Dr. Somiya Siddiqui
Resident, VDGMC Latur
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Cataract Refractive › Complicated cataract surgery
Posterior Polar Cataract
Daljit Singh classification of posterior polar cataract: Type 1: PPC associated with posterior subcapsular cataract. Type 2: Round or oval discoid opacity with a ringed appearance like an onion with or without grayish spots at the edge. Type 3: Round or oval discoid opacity sharply defined with dense white spots at the edge often associated with weak, thin, or absent posterior capsule. The white dense spots are a diagnostic sign (Daljit Singh sign) of posterior capsule rupture or extreme thinning. Type 4: Combination of the above 3 types with nuclear sclerotic cataract
Cornea › Vernal keratoconjunctivitis (VKC)
Horner tranta Dots in VKC
Horner-Trantas dots are small, chalky-white or yellowish spots that form at the border of the cornea and the sclera (the limbus). They are a classic sign of Vernal Keratoconjunctivitis (VKC). They Are Made Of Dead and dying surface cells from the eye (epithelial cells), White blood cells, eosinophils and Cellular debris from immune reactions
Ocular Trauma › Eyelid laceration
Complete thickness lower lid tear
Canalicular trauma refers to physical injury that results in damage to the canaliculus, part of the lacrimal drainage system of the eye. The lacrimal canaliculi are located within the medial aspect of the eyelid. This area is unlike the rest of the eyelid because it does not contain a tarsal substructure. Therefore, a force which displaces the eyelid from its strong attachment at the medial canthal tendon, lacrimal, and maxillary bone, tend to cause avulsion in the medial aspect of the eyelid. Canalicular lacerations are identified by direct observation of a laceration medial to the punctum or by probing (usually with a Bowman probe or irrigation cannula) of the canalicular system. Canalicular laceration may not be obvious on presentation, but should always be suspected in cases from dog bites or with medial eyelid injury. In young children, an examination under anesthesia with dilation and probing may be necessary to make the diagnosis. Severe medial laceration with lateral displacement of the medial canthus alerts the physician to obvious underlying lacrimal system damage. The proximal end of the laceration is easily identifiable with the use of a Bowman probe, but the distal/nasal portion of the canaliculus is often more difficult to identify. The surgeon begins by cleaning the wound and looking for white circular tissue within the pink area of orbicularis muscle. If this is not identified easily, fluorescein or air may be injected via a 27 gauge cannula into the opposite punctum. The surgeon may then observe dye appearance or bubbles (when the nasal canaliculus of interest is submerged) emanating from the nasal portion of the canaliculus.
Cornea › Bacterial keratitis
Central leucomatous Corneal Opacity
Corneal leukoma is also known as corneal opacity. The causes of corneal leukoma can be diverse and may include: Infections: Bacterial, viral, or fungal infections, such as corneal ulcers or herpes simplex virus keratitis, can lead to corneal leukoma. Injuries: Trauma to the cornea, such as penetrating or chemical injuries, can cause scarring and corneal opacification. Inflammation: Conditions like uveitis, ocular cicatricial pemphigoid, or Stevens-Johnson syndrome can result in corneal inflammation and subsequent leukoma formation. Congenital Disorders: Genetic disorders like congenital glaucoma, congenital hereditary endothelial dystrophy, or congenital rubella syndrome may lead to corneal leukoma from birth. Degenerative Conditions: Corneal dystrophies, such as Fuchs endothelial dystrophy or lattice corneal dystrophy, can cause progressive corneal opacification over time.
Oculoplasty › Ptosis
Blepharophimosis-Ptosis-Epicanthus Inversus Syndrome.
Blepharophimosis syndrome (BPES), which stands for blepharophimosis, ptosis, epicanthus inverse syndrome, is a rare genetic disorder primarily affecting eyelid development, resulting in a distinct facial appearance. The syndrome is characterized by: Telecanthus: Increased distance between the inner corners of the eyes Ptosis: Drooping of the upper eyelid Epicanthus inversus: Upward fold of skin near the inner corner of the eye BPES is classified into 2 types.The 4 traditional clinical signs—telecanthus, epicanthus inversus, ptosis, and blepharophimosis—are present in every form. Type I is linked to early ovarian failure. Only the traditional facial traits define type II.
Cornea › Penetrating keratoplasty (PK)
Penetrating Keratoplasty
Penetrating keratoplasty (PKP) or optical penetrating keratoplasty (OPK) is a technique of performing full-thickness corneal transplantation where a diseased cornea is removed and replaced with a healthy and viable donor corneal button. Eduard Konrad Zirm was the first to perform a solid organ corneal transplant in 1905. He successfully completed the first full-thickness corneal transplant. Penetrating Keratoplasty Types Tectonic: To restore the anatomical integrity of the globe Therapeutic/ reconstructive: To eliminate the infective load from the eye Cosmetic: Keratoplasty is done to remove the corneal opacity Optical: Keratoplasty is done to restore vision
Glaucoma › Lens-induced glaucoma
Phacomorphic Glaucoma
Lens-induced glaucoma represents a group of secondary glaucomas caused by alterations in lens position, integrity, or permeability that disrupt normal aqueous humor dynamics and acutely elevate intraocular pressure. Clinical presentation often includes sudden ocular pain, decreased vision, headache, nausea, and conjunctival injection, although manifestations vary by underlying mechanism. Phacomorphic mechanism (intumescent lens) As a cataract matures, osmotic changes cause the lens to swell. The increased lens volume pushes the iris anteriorly, narrows the anterior chamber angle, and produces a relative pupillary block. This culminates in acute angle-closure glaucoma, often associated with severe pain, corneal edema, and markedly elevated IOP