1. Articles 24 min read

   Corneal Dystrophy: A Ready Reckoner for Postgraduates

   Corneal dystrophies are classically defined as a group of inherited disorders of the cornea which is bilateral, symmetric, slowly progressive, and not related to any environmental or systemic factors.1,2 Most of the corneal dystrophies begin in the early decades of life and progress gradually. The effect of these changes in some of the dystrophies may not be clinically apparent till the later years. The underlying basis of all corneal dystrophies are genetic mutations some of which have been mapped, while others are yet to be identified.1-3 Most of these mutations result in the transcription of aberrant proteins. These proteins are deposited in various corneal layers and give rise to the characteristic clinical features. The pace of deposition also determines the natural history of the corneal dystrophy. Corneal dystrophies were first reported by Groenouw in his article published in 1890.1 He described one patient with granular corneal dystrophy and another patient with macular corneal

   Dr. Samrat Chatterjee
2. Articles 21 min read

   Therapeutic Keratoplasty : A Comprehensive Review

   Microbial keratitis is a common vision-threatening disease that occurs in all parts of the world and is an important cause of avoidable corneal blindness. Medical therapy is considered a mainstay in the management of microbial keratitis, however, cases that worsen despite medical therapy or have perforation require surgical management1. Therapeutic keratoplasty is a surgical procedure whose primary purpose is to get rid of the infectious or non-infectious inflammatory tissue along with the restoration of the structural integrity of the eye (tectonic support)2. The surgical procedure, postoperative course, and chances of graft survival in therapeutic keratoplasty are different from optical keratoplasty as surgery is performed on an inflamed eye. Therapeutic keratoplasty could be Therapeutic Penetrating Keratoplasty(ThPK) Therapeutic lamellar keratoplasty- Deep Anterior Lamellar Keratoplasty(Th-DALK) Patch graft In therapeutic penetrating keratoplasty, a full-thickness button of the dise

   Dr. Nikhil S. Gokhale · Dr. Bhupesh P Jain
3. Interesting Reads 7 min read

   Ten Pearls for a Safe Vitrectomy

   This write up is based on my own learning experience over many years and what I have observed while training fellows. This also includes the common mistakes that I have made and what the fellows make during the training process. Today with micro incisional vitreous surgery (MIVS) and better fluidics, learning basic Vitrectomy is a very quick process for most trainees. I will now enumerate 10 steps which may be useful for a beginner. Step 1 Pre-operatively assess the eye to be operated. Is it the right eye or the left eye I am going to operate? Is it a sunken eye placed in a deep socket? It is more easy to operate the right eye because the dominant right hand performing most of the manoeuvre has a wide field of action. The same is not true for the left eye where the movement of the dominant right hand may be restricted because of the brow and the nose. This becomes even more pronounced in a deep-set eye. Therefore your nasal sclerotomy in the left eye should be about half clock hour tow

   Dr. Giridhar Anantharaman, MS, FVRS
4. Articles 18 min read

   A Postgraduate's Guide To Tonometry

   Tonometry is the procedure for the measurement of intraocular pressure. It is the most important risk factor for the development and progression of glaucoma. It is the only factor that can be treated and modified in the management of glaucoma. Therefore, the need for accurate and reproducible measurement of IOP is of utmost importance. Clinical measurement of IOP has undergone several technical advances from the initial digital tension measurements, through indentation tonometry, to applanation tonometry and non-contact tonometry. The current gold standard for the measurement of IOP is the Goldmann applanation tonometer. Tonometer in which the IOP is negligibly raised during measurements, for example less than 5%, are termed low-displacement tonometer. Tonometer that displace a large volume of fluid and consequently raise IOP significantly are termed high-displacement tonometer. Classification and Types of Tonometers are shown in Flowcharts 1 & 2. Classification of Tonometer 1 Classifi

   Dr. Vidya Chelerkar · Dr. Mrunall Borrse
5. Interesting Reads 9 min read

   Ten Tips on Textbooks to Thrive in Ophthalmology

   At the very outset, please allow us to congratulate you on having chosen to specialize in ophthalmology. Welcome to this fascinating world! Most of us breeze through ophthalmology during our MBBS by reading either Parsons or any other textbook available out there which suits us. Unlike, say medicine, where we are familiar with books like Harrison's, in ophthalmology, we find it rarely necessary to venture beyond the essential texts, unless perhaps for a seminar preparation or the like. As a result, today, as the newly joined ophthalmology resident, it is perfectly normal to feel overwhelmed, and a bit lost when you enter the library and see the whole world of ophthalmic literature available. So, we thought it would be a good idea to make a list of textbooks to help the beginner navigate this world. Of course, each one of us is unique, and we have different learning styles. We have tried to curate a list of the 'most popular' books and it is far from complete, let alone perfect. But ple

   Dr. Amanda Mohanan · Dr. Prabrisha Banerjee
6. Articles 2 min read

   Ten Tips to Achieve a Complete Curvilinear Capsulorhexis

   1. See clearly: Focus the microscope in such a way that the anterior capsule is exactly in focus. Low magnification would help in increasing depth perception, even though things don’t appear grossly magnified. Even if the patient moves the eye a little, things don’t go out of focus. 2. Stain if needed: If the red glow is not very clearly seen, and the cut end of the anterior capsular flap may not be easily visible, its best to stain the capsule by trypan blue. This should be done before starting the capsulorhexis. 3. The pressure above should be more than the pressure below. The capsulorhexis flap shall not extend to the periphery if the pressure above it is more than the pressure below it. If superior rectus muscle suture has been taken, loosen it. Loosen a tight speculum. Both increase the pressure on the globe, pushing the vitreous up and putting strain on the posterior capsule. 4. Do CCC slowly: The time spent on it is completely worth it. The success of surgery, especially in phac

   Dr. Parikshit Gogate
7. Interesting Reads 9 min read

   Mirrorless Camera Assisted Ophthalmic Surgery Recording Systems

   Introduction Surgical videos are an invaluable medium for surgical education. They allow not only for objective assessment & informative audits but also permit introspective critical analyses of surgical techniques. One may be doing a fantabulous job in his / her operating room but shall never be able to share his/her experience and skill unless the surgical video is recorded in good quality. One of the biggest challenges faced by ophthalmologists is the steep rise in the price of medical equipment. A good quality medical grade HD recording system set up (3 chip CCD camera + C-mount+ HD recorder) is priced anywhere between 12 to 15 lakhs and sometimes this can turn out more expensive than the operating microscopes used by many solo practicing ophthalmologists and even some of the medical colleges. The story behind selecting the mirrorless cameras… It is said, “If necessity is the mother of invention, frustration is the father of creativity.” It was our keen desire to be active in acade

   Dr. Raju Sampangi, MD (AIIMS), DNB · Dr. Sumeet Khanduja, MD (AIIMS) · +1 other
8. Articles 6 min read

   Ten Tips for Youngsters to Increase Proficiency in Phacoemulsification

   Phacoemulsification, like any other surgery, comes with its learning curve. Here are some pearls, from my experience, to help you ‘shorten’ and ‘Flatten the curve’. 1. Believe in yourself: The first step to successfully doing anything in life is to believe in yourself. Believe you can and you are half way there. 2. Observe, Observe, Observe & Learn I am a firm believer of this quote by Marilyn vos Savant, “To acquire knowledge, one must study; but to acquire wisdom, one must observe.” Each skill in life can be improved by observing others. It is the same case for surgeries too. The more you observe a particular type of surgery, the better you get at it. Observe your seniors. Observe their hand movements, observe how they complete a straight-forward case and observe how they tackle complications. Try and observe as many people surgeons as you can, as each and every phacoemulsification procedure teaches you something new. Residents in today’s era are blessed with easy availability of the

   Prof. (Dr.) Mahipal S. Sachdev
9. Interesting Reads 12 min read

   New normal - Tenets with Cataract Surgery Every Ophthalmologist Should Know during COVID-19 pandemic

   Introduction: Cataract is the second most common cause of preventable blindness worldwide and the most common cause of preventable blindness in India, affecting nearly 65.2 million worldwide [1-5]. To control the number, a high cataract surgery rate (CSR) is required. Sudden lockdown due to the current pandemic led to the cessation of elective cataract surgery [6,7], causing a sharp decline in the required CSR. In India as per the National Programme for Control of Blindness (NPCB) data 2018-19, the desired CSR was 947866 which could not be achieved [7]. As the unlock process has started, resumption of elective cataract surgeries is being initiated with precautionary measures. In this article, we have tried to summarize the current guidelines for elective cataract surgery. Preferred practice for cataract surgery: 1. General measures: The Govt. of India (GOI), Ministry of Health and Family Welfare (MoHFW) have advised certain preventive measures to avoid transmission (mask, hand hygiene,

   Dr. Jatinder Singh Bhalla · Dr. Satinder pal Singh · +1 other
10. Anatomy of eye 28 min read

    Anatomy of Retina

    The retina is the innermost of the three coats of the eye. This layer is responsible for converting relevant information from the image of the external environment into neural impulses that are transmitted to the brain. Broadly retina consists of two primary layers: an inner neurosensory retina and retinal pigment epithelium (RPE). 1 ? Sensory retina develops from the inner layer of the neuroectoderm, whereas RPE is derived from the outer layer of the neuroectoderm. The RPE is continuous anteriorly with the pigment epithelium of the ciliary body. Sensory retina extends from the optic disc to ora serrata, where it is continuous with non-pigmented ciliary epithelium.1 Between the neural retina and RPE, there is a potential space known as subretinal space. The adhesion between neural retina and RPE is relatively weak. The neural retina is firmly attached at its anterior termination, the ora serrata, and at the margins of the optic nerve head. The ora serrata is located 4-6 mm behind cilia

    Dr. Parthopratim Dutta Majumder

More articles