Topic

#Oculoplasty

15 articles
  1. Articles 1 Sep 2021 9 min read

    Ptosis Surgeries: Made Simple for The Postgraduates

    Ptosis refers to a vertical narrowing of the palpebral fissure secondary to drooping of the upper eyelid to a lower than normal position. Multiple surgical procedures can be used to correct ptosis including, frontalis sling, levator advancement, Fasanella Servat operation, and Mullerectomy. The selection of one technique over another depends on the consideration of several factors including the degree of ptosis, the degree of levator muscle function as well as the surgeon experience. Detailed examination and accurate measurements help to decide the procedure that may be required in each patient. When to treat The primary indications for treatment of congenital ptosis are amblyopia and abnormal head positioning. In the setting of severe unilateral ptosis, stimulus deprivation amblyopia is imminent and early surgery is advised and routinely performed at preschool age. Severe bilateral (or unilateral) ptosis can cause a patient to assume an obvious chin-up head position that can interfere

    Dr. Namrata Adulkar
  2. Students Gallery 28 Aug 2021 10 min read

    i-File: Floppy Eyelid Syndrome

    History of Present Illness: A 60-year old male patient presented with recurrent episodes of watering and foreign body sensation of both eyes for 8 years. He gave no history of redness or discharge from the eyes. There was no history of spontaneous eversion of the eyelids. He was treated conservatively with lubricants but had no relief of symptoms. He complained of snoring during sleep with associated daytime somnolence. Past Ocular History: No history of ocular trauma or surgery in the past. Past Medical History/ History of Medication: He was diagnosed with Rheumatoid arthritis 1.5 years ago and hypertension for which he is on treatment. Family History: No significant family history 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): 6/6P, N6 Left eye (OS): 6/6, N6 Ocular Motility/Alignment: Hirshberg corneal reflex- Orthophoric, EOM-Full, f

    Dr. Kirthi Koka · Dr. Jazz K Manadan
  3. Articles 22 Jul 2021 12 min read

    i-File: Thyroid Eye Disease

    Case presentation: A 65-year-old man presented to our clinic with gradually progressive protrusion and swelling of both eyes and double vision for 1 year associated with progressive drooping of the right upper eyelid. There is acute onset of pain in the left eye for 10 days. A smoker for 25 years. Past ocular history No h/o previous ocular surgery or trauma Past medical history The patient is a diagnosed case of hyperthyroidism, Graves’ disease for 2 years. On treatment with Tablet Neomercazole 5mg per day. No history of radio-iodine therapy. The patient has no history of diabetes, hypertension, or cardiac disease. Family history No significant history Ocular Examination: Right Eye Left Eye IOP 18 mmHg 21 mmHg VISUAL ACUITY (UCVA) 6/60 3/60 BCVA 6/24 6/60 COLOUR VISION NORMAL 8/21 OCULAR MOTILITY -1 RESTRICTION IN ALL DIRECTIONS -3 RESTRICTION IN ELEVATION -2 RESTRICTION IN ALL DIRECTION PALPATION NO PALPABLE MASS NO PALPABLE MASS LIDS AND LASHES NEAR-COMPLETE PTOSIS NO LAGOPHTHALMOS L

    Dr. Rwituja Thomas · Dr. Garvita Singh
  4. Articles 7 Jun 2021 5 min read

    Pearls in the Diagnosis and Management of Rhino-Orbito-Cerebral-Mucormycosis

    “The more you know about the past, the better you are prepared for the future.” – Theodore Roosevelt 1. Elicit adequate history Considering the lethal and angio-invasive nature of Rhino-Orbital-Cerebral-Mucormycosis (ROCM) supplemented in this COVID-19 era, it is mandatory to understand the causative factors of the disease. Diabetes mellitus, oral and systemic corticosteroids, immunosuppressive drugs like tocilizumab, remdesivir, hospital admission, supplemental oxygen, mechanical ventilation, primary or secondary immunodeficiency, hematological malignancies, stem cell transplantation, solid organ malignancies and solid organ transplantation, iron overload etc have been considered the important predisposing factors. The history acts like the guiding lantern onto the path towards appropriate management. “Ignoring the signs is a good way to end up in the wrong destination” 2. Identify the Red Flag signs In-depth knowledge about the red flag signs enables the clinicians to recognize the w

    Dr. Rolika Bansal · Dr. Santosh G Honavar, MD, FACS
  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. Articles 2 Apr 2021 21 min read

    Long Case of Ptosis

    Blepharoptosis refers to the inferodisplacement or drooping of the upper eyelids.The condition can be congenital associated with the presence of a dystrophic levator muscle or acquired due to a myogenic, neurogenic, mechanical, aponeurotic or traumatic cause. We aim to provide certain general guidelines to the management of a patient with ptosis. In assessment of long case of ptosis the clinical examination should start with History as with any other case. History: Obtain a thorough medical and ophthalmic history. The onset of ptosis, Alleviating or aggravating factors, Family history of ptosis Whether increasing, decreasing, or constant since the time of manifestation Association with Jaw movements Abnormal ocular movements Abnormal head posture History of Trauma or previous surgery Poisoning Use of steroid drops Any reaction with anesthesia Bleeding tendency Previous photographs may prove to be of great help. Ocular Examination: Head Posture: A significant head posture (usually chin

    Dr. A. K. Grover · Dr. Shaloo Bageja · +1 other
  7. Articles 2 Apr 2021 14 min read

    Eyelid Trauma

    In recent times, eyelid injuries are on the rise primarily because of the increasing incidence of road traffic accidents, industrial mishaps and intentional assaults on the human body. Injury to the eyelids, lacrimal system or orbital wall may be isolated or may occur in association with mid facial injuries. History A precise history is essential to assess the severity of the injury. In some cases, an ophthalmologist can anticipate the extent and severity of injury from the mechanism of injury. It is important to elicit the mode of injury, whether it is with sharp or blunt objects or due to thermal or chemical injury or due to dog bites. In cases of animal bites, a complete tetanus immunization history is obtained and if required proper immunization should be given. Examination Of The Patient The patient’s injury must be dealt with according to the priority. The basic “ABC’s” (Airway, Breathing, Circulation) must be evaluated, before proceeding to the management of localized injury. Th

    Dr. A. K. Grover · Dr. Shaloo Bageja · +1 other
  8. Interesting Reads 1 Apr 2021 11 min read

    Contemplating Dacryology

    Dacryology is the study of the lacrimal system of the human body. Dr. Rohit Rao and Dr. Bindu Malini from eOphtha spoke to Dr. Javed Ali, one of the pioneers in the field of dacryology. We hope this discussion would shed light on the field of dacryology and would answer some common queries pertaining to the surgical management of dacryocystitis. Dr. Javed Ali is the Head, Govindram Seksaria Institute of Dacryology, LVPEI, Hyderabad. He is also serving as the Hong-Leong Professor, University of Singapore, Singapore. and Professor, Friedrich Alexander University, Nuremberg, Germany, Adjunct Associate Professor, University of Rochester, New York, Senior Von Humboldt Scientist, FAU, Nurnberg, Germany. He completed his basic medical education and MS Ophthalmology from NTR University of Health Sciences, Hyderabad. He obtained his fellowship of Royal College of General Practitioners (FRCGP), UK in 2003 and fellowship of Royal College of Physicians and Surgeons of Glasgow (FRCS) in 2008. He al

    Dr. Rohit Rao · Dr. Bindu Malini
  9. Students Gallery 1 Apr 2021 7 min read

    Ten Tips for the Beginner to Examine a Patient of Ptosis

    1. History A careful history helps in identifying the etiology of ptosis (Fig 1). The age at onset of ptosis and its duration will usually distinguish congenital from acquired cases. Relevant history should be elicited in all patients regarding the variability of ptosis during the day, associations with any jaw movements, abnormal ocular movements and head posture, diplopia, or tiredness. Old photographs often reveal important information. A family history of similar conditions should be determined to rule out Congenital or hereditary ptosis, blepharophimosis, ocular myopathies, etc. Any history of previous surgery, trauma, or use of steroids should be recorded. According to its etiology, it can be classified as myogenic, aponeurotic, neurogenic, neuromuscular, mechanical, or traumatic. Figure 1: Young female with Left eye severe ptosis 2. Ruling out pseudoptosis There are conditions that can mimic ptosis include enophthalmos, anophthalmos, contralateral proptosis, contralateral lid re

    Dr. A. K. Grover · Dr. Shaloo Bageja · +1 other
  10. Articles 1 Apr 2021 7 min read

    Panophthalmitis: A Ready Reckoner for Postgraduates

    Introduction Panophthalmitis is a severe ocular and orbital condition which can lead to phthisis bulbi or may necessitate evisceration. Severe inflammation of the anterior and posterior segments is frequently accompanied by microbial keratitis, necrotizing scleritis, and perforation or rupture following trauma. The disease develops rapidly and the prognosis is poor. The management of patients with intractable panophthalmitis remains challenging with eye salvage almost impossible in most cases. Etiology and Pathogenesis Panophthalmitis is a purulent inflammation of all coats of the eyeball including intraocular structures. Although post-traumatic endophthalmitis is the most common preceding event, the infection can result after postoperative endophthalmitis following cataract surgery, keratoplasty, or rarely after posterior segment procedures. It can also be caused by septicemia or can spread from a pus-producing infection in another part of the body. [Table 1] Organisms implicated incl

    Dr. Namrata Adulkar

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