Topic

#Case Discussion

19 articles
  1. Students Gallery 5 Aug 2022 8 min read

    iFile: Ruptured Retinal Artery Macroaneursm

    Chief Complaint: A 67 years old female came with the complaint of sudden painless diminution of vision in the left eye for 1 day. History of Present Illness: Sudden painless diminution of vision with associated floaters in the left eye for the last 1 day. There was no history of any trauma, redness, watering or discharge. Past Ocular History: No history of any past ocular disease Past Medical History/ History of Medication: The patient was diagnosed to have diabetes mellitus type 2 and essential hypertension five years back and was on medications for the same. Family History: No significant family history was present OCULAR EXAMINATION Best Corrected Visual Acuity (Snellen) Right eye (OD): 6/6, N6 Left eye (OS): 6/36, N18 Ocular Motility/Alignment: Full, free and painless in all gazes Intraocular Pressure (IOP) OD: 16 mmHg OS: 18 mmHg Pupils: OU Round, regular and reacting to light Slit-lamp Exam: OD OS Lid/Lashes Normal Normal Conjunctiva/sclera Normal Normal Cornea Normal Normal Ante

    Dr. Suklengmung Buragohain · Dr. Subham Sinha Roy
  2. 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
  3. Students Gallery 9 Nov 2021 14 min read

    i-File: Optic Neuritis

    A 23 years old female presented to the ophthalmology clinic with complaints of blurring of vision in the left eye since the past 4-5 days with associated mild pain around the left eye, mainly on ocular movements History of Present Illness: Patient did not give any history of associated nausea, vomiting, headache, tingling numbness or limb weakness. There was no history of any preceding febrile illness nor any history of vaccination in the recent past. Past Ocular History: There was no history of any similar episode, any ocular trauma or surgery in the past. Past Medical History: No history of any significant systemic illness or any medications. Family History: No significant history. Systemic Examination: Within normal limits. Pulse rate: 82/min, BP: 124/76 mmHg, Respiratory rate:12/min OCULAR EXAMINATION: Best Corrected Visual Acuity (BCVA) Right eye (OD): 6/6,N6 Left eye (OS): 6/24,N8 Colour Vision (CV) using Ishihara pseudoisochromatic plates: OD: Normal 21/21 OS: Impaired 1/21(iden

    Dr. Siddharth Sheth
  4. Students Gallery 1 Oct 2021 11 min read

    i-File: Normal Tension Glaucoma

    Chief Complaint: A 37 years old male presented to us with a history of progressive deterioration of vision on 30/09/2020. History of Present Illness: He was diagnosed elsewhere to have glaucoma and came to us for further management. Past Ocular History: He was already on on Latanoprost ED HS, Dorzolamide + Timolol combination BD. The patient underwent Trabeculectomy in both eyes in the year 2010 and 2013 Baseline IOP from old records was noted to be 18 mm of Hg in the right eye and 17 mm of Hg in the left eye Family History: Strong family history of glaucoma in father and elder sister Review of Systems/Systemic Examination Not a known case of hypertension, diabetes, asthma or cardiological problem, not on any systemic medication. OCULAR EXAMINATION Best Corrected Visual Acuity (Snellen) Right eye (OD): 6/6,N6 Left eye (OS): 6/9,N6 Ocular Motility/Alignment- EOM full and free Intraocular Pressure (IOP) OD: 11 mm of Hg OS: 10 mm of Hg Pupils: OD – round , regular and reacting to light OS

    Dr. Tamonash Basu
  5. Articles 30 Aug 2021 5 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
  6. Students Gallery 28 Aug 2021 10 min read

    i-File: Floppy Eyelid Syndrome

    History of Present Illness: A 60-year old male patient presented with recurrent episodes of watering and foreign body sensation of both eyes for 8 years. He gave no history of redness or discharge from the eyes. There was no history of spontaneous eversion of the eyelids. He was treated conservatively with lubricants but had no relief of symptoms. He complained of snoring during sleep with associated daytime somnolence. Past Ocular History: No history of ocular trauma or surgery in the past. Past Medical History/ History of Medication: He was diagnosed with Rheumatoid arthritis 1.5 years ago and hypertension for which he is on treatment. Family History: No significant family history 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): 6/6P, N6 Left eye (OS): 6/6, N6 Ocular Motility/Alignment: Hirshberg corneal reflex- Orthophoric, EOM-Full, f

    Dr. Kirthi Koka · Dr. Jazz K Manadan
  7. Students Gallery 24 Aug 2021 2 min read

    i-File: Systemic Hypertension

    A 60-year male presented with C/O diminution of vision in the Right Eye. The patient is not a known case of any known systemic illness, although gives a vague c/o chest pain and the occasional headache. Examination revealed a vision of 4/60 with an IOP of 16mmHg as measured by GAT. The right Eye reveals the unremarkable anterior segment with minimal lenticular changes. Vitreous cavity quiet with fundus as shown. The left eye reveals a normal anterior and posterior segment. Question What are the positive findings as depicted in the fundus photo.? What are the investigations you would ask for? How will you manage this case? Answer Ocular 1) FUNDUS FLUORESCEIN ANGIOGRAM: disruption of retinal layers. These in turn will again help in educating the patient in terms of visual gain he is expected to gain In this case if one had to choose between FFA and OCT, FFA would be a better option. Management Managing this case is again in collaboration with a physician/ cardiologist Ocular 1) After con

    Dr. Bikramjit Pal
  8. Articles 20 Aug 2021 6 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
  9. Students Gallery 5 Aug 2021 2 min read

    Ten Tips for OSCE

    Objective structured clinical exam (OSCE) has regained popularity as a significant part of practical examinations in recent times. This is in part due to the pandemic making it difficult to hold exams with actual patients. It also removes subjective bias and is considered a fair way to examine candidates. There are certain strategies that enable the student taking an OSCE based exam to do well and score maximum points. Here are some tips Preparation stage 1. Go through images in an atlas. Most OSCEs are image-based. So pay attention to clinical features by going through as many online free atlases that are available on the internet. Practice describing findings to your study partner. 2. Go through surgical videos. Videos of surgery may be shown as part of OSCEs with a review of steps and complications may be asked as an OSCE. 3. Revise the clinical trials and the acronyms. These are often asked as well. Many websites and textbooks have comprehensive tables that make revising trials eas

    Dr. Meenakshi Swaminathan
  10. Articles 22 Jul 2021 12 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

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