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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 Sep 2021 9 min read

    Ptosis Surgeries: Made Simple for The Postgraduates

    Ptosis refers to a vertical narrowing of the palpebral fissure secondary to drooping of the upper eyelid to a lower than normal position. Multiple surgical procedures can be used to correct ptosis including, frontalis sling, levator advancement, Fasanella Servat operation, and Mullerectomy. The selection of one technique over another depends on the consideration of several factors including the degree of ptosis, the degree of levator muscle function as well as the surgeon experience. Detailed examination and accurate measurements help to decide the procedure that may be required in each patient. When to treat The primary indications for treatment of congenital ptosis are amblyopia and abnormal head positioning. In the setting of severe unilateral ptosis, stimulus deprivation amblyopia is imminent and early surgery is advised and routinely performed at preschool age. Severe bilateral (or unilateral) ptosis can cause a patient to assume an obvious chin-up head position that can interfere

    Dr. Namrata Adulkar
  2. 30 Aug 2021 6 min read

    Anomalies of Accommodation

    Ocular accommodation is an integral visual function that optimizes the visual perception through the focusing ability of the crystalline lens. This closed-loop system constantly interacts with the oculomotor system for finer focusing and alignment of the eyes under naturalistic binocular viewing conditions. This write-up is intended to provide an overview of the commonest anomalies of accommodation encountered by an eyecare practitioner through case-based learning. For detailed reading, the readers are requested to refer to Scheiman & Wick.1 The table below provides an overview of the commonest clinical signs, and symptoms seen in different anomalies of accommodation. 1, 2 ANOMALIES OF ACCOMMODATION DIAGNOSTIC CRITERIA ETIOLOGY PRIMARY SIGNS SYMPTOMS Accommodative insufficiency (Not due to sclerosis of the crystalline lens) Accommodation amplitudes (AA) lesser than expected for the patient’s age Usually idiopathic, can result from certain systemic medications Decreased AA for age (2D l

    Dr. Jameel Rizwana Hussaindeen, M.Phil Opt, Ph.D.,FCOVD-I, FAAO
  3. 26 Aug 2021 9 min read

    How to Quickly Read a Macular OCT Scan?

    Optical Coherence Tomography (OCT) is a quick, non-invasive, reproducible, and optical analog of ultrasound imaging which is as good as in vivo viewing of individual retinal layers histologically. In today’s practice, OCT is indisputably an essential diagnostic tool for every retinal surgeon. And so correct interpretation of OCT scans helps us in understanding the disease pathologically which in turn aids in prognosticating and making treatment decisions. How to quickly read a macular OCT? An OCT image gives you layer by layer information of retinal tissue. So if we segment the OCT image into 5 layer-wise sub-segments, it becomes very easy to read and interpret the retinal pathology. And also just by looking at the diseased/damaged retinal layer, we can identify probable clinical disease. These 5 OCT sub-segments can be used for quick interpretation of macular OCT scans. 1: VR (Vitreo-Retinal) Interface 2: Inner Retina 3: Outer retina 4: RPE/ BRUCHS MEMBRANE 5: Choroid Let us first rev

    Dr. Deepak Bhojwani
  4. 24 Aug 2021 7 min read

    How to Make Your Online Presence Felt : Tips & Tricks

    Introduction Covid has accelerated the digital shift for healthcare. We all know that It was probably going to take a few more years to happen but now as more and more people take the digital route for any requirement they may have, it becomes important for business owners to think about their online presence. This is true even for ophthalmologists. More so for those who have established their own practices versus working in an eye institute and this difference is because those who have established their own practices have in one way become entrepreneurs and whether they like it or not as time goes by the most important job as the owner of an ophthalmic practice would be to increase or drive patients to that practice. This is where online presence comes in. So what does online presence mean? When people look for you or for things you do there are places that showcase you or your practice. These could be Youtube videos Listing in Practo and similar sights A Website Writing a Blog A News

    Dr. Deepak Garg
  5. 20 Aug 2021 7 min read

    i-File: Asteroid Hyalosis

    Chief Complaint: A female patient of 58 years old who came for a routine eye examination. History of Present Illness: No specific complaints. Past Ocular History: No H/O any previous injury. Past Medical History/ History of Medication: Known diabetic for the past 10 years and on control with oral hypoglycemic agents. Family History: No significant family history. Review of Systems/Systemic Examination Pulse rate - 88/min, respiratory rate - 16/minute. BP- 120/80 mm Hg. Examination of other systems were normal. Ocular Examination Best Corrected Visual Acuity (Snellen) Right eye (OD): 6/6 p N6 Left eye (OS): 6/6 N6 Ocular Motility/Alignment Extraocular motility was full and free in all gazes in both eyes. Intraocular Pressure (IOP)- By Applanation tonometry Right eye (OD): 14mm Left eye (OS): 16mm Pupils: Both eyes (OU) - round and briskly reacting to light. Slit-lamp examination: Lids/lashes: Both eyes (OU)- normal. Conjunctiva/sclera: Both eyes (OU) - normal. Cornea: Both eyes (OU) – c

    Dr. Priya Rasipuram Chandrasekaran
  6. 17 Aug 2021 5 min read

    Ten Mistakes to Avoid while Treating a Case of Diabetic Retinopathy

    Diabetic Retinopathy is a common retinal disorder that is seen, managed, and followed up by not only a retina specialist but all ophthalmologists. It is a disease that is easy to diagnose, but often difficult to manage in a long run. For achieving optimal results besides the role of an ophthalmologist, one needs to have the involvement of a physician. The single most important factor for achieving a good outcome is patient compliance, as the disease, diabetes needs lifelong care. Here are few mistakes we need to avoid while managing a case of DR. 1. I can detect DME clinically, I don’t need OCT OCT is not mandatory if there are no signs of DR, or in very mild retinopathy (1 D, Amblyopia, Unilateral elevated intraocular pressure, Complete posterior vitreous detachment, Unilateral carotid artery stenosis, and Chorioretinal scarring 5. Ignoring a rapid progression of milder NPDR to PDR A rapidly progressive NPDR to proliferative retinopathy in a span of a few months (4-6 months) is rare a

    Dr. Rajiv Raman
  7. 4 Aug 2021 12 min read

    How to Present a Case of Corneal Ulcer in the Examination

    1. Obtain a detailed history : a. A history of injury and the injuring agent - some pointers from this would be the occurrence of fungal infections in injuries with vegetable matter/insect wing cases; bacillus infections in patients with broomstick injuries; gram-positive infections with metal foreign bodies and so on b. A history of past such similar episodes - typically, this suggests the possibility of viral infections c. History of contact lens use - in such cases, while there is the possibility of a sterile infiltrate, especially if such infiltrates are present at 3 and 9 o? clock periphery, it is imperative to keep in mind serious infections such as pseudomonas d. Prior treatment history - obtain a detailed history of the name of antibiotic used, the frequency of use suggested, and the compliance of the patient with therapy. Failure to respond to adequate dose and duration of appropriate antibiotics suggests the possibility of a fungal or parasitic infection. e. Pain, discharge,

    Dr. Srinivas K Rao, DO DNB FRCSEd
  8. 28 Jul 2021 16 min read

    Papilledema- A Ready Reckoner for Postgraduates

    Introduction Papilledema is used to describe optic disc edema resulting from increased intracranial pressure while disc edema could be due to any cause. While disc edema can be unilateral or bilateral, papilledema is usually bilateral, however, it can be asymmetric, to begin with. Another important differential of true papilledema is pseudo papilledema which is seen in conditions like a small hyperopic optic disc or optic disc drusen, etc. This chapter shall entail a discussion on the etiopathogenesis of papilledema and the approach to diagnosis and management of papilledema. Papilledema and its mechanism It’s a form of bilateral optic disc swelling associated with increased intracranial pressure. An increase in intracranial pressure can occur secondary to an intracranial space-occupying lesion, cerebral venous thrombosis, or can be idiopathic as in the case of Idiopathic Intracranial hypertension (IIH). Figure 1 depicts the mechanism of the development of papilledema. Pseudo vs true p

    Prof. Rohit Saxena · Dr. Monika Yadav · +1 other
  9. 27 Jul 2021 13 min read

    Astigmatism - The clinical pearls in Refractive care

    Preface: Astigmatism is a common type of refractive error that we come across in vision clinics on a regular basis. It causes the deterioration of retinal image quality and leads to specific vision-related symptoms. Prevalence of this condition is reported to vary with age, gender, and ethnicity. The clinical diagnosis and management of astigmatism necessitate an understanding of its nature and characteristics. Hence, this particular write-up is prepared as a consolidation of integrated information related to ‘astigmatism’ by focusing on its definition, classic types, relevant clinical evaluation components, and appropriate management options. What is astigmatism? Astigmatism is a type of refractive error/ametropia that occurs when parallel rays of light entering the ocular media (non-accommodative state) are not focused well on the retina. In an optical system with astigmatic error, light rays propagate in two different planes and the incident light rays fail to converge at a single f

    Najiya Sundus K. Meethal · Dr. Krishna Kumar Ramani
  10. 22 Jul 2021 13 min read

    i-File: Thyroid Eye Disease

    Case presentation: A 65-year-old man presented to our clinic with gradually progressive protrusion and swelling of both eyes and double vision for 1 year associated with progressive drooping of the right upper eyelid. There is acute onset of pain in the left eye for 10 days. A smoker for 25 years. Past ocular history No h/o previous ocular surgery or trauma Past medical history The patient is a diagnosed case of hyperthyroidism, Graves’ disease for 2 years. On treatment with Tablet Neomercazole 5mg per day. No history of radio-iodine therapy. The patient has no history of diabetes, hypertension, or cardiac disease. Family history No significant history Ocular Examination: Right Eye Left Eye IOP 18 mmHg 21 mmHg VISUAL ACUITY (UCVA) 6/60 3/60 BCVA 6/24 6/60 COLOUR VISION NORMAL 8/21 OCULAR MOTILITY -1 RESTRICTION IN ALL DIRECTIONS -3 RESTRICTION IN ELEVATION -2 RESTRICTION IN ALL DIRECTION PALPATION NO PALPABLE MASS NO PALPABLE MASS LIDS AND LASHES NEAR-COMPLETE PTOSIS NO LAGOPHTHALMOS L

    Dr. Rwituja Thomas · Dr. Garvita Singh