Topic

#Preferred Practise Pattern

30 articles
  1. Articles 1 Apr 2021 9 min read

    How do we treat inflammatory CNVM ?

    Inflammatory choroidal neovascular membranes (CNVM) cause an acute and significant visual loss 1,2. Mostly affecting eyes with posterior or panuveitis, the chronic recurrent nature of inflammation further worsens the visual prognosis in these eyes, such as serpiginous like choroiditis, punctuate inner choroidopathy (PIC), multifocal choroiditis, Vogt-Koyanagi-Harada (VKH) disease, presumed ocular histoplasmosis syndrome, toxoplasma retinochoroiditis, etc,.3,4 . The angiogenic stimulus in inflammatory CNVM is driven by local inflammation and/or a degenerative breach in retinal pigment epithelium (RPE)-Bruch’s membrane complex4. An active intraocular inflammation induces the release of several inflammatory mediators including cytokines, chemokines, vascular endothelial growth factor (VEGF) and complement activation, which in turn promote retinal and choroidal neovascularization. Majority of inflammatory CNVM are classic (on fundus fluorescein angiography), and type 2 on spectral domain o

    Dr. Krinjeela Bazgain · Dr. Nitin Kumar · +1 other
  2. Articles 1 Apr 2021 11 min read

    Tips on Management of Intraocular Foreign Body

    Introduction Open globe injuries (OGI) are associated with retained intraocular foreign body (IOFB)in 18 to 41% of cases1. Retained IOFB is an important cause of visual morbidity and blindness, especially in working-age population with male predominance. Majority of the IOFBs are related to trauma at workplace1. Types of IOFB Majority of IOFB are metallic1,2. It is followed by organic IOFB and metallic non magnetic IOFB. Metallic IOFB like iron or copper can cause metallosis leading to poorer visual outcomes if left untreated. Organic IOFB are associated with high incidence of fungal endophthalmitis and need treatment on emergency basis. Inert IOFB like glass or noble metal like gold can be present in a minority of patients. Theoretically these can be managed conservatively, however with advancements in Vitreoretinal Surgery it is seldom done. Location of IOFB Most common resting place for IOFB is vitreous cavity. Though it may be lodged in any part of the eye. IOFB might be present in

    Dr. Maneesh Bapaye
  3. Articles 1 Apr 2021 9 min read

    Management of Dropped Nucleus and Retained Lens Fragment

    Introduction: Drooped nucleus and retained lens fragment is a complication not so rare in clinical practice. In the era where cataract surgery is being performed for visual enhancement rather than visual rehabilitation, the management of a dropped nucleus saves the patient from unnecessary anxiety and hastens visual recovery. In this chapter risk factors, the timing of surgery, various approaches for removal of the lens will be discussed. Incidence: Dropped nucleus and cortical remnants occur more frequently in phacoemulsification than other techniques of cataract surgery 1,2 . Surveys in developed nations like U.S and U.K have reported incidences of 0.3 % 1 and 1.1 % respectively. In India, few studies have quoted its incidence to be around 0.8 %. [3] Risk Factors: The exact cause for the posterior displacement of the nucleus is difficult to determine but certain conditions predispose for complication4 Pseudoexfoliation syndrome Traumatic cataract Fellow eye of complicated cataract su

    Dr. Dhanashree Ratra · Vineet Ratra · +1 other
  4. Articles 1 Apr 2021 14 min read

    Corneal Trauma and its Management

    Introduction The cornea is prone to a variety of injuries by virtue of its location as the window of the eye. Apart from chemical injuries, physical trauma to the cornea can range from epithelial abrasions to loss of integrity of the stroma. Corneal injuries of this nature can occur in two distinct populations – in young children from play-related activities, and in young adults from due to their work environment. Although the general principles of management are not too different, special consideration in the pediatric population must be given to the timing of appropriate surgical interventions as the developing visual system in children is prone to amblyopic visual loss. Males are usually more prone to ocular injury than females; this is seen clearly in children, while the ratio of boys vs girls involved in accidents with ocular trauma is 4:1 [1]. The injuries can be caused by large blunt objects often resulting in ruptures of other parts of the ocular coats as well. On the other han

    Dr. Sanjeev P Srinivas · Dr. Amanda Mohanan · +1 other
  5. Articles 1 Apr 2021 10 min read

    Binocular Indirect Ophthalmoscopy : The Beginner's Guide

    The technique of examining the fundus of the eye is called ophthalmoscopy. In direct ophthalmoscopy, a virtual and erect image of the fundus is seen. In indirect ophthalmoscopy, a real and inverted image is formed between the condensing lens and the observer. The advantage of stereopsis (depth perception) and a larger field of view makes indirect ophthalmoscope (IDO) more useful both in retina clinics and during posterior segment surgeries. Inventions and innovations The journey of developing ophthalmoscopy began with an idea by the great physicist, Hermann von Helmholtz, who described the optical principles of direct ophthalmoscopy in 1851 (Fig:1a). This was followed by series of innovations and methods of examination including the indirect method of ophthalmoscopy developed by Reute in 1852 (Fig:1b), binocular model by Marc-Antoine Giraud-Teulon (Fig:1c) and more practical hand-held reflex-free binocular ophthalmoscope by Allvar Gullstrand (Fig:1d). It was Charles Schepens who popula

    Dr. Nagesha CK
  6. Articles 1 Apr 2021 11 min read

    Ten Tenets on Corneal Collagen Crosslinking

    Corneal collagen crosslinking (CXL) is a minimally invasive procedure that is currently the gold standard treatment to arrest the progression of corneal ectatic conditions. It promotes the induction of crosslinks in stromal collagen of the cornea, thereby strengthening and stiffening the cornea in ectatic conditions. 1.HISTORY It was observed that corneas in diabetic patients were stiffer due to the natural crosslinking occurring from glycosylation and hence had a lower incidence of keratoconus. Based on this observation, various experiments were conducted to crosslink the cornea manually using chemical agents and sugar aldehydes. Following multiple trials, it was found that this could be safely done by making use of the photochemical reaction induced by the absorption of UV light by riboflavin.1 The first in vivo study was done by Wollensak et al., and they reported in 2003 that CXL was effective in stopping the progression of moderate to advanced progressive keratoconus, in 23 eyes f

    Dr. Amanda Mohanan · Dr. Sanjeev P Srinivas · +1 other
  7. Articles 1 Apr 2021 6 min read

    Learn from the Masters : Tips & Tricks of Managing Dry Eye

    As we all know that India is on the brink of a dry eye disease epidemic, this interview with the maestros in this field will help us to streamline our approach in managing the increasing number of dry eye patients. The availability of innumerable diagnostic tests always baffles us about how to use what in which time. The need for an integrated scheme in assessing and prognosticating dry eye cases is of utmost importance for a successful treatment outcome. Some of the very basic but most important areas are discussed by the unparallels in their field to clear the doubts of young ophthalmologists. Dr. Srinivas K. Rao DO, DNB, FRCSEd has worked as a Senior Consultant at Sankara Nethralaya for 15 years before joining as Professor in the Chinese University of Hong Kong from September 2004 till August 2006. Since October 2006 he is Director of Darshan Eye Care and Darshan Surgical Centre, Chennai. He is also Visiting Professor, Sri Ramachandra Medical University, Cornea Head at Sankara Hospi

    Dr. Sumana Chatterjee
  8. Articles 1 Apr 2021 17 min read

    Learn from the Masters : Tips and Tricks of Vitreoretinal Surgery

    “If you are brave enough to start the right way, you will be strong enough to finish at the right place.” The most crucial aspect of vitreoretinal surgery is learning it the right way. And if you have the guidance of teachers with experiences of a lifetime, there is an abundant pool of knowledge you can extract. Plenty of young VR surgeons are facing difficulties in the basic principles and doctrines of surgery. Some of these basic questions were compiled together and addressed to the top-notch VR surgeons of India, owing to a simple and lucid explanation for the same. Dr. Atul Kumar, MD, FAMS, FRCS(Ed) is the Chief & Professor of Ophthalmology at Dr. R.P. Centre, AIIMS, New Delhi since 1st January 2016. He completed MD & Sr. Residency from Dr. R.P. Centre, AIIMS New Delhi India & joined as Assistant Professor in the same institute in 1987 (Discipline: -Vitreous-Retina). He pursued Retina Fellowship from the University of Maryland, Baltimore, USA, 1990. He has 313 indexed & non-indexed

    Dr. Dhaivat Shah
  9. Articles 1 Apr 2021 17 min read

    Computer Vision Syndrome

    To most of us, computers have become an irreplaceable necessity in our lives at work and at home. Working on the computer screen at such a short distance can result in eyestrain, blurred vision, redness, irritation of eyes, and posture-related musculoskeletal problems, which is called Computer vision syndrome or digital eye strain. Definition The American Association of Optometrists defines Computer Vision Syndrome is a complex of eye & vision problems related to the activities that stress the near vision and which are experienced in relation to or during the use of computers1 They include eyestrain, headache, blurry near vision, slowness in changing focus, light sensitivity, eye irritation. Improper ergonomic practices can lead to pain in the neck, shoulder, and back, carpal tunnel syndrome, etc. In the current digital world, there has been a rapid shift from paper to computers, mobiles, e-readers & other Visual Display Terminals (VDTs). Our eyes have not got fully adapted to working

    Dr. Shilpa Joshi

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