Scleral Fixated Intraocular Lens Implantation- A Comprehensive Review
Introduction Ideally a cataract surgery should result in the placement of an intraocular lens (IOL) within the capsular bag. However, this desirable outcome might be averted due to either preexisting zonular deficit or intraoperative posterior capsular tear, resulting in aphakia. This necessitates the need for an alternate means of IOL implantation. The surgeon can exercise the options of an anter...Read More
Peripheral Retinal Degenerations: A Ready Reckoner
Introduction Peripheral retinal degenerations (PRD) are considered a risk factor for rhegmatogenous retinal detachment (RRD) [1, 2]. The annual incidence of RRD varies between 6.3 and 18.2 cases per 100,000. RRD develops when liquefied vitreous humor accelerated by rotary eye movements passes through retinal tears or retinal holes into subretinal space and detaches neurosensory retina from the und...Read More
The Novice VR Surgeon -Ten mistakes to avoid
Mastering vitreoretinal surgery is a slow and arduous process with each case being different from the other and it is just about possible to have only a “feel” of a kind of case during the fellowship, not mastery of it. The budding VR surgeon would necessarily have to hone her / his skills in the real world outside their alma mater and the following guidelines can aid mitigate the stress and angst...Read More
Evaluation of a case of Diplopia
What is diplopia or double vision? Diplopia or double vision by definition is the simultaneous perception of two images of a single object that may be displaced in any direction. Other terms could be blurred vision, shadowing, or confusion. Is it uniocular or binocular diplopia? The first step to evaluate diplopia is to differentiate between uniocular and binocular diplopias as the management vari...Read More
Ten Pearls for Treatment of TB Uveitis
1. In TB-endemic countries, think of TB as a probable/possible etiology of uveitis in Presence of one or a few large full-thickness choroidal granulomas that show enhanced vascularity/RAP on FFA Retinal periphlebitis with subvascular retinitis/choroiditis lesions/scars that show extensive peripheral retinal ischemia. Multifocal serpiginoid choroiditis/Serpiginous-like choroiditis lesions with vitr...Read More
Ten Pearls in Interpreting Humphrey Visual Field
A visual field encompasses the area of space or area of the external environment that is seen by a steadily fixating eye. Advances in the technology of visual field testing have changed our clinical perception of normal and abnormal fields of vision. It is of great importance to diagnose and monitor optic nerve diseases, notably glaucoma. Automated perimetry is now the current gold standard for bo...Read More
Monocular elevation Deficit/ Double elevator palsy
Definition: Double elevator palsy is classically defined as a congenital inability to elevate one eye, with the limitation more in abduction than adduction.1 MED is most often associated with ptosis/pseudoptosis. The word Double elevator palsy was coined by Dunlap to describe the weakness affecting both muscles of elevation i.e. superior rectus and inferior oblique. Pathogenesis/Theories: 2 Superi...Read More
Down's Syndrome: Ten Points All Ophthalmologists Should Know
Down’s syndrome is a trisomy caused by an extra copy of chromosome 211. The extrachromosomal material is transmitted either by non-disjunction, unbalanced translocation, or mosaicism. It is the most common chromosomal anomaly seen in live births2. As an ophthalmologist, it is important to screen for ocular abnormalities since the incidence of ophthalmic disorders is between 46-100%3. One study fou...Read More
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 i...Read More
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 intrao...Read More