This lecture is based on post-graduate students of Ophthalmology (DO, DCO, MCPS, FCPS, MS) and optical principle of GAT has to know for a student to use the instrument friendly
Keratometer is an ophthalmic instruments and has a very important role in optometry field specially for IOL power calculation, Contact lens fitting, to rule out corneal pathology and its progression ie Keratoconus, PMCD.
what is Duochrome Test, Why do we take Red and Green color only,
What is the Principal of Duochrome Test, Why Hyperopic Pt sees green better than red and vice versa
Keratometer is an ophthalmic instruments and has a very important role in optometry field specially for IOL power calculation, Contact lens fitting, to rule out corneal pathology and its progression ie Keratoconus, PMCD.
what is Duochrome Test, Why do we take Red and Green color only,
What is the Principal of Duochrome Test, Why Hyperopic Pt sees green better than red and vice versa
Detailed instumentaion and use of manual Lensometer and just a outline of automated lensometer.
I have used the picture of manual lensometer with out the parts describtion because i have explained orally by showing the picture..
Hope u all like it and may help you in learning better. :)
Accommodation/ Accommodation of Eye, Measurement of Accommodation of Eye (hea...Bikash Sapkota
CLICK HERE TO DOWNLOAD FULL PPT ❤❤ https://healthkura.com/measurement-of-accommodation-of-eye/ ❤❤
Dear viewers Check Out my other piece of works at ❤❤❤ https://healthkura.com ❤❤❤
Measurement of Accommodation of eye:
Amplitude, Facility,
Relative Accommodation, Fatigue, Lag,
Dynamic Retinoscopy
Presentation Layout:
-Introduction to accommodation of eye
-Mechanism
-Components
-Measurement of accommodation of eye
- Amplitude
- Facility
- Relative accommodation
- Lag
-Dynamic Retinoscopy
Accommodation
-dioptric adjustment of the crystalline lens of the eye
- to obtain clear vision for a given target of regard
-process by which the refractive power of eye is altered
- to ensure a clear retinal image
For further reading
-Clinical Procedures in Optometry by J.D. Bartlett, J.B. Eskridge, J.F. Amos
-Primary Care Optometry by Theodere Grosvenor
-Borish’s Clinical Refraction by W.J. Benjamin
-Clinical Procedures for Ocular examination by Carlson et al
-American Academy of Ophthalmology
-Optometric Clinical Practice Guideline by American Optometric Association
-Internet
Follow me to get in touch with optometric and ophthalmic updates
Detailed instumentaion and use of manual Lensometer and just a outline of automated lensometer.
I have used the picture of manual lensometer with out the parts describtion because i have explained orally by showing the picture..
Hope u all like it and may help you in learning better. :)
Accommodation/ Accommodation of Eye, Measurement of Accommodation of Eye (hea...Bikash Sapkota
CLICK HERE TO DOWNLOAD FULL PPT ❤❤ https://healthkura.com/measurement-of-accommodation-of-eye/ ❤❤
Dear viewers Check Out my other piece of works at ❤❤❤ https://healthkura.com ❤❤❤
Measurement of Accommodation of eye:
Amplitude, Facility,
Relative Accommodation, Fatigue, Lag,
Dynamic Retinoscopy
Presentation Layout:
-Introduction to accommodation of eye
-Mechanism
-Components
-Measurement of accommodation of eye
- Amplitude
- Facility
- Relative accommodation
- Lag
-Dynamic Retinoscopy
Accommodation
-dioptric adjustment of the crystalline lens of the eye
- to obtain clear vision for a given target of regard
-process by which the refractive power of eye is altered
- to ensure a clear retinal image
For further reading
-Clinical Procedures in Optometry by J.D. Bartlett, J.B. Eskridge, J.F. Amos
-Primary Care Optometry by Theodere Grosvenor
-Borish’s Clinical Refraction by W.J. Benjamin
-Clinical Procedures for Ocular examination by Carlson et al
-American Academy of Ophthalmology
-Optometric Clinical Practice Guideline by American Optometric Association
-Internet
Follow me to get in touch with optometric and ophthalmic updates
Describes the basic of applanation tonometry, the factors affecting it and also how to perform the ideal tonometry. The slide are borrowed but it gives complete idea of mastering Applanation tonometry.
If the original owner of the slides has an objection i shall take down the ppt with due apologies.
TONOMETRY IN OPTOMETRY & OPHTHALMOLOGY .PPTXANUJA DHAKAL
My presentation delves into the fascinating realm of tonometry—a pivotal diagnostic tool in ophthalmology. "Eyes Under Pressure" aims to shed light on the significance of measuring intraocular pressure and its critical role in detecting and managing ocular conditions, particularly glaucoma.We will explore the various tonometry techniques, from the classic applanation methods to emerging technologies, providing a comprehensive understanding of how these tests unveil the subtle dynamics within the eye. The presentation will highlight the importance of early detection through tonometry, emphasizing its impact on preventing vision loss and preserving ocular health.
Visualized Treatment Objective was coined by Holdaway.
A VTO is a cephalometric tracing representing the changes that are expected during treatment (Proffit).
Ricketts defines VTO as a visual plan to forecast the normal growth of the patient and anticipated influences of treatment, to establish individual objectives that are to be achieved for that patient.
Intraocular pressure
Intraocular pressure (IOP) is the fluid pressure inside the eye. . IOP is an important aspect in the evaluation of patients at risk of glaucoma.
Tonometry is the method eye care professionals use to determine this. Most tonometers are calibrated to measure pressure in millimeters of mercury (mmHg).
Physiology
• Intraocular pressure is determined by the production and drainage of aqueous humour by the ciliary body and its drainage via the trabecular meshwork and uveoscleral outflow. The reason for this is because the vitreous humour in the posterior segment has a relatively fixed volume and thus does not affect intraocular pressure regulation.
• The intraocular pressure (IOP) of the eye is determined by the balance between the amount of aqueous humor - that the eye makes and the ease with which it leaves the eye.
The Goldmann equation states:
Po = (F/C) + Pv
Po is the IOP in millimeters of mercury (mmHg),
F is the rate of aqueous formation,
C is the facility of outflow,
Pv is the episcleral venous pressure.
Measurements
Intraocular pressure is measured with a tonometer as part of a comprehensive eye examination.
Types of Tonometry
1. Applanation tonometry
Applanation tonometry is based on the Imbert-Fick principle, which states that;
‘’The pressure inside an ideal dry, thin-walled sphere equals the force necessary to flatten its surface divided by the area of flattening’’
P = F/A
where P = pressure, F = force and A = area
In applanation tonometry, the cornea is flattened and the IOP is determined by varying the applanating force or the area flattened.
Goldmann and Perkins applanation tonometry
Equipment
• Tonometer, either Goldmann (used on slit lamps) or Perkins (hand-held)
• Applanation prism
• Local anaesthetic drops
• Fluorescein strips
• Clean cotton wool or gauze swabs.
Method
• The Goldmann applanation tonometer measures the force necessary to flatten an area of the cornea of 3.06mm diameter. At this diameter, the resistance of the cornea to flattening is counterbalanced by the capillary attraction of the tear film meniscus for the tonometer head.
• The IOP (in mm Hg) equals the flattening force (in grams) multiplied by 10. Fluorescein dye is placed in the patient’s eye to highlight the tear film. A split-image prism is used such that the image of the tear meniscus is divided into a superior and inferior arc. The intraocular pressure is taken when these arcs are aligned such that their inner margins just touch.
• Applanation tonometry measurements are affected by the central corneal thickness (CCT). When Goldmann designed his tonometer, he estimated an average corneal thickness of 520 microns to cancel the opposing forces of surface tension and corneal rigidity to allow indentation. It is now known that a wide variation exists in corneal thickness among individuals. Thicker CCT may give an artificially high IOP measurement, whereas thinner CCT can give an arti
This lecture is based on medical students those are preparing for postgraduate degree namely FCPS/MS/MD/ any any subject coz hypertension is a systemic disease and by seeing the ocular fundus we can asses the general condition of blood vessels in major organ.
This lecture is based on post-graduate students of Ophthalmology (DO, DCO, MCPS, FCPS, MS) and optical principle of LASER, construction of laser and laser tissue interaction has cover the lecture
This lecture is based on post-graduate medical students of all subject those who are students MS/MD/FCPS of different subject on Central Tendency and Dispersion.
This is the 5 th lecture on "Research Methodology through zoom. The lecture was based on postgraduate Medical students those are different courses of FCPS/MS/MD/PhD (any Specialty)
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
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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.
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New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
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Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
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2. Goldman Applanation Tonometer
In Goldman Applanation tonometry, slit-lamp is used to
illuminate the tonometer tip and fluorescein – stained
cornea. Magnification has very little importance in this
procedure.
Applanation tonometery is the best available procedure to
record intraocular tension. It is least affected by scleral
rigidity, which is an inherent deterrent of indentation
tonometry (1) (PK Muk: 119)
3. Optical Principle of gat
Goldmann Applanation tonometer is based on the
Imbert–Fick principle, which states that for a dry
thin-walled sphere, the pressure (P) inside the sphere
equals the force (F) necessary to flatten its surface
divided by the area (A) of flattening (i.e. P = F/A). It
applies to surfaces which are perfectly spherical, dry,
flexible, elastic, and infinitely thin.
4. Optical Principle of gat
Theoretically, average corneal rigidity (taken as 520 μm
for GAT) and the capillary attraction of the tear
meniscus cancel each other out when the flattened area
has the 3.06 mm diameter contact surface of the
Goldmann prism, which is applied to the cornea using
the Goldmann tonometer with a measurable amount of
force from which the IOP is deduced.
5. Fig: Representation of forces
involved in Applanation
tonometry. F = tonometer
force; s = surface tension
of precorneal tear
film; P = intraocular
pressure; A = area of
Applanation; b = corneal
rigidity/resistance to
bending.
6. Technique of measurement
i. Plastic biprism which contacts cornea creates two
semicircles
ii. Edge of corneal contact is visible after placing
fluorescein into tear film & viewing with cobalt
blue light
iii. Manually rotate the dial calibrated in grams, force is
adjusted by changing the length of a spring within
the device.
iv. Inner margins of semicircles touch when 3.06 mm
of cornea is applanated.
7. Instructions to patient
a) Press head firmly against chin and forehead rest.
b) look straight ahead and fixate on a target (e.g.
examiners opposite ear)
c) breathe normally, do not hold your breath
d) Blink immediately prior to measurement to moisten
cornea.
8. Instructions to patient
e) Position patient’s head with forehead rest well above
eyebrows, allowing raising of eyebrows.
f) anesthetic & fluorescein (0.25%), drop applied
g) maximal illumination of biprism the lamp is moved
toward the eye until the tip of biprism contacts the
apex of the cornea
h) stop moving forward when limbus shines with light,
9. Instructions to patient
i) After contact, semicircles visible through left (or right)
ocular. Center in field of view.
j) Adjust vertically until semicircles equal in size.
k) Tension dial adjusted so that inner edge of upper and
lower semicircles are aligned.
l) Multiply dial reading (grams of force) by 10 to obtain
IOP (mmHg)
10. Instructions to patient
m) Read at median over which arcs glide to control for
excursions due to ocular pulsations.
n) If slit-lamp moved too far toward patient the
pressure arm will push against a spring which will
press against the eye with a low inoffensive force.
o) Mires (flattened area) too large, moving dial doesn’t
alter appearance.
11. Instructions to patient
p) Solution: Draw back until regular pulsation noted
and appearance of mires normalizes.
q) Blue central area represents applanated cornea,
green semicircles are fluorescein-stained tears, inner
border of ring is demarcation between flattened and
non-flattened cornea.
12. Instructions to patient
r) Without staining of tears, bright reflection from air-
cornea interface is seen; leads to underestimation of
IOP.
s) Mires should be approximately 10% of circle width.
13. Errors in Measurement: fluorescein ring
The fluorescein ring is too wide or too narrow:
Too wide: occurs if prism not dried after cleaning or
lids touch prism. Overestimates IOP.
• Solution: dry prism
Too narrow: inadequate fluorescein concentration may
cause hypofluorescence. Underestimates IOP.
• Solution: patient blinks or additional fluorescein added.
14. Errors in Measurement: Corneal astigmatism
• Corneal astigmatism: When regular astigmatism is present, an
elliptical contact with tonometer head occurs.
• This results in an under estimation of IOP in with-the-rule
astigmatism and
• an over estimation with against-the-rule astigmatism,
• with an error range of about -2.5 to +2.5 mmHg.
15. Errors in Measurement: Corneal curvature
Steeper corneas need to be indented more to produce the
standard area of contact, necessitating more force and
therefore indicating a higher IOP reading. It has been
suggested that over the range of corneal curvature of
40 to 49 diopters, the error in IOP reading is about
3mmHg
16. Errors in Measurement: Corneal oedema
Goldmann Applanation Tonometry underestimates the
IOP in eyes with moderate corneal edema. This
underestimation was attributed to the observation that
the epithelium of edematous corneas is easier to
indent than normal epithelium.
17. Errors in Measurement: Corneal thickness
Thin corneas tend to produce underestimation and thick
corneas produce overestimation of IOP. Clinical
implication of this fact in patients with thin corneas
may be wrongly diagnosed as normal tension glaucoma
and thick corneas wrongly as ocular hypertension
emphasizing importance of checking central corneal
thickness on a routine basis in glaucoma clinics.