Jul 26, 2021

Retina - enables vision

55 yr old operated for retinal detachment
55 yr old operated for retinal detachment

A 55 yr old gentleman vide MRD # 119612 was seen at our hospital in the month of February 2021. On examination he complained of diminution of vision in both eyes since many years. He is a known hypertensive since 20 yrs on treatment. He had taken retinal laser treatment elsewhere and lost follow-up due to covid 19. His visual acuity in both eyes was presence of perception of light in both eyes. Anterior segment examination showed presence of cataract in both eyes. Fundus examination showed vitreous haemorrhage with retinal detachment in both eyes. He was advised to undergo cataract surgery in left eye followed by surgical intervention for retinal detachment.

 

He underwent left eye cataract surgery on 09.02.2021. when he was reviewed on 26.02.2021; eye was quiet and cornea was clear and IOL was in place. He was advised to undergo LEFT EYE VITRECTOMY + ENDOLASER + FLUID GAS EXCHANGE + MEMBRANE PEELING + SILICONE OIL INJECTION UNDER LOCAL ANAESTHESIA.

 

Surgical Management:

After undergoing all preliminary investigations (physical fitness) he was posted for surgery on 02.03.2021 @ 02:00 pm. The operating team consisted of Dr.Vinaya Kumar K – Operating surgeon, Dr.Manasi – Assistant Doctor, Mr.Umesh - Surgery Assistant, Dr. Naveen – Anesthetist, and OT Assistants- Mr.Mahadevaswamy & Mr.Samuel Dennis.

 

The surgery lasted for 2 hrs. He was discharged on 03.03.2021 with an advice to maintain strict prone position for 13-14 hrs a day for 3 weeks and review after 1 week. As on 30.03.2021; he is doing well and retina is ON and has been advised to review after 2 weeks. His visual acuity in left is counting fingers at 2 mtr distance.

 

He is basically a flower vendor. He supports his sister in this work. He is satisfied with the surgery outcome and is happy that he is able to extend his helping hands to his sister who is a caretaker.

Jun 11, 2021

Prevention therapy

baby treated for APROP
baby treated for APROP

Premature babies are the number-one risk group for retinopathy of prematurity. In general, the smaller and more premature the infant, the more likely he or she is to develop ROP, and the more likely to need treatment. The eye functions like camera. At the back of the eye is the retina: Like film in the camera, this layer of nerve tissue is necessary to record the information that’s coming in and allow the brain to “develop” it into an image. In premature babies the blood vessels that feed the retina usually haven’t finished growing. ROP occurs when these vessels actually stop growing for a time, and then begin growing abnormally and randomly

 

 A 15 weeks male baby (twin 1st) born in 29 weeks of gestation weighing 1060 gms was reviewed on 25.12.2020 by Dr.Krishna R Murthy. The baby was administered antivegf injection (Antivegf is the use of medications that block vascular endothelial growth factor) to both eyes in the month of November 2020 for APROP (APROP-Aggressive Posterior ROP). On follow-up eye fundus photos of the baby showed presence of ROP in stage 3 in zone 2 in both eyes with plus disease. The baby was advised for laser treatment to both eyes.

In stage 3 ROP the abnormal blood vessels grow toward the center of the eye instead of following their normal growth pattern along the surface of the retina.

 

The baby underwent laser treatment on 08.01.2021.

Jun 7, 2021

Eye - powerful symbol

9 months old child operated for medial coloboma
9 months old child operated for medial coloboma

 

Learning disabilities are another concern with school-age children. Vision problems are common among school-age kids. In this age group children have vision problems that, if left untreated, can affect their learning ability, personality and adjustment in school. School-age children also spend a lot of time in recreational activities that require good vision but playing outside or participating in a team sport may not be as fun if the child faces vision problem. Frequent eye exams are important to identify eye ailments in children.

1. Traumatic Cataract

A 13 year old female child was seen at our hospital on 10.02.2021 by Dr.Vandana Sayra, Consultant & Surgeon - Cornea & General Ophthalmology Services. On examination the child’s father gave a history of trauma to her right eye 5 days ago while tearing a piece of cloth which hit her right eye while doing so. The child did not inform the parents out of fear. When her right eye became red ; her parents noticed and purchased eye drops in pharmacy and instilled to her right eye; when the redness did not subside and the child complained of dimness of vision; parents consulted eye doctor nearby where she was advised surgery.Her visual acuity in right eye was presence of projection of rays and hand movements close to face. Anterior segment examination showed cortical matter in anterior chamber with anterior capsule breach, + traumatic cataract. Bscan was done to assess the status of retina; the scan findings showed retina ON. The child was advised to undergo RIGHT EYE CATARACT EXTRACTION + ANTERIOR VITRECTOMY+ 3PIECE INTRAOCULAR LENS IMPLANTATION UNDER GENERAL ANAESTHESIA

The child underwent the same on 11.02.2021 and as on 27.03.2021 she is doing well and her visual acuity is 6/12, ph 6/9.

 2. Medial Coloboma with lipodermoid

 A 9 months old male child with Goldenhar syndrome was seen at our hospital 06.04.2021 by Dr. Smitha- Squint and Orbit surgeon. Goldnhar syndrome is a craniofacial syndrome, which means that it causes certain abnormalities in the formation of the face and head. It is considered a rare disease and a congenital one, meaning it is present at birth. In people with Goldenhar syndrome, abnormalities appear mostly in the areas of the ears, eyes, and spine. This condition can also affect the structure of the face, and some internal organs. The most recognizable symptom is the presence of facial abnormalities, in particular hemifacial microsomia. These occur when the bones and muscles in the face are underdeveloped on just one side of the face. Those with Goldenhar may also have a cleft lip or cleft palate. Other characteristics of the syndrome include defects in the eyes, ears, and spine. This can mean growths on the eyes, small eyes, missing eyelids, small ears, missing ears, ear tags, or even hearing loss. A dermoid is an overgrowth of normal, non-cancerous tissue in an abnormal location. Dermoids occur all over the body. The ones in and around the eye are usually comprised of skin, hair, and/or fat. The child was advised for upperlid reconstruction + lipodermoid excision + amniotic membrane + tisseal glue under general anaesthesia.

The child underwent the surgery on 07.04.2021.

13 yr old operated for traumatic cataract
13 yr old operated for traumatic cataract
 
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