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86 articles
  1. Articles 1 Apr 2021 13 min read

    Entropion And Ectropion

    Entropion is the turning inward of the eyelid margin. Unlike ectropion, it is symptomatic and injures the ocular surface. The patient seeks medical care early. Ectropion is an eyelid malposition in which the eyelid margin does not oppose the globe. We shall discuss the relevant anatomy and clinical examination for the two entities together. Relevant Anatomy The eyelid can be grossly divided into Anterior lamella composed of skin and orbicularis Posterior lamella composed of tarsus and conjunctiva Factors contributing to the stability of the lower eyelid Appropriate horizontal tension of the lower lid so that the eyelid is apposed to the eyeball. This is supplied by the medial and lateral canthal tendons. Lower lid retractors applying appropriate tension to the inferior margin of the tarsus, pulling the lower edge of the tarsus inferiorly, and thus preventing the lid margin from turning inward as in entropion, or outward as in ectropion. Synchronous movement of the inferior rectus and l

    Dr. Roshmi Gupta · Dr. Rwituja Thomas · +1 other
  2. Articles 1 Apr 2021 17 min read

    Evaluation of The Optic Nerve Head in Glaucoma

    Introduction The diagnosis of primary open-angle glaucoma is based on the triad of increased intraocular pressure, visual field changes and optic nerve head changes. Apart from the glaucomatous changes in the optic nerve head, the other two factors in isolation lack diagnostic sensitivity. In fact, studies have shown that careful evaluation of the optic nerve head has high specificity and that an experienced observer may be better in distinguishing a normal from a glaucomatous disc as compared to any other technology, like the HRT or OCT.[1-3] IOP can be normal in 50% of patients of glaucoma.[4] Studies by Quigley et al have shown that up to 40% of the axons could be lost before a visual field defect develops on Goldmann perimetry and that 20% of axons are lost before a 5 db loss is detected on standard automated perimetry.[5] So to pick up early or pre-perimetric glaucoma, in the absence of imaging, a sound knowledge of assessment of optic nerve head changes in glaucoma is imperative.

    Dr. Sahebaan Sethi
  3. Articles 1 Apr 2021 24 min read

    Corneal Dystrophy: A Ready Reckoner for Postgraduates

    Corneal dystrophies are classically defined as a group of inherited disorders of the cornea which is bilateral, symmetric, slowly progressive, and not related to any environmental or systemic factors.1,2 Most of the corneal dystrophies begin in the early decades of life and progress gradually. The effect of these changes in some of the dystrophies may not be clinically apparent till the later years. The underlying basis of all corneal dystrophies are genetic mutations some of which have been mapped, while others are yet to be identified.1-3 Most of these mutations result in the transcription of aberrant proteins. These proteins are deposited in various corneal layers and give rise to the characteristic clinical features. The pace of deposition also determines the natural history of the corneal dystrophy. Corneal dystrophies were first reported by Groenouw in his article published in 1890.1 He described one patient with granular corneal dystrophy and another patient with macular corneal

    Dr. Samrat Chatterjee
  4. Articles 1 Apr 2021 21 min read

    Therapeutic Keratoplasty : A Comprehensive Review

    Microbial keratitis is a common vision-threatening disease that occurs in all parts of the world and is an important cause of avoidable corneal blindness. Medical therapy is considered a mainstay in the management of microbial keratitis, however, cases that worsen despite medical therapy or have perforation require surgical management1. Therapeutic keratoplasty is a surgical procedure whose primary purpose is to get rid of the infectious or non-infectious inflammatory tissue along with the restoration of the structural integrity of the eye (tectonic support)2. The surgical procedure, postoperative course, and chances of graft survival in therapeutic keratoplasty are different from optical keratoplasty as surgery is performed on an inflamed eye. Therapeutic keratoplasty could be Therapeutic Penetrating Keratoplasty(ThPK) Therapeutic lamellar keratoplasty- Deep Anterior Lamellar Keratoplasty(Th-DALK) Patch graft In therapeutic penetrating keratoplasty, a full-thickness button of the dise

    Dr. Nikhil S. Gokhale · Dr. Bhupesh P Jain
  5. Articles 1 Apr 2021 18 min read

    A Postgraduate's Guide To Tonometry

    Tonometry is the procedure for the measurement of intraocular pressure. It is the most important risk factor for the development and progression of glaucoma. It is the only factor that can be treated and modified in the management of glaucoma. Therefore, the need for accurate and reproducible measurement of IOP is of utmost importance. Clinical measurement of IOP has undergone several technical advances from the initial digital tension measurements, through indentation tonometry, to applanation tonometry and non-contact tonometry. The current gold standard for the measurement of IOP is the Goldmann applanation tonometer. Tonometer in which the IOP is negligibly raised during measurements, for example less than 5%, are termed low-displacement tonometer. Tonometer that displace a large volume of fluid and consequently raise IOP significantly are termed high-displacement tonometer. Classification and Types of Tonometers are shown in Flowcharts 1 & 2. Classification of Tonometer 1 Classifi

    Dr. Vidya Chelerkar · Dr. Mrunall Borrse
  6. Interesting Reads 1 Apr 2021 9 min read

    Mirrorless Camera Assisted Ophthalmic Surgery Recording Systems

    Introduction Surgical videos are an invaluable medium for surgical education. They allow not only for objective assessment & informative audits but also permit introspective critical analyses of surgical techniques. One may be doing a fantabulous job in his / her operating room but shall never be able to share his/her experience and skill unless the surgical video is recorded in good quality. One of the biggest challenges faced by ophthalmologists is the steep rise in the price of medical equipment. A good quality medical grade HD recording system set up (3 chip CCD camera + C-mount+ HD recorder) is priced anywhere between 12 to 15 lakhs and sometimes this can turn out more expensive than the operating microscopes used by many solo practicing ophthalmologists and even some of the medical colleges. The story behind selecting the mirrorless cameras… It is said, “If necessity is the mother of invention, frustration is the father of creativity.” It was our keen desire to be active in acade

    Dr. Raju Sampangi, MD (AIIMS), DNB · Dr. Sumeet Khanduja, MD (AIIMS) · +1 other
  7. Interesting Reads 1 Apr 2021 12 min read

    New normal - Tenets with Cataract Surgery Every Ophthalmologist Should Know during COVID-19 pandemic

    Introduction: Cataract is the second most common cause of preventable blindness worldwide and the most common cause of preventable blindness in India, affecting nearly 65.2 million worldwide [1-5]. To control the number, a high cataract surgery rate (CSR) is required. Sudden lockdown due to the current pandemic led to the cessation of elective cataract surgery [6,7], causing a sharp decline in the required CSR. In India as per the National Programme for Control of Blindness (NPCB) data 2018-19, the desired CSR was 947866 which could not be achieved [7]. As the unlock process has started, resumption of elective cataract surgeries is being initiated with precautionary measures. In this article, we have tried to summarize the current guidelines for elective cataract surgery. Preferred practice for cataract surgery: 1. General measures: The Govt. of India (GOI), Ministry of Health and Family Welfare (MoHFW) have advised certain preventive measures to avoid transmission (mask, hand hygiene,

    Dr. Jatinder Singh Bhalla · Dr. Satender Kumar Singh · +1 other
  8. Anatomy of eye 1 Apr 2021 28 min read

    Anatomy of Retina

    The retina is the innermost of the three coats of the eye. This layer is responsible for converting relevant information from the image of the external environment into neural impulses that are transmitted to the brain. Broadly retina consists of two primary layers: an inner neurosensory retina and retinal pigment epithelium (RPE). 1 ? Sensory retina develops from the inner layer of the neuroectoderm, whereas RPE is derived from the outer layer of the neuroectoderm. The RPE is continuous anteriorly with the pigment epithelium of the ciliary body. Sensory retina extends from the optic disc to ora serrata, where it is continuous with non-pigmented ciliary epithelium.1 Between the neural retina and RPE, there is a potential space known as subretinal space. The adhesion between neural retina and RPE is relatively weak. The neural retina is firmly attached at its anterior termination, the ora serrata, and at the margins of the optic nerve head. The ora serrata is located 4-6 mm behind cilia

    Dr. Parthopratim Dutta Majumder
  9. Articles 1 Apr 2021 13 min read

    Glaucoma in Pseudophakia And Aphakia

    Glaucoma in pseudophakia and aphakia is secondary glaucoma in which intraocular pressure (IOP) is elevated following cataract removal. This diagnosis is given only if there was no glaucoma prior to cataract removal.[1] The terms aphakic and pseudophakic glaucoma have been previously used in literature. Currently, this terminology is not preferred. Glaucoma in pseudophakia and aphakia refer to conditions that cause increased intraocular pressure (IOP) soon after surgery as well as to those conditions that occur much later.[2] Epidemiology : Depending on the studies, the estimate for the incidence of glaucoma post-cataract surgery varies widely. In patients with aphakia, chronic glaucoma post-cataract surgery was found to be less prevalent at 3% than a transient increase in pressure with varying percentages of pressure rise post-cataract surgery [3]. Other sources report the incidence of 5-41%[4]. In patients with pseudophakia, the incidence of IOP rise went down with an advent of the ex

    Dr. Aishwarya R. Mulay
  10. 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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