1) I am Dr Md Anisur Rahman Anjum passed MBBS from Dhaka Medical College in 1987. Diploma in Ophthalmology (DO) from the then IPGM&R (now it is Bangabandhu Sheikh Mujib Medical University BSMMU) in 1993. Felllowship in Ophthalmology FCPS from Bangladesh College of Physician and surgeon in 1997. I am now working as associate professor in General Ophthalmology in National Institute of Ophthalmology Dhaka Bangladesh which is the tertiary centre in eye care in Bangladesh.
These OSPE are dedicated to the postgraduate student who are decided to builds their carrier in ophthalmology. I hope that they will be benefitted if they solve these OSPE
This presentation is a detailed description of how a patient should be examined in an oprthoptic clinic. it lists down all the investigations sequentially. the order of investigations mentioned is the best way to investigate a squint case.
Interventions to Reduce Myopia Progression in Children (Journal Club) (health...Bikash Sapkota
DIRECT DOWNLOAD LINK ❤❤https://healthkura.com/reduce-myopia/❤❤
Dear viewers Check Out my other piece of works at___ https://healthkura.com
Interventions to Reduce Myopia Progression in Children (Journal Club)
Objectives:
- To discuss about the different interventions to reduce myopia progression in children
- To determine the effectiveness of different interventions to slow down the progression of myopia in children
Interventions to Reduce Myopia Progression:
Environmental Considerations
- Time Spent Outdoors
- Near-Vision Activities
Spectacles & Contact Lenses
- Gas-Permeable Contact Lens Wear
- Bifocal & Multifocal Spectacles
- Soft Bifocal Contact Lenses
- Orthokeratology
Pharmacological Therapies
- Antimuscarinic Agents: Atropine & Pirenzepine
Under Correction of Myopia
This presentation is a detailed description of how a patient should be examined in an oprthoptic clinic. it lists down all the investigations sequentially. the order of investigations mentioned is the best way to investigate a squint case.
Interventions to Reduce Myopia Progression in Children (Journal Club) (health...Bikash Sapkota
DIRECT DOWNLOAD LINK ❤❤https://healthkura.com/reduce-myopia/❤❤
Dear viewers Check Out my other piece of works at___ https://healthkura.com
Interventions to Reduce Myopia Progression in Children (Journal Club)
Objectives:
- To discuss about the different interventions to reduce myopia progression in children
- To determine the effectiveness of different interventions to slow down the progression of myopia in children
Interventions to Reduce Myopia Progression:
Environmental Considerations
- Time Spent Outdoors
- Near-Vision Activities
Spectacles & Contact Lenses
- Gas-Permeable Contact Lens Wear
- Bifocal & Multifocal Spectacles
- Soft Bifocal Contact Lenses
- Orthokeratology
Pharmacological Therapies
- Antimuscarinic Agents: Atropine & Pirenzepine
Under Correction of Myopia
Ischemic condition affecting the eye.
The ischemia can occur secondary to systemically problem [or] particulary the eye.
Many retinal vascular disorders {like CRAO,CRVO,Diabetic retinopathy,Hypertensive Retinopathy} shows ischemic signs.
Ischemic condition affecting the eye.
The ischemia can occur secondary to systemically problem [or] particulary the eye.
Many retinal vascular disorders {like CRAO,CRVO,Diabetic retinopathy,Hypertensive Retinopathy} shows ischemic signs.
1) I am Dr Md Anisur Rahman Anjum passed MBBS from Dhaka Medical College in 1987. Diploma in Ophthalmology (DO) from the then IPGM&R (now it is Bangabandhu Sheikh Mujib Medical University BSMMU) in 1993. Felllowship in Ophthalmology FCPS from Bangladesh College of Physician and surgeon in 1997. I am now working as associate professor in General Ophthalmology in National Institute of Ophthalmology Dhaka Bangladesh which is the tertiary centre in eye care in Bangladesh.
These OSPE are dedicated to the postgraduate student who are decided to builds their carrier in ophthalmology. I hope that they will be benefitted if they solve these OSPE
1) I am Dr Md Anisur Rahman Anjum passed MBBS from Dhaka Medical College in 1987. Diploma in Ophthalmology (DO) from the then IPGM&R (now it is Bangabandhu Sheikh Mujib Medical University BSMMU) in 1993. Felllowship in Ophthalmology FCPS from Bangladesh College of Physician and surgeon in 1997. I am now working as associate professor in General Ophthalmology in National Institute of Ophthalmology Dhaka Bangladesh which is the tertiary centre in eye care in Bangladesh.
These OSPE are dedicated to the postgraduate student who are decided to builds their carrier in ophthalmology. I hope that they will be benefitted if they solve these OSPE
1) I am Dr Md Anisur Rahman Anjum passed MBBS from Dhaka Medical College in 1987. Diploma in Ophthalmology (DO) from the then IPGM&R (now it is Bangabandhu Sheikh Mujib Medical University BSMMU) in 1993. Felllowship in Ophthalmology FCPS from Bangladesh College of Physician and surgeon in 1997. I am now working as associate professor in General Ophthalmology in National Institute of Ophthalmology Dhaka Bangladesh which is the tertiary centre in eye care in Bangladesh.
These OSPE are dedicated to the postgraduate student who are decided to builds their carrier in ophthalmology. I hope that they will be benefited if they solve these OSPE
I am Dr Md Anisur Rahman Anjum passed MBBS from Dhaka Medical College in 1987. Diploma in Ophthalmology (DO) from the then IPGM&R (now it is Bangabandhu Sheikh Mujib Medical University BSMMU) in 1993. Felllowship in Ophthalmology FCPS from Bangladesh College of Physician and surgeon in 1997. I am now working as associate professor in General Ophthalmology in National Institute of Ophthalmology Dhaka Bangladesh which is the tertiary centre in eye care in Bangladesh.
These OSPE are dedicated to the postgraduate student who are decided to build there carrier in ophthalmology. I hope that they will be benefitted if they solve these OSPE
I am Dr Md Anisur Rahman Anjum working as associate professor at NIO Dhaka Bangladesh. These 10 OSPE were made by me for the MOCK test of FCPS examinee. I hope that these will be helpful for FCPS. MS. & DO students
1) I am Dr Md Anisur Rahman Anjum passed MBBS from Dhaka Medical College in 1987. Diploma in Ophthalmology (DO) from the then IPGM&R (now it is Bangabandhu Sheikh Mujib Medical University BSMMU) in 1993. Felllowship in Ophthalmology FCPS from Bangladesh College of Physician and surgeon in 1997. I am now working as associate professor in General Ophthalmology in National Institute of Ophthalmology Dhaka Bangladesh which is the tertiary centre in eye care in Bangladesh.
These OSPE are dedicated to the postgraduate student who are decided to builds their carrier in ophthalmology. I hope that they will be benefitted if they solve these OSPE
1) I am Dr Md Anisur Rahman Anjum passed MBBS from Dhaka Medical College in 1987. Diploma in Ophthalmology (DO) from the then IPGM&R (now it is Bangabandhu Sheikh Mujib Medical University BSMMU) in 1993. Felllowship in Ophthalmology FCPS from Bangladesh College of Physician and surgeon in 1997. I am now working as associate professor in General Ophthalmology in National Institute of Ophthalmology Dhaka Bangladesh which is the tertiary centre in eye care in Bangladesh.
These OSPE are dedicated to the postgraduate student who are decided to builds their carrier in ophthalmology. I hope that they will be benefitted if they solve these OSPE
I am Dr Md Anisur Rahman Anjum. I have up load these 10 OSPE in Ophthalmology (MOCK test held at NIO on 8 Nov). Here I have up load these with answer key, These will helpful for FCPS. MS. AND DO student. These will also helpful for FRCS exam.
Incidence of Glaucoma & Diabetic Retinopathy in Patients with Diabetes Mellit...QUESTJOURNAL
Background: Vision is a means of communication of man with the external world. The impact of visual loss due to various ocular morbidities has profound implications for the person affected and the society as a whole. Diabetes has become one of the world’s most important public health problems & WHO indicate that 19% of world’s diabetic population lives in India. Diabetes related microvascular complications cause visual disability even in younger age group individuals. Aim: To estimate the magnitude of Glaucoma and diabetic retinopathy in diabetic patients in our institution. To create awareness about avoidable blindness in diabetic patients.To enlighten and thereby motivate the patient for further evaluation and follow up. Materials and methods: The study is a hospital- based , non- interventional, cross-sectional study. The ocular disorders are evaluated in 500 consecutive diabetic patients attending ophthalmology out patient department of Kanyakumari medical college hospital. Estimation of visual acuity, slit lamp examination, intraocular pressure, retinoscopy & fundus examination, visual field analysis , gonioscopy are done to detail the defective vision. Result analysis Data is analysed using SPSS. The common manifestations are cataract- 346 (69%), diabetic retinopathy- 94 patients (18.8%), glaucoma– 34 (6.8%). Patients with cataract are well managed by cataract extraction techniques. Prime importance is to create awareness and also diagnose the early changes of retinopathy and glaucoma.Treatment of glaucoma if instituted early will go a long way in preventing avoidable blindness Therefore periodic visual screening along with control of hyperglycemia and associated risk factors is needed to ensure good quality of vision.
Multiple Choice Questions (MCQs) for Masters of Optometry Entrance Examinatio...RabindraAdhikary
Multiple Choice Questions (MCQs) for Masters of Optometry Entrance Examination, Pokhara University NEPAL
MCQs Optometry Nepal
Here we have included syllabus of entrance examinations for Master of Optometry in Pokhara University, entry requirements of candidate for the master of optometry course and multiple choice questions that appeared in the entrance examinations of 2019.
Prepared by: Rabindra Adhikary
for more MCQs:
http://ravinems.blogspot.com/2019/05/multiple-choice-questions-mcqs-for.html
Journal of Ophthalmology & Visual Sciences is an open access, peer reviewed, scholarly journal dedicated to publish articles covering all areas of Ophthalmology & Visual Sciences.
The journal aims to promote research communications and provide a forum for doctors, researchers, physicians and healthcare professionals to find most recent advances in all areas of Ophthalmology & Visual Sciences. Journal of Ophthalmology & Visual Sciences accepts original research articles, reviews, mini reviews, case reports and rapid communication covering all aspects of Ophthalmology & Visual Sciences.
Journal of Ophthalmology & Visual Sciences strongly supports the scientific up gradation and fortification in related scientific research community by enhancing access to peer reviewed scientific literary works. Austin Publishing Group also brings universally peer reviewed journals under one roof thereby promoting knowledge sharing, mutual promotion of multidisciplinary science.
Topical dorzolamide for macular edema in the early phase after vitrectomy and...Avaleks-Kiev
Background: The purpose of this study was to evaluate prospectively the efficacy of a topical carbonic anhydrase inhibitor in macular edema after vitrectomy.
Цель: оценка перспективы использования топического ингибитора карбоангидразы для профилактики развития макулярного отека после витрэктомии.
http://ophthalmolog.kiev.ua/
This lecture is based on medical students those are preparing for postgraduate degree namely FCPS/MS/MD/ any any subject coz hypertension is a systemic disease and by seeing the ocular fundus we can asses the general condition of blood vessels in major organ.
This lecture is based on post-graduate students of Ophthalmology (DO, DCO, MCPS, FCPS, MS) and optical principle of LASER, construction of laser and laser tissue interaction has cover the lecture
This lecture is based on post-graduate students of Ophthalmology (DO, DCO, MCPS, FCPS, MS) and optical principle of GAT has to know for a student to use the instrument friendly
This lecture is based on post-graduate medical students of all subject those who are students MS/MD/FCPS of different subject on Central Tendency and Dispersion.
This is the 5 th lecture on "Research Methodology through zoom. The lecture was based on postgraduate Medical students those are different courses of FCPS/MS/MD/PhD (any Specialty)
Anti ulcer drugs and their Advance pharmacology ||
Anti-ulcer drugs are medications used to prevent and treat ulcers in the stomach and upper part of the small intestine (duodenal ulcers). These ulcers are often caused by an imbalance between stomach acid and the mucosal lining, which protects the stomach lining.
||Scope: Overview of various classes of anti-ulcer drugs, their mechanisms of action, indications, side effects, and clinical considerations.
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
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.
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
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.
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
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
These lecture slides, by Dr Sidra Arshad, offer a quick overview of 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 leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
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. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
MANAGEMENT OF ATRIOVENTRICULAR CONDUCTION BLOCK.pdfJim Jacob Roy
Cardiac conduction defects can occur due to various causes.
Atrioventricular conduction blocks ( AV blocks ) are classified into 3 types.
This document describes the acute management of AV block.
MANAGEMENT OF ATRIOVENTRICULAR CONDUCTION BLOCK.pdf
OSPE (Ophthalmology) for FCPS, FRCOphth, MS & DO Examinee.
1. Objective Structured Practical
Question (OSPE)
Subject: Ophthalmology
According to the course curriculum of
Bangladesh College of Physician &
Surgeon (BCPS)
Wednesday, July 16, 2014 1anjumk38dmc@gmail.com
2. AUTHOR:
Dr Md Anisur Rahman Anjum.
MBBS (Dhaka Medical College). DO (Dhaka
University) FCPS (EYE)
Associate Professor
National Institute of Ophthalmology
Dhaka, Bangladesh.
Chamber: Mojibunnessa Eye Hospital
House: 18 Road: 6. Dhanmondi, Dhaka, 1205.
Bangladesh.
Email: anjumk38dmc@gmail.com
Cell: 01711-832397
Wednesday, July 16, 2014 2anjumk38dmc@gmail.com
4. Question
A 42-year old lady presented with intermittent eye aches.
She has shallow anterior chamber in both eyes. Her unaided
distant visual acuity 6/6 in OU & her near vision N5 with
+1.25 DS in OU. Her anterior segment appeared normal on
Slit-Lamp examination. For proper management:
1) Mention 3 relevant clinical tests= 3
2) Mention 1 important investigation for anterior segment = 1
3) Name 3 differential diagnosis.= 3
4) Mention 3 treatment options = 3
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5. Answer
1) a) Measurement of IOP. b) Gonioscopy. c) Examination of
ONH & Peripapillary Nerve Fiber Layer.
2) UBM/ AS-OCT
3)
i. Primary Angle Closure Suspect (PACS)
ii. Primary Angle Closure (PAC)
iii. Primary Angle Closure Glaucoma(PACG)
4)
i. Anti-glaucoma drugs/ Pilocarpine 2%
ii. Laser Peripheral Iridotomy (LPI)
iii. Trabeculectomy
•
Wednesday, July 16, 2014 5anjumk38dmc@gmail.com
7. Question
• An 80-year-old man presents with poor vision in his
right eye with sudden onset of pain and conjunctival
hyperemia. The examination reveals an lOP of 45 mm
Hg with a prominent cell and flare reaction without
keratic precipitates, a dense cataract, and an open
anterior chamber angle.
1) What is the most likely diagnosis?
2) Write 3 D/D.
3) Mention 2 treatment
Wednesday, July 16, 2014 7anjumk38dmc@gmail.com
8. Answer
1) Phacolytic glaucoma
2) .
i. phacoantigenic glaucoma
ii. ICE syndrome
iii. Fuchs heterochromic iridocyclitis.
3) Medications to control the lOP should be used
immediately, definitive therapy requires cataract
extraction.
Wednesday, July 16, 2014 8anjumk38dmc@gmail.com
9. Explanation
This is the classic presentation of a patient with
phacolytic glaucoma. Without keratic precipitates.
both phacoantigenic glaucoma and Fuchs
heterochrornic iridocyclitis are unlikely. Fuchs
heteroch romic iridocyclitis is associated with
cataract formation, primarily posterior
subcapsular cataracts, but it tends to present in a
much younger patient. ICE syndrome occurs in
younger patients and causes a secondary angle-
closure glaucoma.
Wednesday, July 16, 2014 9anjumk38dmc@gmail.com
10. Source:
• Source: American Academy of Ophthalmology
Volume: 10. page 108, 109, 110, 111
Wednesday, July 16, 2014 10anjumk38dmc@gmail.com
12. Question
Who is more prone to develop glaucoma &
who is the least
Patient a) has IOP >23.75 to ≤ 25.75 mmHg
and CCT > 555 to ≤ 588 µm.
patient b) has mean IOP 21.to 23.75 mmHg
but CCT ≤ 555 µm
patient c) vertical C/D ratio ≥ 0.50 CCT ≤ 555
µm
Wednesday, July 16, 2014 12anjumk38dmc@gmail.com
13. Question
Mention one corneal diseases where IOP is
usually below 10 mmHg
Wednesday, July 16, 2014 13anjumk38dmc@gmail.com
14. Answer
• Patient C is more prone to develop glaucoma.
& patient A is least prone to develop
glaucoma.
• Keratoconus
Wednesday, July 16, 2014 14anjumk38dmc@gmail.com
16. Question
An 11-year-old patient presents with red, itchy eyes. On
examination, gray, jellylike limbal nodules with vascular
cores are seen.
Q:1 This is suggestive of what diagnosis?
Q: 2 Write two D/Ds?
Q: 3 What is the name of limbal nodule?
Q: 4 Over treatment of this patient may cause a vision
threatening condition, Mention its name.
Q: 5 Parents of this is patient always very much worried.
What advice will you give to them. Mention one advice.
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17. Check list
1) Vernal keratoconjunctivitis
2) Any two
phlyctenular keratoconjunctivitis
atopic keratoconjunctivitis
superior limbic keratoconjunctivitis
3) Horner-Trantas dots.
4) Glaucoma/POAG.
5) It is a self limiting disease and will cure after
teen age.
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18. Marks Distribution
1) Vernal keratoconjunctivitis --------------------- 2
2) Any two --------------------------------- 2x1.5 = 3
phlyctenular keratoconjunctivitis
atopic keratoconjunctivitis
superior limbic keratoconjunctivitis
3) Horner-Trantas dots.----------------------------- 1
4) Glaucoma/POAG. ------------------------------- 2
5) It is a self limiting disease and will cure after
teen age. ----------------------------------- 1 + 1 = 2
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19. • Vernal keratoconjunctivitis usually presents in older
children with symptoms of photophobia and marked
itching. A thick, ropy discharge may be present. In
limbal vernal keratoconjunctivitis, patients develop
gelatinous nodules at the limbus with white centers
(Horner-Trantas dots)
Wednesday, July 16, 2014 19anjumk38dmc@gmail.com
22. Question
This is the Humphrey visual field of a 67 year-old
woman.
a. What type of perimetry is a Humphrey field
analyser? = 2
b. What does the total deviation measure? = 2
c. What is the pattern deviation? =2
d. What does the visual field show? =1
e. List three conditions which may give this field
defect. =3.
Wednesday, July 16, 2014 22anjumk38dmc@gmail.com
23. Answer
a. Humphrey field analyser is a static automated
perimetry.
b. The total deviation measures the difference (in db)
between the patient's threshold values and that of the
age-corrected values.
c. The pattern deviation adjusts the total deviation for
any shift in the patient's overall sensitivity. This
allows localised area of field loss to be clearly
demonstrated.
Wednesday, July 16, 2014 23anjumk38dmc@gmail.com
24. Answer
d. Superior arcuate scotoma.
e.
i. open angle glaucoma with inferior loss of
arcuate nerve fibre layer
ii. optic disc pit
iii. inferior branch retinal vein occlusion
Wednesday, July 16, 2014 24anjumk38dmc@gmail.com
25. Explanation
• a. Humphrey field analyser is a static
automated perimetry.
(In this test, the patient maintains fixation on a
central target and the computer randomly presents
a brief (about 0.2 seconds) and non-moving ie.
static light stimulus at different loci throughout
the visual field. The intensity of the light stimulus
that the patient can see is then recorded.)
• b. The total deviation measures the difference
(in db) between the patient's threshold
values and that of the age-corrected values.
Wednesday, July 16, 2014 25anjumk38dmc@gmail.com
26. Explanation
c. The pattern deviation adjusts the total deviation for any
shift in the patient's overall sensitivity. This allows
localised area of field loss to be clearly demonstrated.
(Many conditions other than glaucoma can cause poor vision
for eg. cataract or corneal oedema. Therefore, to find out how
much of a patient’s relative insensitivity to light is due to
glaucoma rather than to something else, it is important to
"subtract out" these other factors. This can be done because
these others conditions tend to produce a similar pattern of
diffuse visual field loss, while glaucoma tends to produce
localized areas of visual field loss.)
Wednesday, July 16, 2014 26anjumk38dmc@gmail.com
27. Explanation
d. Superior arcuate scotoma.
e.
i. open angle glaucoma with inferior loss of arcuate
nerve fibre layer
ii. optic disc pit
iii. inferior branch retinal vein occlusion
(Visual field should not be interpreted without reference to
ocular examination. An arcuate scotoma can occur in other
conditions other than open angle glaucoma as mentioned
above)
Wednesday, July 16, 2014 27anjumk38dmc@gmail.com
30. Question
1) What are the advantages of this perimetry
over Humphrey perimetry?
2) What are the advantages of Humphry
perimetry over Goldman perimetry?
3) What do the numbers 1-4 mean?
4) What do the numbers I-IV mean?
5) What abnormalities can be seen in this visual
field?
Wednesday, July 16, 2014 30anjumk38dmc@gmail.com
31. Answer
1) The main advantages are:
i. The visual field can extend beyond 30 degree.
ii. Stimuli has different size.
2
i. No examiner bias.
ii. Constant monitoring of fixation.
iii. Automated re-testing of abnormal points.
iv. Computer software for analysis.
Wednesday, July 16, 2014 31anjumk38dmc@gmail.com
32. Answer
3)
They are the intensities of the stimuli.
4)
They are the sizes of the stimuli.
5)
Nasal steep and baring of the blind spot.
These features are suggestive of glaucoma.
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34. Give a possible cause for the following
field defects.
Wednesday, July 16, 2014 34anjumk38dmc@gmail.com
35. Answer
A) The visual field shows bilateral altitudinal
field defect.
Possible causes include:
bilateral ischaemic optic neuropathy (arteritic
or non-arteritic)
bilateral superior hemi-retinal artery occlusion
bilateral superior hemi-retinal vein occlusion
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36. Answer
B) The visual field shows bilateral constricted
visual fields.
Possible causes include:
retinitis pigmentosa
bilateral dense laser pan-photocoagulation
advanced glaucoma
C) The visual field shows a left congruous
horizontal wedge-shaped field defect. It is
seen in lesion of the right lateral geniculate
nucleus such as cerebrovascular accident
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38. This patient underwent an uncomplicated trabeculectomy. When seen
in the clinic three week later, the intraocular pressure measured 27 mm
Hg and the slit-lamp appearance is as shown below.
1) What is the diagnosis?
2) What is responsible for
this appearance?
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39. Answer
1) The picture shows a smooth dome shaped
elevated cyst. This is typical of a Tenon’s
cyst. Encysted bleb,
7/9/20143939Wednesday, July 16, 2014
1) This is caused by an adhesion between the
episclera and Tenon’s capsule so that the
aqueous is trapped and not drained.
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41. 17
• This is the slit lamp
view of an eye.
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42. QUESTION
1.What is the positive finding in this case? (any 2)
2. What is your diagnosis?
3. Is it an ocular emergency?
4. What may be the treatment?
5. Is the fellow eye needs any treatment?
6. If yes mention of it.
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43. ANSWER
1)
Ciliary congestion
Mid dilated pupil, vertically oval.
Cornea hazy
2) Angle closure glaucoma.
3) Yes
4) Treatment is surgical, but first reduced IOP with Tab
Acetazolamide and Mannitol inj. And then go for P, I or
trabeculectomy according to synechia.
5) Yes
6) Pilocarpine 2% eye drop 4 times in a day or prophylactic PI
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46. Question
1) Name the printout.
2) Describe RNLF Thickness maps?
3) What are the abnormalities in RNFL Deviation
maps?
4) Describe TSNIT Graphs.
5) What is NFI & what does it indicate?
6) Mention 2 additional relevant investigations to
confirm your diagnosis.
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47. Answer
1) GDx VCC Printout for RNFL Analysis of both eyes
= 1
2) Absence of warm colors (Red & Yellow) in both
eyes more in left eye indicating thinning/loss of
RNFL = 2
3) Appearance of square pixels in superior & inferior
quadrants of both eyes. = 2
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48. Answer
4)
I. Double hump patterns of TSNIT Graphs are absent.
=1
• II. Graphs are flat.=0.5
• III. inferior humps are more flat. =0.5
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49. Answer
5) Nerve fiver indicator, It’s a Global index ranging
from 1- 100.
1-30 indicates normal RNFL Thickness,
31-50 indicates Borderline &
51-100 indicates Thinning of RNFL. = 1
6)
• Digital Optic Disc Photography. = 1
• SAP (HVFA/Octopus VFA). =1
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52. Question
• Q no 1 What are the disc findings present
here?
• Q no 2 Write the provisional diagnosis depend
upon findings.
• Q no 3 Write the name of investigations for
clinical diagnosis.
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53. Answer
Answer no 1
Increase CDR
Narrow Neuro Retinal Rim (NRR)
Peri Papillary Atrophy (PPA)
Vascular signs
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54. Answer
Answer no 2
• Suspicious disc
• Physiological cup
• Glaucomatous cupping
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55. Answer
Answer no 3
• CCT
• VF
• OCT
• HRT
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56. Marks distribution
One for each correct answer
• Q no 1 = 4
• Q no 2 = 3
• Q no 3 = 3
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60. OSPE=2. History taking of Diplopia
1 Whether double vision is monocular or
binocular.
(Causes of monocular diplopia → cataract,
astigmatism, corneal scars, keratoconus, tear
film irregularity, sublaxated lens, large or
sector iridectomy, malingering)
If binocular → ask whether the diplopia is
horizontal, vertical or torsional.
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61. OSPE=2. History taking of Diplopia
Ask the patient in which direction of gaze is the
diplopia worse→ right, left, up, down, right and
up, right and down, left and up, left and down, or
distance or near.
3) Ask for diurnal variability and fatigability of
diplopia suggestive of myasthenia gravis.
4) Detailed history about mode of onset, duration of
onset, associated pain, history of strabismus in
childhood, history of trauma, neurological
symptoms such as dysphagia or weakness,
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16, 2014
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62. OSPE=2. History taking of Diplopia
Underlying systemic illness such as
hypertension, diabetes, cerebrovascular
disease, cardiac atherosclerotic disease and
multiple sclerosis.
6) History of smoking or alcohol intake should
be elicited.
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2014
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64. Question
Take the relevant history from this SP
(Simulated patient) who is suffering from
double vision.
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65. Answer
1) Greetings & self introduction---------------------------
0.25 + 0.25= 0.50
2) Whether double vision is monocular or binocular.----
--------------- 0.50
3) Direction of double vision: whether the diplopia is
horizontal, vertical or torsional.
4) Ask the patient in which direction of gaze the
diplopia is worse→ right, left, up, down, right and
up, right and down, left and up, left and down, or
distance or near.
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66. Answer
5) Ask for diurnal variability and fatigability of
diplopia.
6) Detailed history about :
i. mode of onset,
ii. duration of onset,
iii. associated pain,
iv. history of strabismus in childhood,
v. history of trauma,
vi. neurological symptoms such as dysphagia or
weakness,
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67. Answer
7) Underlying systemic illness:
i. hypertension,
ii. diabetes,
iii. cerebrovascular disease,
iv. cardiac atherosclerotic disease
v. multiple sclerosis.
8) History of smoking or alcohol intake should be
elicited.
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69. History taking of a patient suffering from recurrent uveitis
• Following points to be noted during history
taking:
1) PATIENT DETAILS:
Age: Juvenile rheumatoid arthritis (JRA) is
common in patients less than 15 years.
Sex: JRA is common in females, HLA – B 27
associated uveitis in males. (but during
history taking you should not asked about
gender)
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2014
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70. History taking of a patient suffering from recurrent uveitis
2) OCULAR HISTORY:
Is the disease unilateral or bilateral ?
When was the first attack?
When was the last/current attack?
What was the approximate frequency of the
attacks between the first and the last attack?
Details of prior ocular treatment.
Any previous history of rise IOP or use any
antiglaucoma agents.
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71. History taking of a patient suffering from recurrent uveitis
3) SYSTEMIC HISTORY:
H/O arthritis or low backache (JRA, HLA –B27 related
uveitis).
H/O fever or respiratory symptoms, gastro-intestinal,
neurological symptoms, genital lesions.
H/O DM, HTN, TB.
H/O exposure/ IV drug abuse/ blood transfusions.
H/O skin lesions (HZO, Psoriasis)
Details of prior systemic treatment.
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73. History taking R.P
Age of onset of symptoms.
Duration of night blindness.
Duration of progressive loss of visual field.
Duration of dimness of vision . Is it progressive?
Family history of R.P.
H/O consanguinity.
H/O trauma.
H/O drug intake.
H/O hearing disorder, ataxia, nystagmus.
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76. Question
• This 26 year-old woman
presented with a two-
week history of
decreased right
vision. The visual acuity
was 6/36 in the right eye
and 6/6 in the left. Her
MRI scan was done.
Answer the following
question..
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77. Question
1) Is this MRI scan a T1 weighted or a T2
weighted images?
2) What are the advantages of MRI scan over
CT scan in brain imaging?
3) What abnormalities are present?
4) What is the likely diagnosis?
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78. Answer
1) T2-weighted MRI.
(This is shown by the high signal of the CSF
within the ventricles. In MRI scan of the
brain, T1-weighted image is useful for
demonstrating anatomical details whereas T2
excellent pathology)
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79. 2) The advantages of MRI over CT scan of the brain
include:
i. Non-ionising radiation
ii. Excellent soft tissue contrast
iii. Multiplanar images (axial, sagittal and coronal)
iv. No artefact from the bone and is especially
useful for posterior fossa imaging.
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80. C) High signal lesions within the periventricular
white matter of both cerebral hemispheres
• (These represent multiple plaques of
demyelination see figure below, these plaques
have high water content and therefore appear
white on T2-weighted images.)
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84. ANSWER
Coronal plane
F.B in the left orbital floor.
The following 3 feature may be present
restricted upgaze
enopthalmos
hypoanaesthesia over the left check
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86. • Substance T1 weighted T2 weighted
• Water/Vitreous/CSF black Light grey or white
• Fat White Light grey
• Muscle Grey Grey
• Air Black Black
• Fatty bone marrow White Light Grey
• Brain: White matter Light Grey Grey
• Brain: Grey matter Grey very light grey
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88. Question
• Convert the following prescriptions to + or - cylinder
notation and state the type of astigmatism which is
present in each
1) +4.00 / -1.50 x 70
2) +1.25 / -3.00 x 90
3) PL / +1.50 x 45
4) -2.00 / +2.00 x 50
5) - 1.75 / -2.00 x 135
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89. Answer
a. + 4.00 / - 1.50 x 70 = + 2.50 / + 1.50 x 160 ;
compound hypermetropic astigmatism.
b. + 1.25 / - 3.00 x 90 = - 1.75 / + 3.00 x 180 ; mixed
astigmatism.
c. PL / + 1.50 x 45 = -1.50 / - 1.50 x 135 ; simple
hypermetropia astigmatism.
d. - 2.00 / + 2.00 x 50 = PL / - 2.00 x 140 ; simple
myopic astigmatism.
e. - 1.75 / - 2.00 x 135 = - 3.75 / + 2.00 x 45 ;
compound myopic astigmatism.
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90. ANSWER
Compound astigmatism occurs when the two principal
meridians of an eye are either both hypermetropic ie.
compound hypermetropic astigmatism or both myopic ie.
compound myopic astigmatism.
Mixed astigmatism occurs when one principal meridian is
hypermetropic and the other myopia.
Simple astigmatism occurs when one principal meridian
of the eye is emmetropia and the other myopia ie. simple
myopic astigmatism or hypermetropic ie. simple
hypermetropic astigmatism.
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93. Question
• Eight weeks after a left cataract extraction and
implant, your patient has the following keratometry:
• 40.00 @90
44.00 @180
1) What is the power and axis of cylinder required to
correct the post-operative astigmatism?
2) If a tight radially placed suture is present, in which
meridian would you most likely to find it?
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94. Answer
1) There is a 4D difference between the two meridians.
So the required cylinder correction is either:
- 4.00 X 90 or
+ 4.00 X180
2) The tight suture is at 1800 and need to be removed.
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96. Scenario
• A 35 year-old man was assaulted 4 weeks ago with a
blunt object over his right temporal region. At the
time of the injury, there was no loss of consciousness
or ocular injury. However, over the next few weeks,
he exprienced progressive swelling and redness of the
right eye. There was no medical history of note.
• On examination,
the right eye was noted red with moderate non-axial
proptosis.
97. Scenario
The right conjunctiva showed dilated vessels .
The visual acuity VAR= 6/12 & VAL= 6/6.
IOP 40 mm of Hg in R/E & 18 mm of Hg in L/E
Gonioscopy showed blood in the right trabecular
meshwork
Fundoscopy= NAD
The proptosis is non-tender to palpation.
Bruit can be heard with the bell of a stethoscope
when the eye was closed.
98. Question
1) What is the most likely diagnosis?
2) What is the gold standard for confirming the
diagnosis.
3) What are the mechanisms of raised intraocular
pressure in this condition?
4) Is this a life-threatening condition?
5) What are the treatment modalities for this
condition?
99. Answer
1) Direct carotid-cavernous fistula secondary to blunt
trauma is the most likely diagnosis.
2) Cerebral angiogram is the gold standard for
confirming the diagnosis.(The patient will undergo
the investigation under neurosurgical supervision.)
3) Usually it is not a life-threatening condition.
4) The outflow facility is disturbed due to elevation of
the episcleral venous pressure.
5) Wait for spontaneous resolution, if not surgery is the
treatment of choice.
100. The current treatment of choice involves endovascular
embolization with coils (Fig. 3.23) or balloons which
may be transvenous or transarterial.