This study compared centering hyperopic corneal refractive surgery ablations on the corneal vertex versus the pupil center. The study included 60 eyes divided into groups with small or large angle kappa. All ablations were centered on the corneal vertex. The study found no significant differences in accuracy, safety, or night vision between groups. However, eyes with large angle kappa had significantly worse contrast sensitivity and increased coma and spherical aberration when measured at the pupil center, but not at the corneal vertex. The conclusion was that ablations should be centered on the corneal vertex rather than the pupil center.
OCT is a great technology,Many ophthalmologist find very difficult to understand it ,SO I have tired to simplify it as much as possible .Hope everyone can understand now onwards the basic about OCT .
Every feedback s most welcomed sothat i can improve further in coming days
Please email your feedback to me in the following address
yourgyanu@gmail.com
OCT is a great technology,Many ophthalmologist find very difficult to understand it ,SO I have tired to simplify it as much as possible .Hope everyone can understand now onwards the basic about OCT .
Every feedback s most welcomed sothat i can improve further in coming days
Please email your feedback to me in the following address
yourgyanu@gmail.com
Accommodation/ Accommodation of Eye, Measurement of Accommodation of Eye (hea...Bikash Sapkota
CLICK HERE TO DOWNLOAD FULL PPT ❤❤ https://healthkura.com/measurement-of-accommodation-of-eye/ ❤❤
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Measurement of Accommodation of eye:
Amplitude, Facility,
Relative Accommodation, Fatigue, Lag,
Dynamic Retinoscopy
Presentation Layout:
-Introduction to accommodation of eye
-Mechanism
-Components
-Measurement of accommodation of eye
- Amplitude
- Facility
- Relative accommodation
- Lag
-Dynamic Retinoscopy
Accommodation
-dioptric adjustment of the crystalline lens of the eye
- to obtain clear vision for a given target of regard
-process by which the refractive power of eye is altered
- to ensure a clear retinal image
For further reading
-Clinical Procedures in Optometry by J.D. Bartlett, J.B. Eskridge, J.F. Amos
-Primary Care Optometry by Theodere Grosvenor
-Borish’s Clinical Refraction by W.J. Benjamin
-Clinical Procedures for Ocular examination by Carlson et al
-American Academy of Ophthalmology
-Optometric Clinical Practice Guideline by American Optometric Association
-Internet
Follow me to get in touch with optometric and ophthalmic updates
To know Humphrey visual field analyser
To know about various types of perimetry
To identify field defect
To recognize that field defect is due to glaucoma or neurological lesion
To know that field defect is progressive or not
Interpretation of HVFA
Accommodation/ Accommodation of Eye, Measurement of Accommodation of Eye (hea...Bikash Sapkota
CLICK HERE TO DOWNLOAD FULL PPT ❤❤ https://healthkura.com/measurement-of-accommodation-of-eye/ ❤❤
Dear viewers Check Out my other piece of works at ❤❤❤ https://healthkura.com ❤❤❤
Measurement of Accommodation of eye:
Amplitude, Facility,
Relative Accommodation, Fatigue, Lag,
Dynamic Retinoscopy
Presentation Layout:
-Introduction to accommodation of eye
-Mechanism
-Components
-Measurement of accommodation of eye
- Amplitude
- Facility
- Relative accommodation
- Lag
-Dynamic Retinoscopy
Accommodation
-dioptric adjustment of the crystalline lens of the eye
- to obtain clear vision for a given target of regard
-process by which the refractive power of eye is altered
- to ensure a clear retinal image
For further reading
-Clinical Procedures in Optometry by J.D. Bartlett, J.B. Eskridge, J.F. Amos
-Primary Care Optometry by Theodere Grosvenor
-Borish’s Clinical Refraction by W.J. Benjamin
-Clinical Procedures for Ocular examination by Carlson et al
-American Academy of Ophthalmology
-Optometric Clinical Practice Guideline by American Optometric Association
-Internet
Follow me to get in touch with optometric and ophthalmic updates
To know Humphrey visual field analyser
To know about various types of perimetry
To identify field defect
To recognize that field defect is due to glaucoma or neurological lesion
To know that field defect is progressive or not
Interpretation of HVFA
Presentation about the 3-Years Results of a Femtosecond Laser-assisted Circular Keratotomy-Treatment of Keratoconus, Comparison with (Iontophoresis-Assisted) Corneal Crosslinking – by Dr. Detlev Breyer at the 36 Congress of the European Society of Cataract and Refractive Surgery in Vienna 2018.
This presentation compares the 5-year-outcomes after small incision lenticule extraction and femtosecond lasik. According to the patient questionnaire, there are less dry eyes, less pain sensation and better patient comfort in ReLEx SMILE group and
ReLEx SMILE is the treatment of choice.
Femtosecond Laser-Assisted Implantation of Toric Multifocal IOL
Based on Automated Corneal Shape Analysis –
Comparison with a Manual Technique, presented at ASCRS 2018 – by Philipp Hagen, D. Breyer, H. Kaymak, K. Klabe, T. Ax, F. Kretz, G. Auffarth
Clínica Rementería | http://www.clinicarementeria.es
Trabajo presentado por el Dr. Fco Javier Hurtado Ceña en el 12th congreso International Conference of the Research Institute of Ophthalmology (RIO 2018) celebrado en la ciudad de El Cairo (Egipto)
New Versus Former-Generation Diffractive Trifocal Intraocular Lens, presented at ASCRS 2018, by Timon Ax, D. Breyer, H. Kaymak, K. Klabe, P. Hagen, F. Kretz, G. Auffarth
Clinical Experiences with a New Diffractive Extended-Depth-of-Focus IOL Versus a Former-Generation Model, presented at ASCRS 2018 – by Timon Ax, D. Breyer, H. Kaymak, K. Klabe, P. Hagen, F. Kretz, G. Auffarth
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
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.
- 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
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.
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.
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
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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,
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In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
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The four main behavioral effects of AUD are impaired control over
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Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
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
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journey
Centration of Hyperopic Corneal Ablations: Corneal Vertex vs. Pupil Center
1. Centration of Hyperopic Corneal Ablations: Corneal Vertex vs. Pupil Center Dan Z Reinstein MD MA(Cantab) FRCSC FRCOphth 1,2,3,4 1. London Vision Clinic, London, UK 2. St. Thomas’ Hospital - Kings College, London, UK 3. Weill Medical College of Cornell University, New York, USA 4. Center Hospitalier National d’Ophtalmologie, (Pr. Laroche), Paris, France
2. Financial Disclosure The author acknowledges a financial interest in Artemis™ VHF digital ultrasound The author is a consultant for Carl Zeiss Meditec AG (Jena, Germany)
3.
4. Centration: Visual Axis vs Entrance Pupil Phoroptor Lens No Angle Kappa Phoroptor Manifest Refraction Excimer Laser Ablation Large Angle Kappa Ablation Profile Phoroptor Lens
5.
6.
7.
8. Study Design: Outcome Measures IF: PUPIL CENTER = CORRECT TREATMENT Small Angle Kappa Large Angle Kappa Safety Good Worse Accuracy Good Worse Contrast Sensitivity Good Worse Pupil wavefront Good Worse Corneal wavefront Good Good Night vision Good Worse
9. Study Design: Outcome Measures IF: CORNEAL VERTEX = CORRECT TREATMENT Small Angle Kappa Large Angle Kappa Safety Good Good Accuracy Good Good Contrast Sensitivity Good Good Pupil wavefront Good Worse Corneal wavefront Good Good Night vision Good Good
10. Methods: Matched Groups Pupillary offset Pupillary offset (mm) Within 0.25 mm 0.17 ± 0.05 mm More than 0.55 mm 0.69 ± 0.10 mm Small angle kappa Large angle kappa N (eyes) 30 30 Min hyperopic meridian (D) +3.85 ± 0.98 D (+2.50 to +5.50D) +3.87 ± 0.90 D (+2.50 to +5.50D) BSCVA 93% eyes ≥ 20/20 7% eyes = 20/25 93% eyes ≥ 20/20 7% eyes = 20/25
16. Results: Pupil center wavefront - WASCA * p=0.004 Aberrations reported in OSA nomenclature All values are in microns and for a 6 mm pupil Small angle kappa Large angle kappa Change in coma and spherical aberration (SA) Pre Post Coma 0.18 ± 0.11 0.55 ± 0.29 SA 0.22 ± 0.15 -0.24 ± 0.19 Pre Post Coma 0.25 ± 0.12 0.87 ± 0.33 SA 0.24 ± 0.13 -0.25 ± 0.22
17. Results: Corneal vertex wavefront Aberrations reported in OSA nomenclature All values are in microns and for a 6 mm pupil Small angle kappa Large angle kappa Change in coma and spherical aberration (SA) * p>0.05 * p>0.05 Pre Post Coma 0.34 ± 0.17 0.69 ± 0.34 SA 0.26 ± 0.08 -0.13 ± 0.21 Pre Post Coma 0.38 ± 0.19 0.72 ± 0.50 SA 0.20 ± 0.09 -0.19 ± 0.19
21. Centration of Hyperopic Corneal Ablations: Corneal Vertex vs. Pupil Center Dan Z Reinstein MD MA(Cantab) FRCSC FRCOphth 1,2,3,4 1. London Vision Clinic, London, UK 2. St. Thomas’ Hospital - Kings College, London, UK 3. Weill Medical College of Cornell University, New York, USA 4. Center Hospitalier National d’Ophtalmologie, (Pr. Laroche), Paris, France Thank You
Editor's Notes
I have a financial interest in the Artemis technology and I am a consultant for Carl Zeiss Meditec
One of the big unresolved questions in refractive surgery is where to center ablations How many of you treat on the pupil center? How many treat on the corneal vertex?
If a patient has no angle kappa and we’re refracting them in the phoroptor, then the visual axis and entrance pupil are both aligned with the phoropter lens. But, if there is an angle kappa, we do not then move the lens away from the corneal vetex to align the lens we are refracting with the entrance pupil, the eye presents it’s vertex to the world, not it’s entrance pupil. So, it’s baffling that most companies are still telling surgeons to centre their treatments on the entrance pupil – which creates a new vertex for the cornea, rather than maintaining the one that God provided! So, ablations need to be centred on the corneal vertex which best approximates the visual axis thank-you Milind.
The purpose of this study was to prove that ablations should be centred on the corneal vertex and not the entrance pupil center
The ideal study design would be to prospectively randomize pupil or vertex centration on a large number of eyes with a large angle kappa, and observe whether pupil or vertex centered eyes did better. The problem with this is that by definition, depending on the answer, a number of eyes would suffer from poor outcomes due to decentration.
Therefore, we designed our study as a proof by contradiction In proof by contradiction, you start with an assumption, then if the result turns out to be different to the expected result, the initial assumption must be wrong The assumption to be tested was therefore that: Ablations should be centred on the pupil center In my practice, with all eyes receiving corneal vertex ablations, we’d expect patients with a large angle kappa to do worse, as these eyes according to the assumption, should have been treated on the entrance pupil center.
The outcome measures were to look at safety, accuracy, contrast sensitivity, ocular wavefront – which is measured from the center of the pupil, vertex centered corneal wavefront, and subjective night vision through a night vision simulator program. If ablations should be centred on the pupil center, the outcomes should be worse for the large angle kappa group – except for the corneal vertex wavefront as the aberrations measured would be aligned with the vertex centered ablation
If ablations should be centred on the corneal vertex, there should be equally good outcomes for both groups – the only exception would be for the pupil centered wavefront – where we would expect the large angle kappa eyes to have increased coma as they would have been ablated “off-center”
The two groups were constructed from a consecutive series of hyperopic LASIK cases. For group 1, the small angle kappa group, the pupil offset was within 1/4-mm of the pupil center, while for group 2, the pupil offset had to be greater than 0.55-mm. Thirty eyes with a minimum of +2.5 D of hyperopia were recruited for each group, ensuring that they were matched for minimum hyperopic meridian and BSCVA (with all eyes being at least 20/25). The cylinder was restricted to a maximum of +2.00 D and the age was restricted up to 60.
Results
First, we measured the centration of the ablation on topography to confirm that the ablation was well centred on the corneal vertex in both groups We found a mean decentration of less than 0.1-mm in each group, and there was no difference in centration between groups.
There was no difference in accuracy between the two groups
There was no difference in safety between the two groups
There was no difference in contrast sensitivity between the two groups
According to pupil centred wavefront measurements, there was no difference in the change in spherical aberration, but there was statistically significantly more induced coma in the large angle kappa group
Vertex centered corneal wavefront showed no difference between groups in the change of either spherical aberration or coma
There was no difference in subjective night vision disturbances between the two groups
There was no difference between groups for any of the outcome measures other than the pupil wavefront The results were NOT worse in the large angle kappa group, which contradicts the initial assumption that ablations should be centered on the entrance pupil
Therefore, this study suggests that ablations should be centred on the corneal vertex and not on the entrance pupil center