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ARTICLES |
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Year : 1979 | Volume
: 27
| Issue : 4 | Page : 30-31 |
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Post-operative uveitis
Daljit Singh
Department of Ophthalmology.. Medical College, Amritsar, India
Correspondence Address: Daljit Singh Department of Ophthalmology.. Medical College, Amritsar India
Source of Support: None, Conflict of Interest: None | Check |
How to cite this article: Singh D. Post-operative uveitis. Indian J Ophthalmol 1979;27:30-1 |
I would like to tell you one trick to avoid post-operative uveitis. It succeeds in cent percent cases. And the trick is: (keep it to yourself) just avoid the operating room.
The undergraduates and postgraduates constantly need cases of postoperative uveitis for study, for presentation and research. So why not learn a few tricks of producing at our will, models of mild, moderate or severe post-operative uveitis?
Avoid painstaking examination of the patient. Have a cursory look and refuse to examine the conjunctiva or the lacrimal sac. A fresh stye or a small boil will be just ideal.
Give least attention to the operating room. Let people move around and inside the operating area. It produces such a congenial atmosphere for surgery and doctor-patient relationship.
Do not wash your hands thoroughly for 5 minutes. If you have an important caller do shake hands with him, or if there are important papers to sign, please go ahead, nobody is looking at you. If somebody is watching you, give him a slip by quickly dipping your hands in lysol solution or spirit... Keep your spirits high.
Operating without an operating gown or a mask, gives a nice feeling, especially during summer. Never take off your wedding ring, else you may lose, oh! you may lose your wife.
Invite important people inside the operation theatre. Invite news reporters. Let them have a look at the marvel of the eye .... or should I say the ... eye that was ... or whatever will remain of it.
Do not bother about pre-operative sterilization of the conjunctival sac with antibiotics. Enema can with a long tube is ideal for washing the eye with plain water.
Talking, laughing and singing during surgery keeps the patient cheerful. A sneeze here and a cough there is just wonderful.
Chemical sterilization of the instruments is easy. If a little chemical sticks to the instruments, it acts as a prophylactic against the undesirable bacteria. You can produce chemical uveitis of any grade at will, which may be treated with broad spectrum antibiotics and as expected if it does not respond-consider the fashionable diagnosis of fungal endophthalmitis or phakoanaphylactica.
Keep your hands and instruments wet, especially during summer. Allow the wonderful shiny spherules of your sweat travel along the instruments into the eye.
Twirl the swab sticks between your fingers to make them smooth, so that they give a nice feeling to the conjunctiva, cornea and the iris of the eye under operation.
Always warm the corneal needle to body temperature, (by keeping it between your fingers) before passing through the sensitive corneal tissue, and be careful to smooth out the tail of the thread between the wet finger tips. Friends, only nervous and incompetent surgeons talk of "no touch technique".
Experienced surgeons always use experienced syringes, full of chalky deposits. Transfusion bottles offer very cheap saline for irrigation of the anterior chamber which can be repeatedly contaminated to produce ideal cases of severe post-operative uveitis.
Manual dexterity improves with time and practice. Learn boxing and weight liftingthey will take fine tremors off your fingers and hands. Only coarse tremors will be left which are ideal to wrestle with the eye and help produce traumatic post-operative uveitis.
And finally, if you still do not succeed, try intraocular lens implants, without knowing anything about them.
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