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#Treatment

24 articles
  1. Students Gallery 1 Apr 2021 26 min read

    Lensopedia: Lenses in Ophthalmology

    Introduction: While there are several instruments in ophthalmological practice, lenses form an inseparable part of an ophthalmologist’s arsenal. Available in various sizes and shapes, they are crucial in aiding the visualization of remote areas of the eye and facilitate therapeutic interventions in those areas which would be next to impossible to even imagine without their availability. Harnessing the unlimited potential of optics, it allows an ophthalmologist to play with the most dynamic form of energy, light, provided he behold sound and in-depth knowledge about the lens. This write-up aims at helping one acquire this knowledge and employ them for a successful practice. Lens: A piece of glass or other transparent material with curved sides for concentrating or dispersing light rays. (Lexico Oxford Dictionary) Classification of lenses (Based on their utility) Lens for the anterior segment: Lens for posterior segment Gonioscopy Principles and Optics The critical angle for the cornea-a

    Dr. Niranjan Karthik Senthil Kumar
  2. Students Gallery 1 Apr 2021 6 min read

    LASERs in Ophthalmology: A Concise Guide for the Postgraduates

    LASER is an acronym for “light amplification by stimulated emission of radiation”. Invented more than 50 years ago, today lasers are synonymous with precision and sophistication. The first medical application of lasers was the use in retinal photocoagulation and that role has been ever-evolving. Today its application is evident in all subspecialties of ophthalmology as a diagnostic and therapeutic tool. Since medieval times, the damaging effects of strong light have been known to mankind. Socrates advocated avoiding direct viewing of the solar eclipse. The first documented use of light therapeutically was by Meyer- Schwickerath. He focused sunlight on the retinas of patients to treat melanomas. An undocumented early experiment with the aim of therapeutic photocoagulation was done by Moran- Salas in the 1940s. Meyer- Schwikerath highlighted that photic burns may be beneficial as a therapy. However, the major limitation of this was the requirement of enough sunlight to achieve the desire

    Dr. Soumya Podury
  3. Articles 1 Apr 2021 20 min read

    Polypoidal Choroidal Vasculopathy

    Introduction Polypoidal Choroidal Vasculopathy (PCV), first described by Yannuzzi et al1 in 1982, is a distinct clinical entity characterized by persistent recurrent serous leakage and hemorrhage in the macula, and is seen in the elderly population. The disorder was poorly understood earlier and had been described by various authors as recurrent pigment epithelial detachment (PED) and posterior uveal bleeding syndrome.2.5 The primary abnormality, as described by Yannuzzi et al,1, 2, 6involves the choroidal circulation, and the characteristic lesion is an inner choroidal vascular network of vessels ending in an aneurysmal bulge visible clinically as a reddish-orange spheroidal polyp like structure. More recently with improvement in choroidal imaging using Enhanced Depth Imaging and Swept-Source optical coherence tomography (EDI-OCT and SS-OCT), PCV is regarded as a part of the Pachychoroid spectrum of diseases and a variant of Type I choroidal neovascularization.7, 8, 9 Epidemiology The

    Dr. Giridhar Anantharaman, MS, FVRS · Dr. Jay Sheth, DNB, FVRS
  4. Articles 1 Apr 2021 14 min read

    Coats Disease

    Introduction History In 1908 George Coats1 original description of the disease was based primarily on histopathologic examination of enucleated eyes and identified retinal vascular aneurysms, arteriovenous malformations, intra- and subretinal hemorrhages, and exudates. Coats categorized eyes with these characteristic morphologic findings into three groups: Group I demonstrated massive subretinal exudate alone, group II consisted of eyes with massive subretinal exudate, intra and subretinal hemorrhage, and retinal vascular dilatations, and group III included eyes with subretinal exudate and retinal arteriovenous malformations. Von Hippel2 later identified group III as a separate entity, angiomatosis retinae, which led to the exclusion of this group from the spectrum of Coats disease. In 1912, Theodor Leber3 described a disorder with similar retinal vascular abnormalities to Coats disease, but without massive subretinal exudate, hemorrhage, and serous retinal detachment. This became know

    Dr. Aditya Bansal · Dr. Vikas Khetan
  5. Articles 1 Apr 2021 9 min read

    How do we treat inflammatory CNVM ?

    Inflammatory choroidal neovascular membranes (CNVM) cause an acute and significant visual loss 1,2. Mostly affecting eyes with posterior or panuveitis, the chronic recurrent nature of inflammation further worsens the visual prognosis in these eyes, such as serpiginous like choroiditis, punctuate inner choroidopathy (PIC), multifocal choroiditis, Vogt-Koyanagi-Harada (VKH) disease, presumed ocular histoplasmosis syndrome, toxoplasma retinochoroiditis, etc,.3,4 . The angiogenic stimulus in inflammatory CNVM is driven by local inflammation and/or a degenerative breach in retinal pigment epithelium (RPE)-Bruch’s membrane complex4. An active intraocular inflammation induces the release of several inflammatory mediators including cytokines, chemokines, vascular endothelial growth factor (VEGF) and complement activation, which in turn promote retinal and choroidal neovascularization. Majority of inflammatory CNVM are classic (on fundus fluorescein angiography), and type 2 on spectral domain o

    Dr. Krinjeela Bazgain · Dr. Nitin Kumar · +1 other
  6. 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
  7. Articles 1 Apr 2021 9 min read

    Management of Dropped Nucleus and Retained Lens Fragment

    Introduction: Drooped nucleus and retained lens fragment is a complication not so rare in clinical practice. In the era where cataract surgery is being performed for visual enhancement rather than visual rehabilitation, the management of a dropped nucleus saves the patient from unnecessary anxiety and hastens visual recovery. In this chapter risk factors, the timing of surgery, various approaches for removal of the lens will be discussed. Incidence: Dropped nucleus and cortical remnants occur more frequently in phacoemulsification than other techniques of cataract surgery 1,2 . Surveys in developed nations like U.S and U.K have reported incidences of 0.3 % 1 and 1.1 % respectively. In India, few studies have quoted its incidence to be around 0.8 %. [3] Risk Factors: The exact cause for the posterior displacement of the nucleus is difficult to determine but certain conditions predispose for complication4 Pseudoexfoliation syndrome Traumatic cataract Fellow eye of complicated cataract su

    Dr. Dhanashree Ratra · Vineet Ratra · +1 other
  8. Articles 1 Apr 2021 19 min read

    A (VAST)IN Saga

    Vascular endothelial growth factor (VEGF)-A is a key mediator of angiogenesis. The discovery of VEGF-A, like many other major discoveries in medicine, happened partly by observations and partly by chance. Napoleone Ferrara and his team were working on a population of non-hormone-secreting cells from the anterior pituitary of cows. (1) One day Ferrara mixed some isolates from cultures of follicular cells with endothelial cells. Ferrara was surprised to see the rapidly proliferating endothelial cells started rapidly. Ferrara understood that the pituitary cells were secreting an angiogenic protein. With this observation, Ferrara worked on the isolation and cloning of this angiogenic protein. In 1989, Napoleone Ferrara and Hazel at Genentech laboratory were the first to isolate and clone vascular endothelial growth factor (VEGF). Ferrara recalls, “I worked on the isolation of VEGF in my spare time during my first six months to a year at Genentech. Once we cloned VEGF in 1989, the company b

    Dr. Bikramjit Pal · Dr. Parthopratim Dutta Majumder
  9. Articles 1 Apr 2021 3 min read

    Five Things You Should Know About Intracameral Bimatoprost Sustained Release Implant

    The Implant Durysta (ALLERGAN) is the first-ever intracameral sustained-release bimatoprost implant. The glaucoma treatment paradigm has shifted towards earlier intervention and targeting the actual pathology. The main problem one faces with glaucoma management is compliance with the medications. The intracameral bimatoprost addresses the problem satisfactorily. Durysta, a 10-microgram bimatoprost implant, becomes the first biodegradable, intracameral sustained release implant indicated to reduce Intraocular pressure (IOP). It is hard for patients to maintain quality of life while being on topical anti-glaucoma medications – The Intracameral Bimatoprost makes it possible. Administration of the Implant Durysta is a rod-like implant preloaded within a sterile applicator with a 28-gauge needle tip. The needle is inserted under an aseptic condition in the anterior chamber and then with the press of a trigger button implant is released. After the implantation, the needle is removed and the

    Dr. Tamonash Basu
  10. 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

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