Dr.

Sabiha Afroz
Registrar(eye)
Content

 Total 5 station:
1. Procedure station
2. Optics
3. Photograph
4. Instruments
5. imaging
Optics

 Lens identification

 Myopia

 Hypermetropia

 lasik
Convex spherical trial lens
 Image of object moves
opposite direction of
lens
 Image magnified
 No image distortion on
rotation of lens
Convex spherical lens
 Uses:
1. Hypermetropia
2. Presbyopia
3. Aphakia
4. As magnifier
Convex cylindrical trial lens
 Image of object moves
opposite direction of
lens.
 Image magnified
 Image distortion on
rotation of lens.
 Uses:hypermetropic
astigmatism
Concave spherical trial lens
 Image of object moves
same direction of lens
 Image minified
 No image distortion on
rotation of lens
 Uses: myopia
Concave cylindrical trial lens
 Image of object moves
same direction of lens.
 Image minified.
 Image distorted on
rotation of lens.
 Uses: myopic
astigmatism
Hypermetropia

 Treatment:
1. Spectacle correction by
convex lens
2. Contact lens
3. LASIK
Complication:
Narrow angle
glaucoma,convergent
squint,blepharitis,chalazi
on,stye,amblyopia
Myopia

Treatment:
 Optical:
 spectacle (concave
lens),contact lens.
 Surgical treatment:
 LASIK
 LASEK
 PRK
 Clear lens extraction
 Phakic IOL(AC/PC)
Pathological myopia
 Criteria:
 More than -6D,progressive.
 Prominent eyeball,large cornea,deep AC
 Posterior cortical cataract
 Posterior vitreous detachment
 Large pale optic disc with temporal cresent
 Tessellated fundus
 Foster fuch’s spot,lattice degeneration,macular hole etc
Complication of pathological
myopia
 POAG
 Posterior staphyloma
 Complicated cataract
 Vitreous liquifection
 Retinal detachment
 divergent squint/exotropia
Criteria of lasik patient

 Refractive power should be stable for at least 1 year.

 Age of patient should be more than 18 years.
 No ocular pathology
 Myopia upto -12D,hypermetropia upto
+4D,astigmatism upto 5D can be corrected by LASIK
Artificial intraocular lens
IOL
 Parts:
 Optic
 Haptic
 Function:
 optical part helps in vision
 Haptic gives support to the lens
 UGH syndrome occur if implanted in anterior
chamber.

 PCO: posterior capsular opacification may be defined

as a condition where posterior capsule become hazy
/opaque usually after cataract surgery.

 Treatment: Nd YAG laser capsulotomy

Photoghaph
Leukocoria
 Leukocoria: white pupillary reflex.
 D/D:
 Congenital cataract/developmental cataract
 Retinoblastoma
 Endophthalmitis
 Coat’s disease
 Persistant hyperplastic primary vitreous
Congenital ptosis
 Definition.
 Complication in children
 Horner’s syndrome criteria
Pterygium
 Identify
 Definition
 Aetiology
 Complication
 Treatment
 Other degenerative condition
Chalazion
 Identify
 Definition
 Treatment
 complication
Ophthalmia neonatorum
 Identify
 Causative organism
 Treatment
 complication
retinoblastoma
Proptosis
B scan USG
Bscan RD
 What is the imaging & positive findings
 Most likely diagnosis
 Clinical presentation of this case
 Treatment option
Two way irrigation cannula/simcoe
 Uses:
 For simultaneous irrigation & aspiration of cortical
matter during cataract surgery
 For aspiration of visco elastic substance/blood clot.
 For washing the anterior chamber
 For forming the anterior chamber
 Complication:
 Posterior capsular rupture
 Endothelial damage
 Iris may be adherent to cannula/injury to iris.
Wire loop vectis
 Uses:
 To express/deliver the lens nucleus in SICS
 For removal of dislocated/subluxated lens
 Complication:
 Posterior capsular rupture
 Endothelial injury
 Injury to iris/iridodialysis
chalazion clamp
Uses:
 During chalazion operation
 To fix the chalazion for surgery & also ensure
haemostasis
 To give intralesional injection of steroid in chalazion
after fixing with the forceps
 Excision of a small granuloma/papilloma of lid
Chalazion scoop
Uses:
For scooping out the content of chalazion during
surgery.
Citelli’s punch forceps
 Uses:
 to cut the bone & enlage the ostium during DCR
operation.
 Complication:
 Injury to nasal mucosa & lacrimal sac
 Damage to surrounding tissue causes bleeding
Cat’s paw retractor
 Uses:

 For retraction & haemostasis during DCR & DCT

operation.
 It may also used in other oculoplastic surgery
Bowman’s melliable lacrimal probe
uses:

 For probing in congenital naso lacrimal obstruction.

 To identify the position of sac in DCR
Nettleship’s punctum dilator
Uses:
 For dilatation of punctum as in:
 Sac patency test
 Identify lacrimal punctum during DCR operation
 Probing in case of congenital dacryocystitis
 Congenital/acquired punctal stenosis.
Complication:
 False passsage
 Injury to surrounding structure
Desmarre’s eye lid retractor
Uses:
It is uses for examination of conjunctiva & anterior
segment of eye -
 In children & non cooperative patient
 In case of severe blepharospasm & photophobia
 In case of lid edema to find out any abrasion, ulcer, FB
 It may be used as tissue retractor in ptosis ,squint
surgery.
entropion clamp
Uses:
 During entropion surgery
 During ectropion surgery
 During tarsorrhaphy for fixation & haemostasis
Keratome knife
crescent knife
Universal eye speculum
Uses:
It is used to separate both eyelids for good exposure of
eyeball mainly during extraocular surgery.eg-
 Foreign body removal
 Pterygium excision
 Squint operation
 Evisceration & enucleation
 To give subconjunctival injection
Wire speculum
Uses:
To expose the eyeball as in
 Foreign body removal
 Intraocular operation such as cataract surgery,peripheral
iridectomy, trabeculectomy.
 Extra ocular surgery-pterygium.
Sclero corneal/spring scissors
Uses:
 To enlarge the sclero corneal incision.
 To cut the conjunctiva as peritomy in
 Intraocular surgery-cataract surgery,trabeculectomy.
 Extraocular surgery-squint surgery,pterygium
Barraquer’s needle holder
Uses:
It is used to catch the fine needle(5/0,6/0,8/0,10/0
suture) for
 Sclero corneal/corneal suturing as in cataract
surgery,trabeculectomy,keratoplasty.
 Suturing the flap in DCR surgery/skin closure.
Atropine sulphate drop(1%)
Mechanism of action:
 Paralysis the sphincter pupillae & ciliary muscle by
inhibit the action of acetylcholin.
Uses:
 Treatment of iridocyclitis,keratitis,enophthalmitis for
relieving ciliary spasm.
 To prevent formation of posterior synaechia.
 To breakdown recently formed synaechia.
Systemic toxicity:
 Dry mouth
 Difficulty in swallowing
 Skin dry,red ,hot.
 Body temperature raised
 Tachycardia
 Behavior change may occur
.4% oxybuprocain eye drop
Uses:
 It act as a topical anaesthesia.so used before-
 IOP measurement(tonometry)
 Superficial corneal & conjunctival FB removal
 Prior to SPT
 Suture removal
 Prior to laser application
 Prior to subconjunctival injection,corneal scrapping
Fluorescein dye
Uses:
 Staining corneal abrasion/ulcer
 Applanation tonometry
 To detect wound leak(seidel test)
 Tear film break up time
 Jones dye test
 FFA
Trypan blue
Procedure
 Procedure done here?
 Write down the steps of this procedure.
 Name the instrument used in this procedure.
 Complication during this procedure.