The retina is the innermost layer of the eyeball and contains several important structures. The optic disc allows nerve fibers to exit the eye, while the macula lutea, located near the center of the retina, provides high-acuity vision. The retina receives blood supply from both the choroid and central retinal artery. Retinal disorders can be congenital, inflammatory, vascular, or degenerative and may affect the optic disc, macula, blood vessels, or retina itself. Common diseases include retinitis, retinal vasculitis, and central retinal artery occlusion which causes sudden vision loss.
The tear film constitutes Three layers :- An outermost lipid (oily) layer An aqueous (watery) layer that makes up 90% of the tear film volume; and A mucin layer that coats the corneal surface.
3. To form smooth optical surface on cornea. To keep the surface of cornea & conjunctiva moist It serve as lubricant It transfer oxygen Provide antibacterial action Wash debris out It provides a pathway for WBC in case of injury
4. Functions of lipid layer Retards evaporation of tear film Prevents the overflow of tears
5. Function of Aqueous Layer Flushes, buffers and lubricates the corneal surface Delivers oxygen and other nutrients to the corneal surface Wash out debris Delivers antibacterial enzymes and antibodies such as lysozyme.
6. Functions of Mucin Layer Spreads tears over corneal surface. Protects the cornea against foreign substances . Makes corneal surface smooth by filling in surface irregularities
Hair loss alopecia baldness male pattern hair loss and homeopathy treatment a...Pranav Pandya
Hair loss, also known as alopecia or baldness, refers to a loss of hair from the head or body. Baldness can refer to general hair loss or male pattern hair loss
The tear film constitutes Three layers :- An outermost lipid (oily) layer An aqueous (watery) layer that makes up 90% of the tear film volume; and A mucin layer that coats the corneal surface.
3. To form smooth optical surface on cornea. To keep the surface of cornea & conjunctiva moist It serve as lubricant It transfer oxygen Provide antibacterial action Wash debris out It provides a pathway for WBC in case of injury
4. Functions of lipid layer Retards evaporation of tear film Prevents the overflow of tears
5. Function of Aqueous Layer Flushes, buffers and lubricates the corneal surface Delivers oxygen and other nutrients to the corneal surface Wash out debris Delivers antibacterial enzymes and antibodies such as lysozyme.
6. Functions of Mucin Layer Spreads tears over corneal surface. Protects the cornea against foreign substances . Makes corneal surface smooth by filling in surface irregularities
Hair loss alopecia baldness male pattern hair loss and homeopathy treatment a...Pranav Pandya
Hair loss, also known as alopecia or baldness, refers to a loss of hair from the head or body. Baldness can refer to general hair loss or male pattern hair loss
Muscular dystrophy (MD) refers to a group of more than 30 genetic diseases that cause progressive weakness and degeneration of skeletal muscles used during voluntary movement. The word dystrophy is derived from the Greek dys, which means "difficult" or "faulty," and troph, or "nourish." These disorders vary in age of onset, severity, and pattern of affected muscles. All forms of MD grow worse as muscles progressively degenerate and weaken. Many patients eventually lose the ability to walk.
Some types of MD also affect the heart, gastrointestinal system, endocrine glands, spine, eyes, brain, and other organs. Respiratory and cardiac diseases may occur, and some patients may develop a swallowing disorder. MD is not contagious and cannot be brought on by injury or activity.
Hemophilia is a common hereditary coagulation disorder due to deficiency or reduce activity of clotting factor VIII or clotting factor IX.
This disorder is a X- linked recessive disorder.
Types:
Hemophilia A- deficiency of clotting factors VIII
Hemophilia B- deficiency of clotting factors IX
Hemophilia C- deficiency of clotting factors XI
Parahaemophilia- deficiency of clotting factor V
Causes of hemophilia
Hemophilia has a sex-linked recessive inheritance.
In most cases Hemophilia caused by a mutation in a gene that encodes for one of the clotting factors .
Since the hemophilia gene is located on the X chromosome, Hemophilia usually occurs in males, and Female is the carrier of hemophilia.
Diagnosis
Complete blood cell count
Coagulation studies
FVIII assay
Normal values for FVIII assays are 50-150%. Values in hemophilia are as follows:
Mild: >5%
Moderate: 1-5%
Severe: <1%
Treatment of Hemophilia
Other Types of Treatment
Desmopressin (DDAVP)
Antifibrinolytic Medicines
Vaccinations- hepatitis A and B.
Gene Therapy
Gene Therapy
New Drugs for Hemophilia treatment
New Drugs for Hemophilia treatment
Bangladesh perspectives
Bangladesh would have 10800 hemophiliacs.
But, initially the patients does not concern about hemophilia.
Patients are usually diagnosed only after bleeding episode and sometimes the episode are causes serious consequences.
Conclusion
Primary diagnosis with the success of gene therapy and availability of the new bioengineered products the prospect of the hemophiliacs will be brighter in near future.
Muscular Dystrophy & Myasthenia Gravis - PPT
By Prof. Dr. R. R. Deshpande
• This PPT is based on the – Syllabus of CCIM ( 2014) for4th BAMS – Kayachikitsa subject – Paper 2 Part A Point No 5 .
• Contents of PPT are – Causes ,Symptoms & Treatment of Muscular Dystrophy & Myasthenia Gravis
• Visit – www.ayurvedicfriend.com
• Phone – 922 68 10 630
A ppt about hemophilia, Including a good video. This is about what is hemophilia, why is it there, is it a genetic disorder? What percentage of people get it? Whats the average lifespan now and then?
The retina (from "net") is the innermost, light-sensitive layer of tissue of the eye of most vertebrates and some molluscs. The optics of the eye create a focused two-dimensional image of the visual world on the retina, which then processes that image within the retina and sends nerve impulses along the optic nerve to the visual cortex to create visual perception
Uveitis
• Inflammation of uveal tissue.
• Associated inflammation of adjacent structures, such as Retina, Vitreous, Sclera and Cornea.
Figure 1 uveitis
Anatomical classification
Clinical classification
Pathological classification
Etiological classification
(Duke Elder’s)
1. Anterior uveitis
Can be divided as follow;
1) Iritis_ inflammation mainly the iris
2) Iridocyclitis _iris and pars plicata involved
3) Cyclitis_ pars plicata is affected
Acute uveitis
Onset is sudden,
Last for less than 3 weeks Granulomatous uveitis
Infective nature
Inflammation is insidious in onset
Chronic in nature with minimum clinical features Infective uveitis
2. Intermediate uveitis
Inflammation of pars plana, peripheral retina and choroid.
Also called as “pars planitis”. Chronic uveitis
Onset is insidious
Duration is more than 3 weeks
Non-granulomatous uveitis
due to allergic or immune related reaction
acute onset
short duration
Allergic uveitis or immune related uveitis
3. Posterior uveitis
Inflammation of choroid(choroiditis)
Associated inflammation of retina (chorioretinitis) Recurrent uveitis
uveitis keeps reoccurring periodically
Toxic uveitis
4. Panuveitis
Inflammation of whole uveal tract Traumatic uveitis
5. Uveitis associated with non-infective systemic diseases
6. Idiopathic uveitis
7. Neoplastic
Figure 2 anatomical classification of uveitis
Panuveitis
Endophthalmitis
Panophthalmitis
Inflammation of all layers of uvea of eye
Can also affect lens, retina, optic nerve and vitreous causing reduced vision or blindness. Inflammation of internal structures of the eye, I;e choroid, retina and vitreous Purulent inflammation of all structures of eye
Including all the three coats and Tenon’s capsule as well.
Etiology
1. Idiopathic
After ruling out other causes
2. Infectious
Tuberculosis
Syphilis
Lyme disease
Leptospirosis
Infectious endophthalmitis
3. Immune related
Sarcoidosis
Vogt-koyanagi-Harada syndrome
Sympathetic ophthalmitis
Behcet syndrome
Etiology
Acute process 1-7 days following intraocular surgery such as Cataract surgery and filtering operation
Commonly caused by Bacteria-staphylococcus, pseudomonas, pneumococcus, streptococcus, E. coli,
Fungus -aspergillus fumigatus, candida albicans, fusarium,
Etiology
1.Exogenous
Due to infected wounds
Common pathogens are pneumococcus, staphylococcus, pseudomonas, pneumococcus, streptococcus, E. coli.
2.Endogenous
Due to metastasis of infected embolus in retinal artery and choroidal vessels.
Clinical Features
• Sudden onset of unilateral pain, redness, photophobia
• Maybe associated with lacrimation
• Visual acuity is usually good at presentation except in eyes with severe hypopyon.
• Low IOP
• Fibrinous exudate
• Posterior synechiae
• Miosis
• Aqueous flare and cells
• Endothelial dusting
Clinical Features
Bacterial endophthalmitis
• Sudden onset with severe pain
• Redness
• Visual loss
• Lid oedema, chemosis, corneal haze
• Low
2. Retina
A thin transparent and delicate membrane which is the
innermost layer of the eyeball.
It extends from optic disc to ora serrata.
Grossly it is divided
into
Posterior pole
Peripheral retina
Posterior pole includes two
areas
Optic disc
Macula lutea
3. Optic disc
Optic disc: a well defined circular area of 1.5-2mm
diameter.
Here all the retinal layers terminate except the nerve fibres
A depression is seen in the disc called as Physiological cup
Significance of physiological cup: the central retinal artey
and vein emerge through the centre of this cup
4. Macula lutea
Also called as the Yellow Spot
It is about 5.5 mm in diameter
Fovea centralis is the central deeper part of macula (1.5mm
in diameter) which is the most sensitive part of the retina
In its centre a shining pit called foveola is located
6. Functional division of retina
Temporal retina Nasal retina
Nerves arising from temporal retina
Pass through optic nerve and optic tract
of same side to terminate in Ipsilateral
Geniculate body
Nerves arising from nasal retina
Pass through optic nerve cross in
optic chiasma and travel to contra
lateral optic tract and eliminate in
contra lateral geniculate body
7. Blood supply
Outer four layers are supplied
by choroidal vessels
Inner six layers are supplied
by central retinal artery , a
branch of Ophthalmic artery
9. Congenital and developmental disorders
Anomalies of optic
disc
Crescents
Situs
inversus
Congenital
pigmentati
on
Coloboma
Drusen
Hypoplasia
of optic
disk
Anomalies of
nerve fibres
Medullated/opa
que nerve
fibres
Anomalies of
vascular
elements
Persistent
hyaloid
artery
Congenital
tortuosity of
retinal vessels
Anomalies of
Retina proper
Albinism
Night
blindness
Day
blindness
Oguchi
disease
Retinal
cyst
Retinal
detachmen
t
Coloboma
of fundus
Anomalies of
macula
Aplasia
Hypoplasia
coloboma
10. Coloboma of optic disc
• Cause: due to failure of closure of embryonic
fissure
• Occurs in two forms:
Minor
coloboma
Fully
developed
coloboma
11. Inflammatory disorders of the retina
Retinitis
Non specific
• Acute purulent: occurs as metastatic infections from patients
having pyaemia resulting in endopthalmitis or panopthalmitis
• Subacute retinitis of Roth: occurs in patients suffering from
SubAcute Bacterial Endocarditis. characterized by multiple
superficial retinal hemorraghes,involving posterior part of fundus
they have a white spot in centre.blurred vision is the symptom
Specific
• Bacterial
• Viral
• Mycotic
• parasitic
12. Retinal vasculitis/Eales’ disease
• Clinical features:
– Sudden appearing
floaters(black spots
infront of the eyes)
– Painless loss of
vision(due to vitreous
hemorrhage)
Inflammation of retinal
vessels
Eales’ disease is idiopathic
inflammation of peripheral
retinal veins
Characterized by recurrent
vitreous hemorrahe
Etiology: hypersensitivity
reaction to tubercular protein
• Stage of inflammation
• Stage of Ischemia
• Stage of retinal
neovascularization
• Stage of sequelae
Clinical
stages
of the
disease
• Treatment
• Oral corticosteroids
• Laser photo
coagulation
• Vitreo retinal
surgery
13. (CRAO) CENTRAL RETINAL
ARTERY OCCLUSION
Signs and symptoms
• Central retinal
artery occlusions
cause sudden,
acute, and painless
loss of vision in one
eye.
Central retinal artery
occlusion (CRAO) is a disease
of the eye where the flow of
blood through the central
retinal artery is blocked
(occluded). There are several
different causes of this
occlusion, the most common
is carotid
artery atherosclerosis.
Fundoscopic exam will
show a red lesion, called a
"cherry red spot," with
surrounding pale retina
(the pale color is caused
by ischemia of the retina)
• The Undersea and Hyperbaric Medical
Society lists Central Retinal Artery Occlusion
(CRAO) as an approved indication
for Hyperbaric Oxygen Therapy.[3] This a
treatment for CRAO that is covered by medical
insurance in North America. Existing
treatments include ocular massage, anterior
chamber paracentesis, and inhalation therapy
of a mixture of 5% carbon dioxide and 95%
oxygen