Epiphora is caused by impairment of lacrimal drainage leading to excess tearing. It can be due to anatomical issues obstructing tear drainage pathways or functional issues with the lacrimal pump. Common anatomical causes include punctal, canalicular, lacrimal sac, or nasolacrimal duct obstructions from congenital abnormalities, infections, trauma, tumors, or other conditions. A patient's history and external/slit lamp exams can provide clues to the cause. Diagnostic tests like dye disappearance tests, probing, and imaging help localize the obstruction. Treatment targets restoring drainage or reducing tear production depending on the underlying etiology.
you will get information about the staphyloma, its types, its etiology, its pathogenesis and its treatment.
you will know about the clinical types of staphyloma in detailed such as anterior staphyloma, posterior staphyloma, equatorial staphyloma, ciliary staphyloma, and Intercalary staphyloma.
you will get information about the staphyloma, its types, its etiology, its pathogenesis and its treatment.
you will know about the clinical types of staphyloma in detailed such as anterior staphyloma, posterior staphyloma, equatorial staphyloma, ciliary staphyloma, and Intercalary staphyloma.
ACAPULCO SE PRESENTA EN LA VITRINA TURÍSTICA DE ANATO EN COLOMBIA.Visita Acapulco
Como parte de las estrategias de promoción y diversificación de mercados para el Puerto de Acapulco, la Secretaría de Turismo del Estado de Guerrero, el Fideicomiso para la Promoción Turística de Acapulco y la Asociación de Hoteles y Empresas Turísticas participaron en la XXXV edición de la Vitrina Turística ANATO 2016, la feria más importante de la región celebrada en Bogotá, Colombia del 24 al 26 de Febrero. A este evento se sumaron seis representantes de hoteles y empresas turísticas, quienes participaron muy activamente en las citas de negocios con mayoristas, donde también se reúnen profesionales, aerolíneas, hoteleros, tour operadores, destinos turísticos y profesionales de esta industria de más de 45 de países.
Ophthalmology Eye care Presentation, nasolacrimal duct obstruction, congenital nasolacrimal duct obstruction, acquired nasolacrimal duct obstruction, medical residency training presentation, ear nose and throat approach to nasolacrimal surgeries, federal medical centre lokoja, kogi state, Nigeria, ophthalmology surgery
A Radiographic Examination of the Nasolacrimal Duct following administration of Iodine Based Contrast Media to define the anatomy of Lacrimal Gland and Nasolacrimal Ducts in search of stenosis and Obstruction
Glaucoma is not a single disease process but a group of disorders characterized by a progressive optic neuropathy resulting in a irreversible visual field defects that are associated frequently raised intraocular pressure (IOP).
IOP is the most common risk factor but not the only risk factor for development of glaucoma.
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
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Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
New Drug Discovery and Development .....NEHA GUPTA
The "New Drug Discovery and Development" process involves the identification, design, testing, and manufacturing of novel pharmaceutical compounds with the aim of introducing new and improved treatments for various medical conditions. This comprehensive endeavor encompasses various stages, including target identification, preclinical studies, clinical trials, regulatory approval, and post-market surveillance. It involves multidisciplinary collaboration among scientists, researchers, clinicians, regulatory experts, and pharmaceutical companies to bring innovative therapies to market and address unmet medical needs.
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
2. • Epiphora implies overflowing of tears due to
impairment lacrimal drainage.
• due to a disruption in the balance between tear
production and tear loss.
4. • Anatomical complete or partial punctal
canalicular or NLD obstruction
• Functional Lacrimal pump failure due to
Anatomical deformity (Laxity, orbicularis weakness)
5. Eyelids
• Horizontal laxity and floppy lids
• Lower lid entropion with orb.oculi overriding
• Lower lid ectropion with ineffective orb.oculi
• Loss of skin / orbicularis
7. Canalicular
• Congenital absence/fistula
• Acquired
Intrinsic
• Canaliculitis
• Trauma/ Post radiation Trauma/ Post radiation
• Tumours
Extrinsic
• Compression by adjacent tumours
8. Lacrimal Sac Abnormality
o Sac inflammation
o Perilacrimal fibrosis
o Dacryolith
o Sac tumors (rare in pediatric age group)
o Adnexal tumors pressing on lacrimal sac or drainage
pathway
9. NASOLACRIMAL DUCT OCCLUSION
Congenital:
• NLD obstruction
• Delayed opening of Hasner’s valve,
• Cranio facial anomalies
• Agenesis.
Acquired:
• Primary obstruction
• Secondary obstruction: tumour, trauma
NASAL CONDITIONS
o Severe Deviated Nasal Septum or Turbinate Hypertrophy
10. Excessive tears production
Reflex lacrimation in response to various factors
Trichiatic cilia severe entropion,
raised IOP allergic conjunctivitis,
corneal exposure, drug irritation
environmental irritants like pollution
11. OTHERS
• Ocular surface disorders like chronic KCS,
conjunctivochalasis, cicatricial ocular surface
pemphigoid, symblephron.
• Neurogenic hypersecretory disorders like
compressive irritation of parasympathetic lacrimal
fibres, Aberrant regeneration of facial nerve
following trauma.
• Facial palsy
13. • Careful history
• External examination
• Slit lamp biomicroscopy
• Syringing and probing
• Imaging
14. HISTORY
• constant versus intermittent tearing
• periods of remission versus no remission
• unilateral or bilateral condition
• subjective ocular surface discomfort
• history of allergies
• use of topical medications
• history of probing during childhood
• prior ocular surface infections
• prior sinus disease or surgery, midfacial trauma, or nasal fracture
• previous episodes of lacrimal sac inflammation
• clear tears versus tears with discharge or blood
15. EXTERNAL EXAMINATION
The eyelids : malpositions, entropion, ectropion,or
lid laxity
The puncta : malpositions, stenosis, agenesis,atresia
or accessory puncta.
16. SLIT LAMP BIOMICROSCOPY:
• abnormalities of eyelids,
• position of punctas,size and patency,discharge,
• size of caruncle,
• eyelid laxity, blinking mechanism,
• marginal tear strip,
• Tearfilm debris,
• papillae or follicles
• pinguecula,pterygium, conjunctival chelosis.
• Ocular cicatricial pemphigoid.
19. Anatomical tests
These tests helps in localization of
obstruction
● Syringing / irrigation
● Diagnostic probing
● Dacryocystography
● CT/MRI
20. Functional tests
● To access functioning of lacrimal apparatus
under physiologic conditions
● Performed only when there is no evidence
of obstruction in anatomical tests
Flourescein dye disappearance test
Scintigraphy
Jones dye test I
21. DYE DISAPPERANCE TEST
• heavily relied upon in children, in whom lacrimal
irrigation is impossible without deep sedation
• Instillation of fluorescein drops 2% into the
conjunctiva of both eyes then examine after 5
minutes .
• Normally, very little or no dye present
• significant residual dye or prolonged retention is an
indication of inadequate drainage of the dye
23. Dye test grading
• 0=No fluorescein in the conjunctival sac
• 1=Thin flurescing marginal tear drop persists
• 2=More fluorescein persists somewhere between 1
and 3 grades
• 3=Wide brightly fluorescein tear strip
• Grades 0 and 1 are considered normal
24. JONES DYE TESTING
Jones I test, or primary dye test:
• Differentiates partial obstruction from
hypersecretion of tears.
• Fluorescein 2% drops instilled into the conjunctiva.
• After about 5 minutes, cotton tipped applicator
inserted under the inferior turbinate.
• Positive: Detection of fluorescein from the nose
means patency of the system.
• Negative: No dye detected, means either a partial or
absolute obstruction or failure of the lacrimal pump.
25.
26. Jones II test, or secondary dye test:
• the residual fluoresce in is flushed from the
conjunctival sac following an negative jones 1 test.
• clear saline is placed in to the inferior canaliculus
using syringe/cannula
• irrigant is retreived from nasal cavity
• Positive: Recovery of dye stained saline from the
nose meaning a partial obstruction of the NLD.
• Negative: Recovery of unstained saline through the
nose means total obstruction of the upper drainage
system or a defective lacrimal pump mechanism.
27.
28.
29. Probing
• After topical anaesthesia, curved lacrimal cannula
on a saline filled syringe is gently inserted into lower
punctum & advanced
• Canula comes to either hard or soft stop
30. • Hard stop:it comes to stop at medial wall of sac
through which rigid lacrimal bone is felt…this
indicates obstruction of nasolacrimal duct
• Soft stop:it comes to stop at junction of common
canaliculus & lacrimal sac(lateral wall)….
it indicates common canalicular block
31.
32. Lacrimal Sac Syringing
• most frequently performed immediately after a DDT
to determine the level of lacrimal drainage system
occlusion
• After instillation of topical anesthesia, the lower
eyelid punctum is dilated
• The irrigating cannula is placed in the canalicular
system.
• To prevent canalicular kinking and difficulty in
advancing the irrigating cannula ,lateral traction of
the lower eye lid
• clear saline is injected and the results noted
34. Complete common canalicular obstruction. A "soft stop" is encountered at the
level of the lacrimal sac, and irrigated fluid ref luxes through the opposite
punctum.
Soft stop is a spongy feeling due to canalicular obstruction
35. Complete nasolacrimal duct obstruction. The cannula is easily advanced to the
medial wall of the lacrimal sac, then a "hard stop" is felt, and irrigation fluid ref
luxes through the opposite punctum.
If the probe touches the medial orbital wall, this means Hard Stop.
36. Partial nasolacrimal duct obstruction. The cannula is easily placed, and
irrigation fluid passes into the nose as well as refluxing through the opposite
punctum.
37. Patent la crimal drainage system. The cannula is placed with ease, and
most of the irrigation fluid passes into the nose .
39. Contrast Dacryocystography (DCG)
• Technique: Plastic catheters are placed into one
canaliculus in both eyes, 1ml lipidol is
simultaneously injected through both catheters
• Water's view radiographs are taken, 5 minutes later,
an erect oblique film is taken.
• Results: The site of obstruction is usually evident.
Diverticula, filling defects due to stones and
strictures can be diagnosed.
40.
41. Lacrimal scintillography
• Scintillography is used to assess the lacrimal
drainage system under physiological conditions.
• Technique: Tchnetium-99 is delivered by a
micropipette to the inferior conjunctival sac. The
tracer is imaged using a gamma camera.
42.
43. CT/MRI
● Epiphora foll. Trauma with NLD obst.
R/o orb. Rim/ max. #
● Infant with cystic mass at med. Can.
Amniocele v/s meningocele
● Suspected malignancy
44. Lacrimal Endoscopy
• 1.0 mm diameter rigid endoscope or fibroptic
flexible endoscopes was inserted through the puncti
and canaliculi to inspect the lining mucosa of
lacrimal system, its contents and investigating DCR
fistulae.