Topic

#Tips & Pearls

50 articles
  1. Interesting Reads 28 Apr 2021 5 min read

    Balancing Clinical and Research Work

    How does one balance between clinical and research work? This is an often-repeated question-probably because the answer is never clear. The fulcrum of the balance is not the same for everyone. Let us pause for a while and try to define certain things to bring clarity. What is clinical work? This is perhaps best defined as the time and effort involved in direct care of patients. Obviously, it also involves the time spent on organising the system that permits the above activity to take place smoothly. What constitutes research work? Technically research involves trying to find answers to the unknown or partially known. This should mean trying to understand the etiopathology of diseases which are poorly understood and finding new ways of managing them better. Broadly clinicians can be involved in clinical research, basic research or both. Clinical research can be prospective research such as observational studies, clinical trials, epidemiological studies etc but could also be retrospectiv

    Dr. Lingam Gopal
  2. Articles 8 Apr 2021 13 min read

    Anterior Vitrectomy Made Easy For Cataract Surgeon

    One of the most dreaded complications of cataract surgery is a posterior capsular tear (PCR). Its rate ranges from 1.3% to 9.6% (from skilled surgeons to trainees)1-5. Early recognition of the PCR and skilled management is necessary for good surgical outcomes and to avoid any devastating sequelae. Hence, anterior vitrectomy is an important skill that every cataract surgeon should master. There are some risk factors that may predispose to PCR like a true posterior polar cataract, dense and mature cataracts, old age (zonular weakness, small pupil, and denser cataract), uncooperative/ anxious patients, poor visualization due to corneal disease, pre-existing ocular trauma leading to capsular rupture/ zonular damage, etc.6,7 A thorough preparation beforehand may avoid confusion and lead to a well-managed surgery. The OT staff should be well aware of the kit to be used for anterior vitrectomy and the settings to be used for the same. Early identification of the posterior capsular tear The ea

    Dr. Vishal Agrawal · Dr. Ketan Rathod · +1 other
  3. Interesting Reads 2 Apr 2021 10 min read

    Scientific Writing: Common Pitfalls & How to Avoid Them

    The preceding chapters have given us a fair idea of how to go about writing an original manuscript for publication: the why, the what, and the how of manuscript writing. We have been primed with inspiration, research tools, and the nitty-gritty of techniques to carve out an original contribution to science from the banalities of repetitious clinical routines. But before we jump headlong into the unforgiving cauldron of publishing research, let us trim our intellectual exuberance with the reality check of the roadblocks, ruts, and pitfalls on the way to the crowning glory of our maiden publication. This wisdom is necessary so that we may avoid some common booby traps in manuscript writing, and learn to both avoid and handle the inevitable and repetitive failures, which should not snuff out our spark at the first setback. BEFORE WE WRITE: the first hiccups The writer’s block hits the prospective authors right at the starting block: how to generate a new idea for research? A few starting

    Dr. Dhananjay Shukla
  4. Interesting Reads 2 Apr 2021 7 min read

    Vernal Keratoconjunctivitis - FIVE Important Points We Should Know

    Allergic conjunctivitis, which includes a spectrum of clinical entities is one of the most common conditions with which patients present to a general ophthalmologist. They include milder forms like seasonal and perennial allergic conjunctivitis as well as severe forms like vernal and atopic which can be sight-threatening. In spite of common clinical and immunological features vernal keratoconjunctivitis differs from the rest in myriad ways. (1)This article brings forth five most pertinent points which will not only improve the understanding but also help identify and manage it. 1. Vernal keratoconjunctivitis can have three distinct forms Vernal keratoconjunctivitis (VKC) is a bilateral, chronic, usually seasonal, recurrent allergic inflammation of the conjunctiva. It mainly affects boys living in tropical countries in their first or second decade of life, mostly seasonal but in tropical countries, it can be perennial too. In the temperate regions, in many parts of Africa, Latin America

    Dr. Shweta Agarwal · Dr. Bhaskar Srinivasan · +1 other
  5. Students Gallery 2 Apr 2021 13 min read

    How to examine a case of strabismus ?

    There is no substitute to good history obtained at the start of the examination As history gives us a direction to look for, and find pertinent signs aiding in diagnosis and management. The various presenting complaints could range from abnormal head posture, deviation noticed by parents or friends, intermittent eye closure, double vision and so on. Some important points to be noted in patients with squint include, Family history of squint and wear of glasses (amongst parents, siblings and distant relatives) Personal history starting from birth history- Factors such as prematurity and birth weight, nature of delivery (normal/forceps/cesarean) Deviation – the age at which it was noticed, the direction of deviation (inward/ outward/ other) the eye deviated, constant or intermittent nature of deviation. Further, if deviation becomes more obvious when the child is inattentive, tired or ill. The diurnal or cyclic pattern if any also has to be noted. Any history of convulsion, illness or tra

    Dr. Sowmya R, MS,FMRF, FAICO · Dr. Prerana Tripathi, DO, DNB, FICO
  6. Students Gallery 2 Apr 2021 4 min read

    Tips To Achieve Ideal Rhexis

    Capsulorhexis was pioneered and popularized by Howard Gimbel. Capsulorhexis is probably the most challenging to learn in cataract surgery, in other words, once a good rhexis is done half the battle is won. All the Post- Graduates and beginners struggle to do rhexis. This article has compiled small tips and tricks to do rhexis better. Ideally, rhexis should be continuous and curvilinear i.e Circular, Central & of Correct size (5.5-6 mm). Circular: for proper IOL centering and stabilization in the bag Continous: to prevent rhexis extension Correct size: for IOL centering and to ensure anterior capsule overlapping IOL optic 360 degrees. It can be done with the help of a double bent 26 G/27 G needle or rhexis forceps. Let's break the table and use the advantages of a needle Needle Utrata Forceps Advantages Cheap Disposable Universally available Customized Small diameter, lightweight Can be done through side port so less chance of AC shallowing Precise control Disadvantages Less precise con

    Dr. Rohit Rao · Dr. Charudutt Kalamkar
  7. Articles 2 Apr 2021 8 min read

    Pan Retinal Photocoagulation (PRP), Focal Laser & Photodynamic Therapy (PDT) Technique & Tips.

    Introduction ‘LASER’ is acronym for “Light Amplification by Stimulated Emission Radiation.” This describes the emission process by which an intense beam of electromagnetic radiation is generated Basic Properties of Laser Always monochromatic (one wavelength) Collimated (all photons run parallel) & focused to a small point Coherent (always in same phase) Highest possible speed Physics Certain substances have property to lase i.e, absorb energy in one form & emit a new form of energy. On pumping these lasing substances electrons are transfered from a lower orbit to higher orbit (Bohr’s theory) Excited atoms in turn decay back to their original orbit of lower energy, emitting photons (packets of energy) This emission can be spontaneous or induced (stimulated) Photocoagulation (PHC) Photothermal reaction Temperature elevation 10 to 20 deg C Protein denaturation Pigment dependent Argon, krypton dye, diode, frequency double Nd Yag Tissue effects Induces moderate sterile inflammation- Creates

    Parag K. Shah, DNB · Dr. Varsha V. Prabhu · +1 other
  8. Interesting Reads 2 Apr 2021 4 min read

    Ten Tips and Tricks to Examine a child in Your Practice

    1. Choosing the best time: Train your clinic receptionist to ask the parents when the child is likely to be cooperative and/or awake. It is not uncommon for infants to sleep a lot during the day. It is also not uncommon for children on anti-seizure medication to be sleepy, thereby making examination difficult. 2. Child-friendly atmosphere: Train your staff to speak to the child and address the child by name and smile and make the family feel welcome. The décor in the waiting area and in the examination room should be colorful with pictures and cut outs appropriate for a child. Furniture chosen should be non-impact and the flooring safe for children, if they fall. It should also be easy to maintain by wiping down frequently to prevent spread of infection. Using many colorful toys during examination takes away the fear of the experience to some extent for the child. 3.White coats: A child often associates white coats with doctors and hospitals. Hence it is best to avoid wearing one. If c

    Dr. Meenakshi Swaminathan
  9. Students Gallery 2 Apr 2021 3 min read

    FIve Points You Must Note While Examining An Optic Disc

    Disc size A normal disk can be of small size and a normal disk can be of a larger size; size by itself does not determine glaucoma. It is relevant because the disk size determines the C:D ratio and the neuroretinal rim thereof. In a large disc one would expect a large cup and a large neuroretinal rim and in a small disc there is usually no cup. Disc size should be grouped as normal, small or large. Graticule on the slit lamp can be used. In cases with CDR discrepancies disc size should be compared to determine true discrepancy. Disc Shape A normal optic disk is vertically oval with the vertical diameter being the maximum diameter and the horizontal being the minimum diameter. Figure: Vertically oval disc. Note that the vertical diameter is longer than the horizontal diameter The variations in shape may be accompanied with astigmatism and amblyopia. An optic disk is considered torted when the vertical axis of the optic disk is rotated >15° from the vertical meridian. A tilted optic disk

    Dr. Amit Pandey
  10. Interesting Reads 2 Apr 2021 11 min read

    Beginners Guide for Performing Vitrectomy

    Know your cutter and machine. Current generation vitrectomy cutters work by guillotine mechanism where vacuum holds the Vitreous fibers and presents it to guillotine blade that severs it in one swift motion without exerting significant on fibers. The cutting process needs a fine balance between the speed of cutting and the “pull” created by the vacuum. Higher cutting rates like 10000 cpm allow the surgeon to use a higher vacuum in the range of 600 mm Hg. The rate of vitreous removal also depends on duty cycle and bore size of lumen. Surgeons should test the efficiency of cutters either on cotton fibers or on the vitreous prolapsing out of sclerotomies. One has to learn to recognize when the cutter is pulling without cutting – the most dangerous situation. The surgeon should also familiarize himself with different functions of vitrectomy systems like air injection, Endodiathermy, venturi or peristaltic pumps, light source/s, Phaco Fragmatome, and Viscous fluid injection. It also helps t

    Dr. Deependra V Singh

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