Topic

#Glaucoma

17 articles
  1. Articles 9 Mar 2022 11 min read

    i-File: Pigmentary Glaucoma

    A 30-year-old male presented to the glaucoma clinic with complaints of gradually progressive diminution of vision in both eyes, left eye more than right, since 5 years. The visual disturbance was not associated with redness, pain, photophobia, or colored haloes. Past Ocular History: He was diagnosed with glaucoma elsewhere 5 years ago and started on anti-glaucoma medications(AGM). His baseline intraocular pressure (IOP) according to the old records was 52 mmHg In both eyes. At the time of his visit to the hospital, he was using 3 AGMs which he had stopped using for the past 7 days. No history of trauma or laser in the past Past Medical history: No history of any systemic illness Family history: No family history of glaucoma Systemic Examination: All vitals and systemic examination was within normal limits Ocular Examination Best Corrected Visual Acuity (Snellens) Right Eye (OD) 6/9 Left Eye (OS) 3/60 Ocular Motility/Alignment Full, free and painless in all gazes Intraocular pressure (I

    Dr. K. Sugepriya · Dr. Rathini David
  2. 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
  3. 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
  4. Interesting Reads 8 May 2021 6 min read

    Smartphone Gonio-imaging: The Truly Frugal Indian Revolution

    Introduction: Gonioscopy is the evaluation of the angle of the anterior chamber, a term coined by Alexios Tarantas.[1] It is one of the three important components to diagnose and classify glaucoma, the visual field changes and the optic nerve head evaluation being the other two. This clinical skill which should be performed on each patient visiting the clinic for the first time is not performed as much as it should be, the deficit fuelled by the enigma of it being one of the most difficult skills to be acquired in any clinical evaluation. Dr Wallace Alward, a doyen in the field of gonioscopy had recently delivered a talk which was titled “Gonioscopy: Still a State of Art after 100 years”.[2] This title beautifully sums up the gap between the demand and its supply. This deficit does not seem to be fulfilled in near future by the conventional examination techniques. So, the field of ophthalmology needs to move to a method that is frugal, easily operable, reproducible, and should hold val

    Dr. Nilesh Kumar
  5. Articles 15 Apr 2021 15 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
  7. Articles 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. Articles 2 Apr 2021 11 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. Students Gallery 2 Apr 2021 3 min read

    FIve Points You Must Note While Examining An Optic Disc

    Disc size A normal disk can be of small size and a normal disk can be of a larger size; size by itself does not determine glaucoma. It is relevant because the disk size determines the C:D ratio and the neuroretinal rim thereof. In a large disc one would expect a large cup and a large neuroretinal rim and in a small disc there is usually no cup. Disc size should be grouped as normal, small or large. Graticule on the slit lamp can be used. In cases with CDR discrepancies disc size should be compared to determine true discrepancy. Disc Shape A normal optic disk is vertically oval with the vertical diameter being the maximum diameter and the horizontal being the minimum diameter. Figure: Vertically oval disc. Note that the vertical diameter is longer than the horizontal diameter The variations in shape may be accompanied with astigmatism and amblyopia. An optic disk is considered torted when the vertical axis of the optic disk is rotated >15° from the vertical meridian. A tilted optic disk

    Dr. Amit Pandey
  10. Interesting Reads 1 Apr 2021 8 min read

    Learn from the Masters : Glaucoma Practice in the COVID-19 Time

    The COVID 19 pandemic and the subsequent lockdown has resulted in an unprecedented scenario, especially as ophthalmologists. These are testing times, but as is natural to humankind, we are rising and growing from this. We are all trying to the best of our abilities to adapt to the new normal and eventually reboot. In these uncertain times, the main focus has been to keep our patients, families, and ourselves safe. The team at eOphtha asked a few important questions on reverting to a functional glaucoma practice from three luminaries in glaucoma. Dr. G Chandrasekhar (GC) MD, FRCS has been associated with L V Prasad Eye Institute (LVPEI) since its inception in 1987 and is currently the Vice-Chair, LVPEI. Dr Chandrasekhar is an esteemed clinician and a passionate teacher. Dr GC is a mentor to many national and international fellows. He has published over 100 papers in national and international peer-reviewed journals and has been a reviewer for numerous ophthalmology journals. He is the C

    Dr. Tamonash Basu

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