Articles

161–170 of 232 articles Page 17 of 24
All Cornea 36 Cataract 17 Glaucoma 13 Retina & Vitreous 72 Neurophthalmology 8 Oculoplasty 15 Uvea & Inflammatory Diseases 24 Miscellaneous 20 Oncology 9 Pediatric Ophthalmology 15
  1. 1 Apr 2021 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
  2. 1 Apr 2021 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
  3. 1 Apr 2021 5 min read

    Ten Tips for Managing a Case of Postoperative Endophthalmitis

    1. Suspect : Any unusual post-operative reaction ( out of proportion to surgical trauma ) should be suspected for Endophthalmitis. 2. Differentiate from TASS : All unusual post-operative reactions may not be infective; Pointers towards Toxic Anterior Segment Syndrome could include: Early onset of Limbus to limbus corneal edema with good fundus glow and no exudates in the vitreous cavity. The presence of Lid edema, chemosis, a marked reduction in vision, vitreous exudates, and low intraocular pressure should alert one for Infective Endophthalmitis. 3. Talk : The most difficult part is how to tell the patient about this. This is a very sensitive issue because in Today`s time, no patient is willing to take any negative news ( Thanks to Trivilisation of eye surgery / googlisation etc.) and there is always a potential for medicolegal issues cropping up. Talking requires some degree of compassion. It is advisable to take a picture of the anterior segment & fundus, even if hazy. Take patient

    Dr. Lalit Verma
  4. 1 Apr 2021 4 min read

    Ten Pearls for Eyelid Tear Management

    1. Key Points Eyelid injuries may be associated with ocular, orbital, and even intracranial injuries hence always rule out associated systemic trauma, occult globe injuries, or traumatic optic neuropathy. Globe involvement has been reported to be around 61% with eyelid injuries. Management of intra-ocular or systemic injuries takes precedence. The presence of orbital fat in the wound indicates the orbital septum has been breached and the repair requires a higher level of expertise to prevent postoperative complications. Laceration in the medial aspect of the eyelids is likely to involve the canalicular system. It is a myth that upper canalicular tears can be left unrepaired. In case the primary surgeon lacks knowledge or expertise in these structures, a prompt referral to an experienced oculoplastic surgeon would prevent any significant and long-lasting cosmetic was well as functional complications. Since the tissues retract along the fibers of orbicularis oculi, the eyelid defect may

    Dr. Bipasha Mukherjee
  5. 1 Apr 2021 11 min read

    Ten Tenets One Should know on Conjunctival Hooding

    Ocular surface anatomy The ocular surface, in a strict sense, consists of the cornea and its major support tissue, the conjunctiva. In a wider anatomical, embryological, and also functional sense, the ocular mucosal adnexa (i.e. the lacrimal gland and the lacrimal drainage system) also belong to the ocular surface. The ocular surface occupies approximately 2.2 cm2 of the human body surface area [1]. The homeostasis of this small area is, however, extremely important for clear vision and comfort. The cornea is one of the most densely innervated structures in the body and hence, surface changes can result in significant discomfort apart from vision loss. The clarity and tectonic integrity of the cornea are maintained by a number of mechanisms, and one of the most important of these is the intactness of the surface epithelium. The limbus provides a constant source of epithelial cells to maintain the normal turnover of the corneal surface but can be impacted by multiple noxious influences

    Dr. Sanjeev P Srinivas · Dr. Amanda Mohanan · +1 other
  6. 1 Apr 2021 11 min read

    Ten Tenets on Corneal Collagen Crosslinking

    Corneal collagen crosslinking (CXL) is a minimally invasive procedure that is currently the gold standard treatment to arrest the progression of corneal ectatic conditions. It promotes the induction of crosslinks in stromal collagen of the cornea, thereby strengthening and stiffening the cornea in ectatic conditions. 1.HISTORY It was observed that corneas in diabetic patients were stiffer due to the natural crosslinking occurring from glycosylation and hence had a lower incidence of keratoconus. Based on this observation, various experiments were conducted to crosslink the cornea manually using chemical agents and sugar aldehydes. Following multiple trials, it was found that this could be safely done by making use of the photochemical reaction induced by the absorption of UV light by riboflavin.1 The first in vivo study was done by Wollensak et al., and they reported in 2003 that CXL was effective in stopping the progression of moderate to advanced progressive keratoconus, in 23 eyes f

    Dr. Amanda Mohanan · Dr. Sanjeev P Srinivas · +1 other
  7. 1 Apr 2021 15 min read

    Learn from the Masters: Endothelial Keratoplasty

    Endothelial keratoplasty involves selective replacement of the diseased host endothelium with a healthy tissue. Because of its advantages over traditional penetrating keratoplasty, it has become the procedure of choice for corneal endothelial disorders. In last two decades the technique of endothelial keratoplasty has underwent tremendous modifications to improve visual outcome and reduce complications. When we think of endothelial keratoplasty, various terms come to our mind like DLEK ,DSEK,DMEK etc. These can be confusing not only for a resident in training but to a general practitioner as well. To improve our understanding in the field of endothelial keratoplasty, we have invited some prominent endothelial keratoplasty surgeons of our country. Dr. Jagadeesh Kumar Reddy, MS. is the Director (Technical) Sankara Eye Centre, Coimbatore. He has done Fellowship in Cornea and has 30 years of clinical practice. He has performed over 80,000 surgeries and his area of interest is new designs o

    Dr. Prateek Gujar
  8. 1 Apr 2021 9 min read

    Ten Pearls for Phacoemulsification in a Soft Cataract

    Soft cataracts are usually seen in pediatric or young adult patients. We encounter them more frequently nowadays due to the increasing patient awareness and evolving lifestyle requirements which bring the patients earlier to the clinic. Another important reason behind the increasing number of soft cataracts in our surgical practice is the fact that the number of pars plana vitrectomies is increasing and we tend to perform combined cataract surgery with pars plana vitrectomy in patients with early cataract. Soft cataract phaco can be quite challenging especially in situations where the pupil starts coming down in the face of an uncooperative patient and positive posterior pressure during surgery. It is no surprise that soft cataract has been termed as “Neither Here-Nor-There” cataract! We will be offering 10 pearls on how to successfully manage such cases with good outcomes. Pearl 1: Need for precise IOL calculations: Most soft cataracts encountered in younger visually active patients c

    Dr. Arup Chakrabarti · Dr. Nirupama Kasturi
  9. 1 Apr 2021 10 min read

    Ten Tips for Management of Nystagmus

    Nystagmus is defined as an involuntary rhythmic oscillation of one or both the eyes. Clinical assessment and eye movement recordings are important to diagnose and classify nystagmus. It is essential to have patience while examining a child, as anxiety often increases nystagmus. 1.Classification Physiological eye movements have to be differentiated from pathological eye movements. The older etiology-based classification of nystagmus is redesigned into characteristics-based new classification by CEMAS (Classification of Eye Movement and Strabismus). Infantile nystagmus syndrome (INS) is characterized by horizontal conjugate nystagmus, infantile-onset, accelerating slow phase, increase with fixation attempt, convergence dampening, and presence of null zone with decreased amplitude. Fusion maldevelopment nystagmus syndrome (FMNS) is characterized by decelerating slow phase, associated strabismus, a latent component with fast phase towards fixing eye and decrease in intensity with adduction

    Dr. Ramesh Kekunnaya · Dr. Mayank Jain
  10. 1 Apr 2021 18 min read

    Learn from the Masters Tips & Tricks in the Management of Pediatric Cataract 2

    Read Learn from the Masters Tips & Tricks in the Management of Pediatric Cataract 1 After the discussion on the etiology of pediatric cataracts, and about when and how to operate we go further to know about choosing the IOL formulae, IOL material and power of IOL to be implanted in children. Also, an insight into the post-operative rehabilitation with follow up eOphtha: Considering the varied opinions in choosing the IOL formulae for pediatric cataracts , what’s the formulae used in your practice ? Do you use different formulae in microphthalmic eyes? Dr. Bharti Gangwani : I use Holladay 1 for young children and small eyes with AL < 22 mm and SRK/T for older children with AL > 22 mm. No I do not use different formula in microphthalmic eyes though many of these eyes are left aphakic if the eye is really small. Dr Kalpana Narendran : SRK - T formula is used. If Axial length 22 – SRK T. Dr. Sudarshan Khokhar: We use modified SRK 2 or SRK/T formula for IOL power correction for all eyes. We

    Dr. Sowmya R, MS,FMRF, FAICO