Pediatric Ophthalmology

11–16 of 16 articles Page 2 of 2
  1. 26 min read

    Learn from the Masters: Tips & Tricks in the Management of Pediatric Cataract 1

    Cataracts in children are one of the most common cause of avoidable blindness. The incidence is in the range of 1.8 to 3.6/10,000 per year and the prevalence is about 1.03 per 10,000 children (0.32– 22.9/10,000). Management at the right time and the right way goes a long way in rehabilitating them . To understand the current practices in management of pediatric cataract Dr. Sowmya R. spoke to a few experts across India. Dr. Bharti Gangwani (Bharti Nihalani) is a practicing Pediatric Ophthalmologist, Assistant Professor of Ophthalmology and also the Director of Clinical Research for the department of Ophthalmology at Boston Children’s Hospital, Harvard medical school. She is actively involved in teaching Pediatric Ophthalmology to the residents and fellows. She has about 50 publications in peer and non-peer reviewed journals, books and review articles. She is a co-editor of a renowned book in strabismus management called “Learning strabismus surgery-A case-based approach”. She has focus

  2. 8 min read

    Ten Commandments in Squint Workup for Postgraduates

    Squint is the Ocular Imbalance in which visual axes of both eyes do not meet at the point of regard. It can be regarded as a form of One Eye Blindness since both eyes are not seeing simultaneously, with a squinting eye being suppressed. Hence strabismus must be treated with due care. Squint evaluation can be simplified by the following checklist. Every squint patient must undergo this checklist of 10 commandments so as to plan management. 1. Determine whether True squint or a Pseudosquint The architecture of face and orbit may give the impression of a person having an apparent deviation. Careful inspection of lids, adnexa, position of globes will reveal no actual squinting of eyes. Two important parameters to rule out Pseudosquint Hirschberg reflex will always be centered No redressal movement on cover test Epicanthus and broad nasal bridge - extra fold of skin on the medial canthus gives the appearance of esotropia. On pinching the nasal bridge, the squint will disappear. Facial asymm

  3. 8 min read

    Intermittent Exotropia Simplified for the Postgraduates

    Intermittent exotropia (IXT) is the most common type of strabismus in children as well as adults, especially in the Asian and South Asian populations. Owing to the intermittent nature of exotropia there is usually good binocular function and stereoacuity at near fixation Small-angle exotropia is observed in normal neonates which usually disappears by the age of 2-4 months. Most adults will have small exophoria usually less than 10 when fully dissociated. Epidemiology Like all forms of strabismus, exotropic deviations can be manifest or latent, and if the former, intermittent or constant. Intermittent exotropia is by far the most common form of manifest XT. Exodeviations occur about one-third less frequently than esodeviations in North America and Europe and occur more frequently in the Asian population. Intermittent exotropia is more common in females with a ratio of 2:1 (F: M). Intermittent exotropia usually noticed by parents in early childhood (2-5 years). Clinical features Intermit

  4. 16 min read

    Peek into the Past - Strabismus as a Subspecialty in India

    The most exciting thing is to revisit and know when and how it all started. As the saying goes, "You've got to always go back in time if you want to move forward," so what better way than to talk to pioneers in the field of strabismus to know the past to forge into a great future in strabismology. Dr. Sowmya R spoke to the pioneers in the field to know the history of strabismology and share their experiences. Dr. Pradeep Sharma MD, FAMS. is currently working as the Professor and Head of Section of Pediatric Ophthalmology, Strabismus, and Neuroophthalmology at Dr. RP Centre, AIIMS, New Delhi. He is also the Vice President of the Ophthalmic Research Association at RPC, AIIMS. After having finished his graduation ( 1979) and postgraduation (1982) at All India Institute of Medical Sciences, New Delhi, he did his Fellowship for Advanced training in strabismus in the USA at Jules Stein Eye Institute UCLA, Wills Eye Hospital Philadelphia and Richmond awarded by International Strabismological

  5. 6 min read

    Monocular elevation Deficit/ Double elevator palsy

    Definition: Double elevator palsy is classically defined as a congenital inability to elevate one eye, with the limitation more in abduction than adduction.1 MED is most often associated with ptosis/pseudoptosis. The word Double elevator palsy was coined by Dunlap to describe the weakness affecting both muscles of elevation i.e. superior rectus and inferior oblique. Pathogenesis/Theories: 2 Superior Rectus palsy: Superior rectus is the main elevator in abduction, adduction, or primary position. Thus, the defective elevation can be explained by the presence of superior rectus palsy alone. Inferior rectus restriction: Subsequently it was found that inferior rectus restriction can also cause such a limitation. The word double elevator palsy is a misnomer, Nearly 70% of cases, the cause for limitation was found to be IR restriction and not palsy. This was confirmed in several studies using saccadic velocity measurement and forced duction test. Supranuclear palsy: The nucleus for upgaze is

  6. 8 min read

    Down's Syndrome: Ten Points All Ophthalmologists Should Know

    Down’s syndrome is a trisomy caused by an extra copy of chromosome 211. The extrachromosomal material is transmitted either by non-disjunction, unbalanced translocation, or mosaicism. It is the most common chromosomal anomaly seen in live births2. As an ophthalmologist, it is important to screen for ocular abnormalities since the incidence of ophthalmic disorders is between 46-100%3. One study found 97 % of children with Down’s syndrome with at least one ocular abnormality4. This proves the necessity to carefully screen these children for any disorders and their prompt treatment. It is recommended that all children diagnosed with Down’s syndrome must undergo evaluation by a Pediatric ophthalmologist before the age of 6 months and then annually thereafter if no abnormalities are found at the first visit 5 Although there are many ophthalmological anomalies seen in Down’s syndrome, we will be discussing only the ten most clinically significant ones below. 1. Refractive Error and Visual ac