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#Tips & Pearls

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Articles 2 Apr 2021 8 min read

A Beginners Guide to Ophthalmic Surgical Microscope

An operating surgical microscope is the most important optical instrument in the modern era of ophthalmic surgeries. It provides the surgeon with a magnified and illuminated high-quality image of the small ophthalmic structures. Being binocular the surgical microscopes gives the additional benefit of high-quality stereoscopy. History The first German doctor to use a stereomicroscope was Dr. Hans Hinselmann (1884-1959), Prof. of Gynaecology under Dr. Otto von Franque at the University Clinic, Bonn, who adapted in 1925 a Leitz stereomicroscope with coaxial illumination to a movable floor stand. He named IT “colposcope” and used it to visualize the female genital organs particularly for cancer of the cervix. Dr. Hans Littmann (1908 – 1991), head of Med-Lab at Zeiss OptonOberkochen, West Germany (now Carl Zeiss A.G.) and his team of technicians designed in 1953 their first ophthalmic operating microscope Prerequisites for an ideal operating microscope Must have stereoscopic visualization.

Dr. Rohit Rao · Dr. Tamonash Basu
Students Gallery 1 Apr 2021 3 min read

Ten Tips for Postgraduates Preparing for Exams

Everyone is going to tell you that you have to study from Day 1 of your course and you have to be systematic. Most of you, however, will end up postponing studying for exams till the very end. So here are some tips to help ease the tension and anxiety associated with exam preparation. Question bank: Familiarize yourself with the question bank for your course, especially for the last 5 years. Questions may be repeated, with the words changed. Get to know how the marking is done for various components of the question. For example, the clinical presentation may be allotted 4 marks and management 6 marks in a question. It is important to write in greater detail for the management part. Diagrams: There is no point in looking at diagrams. It will be impossible to recall the finer details if you are not intimately familiar with the diagram. Practice drawing with the correct color codes in a separate notebook which you can revise before the theory paper. Friends in need: It is not uncommon for

Dr. Meenakshi Swaminathan
Students Gallery 1 Apr 2021 7 min read

Practical Examination DNB Ophthalmology

The following write-up contains some of the frequently asked topics during the DNB practical examinations. Do keep in mind that this is just a sample, the scope of Ophthalmology is vast and it’s the 3 years effort put in during the course of residency that makes you comfortable to face the examination. It is important to have a thorough knowledge of the frequently asked questions, rather than knowing rare, obscure facts. In the end, it’s all back to basics! Any examiner starts questioning with a basic level of questions that he deems are essential knowledge for the candidate to pass or be qualified as an ophthalmologist, once the candidate clears that level only then does the examiner pose level 2 or level 3, the relatively tough/ rare/ newer questions. This should make clear that in order to clear the examination, level 1 questions MUST and should be answered! And that is what the following literature will focus on mostly. Exam Pattern: Most centers usually have: 2 Anterior Segment ca

Dr. Sameeksha Agrawal · Dr. Soumya Podury
Students Gallery 1 Apr 2021 5 min read

How to Publish Your Thesis

Although, thesis submission is a mandatory process for post-graduation, nonetheless, getting it published is an important step towards your career. After all the hard work of bringing the thesis, the next step should be to publish it. The idea of publishing should be clear even before you started the work. Why publish An unpublished work means that the work had never been done. If you wish to be in an academic position in the long-term and wish to be recognized among your colleagues, the best way is to publish your work. In the present era of fast communication and the internet, your works get cited more often, which builds your reputation across the world, in no time. The thesis methodology and literature review will often be outdated in 3-4 years from your thesis, therefore, don’t leave it too long to publish your thesis. Here are a few steps to follow to publish your thesis: Step 1. Before the start Before you decide your thesis topic, do a thorough literature search and propose new

Dr. Jay Chhablani
Students Gallery 1 Apr 2021 6 min read

Ten Pearls for Mastering Small Incision Cataract Surgery

Small incision cataract surgery (SICS) is a prevalent technique in all the high volume centres of India as it is faster, gives excellent visual outcome and is much cheaper than phacoemulsification. Tip no. 1. Do a thorough pre-operative assessment and try selecting ideal cases It is mandatory to perform a proper pre-operative assessment of the patient. Helps in preparing the surgeon to anticipate complications and plan the operation accordingly. Tip No.2. Try to achieve adequate size, shape & couture of the incision Scleral Incision We usually make a frown incision 6mm long and 2mm away from limbus with the help of a 15 number blade. Beginners however may start with a straight incision before transitioning to frown. The incision should be made within the astigmatic neutral funnel. To remain astigmatically neutral, incisions closer to the limbus need to be smaller and longer incisions may be constructed further from the limbus. The incision should be placed on the steep meridian accordi

Prof. Kamaljeet Singh · Dr. Pranav Saluja
Students Gallery 1 Apr 2021 7 min read

Ten Pearls in the Management of Paralytic Strabismus

Paralytic strabismus is an incomitant strabismus resulting from complete (paralysis) or partial (paresis) motor deficiency of one or a group of extraocular muscles, which are supplied by the third, fourth or sixth cranial nerve. 1 History and basic examination Paralytic strabismus may be congenital or acquired. Careful history-taking will rule out an antecedent fever, trauma, neurological symptoms, or systemic illness in acquired cases. Patients complain of ocular deviation, limitation of ocular movements or abnormal head posture. Diplopia is usually a feature of recent-onset strabismus but congenital cases with spontaneous decompensation may also present with diplopia. Facial asymmetry can be noted in some congenital superior oblique palsy(SOP) with a head tilt. Visual acuity is usually preserved in isolated acquired paralytic strabismus. Amblyopia develops only in patients in whom paralysis occurs early and when the patient is unable to maintain binocular single vision in any gaze. F

Dr. Karthika Bhaskaran · Dr. Pradeep Sharma
Students Gallery 1 Apr 2021 3 min read

Ten Mistakes One Should Avoid in Small Incision Cataract Surgery

Mastering Small Incision Cataract Surgery (SICS) lays a solid foundation for achieving sutureless cataract surgery in the majority of the cases. This article aims to bring forth some commonly committed errors in SICS. Nuclear grade: Though a surgeon is not expected to choose a patient, but a beginner should avoid extremes of nuclear grade. A grade 3 nucleus with a 6mm external incision and >6mm capsulorrhexis, are the most comfortable to manage initially. Only topical anesthesia! Anesthesia is meant to make the patient comfortable and the choice depends on the patient’s cooperation, condition of the eye, and the surgeon’s expertise. Attempting topical anesthesia in an uncooperative patient, non-dilating pupil or a novice surgeon can result in disaster. Use of blunt knives The creation of a triplanar incision requires sharp knives. Blunt knives result in ragged wounds and premature entry due to the application of excessive pressure. A poorly constructed wound opens the door to the occur

Dr. Ruchi Goel
Interesting Reads 1 Apr 2021 5 min read

Ten Tips for Beginners to Start Vitreoretinal Practice

1. Higher cause/vision and mission statement : Setting up a vitreoretinal surgery / medical retina practice should come with a higher calling apart from simply making a living. It is very important to have one to sail through tough initial months or years till your practice reached a break-even point. Till the business starts making money this higher calling will keep up your spirits high and motivate you to continue the journey. Having worked in for seven years in other eye hospitals where the primary interest was in cataract and refractive surgery and when the sustainability of stand-alone retina practice was questionable, for me the higher calling was to establish a center for excellence in diseases of vitreoretina and uvea. 2. Base building: It is always good to work in established hospitals or in group practices or with anterior segment surgeons for a couple of years to learn many things that are not taught in medical schools apart from building a base of your satisfied patients a

Dr. Raja Rami Reddy P
Students Gallery 1 Apr 2021 2 min read

Dos and Donts in the Operation theatre on Day One for Postgraduates in COVID times

Dos: Change into OR scrubs and slippers. Make sure your OR cap and mask are separate from the one you have been wearing in OPD. Make sure to cover all strands of hair under the cap, especially for women. A clean shave is recommended for men to ensure a good fit for your N95 mask. Ensure proper usage of protective eyewear and a visor at all times. Wash hands/ use a Sanitizer before entering the OR. Learn to differentiate between sterile and non-sterile areas inside the theatre. Read about the procedures scheduled in the OR the previous day. For what the mind does not know, the eyes do not see. Know your operating microscope, foot controls, and instruments thoroughly. Learn to arrange the instrument trolley, paint, and drape the patient for surgery. Maintain adequate distance from the operation table during observation. Learn the 6 steps of handwashing and perform them for the prescribed amount of time depending on the concentration of Povidone-iodine in your institute. Maintain appropri

Dr. Nikita Pathare

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