Nov 20, 2019

vision therapy

treated with laser for pre retinal haemorrhage
treated with laser for pre retinal haemorrhage

The eye works as a camera. The front of the eye has the lens, which focuses on an image, and the pupil, works like a camera shutter to control how much light enters the eye. 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. When babies are born early, the blood vessels that feed the retina usually haven’t finished growing. In ROP, blood vessels swell and overgrow in the light-sensitive layer of nerves in the retina at the back of the eye. These vessels actually stop growing for a time, and then begin growing abnormally and randomly. The new vessels are fragile and can leak, leaving the retina scarred. In the worst-case scenario, the retina detaches (tears away from the back wall of the eye) and puts the baby at high risk of becoming blind. 

  1. A 7 weeks male baby born in 27 weeks of gestation weighing 960 gms was seen on 16.10.2019 by Dr.Krishna R Murthy. Eye fundus photos of the baby showed absence of ROP. The baby was reviewed on 30.10.2019 eye fundus pictures of the baby showed presence of ROP in both eyes in stage 2 in zone 2 (The zone indicates where the disease is located & Zone 2 covers the middle of the retina) with plus disease. The baby was advised of laser intervention to both eyes (Laser therapy burns away the area around the edge of the retina, which has no normal blood vessels). The baby underwent laser treatment on 07.11.2019. As on 20.11.2019 the baby is doing well; ROP has regressed.

 

  1. An 8 weeks male baby born in 28 weeks of gestation weighing 1600 gms was seen on 04.11.2019 by Dr.Krishna R Murthy. Eye fundus photos of the baby showed presence of ROP in both eyes in stage 2 in zone 2 in right eye and in left eye ROP in stage 3 with pre retinal haemorrhage (Neovascularization extends from the ridge into the vitreous). The baby was advised of laser intervention to both eyes. The baby underwent laser treatment on 04.11.2019. As on 20.11.2019 the baby is doing well; ROP has regressed; left eye vitreous haemorrhage is resolving.
fundus image of pre retinal haemorrhage
fundus image of pre retinal haemorrhage
7 weeks male baby treated with laser
7 weeks male baby treated with laser
Nov 11, 2019

Eyes - Window to world

5 mn old baby operated for developmental cataract
5 mn old baby operated for developmental cataract

To prevent blindness children's vision screenings are an accurate, cost-effective way to find vision problems in children. Children rarely understand if something is wrong with them. Unless they are hurt or ill, most of the times they tend to be reckless and disregard any safety measures to keep themselves out of trouble. Eyes are extremely delicate and any damage to them could not be treated as easily as you think. Children eye care is an essential thing. Rather than reactive, taking proactive measures is essential to prevent vision problems and ensuring a trouble-free childhood. Eyes are our window to the world and children gain a lot of information by just observing and seeing everything around them.

1. DEVELOPMENTAL CATARACT:

A 5 month old male baby was evaluated at our hospital on 20.08.2019 by Dr.Bhargavi Murali (vitreo-retinal consultant) and Dr.Seema A V (paediatric Ophthalmology consultant). During visual acuity examination the baby was unable to fix and follow light in both eyes. Anterior segment examination showed white reflex in pupillary area in both eyes. The child was diagnosed to have developmental total cataract in both eyes. A cataract is any light scattering opacity of the lens. The majority of bilateral congenital or infantile cataracts not associated with a syndrome have no identifiable cause. Genetic mutation is likely the most common cause. If the cataract is felt to be visually significant, surgical intervention is the only option. The timing of surgery is critical for visual development. The child was advised to undergo BOTH EYES LENSECTOMY + ANTRIOR VITRECTOMY + POSTERIOR CAPSULOTOMY UNDER GENERAL ANAESTHESIA. The child underwent right eye surgery on 06.09.2019 and left eye on 17.10.2019. As on 04.11.2019 the child is doing well and is able to fix and follow light in both eyes. The child has been advised for glasses checkup.

 

2. STRABISMUS - Misalignment of eyes: It is a disorder in which the eyes don't look in exactly the same direction at the same time. Causes of strabismus can include nerve injury or dysfunction of the muscles controlling the eye. Crossed eyes can usually be corrected with early treatment. Several treatment options exist to align the eyes. They include special eye wear, use of an eye patch and surgery.

A 4 year old male child was seen at our hospital on 22.08.2019 by paediatric Ophthalmologist. On examination the child’s parents informed of noticing squinting since 10 months of age. The child was diagnosed to have alternating esotropia. Alternating esotropia is a lazy eye condition which allows fixating with either eye, but not at the same time. A surgery will help to fuse the image of both eyes. The child was advised to undergo BOTH EYES SQUINT CORRECTION SURGERY UNDER GENERAL ANAESTHESIA. The child underwent the suggested surgery on 11.10.2019. As on 04.11.2019 the child is doing well and glasses has been suggested.

5 mn old baby 2nd eye operated
5 mn old baby 2nd eye operated
4 yr old boy before squint surgery
4 yr old boy before squint surgery
4 yr old boy post squint surgery
4 yr old boy post squint surgery
Oct 2, 2019

Retina - The Image Sensor

31 yr old male operated with Vitrectomy
31 yr old male operated with Vitrectomy
  1. Background

     

    A 31 yr old male gentleman was seen at our hospital on 15.07.2019 by Dr.Bhagya. He was treated elsewhere for infective retinitis with topical and systemic medications but with no significant improvement. His left eye vision was progressively deteriorating and he presented with visual acuity of counting fingers close to face in left eye and in right eye was 6/18. Anterior segment examination showed fibrin membrane in pupillary area. Fundus examination showed dense vitritis in right eye and with no view in left eye. He was advised for some special blood investigation and was maintained on topical steroid management. Even with topical steroid management his visual acuity in left eye still deteriorated to hand movements close to face. He was advised for RIGHT EYE VITRECTOMY + ANTERIOR CHAMBER VITREOUS TAP FOR FUNGAL, HISTOPATHOLOGY AND KOH GREAM STAIN INVESTIFATIONS + INTRAVIT ANTIBIOTIC AND ANTIFUNGAL INJECTIONS UNDER LOCAL ANAESTHESIA.

    Surgical Management:

    After undergoing all preliminary investigations (physical fitness) he was posted for surgery on 26.07.2019 @ 02:30pm. The operating team consisted of Dr.Krishna R Murthy & Dr.Bhargavi Murali – Operating surgeons, Dr.Anusha – Assistant Doctor, Mr.Suresh - Surgery Assistant, Dr. Raghavendra – Anesthetist, and OT Assistants- Mr.Muthuraju & Mr.Anilkumar. The anterior chamber tap was sent to outsourced lab for the required investigations.The anterior chamber tap came positive for pan fungal genome and he was treated with multiple doses of antifungal intravitreal injections. He was also sent for systemic evaluation to rule out systemic vasculities.

    The surgery lasted for 1 hr 15 min. He was discharged on 27.07.2019 with an advice to follow all medications and to review after 1 week. He was on regular and close follow-up post surgery. His visual acuity started improving gradually and as on 25.09.2019; he is doing fine and his visual acuity in right left eye is 6/6.

    Uveitis is the inflammation of the uvea, the pigmented layer that lies between the inner retina and the outer fibrous layer composed of the sclera and cornea. Iridocyclitis is an inflammation of the iris (the colored part of the eye) and of the ciliary body (muscles and tissue involved in focusing the eye.

    He and his family are dependent on the produce from the agricultural land. He owned around 1 acre of agricultural land on which he used to reap Jowar and millet. Since past 3 years he had been running around to eye hospitals for his eye problem. The expenses of the investigations forced him to sell some portion of his agricultural land. He was very much depressed due to uncertain treatment and management done till now and due to his deteriorating vision he was unable to earn and support the family. Relatives and friends pitched in with some financial support and they guided him to our hospital.

    He is very happy with the improvement in his vision and he is able to carry on his regular work activities. He thanked the entire team for the outcome.

     

 
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