Management of intra ocular foreign body
•Download as PPTX, PDF•
11 likes•4,243 views
The document discusses intraocular foreign bodies (IOFBs), which occur in 41% of open globe injuries. Most IOFBs are metal and enter the eye during hammering accidents. IOFBs can embed anywhere in the eye. Evaluation involves examination to locate the IOFB using techniques like slit lamp, gonioscopy, and fundus examination. Localization is confirmed with x-rays, CT scans, MRI, or ultrasound depending on the material. Indications for removal include toxic or contaminated IOFBs. Surgical removal aims to identify entry/exit sites, reconstruct the eye, and remove the IOFB using magnets or forceps. Outcomes are generally good if the IOFB is accessible and removal
Report
Share
Report
Share
Recommended
INTRAOCULAR FOREIGN BODY
This document discusses intraocular foreign bodies (IOFBs) resulting from penetrating ocular trauma. It describes the classification of IOFBs as toxic (e.g. metallic) or inert (e.g. glass) and the various types of damage they can cause, including mechanical effects, introduction of infection, and reactions to the foreign material. Specific reactions to iron (siderosis) and copper (chalcosis) are also outlined. The locations where IOFBs can lodge in the eye are provided, as well as methods for localizing and managing retained IOFBs. Prompt removal of IOFBs is emphasized to prevent complications like endophthalmitis, secondary glaucoma, and sympathetic o
Step by step IRIS clip
This document discusses the history and evolution of iris clip intraocular lenses (IOLs). It describes generations of IOL designs from 1949 to present day. Key developments include Binkhorst's iris clip lens in 1965 and Worst's iris claw lens in 1978, which pioneered iris fixation without sutures. Modern iris clip IOLs are made of PMMA or foldable materials, have vaulted designs for clearance, and fixate to the iris periphery for unrestricted pupil function. They are indicated for lens implantation in cases of cataract or aphakia.
treatment of non healing corneal ulcer
This document discusses the treatment of non-healing corneal ulcers. It begins by describing the signs and symptoms of a non-healing corneal ulcer. Risk factors include compromised ocular surfaces, dry eye, previous trauma or surgery, and systemic conditions like diabetes or malnutrition. Treatment involves topical antibiotics, debridement of necrotic tissue, bandage contact lenses, and in severe cases, therapeutic keratoplasty.
Target IOP
This document discusses target intraocular pressure (IOP) for treating glaucoma. It defines target IOP as the upper limit of IOP that prevents further glaucoma damage. Establishing an individualized target IOP is important to slow retinal ganglion cell loss and glaucoma progression over a patient's lifetime with minimal effects on quality of life. The target IOP should be based on factors like the amount of existing eye damage, maximum past IOP levels, life expectancy, and risk factors. The target is dynamic and must be reevaluated periodically, lowering it if damage progresses or raising it if side effects occur from low IOP. Clinical studies show that greater IOP reductions correlate with less glaucoma progression
Corneal dystrophies
This document provides an overview of different types of corneal dystrophies, including their classification, clinical features, histopathology, and management. It discusses epithelial and subepithelial dystrophies, corneal dystrophies of Bowman's layer, stromal corneal dystrophies, and Descemet membrane and endothelial dystrophies. The key points are that corneal dystrophies are inherited, bilateral, and slowly progressive disorders that begin early in life and are characterized by corneal opacification without relationship to environmental factors. Diagnosis involves classification based on the anatomical layer affected and treatment typically involves managing symptoms although surgery may be needed if vision is impaired.
Ectopia lentis edit
This document provides information about ectopia lentis, or displacement of the crystalline lens. It begins with classifications of ectopia lentis based on location and etiology. Congenital causes like Marfan syndrome and homocystinuria are described. Presentation, examination findings, complications, workup, and management approaches are outlined. Surgical techniques depend on degree and location of lens subluxation/dislocation and may involve lens removal with or without intraocular lens implantation. Management of subluxated lenses in children poses additional challenges due to risk of complications with contact lenses or suture-fixated intraocular lenses.
Intra ocular foreign body
A 20-year-old male presented with an intraocular foreign body in his left eye after hitting a hammer against metal. Imaging confirmed a metal foreign body stuck in the inferior retina. During primary surgery, the foreign body was removed using a magnet after vitrectomy. This led to discovery of a large retinal tear. Silicone oil was used, but the retina re-detached, requiring a second surgery where the posterior vitreous was removed. The final visual acuity was 20/100 after cataract extraction and IOL implantation. This case raises questions about the optimal approach and extent of primary surgery for intraocular foreign body removal.
Posterior capsular rupture
This document discusses signs, predisposing factors, timing, and management of a posterior capsule tear during cataract surgery. A posterior capsule tear can be identified by sudden pupil dilation, a falling away nucleus, or visible vitreous or capsule in the phaco tip. Risk factors include surgeon hand position, poor visibility from fluid, globe torsion, or underlying pathology. Tears often occur late in surgery during nucleus removal or capsule polishing. Management involves injecting viscoelastic to cover the tear and prevent vitreous prolapse, removing any lens fragments, and determining if an anterior or sulcus IOL placement is possible depending on tear size.
Recommended
INTRAOCULAR FOREIGN BODY
This document discusses intraocular foreign bodies (IOFBs) resulting from penetrating ocular trauma. It describes the classification of IOFBs as toxic (e.g. metallic) or inert (e.g. glass) and the various types of damage they can cause, including mechanical effects, introduction of infection, and reactions to the foreign material. Specific reactions to iron (siderosis) and copper (chalcosis) are also outlined. The locations where IOFBs can lodge in the eye are provided, as well as methods for localizing and managing retained IOFBs. Prompt removal of IOFBs is emphasized to prevent complications like endophthalmitis, secondary glaucoma, and sympathetic o
Step by step IRIS clip
This document discusses the history and evolution of iris clip intraocular lenses (IOLs). It describes generations of IOL designs from 1949 to present day. Key developments include Binkhorst's iris clip lens in 1965 and Worst's iris claw lens in 1978, which pioneered iris fixation without sutures. Modern iris clip IOLs are made of PMMA or foldable materials, have vaulted designs for clearance, and fixate to the iris periphery for unrestricted pupil function. They are indicated for lens implantation in cases of cataract or aphakia.
treatment of non healing corneal ulcer
This document discusses the treatment of non-healing corneal ulcers. It begins by describing the signs and symptoms of a non-healing corneal ulcer. Risk factors include compromised ocular surfaces, dry eye, previous trauma or surgery, and systemic conditions like diabetes or malnutrition. Treatment involves topical antibiotics, debridement of necrotic tissue, bandage contact lenses, and in severe cases, therapeutic keratoplasty.
Target IOP
This document discusses target intraocular pressure (IOP) for treating glaucoma. It defines target IOP as the upper limit of IOP that prevents further glaucoma damage. Establishing an individualized target IOP is important to slow retinal ganglion cell loss and glaucoma progression over a patient's lifetime with minimal effects on quality of life. The target IOP should be based on factors like the amount of existing eye damage, maximum past IOP levels, life expectancy, and risk factors. The target is dynamic and must be reevaluated periodically, lowering it if damage progresses or raising it if side effects occur from low IOP. Clinical studies show that greater IOP reductions correlate with less glaucoma progression
Corneal dystrophies
This document provides an overview of different types of corneal dystrophies, including their classification, clinical features, histopathology, and management. It discusses epithelial and subepithelial dystrophies, corneal dystrophies of Bowman's layer, stromal corneal dystrophies, and Descemet membrane and endothelial dystrophies. The key points are that corneal dystrophies are inherited, bilateral, and slowly progressive disorders that begin early in life and are characterized by corneal opacification without relationship to environmental factors. Diagnosis involves classification based on the anatomical layer affected and treatment typically involves managing symptoms although surgery may be needed if vision is impaired.
Ectopia lentis edit
This document provides information about ectopia lentis, or displacement of the crystalline lens. It begins with classifications of ectopia lentis based on location and etiology. Congenital causes like Marfan syndrome and homocystinuria are described. Presentation, examination findings, complications, workup, and management approaches are outlined. Surgical techniques depend on degree and location of lens subluxation/dislocation and may involve lens removal with or without intraocular lens implantation. Management of subluxated lenses in children poses additional challenges due to risk of complications with contact lenses or suture-fixated intraocular lenses.
Intra ocular foreign body
A 20-year-old male presented with an intraocular foreign body in his left eye after hitting a hammer against metal. Imaging confirmed a metal foreign body stuck in the inferior retina. During primary surgery, the foreign body was removed using a magnet after vitrectomy. This led to discovery of a large retinal tear. Silicone oil was used, but the retina re-detached, requiring a second surgery where the posterior vitreous was removed. The final visual acuity was 20/100 after cataract extraction and IOL implantation. This case raises questions about the optimal approach and extent of primary surgery for intraocular foreign body removal.
Posterior capsular rupture
This document discusses signs, predisposing factors, timing, and management of a posterior capsule tear during cataract surgery. A posterior capsule tear can be identified by sudden pupil dilation, a falling away nucleus, or visible vitreous or capsule in the phaco tip. Risk factors include surgeon hand position, poor visibility from fluid, globe torsion, or underlying pathology. Tears often occur late in surgery during nucleus removal or capsule polishing. Management involves injecting viscoelastic to cover the tear and prevent vitreous prolapse, removing any lens fragments, and determining if an anterior or sulcus IOL placement is possible depending on tear size.
Ocular Foreign Body
The most common presenting complaint of Ophthalmology in Emergency dept. is Foreign body sensation, so just to recall the basics of Ophthalm in ED, read the following PPT.
Siderosis &chalcosis & IOFB
One of the untouched topic in IOFB, will help u guys who r stuck with finding presentstion on this topic. #each one teach one series
Ocular hypertension
Ocular hypertension is defined as an intraocular pressure (IOP) greater than 21 mmHg without evidence of optic nerve damage or visual field defects. It affects 4-10% of people over age 40 and is more common in African descendants and those with thinner central corneas. While the exact cause is unknown, genetic factors may play a role in increasing outflow resistance and IOP. Treatment aims to lower IOP by at least 20% and is recommended for those at high risk of progression to glaucoma based on factors like baseline IOP, optic nerve characteristics, and family history. Annual monitoring is sufficient for low risk patients while high risk patients may require medical treatment with eye drops.
Corneal graft rejection
Corneal graft failure and rejection are the nightmares for an Ophthalmologist. Here is an overview on Rejection vs Failure, identification of risk factors, prevention and Mx of a failure
Bullous keratopathy
Bullous keratopathy refers to corneal swelling caused by insufficient pumping of fluid out of the cornea. It results in the formation of fluid-filled blisters beneath the surface of the eye. It can occur secondary to endothelial dysfunction from trauma, inflammation, dystrophies or other conditions that damage the corneal endothelial pump. Symptoms include blurred vision, glare, pain from ruptured blisters, and potentially scarring. Management involves reducing fluid buildup through hypertonic drops or lenses, lowering eye pressure if high, and corneal transplantation if vision is significantly decreased or pain becomes intolerable.
Intraocular foreign bodies - AJAY DUDANI
This document discusses intraocular foreign bodies (IOFBs), which occur in around 40% of open globe eye injuries. Common causes include hammering, firearms, machinery accidents, and assaults. IOFBs can lodge in the vitreous cavity, anterior chamber, retina, or lens. Evaluation involves history, imaging like CT scans, and examinations. Treatment goals are promptly closing the globe and removing the IOFB to prevent infection or toxicity. Extraction techniques depend on the IOFB's location, size, and composition, utilizing forceps, magnets, or vitrectomy. Complications can include endophthalmitis, retinal detachment, or metal deposition issues. With advances in surgery, outcomes have improved
Intermediate uveitis
Intermediate uveitis is characterized by inflammation of the vitreous and peripheral retina. Symptoms include blurred vision, floaters, and decreased visual acuity. If left untreated, it can cause severe visual loss or sudden vision loss. Diagnosis is made based on the presence of vitreous cells and snowball or snowbank formations in the vitreous. Treatment involves systemic corticosteroids or immunosuppressive drugs to reduce inflammation. Additional treatments may include periocular corticosteroid injections, cryotherapy, or vitrectomy.
Surgical strategies for small pupils - Malyugin Ring
Boris Malyugin, M.D., PhD.'s presentation about Malyugin Ring® pearls. The key learning points of the presentation include the step-wise approach in managing small pupils, the main drivers for the decision to use pupil expander device, and the Malyugin Ring® implantation and removal pearls.
Surgical induced astigmatism
This document discusses surgical induced astigmatism following cataract surgery. It notes that astigmatism has a significant impact on vision and is influenced by surgical technique and incision size and type. Various factors can induce astigmatism including incision location and size, suture type and placement, and wound compression or gape. Evaluating astigmatism involves tools like retinoscopy, keratometry and corneal topography. Managing astigmatism may involve selective suture removal to reduce cylindrical error over time.
Yag capsulotomy
This document summarizes information about Nd:YAG laser capsulotomy procedures. It discusses the laser used, how it works, preoperative assessment, procedure goals and techniques, potential complications, and ways to manage issues like capsulorrhexis contracture and retained lens cortex. The key points are that Nd:YAG laser capsulotomy can treat posterior capsule opacification, careful preoperative evaluation is important, the goal is to create capsulotomy flaps in the periphery to avoid fragments, and complications may include elevated pressure, inflammation, or retinal issues if not performed properly.
Primary angle closure glaucoma
This document discusses primary angle closure glaucoma (PACG), a type of glaucoma where the iris occludes the drainage angle of the eye, obstructing aqueous outflow. PACG is a leading cause of glaucoma worldwide and is particularly common in East Asian populations. It is classified based on the degree of iris occlusion and presence of optic nerve damage and vision loss. Risk factors include older age, female sex, Asian ethnicity, family history, hypermetropia, and shorter axial length. Symptoms include blurred vision, halos around lights, eye pain, and headache. Signs include elevated eye pressure, shallow anterior chamber, iris changes, and optic nerve damage. The document outlines methods for diagnosing
Approach to a case of corneal ulcer
Dr. Tushar Kumar discusses the profiling, examination, diagnostic testing, and management of various types of corneal ulcers. Key points include:
1. A thorough history and physical exam is important to categorize ulcers as infectious, non-infectious, and determine etiology. Signs and symptoms provide clues to common infectious causes.
2. Examination includes visual acuity, slit lamp evaluation of the eyelids, conjunctiva, cornea and anterior chamber. Features of the ulcer like size, depth and borders are noted.
3. Diagnostic testing depends on severity and response to initial treatment, and may include cultures, smears, biopsy or imaging to identify organism or guide management
Malignant Glaucoma
Malignant glaucoma, also known as aqueous misdirection syndrome, is a secondary glaucoma that occurs when aqueous humor takes an abnormal posterior route behind the lens and vitreous instead of flowing normally through the pupil. It presents with a shallow anterior chamber despite high intraocular pressure. Potential causes include prior eye surgery or laser treatment. Diagnosis involves examining for signs of anterior chamber shallowing and ruling out other conditions. Treatment begins with cycloplegic drugs but may require Nd:YAG laser or vitrectomy if unresponsive. Prognosis depends on severity and underlying anatomy.
Trabeculectomy
A surgical procedure featuring a partial thickness scleral flap that creates a fistula between AC and subconjunctival space for filtration of aqueous and creation of conjunctival bleb in an effort to lower IOP
Gonioscopy: gonioscopic lenses, principle and clinical aspects
This document discusses gonioscopy, which is used to examine the anterior chamber angle. It begins by explaining that the angle cannot be viewed directly due to total internal reflection at the cornea. Gonioscopic lenses eliminate this effect by matching the cornea's refractive index. There are two main types of lenses - indirect lenses use mirrors and direct lenses refract light. The document then describes various gonioscopic lenses and techniques like indentation gonioscopy. It outlines the clinical uses of gonioscopy and provides examples of gonioscopic findings. In summary, the document provides an in-depth overview of gonioscopy equipment, techniques, and applications.
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.
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.
Aphakia
- Aphakia is the absence of the crystalline lens from the eye. It can be congenital or caused by surgery or trauma.
- In aphakia, the eye becomes highly hyperopic, the anterior focal point moves forward, and the retinal image is magnified. This decreases visual acuity and field of view.
- Aphakia is treated with spectacles, contact lenses, or intraocular lenses. Spectacles cause issues like increased image size, ring scotomas, and reduced field of view. Contact lenses and IOLs provide better image quality but have risks of complications.
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
Slit Lamp Illumination Techniques
This document describes various illumination techniques used with a slit lamp to examine different parts of the eye. It discusses diffuse, direct, tangential, and specular illumination techniques as well as indirect, retroillumination, and Van Herrick techniques. Each technique is used to illuminate a specific area of the eye in order to observe different structures like the cornea, iris, lens, anterior chamber angle, and detect any pathologies present. Proper illumination angles and magnifications are outlined for visualizing various eye tissues and evaluating properties like surface texture and integrity.
Penetrating Ocular Injuries
Penetrating ocular injuries can be mechanical or non-mechanical. Mechanical injuries include open globe injuries with full thickness wounds and intraocular foreign bodies. Non-mechanical injuries include chemical, thermal, electrical, and radiation injuries. Diagnostic procedures include external examination, tonometry, ophthalmoscopy, slit lamp examination, ultrasound, and electroretinography. Treatment depends on the type and severity of injury but may include antibiotics, suturing of wounds, and surgery to repair damage to the eye. Complications can include retinal detachment, endophthalmitis, and vision loss.
Hyphema
Hyphema refers to blood in the anterior chamber of the eye. It is typically caused by trauma that tears blood vessels in the iris, ciliary body, or trabecular meshwork. Hyphemas are classified based on their etiology (cause), amount of bleeding, and location in the eye. Treatment involves resting the eye, using cycloplegic eye drops to prevent inflammation, and occasionally surgically removing blood if it causes increased pressure or vision loss. The prognosis is generally good if the hyphema involves less than half the anterior chamber, but can be poorer for larger bleeds.
More Related Content
What's hot
Ocular Foreign Body
The most common presenting complaint of Ophthalmology in Emergency dept. is Foreign body sensation, so just to recall the basics of Ophthalm in ED, read the following PPT.
Siderosis &chalcosis & IOFB
One of the untouched topic in IOFB, will help u guys who r stuck with finding presentstion on this topic. #each one teach one series
Ocular hypertension
Ocular hypertension is defined as an intraocular pressure (IOP) greater than 21 mmHg without evidence of optic nerve damage or visual field defects. It affects 4-10% of people over age 40 and is more common in African descendants and those with thinner central corneas. While the exact cause is unknown, genetic factors may play a role in increasing outflow resistance and IOP. Treatment aims to lower IOP by at least 20% and is recommended for those at high risk of progression to glaucoma based on factors like baseline IOP, optic nerve characteristics, and family history. Annual monitoring is sufficient for low risk patients while high risk patients may require medical treatment with eye drops.
Corneal graft rejection
Corneal graft failure and rejection are the nightmares for an Ophthalmologist. Here is an overview on Rejection vs Failure, identification of risk factors, prevention and Mx of a failure
Bullous keratopathy
Bullous keratopathy refers to corneal swelling caused by insufficient pumping of fluid out of the cornea. It results in the formation of fluid-filled blisters beneath the surface of the eye. It can occur secondary to endothelial dysfunction from trauma, inflammation, dystrophies or other conditions that damage the corneal endothelial pump. Symptoms include blurred vision, glare, pain from ruptured blisters, and potentially scarring. Management involves reducing fluid buildup through hypertonic drops or lenses, lowering eye pressure if high, and corneal transplantation if vision is significantly decreased or pain becomes intolerable.
Intraocular foreign bodies - AJAY DUDANI
This document discusses intraocular foreign bodies (IOFBs), which occur in around 40% of open globe eye injuries. Common causes include hammering, firearms, machinery accidents, and assaults. IOFBs can lodge in the vitreous cavity, anterior chamber, retina, or lens. Evaluation involves history, imaging like CT scans, and examinations. Treatment goals are promptly closing the globe and removing the IOFB to prevent infection or toxicity. Extraction techniques depend on the IOFB's location, size, and composition, utilizing forceps, magnets, or vitrectomy. Complications can include endophthalmitis, retinal detachment, or metal deposition issues. With advances in surgery, outcomes have improved
Intermediate uveitis
Intermediate uveitis is characterized by inflammation of the vitreous and peripheral retina. Symptoms include blurred vision, floaters, and decreased visual acuity. If left untreated, it can cause severe visual loss or sudden vision loss. Diagnosis is made based on the presence of vitreous cells and snowball or snowbank formations in the vitreous. Treatment involves systemic corticosteroids or immunosuppressive drugs to reduce inflammation. Additional treatments may include periocular corticosteroid injections, cryotherapy, or vitrectomy.
Surgical strategies for small pupils - Malyugin Ring
Boris Malyugin, M.D., PhD.'s presentation about Malyugin Ring® pearls. The key learning points of the presentation include the step-wise approach in managing small pupils, the main drivers for the decision to use pupil expander device, and the Malyugin Ring® implantation and removal pearls.
Surgical induced astigmatism
This document discusses surgical induced astigmatism following cataract surgery. It notes that astigmatism has a significant impact on vision and is influenced by surgical technique and incision size and type. Various factors can induce astigmatism including incision location and size, suture type and placement, and wound compression or gape. Evaluating astigmatism involves tools like retinoscopy, keratometry and corneal topography. Managing astigmatism may involve selective suture removal to reduce cylindrical error over time.
Yag capsulotomy
This document summarizes information about Nd:YAG laser capsulotomy procedures. It discusses the laser used, how it works, preoperative assessment, procedure goals and techniques, potential complications, and ways to manage issues like capsulorrhexis contracture and retained lens cortex. The key points are that Nd:YAG laser capsulotomy can treat posterior capsule opacification, careful preoperative evaluation is important, the goal is to create capsulotomy flaps in the periphery to avoid fragments, and complications may include elevated pressure, inflammation, or retinal issues if not performed properly.
Primary angle closure glaucoma
This document discusses primary angle closure glaucoma (PACG), a type of glaucoma where the iris occludes the drainage angle of the eye, obstructing aqueous outflow. PACG is a leading cause of glaucoma worldwide and is particularly common in East Asian populations. It is classified based on the degree of iris occlusion and presence of optic nerve damage and vision loss. Risk factors include older age, female sex, Asian ethnicity, family history, hypermetropia, and shorter axial length. Symptoms include blurred vision, halos around lights, eye pain, and headache. Signs include elevated eye pressure, shallow anterior chamber, iris changes, and optic nerve damage. The document outlines methods for diagnosing
Approach to a case of corneal ulcer
Dr. Tushar Kumar discusses the profiling, examination, diagnostic testing, and management of various types of corneal ulcers. Key points include:
1. A thorough history and physical exam is important to categorize ulcers as infectious, non-infectious, and determine etiology. Signs and symptoms provide clues to common infectious causes.
2. Examination includes visual acuity, slit lamp evaluation of the eyelids, conjunctiva, cornea and anterior chamber. Features of the ulcer like size, depth and borders are noted.
3. Diagnostic testing depends on severity and response to initial treatment, and may include cultures, smears, biopsy or imaging to identify organism or guide management
Malignant Glaucoma
Malignant glaucoma, also known as aqueous misdirection syndrome, is a secondary glaucoma that occurs when aqueous humor takes an abnormal posterior route behind the lens and vitreous instead of flowing normally through the pupil. It presents with a shallow anterior chamber despite high intraocular pressure. Potential causes include prior eye surgery or laser treatment. Diagnosis involves examining for signs of anterior chamber shallowing and ruling out other conditions. Treatment begins with cycloplegic drugs but may require Nd:YAG laser or vitrectomy if unresponsive. Prognosis depends on severity and underlying anatomy.
Trabeculectomy
A surgical procedure featuring a partial thickness scleral flap that creates a fistula between AC and subconjunctival space for filtration of aqueous and creation of conjunctival bleb in an effort to lower IOP
Gonioscopy: gonioscopic lenses, principle and clinical aspects
This document discusses gonioscopy, which is used to examine the anterior chamber angle. It begins by explaining that the angle cannot be viewed directly due to total internal reflection at the cornea. Gonioscopic lenses eliminate this effect by matching the cornea's refractive index. There are two main types of lenses - indirect lenses use mirrors and direct lenses refract light. The document then describes various gonioscopic lenses and techniques like indentation gonioscopy. It outlines the clinical uses of gonioscopy and provides examples of gonioscopic findings. In summary, the document provides an in-depth overview of gonioscopy equipment, techniques, and applications.
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.
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.
Aphakia
- Aphakia is the absence of the crystalline lens from the eye. It can be congenital or caused by surgery or trauma.
- In aphakia, the eye becomes highly hyperopic, the anterior focal point moves forward, and the retinal image is magnified. This decreases visual acuity and field of view.
- Aphakia is treated with spectacles, contact lenses, or intraocular lenses. Spectacles cause issues like increased image size, ring scotomas, and reduced field of view. Contact lenses and IOLs provide better image quality but have risks of complications.
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
Slit Lamp Illumination Techniques
This document describes various illumination techniques used with a slit lamp to examine different parts of the eye. It discusses diffuse, direct, tangential, and specular illumination techniques as well as indirect, retroillumination, and Van Herrick techniques. Each technique is used to illuminate a specific area of the eye in order to observe different structures like the cornea, iris, lens, anterior chamber angle, and detect any pathologies present. Proper illumination angles and magnifications are outlined for visualizing various eye tissues and evaluating properties like surface texture and integrity.
What's hot (20)
Surgical strategies for small pupils - Malyugin Ring
Surgical strategies for small pupils - Malyugin Ring
Gonioscopy: gonioscopic lenses, principle and clinical aspects
Gonioscopy: gonioscopic lenses, principle and clinical aspects
Viewers also liked
Penetrating Ocular Injuries
Penetrating ocular injuries can be mechanical or non-mechanical. Mechanical injuries include open globe injuries with full thickness wounds and intraocular foreign bodies. Non-mechanical injuries include chemical, thermal, electrical, and radiation injuries. Diagnostic procedures include external examination, tonometry, ophthalmoscopy, slit lamp examination, ultrasound, and electroretinography. Treatment depends on the type and severity of injury but may include antibiotics, suturing of wounds, and surgery to repair damage to the eye. Complications can include retinal detachment, endophthalmitis, and vision loss.
Hyphema
Hyphema refers to blood in the anterior chamber of the eye. It is typically caused by trauma that tears blood vessels in the iris, ciliary body, or trabecular meshwork. Hyphemas are classified based on their etiology (cause), amount of bleeding, and location in the eye. Treatment involves resting the eye, using cycloplegic eye drops to prevent inflammation, and occasionally surgically removing blood if it causes increased pressure or vision loss. The prognosis is generally good if the hyphema involves less than half the anterior chamber, but can be poorer for larger bleeds.
The Birmingham Eye Trauma Terminology : Suggestions For Re-Inforcement
Presenting Author: Dr. Anand A. Tibdewal, Co-Authors: Dr. Mehul Shah, Dr. Shreya Shah, Dr. Kashyap Patel
penetrating injury to eye
Penetrating eye injuries are commonly caused by sharp objects like needles, sticks, or glass. They can cause mechanical damage to eye structures as well as introduce infection. Symptoms include redness, pain, and vision loss. Examination may reveal lacerations or penetration of the sclera or cornea. Treatment depends on the severity but generally involves antibiotics to prevent infection, with suturing of larger wounds. Globe rupture from blunt trauma risks extrusion of intraocular contents and requires careful examination to avoid further damage.
Foreign bodies in the ear
Foreign bodies in the ear are common, especially in children. Common foreign bodies include cotton, insects, and small toys or objects. Before removing a foreign body, its nature, precise location, and the patient's cooperation should be considered. Living insects should be killed first before removal. Irregular objects can often be removed with forceps, while round, hard objects may require hooks or irrigation. Button batteries require urgent removal to prevent leakage. Foreign bodies deeper in the ear canal may require surgical removal. Younger children may need gentle irrigation to remove objects while gaining their trust. Underlying ear issues should be checked for after removal. Potential complications include ear canal lacerations, ear drum perforations, and facial nerve palsy from
IOFB Poster, SBN V2
1) Male prairie voles given low and medium doses of chronic intranasal oxytocin (OT) had significantly fewer cells containing OT in the paraventricular nucleus (PVN) of the hypothalamus compared to those given saline.
2) This decrease in OT-producing cells in the PVN likely contributed to the abnormal social behaviors previously observed in voles given these doses.
3) In contrast, OT cell numbers in the supraoptic nucleus (SON) were not significantly changed by any dose, suggesting the behavioral effects were mediated by PVN rather than SON projections.
Case report aspirasi corpus alienum
Dokumen tersebut membahas tentang aspirasi benda asing ke dalam saluran pernafasan, termasuk definisi, klasifikasi, faktor risiko, gejala, pemeriksaan pendukung, dan penatalaksanaan dengan bronkoskopi. Benda asing dalam saluran pernafasan dapat menyebabkan berbagai gangguan mulai dari ringan hingga fatal, sehingga diperlukan diagnosis dan penanganan segera.
Teknik Radiografi 3 Pemeriksaan Benda Asing (corpus alienum)
berisi definisi, anatomi, alat dan bahan, teknik pemeriksaan
Injuries2 08.09.16, dr.k.srikanth
This document discusses penetrating ocular injuries and intraocular foreign bodies. Key points include:
1) Evaluate for other injuries, apply a shield, and do not use drops with an open globe injury. Examine under anesthesia if an open globe is suspected.
2) Corneal wounds may be linear or lacerated and may involve the iris. Suturing and cryotherapy may be needed depending on location and size.
3) Traumatic cataracts and injuries to the posterior capsule or iris can result from lens wounds.
4) Intraocular foreign bodies can cause mechanical effects, introduce infection, and elicit specific tissue reactions depending on the material. Diagnosis involves examination for the wound and imaging. Treatment
case of a blunt trauma to the left eye causing traumatic hyphema
28 year old man hit by a stone piece to his left eye causing corneal abrasion traumatic hyphema and uveitis
Benda asing pada bola mata
teknik pemeriksaan radiografi untuk melihat corpus allienum pada bola mata
Ocular trauma simplified
This document discusses the classification and management of ocular trauma. It covers various types of injuries including burns, chemical injuries, extraocular foreign bodies, blunt trauma, penetrating injuries, and their signs, symptoms, and treatments. Specific injuries to structures like the cornea, iris, lens, vitreous, and retina are described. The risks of infection and sympathetic ophthalmia are also outlined. The document provides an overview of evaluating and managing different types of penetrating ocular injuries and retained intraocular foreign bodies.
Trauma ocular
El documento presenta una introducción al trauma ocular, definiendo el trauma como una lesión causada por factores externos. Explica la etiología, incidencia y consecuencias del trauma ocular. Luego describe los tipos de trauma ocular, incluyendo contundentes, penetrantes y aquellos sin compromiso del globo ocular. Finalmente, clasifica los traumas oculares en heridas no penetrantes, heridas penetrantes, quemaduras y fracturas, detallando los diferentes tipos dentro de cada categoría.
Management of foreign body in ear
This document discusses foreign bodies in the ear. It begins by defining a foreign body in the ear as something not normally present. It then lists the common signs and symptoms children experience with a foreign body in their ear, such as ear pain, discharge, hearing loss or reduction. The document categorizes types of foreign bodies as either living or non-living, providing examples like nuts, beans, worms for living and cotton buds, wood, plastic for non-living. It notes most foreign bodies lodge laterally or in the anterior recess. The goal is to educate on identifying and managing foreign bodies in the ear.
The Imaging of the Orbit
This document provides an overview of orbital anatomy and diseases. It describes the major anatomic components of the orbit including the globe, optic nerve, extraconal and intraconal areas. Common pathologies are discussed for each anatomic structure, such as retinoblastoma affecting the globe and optic neuritis involving the optic nerve. Imaging techniques for evaluating the orbit including MRI and CT are also reviewed. Key anatomical structures like the superior orbital fissure and its contents are defined.
Retina Review - Part 3 + 4
The document discusses various retinal conditions and diseases. It provides information on symptoms, clinical findings, inheritance patterns, pathophysiology and testing results for each condition. These include congenital stationary night blindness, fundus albipunctatus, retinitis pigmentosa, cone dystrophy, Stargardt disease, Best disease, gyrate atrophy, choroideremia, juvenile retinoschisis, Bardet-Biedl syndrome, Tay-Sachs disease, Bietti’s crystalline retinopathy and others. It also covers post-traumatic conditions like commotio retinae, choroidal rupture, intraocular foreign bodies, shaken baby syndrome and Valsalva retinopathy.
Foreign body nose
Children and even mentally retarded adults have the tendency to have habit of putting Foreign Bodies in their Nose themselves or by others. However treating surgeons are likely to forget nasal packs and splints as well.
Ocular Emergency
1. The document discusses various ocular emergencies including traumatic injuries like hyphema, ruptured globe, and chemical burns as well as non-traumatic emergencies like acute angle closure glaucoma and orbital cellulitis.
2. Management strategies are provided for different conditions including irrigation for chemical burns, medications to lower IOP for glaucoma, and IV antibiotics for orbital cellulitis.
3. Immediate referral to an ophthalmologist is recommended for penetrating injuries, ruptured globe, retinal artery occlusion, and conditions requiring surgery.
Orbital imaging (X-RAY,CT SCAN,AND MRI)
Three key points about imaging the orbit:
1. CT scans provide the best view of bony details and calcifications in the orbit, and can detect small fractures and foreign bodies. Slice thickness and tissue windows must be optimized for diagnostic quality.
2. Different x-ray views (like Waters, Caldwell's, and lateral) allow visualization of specific orbital structures and are useful for identifying pathology in different areas.
3. Features seen on imaging like changes in bone density, orbital size and shape, and structures like the optic canal can indicate conditions like tumors, infections, fractures, and vascular abnormalities affecting the orbit. Precise imaging analysis is important for diagnosis.
Foreign body nose
A foreign body in the nose is an object that is lodged where it does not belong. Common foreign bodies include small toys, beads, and food items. Button batteries can cause severe damage by releasing toxic chemicals. Symptoms include nasal obstruction, discharge, and pain. Examination and imaging may identify the object. Various techniques are used to remove foreign bodies, depending on factors like size, location, and cooperation. General anesthesia may be needed for complicated or posterior cases.
Viewers also liked (20)
The Birmingham Eye Trauma Terminology : Suggestions For Re-Inforcement
The Birmingham Eye Trauma Terminology : Suggestions For Re-Inforcement
Teknik Radiografi 3 Pemeriksaan Benda Asing (corpus alienum)
Teknik Radiografi 3 Pemeriksaan Benda Asing (corpus alienum)
case of a blunt trauma to the left eye causing traumatic hyphema
case of a blunt trauma to the left eye causing traumatic hyphema
Similar to Management of intra ocular foreign body
Intraocular foreign bodies - AJAY DUDANI
This document discusses intraocular foreign bodies (IOFBs), which occur in up to 40% of open globe injuries. Common causes include hammering, gunshots, machinery accidents, and assaults. IOFBs most often lodge in the vitreous cavity and are usually metallic. Evaluation involves history, imaging like CT scans, and examination to locate the IOFB. Treatment is urgent removal within 24 hours to prevent infections. Surgical techniques depend on IOFB location and include magnets, forceps, or vitrectomy. Complications can include endophthalmitis, retinal detachment, and siderosis from retained iron.
Eye Injuries
1. Corneal injuries can occur due to trauma, infection, or non-infectious causes. Trauma can cause lacerations or perforations, which are diagnosed using tests like Seidel's test. Small wounds may be treated medically but larger ones may require surgery.
2. Perforating eye injuries caused by intraocular foreign bodies often occur in occupational settings. Metallic foreign bodies carry less risk than organic materials. Location and size of the object impacts damage. Examination looks for entry sites and potential endophthalmitis.
3. Blunt eye injuries from impacts can cause globe rupture or retrobulbar hematoma, diagnosed using imaging and symptoms like proptosis. Immediate decomp
Eye,rauma.pptx
This document discusses the classification and management of various types of ocular trauma, including:
1. Mechanical trauma is classified as open or closed globe injuries. Assessing trauma involves examining the incident details, symptoms, history, vision, eye movements, pupils, orbits, and anterior and posterior segments.
2. Chemical injuries cause liquefactive or coagulative necrosis depending on if they are alkaline or acidic. Severity depends on pH, corneal involvement, limbal involvement, and thermal injury. Management involves irrigation and medications.
3. Orbital fractures can cause diplopia, anesthesia, and soft tissue problems. Retrobulbar hematoma is a medical emergency requiring lateral canthotomy to reduce pressure behind
Lecture on Intraocular Foreign Bodies For 4th Year MBBS Undergraduate Studen...
Lecture on Intraocular Foreign Bodies For 4th Year MBBS Undergraduate Students By Prof. Dr. Hussain Ahmad Khaqan
Evaluation and initial management of patients with ocular and adnexal trauma
This document provides guidelines for evaluating and initially managing patients with ocular and adnexal trauma. It outlines the essential steps in the emergency department, which include stabilizing life-threatening injuries, lavaging the eyes if a chemical injury occurred, obtaining medical and ocular histories, and performing an eye examination. The document describes the necessary equipment, how to assess visual acuity, external features, ocular motility, pupils, anterior and posterior segments, and intraocular pressure. It provides referral criteria and recommendations for care, transport, and follow up by ophthalmologists.
ultrasound biomicroscopy
Ultrasound biomicroscopy (UBM) provides high-resolution imaging of ocular structures in the anterior segment of the eye using 50 MHz ultrasound. UBM allows visualization of tissues like the ciliary body and zonules that are not visible by slit lamp examination. UBM can be used to qualitatively and quantitatively evaluate the anterior segment structures and has applications in diagnosing and monitoring conditions like glaucoma, corneal diseases, tumors, and intraocular lenses. While UBM provides excellent detail, it has limitations including only being able to image about 5mm into the eye and requiring contact with the eye, unlike anterior segment OCT which is non-contact.
Toric iol
1) Toric IOLs are used to correct corneal astigmatism during cataract surgery. They have a cylindrical optic to neutralize corneal astigmatism.
2) The material and design of toric IOLs affect their postoperative rotational stability, with acrylic IOLs showing the highest stability. Larger diameter and loop haptic designs also increase stability.
3) Proper patient selection, preoperative measurements, surgical technique, and IOL alignment are important for achieving optimal visual outcomes with toric IOL implantation. Accurate axis alignment is critical to achieve the intended astigmatic correction.
toriciol-160725174313.pdf
1) Toric IOLs are used to correct corneal astigmatism during cataract surgery. They have a cylindrical optic to neutralize corneal astigmatism.
2) The material and design of toric IOLs influence their postoperative rotational stability. Acrylic IOLs with larger diameters and loop haptics demonstrate the best stability.
3) Proper patient selection, preoperative measurements, surgical technique, and IOL alignment are important for achieving optimal visual outcomes with toric IOLs. Accurate alignment is critical to avoid residual astigmatism.
toriciol-160725174313.pdf
1) Toric IOLs are used to correct corneal astigmatism during cataract surgery. They have a cylindrical optic to neutralize corneal astigmatism.
2) The material and design of toric IOLs affect their postoperative rotational stability, with acrylic IOLs showing the highest stability. Larger diameter and loop haptic designs also increase stability.
3) Proper patient selection, preoperative measurements, surgical technique, and IOL alignment are important for achieving optimal visual outcomes with toric IOL implantation. Accurate axis alignment is critical to achieve the intended astigmatic correction.
Surgery for ocular trauma
The document summarizes management of ocular trauma from blunt injuries. It describes mechanisms of injury including kinetic energy transfer and oscillatory tissue damage. Treatment depends on injury severity and location, and may involve repair of open globe injuries, removal of intraocular foreign bodies, management of hyphema, lens subluxation or dislocation, and vitrectomy. The goal is to restore ocular integrity and address complications while minimizing further trauma from intervention.
Ocular injuries new
This document discusses various types of ocular injuries including mechanical and non-mechanical injuries. Mechanical injuries include extraocular foreign bodies, blunt trauma, penetrating injuries, and perforating injuries. Non-mechanical injuries include chemical, thermal, electrical, radiation, and ultraviolet injuries. Specific details are provided on extraocular foreign bodies, blunt trauma, penetrating and perforating injuries including symptoms, signs, treatment, and complications. New terminologies for ocular trauma are also defined.
APHACIC IOL
This document discusses different types of intraocular lenses (IOLs) used in cataract surgery. It covers various factors that influence IOL choice such as material, design, and patient needs. The main materials discussed are polymethylmethacrylate, hydrophobic acrylic, hydrophilic acrylic, and silicone. IOL designs include multifocal, toric, and aspherical lenses. Special considerations are mentioned for choosing IOLs in cases of incomplete capsule support, high myopia, or uveitis. The document provides details on characteristics and indications for different IOL materials and designs.
Yag post capsulotomy
Nd: YAG laser posterior capsulotomy is a common laser procedure used to treat posterior capsule opacification after cataract surgery. It involves using a Nd: YAG laser to create an opening in the clouded posterior capsule. The laser works by photodisruption of tissue at the capsular opening site. Complications can include temporary rise in intraocular pressure, cystoid macular edema, and rarely retinal detachment. Proper technique and postoperative care such as use of eye drops can help reduce risks of complications from the procedure.
RECENT ADVANCES IN INTRAOCULAR LENS
1) Intraocular lenses (IOLs) are artificial lenses implanted during cataract surgery to replace the clouded natural lens and correct vision. 2) IOLs have evolved over generations from rigid PMMA lenses to modern foldable designs made of silicone, acrylic, or hydrogel materials. 3) IOLs can be mono-focal, providing a single vision correction, or multi-focal, attempting to provide both near and distance vision without glasses. Accommodating IOL designs also aim to restore the eye's ability to focus at different distances.
Ocular Injuries 1-2-3Class_01-08-23.pptxt
1. Open-globe injuries involve full-thickness wounds of the eye wall caused by blunt or sharp trauma and can allow infection.
2. Penetrating injuries create a single wound while perforating injuries make two wounds from entry and exit of an object.
3. Retained intraocular foreign bodies can cause mechanical damage, introduce infection, and elicit reactions from inorganic materials like iron or copper alloys. Precise localization is needed before removal.
Intraocular lens
The document summarizes the history and generations of intraocular lenses (IOLs). It discusses the first IOL implanted by Sir Harold Ridley, made of polymethyl methacrylate (PMMA). Later generations included foldable materials, multifocal IOLs, and accommodating IOLs. Premium IOLs now offer features like toric designs to correct astigmatism and aspheric optics for better vision quality. While multifocal IOLs provide simultaneous distance and near vision without glasses, they can cause visual side effects like halos and reduced contrast sensitivity. Accommodating IOLs aim to restore a degree of natural accommodation but may not provide fully unaided near vision for small print.
Pseudophakia
Pseudophakia refers to an artificial lens implanted after cataract extraction. There are several types of intraocular lenses (IOLs) depending on placement, material, and optical correction provided. Posterior chamber IOLs placed in the lens capsule have fewer complications than anterior chamber IOLs. Complications of IOL implantation include incorrect refractive error correction and lens dislocation. IOLs are made of materials like PMMA, silicone, acrylic, and hydrogel. Toric, aspheric, and aniridia IOLs address astigmatism, spherical aberration, and aniridia, respectively.
Ocular Prosthesis
This document discusses ocular prosthetics and management of the anophthalmic socket. It begins by describing the surgical procedures of enucleation, evisceration, and exenteration used to partially or completely remove the eye. It then discusses goals and techniques after these surgeries, including the use of conformers and orbital implants. The document outlines fabrication of ocular prosthetics, including custom made versus ready made, and the impression fitting technique. Common complications are listed along with a study on complications. Ideal management is described to provide comprehensive eye care including prosthesis inspection and specialist referrals.
The anophthalmic socket
This document discusses the anatomy and management of the anophthalmic socket. It begins by defining an anophthalmic socket as an orbit lacking an eye globe, usually due to enucleation. True anophthalmia can be congenital or acquired. The most common causes of acquired anophthalmia are enucleation, exenteration, or evisceration performed to treat painful, blind eyes or remove tumors. The document outlines techniques for each procedure and discusses complications that can arise like socket contracture and management strategies like grafting. It emphasizes the importance of socket maintenance with conformers and prosthetics to prevent complications. In summary, this document provides an overview of anophthalmic socket anatomy,
Iol master
This document discusses the history of intraocular lens (IOL) implantation and development of technologies for calculating IOL power. It begins with Sir Harold Ridley implanting the first IOL in 1949 using the human lens as a model. Over subsequent decades, improvements were made such as developing foldable lenses to allow for smaller incisions. Advances in biometry technologies like ultrasound A-scan and optical biometry using partial coherence interferometry allowed for more accurate measurements of eye dimensions needed for precise IOL power calculations.
Similar to Management of intra ocular foreign body (20)
Lecture on Intraocular Foreign Bodies For 4th Year MBBS Undergraduate Studen...
Lecture on Intraocular Foreign Bodies For 4th Year MBBS Undergraduate Studen...
Evaluation and initial management of patients with ocular and adnexal trauma
Evaluation and initial management of patients with ocular and adnexal trauma
More from ikramdr01
MI LOCALISATION.pptx
A 46-year-old male presented with sudden onset of chest pain radiating to the left arm and shortness of breath. He has risk factors of smoking but no other medical history. On examination, his vitals were stable and heart and lung sounds were normal. The document discusses the arterial supply of the heart and how electrocardiogram leads correspond to different areas of the heart muscle. It provides detailed descriptions of ST segment changes that would indicate occlusions or blocks in different coronary arteries and the regions of the heart affected.
atrial fibrillation 2020 guidelines
The document presents the 2020 ESC Guidelines for the diagnosis and management of atrial fibrillation developed in collaboration with the European Association for Cardio-Thoracic Surgery. It was developed by a task force of experts and provides updated recommendations based on evidence levels. New recommendations include structured characterization of AF, screening recommendations, use of patient-reported outcomes, reassessment of stroke and bleeding risk, and considerations for rhythm control including catheter ablation.
Wheezing dos and donts
This document discusses different types of wheezing in children and approaches to diagnosis and treatment. It addresses acute wheezing in young children which is usually due to bronchiolitis or cold and treated symptomatically. Recurrent wheezing may not indicate asthma, and a risk-based probability approach is recommended to evaluate if symptoms warrant treatment with inhaled corticosteroids. Factors like family history, atopy, frequency of colds can help determine the likelihood that recurrent wheezing is asthma. A trial of ICS may help decide if asthma is present when probability is unclear. Bronchodilators are usually sufficient for infrequent viral-induced wheezing.
Imaging in stroke
1. Imaging plays an important role in the evaluation and management of patients with acute stroke.
2. Different imaging modalities such as CT, CT angiography, CT perfusion, MRI, MR angiography, and MR perfusion have benefits for assessing the brain parenchyma, vasculature, perfusion, and identifying potentially salvageable penumbral tissue.
3. Diffusion-weighted MRI is the most sensitive method for detecting acute ischemia within the first few hours, while perfusion imaging can identify tissue at risk of infarction in the ischemic penumbra that may be rescued with reperfusion therapy.
arterial disorders
This document discusses arterial disorders and provides an overview of arterial anatomy, layers of arteries, arterial pulses, and clinical tests. It describes common arterial conditions like stenosis, aneurysms, arteritis, and small vessel abnormalities. Specific disorders discussed in detail include thromboangiitis obliterans, Takayasu's arteritis, Raynaud's phenomenon, aneurysms, and arteriovenous fistulas. Three case scenarios are presented concerning Leriche syndrome, arteriovenous fistula, and dissecting aortic aneurysm.
interstitial lung diseases
This document provides an overview of interstitial lung diseases (ILDs). It discusses the protective mechanisms of the lung, pathogenesis of ILDs including different presentation patterns, classification of ILDs, diagnostic testing approaches, treatment options including drug therapy and pulmonary rehabilitation. Key points covered include common causes of different radiographic patterns seen on chest imaging for ILDs and rules for approaching a practical diagnosis of ILD based on clinical and imaging features.
Innovative gadgets in anesthesia and medicine
This document provides information on various innovative medical gadgets classified into different categories such as para operative monitors, anesthesia related gadgets, and operation theatre related gadgets. It describes gadgets such as blood pressure monitors, thermometers, weighing scales, pulse oximeters, stethoscopes, ECG machines, glucometers, spirometers, and telehealth solutions. It also discusses smart contact lenses, insulin pens, adhesive bandages, ventilators and other anesthesia equipment that have been developed with new technologies.
Clinical cardiology
This document describes several patient cases presented to highlight important lessons in clinical cardiology. It emphasizes the importance of a thorough history and physical exam over reliance on tests alone. In case 1, careful auscultation revealed pericarditis, not reinfarction. Case 2 showed occult bleeding, not arrhythmia, caused syncope. Case 3 demonstrated a pleural effusion, not refractory heart failure, as the cause of dyspnea. Clinical clues are key to the appropriate management of each case.
Tuberculosis
Tuberculosis can manifest as either pulmonary or extra-pulmonary disease. Pulmonary TB, which accounts for over 78% of cases, is divided into primary TB occurring after initial infection and reactivation post-primary TB. Extra-pulmonary TB involves sites outside the lungs, with lymph nodes, pleura, and the genitourinary tract being most commonly affected. Symptoms vary depending on the infected site but may include cough, fever, night sweats, and weight loss.
Gestational diabetes mellitus
Gestational diabetes (GDM) is glucose intolerance that begins or is first recognized during pregnancy. It can be caused by either pre-existing type 2 diabetes or a new onset of diabetes during pregnancy. The document discusses screening, diagnosis and management of both pre-existing diabetes and GDM during pregnancy. It aims to provide optimal glucose control to support fetal growth while avoiding risks of hyper- and hypoglycemia. Treatment involves medical nutrition therapy, glucose monitoring and may require insulin therapy in some cases. Close monitoring is needed throughout pregnancy and postpartum to support maternal and fetal health.
Gestational trophoblastic diseases
Gestational trophoblastic disease is a heterogeneous group of lesions arising from abnormal placental trophoblast proliferation. It includes premalignant conditions like complete and partial hydatidiform moles, as well as malignant gestational trophoblastic neoplasia (GTN). GTN has varying potential for local invasion and metastasis. While rare, GTN is highly curable even with widespread dissemination. Treatment involves chemotherapy, with single or multi-agent regimens depending on risk factors and disease stage according to the FIGO scoring system. Careful monitoring of beta-hCG levels is important for diagnosis and follow-up.
Heart failure
This document provides an overview of heart failure, including different types (e.g. acute vs chronic, systolic vs diastolic), biomarkers used to monitor patients, standard treatment options like diuretics and ACE inhibitors, newer drugs in development, and management challenges like high treatment costs. It uses the analogy of a donkey to describe escalating medical interventions for heart failure, from initial diuretic use to more aggressive ionotropes or devices like LVADs for end-stage cases. The document highlights biomarkers that can guide discharge decisions and newer biomarkers being explored, as well as newer drugs and devices in development or use such as CRT devices, ECLS, and LVADs.
Scorpion sting
A 14-year-old boy presented to the emergency department with symptoms of an autonomic storm after being bitten by a scorpion. He was diagnosed with scorpion sting in autonomic storm. He was given prazosin, hydrocortisone, and other supportive treatments. His condition stabilized and he was discharged after 6 days. Scorpion stings can cause local effects and a systemic autonomic storm response due to neurotoxins that affect sodium channels and induce catecholamine release. Prazosin is an effective treatment as it blocks alpha receptors and counters the effects of venom.
Sarcoidosis and IgG4
Sarcoidosis and IgG4-related diseases are inflammatory conditions characterized by granuloma formation. Sarcoidosis is a multisystem disorder involving lungs in over 90% of cases and skin, eyes, and liver in about a third of patients each. It is thought to be triggered by an infectious or environmental agent in a genetically susceptible host. IgG4-related disease is a fibroinflammatory condition that can affect virtually any organ, forming tumefactive lesions. Treatment for both conditions typically involves corticosteroids, with immunosuppressants used for chronic or resistant cases.
Neuropathic pain understanding and management
1. The document discusses diabetic neuropathy, including its classification, clinical characteristics, underlying mechanisms, investigations and pharmacological treatment.
2. Key points include that diabetic neuropathy has many subtypes and involves both large and small nerve fibers. The clinical features progress from negative symptoms like loss of sensation to positive symptoms like pain. Investigations include electrodiagnostic testing and skin or nerve biopsies.
3. Treatment involves first-line options like duloxetine, pregabalin and TCAs. Polypharmacy with combinations from different classes may be considered for refractory cases. Factors like comorbidities, side effects, costs and drug interactions must be evaluated when selecting an individual's treatment plan.
Optimizing heart failure management
Cardiac resynchronization therapy (CRT) and implantable cardioverter defibrillators (ICDs) can help optimize heart failure management. CRT improves symptoms, reduces hospitalizations, and increases survival in patients with reduced ejection fraction, left bundle branch block, and wide QRS duration. ICDs prevent sudden cardiac death in high-risk patients with prior heart failure, low ejection fraction, or history of dangerous arrhythmias. New devices use adaptive and multi-point pacing to better resynchronize the left ventricle. Device therapy improves outcomes when guided by clinical evidence and used in appropriate heart failure patients.
Kawasaki disease
Kawasaki disease is an autoimmune disease that causes inflammation in blood vessels throughout the body. It was first described in 1967 by Dr. Kawasaki in Japan. It most commonly affects children under 5 years old. Without treatment, it can lead to fatal coronary artery aneurysms in some children. The cause is unknown but likely involves genetic and environmental factors such as a viral or bacterial infection. Diagnosis is based on symptoms that include prolonged fever and changes in lips, mouth, hands and feet. Echocardiograms are used to check for heart complications which include aneurysms and heart valve issues.
bedside approach to common congenital heart diseases
This document summarizes common congenital heart diseases, their presentations, and physical exam findings. It discusses how conditions like ventricular septal defect (VSD), atrial septal defect (ASD), patent ductus arteriosus (PDA), pulmonary stenosis (PS), and tetralogy of Fallot (TOF) can present in neonates, infants, children or adolescents with symptoms like cyanosis, heart failure, or murmurs. Physical exam findings for each condition are provided to help determine the location and nature of cardiac lesions.
Atrial fibrillation
This document provides an overview of atrial fibrillation (AF), including its pathogenesis, types, diagnosis, and management. Some key points:
- AF is the most common cardiac arrhythmia, affecting around 6% of those over 65. It increases the risk of stroke.
- It occurs when the normal sinus rhythm is overridden by disorganized electrical impulses, usually originating in the lungs.
- Types include paroxysmal, persistent, and permanent. Symptoms range from none to palpitations, dyspnea, chest pain, and neurological issues.
- Diagnosis is made via ECG showing irregular rhythm without P waves. Workup evaluates for underlying causes and stroke risk factors.
Infective endocarditis
Infective endocarditis is a microbial infection of the heart valves or endocardium. It is characterized by the formation of vegetations composed of platelets, fibrin, microorganisms, and inflammatory cells. It occurs more commonly in males and the elderly. Streptococci and Staphylococcus aureus are the most common causes. Diagnosis involves blood cultures, echocardiography, and applying the Duke criteria. Complications include embolisms, heart failure, and metastatic infections. Treatment involves prolonged antibiotic therapy targeted to the infecting organism. Surgery may be needed for complications or uncontrolled infection. Antibiotic prophylaxis is now restricted to highest risk patients undergoing highest risk procedures.
More from ikramdr01 (20)
bedside approach to common congenital heart diseases
bedside approach to common congenital heart diseases
Recently uploaded
Knee anatomy and clinical tests 2024.pdf
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
Integrating Ayurveda into Parkinson’s Management: A Holistic Approach
Explore the benefits of combining Ayurveda with conventional Parkinson's treatments. Learn how a holistic approach can manage symptoms, enhance well-being, and balance body energies. Discover the steps to safely integrate Ayurvedic practices into your Parkinson’s care plan, including expert guidance on diet, herbal remedies, and lifestyle modifications.
Best Ayurvedic medicine for Gas and Indigestion
Here is the updated list of Top Best Ayurvedic medicine for Gas and Indigestion and those are Gas-O-Go Syp for Dyspepsia | Lavizyme Syrup for Acidity | Yumzyme Hepatoprotective Capsules etc
Journal Article Review on Rasamanikya
Rasamanikya is a excellent preparation in the field of Rasashastra, it is used in various Kushtha Roga, Shwasa, Vicharchika, Bhagandara, Vatarakta, and Phiranga Roga. In this article Preparation& Comparative analytical profile for both Formulationon i.e Rasamanikya prepared by Kushmanda swarasa & Churnodhaka Shodita Haratala. The study aims to provide insights into the comparative efficacy and analytical aspects of these formulations for enhanced therapeutic outcomes.
micro teaching on communication m.sc nursing.pdf
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
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-Vitamin-Supplement-Brands-in-India List
Swisschem Dermacare provides the Top 10 Vitamin Supplement Brands in India. To know more about us give us call at our official number
REGULATION FOR COMBINATION PRODUCTS AND MEDICAL DEVICES.pptx
It includes regulation of combination products and medical devices. FDA and industry liaisons.
Role of Mukta Pishti in the Management of Hyperthyroidism
Muktapishti is a traditional Ayurvedic preparation made from Shoditha Mukta (Purified Pearl), is believed to help regulate thyroid function and reduce symptoms of hyperthyroidism due to its cooling and balancing properties. Clinical evidence on its efficacy remains limited, necessitating further research to validate its therapeutic benefits.
Adhd Medication Shortage Uk - trinexpharmacy.com
The UK is currently facing a Adhd Medication Shortage Uk, which has left many patients and their families grappling with uncertainty and frustration. ADHD, or Attention Deficit Hyperactivity Disorder, is a chronic condition that requires consistent medication to manage effectively. This shortage has highlighted the critical role these medications play in the daily lives of those affected by ADHD. Contact : +1 (747) 209 – 3649 E-mail : sales@trinexpharmacy.com
Local Advanced Lung Cancer: Artificial Intelligence, Synergetics, Complex Sys...
Overall life span (LS) was 1671.7±1721.6 days and cumulative 5YS reached 62.4%, 10 years – 50.4%, 20 years – 44.6%. 94 LCP lived more than 5 years without cancer (LS=2958.6±1723.6 days), 22 – more than 10 years (LS=5571±1841.8 days). 67 LCP died because of LC (LS=471.9±344 days). AT significantly improved 5YS (68% vs. 53.7%) (P=0.028 by log-rank test). Cox modeling displayed that 5YS of LCP significantly depended on: N0-N12, T3-4, blood cell circuit, cell ratio factors (ratio between cancer cells-CC and blood cells subpopulations), LC cell dynamics, recalcification time, heparin tolerance, prothrombin index, protein, AT, procedure type (P=0.000-0.031). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and N0-12 (rank=1), thrombocytes/CC (rank=2), segmented neutrophils/CC (3), eosinophils/CC (4), erythrocytes/CC (5), healthy cells/CC (6), lymphocytes/CC (7), stick neutrophils/CC (8), leucocytes/CC (9), monocytes/CC (10). Correct prediction of 5YS was 100% by neural networks computing (error=0.000; area under ROC curve=1.0).
The Electrocardiogram - Physiologic Principles
These lecture slides, by Dr Sidra Arshad, offer a quick overview of the physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar lead (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
6. Describe the flow of current around the heart during the cardiac cycle
7. Discuss the placement and polarity of the leads of electrocardiograph
8. Describe the normal electrocardiograms recorded from the limb leads and explain the physiological basis of the different records that are obtained
9. Define mean electrical vector (axis) of the heart and give the normal range
10. Define the mean QRS vector
11. Describe the axes of leads (hexagonal reference system)
12. Comprehend the vectorial analysis of the normal ECG
13. Determine the mean electrical axis of the ventricular QRS and appreciate the mean axis deviation
14. Explain the concepts of current of injury, J point, and their significance
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. Chapter 3, Cardiology Explained, https://www.ncbi.nlm.nih.gov/books/NBK2214/
7. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
ABDOMINAL TRAUMA in pediatrics part one.
Abdominal trauma in pediatrics refers to injuries or damage to the abdominal organs in children. It can occur due to various causes such as falls, motor vehicle accidents, sports-related injuries, and physical abuse. Children are more vulnerable to abdominal trauma due to their unique anatomical and physiological characteristics. Signs and symptoms include abdominal pain, tenderness, distension, vomiting, and signs of shock. Diagnosis involves physical examination, imaging studies, and laboratory tests. Management depends on the severity and may involve conservative treatment or surgical intervention. Prevention is crucial in reducing the incidence of abdominal trauma in children.
NVBDCP.pptx Nation vector borne disease control program
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
A Classical Text Review on Basavarajeeyam
Basavarajeeyam is a Sreshta Sangraha grantha (Compiled book ), written by Neelkanta kotturu Basavaraja Virachita. It contains 25 Prakaranas, First 24 Chapters related to Rogas& 25th to Rasadravyas.
Recently uploaded (20)
Integrating Ayurveda into Parkinson’s Management: A Holistic Approach
Integrating Ayurveda into Parkinson’s Management: A Holistic Approach
REGULATION FOR COMBINATION PRODUCTS AND MEDICAL DEVICES.pptx
REGULATION FOR COMBINATION PRODUCTS AND MEDICAL DEVICES.pptx
Role of Mukta Pishti in the Management of Hyperthyroidism
Role of Mukta Pishti in the Management of Hyperthyroidism
Tests for analysis of different pharmaceutical.pptx
Tests for analysis of different pharmaceutical.pptx
CHEMOTHERAPY_RDP_CHAPTER 6_Anti Malarial Drugs.pdf
CHEMOTHERAPY_RDP_CHAPTER 6_Anti Malarial Drugs.pdf
Local Advanced Lung Cancer: Artificial Intelligence, Synergetics, Complex Sys...
Local Advanced Lung Cancer: Artificial Intelligence, Synergetics, Complex Sys...
NVBDCP.pptx Nation vector borne disease control program
NVBDCP.pptx Nation vector borne disease control program
Management of intra ocular foreign body
- 1. INTRA OCULAR FOREIGN BODY -K . R . BHARATHI PRIA -CRRI
- 2. FACTS • 41 percent of all open globe injuries. • Most are metal • The majority of patients are injured while wielding a hammer. • May become embedded in any ocular structure, from the anterior chamber to the retina.
- 4. EVALUATION • Focused history - Time , Mechanism of the injury and the composition of the object. • A careful ocular examination, minimizing pressure to avoid further expulsion of its contents, is essential. • Slit lamp examination usually is able to locate an IOFB in the anterior segment. • Examining the iris using retroillumination may reveal a disruption site (Iris Hole). • Gonioscopy is valuable to visualize the angles if suspicion exists about an IOFB in the angle. • Dilated fundus examination usually reveals the IOFB when it is in the posterior segment.
- 5. Intraoperative view of the IOFB, local retinal detachment, and retinal whitening.
- 6. LOCALIZATION AND CONFIRMATION OF DIAGNOSIS • Plain X-ray is useful in radio-opaque foreign bodies only and will not detect radiolucent IOFBs such as wood or glass • The standard “foreign body x-ray series,” includes Water’s, Caldwell, and lateral views. • A foreign body within the globe can be localized with a bone-free examination by eye movement. Anterior segment - The object will rotate in the same direction as the eye. Posterior segment -The object will move in a opposite direction opposite to the eye movement • Localization using METAL LOCATORS either placed on the eye with a contact lens or sutured to limbus may also be done. (Berman, Roper-Hall, and Bronson-Turner)
- 7. • Computed tomography - size, shape, and localization of the foreign body. • MRI generally is not used in metallic IOFB. MRI may be more effective in localizing nonmetallic IOFB such as wood. • Ultrasound - localizing IOFB , determine if the object is metallic , extent of the intraocular damage, determining the presence of a retinal detachment,double perforation, as well as in detecting foreign bodies not seen on x-ray studies. • Ultrasound biomicroscopy is needed if FB in the angle is suspected.
- 9. Indications for Removal • Accessibility VS Harm to the globe. • TOXICITY : Metallic objects consisting of iron, lead or copper and its alloys should be removed because of welldocumented toxic effects on intraocular tissues. • CONTAMINATION : In an outdoor setting, IOFBs are often contaminated with vegetable matter, increasing the risk of infectious endophthalmitis.
- 10. • 1 ) Siderosis bulbi : caused by intraocular toxicity from ionized iron, is characterized by a rust colored corneal stroma, iris heterochromia with brownish-discoloration, a dilated and nonreactive pupil, orange deposits in the lens epithelium and anterior cortex, and retinal degeneration. • 2) Acute chalcosis : occurs with metals with a copper content of 85 percent or more and is characterized by sterile endophthalmitis, corneal and scleral melting, hypopyon and retinal detachment. Other clinical findings include a Kayser-Fleischer ring, iris heterochromia with greenish discoloration, a “sunflower” cataract and retinal degeneration. • Chronic chalcosis : may be seen with metals containing less than 85 percent copper, but this finding rarely leads to blindness.
- 11. Management Tips • The goal in managing an IOFB is to achieve the best visual outcome possible by identifying and closing the entry and exit sites, reconstructing the eye and, if possible, removing the object. • If removal of the object could cause significant damage to an eye that otherwise presents with good visual acuity and no evidence of endophthalmitis, then regular follow-up using visual acuity, slit lamp and serial electroretinograms (ERGs) is a reasonable option. • Risk of endophthalmitis. The incidence of post-traumatic endophthalmitis with a retained IOFB is between 5 and 30 percent. Use of antibiotics. To decrease the risk of endophthalmitis, removal of the IOFB should be done concurrently with primary globe repair and administration of intravitreal and topical antibiotics.
- 12. Removal • Most IOFBs are extracted from a new opening unless the entrance wound is large. • Two types of instruments are used: an intraocular magnet and a forceps. The choice of instrument depends on the foreign body. • A magnet can remove an object of any size, shape and weight with a ferrous content. • For other IOFBs, a variety of forceps may be required depending on the object’s size and shape.
- 13. 1. View of sutured entry wound and band 2. Intraocular foreign body attached to intraocular magnet.
- 14. Anterior chamber placement. The anterior chamber is maintained with viscoelastic. If the object is visible, a limbal incision can be made over the object. Alternatively, an incision is created 90 to 180 degrees from the object for better access with forceps. • If the IOFB is hidden in the angle an endoscope, inserted through an incision 180 degrees from the object, may be used for visualization and the IOFB may be removed with a magnet or forceps through an incision created 90 degrees from the object.
- 15. • Intralenticular placement. An inert IOFB embedded in a lens with no cataract may be observed. The lens may or may not be salvageable after the object is removed. If a cataract is present, the lens may be removed during primary or secondary repair. If the lens is removed, IOL placement should be deferred whenvitreoretinal damage is suspected, since an IOL may interfere with the view of the posterior segment. • IOL placement should also be deferred when endophthalmitis is present or is at high risk of developing. • If an IOL will be placed during primary repair, the integrity of the lens capsule and its zonules should be evaluated.
- 16. • Posterior segment placement. A hyphema, cataract or vitreous hemorrhage that interferes with the view to the posterior segment should be removed. • If the IOFB is visible and free-floating in the vitreous cavity, a pars plana vitrectomy with removal of the object with a magnet and/or forceps may be attempted. • The posterior hyaloid is detached and removed to eliminate any tractional component, and vitreous strands and/ or the fibrous capsule of the IOFB are released to facilitate its removal. Enlarging a pars plana incision site allows for extraction of the object.
- 17. 1. Detaching the posterior cortical vitreous after staining with triamcinolone acetonide. 2. Large retinal break after removing intraocular foreign body. 3. Intraocular foreign body after removal.
- 18. Outcome • Poor prognostic factors include a large entrance wound located posteriorly; large, blunt, nonmetallic objects in the posterior segment; an initial visual acuity of less than 5/200; a relative afferent pupillary defect; and endophthalmitis. • Overall, a favorable prognosis with a final visual acuity of 20/40 or better may be expected in up to 71 percent of eyes.
- 19. Thank you….