Dr. Sneha R
Senior Resident, Hosur
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Cornea › Keratoconus
Moderate to Advanced keratoconus
Corneal shape: Clear ectatic pattern with asymmetric steepening K readings: Kmax ≈ 53.2 D (significantly steep → abnormal) Km ≈ 48.7 D Astigmatism ≈ 2.6 D Corneal thickness: Thinnest pachymetry ≈ 388 µm → markedly thin Thinning is central/paracentral, consistent with keratoconus Elevation maps: Anterior elevation ~ +15 µm (abnormal) Posterior elevation up to ~ +29 µm (strong ectatic sign)
Retina Vitreous › Central serous chorioretinopathy
Cscr
The scan shows a clear, fluid-filled pocket separating the neurosensory retina from the underlying retinal pigment epithelium (RPE) OCT (Optical Coherence Tomography) OCT-The first-line investigation. Key findings include: 1. Subretinal fluid (SRF) — the hallmark of CSCR; resolution can be tracked on serial OCT 2. Fibrin deposits — occasional band-like deposits in the subretinal space 3. Outer retinal dipping/sagging — may touch the RPE or a PED; its location often correlates with the leak site 4. Chronic changes — intraretinal cystic changes, hyperreflective dots, and elongated photoreceptor outer segments 5. Choroidal findings (pachychoroid spectrum) — EDI-OCT shows a thickened choroid (in both affected and fellow eyes), dilated outer choroidal vessels, and choriocapillaris thinning 6. PED — commonly seen, often adjacent to areas of choroidal hyperpermeability on ICGA 7. Double-layer sign — occasionally seen in chronic CSCR, though more typical of polypoidal choroidal vasculopathy (PCV); ICGA helps distinguish the two, as both lie on the pachychoroid spectrum 8. Hyperreflective outer retinal dots — correspond to tiny white dots seen on ophthalmoscopy
Oculoplasty › Eyelid tumors
Sebaceous gland carcinoma
Sebaceous gland tumor of the eyelids may arise from the meibomian glands, glands of Zeis or glands associated with the caruncle. They are included in the list of tumors of the epidermal appendages, so-called adnexal skin structures. On one hand it can mimic as benign lesion as blepharoconjunctivitis, whereas on the other extreme it can have widespread local and fatal distant metastases Two important features differentiate sebaceous carcinoma from other periocular malignancies. First, unlike single origin of other tumors, sebaceous carcinoma appears to arise from multifocal origins. Second, unlike radial spread of basal cell and SCCs, SGC tends to spread superficially in a pattern known as pagetoid spread. Surgical treatment may range from a local excision to orbital exenteration. Radical surgical excision with frozen section control by either a standard method or Moh’s micrographic surgery is the most common and effective method of treatment. The wound edges should be approximated as far as possible. Approximately, 30% of SGCs recur after resection.
Glaucoma › Pseudoexfoliation glaucoma
Nuclear sclerosis 3-4 with pseudoexfoliation
age-related systemic syndrome that targets mainly ocular tissues through the gradual deposition of fibrillary white flaky material from the lens, mainly on the lens capsule, ciliary body, zonules, corneal endothelium, iris and pupillary margin