Topic

#Anterior Segment

7 articles

Articles 3 Jan 2022 11 min read

i-File: Pseudophakic Bullous Keratopathy

A 60-year-old-male presented to the Cornea clinic with diminution of vision in the left eye for 4 months which was associated with intermittent photophobia and colored haloes around lights, especially on waking up in the morning. The patient also complains of pain and watering. No history of associated redness, itching, or discharge. Past Ocular History: H/o OD cataract surgery 6 years, OS cataract surgery 4 months back. No h/o trauma. Past Medical History/ History of Medication: No significant systemic history could be elicited. The patient was not on any medication. No addictions. Family History: No significant family history found Review of Systems/Systemic Examination: Systemic examination was within normal limits. All vitals were within normal limits. OCULAR EXAMINATION Best Corrected Visual Acuity (Snellen) Right eye (OD): 6/9 Left eye (OS): CF 2 m Ocular Motility/Alignment - Full, free, and painless in all gazes Intraocular Pressure (IOP) OD: 18 mm of Hg OS: 14 mm of Hg Pupils-

Dr. Hema Joshi, MBBS, DO, DNB · Dr. Akhilesh Yadav
Articles 30 Nov 2021 24 min read

Ocular Manifestations of HIV

Human immunodeficiency virus (HIV) disease is a pandemic of global concern, not only due to serious health issues affecting all organs of the body but also due to its huge economic burden.(1) The diagnosis is often associated with social stigma that includes changing sexual practices, lack of availability of a vaccine and the chronicity of the disease requiring lifelong treatment.(2) The disease runs a severe course, involving multiple organs. Ocular lesions are varied and can affect any structure, usually in the late phase of HIV infection. Rarely, these lesions can be the presenting manifestations of the disease. While a variety of cell types may be infected by HIV, the immunologic hallmark is the selective loss of the CD4+ T cells. CD4 is a cell surface marker that identi?es the helper/inducer subset of T cells. During the initial phases of infection, a majority of patients remain asymptomatic. With a decrease in the CD4+ T cell count (< 500 cells/µL) the immune system shows evidenc

Dr. Sharanya Abraham
Articles 4 Aug 2021 10 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
Articles 8 Jul 2021 30 min read

Anterior Segment Optical Coherence Tomography in Diseases Of The Ocular Surface And Cornea

I. Introduction : Anterior segment optical coherence tomography (ASOCT) is a sophisticated non-contact imaging device that produces high-resolution images for detailed assessment of the structures of the ocular surface and anterior chamber in various disease conditions. Starting from the earlier generation time-domain devices first described in 1991 by Huang et al [1] to the current Fourier-domain OCT devices, the technological advancement in this device has improved the diagnostic ability tremendously. This imaging modality has evolved into a highly precise tool for clinical diagnosis and management as well as in research and understanding disease pathology. In this review, we describe the evolution of ASOCT, its technology in brief and focus on highlighting the various clinical applications with examples. While Izzat et al first introduced the use of AS-OCT for imaging the anterior segment of the eye [2], it is well known that the OCT initially evolved as a tool for retinal imaging.

Dr. Supriya Sharma · Dr. Somasheila Murthy
Articles 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
Students Gallery 2 Apr 2021 6 min read

Documentation & Drawing in Ophthalmology

Anterior segment finding Documentations From the days of Hippocrates documentation has been a cornerstone of clinical science. But somewhere down the line this has become a lost art rarely ever practiced by many of us. We tend to ignore or to say correctly run away from it under many pretexts like its time consuming, it’s of no use, etc. And surprisingly this resistance to document is prevalent not only among juniors but spans across the whole spectrum of practitioners. So at times we really ponder is documentation really necessary? The answer is an emphatic yes – the reasons being It’s a standard clinical practice worldwide Follow up is possible only if you can compare it with your previous records. Will help you medico legally Last but not the least unless you are documenting it you have not probably seen it correctly(you think you have seen it all but the moment you come to draw it you find that you don’t remember where the break was it at 1 o’clock or 3 o’clock position and so on).

Dr. Parthopratim Dutta Majumder
Articles 1 Apr 2021 8 min read

Slit-lamp Biomicroscopy

A slit-lamp is a binocular microscope used for eye examination using a slit-like light beam. In 1911, Allvar Gullstrand a Swedish Ophthalmologist designed table-mounted binocular eyepiece for 3-dimensional visualization of optically clear eye structures. Later Otto Henker, combined Gullstrand slit lamp with Czapski’s binocular microscope resulting in first slit lamp biomicroscope, allowing hand-free examination of an eye.1 The optical design of the Slit-Lamp Biomicroscope (SLB). Due to the miniature size of the anterior segment of the eye, we need high magnification and clarity to appreciate finer details. This can be achieved by having 2 convex lenses at the observer end (eyepiece) separated at its focal distance (astronomical telescope type alignment) and, a concave-convex combination (Galilean telescope type alignment) at the examinee’s end for further magnification of the image. Telescopic arrangements of lenses need to be focused at near, hence a plus power objective lens is fixed

Dr. Nagesha C K · Dr. Shruthi M N