Topic

#Review

86 articles
  1. Articles 1 Apr 2021 14 min read

    Recurrent Corneal Erosion Syndrome - A Review

    Introduction: Recurrent corneal erosion syndrome (RCES) is a chronic, relapsing condition first described by Hansen1, who termed it as ‘‘intermittent neuralgic vesicular keratitis.’’ Stood in 1901 suggested that trauma to the corneal epithelium and anterior stroma resulted in an inability of the new epithelium to form normal attachments to the injured anterior Bowman’s layer 2. Despite more than a century of advances in corneal science, RCES remains one of the most challenging conditions to manage3. Most patients have a history of epithelial trauma or associated corneal dystrophy and respond initially to a conservative regimen of lubrication. However, they often experience frequent and debilitating recurrences. In this review, we will investigate the etiology and pathogenesis of this challenging disorder, discuss the histopathological changes with a highlight on ASOCT findings, current therapies, and present future directions for research. Etiology and epidemiology: Recurrent corneal e

    Dr. Rishi Swarup D.O · Dr. Divya Jain M.S
  2. Articles 1 Apr 2021 25 min read

    An Approach to a Case of Retinitis

    Inflammation of retinal tissue causes characteristic fundus findings depending on whether it is full-thickness or partial-thickness or outer or inner retinal involvement. Figure 1A: A case of epidemic retinitis: Bright yellow superficial fluffy lesion superiorly to the disc obscuring retinal vessels passing through it is typical of inner or full-thickness retinitis. 1B: A case of progressive outer retinal necrosis: Yellowish lesions with clear retinal overlying vasculature suggests outer retinitis. Full-thickness or inner retinal involvement produces bright yellow fluffy lesions with indistinct borders. (Figure 1A) Retinal vasculature passing through these lesions appears obscured. At times, such lesions can mimic cotton-wool spots and may produce moderate to severe vitritis. Outer retinal inflammatory lesions appear dull orange or yellow with indistinct borders, retinal vessels may remain clear over the lesions (Figure 1B) and vitritis could be mild-moderate. Differentiating retinitis

    Dr. Ankush Kawali · Dr. Sanjay Srinivasan · +1 other
  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

    Ultrasound B-Scan: A Ready Reckoner for the Postgraduates

    The importance of ultrasound imaging cannot be stressed upon more than the fact that whether you are an anterior segment surgeon, posterior segment surgeon or oculoplastic surgeon, the indications for this modality transcend across all genres of ophthalmology. Many a time, postgraduates find this topic daunting to interpret. This article aims to simplify Ultrasound B-scan in terms of mechanics, terminology, actual procedure, and interpretation without delving deep into the confusing jargon. Some common conditions and their typical presentations will also be touched upon. For ease of understanding, we will divide this article into the following sections: History Basic physics and instrumentation Terminology Indications Examination techniques: basic and special Features of commonly encountered posterior segment conditions History Though the concept of ultrasound waves was known to humans in the 18th century (Lazzaro Spallanzini’s observation on the use of ‘sound whistles’ by bats in dark

    Dr. Anmol Naik · Dr. Shveta Gadewar · +1 other
  5. Articles 1 Apr 2021 13 min read

    Thyroid Eye Disease : A Review for the Postgraduates

    Introduction: Thyroid eye disease (TED) or thyroid-associated orbitopathy (TAO) also called Basedow-Grave’s disease. It is an autoimmune inflammatory disorder characterized by enlargement of the orbital fat and extraocular muscles.1 It is a consequence of thyroid gland dysfunction, where antibodies are targeted against thyrotropin receptors (TSHR) known as thyroid-stimulating globulin(TSI).1 It is independent of the serum level of the circulating hormone levels. 2 TED is characterized by an active or inflammatory stage and an inactive or fibrotic stage. The active or the inflammatory stage is characterized by inflammation, adipogenesis, and accumulation of extracellular fluid, glycosaminoglycans which in turn causes enlargement of the extraocular muscles and expansion of the orbital fat. Once the inflammation settles, there is predominant scarring of the orbital tissues which marks the onset of the fibrotic stage. The natural course of the disease is quite variable. The majority of TED

    Dr. Amber Dubey · Dr. Vazhipokkil Anju Chandran · +1 other
  6. Articles 1 Apr 2021 19 min read

    A (VAST)IN Saga

    Vascular endothelial growth factor (VEGF)-A is a key mediator of angiogenesis. The discovery of VEGF-A, like many other major discoveries in medicine, happened partly by observations and partly by chance. Napoleone Ferrara and his team were working on a population of non-hormone-secreting cells from the anterior pituitary of cows. (1) One day Ferrara mixed some isolates from cultures of follicular cells with endothelial cells. Ferrara was surprised to see the rapidly proliferating endothelial cells started rapidly. Ferrara understood that the pituitary cells were secreting an angiogenic protein. With this observation, Ferrara worked on the isolation and cloning of this angiogenic protein. In 1989, Napoleone Ferrara and Hazel at Genentech laboratory were the first to isolate and clone vascular endothelial growth factor (VEGF). Ferrara recalls, “I worked on the isolation of VEGF in my spare time during my first six months to a year at Genentech. Once we cloned VEGF in 1989, the company b

    Dr. Bikramjit Pal · Dr. Parthopratim Dutta Majumder
  7. Articles 1 Apr 2021 12 min read

    Ocular Tuberculosis

    Ocular involvement in TB has been recognized for a long time and was first described in 17111. The spectrum of tuberculosis (TB)-related uveitis is wide. Its diagnosis still remains a challenge due to the lack of uniformity in the diagnostic criteria along with difficulties encountered in confirming the diagnosis by the laboratory methods available. It is a major concern in countries endemic for TB, and intraocular TB is being increasingly reported from various regions2-4. The true prevalence of intraocular TB is not known in India. While it has been reported to be 0.39% in South India, it is much higher (9.86%) in North India1,5. Varying rates of its prevalence have been reported from the world over (0.5% in the U.S.A., 6.31% in Italy, 6.9% in Japan, and 10.5% in Saudi Arabia). The largest series of patients with presumed intraocular TB and their outcome has been recently reported from our center6. Pathogenesis Uveitis due to latent TB has been reported since long. However, their exac

    Dr. Reema Bansal · Prof. Vishali Gupta · +1 other
  8. 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
  9. Articles 1 Apr 2021 18 min read

    Ocular Syphilis

    Introduction: Syphilis is considered as a great mimicker due to its varied protean manifestations. It was first recognized in Europe in the late 15th century.[1] There have been several hypotheses regarding the origin and spread of syphilis and it is believed that the disease was brought back from the New World by the crew of Christopher Columbus, some of whom likely had syphilis on returning to Spain. Since the advent of Penicillin in the mid-20th century, the incidence of syphilis has reduced however it still represents a larger global problem [2] and an estimated 12 million new cases of syphilis are added every year worldwide and more than 90% are from developing countries.[3] The risk is particularly higher in men who have sex with men (MSM) and socially marginalized groups and those with HIV Co-infection.[4] The 2015 statistics from The Center for disease control and prevention (CDC) reported a 7.5 per 100,000 population of primary and secondary syphilis. (4). There has been a rec

    Dr. Mudit Tyagi · Dr. Subhakar Reddy
  10. Articles 1 Apr 2021 8 min read

    A New Paradigm for Refractive Surgery: SMILE-Small Incision Lenticule Extraction

    Automated lamellar keratoplasty (ALK) was a technique to physically remove a refractive lenticule (the lenticule was merely a disc of corneal tissue) from the cornea after lifting a hinged flap and exposing the stroma. A mechanical microkeratome was used to do both steps of the ALK procedure. In the LASIK procedure, the refractive lenticule was ablated with the excimer laser, while the hinged flap was still created with the mechanical microkeratome. In a later iteration, Femto-LASIK involved creation of the hinged flap with a femtosecond laser, and an excimer laser was used to ablate the refractive lenticule. SMILE, a relatively new technique of performing refractive surgery, uses a femtosecond laser for all steps of the keratomileusis procedure. SMILE involves the creation of a refractive lenticule within the cornea using a femtosecond laser, and subsequent extraction of the refractive lenticule from within the cornea. The refractive error that needs to be treated defines the shape of

    Dr. Rupal Shah M.S

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