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Ten Tenets of Diagnostic Vitrectomy
Diagnosis of posterior segment inflammatory or infectious disease is mostly based on clinical presentation, ocular imaging and specific laboratory tests. However, in the absence of a characteristic clinical picture of a specific disease the diagnosis of uveitis can be challenging. It has been reported that upto 33% of uveitis remain undiagnosed. Moreover, some of the malignant or infective diseases of the eye may mimic an inflammatory pathology leading to delay in diagnosis and subsequently poor outcomes. Intraocular biopsy may be helpful in clinching the diagnosis in these situations. With the improvement in laboratory testing and vitrectomy instrumentations, diagnostic vitrectomy is increasingly being performed in clinical practice. 1. Indications 1,2 Diagnostic dilemma Patient fails to respond to standard systemic anti-inflammatory therapy Atypical clinical presentations Inconclusive non-invasive laboratory work-up Significant vitreous inflammation concerning for malignancy, infecti
Dr. Jayanti Singh · Dr. Alok Sen
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Ten mistakes to avoid while testing for RAPD
Introduction: A relative afferent pupillary defect (RAPD) is an important sign that detects a lesion in the afferent pathway of light reflex. It is seen in unilateral or asymmetric bilateral lesions of the retina and optic nerve upto but not involving the chiasm. It has been noted though, even in lesions of optic tract and pretectal afferent fibres of dorsal mid brain. Although the test requires both eyes, it is essential to note that it requires only one working pupil. Swinging flashlight test of Levitan: Before performing the test, one must examine the pupil for shape, size of the pupils, anisocoria if any and reaction to light. It is important to note all these since anisocoria and small sized pupils may make it difficult to detect relative afferent pupillary defect. After completing this basic examination, one must proceed to perform the swinging flash light test, keeping in mind the following ten avoidable mistakes: 1. The ideal light: The test must be performed with a halogen tra
Dr. Nikita Pathare
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Practical Tips for Retinopathy of Prematurity Screening
Retinopathy of Prematurity (ROP) is a proliferative disease of the retina which affects developing retinal vessels of prematurely born infants. The screening process should be carried out within 1 month of delivery of the infant. Delaying this or missing out on screening could result in the progression of abnormal neovascularization, which can lead to the development of tractional retinal detachment in the absence of treatment and this could result in irreversible blindness. There are various aspects one needs to take care of while carrying out ROP screening. Here are a few practical tips for carrying out an effective screening and follow-up in premature infants for ROP. This might be useful for paediatricians / hospital staff as well, to understand the importance of screening and ways to aid in carrying out a successful screening procedure. 1. Infant to be screened: Whom to screen? Different countries have different screening guidelines. Ours is a developing nation with even bigger in
Dr. Deepanshu Agrawal
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External Eye Diseases Of The Eye In Children
External Eye Diseases Of The Eye In Children
Dr. Iddi Ndyabawe
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Accreditation of Eye Care Centres: The 10-Step Simplified Guide
Introduction The quality of health care and the initiatives taken to address various risk and safety issues in hospitals has become a subject of debate. Many countries and organizations are exploring various means to improve the quality of healthcare services. “Accreditation is a status that is conferred on an organization that has been assessed as having met particular standards”. The two conditions for accreditation are an explicit definition of quality (i.e., standards) and an independent review process aimed at identifying the level of congruence between practices and quality standards. This article simplifies the process of accreditation into concise and simplified ten steps. Step 1: Deciding to Get Accredited Accreditation is not a goal but a journey. Accreditation is a continuous process rather than a final destination. Step 2: Assessing the Current Situation and Doing Background Research What stage is your organization at with regard to implementing quality standards? Consideri
Dr. Nirmal Fredrick T · Dr. Sunitha Nirmal · +1 other
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Endogenous Endophthalmitis: A Review
Introduction Endophthalmitis is defined as an inflammation of the inner layers of the eye with exudation in the vitreous cavity resulting from intraocular colonization by microorganisms. It can be exogenous or endogenous. It is an ocular emergency with poor visual prognosis and multifactorial etiology. Endogenous endophthalmitis is much less common than exogenous endophthalmitis and is estimated to account for 2% to 8% of all endophthalmitis cases.1,2 It occurs when bacteria or fungi are hematogenously disseminated into the ocular circulation. The visual prognosis is often poor. The risk of septicaemia with a mortality rate of 5-15%.2 is reported, and therefore a prompt diagnosis of the underlying cause of endogenous endophthalmitis along with the control of eye infection is of utmost importance. Risk factors Endogenous endophthalmitis has multiple factors playing a role in its occurrence. (Table 1) The following are the risk factors for endogenous endophthalmitis- long-term indwelling
Dr. Manisha Agarwal · Dr. Isha Agarwal
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What's Hot in Vascular Tumors of Retina and Choroid
What's Hot in Vascular Tumors of Retina and Choroid
Dr. Sunil Ganekal
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