BHJ

IS A ROUTINE EYE CHECK-UP NECESSARY?(THE EYE - A WINDOW TO OUR HEALTH)

Sonali Sontakke, Asmita Sakle, Mayur R. Moreker

Is a Routine Eye Check-up Necessary?(The Eye - a Window to Our Health)

[Year:2019] [Month:October] [Volume:61 ] [Number:4] [Pages No:240-243]


ABSTRACT


While we, the authors of this article, cannot be always sure whether ""the eyes are the window to the soul"" in every human being, we are a hundred percent sure that the eyes are a window to one's health. This is true because a routine eye examination may at times reveal medical conditions not obvious elsewhere; because the first signs of disease may, at times appear in the eye. Right from birth, till almost the last breath of life, a comprehensive eye check-up may clench a systemic diagnosis, corroborate a particular diagnosis, help in differential diagnosis, assist in management or be useful in prognosticating a systemic condition. This holds true for all clinical specialties / super-specialties of medicine.

OUR PATIENT'S EYES ARE RED: IS IT COMPUTER VISION SYNDROME? (COMPUTER VISION SYNDROME)

Neepa Dave, Jyoti Dodhi, Trupti Khaladkar, Sahil Mhatre, Nagendra Shah

Our Patient's Eyes are Red: Is it Computer Vision Syndrome? (Computer Vision Syndrome)

[Year:2019] [Month:October] [Volume:61 ] [Number:4] [Pages No:244-247]


ABSTRACT


A red eye is the most common ocular disorder that primary care physicians encounter. Redness also has a significant cor-relation with gadget use e.g. Computers. Computers are probably one of the biggest scientific inventions of the modern era and they have become an integral part of our life. The increased use of computers has led to variety of ocular symptoms which include redness, eyestrain, tired eyes, blurred vision and diplopia collectively referred as Computer Vision Syndrome (CVS). CVS may have a significant impact not only on visual comfort but also occupational productivity since between 64% and 90% of computer users experience visual symptoms after prolonged computer use.

OUR PATIENT'S EYES ARE RED: IS IT A CONTACT LENS RELATED INFECTION? (CONTACT LENS RELATED MICROBIAL KERATITIS)

Asmita Sakle, Paresh Marathe, Shilpa Moreker, Mayur R. Moreker, Tanuj Sharma, Rashmikant Patel

Our Patient's Eyes are Red: Is it a Contact Lens Related Infection? (Contact Lens Related Microbial Keratitis)

[Year:2019] [Month:October] [Volume:61 ] [Number:4] [Pages No:248-251]


ABSTRACT


Treatment of corneal infections needs to be aggressive to achieve control of infection and also associated ocular inflammation.
It requires

  • Objective identification of the microorganism responsible for the infection
  • Use of appropriate anti-microbial in adequate dose and frequency

OUR PATIENT'S EYES ARE RED: IS IT JUST A CONJUNCTIVITIS OR A COMPLEX DISORDER LIKE OCULAR CICATRICIAL PEMPHIGOID? (OCULAR CICATRICIAL PEMPHIGOID - CLINICAL FEATURES FOR DIAGNOSIS)

Tanuj Sharma, Mayur R. Moreker

Our Patient's Eyes are Red: Is It Just a Conjunctivitis or a Complex Disorder Like Ocular Cicatricial Pemphigoid? (Ocular Cicatricial Pemphigoid - Clinical Features for Diagnosis)

[Year:2019] [Month:October] [Volume:61 ] [Number:4] [Pages No:252-256]


ABSTRACT


Red eye is a common presenting complaint in ambulatory practice. A small percentage of these patients need ophthalmological referral and treatment, although the vast majority can be treated by the primary care clinician.

OUR PATIENT'S EYES ARE RED: IS IT A MANIFESTATION OF A SYSTEMIC DISEASE? (UVEITIS AND SCLERITIS CAN HERALD A SYSTEMIC DISEASE)

Mayur R. Moreker, Tanuj Sharma

Our Patient's Eyes are Red: Is it a Manifestation of a Systemic Disease? (Uveitis and Scleritis Can Herald A Systemic Disease)

[Year:2019] [Month:October] [Volume:61 ] [Number:4] [Pages No:257-260]


ABSTRACT


Red eye is a common presenting complaint in primary care practice. Often it may happen that a red eye would be a presenting sign of a hidden systemic disease.

OUR PATIENT HAS HIGH EYE PRESSURE: IS IT A PROBLEM? (RAISED INTRAOCULAR PRESSURE - GLAUCOMA)

Anuradha Khodake, Shubhangini Jambhrunkar, Sandeep Kataria, Nagendra Shah, Ajay Dudani, Rashmikant Patel

Our Patient has High Eye Pressure: Is it a Problem? (Raised Intraocular Pressure - Glaucoma)

[Year:2019] [Month:October] [Volume:61 ] [Number:4] [Pages No:261-268]


ABSTRACT


Raised intraocular pressure (IOP) causes or can progress to glaucoma which is a silent thief of sight, being leading cause of irreversible blindness worldwide. It can remain asymptomatic until a relatively late stage.1 Most of the cases are detected on routine ophthalmological examination. As late detection of the disease is considered as one of the most significant poor prognostic factors in the course of the disease,2 early detection and prompt management becomes an important step to fight with this potentially blinding disorder. Intraocular pressure is a key modifiable factor in the treatment of glaucoma. This review describes the significance of treating increased intraocular pressure as early as possible after its detection and a clinical approach towards its proper management.

OUR PATIENT IS AGEING: IS MACULAR DEGENERATION GOING TO BE A PROBLEM? (AGE RELATED MACULAR DEGENERATION)

Sandeep Kataria, Roma Vakade, Nagendra Shah, Priyanka Sathe, Ajay DudanI, Karobi Lahiri Coutinho

Our Patient is Ageing: Is Macular Degeneration Going to be a Problem? (Age Related Macular Degeneration)

[Year:2019] [Month:October] [Volume:61 ] [Number:4] [Pages No:269-272]


ABSTRACT


Age-related macular A degeneration (AMD) is the leading cause of blindness in the world with people over 50 years. The prevalence of AMD in Asian population is estimated to be 4.6%. Among the North Americans, 11 million (85%- 90% of all AMD patients) currently have ""dry"" (non neovascular, or non-exudative type) AMD and 1.5 million people (10%- 15% of all AMD patients) have ""wet"" (neovascular type) AMD. AMD results in a central scotoma or a central defect in the visual field.

OUR PATIENT HAS DROOPY EYE LIDS: WHAT TO DO? (PTOSIS)

Nagendra Shah, Sailie Shirodkar, Priyanka Sathe, Roma Vakade, Jyoti Dodhi, Trupti Khaladkar

Our Patient Has Droopy Eye Lids: What to do? (Ptosis)

[Year:2019] [Month:October] [Volume:61 ] [Number:4] [Pages No:273-276]


ABSTRACT


Blepharoptosis, more commonly referred to as ptosis, is defined as an abnormally low position of the upper lid.1 As a fairly common entity encountered in clinical practice, a detailed and comprehensive evaluation assumes vital importance for effective surgical correction. An equal, if not additional, significance may be attached to distinguishing it from conditions masquerading as ptosis, to circumvent needless refer rals and surgical intervention. The following abstract aims at providing one with a general overview of the condition, along with some approaches that may be followed during evaluation of a case.

OUR PATIENT CAN'T SEE: IS IT A NEURO-OPHTHALMIC DISORDER? (NEUROLOGICAL CAUSES OF ACUTE VISION DISTURBANCE)

Mayur R. Moreker, Tanuj Sharma, Sahil Mhatre, Jyoti Dodhi, Neepa Dave, Rashmikant Patel

Our Patient Can't See: Is it a Neuro-ophthalmic Disorder? (Neurological Causes of Acute Vision Disturbance)

[Year:2019] [Month:October] [Volume:61 ] [Number:4] [Pages No:277-280]


ABSTRACT


Diagnostic Case Scenarios
Descriptive Case 1: A 19-year-old lady presented to the Neuro- DO phthalmology Services of Bombay Hospital and Medical Research Centre with Right Occipito-frontal headache with vertigo. On examination, she had Right Eye: 6/9, N6, Normal Colour Vision and Left Eye: Finger Counting 2 metre, N36 with a severely affected Colour Vision. Fundus Examination showed bilateral optic neuritis (Left More than Right). MRI Brain showed Demyelinating lesion and she was treated for Multiple Sclerosis.

OUR PATIENT HAS LARGE PROTRUDING EYES: IS IT RELATED TO THE THYROID GLAND? (THYROID EYE DISEASE)

Nagendra Shah, Sailie Shirodkar, Priyanka Sathe, Roma Vakade, Ajay Dudani, Rashmikant Patel

Our Patient has Large Protruding Eyes: Is it Related to the Thyroid Gland? (Thyroid Eye Disease)

[Year:2019] [Month:October] [Volume:61 ] [Number:4] [Pages No:281-284]


ABSTRACT


Proptosis, or abnormal protrusion of the eyeballs in relation to the skull, remains a common presenting complaint for a wide variety of orbital and systemic conditions. When the offending lesion is 'intraconal' or within the muscle cone, it leads to axial proptosis. On the other hand, eccentric proptosis may be caused by orbital lesions outside the muscle cone, or lesions in the adjacent structures such as the paranasal sinuses, the cranial cavity etc. Oftentimes, the exact causative mechanism leading to proptosis may be difficult to delineate, due to the inaccessibility of the structures in the orbit. It may be due to a variety of inflammatory, infectious, vascular, neoplastic or traumatic causes.1

OUR PATIENT HAS DIABETES: WILL IT AFFECT HIS RETINA? (DIABETIC RETINOPATHY)

Ajay Dudani, Priyanka Sathe, Sailie Shirodkar, Sandeep Kataria, Karobi Lahiri Coutinho, Rashmikant Patel

Our Patient has Diabetes: Will it Affect his Retina? (Diabetic Retinopathy)

[Year:2019] [Month:October] [Volume:61 ] [Number:4] [Pages No:285-290]


ABSTRACT


Diabetic retinopathy (DR) is defined as the progressive dysfunction of the retinal vasculature due to chronic hyperglycaemia resulting in structural damage to the neural retina.1

OUR PATIENT HAS RETINAL VASCULAR OCCLUSION: WHAT SHOULD BE DONE? (RETINAL VASCULAR OCCLUSIONS)

Sandeep Kataria, Anuradha Khodake, Sailie Shirodkar, Nagendra Shah, Ajay Dudani, Karobi Lahiri

Our Patient has Retinal Vascular Occlusion: What should be Done? (Retinal Vascular Occlusions)

[Year:2019] [Month:October] [Volume:61 ] [Number:4] [Pages No:291-299]


ABSTRACT


Retinal vascular occlusive diseases are often associated with a variety of systemic disorders including arterial hypertension, diabetes mellitus, dyslipidaemia, systemic vasculitis, atherosclerosis related thromboembolism and thrombophilic disorders. Various types of vascular occlusions are categorised on the basis of the site of occlusion and on the type of consequent vascular damage. All present with painless diminution of vision. Clinical and fundoscopy characteristics, prognosis and, at least in part, therapeutic approach depends on both the site of vessel occlusion and the type of consequent vascular damage. Changing treatment paradigms necessitate early and appropriate diagnosis and treatment of the condition.

OUR KID PATIENT HAS GLASSES: WHAT TO DO? (REFRACTIVE ERRORS IN CHILDREN)

Neepa Dave, Sahil Mhatre, Trupti Khaladkar, Jyoti Dodhi, Roma Vakade, Karobi Lahiri Coutinho

Our Kid Patient has Glasses: What to do? (Refractive Errors in Children)

[Year:2019] [Month:October] [Volume:61 ] [Number:4] [Pages No:300_303]


ABSTRACT


The most common reasons a child needs to wear glasses are:

  1. To improve vision and help the child to function better in his environment, by correcting refractive errors.
  2. To help straighten eyes that are crossed or misaligned, (strabismus or squint)
  3. To help strengthen a weak or lazy eye.
  4. To protect one eye, if the child has poor vision in the other.
It is important to remember that during early childhood visual system is growing and developing and glasses can help ensure normal vision development.
Glasses are most commonly used to treat refractive errors.
Refractive errors in kids include nearsightedness (difficulty seeing things that are far away), farsightedness (trouble seeing things close by), and astigmatism (distorted vision caused by an irregularly shaped cornea).

OUR PATIENT IS A PREMATURE BABY: IS AN EYE CHECK REQUIRED? (RETINOPATHY OF PREMATURITY)

Karobi Lahiri Coutinho, Anisha Rathod, Priyanka Sathe, Roma Vakade, Sailie Shirodkar, Neepa Dave

Our Patient is a Premature Baby: Is an Eye Check Required? (Retinopathy of Prematurity)

[Year:2019] [Month:October] [Volume:61 ] [Number:4] [Pages No:304-309]


ABSTRACT


What is Retinopathy of Prematurity?
Retinopathy of prematurity (ROP) is a developmental disorder that occurs in the incompletely vascularised retina of premature infants and is an important cause of blindness in children in both the developed and the developing countries. Why should we worry?

OUR KID PATIENT IS A CHALLENGED CHILD: WHAT TO DO? (VISUAL ASSESSMENT IN NEURO-DEVELOPMENTAL DISORDERS)

Karobi Lahiri Coutinho, Sailie Shirodkar, Trupti Khaladkar, Anisha Rathod, Roma Vakade, Priyanka Sathe, Neepa Dave

Our Kid Patient is a Challenged Child: What to do? (Visual Assessment In Neuro-developmental Disorders)

[Year:2019] [Month:October] [Volume:61 ] [Number:4] [Pages No:310-313]


ABSTRACT


Neurodevelopmental disorders (NDDs) arise due to a significant and persistent disruption to the complex and dynamic relationship between genetic, neurological, cognitive, emotional and behavioural processes during the period of active development.1 They comprise a wide range of conditions, presenting with intellectual, behavioural and motor impairments, and a significant proportion of them are complicated by visual difficulties. Due to paucity of substantial data regarding the burden and risk factors of these conditions, definitive guidelines and protocols for their effective management and rehabilitation, are severely lacking.

OUR PATIENT DESIRES NO LESS THAN 20/20: WITH ANY NEW LENSES OR SURGERIES, IS IT ACHIEVABLE? (NEWER LENSES AND REFRACTIVE EYE SURGERIES)

Shubhangini Jambhrunkar, Anuradha Khodake, Tanuj Sharma, Sandeep Kataria, Sailie Shirodkar, Rashmikant Patel

Our Patient Desires no Less Than 20/20: with any New Lenses or Surgeries, is it Achievable? (Newer Lenses and Refractive Eye Surgeries)

[Year:2019] [Month:October] [Volume:61 ] [Number:4] [Pages No:314-320]


ABSTRACT


Cataract and refractive errors are the common causes of preventable blindness in both developed and de v e l oping c ount r i e s . Gl obal l y , uncorrected refractive error remains the main cause of visual impairment. Refractive error is commonly corrected with help of spectacle, contact lenses and refractive surgery. From 1990 to 2010 the number of blind and visually impaired people due to cataract has decreased.1 However, the total number of cataract surgeries has increased considerably in all the regions of the world, especially in Asia, with improvement of surgical techniques and in turn lower rate of complications.2,3 Current treatment options for cataract is surgical removal of the crystalline lens, and replacement with an intraocular lens (IOL). Majority of patients improve their visual acuity through this procedure. According the current records of NPCB for the year 2017-2018, 150% cataract surgeries were done. And 24% free spectacles were given to school children. With the advent of the newer techniques and increased standard of living, patients with cataract nowadays have a higher demand on postoperat ive visual performance.

IS OVERALL PATIENT SATISFACTION RELATED TO PATIENT WAITING TIME EVEN IN SPECIALISED PRACTICES?

Mayur R. Moreker, Shilpa R. Moreker, Amitkumar R. Vyas, Tanuj R. Sharma, Avani Bhanushali, Asmita S. Sakle, Paresh Marathe, Rashmikant C. Patel

Is Overall Patient Satisfaction Related to Patient Waiting Time Even in Specialised Practices?

[Year:2019] [Month:October] [Volume:61 ] [Number:4] [Pages No:321-328]


ABSTRACT


Improving the flow of patients in an eye care clinic is about making their journey easier while making the best use of the doctor's time and resources in the eye clinic. It involves eliminating unnecessary steps and processes, giving the doctor more time to focus on patients and on providing good and friendly services.1 Eye care administrators and managers benefit too: better patient flow reduces waste and makes more efficient use of time and human resources, which in turn reduces costs, attracts more patients, and improves cost recovery.1 Thinking about what a patient values can help us to optimise patient flow. Generally speaking, patients value everything that provides them with a good outcome: appropriate referral, a correct diagnosis, the right information and advice, the right treatment, and appropriate follow-up and aftercare.1 They do not value things that seem unnecessary to them, for example: waiting longer than seems reasonable, having to provide the same information more than once, or travelling to the hospital more than once when two visits can be safely combined.1 It is therefore very helpful to look at eye care service as a whole from time to time and examine everything done: from the moment of first contact with the patients to the time they are finally discharged after a successful examination.1

CORNEAL BLINDNESS - HOW CAN WE HELP? (EYE DONATION FACTS)

Sameer Datar, Tanuj Sharma, Mayur Moreker, Rashmikant C. Patel

Corneal Blindness - How Can We Help? (Eye Donation Facts)

[Year:2019] [Month:October] [Volume:61 ] [Number:4] [Pages No:329-332]


ABSTRACT


Corneally blind persons can get sight only when their damaged cornea is replaced by a healthy cornea which is received from a deceased donor. So, if we have God's gift of vision, why not try to pass it on to someone who doesn't have it, instead of burning or burying? To eradicate corneal blindness, we need a greater number of eye donations in our country. One eye donation can give sight to 2 corneally blind persons. There is no substitute for human cornea. The transplantation surgery depends upon the priceless gift of cornea donation from one human to next.

I HEARD OF ARTIFICIAL INTELLIGENCE: WILL IT HELP OUR PATIENT? (A FUTURISTIC IDEA TO PREDICT STROKE)

Nivesh Tiwari, Paresh Marathe, Shilpa R. Moreker, Tanuj Sharma, Mayur R. Moreker, Sahil Mhatre, Sonali Sontakke , Ajay Dudani , Rashmikant Patel

I Heard of Artificial Intelligence: Will it Help Our Patient? (A Futuristic Idea To Predict Stroke)

[Year:2019] [Month:October] [Volume:61 ] [Number:4] [Pages No:333-336]


ABSTRACT


What is Artificial Intelligence? rtificial Intelligence A (AI) is a constellation of technologies that enable machines to act with higher levels of intelligence and emulate the human capabilities of sense, comprehend and act. Figure 1 below incorporated from a Discussion Paper - National Strategy for A r t i f i c i a l I n t e l l i g e n c e (https://smartnet.niua.org/content/2bc 031e8-955b-46dd-a722-6513236d9635) explains Artificial Intelligence.

GENERAL PRACTITIONER'S SECTION

OP Kapoor

Do Not Diagnose Biliary Colic if Pain is More Than 6 Hours' Duration

[Year:2019] [Month:October] [Volume:61 ] [Number:4] [Pages No:337-348]


ABSTRACT


Most of the times, gall stones are silent but if they do cause an attack of biliary colic similar to renal colic, there is very severe pain felt in the epigastrium and right hypochondrium and at the back associated with severe vomiting and sweating.

SUBJECT INDEX

Subject Index

[Year:2019] [Month:October] [Volume:61 ] [Number:4] [Pages No:349-351]


ABSTRACT

AUTHOR INDEX

Author Index

[Year:2019] [Month:October] [Volume:61 ] [Number:4] [Pages No:352-353]


ABSTRACT