Articles

221–230 of 232 articles Page 23 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. 5 Apr 2020 14 min read

    Endophthalmitis Management in India: a decade and half after the Endophthalmitis Vitrectomy Study

    The current management of post-cataract surgery acute endophthalmitis is greatly influenced by the Endophthalmitis Vitrectomy Study (EVS). The EVS was a multicentric randomized clinical trial that had asked two important questions: (1) Is vitrectomy necessary in all cases of post intraocular lens (IOL) acute bacterial endophthalmitis? and (2) Does systemic antibiotics help in these cases? The EVS recruited 420 patients with acute bacterial post IOL endophthalmitis in 24 centers in the USA. The study recommended that while intravitreal antibiotics must be given to all eyes, vitrectomy should be reserved for eyes with worse presenting vision (light perception, LP, only) and the study did not find any additional benefit of intravenous antibiotics. [1] The major findings of the EVS are listed in Table 1. Are these recommendations followed strictly a decade and half after its first publication in 1995? We will discuss in this article the management strategies we currently practice at the L

    Taraprasad Das · Tapas R Padhi · +1 other
  2. 5 Apr 2020 26 min read

    Diabetic Maculopathy

    Diabetic maculopathy is the most common cause of visual impairment in patients with diabetes mellitus. Classification Diabetic maculopathy is classified as – Exudative Maculopathy Ischemic Maculopathy Mixed Maculopathy 1. Exudative Maculopathy (Diabetic Macular Edema) It is diagnosed stereoscopically as retinal thickening within 1 disc diameter of the center of the macula using fundus biomicroscopy. To characterize the severity of macular edema and for treatment guidelines, the term clinically significant macular edema (CSME) is used. Macular edema is clinically significant if one of the following conditions is present: Retinal thickening at or within 500 mm of the center of the macula; and/or Hard exudates at or within 500 mm of the center of the macula if associated with thickening of the adjacent retina; and/or A zone or zones of retinal thickening 1 disk area in size, at least part of which is within 1 disk diameter of the macular center. It is more common in type 2 diabetes (Adult

    Priyank Garg · Samarth Agarwal · +2 others
  3. 5 Apr 2020 13 min read

    Advanced Custom Ablation: New Technology for Better Quality of Vision

    LASIK is the most widely used technology for the correction of most spherocylindrical ametropias because of its safety and its predictability that leads to excellent outcomes for both the patient and the surgeon. Over the years there has been a progressive refinement of the technique. Customised correction of refractive errors using wavefront technology has revolutionised the way we plan and execute the treatment of refractive errors there are two specific reasons why customised treatment is transforming the entire LASIK arena. The first is that wavefront technology allows us to treat or not the only second order aberrations such as sphere and cylinder but also a higher order aberrations such as coma and spherical aberrations which exist in normal individuals as well as post refractive surgery patients. A major shift in the thought process of refractive surgery is that the LASIK surgeon now seeks to enhance vision beyond what nature itself and designed. With the advent of adaptive opti

    Dr. Keiki R. Mehta · Dr. Cyres K. Mehta
  4. 5 Apr 2020 17 min read

    OCT in Age Related Macular Degeneration (ARMD) and Polypoidal Choroidal Vasculopathy (PCV)

    Optical Coherence tomography (OCT) has revolutionized the way we look at retinal disorders. The earliest version of OCT was the time domain OCT following which spectral domain OCT arrived. Advances such as enhanced depth imaging and swept source OCT have furthered our understanding of retinal disorders. Beginning from the early 90s , OCT has vastly improved the way we diagnose, prognosticate , treat and follow-up retinal disorders.(1) Why OCT? OCT has established itself as one the main imaging modalities in retinal conditions or macular disorders to be more specific. OCT is the most précised method measuring retinal thickness in-vivo.(1) Let us take age related macular degeneration (ARMD) as an example. Understanding the location of the neovascular membrane and its consequences such as intra/subretinal fluid can be clearly understood with the help of an OCT.(2) Prognostic factors such as integrity of the outer retinal layer , RPE alterations such as thickening or fragmentation and the

    Dr. Vishal Gowindhari · Dr. Jay Chhablani
  5. 5 Apr 2020 37 min read

    Retinablastoma:The current concepts

    Introduction Retinoblastoma is the most common intraocular malignancy in children, with a reported incidence ranging from 1 in 15,000 to 1 in 18,000 live births.1 It is second only to uveal melanoma in the frequency of occurrence of malignant intraocular tumors. There is no racial or gender predisposition in the incidence of retinoblastoma. Retinoblastoma is bilateral in about 25 to 35% of cases. 2 The average age at diagnosis is 18 months, unilateral cases being diagnosed at around 24 months and bilat eral cases before 12 months. 2 Pawius described retinoblastoma as early as in 1597.3 In 1809, Wardrop re ferred to the tumor as fungus haematodes and suggested enucleation as the primary mode of management.3 The discovery of ophthalmoloscope in 1851 facilitated recognition of specific clini cal features of retinoblastoma. Initially thought to be derived from the glial cells, it was called a glioma of the ret ina by Virchow (1864)3.Flexner (1891) and Wintersteiner (1897) believed it to be

    Dr. Santosh G Honavar, MD, FACS
  6. 5 Apr 2020 18 min read

    Ocular Histopathology: A ready reckoner

    Basic histology of the eye Eyelid: Each eyelid consists of skin, subcutaneous tissue, striated muscle fibers of orbicularis oculi, orbital septum and tarsal plates, smooth muscle and conjunctiva. The skin contains sebaceous glands and small sweat glands.The eyelashes are more numerous in the uppereyelid than in the lower. The sebaceous glands of Zeis open into each follicle. Histological photograph of eyelid Conjunctiva: The conjunctiva is made up of an epithelium consisting of stratified columnar cells resting on a lamina propria of loose connective tissue, the submucosa. At the limbus there is a change to stratified squamous nonkeratinised epithelium which is continuous with the corneal epithelium. At thelimbus, the laminapropria forms the papillae. On the posterior edge of the lid margin, the conjunctiva joins the skin. Here the nonkeratinised squamous epithelium of the conjunctiva becomes continuous with the keratinized stratified squamous epithelium of the epidermis. The conjuncti

    Dr. Kalpana Babu
  7. 5 Apr 2020 16 min read

    Serpiginous Choroiditis: An Update

    The word “serpiginous” is an adjective which means “with a wavy or indented margin”. The serpiginous choroiditis shows the similar wavy or amoeboid like lesions in choroid as a result of inflammation of unknown aetiology. The serpiginous choroiditis may be defined as a chronic, progressive, usually bilateral, recurrent in?ammatory condition which affects the choroid, choriocapillaries and retinal pigment epithelium. This clinical entity was first reported by Junius in 1932 who termed it as “peripapillary retinochoroiditis”. Thereafter this clinical entity has passed through various nomenclatures by various authors (Table 1). The term “serpiginous choroidopathy” was coined by Gass in 1987. Table 1: Different nomenclatures of Serpiginous choroiditis by various authors Peripapillary choroidalsclerosis by Sorsby, 1939 Helicoid peripapillary chorioretinal degeneration by Franceschetti, 1962 Geographic helicoids peripapillary choroidopathy by Schatz,1974 Geographic choroiditis by Baarsma,197

    Dr. Parthopratim Dutta Majumder
  8. 5 Apr 2020 15 min read

    Retinal Vasculitis

    Retinal vasculitis is an inflammatory disease of the blood vessels of the retina that may be associated with primary ocular conditions or with inflammatory or infectious diseases in other parts of the body (systemic diseases). It has been defined as the vascular leakage and staining of vessel walls on fluorescein angiography, with or without the clinical appearance of fluffy, white perivascular infiltrates in an eye with evidence of inflammatory cells in the vitreous body or aqueous humor 1. Typically, retinal vasculitis is divided into entities localized to the retina and into systemic diseases involving the eye. These include certain ocular disorders, systemic autoimmune disorders, and some infectious diseases. Etiology: The common primary causes of retinal vasculitis where vessel is the primary target of the inflammatory process are: (a) Localized to the eye - Idiopathic - Intermediate uveitis of the pars planitis type - Frosted branch angiitis - Idiopathic retinal vasculitis, aneur

    Dr. Reema Bansal · Prof. Amod Gupta
  9. 5 Apr 2020 24 min read

    Management of Rhegmatogenous Retinal detachments- Evidence based Review

    Introduction Rhegmatogenous retinal detachment (RRD) although rare, it is a serious ophthalmic condition that can lead to significant loss of vision or blindness without timely and appropriate management. It has been nearly a century (1918) since Jules Gonin demonstrated the importance of localizing and sealing retinal breaks, a procedure termed ignipuncture.1 Scleral buckling techniques, introduced by Custodis2 and refined by Schepens and later Robert Machemer’s pars plana vitrectomy, revolutionized repair of RRDs. Pneumatic retinopexy introduced in the mid 1980s allowed treatment of retinal detachments as an outpatient procedure in selected retinal detachments 3 Above techniques either alone or in combination has resulted in surgical success rates close to 90%. For most surgeons, choice of surgical procedure for primary retinal detachment will depend on the individual clinical situation combined with each surgeon's experience; bias and comfort level with a particular procedure. Recen

    Dr. Raju Sampangi, MD (AIIMS), DNB · Dr. Hemalatha B C, MS, FMRF
  10. 5 Apr 2020 10 min read

    Pseudophakic Cystoid Macular Edema

    Pseudophakic cystoid macular edema (PCME) is a common cause of visual impairment after cataract surgery. This article systematically reviews and discusses the epidemiology, risk factors, diagnosis, and treatment of PCME, with a focus on advances in the past 1–2 years.In 1953, Irvine described a cystoid macular edema (CME) that specifically arised after cataract surgery.1 Gass and Norton subsequently studied the characteristics of the new disease entity with fluorescein angiography.2,3 Despite advances in cataract surgery, cystoid macular oedema (CMO) is still recognised as one of the most common causes of poor visual outcome following cataract surgery.4 Clinical cystoid macular edema(CCME) produces a variable degree of eyesight deterioration, in a percentage between 0.2 and 13%of patients operated for cataract with or without complications.5,6,7 Studies have shown that 12% of patients may have retinal thickening following uncomplicated cataract surgery.8 Retinal thickening most commonl

    Priyank Garg · Dr. Anu Malik · +1 other