Macular hole
•Download as PPTX, PDF•
35 likes•10,476 views
The macula is a round yellow area at the back of the eye that is responsible for central vision. A macular hole is a break or defect in the macula that can cause vision loss. Macular holes are classified into four stages based on their size and severity. Stage 1 holes are subtle with little vision impact, while stage 4 holes are large with complete detachment of the vitreous gel from the retina. Surgery involving vitrectomy and gas or oil tamponade is often used to treat more advanced macular holes and works by relieving traction on the retina. Post-operative care involves keeping face down for up to two weeks to aid in hole closure.
Report
Share
Report
Share
Recommended
Macular hole
Macular hole is a defect in the macula involving its full thickness. It was first described in 1869. Idiopathic macular holes are the most common type and affect people over age 55. Staging of macular holes ranges from stage 1 to 4 based on size and pathology. Symptoms include decreased vision and metamorphopsia. Diagnosis involves examination, OCT, and sometimes FA. Treatment is usually vitrectomy surgery for stages 2-4 to relieve traction on the macula. Prognosis depends on pre-op vision and hole size/duration, with most patients gaining vision after surgery.
Epiretinal membrane
An epiretinal membrane is an avascular fibrocellular membrane that grows on the inner surface of the retina, causing macular dysfunction. It consists of various cell types and collagen. Symptoms include blurry vision and metamorphopsia. Observation is usually sufficient for mild cases, but surgery is recommended for significant vision loss or distortion. Peeling the membrane improves vision in most cases, though cataracts are a common complication. Prognosis is better when pre-op vision is good and the duration of symptoms is short.
Macular hole
This document summarizes macular hole and epiretinal membrane. It discusses the vitreous, macula, OCT imaging, pathogenesis and stages of macular hole. It covers risk factors, signs, differential diagnosis and treatment of macular hole including vitrectomy. It also discusses prevalence, risk factors, pathogenesis and components of epiretinal membrane formation.
Intrastromal Corneal Ring Segment (ICRSs)
Intracorneal ring segments, such as INTACS, are thin plastic rings that are implanted into the corneal stroma to flatten the cornea and reduce myopia. They are placed in a lamellar channel using either a mechanical or laser procedure. Thicker rings provide greater flattening and myopia correction. Potential risks include visual disturbances and complications requiring removal. Intracorneal rings have been used off-label to treat conditions like post-LASIK ectasia and keratectasia with some success in improving vision.
Peripheral fundus & its disorders
Peripheral fundus & its disorders
Presented by Dr Rohit Rao
This document summarizes the key anatomical structures and pathologies of the peripheral retina. It describes the ora serrata, pars plana, vitreous base, dentate processes, meridional folds, and other peripheral features. It then discusses various degenerative conditions like lattice degeneration, retinoschisis, and pavingstone degeneration. Treatment options for retinal breaks including cryopexy and laser photocoagulation are also summarized.
Types of iol
Types of intraocular lenses include foldable acrylic and silicone lenses. IOLs are either single piece or multipiece, and have different optic designs like aspheric, toric, or multifocal to correct vision. IOLs are implanted either in the capsular bag or ciliary sulcus, and are made of materials like acrylic, silicone, or hydrogels. Newer accommodating IOL designs aim to restore accommodation.
Diabetic macular edema
This document discusses macular edema in diabetic retinopathy and its treatment. It explains that macular edema is caused by chronic hyperactivity of the polyol pathway and increased vascular endothelial growth factor, which leads to increased vascular permeability. Laser photocoagulation and intravitreal anti-VEGF injections are effective treatments that work by reducing hypoxia and VEGF levels in the retina. Several studies found that treatments with drugs like ranibizumab and aflibercept were more effective at improving vision outcomes than laser alone in patients with diabetic macular edema.
Occular Ischemic Syndrome
Ischemic condition affecting the eye.
The ischemia can occur secondary to systemically problem [or] particulary the eye.
Many retinal vascular disorders {like CRAO,CRVO,Diabetic retinopathy,Hypertensive Retinopathy} shows ischemic signs.
Recommended
Macular hole
Macular hole is a defect in the macula involving its full thickness. It was first described in 1869. Idiopathic macular holes are the most common type and affect people over age 55. Staging of macular holes ranges from stage 1 to 4 based on size and pathology. Symptoms include decreased vision and metamorphopsia. Diagnosis involves examination, OCT, and sometimes FA. Treatment is usually vitrectomy surgery for stages 2-4 to relieve traction on the macula. Prognosis depends on pre-op vision and hole size/duration, with most patients gaining vision after surgery.
Epiretinal membrane
An epiretinal membrane is an avascular fibrocellular membrane that grows on the inner surface of the retina, causing macular dysfunction. It consists of various cell types and collagen. Symptoms include blurry vision and metamorphopsia. Observation is usually sufficient for mild cases, but surgery is recommended for significant vision loss or distortion. Peeling the membrane improves vision in most cases, though cataracts are a common complication. Prognosis is better when pre-op vision is good and the duration of symptoms is short.
Macular hole
This document summarizes macular hole and epiretinal membrane. It discusses the vitreous, macula, OCT imaging, pathogenesis and stages of macular hole. It covers risk factors, signs, differential diagnosis and treatment of macular hole including vitrectomy. It also discusses prevalence, risk factors, pathogenesis and components of epiretinal membrane formation.
Intrastromal Corneal Ring Segment (ICRSs)
Intracorneal ring segments, such as INTACS, are thin plastic rings that are implanted into the corneal stroma to flatten the cornea and reduce myopia. They are placed in a lamellar channel using either a mechanical or laser procedure. Thicker rings provide greater flattening and myopia correction. Potential risks include visual disturbances and complications requiring removal. Intracorneal rings have been used off-label to treat conditions like post-LASIK ectasia and keratectasia with some success in improving vision.
Peripheral fundus & its disorders
Peripheral fundus & its disorders
Presented by Dr Rohit Rao
This document summarizes the key anatomical structures and pathologies of the peripheral retina. It describes the ora serrata, pars plana, vitreous base, dentate processes, meridional folds, and other peripheral features. It then discusses various degenerative conditions like lattice degeneration, retinoschisis, and pavingstone degeneration. Treatment options for retinal breaks including cryopexy and laser photocoagulation are also summarized.
Types of iol
Types of intraocular lenses include foldable acrylic and silicone lenses. IOLs are either single piece or multipiece, and have different optic designs like aspheric, toric, or multifocal to correct vision. IOLs are implanted either in the capsular bag or ciliary sulcus, and are made of materials like acrylic, silicone, or hydrogels. Newer accommodating IOL designs aim to restore accommodation.
Diabetic macular edema
This document discusses macular edema in diabetic retinopathy and its treatment. It explains that macular edema is caused by chronic hyperactivity of the polyol pathway and increased vascular endothelial growth factor, which leads to increased vascular permeability. Laser photocoagulation and intravitreal anti-VEGF injections are effective treatments that work by reducing hypoxia and VEGF levels in the retina. Several studies found that treatments with drugs like ranibizumab and aflibercept were more effective at improving vision outcomes than laser alone in patients with diabetic macular edema.
Occular Ischemic Syndrome
Ischemic condition affecting the eye.
The ischemia can occur secondary to systemically problem [or] particulary the eye.
Many retinal vascular disorders {like CRAO,CRVO,Diabetic retinopathy,Hypertensive Retinopathy} shows ischemic signs.
Macular hole
This document provides an overview of macular holes, including:
- Classification into primary (idiopathic) and secondary holes. Primary holes are caused by vitreous traction while secondary have other causes like trauma.
- Stages of macular hole formation based on Gass classification from early detachment to full thickness hole.
- Surgical treatment involves vitrectomy to relieve traction along with internal limiting membrane peeling which has good outcomes in improving vision.
- Differential diagnosis includes epiretinal membranes and pseudoholes which have different presentations and prognoses.
Bandage Contact Lens
This document discusses the use of bandage contact lenses after refractive surgery procedures like LASIK and PRK. It describes how bandage contact lenses can help reduce pain, promote healing of the epithelium, and prevent complications like striae or epithelial in-growth after surgery. Different types of bandage contact lens materials are reviewed, including hydrogels, silicone hydrogels, collagen shields, and scleral lenses. Factors like oxygen transmissibility, diameter, and disposable versus reusable lenses are discussed when selecting a bandage contact lens. Potential complications are also mentioned.
Optical coherence tomography in glaucoma - Dr Shylesh Dabke
This document discusses optical coherence tomography (OCT) in evaluating glaucoma. It begins by outlining the importance of early glaucoma detection to prevent vision loss. OCT is described as the most appropriate technology for detecting glaucoma as it can assess retinal nerve fiber layer (RNFL) thickness before visual field or optic disc changes occur. RNFL thinning is an early sign of glaucoma. The document then provides details on OCT technology and analysis of RNFL thickness, optic nerve head, and macula to diagnose and monitor glaucoma. RNFL analysis, especially of the inferior quadrant, is highlighted as the most useful OCT assessment for detecting early glaucoma.
Fuchs dystrophy and pseudophakic bullous keratopathy
This document discusses Fuchs endothelial dystrophy and pseudophakic bullous keratopathy. It describes the characteristics, classification, pathology, signs, and treatment of Fuchs endothelial dystrophy. It also covers the etiology, clinical features, evaluation techniques including specular microscopy and pachymetry, and management including corneal transplant and conjunctival flap procedures for pseudophakic bullous keratopathy resulting from traumatic endothelial damage following cataract surgery.
Refrective surgery ppt
This document discusses various refractive surgery procedures used to correct refractive errors of the eye, including incisional keratotomy techniques, lamellar procedures, laser ablation procedures, corneal implants, and lens-based procedures. It provides details on common procedures like radial keratotomy, LASIK, PRK, and LASEK. It covers patient evaluation, surgical techniques, potential complications, and advantages of different approaches. Wavefront-guided customized excimer laser surgery is also introduced to correct higher-order aberrations in addition to spherical and cylindrical errors.
Intermitent exotropia
This document discusses intermittent exotropia, including its theories, presentation, examination, classification, treatment, and surgical management. The key points are:
1. Intermittent exotropia is thought to be caused by an imbalance between convergence and divergence muscles. It typically begins as exophoria in infancy and progresses to intermittent exotropia.
2. Examination includes measuring the deviation at distance and near with and without lenses to classify the type. Non-surgical treatment aims to improve vergence control through patching, lenses, and orthoptics.
3. Surgical treatment is indicated for deviations over 20 prism diopters, worsening control, or failure of conservative therapy.
Double elevator palsy
1. Monocular elevation deficiency (MED), also known as double elevator palsy, is characterized by an inability to elevate one eye in all fields of gaze, resulting in hypotropia of the affected eye.
2. The condition can be congenital or acquired, with causes including superior rectus palsy, inferior rectus restriction, and supranuclear lesions.
3. Surgical management of MED depends on forced duction test results and may include inferior rectus recession, superior rectus resection, or Knapp's procedure to transpose the horizontal rectus muscles. The goal is to improve eye position and increase binocular vision.
Lasers in Glaucoma
This document discusses the use of lasers in the treatment of glaucoma. It begins by introducing different types of lasers used, including Nd:YAG lasers. It then covers specific laser procedures for glaucoma such as laser iridotomy to relieve pupillary block, laser iridoplasty to modify the iris, and laser trabeculoplasty to increase outflow. It compares argon laser trabeculoplasty to selective laser trabeculoplasty. The document also discusses laser techniques for angle closure glaucoma, post-operative treatment, and cyclophotocoagulation to reduce aqueous production. Throughout, it provides details on laser parameters and outcomes of these procedures.
Dalk
This document discusses deep anterior lamellar keratoplasty (DALK), a type of corneal transplant surgery. It provides:
1) A brief history of DALK, beginning with early successful transplants in the late 19th century and developments in techniques in the 1950s and 1980s.
2) Indications for DALK including keratoconus, post-LASIK ectasia, hereditary stromal dystrophies, infectious keratitis, and tectonic indications.
3) An overview of various surgical techniques for DALK including manual dissection, air-assisted dissection, and techniques using viscoelastic or femtosecond lasers.
4) Preparation of
Choroidal neovascular membranes (CNVM)
Choroidal neovascularization (CNV) involves the abnormal growth of new blood vessels from the choroid layer of the eye through Bruch's membrane. This can cause vision loss and is a common cause of wet macular degeneration. CNV occurs due to alterations in Bruch's membrane and high levels of vascular endothelial growth factor. It is classified based on its location relative to the retinal pigment epithelium and fovea. Symptoms include sudden vision loss and visual distortions. CNV is diagnosed through imaging like optical coherence tomography and fluorescein angiography and treated with injections of anti-VEGF drugs to inhibit blood vessel growth.
Anatomy of vitreous
This document discusses the anatomy and development of the vitreous humor in the eye. It begins by describing the embryological origin of vitreous cells from surface ectoderm, neuroectoderm, and mesodermal tissues. During the primary vitreous stage, the vitreous body begins forming before closure of the choroidal fissure and appears as a fibrillated secretion filling the vitreous space. The document then covers the general features, structure including hyaloid layers, cortical and medullary regions, attachments, composition and transport processes of the mature vitreous humor. It concludes by describing the physicochemical properties and factors affecting expansion and contraction of the vitreous gel.
Pentacam
The document describes the use of various Pentacam maps and indices for screening patients for keratoconus, including:
1) The standard 4-map composite report, keratoconus map, Holladay report, and Belin/Ambrosio Enhanced Ectasia Display.
2) Key features to examine on each map include anterior and posterior elevation maps, pachymetry maps, curvature maps, and indices values.
3) The Belin/Ambrosio Enhanced Ectasia Display aims to improve sensitivity by calculating an "enhanced" best fit sphere reference surface that excludes the thinnest corneal region, highlighting differences between normal and ectatic corneas.
Coats' Disease
Coats' disease is a rare eye condition characterized by abnormal blood vessels in the retina. It most commonly affects young boys under 10 years old. The document discusses the history, signs and symptoms, classification, diagnosis, differential diagnosis, and management of Coats' disease. Treatment options depend on the stage of the disease and aim to obliterate abnormal retinal vessels using laser photocoagulation, cryotherapy, surgery, or newer adjunct treatments like intravitreal anti-VEGF agents. Indian studies found Coats' disease patients often present with more severe vision loss and extensive retinal involvement compared to other populations.
Iol power calculation in pediatric patients
- Many factors affect intraocular lens (IOL) power calculation in pediatric patients including age at surgery, laterality, amblyopia, axial length, keratometry, and expected myopic shift due to ongoing eye growth.
- Normal eye development involves rapid growth of the axial length and changes in lens power in the first years of life.
- Target postoperative refraction must account for this myopic shift and generally involves undercorrecting more in younger patients.
- Accurate biometry using immersion ultrasound or optical techniques is important to minimize errors from corneal compression.
- Formulas, IOL type and position can further influence outcomes.
NW2010 Epiretinal membrane
This document discusses epiretinal membrane (ERM), a fibrocellular membrane that forms on the inner surface of the retina. It causes varying degrees of macular dysfunction. ERM can be idiopathic or secondary to conditions like retinal detachment repair. Symptoms include vision loss and metamorphopsia. Diagnosis is usually clinical but OCT and FFA can help. Treatment is usually vitrectomy to peel the membrane if it is causing visual symptoms. Outcomes are generally good with most patients improving, but recurrence or worse vision is possible.
binocular single vision
Binocular single vision refers to simultaneous vision with two eyes that occurs when an individual fixates on an object. There are three grades of binocular vision: simultaneous perception, fusion, and stereopsis. Fusion is the ability to see a composite picture from two similar images, while stereopsis provides the impression of depth by superimposing images from slightly different angles. Tests for binocular vision include those for simultaneous perception, fusion, and stereopsis using instruments like the synaptophore. Binocular vision develops through infancy and childhood as the visual axes become coordinated to direct each fovea at the object of regard.
Choroidal neovascularisation(cnv)
This document discusses choroidal neovascularization (CNV), which is the abnormal growth of blood vessels from the choroid into the retina or subretinal space. It is a cause of vision loss and the main feature of exudative age-related macular degeneration. The document defines CNV and lists various conditions that can cause it. It then focuses on CNV caused by age-related macular degeneration, covering risk factors, pathogenesis, symptoms, diagnostic findings on fluorescein angiography and OCT, and various treatment options including anti-VEGF drugs, photodynamic therapy, and laser photocoagulation.
Anatomy of macula
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.
Corneal anatomy and physiology 2
This document provides information on the anatomy and physiology of the cornea. It describes the layers of the cornea including the epithelium, Bowman's membrane, stroma, Dua's layer, Descemet's membrane, and endothelium. It discusses the transparency of the cornea, metabolic processes, drug permeability, wound healing, and the effects of contact lens wear on corneal physiology. The cornea has several specialized functions including refracting light and protecting the interior of the eye.
Adaptive mechanism of squint
This document summarizes adaptations in the visual system that can occur in response to abnormal binocular vision due to strabismus. It describes sensory adaptations that depend on factors such as the age when abnormal vision began and its severity. In a mature visual system, diplopia and confusion may occur, while an immature system can develop suppression, amblyopia, monofixation syndrome, or abnormal retinal correspondence. The document outlines tests to diagnose these conditions and explains adaptations like suppression, fusion, and diplopia that the visual system employs to eliminate double vision. It provides examples of sensory tests and their results in different binocular alignment conditions.
Macular hole
This document summarizes macular hole formation and treatment. It describes the stages of macular hole development classified by Gass. Vitrectomy surgery involving fluid-gas exchange has been shown to successfully reattach the macula and improve vision in 58-73% of cases. The author reports high success rates for macular hole closure and visual improvement with vitrectomy using various tamponades and adjuncts like internal limiting membrane peeling. Face down positioning after surgery is important for compliance and optimal outcomes.
Evaluation and Management of Macular Holes
This document summarizes evaluation and management of macular holes. It describes the epidemiology, pathogenesis, classification, diagnosis, treatment and outcomes of macular hole surgery. Key points include: macular holes are more common in females over 70; stage 3 holes have the worst vision; surgery involves vitrectomy to remove traction and seal the hole with gas or oil; post-op vision improves in 90% of cases with closure rates over 90% when internal limiting membrane is peeled. Complications are low but include retinal detachment and reopening in some cases.
More Related Content
What's hot
Macular hole
This document provides an overview of macular holes, including:
- Classification into primary (idiopathic) and secondary holes. Primary holes are caused by vitreous traction while secondary have other causes like trauma.
- Stages of macular hole formation based on Gass classification from early detachment to full thickness hole.
- Surgical treatment involves vitrectomy to relieve traction along with internal limiting membrane peeling which has good outcomes in improving vision.
- Differential diagnosis includes epiretinal membranes and pseudoholes which have different presentations and prognoses.
Bandage Contact Lens
This document discusses the use of bandage contact lenses after refractive surgery procedures like LASIK and PRK. It describes how bandage contact lenses can help reduce pain, promote healing of the epithelium, and prevent complications like striae or epithelial in-growth after surgery. Different types of bandage contact lens materials are reviewed, including hydrogels, silicone hydrogels, collagen shields, and scleral lenses. Factors like oxygen transmissibility, diameter, and disposable versus reusable lenses are discussed when selecting a bandage contact lens. Potential complications are also mentioned.
Optical coherence tomography in glaucoma - Dr Shylesh Dabke
This document discusses optical coherence tomography (OCT) in evaluating glaucoma. It begins by outlining the importance of early glaucoma detection to prevent vision loss. OCT is described as the most appropriate technology for detecting glaucoma as it can assess retinal nerve fiber layer (RNFL) thickness before visual field or optic disc changes occur. RNFL thinning is an early sign of glaucoma. The document then provides details on OCT technology and analysis of RNFL thickness, optic nerve head, and macula to diagnose and monitor glaucoma. RNFL analysis, especially of the inferior quadrant, is highlighted as the most useful OCT assessment for detecting early glaucoma.
Fuchs dystrophy and pseudophakic bullous keratopathy
This document discusses Fuchs endothelial dystrophy and pseudophakic bullous keratopathy. It describes the characteristics, classification, pathology, signs, and treatment of Fuchs endothelial dystrophy. It also covers the etiology, clinical features, evaluation techniques including specular microscopy and pachymetry, and management including corneal transplant and conjunctival flap procedures for pseudophakic bullous keratopathy resulting from traumatic endothelial damage following cataract surgery.
Refrective surgery ppt
This document discusses various refractive surgery procedures used to correct refractive errors of the eye, including incisional keratotomy techniques, lamellar procedures, laser ablation procedures, corneal implants, and lens-based procedures. It provides details on common procedures like radial keratotomy, LASIK, PRK, and LASEK. It covers patient evaluation, surgical techniques, potential complications, and advantages of different approaches. Wavefront-guided customized excimer laser surgery is also introduced to correct higher-order aberrations in addition to spherical and cylindrical errors.
Intermitent exotropia
This document discusses intermittent exotropia, including its theories, presentation, examination, classification, treatment, and surgical management. The key points are:
1. Intermittent exotropia is thought to be caused by an imbalance between convergence and divergence muscles. It typically begins as exophoria in infancy and progresses to intermittent exotropia.
2. Examination includes measuring the deviation at distance and near with and without lenses to classify the type. Non-surgical treatment aims to improve vergence control through patching, lenses, and orthoptics.
3. Surgical treatment is indicated for deviations over 20 prism diopters, worsening control, or failure of conservative therapy.
Double elevator palsy
1. Monocular elevation deficiency (MED), also known as double elevator palsy, is characterized by an inability to elevate one eye in all fields of gaze, resulting in hypotropia of the affected eye.
2. The condition can be congenital or acquired, with causes including superior rectus palsy, inferior rectus restriction, and supranuclear lesions.
3. Surgical management of MED depends on forced duction test results and may include inferior rectus recession, superior rectus resection, or Knapp's procedure to transpose the horizontal rectus muscles. The goal is to improve eye position and increase binocular vision.
Lasers in Glaucoma
This document discusses the use of lasers in the treatment of glaucoma. It begins by introducing different types of lasers used, including Nd:YAG lasers. It then covers specific laser procedures for glaucoma such as laser iridotomy to relieve pupillary block, laser iridoplasty to modify the iris, and laser trabeculoplasty to increase outflow. It compares argon laser trabeculoplasty to selective laser trabeculoplasty. The document also discusses laser techniques for angle closure glaucoma, post-operative treatment, and cyclophotocoagulation to reduce aqueous production. Throughout, it provides details on laser parameters and outcomes of these procedures.
Dalk
This document discusses deep anterior lamellar keratoplasty (DALK), a type of corneal transplant surgery. It provides:
1) A brief history of DALK, beginning with early successful transplants in the late 19th century and developments in techniques in the 1950s and 1980s.
2) Indications for DALK including keratoconus, post-LASIK ectasia, hereditary stromal dystrophies, infectious keratitis, and tectonic indications.
3) An overview of various surgical techniques for DALK including manual dissection, air-assisted dissection, and techniques using viscoelastic or femtosecond lasers.
4) Preparation of
Choroidal neovascular membranes (CNVM)
Choroidal neovascularization (CNV) involves the abnormal growth of new blood vessels from the choroid layer of the eye through Bruch's membrane. This can cause vision loss and is a common cause of wet macular degeneration. CNV occurs due to alterations in Bruch's membrane and high levels of vascular endothelial growth factor. It is classified based on its location relative to the retinal pigment epithelium and fovea. Symptoms include sudden vision loss and visual distortions. CNV is diagnosed through imaging like optical coherence tomography and fluorescein angiography and treated with injections of anti-VEGF drugs to inhibit blood vessel growth.
Anatomy of vitreous
This document discusses the anatomy and development of the vitreous humor in the eye. It begins by describing the embryological origin of vitreous cells from surface ectoderm, neuroectoderm, and mesodermal tissues. During the primary vitreous stage, the vitreous body begins forming before closure of the choroidal fissure and appears as a fibrillated secretion filling the vitreous space. The document then covers the general features, structure including hyaloid layers, cortical and medullary regions, attachments, composition and transport processes of the mature vitreous humor. It concludes by describing the physicochemical properties and factors affecting expansion and contraction of the vitreous gel.
Pentacam
The document describes the use of various Pentacam maps and indices for screening patients for keratoconus, including:
1) The standard 4-map composite report, keratoconus map, Holladay report, and Belin/Ambrosio Enhanced Ectasia Display.
2) Key features to examine on each map include anterior and posterior elevation maps, pachymetry maps, curvature maps, and indices values.
3) The Belin/Ambrosio Enhanced Ectasia Display aims to improve sensitivity by calculating an "enhanced" best fit sphere reference surface that excludes the thinnest corneal region, highlighting differences between normal and ectatic corneas.
Coats' Disease
Coats' disease is a rare eye condition characterized by abnormal blood vessels in the retina. It most commonly affects young boys under 10 years old. The document discusses the history, signs and symptoms, classification, diagnosis, differential diagnosis, and management of Coats' disease. Treatment options depend on the stage of the disease and aim to obliterate abnormal retinal vessels using laser photocoagulation, cryotherapy, surgery, or newer adjunct treatments like intravitreal anti-VEGF agents. Indian studies found Coats' disease patients often present with more severe vision loss and extensive retinal involvement compared to other populations.
Iol power calculation in pediatric patients
- Many factors affect intraocular lens (IOL) power calculation in pediatric patients including age at surgery, laterality, amblyopia, axial length, keratometry, and expected myopic shift due to ongoing eye growth.
- Normal eye development involves rapid growth of the axial length and changes in lens power in the first years of life.
- Target postoperative refraction must account for this myopic shift and generally involves undercorrecting more in younger patients.
- Accurate biometry using immersion ultrasound or optical techniques is important to minimize errors from corneal compression.
- Formulas, IOL type and position can further influence outcomes.
NW2010 Epiretinal membrane
This document discusses epiretinal membrane (ERM), a fibrocellular membrane that forms on the inner surface of the retina. It causes varying degrees of macular dysfunction. ERM can be idiopathic or secondary to conditions like retinal detachment repair. Symptoms include vision loss and metamorphopsia. Diagnosis is usually clinical but OCT and FFA can help. Treatment is usually vitrectomy to peel the membrane if it is causing visual symptoms. Outcomes are generally good with most patients improving, but recurrence or worse vision is possible.
binocular single vision
Binocular single vision refers to simultaneous vision with two eyes that occurs when an individual fixates on an object. There are three grades of binocular vision: simultaneous perception, fusion, and stereopsis. Fusion is the ability to see a composite picture from two similar images, while stereopsis provides the impression of depth by superimposing images from slightly different angles. Tests for binocular vision include those for simultaneous perception, fusion, and stereopsis using instruments like the synaptophore. Binocular vision develops through infancy and childhood as the visual axes become coordinated to direct each fovea at the object of regard.
Choroidal neovascularisation(cnv)
This document discusses choroidal neovascularization (CNV), which is the abnormal growth of blood vessels from the choroid into the retina or subretinal space. It is a cause of vision loss and the main feature of exudative age-related macular degeneration. The document defines CNV and lists various conditions that can cause it. It then focuses on CNV caused by age-related macular degeneration, covering risk factors, pathogenesis, symptoms, diagnostic findings on fluorescein angiography and OCT, and various treatment options including anti-VEGF drugs, photodynamic therapy, and laser photocoagulation.
Anatomy of macula
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.
Corneal anatomy and physiology 2
This document provides information on the anatomy and physiology of the cornea. It describes the layers of the cornea including the epithelium, Bowman's membrane, stroma, Dua's layer, Descemet's membrane, and endothelium. It discusses the transparency of the cornea, metabolic processes, drug permeability, wound healing, and the effects of contact lens wear on corneal physiology. The cornea has several specialized functions including refracting light and protecting the interior of the eye.
Adaptive mechanism of squint
This document summarizes adaptations in the visual system that can occur in response to abnormal binocular vision due to strabismus. It describes sensory adaptations that depend on factors such as the age when abnormal vision began and its severity. In a mature visual system, diplopia and confusion may occur, while an immature system can develop suppression, amblyopia, monofixation syndrome, or abnormal retinal correspondence. The document outlines tests to diagnose these conditions and explains adaptations like suppression, fusion, and diplopia that the visual system employs to eliminate double vision. It provides examples of sensory tests and their results in different binocular alignment conditions.
What's hot (20)
Optical coherence tomography in glaucoma - Dr Shylesh Dabke
Optical coherence tomography in glaucoma - Dr Shylesh Dabke
Fuchs dystrophy and pseudophakic bullous keratopathy
Fuchs dystrophy and pseudophakic bullous keratopathy
Viewers also liked
Macular hole
This document summarizes macular hole formation and treatment. It describes the stages of macular hole development classified by Gass. Vitrectomy surgery involving fluid-gas exchange has been shown to successfully reattach the macula and improve vision in 58-73% of cases. The author reports high success rates for macular hole closure and visual improvement with vitrectomy using various tamponades and adjuncts like internal limiting membrane peeling. Face down positioning after surgery is important for compliance and optimal outcomes.
Evaluation and Management of Macular Holes
This document summarizes evaluation and management of macular holes. It describes the epidemiology, pathogenesis, classification, diagnosis, treatment and outcomes of macular hole surgery. Key points include: macular holes are more common in females over 70; stage 3 holes have the worst vision; surgery involves vitrectomy to remove traction and seal the hole with gas or oil; post-op vision improves in 90% of cases with closure rates over 90% when internal limiting membrane is peeled. Complications are low but include retinal detachment and reopening in some cases.
NW2010 Macular hole
This document provides an overview of macular holes (MH), including their epidemiology, pathogenesis, classification, diagnosis, natural course, treatment, and outcomes. Some key points:
- MHs are full-thickness defects in the macula that result in central vision loss. The most common cause is idiopathic vitreous traction.
- MHs are classified into 4 stages based on size and the presence of a posterior vitreous detachment. Stage 3 holes over 400 microns rarely close spontaneously.
- Treatment involves pars plana vitrectomy to relieve vitreous traction, with or without internal limiting membrane peeling. An air-gas bubble or silicone oil is used to tampon
AHS13 Peter Polack — The Role of Diet in Dry Eye Disease
This document discusses the role of diet in ocular surface disease. It notes that 14-33% of the US population has dry eye, and while aqueous deficiency accounts for 34% of dry eye cases, 95% of products on the market treat evaporative dry eye which accounts for 65-86% of cases. Dietary changes, hormonal effects, aging population, electronic device use, and better diagnostics all contribute to rising dry eye rates. Treatment options discussed include cyclosporine, steroids, nutritional supplements containing omega-3s and GLA, and procedures like LipiFlow. The document emphasizes the importance of addressing underlying inflammation and meibomian gland dysfunction in dry eye treatment.
Central Serous Chorioretinopathy
Central serous chorioretinopathy (CSCR) is a disease characterized by a serous detachment of the neurosensory retina over an area of leakage from the choriocapillaris through the retinal pigment epithelium. It commonly affects middle-aged men and presents with blurred vision, metamorphopsia, and micropsia. Imaging such as optical coherence tomography and fluorescein angiography can help diagnose focal leaks at the level of the RPE. While the condition typically resolves spontaneously, recurrence is common and chronic cases can lead to permanent vision loss. Treatment may include oral carbonic anhydrase inhibitors or laser photocoagulation for persistent or recurrent cases.
CENTRAL SEROUS CHORIOETINOPATHY
This document provides an overview of central serous chorioretinopathy (CSC), including its pathogenesis, clinical presentation, diagnosis, course and treatment. CSC is characterized by a localized serous retinal detachment in the macula due to leakage of fluid from the choroid. It typically affects men ages 30-50 and can be associated with stress, corticosteroid use, hypertension and type A personality. Diagnosis is usually clinical but can be confirmed with fluorescein angiography showing characteristic leakage patterns or optical coherence tomography identifying subretinal fluid. While most cases resolve spontaneously, laser photocoagulation or photodynamic therapy may be used in persistent or recurrent cases to seal leaking sites and accelerate resolution.
Macular function tests
The document discusses the anatomy and function of the macula and various tests used to evaluate macular function. The macula is located at the center of the retina and contains the highest concentration of photoreceptors, enabling sharp, central vision and color perception. Several tests are described that can help diagnose and monitor macular diseases by assessing visual acuity, contrast sensitivity, retinal imaging, and potential remaining vision in the context of opaque ocular media.
Ripandelli posterior buckling for macular hole
Ripandelli posterior buckling for macular holeThessaloniki International Vitreo-Retinal Summer School
This document discusses surgical techniques for treating retinal detachment in highly myopic eyes, specifically posterior buckling procedures. It describes the pathogenesis of retinal detachment in high myopia, which is often caused by persistent adherence of rigid epiretinal tissue and retinal/choroidal defects in the staphyloma area. Both posterior buckling and vitrectomy are discussed as surgical options, with buckling recommended for cases with severe staphylomas, pronounced retinal schisis, or when epiretinal membranes cannot be easily cleaved from the retina during vitrectomy. The posterior buckling procedure and silicone buckle element are described in detail. In conclusions, vitrectomy is primarily recommended but buckling may be useful asDry Eye Treatment - Artificial Tears and Punctal Plugs
Dr. Emil Chynn was the 1st eye surgeon in NYC to have LASIK himself (in 1999) but switched to the safer, noncutting SafeSight procedure in 2005 to avoid the night glare and dry eyes he and his patients had after LASIK. By avoiding cutting a flap, Dr. Chynn avoids cutting the corneal nerves, which causes dry eyes--so no dry eyes after LASEK!
Microscopic structure of retina dr paresh varsat
The retina consists of 10 layers from the outermost retinal pigment epithelium to the innermost internal limiting membrane. It contains two types of photoreceptor cells - rods and cones. Rods are responsible for peripheral and low light vision, while cones provide high-resolution central vision and color perception. The retina has three neuronal layers - the outer nuclear layer containing photoreceptor cell nuclei, the inner nuclear layer containing nuclei of bipolar, horizontal, amacrine and Muller cells, and the ganglion cell layer containing ganglion cell nuclei. Between these layers lie the two plexiform layers where synapses occur between the different neuronal types.
Treatment of dry eye syndrome
Dry eye syndrome is a common condition affecting around 50% of LASIK patients that can decrease satisfaction with the procedure's outcomes. Artificial tears were administered on a tapering schedule over 90 days to treat dry eye symptoms. Variables like corneal staining, conjunctival staining, tear break-up time, and Schirmer test were measured. Treatment for dry eye may include artificial tears, ointment, humidification, punctal plugs, oral pilocarpine, or topical cyclosporine. Women are affected by dry eye more commonly than men, and it is a frequent complication of Sjögren's syndrome.
Dry eye: A Multifactorial Disease
Dry eye, also known as dry eye disease, is a multifaceted condition that affects millions of people worldwide. It occurs when the eye does not produce enough tears or when the tears are not of the correct quality and consistency. Common symptoms include dryness, pain, discomfort, and visual disturbance. The prevalence increases with age, with over 75% of people over 65 affected. Women are more likely to suffer from dry eye than men. It can be caused by various underlying factors including meibomian gland dysfunction, autoimmune conditions like Sjogren's syndrome, allergies, medications, and environmental conditions. Dry eye exists on a spectrum of severity and can negatively impact quality of life.
Retina class 7th semester
The document summarizes the anatomy of the retina. It describes the layers of the retina in detail and explains conditions like central retinal artery occlusion (CRAO) and central retinal vein occlusion (CRVO).
The retina has two main regions - the posterior pole containing the optic disc and macula lutea, and the peripheral retina. The macula lutea contains the fovea centralis, which has tightly packed cones and thin retinal layers. CRAO and CRVO can cause vision loss due to obstruction of the central retinal artery or vein respectively. Management involves treatments like lowering IOP and anti-coagulants.
Dark room
This document describes various instruments used in ophthalmic examinations including retinoscopes, trial frames, Placido's disc, Maddox wing and rod, lenses, occluders, pin holes, and stenopic slits. It provides details on how each instrument is constructed and its purpose in examining patients, determining refractive error, and testing for conditions like keratoconus and heterophoria.
MACULAR DYSTROPHIES
This document provides information on hereditary macular dystrophies and macular function tests. It begins by describing the anatomical landmarks of the macula, including the fovea and foveola. It then discusses psychophysical macular function tests such as visual acuity testing, color vision testing, photostress testing, and Amsler grid testing. The document also covers electrophysiological tests like electroretinography (ERG) which objectively measures retinal electrical activity in response to light. ERG testing analyzes the a-wave from photoreceptors and b-wave from bipolar cells.
A macular pathology and oct update for optometrists
This document provides an overview of macular pathology and OCT interpretation. It discusses various retinal conditions including:
- Retinal hemorrhages and their locations (vitreous, pre-retinal, intraretinal, subretinal)
- Common findings on OCT including pathology involving different retinal layers (inner retina, outer retina) and features like the photoreceptor integrity line.
- Examples of diseases like diabetic retinopathy, retinal vein occlusions, AMD (dry and wet), central serous retinopathy, macular holes, optic disc pits, and retinitis pigmentosa.
It emphasizes assessing retinal layers, fluid locations, RPE appearance, and photoreceptor integrity to
B scan
Ultrasonography, also known as B-scan, was first used in ophthalmology in the 1940s. It uses high frequency sound waves to generate images of the inside of the eye. B-scans can be used to evaluate conditions like tumors, retinal detachments, and vitreous opacities. The document discusses the history, physics, principles and various applications of B-scan ultrasonography for examining the eye. Key aspects covered include probe orientation, scan types, interpretation of echogenicity and advantages in providing a non-invasive evaluation of intraocular structures.
Rhegmatogenous retinal detachment
This document provides information on rhegmatogenous retinal detachment including:
- The pathogenesis which involves vitreoretinal traction from liquefaction of the vitreous gel creating a hole that allows fluid into the subretinal space.
- Symptoms include photopsia, floaters, and visual field defects.
- Signs include Marcus Gunn pupil, low intraocular pressure, retinal breaks, and mild iritis.
- Treatment options depend on factors like location and size of retinal break, state of vitreous gel, and include laser photocoagulation, cryotherapy, scleral buckling, pneumatic retinopexy, and drainage of subretinal fluid in
Optic nerve
Coloboma of the optic disc results from a failure in closure of the embryonic fissure. Medullated nerve fibers represent myelination of retinal nerve fibers that normally proceeds from the brain downwards but stops at the lamina cribrosa. Persistent hyaloid artery congenital remnants can take different forms like Bergmester's papilla or a vascular loop in the vitreous. Optic neuritis includes inflammatory and demyelinating disorders of the optic nerve that can be idiopathic, infectious, or toxic in etiology. Papilloedema is optic disc swelling associated with increased intracranial pressure that is usually bilateral.
Vitreomacular traction
Vitreomacular traction (VMT) is a disorder characterized by an incomplete posterior vitreous detachment resulting in abnormal adherence of the vitreous to the macula. It can cause decreased vision and metamorphopsia. On OCT, VMT appears as thickened, taut posterior hyaloid attached to the fovea. Management includes initial observation, pharmacologic vitreolysis using ocriplasmin to weaken adhesion, or vitrectomy for cases with decreased vision or progression. Surgical risks include cataract and retinal tears while poor prognostic factors include chronic or severe preoperative findings.
Viewers also liked (20)
AHS13 Peter Polack — The Role of Diet in Dry Eye Disease
AHS13 Peter Polack — The Role of Diet in Dry Eye Disease
Dry Eye Treatment - Artificial Tears and Punctal Plugs
Dry Eye Treatment - Artificial Tears and Punctal Plugs
A macular pathology and oct update for optometrists
A macular pathology and oct update for optometrists
Similar to Macular hole
PCR management presentation of pcrPPT.pptx
This document discusses management of posterior capsule tears that occur during cataract surgery. It notes that posterior capsule tears can complicate the postoperative course by increasing the risk of complications like cystoid macular edema. For small central tears less than 3mm, conversion to continuous curvilinear capsulorhexis may be attempted. Larger tears require anterior vitrectomy and intraocular lens implantation in the ciliary sulcus. Vitreoretinal surgery may be needed for posteriorly dislocated lens fragments or associated retinal detachment. The key steps involve pars plana vitrectomy, removal of all lens matter, intraocular lens management, and treatment of complications.
Full Thickness Macular Hole (FTMH)
Common cause of central visual field loss
It is most common in females
The role of vitreomacular traction is major cause of macular hole
Other causes include high myopia, which leads to macular retinal detachment and blunt trauma
Disorders of vitreomacular interface by dr navid
Vitreomacular interface disorders involve abnormal attachments between the vitreous and the macula that can cause vision problems. These include vitreomacular adhesion (VMA), vitreomacular traction (VMT), macular holes, and epiretinal membranes. VMA is an asymptomatic focal adhesion within the macula, while VMT causes macular distortion from traction. Macular holes are full-thickness defects in the macula classified by size. Epiretinal membranes can cause macular wrinkling or distortion. OCT is useful for diagnosing and staging these vitreomacular disorders.
Macular hole
A macular hole is a full-thickness defect in the neurosensory retina located within or just eccentric to the fovea. It is commonly classified based on size and associated findings on exam and OCT imaging. Stage 1 holes show early changes like cysts or pseudocysts at the fovea. Stage 2 holes are full-thickness defects under 400um. Stage 3 holes are larger, over 400um. Stage 4 holes have a complete posterior vitreous detachment. Risk factors include age, female sex, myopia, and trauma. Patients may experience vision distortion or loss.
Vitreoretinal interface disorders
Vitreoretinal interface disorders involve abnormal adherence between the vitreous gel and the retina. Posterior vitreous detachment normally occurs in older individuals as the vitreous liquefies and separates from the retina. Vitreomacular adhesion and traction occur when the vitreous remains abnormally attached to the macula, which can cause macular edema or hole formation. Optical coherence tomography is useful for diagnosing and monitoring these disorders. Treatment may involve observation, pharmacologic vitreolysis to release attachments, or vitrectomy surgery to remove tractional forces on the macula.
keratoprosthesis
Keratoprosthesis is a surgical procedure that replaces a severely damaged or diseased cornea with an artificial cornea to restore vision. The first attempts at keratoprosthesis in humans date back to the mid-19th century, but most implants failed. Modern keratoprosthesis designs like the Boston KPro and AlphaCor KPro sandwich a donor corneal graft between plastic plates. Complications can include melting/extrusion of the implant, infection, glaucoma, retinal detachment, and formation of membranes behind the implant. Close post-operative monitoring is required to manage complications and maintain vision with keratoprosthesis implants.
KERATOPROSTHESIS
Keratoprosthesis is a surgical procedure that replaces a severely damaged or diseased cornea with an artificial cornea to restore vision. The first successful keratoprosthesis implantation in a human was in 1859. Modern devices like the Boston KPro (types 1 and 2), AlphaCor KPro, and osteo-odonto keratoprosthesis are commonly used today. The Boston KPro uses a donor corneal graft sandwiched between a front and back plate made of polymethyl methacrylate. The AlphaCor is made of a biocompatible polymer and integrates with surrounding tissues. Complications include melts and extrusion, infection, glaucoma, retroprosthetic membranes, and retinal
Visual pathways
Vision begins when light is detected by photoreceptors in the retina. The optic nerve carries visual information from the retina to the optic chiasm, where some nerve fibers from each retina cross over. The optic tract then carries the fibers to the lateral geniculate nucleus. From there, the optic radiations transmit visual information to the primary visual cortex. Damage to the visual pathways at different points can result in distinct visual field defects.
Vitreo macular interface disorder
Comprehensive discussion on Vitreo-Macular interface disorder, with ILM peeling and Ocriplasmin in details
Degenerative condition of eye
This document summarizes various degenerative conditions of the conjunctiva, cornea, and retina. It describes conditions such as pterygium, pinguecula, and concretions of the conjunctiva. For the cornea, it discusses recurrent erosion, arcus senilis, and lipid keratopathy. Regarding the retina, it outlines microcystoid degeneration, retinoschisis, and paving stone degeneration. The document provides details on the signs, symptoms, etiology, and treatment of these various ocular degenerative diseases.
Pediatric Ocular Trauma.pptx
This document provides an overview of pediatric ocular trauma, including:
1. Closed and open globe injuries are classified and their distinguishing physical exam findings described.
2. Specific injuries like hyphema, endophthalmitis, retinal detachment, and traumatic optic neuropathy are discussed in terms of symptoms, signs, and management.
3. Risk factors, mechanisms, and ocular signs of non-accidental injury like shaken baby syndrome are outlined.
MACULAR_HOLE presentation dhir hospital bhiwani.pptx
- A macular hole is a full-thickness opening in the neurosensory retina at the foveal center that causes metamorphopsia and central vision loss.
- Macular holes form due to vitreomacular traction or cystoid macular edema and are classified into stages based on size and morphology on OCT imaging.
- Surgical repair via pars plana vitrectomy and gas tamponade is effective for most macular holes, especially smaller and newer ones, leading to hole closure and vision improvement in many cases.
Keratoprosthesis
Keratoprosthesis is a surgical procedure where a severely damaged or diseased cornea is replaced with an artificial cornea to restore vision. The most commonly used procedure is the Boston Keratoprosthesis, which uses a donor corneal graft sandwiched between a front and back plate. Complications include melts and extrusion of the graft, infectious endophthalmitis, glaucoma, and retroprosthetic membranes. Close follow up is required after surgery to monitor for and manage any complications.
Keratoplasty
This document discusses different types of keratoplasty procedures including penetrating keratoplasty, lamellar keratoplasty, and Descemet stripping endothelial keratoplasty. Penetrating keratoplasty involves replacing the entire diseased cornea and is used for conditions involving all corneal layers. Lamellar keratoplasty replaces only partial layers of the cornea. Deep anterior lamellar keratoplasty removes tissue to the level of Descemet's membrane while Descemet stripping endothelial keratoplasty only replaces the diseased endothelium and Descemet's membrane through a small incision.
TOPIC vireous.pptx
The vitreous body serves optical and mechanical functions in the eye. It develops from neuroectoderm and provides a pathway for nutrients. Vitreous opacities appear as floating spots and are caused by developmental remnants, degeneration, inflammation or trauma. Vitreous detachment involves separation from the retina and can cause flashes or floaters, occasionally leading to retinal tears or detachment. Vitrectomy techniques such as three-port pars plana removal are used to treat various vitreous pathologies or as part of retinal surgery.
Corneal Ectasias
Corneal ectasias are disorders affecting the shape of the cornea. The main types are inflammatory and non-inflammatory. Keratoconus is a non-inflammatory ectasia with progressive thinning and protrusion of the cornea leading to irregular astigmatism. Diagnosis involves corneal topography showing an asymmetric bowtie pattern. Treatments include rigid contact lenses, collagen cross-linking to strengthen the cornea, and keratoplasty for severe cases. INTACS inserts are also used to flatten the cornea in mild to moderate keratoconus.
Femtosecond laser assisted cataract surgery
Femtosecond lasers can be used to assist with cataract surgery by performing three key steps: creating a precise capsulotomy, fragmenting the lens, and making incisions. The laser uses ultrashort pulses to precisely cut tissue with minimal collateral damage. During femtosecond laser-assisted cataract surgery (FLACS), the laser performs several pre-operative steps, then the surgeon completes phacoemulsification and lens implantation manually. Potential advantages include more reproducible incisions and capsulotomies, decreased ultrasound energy, and reduced stress on zonules, but the procedure takes more time and has a higher cost than conventional cataract surgery.
RETINA-retinal detatchment powerpoint presentation
This document summarizes various retinal conditions including retinal detachment, retinoblastoma, and retinitis pigmentosa. It describes the classification, causes, clinical features, investigations, and treatments of these conditions. Retinal detachment can be rhegmatogenous, tractional, or exudative in nature. Retinoblastoma is a malignant tumor of childhood that may appear as a white pupil reflex and is typically treated with chemotherapy, radiation, or enucleation. Retinitis pigmentosa is a genetic retinal dystrophy characterized by night blindness and bony spicule pigmentation.
keratoplasty.pptx
This document discusses corneal transplantation, including definitions, types (penetrating keratoplasty and lamellar keratoplasty), indications, donor evaluation and storage, contraindications, surgical techniques, and postoperative care and complications. It provides details on penetrating keratoplasty, including that it is the most common type and its main indications are diseases involving all corneal layers. It also summarizes anterior and posterior lamellar keratoplasty.
PSEUDOEXFOLIATION GLAUCOMA.pptx
This document discusses pseudoexfoliation glaucoma. It is the most common identifiable cause of open-angle glaucoma worldwide. It is caused by an inherited microfibrillopathy that results in the production of abnormal extracellular matrix material that is deposited in ocular and other tissues. It can cause open-angle or angle-closure glaucoma. Pseudoexfoliation glaucoma is more aggressive than other types of glaucoma and has a poorer prognosis. Management involves lowering intraocular pressure through medications like prostaglandin analogs or surgeries like filtering procedures or drainage devices.
Similar to Macular hole (20)
MACULAR_HOLE presentation dhir hospital bhiwani.pptx
MACULAR_HOLE presentation dhir hospital bhiwani.pptx
RETINA-retinal detatchment powerpoint presentation
RETINA-retinal detatchment powerpoint presentation
More from Samuel Ponraj
Optical aberrations
The document discusses optical aberrations in the eye, including monochromatic and chromatic aberrations. It describes how aberrations can be measured using wavefront analysis techniques like the Shack-Hartman test. Common aberrations discussed include defocus, astigmatism, coma, and spherical aberration. The document explains how these aberrations affect image quality and discusses techniques to measure and correct for aberrations.
B scan
B-scan ultrasonography provides two-dimensional images of the eye that can reveal information about the shape, location, extension, mobility, and thickness of tissues. It uses high frequency sound waves reflected off structures in the eye. The transducer sends pulses and receives echoes to build an image. B-scan is useful when the ocular media is opaque and for evaluating conditions like tumors, detachments, inflammation and measuring the eye's dimensions. Pathological features seen on B-scan include vitreous hemorrhage, asteroid hyalosis, retinoschisis, choroidal detachment, retinal detachment in various configurations, cysticercosis, choroidal melanoma and more.
Wide angle viewing field systems in vr surgery
Wide angle viewing systems provide panoramic views of the retina during vitreous surgery. There are contact and non-contact systems. Contact systems include vitreous panfundoscopes, contact wide field lenses, advanced visual instrument systems, and reinverting operating lens systems. These provide good image resolution but require an inverter due to the inverted image and have risks of corneal trauma. Non-contact systems like the BIOM and Resight provide upright images without inversion but have poorer image quality. Newer non-contact systems aim to provide wide fields of view with upright high resolution images.
A scan ultrasonography
Ultrasonography uses ultrasound to image tissues within the body. A-scan ultrasonography provides a one-dimensional view of the eye by measuring the echoes of ultrasound waves. It can be used to detect and measure tumors, assess eye structures for IOL calculation, and interpret pathology. The ultrasound is reflected at interfaces between tissues, appearing as spikes on the display. Immersion techniques provide more accurate measurements than contact techniques by avoiding compression artifacts. Limitations include artifacts, small lesions, missed foreign bodies, and misalignment issues.
Nyctalopia & retinitis pigmentosa
Rods contain the visual pigment rhodopsin, which consists of the protein opsin bound to the chromophore retinal. Rhodopsin absorbs blue light at 500nm and allows rods to function in low light conditions. Rods are more numerous and sensitive to light than cones, allowing vision in dim environments. When shifting from light to dark, the processes of pigment regeneration and phototransduction take place over 30 minutes to restore night vision through the visual pigment rhodopsin in rods. Nyctalopia, or night blindness, can result from vitamin A deficiency or other causes that impair rod function.
Keratoprosthesis
This document reviews a study of 55 keratoprosthesis insertions in 35 patients over periods ranging from 1 month to 15 years. Keratoprosthesis is a surgical procedure that replaces a severely damaged cornea with an artificial cornea to restore vision. There are two main types - Type 1 is a collar button shaped device that perforates the cornea, while Type 2 is a through-the-lid design with an anterior nub to penetrate a tarsorrhaphy. Indications for each type are described. Complications can include rejection, infections, and extrusion. The aim of the study was to review visual outcomes, retention time, and complications of keratoprosthesis surgery.
Corneal drawings
This document provides guidance on drawing corneal pathology as a method for standardized documentation, follow-up, teaching, and lower cost compared to photography. It outlines color-coding conventions for different corneal features and structures: black for scars, sutures, etc.; blue for edema; yellow for infiltrates; green for defects and staining; red for blood vessels; and brown for pigments. Detailed instructions are given for depicting the frontal and slit views of the cornea, including dimensions, landmarks, and representations of specific conditions. Following a systematic clock-hour approach is emphasized for accurate drawings.
Congenital anophthalmia
This document discusses congenital anophthalmia and recent advances in its management. It describes how the introduction of hydrogel socket expanders and orbital expanders has modified the rehabilitation approach. The goals of treatment are to simultaneously expand soft tissues and orbital bones to replace lost volume, maintain orbital structure, and allow prosthesis motility. Various types of orbital implants and expanders are discussed, including advantages and disadvantages. Guidelines for successful socket reconstruction with adequate volume, fornices, eyelid tone and prosthesis motility and comfort are provided.
A case of atypical disc edema
This document presents a case study of a 42-year-old female who presented with sudden loss of vision in her left eye and headache for one week. Her ocular examination revealed blurry margins, peripapillary edema, and serous detachment of the macula in her left eye. A B-scan showed edema around the optic nerve head. Differential diagnoses included posterior scleritis and optic neuritis. Treatment with oral steroids and antibiotics improved her vision. She was later readmitted due to congestion from frequent steroid use.
Interpretation of fields
This document provides guidance on interpreting visual field tests. It outlines the key steps which include checking patient and test data, obtaining a general impression, observing defects and curves, and reviewing statistics. Various plots and indices are described that analyze retinal sensitivity values, compare them to normal values, and evaluate for abnormalities. Global indices like mean deviation and pattern standard deviation reduce the field data into single numbers. The reliability and quality of the test are also important to evaluate. Factors like eye conditions, testing procedures, and artifacts can influence results.
Perimetry 1
The document discusses principles of perimetry, which is the measurement of visual functions across the visual field. It describes the history of automated perimeters beginning in 1970. Static perimetry uses computerized testing to determine contrast sensitivity thresholds at preset locations, while kinetic perimetry manually maps sensitivity points along meridians. Both methods are used to identify decreases in retinal sensitivity indicative of conditions like glaucoma. Automated static perimetry provides quantifiable and reproducible data but is time-consuming, while kinetic perimetry rapidly defines field contours but requires more operator skill.
Angle closure glaucoma
This document provides information on angle closure glaucoma, including its causes, risk factors, stages, clinical presentation, diagnostic tests, and treatment options. Angle closure glaucoma results from obstruction of the aqueous outflow pathway due to apposition or adhesion of the iris to the trabecular meshwork. It is more common in individuals with anatomically narrow anterior chamber angles and certain ethnic groups. Treatment involves lowering intraocular pressure through medications, laser procedures such as peripheral iridotomy or iridoplasty, or incisional surgeries like goniosynechialysis or trabeculectomy if needed.
Implantable collamer lens(ICL)
The Implantable Collamer Lens (ICL) is a soft, flexible, posterior chamber phakic intraocular lens made of collagen-copolymer material called Collamer. Studies have shown ICL implantation is safe and effective for correcting myopia between -3 to -25 diopters and astigmatism up to -6 diopters. It provides stable refractive results with few complications over 4 years. Toric ICL models were found to be superior to LASIK in safety, efficacy, predictability and stability for high myopic astigmatism. The procedure is reversible and preserves corneal tissue, reducing risks compared to LASIK.
Neovascular glaucoma
Neovascular glaucoma is a secondary glaucoma caused by the growth of new blood vessels on the iris and in the anterior chamber angle due to underlying retinal ischemia or disease. The new vessels are stimulated by hypoxic factors and can contract, pulling the iris forward and occluding the drainage angle. This leads to increased eye pressure and vision loss if not treated. Treatment options aim to reduce the stimulus for new vessel growth such as panretinal photocoagulation laser or anti-VEGF injections, lower eye pressure through filtration surgeries or cyclodestructive procedures, and manage pain.
Post operative endophthalmitis
1. Post-operative endophthalmitis is an intraocular inflammation that can occur after eye surgery or trauma as a complication. It involves inflammation in the anterior and posterior segments of the eye.
2. It is classified as infectious or non-infectious. Infectious endophthalmitis can be exogenous from surgery or trauma, or endogenous from hematogenous spread. Acute infectious endophthalmitis typically occurs within 6 weeks of surgery.
3. Management involves medical therapy including intravitreal and systemic antibiotics, as well as vitrectomy in some cases depending on visual acuity. The Endophthalmitis Vitrectomy Study showed vitrectomy is beneficial for patients
Malignant melanoma
This document discusses melanoma and its characteristics. It notes that pigmentation is a hallmark of melanoma. Features suggestive of melanoma include changes in existing pigmented lesions or presence of irregular, asymmetrical, or multiple colored lesions over 6mm in diameter. Risk factors include white race, older age, and intense sunlight exposure. Pathology shows anaplastic malignant melanocytic cells. Types include lesions arising from nevi or de novo. Diagnosis and treatment options are also summarized.
Nodule at the limbus
The limbus is the transitional zone between the sclera and cornea. Lesions of the limbus can be classified as congenital, inflammatory, allergic, vascular, traumatic, degenerative, nutritional, neoplastic, or miscellaneous. Common limbal lesions include dermoids, dermolipomas, raised nevi, episcleritis, scleritis, phlyctenules, vernal catarrh, ophthalmia nodosa, hemangiomas, granulomas, implantation cysts, pinguecula, cystic pterygium, papillomas, squamous cell carcinoma, and primary melanoma. The document provides details on characteristics, causes, and treatment of various limbal
Diabetic retinopathy
This document summarizes diabetic retinopathy, including its risk factors, pathogenesis, classification, signs, investigations, and treatments. It notes that diabetic retinopathy is caused by damage to the small blood vessels in the retina from high blood sugar levels over time. The main risk factors are duration of diabetes, poor blood sugar control, pregnancy, and other systemic diseases. The document describes the classification of diabetic retinopathy from mild non-proliferative to more severe proliferative stages. Key signs and investigations are also outlined, along with medical, laser, and surgical therapy options.
Vision assessment
This document provides an overview of visual assessment techniques for both adults and children. It discusses examining visual acuity, visual fields, dark adaptation, color vision, and retinal function. For adults, it describes using the Snellen chart to test distance visual acuity and Jaeger or Roman charts for near acuity. For children, techniques appropriate for different age groups are outlined, such as preferential looking tests for infants and Tumbling E, Landolt C, and HOTV tests for older children. Retinal function can be assessed using Amsler grids, photostress testing, and color vision evaluations.
Anatomy & physiology of eyelids
The document summarizes the anatomy and physiology of the eyelids. It describes the main parts of the eyelids including the palpebral aperture, lid margin, tarsal plate, conjunctiva and glands. It discusses the layers of the eyelids from anterior to posterior including the skin, subcutaneous tissue, muscle and conjunctiva layers. It also summarizes the blood supply, nerves and functions of the eyelids.
More from Samuel Ponraj (20)
Recently uploaded
8 Surprising Reasons To Meditate 40 Minutes A Day That Can Change Your Life.pptx
8 Surprising Reasons To Meditate 40 Minutes A Day That Can Change Your Life.pptxHolistified Wellness
We’re talking about Vedic Meditation, a form of meditation that has been around for at least 5,000 years. Back then, the people who lived in the Indus Valley, now known as India and Pakistan, practised meditation as a fundamental part of daily life. This knowledge that has given us yoga and Ayurveda, was known as Veda, hence the name Vedic. And though there are some written records, the practice has been passed down verbally from generation to generation.REGULATION FOR COMBINATION PRODUCTS AND MEDICAL DEVICES.pptx
It includes regulation of combination products and medical devices. FDA and industry liaisons.
Efficacy of Avartana Sneha in Ayurveda
Avartana Sneha is a unique method of Preparation of Sneha Kalpana in Ayurveda, mainly it is indicated for the Vataja rogas.
Top Effective Soaps for Fungal Skin Infections in India
Swisschem Dermacare has mentioned the List of The Best Antifungal Soap In India 2022. All of these soaps are trusted by various Dermatology Experts.
Artificial Intelligence Symposium (THAIS)
Artificial Intelligence Symposium (THAIS). Parc Taulí. Sabadell
All info about Diabetes and how to control it.
One health condition that is becoming more common day by day is diabetes.
According to research conducted by the National Family Health Survey of India, diabetic cases show a projection which might increase to 10.4% by 2030.
Cell Therapy Expansion and Challenges in Autoimmune Disease
There is increasing confidence that cell therapies will soon play a role in the treatment of autoimmune disorders, but the extent of this impact remains to be seen. Early readouts on autologous CAR-Ts in lupus are encouraging, but manufacturing and cost limitations are likely to restrict access to highly refractory patients. Allogeneic CAR-Ts have the potential to broaden access to earlier lines of treatment due to their inherent cost benefits, however they will need to demonstrate comparable or improved efficacy to established modalities.
In addition to infrastructure and capacity constraints, CAR-Ts face a very different risk-benefit dynamic in autoimmune compared to oncology, highlighting the need for tolerable therapies with low adverse event risk. CAR-NK and Treg-based therapies are also being developed in certain autoimmune disorders and may demonstrate favorable safety profiles. Several novel non-cell therapies such as bispecific antibodies, nanobodies, and RNAi drugs, may also offer future alternative competitive solutions with variable value propositions.
Widespread adoption of cell therapies will not only require strong efficacy and safety data, but also adapted pricing and access strategies. At oncology-based price points, CAR-Ts are unlikely to achieve broad market access in autoimmune disorders, with eligible patient populations that are potentially orders of magnitude greater than the number of currently addressable cancer patients. Developers have made strides towards reducing cell therapy COGS while improving manufacturing efficiency, but payors will inevitably restrict access until more sustainable pricing is achieved.
Despite these headwinds, industry leaders and investors remain confident that cell therapies are poised to address significant unmet need in patients suffering from autoimmune disorders. However, the extent of this impact on the treatment landscape remains to be seen, as the industry rapidly approaches an inflection point.
TEST BANK For Community and Public Health Nursing: Evidence for Practice, 3rd...
TEST BANK For Community and Public Health Nursing: Evidence for Practice, 3rd Edition by DeMarco, Walsh, Verified Chapters 1 - 25, Complete Newest Version TEST BANK For Community and Public Health Nursing: Evidence for Practice, 3rd Edition by DeMarco, Walsh, Verified Chapters 1 - 25, Complete Newest Version TEST BANK For Community and Public Health Nursing: Evidence for Practice, 3rd Edition by DeMarco, Walsh, Verified Chapters 1 - 25, Complete Newest Version Test Bank For Community and Public Health Nursing: Evidence for Practice 3rd Edition Pdf Chapters Download Test Bank For Community and Public Health Nursing: Evidence for Practice 3rd Edition Pdf Download Stuvia Test Bank For Community and Public Health Nursing: Evidence for Practice 3rd Edition Study Guide Test Bank For Community and Public Health Nursing: Evidence for Practice 3rd Edition Ebook Download Stuvia Test Bank For Community and Public Health Nursing: Evidence for Practice 3rd Edition Questions and Answers Quizlet Test Bank For Community and Public Health Nursing: Evidence for Practice 3rd Edition Studocu Test Bank For Community and Public Health Nursing: Evidence for Practice 3rd Edition Quizlet Test Bank For Community and Public Health Nursing: Evidence for Practice 3rd Edition Stuvia Community and Public Health Nursing: Evidence for Practice 3rd Edition Pdf Chapters Download Community and Public Health Nursing: Evidence for Practice 3rd Edition Pdf Download Course Hero Community and Public Health Nursing: Evidence for Practice 3rd Edition Answers Quizlet Community and Public Health Nursing: Evidence for Practice 3rd Edition Ebook Download Course hero Community and Public Health Nursing: Evidence for Practice 3rd Edition Questions and Answers Community and Public Health Nursing: Evidence for Practice 3rd Edition Studocu Community and Public Health Nursing: Evidence for Practice 3rd Edition Quizlet Community and Public Health Nursing: Evidence for Practice 3rd Edition Stuvia Community and Public Health Nursing: Evidence for Practice 3rd Edition Test Bank Pdf Chapters Download Community and Public Health Nursing: Evidence for Practice 3rd Edition Test Bank Pdf Download Stuvia Community and Public Health Nursing: Evidence for Practice 3rd Edition Test Bank Study Guide Questions and Answers Community and Public Health Nursing: Evidence for Practice 3rd Edition Test Bank Ebook Download Stuvia Community and Public Health Nursing: Evidence for Practice 3rd Edition Test Bank Questions Quizlet Community and Public Health Nursing: Evidence for Practice 3rd Edition Test Bank Studocu Community and Public Health Nursing: Evidence for Practice 3rd Edition Test Bank Quizlet Community and Public Health Nursing: Evidence for Practice 3rd Edition Test Bank Stuvia
Recently uploaded (20)
8 Surprising Reasons To Meditate 40 Minutes A Day That Can Change Your Life.pptx
8 Surprising Reasons To Meditate 40 Minutes A Day That Can Change Your Life.pptx
REGULATION FOR COMBINATION PRODUCTS AND MEDICAL DEVICES.pptx
REGULATION FOR COMBINATION PRODUCTS AND MEDICAL DEVICES.pptx
Top Effective Soaps for Fungal Skin Infections in India
Top Effective Soaps for Fungal Skin Infections in India
CHEMOTHERAPY_RDP_CHAPTER 6_Anti Malarial Drugs.pdf
CHEMOTHERAPY_RDP_CHAPTER 6_Anti Malarial Drugs.pdf
Cell Therapy Expansion and Challenges in Autoimmune Disease
Cell Therapy Expansion and Challenges in Autoimmune Disease
Vestibulocochlear Nerve by Dr. Rabia Inam Gandapore.pptx
Vestibulocochlear Nerve by Dr. Rabia Inam Gandapore.pptx
TEST BANK For Community and Public Health Nursing: Evidence for Practice, 3rd...
TEST BANK For Community and Public Health Nursing: Evidence for Practice, 3rd...
Macular hole
- 3. MACULA : Round yellow area at posterior pole 5.5 mm size – 3 mm temporal 1 mm inferior to disc
- 4. Fovea - 1.5 mm wide , thin bottom- 22” clivity thick basement margin - prone for macular holes -Henle’s layer-oblique cones Foveola - 0.35 mm wide , thin pit , Densely cones Bowing vitreally- fovea externa Umbo - Tiny depression - Foveal light reflex 0.15 mm - bouquet of cones - narrowed gateau nucleaire
- 5. A dehiscence in the Retina at the location of Fovea. In Lamellar hole - some layer are intact Full thickness hole - RPE exposed
- 6. Older female patients Younger Myopic patients Post Traumatic Chronic cystoid macular edema Associated with Retinal detachment Inadvertent exposure to laser therapy
- 7. Loss of Central Vision Central Scotoma Metamorphospia
- 8. Oblique/anteroposterior traction via a persistent vitreofoveolar attachment following perifoveal vitreous separation. Tangential vitreoretinal traction.
- 9. Stage O – Premacular hole - Perifoveal vitreous detachment - Loss of foveal depression - Subtle macular topograph changes - Normal visual acuity
- 10. Stage 1a: ‘Impending’ macular hole - flattening of the foveal depression with an underlying yellow spot. - Pseudocyst – a perifoveal vitreoretinal detachment Pathology: inner retinal layers detach from the underlying photoreceptor layer, with the formation of a schisis cavity.
- 11. Stage 1b: Occult macular hole Signs: a yellow ring with metamorphopsia or a mild decrease in visual acuity. - Progression of pseudocyst to outer foveal layer separation Pathology: loss of structural support with centrifugal displacement of photoreceptors.
- 12. Stage 2: Small /Early full-thickness hole Signs: full-thickness hole < 400 µm in diameter The defect may be central, eccentric or crescent-shaped. Pseudo operculum – prefoveal cortical vitreous contraction Pathology: a dehiscence develops in the roof [inner layer]of the schitic cavity, often with persistent vitreofoveolar adhesion.
- 13. Stage 3: Full-size /Established macular hole Signs: full-thickness hole > 400 µm in diameter red base with yellow-white dots seen. Surrounding grey cuff of subretinal fluid Pathology: Avulsion of the roof of the cyst with an operculum and persistent parafoveal and optic disc attachment of the vitreous cortex.
- 14. Stage 4: Full-size macular hole with complete PVD Pathology: the posterior vitreous is completely detached, often suggested by the presence of a Weiss ring.
- 17. Fluorescein Angiography Hyperfluorescence -transmission defect (RPE atrophy) OCT Evaluation of retinal thickness and staging of macular hole.
- 19.
- 20. Watzke Allen test On projecting a thin slit beam of light on to the macula ,a broken or thinned out appearance is poistive. Laser aiming beam test A spot of laser beam of 50 microns when projected on macula has disappeared.
- 21. Surgery not recommended in stage 1 50 % chance of spontaneous resolution . Stage 3 and 4 with visual acuity < 6/18 require surgery Contraindications for surgery - Coexisting choroidal rupture - Traumatic RPE rupture - Chronic Cystoid macular edema - Optic nerve disorders
- 22. Pars Plana Vitrectomy Anaesthesia is local or general . Conjunctival peritomy is done. Three sclerotomies in superotemporal ,superonasal and inferotemporal at 3.5 mm from limbus . Induction of Posterior vitreous detachment by suction of cutter , suction cannula or forceps close to disc. Use of intravitreal triamcinolone acetonide for improving visualization.
- 23. Internal gas tamponade : A non expansile mixture of C3F8 and air is used and patient lie down in prone for 14 hours for first 10 days . Internal Limiting Membrane (ILM) Peeling : Stains like trypan blue , Brilliant blue , ICG , Triamcinolone acetonide to improve visualization of ILM. Special forceps to grasp ILM membrane in a circular fashion around macular hole for 2 disc diameters.
- 24. Cataract formation Iatrogenic retinal breaks Rhegmatogenous retinal detachment Transient rise in Intraocular pressure.
- 25. Following a macular pucker , there is a centripetal pull of the inner sides of epiretinal membrane – resembles Macular hole.
- 26. Partial thickness macular hole where the inner layers of fovea are involved with traction and detached from underlying cellular layers.
- 28. Gass Atlas of Macular diseases by Anita Agarwal American Academy of Ophthalmology , Vol 12 , Retina and Vitreous Kanski ,Clinical Ophthalmology , a Systemic Approach 7 th edition