Non-infectious corneal ulcers can be caused by local factors like punctate marginal keratitis due to hypersensitivity to medications or peripheral keratitis associated with blepharitis, or systemic immune-mediated diseases like rheumatoid arthritis. Marginal keratitis is characterized by chronic blepharitis and subepithelial marginal infiltrates separated from the limbus by a clear zone. Mooren's ulcer is a rare autoimmune disease seen as progressive peripheral circumferential stromal ulceration. Terrien marginal degeneration is an idiopathic thinning of the peripheral cornea. Peripheral ulcerative keratitis can be associated with underlying systemic autoimmune diseases like rheumatoid arthritis.
thyroid eye disease is becoming a very common eye disorder with more than 42 million people affected in india with thyroid disease. About 2.9 men and 16 women/lac/year are newly diagnosed with thyoid disease.
congenital cataract for undergraduate MBBS Students.
Also covers salient points for PGMEE.
Aetiology, clinical features and management discussed in detail.
Great talk about uveitis anterior uveitis and posterior uveitis for those who may have missed it or are not members of American Academy of Ophthalmology Meeting. Kudos to Dr. Lowder
thyroid eye disease is becoming a very common eye disorder with more than 42 million people affected in india with thyroid disease. About 2.9 men and 16 women/lac/year are newly diagnosed with thyoid disease.
congenital cataract for undergraduate MBBS Students.
Also covers salient points for PGMEE.
Aetiology, clinical features and management discussed in detail.
Great talk about uveitis anterior uveitis and posterior uveitis for those who may have missed it or are not members of American Academy of Ophthalmology Meeting. Kudos to Dr. Lowder
This presentation describes all clinical aspects of infectious corneal ulcers
You can watch the illustrated presentation in this link :
https://www.youtube.com/watch?v=okWDPG3C34g&list=PLZ_mM13I_TrhwqZuGjB6M9Z3n7MntrURd
Behçet disease is an inflammatory disorder - vasculitis of small and large arteries and/or veins ---> Arterial and venous thrombosis
Typically affects patients from eastern Mediterranean region and Japan. Most common along the silk route from the Mediterranean to China
Strongly associated with human Leucocyte antigen (HLA) B51
Man >female with more severe symptoms
Peak of onset is at 30s , but can be of any age
This presentation describes all the clinical aspects of keratoconus management
You can watch the illustrated presentation in this link :
https://www.youtube.com/watch?v=pYxwZPGm7e4&list=PLZ_mM13I_TrhWavjTmE9NjW1O5bGxkONO&index=13
This presentation describes all clinical aspects of glaucoma medications.....you can watch this presentation in video form at the following link
https://www.youtube.com/watch?v=92xurWP41dA
This presentation describes all clinical aspects of congenital glaucoma....you can watch this presentation in video form at the following link
https://www.youtube.com/watch?v=Y5YA2CYzb5c
Femtolasik...Indications and limitationsAmr Mounir
This presentation describes all indications and limitations of femtosecond laser surgery.....you can watch the illustrated video presentation in the following link:
https://youtu.be/vCwu-_hpWxA
This presentation describes all clinical aspects about primary open angle glaucoma ......
you can watch the illustrated video presentation at the following link : https://youtu.be/eA44Pu4l8Ow
This presentation describes all clinical aspects of primary angle closure glaucoma in a concentrated and simplified manner....you can watch the illustrated presentation at the following link:
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
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Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
2. Corneal Ulcers
Def: Corneal ulcers are defects in the corneal epithelium
with or without stromal infiltration.
Types:
A) Infectious ulcerative keratitis
B) Non infectious ulcerative keratitis
3. Bacteria and
Fungi Viruses Acanthamoeba
Systemic
Autoimmune/
Inflammatory
Local Toxic
InfectiousNon infectious
Etiology
4. Non Infectious Ulcerative Keratitis
Causes:
Local causes:
Punctate marginal keratitis: Staphylococci, Streptococci, hypersensitivity to
medications
Peripheral keratitis associated with blepharitis:
Systemic causes:
Generally manifestation of systemic, immune-mediated disease
Most common: Rheumatoid arthritis, Wegener’s granulomatosis and
polyarteritis nodosa
8. Marginal Keratitis
• Caused by hypersensitivity reaction against
Staphylococcal exotoxin and cell wall proteins with
deposition of Ag-Ab complex in peripheral cornea
• Lesions are culture negative but S. aureus can be
isolated from lid margin
9. Signs and symptoms
• Chronic Blepheritis
• Subepithelial marginal infiltrates seperated from
limbus by a clear zone
• Conjunctival Injection
• Coalescence and circumferential spread
• Little or no AC reaction
• Resolution usually occurs in 1-4 wks, occasionally
there is residual superficial scarring
10.
11. Treatment
• Weak topical steroid
• May be combined with a topical antibiotic
• Tetracycline orally
• For children , breastfeeding and pregnancy
erythromycin
• Treatment of blepheritis
12. Mooren's Ulcer
• Rare autoimmune disease
• Characterized by
– Progressive,
– Peripheral,with Limbitis
– Circumferential, stromal corneal ulceration
Vascularization involving the bed of the ulcer up to its leading edge but not
beyond
– Later central spread
Risk factors for Mooren's ulcer include corneal surgery, previous trauma,
and infection.
15. Complications
• Severe astigmatism due to extensive vascularization &
fibrosis
• Perforation following minor trauma
• Secondary bacterial infection
16. Management
• Topical
– Steroids
– Cyclosporin (weeks to show significant effect)
– Artificial tears
– Collagenase inhibitors (acetylcystine)
• bandage contact lenses
• Conjunctival resection
• Immunosuppression
• Systemic collagenase inhibitors such as doxycycline
Lamellar keratoplasty, keratoepithelioplasty and conjunctival flap and patch grafts
17. Terrien marginal degeneration
• Idiopathic thinning of the peripheral cornea
• Young adult to elderly patients
• Uncommon
• 75% males
• Usually bilateral
18. Symptoms
• Asymptomatic
• Gradual visual deterioration can occur due to
astigmatism
• A few patients experience episodic pain and
inflammation
19. Signs
It causes a slowly progressive non-inflammatory, unilateral
or asymmetrically bilateral peripheral corneal thinning and
is associated with corneal neovascularization, Opacification
and lipid deposition
20. - Perforation is rare but may be spontaneous or follow blunt
trauma
- Pseudopterygia sometimes develop
21.
22. Management
• Safety spectacles if thinning is significant
• Contact lenses for astigmatism.
Scleral or soft lenses
with rigid gas permeable
• Surgery :- Cresentric excision of the gutter
with lamellar or full-thickness
corneoscleral patch grafts transplantation
24. Destructive inflammation of the peripheral cornea
associated with corneal epithelial sloughing and
Keratolysis
The mechanism includes immune complex
deposition in peripheral cornea, episcleral and
conjunctival capillary occlusion with secondary
cytokine release and inflammatory cell recruitment,
the upregulation of collagenases and reduced activity
of their inhibitors
25. Systemic associations
• Rheumatoid arthritis (most common)
– PUK is bilateral in 30% and tends to occur in advanced RA
• Wegener granulomatosis (2nd most common)
– In contrast to RA ocular complications are the initial presentation in
50%
• Other conditions include polyarteritis nodosa, relapsing
polychondritis ,SLE , Churg – Strauss ,Microscopic Polyangiitis,
Inflammatory Bowel Disease
28. Peripheral corneal involvement in
rheumatoid arthritis
• Chronic and asymptomatic
• Circumferential thinning with intact
epithelium (‘contact lens cornea’)
• Acute and painful
• Circumferential ulceration and
infiltration
Without inflammation With inflammation
29. Management
Principally with systemic immunosuppression in
collaboration with a rheumatologist
Topical
Artificial tears (preservative-free)
Antibiotics as prophylaxis
Steroids may worsen thinning so are generally avoided
Systemic
Steroids (via pulsed IV administration) are used to control
acute disease, with immunosuppressive therapy and
biological blockers for longer-term management
Tetracycline for its anticollagenase effect
30. Dellen
Localized corneal disturbance associated with
drying of a focal area
Usually associated with an adjacent elevated
lesion as pinguecula or large subconjunctival
haemorrhage that impairs physiological
lubrication
32. Phlyctenulosis
Uncommon, unilateral - typically affects children
Severe photophobia, lacrimation and blepharospasm
Delayed hypersensitivity reaction to staphylococcal
antigen.
In developing countries, the majority are associated with
tuberculosis or helminthic infestation
33. • Small pinkish-white nodule
near limbus
• Usually transient and resolves
spontaneously
• Starts astride limbus
• Resolves spontaneously or extends
onto cornea
Conjunctival phlycten
Treatment - Topical steroids
Corneal phlycten