My Talk In National Eye Center , Cairo Egypt On 4th April , 2016

1. N.B !N.B !
By
Dr.Ahmed Alsherbiny
MSc. Ophth

2. WARNING
This presentation occasionally contains
violent photos which maybe unsuitable
for children and delicate people ! ;)

3. According to Kollner’s rule, retinal
diseases cause acquired blue-yellow
color vision defects,
whereas optic nerve diseases affect
red-green discrimination except in
glaucoma & A.D optic atrophy.

4. A patient with a corneal abrasion from
a dirty source (contact lens use, tree
branch) is at risk for a corneal ulcer
and should not be patched while
healing.

5. Immediately irrigate any patient
with a chemical ocular injury from an
alkali or acid, without taking a history
or performing examination

6. Recurrent subconjunctival hemorrhages
should be evaluated to rule out
uncontrolled hypertension or blood
dyscrasias

7. Ask about gastric bypass procedures in
patients who have recent severe dry
eye with no discernible cause.
Vitamin A deficiency may be the
reason.

8. If a patient presents with symptoms
consistent with recurrent corneal
erosion syndrome but no findings, look
for an underlying dystrophy,
specifically epithelial basement
membrane dystrophy.

9. Always check the pressure in the
contralateral eye in a patient with
ocular trauma.
Asymmetrically low intraocular pressure
may be an important clue to a potential
ruptured globe.

10. Patients with traumatic ocular injuries
must be evaluated for systemic injuries
as well.

11. Patients recovering from a traumatic
hyphema are at increased risk for
glaucoma and retinal detachments in
the future. They need ongoing
ophthalmic evaluation for the rest of
their lives.

12. Complete evaluation by a pediatrician is
mandatory for any infant with a
congenital cataract.

13. The most common cause of unilateral or
bilateral proptosis is thyroid eye disease
(Graves’ ophthalmopathy).

14. Suspect thyroid-related ophthalmopathy
(TRO) in patients with nonspecific
redness and inflammation of the eyes
even if there is no history of a systemic
thyroid imbalance.

15. Young patients with xanthelasma should be
evaluated for diabetes mellitus and
hypercholesterolemia.

16. All patients who have anterior uveitis must
have a dilated examination to exclude
associated posterior segment disease

17. Perform iris examination and gonioscopy
prior to dilation in a patient with a
central retinal vein occlusion. Neovascular
glaucoma is the most feared complication
of a central retinal vein occlusion.

18. Overestimation of IOP may be due to
tight collar which obstructs venous
return and causes IOP to rise

19. In patients with macular disease VA is
frequently worse when the patient looks
through a pin-hole

20. All patients with sporadic aniridia should have
abdominal U/S to detect Wilm’s tumor every 3
months until 5 years of age, then every 6 months
until 10 years and then annually until 16 years of
age or until molecular genetic analysis confirms
and intragenic mutant without extragenic
involvement

21. Central corneal thickness is increased in
eyes with aniridia which may result in
incorrect measurement of IOP

22. It is important to examine the optic disc
carefully in all patients with suspected
central serous retinopathy

23. It is very important not to mistake a
‘recurrent chalizion’ for sebaceous
gland carcinoma. In doubtful cases,
the lesion should be biopsied and
examined histologically

24. Tetracycline should not be used in
children under the age of 12 years
(erythromycin is an alternative) or in
pregnant or breast-feeding women
because they are deposited in growing
bone and teeth, and may cause staining
of teeth and dental hypoplasia

25. It is important to exclude
congenital glaucoma in an infant
with watering eye

26. In pulsating proptosis , mild
pulsation is best detected on the
slit-lamp particularly when
performing applanation tonometry

27. In TED restrictive myopathy , a rectus
muscle should never be resected but only
recessed

28. Most common cause of acute unilateral
proptosis in a child is orbital cellulitis while
the most dangerous cause to be excluded is
rhabdomyosarcoma

29. In preseptal cellulitis , unlike orbital
cellulitis: proptosis and chemosis are
absent, visual acuity, pupillary
reactions and ocular motility are
unimpaired

30. Child with bilateral Horner’s syndrome ,
you should exclude neuroblastoma by
abdominal U/S

31. The lash line should be examined
carefully in patients with chronic
conjunctivitis so as to not to
overlook a molluscum lesion

32. Giving a general anaesthetic without
prior knowledge of the diagnosis of
homocystinuria can be life-
threatening

33. It is less common for primary
uveitis to first manifest in old age;
suspect a masquerade syndrome,
especially intraocular lymphoma

34. MRI should never be performed if
a metallic foreign body is suspected

35. After ocular trauma , especially rupture
globe , In follow up visits after primary
repair , careful examination of the
other eye is very important to detect
sympathetic ophthalmitis

36. Thank You