Slit Lamp profile of Pseudoexfoliation eyes

2021 ◽  
Vol 12 (3) ◽  
pp. 66-69
Author(s):  
Shilpi Kapoor ◽  
Arjit Kapoor ◽  
Dinesh Gupta
Keyword(s):  
Intraoperative Complications ◽  
Pseudoexfoliation Syndrome ◽  
Slit Lamp ◽  
Slit Lamp Examination ◽  
Pupillary Dilatation ◽  
Medical College ◽  
Age Related ◽  
Department Of Ophthalmology ◽  
D 12 ◽  
Operative Assessment

Background: Pseudoexfoliation syndrome is an age-related systemic microfibrillopathy, caused by progressive accumulation and gradual deposition of extracellular grey and white material over various tissues. It is associated with many intraocular abnormalities like poor pupillary dilatation, zonular dehiscence, glaucoma etc. Hence it is important to do detailed slit lamp examination with dilated pupil to detect the pseudoexfoliative deposits in eye, especially in elderly to prevent unforeseen complications. Aims and Objective: To study pattern of distribution of pseudoexfoliative material in eyes with pseudoexfoliation syndrome and to study the dilatation profile of pupil in such eyes. Materials and Methods: This observational study was conducted on patients with pseudoexfoliation syndrome who attended OPD in the Upgraded Department of Ophthalmology, Government Medical College, Jammu from 1st April 2018 for a period of 6 months. The clearance was taken from ethical committee for the study in reference. Informed consent was taken from all the patients enrolled in the study. Results: Pupillary margin was found to be the most common site for deposition of pex material i.e. 51 (75%) patients followed by anterior surface of lens in 32(47.05%) patients. Patients had simultaneous deposition of pex material over various parts of the eye. 64 (94.12%) patients had pex material deposited on pupil or lens. Only 1(1.47%) patient had pex deposits over cornea. 56 (82.35%) patients attained good to moderate dilatation of pupil with 0.8% tropicamide e/d. 12(17.65%) patients had pupillary dilatation of ≤4mm hence poor dilatation. Conclusion: Pseudoexfoliation presents challenges that must be adequately addressed with detailed slit lamp examination. Cases may go undetected due to failure to dilate the pupil or to examine with slit lamp after dilatation. Adequate pre-operative assessment should especially be done before cataract surgery with the aim to identify problems like the possibility of fragile zonules and inadequate mydriasis which could increase intraoperative complications arising from undue manipulations.

scholarly journals Intraoperative and postoperative complications of phacoemulsification in cataract eyes with pseudoexfoliation syndrome

2017 ◽  
Vol 145 (3-4) ◽  
pp. 124-128
Author(s):  
Aleksandar Veselinovic ◽  
Marija Cvetanovic ◽  
Zoran Milosevic ◽  
Dragan Veselinovic
Keyword(s):  
Postoperative Complications ◽  
Pupil Diameter ◽  
Intraoperative Complications ◽  
Corneal Edema ◽  
Significant Rise ◽  
Pseudoexfoliation Syndrome ◽  
Control Group ◽  
Ophthalmological Examination ◽  
Age Related ◽  
Systemic Disorder

Introduction/Objective. Pseudoexfoliation syndrome (PEX) is an age-related systemic disorder characterized by deposition of fibrillary white flaky material mainly on the lens capsule, corneal endothelium, zonules, ciliary body, iris, and pupillary margin. Zonular weakness progressively increases along with the hardness of the lens, patient?s age, and the presence of glaucoma. The objective of the study is to compare the intraoperative and postoperative complications of phacoemulsification in cataract eyes with PEX with cataract eyes without PEX. Methods. The study enrolled 300 eyes with consequently operated senile cataract and PEX and 300 consequently operated eyes with cataract without PEX who underwent phacoemulsification performed by one experienced surgeon (single-surgeon series). A complete ophthalmological examination of all patients was performed preoperatively, as well as on the first, seventh, and 180th day postoperatively. Results. Significant statistical differences between the observed groups were the following: patients with PXF were older (74.2 ? 8; range 56?82 years vs. 68.1 ? 9.6; range 56?79 years), had smaller pupil diameter, and higher intraocular pressure (IOP) preoperatively (16.1 ? 4.1 vs. 13.8 ? 3.7 mmHg). There were no differences between the groups regarding intraoperative complications. Early postoperative complications were a significant rise of IOP (33 vs. six patients; p < 0.001), more frequent postoperative corneal edema (36 vs. 21 patients; p < 0.036), and anterior chamber inflammation (17 vs. seven patients; p < 0.037) in the PEX group, comparing to the control group. The significant late postoperative complication was elevated IOP (24 vs. five patients; p < 0.0002) in patients with PEX. Conclusion. In the hands of an experienced and careful surgeon, phacoemulsification is a safe and beneficial surgery to treat cataract with associated pseudoexfoliation. The greatest problem a surgeon faces is a narrow pupil and zonule instability, and difficulty in recognizing eyes that are particularly at risks, such as those having glaucoma and phacodonesis.

scholarly journals Genetic testing for Mendelian cataract

2017 ◽  
Vol 1 (s1) ◽  
pp. 66-69
Author(s):  
Andi Abeshi ◽  
Alessandra Zulian ◽  
Tommaso Beccari ◽  
Munis Dundar ◽  
Lucia Ziccardi ◽  
...  
Keyword(s):  
Clinical Utility ◽  
Scientific Literature ◽  
Genetic Test ◽  
Age Of Onset ◽  
Clinical Findings ◽  
Insufficient Data ◽  
Ophthalmological Examination ◽  
Slit Lamp ◽  
Slit Lamp Examination ◽  
Age Related

Abstract We studied the scientific literature and disease guidelines in order to summarize the clinical utility of the genetic test for Mendelian cataract (MC). MC is caused by variations in the AGK, BFSP1, BFSP2, CHMP4B, CRYAA, CRYAB, CRYBA1, CRYBA2, CRYBA4, CRYBB1, CRYBB2, CRYBB3, CRYGC, CRYGD, CRYGS, EPHA2, EYA1, FYCO1, FOXE3, FTL, GALK1, GCNT2, GJA3, GJA8, HSF4, LEMD2, LIM2, LSS, MAF, MIP, NHS, PITX3, PAX6, SIPA1L3, SLC16A12, TDRD7, UNC45B, VIM, VSX, and WFS1 genes. The overall prevalence of congenital forms is 71 per 100 000, whereas there is insufficient data to determine the prevalence of the juvenile and age-related forms. Clinical diagnosis is based on clinical findings, age of onset, family history, ophthalmological examination and slit-lamp examination. The genetic test is useful for confirming diagnosis, and for differential diagnosis, couple risk assessment and access to clinical trials.

scholarly journals Outcome and Complications of Phacoemulsification Combined with Pars Plana Vitrectomy

2021 ◽  
Vol 15 (5) ◽  
pp. 1051-1053
Author(s):  
Ali Zain Ul Abidin ◽  
Munib Ur Rehman ◽  
Shahid Mahmood Dayal
Keyword(s):  
Retinal Detachment ◽  
Pars Plana Vitrectomy ◽  
Intraoperative Complications ◽  
Treatment Modalities ◽  
Medical College ◽  
Vitreoretinal Disease ◽  
Department Of Ophthalmology ◽  
Pars Plana ◽  
Male Patients ◽  
Medical Histories

Aim: To determine the outcomes of phacoemulsification also examine the complications associated to phacoemulsification combined with pars plana vitrectomy. Study design: Observational study Place and duration of study: Department of Ophthalmology, Khawaja Muhammad Safdar Medical College, Allama Iqbal Memorial Teaching Hospital, Sialkot, from 15th July 2020 to 14thJanuary 2021. Methodology: Twenty patients of both genders whom had undergoing phacovitrectomy were included. Patient’s ages were ranging from 20 to 80 years. Patient’s detailed medical histories were examined after taking informed consent. Patient’s retinal diagnosis, intraocular pressure, visual acuity, intra and post-operative complications were recorded. All the patients had received clear corneal phacoemulsification and 23-guage pars plana vitrectomy. Results: There were 15(75%) male patients while 5(25%) female patients with mean age was 54.52±12.45 years. Five patients (25%) had vitreos hemorrhage, 7(35%) patients had rhegmatogenous retinal detachment, 3(15%) patients had intraocular foreign body, 2(10%) had epiretinal membrane, 2(10%) had macular hole and 1(5%) had tractional retinal detachment. Miosis and rupture of posterior capsule were the most common intraoperative complications found in 85% and 10%. Fibrin was found in 3 (15%) cases, posterior synechia was found in 2 (10%) cases. Conclusion: The phacoemulsification with pars plana vitrectomy is safe and effective treatment modalities in patients with cataract coexist with vitreoretinal disease. Keywords: Phacoemulsification, Pars plana vitrectomy, Cataract, Complications, Outcomes

Age related volume of cadaver-prostates in Bangladesh

1970 ◽  
Vol 4 (2) ◽  
pp. 74-77
Author(s):  
Rukshana Ahmed ◽  
Shamim Ara
Keyword(s):  
Prostate Gland ◽  
Age Groups ◽  
Clinical Settings ◽  
Cross Sectional ◽  
Medical College ◽  
Age Related ◽  
Group A ◽  
Key Words Prostate ◽  
The Mean ◽  
Group B

Pathological changes in the prostate gland occur commonly with advancing age including inflammation, atrophy, hyperplasia and carcinoma and a change in volume is also evident. Estimation of volume of prostate may be useful in a variety of clinical settings. A cross-sectional descriptive study was designed to see the changes in volume of the prostate with advancing age and done in the Department of Anatomy, Dhaka Medical College, Dhaka from August 2006 to June 2007. The study was performed on 70 post-mortem human prostates collected from the unclaimed dead bodies that were under examination in the Department of Forensic Medicine, Dhaka Medical College, Dhaka. The samples were divided into three age groups; group A (10-20 years), group B (21-40 years) and group C (41-70 years). Volume of the sample was measured by using the ellipsoid formula. The mean ± SD volume of prostate was 7.68 ± 3.64 cm3 in group A, 10.61 ± 3.99 cm3 in group B and 15.40 ± 6.31 cm3 in group C. Mean difference in volume between group A and group C, group B and group C were statistically significant (p<0.001). Statistically significant positive correlation was found between age and volume of prostate (r = + 0.579, p < 0.001). Key Words: Prostate; volume; Bangladeshi. DOI: 10.3329/imcj.v4i2.6501Ibrahim Med. Coll. J. 2010; 4(2): 74-77

Late-onset malignant glaucoma

2020 ◽  
Vol 3 ◽  
pp. 1
Author(s):  
Ramiro José Daud ◽  
Horacio Freile ◽  
Mauricio Freile ◽  
Soledad Mariano
Keyword(s):  
Intraocular Pressure ◽  
Case Report ◽  
Acute Pain ◽  
Late Onset ◽  
Slit Lamp ◽  
Normal Range ◽  
Slit Lamp Examination ◽  
Complete Occlusion ◽  
Malignant Glaucoma ◽  
The Right

A case report on a 49-year-old female with diagnoses of ocular hypertension in her left eye (LE) treated with 250 mg/day acetazolamide for 2 years. During the slit-lamp examination, complete occlusion of both iridocorneal angles was detected. Intraocular pressure (IOP) was 10 and 35 mmHg in the right eye and LE, respectively. Phacotrabeculectomy was performed in the LE. After 1 month of the procedure, the patient developed a slowly progressive miopization from −1 to −3 diopters (D) the following months. Approximately 3 months after surgery, the patient developed an episode of acute pain, athalamia, and IOP 45 mmHg in her LE. Late-onset malignant glaucoma was suspected and the patient was treated with topical hypotensive and cycloplegic agent until a prompt vitrectomy was performed. Deepening of the anterior chamber and restoration of IOP to normal range was obtained after surgery.

Study on Knowledge and Prevalence of Computer Vision Syndrome among Computer Operators in Nobel Medical College Teaching Hospital, Biratnagar, Nepal

2020 ◽  
Vol 9 (2) ◽  
pp. 45-49
Author(s):  
Pramod Sharma Gautam ◽  
Uday Chandra Prakash ◽  
Subreena Dangol
Keyword(s):  
Computer Vision ◽  
Teaching Hospital ◽  
Human Life ◽  
College Teaching ◽  
Extended Period ◽  
Visual Display ◽  
Work Place ◽  
Medical College ◽  
Computer Vision Syndrome ◽  
Department Of Ophthalmology

Background: The eye and vision related problems that results from continuous use of computers and other visual display terminals for extended period of time leads to computer vision syndrome. Due to rapid digitalization in human life, the risk of developing it has also increased in many folds. So, with an aim of determining the prevalence and level of awareness of computer vision syndrome among computer users along with their attitude and practices to prevent it, this study was conducted in the office employees who use computer for a considerable period of time. Materials and Methods: A hospital based observational descriptive study was conducted in the out-patient department of Ophthalmology in Nobel Medical College and Teaching Hospital, Biratnagar, where 105 employees working in different work stations of same institution were enrolled. A questionnaire and the clinical findings were used to collect data. Results: About 80% of the employees were using computer for about (8-11) hours per day. Prevalence of computer vision syndrome noted was (92.4%) with low level of knowledge (85.7%) about it. About 45% of them wore glasses for their refractive errors but attitude and practices in work place to prevent the bad effects of using visual display terminals were found to be lacking (53.3%). Burning sensation in the eye, headache, ocular irritation and itching and neck, shoulder or back pain were the common symptoms. Around (60-70)% of the eyes tested positive for dry eye. Conclusion: Lack of awareness of computer vision syndrome and lack of personal protective measures were associated with its high level of prevalence.  

scholarly journals Identification of a Novel Missense KRT12 Mutation in a Vietnamese Family with Meesmann Corneal Dystrophy

2020 ◽  
Vol 11 (1) ◽  
pp. 120-126
Author(s):  
Pham Ngoc Dong ◽  
Le Xuan Cung ◽  
Tran Khanh Sam ◽  
Do Thi Thuy Hang ◽  
Doug D. Chung ◽  
...  
Keyword(s):  
Sanger Sequencing ◽  
Novel Mutation ◽  
Family Members ◽  
Corneal Dystrophy ◽  
Slit Lamp ◽  
Slit Lamp Examination ◽  
Corneal Epithelial ◽  
Epithelial Phenotype ◽  
History Of ◽  
Characteristic Features

Meesmann epithelial corneal dystrophy (MECD) is a rare dominantly inherited disorder that is characterized by corneal epithelial microcysts and is associated with mutations in the keratin 3 (KRT3) and keratin 12 (KRT12) genes. In this study, we report a novel mutation in the KRT12 gene in a Vietnamese pedigree with MECD. Slit-lamp examination was performed on each of the 7 recruited members of a Vietnamese family to identify characteristic features of MECD. After informed consent was obtained from each individual, genomic DNA was isolated from saliva samples and screening of KRT3and KRT12 genes was performed by Sanger sequencing. The proband, a 31-year-old man, complained of a 1-year history of eye irritation and photophobia. Slit-lamp examination revealed intraepithelial microcysts involving only the corneal periphery in each eye with clear central corneas and no stromal or endothelial involvement. Three family members demonstrated similar intraepithelial microcysts, but with diffuse involvement, extended from limbus to limbus. Sanger sequencing of KRT3 (exon 7) and KRT12 (exons 1 and 6) in the proband revealed a novel heterozygous KRT12 variant (c.1273G>A [p.Glu425Lys]) that was present in the three affected family members but was absent in the three family members with clear corneas. This study is the first report of a Vietnamese family affected with MECD, associated with an atypical peripheral corneal epithelial phenotype in the proband and a novel mutation in KRT12.

scholarly journals Severe Corneal Morphological Alterations after Excimer Laser Surface Ablation for a High Astigmatism

2021 ◽  
pp. 492-496
Author(s):  
Anna M. Roszkowska ◽  
Giovanni W. Oliverio ◽  
Giuseppe A. Signorino ◽  
Mario Urso ◽  
Pasquale Aragona
Keyword(s):  
Excimer Laser ◽  
Corneal Stroma ◽  
Corneal Topography ◽  
Laser Surface ◽  
Slit Lamp ◽  
Slit Lamp Examination ◽  
Morphological Alterations ◽  
Surface Ablation ◽  
Confocal Images

We report long-term alterations of anterior corneal stroma after excimer laser surface ablation for a high astigmatism. The patient claimed progressive visual loss in his right eye (RE) during the last 3 years after bilateral laser-assisted subepithelial keratectomy (LASEK) surgery. His examination comprised visual acuity (UDVA and CDVA), slit-lamp examination, corneal topography and tomography, AS-OCT, and confocal microscopy. The UDVA was 0.1 in his RE and 1.0 in the left eye. The CDVA in the RE was 0.8. The slit-lamp examination showed a stromal lesion in the inferior paracentral corneal zone, with multiple vertical tissue bridges and severe thinning. Corneal topography and tomography showed central flattening with inferior steepening and severe alteration in elevation maps. AS-OCT showed void areas in the anterior stroma with thinning of the underlying tissue, and confocal images were not specific. In this case, progressive corneal steepening and thinning that manifest topographically as inferior ectasia occurred in correspondence to the singular stromal alterations after LASEK.

Progressive multifocal leukoencephalopathy in a patient with occult hypogammaglobulinemia experiencing bilateral visual impairment

2021 ◽  
pp. 112067212199053
Author(s):  
Sameera Hettipathirannahelage ◽  
Sidath Wijetilleka ◽  
Hugh Jewsbury
Keyword(s):  
Progressive Multifocal Leukoencephalopathy ◽  
Visual Impairment ◽  
Demyelinating Disease ◽  
Parietal Lobe ◽  
Previous History ◽  
White Matter Lesions ◽  
Slit Lamp ◽  
Slit Lamp Examination ◽  
History Of ◽  
Ishihara Test

Introduction: Progressive multifocal leukoencephalopathy (PML) is a rare, lethal, demyelinating disease classically seen in profoundly immunosuppressed individuals. It is caused by intracerebral infection by John Cunningham polyomavirus (JCV). We report a rare case of PML in a man with presumed immunocompetence at presentation experiencing bilateral painless visual impairment. Case Description: A 60-year-old man with a 3-week history of bilateral painless visual impairment attended our ophthalmology department. Unusually, he navigated around the room well and was able to read 4 of 13 Ishihara test plates in spite of a best-corrected visual acuity of counting fingers at 1 m bilaterally. Slit lamp examination, routine blood tests and optical coherence tomography (OCT) of the maculae and discs were unremarkable. Diffuse hyperintense white matter lesions on T2-weighted magnetic resonance imaging of the brain and detection of JCV within the parietal lobe tissue obtained by biopsy confirmed PML. Additional investigations identified an underlying hypogammaglobulinaemia, which may have initiated PML. He received intravenous immunoglobulin but passed away 2 months after diagnosis. Conclusions: To our knowledge this case is one of only a handful worldwide to describe PML developing in a patient with presumed immunocompetence at presentation – there was no previous history of recurrent, chronic, or atypical infections. There has only been one other report of visual symptoms presenting as the primary complaint. The case illustrates the importance of ruling out organic, central nervous system pathology in patients presenting with visual loss and normal objective visual function tests such as slit lamp examination and OCT.

scholarly journals Phaco-nucleotomy techniques in management of pseudoexfoliation syndrome

2017 ◽  
Vol 8 (2) ◽  
pp. 144-150 ◽  
Author(s):  
Amol Bansal ◽  
K. P.S. Malik ◽  
V. K. Malik ◽  
Kirti Jain
Keyword(s):  
Intraoperative Complications ◽  
Divide And Conquer ◽  
Pseudoexfoliation Syndrome ◽  
Extracellular Material ◽  
Ocular Tissues ◽  
Operative Complications ◽  
Pupil Constriction ◽  
The Mean ◽  
Almost All ◽  
Systemic Condition

Introduction: Pseudoexfoliation syndrome is a common clinically important systemic condition characterized by the pathological production and accumulation of an abnormal fibrillar extracellular material in many intraocular and extra ocular tissues. Many studies have shown that pseudoexfoliation syndrome patients have higher rates of intraoperative complications during cataract surgery compared to the patients without it. Objectives: To compare Phaco-chop and Divide and Conquer techniques of phacoemulsification, in the management of pseudoexfoliation syndrome in terms of intraoperative complications. Materials and methods: It is a hospital based prospective study of 90 patients with cataract and pseudoexfoliation syndrome attending ophthalmology outpatient department in our hospital. Results: The mean age of patients in the study was 61.7 years with equal number of unilateral and bilateral cases. Intra operative complications noted in vertical chopping technique was only pupil constriction in 6.7%, no other complications were seen in this technique, whereas in horizontal chopping, 13.3% had pupil constriction, 6.7% had difficulty in chopping, 3.3% had zonular dehiscence and 3.3% had posterior capsular rent . In divide and conquer technique 16.7% had pupil constriction, 10% had difficulty in trenching, 3.3% had posterior capsular rent. Almost all the patients (97.8%) were implanted with intraocular lens after employment of various surgical modifications. Conclusion: Vertical chopping techniques scores over horizontal chopping and divide and conquer technique of phacoemulsification with good surgical outcome because of less complications. 

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