Articles

41–50 of 232 articles Page 5 of 24
  1. 2 Nov 2021 7 min read

    Diplopia Charting: A Ready Reckoner for the Postgraduates

    Diplopia charts are kept in postgraduate examinations during viva sessions. Even in theory examinations also, these topics may be asked. It is not difficult to interpret the charts and all PGs should practice recording the results of these charts. Principle: Dissociation of eyes by means of complementary colors. We use red and green goggles (Armstrong google). In diplopia charting, Red is always in the Right eye and patients perceive one object as two fused images. Let us see the method of interpretations of these charts See the chart Remember red and green goggles are used. Red in front of the right eye and Green in front of the left eye. To your right side (The right side of the picture). Version positions. Dextrum version. Elevation and Depressions are there. The left side of you is the left side positions like levoversion, elevation and levodepression are there Primary position elevation and depressions are noted. Totally we have nine quadrants Never forget to write the name of the

  2. 25 Oct 2021 8 min read

    Anti-VEGFs made Easy for the Postgraduates

    The retina is a highly metabolic tissue and needs a constant high supply of oxygen. Insult to either choroidal or retinal vasculature can lead to a hypoxic state. Throughout the years, neovascularization has been seen to occur in areas neighboring such hypoxic areas. In 1989, this hypoxia-inducible and diffusible factor was discovered to be Vascular Endothelial Growth Factor (VEGF), initially coined as Vascular Permeability Factor (VPF). VEGF was found to be answerable for many types of retinopathies and the increased vascular permeability seen in them. VEGF is a heparin-binding dimeric glycoprotein with di-sulfide-linked A and B subunits. VEGF has been found to be produced by many cell types in the retina including vascular endothelial cells, retinal pigment epithelium, pericytes, Muller cells, retinal neurons, and astrocytes. It is necessary for the survival of retinal cells; prenatally for proper embryological development of the retina as well as postnatally for preserving adult mic

  3. 7 Oct 2021 6 min read

    Normal flora /Microbiome of the Eye: 10 Facts

    1. Definition of Microbiome Microbiomes are communities of organisms (bacteria, fungi, viruses) that normally reside on any part of the human body (both external and internal) and are in a symbiotic relationship with the host. The members of the microbiome live in close harmony, sharing food and shelter and offering benefits to each other, e.g. some members give protection by secreting extracellular polymeric substances to form a protective covering of biofilm around the community, while some excrete metabolic by-products which are useful substrates for the others. 2. Relation of Microbiome with the host Most of the organisms of the microbiome provide support to the good health of the host (like preventing colonization by harmful pathogens by competing for shelter and food niches, occupying the pathogen receptor sites, or secreting antibiotics and metabolic by-products like acetic and lactic acids which harm such pathogens). But some of the members can also act as opportunistic pathoge

  4. 28 Sep 2021 7 min read

    Top-Ten-Must-Not-Forget-In-Strabismus-Evaluation

    1. External face features affecting the eye position Facial asymmetry and palpebral fissure shape changes alter the ocular position, possibly due to extra-ocular muscle heterotopy The common extra-ocular features affecting ocular position are craniosynostosis, hydrocephalus, facial fracture, mongoloid and anti-mongoloid slant, telecanthus, congenital superior oblique palsy (face fuller on the affected side), facial nerve palsy. 2. Head posture Head does what eye cannot do Look for abnormal head posture when a patient is reading best-corrected visual acuity with proper refractive correction. The target should preferably be at the eye level of the patient in order to avoid a false chin-up position Head tilt, turn, chin-up/down Head turn is the opposite side of the ear seen Measure with a goniometer Look for incomitant strabismus and nystagmus Keep patient’s head straight throughout the examination – eg. In patients with Duane syndrome, small change in head posture can cause large ocular

  5. 23 Sep 2021 13 min read

    Ten Pearls for Treating A Case of Retinopathy of Prematurity

    Introduction Retinopathy of Prematurity (ROP) is a potentially blinding retinal vasoproliferative disorder affecting premature and low birth weight infants. With improving survival of preterm infants with lower birth weights and gestational ages, ROP is reaching epidemic proportions in many middle- income countries.1 Although a majority of infants would develop a mild self-limiting disease, some can progress to tractional retinal detachment and become permanently and irreversibly blind. Timely detection and treatment along with good supportive neonatal care offer the best chance of successful outcomes in these infants. Key pearls of ROP management are described as under: Pearl 1: Which infants should be examined for ROP? The guidelines for screening infants for ROP vary between different countries and geographical regions based on individual incidence rates. For India, the current guidelines recommend that all infants with a birth weight of 2000 grams or less and /or gestational age le

  6. 17 Sep 2021 9 min read

    Visual Fields in Neuro-Ophthalmology : 10 Pearls for the Postgraduates

    1. Is there something we can do before ordering a visual field in neuro-ophthalmology? Confrontation visual field testing is an important clinical examination, especially when it comes to neuro-ophthalmology cases. A simple test can give us clues as to what may be the underlying cause of patients’ symptoms. The test is done presuming the visual field of the examiner is normal. Both the patient and the examiner should be seated at an equal height at a distance of 1 meter. The right eye field is tested by asking the patient to close their left eye and the examiner closes his/her right eye. The first question the examiner must ask the patient, if they are able to see the examiner’s face clearly, without any parts missing. The examiner then moves a pin-point target from out to in all 4 quadrants, while instructing the patient to continuously look into the examiner’s eye. When the patient sees the object, they inform the examiner, who is then able to compare when they themselves saw the obj

  7. 13 Sep 2021 31 min read

    Central Retinal Vein Occlusion: A Comprehensive Review

    Introduction: The clinical entity of Central Retinal Vein Occlusion (CRVO) has been known since 1878 (1), and it is a common visually disabling disorder that may cause significant ocular morbidity. It commonly affects men and women equally and occurs predominantly in persons over the age of 65 years (2-4). Associated systemic vascular disease, including hypertension and diabetes, are present in these population groups. The prevalence rates range from 0.1% to 0.5% in the older adult population. (3-5) Younger individuals may have an underlying hypercoagulable or inflammatory Etiology (6,7) CRVO is the second most common retinal vascular disorder after diabetic retinopathy and is considered to be an important cause of visual loss. (8) The annual risk of developing any type of retinal vascular occlusion in the fellow eye is approximately 1% per year, and it is estimated that up to 7% of persons with CRVO may develop CRVO in the fellow eye within 5 years of onset in the first eye (9-11). CR

  8. 10 Sep 2021 10 min read

    Ten Clinical Signs A Postgraduate Must Look For While Examining the Fundus

    1. Red Dots! : Microaneurysms Seen in Diabetic Retinopathy, retinal vein occlusions, hypertensive retinopathy, radiation retinopathy. Microaneurysms are usually the first ophthalmoscopically detectable sign of diabetic retinopathy. They are focal saccular outpouchings of the capillary wall due to pericyte loss. Arise from the deep part of the inner retinal capillary plexus, and are present in the inner nuclear layer.1 Features: Appear as small round red dots - usually seen at the posterior pole, especially temporal to the fovea. 10- 100 microns in diameter. Only > 30 microns is visible ophthalmoscopically (better on red-free illumination). < 30 microns can be seen on FFA and hence more microaneurysms are seen on FFA than fundus examination. Shapes – saccular, fusiform, pedunculated, focal bulge, irregular, mixed. FFA- Hyperfluorescent with leakage. OCT – Ring sign, span more than 1 retinal layer. Course- disappear in 3-6 months. Can continue to exudate, bleed or thrombose. 2. And it wa

  9. 6 Sep 2021 20 min read

    Basics of limbal Stem Cell Deficiency for the Postgraduates

    Limbal Epithelial Stem Cells Anatomy: The healthy corneo-scleral limbus (Figure 1) is a gradual transition zone from the stratified, non- keratinised squamous epithelium of the cornea to the stratified, non- keratinised columnar epithelium with mucin-secreting goblet cells of the conjunctiva. It has 7-10 layers of cells, which have attachments similar to the corneal cells. Figure 1: Slit-lamp photograph (high magnification) of the normal limbus showing arrangement of pigmentated Palisades of Vogt in the inferior quadrant. This zone contains limbal epithelial stem cells (LSCs) that generate new epithelial cells during homeostasis and after injury or insult, to maintain corneal transparency and vision. LSCs are believed to be located within the basal layer of limbal crypts (in the palisades of Vogt) [1] and focal stromal projections (finger-like projections of stroma containing a central blood vessel, and extend upward into the corneal limbal epithelium and are surrounded by small, tight

  10. 4 Sep 2021 6 min read

    Ten Points One Must Know on Toxic Anterior Segment Syndrome (TASS)

    TASS is an uncommon, non-infectious condition causing severe inflammation of the anterior segment structures without vitreous involvement [1],[2],[5]. The name TASS was coined by Monson and colleagues in 1992 [1],[3]. It is usually associated with phacoemulsification surgery but can also happen after procedures like penetrating keratoplasty, descemet stripping automated endothelial keratoplasty, deep anterior lamellar keratoplasty, vitrectomy and anterior and posterior segment phakic intraocular lenses. The alternative names of TASS include sterile post -operative endophthalmitis, toxic lens syndrome, toxic endothelial cell destruction syndrome and localized endophthalmitis [1],[3],[7]. 1. What is TASS? It is an acute sterile post-operative inflammatory condition affecting the anterior segment structures following intraocular surgery. It is usually seen within 12-48 hours of surgery and is due to the reaction of anterior segment structures to some toxic substance usually associated wit