Topic

#Neurophthalmology

7 articles

Students Gallery 9 Nov 2021 14 min read

i-File: Optic Neuritis

A 23 years old female presented to the ophthalmology clinic with complaints of blurring of vision in the left eye since the past 4-5 days with associated mild pain around the left eye, mainly on ocular movements History of Present Illness: Patient did not give any history of associated nausea, vomiting, headache, tingling numbness or limb weakness. There was no history of any preceding febrile illness nor any history of vaccination in the recent past. Past Ocular History: There was no history of any similar episode, any ocular trauma or surgery in the past. Past Medical History: No history of any significant systemic illness or any medications. Family History: No significant history. Systemic Examination: Within normal limits. Pulse rate: 82/min, BP: 124/76 mmHg, Respiratory rate:12/min OCULAR EXAMINATION: Best Corrected Visual Acuity (BCVA) Right eye (OD): 6/6,N6 Left eye (OS): 6/24,N8 Colour Vision (CV) using Ishihara pseudoisochromatic plates: OD: Normal 21/21 OS: Impaired 1/21(iden

Dr. Siddharth Sheth
Articles 2 Nov 2021 5 min read

Diplopia Charting: A Ready Reckoner for the Postgraduates

Diplopia charts are kept in postgraduate examinations during viva sessions. Even in theory examinations also, these topics may be asked. It is not difficult to interpret the charts and all PGs should practice recording the results of these charts. Principle: Dissociation of eyes by means of complementary colors. We use red and green goggles (Armstrong google). In diplopia charting, Red is always in the Right eye and patients perceive one object as two fused images. Let us see the method of interpretations of these charts See the chart Remember red and green goggles are used. Red in front of the right eye and Green in front of the left eye. To your right side (The right side of the picture). Version positions. Dextrum version. Elevation and Depressions are there. The left side of you is the left side positions like levoversion, elevation and levodepression are there Primary position elevation and depressions are noted. Totally we have nine quadrants Never forget to write the name of the

Dr. (Capt) V.R Vijayaraghavan
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
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
Articles 1 Apr 2021 25 min read

Learn from the Masters: Clinical Highlights in Neuro-ophthalmology

Neuro-ophthalmology is a unique subspecialty of ophthalmology and neurology where there is a complex interaction of neurologic and systemic disorders in the visual system. Neuro-ophthalmic conditions are not only about vision-threatening but sometimes life-threatening too! It needs the most comprehensive examination from ophthalmic, neurologic, and medical viewpoint. The trick lies with a systematic approach starting from history taking to specific examination techniques and localization of the condition. We have put together a few fundamental questions on clinical highlights in neuro-ophthalmology, and they were addressed to the experts who have been phenomenal in the field. Let’s learn from their vivid explanation and expand our neuro-ophthalmology skills. Dr. Ambika Selvakumar is a senior consultant and the head of the Neuro-ophthalmology services, Sankara Nethralaya, Chennai, India. She has done MBBS from prestigious Stanley medical college, Chennai. Postgraduation in ophthalmology

Dr. DurgaPriyadarshini S
Articles 1 Apr 2021 9 min read

Ten Tips for Management of Nystagmus

Nystagmus is defined as an involuntary rhythmic oscillation of one or both the eyes. Clinical assessment and eye movement recordings are important to diagnose and classify nystagmus. It is essential to have patience while examining a child, as anxiety often increases nystagmus. 1.Classification Physiological eye movements have to be differentiated from pathological eye movements. The older etiology-based classification of nystagmus is redesigned into characteristics-based new classification by CEMAS (Classification of Eye Movement and Strabismus). Infantile nystagmus syndrome (INS) is characterized by horizontal conjugate nystagmus, infantile-onset, accelerating slow phase, increase with fixation attempt, convergence dampening, and presence of null zone with decreased amplitude. Fusion maldevelopment nystagmus syndrome (FMNS) is characterized by decelerating slow phase, associated strabismus, a latent component with fast phase towards fixing eye and decrease in intensity with adduction

Dr. Ramesh Kekunnaya · Dr. Mayank Jain
Articles 1 Apr 2021 13 min read

Evaluation of a case of Diplopia

What is diplopia or double vision? Diplopia or double vision by definition is the simultaneous perception of two images of a single object that may be displaced in any direction. Other terms could be blurred vision, shadowing, or confusion. Is it uniocular or binocular diplopia? The first step to evaluate diplopia is to differentiate between uniocular and binocular diplopias as the management varies completely. If the diplopia disappears on covering either eye the diplopia is binocular. If diplopia is persistent or worsens if one of the eyes is occluded then it’s uniocular diplopia of the other eye. Uniocular diplopia Any corneal surface problems like tear film abnormalities, uncorrected astigmatism, early stages of cataract, subluxated lens, or early macular issues can cause uniocular diplopia. A simple pinhole test can confirm the same. The management of this is to address the cause. Binocular diplopia Binocular diplopia is double vision typically arising as a result of strabismus or

Dr. Kavitha Kalaivani · Dr. Hennaav Kaur Dhillon