Articles

171–180 of 232 articles Page 18 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 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

    Dr. Sowmya R, MS,FMRF, FAICO
  2. 1 Apr 2021 12 min read

    Ten Tips for Phacoemulsification in Small Pupil

    Phacoemulsification in eyes with preoperative non-dilating pupil or with intraoperative miosis is fraught with complications [1,2]. The following tips will help understand the small pupil and optimize strategy to deliver better outcomes. 1. Every eye is an IFIS candidate; Reduce threshold for using Pupil expansion devices: Since its original association with tamsulosin intake, Intraoperative Floppy Iris Syndrome (IFIS) has been positively correlated with a plethora of risk factors which include: gender, age, hypertension, other a1-adrenergic receptor antagonists, finasteride, angiotensin II receptor inhibitors, benzodiazepines, antipsychotics, hypertension drugs and decreased dilated pupil diameter [1,3,4]. The risk of IFIS exists regardless of alpha antagonist treatment, in eyes with 7.0 mm or smaller pupil [5]. Hence, it would be prudent to consider every eye a potential IFIS candidate. Increased patient expectations, surgeon's desire to consistently deliver good outcomes, use of tor

    Dr. Suven Bhattacharjee
  3. 1 Apr 2021 8 min read

    Retinoblastoma : Top Ten Tenets for an Ophthalmologist

    1.Common and Curable Retinoblastoma is the most common childhood ocular malignancy. Annually there are about 6000 new cases worldwide. It is most commonly diagnosed at 15-18 months of age although in developing countries, older children also present with the disease. It is potentially curable if detected early and with proper management. Currently, the survival rate is as high as 95% with 90% eye salvage and 85% vision salvage. 2 The root of the Family Tree Retinoblastoma can be associated with germline mutation or somatic mutations of the RB1 gene on the long arm of chromosome 13. Heritable retinoblastoma constitutes 30-40% of all retinoblastomas while the rest are non- heritable. 25% of the germline mutations are familial with autosomal dominant inheritance and the remaining occur de novo. In heritable retinoblastoma, patients are prone to other second primary neoplasia including pinealoblastoma, osteosarcoma and soft tissue sarcomas. Genetic testing for germline mutations are availa

    Dr. Mrittika Sen · Dr. Santosh G Honavar, MD, FACS
  4. 1 Apr 2021 14 min read

    ILM Peeling Simplified - Ten Tips for the Beginners

    1 How to choose the right cases to start Idiopathic macular hole in non-myopic eye is a good case. ILM comes off as a single sheet and underlying retina is healthy. Same applies to traumatic macular holes. Beginners can also start peeling ILM in eyes with epiretinal membrane. Unsuccessful peeling may not jeopardize the long-term outcome significantly here. Peeling ILM for Myopic macular holes or in eyes with Diabetic Retinopathy needs more experience but can be achieved easily if one understands the basics of peeling. 2 Arrange your Inventory – Forceps is the key Lander's ring with Macular contact lens, Disposable ILM forceps and BBG dye serve as a formidable low-cost inventory for ILM peeling. A good ILM forceps should match your technique of ILM peeling. Because most of us initiate peel by "Pinch Technique", forcep is desired to have a structure that can "pinch". It needs to have fine teeth on opposing surfaces and good range of movement for its prongs. It should also be light weight

    Dr. Deependra V Singh · Prof. (Dr.) Yog Raj Sharma
  5. 1 Apr 2021 9 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

    Dr. R Krishnaprasad · Dr. Sayali D Mahajan
  6. 1 Apr 2021 14 min read

    Ten Pearls for The Management of Pseudophakic Corneal Edema

    Corneal edema refers to the accumulation of excess fluid in the corneal layers, with a loss of corneal clarity, resulting in vision loss. The normal cornea maintains a state of 78% hydration due to a complex interplay between stromal swelling pressure, the barrier function of the epithelium and endothelium, endothelial pump, tear evaporation and intraocular pressure [1]. Any condition that interferes with this balance causes a loss of homeostasis and accumulation of fluid. 1. The Natural History of Corneal Edema In the early stages of corneal edema, reduced vision is often related to an irregular corneal surface and can interfere significantly with daily activities. This impact on vision is often underestimated by quantitative visual acuity measurements in standard lighting conditions using high contrast charts, as in a refracting lane. Initially, these patients often experience blurred vision on awakening, owing to the accumulation of fluid in the closed eye state during sleep. As the

    Dr. Sanjeev P Srinivas · Dr. Amanda Mohanan · +1 other
  7. 1 Apr 2021 8 min read

    Ten Pearls for Phacoemulsification in a Hard Cataract

    Phacoemulsification of the very dense cataract presents the surgeon with a series of specific and difficult challenges. How hard is hard and what level of hardness makes it challenging depends largely on the experience of the surgeon. LOCS III classification does not always reveal the real hardness of the cataract, and that aside there is no definition in the literature that classifies the hardness of cataract. A hard cataract is a relative term relative to the surgeon’s experience and confidence! I have over the years put some criteria for myself when I call it a difficult situation. These are dark brown to the black nucleus, no visibility of the posterior slit beam due to the nuclear sclerosis, an older patient, diabetic patient, and preoperative poor vision. Ocular co-morbidities such as pseudo exfoliation, absence of pupillary ruff and calcific spots on the anterior capsule are some of my personal markers which add further to an already challenging surgery Pearl 1: Preoperative con

    Dr. Ashok Rangarajan, MS; DNB; FRCS (Glasgow)
  8. 1 Apr 2021 2 min read

    Ten Pearls of Phacoemulsification in Subluxated Cataracts

    Phacoemulsification in subluxated cataracts is a challenging situation for the phaco surgeon due to lot of variables like management of the subluxation, management of the cataract, vitreous etc. Here are the top ten Pearls for Phaco in subluxated Cataracts. 1 Pre-Op Assessment Careful slit-lamp examination for a) Extent of Subluxation b) The density of the cataract c) Presence or absence of vitreous in Anterior chamber d) Status of the corneal endothelium e) Age of the patient 2 Devices & Instrumentation a) Capsular Tension Ring (CTR) size 10 – 12 mm size 11 – 13 mm b) CIONNI Ring (1 or 2 eyelets) c) CT Segment (Ahmed Segment) d) Capsular Hooks e) Iris Hooks f) Micro Surgical instrumentation like Microrhexis forceps etc. 3 Proper Surgical Planning Zonule loss less than 1 quadrant: Place 3 piece IOL in the axis of the Zonular loss 1 to 2 quadrants: CTR Standard 2 to 3 quadrants: CIONNI 1 or 2 or CT segment (Ahmed) More than 3 quadrants: Above or scleral fixated IOL 4 Surgical Plan Site

    Dr. Mohan Rajan
  9. 1 Apr 2021 4 min read

    Five Things You Should Know About Intracameral Bimatoprost Sustained Release Implant

    The Implant Durysta (ALLERGAN) is the first-ever intracameral sustained-release bimatoprost implant. The glaucoma treatment paradigm has shifted towards earlier intervention and targeting the actual pathology. The main problem one faces with glaucoma management is compliance with the medications. The intracameral bimatoprost addresses the problem satisfactorily. Durysta, a 10-microgram bimatoprost implant, becomes the first biodegradable, intracameral sustained release implant indicated to reduce Intraocular pressure (IOP). It is hard for patients to maintain quality of life while being on topical anti-glaucoma medications – The Intracameral Bimatoprost makes it possible. Administration of the Implant Durysta is a rod-like implant preloaded within a sterile applicator with a 28-gauge needle tip. The needle is inserted under an aseptic condition in the anterior chamber and then with the press of a trigger button implant is released. After the implantation, the needle is removed and the

    Dr. Tamonash Basu
  10. 1 Apr 2021 6 min read

    Learn from the Masters : Tips & Tricks of Managing Dry Eye

    As we all know that India is on the brink of a dry eye disease epidemic, this interview with the maestros in this field will help us to streamline our approach in managing the increasing number of dry eye patients. The availability of innumerable diagnostic tests always baffles us about how to use what in which time. The need for an integrated scheme in assessing and prognosticating dry eye cases is of utmost importance for a successful treatment outcome. Some of the very basic but most important areas are discussed by the unparallels in their field to clear the doubts of young ophthalmologists. Dr. Srinivas K. Rao DO, DNB, FRCSEd has worked as a Senior Consultant at Sankara Nethralaya for 15 years before joining as Professor in the Chinese University of Hong Kong from September 2004 till August 2006. Since October 2006 he is Director of Darshan Eye Care and Darshan Surgical Centre, Chennai. He is also Visiting Professor, Sri Ramachandra Medical University, Cornea Head at Sankara Hospi

    Dr. Sumana Chatterjee