Topic

#Cornea and External Eye Diseases

34 articles
  1. 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
  2. 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
  3. Articles 6 Sep 2021 19 min read

    Basics of limbal Stem Cell Deficiency for the Postgraduates

    Limbal Epithelial Stem Cells Anatomy: The healthy corneo-scleral limbus (Figure 1) is a gradual transition zone from the stratified, non- keratinised squamous epithelium of the cornea to the stratified, non- keratinised columnar epithelium with mucin-secreting goblet cells of the conjunctiva. It has 7-10 layers of cells, which have attachments similar to the corneal cells. Figure 1: Slit-lamp photograph (high magnification) of the normal limbus showing arrangement of pigmentated Palisades of Vogt in the inferior quadrant. This zone contains limbal epithelial stem cells (LSCs) that generate new epithelial cells during homeostasis and after injury or insult, to maintain corneal transparency and vision. LSCs are believed to be located within the basal layer of limbal crypts (in the palisades of Vogt) [1] and focal stromal projections (finger-like projections of stroma containing a central blood vessel, and extend upward into the corneal limbal epithelium and are surrounded by small, tight

    Dr. Purvasha Narang
  4. 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
  5. Articles 20 Jul 2021 12 min read

    Pterygium: A Review

    Introduction A pterygium is a fibrovascular, wing-shaped encroachment of the conjunctiva onto the cornea, usually in the horizontal meridian of the palpebral fissure. Histopathology shows hyaline degeneration with elastotic proliferation. Risk factors Exposure to ultraviolet light and environmental microtrauma to the ocular surface is thought to predispose to pterygium formation. A localized limbal stem cell dysfunction, possibly related to ultraviolet induced damage and a genetic predisposition has also been postulated. Pathogenesis Pterygium pathogenesis can be considered as occurring in two stages: the initial disruption of the limbal corneal-conjunctival epithelial barrier, and the progressive “conjunctivalization” of the cornea characterized by cellular proliferation, inflammation, connective tissue remodeling, and angiogenesis Morphology Head—the part which rests on the cornea Neck— constricted portion seen at the limbus Body – remaining bulk of mass Cap—a semilunar infiltrating

    Dr. Ramya Subramaniam, DNB · Dr. Srinivas K Rao, DO DNB FRCSEd
  6. 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
  7. Articles 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. Articles 5 May 2021 23 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
  9. Students Gallery 12 Apr 2021 12 min read

    i-File: Fuchs Endothelial Dystrophy

    A 55-year-old female presented to the Cornea clinic with gradually progressive diminution of vision in both eyes for 1 year, which was associated with intermittent photophobia and colored haloes around lights, especially on waking up in the morning. The blurry vision gradually became clearer as the day progressed. No history of associated pain, watering, redness, itching, or discharge. Past Ocular History: No history of ocular trauma or surgery in the past Past Medical History/ History of Medication: No significant systemic history could be elicited. 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): 6/36 Left eye (OS): 6/12 Ocular Motility/Alignment Full, free, and painless in all gazes Intraocular Pressure (IOP) OD: 16 mm of Hg OS: 16 mm o

    Dr. Hema Joshi, MBBS, DO, DNB
  10. Articles 2 Apr 2021 16 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

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