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#Top Ten Series

55 articles
  1. Interesting Reads 1 Apr 2021 6 min read

    Ten Yoga Poses Every ophthalmologist Should Know & Practise

    Doctors, both frontline COVID warriors, and practitioners are passing through one of the most challenging phases in their professional careers. A recent survey article in the “Indian journal of ophthalmology “ showed alarming levels of depression and suicidal tendencies among ophthalmologists during this lockdown. Practicing yoga postures will definitely help to uplift and balance your energies on a daily base, so you can remain peaceful, positive, and energized. These are 10 Yoga postures that every ophthalmologist should know and practise to balance, rejuvenate and revitalize your mind, body, and spirit 1 Samasthiti (equal standing pose) Stand with both the feet together The body is straight and aligned with shoulders relaxed Palms are beside the body Keep your eyes closed and balance your body Awareness on your Breath to balance your breath pattern (deep inhalation and deep exhalation) Hold the posture for 3 mins Samasthiti is to maintain a connection with the inner line of gravity

    Mrs. Naina Shetty
  2. 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
  3. Articles 1 Apr 2021 8 min read

    Ten Pearls for Multifocal IOL

    1. Science behind Multifocal Intraocular Lens (MFIOL) Multifocal intraocular lenses are IOLs which can separate incoming light into two or more foci, thus resulting in multiple coexisting retinal images. At any given point, only one of the images (distance, intermediate or near) is the sharpest, and hence selected by the brain for visualisation. This concept is known as simultaneous vision. The visual system in any mammal is not known to be multifocal, hence the implantation of these IOLs initiate a process of neuroadaptation in the recipient’s brain, and its best effect is seen only after some days to weeks. The splitting of light to form multiple images leads to loss of contrast for each image. However, despite these limitations, MFIOLs continue to be one of the best technologies to provide spectacle independence for all distances after cataract surgery. 2. Types of MFIOL MFIOL can be classified in two ways: Based on focality or the number of foci or images created by the lens: Tradi

    Dr. Partha Biswas · Dr. Sneha Batra
  4. Interesting Reads 1 Apr 2021 10 min read

    Ten Things You Should Know about 3D Viewing System in Ophthalmology

    1. Evolution of this latest state of the art technology in ophthalmology: Three-dimensional (3D) display systems were first developed for aircraft and military use. The term “heads-up surgery” derived from the so-called “head-up display”, a display system first used in aircraft flight decks that projects an image into the normal field of view. This display system allows visualization in a “heads-up” position. In this procedure, the operating surgeon does not perform by looking at the eyepieces of the microscope, but by viewing the microscopic image on a panel display sent from a 3D camera[1]. After the creation of the TrueVision 3D Visualization System for Microsurgery, this innovative, ground-breaking technological boon has entered the operating room. 2. Major types of 3D visualization technique: Conventional 3D systems are classified as either active or passive systems. In active systems, the 3D image is obtained by showing high-speed consecutive images for the right and left eyes al

    Dr. Aniruddha Maiti, MBBS, DO, DNB, MNAMS,FRVS, FICO, MRCSED(Ophth) · Dr. Joydeep Majumdar, MBBS,DNB
  5. Articles 1 Apr 2021 10 min read

    Ten Pearls for Descemet's Membrane Detachment Repair

    1. Embryology Understanding the embryological development of the cornea helps us appreciate the reasons for a Descemet's membrane (DM) detachment during surgery. After the lens vesicle separates from the surface epithelium, a wave of mesenchyme forms the primary corneal stroma. A second wave then forms the endothelium, which secretes the DM. The DM, hence, has a potential plane of separation from the corneal stroma, which we use to our benefit in DMEK surgery and which works against us in an inadvertent DM detachment. Throughout the life of an individual, the DM thickens as the posterior non-banded layer is secreted by the endothelium. The anterior fetal banded layer tends to remain the same. However, in most instances, the separation happens between the DM and the cornea stroma1. The thickness of the DM varies between 10 and 15 microns, increasing with age. DM does not regenerate after any damage2. 2. Cataract Surgery and DM Detachment A post-cataract DM detachment occurs in 0.26% of

    Dr. Amanda Mohanan · Dr. Sanjeev P Srinivas · +1 other
  6. Articles 1 Apr 2021 16 min read

    Herpetic Eye Disease Study: All You Should Know

    Herpes simplex virus (HSV) keratitis is the leading cause of corneal blindness in developed as well as developing countries. The ocular disease affects approximately 10 million people worldwide. Herpes viruses are a group of double-stranded DNA viruses with three subfamilies: alpha-, beta- and gamma- herpes viruses. HSV-1, HSV-2, and varicella-zoster virus (VZV) belong to the alpha-subfamily. HSV spreads by direct contact with virus shed by saliva or genital secretions. During primary infection, HSV-1 infiltrates the corneal epithelial cells. Here it lyses the host cells and releases virions which in turn infect neighboring cells. Then the HSV travels via neuronal cells to trigeminal ganglion and establishes a latent infection. HSV can remain latent for lifetime by storing its genome in the nucleus of the host neuronal cell. While latent, it produces latency-associated transcripts (LATs) that maintain the integrity of the viral genome. The latent HSV-1 can reactivate and return to the

    Dr. Hema Joshi, MBBS, DO, DNB
  7. Interesting Reads 1 Apr 2021 7 min read

    Ten Pearls to Write a Case Report

    A thorough and detailed analysis of a single patient history, clinical presentation, course, and outcomes often helps in improving our understanding of the pathophysiological mechanisms of disease. However, at times, there are certain nuances in every patient that cannot be explained by large dataset-based manuscripts, where there is every chance that several minor, but relevant aspects can be ignored. Therefore, single patient case reports or a short series of patients provided valuable information that can be very useful clinical snippet and has the potential to lead into newer research ideas. I am sharing below some of my thoughts on how one should focus on writing a case report (disclaimer: I am not an expert!). Before I list my “pearls”, I would like to state that the scientific depth and accuracy of your thought process at the time of the clinical visit with the patient will ultimately guide your chances to the publication. 1. Identify phenotype and presentation It is vital for t

    Dr. Aniruddha Agarwal
  8. Articles 1 Apr 2021 6 min read

    Ten Pearls for Corneal Scrapping

    The management of microbial keratitis requires corneal scraping material for smear and culture. Scraping is a superficial keratectomy procedure to procure samples from central infiltrates or any infiltrate more than 2 mm in size. Stain/ wet mount gives a rapid clue to the diagnosis to initiate appropriate therapy. Inoculation of the sample on culture media help identify the offending organism and antibiogram help choose an appropriate therapeutic agent. Erasmus Darwin the grandfather of Charles Darwin was the first to suggest corneal therapeutic debridement to try and make cornea transparent in 1795. 1. Proper documentation of corneal ulcer should be done before going ahead with corneal scraping Before corneal scraping is planned it is important to document the corneal ulcer either diagrammatically or by photo documentation as this helps in showing progression or worsening of the therapeutic management. Areas of clinically active margins should be noted and always check the area of max

    Dr. Manokamna Agarwal · Dr. Meena Lakshmipathy
  9. Articles 1 Apr 2021 4 min read

    Ten Tips for Managing a Case of Postoperative Endophthalmitis

    1. Suspect : Any unusual post-operative reaction ( out of proportion to surgical trauma ) should be suspected for Endophthalmitis. 2. Differentiate from TASS : All unusual post-operative reactions may not be infective; Pointers towards Toxic Anterior Segment Syndrome could include: Early onset of Limbus to limbus corneal edema with good fundus glow and no exudates in the vitreous cavity. The presence of Lid edema, chemosis, a marked reduction in vision, vitreous exudates, and low intraocular pressure should alert one for Infective Endophthalmitis. 3. Talk : The most difficult part is how to tell the patient about this. This is a very sensitive issue because in Today`s time, no patient is willing to take any negative news ( Thanks to Trivilisation of eye surgery / googlisation etc.) and there is always a potential for medicolegal issues cropping up. Talking requires some degree of compassion. It is advisable to take a picture of the anterior segment & fundus, even if hazy. Take patient

    Dr. Lalit Verma
  10. Articles 1 Apr 2021 4 min read

    Ten Pearls for Eyelid Tear Management

    1. Key Points Eyelid injuries may be associated with ocular, orbital, and even intracranial injuries hence always rule out associated systemic trauma, occult globe injuries, or traumatic optic neuropathy. Globe involvement has been reported to be around 61% with eyelid injuries. Management of intra-ocular or systemic injuries takes precedence. The presence of orbital fat in the wound indicates the orbital septum has been breached and the repair requires a higher level of expertise to prevent postoperative complications. Laceration in the medial aspect of the eyelids is likely to involve the canalicular system. It is a myth that upper canalicular tears can be left unrepaired. In case the primary surgeon lacks knowledge or expertise in these structures, a prompt referral to an experienced oculoplastic surgeon would prevent any significant and long-lasting cosmetic was well as functional complications. Since the tissues retract along the fibers of orbicularis oculi, the eyelid defect may

    Dr. Bipasha Mukherjee

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