Thonburi Bumrungmuang Ophthalmology and LASIK Center provides diagnostic services for diseases and eye disorders in both children and adults and is capable of treatments and surgeries in complicated cases. Equipped with a team of doctors specialized in Opthalmology, state-of-the-art tools, and trained healthcare professionals, we commit to standardization for effective patient care.

Medical Services

Ophthalmology and LASIK Center, Thonburi Bumrungmuang Hospital, diagnosis and treatment of eye diseases such as:

• ◼️ Optometry
• ◼️ Examination for general eye diseases such as cataracts, glaucoma, optic nerve disorderse
• ◼️ Eye treatment in children
• ◼️ Eye Health Screening for vision disorders
• ◼️ Screening and treatment of diabetic retinopathy
• ◼️ Intravitreal injections for retinal diseases
• ◼️ Glaucoma surgery
• ◼️ Pterygium surgery
• ◼️ Cataract surgery and replacement of artificial lens with phacoemulsification
• ◼️ Surgery for vision disorders with ReLEx CLEAR technology
• ◼️ Other surgeries such as eyelid and eye socket treatment

Tools & Technology

Optical Coherence Tomography

A laser optic terminal cross-sectional image analyzer, or OCT, is a tool used to take retinal imaging to assess the characteristics of the retina. The structure of the optic nerve terminals and optic nerve fibers It helps in the diagnosis and monitoring of the progression of retinal diseases, glaucoma, and other disorders of the optic nerve and visual aggregation points.

In diagnostic examination, the machine performs retinal imaging using low-energy laser light in a 3D cross-section, allowing the ophthalmologist to examine the thickness of the retinal layer and the pathology of the retina. Diagnosis of eye diseases with a laser optic nerve cross-sectional analyzer can diagnose eye diseases as follows:

• Glaucoma: An eye disease in which patients are usually unaware of the risks including people over the age of 40 who have chronic inflammation in the iris and have a family history of glaucoma.
• Age-related macular degeneration: More common in people over 50 years of age. It is a major cause of vision loss. More incidences were observed with increased age.
• Diabetes-related retinopathy: A major cause of vision problems and vision loss. It is caused by prolonged hyperglycemia resulting in capillary dysfunction in the retina, leading to other disorders that follow.
• Epiretinal membrane or Macular pucker: A type of fibrosis that occurs on the surface layer of the retina, whereby this fibrosis may be enlarged and pulled around the retinal surface causing vision disorders, especially in the central retinal area (Macula).
• Cystoid macular edema: A complication of conditions such as diabetes and venous thrombosis in the eye.
• Macular hole or detachment: With age, vitreomacular traction may occur and cause degeneration of vitreous jelly. he vitreous jelly in the middle of your eye starts to pull away from the retina and macula at the back of the eye leading to macular hole and affects vision.

Cataract

What is Cataract?

Cataract is when lens which are normally clear becomes clouded. This generally happens as you age especially after 40. With cataracts, activities become more difficult. Reading, driving, and event reading facial expression will be harder than usual thereby affecting adversely on quality of life. There are many types of cataracts in which seeing Ophthalmologist is very important to accurately diagnose and plan appropriate treatment for each individuals.

Risk Factors

1. 1. Smoking
2. 2. Overexposure to Sunlight or UV
3. 3. Diabetes
4. 4. Prolonged Steroid usage
5. 5. History of eye trauma or accident

Symptoms

Cataract’s symptoms are apparent as what you see have changed from normal:

• Blurred, Clouded, dim vision
• Seeing halos around lights
• Sensitive to lights
• Double vision
• Difficult seeing at night
• Need brighter light to read
• Changes to the way you see colors such as fading or yellowing of sights

Treatment

If the symptoms are mild, glasses or contacts prescription by an Ophthalmologist may be sufficient. If the symptoms become a problem, the main treatment of cataracts is surgery which is mostly done in out-patient setting and does not require admission. Consultation with Ophthalmologist together with patient’s preference can be planned accordingly.

When to see a doctor?

If you think you have cataracts, appointments should be made with an Ophthalmologist to receive the right diagnosis. Symptoms which may need you to see a doctor include:

• - Blurred sights when looking at things from afar
• - Rapidly changed nearsightedness until you need multiple glasses changed
• - Unclear vision in bright light
• - Double visions
• - Changes to how you see color especially yellowing of sight

Pinguecula and Pterygium (Surfer's Eye)

What is Pinguecula and Pterygium (Surfer's Eye)?

Pinguecula and Pterygium is a raised growth on your eye’s conjunctiva or the white part of the eyes. If the growth is confined to just the conjunctiva, this would be called Pinguecula. If the growth is wedged or triangular-shaped growing from either corner of the eye and spread outward to the cornea or the clear part of your eye, this would be called Pterygium also known as Surfer’s eye. The size will depend on the blood vessels running to the cornea. Most cases for both conditions usually grow from the corner closest to your nose.

Risk Factors

• ◼️ Continuous exposure to Ultraviolet light (UV)from sunlight
• ◼️ Chronic eye dryness and irritation

Symptoms

 Pinguecula

• ◼️ Small white or yellow growth in white part of the eye
• ◼️ Dryness
• ◼️ Redness

 Pterygium

• ◼️ Wedge-shaped growth that extends onto the cornea
• ◼️ Irritation
• ◼️ Redness
• ◼️ Feeling of having something in the eye
• ◼️ Late symptoms include increased in the size of lesion and blurred or double vision

Treatment

Treatment for both Pinguecula and Pterygium depends on the severity of the disease. If the size is small and symptoms are mild, no significant irritations and normal vision, preventing further disease progression is recommended by protecting the eyes from UV exposure. Sunglasses are important in protection against UV exposure.

        If signs of inflammation are seen, your Ophthalmologist may prescribe a topical eye solution to alleviate the irritation and other symptoms. In case, Pterygium extended further into cornea with an increased size and inflammation, Ophthalmologist may recommend surgical treatment in Outpatient setting which takes around 30 minutes and rest for observation around 3-6 around on case-by-case basis.

When to see a doctor?

If you notice any change in vision or think you might have pinguecula or pterygium, make an appointment to your Ophthalmologist to confirm diagnosis whether it requires just monitoring, symptomatic treatment with medication, or surgical treatment.

Glaucoma

What is Glaucoma?

Glaucoma is a group of eye conditions where the optic nerve is deteriorated and damaged which may result in loss of vision. This damage often relates to the high pressure in your eye. Glaucoma is also one of the leading causes of blindness around the world. Glaucoma has many subtypes therefore it is important to see your Ophthalmologist to receive proper diagnosis.

Risk factors

• ◼️ Race: African-American had higher risk than Caucasian by 6-8 times. Asian is prone to have open-angle glaucoma
• ◼️ Age more than 40
• ◼️ Family history
• ◼️ High pressure in eye
• ◼️ History of eye trauma and accident
• ◼️ Steroid medication usage
• ◼️ Other risk factors such as farsightedness and nearsightedness, thin cornea, diabetes, migraine

Symptoms

In general, glaucoma does not exhibit symptoms or warning signs in early stages. Glaucoma can be separated into two groups: Open-angle glaucoma and angle-closure glaucoma.

1.Open-angle glaucoma is the most prevalent type of glaucoma. Most will not exhibit symptoms in early stage. The optic nerve gradually deteriorates, and the patient will gradually lose their sight slowly with fog-like blindness at the side for many years until they are completely blinded.

2.Angle-closure glaucoma can be found lesser than open-angle glaucoma. Typical symptoms are acute pain, red eyes, seeing halos around the light, and experience nausea and vomiting. This type of glaucoma can be cured by receiving early treatment with an Ophthalmologist.

3.Other types of glaucoma include Primary congenital glaucoma in newborn or children and glaucoma secondary to other eye diseases and complications.                

Treatment

Glaucoma can only be treated by means of reducing eye pressure to allow drainage of fluid in the eye. The damaged optic nerve is irreversible and cannot be cured. There are 3 ways to treat glaucoma:

1. 1. Topical Medication to reduce production of fluid in the eye or increase drainage of the fluid to reduce eye pressure
2. 2. Laser treatment to control eye pressure and increase fluid drainage. An ophthalmologist treats with laser when the topical medication does not work.
3. 3. Surgery is the last resort if laser treatment does not work. Two approaches can be done, to increase fluid drainage with various surgical technique or use drainage tube to help.

When to see a doctor?

If you experienced blurred vision, halos, light sensitivities, vision loss, you should make an appointment with an ophthalmologist as soon as possible. If symptoms came suddenly with severe headache and eye pain, this may suggest acute angle-glaucoma and treatment is immediately needed. Contact emergency room or ophthalmologist immediately.

AMD

What is AMD (Age-related Macular Degeneration)

AMD is a disorder of the small central portion of your retina or “macular” resulting in loss of vision at the center. Mostly found in age more than 65. AMD is an incurable condition and decreases ability to see until the patient is completely blinded within 2 years if left untreated. If the condition is found in one eye, the other eye has 40% chance of having AMD within 5 years.

Risk Factors

1.Age in more than 50 years old

2.Family history – recommended to have eye checkup annually

3.Race and gender – found mostly in European and American and in woman more than 60 years old

4.Smoking increase risk by 4 times

5.High blood pressure – patient who needed to take blood pressure and lipid lowering drugs with low serum carotenoid level is at high risk for Wet AMD

6.Menopause – woman entering menopause and did not take hormone replacement (estrogen) is at risk

Symptoms

AMD is classified into two groups: Dry AMD and Wet AMD

1. Dry AMD

• ◼️ Most prevalent type of AMD from degeneration and thinning of macular
• ◼️ Initial symptom includes blurry vision and needing more lights for each activity. Some patient may start with little blurry vision and deteriorates gradually over time.

2. Wet AMD

• ◼️ Accounts for 10-15% of AMD
• ◼️ Fast progression to lose sight and leading cause of blindness from blood vessel growth under the retina
• ◼️ Blood and fluid leakage under retina results in edema of central macular and patients will start seeing distorted sight at the center, discoloration, and may see black spot
• ◼️ The optic nervous cell eventually dies, and blindness will be permanent

Treatment

Dry AMD

As of today, there is no cure for Dry AMD, only to delay progression of the disease by controlling the risk factors and follow up with your ophthalmologist for regular eye checkup.

Wet AMD

Several treatment options are available for Wet AMD

1. 1. Laser Photocoagulation

    To inhibit or delay disorder in blood vessel causing leakage under the retina. The area of retina in contact with laser treatment will be destroyed with heat causing permanent dark spot immediately after treatment. This treatment option would be recommended for the disorder occurred far from the macular.   

2. 2. Photodynamic Therapy (PDT)

    Medication will be administered through vein into circulation system and binds to the abnormal cell which multiplies at the blood vessel wall under the retina. Then the patients will receive phototherapy to catalyze medication in destroying abnormal blood vessel which does not affect the retina. Patients can still see like before receiving treatment and in some mild cases can have visions restored back to near normal state.

3. 3. Intravitreal injection of Anti-Vascular Endothelial Growth Factor (Anti-VEGF)

    Eye injection with Anti-VEGF to inhibit growth of blood vessel for disease control. Initially the drug has to be administered at least 3 times per month and every 2-3 months in later stages.

1. 4. Surgery

    Surgery is done in case bleeding occurs under the macular by administering medication to help loosen blood clot and injecting gas to push blood out of the macular.

When to see a doctor?

If you notice changes to your central vision and changes to the way you see colors and fine details, make an appointment to see an Ophthalmologist as soon as possible.

Ptosis

Ptosis or sagging eyelids It is a common abnormality of the eyelids. It may be found in one eye or both eyes. in the case of both sides The patient will look like a sleepy person.

Symptoms of ptosis

In general, ptosis is not painful. But will affect the quality of life due to decreased vision

Blepharoplasty caused by serious diseases such as Myasthenia gravis may also be accompanied by other symptoms, such as double vision. Weakness of arms or legs, difficulty speaking, breathing or swallowing

ptosis in children May cause lazy eye (Amblyopia) if the eyelids fall closed It may block vision or cause blurred vision or strabismus, which may affect eye movements.

Eyelid conditions are categorized according to the following causes:

Hereditary or from abnormalities during pregnancy

The tendon of the muscle that lifts the eyelid sags or slips from the island. Make muscle eyes are not strong Excess fat therefore accumulates in the eyelids and under the eyes, causing the eyebrows to droop, eyelids, and bags under the eyes. It is the most common cause of ptosis in adults.

Musculoskeletal disorders, such as muscle weakness or nerve inflammation

Behaviors that cause eye muscles to stretch or injury, such as eye allergies, rubbing eyes frequently, wearing contact lenses with improper curvature or allergic to contact lenses due to poor cleaning or wearing contact lenses for a long time

Eye surgery or eye surgery that affects the muscles that open the eye

Treatment of ptosis with eyelid surgery

Treatment by eyelid surgery to correct ptosis. The surgeon will operate the eyelid to adjust the adhesion position. or increase the lifting force of the muscle fascia that lifts the slipped eyelid. and or stretch This may be done in conjunction with partial surgery of the sagging eyelid skin. which obscures vision or lifting and tightening the deep layers of the face, especially around the eyebrows

Femto Robotic Cataract Surgery

Bamrung Muang Hospital Eye Center uses FEMTO LDV Z8 technology to optimize bladeless cataract surgery. By virtue of its outstanding features in terms of low energy consumption. Create tenderness to the corneal tissue. and increase accuracy for higher efficiency and safety

treatment

o The ophthalmologist will carefully plan the treatment. The computer generates three-dimensional images using a high-resolution laser cross-sectional imaging (OCT) camera to determine the characteristics of each patient's eye and cataracts.

o The doctor uses a FEMTO LDV Z8 laser to create an opening in the front layer of the lens sac. The opening on the lens cover is small and the edges are smooth, reducing the risk of tearing.

o Doctors use FEMTO laser to break down the cloudy cataract lens into small pieces. Then open the lens cover. Use a low-power ultrasound phacoemulsifier. The lens is then quickly sucked out through a small opening in the cornea.

o A permanent implant suitable for the patient is inserted for better results. especially in the case of wearing multifocal intraocular lenses

The whole process generally takes 15 minutes for the eyes. Vision will improve by 80-90% the next day.

Video Femto Robotic Cataract Surgery

Business days and hours : Monday - Sunday from 8:00 a.m. to 5:00 p.m.
Place : Eye Center and LASIK, 4th floor, Thonburi Bamrungmuang Hospital
Ask and make an appointment with a doctor : Tel. 02 220 7999 ext. 84220