Non - surgical treatment of squint i.e. all types of squint have some modalities of treatment [ optical treatment, orthoptic treatment, Prismo-therapy, and pharmacological treatment] except surgical treatment.
1. OPTICAL TREATMENT -
in optical treatment, it should be include correction of refractive error and prismotherapy.
SPECTACLES should be prescribed in every cases.
It may correct to squint partially or completely.
IN PRISMOTHERAPY, for correction of squint, This is light weight, and easy to apply on the back surface of glass.
It is useful in heterophoria, nystagmus, convergence insufficiency, managing diplopia and maintain binocular single vision.
IN PHARMACOLOGICAL TREATMENT, miotics, atropine and botulinum toxin are prescribed in some types of cases of strabismus.
IN ORTHOPTIC TREATMENT, means straight eyes.
It is used as a diagnostic purpose and therapeutic purposes.
- to increase fusion amplitude.
- anti suppression exercises.
- treatment of amblyopia.
- treatment of abnormal retinal correspondance.
- to control deviations.
ORDER OF ORHOPTIC TREATMENT -
. amblyopia is treated firstly.
. anti- suppression therapy.
- diplopia training.
- amplitude improvement.
this is a brief description of management of esotropia with pictures that is very helpful for juniour ophthalmologist by resident of civil hospital karachi, DUHS.
this is a brief description of management of esotropia with pictures that is very helpful for juniour ophthalmologist by resident of civil hospital karachi, DUHS.
Unit IV 4.3 & 4.4 Management Strategy and Treatment Options in Pediatric Pat...RhezaMarisseBadon
Management strategy and Treatment Options of a pediatric patient
Reference by:
Visual development, diagnosis and treatment of the pediatric patient, 2nd edition by Pamela H. Schnell, Marc B. Taub and Robert H. Duckman
Glaucoma is not a single disease process but a group of disorders characterized by a progressive optic neuropathy resulting in a irreversible visual field defects that are associated frequently raised intraocular pressure (IOP).
IOP is the most common risk factor but not the only risk factor for development of glaucoma.
Uveal tissue is the middle vascular coat of the eyeball.
From anterior to posterior, it can be divided into 3 parts –
IRIS, CILIARY BODY CHOROID.
Iris is the anterior most part of the uveal tract.
The iris consists of four layers,
Anterior limiting layer
Iris stroma
Anterior epithelial layer
Posterior epithelial layer
The colour of iris depends on Anterior limiting layer.
The eyelids are mobile tissue curtains placed in front of the eyeballs. These act as shutters protecting the eyes from injuries and excessive light. These also perform an important function of spreading the tear film over the cornea and conjunctiva and also help in drainage of tears by lacrimal pump system.
The orbits are conical or four-sided pyramidal cavities, which open into the midline of the face and point back into the head. Each consists of a base, an apex and four walls.[4]
Each orbit is formed by seven bones –
Frontal bone
Ethmoidal bone
Lacrimal bone
Palatine bone
Maxilla bone
Zygomatic bone
Sphenoid bone
This pdf describes the details of some pathological conditions with their treatment.
some conditions
Albinism,
Aniridia
Coloboma
Corneal dystrophies
Cataract
Dislocated lens
Diabetic retinopathy
Keratoconus
Macular hole
Glaucoma
Myopic degeneration
Nystagmus
Optic trophy
Retnial detachment
Retinopathy of prematurity
Retinitis pigmentosa
Stargardt's disease
About disease of Conjunctiva
1. inflammatory conditions of conjunctiva
2.Symptomatic conditions of conjunctiva
3. degenerative conditions of conjunctiva
4. tumors of conjunctiva
5. cyst of conjunctiva
Amsler grid, to check central visual field about with in 20 degree.
It is diagnostic tool, to use detection of macular diseases, optic nerve and visual pathway.
Management of visual problems with agingMeghna Verma
Aging bring a continuous changes in visual system.
The visual system is also affected by age related ocular pathological conditions.
In it, routine ocular examination is compulsory.
Telescope have a small device but an important place in low vision.
Telescope eyelenses magnify the apparent size of distant objects.
Binoculars placed into eyeglass frame is called telescopic spectacle or spectacle mounted telescope.
TYPES
1. handheld monocular telescope
2. clip on spectacle mounted telescope
3. bioptic telescope
Telescope are of two types of designs-
1. galilean telescope
2. keplerian telescope
These are various structures in an eye , which are changing with age.
# ocular adnexa/ eyelids
# eyelashes / eyelid margin
# tear film
# cornea
# conjunctiva
# anterior chamber
# ciliary body
# pupil /iris
# crystalline lens
# vitreous
# choroid
# retina
Low vision patient have serious visual problems that have caused serious visual loss.
1. Contrast sensitivity testing and visual field testing
2. subjective testing of patients with media loss
# potential acuity meter
# interferometry
# photostress recovery test
# glare test
# color vision test
# dark adaptometry
3. objective testing of retinal loss
# USG
ERG/EOG
It is not a refractive error but a physiological insufficiency of accommodation.
It leads to progressive fall in near vision.
Decrease in the accommodative power of crystalline lens due to increasing age related conditions , leads to presbyopia.
1. decrease in the elasticity and plasticity of crystalline lens.
2. decease in the power of ciliary muscles.
Some conditions to generate premature presbyopia -
1 uncorrected hypermetropia
2. premature sclerosis of crystalline lens
3. weakness of ciliary muscles.
4. chronic simple glaucoma
SOME SYMPTOMS -
fever, blurring, asthenopic symptoms, fatigue, illness, diplopia
TREATMENT -
bifocal lens, trifocal lens and progressive addition lens
convex lens should be prescribed to correct presbyopia.
Magnifiers is a type of magnifying glass or lens.
It consists of high convex lens.
It is mounted on a frame with handle or without handle.
Magnifiers mostly used in low vision patients.
Magnifiers are of 5 types available;
1. Hand magnifiers
2. Spectacle magnifier
3. Stand magnifier
4. Telescopic magnifier
5. CCTV
These types of magnifiers details in this pdf.
THANK YOU..
SOFT CONTACT LENS FITTING
1. Alternative names of soft contact lens.
2. Need to know fitting requirement and performance requirements.
3. Centration and decentration of soft contact lens. -- There are cartesian system and binasal system.
4. what governs fitting of lens.
5. There are need to know about physical properties of soft contact lens.
6. Now, what is sag and sagital depth.
7. Finally, SAME SAG AND SAME DIAMETER but DIFFERENT DESIGN AND DIFFERENT BEHAVIOUR.
8. Parameters of soft contact lens -
total diameter
back optic zone radius
centre thickness
front optic zone radius
water content
9. There are two types of prescribing methods -
empirical prescribing
trial fit prescribing
10. Effect of a blink with soft contact lens - too flat and too steep.
11. Requirements of lens movement.
12. Lens lag position - primary gaze, up gaze and lateral gaze position.
13. Compulsory of lower lid push up test.
14. Ranges of fitting of soft contact lens - either too fit or too loose or ideal fitting.
15. All step of soft contact lens fitting is done.
Astigmatism
Definition - It is a type of refractive error where in the refraction varies in the different meridian.
The rays of light entering the eye can not converge to a point focus but form a focal lne.
Types of astigmatism -
1. Regular astigmatism 2. Irregular astigmatism
Etiology of regular astigmatism -
1. corneal astigmatism 2. lenticular astigmatism 3. retinal astigmatism
Types of regular astigmatism -
1. depending upon axis and angle b/w two principal meridian-
-with the rule astigmatism
- against the rule astigmatism
- oblique astigmatism
- bi oblique astigmatism
2. depending upon their position of two focal lines-
- simple astigmatism
- compound astigmatism
- mixed astigmatism
Optics of regular astigmatism
Treatment of regular astigmatism
Irregular astigmatism
Etiological types
Symptoms of astigmatism
Treatment
Synthetic Fiber Construction in lab .pptxPavel ( NSTU)
Synthetic fiber production is a fascinating and complex field that blends chemistry, engineering, and environmental science. By understanding these aspects, students can gain a comprehensive view of synthetic fiber production, its impact on society and the environment, and the potential for future innovations. Synthetic fibers play a crucial role in modern society, impacting various aspects of daily life, industry, and the environment. ynthetic fibers are integral to modern life, offering a range of benefits from cost-effectiveness and versatility to innovative applications and performance characteristics. While they pose environmental challenges, ongoing research and development aim to create more sustainable and eco-friendly alternatives. Understanding the importance of synthetic fibers helps in appreciating their role in the economy, industry, and daily life, while also emphasizing the need for sustainable practices and innovation.
The Indian economy is classified into different sectors to simplify the analysis and understanding of economic activities. For Class 10, it's essential to grasp the sectors of the Indian economy, understand their characteristics, and recognize their importance. This guide will provide detailed notes on the Sectors of the Indian Economy Class 10, using specific long-tail keywords to enhance comprehension.
For more information, visit-www.vavaclasses.com
This is a presentation by Dada Robert in a Your Skill Boost masterclass organised by the Excellence Foundation for South Sudan (EFSS) on Saturday, the 25th and Sunday, the 26th of May 2024.
He discussed the concept of quality improvement, emphasizing its applicability to various aspects of life, including personal, project, and program improvements. He defined quality as doing the right thing at the right time in the right way to achieve the best possible results and discussed the concept of the "gap" between what we know and what we do, and how this gap represents the areas we need to improve. He explained the scientific approach to quality improvement, which involves systematic performance analysis, testing and learning, and implementing change ideas. He also highlighted the importance of client focus and a team approach to quality improvement.
How to Make a Field invisible in Odoo 17Celine George
It is possible to hide or invisible some fields in odoo. Commonly using “invisible” attribute in the field definition to invisible the fields. This slide will show how to make a field invisible in odoo 17.
The Roman Empire A Historical Colossus.pdfkaushalkr1407
The Roman Empire, a vast and enduring power, stands as one of history's most remarkable civilizations, leaving an indelible imprint on the world. It emerged from the Roman Republic, transitioning into an imperial powerhouse under the leadership of Augustus Caesar in 27 BCE. This transformation marked the beginning of an era defined by unprecedented territorial expansion, architectural marvels, and profound cultural influence.
The empire's roots lie in the city of Rome, founded, according to legend, by Romulus in 753 BCE. Over centuries, Rome evolved from a small settlement to a formidable republic, characterized by a complex political system with elected officials and checks on power. However, internal strife, class conflicts, and military ambitions paved the way for the end of the Republic. Julius Caesar’s dictatorship and subsequent assassination in 44 BCE created a power vacuum, leading to a civil war. Octavian, later Augustus, emerged victorious, heralding the Roman Empire’s birth.
Under Augustus, the empire experienced the Pax Romana, a 200-year period of relative peace and stability. Augustus reformed the military, established efficient administrative systems, and initiated grand construction projects. The empire's borders expanded, encompassing territories from Britain to Egypt and from Spain to the Euphrates. Roman legions, renowned for their discipline and engineering prowess, secured and maintained these vast territories, building roads, fortifications, and cities that facilitated control and integration.
The Roman Empire’s society was hierarchical, with a rigid class system. At the top were the patricians, wealthy elites who held significant political power. Below them were the plebeians, free citizens with limited political influence, and the vast numbers of slaves who formed the backbone of the economy. The family unit was central, governed by the paterfamilias, the male head who held absolute authority.
Culturally, the Romans were eclectic, absorbing and adapting elements from the civilizations they encountered, particularly the Greeks. Roman art, literature, and philosophy reflected this synthesis, creating a rich cultural tapestry. Latin, the Roman language, became the lingua franca of the Western world, influencing numerous modern languages.
Roman architecture and engineering achievements were monumental. They perfected the arch, vault, and dome, constructing enduring structures like the Colosseum, Pantheon, and aqueducts. These engineering marvels not only showcased Roman ingenuity but also served practical purposes, from public entertainment to water supply.
Instructions for Submissions thorugh G- Classroom.pptxJheel Barad
This presentation provides a briefing on how to upload submissions and documents in Google Classroom. It was prepared as part of an orientation for new Sainik School in-service teacher trainees. As a training officer, my goal is to ensure that you are comfortable and proficient with this essential tool for managing assignments and fostering student engagement.
How to Create Map Views in the Odoo 17 ERPCeline George
The map views are useful for providing a geographical representation of data. They allow users to visualize and analyze the data in a more intuitive manner.
The Art Pastor's Guide to Sabbath | Steve ThomasonSteve Thomason
What is the purpose of the Sabbath Law in the Torah. It is interesting to compare how the context of the law shifts from Exodus to Deuteronomy. Who gets to rest, and why?
3. NON – SURGICAL TREATMENT
AIMS OF TREATMENT OF STRABISMUS –
To restore good visual acuity in each eye.
To achieve satisfactory cosmetic appearance.
To restore, if possible,normal vision.
4. TREATMENT MODALITIES –
A.) OPTICAL TREATMENT
B.) PHARMACOLOGICAL TREATMENT
C.) ORTHOPTIC TREATMENT
D.) SURGICAL TREATMENT
Non surgical treatment is essential in almost all strabismus cases & in many cases
may be sufficient to successfully treat the strabismus without surgery.
5. OPTICAL TREATMENT
1.) CORRECTION OF REFRACTIVE ERROR :-
Spectacles for correction of Refractiveerror shouldbe prescribed in every
case.
Refractivecorrection also provide a proper balance b/w accommodation
& convergence
This,at fimes may correct the squint partially or completely.
6. GENERAL PRINCIPLES –
• In general, full cycloplegiccorrection shouldbe prescribed.
• In school going children,the refractive correctionprescribed shouldbe such that
would provide an optimal distant vision.
• An overcorrection of +1.00 DS to +3.00 DS of the amblyopiaeye has been
advocated.
7. ROLE OF GLASSES IN ESOTROPIA –
RefractiveaccommodativeESOTROPIA with CYCLOPLEGICCORRECTION.
Non – Refractive accommodative esotropiawith high AC/A ratio needs to be
treated with BIFOCAL GLASSSES.
Esotropia patients having associated myopicshouldbe prescribed minimum
MINUS (-VE) LENS.
Esotropia patients having associated myopiaand high AC/A ratio also require
BIFOCAL GLASSSES.
Residual esotropia of small amount shouldbe prescribed the maximum
HYPERMETROPIC(+VE) CORRECTION.
Consecutive esotropiaof small amount persisting after 3 weeks of surgery for
intermittent exotropia can be treated.
8. ROLE OF GLASSES IN EXOTROPIA –
An undercorrection of hypermetropiaeroor recommendedto reduce the
degree of consecutiveexotropia.
Overcorrection of myopiamay sometimes help in controlling the
intermittent exotropia by stimulating accommodation & convergence.
9. 2.) PRISMOTHERAPY –
PRISMOTHERAPY for strabismus has become popular after the introductionof
fresnel press on prisms.
Light weight.
Cosmetically acceptable.
Easy to apply on the back of the patient’s glasses.
Availability in powers from 0.5∆ to 30∆.
10. INDICATIONS –
Role of prism to assess the effect of surgery.
Role of prism in managing diplopiaand abnormal head posture.
Maintenance of binocular single vision by neutrilizing the deviation.
Management of convergence insufficiency.
Management of heterophoria.
Role of prisms in Nystagmus.
11. METHODS OF USING PRISMS –
As fresnel prism
In spectacle frames.
As clip on prism.
12. PHARMACOLOGICAL TREATMENT
1.) MIOTICS-
Mechanismof action-
It includes miosis and spasm of accommodation, their utility in strabismus is
through their effect on accommodation.
It includes – long acting cholinesterase inhibitors such as echothiophate,
Demacarium bromide.
2.) ATROPINE – call mmon use of atropine
Cycloplegicrefraction
Therapy of accommodative esotropia
Amblyopia
13. 3.) BOTULINUM TOXIN –
Mechanismof action –
When injected into an extraocular muscles blocks release of acetylcholine and thus
cause chemical denervation and thus paralysis of muscle for several weeks.
INDICATIONS- useful in short term treatment of –
Infertile ESOTROPIA
Paralytic strabismus
Surgical overcorrection
Graves ophthalmopathy and nystagmus
COMPLICATIONS –
Diplopia
Blepharoptosis
Vertical deviations
Perforation of globe
14. ORTHOPTIC TREATMENT
Literally, the word ORTHOPTIC means STRAIGHT EYES.
Practically, ORTHOPTIC training is used to treat
convergence insufficiency, to combat suppression,
amblyopia, & abnormal Retinal correspondence
and to improve fusional amplitude and stereopsis.
15. GOALS OF ORTHOPTIC TREATMENT –
Visual acuity levels in each eye should be best possible.
Eyes should be straight with/ without Surgical help.
Binocular single vision.
Fusion with good amplitude & reservers.
Reduction of Refractive glasses.
16. INDICATIONS-
1.) Diagnostic indications
2.) Therapeutic indications
Elimination of convergence insufficiency.
Fusion training, to increase fusion amplitude.
Anti suppression exercise
Treatment of abnormal Retinal correspondence.
Treatment of amblyopia
Control of deviations.
17. ORDER OF ORTHOPTIC TREATMENT –
Amblyopia is treated first.
Anti suppression therapy
Diplopia training.
Amplitude improvement.
18. DELIVERY OF ORTHOPTIC TREATMENT –
1.) TREATMENT OF CONVERGENCE INSUFFICIENCY –
Pencil convergence exercise
Physiological diplopia exercise.
Training for increasing fusional convergence with base
out prisms or synoptophore.
2.) EXERCISES FOR INCREASING FUSIONAL AMPLITUDE –
Both convergence and divergence.
Prisms
Major amblyoscope/ synoptophore.
19. 3.) ORTHOPTIC TREATMENT OF SUPPRESSION –
Diplopia exercises.
Vergence control in heterophoria.
Surgical alignment of eyes in large tropias.
Differential stimulation.
Macular massage.
Occlusion therapy.
20. SUGICAL TREATMENT
Extra ocular muscles is only a part of the therapeutic management of a
strabismus patients.
The squint surgery is aimedto procedure and maintaina condition in
which the visual axes of the two eyes are directed, without consious effort
to the object of fixation whatever it’s position.
21. INDICATIONS –
To correct squint cosmetically as well as functionally.
To correct the squint only cosmetically.
Marked asthenopic.
To correct abnormal head posture.
To relievemechanical restrictions or to improve appearance.
22. OPTIMAL TIME FOR SQUINT SURGERY –
1.) CONCOMITANT SQUINT –
Children too young for orthoptic treatment .
a) For constant squint
b) For intermittent squint
Children old enough for orthoptic treatment.
23. 2.) PARALYTIC SQUINT –
Commonsurgical techniques for squint corrections –
A.) MUSCLE WEAKENING PROCEDURE –
Recession
Marginal myotomy
Myectomy
Free tenotomy
Posterior fixation suture.
Recession of conjunctivaand tenons capsule.
Muscle lengthening by insertionof a siliconexpander /non
absorbable suture material.
24. B.) MUSCLE STRENGTHENING PROCEDURE –
Resection
Advancement.
Tucking.
C.) PROCEDURE THAT CHANGE DIRECTION OF MUSCLE ACTION –
Vertical transpositioning of the horizontal rectus muscles.
Horizontal transpositioning of vertical rectus muscles .
Slanting of the rectus muscle insertion.
Transplantationof musclein paralytic squint.