OPHTHALMOBYTES

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-Free cap is an intra-operative complication of LASIK. -In LASIK, a hinged corneal flap is created that allows the excimer laser to be applied on the exposed stromal bed. -If the hinge of the corneal flap detaches, the flap becomes a free cap. LOOK ABOVE FOR THE RISK FACTORS! Tomorrow look out for management of free caps! www.ophthalmobytes.com Image from Rajan Eye Care Hospital⁣ #ophthalmology #ophthal #lens #flap #freecap #LASIK #refractivesurgery #doctor #health #medical #

-Vitreous prolapse or loss is a condition in which the vitreous gel becomes displaced beyond the posterior capsule into the anterior segment of the eye. -Surgical complication of cataract surgery that can induce macular edema, corneal decompensation, glaucoma, and retinal detachment. Possible risk factors during surgery: -Age <40 years. -Pseudoexfoliation. -Deep set eyes. -High myopia. -Previous history of vitreous loss. -PC tear. -Nd:Yag capsulotomy in pseudophakics. Managem

-It is a congenital, funnel shaped excavation of the posterior fundus that incorporates the optic disk. •Unilateral condition. •Visual acuity 6/60 to finger counting. •Females > males •The disk is markedly enlarged, orange or pink in color, and it may appear to be recessed or elevated centrally within the confines of a funnel shaped peripapillary excavation. •A wide annulus of chorioretinal pigmentary disturbance surrounds the disk within the excavation. •A white tuft of glia

-Retinal pigment epithelial detachments (PEDs) are characterized by separation between the RPE and the inner most aspect of Bruch's membrane. PATHOGENESIS: - PED from the inner collagenous layer of Bruch's membrane is caused by disruption of the physiological forces maintaining adhesion. - MOA: Reduction of hydraulic conductivity of a thickened and dysfunctional Bruch's membrane, impending movement of fluid from RPE to the choroid. TYPES: -Serous. -Fibrovascular. -Drusenoid.

-Dependable indicator of inflammatory activity. -Grading is done by estimating the number of cells in a 1 mm by 1 mm slit beam field, employing adequate light intensity and magnification. -Should be done before pupillary dilatation which can lead to shedding of pigment cells into the aqueous. www.ophthalmobytes.com Image from Rajan Eye Care Hospital #ophthalmology #ophthal #doctor #health #medical #vision #education #optometry #medicalstudent #optometrist #medicine #eye #opht

-Also known as Bonnet-Bechaume-Blanc syndrome, Congenital Unilateral Retinocephalic Vascular Malformation Syndrome, Racemose Angiomatosis. -Non-hereditary congenital neurocutaneous disorder leading to arteriovenous malformations of the brain, orbit, retina and skin. -Caused by an abnormality in the development of blood vessels during embryonic or fetal growth. DIAGNOSIS: -Fundus Exam: Unilateral tortuous dilated retinal vessels. -FFA: Rapid filling of vascular anomalies witho

Descemet's Stripping Endothelial Keratoplasty! -In DSEK: the patient’s Descemet membrane is peeled off and replaced with a partial thickness graft: a transplanted disc of Posterior Stroma, Descemet and Endothelium. Both donor and host cornea are manually dissected. -In DSAEK: the donor dissection is carried out using a mechanical microkeratome. GOAL of DSEK: -To transplant a healthy endothelial cell layer that will pump the fluid out of the cornea. -Expected to restore cornea

-Symptoms are usually more than signs. RISK FACTORS: OCULAR FACTORS • Trauma. • Ocular surface disorders. • Contact lens wear • Drugs (Corticosteroids) SYSTEMIC FACTORS • Diabetes mellitus, HIV positive patients (immunocompromised states). SLIT LAMP EXAMINATION: -An epithelial defect with surrounding stromal infiltration which is usually different for different organisms. -Suppurative stromal infiltration. -Associated conjunctivitis is certain organisms (gonococcal, pne

-Autosomal Recessive disorder. -Massive mosaic hyaline excrescences along the cuticular layer of Bruch's membrane giving the appearance of multiple yellowish-white lesions of various size extending to the far periphery and sparing the fovea. -Clinically there is no night blindness or any delay in dark adaptation. -FAF: multiple hyperautofluorescent lesions corresponding in location with the flecks. -SD-OCT: discrete deposit accumulation located posterior to the photoreceptor

-Most common complication of cataract surgery. Lens Epithelial Cells → Migration → Proliferation → Differentiation Two types of PCO: 1) FIBROUS: Abnormal proliferation of LEC → presents as wrinkles and folds on the posterior capsule site at the fusion of anterior and posterior capsules 2) PROLIFERATIVE → Elsching’s Pearls Elsching’s Pearls result from aberrant attempts by lens cells attached to the capsule to form new lens fibres -Normally differentiated LEC that line the equ

-Petaloid/rosette-shaped opacifications are seen in patients who have sustained blunt or penetrating physical trauma to the eye, and rarely due to electric shock, exposure to infrared energy or ionising radiation. -The force of the blunt trauma may result in coup, contrecoup injury or axial expansion of the lens. -The coup ocular injury is a result of direct impact, and results in formation of a Vossius ring as a consequence of compression of the pigmented posterior iris epit

2 types! 1) Refractive Type: -They have annular zones of different refractive powers to provide focus for near and far objects. -Dependent on the size of the pupil to utilize the required zone of lens. -Limitations: a high incidence of dysphotopsic symptoms, high intolerance to pupil decentration and large angle kappa, and a significant loss of contrast sensitivity. 2) Diffractive Type: -These IOLs are engineered with microscopic steps on its surface with a specific phase del

-Myelination of the optic nerve fibers normally begins at the lateral geniculate body and ceases at the lamina cribrosa. -An abnormal intraocular myelination of the peripapillary nerve fibre layer anterior to the lamina cribrosa is called myelinated nerve fibre layer (MNFL) -Usually unilateral - can be sporadic/ familial/ acquired CAUSE: -Oligodendrocytes are involved- a structural or biochemical defect allows oligodendrocytes to migrate intraocularly and continue myelination

-Steep fit shows central pooling surrounded by a ring of touch which restricts tear flow and interferes with corneal metabolism. -Usually centers well. -Shows less movement with blink. Movement is rather static and sluggish even when the lens is pushed. -The appearance of central green tear pooling beneath the lens is sometimes seen with trapped bubbles under the lens, blue heavy touch of the lens at the mid peripheral transition region and minimal lens edge clearance. www.op

-Cotton Wool Spots: Nerve fibre layer. -Microaneursyms: Inner nuclear layer. -Dot blot hemorrhages: Inner nuclear & Outer plexiform layer. -Flame-shaped hemorrhages: Nerve fibre layer. -Hard exudates: Outer plexiform layer. www.ophthalmobytes.com⁣ ⁣ Image from Rajan Eye Care Hospital #ophthalmology #ophthal #doctor #health #medical #vision #education #optometry #medicalstudent #optometrist #medicine #eye #ophtho #ophthalmologist #ophthalmo #med #medicaleducation #ophthalmolog

•Bilateral, non-inflammatory, non-hereditary peripheral corneal thinning usually inferiorly (4 to 8 ‘o’ clock). ONSET: •2nd to 5th decade of life. PATHOPHYSIOLOGY: •Thought to be secondary to collagen abnormalities, similar to keratoconus. •The thin, weakened cornea is said to protrude as a result of intraocular pressure. SYMPTOMS: •Progressive deterioration of visual acuity due to irregular astigmatism. •Rare – pain due to acute corneal hydrops. SIGNS: •Peripheral band of co

•Bilateral lipid degeneration of the cornea. •Two forms: Primary & Secondary. Occurs mainly in secondary form. •May be peripheral/ central / diffuse. ETIOLOGY: •Accumulation of lipids may result from excessive production, impaired lipid metabolization or both mechanisms. RISK FACTORS: •Secondary to systemic disorders of lipid metabolism- Defects in cholesterol esterification, in lipoprotein scavenging, Fish-eye disease, Tangier disease. •Secondary form: associated with previo

Grades of Hyphema! Art by @mahuness www.ophthalmobytes.com⁣ ⁣ #ophthalmology #ophthal #doctor #health #medical #vision #education #optometry #medicalstudent #optometrist #medicine #eye #ophtho #ophthalmologist #ophthalmo #med #medicaleducation #ophthalmologyresident #ophthalmologyresidency #medicaldoctor #doc #apaoyo #ophthalmicphotography

Serum lipid levels correlate with extent of hard exudates! www.ophthalmobytes.com⁣ ⁣ Image from Rajan Eye Care Hospital #ophthalmology #ophthal #doctor #health #medical #vision #education #optometry #medicalstudent #optometrist #medicine #eye #ophtho #ophthalmologist #ophthalmo #med #medicaleducation #ophthalmologyresident #ophthalmologyresidency #medicaldoctor #apaoyo #diabetes #diabeticretinopathy