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#Top Ten Series

55 articles
  1. Articles 1 Jun 2021 10 min read

    Ten Microbiological Facts on Mucormycosis All Ophthalmologists Should Know

    The present overview highlights major microbiological aspects of mucormycosis and attempts to increase the awareness of this ubiquitous group of fungi that are responsible for the difficult-to-manage infections presently being encountered in the setting of the ongoing COVID-19 pandemic. 1. What is Mucormycosis and why is mucormycosis emerging as a serious threat in the present COVID-19 pandemic? Mucormycosis (previously called zygomycosis; sometimes called black fungus infection) is a serious, but rare fungal infection caused by a group of molds belonging to the order Mucorales(1). Mucormycosis is a fulminant disease with high rates of morbidity and mortality that mainly affects immunocompromised patients. Depending on the location of the infection, the mucormycosis can be rhino-orbito-cerebral (most common), pulmonary, gastrointestinal, cutaneous, or disseminated. Although it has a low incidence rate, varying from 0.005 to 1.7 per million population, a sudden rise in cases of rhino-or

    Dr. A.R Anand
  2. Articles 18 May 2021 9 min read

    Ten Pearls for the Diagnosis & Management of Binocular Vision Anomalies

    The prevalence of non-strabismic binocular vision anomalies is on the rise over the last decade. The prevalence reports from various parts of the globe quote a high prevalence ranging between 28.5-31.5% among school children (1,2). It is also shown in a recent study that clinically significant convergence insufficiency can impair stereo-acuity in children necessitating the diagnosis and management of convergence insufficiency (3). Here are some pearls to ensure accurate diagnosis and provide appropriate management to patients afflicted with binocular vision anomalies. This article specifically focuses on non-strabismic binocular vision anomalies as they are often missed out due to their latent nature, unlike strabismic anomalies. The efficiency of the visual system is beyond 20/20 Many eye care practitioners unfortunately still assume that 20/20 visual acuity ensures an optimally functioning visual system. The efficiency of the visual system is not just dependent on the integrity of th

    Dr. Jameel Rizwana Hussaindeen M.Phil, M.Phil Opt, Ph.D.,FCOVD-I, FAAO
  3. 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
  4. Interesting Reads 1 Apr 2021 8 min read

    Ten Tips for the Beginners for Performing Pediatric Cataract Surgery

    Congenital cataract has a worldwide prevalence of 4.24 per 10,000 people, with the largest prevalence found in Asia (1). It is one of the most important causes of treatable causes of childhood blindness (2). 1.Timing of cataract surgery In order to prevent stimulus deprivation amblyopia, children with dense visually significant bilateral congenital cataracts, surgery should be done at around 6–8 weeks of age (3) and in children with a unilateral visually significant cataract it should be done at the age group of 4-6 weeks (4) due to increased rates of postoperative glaucoma in the first four weeks of life (5). 2.Biometry In small children, axial length can be measured using an immersion/contact A-scan or B-scan ultrasonography. While using contact A-scan values, the value with maximum anterior chamber depth should be chosen to offset the inadvertent indentation of the cornea with the A-scan probe (6). Keratometry values can be obtained using an auto-keratometer. Readings should prefera

    Dr. Parul Chawla Gupta · Prof. Jagat Ram
  5. 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
  6. Students Gallery 1 Apr 2021 7 min read

    Ten Tips for the Beginner to Examine a Patient of Ptosis

    1. History A careful history helps in identifying the etiology of ptosis (Fig 1). The age at onset of ptosis and its duration will usually distinguish congenital from acquired cases. Relevant history should be elicited in all patients regarding the variability of ptosis during the day, associations with any jaw movements, abnormal ocular movements and head posture, diplopia, or tiredness. Old photographs often reveal important information. A family history of similar conditions should be determined to rule out Congenital or hereditary ptosis, blepharophimosis, ocular myopathies, etc. Any history of previous surgery, trauma, or use of steroids should be recorded. According to its etiology, it can be classified as myogenic, aponeurotic, neurogenic, neuromuscular, mechanical, or traumatic. Figure 1: Young female with Left eye severe ptosis 2. Ruling out pseudoptosis There are conditions that can mimic ptosis include enophthalmos, anophthalmos, contralateral proptosis, contralateral lid re

    Dr. A. K. Grover · Dr. Shaloo Bageja · +1 other
  7. 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
  8. 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
  9. 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
  10. 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

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Review Vitreoretina Tips & Pearls Made Easy Macular Diseases Cornea and External Eye Diseases Must Read Preferred Practise Pattern Learn from Masters Treatment Uvea and Intraocular Inflammation Case Discussion Cataract Surgery i-File Pediatric Ophthalmology Glaucoma Imaging Grand Rounds infection