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33 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. 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
  3. Articles 6 Dec 2021 4 min read

    Ten Pearls of Phacoemulsification with PPC

    Posterior Polar Cataract is associated with remnants of Tunica vasculosa lentis. (1) It presents as a white opacity situated on the posterior capsule appearing as a circular plaque with concentric whorls. (2) Surgical management of posterior polar cataracts is a challenge even for skilled surgeons due to high risk of posterior capsular rupture and vitreous loss during surgery. (3) 1. Preoperative Considerations: It has to be identified correctly on slit lamp examination – with its characteristic onion peel or bull’s eye appearance. Patient has to be counselled regarding increased surgical time, higher chances of posterior capsular rupture and even the possibility of posterior segment intervention and delayed visual recovery. (3,4) The fellow eye also needs to be evaluated. Image showing: Characteristic onion peel appearance of Posterior Polar Cataract (Courtesy of Rajan Eye Care Hospital). 2. The Preferred Anaesthesia: Peribulbar anaesthesia is preferred because of longer surgical time

    Dr. Madhuvanthi Mohan · Dr. Sashwanthi Mohan · +1 other
  4. Articles 25 Oct 2021 8 min read

    Anti-VEGFs made Easy for the Postgraduates

    The retina is a highly metabolic tissue and needs a constant high supply of oxygen. Insult to either choroidal or retinal vasculature can lead to a hypoxic state. Throughout the years, neovascularization has been seen to occur in areas neighboring such hypoxic areas. In 1989, this hypoxia-inducible and diffusible factor was discovered to be Vascular Endothelial Growth Factor (VEGF), initially coined as Vascular Permeability Factor (VPF). VEGF was found to be answerable for many types of retinopathies and the increased vascular permeability seen in them. VEGF is a heparin-binding dimeric glycoprotein with di-sulfide-linked A and B subunits. VEGF has been found to be produced by many cell types in the retina including vascular endothelial cells, retinal pigment epithelium, pericytes, Muller cells, retinal neurons, and astrocytes. It is necessary for the survival of retinal cells; prenatally for proper embryological development of the retina as well as postnatally for preserving adult mic

    Dr. Gunjan Prasai · Dr. Anadi Khatri · +1 other
  5. Articles 23 Sep 2021 13 min read

    Ten Pearls for Treating A Case of Retinopathy of Prematurity

    Introduction Retinopathy of Prematurity (ROP) is a potentially blinding retinal vasoproliferative disorder affecting premature and low birth weight infants. With improving survival of preterm infants with lower birth weights and gestational ages, ROP is reaching epidemic proportions in many middle- income countries.1 Although a majority of infants would develop a mild self-limiting disease, some can progress to tractional retinal detachment and become permanently and irreversibly blind. Timely detection and treatment along with good supportive neonatal care offer the best chance of successful outcomes in these infants. Key pearls of ROP management are described as under: Pearl 1: Which infants should be examined for ROP? The guidelines for screening infants for ROP vary between different countries and geographical regions based on individual incidence rates. For India, the current guidelines recommend that all infants with a birth weight of 2000 grams or less and /or gestational age le

    Prof. Mangat Ram Dogra · Dr. Deeksha Katoch
  6. Articles 17 Sep 2021 6 min read

    Visual Fields in Neuro-Ophthalmology : 10 Pearls for the Postgraduates

    1. Is there something we can do before ordering a visual field in neuro-ophthalmology? Confrontation visual field testing is an important clinical examination, especially when it comes to neuro-ophthalmology cases. A simple test can give us clues as to what may be the underlying cause of patients’ symptoms. The test is done presuming the visual field of the examiner is normal. Both the patient and the examiner should be seated at an equal height at a distance of 1 meter. The right eye field is tested by asking the patient to close their left eye and the examiner closes his/her right eye. The first question the examiner must ask the patient, if they are able to see the examiner’s face clearly, without any parts missing. The examiner then moves a pin-point target from out to in all 4 quadrants, while instructing the patient to continuously look into the examiner’s eye. When the patient sees the object, they inform the examiner, who is then able to compare when they themselves saw the obj

    Dr. Simranjeet Aulakh
  7. Articles 13 Sep 2021 30 min read

    Central Retinal Vein Occlusion: A Comprehensive Review

    Introduction: The clinical entity of Central Retinal Vein Occlusion (CRVO) has been known since 1878 (1), and it is a common visually disabling disorder that may cause significant ocular morbidity. It commonly affects men and women equally and occurs predominantly in persons over the age of 65 years (2-4). Associated systemic vascular disease, including hypertension and diabetes, are present in these population groups. The prevalence rates range from 0.1% to 0.5% in the older adult population. (3-5) Younger individuals may have an underlying hypercoagulable or inflammatory Etiology (6,7) CRVO is the second most common retinal vascular disorder after diabetic retinopathy and is considered to be an important cause of visual loss. (8) The annual risk of developing any type of retinal vascular occlusion in the fellow eye is approximately 1% per year, and it is estimated that up to 7% of persons with CRVO may develop CRVO in the fellow eye within 5 years of onset in the first eye (9-11). CR

    Dr. Priyanka Gupta · Dr. Sandeep Kumar · +1 other
  8. Articles 17 Aug 2021 5 min read

    Ten Mistakes to Avoid while Treating a Case of Diabetic Retinopathy

    Diabetic Retinopathy is a common retinal disorder that is seen, managed, and followed up by not only a retina specialist but all ophthalmologists. It is a disease that is easy to diagnose, but often difficult to manage in a long run. For achieving optimal results besides the role of an ophthalmologist, one needs to have the involvement of a physician. The single most important factor for achieving a good outcome is patient compliance, as the disease, diabetes needs lifelong care. Here are few mistakes we need to avoid while managing a case of DR. 1. I can detect DME clinically, I don’t need OCT OCT is not mandatory if there are no signs of DR, or in very mild retinopathy (1 D, Amblyopia, Unilateral elevated intraocular pressure, Complete posterior vitreous detachment, Unilateral carotid artery stenosis, and Chorioretinal scarring 5. Ignoring a rapid progression of milder NPDR to PDR A rapidly progressive NPDR to proliferative retinopathy in a span of a few months (4-6 months) is rare a

    Dr. Rajiv Raman
  9. 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
  10. 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

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