Articles

71–80 of 232 articles Page 8 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. 22 Jun 2021 10 min read

    Making Sclerotomy Ports during a Vitreoretinal Surgery: Tips, Tricks and Concerns

    The advancement of vitreous surgery from the 20-gauge (20G) era to the present day Transconjunctival Sutureless Vitrectomy (TVS) has favorably transformed patient outcomes in the surgical management of retinal diseases. The 20G system (O’Malley and Heintz, 1974) has been the gold standard technique in modern vitreous surgery for nearly three decades, beginning from the earliest 17G vitrectomy as introduced by Machemer in 1971. The 20G systems were associated with sutured port closure, longer and irregular wound healing, higher vitreous turbulence, greater incidence of port-related complications like retinal breaks, and a longer surgical time. On the other hand, the trochar and cannula based micro incision vitrectomy surgery (MIVS) are associated with early post-operative recovery, better and uniform wound healing, lesser port related complications, lesser vitreous turbulence and increased patient comfort with earlier visual recovery. As with any surgical procedure, the decision and pla

    Dr. Aditya Verma
  2. 16 Jun 2021 18 min read

    OCT-Angiography in Retinal Diseases Made Incredibly Simple For Post Graduates

    Introduction: Optical coherence tomography angiography (OCT-A) has emerged as a novel imaging technique for visualizing the retinal and choroidal microvasculature at the macula and optic disc.1 It provides in vivo 3D vascular information by analyzing the movement of flowing red blood cells and thereby enabling the visualization and quantification of functional vessel networks within microcirculatory tissue beds in a non-invasive manner without the use of dye injection.2 Understanding the anatomy of retinal and choroidal microvasculature (figure 1): Retinal microvasculature: Studies have identified 4 retinal vascular capillary networks at the macula which are broadly grouped into 2 vascular plexuses; superficial and deep.3 The superficial vascular plexus (SVP) consists of the superficial capillary plexus and radial peripapillary capillary plexus. The former is located in the ganglion cell layer and the latter in the retinal nerve fibre layer. The SVP receives its blood supply from the c

    Dr. Ramesh Venkatesh, MS, FMRF, FVRF · Dr. Nikitha Gurram Reddy · +1 other
  3. 15 Jun 2021 23 min read

    Complications of Penetrating Keratoplasty

    Penetrating keratoplasty (PK) is a procedure in which full-thickness host corneal tissue is replaced with donor corneal tissue. Objectives of PK maybe Optical-to establish a clear visual axis or to minimize refractive error in severely distorted corneas Tectonic-to provide structural integrity Therapeutic-to eliminate infection Occasionally for cosmoses Complications of PK may be divided as intraoperative, early postoperative, and late postoperative. Intra-operative complications: Intra-operative complications may occur at each step of the surgery. These complications can be avoided with meticulous pre-operative planning and careful attention at each step. 1. Anaesthesia: In the case of the retrobulbar or peri-bulbar block (1), globe perforation may occur. A meticulous pre-operative assessment could avoid this complication as eyes with a posterior staphyloma possess a higher risk of perforation. A retrobulbar block may cause scleral perforation, orbital hemorrhage, optic nerve trauma,

    Dr. Bhupesh P Jain · Dr. Priyanka Kashelkar
  4. 7 Jun 2021 5 min read

    Pearls in the Diagnosis and Management of Rhino-Orbito-Cerebral-Mucormycosis

    “The more you know about the past, the better you are prepared for the future.” – Theodore Roosevelt 1. Elicit adequate history Considering the lethal and angio-invasive nature of Rhino-Orbital-Cerebral-Mucormycosis (ROCM) supplemented in this COVID-19 era, it is mandatory to understand the causative factors of the disease. Diabetes mellitus, oral and systemic corticosteroids, immunosuppressive drugs like tocilizumab, remdesivir, hospital admission, supplemental oxygen, mechanical ventilation, primary or secondary immunodeficiency, hematological malignancies, stem cell transplantation, solid organ malignancies and solid organ transplantation, iron overload etc have been considered the important predisposing factors. The history acts like the guiding lantern onto the path towards appropriate management. “Ignoring the signs is a good way to end up in the wrong destination” 2. Identify the Red Flag signs In-depth knowledge about the red flag signs enables the clinicians to recognize the w

    Dr. Rolika Bansal · Dr. Santosh G Honavar, MD, FACS
  5. 4 Jun 2021 15 min read

    Trials in Glaucoma You Should Know

    Ocular Hypertension Treatment Study (OHTS) This multicentric trial recruited 1,632 patients of ocular hypertension (OHT) to answer two questions. First, if early treatment in patients of OHT with topical medication would prevent the onset of primary open-angle glaucoma (POAG). Second, which patients of OHT are more likely to develop POAG, in other words, what are the risk factors for conversion from OHT to POAG? The patients who had IOP of at least 24 mmHg in one eye and 21 mmHg in other eye, were recruited in this study. They were randomized into two groups-those who received intraocular pressure (IOP) lowering drops (Medication arm) and those who did not receive any IOP lowering drops (Observation arm). The IOP reduction was targeted at 20% in the medication group. After enrollment, patients were examined every 6-months and follow-up included a white-on-white visual field at every visit and stereoscopic disc photograph annually. The endpoint was the development of new, reproducible d

    Dr. Parveen Rewri
  6. 1 Jun 2021 11 min read

    Ten Microbiological Facts on Mucormycosis All Ophthalmologists Should Know

    The present overview highlights major microbiological aspects of mucormycosis and attempts to increase the awareness of this ubiquitous group of fungi that are responsible for the difficult-to-manage infections presently being encountered in the setting of the ongoing COVID-19 pandemic. 1. What is Mucormycosis and why is mucormycosis emerging as a serious threat in the present COVID-19 pandemic? Mucormycosis (previously called zygomycosis; sometimes called black fungus infection) is a serious, but rare fungal infection caused by a group of molds belonging to the order Mucorales(1). Mucormycosis is a fulminant disease with high rates of morbidity and mortality that mainly affects immunocompromised patients. Depending on the location of the infection, the mucormycosis can be rhino-orbito-cerebral (most common), pulmonary, gastrointestinal, cutaneous, or disseminated. Although it has a low incidence rate, varying from 0.005 to 1.7 per million population, a sudden rise in cases of rhino-or

    Dr. A.R Anand
  7. 25 May 2021 9 min read

    Seven Tips to Treat A Treatment Resistant Microbial keratitis

    Microbial keratitis is a common potentially sight-threatening condition and is considered an ocular emergency. Managing them brings forth multiple challenges to the ophthalmologist one of them being to primarily distinguish an infective from non-infective keratitis. Based on signs, symptoms, history, and laboratory investigations a treatment plan is laid out which is modified based on clinical response and antimicrobial sensitivity. However, if the response to treatment is inadequate or the microbial keratitis is resistant to treatment it becomes mandatory to assess the factors causing it and change the therapeutic strategy accordingly. The present article attempts to look at the different factors which cause resistant microbial keratitis and means to manage them. Both local/ocular and systemic factors can contribute to the resistant nature of the ulcer and are listed in table 1. The need to address systemic concerns with the help of a physician along with the ocular factors cannot be

    Dr. Shweta Agarwal · Dr. Bhaskar Srinivasan · +1 other
  8. 18 May 2021 9 min read

    Ten Pearls for the Diagnosis & Management of Binocular Vision Anomalies

    The prevalence of non-strabismic binocular vision anomalies is on the rise over the last decade. The prevalence reports from various parts of the globe quote a high prevalence ranging between 28.5-31.5% among school children (1,2). It is also shown in a recent study that clinically significant convergence insufficiency can impair stereo-acuity in children necessitating the diagnosis and management of convergence insufficiency (3). Here are some pearls to ensure accurate diagnosis and provide appropriate management to patients afflicted with binocular vision anomalies. This article specifically focuses on non-strabismic binocular vision anomalies as they are often missed out due to their latent nature, unlike strabismic anomalies. The efficiency of the visual system is beyond 20/20 Many eye care practitioners unfortunately still assume that 20/20 visual acuity ensures an optimally functioning visual system. The efficiency of the visual system is not just dependent on the integrity of th

    Dr. Jameel Rizwana Hussaindeen, M.Phil Opt, Ph.D.,FCOVD-I, FAAO
  9. 5 May 2021 25 min read

    Simple Limbal Epithelial Transplantation: A Review

    I. Introduction The cornea is lined by non-keratinized, stratified squamous epithelium. At the limbus, there is a gradual transition of these cells to non-keratinized, stratified columnar epithelial cells, along with mucin-secreting goblet cells, forming the conjunctival epithelium. The corneoscleral limbus lies between these two epithelia in a healthy eye. The limbus contains palisades of Vogt, the basal layer of which function as a repository for the corneal epithelial stem cells.(1, 2) These limbal epithelial stem cells (LESC’s) divide whenever the corneal epithelium is required to be replenished. As the stem cells divide, one of the daughter cells retains the primitive nature of the parent cell and functions to maintain the stem cell pool. The other daughter stem cell differentiates to acquire the physiological nature of a specific tissue, like the corneal epithelium. These cells are known as ‘transient amplifying cells’, which then divide and migrate centripetally, circumferential

    Dr. Supriya Sharma · Dr. Swapna Shanbhag · +1 other
  10. 21 Apr 2021 18 min read

    Facial Spasms: Diagnosis and Management

    Introduction Dystonia is defined as a movement disorder characterized by sustained or intermittent muscle contractions causing abnormal, often repetitive, movements, postures, or both [1]. They may be isolated or combined with other neurological symptoms or movement disorders [1]. Dystonia is classified based on the age of onset, etiology, clinical features, and body distribution. The body distribution may be either focal, segmental, multifocal, generalized, or hemi-dystonia. Only one region of the body is affected by focal dystonia. It emerges in late adulthood [1]. Patients with movement disorders isolated to the facial region often visit an Ophthalmologist. A brief knowledge about the identification and differentiation of the various facial movement disorders is essential. The disorder can be functionally or socially distressing to the patients. The facial movement disorders include orbicularis myokymia, Benign Essential Blepharospasm (BEB), Apraxia of Lid Opening (ALO), Hemifacial

    Dr. Varshitha Hemanth Vasanthapuram · Dr. Milind N Naik