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39 articles
  1. Articles 10 Sep 2021 10 min read

    Ten Clinical Signs A Postgraduate Must Look For While Examining the Fundus

    1. Red Dots! : Microaneurysms Seen in Diabetic Retinopathy, retinal vein occlusions, hypertensive retinopathy, radiation retinopathy. Microaneurysms are usually the first ophthalmoscopically detectable sign of diabetic retinopathy. They are focal saccular outpouchings of the capillary wall due to pericyte loss. Arise from the deep part of the inner retinal capillary plexus, and are present in the inner nuclear layer.1 Features: Appear as small round red dots - usually seen at the posterior pole, especially temporal to the fovea. 10- 100 microns in diameter. Only > 30 microns is visible ophthalmoscopically (better on red-free illumination). < 30 microns can be seen on FFA and hence more microaneurysms are seen on FFA than fundus examination. Shapes – saccular, fusiform, pedunculated, focal bulge, irregular, mixed. FFA- Hyperfluorescent with leakage. OCT – Ring sign, span more than 1 retinal layer. Course- disappear in 3-6 months. Can continue to exudate, bleed or thrombose. 2. And it wa

    Dr. Sashwanthi Mohan · Dr. Snehal Bavaskar
  2. Articles 4 Sep 2021 6 min read

    Ten Points One Must Know on Toxic Anterior Segment Syndrome (TASS)

    TASS is an uncommon, non-infectious condition causing severe inflammation of the anterior segment structures without vitreous involvement [1],[2],[5]. The name TASS was coined by Monson and colleagues in 1992 [1],[3]. It is usually associated with phacoemulsification surgery but can also happen after procedures like penetrating keratoplasty, descemet stripping automated endothelial keratoplasty, deep anterior lamellar keratoplasty, vitrectomy and anterior and posterior segment phakic intraocular lenses. The alternative names of TASS include sterile post -operative endophthalmitis, toxic lens syndrome, toxic endothelial cell destruction syndrome and localized endophthalmitis [1],[3],[7]. 1. What is TASS? It is an acute sterile post-operative inflammatory condition affecting the anterior segment structures following intraocular surgery. It is usually seen within 12-48 hours of surgery and is due to the reaction of anterior segment structures to some toxic substance usually associated wit

    Dr. Priya Rasipuram Chandrasekaran
  3. Articles 30 Aug 2021 6 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
  4. Articles 24 Aug 2021 7 min read

    How to Make Your Online Presence Felt : Tips & Tricks

    Introduction Covid has accelerated the digital shift for healthcare. We all know that It was probably going to take a few more years to happen but now as more and more people take the digital route for any requirement they may have, it becomes important for business owners to think about their online presence. This is true even for ophthalmologists. More so for those who have established their own practices versus working in an eye institute and this difference is because those who have established their own practices have in one way become entrepreneurs and whether they like it or not as time goes by the most important job as the owner of an ophthalmic practice would be to increase or drive patients to that practice. This is where online presence comes in. So what does online presence mean? When people look for you or for things you do there are places that showcase you or your practice. These could be Youtube videos Listing in Practo and similar sights A Website Writing a Blog A News

    Dr. Deepak Garg
  5. Students Gallery 12 Aug 2021 10 min read

    Retina Case Presentation in Practical Exam: 10 Tips

    DNB practical exam is a time-bound test of knowledge, presentation skills, swiftness and presence of mind. In the exam, a candidate usually gets 4 long cases with 20 mins per case (a whole 2 minutes more than you can take to write each answer in the theory exam). That usually includes 2 anterior and 2 posterior segment cases. Although 2 posterior segment cases may seem like a daunting task, there are ways to excel the viva; otherwise, the sheer stress of exam often changes the performance, pace and quality and a lot of brilliant minds start fumbling under stress. The 20 minutes that are provided are for not just taking the case (which includes history taking and examination) but also writing the case sheet and in retina cases- a good diagram or illustration preferably on the Amsler-Dubois chart. Here are 10 simple tips for presenting a retina-based case in a DNB practical exam. 1. Don’t screw the basics: In the exam, unlike in the clinics of most DNB hospitals (where we have an optomet

    Dr. Puja Maitra · Dr. Dhaivat Shah
  6. Students Gallery 9 Aug 2021 5 min read

    Pearls for Practical Exam in Ophthalmology for Postgraduates

    Facing PG practical examination in ophthalmology is not difficult. However, the student must prepare properly to face it. Please remember the examiners are coming to help only. Therefore, the student should not be afraid of the examiners. Preparations for the practical exams During the course The preparation to face the exams is a continuous process starting from the beginning of the course. Students must discuss about the patients with classmates, seniors also, apart from presenting to the teachers. Always take the guidance of teachers. Don’t feel shy to ask any doubts to your teachers. Teachers will definitely help you. Don’t hesitate to present cases many times before appearing for the exams. Nothing wrong with presenting the same patient to different consultants. This will help you to know the different views of different teachers. These types of approaches during your residency period will give you enough confidence. Learn the method of interpreting different investigations charts

    Dr. (Capt) V.R Vijayaraghavan
  7. Articles 4 Aug 2021 12 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
  8. Articles 28 Jul 2021 16 min read

    Papilledema- A Ready Reckoner for Postgraduates

    Introduction Papilledema is used to describe optic disc edema resulting from increased intracranial pressure while disc edema could be due to any cause. While disc edema can be unilateral or bilateral, papilledema is usually bilateral, however, it can be asymmetric, to begin with. Another important differential of true papilledema is pseudo papilledema which is seen in conditions like a small hyperopic optic disc or optic disc drusen, etc. This chapter shall entail a discussion on the etiopathogenesis of papilledema and the approach to diagnosis and management of papilledema. Papilledema and its mechanism It’s a form of bilateral optic disc swelling associated with increased intracranial pressure. An increase in intracranial pressure can occur secondary to an intracranial space-occupying lesion, cerebral venous thrombosis, or can be idiopathic as in the case of Idiopathic Intracranial hypertension (IIH). Figure 1 depicts the mechanism of the development of papilledema. Pseudo vs true p

    Prof. Rohit Saxena · Dr. Monika Yadav · +1 other
  9. Articles 27 Jul 2021 13 min read

    Astigmatism - The clinical pearls in Refractive care

    Preface: Astigmatism is a common type of refractive error that we come across in vision clinics on a regular basis. It causes the deterioration of retinal image quality and leads to specific vision-related symptoms. Prevalence of this condition is reported to vary with age, gender, and ethnicity. The clinical diagnosis and management of astigmatism necessitate an understanding of its nature and characteristics. Hence, this particular write-up is prepared as a consolidation of integrated information related to ‘astigmatism’ by focusing on its definition, classic types, relevant clinical evaluation components, and appropriate management options. What is astigmatism? Astigmatism is a type of refractive error/ametropia that occurs when parallel rays of light entering the ocular media (non-accommodative state) are not focused well on the retina. In an optical system with astigmatic error, light rays propagate in two different planes and the incident light rays fail to converge at a single f

    Najiya Sundus K. Meethal · Dr. Krishna Kumar Ramani
  10. Articles 20 Jul 2021 6 min read

    Ocular Oncology Basics: Salient Points from The Pandora's Box

    RETINOBLASTOMA Grouping: Clinical determination of the extent of disease with the focus being the eye. It is a preoperative evaluation with the main outcome being the salvagable status of vision or the eye. Staging: It combines clinical, various imaging, and post-operative histopathological results to determine the extent of the disease. The main outcome is focused on the survival of the patient. International Classification of Retinoblastoma ( grouping) [1] Group A: Tumours smaller than 3mm or less Should be 2DD ( 3mm) from the fovea Should be 1DD (1.5mm) from optic nerve head Group B: Tumours bigger than those in group A Located within 2DD from the fovea Located within 1DD from optic nerve head Localized cuff of subretinal fluid( < 5mm) No seeding is allowed in the group. Group C: Localized tumor dissemination Vitreous seeding not more than 3mm from the base of tumor Subretinal seeding not more than 3mm from the base of tumor Group D: Diffuse tumor dissemination Vitreous seeding may

    Dr. Bikramjit Pal

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