shetty. With this research, he has taken baton of promoting awareness about the condition, not only through medical advice & information but also by treating them. Dr. Shetty is aims at devising cost-effective screening tests and affordable treatment options for these community outreach programmes.
About Dr. Rohit Shetty
Dr. Rohit Shetty completed his basic medical education from Kempegowda Institute of Medical Sciences, Bangalore, & Postgraduation (DNB) from St. John’s National Academy of Health Sciences, Bangalore. He subsequently did a neuro-ophthalmology Observership at UC Irvine (USA) and a Refractive surgery Observership at University of Mainz, Germany. He did his FRCS (Glasgow) in 2006. He is a member of KOS, ASCRS, and International society of electrophysiology and vision. He has around 100 publications in national and international peer reviewed journals. His other interests include Refractive surgery, Clinical Electrophysiology, Neuro-ophthalmology and Clinical research.He is currently a senior consultant and Vice Chairman of Narayana Nethralaya.