Articles

81–90 of 232 articles Page 9 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. 15 Apr 2021 16 min read

    i-File: Exfoliation Glaucoma

    A 65-year-old male presented to the OPD with complaints of painless, gradually progressive dimunision of vision of the right eye over several months. History of Present Illness: The Patient was apparently normal 1 year ago since when he noticed dimunision of vision of the right eye by closing the left eye by chance. The vision progressively got worse. No h/o pain, watering, halos, glare or double vision. Past Ocular History: No H/o trauma or ocular surgery. Past Medical History/ History of Medication: No systemic illnesses. No H/O taking any steroids or long term medications Family History: Not significant. No family history of glaucoma. Review of Systems/Systemic Examination: Normal. Vitals were normal. OCULAR EXAMINATION Best Corrected Visual Acuity (Snellen) Right eye (OD): 6/60 Left eye (OS): 6/9 Ocular Motility/Alignment: Full, free, and painless in all gazes. Intraocular Pressure (IOP) OD: 55mmHg (@ 2pm using Goldmann Applanation Tonometry) OS: 19mmHg (@ 2pm using Goldmann Applan

    Dr. Sahebaan Sethi
  2. 12 Apr 2021 28 min read

    Choroidal Neovascular Membrane: Made Easy For Postgraduates

    Introduction Choroidal neovascularization (CNV) or choroidal neovascular membrane (CNVM) is a growth of new choroidal vessels into the subretinal space through breaks in the Bruch's membrane. Ophthalmoscopically the CNVM appears as a greenish-grey lesion, often with a detachment of the sensory retina, subretinal blood, and exudates. Choroidal neovascularization can be multifactorial with the commonest being due to age-related macular degeneration (AMD), called the wet or exudative AMD. The other causes of include high myopia, angioid streaks, presumed ocular histoplasmosis syndrome, choroidal rupture post-trauma, osteoma, macular telangiectasia, inflammatory and idiopathic. Since the most common cause of CNVM remains age-related, this writeup will focus on the same. Age-related macular degeneration is the most common cause of blindness in the western world over the age of 65 years. With a worldwide UN estimate of about 20-25million, 8 million individuals are in the USA alone.1 The numb

    Dr. Santosh Gopi Krishna Gadde · Dr. Nikitha Reddy Gurram · +1 other
  3. 8 Apr 2021 14 min read

    Anterior Vitrectomy Made Easy For Cataract Surgeon

    One of the most dreaded complications of cataract surgery is a posterior capsular tear (PCR). Its rate ranges from 1.3% to 9.6% (from skilled surgeons to trainees)1-5. Early recognition of the PCR and skilled management is necessary for good surgical outcomes and to avoid any devastating sequelae. Hence, anterior vitrectomy is an important skill that every cataract surgeon should master. There are some risk factors that may predispose to PCR like a true posterior polar cataract, dense and mature cataracts, old age (zonular weakness, small pupil, and denser cataract), uncooperative/ anxious patients, poor visualization due to corneal disease, pre-existing ocular trauma leading to capsular rupture/ zonular damage, etc.6,7 A thorough preparation beforehand may avoid confusion and lead to a well-managed surgery. The OT staff should be well aware of the kit to be used for anterior vitrectomy and the settings to be used for the same. Early identification of the posterior capsular tear The ea

    Dr. Vishal Agrawal · Dr. Ketan Rathod · +1 other
  4. 2 Apr 2021 17 min read

    Allergic Eye Diseases

    Introduction Allergic eye disease (AED) is a common problem, owing to the fact that the eye is the first organ to encounter environmental allergens. It has been reported to affect 20% of the population worldwide1, 2. Allergic eye disease is found to be on the rise in line with other atopic diseases like asthma, due to environmental reasons. Classification of Allergic Eye Diseases 1, 4 1. Allergic conjunctivitis Acute allergic conjunctivitis Seasonal allergic conjunctivitis Toxic induced (acute contact with irritant) Chronic allergic conjunctivitis Perennial allergic conjunctivitis Toxic induced (long standing) 2. Contact dermatoblepharitis 3. Vernal keratoconjunctivitis 4. Atopic keratoconjunctivitis 5. Giant papillary conjunctivitis 6. Microbial allergic conjunctivitis Staphylococcal blepharoconjunctivitis Phylectenular keratoconjunctivitis Splendore Hoeppli phenomenon (allergic granulomatous Nodules) Immunopathology in allergic eye disease 3, 5 The ocular surface exhibits a variety o

    Dr. P.Vijayalakshmi
  5. 2 Apr 2021 16 min read

    Peripheral Ulcerative Keratitis

    Peripheral ulcerative keratitis (PUK) is a form of ocular inflammation that involves the peripheral portion of cornea and may be associated with systemic conditions such as Rheumatoid Arthritis(RA), Wegener’s Granulomatosis(WG), and other systemic conditions. It is a potentially devastating disorder consisting of a crescent-shaped destructive inflammation at the margin of corneal stroma that is associated with an epithelial defect, presence of stromal inflammatory cells, and progressive stromal degradation and thinning. The onset of Peripheral Ulcerative Keratitis has been linked to various anatomical factors of central and peripheral cornea and adjoining limbus. Though the local concentration of small and medium weight proteins like IgA, IgG and most complements are similar in central and peripheral cornea, the peripheral cornea has been found to be associated with higher concentrations of higher molecular weight(HMW) protein molecules like IgM and complement C1(5 times), possibily ow

    Dr. A. Agarwal, MD · Dr. A.Panda, MD, FAMS, FICS, FICO, MRC Ophthalmology
  6. 2 Apr 2021 11 min read

    DCR: When You Start,Do It Right !!

    Introduction: Dacryocystorhinostomy (DCR) is a procedure wherein an alternate passage is created between the lacrimal sac and nasal mucosa through a bony ostium, bypassing the normal lacrimal pathway. Indications: 1. Persistent congenital lacrimal duct obstruction unresponsive to conservative management. 2. Primary acquired nasolacrimal duct obstruction (PANDO). 3. Secondary acquired nasolacrimal duct obstruction (SALDO). Types: DCR can be classified as either external or internal. In external DCR the bone of lacrimal sac fossa is accessed through a cutaneous incision over the medial canthus. In internal DCR the normal openings around the lacrimal outflow system ( puncta, canaliculus, nasal cavity) are utilized to create the passage between the lacrimal sac and nasal cavity, without any skin incision. Internal DCR is most commonly performed through an endonasal approach and can be performed by using roungers, drills and even lasers. Endonasal DCR s can be performed either under endosco

    Dr. Md. Shahid Alam · Dr. Bipasha Mukherjee
  7. 2 Apr 2021 14 min read

    Primary Angle Closure Glaucoma

    Primary Angle Closure Glaucoma is a condition in which elevation of intraocular pressure (IOP) occurs as a result of obstruction of aqueous outflow by partial or complete closure of angle by the peripheral iris. I. Classical Classification: Prodromal Stage Stage of constant instability Acute Congestive Stage Chronic Angle Closure Stage Absolute Stage II. Newer Classification: Recommended by the American Academy of Ophthalmology (AAO) and World Glaucoma Association (WGA). 1. Primary Angle Closure Suspect This includes any eye that has a primary, abnormally narrow angular width of the anterior-chamber-angle recess, wherein the peripheral iris is located close to, yet not touching, the posterior pigmented trabecular meshwork. Patients with primary anatomic narrow anterior-chamber angles are at risk for subsequent primary angle closure (PAC). 2. Primary Angle Closure and Primary Angle-Closure Glaucoma Any eye that has a primary anatomic narrow anterior-chamber angle and evidence such as pe

    Dr. Srinivasan Kavitha · Dr. Rengaraj Venkatesh
  8. 2 Apr 2021 16 min read

    Newer Imaging Technology in Glaucoma

    Clinical examination of the disc has been the basis of disc and nerve fibre layer evaluation for ages but it is marred by its subjectivity and non-reproducibility, in the diagnosis and detection of glaucoma. Though visual field changes give concrete and reproducible evidence of glaucomatous changes, it becomes manifest only after considerable damage has occurred to the retinal ganglion cells(RGCs) and the nerve fibre layer(NFL). There are normally 1.2 - 2.4 million nerve fibres and corresponding number of ganglion cells in the retina. Kerrigan-Baumann and Quigley et al 1 documented that a loss of 35.7% of the RGCs was required for the manifestation of corrected pattern standard deviation(CPSD) 90 seconds per eye Figure4: Print out of a normal C20 programme Threshold program (N20 and N30): This program uses more contrast levels to search for the patient's threshold at each of the tested location. N30- horizontal area extended to include an extra portion of the nasal visual field, result

    Prof. Sushmita Kaushik · Dr. SS Pandav
  9. 2 Apr 2021 5 min read

    Intravitreal Injections -technique and tips

    Intravitreal injections involve injecting therapeutic agents (drugs/air/gases) inside the vitreous cavity through pars plana under aseptic precautions Surgical anatomy Site of injection: Pars plana Ciliary body: Consists of two parts a) anterior pars plicata b) posterior pars plana Pars plicata Circumferential zone 2.5mm in anteroposterior diameter Pars plana Varies in anteroposterior diameter nasally 3mm wide and temporally 4.5mm wide. This variation is because of the posterior globe on temporal side curves posteriorly & laterally more than on the nasal side. Pars plana extend from pars plicata anteriorly to ora serrata (termination of the retina) posteriorly. Blood vessels in pars plana are radially oriented but circumferential incisions across these vessels cause no bleeding. Also, lens zonules insert into ciliary body avoiding pars plana Thus, needle punctures 3.5 mm posterior to limbus enter globe through pars plana Not damaging lens Not puncturing the retina Not tethering / damag

    Parag K. Shah, DNB · Dr. Varsha V. Prabhu
  10. 2 Apr 2021 23 min read

    The Lacrimal Apparatus

    Development of the lacrimal secretory apparatus: The lacrimal gland develops from solid ectodermal buds in the anterior superolateral part of the orbit. The gland does not start functioning fully until approximately 6 weeks after birth. Newborn infants do not produce tears while crying. Development of the lacrimal excretory system: The Nasolacrimal duct opens in the inferior meatus of the nose. Failure of the caudal end to canalize at birth results in congenital nasolacrimal duct obstruction, which resolves spontaneously in the majority of cases within 4-6 weeks of birth. Anatomy of the lacrimal system: The lacrimal secretory apparatus Tears are secreted by the main and accessory lacrimal glands. The main lacrimal gland is located in the lacrimal gland fossa in the superotemporal quadrant of the orbit. The lacrimal gland has two lobes, the larger almond-shaped orbital, and the smaller palpebral lobe. These lobes are divided by the lateral horn of the levator aponeurosis. The palpebral

    Dr. Jayant Kadaskar · Dr. Md. Shahid Alam · +1 other