Topic

#infection

16 articles

Articles 1 Apr 2021 25 min read

An Approach to a Case of Retinitis

Inflammation of retinal tissue causes characteristic fundus findings depending on whether it is full-thickness or partial-thickness or outer or inner retinal involvement. Figure 1A: A case of epidemic retinitis: Bright yellow superficial fluffy lesion superiorly to the disc obscuring retinal vessels passing through it is typical of inner or full-thickness retinitis. 1B: A case of progressive outer retinal necrosis: Yellowish lesions with clear retinal overlying vasculature suggests outer retinitis. Full-thickness or inner retinal involvement produces bright yellow fluffy lesions with indistinct borders. (Figure 1A) Retinal vasculature passing through these lesions appears obscured. At times, such lesions can mimic cotton-wool spots and may produce moderate to severe vitritis. Outer retinal inflammatory lesions appear dull orange or yellow with indistinct borders, retinal vessels may remain clear over the lesions (Figure 1B) and vitritis could be mild-moderate. Differentiating retinitis

Dr. Ankush Kawali · Dr. Sanjay Srinivasan · +1 other
Articles 1 Apr 2021 6 min read

Ten Pearls for Corneal Scrapping

The management of microbial keratitis requires corneal scraping material for smear and culture. Scraping is a superficial keratectomy procedure to procure samples from central infiltrates or any infiltrate more than 2 mm in size. Stain/ wet mount gives a rapid clue to the diagnosis to initiate appropriate therapy. Inoculation of the sample on culture media help identify the offending organism and antibiogram help choose an appropriate therapeutic agent. Erasmus Darwin the grandfather of Charles Darwin was the first to suggest corneal therapeutic debridement to try and make cornea transparent in 1795. 1. Proper documentation of corneal ulcer should be done before going ahead with corneal scraping Before corneal scraping is planned it is important to document the corneal ulcer either diagrammatically or by photo documentation as this helps in showing progression or worsening of the therapeutic management. Areas of clinically active margins should be noted and always check the area of max

Dr. Manokamna Agarwal · Dr. Meena Lakshmipathy
Articles 1 Apr 2021 19 min read

Cytomegalovirus Retinitis Simplified

Introduction: Cytomegalovirus (CMV) retinitis is an opportunistic viral posterior uveitis that occurs mostly in severely immunocompromised Acquired Immunodeficiency Syndrome (AIDS) patients or, rarely, in those on immunosuppressive therapy after organ transplantation, or who are on systemic corticosteroids.1 More than 75% of AIDS patients with CD4+ counts less than 50 cells/?L have CMV retinitis. It is the most common ocular opportunistic infection in AIDS patients and accounts for 75-85% of all CMV end-organ disease.2 Before the introduction of Highly Active Antiretroviral Treatment (HAART), 30% of patients with Human Immunodeficiency Virus (HIV) developed CMV retinitis during their lifetime, but with the advent of HAART, there is a 75% reduction in the number of new cases of CMV retinitis.3 Rarely, CMV retinitis may occur in non-HIV patients having some degree of immune dysfunction, such as advanced age, diabetes mellitus, corticosteroid, and non-cytotoxic immunosuppressive drug usag

Dr. Swapnil Parchand · Dr. Anil Gangwe
Articles 1 Apr 2021 36 min read

Viral Uveitis: Ready reckoner for the Postgraduates

Viral ocular infections can cause sight-threatening diseases in humans either as an isolated ocular infection or as a part of systemic illness. Although many viruses may naturally be harbored in human beings, the common ones causing ocular infections include herpes simplex virus (HSV), varicella-zoster virus (VZV), and cytomegalovirus (CMV). They may remain dormant for several years with periodic asymptomatic virus shedding in immunocompetent individuals. However, in situations where the immunity is reduced due to age or, comorbidities, the symptomatic disease can occur. Ocular damage is caused by the direct cellular damage by the virus itself or the inflammatory response to the infection. Virus-specific T lymphocytes as well as humoral immunity with specific antibodies help to control the acute infection. Here we look at anterior and posterior viral uveitis in two separate sections and the common causative viruses. Viral Anterior Uveitis ( VAU) Introduction Anterior uveitis (AU) is th

Dr. Vinita Rao · Dr. Gazal Patnaik
Articles 1 Apr 2021 13 min read

Dos and Donts In Managing Cluster Endophthalmitis

“Everything in life has some risk, and what you have to actually learn to do is how to navigate it.” -Reid Hoffman The above quote holds true for any surgical procedure whether minor or major. The biggest fear of any surgical intervention is that of infection postoperatively. Infection can occur in the best of hands and also in the most modern operating rooms. Cataract surgery is one of the most common intraocular surgeries performed in India and around 90% of postoperative endophthalmitis occurs after cataract surgery. 1 Acute endophthalmitis is severe intraocular inflammation presumed to be due to the entry of microbes into the eye during the perioperative period. It is identified usually in the initial weeks after surgery and could present as a red painful eye with severe anterior uveitis, often with fibrin and hypopyon, and vitritis. It is one of the most serious postoperative complications of intraocular procedures and, despite treatment, often results in a very poor visual outcom

Dr. Dhaivat Shah · Dr. Meghna Jain
Articles 1 Apr 2021 8 min read

Learn from the Masters : Viral Keratitis Decoded

Viral Infections are more commonly encountered in individual practice than what presents in tertiary or referral eye care. Its presentation is myriad & baffling often a misdiagnosis as bacterial or fungal causing more harm. Also, with more choices on the availability of antivirals, individual practice varies. Here we discuss key presenting clinical features & know from the leading cornea experts their preferred treatment practices. Dr. Manisha Acharya is a practicing ophthalmologist hailing from Delhi. She received her MS degree (2003) from Jawaharlal Nehru Medical College, Aligarh following which she completed her fellowship at Dr. Shroff’s Charity Eye Hospital. She has also been trained at– Bascom Palmer Eye Institute, Miami, Florida, and LVPEI, Hyderabad. She is currently working as Senior Consultant, Department of Cornea and Refractive Surgery with Dr. Shroff’s Charity Eye Hospital, New Delhi. Apart from being a proficient corneal surgeon, Dr. Acharya is the Medical Director of the

Dr. Jaya Gupta