Bullous keratopathy refers to corneal swelling caused by insufficient pumping of fluid out of the cornea. It results in the formation of fluid-filled blisters beneath the surface of the eye. It can occur secondary to endothelial dysfunction from trauma, inflammation, dystrophies or other conditions that damage the corneal endothelial pump. Symptoms include blurred vision, glare, pain from ruptured blisters, and potentially scarring. Management involves reducing fluid buildup through hypertonic drops or lenses, lowering eye pressure if high, and corneal transplantation if vision is significantly decreased or pain becomes intolerable.
Cystoid macular edema is a pathological accumulation of fluid in the macula that can be caused by conditions like diabetic retinopathy, retinal vein occlusions, or following cataract surgery. It is diagnosed using optical coherence tomography or fluorescein angiography and treated initially with anti-inflammatory eye drops, corticosteroid injections, or anti-VEGF drugs to reduce fluid accumulation. Laser therapy or vitrectomy may also be used in some cases to treat underlying causes like vitreomacular traction.
Papilloedema is swelling of the optic nerve head caused by increased intracranial pressure (ICP). It is nearly always bilateral and patients should be evaluated for an intracranial mass. Papilloedema can be caused by idiopathic intracranial hypertension, obstructive lesions, space occupying lesions, impaired CSF absorption, cerebral venous sinus thrombosis, cerebral edema from head trauma, or severe hypertension. Treatment involves reducing ICP through measures like mannitol infusion, CSF withdrawal, sedation, or surgery to remove masses. Complications can include visual loss or chronic headaches.
1. Orbital cellulitis is an acute infection of the soft tissues behind the orbital septum that may progress to a subperiosteal or orbital abscess.
2. It is commonly caused by bacteria like Streptococcus pneumoniae, Staphylococcus aureus, and Streptococcus pyogenes entering through the sinuses, face, or eyes.
3. Symptoms include eye swelling, pain, and vision issues. Left untreated, it can lead to complications affecting the eye, orbit, sinuses, or brain.
Cataract formation is commonly caused by blunt trauma to the eye and can result in flower-shaped opacities in the lens. Subluxation or dislocation of the lens may also occur due to trauma tearing the suspensory ligament. A cataract surgery may be needed to remove a visually significant cataract caused by trauma or other conditions like uveitis. Special considerations for surgery include damage to other ocular tissues, retained foreign bodies, inflammation, and zonular dehiscence.
The limbus is the transitional zone between the sclera and cornea. Lesions of the limbus can be classified as congenital, inflammatory, allergic, vascular, traumatic, degenerative, nutritional, neoplastic, or miscellaneous. Common limbal lesions include dermoids, dermolipomas, raised nevi, episcleritis, scleritis, phlyctenules, vernal catarrh, ophthalmia nodosa, hemangiomas, granulomas, implantation cysts, pinguecula, cystic pterygium, papillomas, squamous cell carcinoma, and primary melanoma. The document provides details on characteristics, causes, and treatment of various limbal
Difference between follicles & papillae.Kape John
Follicles are localized areas of lymphoid hyperplasia that appear as white or gray elevations in the upper or lower tarsal conjunctiva and may be accompanied by inflammation. Papillae are flat-topped elevations in the tarsal conjunctiva containing blood vessels and having a smooth, velvety appearance, present in some forms of allergic conjunctivitis. The document distinguishes between follicles and papillae, defining each term and noting when they may be present.
A surgical procedure featuring a partial thickness scleral flap that creates a fistula between AC and subconjunctival space for filtration of aqueous and creation of conjunctival bleb in an effort to lower IOP
Bullous keratopathy refers to corneal swelling caused by insufficient pumping of fluid out of the cornea. It results in the formation of fluid-filled blisters beneath the surface of the eye. It can occur secondary to endothelial dysfunction from trauma, inflammation, dystrophies or other conditions that damage the corneal endothelial pump. Symptoms include blurred vision, glare, pain from ruptured blisters, and potentially scarring. Management involves reducing fluid buildup through hypertonic drops or lenses, lowering eye pressure if high, and corneal transplantation if vision is significantly decreased or pain becomes intolerable.
Cystoid macular edema is a pathological accumulation of fluid in the macula that can be caused by conditions like diabetic retinopathy, retinal vein occlusions, or following cataract surgery. It is diagnosed using optical coherence tomography or fluorescein angiography and treated initially with anti-inflammatory eye drops, corticosteroid injections, or anti-VEGF drugs to reduce fluid accumulation. Laser therapy or vitrectomy may also be used in some cases to treat underlying causes like vitreomacular traction.
Papilloedema is swelling of the optic nerve head caused by increased intracranial pressure (ICP). It is nearly always bilateral and patients should be evaluated for an intracranial mass. Papilloedema can be caused by idiopathic intracranial hypertension, obstructive lesions, space occupying lesions, impaired CSF absorption, cerebral venous sinus thrombosis, cerebral edema from head trauma, or severe hypertension. Treatment involves reducing ICP through measures like mannitol infusion, CSF withdrawal, sedation, or surgery to remove masses. Complications can include visual loss or chronic headaches.
1. Orbital cellulitis is an acute infection of the soft tissues behind the orbital septum that may progress to a subperiosteal or orbital abscess.
2. It is commonly caused by bacteria like Streptococcus pneumoniae, Staphylococcus aureus, and Streptococcus pyogenes entering through the sinuses, face, or eyes.
3. Symptoms include eye swelling, pain, and vision issues. Left untreated, it can lead to complications affecting the eye, orbit, sinuses, or brain.
Cataract formation is commonly caused by blunt trauma to the eye and can result in flower-shaped opacities in the lens. Subluxation or dislocation of the lens may also occur due to trauma tearing the suspensory ligament. A cataract surgery may be needed to remove a visually significant cataract caused by trauma or other conditions like uveitis. Special considerations for surgery include damage to other ocular tissues, retained foreign bodies, inflammation, and zonular dehiscence.
The limbus is the transitional zone between the sclera and cornea. Lesions of the limbus can be classified as congenital, inflammatory, allergic, vascular, traumatic, degenerative, nutritional, neoplastic, or miscellaneous. Common limbal lesions include dermoids, dermolipomas, raised nevi, episcleritis, scleritis, phlyctenules, vernal catarrh, ophthalmia nodosa, hemangiomas, granulomas, implantation cysts, pinguecula, cystic pterygium, papillomas, squamous cell carcinoma, and primary melanoma. The document provides details on characteristics, causes, and treatment of various limbal
Difference between follicles & papillae.Kape John
Follicles are localized areas of lymphoid hyperplasia that appear as white or gray elevations in the upper or lower tarsal conjunctiva and may be accompanied by inflammation. Papillae are flat-topped elevations in the tarsal conjunctiva containing blood vessels and having a smooth, velvety appearance, present in some forms of allergic conjunctivitis. The document distinguishes between follicles and papillae, defining each term and noting when they may be present.
A surgical procedure featuring a partial thickness scleral flap that creates a fistula between AC and subconjunctival space for filtration of aqueous and creation of conjunctival bleb in an effort to lower IOP
- Proptosis refers to forward displacement of the eyeball beyond the orbital rim, usually due to an increased mass or volume within the orbit. Common causes include tumors, inflammation, trauma, thyroid eye disease, and vascular lesions.
- Examination involves measuring exophthalmometry, inspecting for signs of mass effect, pulsation or displacement of the globe, and evaluating for neurologic deficits. Imaging with CT or MRI is important to characterize the lesion causing proptosis.
Dr. Karan Bhatia provides an overview of keratoplasty (corneal transplantation). There are different types including penetrating keratoplasty (replacing the full thickness of the diseased cornea), partial thickness lamellar keratoplasty, and rotational keratoplasty. Penetrating keratoplasty has been the standard procedure but carries risks. The history and techniques of penetrating keratoplasty are described in detail including pre-operative evaluation, donor cornea excision, recipient cornea trephination, suturing, and post-operative management. Potential complications are also reviewed. Lamellar keratoplasty is introduced as an alternative to penetrating keratoplasty to reduce risks
This document discusses various imaging techniques used to evaluate glaucoma, including OCT, HRT, and GDx. OCT uses interferometry to measure retinal nerve fiber layer thickness. HRT uses confocal laser scanning to create 3D images of the optic nerve and measure disc parameters. GDx uses scanning laser polarimetry to measure retinal nerve fiber layer thickness and detect glaucomatous damage through thickness maps, deviation maps, and TSNIT plots compared to normative data. Together these quantitative imaging techniques provide objective assessment to aid in glaucoma diagnosis and detection of progression.
Benign epithelial tumors of the ocular surface include papillomas, which are caused by HPV infection and can be either pedunculated or sessile. Sessile papillomas have a risk of malignant transformation. Malignant epithelial tumors include ocular surface squamous neoplasia (OSSN), which presents as dysplasia or carcinoma in situ and can invade the cornea or globe if not treated with surgical excision or topical chemotherapy. Neuroectodermal tumors of the ocular surface include freckles, benign acquired melanosis (BAM), and primary acquired melanosis (PAM), which has a risk of progressing to conjunctival melanoma. Close monitoring is important to detect malignant transformation
This document discusses congenital ptosis, including its types, causes, signs, and treatments. There are several types of congenital ptosis, including simple congenital ptosis which is not associated with other anomalies, ptosis associated with weakness of the superior rectus muscle, and blepharophimosis syndrome where ptosis occurs with additional facial features. Congenital ptosis is caused by underdevelopment of the levator palpebrae superioris muscle. Treatment depends on the severity of ptosis and amount of levator function, and may include conjunctiva-Müller resection for mild ptosis, levator resection for moderate ptosis with sufficient levator function, or brow suspension for severe ptosis with poor
Herpes Zoster Ophthalmicus (HZO), also known as shingles or zoster, is a viral disease caused by the varicella zoster virus (VZV) that causes a painful skin rash in one or more dermatomes of the fifth cranial nerve, which innervates the eye and orbit. It presents a risk of ocular involvement. Clinically, it manifests as acute skin lesions and various ocular diseases in both the acute phase and chronic phase, including conjunctivitis, keratitis, uveitis, retinitis, increased intraocular pressure, and postherpetic neuralgia. Management involves oral or intravenous antiviral therapy in the acute phase as well
Pseudo-ophthalmology is the study of conditions that mimic eye diseases but have different underlying causes. The document discusses various "pseudo" conditions that resemble other true conditions, such as pseudoptosis resembling ptosis, pseudoproptosis resembling proptosis, and pseudopapilledema resembling papilledema. For each pseudo condition, the document provides the defining features and potential underlying causes that differentiate it from the true condition it mimics. In total, over 30 different pseudo-conditions are defined and compared to their true namesakes in the field of ophthalmology.
[1] Ocular Surface Squamous Neoplasia (OSSN) refers to a spectrum of dysplastic and malignant squamous lesions of the conjunctiva and cornea.
[2] Diagnosis is usually clinical but can be confirmed with biopsy. For suspected OSSN less than 3 clock hours, excision biopsy with cryotherapy and alcohol epitheliectomy is performed. Larger lesions may require chemoreduction with topical chemotherapy prior to surgery and cryotherapy.
[3] Risk factors include ultraviolet light, HIV, and human papillomavirus. While rare, metastasis can occur to local lymph nodes or distant sites like lungs. Recurrence after treatment ranges from 15-52% depending
The document discusses visual field testing in glaucoma. It defines the visual field and perimetry, and describes the major types of clinical perimetry tests including full threshold, SITA standard, and SITA fast on Humphrey and normal, dynamic, and TOP strategies on Octopus. It explains parameters such as test patterns, reliability, age-corrected plots, tests like GHT and Bebie curve, and global indices including MD, PSD, SF, and CPSD. The purpose of visual field testing in glaucoma is to detect and monitor disease by measuring light sensitivity across the retinal field.
This document discusses papilledema, which is swelling of the optic disc due to increased intracranial pressure. It defines papilledema and outlines its causes, signs, symptoms, grading, histopathology, investigations, differential diagnosis, and treatment. The main points are that papilledema is caused by increased intracranial pressure, it can be graded on a scale from 0-5 based on severity, and treatment involves addressing the underlying cause of pressure increase as well as surgical decompression in severe cases to prevent vision loss.
Endophthalmitis is an inflammation of the inner coats of the eyeball that can be infective or non-infective. Infective endophthalmitis is classified as exogenous or endogenous. Acute bacterial endophthalmitis is a complication of intraocular surgery where the infective source is usually the patient's own flora. Signs include lid edema, chemosis, hypopyon, and retinal periphlebitis. Treatment involves intravitreal and systemic antibiotics, intravitreal and topical steroids, and sometimes pars plana vitrectomy to treat severe or non-improving cases. Panophthalmitis is a more severe inflammation of the whole eyeball that
Vernal keratoconjunctivitis ophthalmology TONY SCARIA
This document discusses vernal keratoconjunctivitis (VKC), a recurrent, seasonal eye condition seen primarily in children and young adults. VKC involves inflammation of the conjunctiva and cornea and is caused by an allergic reaction, often to pollen allergens. Symptoms include itching, tearing, and thick discharge. Signs include raised papillae on the conjunctiva that resemble cobblestones. Treatment focuses on reducing inflammation and symptoms using topical steroids, mast cell stabilizers, and antihistamines. The condition typically resolves spontaneously by adulthood.
Malignant glaucoma, also known as aqueous misdirection syndrome, is a secondary glaucoma that occurs when aqueous humor takes an abnormal posterior route behind the lens and vitreous instead of flowing normally through the pupil. It presents with a shallow anterior chamber despite high intraocular pressure. Potential causes include prior eye surgery or laser treatment. Diagnosis involves examining for signs of anterior chamber shallowing and ruling out other conditions. Treatment begins with cycloplegic drugs but may require Nd:YAG laser or vitrectomy if unresponsive. Prognosis depends on severity and underlying anatomy.
- The document discusses the evaluation of proptosis, which is the abnormal forward protrusion of the eyeball. It defines different types of orbital abnormalities and provides the approach to examining a patient with proptosis, including taking a thorough history, performing a local and systemic examination, ordering appropriate imaging and lab tests, and considering histopathological studies if needed. The causes of proptosis can be divided into categories such as inflammatory, mass effect, vascular changes, and infiltrative processes. Key aspects of the evaluation are to determine if the proptosis is unilateral or bilateral and whether there are associated signs and symptoms to suggest an underlying cause.
ETIOLOGY, PATHOLOGY AND PATHOGENESIS OF CORNEAL ULCERDr Samarth Mishra
Corneal ulcer is a discontinuation of the normal corneal epithelial surface associated with necrosis of surrounding corneal tissue, characterized pathologically by edema and cellular infiltration. It can be classified based on location, purulence, association with hypopyon, depth, and slough formation. Common bacterial causes include Staphylococcus aureus and Pseudomonas aeruginosa. Fungal keratitis is associated with filamentous fungi like Aspergillus. Herpes simplex virus causes infectious epithelial keratitis manifesting as dendritic or geographic ulcers. Mooren's ulcer is a severe, peripheral ulcerative keratitis of unknown etiology.
This document provides information on angle closure glaucoma, including its causes, risk factors, stages, clinical presentation, diagnostic tests, and treatment options. Angle closure glaucoma results from obstruction of the aqueous outflow pathway due to apposition or adhesion of the iris to the trabecular meshwork. It is more common in individuals with anatomically narrow anterior chamber angles and certain ethnic groups. Treatment involves lowering intraocular pressure through medications, laser procedures such as peripheral iridotomy or iridoplasty, or incisional surgeries like goniosynechialysis or trabeculectomy if needed.
This document summarizes Herpes Simplex Virus (HSV) keratitis and Herpes Zoster Ophthalmicus. It discusses the pathology, clinical features, diagnosis, and treatment of HSV epithelial keratitis and stromal/endothelial keratitis. It presents two case scenarios of recurrent HSV keratitis. It also summarizes the findings of the Herpetic Eye Disease Study regarding the efficacy of antivirals and steroids for treating HSV eye infections.
AMNIOTIC MEMBRANE TRANSPLANTATION
The amniotic membrane is the innermost layer of the placenta with 5 layers. It has anti-inflammatory, anti-fibrotic and antimicrobial properties making it useful for ocular surface reconstruction. Amniotic membrane transplantation involves placing the membrane on defects of the cornea, conjunctiva or ocular surface to promote healing. The membrane acts as a biological bandage to promote epithelization and inhibit fibrosis. Complications can include infection transmission or premature dissolution but techniques using fibrin glue or devices like Prokera are being developed for sutureless fixation.
This document provides an overview of ocular trauma and basic management principles. It begins with an introduction on the importance of the eyes and prevalence of ocular trauma. It then covers epidemiology, classifications using the BETTS system, evaluation of patients, investigations, general management principles, and management of specific injuries such as closed globe, open globe, lid injuries and subconjunctival hemorrhage. The document aims to outline the evaluation and basic management of common ocular trauma presentations.
Fungal corneal ulcers are common, caused mainly by Aspergillus in India. Risk factors include ocular trauma, contact lens use, pre-existing eye conditions, and systemic immunosuppression. Diagnosis involves corneal scrapings, cultures, and stains showing fungal hyphae or spores. Treatment consists of topical natamycin or amphotericin B, sometimes with adjunctive debridement, intracameral/intracorneal injections, or therapeutic keratoplasty for severe cases. Systemic antifungals may also be used for extensive infections.
1. The patient presented with a palatal swelling and MRI revealed another parotid lesion. Biopsies found polymorphous adenocarcinoma in the palate and pleomorphic adenoma in the parotid gland.
2. Both lesions were surgically removed. Post-operative radiation was recommended for the palatal tumor due to perineural invasion.
3. Having multiple salivary gland tumors is unusual but not unheard of. MRI proved useful for detecting the additional concealed parotid lesion in this case. Each tumor requires separate diagnosis and treatment.
- Proptosis refers to forward displacement of the eyeball beyond the orbital rim, usually due to an increased mass or volume within the orbit. Common causes include tumors, inflammation, trauma, thyroid eye disease, and vascular lesions.
- Examination involves measuring exophthalmometry, inspecting for signs of mass effect, pulsation or displacement of the globe, and evaluating for neurologic deficits. Imaging with CT or MRI is important to characterize the lesion causing proptosis.
Dr. Karan Bhatia provides an overview of keratoplasty (corneal transplantation). There are different types including penetrating keratoplasty (replacing the full thickness of the diseased cornea), partial thickness lamellar keratoplasty, and rotational keratoplasty. Penetrating keratoplasty has been the standard procedure but carries risks. The history and techniques of penetrating keratoplasty are described in detail including pre-operative evaluation, donor cornea excision, recipient cornea trephination, suturing, and post-operative management. Potential complications are also reviewed. Lamellar keratoplasty is introduced as an alternative to penetrating keratoplasty to reduce risks
This document discusses various imaging techniques used to evaluate glaucoma, including OCT, HRT, and GDx. OCT uses interferometry to measure retinal nerve fiber layer thickness. HRT uses confocal laser scanning to create 3D images of the optic nerve and measure disc parameters. GDx uses scanning laser polarimetry to measure retinal nerve fiber layer thickness and detect glaucomatous damage through thickness maps, deviation maps, and TSNIT plots compared to normative data. Together these quantitative imaging techniques provide objective assessment to aid in glaucoma diagnosis and detection of progression.
Benign epithelial tumors of the ocular surface include papillomas, which are caused by HPV infection and can be either pedunculated or sessile. Sessile papillomas have a risk of malignant transformation. Malignant epithelial tumors include ocular surface squamous neoplasia (OSSN), which presents as dysplasia or carcinoma in situ and can invade the cornea or globe if not treated with surgical excision or topical chemotherapy. Neuroectodermal tumors of the ocular surface include freckles, benign acquired melanosis (BAM), and primary acquired melanosis (PAM), which has a risk of progressing to conjunctival melanoma. Close monitoring is important to detect malignant transformation
This document discusses congenital ptosis, including its types, causes, signs, and treatments. There are several types of congenital ptosis, including simple congenital ptosis which is not associated with other anomalies, ptosis associated with weakness of the superior rectus muscle, and blepharophimosis syndrome where ptosis occurs with additional facial features. Congenital ptosis is caused by underdevelopment of the levator palpebrae superioris muscle. Treatment depends on the severity of ptosis and amount of levator function, and may include conjunctiva-Müller resection for mild ptosis, levator resection for moderate ptosis with sufficient levator function, or brow suspension for severe ptosis with poor
Herpes Zoster Ophthalmicus (HZO), also known as shingles or zoster, is a viral disease caused by the varicella zoster virus (VZV) that causes a painful skin rash in one or more dermatomes of the fifth cranial nerve, which innervates the eye and orbit. It presents a risk of ocular involvement. Clinically, it manifests as acute skin lesions and various ocular diseases in both the acute phase and chronic phase, including conjunctivitis, keratitis, uveitis, retinitis, increased intraocular pressure, and postherpetic neuralgia. Management involves oral or intravenous antiviral therapy in the acute phase as well
Pseudo-ophthalmology is the study of conditions that mimic eye diseases but have different underlying causes. The document discusses various "pseudo" conditions that resemble other true conditions, such as pseudoptosis resembling ptosis, pseudoproptosis resembling proptosis, and pseudopapilledema resembling papilledema. For each pseudo condition, the document provides the defining features and potential underlying causes that differentiate it from the true condition it mimics. In total, over 30 different pseudo-conditions are defined and compared to their true namesakes in the field of ophthalmology.
[1] Ocular Surface Squamous Neoplasia (OSSN) refers to a spectrum of dysplastic and malignant squamous lesions of the conjunctiva and cornea.
[2] Diagnosis is usually clinical but can be confirmed with biopsy. For suspected OSSN less than 3 clock hours, excision biopsy with cryotherapy and alcohol epitheliectomy is performed. Larger lesions may require chemoreduction with topical chemotherapy prior to surgery and cryotherapy.
[3] Risk factors include ultraviolet light, HIV, and human papillomavirus. While rare, metastasis can occur to local lymph nodes or distant sites like lungs. Recurrence after treatment ranges from 15-52% depending
The document discusses visual field testing in glaucoma. It defines the visual field and perimetry, and describes the major types of clinical perimetry tests including full threshold, SITA standard, and SITA fast on Humphrey and normal, dynamic, and TOP strategies on Octopus. It explains parameters such as test patterns, reliability, age-corrected plots, tests like GHT and Bebie curve, and global indices including MD, PSD, SF, and CPSD. The purpose of visual field testing in glaucoma is to detect and monitor disease by measuring light sensitivity across the retinal field.
This document discusses papilledema, which is swelling of the optic disc due to increased intracranial pressure. It defines papilledema and outlines its causes, signs, symptoms, grading, histopathology, investigations, differential diagnosis, and treatment. The main points are that papilledema is caused by increased intracranial pressure, it can be graded on a scale from 0-5 based on severity, and treatment involves addressing the underlying cause of pressure increase as well as surgical decompression in severe cases to prevent vision loss.
Endophthalmitis is an inflammation of the inner coats of the eyeball that can be infective or non-infective. Infective endophthalmitis is classified as exogenous or endogenous. Acute bacterial endophthalmitis is a complication of intraocular surgery where the infective source is usually the patient's own flora. Signs include lid edema, chemosis, hypopyon, and retinal periphlebitis. Treatment involves intravitreal and systemic antibiotics, intravitreal and topical steroids, and sometimes pars plana vitrectomy to treat severe or non-improving cases. Panophthalmitis is a more severe inflammation of the whole eyeball that
Vernal keratoconjunctivitis ophthalmology TONY SCARIA
This document discusses vernal keratoconjunctivitis (VKC), a recurrent, seasonal eye condition seen primarily in children and young adults. VKC involves inflammation of the conjunctiva and cornea and is caused by an allergic reaction, often to pollen allergens. Symptoms include itching, tearing, and thick discharge. Signs include raised papillae on the conjunctiva that resemble cobblestones. Treatment focuses on reducing inflammation and symptoms using topical steroids, mast cell stabilizers, and antihistamines. The condition typically resolves spontaneously by adulthood.
Malignant glaucoma, also known as aqueous misdirection syndrome, is a secondary glaucoma that occurs when aqueous humor takes an abnormal posterior route behind the lens and vitreous instead of flowing normally through the pupil. It presents with a shallow anterior chamber despite high intraocular pressure. Potential causes include prior eye surgery or laser treatment. Diagnosis involves examining for signs of anterior chamber shallowing and ruling out other conditions. Treatment begins with cycloplegic drugs but may require Nd:YAG laser or vitrectomy if unresponsive. Prognosis depends on severity and underlying anatomy.
- The document discusses the evaluation of proptosis, which is the abnormal forward protrusion of the eyeball. It defines different types of orbital abnormalities and provides the approach to examining a patient with proptosis, including taking a thorough history, performing a local and systemic examination, ordering appropriate imaging and lab tests, and considering histopathological studies if needed. The causes of proptosis can be divided into categories such as inflammatory, mass effect, vascular changes, and infiltrative processes. Key aspects of the evaluation are to determine if the proptosis is unilateral or bilateral and whether there are associated signs and symptoms to suggest an underlying cause.
ETIOLOGY, PATHOLOGY AND PATHOGENESIS OF CORNEAL ULCERDr Samarth Mishra
Corneal ulcer is a discontinuation of the normal corneal epithelial surface associated with necrosis of surrounding corneal tissue, characterized pathologically by edema and cellular infiltration. It can be classified based on location, purulence, association with hypopyon, depth, and slough formation. Common bacterial causes include Staphylococcus aureus and Pseudomonas aeruginosa. Fungal keratitis is associated with filamentous fungi like Aspergillus. Herpes simplex virus causes infectious epithelial keratitis manifesting as dendritic or geographic ulcers. Mooren's ulcer is a severe, peripheral ulcerative keratitis of unknown etiology.
This document provides information on angle closure glaucoma, including its causes, risk factors, stages, clinical presentation, diagnostic tests, and treatment options. Angle closure glaucoma results from obstruction of the aqueous outflow pathway due to apposition or adhesion of the iris to the trabecular meshwork. It is more common in individuals with anatomically narrow anterior chamber angles and certain ethnic groups. Treatment involves lowering intraocular pressure through medications, laser procedures such as peripheral iridotomy or iridoplasty, or incisional surgeries like goniosynechialysis or trabeculectomy if needed.
This document summarizes Herpes Simplex Virus (HSV) keratitis and Herpes Zoster Ophthalmicus. It discusses the pathology, clinical features, diagnosis, and treatment of HSV epithelial keratitis and stromal/endothelial keratitis. It presents two case scenarios of recurrent HSV keratitis. It also summarizes the findings of the Herpetic Eye Disease Study regarding the efficacy of antivirals and steroids for treating HSV eye infections.
AMNIOTIC MEMBRANE TRANSPLANTATION
The amniotic membrane is the innermost layer of the placenta with 5 layers. It has anti-inflammatory, anti-fibrotic and antimicrobial properties making it useful for ocular surface reconstruction. Amniotic membrane transplantation involves placing the membrane on defects of the cornea, conjunctiva or ocular surface to promote healing. The membrane acts as a biological bandage to promote epithelization and inhibit fibrosis. Complications can include infection transmission or premature dissolution but techniques using fibrin glue or devices like Prokera are being developed for sutureless fixation.
This document provides an overview of ocular trauma and basic management principles. It begins with an introduction on the importance of the eyes and prevalence of ocular trauma. It then covers epidemiology, classifications using the BETTS system, evaluation of patients, investigations, general management principles, and management of specific injuries such as closed globe, open globe, lid injuries and subconjunctival hemorrhage. The document aims to outline the evaluation and basic management of common ocular trauma presentations.
Fungal corneal ulcers are common, caused mainly by Aspergillus in India. Risk factors include ocular trauma, contact lens use, pre-existing eye conditions, and systemic immunosuppression. Diagnosis involves corneal scrapings, cultures, and stains showing fungal hyphae or spores. Treatment consists of topical natamycin or amphotericin B, sometimes with adjunctive debridement, intracameral/intracorneal injections, or therapeutic keratoplasty for severe cases. Systemic antifungals may also be used for extensive infections.
1. The patient presented with a palatal swelling and MRI revealed another parotid lesion. Biopsies found polymorphous adenocarcinoma in the palate and pleomorphic adenoma in the parotid gland.
2. Both lesions were surgically removed. Post-operative radiation was recommended for the palatal tumor due to perineural invasion.
3. Having multiple salivary gland tumors is unusual but not unheard of. MRI proved useful for detecting the additional concealed parotid lesion in this case. Each tumor requires separate diagnosis and treatment.
A 10-year-old male presented with a rapidly growing swelling on his right upper eyelid that was bleeding and causing irritation. On examination, a 1cm x 0.5cm x 0.3cm lobulated mass was seen on the upper tarsal conjunctiva. Based on the appearance of a single, red, pedunculated papule on the conjunctival mucosa that increased rapidly in size, a clinical diagnosis of pyogenic granuloma was made. The mass was completely excised surgically and histopathology confirmed the diagnosis. Pyogenic granuloma, also known as granuloma pyogenicum, is a common benign vascular tumor that arises in skin and mucous membranes, with an unknown
Rhabdomyosarcoma is the most common soft tissue sarcoma in children. It arises from skeletal muscle and can occur anywhere in the body. The two main histologic subtypes are embryonal and alveolar. Treatment involves chemotherapy, surgery if possible, and radiation therapy. The chemotherapy regimens most often used are VAC or IVA. Prognosis depends on factors like age, location, stage and histology. With multimodal treatment, the 5-year survival rate for localized disease is over 70% while metastatic disease has a lower survival rate of around 25%.
2010 ahmed-bilateral transverse facial cleft as an isolated and asyndromic de...Klinikum Lippe GmbH
This case report describes a rare case of bilateral transverse facial cleft (macrostomia) as an isolated, non-syndromic deformity in a 7-year-old male child. Examination found wide mouth bilaterally lined with skin and buccal mucosa internally, with normal dentition and no other abnormalities. The defect was repaired using a W-plasty technique, which involves incisions in the shape of a W, to close the skin and reconstruct the orbicularis oris muscle and oral sphincter integrity. This achieved symmetric lips and commissures with minimal scarring. Follow-up at 3 months found marked improvement in appearance and function. Bilateral isolated transverse facial cleft is uncommon
This case report describes a 74-year-old male patient diagnosed with Gorlin-Goltz syndrome based on presenting with over 50 basal cell carcinomas on his face, chest, and back as well as a family history of similar lesions in his brother. Gorlin-Goltz syndrome is a rare autosomal dominant disorder characterized by basal cell carcinomas, jaw cysts, and skeletal abnormalities caused by mutations in the PTCH gene. The patient underwent surgical excision of basal cell carcinomas on his face. Regular screening was recommended due to risks of additional cancers and basal cell carcinomas associated with this syndrome.
An 8-year-old Russian boy presented with haziness in vision for two years. Examination found high intraocular pressures and severe optic disc cupping, indicating primary congenital glaucoma. He was diagnosed with primary congenital open angle glaucoma and successfully managed with medications, with intraocular pressures and vision stabilized over one year follow up.
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This document presents a case study of a 7-month-old male child brought to the pediatric ophthalmology clinic with watering and mucopurulent discharge from the left eye for 7 months. Examination found enlarged discs and asymmetric cupping between the eyes. The child was diagnosed with nasolacrimal duct obstruction and congenital glaucoma in the left eye. Over several follow up visits, treatment with eye drops and surgery was performed to manage intraocular pressure and treat the glaucoma. The case highlights the evaluation, management, and long term follow up of congenital glaucoma in infants.
Porocarcinoma of the nose- reconstructed with seagull flap
Authors:Balasubramaniam, Ramanandham, Pradeep, Sivakumar, Kalpa Pandya
Int J Biol Med Res. 2024; 15(1): 7760-7763
https://www.biomedscidirect.com/2847/porocarcinoma-of-the-nose-reconstructed-with-seagull-flap
Abstract: Of all the cutaneous tumours, the reported incidence of porocarcinoma is as low as 0.005-0.01%. Very few cases of porocarcinoma of the nose have been described in English literature. Median forehead flap, also known as seagull flap is an excellent reconstruction modality for the nasal defect. We describe here an interesting case of porocarcinoma of the dorsum of the nose which was reconstructed in the first stage using a seagull flap providing the patient with a pleasing nasal profile.
Porocarcinoma of the nose- reconstructed with seagull flap
Authors:Balasubramaniam, Ramanandham, Pradeep, Sivakumar, Kalpa Pandya
Int J Biol Med Res. 2024; 15(1): 7760-7763
https://www.biomedscidirect.com/2847/porocarcinoma-of-the-nose-reconstructed-with-seagull-flap
Case Report : Chorodial Melanoma With Secondary Glaucoma In Asian Race.Dr. Jagannath Boramani
1) A 60-year-old Asian male presented with loss of vision and severe headache in his right eye for 3 months. Examination revealed a large pigmented mass in the retrolental space, retinal detachment, and secondary glaucoma in the right eye.
2) Ultrasound and MRI confirmed a choroidal melanoma arising from the cilio-choroidal junction in the right eye, measuring over 1 cm3.
3) The patient underwent enucleation of the right eye. Histopathology revealed a Type A spindle cell melanoma with occasional mitoses and no scleral extension.
Sebaceous Carcinoma Masquerading As Chronic BlepharoconjunctivitisNot Relevant
This document describes a case of conjunctival sebaceous carcinoma that initially masqueraded as chronic blepharoconjunctivitis in a 74-year old woman. Her symptoms were unresponsive to medical treatment and a biopsy revealed the underlying malignancy. Sebaceous carcinoma can spread intraepithelially and be difficult to diagnose, often leading to delays in treatment and poorer outcomes. All cases of persistent external ocular inflammation should be thoroughly evaluated to rule out malignancy as an underlying cause.
A Rare Case Of Giant Molluscum Contagiosum Lesion Presenting As Lid Tumor In ...Dr. Jagannath Boramani
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Pediatric Meningiomas- A Case Report and Review of the Literature_ Crimson Pu...Crimsonpublisherssmoaj
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Similar to A Rare Case Of Capillary Haemangioma Of Eyelid In A Child. (20)
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Rate Controlled Drug Delivery Systems, Activation Modulated Drug Delivery Systems, Mechanically activated, pH activated, Enzyme activated, Osmotic activated Drug Delivery Systems, Feedback regulated Drug Delivery Systems systems are discussed here.
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A Rare Case Of Capillary Haemangioma Of Eyelid In A Child.
1. Dr. Sagar Chaudhari ( MS
Ophthalmology)
Dr. Ashutosh Patil ( DOMS, FGO)
Dr. Rohini Waghmare ( Post Graduate
Student)
A rare case of capillary
haemangioma of eyelid in a
child.
2. INTRODUCTION:
Capillary hemangiomas are the most common benign
tumors found in children more commonly in lid.
These tumors show no pattern of inheritance from
either parent , nor specific ethnic or national
preference.1
Capillary hemangiomas are caused by a proliferation
of large, aggregated endothelial cells and
anastomosing blood filled channels.
Spontaneous resolution of the tumor is seen in many
patients. Forty percent resolve by the time a child is
four years old and 70% resolve by the age of seven.2
Many infants are at risk for developing amblyopia,
anisometropia and strabismus.3
3. CASE REPORT:
HISTORY
A nine years old male child presented with a four-
month history of non fluctuating swelling of the
upper lid of right eye.
There is no history of such lesion at the same
site till the present presentation.
Fig- 1
4. EXAMINATION
On examination, A well-defined, soft lesion in the
medial side of right upper eyelid could be
palpated, just below the superior orbital rim,
without associated inflammatory signs.
It measured 0.5x0.5cm and was round to oval in
shape. (see figure 1).
Lid position and extraocular movements were
normal, with examination of anterior and posterior
segment of both eyes revealing no abnormality.
Both eyes had visual acuity 6/6 with intraocular
pressure 17.3mm of Hg.
5. TREATMENT
Considering the fact that its superficial and
accessible location of the lesion, direct surgical
exicision without any local investigation was
planned.
Patient underwent excisional biopsy of the lesion
under general anesthesia (Fig- 2 to 5) and the
mass was sent for histopathology which
conformed the diagnosis of capillary
haemangioma (Fig- 6).
Patients had uneventful post-operative recovery.
There was no recurrence after 6 months.
7. DISCUSSION:
Capillary hemangiomas are the most common
eyelid and orbital tumors of childhood.
This tumor has been referred by many names
(infantile hemangioma, juvenile hemangioma,
hemangioblastoma, benign
hemangioendothelioma, hypertrophic
hemangioma), but is most commonly called
‘capillary hemangioma.’
This term is most common as it accurately
describes the capillary unit structure of
endothelial cells surrounded by pericytes.4
8. These tumors can present as small isolated
lesions, or large masses that can cause visual
impairment, systemic effects, or exist as part of a
syndrome.
Fig- 6
9. Many capillary hemangiomas can be diagnosed
on examination, but occasionally identification
may require the use of ultrasonography,
computed tomography or magnetic resonance
imaging for accurate diagnosis.
Understanding of this tumor, its natural history,
and the indications for treatment are necessary
for management of the tumor and to help the
patient's family understand the disease process.5
This case is unique in being presented for the first
time at nine years of age and without any
recurrence for 6 months after surgical exicision.
11. REFERENCES:
1. Stigmar G, Crawford JS, Ward CM, Thomson HG.
Ophthalmic sequelae of infantile hemangiomas of the
eyelids and orbit. Am J Ophthalmol 1978;93:496-506
2. Aguilar G, Egbert P. Eyelid tumors. Curr Opin
Ophthalmol 1992;3:333-40..
3. Schwartz SR, Blei F, Ceisler E, et al. Risk factors for
amblyopia in children with capillary hemangiomas of the
eyelids and orbit. J AAPOS. 2006;10:262–268.
4. Haik BG, Jakobiec FA, Ellsworth RM, Jones IS.
Capillary hemangioma of the lids and orbit: an analysis of
the clinical features and therapeutic results in 101 cases.
Ophthalmol 1979;86:760-89.
5. Wasserman BN, Medow NB, Homa-Palladino M, Hoehn
ME. Treatment of periocular capillary hemangiomas. J
AAPOS. 2004;8:175–181