1. Articles 12 min read

   Ocular Tuberculosis

   Ocular involvement in TB has been recognized for a long time and was first described in 17111. The spectrum of tuberculosis (TB)-related uveitis is wide. Its diagnosis still remains a challenge due to the lack of uniformity in the diagnostic criteria along with difficulties encountered in confirming the diagnosis by the laboratory methods available. It is a major concern in countries endemic for TB, and intraocular TB is being increasingly reported from various regions2-4. The true prevalence of intraocular TB is not known in India. While it has been reported to be 0.39% in South India, it is much higher (9.86%) in North India1,5. Varying rates of its prevalence have been reported from the world over (0.5% in the U.S.A., 6.31% in Italy, 6.9% in Japan, and 10.5% in Saudi Arabia). The largest series of patients with presumed intraocular TB and their outcome has been recently reported from our center6. Pathogenesis Uveitis due to latent TB has been reported since long. However, their exac

   Dr. Reema Bansal · Prof. Vishali Gupta · +1 other
2. Interesting Reads 10 min read

   Publish or Perish

   The catch phrase ‘Publish or perish’ among the scientific community to mean ‘either publish your research or lose your job’ is a constant threat that hangs like a Damocles’ sword on their heads. ‘Publish or perish’ also signifies the reality and pressures for progress of science in the world of academia that is becoming hugely competitive. In an increasingly connected and globalized world, nobody, located in how so ever remote an institution, can claim to be untouched by this menace. Why do science? Science is altruistic, it is selfless without any motive except gaining recognition for the person doing it or the institution or the lab where the science is being done. There are no immediate personal financial gains for the scientists except that recognition in the peer group nationally and internationally is an award itself. It also facilitates easier acceptance of future grants for the individual scientists and the institutions from various funding agencies. What is science? Science is

   Prof. Amod Gupta
3. Articles 14 min read

   Corneal Trauma and its Management

   Introduction The cornea is prone to a variety of injuries by virtue of its location as the window of the eye. Apart from chemical injuries, physical trauma to the cornea can range from epithelial abrasions to loss of integrity of the stroma. Corneal injuries of this nature can occur in two distinct populations – in young children from play-related activities, and in young adults from due to their work environment. Although the general principles of management are not too different, special consideration in the pediatric population must be given to the timing of appropriate surgical interventions as the developing visual system in children is prone to amblyopic visual loss. Males are usually more prone to ocular injury than females; this is seen clearly in children, while the ratio of boys vs girls involved in accidents with ocular trauma is 4:1 [1]. The injuries can be caused by large blunt objects often resulting in ruptures of other parts of the ocular coats as well. On the other han

   Dr. Sanjeev P Srinivas · Dr. Amanda Mohanan · +1 other
4. Articles 18 min read

   Ocular Syphilis

   Introduction: Syphilis is considered as a great mimicker due to its varied protean manifestations. It was first recognized in Europe in the late 15th century.[1] There have been several hypotheses regarding the origin and spread of syphilis and it is believed that the disease was brought back from the New World by the crew of Christopher Columbus, some of whom likely had syphilis on returning to Spain. Since the advent of Penicillin in the mid-20th century, the incidence of syphilis has reduced however it still represents a larger global problem [2] and an estimated 12 million new cases of syphilis are added every year worldwide and more than 90% are from developing countries.[3] The risk is particularly higher in men who have sex with men (MSM) and socially marginalized groups and those with HIV Co-infection.[4] The 2015 statistics from The Center for disease control and prevention (CDC) reported a 7.5 per 100,000 population of primary and secondary syphilis. (4). There has been a rec

   Dr. Mudit Tyagi · Dr. Subhakar Reddy
5. Articles 8 min read

   A New Paradigm for Refractive Surgery: SMILE-Small Incision Lenticule Extraction

   Automated lamellar keratoplasty (ALK) was a technique to physically remove a refractive lenticule (the lenticule was merely a disc of corneal tissue) from the cornea after lifting a hinged flap and exposing the stroma. A mechanical microkeratome was used to do both steps of the ALK procedure. In the LASIK procedure, the refractive lenticule was ablated with the excimer laser, while the hinged flap was still created with the mechanical microkeratome. In a later iteration, Femto-LASIK involved creation of the hinged flap with a femtosecond laser, and an excimer laser was used to ablate the refractive lenticule. SMILE, a relatively new technique of performing refractive surgery, uses a femtosecond laser for all steps of the keratomileusis procedure. SMILE involves the creation of a refractive lenticule within the cornea using a femtosecond laser, and subsequent extraction of the refractive lenticule from within the cornea. The refractive error that needs to be treated defines the shape of

   Dr. Rupal Shah M.S
6. Articles 13 min read

   Entropion And Ectropion

   Entropion is the turning inward of the eyelid margin. Unlike ectropion, it is symptomatic and injures the ocular surface. The patient seeks medical care early. Ectropion is an eyelid malposition in which the eyelid margin does not oppose the globe. We shall discuss the relevant anatomy and clinical examination for the two entities together. Relevant Anatomy The eyelid can be grossly divided into Anterior lamella composed of skin and orbicularis Posterior lamella composed of tarsus and conjunctiva Factors contributing to the stability of the lower eyelid Appropriate horizontal tension of the lower lid so that the eyelid is apposed to the eyeball. This is supplied by the medial and lateral canthal tendons. Lower lid retractors applying appropriate tension to the inferior margin of the tarsus, pulling the lower edge of the tarsus inferiorly, and thus preventing the lid margin from turning inward as in entropion, or outward as in ectropion. Synchronous movement of the inferior rectus and l

   Dr. Roshmi Gupta · Dr. Rwituja Thomas · +1 other
7. Articles 17 min read

   Evaluation of The Optic Nerve Head in Glaucoma

   Introduction The diagnosis of primary open-angle glaucoma is based on the triad of increased intraocular pressure, visual field changes and optic nerve head changes. Apart from the glaucomatous changes in the optic nerve head, the other two factors in isolation lack diagnostic sensitivity. In fact, studies have shown that careful evaluation of the optic nerve head has high specificity and that an experienced observer may be better in distinguishing a normal from a glaucomatous disc as compared to any other technology, like the HRT or OCT.[1-3] IOP can be normal in 50% of patients of glaucoma.[4] Studies by Quigley et al have shown that up to 40% of the axons could be lost before a visual field defect develops on Goldmann perimetry and that 20% of axons are lost before a 5 db loss is detected on standard automated perimetry.[5] So to pick up early or pre-perimetric glaucoma, in the absence of imaging, a sound knowledge of assessment of optic nerve head changes in glaucoma is imperative.

   Dr. Sahebaan Sethi
8. Articles 10 min read

   Binocular Indirect Ophthalmoscopy : The Beginner's Guide

   The technique of examining the fundus of the eye is called ophthalmoscopy. In direct ophthalmoscopy, a virtual and erect image of the fundus is seen. In indirect ophthalmoscopy, a real and inverted image is formed between the condensing lens and the observer. The advantage of stereopsis (depth perception) and a larger field of view makes indirect ophthalmoscope (IDO) more useful both in retina clinics and during posterior segment surgeries. Inventions and innovations The journey of developing ophthalmoscopy began with an idea by the great physicist, Hermann von Helmholtz, who described the optical principles of direct ophthalmoscopy in 1851 (Fig:1a). This was followed by series of innovations and methods of examination including the indirect method of ophthalmoscopy developed by Reute in 1852 (Fig:1b), binocular model by Marc-Antoine Giraud-Teulon (Fig:1c) and more practical hand-held reflex-free binocular ophthalmoscope by Allvar Gullstrand (Fig:1d). It was Charles Schepens who popula

   Dr. Nagesha CK
9. Articles 6 min read

   Ten Pearls for Corneal Scrapping

   The management of microbial keratitis requires corneal scraping material for smear and culture. Scraping is a superficial keratectomy procedure to procure samples from central infiltrates or any infiltrate more than 2 mm in size. Stain/ wet mount gives a rapid clue to the diagnosis to initiate appropriate therapy. Inoculation of the sample on culture media help identify the offending organism and antibiogram help choose an appropriate therapeutic agent. Erasmus Darwin the grandfather of Charles Darwin was the first to suggest corneal therapeutic debridement to try and make cornea transparent in 1795. 1. Proper documentation of corneal ulcer should be done before going ahead with corneal scraping Before corneal scraping is planned it is important to document the corneal ulcer either diagrammatically or by photo documentation as this helps in showing progression or worsening of the therapeutic management. Areas of clinically active margins should be noted and always check the area of max

   Dr. Manokamna Agarwal · Dr. Meena Lakshmipathy
10. Articles 25 min read

    Learn from the Masters: Clinical Highlights in Neuro-ophthalmology

    Neuro-ophthalmology is a unique subspecialty of ophthalmology and neurology where there is a complex interaction of neurologic and systemic disorders in the visual system. Neuro-ophthalmic conditions are not only about vision-threatening but sometimes life-threatening too! It needs the most comprehensive examination from ophthalmic, neurologic, and medical viewpoint. The trick lies with a systematic approach starting from history taking to specific examination techniques and localization of the condition. We have put together a few fundamental questions on clinical highlights in neuro-ophthalmology, and they were addressed to the experts who have been phenomenal in the field. Let’s learn from their vivid explanation and expand our neuro-ophthalmology skills. Dr. Ambika Selvakumar is a senior consultant and the head of the Neuro-ophthalmology services, Sankara Nethralaya, Chennai, India. She has done MBBS from prestigious Stanley medical college, Chennai. Postgraduation in ophthalmology

    Dr. DurgaPriyadarshini S

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