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  Most popular articles (Since April 01, 2005)

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Interpreting automated perimetry
Ravi Thomas, Ronnie George
April-June 2001, 49(2):125-140
Visual field testing is mandatory for many ophthalmic conditions including glaucoma. The current gold standard for visual field testing is automated perimetry. In this article we familiarize the reader with the components of an automated perimetry printout. We describe a systematic approach that leads to a thorough interpretation of the printout. With the help of examples the reader should be able to learn to identify a normal field, detect the presence of a field defect, determine whether it is due to glaucoma, and establish progression, if any.
  59,725 1 2
Bloody tears (haemolacria)
BK Ahluwalia, AK Khurana, S Sood
January-February 1987, 35(1):41-43
A case of bloody tears in a young hysterical female is described and rarity of the condition is stressed.
  41,190 0 3
Ocular manifestations in the Hutchinson-Gilford progeria syndrome
Shivcharan L Chandravanshi, Ashok Kumar Rawat, Prem Chand Dwivedi, Pankaj Choudhary
November-December 2011, 59(6):509-512
DOI:10.4103/0301-4738.86327  PMID:22011502
The Hutchinson-Gilford progeria (HGP) syndrome is an extremely rare genetic condition characterized by an appearance of accelerated aging in children. The word progeria is derived from the Greek word progeros meaning 'prematurely old'. It is caused by de novo dominant mutation in the LMNA gene (gene map locus 1q21.2) and characterized by growth retardation and accelerated degenerative changes of the skin, musculoskeletal and cardiovascular systems. The most common ocular manifestations are prominent eyes, loss of eyebrows and eyelashes, and lagophthalmos. In the present case some additional ocular features such as horizontal narrowing of palpebral fissure, superior sulcus deformity, upper lid retraction, upper lid lag in down gaze, poor pupillary dilatation, were noted. In this case report, a 15-year-old Indian boy with some additional ocular manifestations of the HGP syndrome is described.
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Amniotic membrane transplantation: A review of current indications in the management of ophthalmic disorders
Virender S Sangwan, Sanghamitra Burman, Sushma Tejwani, Sankaranarayana Pillai Mahesh, Ramesh Murthy
July-August 2007, 55(4):251-260
DOI:10.4103/0301-4738.33036  PMID:17595472
Amniotic membrane transplantation is currently being used for a continuously widening spectrum of ophthalmic indications. It has gained widespread attention as an effective method of reconstruction of the ocular surface. Amniotic membrane has a unique combination of properties, including the facilitation of migration of epithelial cells, the reinforcement of basal cellular adhesion and the encouragement of epithelial differentiation. Its ability to modulate stromal scarring and its anti-inflammatory activity has led to its use in the treatment of ocular surface pathology as well as an adjunct to limbal stem cell grafts. Amniotic membrane transplantation has been used for reconstruction of the corneal surface in the setting of persistent epithelial defects, partial limbal stem cell deficiency, bullous keratopathy and corneoscleral ulcers. It has also been used in conjunction with limbal stem cell transplantation for total limbal stem cell deficiency. Amniotic membrane grafts have been effectively used as a conjunctival substitute for reconstruction of conjunctival defects following removal of pterygia, conjunctival lesions and symblephara. More recently, amniotic membrane has been used as a substrate for ex vivo cultivation of limbal, corneal and conjunctival epithelial cells. This article reviews the current literature on the applications of amniotic membrane transplantation and its outcome in various ophthalmic conditions.
  32,694 3,379 37
White with pressure (WWP) and white without pressure (WWOP) lesions
Manoj Shukla, OP Anuja
May-June 1982, 30(3):129-132
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Posterior Capsule Opacification : A Review of the Aetiopathogenesis, Experimental and Clinical Studies and Factors for Prevention
Suresh K Pandey, David J Apple, L Werner, Anthony J Maloof, E John Milverton
April-June 2004, 52(2):99-112
Posterior capsule opacification (PCO, secondary cataract, after cataract) is a nagging postsurgical complication following extracapsular cataract surgery (ECCE) and intraocular lens (IOL) implantation. PCO should be eliminated since it has deleterious sequelae and Neodynium: Yttrium Aluminium Garnet (Nd: YAG) laser treatment often is an unnecessary financial burden on the health care system. PCO following cataract surgery could be a major problem, since patient follow-up is difficult and the Nd:YAG laser is not always available. Advances in surgical techniques, IOL designs/biomaterials have been instrumental in bringing about a gradual and unnoticed decrease in the incidence of PCO. We strongly believe that the overall incidence of PCO and hence the incidence of Nd:YAG laser posterior capsulotomy is now rapidly decreasing - from 50% in the 1980s and early 1990s to less than 10% currently. Superior tools, surgical procedures, skills and appropriate IOL designs have all helped to significantly reduce this complication. In this article, we review the aetio pathogenesis, experimental and clinical studies and propose surgical and implant-related factors for PCO prevention. Careful application and utilisation of these factors by surgeons could lead to a significant reduction is secondary cataract, the second most common cause of visual loss worldwide
  30,391 4,035 34
Amplitude of Accommodation and its Relation to Refractive Errors
Lekha Mary Abraham, Thomas Kuriakose, Viswanathan Sivanandam, Nithya Venkatesan, Ravi Thomas, Jayaprakash Muliyil
April-June 2005, 53(2):105-108
DOI:10.4103/0301-4738.16173  PMID:15976465
Aims: To evaluate the relationship between amplitude of accommodation and refractive errors in the peri-presbyopic age group. Materials and Methods: Three hundred and sixteen right eyes of 316 consecutive patients in the age group 35-50 years who attended our outpatient clinic were studied. Emmetropes, hypermetropes and myopes with best-corrected visual acuity of 6/6 J1 in both eyes were included. The amplitude of accommodation (AA) was calculated by measuring the near point of accommodation (NPA). In patients with more than 2 diopter sphere correction for distance, the NPA was also measured using appropriate soft contact lenses. Results: There was a statistically significant difference in AA between myopes and hypermetropes ( P <0.005) and between myopes and emmetropes ( P <0.005) in the 35-39 year age group. In the 40- 44 year age group, there was a significant difference in AA between emmetropes and hypermetropes ( P <0.0001), emmetropes and myopes ( P <0.01) and hypermetropes and myopes ( P <0.0001). In patients above 45 years of age there was no significant difference ( P >0.5). Conclusion: Our study showed higher amplitude of accommodation among myopes between 35 and 44 years compared to emmetropes and hypermetropes
  29,142 1,243 17
Management of vitreous haemorrhage.
S Saxena, S Jalali, L Verma, A Pathengay
April-June 2003, 51(2):189-196
Vitreous hemorrhage is one of the most common differential diagnoses for sudden painless decrease in vision. Often, it is caused by retinal vascular disorders secondary to common systemic ailments such as diabetes mellitus, systemic hypertension and haematological abnormalities. Sometimes it may be the beginning of a retinal tear and consequent retinal detachment that can be vision threatening if not operated early. This paper lays out practical guidelines for a tailored approach needed to arrive at the aetiology of vitreous haemorrhage so that appropriate, timely treatment can be planned.
  27,931 1,488 2
Limbal stem cell deficiency : Concept, aetiology, clinical presentation, diagnosis and management.
HS Dua, JS Saini, A Azuara-Blanco, P Gupta
April-June 2000, 48(2):83-92
Defects in renewal and repair of ocular surface as a result of limbal stem cell deficiency are now known to cause varying ocular surface morbidity including persistent photophobia, repeated and persistent surface breakdown and overt conjunctivalisation of the cornea. Ocular conditions with abnormalities of ocular surface repair include pterygium, limbal tumours, aniridia, severe scarring following burns, cicatricial pemphigoid and Stevens-Johnson Syndrome, sequelae of mustard gas exposure and Herpes simplex epithelial disease, radiation keratopathy, contact lens induced keratopathy, neuroparalytic keratitis and drug toxicity. Restoring ocular health in these eyes has traditionally been frustrating. An understanding of these intricate cell renewal and maintenance processes has spurred the evolution in recent years of new treatment methods for several blinding diseases of the anterior segment; many more exciting modalities are in the offing. However, there is inadequate awareness among ophthalmologists about the current principles of management of ocular surface disorders. The purpose of this article is to help elucidate the important principles and current treatment methods relevant to ocular surface disorders.
  26,458 17 42
Orbital regional anesthesia: Complications and their prevention
CM Kumar
April-June 2006, 54(2):77-84
DOI:10.4103/0301-4738.25826  PMID:16770022
Serious complications following orbital regional anesthesia are rare, but occur following both needle and blunt cannula (sub-Tenon's) techniques. Each technique of orbital regional anesthesia has its own risk/benefit profile. This article reviews the etiology, risk factors, treatment and prevention of complications of commonly used akinetic orbital blocks. Ophthalmologists and ophthalmic anesthesiologists must be prepared to deal with rare, but serious complications, that can occur with any technique of orbital regional anesthesia.
  24,474 1,559 26
Retinal vein occlusion
Sohan Singh Hayreh
July-September 1994, 42(3):109-132
In this review of the retinal vein occlusion (RVO), I have summarized recent advances on several controversial and clinically important topics: classification of RVO into six distinct clinical entities; pathogeneses and demographic characteristics of various types of RVO; differentiation of non-ischemic from ischemic central retinal vein occlusion (CRVO); differentiation of hemi-CRVO (HCRVO) from major branch RVO (BRVO); and the course, complications and management of various types of RVO
  24,054 2 38
Finding the retinal break in rhegmatogenous retinal detachment
Sandeep Saxena, Harvey Lincoff
July-September 2001, 49(3):199-202
The development of subretinal fluid is governed by a limited number of anatomical factors and gravity. As a result, rhegmatogenous retinal detachments form in a predictable manner around the retinal break of their origin. The shape of the detachments points to the position of the break. The purpose of this review is to describe the characterstic contours of subretinal fluid in rhegmatogenous retinal detachments, and to highlight some rules and methodology which can help in the detection of the retinal break in phakic, psuedophakic and recurrent retinal detachments.
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Mooren's ulcer : Current concepts in management
VS Sangwan, P Zafirakis, CS Foster
January-March 1997, 45(1):7-17
Mooren's ulcer is strictly a peripheral ulcerative keratitis (PUK) with no associated scleritis. It occurs completely in absence of any diagnosable systemic disorder that could be responsible for the progressive destruction of the cornea. The aetiology of Mooren's ulcer remains uncertain. However, recent studies indicate that it is an autoimmune disease directed against a specific target molecule in the corneal stroma, probably triggered in genetically susceptible individuals by one of several possible provocateurs. Advances have been made in the management of this disease. Immunosuppressive therapy has been shown increasingly successful in patients unresponsive to conventional treatment and in bilateral progressive destructive ocular disease.
  22,571 2 -
Complications of laser-in-situ-keratomileusis
Mittanamalli S Sridhar, Srinivas K Rao, Rasik B Vajpayee, Murali K Aasuri, S Hannush, R Sinha
October-December 2002, 50(4):265-282
Laser-in-situ-keratomileusis (LASIK) has become a popular technique of refractive surgery because of lower postoperative discomfort, early visual rehabilitation and decreased postoperative haze. Compared to photorefractive keratectomy (PRK), LASIK involves an additional procedure of creating a corneal flap. This may result in complications related to the flap, interface and underlying stromal bed. The common flap-related complications include thin flap, button holing, free caps, flap dislocation and flap striae. The interface complications of diffuse lamellar keratitis, epithelial ingrowth and microbial keratitis are potentially sight threatening. Compared to PRK, there is less inflammation and faster healing after LASIK, but there is a longer period of sensory denervation leading to the complication of dry eyes. The refractive complications include undercorrection, regression, irregular astigmatism, decentration and visual aberrations. Honest and unbiased reporting is important to understand the aetiology and redefine the management.
  20,411 1,989 20
Management of ischemic optic neuropathies
Sohan Singh Hayreh
March-April 2011, 59(2):123-136
DOI:10.4103/0301-4738.77024  PMID:21350282
Ischemic optic neuropathies (IONs) consist primarily of two types: anterior ischemic optic neuropathy (AION) and posterior ischemic optic neuropathy (PION). AION comprises arteritic AION (A-AION: due to giant cell arteritis) and non-arteritic AION (NA-AION: due to other causes). PION consists of arteritic PION (A-PION: due to giant cell arteritis), non-arteritic PION (NA-PION: due to other causes), and surgical PION (a complication of several systemic surgical procedures). These five types of ION are distinct clinical entities etiologically, pathogenetically, clinically and from the management point of view. In the management of AION, the first crucial step with patients aged 50 and over is to identify immediately whether it is arteritic or not because A-AION is an ophthalmic emergency and requires urgent treatment with high-dose steroid therapy to prevent any further visual loss in one or both eyes. Patients with NA-AION, when treated with systemic corticosteroid therapy within first 2 weeks of onset, had significantly better visual outcome than untreated ones. Systemic risk factors, particularly nocturnal arterial hypotension, play major roles in the development of NA-AION; management of them is essential in its prevention and management. NA-PION patients, when treated with high-dose systemic steroid therapy during the very early stages of the disease, showed significant improvement in visual acuity and visual fields, compared to untreated eyes. A-PION, like A-AION, requires urgent treatment with high-dose steroid therapy to prevent any further visual loss in one or both eyes. There is no satisfactory treatment for surgical PION, except to take prophylactic measures to prevent its development.
  21,060 1,219 17
Complications of cataract surgery
Madhukar K Reddy
October-December 1995, 43(4):201-209
  22,154 1 -
Amplitude of accommodation in different age groups and age of on set of presbyopia in Bengalee population
DN Chattopadhyay, GN Seal
March-April 1984, 32(2):85-87
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Practical approach to diagnosis of strabismus
Ravi Thomas, Andrew Braganza, Thomas George
April-June 1996, 44(2):103-112
  21,870 1 -
Choroidal neovascular membrane
NS Bhatt, JG Diamond, S Jalali, T Das
April-June 1998, 46(2):67-80
Choroidal neovascular membrane in the macular area is one of the leading causes of severe visual loss. Usually a manifestation in elderly population, it is often associated with age-related macular degeneration. The current mainstay of management is early diagnosis, usually by fundus examination, aided by angiography and photocoagulation in selected cases. Various other modalities of treatment including surgery are being considered as alternate options, but with limited success. The purpose of this review is to briefly outline the current concepts and the management strategy from a clinician's viewpoint.
  21,786 9 -
Interpretation of computed tomography imaging of the eye and orbit. A systematic approach
Milind N Naik, Kishore L Tourani, G Chandra Sekhar, Santosh G Honavar
October-December 2002, 50(4):339-353
Computed tomography (CT) has revolutionised the diagnosis and management of ocular and orbital diseases. The use of thin sections with multiplanar scanning (axial, coronal and sagittal planes) and the possibility of three-dimensional reconstruction permits thorough evaluation. To make the most of this technique, users must familiarize themselves with the pertinent CT principles and terminology. The diagnostic yield is optimal when the ophthalmologist and radiologist collaborate in the radiodiagnostic workup. In this article we describe a systematic approach to the interpretation of ocular and orbital CT scans.
  19,542 1,842 4
Accommodative-convergence over accommodation (AC/A) ratio (in normal Indian subjects)
DK Sen, S.R.K Malik
December 1972, 20(4):153-157
  21,105 0 -
Physical and mechanical principles of phacoemulsification and their clinical relevance
L Yow, S Basti
October-December 1997, 45(4):241-249
A clear understanding of the physical and mechanical principles that govern phacoemulsification can facilitate usage of this technique for effective and efficient cataract removal in a variety of clinical situations. This article addresses separately, concepts pertaining to the three essential components of phacoemulsification, namely, irrigation, aspiration and emulsification. Machine settings are suggested for the various techniques presently in use. Finally, alternative approaches for lens removal that are currently being investigated are briefly discussed.
  21,005 0 -
Global variation and pattern changes in epidemiology of uveitis
SR Rathinam, P Namperumalsamy
May-June 2007, 55(3):173-183
DOI:10.4103/0301-4738.31936  PMID:17456933
Uveitis, a complex intraocular inflammatory disease results from several etiological entities. Causes of uveitis are known to vary in different populations depending upon the ecological, racial and socioeconomic variations of the population studied. Tropical countries are unique in their climate, prevailing pathogens and in the existing diseases, which further influence the epidemiological and geographical distribution of specific entities. We provide an overview of the pattern of uveitis of 15221 cases in 24 case series reported from several countries over 35 years (1972-2007) and we integrate it with our experience of an additional 8759 cases seen over six years (1996-2001) at a large community-based eye hospital. Uveitis accounted for 0.8% of our hospital-based outpatient visits. The uveitis was idiopathic in 44.6%, the most commonly identified entities in the cohort included leptospiral uveitis (9.7%), tuberculous uveitis (5.6%) and herpetic uveitis (4.9%). The most common uveitis in children below 16 years (616 patients; 7.0% of the total cohort) was pediatric parasitic anterior uveitis, (182 children, 29.5% of the pediatric cohort), whereas the most common uveitis in patients above 60 years (642 patients; 7.3% of the total cohort) was herpetic anterior uveitis, (78 patients, 12.1% of the elderly cohort). Etiologies varied with the age group of the patients. As in other tropical countries, a high prevalence of infectious uveitis was seen in this population.
  16,794 4,168 74
Pneumatic retinopexy: principles and practice
George F Hilton, Taraprasad Das, Ajit B Majji, Subhadra Jalali
July-September 1996, 44(3):131-143
Pneumatic retinopexy (PR) is an alternative to scleral buckling for the surgical repair of selected retinal detachments. A gas bubble is injected into the vitreous cavity, and the patient is positioned so that the bubble closes the retinal break (s), allowing absorption of the subretinal fluid. Cryotherapy or laser photocoagulation is applied around the retinal break(s) to form a permanent seal. The procedure can be done in an outpatient setting, and no incisions are required. A multicenter randomized controlled clinical trial has demonstrated that the anatomic success rate is comparable to scleral buckling, but the morbidity is significantly less with PR. If the macula was detached for less than two weeks, the visual results are significantly better with PR than with scleral buckling. Cataract surgery was required significantly more often following scleral buckling than following PR. Two independent reports have shown that an attempt with PR does not disadvantage the eye; such that the results of scleral buckling after failed PR are not significantly different than primary scleral buckling. A comprehensive review of the world literature on PR revealed 27 statistical series totaling 1,274 eyes. These combined series had a single-operation success rate of 80%, and 98% were cured with reoperations. Pneumatic retinopexy should be considered in cases without inferior or extensive retinal breaks and without significant proliferative vitreoretinopathy. The cost of buckling varies from 4 to 10 times that of PR.
  20,548 0 -
Speciation of Coagulase Negative Staphylococcus causing Bacterial Keratitis
P Manikandan, M Bhaskar, R Revathy, Rajesh K John, Kalpana Narendran, V Narendran
January-March 2005, 53(1):59-60
DOI:10.4103/0301-4738.15288  PMID:15829750
Thirty-five coagulase negative Staphylococcus (CoNS) cultured from corneal ulcer were speciated and antibiotic sensitvity tested. S epidermidis was the commonest isolate and it was sensitive to ampicilin and vanconycin.
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