1. Interesting Reads 6 min read

   Ten Yoga Poses Every ophthalmologist Should Know & Practise

   Doctors, both frontline COVID warriors, and practitioners are passing through one of the most challenging phases in their professional careers. A recent survey article in the “Indian journal of ophthalmology “ showed alarming levels of depression and suicidal tendencies among ophthalmologists during this lockdown. Practicing yoga postures will definitely help to uplift and balance your energies on a daily base, so you can remain peaceful, positive, and energized. These are 10 Yoga postures that every ophthalmologist should know and practise to balance, rejuvenate and revitalize your mind, body, and spirit 1 Samasthiti (equal standing pose) Stand with both the feet together The body is straight and aligned with shoulders relaxed Palms are beside the body Keep your eyes closed and balance your body Awareness on your Breath to balance your breath pattern (deep inhalation and deep exhalation) Hold the posture for 3 mins Samasthiti is to maintain a connection with the inner line of gravity

   Mrs. Naina Shetty
2. Articles 12 min read

   Low Vision Assessment

   WHO (ICD-10) defines low vision as “A person who has impairment of visual functioning even after treatment and/ or standard refractive correction, and has a visual acuity of less than 6/18 to light perception, or a visual field less than 10 degrees from the point of fixation, but who uses, or is potentially able to use, vision for the planning and/ or execution of a task for which vision is essential” NPCB (National Program for Control of Blindness) defines low vision as “Visual acuity of less than 6/18 but equal to or better than 6/60 in the better eye with available correction or a visual field loss of less than 10° from the point of fixation”, and, blindness as “Visual acuity less than 6/60 in the better eye or a corresponding visual field loss of less than 10° The goal of low vision assessment is to: Address the visual demands of the patient Identify and evaluate the cause of low vision Assess ocular health Emphasize the need for the patient/ beneficiary Clinical Assessment Maintai

   Dr. Rahul Deshpande
3. Articles 26 min read

   Optical Coherence Tomography

   Introduction Optical Coherence Tomography is a powerful noninvasive imaging modality that performs high resolution, micron-scale, cross-sectional imaging of the retina. Originally developed in 1991 by Huang et al, [1] OCT technology has continually evolved and expanded within ophthalmology and has been explored in a wide range of clinical applications. With the introduction of Spectral/ Fourier Domain OCT (SD-OCT, FD-OCT) and Swept Source OCT (SS-OCT), there is greater tissue resolving power, significantly higher scan density, and faster data acquisition than original Time Domain OCT. Thus, OCT has revolutionized the practice of ophthalmology and, in particular the diagnosis and management of patients with retinal disease. This chapter describes the basics of OCT technology and its clinical applications in retinal disorders. OCT technology and working principle [2-8] OCTs operate on the principle of indirect low-coherence interferometry, in which a beam of light is directed into the re

   Dr. Remya Paulose · Dr. Jay Chhablani
4. Articles 6 min read

   Refraction Simplified for the Post Graduates

   The optics of the eye normally creates a clear image by refracting rays of light to focus on the retina. Imperfections in this optical system create aberrations and thus blurred images. The goal is to analyze them and devise a means to eliminate them. Lower order aberrations are primarily refractive errors when parallel rays of light after refracting, do not focus on the retina with accommodation at rest. 1. Retinoscopy It is the objective method of detecting refractive errors by a method of neutralization. Point focus formed at a far point of the eye according to its refractive status. For e.g. In a patient with 1 dioptre of myopia, the far point is at 1 meter. For easy mathematical calculations, 1metre is used for retinoscopy. But practically, 66cm is preferred as it is easier to perform retinoscopy at an arm’s length (which is 66cm). The two principal meridia are recognized and power is determined by neutralization. Usually the two meridia are 90 degrees and 180 deg. In cases of obl

   Dr. R Krishna Prasad · Dr. Sayali D Mahajan
5. Articles 39 min read

   Fungal Keratitis: A Review for the Post-Graduates

   Introduction Fungal or mycotic keratitis is a leading cause of ocular morbidity, opacification and preventable blindness.1 The approximate annual incidence of fungal keratitis in India is said to be 11.3/10,000 population.2 Frequently it is caused by filamentous fungi (Aspergillus, Fusarium, Curvularia) in the tropical areas, while in temperate regions it is predominantly caused by Candida species (C. albicans, C. Parapsilosis). It is considered as one of the most difficult forms of microbial keratitis for the Ophthalmologist to diagnose and manage. Medical therapy alone is often inadequate and surgical therapy like therapeutic penetrating keratoplasty, conjunctival flap, lamellar keratoplasty or cryotherapy is required for control of infection. Epidemiology and Demographics Fungal keratitis incidence or prevalence is more in tropical regions of the world like India and Southern USA and is less commonly encountered in the temperate zones.3 In East India, fungal keratitis was found to b

   Dr. Ankit Anil Harwani · Dr. Meena Lakshmipathy
6. Articles 9 min read

   How do we treat inflammatory CNVM ?

   Inflammatory choroidal neovascular membranes (CNVM) cause an acute and significant visual loss 1,2. Mostly affecting eyes with posterior or panuveitis, the chronic recurrent nature of inflammation further worsens the visual prognosis in these eyes, such as serpiginous like choroiditis, punctuate inner choroidopathy (PIC), multifocal choroiditis, Vogt-Koyanagi-Harada (VKH) disease, presumed ocular histoplasmosis syndrome, toxoplasma retinochoroiditis, etc,.3,4 . The angiogenic stimulus in inflammatory CNVM is driven by local inflammation and/or a degenerative breach in retinal pigment epithelium (RPE)-Bruch’s membrane complex4. An active intraocular inflammation induces the release of several inflammatory mediators including cytokines, chemokines, vascular endothelial growth factor (VEGF) and complement activation, which in turn promote retinal and choroidal neovascularization. Majority of inflammatory CNVM are classic (on fundus fluorescein angiography), and type 2 on spectral domain o

   Dr. Krinjeela Bazgain · Dr. Nitin Kumar · +1 other
7. Articles 12 min read

   Duanes Retraction Syndrome Made Ridiculously Simple

   Synonyms: Stilling–Turk–Duane syndrome. Duane Retraction Syndrome is a type of congenital cranial dysinnervation which occurs in 1-4% of strabismus cases. It has varied presentation mostly involving variable horizontal duction deficits, with narrowing of the palpebral fissure and globe retraction on attempted adduction, occasionally accompanied by upshoot or down shoots Etiopathogenesis Various theories have been proposed earlier for the cause of DRS but currently, the most accepted theory is that of innervational anomalies which leads to all the features of DRS. It is considered to be a part of congenital cranial dysinnervation syndrome as it’s a developmental anomaly of the 6th cranial nerve or its nucleus leading to innervational deficiency of lateral rectus muscle which might be associated with secondary innervational abnormality with Medial rectus. The lack of normal innervations of lateral rectus was proved by electromyographic studies. It is also associated with paradoxical inne

   Dr. Prerana Tripathi, DO, DNB, FICO · Dr. Sowmya R, MS,FMRF, FAICO
8. Students Gallery 2 min read

   Dos and Donts in the Operation theatre on Day One for Postgraduates in COVID times

   Dos: Change into OR scrubs and slippers. Make sure your OR cap and mask are separate from the one you have been wearing in OPD. Make sure to cover all strands of hair under the cap, especially for women. A clean shave is recommended for men to ensure a good fit for your N95 mask. Ensure proper usage of protective eyewear and a visor at all times. Wash hands/ use a Sanitizer before entering the OR. Learn to differentiate between sterile and non-sterile areas inside the theatre. Read about the procedures scheduled in the OR the previous day. For what the mind does not know, the eyes do not see. Know your operating microscope, foot controls, and instruments thoroughly. Learn to arrange the instrument trolley, paint, and drape the patient for surgery. Maintain adequate distance from the operation table during observation. Learn the 6 steps of handwashing and perform them for the prescribed amount of time depending on the concentration of Povidone-iodine in your institute. Maintain appropri

   Dr. Nikita Pathare
9. Articles 9 min read

   Embryology of Eye

   Introduction The eyeball development begins early in the 4th week of intrauterine life with formation of optic vesicle (a diverticulum) from diencephalon. The structure of eyeball is shown in Figure 1. Various components of eyeball are derived from the following sources: Retina, iris and optic nerves are derived from optic vesicle that arises from neuroectoderm of diencephalon. Lens and corneal epithelium are derived from lens placode that arises from surface ectoderm. Fibrous and vascular coats of eyeball are derived from mesodermal condensation surrounding the optic vesicle. Choroid and sclera are derived from migrating neural crest cells. Figure 1: Fully developed eyeball Optic Vesicle and Lens Vesicle Formation of optic sulcus: On 22nd day, wall of the diencephalon shows thickening and depression to form optic sulcus. Formation of the optic sulcus or groove is the first indication for development of the eye (Figure 2A). Formation of optic vesicle: Optic sulcus further invaginates l

   Dr. Yogesh Sontakke
10. Articles 7 min read

    Panophthalmitis: A Ready Reckoner for Postgraduates

    Introduction Panophthalmitis is a severe ocular and orbital condition which can lead to phthisis bulbi or may necessitate evisceration. Severe inflammation of the anterior and posterior segments is frequently accompanied by microbial keratitis, necrotizing scleritis, and perforation or rupture following trauma. The disease develops rapidly and the prognosis is poor. The management of patients with intractable panophthalmitis remains challenging with eye salvage almost impossible in most cases. Etiology and Pathogenesis Panophthalmitis is a purulent inflammation of all coats of the eyeball including intraocular structures. Although post-traumatic endophthalmitis is the most common preceding event, the infection can result after postoperative endophthalmitis following cataract surgery, keratoplasty, or rarely after posterior segment procedures. It can also be caused by septicemia or can spread from a pus-producing infection in another part of the body. [Table 1] Organisms implicated incl

    Dr. Namrata Adulkar

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