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#Review

86 articles
  1. Articles 2 Apr 2021 10 min read

    Chemical Injuries of Eye - An Update.

    Introduction It is very frequent to encounter chemical injury in our routine ophthalmic practice. Most of the chemical injuries are minor, which heal without any squeal. Most are acids and alkalis. Alkali injuries are more common (nearly twice) than acids and are more severe in nature. It is of utmost importance to recognize the nature of chemicals for treating such patients. Here, we review the chemical injuries of the eye with their recent management update. Epidemiology Chemical burn 7.9-9% of all reported ocular burns. 23 -42% are bilateral. Young males are affected mostly. Most are industrial accidents (at workplace 60-70%, at homes 25-30%, criminal assault, and others comprise 2-3%) Sources of common chemicals Alkalis Acids 1.Ammonium hydroxide and Ammonia- fertilizers, laboratory refrigerator, household cleansing agent, bleaching powder 2. Sodium hydroxide-drain cleaner, soap 3. Potassium hydroxide- soap 3.Calcium hydroxide- plaster, cement, mortar, whitewash(chuna) 4.Magnesium

    Dr. Sushobhan Dasgupta · Dr. Tarannum Shakeel · +1 other
  2. Articles 1 Apr 2021 18 min read

    Proliferative Diabetic Retinopathy

    Diabetic retinopathy (DR) is the leading cause of visual impairment worldwide. It almost accounts for 2.6% of treatable blindness globally (1). It is estimated that the overall prevalence of diabetic retinopathy is 34.6 % worldwide, while the prevalence of proliferative diabetic retinopathy (PDR) is 6.96% and that of vision-threatening DR (VTDR) is computed to be 10.2% (2). Currently, the prevalence of PDR in India is estimated to be 17% which is significantly higher compared to patients from other locations of Asia (3). Early detection and treatment is the only key to avoiding complications and risks of vision loss (4). But the major obstacle ahead of us in India is the failure to diagnose DR in early stages; as it is observed that only 18–35% of diabetics undergo ophthalmologic evaluation regularly (5). Pathogenesis Diabetic retinopathy is recognized as a neuro-vascular complication of diabetes. The triad of hyperglycemia, inflammation, and hypoxia along with retinal neurodegeneratio

    Dr. Aditya Kelkar · Dr. Mounika Bolisetty
  3. Students Gallery 1 Apr 2021 26 min read

    Lensopedia: Lenses in Ophthalmology

    Introduction: While there are several instruments in ophthalmological practice, lenses form an inseparable part of an ophthalmologist’s arsenal. Available in various sizes and shapes, they are crucial in aiding the visualization of remote areas of the eye and facilitate therapeutic interventions in those areas which would be next to impossible to even imagine without their availability. Harnessing the unlimited potential of optics, it allows an ophthalmologist to play with the most dynamic form of energy, light, provided he behold sound and in-depth knowledge about the lens. This write-up aims at helping one acquire this knowledge and employ them for a successful practice. Lens: A piece of glass or other transparent material with curved sides for concentrating or dispersing light rays. (Lexico Oxford Dictionary) Classification of lenses (Based on their utility) Lens for the anterior segment: Lens for posterior segment Gonioscopy Principles and Optics The critical angle for the cornea-a

    Dr. Niranjan Karthik Senthil Kumar
  4. Articles 1 Apr 2021 42 min read

    Retinopathy of Prematurity

    Introduction First described in 1942, retinopathy of prematurity (ROP) is a vasoproliferative retinopathy affecting premature infants of low birth weight. As per the original description by Terry et al, this disease was labelled as retrolental fibroplasia (RLF) based on the hypothesis that it involved the proliferation of the embryonic hyaloid system[1] But Owens and Owens later described that in these infants, the hyaloid system was normal at birth and the RLF developed postnatally.[2] The term “retinopathy of prematurity” was coined later as the disease pathogenesis and clinical presentation got better understood. [3]In the 1950s, the association between supplemental oxygen and ROP pathogenesis was first established by controlled studies done in the neonatal intensive care units. {4,5] The spectrum of ROP ranges from mild cases that may resolve spontaneously with no visual impairment to advanced cases with bilateral irreversible blindness within the first few months of life. Epidemio

    Dr. Parveen Sen · Dr. Aditya Maitray
  5. Students Gallery 1 Apr 2021 6 min read

    LASERs in Ophthalmology: A Concise Guide for the Postgraduates

    LASER is an acronym for “light amplification by stimulated emission of radiation”. Invented more than 50 years ago, today lasers are synonymous with precision and sophistication. The first medical application of lasers was the use in retinal photocoagulation and that role has been ever-evolving. Today its application is evident in all subspecialties of ophthalmology as a diagnostic and therapeutic tool. Since medieval times, the damaging effects of strong light have been known to mankind. Socrates advocated avoiding direct viewing of the solar eclipse. The first documented use of light therapeutically was by Meyer- Schwickerath. He focused sunlight on the retinas of patients to treat melanomas. An undocumented early experiment with the aim of therapeutic photocoagulation was done by Moran- Salas in the 1940s. Meyer- Schwikerath highlighted that photic burns may be beneficial as a therapy. However, the major limitation of this was the requirement of enough sunlight to achieve the desire

    Dr. Soumya Podury
  6. Articles 1 Apr 2021 20 min read

    Uveitic Macular Edema

    Introduction: Macular edema is defined as swelling of the layers of neurosensory retina within the macula. Cystoid macular edema (CME) is a subtype of macular edema characterized by extracellular accumulation of fluid within the outer plexiform layer of the retina in the form of intraretinal cyst. It is known as one of the complications, that develops consequent to a final common pathway in diverse diseases affecting the blood-retinal barrier. CME is a major cause of visual loss in uveitis. The overall reported prevalence of visual impairment associated with uveitic CME is 33–42 % and is influenced by the age, location, severity, and duration of retinal edema. [1,2] In young age, the retinal tissue shows resistance to development of CME, but advanced age is independently associated with early development of CME, regardless of the duration of uveitis. In contrast, the most frequent causes of visual loss in pediatric uveitis are retinal scars and glaucoma. [3] Panuveitis and intermediate

    Dr. Amit H Palkar · Dr. Parthopratim Dutta Majumder
  7. Articles 1 Apr 2021 20 min read

    Polypoidal Choroidal Vasculopathy

    Introduction Polypoidal Choroidal Vasculopathy (PCV), first described by Yannuzzi et al1 in 1982, is a distinct clinical entity characterized by persistent recurrent serous leakage and hemorrhage in the macula, and is seen in the elderly population. The disorder was poorly understood earlier and had been described by various authors as recurrent pigment epithelial detachment (PED) and posterior uveal bleeding syndrome.2.5 The primary abnormality, as described by Yannuzzi et al,1, 2, 6involves the choroidal circulation, and the characteristic lesion is an inner choroidal vascular network of vessels ending in an aneurysmal bulge visible clinically as a reddish-orange spheroidal polyp like structure. More recently with improvement in choroidal imaging using Enhanced Depth Imaging and Swept-Source optical coherence tomography (EDI-OCT and SS-OCT), PCV is regarded as a part of the Pachychoroid spectrum of diseases and a variant of Type I choroidal neovascularization.7, 8, 9 Epidemiology The

    Dr. Giridhar Anantharaman, MS, FVRS · Dr. Jay Sheth, DNB, FVRS
  8. Articles 1 Apr 2021 11 min read

    Drug Induced Maculopathy: A Quick Look

    Generally all the drugs are likely to have some side effects. For ophthalmologists, it is essential to know the drugs which affect the vision or involve the eye as a part of their side-effects. This is a summary of the drugs causing damage to the posterior segment of the eye. Patterns of retinal toxicity: Disruption of the retina and retinal pigment epithelium Vascular damage Retinal folds Phenoithiazine Qunine sulfate Thioridazine Clofazimine Cholopromazine Deferoxamine Chloroquine derivatives Corticosteroid Chloroquine Cisplatin& carmustine Hydroxychloroquine Cisplatin & carmustine Qunine sulfate Aminogycoside Interferon Ergot derivatives Talc Phenylpropanolamine Oral contraceptives Cystoid macular edema Epinephrine Latanoprost Nicotinic acid Sulfa derivatives Hydroxychlorothiazide Acetazolamide Triamterene Metronidazole Chlorthalidone Crystalline retinopathy Uveitis Tamoxifen Talc Canthaxanthine Nitrofurantoin Methoxyflurane Rifabutin Cidofovir Miscellaneous Digoxin Methanol CHLOROQ

    Dr. Jay Chhablani
  9. Articles 1 Apr 2021 14 min read

    Coats Disease

    Introduction History In 1908 George Coats1 original description of the disease was based primarily on histopathologic examination of enucleated eyes and identified retinal vascular aneurysms, arteriovenous malformations, intra- and subretinal hemorrhages, and exudates. Coats categorized eyes with these characteristic morphologic findings into three groups: Group I demonstrated massive subretinal exudate alone, group II consisted of eyes with massive subretinal exudate, intra and subretinal hemorrhage, and retinal vascular dilatations, and group III included eyes with subretinal exudate and retinal arteriovenous malformations. Von Hippel2 later identified group III as a separate entity, angiomatosis retinae, which led to the exclusion of this group from the spectrum of Coats disease. In 1912, Theodor Leber3 described a disorder with similar retinal vascular abnormalities to Coats disease, but without massive subretinal exudate, hemorrhage, and serous retinal detachment. This became know

    Dr. Aditya Bansal · Dr. Vikas Khetan
  10. Articles 1 Apr 2021 15 min read

    The Effects & Techniques of Scleral Buckle in Treatment of Retinal Detachment

    Introduction: Scleral buckle surgery is indicated for uncomplicated rhegmatogenous retinal detachments. Scleral buckling indents the sclera and the overlying choroid retinal pigment epithelium complex towards the retinal break in the detached retina, resulting in retinal reattachment. Scleral buckle surgery evolved out of the works of Jules Gonin, who identified retinal breaks as the cause of retinal detachment, Custodis, Lincoff and Schepens who devised ways of using an epi / intrascleral implant to “buckle” the sclera inward to create the indent.1-3 Principles of scleral buckling: The aim of scleral buckling is to close all retinal breaks to achieve permanent reattachment of the retina. General principles of retinal detachment surgery- Search for the breaks, find all the breaks, seal all the breaks, and relieve vitro retinal traction. This is achieved by - Identification of the retinal break Retinopexy – creating a sterile inflammatory reaction that would result subsequently in chori

    Dr. P. Mahesh Shanmugam · Dr. Pradeep Sagar · +3 others

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