1. Students Gallery 3 min read

   FIve Points You Must Note While Examining An Optic Disc

   Disc size A normal disk can be of small size and a normal disk can be of a larger size; size by itself does not determine glaucoma. It is relevant because the disk size determines the C:D ratio and the neuroretinal rim thereof. In a large disc one would expect a large cup and a large neuroretinal rim and in a small disc there is usually no cup. Disc size should be grouped as normal, small or large. Graticule on the slit lamp can be used. In cases with CDR discrepancies disc size should be compared to determine true discrepancy. Disc Shape A normal optic disk is vertically oval with the vertical diameter being the maximum diameter and the horizontal being the minimum diameter. Figure: Vertically oval disc. Note that the vertical diameter is longer than the horizontal diameter The variations in shape may be accompanied with astigmatism and amblyopia. An optic disk is considered torted when the vertical axis of the optic disk is rotated >15° from the vertical meridian. A tilted optic disk

   Dr. Amit Pandey
2. Articles 49 min read

   Viral Uveitis

   Viral uveitis has myriad presentations. They may present as anterior uveitis, intermediate uveitis, acute retinal necrosis (ARN), progressive outer retinal necrosis (PORN) and neuroretinitis. The causative viruses mainly include herpes group of viruses and human immunodeficiency virus (HIV). Other DNA viruses which cause uveitis are poxviruses, adenoviruses especially those that produce epidemic keratoconjunctivitis and pharyngoconjunctival fever. RNA viruses isolated are influenza virus, mumps virus, measles virus, rubella virus, rift valley fever virus and Newcastle virus. Here we have discussed all the different types of viral uveitis except opportunistic viral infections in HIV. ANTERIOR UVEITIS Viral anterior uveitis is caused mainly by herpes simplex virus (HSV) type 1 and 2, varicella zoster virus (VZV), cytomegalovirus virus (CMV), Epstein-Barr virus (EBV) and human herpes virus (HHV) type 6, 7 and 8 (1-3). Herpes literally means ‘to crawl’ from the Greek word ‘herpein’. Herpes

   GD Dr. Vinita Rao · Dr. Gunjan Deshpande
3. Interesting Reads 11 min read

   Beginners Guide for Performing Vitrectomy

   Know your cutter and machine. Current generation vitrectomy cutters work by guillotine mechanism where vacuum holds the Vitreous fibers and presents it to guillotine blade that severs it in one swift motion without exerting significant on fibers. The cutting process needs a fine balance between the speed of cutting and the “pull” created by the vacuum. Higher cutting rates like 10000 cpm allow the surgeon to use a higher vacuum in the range of 600 mm Hg. The rate of vitreous removal also depends on duty cycle and bore size of lumen. Surgeons should test the efficiency of cutters either on cotton fibers or on the vitreous prolapsing out of sclerotomies. One has to learn to recognize when the cutter is pulling without cutting – the most dangerous situation. The surgeon should also familiarize himself with different functions of vitrectomy systems like air injection, Endodiathermy, venturi or peristaltic pumps, light source/s, Phaco Fragmatome, and Viscous fluid injection. It also helps t

   Dr. Deependra V Singh
4. Articles 8 min read

   A Beginners Guide to Ophthalmic Surgical Microscope

   An operating surgical microscope is the most important optical instrument in the modern era of ophthalmic surgeries. It provides the surgeon with a magnified and illuminated high-quality image of the small ophthalmic structures. Being binocular the surgical microscopes gives the additional benefit of high-quality stereoscopy. History The first German doctor to use a stereomicroscope was Dr. Hans Hinselmann (1884-1959), Prof. of Gynaecology under Dr. Otto von Franque at the University Clinic, Bonn, who adapted in 1925 a Leitz stereomicroscope with coaxial illumination to a movable floor stand. He named IT “colposcope” and used it to visualize the female genital organs particularly for cancer of the cervix. Dr. Hans Littmann (1908 – 1991), head of Med-Lab at Zeiss OptonOberkochen, West Germany (now Carl Zeiss A.G.) and his team of technicians designed in 1953 their first ophthalmic operating microscope Prerequisites for an ideal operating microscope Must have stereoscopic visualization.

   Dr. Rohit Rao · Dr. Tamonash Basu
5. Students Gallery 6 min read

   Documentation & Drawing in Ophthalmology

   Anterior segment finding Documentations From the days of Hippocrates documentation has been a cornerstone of clinical science. But somewhere down the line this has become a lost art rarely ever practiced by many of us. We tend to ignore or to say correctly run away from it under many pretexts like its time consuming, it’s of no use, etc. And surprisingly this resistance to document is prevalent not only among juniors but spans across the whole spectrum of practitioners. So at times we really ponder is documentation really necessary? The answer is an emphatic yes – the reasons being It’s a standard clinical practice worldwide Follow up is possible only if you can compare it with your previous records. Will help you medico legally Last but not the least unless you are documenting it you have not probably seen it correctly(you think you have seen it all but the moment you come to draw it you find that you don’t remember where the break was it at 1 o’clock or 3 o’clock position and so on).

   Dr. Parthopratim Dutta Majumder
6. Students Gallery 9 min read

   How to Excel In Microsoft Excel

   Introduction: Microsoft Excel is a vital tool for collecting and analyzing research data. It is available on the Windows platform and seamlessly works on different versions of the Windows operating system. It comes as a part of the Microsoft Office suite and is available with most basic Office versions. Though working on Excel does not require extraordinary knowledge of computers; it does require basic knowledge of the controls on the Excel workbook. Apart from that, Excel has a jargon of its own which needs to be understood to make use of all its features. The aim of this chapter is to enable readers to understand entry, storage, and analysis of data in the Excel sheet. The chapter is divided into three sections dealing with various aspects of Excel. Readers are suggested to use this chapter for a basic overall understanding of Microsoft Excel workspace. At any point, clicking on the “Help” button in Excel will guide them to the Windows Help link on that issue. Section 1: Excel Compon

   Dr. Kumar Saurabh · Dr. Bikramjit Pal
7. Articles 35 min read

   Idiopathic Macular Hole

   Introduction Recent advances in the pathogenesis, classification, and surgical intervention of idiopathic macular holes have generated a renewed interest in this entity. Better indicators of the visual outcome, as well as refinements in the surgical technique, have led to improvements in the success of macular hole surgery. Clinical characterization and theories on the pathogenesis of macular hole have continued to evolve. Although originally thought to be the result of trauma, it is now recognized that most macular holes occur in the absence of antecedent injury and are referred to as idiopathic. Theories for the pathogenesis of idiopathic macular holes have included progressive thinning of the foveal tissue and pre hole cyst formation. The primary pathogenic role of the vitreous was suggested by studies that indicated a low relative risk for macular hole formation in eyes with complete posterior vitreous detachment. Gass proposed a theory whereby shrinkage of adherent cortical vitreo

   SS M Sandeep Saxena · MAMS
8. Articles 12 min read

   Eales Disease: Current Concepts in Etiopathogenesis and Management

   Introduction Eales’ disease is an idiopathic retinal periphlebitis that primarily affects the peripheral retina in young adults. Eales’ disease was first described by Henry Eales, a British ophthalmologist, in 1880 and 1882.1,2 He found it in seven young, male patients ranging in age from 14 to 29 years with recurrent vitreous hemorrhage. In addition, these patients had history of headache, variation in peripheral circulation, chronic constipation and epistaxis. In the next century, the disease was redefined by several investigators. 3-6 Elliot first recognized the inflammation of retinal vein and described it as periphlebitis retinae.4 Subsequently several investigators documented both venular and arteriolar inflammation.5,7 Eales’ disease most commonly affects healthy young adult males and is an important cause of preventable blindness in young adults. The predominant age of onset of symptoms is 20-30 years. The disease is more commonly seen in the Indian subcontinent. However, it ha

   SS M Sandeep Saxena · MAMS
9. Articles 6 min read

   Malarial Retinopathy: A Diagnostic Clue

   Introduction Malaria is the most important of parasitic diseases of humans and remains today, as it has been for centuries a large burden on tropical communities. Cerebral malaria is the most important complication of falciparum malaria and also the leading cause of death in malaria 1. It is defined as an acute, symmetric encephalopathy associated with sequestration of parasite-infected erythrocytes in the cerebral vessels and capillaries in patients with falciparum malaria 2. WHO Criteria for Diagnosis The World Health Organization has laid down definite guidelines for diagnosis and management of cerebral malaria 3. This definition requires the presence of unarousable coma using the Glasgow Coma Scale (GCS), exclusion of other encephalitides, especially bacterial meningitis and if possible, locally prevalent encephalitis and the presence of asexual forms of P. falciparum in the blood film. Retinal Involvement in Cerebral Malaria Eye being an extension of the brain, retina provides a u

   SS M SM Sandeep Saxena · MAMS · +2 others
10. Articles 55 min read

    Retinal vein occlusion

    Introduction Retinal vein occlusion (RVO) is the second most common retinal vascular disease to cause visual loss in adults after diabetic retinopathy. RVO has been classified into two main types, namely Central retinal vein occlusion (CRVO), Branch retinal vein occlusion (BRVO), the latter being more prevalent. Hemi-retinal vein occlusion has been classified separately since pathogenetically they are different as compared to the above two groups. In the following chapter a brief introduction to these variants of RVO, along with their epidemiology, clinicopathological profile, and treatment has been discussed. Epidemiology [1] The most recently published study summarizing 68,751 individuals from 15 studies, quoted that the prevalence of RVO was 5.20 per 1000 (for any form of RVO). The prevalence of BRVO alone was 4.42 per 1000 (95% CI 3.65–5.19) and that of CRVO was 0.80 per 1000. According to Hayreh et al, prevalence varied by ethnicity and increased with age, but do not differ by gen

    DM RR Dr. P. Mahesh Shanmugam · Divyansh Mishra · +1 other

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