This document provides an overview of pre-operative and post-operative management of cataract surgery. It discusses evaluating patients, indications for surgery, special tests performed, pre-operative medications and management, the surgical procedure, and post-operative examination, management, and follow-up care. Key aspects addressed include assessing ocular health history, visual acuity, biometry measurements to calculate IOL power, and monitoring for complications after surgery. The goal is to ensure patients have a thorough evaluation before surgery and close monitoring after to optimize visual outcomes.
TONOMETRY • Tonometry is the procedure performed to determine the intraocular pressure (IOP).
3. CLASSIFICATION TONOMETRY DIRECT INDIRECT Indentation Applanation Manometer
4. APPLANATION Contact Non-contact Goldmann Perkins Air-puff Pulse air
5. INDENTATION TONOMETER • It is based on fundamental fact that plunger will indent a soft eye more than hard eye. • The indentation tonometer in current use is that of Schiotz . • It was devised in 1905 and continued to refine it through 1927.
6. PROCEDURE • Patient should be anaesthetising with 4% lignocaine or 0.5% proparacaine. • with the patient in supine position, looking up at a fixation target while examiners separates the lids and lower the tonometer plate to rest on the cornea so that plunger is free to move. •
complete information about the refractive errors due to the problem in the acomodation of eye lense , disturbed image formation in the retina, contains -types of disease condition .
About awareness of eye donation. Author is assistant professor in Ayurvedic Ophthalmology MES Ayurved Mahavidyalaya and consulting ayurvedic ophthalmologist at Shree Vyankatesh Netralay Chiplun.
This is a seminar presentation conducted by 4th year medical student under supervision of a lecturer. This is for ophthalmology posting seminar. Source of information are from google, few textbooks and also based on previous ophthalmology posting group's seminar.
A group of eye disorders, glaucoma is characterized by high intraocular pressure (IOP) that damages the optic nerve.
Glaucoma is one of the leading causes of irreversible blindness in the world and is the leading cause of blindness among adults in the United States.
Glaucoma may occur as primary or congenital disease or secondary to other causes, such as injury, infection, surgery, or prolonged use of topical corticosteroids.
Primary glaucoma has mainly two forms :
1. Open angle glaucoma ( chronic, simple, or wide angle glaucoma)
2. Angle –closure glaucoma( Acute or narrow angle glaucoma)
Angle –closure glaucoma occurs suddenly and may cause permanent or irreversible vision loss in 48 to 72 hours.
complete information about the retinal detachment , types, , symptoms , sign, etiology, causes, diagnosis, complications, medical management, nursing management, home care, patient teaching. nursing reserch.
The corneal diseases are one of the leading causes of blindness in the world. in most cases, these infections are preventable or treatable.
This seminar provides an overview of the anatomy and physiology of the cornea, as well as an overview of common conditions.
TONOMETRY • Tonometry is the procedure performed to determine the intraocular pressure (IOP).
3. CLASSIFICATION TONOMETRY DIRECT INDIRECT Indentation Applanation Manometer
4. APPLANATION Contact Non-contact Goldmann Perkins Air-puff Pulse air
5. INDENTATION TONOMETER • It is based on fundamental fact that plunger will indent a soft eye more than hard eye. • The indentation tonometer in current use is that of Schiotz . • It was devised in 1905 and continued to refine it through 1927.
6. PROCEDURE • Patient should be anaesthetising with 4% lignocaine or 0.5% proparacaine. • with the patient in supine position, looking up at a fixation target while examiners separates the lids and lower the tonometer plate to rest on the cornea so that plunger is free to move. •
complete information about the refractive errors due to the problem in the acomodation of eye lense , disturbed image formation in the retina, contains -types of disease condition .
About awareness of eye donation. Author is assistant professor in Ayurvedic Ophthalmology MES Ayurved Mahavidyalaya and consulting ayurvedic ophthalmologist at Shree Vyankatesh Netralay Chiplun.
This is a seminar presentation conducted by 4th year medical student under supervision of a lecturer. This is for ophthalmology posting seminar. Source of information are from google, few textbooks and also based on previous ophthalmology posting group's seminar.
A group of eye disorders, glaucoma is characterized by high intraocular pressure (IOP) that damages the optic nerve.
Glaucoma is one of the leading causes of irreversible blindness in the world and is the leading cause of blindness among adults in the United States.
Glaucoma may occur as primary or congenital disease or secondary to other causes, such as injury, infection, surgery, or prolonged use of topical corticosteroids.
Primary glaucoma has mainly two forms :
1. Open angle glaucoma ( chronic, simple, or wide angle glaucoma)
2. Angle –closure glaucoma( Acute or narrow angle glaucoma)
Angle –closure glaucoma occurs suddenly and may cause permanent or irreversible vision loss in 48 to 72 hours.
complete information about the retinal detachment , types, , symptoms , sign, etiology, causes, diagnosis, complications, medical management, nursing management, home care, patient teaching. nursing reserch.
The corneal diseases are one of the leading causes of blindness in the world. in most cases, these infections are preventable or treatable.
This seminar provides an overview of the anatomy and physiology of the cornea, as well as an overview of common conditions.
Optical coherence tomography angiography optovue a very basic lecture detailing the new advancement of dyeless angiography by spectral domain OCT system and SSADA and Motion correction algorithm
pars plana vitrectomy for lens nucleus drop with video demonstration. Vitreo retinal surgery, ophthalmology, residency training presentation, cataract surgery commplications,
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.
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
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
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
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.
- 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
Adv. biopharm. APPLICATION OF PHARMACOKINETICS : TARGETED DRUG DELIVERY SYSTEMSAkankshaAshtankar
MIP 201T & MPH 202T
ADVANCED BIOPHARMACEUTICS & PHARMACOKINETICS : UNIT 5
APPLICATION OF PHARMACOKINETICS : TARGETED DRUG DELIVERY SYSTEMS By - AKANKSHA ASHTANKAR
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.
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
Knee anatomy and clinical tests 2024.pdfvimalpl1234
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.
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
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.
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
2. 1. American Academy of Ophthalmology
(section - 11 Lens & Cataract)
2. Clinical Ophthalmology (Kanski fouth edition)
3. Clinical Ophthalmology (Myron Yanoff)
4. Oxford hand book of ophthalmology (second
edition)
5. Cataract surgery and its complications (6th
edition, N.JAFFE, M. JAFFE, G.JAFFE)
03/01/152
References
3. ∗ Introduction to cataract
∗ Introduction to cataract surgery
∗ Preoperative management
∗ Post- operative management
∗ Summary
03/01/153
Presentation Layout
4. ∗ Cataract derives from the Latin word
‘cataracta’ meaning "waterfall“
∗ Any opacity in the human crystalline lens that causes
it to loose it’s transparency and /or scatter light
compromising the visual acuity
∗ Any opacification of IOL after cataract surgery is
known as after cataract
03/01/154
Introduction
5. ∗ It is estimated around 20 million people are
blind due to this disease
∗ Estimated 50 million people blind due to
cataract by 2020
∗ By the year 2020, the final target should be 32
million cataract surgeries annually
03/01/155
Global Cataract Blindness:
6. According to Nepal Blindness Survey(1980-1981):
• A. Cataract and its sequelae(72%)
• B. Trachoma
• C. Ocular infections
• D. Xerophthalmia
• E. Glaucoma
• According to study “Prevalence of blindness and cataract
surgery in Gandaki Zone, Nepal” cause of blindness due to
cataract was found to be 60.5%
03/01/156
Cataract Blindness in Nepal:
7. ∗ Common indication
* Loss of stereopsis
* Decrease of peripheral vision
* Bothersome glare
* Symptomatic anisometropia
03/01/157
INDICATION FOR CATARACT SURGERY
8. ∗ Medical indication
* Phacolytic glaucoma (mature,hypermature cataract)
* Phacoantigenic uveitis (traumatic cataract)
* Phacomorphic glaucoma (intumescent cataractous
lens)
* Dislocation of lens into AC
* Lenticular tumor: Epithelioma, epitheliocarcinoma.
* Dense cataracts
03/01/158
Contd…
9. ∗ Patients with significant cataracts
∗ Patients decide to seek of visual function through
cataract surgery.
∗ Cosmetic indication: Mature cataract in the blind
eye (for restore the black pupil only)
∗ May require cataract surgery:
* Posterior subcapsular cataracts (near VA < N8
even though far VA still 6/12).
* Nuclear cataracts that far VA 6/18 even though
near VA still N5.
03/01/159
Contd…
10. ∗ GENERAL HEALTH
* Diabetes mellitus
* Ischemic heart disease
* Smoking
* HTN
* Chronic obstructive pulmonary disease
* Bleeding disorder
* Drug sensitivities & medications: immunosuppressant
or anticoagulant…
03/01/1510
Pre operative evaluation
11. PERTINENT OCULAR HISTORY
* H/o of trauma
* Inflammation
* Amblyopia
* Glaucoma
* H/o has already had cataract extraction
(compl: vitreous loss….)
03/01/1511
12. * Look for abnormalities of external eyes and adnexa:
. Blepharitis
. Entropion, ectropion
. Decrease of corneal sensation
. Abnormal tear function, Exposure keratitis
. Dacryocystitis
. Other condition: head tremor…
* Motility: EOM, Cover test, Strabismus + Amblyopia..
* Pupil: Reacting to light…RAPD (+/-)
03/01/1512
EXTERNAL EXAMINATION
14. b)- Cornea:
. Specular reflection with slit-lamp can estimate
the endothelium cell count and morphology.
. If abnormal or C- thickness > 600 µm is poor
prognosis for corneal clarity.
. Corneal dystrophy
. Keratoconjunctivitis sicca
03/01/1514
Contd…
15. c)- Anterior chamber:
. Shallow (intumescent of lens or forward
displacement by posterior pathology)
. Gonioscopy to rule out the angle abnormalities
(synechia, neovasculization).
d)- Iris:
. Pupil size after dilation is noted
. Posterior or anterior synechia (+/-)
03/01/1515
16. e)- Crystalline lens:
. The visual significance of oil droplet nuclear
cataracts & small posterior subcapsular cataracts are
the best appropriated before dilation.
. Exfoliation syndrome is the best seen follow
dilation.
. Small posterior subcapsular cataracts can cause
severe visual loss
03/01/1516
Contd…
17. b)- In DM patient,we should look for: Macular edema,
retinal ischemia, vitreous retinal traction, lattice
degeneration, macular hole.
c)- Mature cataracts, evaluated by B- Scan
Ultrasonography that helpful in RD & posterior
segment tumor
03/01/1517
FUNDUS…….
18. ∗ a)-Visual acuity testing ( N & D)
∗ b)- Brightness acuity
* Pts complain of glare (should check distance & near
acuity in well lighted room with non projected or
projected eye chart.
* Pts with significant cataracts show decrease VA of
three or more lines under this condition
03/01/1518
Measurement of visual function
19. ∗ c)- Contrast sensitivity
∗ d)- Visual field testing (Goldmann & Automated)
∗ e)- Color vision
03/01/1519
Contd…
20. ∗ SPECIAL TESTS
a)- Potential acuity estimation
• Clinical Interferometers & Potential Acuity Meter are able to
measure macular acuity directly by projecting grating patterns or
Snellen letter on the retina.
• This test can be misleading in present of: Age related macular
degeneration, amblyopia, macular edema, glaucoma, small macular
scar & serous RD.
03/01/1520
PREOPERATIVE EVALUATION (Cont)
21. b)- Testing for macular function
* Maddox Rod: large scotoma (macular disease)
* Purkinje’s entoptic phenomenon ( Retina)
(light shone through close eyelid…shadow).
* Two light discrimination indicates normal
macular function, if two point light sources can be
distinguished when held 2 inches apart & 2 feet from
the eye
03/01/1521
Special tests
22. ∗ REFRACTION
∗ BIOMETRY (keratometry & A-Scan)
Performed to calculate the approximate IOL power implantation.
Use SRK formula (Sanders, Retlaff & Kraff)
P = A – 2.5L – 0.9K
P : Lens implant power for emmetropia (D)
L : Axial length (mm)
K : Average keratometric reading (D)
A : Constant specific to the lens implant to be used
That A = 113 for AC lenses & 119 for PC lenses.
03/01/1522
Pre operative measurement
23. ∗ Check that biometry does indeed belong to your
patient
∗ Check for intraocular consistency in axial length and
K values (i.e that they are similar and the standard
deviation is low)
03/01/1523
IOL selection
24. ∗ Check for interocular consistency in axial length and
K values
∗ If axial length difference >0.3mm confirm by B-scan
and if the difference in K readings >1D then consider
corneal topography
03/01/1524
Contd…
25. ∗ CORNEAL PACHYMETRY
* Ultrasonic pachymeters can accurately & reliably
measure endothelial cell function.
* If thickness > 600 µm maybe consistent with corneal
edema & endothelium dysfunction that increase the
likelihood postoperative clinical corneal edema.
03/01/1525
26. ∗ SPECULAR MICROSCOPY: (endothelium cells)
* A normal cell count > 2400 cells/mm2
* If a cell count fewer than 1000 cells/mm2
is risk of
postoperative corneal decompensation.
03/01/1526
Contd…
27. ∗B-Scan ultrasonography
Useful whenever it is impossible to view the retina & can
determine of posterior segment with regard to the
potential for:
* RD
* Vitreous opacity
* Posterior pole tumor
∗ Complete blood counts, Hb…
∗ Blood sugar
∗ Urinalysis
∗ Chest X-ray
03/01/1527
Laboratory investigations
29. ∗ Pediatric IOL: size, design and power
∗ 1. Size of IOL above the age of 2 years may be
standard 12 to 12.75mm diameter for the bag
implantation
∗ 2. Design of IOL recommended is one- piece PMMA
with modified C- shaped haptics (preferably heparin
coated)
03/01/1529
Pre operative management in
pediatric age groups
30. ∗ Power of IOL in children between 2-8 years of age 10%
undercorrection from the calculated biometric power
is recommended to counter the myopic shift
∗ Below 2 years on undercorrection by 20% is
recommended
03/01/1530
Contd…
31. ∗ Topical antibiotics : tobramycin, gentamycin or
ciprofloxacin QID for 3 days
∗ Preparation of eye to be operated : eyelashes of
upper lid should be trimmed at night
∗ An informed and detail consent should be obtained
03/01/1531
Preoperative medications
32. ∗ IOP should be lowered by acetazolamide 500mg stat
2 hours before surgery and glycerol 60ml mixed with
equal amount of water or lemon juice 1 hour before
Sx or, IV mannitol 1gm/kg body weight half hour
before Sx
03/01/1532
33. ∗ To sustain dilated pupil
∗ antiprostaglandin eye drops such as indomethacin or
flurbiprofen TID 1 day prior to surgery
∗ Adequate dilation also by 1% tropicamide
03/01/1533
34. ∗ Patient is asked to lie quietly upon the back for 3/ 4
hours
∗ For mild to moderate post-operative pain injection
diclofenac sodium may be given
∗ Next morning bandage is removed & inspected for
post-op complication
∗ Antibiotic-steroid eye drops are used two hourly 1
week,QID 4 week then tapering, TID, BD and OD for
each week
03/01/1534
Post- operative management
35. ∗ Tear supplements are given for at least one month or
more depending upon the patients complain to
prevent post cataract surgery dry eyes
03/01/1535
Contd…
36. ∗ Cornea: wounds sealed (Seidel test negative), clarity
∗ AC: formed, activity
∗ Pupil: round, regular and reacting
∗ PCIOL: centred and in the bag
∗ Consider : IOP checking
03/01/1536
Post -op examination
37. ∗ Give clear instructions re postoperative drops
∗ Use of clear shield
∗ What to expect (discomfort, watering)
∗ What to worry about (increasing pain/ redness,
worsening vision)
∗ Where to get help (including telephone number)
03/01/1537
38. ∗ Examination
∗ VA: unaided/aided
∗ Cornea: wounds sealed (Seidel test
negative), clarity
∗ AC: depth and clarity
∗ Pupil: round, regular and reacting
03/01/1538
Final review (2-4wks later)
39. ∗ IOP
∗ Fundus : no cystoid macular oedema, flat retina
∗ If good result then either list for second eye (in
bilateral cases) or discharge to optometrist for
refraction as appropriate
03/01/1539
Contd…
40. ∗ If disappointing VA (unaided) perform
refraction/autorefraction to look for ‘refractive error’
and dilated fundoscopy to check for the subtle CMO
(specially if VA (pinhole) < VA (unaided)) and if in
doubt, consider OCT
03/01/1540
Contd…
41. ∗ In patients where the refractive outcome is harder to
predict (high ametropia, previous corneal refractive
surgery), review patients early (1 week) with
refraction to permit the option of an early IOL
exchange if a large discrepancy noticed
03/01/1541
Refractive surprises
42. ∗ After 6-8 weeks of operation corneoscleral sutures
are removed (when applied)
∗ Final spectacles are prescribed after about 8 weeks of
operation
03/01/1542
Contd…
43. ∗ Correction of paediatric aphakia
∗ Children above the age of 2 years corrected by PC-IOL
during surgery
∗ Children below the age of 2 years should be
preferably corrected by extended wear CL
∗ Spectacles can be prescribed in B/L cases
03/01/1543
Postoperative management of
pediatric age group
44. ∗ Later on secondary IOL implantation may be
considered
∗ Primary implantation at earliest possible (2-3 months)
specially in unilateral cases
∗ Management of amblyopia in long term follow up
03/01/1544
Contd…
45. ∗ Every 6 months follow up for first five years and then
followed by yearly follow up
∗ Correction of refractive error as far as possible to
prevent amblyopia
03/01/1545
Contd…
46. ∗ Refractive error is assessed at 8th
week of cataract
surgery
∗ Refractive correction is prescribed only if the error
persist even after three months of cataract surgery
03/01/1546
Management of refractive error in
adults