1. Articles 13 min read

   A Beginner's Guide to Ultrasound Biomicroscopy

   Introduction: Anterior segment ocular imaging has gone through various inventions starting from the ultrasound in the 20th century to the recent AS- OCT.1 Ultrasound bio-microscopy, one of the ocular imaging devices is a high-resolution technique, which allows in vivo assessment of the structures of the anterior segment of the eye where cross-sectional images of ocular structures are obtained at microscopic resolution. 2The higher frequency of UBM ranging between 35 and 50 MHz, gives a depth of about 4 mm and an axial and lateral resolution of approximately 25 and 50 microns, respectively. 3 Being a non-invasive technique, efficient regardless of the clarity of the optical media and due to its portability can be performed both in adults and children with no complications.4 The internal acoustic characteristics of UBM, accompanied by the very fine backscatter speckle patterns, permit clear differentiation of ocular tissue at various levels.5 UBM imaging has been very useful in understan

   Dr. Sowkath Ali · Dr. Eunice Goh · +1 other
2. Anatomy of eye 21 min read

   Anatomy of Uvea

   Uvea is the middle vascular coat of the eyeball. From anterior to posterior, the uvea or uveal tract can be divided into three parts- Iris, Ciliary body, and choroid. The name “uvea” has originated from the Latin word grape. Why a grape? If the stem is removed from a grape, the hole looks like the pupil and the grape the eyeball. Iris : Iris is the anterior-most part of the uveal tract. It is a thin and circular structure which forms a diaphragm like structure in front of the crystalline lens. The word “iris” has originated from a Greek word. In Greek mythology, the iris is the name of the Greek goddess of the rainbow. The diaphragm formed by the iris contains a central aperture known as the pupil. The location of the pupil is not exactly central, its little nasal to the center. The pupil determines the amount of light entering the eye. The normal size of the pupillary aperture is 3-4 mm. Details on the pupil will be discussed in chapter "Pupil". Iris is attached to the middle of the a

   Dr. Parthopratim Dutta Majumder
3. Articles 30 min read

   Clinical Applications of Multicolor Imaging

   Multicolor imaging (MCI) is a non-invasive retinal imaging modality available in the Spectralis platform (Heidelberg Engineering, Heidelberg, Germany). It simultaneously acquires three reflectance images of the retina using three individual lasers of different wavelengths: blue (488 nm), green (515 nm), and infrared (820 nm). These penetrate the tissue to different depths, simultaneously capturing and depicting information originating from different retinal structures. The infrared reflectance (IR) image visualizes structures at the level of the outer retina and choroid. The green reflectance (GR) image allows imaging of retinal blood vessels, hemorrhages, and exudates. The blue reflectance (BR) particularly provides details of the inner retina and the vitreoretinal interface such as epiretinal membranes, retinal nerve fiber layer (RNFL) thinning, and macular pigment changes. The information from these three images is integrated to form a composite multicolor image.1 Color fundus photo

   Dr. Sugandha Goel · Dr. Rupak Roy
4. Articles 19 min read

   Cytomegalovirus Retinitis Simplified

   Introduction: Cytomegalovirus (CMV) retinitis is an opportunistic viral posterior uveitis that occurs mostly in severely immunocompromised Acquired Immunodeficiency Syndrome (AIDS) patients or, rarely, in those on immunosuppressive therapy after organ transplantation, or who are on systemic corticosteroids.1 More than 75% of AIDS patients with CD4+ counts less than 50 cells/?L have CMV retinitis. It is the most common ocular opportunistic infection in AIDS patients and accounts for 75-85% of all CMV end-organ disease.2 Before the introduction of Highly Active Antiretroviral Treatment (HAART), 30% of patients with Human Immunodeficiency Virus (HIV) developed CMV retinitis during their lifetime, but with the advent of HAART, there is a 75% reduction in the number of new cases of CMV retinitis.3 Rarely, CMV retinitis may occur in non-HIV patients having some degree of immune dysfunction, such as advanced age, diabetes mellitus, corticosteroid, and non-cytotoxic immunosuppressive drug usag

   Dr. Swapnil Parchand · Dr. Anil Gangwe
5. Articles 36 min read

   Viral Uveitis: Ready reckoner for the Postgraduates

   Viral ocular infections can cause sight-threatening diseases in humans either as an isolated ocular infection or as a part of systemic illness. Although many viruses may naturally be harbored in human beings, the common ones causing ocular infections include herpes simplex virus (HSV), varicella-zoster virus (VZV), and cytomegalovirus (CMV). They may remain dormant for several years with periodic asymptomatic virus shedding in immunocompetent individuals. However, in situations where the immunity is reduced due to age or, comorbidities, the symptomatic disease can occur. Ocular damage is caused by the direct cellular damage by the virus itself or the inflammatory response to the infection. Virus-specific T lymphocytes as well as humoral immunity with specific antibodies help to control the acute infection. Here we look at anterior and posterior viral uveitis in two separate sections and the common causative viruses. Viral Anterior Uveitis ( VAU) Introduction Anterior uveitis (AU) is th

   Dr. Vinita Rao · Dr. Gazal Patnaik
6. Articles 13 min read

   Dos and Donts In Managing Cluster Endophthalmitis

   “Everything in life has some risk, and what you have to actually learn to do is how to navigate it.” -Reid Hoffman The above quote holds true for any surgical procedure whether minor or major. The biggest fear of any surgical intervention is that of infection postoperatively. Infection can occur in the best of hands and also in the most modern operating rooms. Cataract surgery is one of the most common intraocular surgeries performed in India and around 90% of postoperative endophthalmitis occurs after cataract surgery. 1 Acute endophthalmitis is severe intraocular inflammation presumed to be due to the entry of microbes into the eye during the perioperative period. It is identified usually in the initial weeks after surgery and could present as a red painful eye with severe anterior uveitis, often with fibrin and hypopyon, and vitritis. It is one of the most serious postoperative complications of intraocular procedures and, despite treatment, often results in a very poor visual outcom

   Dr. Dhaivat Shah · Dr. Meghna Jain
7. Articles 8 min read

   Learn from the Masters : Viral Keratitis Decoded

   Viral Infections are more commonly encountered in individual practice than what presents in tertiary or referral eye care. Its presentation is myriad & baffling often a misdiagnosis as bacterial or fungal causing more harm. Also, with more choices on the availability of antivirals, individual practice varies. Here we discuss key presenting clinical features & know from the leading cornea experts their preferred treatment practices. Dr. Manisha Acharya is a practicing ophthalmologist hailing from Delhi. She received her MS degree (2003) from Jawaharlal Nehru Medical College, Aligarh following which she completed her fellowship at Dr. Shroff’s Charity Eye Hospital. She has also been trained at– Bascom Palmer Eye Institute, Miami, Florida, and LVPEI, Hyderabad. She is currently working as Senior Consultant, Department of Cornea and Refractive Surgery with Dr. Shroff’s Charity Eye Hospital, New Delhi. Apart from being a proficient corneal surgeon, Dr. Acharya is the Medical Director of the

   Dr. Jaya Gupta
8. Interesting Reads 5 min read

   Word Root : Origin of Ophthalmic Terms

   The study of the origin of word is known as etymology. Most of the ophthalmic terminology is derived from Greek and Latin words. Most probably Hippocrates (460-370 BC) was the first to use specific ophthalmic terms that we are still using nowadays. He has been credited for using the terms like amblyopia, hippus, nystagmus & phthisis. Similarly, terms like canthus, exophthalmos, glaucoma, and leukoma are thought o be the contribution of Aristotle (384-322 BC). It was Galen (13 l-201 AD) who used the terms like chalazion, chemosis, iris, mydriasis, pterygium, strabismus, and trichiasis. Here in this section, I have compiled some terms of ophthalmology with their root of origin. Canthus = Greek word “kanthas” = angle Levator palpebrae superioris = In Latin, “levator” = to lift, “palpebrae” = an eyelid, superioris = upper Caruncle = Latin word means flesh. Plica semilunaris = Latin word “Plicare” = to fold, “semilunaris” = half moon. Tarsus = Greek word means flat, Ancient greeks used to c

   Dr. Parthopratim Dutta Majumder
9. Articles 14 min read

   Various Classifications and Grading Systems in Oculoplasty

   Introduction: Grading & Classification of diseases is an ever-evolving concept. This article is a collection of various clinical grading and Classification systems in the practice of various Oculoplasty and Orbital diseases. These grading systems are useful for Trainee doctors, PG students, PG residents, and optometrists which will help them in preparations of various examinations and the initial phase of their clinical practice for systematic management of various oculoplasty cases. Commonly used classifications in oculoplasty are: Classification of Entropion Classification Ectropion Classification Ptosis Classification of Contracted Socket Classification of Eyelid Tumor Classification of Facial Nerve Palsy Classification of TRO Classification of Orbital Cellulitis Entropion : Entropion is a common eyelid malposition in which the margin turns inward against the globe. Two other conditions that are close to it is trichiasis and distichiasis which must be well differentiated from trichi

   Dr. Joyeeta Das
10. Articles 14 min read

    Valved Drainage Devices for Pediatric Glaucoma

    Introduction Pediatric glaucoma includes a wide variety of conditions that result in elevated intraocular pressure and optic nerve damage, ranging from primary congenital glaucoma since birth to developmental glaucoma associated with other diseases and acquired glaucoma secondary to multiple causes. Depending on the age of the patient, it presents with particular features and circumstances that need to be taken into account and frequently require surgical intervention. Glaucoma drainage implant surgery has a definitive role in managing infants and other children with glaucoma refractory to angle surgery and trabeculectomy. GDDs are even preferred nowadays as a primary procedure in selected cases where other surgeries are contraindicated or have very few chances to succeed. Furthermore, it has been found that 20% of pediatric glaucoma patients often require 2 or more surgical procedures for adequate IOP control, and GDDs are frequently used in the second or third surgical attempt.1 Glau

    Dr. Rinal Pandit · Dr. Abhay Raghukant Vasavada

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