Dr. Amit Agarwal

Fellow, Kbhb

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Cataract Refractive › Complicated cataract surgery

Incomplete Dislocation of a Rigid PMMA IOL into the Anterior Chamber

Partial displacement of a rigid polymethyl methacrylate (PMMA) intraocular lens into the anterior chamber, with potential for corneal endothelial damage, inflammation and secondary glaucoma.

Glaucoma › Glaucoma medications

Reticular Corneal Epithelial Edema

Rare adverse effect of ROCK inhibitors (netarsudil/ripasudil) characterized by a distinctive honeycomb or reticular pattern of corneal epithelial edema.

Glaucoma › Malignant glaucoma

Malignant Glaucoma

Slit-lamp examination showing flat peripheral anterior chamber (Van Herick grade 1) with markedly shallow central anterior chamber depth, characteristic of malignant glaucoma.

Strabismus › Esotropia

Accommodative Esotropia

Upper image shows right eye esotropia; lower image demonstrates correction of the deviation with full hyperopic correction.

Glaucoma › Pigmentary glaucoma

Krukenberg Spindle

Vertical, spindle-shaped deposition of pigment on the corneal endothelium, characteristic of pigment dispersion.

Ocular Trauma › Blunt trauma

Vitreous in Anterior Chamber with Hyphema

Vitreous prolapse into the anterior chamber associated with intraocular bleeding, suggesting disruption of the posterior capsule or zonular support.

Glaucoma › Primary open-angle glaucoma

Progression of Glaucomatous Optic Neuropathy

Progressive optic disc cupping with increasing neuroretinal rim thinning and corresponding loss of retinal nerve fibre layer.

Glaucoma › Pseudoexfoliation glaucoma

Pseudoexfoliation Material on IOL

Whitish, flaky pseudoexfoliative material deposited over the intraocular lens, consistent with pseudoexfoliation syndrome.

Glaucoma › Trabeculectomy

Trabeculectomy Bleb

Elevated, diffuse filtering bleb following trabeculectomy, indicating subconjunctival aqueous filtration.

Retina Vitreous › Macular hole

Vitreomacular traction

OCT macula showing VMT causing increased foveal thickness, distorted contour, intraretinal cystic spaces and traction

Oculoplasty › Blepharitis

Anterior Blepharitis

Crusty scales with matting of eyelashes seen.

Cataract Refractive › Complicated cataract surgery

Retained cortex post msics surgery

Slit lamp photo showing retained cortex post msics surgery. Post operative day 1. Patient was treated by oral and topical steroids.

Anatomy Optics › Iris and ciliary body anatomy

Persistent pupillary membrane

Persistent pupillary membrane represents remnants of anterior tunica vasculosa lentis. Embryologically, the iris forms as a solid sheet of mesodermal tissue known as the pupillary membrane. It is composed of vessels derived from anterior ciliary arteries and mesenchyme and lies ventral to the lens. The dorsal posterior hyaloid vessels anastomose with the network of vessels in the pupillary membrane to form tunica vasculosa lentis which provides nutrition to the lens. The pupillary membrane undergoes regression aided by macrophage phagocytosis in the sixth month and disappears completely by the eighth month of gestation. A failure of resorption of pupillary membrane leads to persistent pupillary membrane.

Cataract Refractive › Complicated cataract surgery

ACIOL

Anterior chamber intraocular lens with quiet anterior chamber following msics surgery. Pupil is oval with a well-placed lens with haptics in Z-orientation.

Ocular Trauma › Hyphema

Hyphaema

The clinical image depicts a vertically oriented clotted hyphaema within the anterior chamber.