Ophthalmology Practicals Viva

1. Pseudophakia
1) what are the positive findings in a case of pseudophakia?
@ --history of diminution of vision followed by history of operation and improvement of
vision
--surgical scar at limbus over sclera or over cornea depending upon the type of surgery
done
--comparatively deep anterior chamber
--pupil colour black with shinning reflex in pupillary area
2) what is pseudophakia?
@ literally pseudo means artificial and phakia means lens
so pseudophakia is an artificial lens. Usually it is implanted after extraction of
cataractous lens. Then the condition is called pseudophakia.
3) what are types of IOLs?
@ --depending upon the type of placement = anterior chamber and posterior chamber
--depending upon the material = rigid and foldable
--depending upon the correction they provide = mono, multifocal and accommodative
4) between anterior chamber and posterior chamber IOL which is better?
@ --posterior chamber IOL are better than anterior chamber IOL. as they are implanted in
posterior chamber in a bag which is normal position of natural lens
--complications are less in posterior chamber IOLs.

2. 5) What are the complications in anterior chamber IOLs?
@ --loss of endothelial cells leading to bullous keratopathy
--uveitis, glaucoma and hyphaema - UGH syndrome
6) what are the complications of posterior chamber IOL implantation?
@ complications of PC IOL are fewer -- over or under correction of power
-- decantation of IOL leading to sunset syndrome, sunrise syndrome,
-- lens lost syndrome-may be due to PC rent or zonular loss
-- toxic lens syndrome may be due to ethylene oxide gas
with which it is sterilized or due to lens material itself
-- wind shield wiper syndrome due to large capsulorrhexis
and small size of lens
7) what are the materials with which intra ocular lenses are made up of?
@ -- rigid IOL are made up of PMMA
-- foldable IOLs are made up of silicone, acrylic, hydrogel, cholomer, can be implanted in 2-2.2mm
incision
-- rollable IOL are ultrathin IOLs implanted through 1mm incision..these are made up of hydro gel.
8) what do u understand by unifocal, multifocal, accommodative IOL?
@ unifocal— most commonly used having unifocal power. Depending upon the IOL implanted these can
make patient emmetropic, myopic or hypermetropic
multifocal— have separate optic to focus distant and near ,also called pseudo accommodative IOL
accommodative IOL— exhibit some anterior movement of optic to improve the near vision.
so in multifocal or accommodative IOL patient need not use glasses for both distant and near
in unifocal IOL patient need to use glasses for near

3. 9) What do you understand by phakic IOL?
@ in addition to aphakic IOL which are implanted after lens extraction special phakic IOL are required
to treat refractive error. These are also called implantable contact lenses or ICLs.
These are used for correction of myopia >8D.in this technique special type of intra ocular
lens can be implanted in the anterior chamber or posterior chamber anterior to natural
crystalline lens.
10) can we correct pre existing astigmatism by IOL implantation?
@ yes by toric IOLs
11) what do you understand by aspheric IOL?
@ These are intra ocular lenses to reduce the spherical aberration
12) what do you understand by aniridia IOL?
@ these are cosmetic device to cover the aniridia or partial loss or iris due to trauma .in these lenses
around central optical part there is a black diaphragm.
13) what are parts of IOL?
@ Optic for refraction and haptic for holding.
14) what is the size of IOL?
@ from one end to other end they can be 12-12.5mm for back fixation 13 mm for sulcus fixation.
Optic size can be 5.5, 6,6.5mm.
15) how will you sterilize the IOL?
@ by ethylene gas
16) what do you understand by glued IOL?
@ glued IOL are scleral fixation posterior chamber IOL and an alternative to anterior chamber
IOL. these are implanted when there is no posterior capsule. Posterior chamber IOL can be
fixated to sclera in ciliary sulcus region with the help of sutures or biological glue.

4. 17) What do you understand by square edge IOL?
@ the square edge IOL are designed to delay posterior capsule opacification and there
edges are made square.
18) what are the types of anterior chamber IOL?
@ anterior chamber IOL are 2 type
-- kelmen multiflex IOL – lies entirely in front of iris and
supported in angle of anterior chamber
-- iris supported IOL -- these are also anterior chamber IOL
fixed with sutures or claws (ex. singh and worse)
19) what are the types if IOLs depending on shape?
@ -- planoconvex or biconvex IOLs
-- C loop & J loop
-- modified C loop & J loop
of all the above modified C loop biconvex lenses are better and used in bag fixation
20) what are contra indications for IOL implantation?
@ --recurrent intra ocular inflammation
--corneal endothelial decompensation or low endothelial cell count
--child below 3yeas of age
21) who invented the IOLs and which year first IOL implanted?
@
22) what is power of lens used in emmetropic eye?
@ +18D