This document discusses different types of cataracts, including age-related cataracts, traumatic cataracts, and cataracts caused by other factors like radiation, chemicals, and medical conditions. It describes the typical appearance and progression of nuclear, cortical, and posterior subcapsular cataracts. Traumatic cataracts are outlined including those caused by contusion, penetrating injuries, radiation, chemicals, electricity and intraocular foreign bodies. The lens' sensitivity to ionizing radiation is also summarized.
This document summarizes Herpes Simplex Virus (HSV) keratitis and Herpes Zoster Ophthalmicus. It discusses the pathology, clinical features, diagnosis, and treatment of HSV epithelial keratitis and stromal/endothelial keratitis. It presents two case scenarios of recurrent HSV keratitis. It also summarizes the findings of the Herpetic Eye Disease Study regarding the efficacy of antivirals and steroids for treating HSV eye infections.
This document discusses amblyopia, including its definition, etiology, neurological mechanisms, types, and treatment. It defines amblyopia as a reduction in best corrected visual acuity that cannot be attributed to structural eye abnormalities. The main types are strabismic, anisometropic, isoametropic, and deprivation amblyopia. Treatment involves full optical correction, occlusion of the better eye, and sometimes penalization of the better eye to encourage use of the amblyopic eye. Proper treatment is important during early childhood for amblyopia to be effectively reversed.
This document discusses various types of non-ulcerative keratitis including diffuse superficial keratitis, superficial punctate keratitis, and degenerations like fatty degeneration, calcific degeneration, and Salzmann's nodular degeneration. It also discusses various corneal dystrophies like epithelial basement membrane dystrophy, Reis-Buckler dystrophy, Meesman's dystrophy, granular dystrophy, macular dystrophy, lattice dystrophy, Fuch's dystrophy, congenital hereditary endothelial dystrophy, and keratoconus. Keratoconus is a noninflammatory ectatic condition of the cornea that usually starts at puberty and progresses slowly, causing defective vision due to progressive myopia and irregular ast
Posterior vitreous detachment (PVD) occurs when the vitreous gel in the eye separates from the retina. It is a natural aging process that usually happens in people's 60s and 70s. PVDs are often asymptomatic, but can sometimes cause floaters, flashes of light, or a cobweb-like visual effect. While PVD itself does not affect vision, on rare occasions it can cause retinal tears or detachments, which require prompt treatment to prevent vision loss if left untreated. PVD is typically diagnosed via dilated eye exam but may also require tests like OCT or ultrasound. No treatment is needed for most PVDs but follow up exams are recommended to check for complications.
Gonioscopy is an examination of the anterior chamber angle using a gonioscopy lens and slit lamp microscope. It allows visualization of key angle structures including the trabecular meshwork, Schwalbe's line, scleral spur, and ciliary body band. The examination is used to diagnose glaucoma and angle closure risk. There are two main techniques - direct gonioscopy using a contact lens and indirect gonioscopy using a single or multiple mirror lens. Angle structures may be difficult to see, requiring manipulations like indentation and corneal wedge to improve visualization. Gonioscopy is essential for glaucoma evaluation and management.
This document defines astigmatism as a condition where light rays are not focused to a single point on the retina due to irregular curvature or refractive index of the cornea or lens. It classifies astigmatism based on etiology, orientation of refractive meridians, and location of focal points relative to the retina. Signs include distorted vision and headaches. Clinical tests include refraction, keratometry, and retinoscopy. Management options are spectacles, contact lenses, and refractive surgery to correct the astigmatism.
This document discusses ocular tuberculosis. It begins with an introduction to tuberculosis as a systemic disease caused by Mycobacterium tuberculosis. It then covers the clinical criteria for systemic TB disease and laboratory diagnostic criteria. It discusses the pathophysiology, transmission, and pathogenesis of TB infection. The document outlines various clinical presentations of ocular TB including anterior uveitis, intermediate uveitis, posterior segment manifestations, neuro-ophthalmic manifestations, adnexal involvement, and drug-related ocular toxicity. Investigations for diagnosing ocular TB such as the Mantoux test, chest imaging, and ocular exams are also summarized.
This document discusses different types of cataracts, including age-related cataracts, traumatic cataracts, and cataracts caused by other factors like radiation, chemicals, and medical conditions. It describes the typical appearance and progression of nuclear, cortical, and posterior subcapsular cataracts. Traumatic cataracts are outlined including those caused by contusion, penetrating injuries, radiation, chemicals, electricity and intraocular foreign bodies. The lens' sensitivity to ionizing radiation is also summarized.
This document summarizes Herpes Simplex Virus (HSV) keratitis and Herpes Zoster Ophthalmicus. It discusses the pathology, clinical features, diagnosis, and treatment of HSV epithelial keratitis and stromal/endothelial keratitis. It presents two case scenarios of recurrent HSV keratitis. It also summarizes the findings of the Herpetic Eye Disease Study regarding the efficacy of antivirals and steroids for treating HSV eye infections.
This document discusses amblyopia, including its definition, etiology, neurological mechanisms, types, and treatment. It defines amblyopia as a reduction in best corrected visual acuity that cannot be attributed to structural eye abnormalities. The main types are strabismic, anisometropic, isoametropic, and deprivation amblyopia. Treatment involves full optical correction, occlusion of the better eye, and sometimes penalization of the better eye to encourage use of the amblyopic eye. Proper treatment is important during early childhood for amblyopia to be effectively reversed.
This document discusses various types of non-ulcerative keratitis including diffuse superficial keratitis, superficial punctate keratitis, and degenerations like fatty degeneration, calcific degeneration, and Salzmann's nodular degeneration. It also discusses various corneal dystrophies like epithelial basement membrane dystrophy, Reis-Buckler dystrophy, Meesman's dystrophy, granular dystrophy, macular dystrophy, lattice dystrophy, Fuch's dystrophy, congenital hereditary endothelial dystrophy, and keratoconus. Keratoconus is a noninflammatory ectatic condition of the cornea that usually starts at puberty and progresses slowly, causing defective vision due to progressive myopia and irregular ast
Posterior vitreous detachment (PVD) occurs when the vitreous gel in the eye separates from the retina. It is a natural aging process that usually happens in people's 60s and 70s. PVDs are often asymptomatic, but can sometimes cause floaters, flashes of light, or a cobweb-like visual effect. While PVD itself does not affect vision, on rare occasions it can cause retinal tears or detachments, which require prompt treatment to prevent vision loss if left untreated. PVD is typically diagnosed via dilated eye exam but may also require tests like OCT or ultrasound. No treatment is needed for most PVDs but follow up exams are recommended to check for complications.
Gonioscopy is an examination of the anterior chamber angle using a gonioscopy lens and slit lamp microscope. It allows visualization of key angle structures including the trabecular meshwork, Schwalbe's line, scleral spur, and ciliary body band. The examination is used to diagnose glaucoma and angle closure risk. There are two main techniques - direct gonioscopy using a contact lens and indirect gonioscopy using a single or multiple mirror lens. Angle structures may be difficult to see, requiring manipulations like indentation and corneal wedge to improve visualization. Gonioscopy is essential for glaucoma evaluation and management.
This document defines astigmatism as a condition where light rays are not focused to a single point on the retina due to irregular curvature or refractive index of the cornea or lens. It classifies astigmatism based on etiology, orientation of refractive meridians, and location of focal points relative to the retina. Signs include distorted vision and headaches. Clinical tests include refraction, keratometry, and retinoscopy. Management options are spectacles, contact lenses, and refractive surgery to correct the astigmatism.
This document discusses ocular tuberculosis. It begins with an introduction to tuberculosis as a systemic disease caused by Mycobacterium tuberculosis. It then covers the clinical criteria for systemic TB disease and laboratory diagnostic criteria. It discusses the pathophysiology, transmission, and pathogenesis of TB infection. The document outlines various clinical presentations of ocular TB including anterior uveitis, intermediate uveitis, posterior segment manifestations, neuro-ophthalmic manifestations, adnexal involvement, and drug-related ocular toxicity. Investigations for diagnosing ocular TB such as the Mantoux test, chest imaging, and ocular exams are also summarized.
1. Myopia, or nearsightedness, is a refractive defect where parallel light rays focus in front of the retina. There are several types of myopia based on etiology, including axial, curvatural, index, and positional myopia.
2. Simple myopia develops due to normal biological variation and inheritance, usually occurring between ages 5-20 and rarely exceeding -8 diopters. Pathological myopia is a degenerative form associated with rapid eyeball growth and structural changes like staphyloma.
3. Treatment options for myopia include optical corrections like glasses and contact lenses, as well as surgical procedures like LASIK, intraocular lenses, and low vision aids for advanced cases
Lenses of slit lamp biomicroscope & indirect ophthalmoscope.Ayat AbuJazar
This document discusses different lenses used for ophthalmic examination, including Volk double aspheric lenses, Goldmann three mirror lenses, and indirect ophthalmoscope lenses. Volk lenses come in 60D, 78D, and 90D powers and are used for slit lamp biomicroscopy. The 60D provides high magnification of the posterior pole, while the 78D is for general diagnosis and the 90D is for small pupils. Goldmann three mirror lenses provide a 3D view of the anterior chamber and fundus and require a coupling agent. Indirect lenses act as condensing lenses, with higher powered lenses providing less magnification but wider field of view.
This document discusses different types of cataracts including age-related (senile) cataract, drug-induced cataract, and traumatic cataract. It provides details on the pathogenesis, clinical presentation, and histopathology of nuclear, cortical, and posterior subcapsular cataracts. Drug-induced cataracts caused by corticosteroids, phenothiazines, miotics, and amiodarone are described. Traumatic cataracts can result from mechanical injury, physical forces like radiation or electricity, or osmotic influences in diabetes. Radiation-induced and chemical-induced cataracts are also summarized.
1. Viral corneal ulcers have increased due to antibiotics reducing bacterial flora. Herpes simplex virus is a common cause, initially infecting epithelium and potentially becoming neurotropic. Primary infection involves non-immune individuals while recurrent infections reactivate dormant virus.
2. Herpes simplex keratitis manifestations include punctate epithelial keratitis, dendritic ulcers, and stromal keratitis treated with antivirals like acyclovir along with supportive measures. Herpes zoster ophthalmicus affects the trigeminal nerve causing vesicular skin lesions and ocular complications in 50% of cases like keratitis, treated with antivirals and steroids.
The document discusses the anatomy, embryology, and function tests of the macula lutea. It describes the macula lutea as a 5.5mm circular area at the posterior pole of the retina that subserves central vision. It notes the macula's delayed development until 8 months gestation and specialization of the fovea which contains the highest concentration of cones. The document outlines various macular function tests used to evaluate macular diseases, including visual acuity, Amsler grid, microperimetry, and electroretinography. It provides details on the anatomy and cell layers of the fovea centralis and techniques for assessing macular integrity with tests like the Maddox rod.
Mr. Vasanth, a 15-year-old male, presented with a traumatic cataract in his right eye following an injury from a stick one week prior. Examination revealed an anterior capsular tear and cataract in the right eye. He was diagnosed with traumatic cataract and prescribed topical and oral steroids as well as planned for cataract surgery once inflammation subsides to avoid amblyopia. Traumatic cataracts are a common sequel to ocular trauma and are the most common cause of unilateral cataract in young individuals.
Corneal degeneration refers to degenerative changes in the normal cells of the cornea under the influence of age or pathology. There are various types classified by location (axial or peripheral) or etiology (age-related or pathological). Common age-related degenerations include arcus senilis, Vogt's white limbal girdle, and Hassal-Henle bodies. Pathological degenerations comprise fatty degeneration, amyloidosis, calcific/band keratopathy, Salzmann's nodular degeneration, and pellucid marginal degeneration. Treatment options include phototherapeutic keratectomy, corneal transplantation, or superficial keratectomy depending on the type and severity of degeneration.
This document provides an overview of the anatomy, nerve and blood supply of the uvea, which includes the iris, ciliary body, and choroid. It begins with an introduction to the uvea and its embryological development. It then discusses the anatomy and structures of the iris, ciliary body, and choroid in detail. It also reviews the blood supply and some clinical applications related to the uvea. The document is presented as part of an optometry lecture covering this topic in detail over several slides.
This document discusses various viral and protozoal causes of corneal ulcers, including herpes simplex virus (HSV), herpes zoster virus, and acanthamoeba. It describes the etiology, clinical features, diagnosis, and treatment of these conditions. Primary and recurrent HSV keratitis present with punctate epithelial lesions and dendritic ulcers. Herpes zoster ophthalmicus causes vesicular skin lesions following reactivation of varicella zoster virus in the trigeminal ganglion. Acanthamoeba keratitis is an opportunistic infection associated with contact lens use that presents with epithelial lesions and stromal infiltrates. Treatment involves antiviral medications for viruses and anti-am
This document discusses the classification and etiology of cataracts. It describes the main types of cataract as developmental, age-related/senile, cataracts associated with ocular or systemic diseases, traumatic cataracts, and drug-induced cataracts. It provides details on cortical and nuclear senile cataracts, including their signs and symptoms. Complications and differential diagnoses are also summarized.
This document presents a case study of a 10-year-old male student presenting with redness and itching in both eyes for 15 days. On examination, the patient was found to have mild eyelid edema, conjunctival congestion and papillae in both eyes. Based on the signs and symptoms, the patient was diagnosed with vernal keratoconjunctivitis (VKC). Treatment included topical medications which improved the symptoms over subsequent follow-ups. The document concludes with a discussion of VKC including its prevalence, symptoms, signs, classification, treatment options and management.
This document discusses heterophoria, which is a latent misalignment of the eyes that is kept in check by the fusional reflex. It can be compensated, meaning the eyes are able to fuse at the fixation point without symptoms, or decompensated, where symptoms appear when binocular vision is disrupted. Common types include esophoria (inward deviation), exophoria (outward deviation), and cyclophorias (upward or rotational deviations). Heterophoria is usually asymptomatic but can cause eye strain, headaches, and difficulty changing focus. It is assessed using cover tests and phoria tests like Maddox Rod and Maddox Wing. Treatment involves correcting refractive errors if present,
This document provides guidelines for prescribing glasses in children. It defines various refractive errors such as myopia, hyperopia, and astigmatism. It recommends fully correcting refractive errors over ±4 diopters as these can cause amblyopia. For lower refractive errors, it recommends considering the child's age and visual needs. Anisometropia over 1.5 diopters should also be corrected. Special cases like accommodative esotropia may require bifocals. The goal of treatment is to provide a clear retinal image while maintaining proper accommodation and convergence.
Astigmatism is a refractive error where the refraction varies in different meridians. There are two types: regular and irregular. Regular astigmatism has two principal meridians and can be with-the-rule, against-the-rule, oblique, or bi-oblique depending on the axis. Irregular astigmatism has an irregular change in refractive power. Both cause blurred vision and symptoms. Regular astigmatism is treated with cylindrical lenses, contact lenses, or LASIK while irregular astigmatism may require contact lenses, phototherapeutic keratectomy, or surgery.
Hypermetropia, also known as hyperopia or longsightedness, is a refractive error where the eye focuses images behind the retina rather than directly on it. It can be caused by the eyeball being too short, the cornea being too flat, or changes in the lens with age. Hypermetropia is classified as simple, pathological, or functional. It is usually corrected using convex lenses, contact lenses, or refractive surgery depending on the degree of nearsightedness and any other factors. Early diagnosis and treatment of hypermetropia in children is important to prevent vision problems.
This document discusses myopia (nearsightedness), including its optics, etiological classifications, clinical varieties, and treatment options. Myopia occurs when light rays focus in front of the retina rather than directly on it. It can be axial, curvatural, or positional. Treatment includes optical correction with glasses or contacts, as well as refractive surgeries like LASIK, PRK, clear lens extraction, phakic IOL implantation, intracorneal ring segments, and orthokeratology. More advanced techniques like LASIK and ICLs can correct higher degrees of myopia over -12 diopters.
- Squint, or strabismus, is a misalignment of the visual axes that leads to loss of binocular single vision. It can be caused by issues in the orbit, eye muscles, motor nerves, or brainstem.
- Strabismus is classified as apparent, latent, or manifest. Manifest strabismus is further divided into concomitant, where the deviation is the same in all gazes, and incomitant, where the deviation varies with gaze.
- Evaluation of strabismus involves assessing history, visual acuity, refractive error, eye alignment tests, and binocular vision. Accurately measuring any refractive errors and prescribing corrections as needed is important for diagnosis and treatment of
Presbyopia is the loss of accommodation that occurs with aging. It results in a decreased ability to focus on near objects and is caused by lenticular and extralenticular changes within the eye. Symptoms typically begin around age 40 and accommodation is completely lost by ages 50-60, affecting 100% of the population. Treatment options include reading glasses, bifocal and multifocal contact lenses, refractive surgery such as LASIK, and intraocular lens implants. Newer treatments being researched include corneal inlays and injectable accommodating intraocular lenses.
Endophthalmitis is an inflammation of the inner coats of the eyeball that can be infective or non-infective. Infective endophthalmitis is classified as exogenous or endogenous. Acute bacterial endophthalmitis is a complication of intraocular surgery where the infective source is usually the patient's own flora. Signs include lid edema, chemosis, hypopyon, and retinal periphlebitis. Treatment involves intravitreal and systemic antibiotics, intravitreal and topical steroids, and sometimes pars plana vitrectomy to treat severe or non-improving cases. Panophthalmitis is a more severe inflammation of the whole eyeball that
Hypermetropia, also known as farsightedness or hyperopia, is a refractive error where the eye focuses light behind the retina. It occurs when the eyeball is too short or the cornea is too flat. Hypermetropia can be classified as physiological, pathological, or functional. It is commonly diagnosed using a retinoscope or autorefractor. Symptoms include blurry vision and eye strain. Treatment options include corrective lenses, refractive surgery such as LASIK, or intraocular lens implantation.
1. Myopia, or nearsightedness, is a refractive defect where parallel light rays focus in front of the retina. There are several types of myopia based on etiology, including axial, curvatural, index, and positional myopia.
2. Simple myopia develops due to normal biological variation and inheritance, usually occurring between ages 5-20 and rarely exceeding -8 diopters. Pathological myopia is a degenerative form associated with rapid eyeball growth and structural changes like staphyloma.
3. Treatment options for myopia include optical corrections like glasses and contact lenses, as well as surgical procedures like LASIK, intraocular lenses, and low vision aids for advanced cases
Lenses of slit lamp biomicroscope & indirect ophthalmoscope.Ayat AbuJazar
This document discusses different lenses used for ophthalmic examination, including Volk double aspheric lenses, Goldmann three mirror lenses, and indirect ophthalmoscope lenses. Volk lenses come in 60D, 78D, and 90D powers and are used for slit lamp biomicroscopy. The 60D provides high magnification of the posterior pole, while the 78D is for general diagnosis and the 90D is for small pupils. Goldmann three mirror lenses provide a 3D view of the anterior chamber and fundus and require a coupling agent. Indirect lenses act as condensing lenses, with higher powered lenses providing less magnification but wider field of view.
This document discusses different types of cataracts including age-related (senile) cataract, drug-induced cataract, and traumatic cataract. It provides details on the pathogenesis, clinical presentation, and histopathology of nuclear, cortical, and posterior subcapsular cataracts. Drug-induced cataracts caused by corticosteroids, phenothiazines, miotics, and amiodarone are described. Traumatic cataracts can result from mechanical injury, physical forces like radiation or electricity, or osmotic influences in diabetes. Radiation-induced and chemical-induced cataracts are also summarized.
1. Viral corneal ulcers have increased due to antibiotics reducing bacterial flora. Herpes simplex virus is a common cause, initially infecting epithelium and potentially becoming neurotropic. Primary infection involves non-immune individuals while recurrent infections reactivate dormant virus.
2. Herpes simplex keratitis manifestations include punctate epithelial keratitis, dendritic ulcers, and stromal keratitis treated with antivirals like acyclovir along with supportive measures. Herpes zoster ophthalmicus affects the trigeminal nerve causing vesicular skin lesions and ocular complications in 50% of cases like keratitis, treated with antivirals and steroids.
The document discusses the anatomy, embryology, and function tests of the macula lutea. It describes the macula lutea as a 5.5mm circular area at the posterior pole of the retina that subserves central vision. It notes the macula's delayed development until 8 months gestation and specialization of the fovea which contains the highest concentration of cones. The document outlines various macular function tests used to evaluate macular diseases, including visual acuity, Amsler grid, microperimetry, and electroretinography. It provides details on the anatomy and cell layers of the fovea centralis and techniques for assessing macular integrity with tests like the Maddox rod.
Mr. Vasanth, a 15-year-old male, presented with a traumatic cataract in his right eye following an injury from a stick one week prior. Examination revealed an anterior capsular tear and cataract in the right eye. He was diagnosed with traumatic cataract and prescribed topical and oral steroids as well as planned for cataract surgery once inflammation subsides to avoid amblyopia. Traumatic cataracts are a common sequel to ocular trauma and are the most common cause of unilateral cataract in young individuals.
Corneal degeneration refers to degenerative changes in the normal cells of the cornea under the influence of age or pathology. There are various types classified by location (axial or peripheral) or etiology (age-related or pathological). Common age-related degenerations include arcus senilis, Vogt's white limbal girdle, and Hassal-Henle bodies. Pathological degenerations comprise fatty degeneration, amyloidosis, calcific/band keratopathy, Salzmann's nodular degeneration, and pellucid marginal degeneration. Treatment options include phototherapeutic keratectomy, corneal transplantation, or superficial keratectomy depending on the type and severity of degeneration.
This document provides an overview of the anatomy, nerve and blood supply of the uvea, which includes the iris, ciliary body, and choroid. It begins with an introduction to the uvea and its embryological development. It then discusses the anatomy and structures of the iris, ciliary body, and choroid in detail. It also reviews the blood supply and some clinical applications related to the uvea. The document is presented as part of an optometry lecture covering this topic in detail over several slides.
This document discusses various viral and protozoal causes of corneal ulcers, including herpes simplex virus (HSV), herpes zoster virus, and acanthamoeba. It describes the etiology, clinical features, diagnosis, and treatment of these conditions. Primary and recurrent HSV keratitis present with punctate epithelial lesions and dendritic ulcers. Herpes zoster ophthalmicus causes vesicular skin lesions following reactivation of varicella zoster virus in the trigeminal ganglion. Acanthamoeba keratitis is an opportunistic infection associated with contact lens use that presents with epithelial lesions and stromal infiltrates. Treatment involves antiviral medications for viruses and anti-am
This document discusses the classification and etiology of cataracts. It describes the main types of cataract as developmental, age-related/senile, cataracts associated with ocular or systemic diseases, traumatic cataracts, and drug-induced cataracts. It provides details on cortical and nuclear senile cataracts, including their signs and symptoms. Complications and differential diagnoses are also summarized.
This document presents a case study of a 10-year-old male student presenting with redness and itching in both eyes for 15 days. On examination, the patient was found to have mild eyelid edema, conjunctival congestion and papillae in both eyes. Based on the signs and symptoms, the patient was diagnosed with vernal keratoconjunctivitis (VKC). Treatment included topical medications which improved the symptoms over subsequent follow-ups. The document concludes with a discussion of VKC including its prevalence, symptoms, signs, classification, treatment options and management.
This document discusses heterophoria, which is a latent misalignment of the eyes that is kept in check by the fusional reflex. It can be compensated, meaning the eyes are able to fuse at the fixation point without symptoms, or decompensated, where symptoms appear when binocular vision is disrupted. Common types include esophoria (inward deviation), exophoria (outward deviation), and cyclophorias (upward or rotational deviations). Heterophoria is usually asymptomatic but can cause eye strain, headaches, and difficulty changing focus. It is assessed using cover tests and phoria tests like Maddox Rod and Maddox Wing. Treatment involves correcting refractive errors if present,
This document provides guidelines for prescribing glasses in children. It defines various refractive errors such as myopia, hyperopia, and astigmatism. It recommends fully correcting refractive errors over ±4 diopters as these can cause amblyopia. For lower refractive errors, it recommends considering the child's age and visual needs. Anisometropia over 1.5 diopters should also be corrected. Special cases like accommodative esotropia may require bifocals. The goal of treatment is to provide a clear retinal image while maintaining proper accommodation and convergence.
Astigmatism is a refractive error where the refraction varies in different meridians. There are two types: regular and irregular. Regular astigmatism has two principal meridians and can be with-the-rule, against-the-rule, oblique, or bi-oblique depending on the axis. Irregular astigmatism has an irregular change in refractive power. Both cause blurred vision and symptoms. Regular astigmatism is treated with cylindrical lenses, contact lenses, or LASIK while irregular astigmatism may require contact lenses, phototherapeutic keratectomy, or surgery.
Hypermetropia, also known as hyperopia or longsightedness, is a refractive error where the eye focuses images behind the retina rather than directly on it. It can be caused by the eyeball being too short, the cornea being too flat, or changes in the lens with age. Hypermetropia is classified as simple, pathological, or functional. It is usually corrected using convex lenses, contact lenses, or refractive surgery depending on the degree of nearsightedness and any other factors. Early diagnosis and treatment of hypermetropia in children is important to prevent vision problems.
This document discusses myopia (nearsightedness), including its optics, etiological classifications, clinical varieties, and treatment options. Myopia occurs when light rays focus in front of the retina rather than directly on it. It can be axial, curvatural, or positional. Treatment includes optical correction with glasses or contacts, as well as refractive surgeries like LASIK, PRK, clear lens extraction, phakic IOL implantation, intracorneal ring segments, and orthokeratology. More advanced techniques like LASIK and ICLs can correct higher degrees of myopia over -12 diopters.
- Squint, or strabismus, is a misalignment of the visual axes that leads to loss of binocular single vision. It can be caused by issues in the orbit, eye muscles, motor nerves, or brainstem.
- Strabismus is classified as apparent, latent, or manifest. Manifest strabismus is further divided into concomitant, where the deviation is the same in all gazes, and incomitant, where the deviation varies with gaze.
- Evaluation of strabismus involves assessing history, visual acuity, refractive error, eye alignment tests, and binocular vision. Accurately measuring any refractive errors and prescribing corrections as needed is important for diagnosis and treatment of
Presbyopia is the loss of accommodation that occurs with aging. It results in a decreased ability to focus on near objects and is caused by lenticular and extralenticular changes within the eye. Symptoms typically begin around age 40 and accommodation is completely lost by ages 50-60, affecting 100% of the population. Treatment options include reading glasses, bifocal and multifocal contact lenses, refractive surgery such as LASIK, and intraocular lens implants. Newer treatments being researched include corneal inlays and injectable accommodating intraocular lenses.
Endophthalmitis is an inflammation of the inner coats of the eyeball that can be infective or non-infective. Infective endophthalmitis is classified as exogenous or endogenous. Acute bacterial endophthalmitis is a complication of intraocular surgery where the infective source is usually the patient's own flora. Signs include lid edema, chemosis, hypopyon, and retinal periphlebitis. Treatment involves intravitreal and systemic antibiotics, intravitreal and topical steroids, and sometimes pars plana vitrectomy to treat severe or non-improving cases. Panophthalmitis is a more severe inflammation of the whole eyeball that
Hypermetropia, also known as farsightedness or hyperopia, is a refractive error where the eye focuses light behind the retina. It occurs when the eyeball is too short or the cornea is too flat. Hypermetropia can be classified as physiological, pathological, or functional. It is commonly diagnosed using a retinoscope or autorefractor. Symptoms include blurry vision and eye strain. Treatment options include corrective lenses, refractive surgery such as LASIK, or intraocular lens implantation.
Hypermetropia
BY
RAIN HEALTH CARE
EYE & LIFESTYLE DISEASE CONSULTATION & MANAGEMENT CENTER
WHAT IS HYPERMETROPIA
TYPES OF HYPERMETROPIA
ETILOGY OF HYPERMETROPIA
CLINICAL FEATURES OF HYPERMETROPIA
HYPERMETROPIA PPT
a detailed informative compilation on everything related to hypermetropia or hyperopia required in ophthalmic or optometric clinical practice and education
Hypermetropia, also known as hyperopia or longsightedness, is a refractive error where the eye focuses images behind the retina. It has various causes including a short axial length of the eye or flattened cornea. Symptoms include blurry near vision and asthenopia. Treatment involves prescribing convex lenses to correct refractive errors or refractive surgery for more severe cases. Early treatment of hypermetropia in children is important to prevent amblyopia and strabismus.
A View On Hypermetropia by Robin Singh (BMCO)Robin Singh
This document discusses hypermetropia (farsightedness) including its terminology, causes, signs, symptoms, and treatment options. Hypermetropia occurs when light rays focus behind the retina rather than on it. It can be caused by the eyeball being too short or the cornea or lens being flatter than normal. Symptoms range from none for mild cases to defective vision and eyestrain for more severe cases. Treatment involves prescribing convex lenses to correct the refractive error through glasses or contacts. Surgery may also be used in some cases.
Hypermetropia, or farsightedness, occurs when the eye is too short, causing light rays to focus behind the retina. There are several types of hypermetropia based on its cause, including axial hypermetropia due to a short eyeball, and index hypermetropia which occurs in older patients due to changes in the lens. Hypermetropia is classified by severity and can range from asymptomatic to causing blurred vision. Treatment involves prescribing convex lenses to optically shift the focal point of light rays to the retina.
Hypermetropia, also known as farsightedness or long-sightedness, is a refractive error where the eye focuses light behind the retina instead of directly on it. There are several types of hypermetropia based on etiology, including axial, curvatural, index, and positional. Hypermetropia is classified based on degree as low, moderate, or high. It can be diagnosed through visual acuity screening and retinoscopy. Management includes optical correction with convex lenses via spectacles or contact lenses, as well as refractive surgery for more severe cases once the eye is fully developed. Untreated hypermetropia can lead to complications and negatively impact quality of life.
Hypermetropia, or long-sightedness, is a refractive error where light rays focus behind the retina at rest. It occurs when the eye has insufficient converging power. There are different types including total, latent, and manifest hypermetropia. Symptoms include asthenopia and loss of near vision. Signs include esophoria/esotropia, a positive angle kappa, and pseudopapilledema. It is graded as low, moderate, or high. Treatment involves prescribing convex lenses through refraction under cycloplegia. Surgical options include laser and conductive keratoplasty procedures.
Hypermetropia, also known as farsightedness or longsightedness, is a vision disorder where parallel rays of light focus behind the retina when the eye is at rest. There are several types of hypermetropia including congenital, developmental, and acquired. Accommodation can affect the manifestation of hypermetropia as either total, latent, or manifest hypermetropia. Symptoms include difficulty with close work and blurred vision. Treatment involves prescribing convex spherical lenses through refraction. Several homeopathic remedies may help restore ciliary muscle power or treat eye strain symptoms.
This document discusses different types of optical anomalies of the eye including hypermetropia and astigmatism. It defines hypermetropia as a refractive error where light focuses behind the retina. The causes of hypermetropia include axial shortening of the eyeball or increased curvature of the refractive surfaces. Astigmatism is defined as a refractive error where refraction varies in different meridians, causing blurred vision. Regular astigmatism can be with-the-rule, against-the-rule or oblique, while irregular astigmatism results from corneal scarring. Treatment options discussed include refractive correction with glasses or contacts as well as refractive surgery.
This document summarizes hyperopia (farsightedness), including its etiology, clinical types, latent and manifest presentations, symptoms, signs, and treatment options. The main points are:
Hyperopia is caused by an eyeball that is too short or a cornea that is too flat. It can be developmental, pathological, or functional in nature. Symptoms include tiredness, headaches, and blurred distance vision. Examination may reveal a small eye size. Treatment includes glasses, contact lenses, or refractive surgery to bring light to a focus on the retina.
This document defines various types of hyperopia (farsightedness) and discusses their prevalence, natural history, diagnosis, and management. It defines classifications of hyperopia including simple/physiological, pathological, and functional. It also discusses evaluating and managing hyperopia in young children, older children/younger adults, and those developing presbyopia. Key points covered include the need to monitor and treat moderate-high hyperopia to prevent amblyopia and strabismus in young children, and addressing both distance and near vision with age.
Hypermetropia, also known as farsightedness or longsightedness, occurs when the light rays from distant objects focus behind the retina rather than directly on it. There are several types and causes of hypermetropia, including axial hypermetropia from a shortened eyeball, curvatural hypermetropia from an increased curvature of the cornea or lens, and index hypermetropia that develops with age due to changes in the lens. Hypermetropia is generally treated with optical correction using lenses, but surgical procedures like LASIK or phakic intraocular lenses may be used for higher degrees of hypermetropia. Untreated hypermetropia can lead to issues like ey
Hypermetropia, also known as farsightedness, is a refractive error where the eye focuses light behind the retina when the eye is at rest. There are several types of hypermetropia including axial, refractive, index, curvature, and anterior chamber hypermetropia. Hypermetropia can also be classified as simple, pathological, or functional based on physiological and anatomical factors. It can be further broken down into total, manifest, latent, and facultative hypermetropia depending on whether it can be corrected with accommodation. Treatment options include spectacle correction with convex lenses, contact lenses, and refractive surgery procedures like LASIK.
This document provides information about hypermetropia (farsightedness), including its definition, causes, types, clinical features, treatment, and management in different populations. Key points:
- Hypermetropia is a refractive condition where light focuses behind the retina when accommodation is relaxed.
- It can be caused by factors like short axial length, flat cornea curvature, or decreased lens refractive index.
- Clinical features include defective near vision, eyestrain, and occasionally esotropia.
- Treatment involves spectacles, contact lenses, or refractive surgery to use plus lenses to increase the optical power.
- In children, full correction may not be needed if certain criteria are met, while
Hypermetropia also known as Hyperopia or Farsightedness is a common type of r...Khagendra Shrestha
Hypermetropia also known as "Hyperopia' or "Farsightedness" is a common type of refractive error where distant objects may be seen more clearly than objects that are near.
Refractive errors occur when there is a mismatch between the eye's optical power and its axial length, causing light rays to focus in front or behind the retina. The most common refractive errors are myopia, hyperopia, and astigmatism. Diagnosis involves using instruments like autorefractors and retinoscopes to measure how light enters the eye. Optical corrections include spectacle lenses, contact lenses, and intraocular lenses, with the type chosen based on factors like comfort, durability, and amount of correction needed.
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3. HISTORY
• First suggested in year 1755 by KASTNER
• Later by DONDERS 1858 Hyperopia
• HELMHOLTZ termed as Hypermetropia
• Hypermetropia indicates;
Hyper: Excess
Met: measure
Opia: Of the eye
4. Introduction
• Hypermetropia is that ametropia where parallel rays are brought to focus
behind the photosensitive layer of the retina when accommodation is at
rest.
• Accommodation can partially or completely eliminate hypermetropia
• It is generally bilateral and equal (isometropic)
• However, some cases may be unilateral with normal vision in the other eye
(anisometropia).
• Unilateral hypermetropia is more common than unilateral myopia
5. • Unilateral hypermetropia is more prone to develop
anisometropic amblyopia and squint.
• All children except congenital myopics are born
hypermetropic by about 3.0D sphere
• This is a paradox because the axial length of the
newborn eye is 16.5–17.5 mm
• To be ametropic, an eye should be about 24 mm
6. Emmetropia when accommodation is at rest,
parallel rays are brought to focus on the retina
Hypermetropia when accommodation is at
rest, parallel rays are brought to focus behind the
retina
Hypermetropia when accommodation
is active, the parallel rays are brought to focus on
the retina (hypermetropia is corrected)
7. The discrepancy is explained by two facts:
1. The lens of a newborn is more spherical than adult
2. The cornea of newborn is steeper in relation to axial length.
It has been pointed out earlier that 1 mm steeping of
cornea causes 7D of myopia
NOTE: Thus, the two factors, i.e. lenticular steepening and
corneal steepening added together neutralize the axial
hypermetropia mostly, leaving only +3D of error of refraction
8. IMPORTANT POINTS TO REMEMBER
• As the child grows, the axial length increases rapidly and by 5–6 years, it
reaches the emmetropic length. At this stage, 3 things can happen:
1. Eye fails to reach emmetropic length and the eye becomes
hypermetropic.
2. The eye reaches the emmetropic length and becomes emmetropic.
3. The axial length overshoots emmetropic length and becomes myopic.
Note: Though the axial length in adult hypermetropia is shorter, the
refractive power of the cornea and the lens are within normal limits.
9. CLASSIFICATION OF HYPERMETROPIA
1. On the basis of degree (Upto +2D [Mild], +2 to
+5D [Moderate], >+5D [High]
2. On the basis of clinical types (Simple, Pathological
& Functional)
3. On the basis of accommodation (Latent &
manifest)
10. 1. Simple Hypermetropia:
• Most common
• Results from normal biological variations in the development of eyeball
• It includes axial & curvatural Hypermetropia
• may be herediatery
2. Pathological Hypermetropia
• Anomalies lies outside the limits if biological variation
• It is of three types;
a. Acquired hypermetropia: Due to decrease in curvature of outer lens
fibers in old age
• Cortical sclerosis
b. Positional Hypermetropia: Due to lens dislocation
c. Aphakia : Due to absence of lens
d. Consecutive Hypermetropia: Due to surgical mistake
11. 3. Functional Hypermetropia
• It results from paralysis of accommodation
• Seen in patient with 3rd nerve (Coulomotor nerve) paralysis &
internal ophthalmoplegia
14. Structural Hypermetropia
• It will be caused by the following factors
1. Axial length: A shortening of 1 mm of the axial length causes 3D
of hypermetropia.
Axial hypermetropia is rarely more than +6D except in congenital
conditions like nanophthalmos.
In microphthalmos, not only the axial length is short, but the
cornea is also flatter, which added to short axial length makes
hypermetropia worse.
15. 2. Curvature: A flattening of 1 mm of the corneal or lenticular
curvature causes 6D of hypermetropia.
3. Refractive index: If the refractive index is reduced to less
than 1.37, the eye becomes hypermetropic.
• The exact relation between refractive index and
hypermetropia is not well understood
• The common cause of index hypermetropia;
Age: As age advances, the cortex becomes less convergent
and the lenticular curvature also flattens.
Hypoglycemia: Persons during initial stages of treatment for
diabetes are prone to develop hypermetropia due to relative
dehydration of the lens
16. 4. Lens subluxation/Displacement: Backward shift of 1 mm the lens
in optical axis causes 1.4D of hypermetropia.
• Total absence of lens as in aphakia of any etiology causes
maximum hypermetropia, which is roughly +10D sphere.
Other causes of hypermetropia are mostly iatrogenic:
o Pharmacological: Facultative hypermetropia may pass into
absolute hypermetropia following ingestion of parasympatholytic
drugs.
o Hypermetropia can be unmasked by use of cycloplegic locally.
o Optical: Overcorrection of myopia by contact lens or spectacle.
o Surgical: Overcorrection of myopia by radial keratotomy (RK) or
laser-assisted in situ keratomileusis (LASIK).
o Residual hypermetropia following IOLimplant
17.
18.
19. Hypermetropia According
to Available Accommodation
• On the basis of accommodation, the
hypermetropia can be latent and manifest
• The manifest hypermetropia is again divided into
facultative and absolute
• The sum of all is called total hypermetropia
20. Total Hypermetropia
• This is the sum of all hypermetropias
• It can only be fully elicited under complete cycloplegia by
atropine
• One example of total hypermetropia is aphakia where there is no
lens; hence the eye is in the perpetual state of absence of
accommodation
• The other conditions that can precipitate absolute hypermetropia
are internal and total III nerve palsy
21.
22. Latent hypermetropia: This is due to inherent tone of
ciliary muscle and is present in all hypermetropic
eyes without being felt by the person, because it is
symptoms less.
• It can be unmasked by subtracting manifest
hypermetropia from total hypermetropia.
• It varies between 0.5D and 1.0D sphere and
gradually declines with age with little clinical
significance
23. • Manifest hypermetropia: This represents total
hypermetropia—latent hypermetropia and is sum of
facultative hypermetropia and absolute hypermetropia.
• Thus, AH + FH = MH = TH – LH
• This can be elicited without cycloplegia provided the patient
fixes a distant object.
• It is partly corrected by patient’s available accommodation
and the remaining correction is corrected by plus sphere.
• The strongest plus sphere with which the patient remains 6/6
denotes manifest hypermetropia.
• Thus, MH = Accommodation + Convex lens
24. A. Facultative hypermetropia: This is that part of hypermetropia,
which can be corrected by the effect of accommodation.
• The patient has 6/6 distant vision and remains 6/6 by adding plus
lenses till a stage is reached when the vision starts declining.
• This power gives the amount of facultative hypermetropia.
• It is the difference between manifest and absolute hypermetropia
B. Absolute hypermetropia: This is not corrected by the effort of
accommodation the patient has diminished distant vision.
• All facultative hypermetropes are likely to be converted into
absolute hypermetropia after 60 years of age.
• The following examples depict various components of
hypermetropia:
25. a. Suppose an eye has a total hypermetropiaof +5D as arrived
following retinoscopy under atropine and has a latent
hypermetropia of 0.5D.
b. The patient manifest hypermetropia is +5.0D – 0.5D = +4.5D,
which can be arrived by retinoscopy even without cycloplegia
provided, the patient fixes a distant object, relaxing
accommodation completely
c. Out of this, +4.5D manifest hypermetropia, +1.5D sphere is
facultative. Hence, he/she is left with absolute hypermetropia of
+3D sphere that require to be corrected by plus lenses because
eyes with absolute hypermetropia are bound to have subnormal
distant vision.
26. Example In Different Way
1. Let us consider an eye with subnormal vision that subjectively shows to have
hypermetropia of +5.0D.
• This is absolutehypermetropia.
2. The eye retains vision 6/6 till this power is increased to +7D showing that he/she
has been corrected +7D – (+5D) = +2D by accommodation.
3. +7D is manifest hypermetropia.
4. Under full cycloplegia, refraction comes to +7.5D out of which, +0.5D is latent
hypermetropia.
5. Thus, he/she has got a +7.5D of the total hypermetropia
28. Signs
• In case of low hypermetropia, there may be no
external signs that may point toward presence of
hypermetropia even distant vision may be normal and
the patient may be able to read small prints without
glasses.
• The signs become evident in moderate to high
hypermetropia.
• They include:
29. 1. Relatively narrow interpalpebral aperture due to small eyeball.
2. Eyeball is small in axial hypermetropia. It is normal in curvature and index
hypermetropia.
• Obviously, it will be within normal limits in aphakia.
3. The cornea is smaller than in emmetropia.
4. Anterior chamber is shallow and prone to angle closure after 40 years of
age.
5. Angle kappa is positive, giving an impression of divergent squint.
6. Exophoria.
7. Accommodative esotropia.
8. Small pupil that takes more time to dilate with weak cycloplegia.
9. Low accommodative convergence/accommodation (AC/A).
10. Sclera has sharp curve at the equator.
11. The ciliary muscles are well developed.
30. 12. The circular fibers are hypertrophied (this is not visible
externally).
13. The fundus is small. It has shot-silk appearance.
• The retinal vascular reflexes are accentuated, may be mistaken as
sclerosed.
14. The disk is small, giving an appearance of pseudoneuritis.
15. Fovea is dull.
16. Vision may be normal or subnormal.
17. Anisometropia is more common.
18. Uncorrected eyes are likely to develop amblyopia.
19. Amblyopia is more common in unilateral hypermetropia.
20. Presbyopia sets in early than in emmetropia
31. FUNDUS SIGNS:
• Disc: Dark reddishcolor, irregular margins, confused
with papillitis so termed as pseudo-papillitis
• Macula: Situated farther from the disc than usual,
large positive angle alpha, apparent divergent
squint
• Blood vessels: Show undue tortuosity & abnormal
branching
• Background: Shot-silk Retina
32. Symptoms
• The term farsightedness for hypermetropia is irrelevant.
• It gives an impression as if all hypermetropic eyes have good
distant vision.
• In fact, 50% of eyes in adults and all secondary
hypermetropias like aphakia, dislocated lens and
nanophthalmos are bound to have subnormal distance vision
• The symptoms depend on available accommodation, which
in turn depends on:
33. 1. Age of the patient:
a. Children are more likely to be symptoms free because of their ability to
accommodate more.
b. The 75% of hypermetropes above 60 have diminished distant vision due to less
availability of accommodation
2. Near vision requirements: Adults who are engaged in prolonged near work are
more likely to develop symptoms of asthenopia and blurred distant vision
3. All aphakes are bound to have diminished distant as well as near vision
4. Patient may report with esotropia and are found to have hypermetropia.
5. Asthenopia.
6. Difficulty in near work
7. Diminished distant vision.
8. Recurrent blepharitis, stye chalazion, chronic conjunctivitis.
9. The symptoms may be any of the above or a combination of two or more
34. INVESTIGATIONS & DIAGNOSIS
• By checking Visual acuity
• By doing retinoscopy
• By subjective & cycloplegics refraction
• By fundoscopy, slit-lamp & A-scan
38. MANAGEMENT
1. This depends upon the available accommodation
2. The effort should be to bring back the posterior
focal plane that is situated behind the retina to the
retina.
3. This is achieved by prescribing plus lenses
4. The principle involved in prescription of glasses to
hypermetropes
39. The principle involved in prescription of glasses to
hypermetropes
a. Unlike myopia, all persons with hypermetropia need not be corrected.
b. Only symptomatic patients should be corrected.
c. Extent of hypermetropia in persons under 50 years should be determined
under cycloplegia.
d. All patients under 10 years should be refracted under atropine.
e. Manifest hypermetropia below 1D can be ignored, unless the patient is
symptomatic
40. f. The first prescription should be lowest that gives 6/6 vision.
g. It is preferably increased over months till the manifest hypermetropia has been
reached.
h. The best method is to add 1/4th of latent to the manifest (Donder).
i. Hypermetropia with accommodative squint should be given full correction
j. Amblyopia should always be suspected in unilateral hypermetropia and when
detected should be treated by antiamblyopia treatment.
k. In some children, hypermetropia gets neutralized as the child grows and the eyeball
elongates.
• Hence, all the hypermetropic children during their growing age should be
refracted yearly under cycloplegia.
41. l. Patients above 50 years who are prone to develop central nuclear sclerosis
may discard their plus correction due to second sight.
m. Pre-presbyopic patients who complain of difficulty in near work should be
given full distant correction.
• This generally eliminates additional near correction.
n. Astigmatism when present, should be fully corrected, it should neither be
under or over corrected because astigmatism is independent of
accommodation.
o. Contact lens power in hypermetropia is more than spectacle power.
p. Surgical treatment in hypermetropia is not as rewarding as in myopia and
should be performed only after 20 years of age
42. MODE OF TREATMENT
1. SPECTACLE (Temporary Treatment)
2. CONTACT LENS (Temporary Treatment)
3. SURGICAL (Permanent Treatment)
NOTE: No treatment required if
• Error is small
• Asymptomatic
• Visual acuity normal
• No muscular imbalance
44. Contact lens
• Prescribe plus contact les
• Advantage:
-Cosmetically good
-Increased field of view
-Less magnification
-Elimination of aberration & prismatic effects
45. Refractive Surgery
• It is not as effective as in myopia
• Types;
1. Hexagonal Keratotomy
2. Laser thermal keratoplasty
3. Photorefractive keratectomy
4. Laser in situ keratomileusis (LASIK)
5. Phakic IOL & clear lens extraction
48. • It is for low to moderate degree of hypermetropia
• The number of incisions is six, giving a configuration of
hexagon; hence the procedure is also called hexagonal
keratotomy
51. • Laser thermal keratoplasty (LTK) is suitable for low hypermetropia in persons
between 40 and 50 years, presbyopia and astigmatism
• It is a collagen shrinkage surgery
• It takes very little time to perform and is claimed to have fast recovery
• The infrared laser is directed by a contact fiber optics handpiece or non-contact
slit lamp delivery
• The wavelength of the laser is midinfrared at 2.06 micrometers with a pulse
duration of 300 microseconds, repetition rate of 15 Hz and power 19 mJ
• The laser used is holmium: YAG laser
• The function of the laser procedure is to produce mild charring of midstroma,
resulting in formation of a constricting band all round, forcing the central cornea
to be steeped
• The optical zone is large, i.e. 6.00 mm
• The laser beams are applied in two rows; one at 6.00 mm and the subsequent at
7.00 mm.
• Each ring of burns is generally eight in number
COMPLICATION: Regression and introduction of astigmatism
54. • Conductive keratoplasty is collagen shrinkage procedure
• In this procedure, 350 kHz of radiofrequency is used
• The energy is delivered to the stroma at multiple spots in a
circular fashion
• The energy is delivered through a contact delivery system
comprising of a stainless steel probe
• The energy, on reaching the stroma, causes a shrinkage of the
collagen
• The shrinkage results in steeping of central cornea
• This procedure can also be used to correct presbyopia and
keratoplasty-induced astigmatism
COMPLICATION: Initial overcorrection, regression and iatrogenic
astigmatism
56. • Hypermetropic PRK, an ablation procedure
• Using excimer laser, done on eyes with hypermetropia up to
4D
• The laser ablation is done beyond a large optical zone of 6
mm, which is surrounded by a transition zone of 9 mm
• The number of laser spots is three times more than required
for myopia of same order
• The procedure produces a large doughnut-shaped ring of
ablation all around with a large epithelial defect that requires
longer healing time
COMPLICATION: Regression is common
58. • An ablation procedure, done under the corneal flap,
similar to done in myopia
• The process is used for moderate hypermetropia
(Principal: The principle involved is to create a central
steeping by peripheral circular ablation)
• The diameter of the flap is 9.0–10.0 mm
• The flap is mostly created by microkeratome.
• A better alternative is a femtosecond laser
59. Advantage and Disadvantage of LASIK
Advantage
• There is fast visual gain.
• Less regression
• Quick epithelial healing with
minimal haze.
• It can be performed with thinner
cornea as compared to myopia
Disadvantage
• Introduction of astigmatism.
• Over- and under-correction.
• Inter, face scarring.
• Hypermetropic LASEK or epi-LASIK
are also claimed to be viable
alternative in hypermetropia.
61. Complications of Hypermetropia
1. Hypermetropic eyes are more prone to develop amblyopia, especially in
anisometropia and in presence of high astigmatism.
2. Accommodative esotropia is more common n children. This may be seen in children
as young as 2–3 years. Conversely, all children with esotropia should be refracted
under atropine and prescribed glasses as per retinoscopy, including bifocals if needed.
3. The following two are the acute complications that are seen after 40 years of age:
a. Acute narrow angle glaucoma.
b. Non-arteritic anterior ischemic optic neuropathy. Secondary hypermetropia mainly
includes postsurgical aphakia, ectopia lentis, overcorrection of myopia, etc.
• Among these aphakia is the most important and is detailed below
62. References
Ak khurana: Optics & refraction book
Borish
PK Mukherjee: Manual of optics and refraction
Visual optics book
Internet & chrome