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#Review

86 articles
  1. Articles 30 May 2022 22 min read

    Ocular Toxoplasmosis

    Introduction: Toxoplasmosis is the most common cause of posterior uveitis in the world, accounting for over 80% of the cases in some regions[1-5]. For many years, ocular toxoplasmosis was considered to be the result of the recurrence of the congenital form of the disease [6]. However, it is recently believed that acquired infections might be a more important cause of ocular diseases than congenital ones[7-9]. Acquired infections occur secondary to ingestion of uncooked and infected meat, contaminated vegetables, or water. Epidemiology: The Toxoplasma Gondii infection is one of the most common zoonoses in the world. A large percentage of the population has chronic asymptomatic disease[10]. The prevalence varies extensively in different regions, depending on socioeconomic, geographic, and climatic factors. A high prevalence is found in tropical areas close to sea level, and a lower prevalence is found in arid regions, cold climates, and at high altitudes. In addition, the habit of eating

    Dr. Deepika MP · Dr. Nidhi Dubey · +1 other
  2. Articles 30 Nov 2021 24 min read

    Ocular Manifestations of HIV

    Human immunodeficiency virus (HIV) disease is a pandemic of global concern, not only due to serious health issues affecting all organs of the body but also due to its huge economic burden.(1) The diagnosis is often associated with social stigma that includes changing sexual practices, lack of availability of a vaccine and the chronicity of the disease requiring lifelong treatment.(2) The disease runs a severe course, involving multiple organs. Ocular lesions are varied and can affect any structure, usually in the late phase of HIV infection. Rarely, these lesions can be the presenting manifestations of the disease. While a variety of cell types may be infected by HIV, the immunologic hallmark is the selective loss of the CD4+ T cells. CD4 is a cell surface marker that identi?es the helper/inducer subset of T cells. During the initial phases of infection, a majority of patients remain asymptomatic. With a decrease in the CD4+ T cell count (< 500 cells/µL) the immune system shows evidenc

    Dr. Sharanya Abraham
  3. 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
  4. 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
  5. Articles 6 Sep 2021 19 min read

    Basics of limbal Stem Cell Deficiency for the Postgraduates

    Limbal Epithelial Stem Cells Anatomy: The healthy corneo-scleral limbus (Figure 1) is a gradual transition zone from the stratified, non- keratinised squamous epithelium of the cornea to the stratified, non- keratinised columnar epithelium with mucin-secreting goblet cells of the conjunctiva. It has 7-10 layers of cells, which have attachments similar to the corneal cells. Figure 1: Slit-lamp photograph (high magnification) of the normal limbus showing arrangement of pigmentated Palisades of Vogt in the inferior quadrant. This zone contains limbal epithelial stem cells (LSCs) that generate new epithelial cells during homeostasis and after injury or insult, to maintain corneal transparency and vision. LSCs are believed to be located within the basal layer of limbal crypts (in the palisades of Vogt) [1] and focal stromal projections (finger-like projections of stroma containing a central blood vessel, and extend upward into the corneal limbal epithelium and are surrounded by small, tight

    Dr. Purvasha Narang
  6. Articles 20 Jul 2021 12 min read

    Pterygium: A Review

    Introduction A pterygium is a fibrovascular, wing-shaped encroachment of the conjunctiva onto the cornea, usually in the horizontal meridian of the palpebral fissure. Histopathology shows hyaline degeneration with elastotic proliferation. Risk factors Exposure to ultraviolet light and environmental microtrauma to the ocular surface is thought to predispose to pterygium formation. A localized limbal stem cell dysfunction, possibly related to ultraviolet induced damage and a genetic predisposition has also been postulated. Pathogenesis Pterygium pathogenesis can be considered as occurring in two stages: the initial disruption of the limbal corneal-conjunctival epithelial barrier, and the progressive “conjunctivalization” of the cornea characterized by cellular proliferation, inflammation, connective tissue remodeling, and angiogenesis Morphology Head—the part which rests on the cornea Neck— constricted portion seen at the limbus Body – remaining bulk of mass Cap—a semilunar infiltrating

    Dr. Ramya Subramaniam, DNB · Dr. Srinivas K Rao, DO DNB FRCSEd
  7. Articles 21 Apr 2021 16 min read

    Facial Spasms: Diagnosis and Management

    Introduction Dystonia is defined as a movement disorder characterized by sustained or intermittent muscle contractions causing abnormal, often repetitive, movements, postures, or both [1]. They may be isolated or combined with other neurological symptoms or movement disorders [1]. Dystonia is classified based on the age of onset, etiology, clinical features, and body distribution. The body distribution may be either focal, segmental, multifocal, generalized, or hemi-dystonia. Only one region of the body is affected by focal dystonia. It emerges in late adulthood [1]. Patients with movement disorders isolated to the facial region often visit an Ophthalmologist. A brief knowledge about the identification and differentiation of the various facial movement disorders is essential. The disorder can be functionally or socially distressing to the patients. The facial movement disorders include orbicularis myokymia, Benign Essential Blepharospasm (BEB), Apraxia of Lid Opening (ALO), Hemifacial

    Dr. Varshitha Hemanth Vasanthapuram · Dr. Milind N Naik
  8. Articles 2 Apr 2021 16 min read

    Allergic Eye Diseases

    Introduction Allergic eye disease (AED) is a common problem, owing to the fact that the eye is the first organ to encounter environmental allergens. It has been reported to affect 20% of the population worldwide1, 2. Allergic eye disease is found to be on the rise in line with other atopic diseases like asthma, due to environmental reasons. Classification of Allergic Eye Diseases 1, 4 1. Allergic conjunctivitis Acute allergic conjunctivitis Seasonal allergic conjunctivitis Toxic induced (acute contact with irritant) Chronic allergic conjunctivitis Perennial allergic conjunctivitis Toxic induced (long standing) 2. Contact dermatoblepharitis 3. Vernal keratoconjunctivitis 4. Atopic keratoconjunctivitis 5. Giant papillary conjunctivitis 6. Microbial allergic conjunctivitis Staphylococcal blepharoconjunctivitis Phylectenular keratoconjunctivitis Splendore Hoeppli phenomenon (allergic granulomatous Nodules) Immunopathology in allergic eye disease 3, 5 The ocular surface exhibits a variety o

    Dr. P.Vijayalakshmi
  9. Articles 2 Apr 2021 16 min read

    Peripheral Ulcerative Keratitis

    Peripheral ulcerative keratitis (PUK) is a form of ocular inflammation that involves the peripheral portion of cornea and may be associated with systemic conditions such as Rheumatoid Arthritis(RA), Wegener’s Granulomatosis(WG), and other systemic conditions. It is a potentially devastating disorder consisting of a crescent-shaped destructive inflammation at the margin of corneal stroma that is associated with an epithelial defect, presence of stromal inflammatory cells, and progressive stromal degradation and thinning. The onset of Peripheral Ulcerative Keratitis has been linked to various anatomical factors of central and peripheral cornea and adjoining limbus. Though the local concentration of small and medium weight proteins like IgA, IgG and most complements are similar in central and peripheral cornea, the peripheral cornea has been found to be associated with higher concentrations of higher molecular weight(HMW) protein molecules like IgM and complement C1(5 times), possibily ow

    Dr. A. Agarwal, MD · Dr. A.Panda, MD, FAMS, FICS, FICO, MRC Ophthalmology
  10. Articles 2 Apr 2021 14 min read

    Primary Angle Closure Glaucoma

    Primary Angle Closure Glaucoma is a condition in which elevation of intraocular pressure (IOP) occurs as a result of obstruction of aqueous outflow by partial or complete closure of angle by the peripheral iris. I. Classical Classification: Prodromal Stage Stage of constant instability Acute Congestive Stage Chronic Angle Closure Stage Absolute Stage II. Newer Classification: Recommended by the American Academy of Ophthalmology (AAO) and World Glaucoma Association (WGA). 1. Primary Angle Closure Suspect This includes any eye that has a primary, abnormally narrow angular width of the anterior-chamber-angle recess, wherein the peripheral iris is located close to, yet not touching, the posterior pigmented trabecular meshwork. Patients with primary anatomic narrow anterior-chamber angles are at risk for subsequent primary angle closure (PAC). 2. Primary Angle Closure and Primary Angle-Closure Glaucoma Any eye that has a primary anatomic narrow anterior-chamber angle and evidence such as pe

    Dr. Srinivasan Kavitha · Dr. Rengaraj Venkatesh

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