Feb 25, 2019

Eyes - Vision Faculty

9 weeks old female baby treated for ROP
9 weeks old female baby treated for ROP

ROP is a problem with the way the blood vessels develop on the surface of the retina. When a baby is born prematurely these blood vessels are immature like the rest of the baby. In most premature babies the retinal blood vessels grow properly. In some premature infants the blood vessels start to grow the wrong way. Instead of branching like a tree the vessels link up side to side and in some cases grow away from the retina towards the centre of the eye. The severity of ROP is graded from stage one to stage five. Stage one is the mildest and stage five the most severe.

1. A 9 weeks female baby born in 31 weeks of gestation weighing 900 gms was reviewed on 26.11.2018 by Dr.Krishna R Murthy. The baby was diagnosed to have ROP Retinopathy of Prematurity (ROP) in stage 2 in zone 2 with early plus disease. The baby was advised for laser intervention to both eyes to avascular retina at the earliest. The baby underwent both eyes laser treatment on 01.12.2018. As on 14.01.2019 ROP has regressed in both eyes and the baby has been advised to review after 6 months with an Ophthalmologist locally.

 

 2. A 4 weeks female baby born in 28 weeks of gestation weighing 118 gms was on close follow-up for detection of ROP. The baby was administered antivegf injection when the baby was 13 weeks old. When the baby was reviewed in Dec 2018; increase in vessel tortuosity was noted and the baby was advised for laser intervention to both eyes to avascular retina. The baby underwent both eyes laser treatment on 12.12.2018. As on 28.01.2019 ROP has regressed in both eyes and the baby has been advised to review after 2 weeks.

 

 3. A 5 weeks female baby twins born in 29 weeks of gestation weighing 1100 and 1300 gms were evaluated on 29.12.2018; The babies were diagnosed to have ROP in stage 2 in zone 2 with plus disease. The babies were advised for laser intervention to both eyes to avascular retina. The babies underwent both eyes laser treatment on 02.01.2019. As on 16.02.2019 ROP has regressed in both eyes in both babies and are doing well.

All babies are in embrace nest

twin babies treated for ROP
twin babies treated for ROP
4 weeks old baby treated for ROP
4 weeks old baby treated for ROP
Feb 13, 2019

Eyes - Symbolic sense organ

child operated for congenital cataract
child operated for congenital cataract

Healthy eyes and vision are a critical part of child development. Signs that a child may have vision problems include constant eye rubbing, extreme light sensitivity, poor focusing, poor visual tracking (following an object) abnormal alignment or movement of the eyes (after 6 months of age) chronic redness of the eyes, chronic tearing of the eyes, a white pupil instead of black. Regular eye exams can detect and correct this and other vision problems.

CONGENITAL CATARACT: cataract present at birth.

A 7 months old female child was seen by us in the month of August 2018; the baby was under treatment for Down’s syndrome and congenital heart disease. Down syndrome is a chromosomal condition that is associated with intellectual disability, a characteristic facial appearance, and weak muscle tone (hypotonia) in infancy. Children with Down syndrome have an increased risk of developing several medical conditions and have an increased risk of hearing and vision problems. On examination the baby was able to follow light well in all directions. The baby was diagnosed to have calcified cataract with Nystagmus. Nystagmus is a vision condition in which the eyes make repetitive, uncontrolled movements. The child was advised for BOTH EYES CATARACT EXTRACTION + ANTERIOR VITRECTOMY + PARSPLANA CAPSULOTOMY UNDER GENERAL ANAESTHESIA. The child underwent the surgery on 21.12.2018.

CORNEAL SCAR: Injury to cornea - The cornea is the eye’s outermost layer. It is the clear, dome­shaped surface that covers the front of the eye. It plays an important role in focusing our vision. The cornea and lens of the eye are built to focus light on the retina, which is the light-sensitive tissue at the back of the eye. When light strikes the cornea, it bends—or refracts—the incoming light onto the lens. The lens refocuses that light onto the retina, which starts the translation of light into vision. Minor injuries or scratches, the cornea usually heals on its own. Deeper injuries can cause corneal scarring, resulting in a haze on the cornea that impairs vision.

An 11 yrs old boy was presented to us with the above condition He came to us with diminution of vision in left eye; his visual acuity in left eye was counting fingers at ½ mtr distance. Anterior segment examination showed corneal scar which necessitated surgical intervention of LEFT EYE KERATOPLASTY UNDER GENERAL ANAESTHESIA. The child underwent the surgery on 07.01.2019. As on 07.02.2019; the child is doing well, his visual acuity in left eye is counting fingers at 2 mtr distance.

CONGENITAL GLAUCOMA: Congenital glaucoma is a developmental glaucoma that results from the abnormal development of the aqueous drainage structure, characterized by an elevated intra-ocular pressure, enlargement of globe (buphthalmos), corneal edema and optic nerve cupping.

A 14 yr old boy has been under our care and management for congenital glaucoma since 2011. The child has undergone multiple surgical interventions to retain the vision in the only Seeing Eye – right eye. On follow-up on 07.01.2019; the intraocular pressure (IOP) in right eye was 34 mmHg which is a sight threatening condition. The child was advised to undergo RIGHT EYE AADI (AUROLAB AQUEOUS DRAINAGE IMPLANT) UNDER GENERAL ANAESTHESIA. The child underwent the same on 31.01.2019. As on 07.02.2019; IOP is well controlled and his visual acuity is counting fingers at 2.5 mtr.

operated for congenital glaucoma
operated for congenital glaucoma
operated for corneal scar
operated for corneal scar
Nov 28, 2018

Power of perception

ROP stage 2 eye fundus photo
ROP stage 2 eye fundus photo

In the womb, the retina (the light sensitive surface at the back of the eye that converts images into nerve signals that the brain understands) develops slowly and the retinal blood vessels often only complete growing by the end of gestation. ROP occurs when a baby is born too early to have reached an important milestone in the development of their eyes. It is not passed on from parents to children. The blood vessels that supply this blood usually develop between weeks 16 and 36 of pregnancy. If a child is born prematurely these blood vessels can grow abnormally causing damage to the retina and baby’s vision.

1. A 12 weeks male baby born in 28 weeks of gestation weighing 1000 gms was evaluation on 19.09.2018 by Dr.Krishna R Murthy. The baby was diagnosed to have ROP Retinopathy of Prematurity (ROP) in stage 3 in zone 1 with early plus disease. The baby was advised for laser intervention to both eyes to avascular retina at the earliest. The baby underwent both eyes laser treatment on 22.09.2018. As on 22.10.2018 ROP has regressed in right eye and vitreous haemorrhage in noted in left eye, the baby has been advised to review at base hospital for left eye retinal evaluation at the earliest.

2. A 7 weeks male baby born in 28 weeks of gestation weighing 800 gms was evaluated on 22.10.2018; The baby was under treatment for Respiratory distress syndrome & neonatal jaundice. The baby was kept in the isolation ward for treatment. The fundus photos showed presence of ROP in stage 2 in zone 2 with plus disease. The baby was advised for laser intervention to both eyes to avascular retina. The baby underwent both eyes laser treatment on 31.10.2018. As on 12.11.2018 ROP has regressed in both eyes.

3. A 3 weeks old male baby (Twin 1) born in 31 weeks of gestation weighing 1850 gms was seen on 27.10.2018. The baby was diagnosed to have ROP Retinopathy of Prematurity (ROP) in stage 3 in zone 2 with early plus disease. The baby was advised for laser intervention to both eyes to avascular retina at the earliest. The baby underwent both eyes laser treatment on 31.10.2018. As on 17.11.2018 ROP has regressed and is advised to review after 1 week.

Regressed ROP post laser
Regressed ROP post laser
ROP Stage 3
ROP Stage 3
 
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