Actions are divided into three types Primary, secondary and tertiary.
1) Through diagram.
2) Trick: Recti muscles are adductors
1) Diagram off course!
2) Trick: Superior muscles are Intorters and inferior muscles are extorters.
Since my mom first introduced me to the slit lamp view of the eye and dad to the indirect ophthalmoscopy, I developed a liking for ophthalmology. The magnified view of the eye through the slit lamp just looks 'oh so beautiful' and it's such a fun challenge to master indirect ophthalmoscopy- I didn't think much in the counselling room while 'locking' the MS Oph option. Also, the fact that you have to work with all the cool gadgets and gizmos, lasers and stuff made me incline towards it.
Ophthalmology is a mutifaceted branch. Those who are into diagnostics and literature get their own share as well as those who want to take matters into their own hands and like to cut,paste, and remove things. The puzzle of diagnosis and the thrill of surgery, both can be had here.
Though not as demanding as general medicine or surgery, ophthalmic surgeries like cataract have a steep learning curve,a personal opinion of mine. But when you make sure that all the things fall into places rightly, it is highly satisfying an experience. The patient's smile the next day when they see clearly feels so good to the heart.
Experience in residency varies per college. I for one am happy with mine. I have done a few basic surgeries like pterygium and dacryocystectomy independently but under supervision during my first year itself. Currently, I'm working on tunnel making in cataract surgery.
I have seen a lot of interesting cases of lids, cornea, and the fundus.
At times though, performing sac syringing of every pre op patient and filling up of discharge cards of the post op patients makes me go meh. But this is just nitpicking, I have a fair idea about the extreme workload of redundant stuff in other colleges.
After passing out, there are many fellowship programs offered by institutions. Getting a fellowship done is sort of a norm nowdays.
As mentioned before, this is an investment intensive branch, one needs to continually upgrade their machines and bring in new ones
if interested in establishing a privately owned set up. A job in an institution can be an option but things may get pushy or so I've heard.
Summing it up, this is like a cute little baby who is rather tough to please, but when you get it right, the smile is priceless.
Sequels of corneal ulcer perforation :
"SILICA PAPA"
S- Subluxation of lens
I - Iris prolapse
L- Leucoma
I - Intraocular haemorrhage
C- Corneal fistula
A- Adherent Leucoma
P- Phthisis bulbi
A- Anterior synechiae
P- Purulent infection
A- Anterior Staphyloma
Thank you :)
~Pratheek Prabhu
Complications of corneal ulcer - "DEPICT"
D- Descemetocele
E- Ectatic cicatrix ( Keratectasia )
P- Perforation
I - Inflammatory glaucoma
C- Corneal scarring
T- Toxic iridocyclitis
Thank you :)
~ Pratheek Prabhu
Differential diagnosis of neonatal cloudy cornea - "STUMPED"
S-Sclerocornea
T-Tear in Descemet's membrane
U-Ulcer
M-Metabolic condition
P-Posterior corneal defect
E- Endothelial dystrophy
D-Dermoid
Thank you :)
~Pratheek Prabhu
Courtesy :- Comprehensive Ophthalmology 6th edition ; AK Khurana ; Pg.314 |
Sl . no
|
Site of lesion
|
Type of lesion
|
1
|
Optic nerve
|
Complete blindness on ipsilateral side
|
2
|
Anterior Chiasma
|
Junctional scotoma
|
3
|
Central chiasma
|
Bitemporal hemianopia
|
4
|
Lateral chiasma
|
Binasal hemianopia
|
5
|
Optic tracts / LBG
|
Incongruous homonymous hemianopia
|
6
|
Part of optic radiations in temporal lobe
|
Superior quadrant hemianopia (pie in sky )
|
7
|
Part of optic radiations in parietal lobe
|
Inferior quadrant hemianopia (pie on floor )
|
8
|
Optic radiations
|
Complete homonymous hemianopia
|
9
|
Visual cortex sparing macula
|
Congruous homonymous hemianopia
|
10
|
Visual cortex , only macula
|
Congruous homonymous macular defect
|
11
|
Bilateral Visual cortex , only macula
|
Bilateral homonymous macular defect
|
Here are some fun facts about Ocular Toxoplasmosis and HIV!
Ocular toxoplasmosis usually causes a retinal lesion with inflammation, giving the classical "headlight in the fog" appearance.
Headlight is the lesion and the fog is due to the inflammation (WBCs).
HIV being an immunodeficient condition, there are lesser number of WBCs and hence there's no fog - Just the headlight.
The drug of choice for treatment of ocular toxoplasmosis is pyrimethamine.
However, it is contraindicated in pregnancy and HIV due to the risk of megaloblastic anemia and neural tube defects, respectively.
In pregnancy, spiramycin is preferred.
In HIV, the preferred drugs are clindamycin, azithromycin or quinolones.
- Written by Dr²
Latanoprost increases the uveoscleral outflow of the aqueous humor. Pilocarpine has a constrictive effect on the ciliary body as a whole. Hence, when the two are used together, their effects end up getting nullified with the physician bungling to achieve the target IOP.
That's all!
-Sushrut Dongargaonkar