1) The document discusses various malignant eyelid tumours including basal cell carcinoma, squamous cell carcinoma, sebaceous gland carcinoma, melanoma, and rare tumours.
2) It describes the clinical features, risk factors, histology, signs and symptoms, and treatment options for each tumour type.
3) Reconstruction after tumour excision depends on the extent of tissue removed and may involve techniques such as direct closure, flaps, or free grafts to reconstruct the posterior or anterior lamellae as needed.
This document discusses various conjunctival tumors including benign and malignant/premalignant tumors. Some key points:
- Benign tumors include conjunctival naevus, papilloma, limbal dermoid, dermolipoma, and pyogenic granuloma.
- Malignant/premalignant tumors include primary acquired melanosis (PAM), conjunctival melanoma, ocular surface squamous neoplasia, and Kaposi sarcoma. PAM can progress to conjunctival melanoma in situ or invasive melanoma.
- Conjunctival melanoma often arises from an area of PAM and has a mortality rate up to 30% from metastasis to lymph nodes, lung
Rhabdomyosarcoma is a malignant mesenchymal tumor with features of skeletal muscle. It is the most common childhood and adolescent soft tissue sarcoma, frequently involving the head and neck in children.
This document provides information on retinal lasers, including their mechanism of action, properties that distinguish them from normal light, types of tissue interaction, parameters that can be adjusted, delivery methods, and applications in treating various retinal conditions. It describes techniques like photocoagulation, photodynamic therapy, and transpupillary thermotherapy; the lasers and parameters used; and indications for treating diseases such as diabetic retinopathy, retinal vein occlusions, and wet age-related macular degeneration.
This document discusses various refractive surgery procedures used to correct refractive errors of the eye, including incisional keratotomy techniques, lamellar procedures, laser ablation procedures, corneal implants, and lens-based procedures. It provides details on common procedures like radial keratotomy, LASIK, PRK, and LASEK. It covers patient evaluation, surgical techniques, potential complications, and advantages of different approaches. Wavefront-guided customized excimer laser surgery is also introduced to correct higher-order aberrations in addition to spherical and cylindrical errors.
This document provides information on tumors of the eyelids, including their classification, anatomical considerations, and management. It discusses benign and malignant tumors, describing key features such as appearance, histopathology, and treatment for various tumor types, including seborrheic keratosis, keratoacanthoma, nevi, basal cell carcinoma, squamous cell carcinoma, and melanoma. It outlines the importance of biopsy for diagnosis and discusses surgical excision, Mohs micrographic surgery, radiotherapy, and cryotherapy as main treatment approaches.
An epiretinal membrane is an avascular fibrocellular membrane that grows on the inner surface of the retina, causing macular dysfunction. It consists of various cell types and collagen. Symptoms include blurry vision and metamorphopsia. Observation is usually sufficient for mild cases, but surgery is recommended for significant vision loss or distortion. Peeling the membrane improves vision in most cases, though cataracts are a common complication. Prognosis is better when pre-op vision is good and the duration of symptoms is short.
This document discusses choroidal coloboma, beginning with definitions and epidemiology. It describes the embryonic development of the eye and how failure of fusion of the embryonic fissure can result in coloboma. Types of coloboma are classified based on location and presence of other anomalies. Complications like retinal detachment are discussed. Management of cataracts and other ocular issues in the context of coloboma are covered. The prognosis depends on factors like presence of microphthalmos, corneal diameter, and type and timing of surgery.
1) The document discusses various malignant eyelid tumours including basal cell carcinoma, squamous cell carcinoma, sebaceous gland carcinoma, melanoma, and rare tumours.
2) It describes the clinical features, risk factors, histology, signs and symptoms, and treatment options for each tumour type.
3) Reconstruction after tumour excision depends on the extent of tissue removed and may involve techniques such as direct closure, flaps, or free grafts to reconstruct the posterior or anterior lamellae as needed.
This document discusses various conjunctival tumors including benign and malignant/premalignant tumors. Some key points:
- Benign tumors include conjunctival naevus, papilloma, limbal dermoid, dermolipoma, and pyogenic granuloma.
- Malignant/premalignant tumors include primary acquired melanosis (PAM), conjunctival melanoma, ocular surface squamous neoplasia, and Kaposi sarcoma. PAM can progress to conjunctival melanoma in situ or invasive melanoma.
- Conjunctival melanoma often arises from an area of PAM and has a mortality rate up to 30% from metastasis to lymph nodes, lung
Rhabdomyosarcoma is a malignant mesenchymal tumor with features of skeletal muscle. It is the most common childhood and adolescent soft tissue sarcoma, frequently involving the head and neck in children.
This document provides information on retinal lasers, including their mechanism of action, properties that distinguish them from normal light, types of tissue interaction, parameters that can be adjusted, delivery methods, and applications in treating various retinal conditions. It describes techniques like photocoagulation, photodynamic therapy, and transpupillary thermotherapy; the lasers and parameters used; and indications for treating diseases such as diabetic retinopathy, retinal vein occlusions, and wet age-related macular degeneration.
This document discusses various refractive surgery procedures used to correct refractive errors of the eye, including incisional keratotomy techniques, lamellar procedures, laser ablation procedures, corneal implants, and lens-based procedures. It provides details on common procedures like radial keratotomy, LASIK, PRK, and LASEK. It covers patient evaluation, surgical techniques, potential complications, and advantages of different approaches. Wavefront-guided customized excimer laser surgery is also introduced to correct higher-order aberrations in addition to spherical and cylindrical errors.
This document provides information on tumors of the eyelids, including their classification, anatomical considerations, and management. It discusses benign and malignant tumors, describing key features such as appearance, histopathology, and treatment for various tumor types, including seborrheic keratosis, keratoacanthoma, nevi, basal cell carcinoma, squamous cell carcinoma, and melanoma. It outlines the importance of biopsy for diagnosis and discusses surgical excision, Mohs micrographic surgery, radiotherapy, and cryotherapy as main treatment approaches.
An epiretinal membrane is an avascular fibrocellular membrane that grows on the inner surface of the retina, causing macular dysfunction. It consists of various cell types and collagen. Symptoms include blurry vision and metamorphopsia. Observation is usually sufficient for mild cases, but surgery is recommended for significant vision loss or distortion. Peeling the membrane improves vision in most cases, though cataracts are a common complication. Prognosis is better when pre-op vision is good and the duration of symptoms is short.
This document discusses choroidal coloboma, beginning with definitions and epidemiology. It describes the embryonic development of the eye and how failure of fusion of the embryonic fissure can result in coloboma. Types of coloboma are classified based on location and presence of other anomalies. Complications like retinal detachment are discussed. Management of cataracts and other ocular issues in the context of coloboma are covered. The prognosis depends on factors like presence of microphthalmos, corneal diameter, and type and timing of surgery.
The document discusses various types of orbital tumours and pathologies. It describes three main intraorbital spaces - intraconal, conal and extraconal - and examples of pathologies that can occur in each space. It provides details on orbital lymphoma, rhabdomyosarcoma, orbital metastasis and dermoid cysts. For each condition, it outlines clinical features, location in the orbit, radiological features on CT and MRI such as signal characteristics, enhancement patterns and appearance. Common primary cancers that metastasize to the orbit are also listed.
This document provides information on lacrimal gland tumors, including:
1) Lacrimal gland tumors typically present with upper eyelid fullness, alteration of the eyelid contour, and downward displacement of the globe. They can be either epithelial or non-epithelial tumors.
2) Epithelial tumors include pleomorphic adenoma (the most common), adenoid cystic carcinoma, and adenocarcinoma. Pleomorphic adenomas are usually benign but can become malignant. Adenoid cystic carcinoma often invades surrounding bone.
3) Treatment involves complete surgical removal with postoperative radiation for malignant or invasive tumors. Prognosis depends on tumor type, with adenocarcinomas having
Angioid streaks are cracks in Bruch's membrane that were first described in 1889. They are typically bilateral and radiate out from the optic disc in a cruciate pattern. The cracks are caused by calcification and degradation of Bruch's membrane. The most common complication is choroidal neovascularization, which can cause vision loss if untreated. Modern treatments with anti-VEGF agents have shown promise in preventing scarring and vision loss from neovascularization in angioid streaks.
Diabetic retinopathy is damage to the blood vessels of the retina due to diabetes. A study compared the standard treatment of pan-retinal photocoagulation (PRP) to initial treatment with intravitreal anti-VEGF injections (ranibizumab) to delay or prevent the need for PRP. At 2 years, vision was maintained or improved in the ranibizumab group while vision remained unchanged in the PRP group. The study suggests initial treatment of proliferative diabetic retinopathy with anti-VEGF injections like ranibizumab may be as effective as immediate PRP treatment and could help delay or reduce the need for destructive PRP therapy.
This document discusses intermittent exotropia, including its theories, presentation, examination, classification, treatment, and surgical management. The key points are:
1. Intermittent exotropia is thought to be caused by an imbalance between convergence and divergence muscles. It typically begins as exophoria in infancy and progresses to intermittent exotropia.
2. Examination includes measuring the deviation at distance and near with and without lenses to classify the type. Non-surgical treatment aims to improve vergence control through patching, lenses, and orthoptics.
3. Surgical treatment is indicated for deviations over 20 prism diopters, worsening control, or failure of conservative therapy.
Specular microscopy is used to examine the corneal endothelium and analyze pathological changes. There are contact and non-contact types, with contact providing higher resolution but potential discomfort. The procedure involves placing the patient comfortably and using fixation to keep the eye still while obtaining images. Images are then analyzed to study normal endothelium morphology, diagnose corneal endothelial diseases, and monitor conditions like aging, diabetes, surgery, trauma, and compare surgical techniques. Specular microscopy can detect disorders like Fuchs' endothelial dystrophy and help with decisions like eye banking and surgery.
Macular hole is a defect in the macula involving its full thickness. It was first described in 1869. Idiopathic macular holes are the most common type and affect people over age 55. Staging of macular holes ranges from stage 1 to 4 based on size and pathology. Symptoms include decreased vision and metamorphopsia. Diagnosis involves examination, OCT, and sometimes FA. Treatment is usually vitrectomy surgery for stages 2-4 to relieve traction on the macula. Prognosis depends on pre-op vision and hole size/duration, with most patients gaining vision after surgery.
The Amsler grid is a test to qualitatively assess the central 10 degrees of vision. It consists of a grid of white lines on a black background. Patients are asked to report any missing or distorted lines when fixating on a central dot. Abnormal findings may indicate macular diseases like age-related macular degeneration. The test is performed monocularly at 30 cm with an appropriate near correction to check for relative scotomas, absolute scotomas, metamorphopsia, and other visual disturbances in the macula. Various chart types and recording methods exist to accurately document any defects found during testing.
Optical coherence tomography in glaucoma - Dr Shylesh DabkeShylesh Dabke
This document discusses optical coherence tomography (OCT) in evaluating glaucoma. It begins by outlining the importance of early glaucoma detection to prevent vision loss. OCT is described as the most appropriate technology for detecting glaucoma as it can assess retinal nerve fiber layer (RNFL) thickness before visual field or optic disc changes occur. RNFL thinning is an early sign of glaucoma. The document then provides details on OCT technology and analysis of RNFL thickness, optic nerve head, and macula to diagnose and monitor glaucoma. RNFL analysis, especially of the inferior quadrant, is highlighted as the most useful OCT assessment for detecting early glaucoma.
Coloboma is a congenital defect caused by the failure of the fetal fissure to close during eye development between weeks 5-7 of gestation. It can affect various eye structures traversed by the fetal fissure, most commonly the iris, choroid, retina, and optic nerve. Coloboma is classified as typical (inferonasal quadrant) or atypical (elsewhere). It may be isolated or associated with syndromes like CHARGE. Treatment depends on the site and severity but may include lubricants, patching, or reconstructive eyelid surgery to address issues like exposure. Prognosis relates to the structures involved and presence of other ocular or systemic abnormalities.
Orbital tumors can be primary, secondary, or metastatic in origin. The most common malignant orbital tumor in adults is lymphoma, which typically involves the lacrimal gland. Malignant melanoma of the uvea is also relatively common and can arise in the iris, ciliary body, or choroid. Treatment options depend on the type and size of the tumor but may include surgery, radiation therapy such as plaque brachytherapy, proton beam therapy, or stereotactic radiotherapy. Complications can include vision loss, glaucoma, and cataracts.
1. Monocular elevation deficiency (MED), also known as double elevator palsy, is characterized by an inability to elevate one eye in all fields of gaze, resulting in hypotropia of the affected eye.
2. The condition can be congenital or acquired, with causes including superior rectus palsy, inferior rectus restriction, and supranuclear lesions.
3. Surgical management of MED depends on forced duction test results and may include inferior rectus recession, superior rectus resection, or Knapp's procedure to transpose the horizontal rectus muscles. The goal is to improve eye position and increase binocular vision.
Microtropia - Definition, Types and Shot NoteMero Eye
Microtropia is a small-angle strabismus less than 6-8 PD that is difficult to detect on cover test. It is also known as monofixation syndrome. There are three types based on fixation pattern. Microtropia can be caused by residual strabismus, anisometropia, foveal lesions, heredity, or amblyopia. Clinical features include a foveal scotoma, mild amblyopia, parafoveal eccentric fixation, and low-level stereoacuity between 60-3000 seconds of arc. Investigations include visual acuity tests, cover test, four prism diopter test, Amsler charts, Bagolini
This document provides an evaluation of proptosis (abnormal protrusion of the eyeball) through a detailed algorithm and assessment process. It begins by defining key terms like exophthalmos and differentiating causes of proptosis. The evaluation involves a thorough history, eye examination measuring proptosis, assessing any mass, and appropriate imaging and tests. Causes of proptosis are classified as infectious, inflammatory, vascular, traumatic, pseudoproptosis, or neoplastic. Key imaging modalities like CT are discussed. Common etiologies like Graves' disease, infections, and tumors are highlighted.
Real pediatric refraction and spectacle power prescription in pediatrics.Bipin Koirala
The document discusses pediatric refraction and spectacle prescription. It covers several topics including emmetropization, refractive changes with age, types of pediatric refraction such as near retinoscopy and cycloplegic refraction, and considerations for spectacle prescription in children. Cycloplegic refraction is recommended for all non-verbal children to fully paralyze the ciliary muscles and determine the total refractive error, as the eye's refraction can change dramatically during development. The challenges of pediatric refraction include a child's ability to accommodate and their lack of cooperation, emphasizing the need for objective refraction techniques.
Fuchs dystrophy and pseudophakic bullous keratopathyunleng
This document discusses Fuchs endothelial dystrophy and pseudophakic bullous keratopathy. It describes the characteristics, classification, pathology, signs, and treatment of Fuchs endothelial dystrophy. It also covers the etiology, clinical features, evaluation techniques including specular microscopy and pachymetry, and management including corneal transplant and conjunctival flap procedures for pseudophakic bullous keratopathy resulting from traumatic endothelial damage following cataract surgery.
This document summarizes acute retinal necrosis (ARN), a rare viral infection of the retina. It begins by describing the initial 1971 case report and clinical features of ARN, which include anterior uveitis, vitritis, and characteristic retinal lesions. The document then discusses the epidemiology, diagnostic criteria, etiology as herpes virus, and treatment with antivirals like acyclovir. It also briefly mentions a more severe variant, progressive outer retinal necrosis (PORN), which mostly affects immunocompromised patients and has a poor prognosis.
The document describes the Hess screen test procedure and principles for evaluating eye muscle function and diagnosing ocular motility disorders. Key points covered include how the test is performed, what different Hess chart presentations indicate in terms of muscle underaction and overaction, and how the test can be used to measure deviations and assess conditions over time.
This document discusses the use of lasers in the treatment of glaucoma. It begins by introducing different types of lasers used, including Nd:YAG lasers. It then covers specific laser procedures for glaucoma such as laser iridotomy to relieve pupillary block, laser iridoplasty to modify the iris, and laser trabeculoplasty to increase outflow. It compares argon laser trabeculoplasty to selective laser trabeculoplasty. The document also discusses laser techniques for angle closure glaucoma, post-operative treatment, and cyclophotocoagulation to reduce aqueous production. Throughout, it provides details on laser parameters and outcomes of these procedures.
This document provides information about tumors of the eye. It discusses various types of benign and malignant tumors that can occur in different parts of the eye, including the orbit, lacrimal gland, eyelids, conjunctiva, uveal tract, and retina. For each tumor type, it describes the classification (benign vs malignant), common sites of occurrence, signs and symptoms, diagnostic evaluation, and treatment approaches. For example, it explains that choroidal melanoma is the most common primary malignant tumor of the uveal tract, often appearing initially as an asymptomatic elevated pigmented mass, and treatment may involve plaque radiotherapy, enucleation, or charged particle radiation depending on tumor characteristics and prognosis. The document aims to
The document discusses various types of orbital tumours and pathologies. It describes three main intraorbital spaces - intraconal, conal and extraconal - and examples of pathologies that can occur in each space. It provides details on orbital lymphoma, rhabdomyosarcoma, orbital metastasis and dermoid cysts. For each condition, it outlines clinical features, location in the orbit, radiological features on CT and MRI such as signal characteristics, enhancement patterns and appearance. Common primary cancers that metastasize to the orbit are also listed.
This document provides information on lacrimal gland tumors, including:
1) Lacrimal gland tumors typically present with upper eyelid fullness, alteration of the eyelid contour, and downward displacement of the globe. They can be either epithelial or non-epithelial tumors.
2) Epithelial tumors include pleomorphic adenoma (the most common), adenoid cystic carcinoma, and adenocarcinoma. Pleomorphic adenomas are usually benign but can become malignant. Adenoid cystic carcinoma often invades surrounding bone.
3) Treatment involves complete surgical removal with postoperative radiation for malignant or invasive tumors. Prognosis depends on tumor type, with adenocarcinomas having
Angioid streaks are cracks in Bruch's membrane that were first described in 1889. They are typically bilateral and radiate out from the optic disc in a cruciate pattern. The cracks are caused by calcification and degradation of Bruch's membrane. The most common complication is choroidal neovascularization, which can cause vision loss if untreated. Modern treatments with anti-VEGF agents have shown promise in preventing scarring and vision loss from neovascularization in angioid streaks.
Diabetic retinopathy is damage to the blood vessels of the retina due to diabetes. A study compared the standard treatment of pan-retinal photocoagulation (PRP) to initial treatment with intravitreal anti-VEGF injections (ranibizumab) to delay or prevent the need for PRP. At 2 years, vision was maintained or improved in the ranibizumab group while vision remained unchanged in the PRP group. The study suggests initial treatment of proliferative diabetic retinopathy with anti-VEGF injections like ranibizumab may be as effective as immediate PRP treatment and could help delay or reduce the need for destructive PRP therapy.
This document discusses intermittent exotropia, including its theories, presentation, examination, classification, treatment, and surgical management. The key points are:
1. Intermittent exotropia is thought to be caused by an imbalance between convergence and divergence muscles. It typically begins as exophoria in infancy and progresses to intermittent exotropia.
2. Examination includes measuring the deviation at distance and near with and without lenses to classify the type. Non-surgical treatment aims to improve vergence control through patching, lenses, and orthoptics.
3. Surgical treatment is indicated for deviations over 20 prism diopters, worsening control, or failure of conservative therapy.
Specular microscopy is used to examine the corneal endothelium and analyze pathological changes. There are contact and non-contact types, with contact providing higher resolution but potential discomfort. The procedure involves placing the patient comfortably and using fixation to keep the eye still while obtaining images. Images are then analyzed to study normal endothelium morphology, diagnose corneal endothelial diseases, and monitor conditions like aging, diabetes, surgery, trauma, and compare surgical techniques. Specular microscopy can detect disorders like Fuchs' endothelial dystrophy and help with decisions like eye banking and surgery.
Macular hole is a defect in the macula involving its full thickness. It was first described in 1869. Idiopathic macular holes are the most common type and affect people over age 55. Staging of macular holes ranges from stage 1 to 4 based on size and pathology. Symptoms include decreased vision and metamorphopsia. Diagnosis involves examination, OCT, and sometimes FA. Treatment is usually vitrectomy surgery for stages 2-4 to relieve traction on the macula. Prognosis depends on pre-op vision and hole size/duration, with most patients gaining vision after surgery.
The Amsler grid is a test to qualitatively assess the central 10 degrees of vision. It consists of a grid of white lines on a black background. Patients are asked to report any missing or distorted lines when fixating on a central dot. Abnormal findings may indicate macular diseases like age-related macular degeneration. The test is performed monocularly at 30 cm with an appropriate near correction to check for relative scotomas, absolute scotomas, metamorphopsia, and other visual disturbances in the macula. Various chart types and recording methods exist to accurately document any defects found during testing.
Optical coherence tomography in glaucoma - Dr Shylesh DabkeShylesh Dabke
This document discusses optical coherence tomography (OCT) in evaluating glaucoma. It begins by outlining the importance of early glaucoma detection to prevent vision loss. OCT is described as the most appropriate technology for detecting glaucoma as it can assess retinal nerve fiber layer (RNFL) thickness before visual field or optic disc changes occur. RNFL thinning is an early sign of glaucoma. The document then provides details on OCT technology and analysis of RNFL thickness, optic nerve head, and macula to diagnose and monitor glaucoma. RNFL analysis, especially of the inferior quadrant, is highlighted as the most useful OCT assessment for detecting early glaucoma.
Coloboma is a congenital defect caused by the failure of the fetal fissure to close during eye development between weeks 5-7 of gestation. It can affect various eye structures traversed by the fetal fissure, most commonly the iris, choroid, retina, and optic nerve. Coloboma is classified as typical (inferonasal quadrant) or atypical (elsewhere). It may be isolated or associated with syndromes like CHARGE. Treatment depends on the site and severity but may include lubricants, patching, or reconstructive eyelid surgery to address issues like exposure. Prognosis relates to the structures involved and presence of other ocular or systemic abnormalities.
Orbital tumors can be primary, secondary, or metastatic in origin. The most common malignant orbital tumor in adults is lymphoma, which typically involves the lacrimal gland. Malignant melanoma of the uvea is also relatively common and can arise in the iris, ciliary body, or choroid. Treatment options depend on the type and size of the tumor but may include surgery, radiation therapy such as plaque brachytherapy, proton beam therapy, or stereotactic radiotherapy. Complications can include vision loss, glaucoma, and cataracts.
1. Monocular elevation deficiency (MED), also known as double elevator palsy, is characterized by an inability to elevate one eye in all fields of gaze, resulting in hypotropia of the affected eye.
2. The condition can be congenital or acquired, with causes including superior rectus palsy, inferior rectus restriction, and supranuclear lesions.
3. Surgical management of MED depends on forced duction test results and may include inferior rectus recession, superior rectus resection, or Knapp's procedure to transpose the horizontal rectus muscles. The goal is to improve eye position and increase binocular vision.
Microtropia - Definition, Types and Shot NoteMero Eye
Microtropia is a small-angle strabismus less than 6-8 PD that is difficult to detect on cover test. It is also known as monofixation syndrome. There are three types based on fixation pattern. Microtropia can be caused by residual strabismus, anisometropia, foveal lesions, heredity, or amblyopia. Clinical features include a foveal scotoma, mild amblyopia, parafoveal eccentric fixation, and low-level stereoacuity between 60-3000 seconds of arc. Investigations include visual acuity tests, cover test, four prism diopter test, Amsler charts, Bagolini
This document provides an evaluation of proptosis (abnormal protrusion of the eyeball) through a detailed algorithm and assessment process. It begins by defining key terms like exophthalmos and differentiating causes of proptosis. The evaluation involves a thorough history, eye examination measuring proptosis, assessing any mass, and appropriate imaging and tests. Causes of proptosis are classified as infectious, inflammatory, vascular, traumatic, pseudoproptosis, or neoplastic. Key imaging modalities like CT are discussed. Common etiologies like Graves' disease, infections, and tumors are highlighted.
Real pediatric refraction and spectacle power prescription in pediatrics.Bipin Koirala
The document discusses pediatric refraction and spectacle prescription. It covers several topics including emmetropization, refractive changes with age, types of pediatric refraction such as near retinoscopy and cycloplegic refraction, and considerations for spectacle prescription in children. Cycloplegic refraction is recommended for all non-verbal children to fully paralyze the ciliary muscles and determine the total refractive error, as the eye's refraction can change dramatically during development. The challenges of pediatric refraction include a child's ability to accommodate and their lack of cooperation, emphasizing the need for objective refraction techniques.
Fuchs dystrophy and pseudophakic bullous keratopathyunleng
This document discusses Fuchs endothelial dystrophy and pseudophakic bullous keratopathy. It describes the characteristics, classification, pathology, signs, and treatment of Fuchs endothelial dystrophy. It also covers the etiology, clinical features, evaluation techniques including specular microscopy and pachymetry, and management including corneal transplant and conjunctival flap procedures for pseudophakic bullous keratopathy resulting from traumatic endothelial damage following cataract surgery.
This document summarizes acute retinal necrosis (ARN), a rare viral infection of the retina. It begins by describing the initial 1971 case report and clinical features of ARN, which include anterior uveitis, vitritis, and characteristic retinal lesions. The document then discusses the epidemiology, diagnostic criteria, etiology as herpes virus, and treatment with antivirals like acyclovir. It also briefly mentions a more severe variant, progressive outer retinal necrosis (PORN), which mostly affects immunocompromised patients and has a poor prognosis.
The document describes the Hess screen test procedure and principles for evaluating eye muscle function and diagnosing ocular motility disorders. Key points covered include how the test is performed, what different Hess chart presentations indicate in terms of muscle underaction and overaction, and how the test can be used to measure deviations and assess conditions over time.
This document discusses the use of lasers in the treatment of glaucoma. It begins by introducing different types of lasers used, including Nd:YAG lasers. It then covers specific laser procedures for glaucoma such as laser iridotomy to relieve pupillary block, laser iridoplasty to modify the iris, and laser trabeculoplasty to increase outflow. It compares argon laser trabeculoplasty to selective laser trabeculoplasty. The document also discusses laser techniques for angle closure glaucoma, post-operative treatment, and cyclophotocoagulation to reduce aqueous production. Throughout, it provides details on laser parameters and outcomes of these procedures.
This document provides information about tumors of the eye. It discusses various types of benign and malignant tumors that can occur in different parts of the eye, including the orbit, lacrimal gland, eyelids, conjunctiva, uveal tract, and retina. For each tumor type, it describes the classification (benign vs malignant), common sites of occurrence, signs and symptoms, diagnostic evaluation, and treatment approaches. For example, it explains that choroidal melanoma is the most common primary malignant tumor of the uveal tract, often appearing initially as an asymptomatic elevated pigmented mass, and treatment may involve plaque radiotherapy, enucleation, or charged particle radiation depending on tumor characteristics and prognosis. The document aims to
Retinoblastoma is a rare eye cancer that affects children. It is caused by mutations in the RB1 tumor suppressor gene. There are two main types - sporadic which occurs spontaneously, and hereditary which is inherited. Treatment depends on tumor size and extent, and may include chemotherapy, laser therapy, cryotherapy, plaque brachytherapy, or enucleation of the eye for large tumors. The goal is to save vision if possible or life if the eye cannot be saved. Screening of family members is important given the hereditary risk.
The document describes the steps for examining an eyelid mass, including inspection and palpation to evaluate characteristics like shape, size, color, texture, and mobility. It then covers the anatomy and types of benign and malignant eyelid lesions. Common benign lesions include seborrheic keratosis, actinic keratosis, melanocytic nevi, dermoid cysts, and chalazia. Malignant lesions include basal cell carcinoma and melanoma. Surgical excision is a common treatment, while some lesions may be observed or treated with cryotherapy, laser, or radiation.
Retinoblastoma for undergraduate MBBS Students.
Covers the basics of Aetiology, Genetics, pathophysiology, clinical features, Classification and management of Retinoblastoma.
Also encompasses salient points for PGMEE
Ocular tumors can arise in the eyelids, eye, and orbit. Early diagnosis is important to preserve vision and life. There are several types of benign and malignant tumors, including tumors of the orbit, eyelids, conjunctiva, uveal tract, and retina. Common orbital tumors are dermoid cysts, rhabdomyosarcoma, and orbital metastases. Eyelid tumors include basal cell carcinoma, squamous cell carcinoma, and sebaceous carcinoma. Conjunctival tumors include naevi, papilloma, primary acquired melanosis, and melanoma. Intraocular tumors involve the iris, ciliary body, and choroid, such as melanomas.
This document provides an overview of choroidal melanoma, including its diagnosis, differential diagnosis, classification, investigations, treatment, and prognosis. Choroidal melanoma is the most common primary intraocular malignancy in adults. Key points include that it typically presents in individuals around age 60 and can be diagnosed based on its appearance on ophthalmic examination. Investigations like ultrasound and genetic testing help determine prognosis, with larger tumor size and certain genetic profiles associated with higher risks of metastasis. Treatment may include radiotherapy, thermotherapy, or enucleation depending on the characteristics and size of the tumor.
Retinoblastoma is a rapidly developing cancer of the retina that mostly affects young children. It can be hereditary, arising from a genetic mutation, or non-hereditary. Clinical features include a white pupil reflex or leukocoria. Diagnosis involves eye examination and imaging tests. Treatment depends on tumor stage but may include chemotherapy, radiation therapy, cryotherapy, or eye removal. Close monitoring of family members is needed if hereditary to screen for the condition.
The document summarizes malignant intraocular tumors, focusing on retinoblastoma. It discusses retinoblastoma genetics, clinical features, diagnosis, staging, and treatment. Retinoblastoma is the most common intraocular malignancy in children, caused by deletion of the RB1 tumor suppressor gene. Clinical features include leukocoria. Diagnosis involves ophthalmic examination, imaging like CT/MRI, and histopathology showing Flexner-Wintersteiner rosettes. Staging systems include Reese-Ellsworth and the International Classification. Treatment depends on staging and includes focal therapies, chemotherapy, radiation, and enucleation. The goal is survival while retaining eyes and vision when possible
Retinoblastoma is a type of eye tumor which can run in families. This ppt explains different types of Retinoblastomas , their treatments and possible outcomes. This can be a useful guide in eye research.
Retinoblastoma - Diagnosis and Management Presentationdocumesh
This document provides an overview of retinoblastoma, a rare eye cancer that affects children. It discusses the following key points:
- Retinoblastoma is the most common eye cancer in children. It is caused by mutations in the RB1 tumor suppressor gene.
- Presenting symptoms often include leukocoria (white pupil reflex) or strabismus. Diagnosis is usually made through ultrasound, MRI, CT scan, or histopathology.
- Treatment depends on factors like tumor stage and genetics. Options include focal therapies like cryotherapy or thermotherapy, external beam radiation, chemotherapy, and enucleation. The goal is usually tumor control while preserving vision and the eye.
This document discusses craniopharyngioma and vestibular schwannoma. It provides details on the epidemiology, pathology, clinical presentation, investigations, treatment and complications of craniopharyngioma. It discusses the various treatment options for craniopharyngioma including surgical resection with or without radiotherapy. It also discusses vestibular schwannoma including its epidemiology, pathology, clinical features, investigations and treatment options such as surgery and radiotherapy.
This document discusses various retinal and choroidal conditions that can be evaluated with head and neck imaging. It describes the imaging appearance of retinal detachments, choroidal detachments, retinoblastoma, Coats disease, persistent hyperplastic primary vitreous, ocular larva migrans, and retinopathy of prematurity. Key findings discussed include the presence or absence of calcifications, retinal detachment, subretinal fluid, globe size abnormalities, and enhancement patterns. Imaging with CT, MRI, and ultrasound can help differentiate these conditions.
This document provides a classification and overview of ocular surface squamous neoplasia (OSSN). It discusses the epidemiology, etiology, clinical features, diagnosis, treatment and management of OSSN. Key points include:
- OSSN refers to the spectrum of pre-invasive and malignant squamous lesions of the conjunctiva and cornea.
- Risk factors include UV light exposure, HPV infection, HIV/AIDS, and vitamin A deficiency.
- Clinical features may include growths or thickened patches over the ocular surface. Diagnosis involves cytology, biopsy and histopathological examination.
- Treatment depends on size and invasiveness but may include surgical excision, cryotherapy
Retinoblastoma is a rare cancer that affects the retina. It is caused by mutations in the RB1 gene. There are two main types - hereditary retinoblastoma, which requires only one mutation, and sporadic retinoblastoma, which requires two mutations. Symptoms include leukocoria. Diagnosis involves ophthalmoscopy, imaging like ultrasound and MRI, and sometimes biopsy. Treatment depends on factors like tumor size and location, and may include focal therapies like cryotherapy, chemotherapy, external beam radiation, plaque brachytherapy, or enucleation of the eye. Prognosis depends on extent of disease and risk of metastasis.
1. The document discusses craniopharyngioma and vestibular schwannoma, two types of brain tumors.
2. Craniopharyngiomas arise from epithelial remnants of the Rathke's pouch and commonly present with symptoms of increased intracranial pressure and endocrine dysfunction. Complete surgical resection is the primary treatment when possible.
3. Vestibular schwannomas originate from the vestibular nerve and typically present with hearing loss and tinnitus. Surgical resection or stereotactic radiosurgery are the main treatment options depending on tumor size and location.
1. Dysthyroid eye disease, or Graves' ophthalmopathy, is an autoimmune disorder where the eyes and surrounding tissues become inflamed and swollen. It is commonly associated with Graves' disease and hyperthyroidism.
2. The causes are not fully understood but involve an autoimmune reaction affecting the muscles and fatty tissues around the eyes.
3. Treatment depends on the severity but may include lubricating eye drops, orbital decompression surgery, radiation therapy, or steroids to reduce swelling and inflammation.
presentation on intraolcular tumors including detailed explaination on their pathology diagnosis and treatment including details of retinoblastoma. enucleation
Dr. Renesha Islam and Dr. Farzana Alam Mou presented on retinoblastoma. The presentation included an overview of retinoblastoma including its: anatomy and histology; classification based on laterality, focality, heredity, family history and growth pattern; genetics involving mutations in the RB1 gene; clinical presentations; investigations including examination under anesthesia and imaging; treatment options; and prognosis. Retinoblastoma is a malignant tumor of the retina that predominantly affects young children.
LAND USE LAND COVER AND NDVI OF MIRZAPUR DISTRICT, UPRAHUL
This Dissertation explores the particular circumstances of Mirzapur, a region located in the
core of India. Mirzapur, with its varied terrains and abundant biodiversity, offers an optimal
environment for investigating the changes in vegetation cover dynamics. Our study utilizes
advanced technologies such as GIS (Geographic Information Systems) and Remote sensing to
analyze the transformations that have taken place over the course of a decade.
The complex relationship between human activities and the environment has been the focus
of extensive research and worry. As the global community grapples with swift urbanization,
population expansion, and economic progress, the effects on natural ecosystems are becoming
more evident. A crucial element of this impact is the alteration of vegetation cover, which plays a
significant role in maintaining the ecological equilibrium of our planet.Land serves as the foundation for all human activities and provides the necessary materials for
these activities. As the most crucial natural resource, its utilization by humans results in different
'Land uses,' which are determined by both human activities and the physical characteristics of the
land.
The utilization of land is impacted by human needs and environmental factors. In countries
like India, rapid population growth and the emphasis on extensive resource exploitation can lead
to significant land degradation, adversely affecting the region's land cover.
Therefore, human intervention has significantly influenced land use patterns over many
centuries, evolving its structure over time and space. In the present era, these changes have
accelerated due to factors such as agriculture and urbanization. Information regarding land use and
cover is essential for various planning and management tasks related to the Earth's surface,
providing crucial environmental data for scientific, resource management, policy purposes, and
diverse human activities.
Accurate understanding of land use and cover is imperative for the development planning
of any area. Consequently, a wide range of professionals, including earth system scientists, land
and water managers, and urban planners, are interested in obtaining data on land use and cover
changes, conversion trends, and other related patterns. The spatial dimensions of land use and
cover support policymakers and scientists in making well-informed decisions, as alterations in
these patterns indicate shifts in economic and social conditions. Monitoring such changes with the
help of Advanced technologies like Remote Sensing and Geographic Information Systems is
crucial for coordinated efforts across different administrative levels. Advanced technologies like
Remote Sensing and Geographic Information Systems
9
Changes in vegetation cover refer to variations in the distribution, composition, and overall
structure of plant communities across different temporal and spatial scales. These changes can
occur natural.
How to Setup Warehouse & Location in Odoo 17 InventoryCeline George
In this slide, we'll explore how to set up warehouses and locations in Odoo 17 Inventory. This will help us manage our stock effectively, track inventory levels, and streamline warehouse operations.
ISO/IEC 27001, ISO/IEC 42001, and GDPR: Best Practices for Implementation and...PECB
Denis is a dynamic and results-driven Chief Information Officer (CIO) with a distinguished career spanning information systems analysis and technical project management. With a proven track record of spearheading the design and delivery of cutting-edge Information Management solutions, he has consistently elevated business operations, streamlined reporting functions, and maximized process efficiency.
Certified as an ISO/IEC 27001: Information Security Management Systems (ISMS) Lead Implementer, Data Protection Officer, and Cyber Risks Analyst, Denis brings a heightened focus on data security, privacy, and cyber resilience to every endeavor.
His expertise extends across a diverse spectrum of reporting, database, and web development applications, underpinned by an exceptional grasp of data storage and virtualization technologies. His proficiency in application testing, database administration, and data cleansing ensures seamless execution of complex projects.
What sets Denis apart is his comprehensive understanding of Business and Systems Analysis technologies, honed through involvement in all phases of the Software Development Lifecycle (SDLC). From meticulous requirements gathering to precise analysis, innovative design, rigorous development, thorough testing, and successful implementation, he has consistently delivered exceptional results.
Throughout his career, he has taken on multifaceted roles, from leading technical project management teams to owning solutions that drive operational excellence. His conscientious and proactive approach is unwavering, whether he is working independently or collaboratively within a team. His ability to connect with colleagues on a personal level underscores his commitment to fostering a harmonious and productive workplace environment.
Date: May 29, 2024
Tags: Information Security, ISO/IEC 27001, ISO/IEC 42001, Artificial Intelligence, GDPR
-------------------------------------------------------------------------------
Find out more about ISO training and certification services
Training: ISO/IEC 27001 Information Security Management System - EN | PECB
ISO/IEC 42001 Artificial Intelligence Management System - EN | PECB
General Data Protection Regulation (GDPR) - Training Courses - EN | PECB
Webinars: https://pecb.com/webinars
Article: https://pecb.com/article
-------------------------------------------------------------------------------
For more information about PECB:
Website: https://pecb.com/
LinkedIn: https://www.linkedin.com/company/pecb/
Facebook: https://www.facebook.com/PECBInternational/
Slideshare: http://www.slideshare.net/PECBCERTIFICATION
Chapter wise All Notes of First year Basic Civil Engineering.pptxDenish Jangid
Chapter wise All Notes of First year Basic Civil Engineering
Syllabus
Chapter-1
Introduction to objective, scope and outcome the subject
Chapter 2
Introduction: Scope and Specialization of Civil Engineering, Role of civil Engineer in Society, Impact of infrastructural development on economy of country.
Chapter 3
Surveying: Object Principles & Types of Surveying; Site Plans, Plans & Maps; Scales & Unit of different Measurements.
Linear Measurements: Instruments used. Linear Measurement by Tape, Ranging out Survey Lines and overcoming Obstructions; Measurements on sloping ground; Tape corrections, conventional symbols. Angular Measurements: Instruments used; Introduction to Compass Surveying, Bearings and Longitude & Latitude of a Line, Introduction to total station.
Levelling: Instrument used Object of levelling, Methods of levelling in brief, and Contour maps.
Chapter 4
Buildings: Selection of site for Buildings, Layout of Building Plan, Types of buildings, Plinth area, carpet area, floor space index, Introduction to building byelaws, concept of sun light & ventilation. Components of Buildings & their functions, Basic concept of R.C.C., Introduction to types of foundation
Chapter 5
Transportation: Introduction to Transportation Engineering; Traffic and Road Safety: Types and Characteristics of Various Modes of Transportation; Various Road Traffic Signs, Causes of Accidents and Road Safety Measures.
Chapter 6
Environmental Engineering: Environmental Pollution, Environmental Acts and Regulations, Functional Concepts of Ecology, Basics of Species, Biodiversity, Ecosystem, Hydrological Cycle; Chemical Cycles: Carbon, Nitrogen & Phosphorus; Energy Flow in Ecosystems.
Water Pollution: Water Quality standards, Introduction to Treatment & Disposal of Waste Water. Reuse and Saving of Water, Rain Water Harvesting. Solid Waste Management: Classification of Solid Waste, Collection, Transportation and Disposal of Solid. Recycling of Solid Waste: Energy Recovery, Sanitary Landfill, On-Site Sanitation. Air & Noise Pollution: Primary and Secondary air pollutants, Harmful effects of Air Pollution, Control of Air Pollution. . Noise Pollution Harmful Effects of noise pollution, control of noise pollution, Global warming & Climate Change, Ozone depletion, Greenhouse effect
Text Books:
1. Palancharmy, Basic Civil Engineering, McGraw Hill publishers.
2. Satheesh Gopi, Basic Civil Engineering, Pearson Publishers.
3. Ketki Rangwala Dalal, Essentials of Civil Engineering, Charotar Publishing House.
4. BCP, Surveying volume 1
How to Manage Your Lost Opportunities in Odoo 17 CRMCeline George
Odoo 17 CRM allows us to track why we lose sales opportunities with "Lost Reasons." This helps analyze our sales process and identify areas for improvement. Here's how to configure lost reasons in Odoo 17 CRM
This slide is special for master students (MIBS & MIFB) in UUM. Also useful for readers who are interested in the topic of contemporary Islamic banking.
Main Java[All of the Base Concepts}.docxadhitya5119
This is part 1 of my Java Learning Journey. This Contains Custom methods, classes, constructors, packages, multithreading , try- catch block, finally block and more.
Strategies for Effective Upskilling is a presentation by Chinwendu Peace in a Your Skill Boost Masterclass organisation by the Excellence Foundation for South Sudan on 08th and 09th June 2024 from 1 PM to 3 PM on each day.
Beyond Degrees - Empowering the Workforce in the Context of Skills-First.pptxEduSkills OECD
Iván Bornacelly, Policy Analyst at the OECD Centre for Skills, OECD, presents at the webinar 'Tackling job market gaps with a skills-first approach' on 12 June 2024
RHEOLOGY Physical pharmaceutics-II notes for B.pharm 4th sem students
Childhood ocular tumor
1. CHILDHOOD OCULAR TUMOR
AND MANAGEMENT
Dr. Md. Almas Hossain
Associate Professor
Department of Ophthalmology
Sylhet MAG Osmani Medical College.
2. Childhood Ocular Tumors
► Intra or Extra ocular (Orbit & Lid) .
► May be benign or malignant .
► Benign tumors are much more common than malignant
tumors.
► Many tumors of childhood show variable qualities and
sometimes difficult to categories .
► The overall incidence of childhood ocular malignancy is
more during the first five years of life.
3. Common presentations of childhood
ocular tumors
• Swelling and discoloration of eye lids.
• Proptosis or other displacement of the globe.
• Ptosis.
• Strabismus (squint).
• Impairment of vision.
4. Primary malignant neoplasm
► Arises from orbital tissue elements e.g. – Sarcomas
(Rhabdomyosarcoma).
► Tumors of epithelial origin e.g. – Ca. of Lacrimal
glands.
5. RHABDOMYOSARCOMA
• Most common primary paediatric orbital malignancy.
• Average age of onset is 5 – 7 yrs.
• 5% before the age of 1 yr.
• 15% after 10 yrs.
• 90% occurs before the age of 16 yrs.
• Prognosis – good if treated properly.
7. C/F of Rhabdomyosarcoma
Proptosis – developed rapidly (within few days).
Ptosis & squinting also common.
Differential Diagnosis:
● Orbital cellulites.
● Granulocytic sarcoma.
CT & MRI – Irregular but well circumscribed mass of
uniform density.
Biopsy is required for the confirmation.
9. Treatment of Rhabdomyosarcoma
Small encapsulated or well localized Rhabdomyosarcoma
should be totally excised.
For larger & more extensive cases – Chemo & radiotherapy.
► The prognosis depends on the stage & location of disease
at the time of diagnosis.
● Patients with tumors localized to the orbit have approximate
95% cure rate.
10. CHILDHOOD METASTATIC TUMORS
Neuroblastoma
► Most common childhood cancer.
► Frequent source of orbital metastasis.
► Originates in either adrenal gland or sympathetic ganglion chain in the
retroperitoneal mediastinum.
► Metastatic Neuroblastoma in the orbit typically produces proptosis, &
periorbital ecchymosis.
► CT – shows evidence of bone destruction.
► With intensive treatment including radio & chemotherapy prognosis is
considerably better in infants under the age of 1 yr. than older children.
12. Wilms Tumor
► Though most common childhood cancer but rarely
metastasizes from the kidney to orbit.
Leukemia
► Most common malignancy of childhood.
► Leukemic cells causing proptosis, lid swelling &
ecchymosis. If infiltration of the optic nerve by leukemic
cells may cause papilloedema even loss of vision.
13. CHILDHOOD BENIGN ORBITAL TUMORS
Capillary Haemangioma:
► Most common benign orbital & periorbital tumors in
childhood.
► Female child more affected than male child (2:1).
► Skin has a characterized raised , red dimpled appearance
(strawberry nevus).
► 90% are recognized by the age of 6 month.
14. Cont-2 (Capillary Haemangioma)
► Maximum size usually raised between 6 to 12 months of age.
► Spontaneous involution begins during the second year of life.
► Regression is about 40% by the age of 4 yrs & 80% by age
of 8 yrs.
► Approximately half of the children with eyelid & orbital
haemangioma develop some degree of amblyopia resulting
form anisometropic astigmatism.
16. LYMPHANGIOMA
► Most common orbital tumor of vascular origin is childhood.
► Lesion consists largely of lymph filled channels lined by endothelium.
► Complete excision is difficult.
No treatment is indicated when the only symptom is mild
proptosis. Surgical evacuation should be considered when CT
or MRI shows large blood filled cavities indicating acute
hemorrhagic deterioration.
19. TREATMENT OF CHILDHOOD BENIGN
ORBITAL TUMORS
Indication:
■ To prevent development of amblyopia.
■ To prevent optic nerve compression.
■ To prevent exposure keratopathy.
Treatment Method:
► Intralesional injection of corticosteroids 1-2ml of short &
long acting agents (Betamethasone 6mg/ml and
Triamcinolone 40mg/ml) combined 1:1 mixture.
► Oral Corticosteroids (Prednisolone 2mg/kg/day)
alternately may also be effective treatment.
• Shrinkage usually during the first to second week of
treatment start.
20. CHILDHOOD INTRAOCULAR
BENIGN TUMOTRS
Though benign intraocular tumor is less common but some of
tumors are found as bellows:
● Congenital hypertrophy of RPE.
● Combined hamartoma of the retina and RPE.
● Uveal nevus.
● Hemangioma of the choroid and retina.
21. CHILDHOOD INTRAOCULAR
MALIGNANT TUMOTRS
Retinoblastoma
Most common primary intraocular malignant tumor of
childhood originating in the outer nuclear layer of the retina &
one of the most common of all pediatric solid tumors (3%) with
an incidence of about 1:2000 live birth.
22. * Positive family history 6% & usually bilateral.
* Sporadic 94% (Unilateral).
* It is autosomal dominant.
* Usually diagnosed during the first yr of life.
* Onset later than 7 yrs of age is rare.
* Most common initial sign is leukocoria (white pupillary
reflex ) 60%, first noticed by the family.
* Squinting 20% cases, so fundus examination is mandatory in
squinting pt. of childhood.
Inheritance of Retinoblastoma
23. ► Visual impairment.
► Hyphaema.
► Vitreous Hge.
► Glaucoma.
► Orbital inflammation.
Common Presentation
of Retinoblastoma
24. Type of Retinoblastoma
Endophytic Retinoblastoma
- Associated with vitreous seeding.
- Grows inwards towards the vitreous cavity prosecuting from the
retinal surface as a white, cottage cheese like mass with surface
blood vessels.
Exophytic Retinoblastoma
- Associated with sub-retinal fluid accommodation.
- Grows outwards as a sub-retinal multi lobulated white mass,
causing RD.
25. STAGES OF RETINOBLASTOMA
► Quiescent stage (6-12 month).
► Glaucomatous stage.
► Stage of extra ocular extension.
► Stage of metastasis.
26. Spread of Retinoblastoma
Direct spread
► To intra ocular tissue.
► Into the extra ocular tissue.
● Into CNS
● Into orbit
Lymphatic spread
► Along the lymph channels pre ocular with cervical lymph nodes.
By blood stream
► Choroidal invasion is the main route.
► Common site are Bones & Liver.
► Lung is the least common site.
27. INVESTIGATION OF RETINOBLASTOMA
* Indirect ophthalmoscopy with scleral indentation & pupil must be
dilated with mydriatics and both eyes should be checked.
Special Investigations :
* Ultrasonography – B scan Asses tumor size and calcification within the
tumor.
* CT scan- Demonstrates gross involvement of the optic nerve, orbital &
CNS extension.
* Systemic Investigations:
. Bone marrow aspiration.
. Lumber puncture.
Only perform when patient with optic nerve involment or evidence of
extra ocular extension.
30. TREATMENT OF RETINOBLASTOMA
(Related to tumor size, location)
Associated findings –
* RD
* Sub retinal & Vitreous tumor seeds.
* The state of the fellow eye.
Small tumor - < 4mm diameter & 2mm thickness without
vitreous seeds or sub retinal seeds can be treated with trans-
pupillary thermo leaser or chemotherapy.
31. Medium size tumors-
* Bracytheraphy- indicated for the tumor size < 12 mm dia
and 6 mm thickness.
* Chemotherapy with carboplatin, vincristin & etoposide
may be combined with cyclosporine in IV route, 3 cycle
over 4 to 9 months period depending on disease severity.
Large tumors-
* Chemotherapy to shrink the tumor ( Chemo reduction).
* Enucleation with long piece of optic nerve (8-12mm)
- If chemo reduction fails.
32. If extra ocular extension-
- beyond the lemina cribosa is treated with chemotherapy
after enucleation.
- Extension to the cut end of the optic nerve or extension
through the sclerais treated with chemo & radiotherapy
of the affected orbit.
Incase of metastatic condition-
Treated with high dose chemotherapy. Patient with malignant
cells in the CSF may required intrathecal methotrexate.
33. Prognostic Factors of Retinoblastoma
The overall mortality rate is 2 to 5% & related to the followings:
* Tumor size & location.
* Cellular differentiation.
* Optic nerve involvement.
* Invasion.
* Extrascleral spread Most grave prognosis.