LRR Proff 3 Ophtha

CATARACT
TYPES OF CONGENITAL CATARACT

CAUSES OF ECTOPIA LENTIS
ACQUIRED:
1.TRAUMA
2. BUPHTHALMOS
3. HIGH MYOPIA
4.HYPERMATURE NUCLEAR SCLEROTIC CATARCT
5. CHRONIC UVEITIS
CONGENITAL
TYPES OF IOL
A 65 years old male with a history of an uneventful
cataract surgery right eye, 6 months ago, with good
post-operative visual recovery, has now presented
with painless progressive diminution of vision in the
right eye. Answer the following questions: What is
the diagnosis List the early and late post-operative
complications of cataract surgery.f Describe in detail
the etiopathogenesis, clinical features and
management of any one of these.
PEROPERATIVE :
1. PC TEAR : WITH OR WITHOUT VITREOUS LOSS [CME,

RD,ENDOPHTHALMITIS ,GLAUCOMA ]
2. SUPRACHOROIDAL HAEMORRHAGE : ;LEAD TO EXPULSIVE
HAEMORRHAGE
3. UGH SYNDROME
4. DM DETACHMENT
ACUTE POSTOPERATIVE
1. SHALLOW AC : LEAK OR PB GLAUCOMA
2. ENDOPHTHALMITIS : PURULENT INFLAMMATION

OF INTRAOCULAR FLUIDS
CHRONIC POSTOPERATIVE
1. LATE ONSET ENDOPHTHALMITIS :
2. AFTER CATARACT
3. CME
4. REFRACTIVE SURPRISE
LENS INDUCED GLAUCOMA
1. PHACOLYTIC
2. PHACOMORPHIC
3. PHACOTOXIC
4. PHACOANAPHYLACTIC
5. PHACOTOPIC
GLAUCOMA
VISUAL FIELD DEFECTS IN POAG
Q A 5 yrs old boy suffering from Protein Energy
malnutrition weighing 12 Kg came to OPD with
mother complains of dry and lusterless eye with
white foamy triangular patch on the inter palpebral
area of both eyes. What is your Probable diagnosis?
What are the clinical features and management of
this condition?
Xerophthalmia
Q What are the clinical features, types and
management of Vernal keratoconjunctivitis ?
C/F AND MX OF PTERYGIUM
IRIDOCYCLITIS
ETIOLOGY :
MC : IDIOPATHIC
1. INFECTIOUS : TB,SYPHILIS,HERPES ,
LEPROSY
2. NON-INFECTIOUS : SARCOIDOSIS ,
BEHCETS ,ARTHRITIS, DRUG INDUCED .
3. MASQUERADE SYNDROME : RB,
MELANOMAS
SYMPATHETIC OPHTHALMITIS
Q How will you evaluate a case of epiphora in an adult
and treat. ?
• REGURGITATION TEST
• SYRINGING : HARD STOP OR SOFT STOP
• HARD STOP :
SALINE REACHES THROAT : PATENT, PUNCTAL
STENOSIS OR LACRIMAL PUMP FAILURE OR PARTIAL
OBSTRUCTION .
DOES NOT REACH : NLD OBSTRUCTION :

REGURGITATION FROM BOTH PUNCTA
LAYERS OF CORNEA
BACTERIAL KERATITIS
FUNGAL KERATITIS
CORNEAL OPACITIES
SIGNS OF KERATOCONUS
• ANTERIOR LAMELLA : SKIN , SUBCUTANEOUS TISSUE .
ORBICULARIS OCULI
• POSTERIOR LAMELLA : TARSAL PLATE WITH RETRACTORS

[LPS AND MULLERS ] , LOWER LID RETRACTORS AND
CONJUNCTIVA
ACCOMODATION
ACCOMODATION
Q Define hypermetropia. Discuss its clinical features
and management
Clinical features of hyperopia
Clinical features
1. Asthenopic symptoms like headache and pain and eye

strain due to increased use of accomdation. If
accommodation is sufficient then no symptoms .
2. Blurring of both near and distance in large
hypermetropia
3. Recurrent stye or chalazion
• O/E:
• 1. Shorter axial length
• 2. Small cornea / Shallow AC/ Normal lens : hence

risk of PACG
3. Retina :Short-Silk Retina [ peculiar sheen ]
4. Small disc with blurred disc margin: pseudopapillitis

Hypermetropia
• Most common refractive error.
TYPES
• Axial : Decreased axial length
• Curvature: Flat cornea[increased radius of curvature]
• Index: Decreases physiologically in old age
• Positional: Posterior dislocation of lens
]
• Index: Decreases physiologically in old age
• Positional: Posterior dislocation of lens
O/E
1. In children it can lead to esotropia : Accomodative
Convergent Squint : it is due to dissociation of
convergence and accomdation leading to muscle
imbalance’
2. Pseudomyopia
• Specks
• Contact lens
• IOLs
• Refractive surgeries
• O difficulty
1. Long eye:
2. AC: deep
3. Absence of stimulus to accommodation leads to atrophy of the
ciliary muscles
4. Thin sclera
5. Retinal changes in Pathological Myopia
• Axial Myopia: In increased axial length
• Curvature Myopia: In increased curvature of the
cornea[decreased radius of curvature]
• Index Myopia: When refractive index is increasing as in
nuclear sclerosis
• Positional Myopia: More power if lens is dislocated
anteriorly
• Specks
• Contact lens
• Refractive Surgeries
QA man was hit on his right eye by cricket ball while
playing. On examination his vision was 6/6 both eyes.
He had binocular diplopia and periorbital ecchymosis
with crepitus in right eye. Answer the followng
questions: What type of ocular trauma he
encountered Two causes of diplopia probable in
this patient Two other clinical signs likely in this
patient Four causes of decreased vision following
blunt trauma to eye How will you manage this
patient
BLUNT TRAUMA
RETINITIS PIGMENTOSA
ROP
STAGES OF ROP
DR : FUNDUS PICTURE
CAUSES OF CHERRY RED SPOT
PUPILLARY PATHWAY
Orbital cellulitis
SHORT NOTES
CAUSES OF NYCTALOPIA
1. XEROPHTHALMIA
2. RP
3. HIGH MYOPIA
4. LATE STAGE OF POAG
5. CONGENITAL STAIONARY NB
6. CHOROIDAL DYSTROPHIES
COMPLICATIONS OF ANTERIOR
UVEITIS
1.COMPLICATED CATARACT
2. SECONDARY GLAUCOMA
3. CME
4. BSK
5. HYPOTONY
6. PTHISIS BULBI
PTHISIS BULBI
• Phthisis bulbi is an clinical condition representing end-stage ocular response to severe
eye injury or disease
• Retinoblastoma
• Choroidal melanoma
• Trauma
• Chemical injury —alkali burn
• Radiation
• Infections
• Keratitis
• Endophthalmitis
• Panophthalmitis
• Chronic retinal detachment
• Postoperative
SYNDROMES ASSOCIATED WITH
CATARACT
1. DOWNS SYNDROME
2. LOWES SYNDROME
3. CONGENITAL RUBELLA SYNDROME
4. GALACTOSEMIA
5. WILSONS DISEASE
6. NF2
CHALCOSIS
INDICATIONS OF PARACENTESIS
1. Management of uveitis
2. Emergency treatment in APAC
3. After intravitreal injections
PIN HOLE TEST
ACTION AND USES OF ATROPINE
Its an anti cholinergic . Inhibitor of muscarinic action

of Ach. Cycloplegia and Mydriasis
Uses :
1. Retinoscopy
2. Treatment of lazy eye : penalisation
3. Treatment of anterior uveitis
WHAT IS LASER ? TWO USES OF
NdYAG ?
• LIGHT AMPLIFICATION BY THE STIMULATED
EMISSION OF RADIATION .
SUBCONJUNCTIVAL HAEMORRHAGE
CAUSES OF VITREOUS
HAEMORRHAGE
1. DR
2. Trauma
3. RD
4. PVD
5. Eales ds
6. Sickle cell anemia
7. Blood Dyscrasias
SAFE STRATEGY
AMBLYOPIA
TESTS FOR DRY EYE
USES OF FLOURESCEIN
1. Corneal abrasions and ulcers
2. Goldmann perimetry
3. Siedel test
4. BUT test
5. Staining in dry eye
6. jones dye test
CAUSES OF LEUKOCORIA
HUTCHISONS SIGN
CHALAZION
CHALAZION OPERATION
NODULAR SCLERITIS
LASIK
FUNCTIONS OF EYE BANK
It is A non profit community organization which deals

with the collection , storage , & distribution of cornea
for the purpose of corneal grafting , research &
supply of the other eye tissues for the other purpose.
THE FUTURE IS CREATED THROUGH OUR ACTIONS IN
THE PRESENT MOMENT. IF YOU LOOSE TODAY , WIN
TOMORROW. IN THIS NEVER ENDING SPIRIT OF
CHALLENGE IS FOUND THE HEART OF THE VICTOR.

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CATARACT

TYPES OF CONGENITAL CATARACT

1. PC TEAR : WITH OR WITHOUT VITREOUS LOSS [CME,

2. ENDOPHTHALMITIS : PURULENT INFLAMMATION

DOES NOT REACH : NLD OBSTRUCTION :

• POSTERIOR LAMELLA : TARSAL PLATE WITH RETRACTORS

1. Asthenopic symptoms like headache and pain and eye

• 1. Shorter axial length

• 2. Small cornea / Shallow AC/ Normal lens : hence

3. Retina :Short-Silk Retina [ peculiar sheen ]

4. Small disc with blurred disc margin: pseudopapillitis

3. CONGENITAL RUBELLA SYNDROME

Its an anti cholinergic . Inhibitor of muscarinic action

It is A non profit community organization which deals

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