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#Made Easy

39 articles
  1. Articles 16 Jun 2021 18 min read

    OCT-Angiography in Retinal Diseases Made Incredibly Simple For Post Graduates

    Introduction: Optical coherence tomography angiography (OCT-A) has emerged as a novel imaging technique for visualizing the retinal and choroidal microvasculature at the macula and optic disc.1 It provides in vivo 3D vascular information by analyzing the movement of flowing red blood cells and thereby enabling the visualization and quantification of functional vessel networks within microcirculatory tissue beds in a non-invasive manner without the use of dye injection.2 Understanding the anatomy of retinal and choroidal microvasculature (figure 1): Retinal microvasculature: Studies have identified 4 retinal vascular capillary networks at the macula which are broadly grouped into 2 vascular plexuses; superficial and deep.3 The superficial vascular plexus (SVP) consists of the superficial capillary plexus and radial peripapillary capillary plexus. The former is located in the ganglion cell layer and the latter in the retinal nerve fibre layer. The SVP receives its blood supply from the c

    Dr. Ramesh Venkatesh, MS, FMRF, FVRF · Dr. Nikitha Gurram Reddy · +1 other
  2. 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
  3. Articles 1 Jun 2021 11 min read

    Ten Microbiological Facts on Mucormycosis All Ophthalmologists Should Know

    The present overview highlights major microbiological aspects of mucormycosis and attempts to increase the awareness of this ubiquitous group of fungi that are responsible for the difficult-to-manage infections presently being encountered in the setting of the ongoing COVID-19 pandemic. 1. What is Mucormycosis and why is mucormycosis emerging as a serious threat in the present COVID-19 pandemic? Mucormycosis (previously called zygomycosis; sometimes called black fungus infection) is a serious, but rare fungal infection caused by a group of molds belonging to the order Mucorales(1). Mucormycosis is a fulminant disease with high rates of morbidity and mortality that mainly affects immunocompromised patients. Depending on the location of the infection, the mucormycosis can be rhino-orbito-cerebral (most common), pulmonary, gastrointestinal, cutaneous, or disseminated. Although it has a low incidence rate, varying from 0.005 to 1.7 per million population, a sudden rise in cases of rhino-or

    Dr. A.R Anand
  4. 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
  5. Interesting Reads 11 May 2021 8 min read

    Seven Points You Should Know about Mucormycosis

    What is Mucormycosis? Mucormycosis is a fungus that is ubiquitous. This organism is present in the soil and all around us and is also a commensal that is present in the nose and oropharynx. It is an opportunistic organism – this means that it invades and causes infection only when the host’s immune system is compromised. A normal healthy person’s immune system would easily be able to fight a fungal infection like mucormycosis. It invades the nose and the paranasal sinuses. It then gradually spreads to the neighboring structures which is the orbit-it then affects the extraocular muscles, the optic nerve and the orbital apex beyond which it then spreads intracranially involving the cavernous sinus, the leptomeninges, and the brain. This form of invasive mucormycosis which is the commonest clinical manifestation is called Rhino-Orbital-Cerebral Mucormycosis (ROCM). Why are we seeing so much of it now? Typically one would come across fewer than a handful of cases of mucormycosis in an enti

    Dr. Akshay Gopinathan Nair
  6. Students Gallery 13 Apr 2021 9 min read

    Mendeley Reference Manager: A Step-by-step Guide

    Reference managers (such as Mendeley, Zotero, Endnote) are applications that help scientific writers to search, store and organize literature. Additionally, these platforms allow to systematically insert citations and references in any chosen style while writing manuscripts. These tools allow changing reference style with a few clicks. Reference managers are tools made aiming at academicians and authors of scientific writing. This comes in handy for students for writing thesis and assignments. Writing scholarly papers in any discipline requires the citation of relevant literature. Managing references, in-text citations, and integrating these in the suggested format is a tedious process, especially when done manually. Digital storing of scholarly publications has been available for more than 25 years. In the past 10 years, the ‘Reference Managers’ have become an indispensable part of the scientific writers. Amongst others ‘Mendeley’ is an open reference manager which allows easy storing

    Deepmala Mazumdar · Najiya Sundus K. Meethal
  7. Articles 8 Apr 2021 14 min read

    Anterior Vitrectomy Made Easy For Cataract Surgeon

    One of the most dreaded complications of cataract surgery is a posterior capsular tear (PCR). Its rate ranges from 1.3% to 9.6% (from skilled surgeons to trainees)1-5. Early recognition of the PCR and skilled management is necessary for good surgical outcomes and to avoid any devastating sequelae. Hence, anterior vitrectomy is an important skill that every cataract surgeon should master. There are some risk factors that may predispose to PCR like a true posterior polar cataract, dense and mature cataracts, old age (zonular weakness, small pupil, and denser cataract), uncooperative/ anxious patients, poor visualization due to corneal disease, pre-existing ocular trauma leading to capsular rupture/ zonular damage, etc.6,7 A thorough preparation beforehand may avoid confusion and lead to a well-managed surgery. The OT staff should be well aware of the kit to be used for anterior vitrectomy and the settings to be used for the same. Early identification of the posterior capsular tear The ea

    Dr. Vishal Agrawal · Dr. Ketan Rathod · +1 other
  8. Articles 2 Apr 2021 5 min read

    Intravitreal Injections -technique and tips

    Intravitreal injections involve injecting therapeutic agents (drugs/air/gases) inside the vitreous cavity through pars plana under aseptic precautions Surgical anatomy Site of injection: Pars plana Ciliary body: Consists of two parts a) anterior pars plicata b) posterior pars plana Pars plicata Circumferential zone 2.5mm in anteroposterior diameter Pars plana Varies in anteroposterior diameter nasally 3mm wide and temporally 4.5mm wide. This variation is because of the posterior globe on temporal side curves posteriorly & laterally more than on the nasal side. Pars plana extend from pars plicata anteriorly to ora serrata (termination of the retina) posteriorly. Blood vessels in pars plana are radially oriented but circumferential incisions across these vessels cause no bleeding. Also, lens zonules insert into ciliary body avoiding pars plana Thus, needle punctures 3.5 mm posterior to limbus enter globe through pars plana Not damaging lens Not puncturing the retina Not tethering / damag

    Parag K. Shah, DNB · Dr. Varsha V. Prabhu
  9. Students Gallery 2 Apr 2021 14 min read

    How to examine a case of strabismus ?

    There is no substitute to good history obtained at the start of the examination As history gives us a direction to look for, and find pertinent signs aiding in diagnosis and management. The various presenting complaints could range from abnormal head posture, deviation noticed by parents or friends, intermittent eye closure, double vision and so on. Some important points to be noted in patients with squint include, Family history of squint and wear of glasses (amongst parents, siblings and distant relatives) Personal history starting from birth history- Factors such as prematurity and birth weight, nature of delivery (normal/forceps/cesarean) Deviation – the age at which it was noticed, the direction of deviation (inward/ outward/ other) the eye deviated, constant or intermittent nature of deviation. Further, if deviation becomes more obvious when the child is inattentive, tired or ill. The diurnal or cyclic pattern if any also has to be noted. Any history of convulsion, illness or tra

    Dr. Sowmya R, MS,FMRF, FAICO · Dr. Prerana Tripathi, DO, DNB, FICO
  10. Students Gallery 2 Apr 2021 4 min read

    Tips To Achieve Ideal Rhexis

    Capsulorhexis was pioneered and popularized by Howard Gimbel. Capsulorhexis is probably the most challenging to learn in cataract surgery, in other words, once a good rhexis is done half the battle is won. All the Post- Graduates and beginners struggle to do rhexis. This article has compiled small tips and tricks to do rhexis better. Ideally, rhexis should be continuous and curvilinear i.e Circular, Central & of Correct size (5.5-6 mm). Circular: for proper IOL centering and stabilization in the bag Continous: to prevent rhexis extension Correct size: for IOL centering and to ensure anterior capsule overlapping IOL optic 360 degrees. It can be done with the help of a double bent 26 G/27 G needle or rhexis forceps. Let's break the table and use the advantages of a needle Needle Utrata Forceps Advantages Cheap Disposable Universally available Customized Small diameter, lightweight Can be done through side port so less chance of AC shallowing Precise control Disadvantages Less precise con

    Dr. Rohit Rao · Dr. Charudutt Kalamkar

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Review Vitreoretina Top Ten Series Tips & Pearls Macular Diseases Cornea and External Eye Diseases Must Read Preferred Practise Pattern Learn from Masters Treatment Uvea and Intraocular Inflammation Case Discussion Cataract Surgery i-File Pediatric Ophthalmology Imaging Glaucoma Grand Rounds infection