Thursday, September 30, 2010
Eye cpc on endoscopic DCR at Railway hospital, rawalpindi
Today a CPC on endolaser DCR vs conventional DCR was held in railway hospital, in with Prof. Baqai from medicine, Dr. Aneeq and myself from eye and medical students attended the meeting.
Tuesday, September 28, 2010
BCC?
Planned to undergo surgery and final diagnosis will be made.
Age of the the patient is 72 years old female
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Friday, September 24, 2010
A case report of ochronosis with ocular involvement
Today I saw a 45 years old patient who came to me for routine eye examination when I found black bluish spots at his palms. I found bilateral episcleral/scleral pigmentation on temporal sides of both eyes. On reviewing the literature in which nasal espisclera is involved most of the times and ocular involvement in the form of scleral/episcleral pigmentation occures between the age of 30-39.
I could not find another sign of this disease in this patient.
Ochronosis is an association of alkaptonuria.
These are the photographs of the patient I took, who is a resident of Pakistan and he gives a positive history of this autosomal recessive rare disorder.
The prevalence is of 1 case per 1 million population in american population.
And 1 case per 25000 inhabitants worldwide with peak prevalence at Czech Republic and Santo Domingo.
we don't have any records for pakistan
Dr. Shahzad waseem
I could not find another sign of this disease in this patient.
Ochronosis is an association of alkaptonuria.
These are the photographs of the patient I took, who is a resident of Pakistan and he gives a positive history of this autosomal recessive rare disorder.
The prevalence is of 1 case per 1 million population in american population.
And 1 case per 25000 inhabitants worldwide with peak prevalence at Czech Republic and Santo Domingo.
we don't have any records for pakistan
Dr. Shahzad waseem
Thursday, September 23, 2010
Wednesday, September 22, 2010
Monday, September 20, 2010
corneal tear
White line of full thickness corneal opacity is visible in tha above photograph.
Vision is 6/18 with -2.00DC, k readings are 43 D in both meridians. Patient,s complaint is diplopia and confusion on binocular vision., though no lenticular changes are visible at this time, -2.00 DC lenticular astigmatism,is corrected and he will be followed up after 2 weeks
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von Graefe sign
Today I saw patient in which I found von Graefe sign (Lid lg in down gaze). There is proptosis on left side 0f 23mm and the difference between two eyes is more than 2 mm.
Patient has beent sent to medical specialist.
Patient has beent sent to medical specialist.
Sunday, September 19, 2010
Tarsorrhaphy
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Fungal corneal ulcer?
I found feathery edges and corneal infiltrates (visible on 11'clock position. near pupil yellowish spot is light reflex of slit-lamp) and I feel its fungal ulcer. Following treatment is started
5% natamycin eye drops
Getifoxacin eye drops ,
Atropine eye drops
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Saturday, September 18, 2010
MICS
Detail steps of MICS will be posted soon. The micro-incision-cataract-surgery, where phaco machine is not available.
please come back to read.
Later on I will try to record a video with all these steps and will try to post here
Regards
Dr. Shahzad waseem
please come back to read.
Later on I will try to record a video with all these steps and will try to post here
Regards
Dr. Shahzad waseem
Fw: above condition after DCR with intubation
-----Original Message-----
From: "Dr. Shahzad Waseem" <2drshahzadwaseem@gmail.com>
Date: Sat, 18 Sep 2010 19:33:20
To: shamshadwaseem eyehospital.com<attrit266gaiety@m.facebook.com>
Reply-To: 2drshahzadwaseem@gmail.com
Subject: above condition after DCR with intubation
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Fw: mucocele before surgery
-----Original Message-----
From: "Dr. Shahzad Waseem" <2drshahzadwaseem@gmail.com>
Date: Sat, 18 Sep 2010 19:32:06
To: shamshadwaseem eyehospital.com<attrit266gaiety@m.facebook.com>
Reply-To: 2drshahzadwaseem@gmail.com
Subject: mucocele before surgery
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Pseudophakic bullous keratopathy
I operated upon a patients and due to PC rent, PCIOL could not be implanted. Later after anterior vitrectomy, I inserted ACIOL. The lens is in place and not in contact with iris or cornea. There is no vitreous strand visible on SLE, but the patient developed bullous keratopathy.
I started hypertonic saline every 1 hour with steroid eye drops every 2-4 hours. IOP was 10 mm, but I also started betabloker BD and 1/2 tablet acetazolamide to reduce the production of aqueous humor.
The vision is CF.
He has been on this treatment but the condition is static. I am now planning to refer him for penetrating keratoplasy.
I need kind opinion of anyone who is concerned.
Regards
Dr. shahzad waseem
I started hypertonic saline every 1 hour with steroid eye drops every 2-4 hours. IOP was 10 mm, but I also started betabloker BD and 1/2 tablet acetazolamide to reduce the production of aqueous humor.
The vision is CF.
He has been on this treatment but the condition is static. I am now planning to refer him for penetrating keratoplasy.
I need kind opinion of anyone who is concerned.
Regards
Dr. shahzad waseem
Friday, September 17, 2010
Medical education
Dear Dr. Barahona
I hope you are doing fine. Here in Pakistan we have been following the conventional method of teaching in MBBS , in which we learn basic sciences in 1st 2 years and then in the remaining 3 years the clinical sunjects.
I have recently completed my diploma in Ethics and medical education, in which we are transforming the conventional method of teaching into integrated teaching in which students learn basic sciences and clinical subjects together.. Its a hot subject these days in Pakistan and many medical colleges are adopting it, as it has by many countries.
Please share your experience, if any, in this field.
Regards
Dr. Shahzad waseem
I hope you are doing fine. Here in Pakistan we have been following the conventional method of teaching in MBBS , in which we learn basic sciences in 1st 2 years and then in the remaining 3 years the clinical sunjects.
I have recently completed my diploma in Ethics and medical education, in which we are transforming the conventional method of teaching into integrated teaching in which students learn basic sciences and clinical subjects together.. Its a hot subject these days in Pakistan and many medical colleges are adopting it, as it has by many countries.
Please share your experience, if any, in this field.
Regards
Dr. Shahzad waseem
Thursday, September 16, 2010
To see or not to see... that's the question...
The first successful corneal transplant was performed as early as 1835 by a British army surgeon in India whose pet antelope, who had only one eye, had a badly scarred cornea. He removed a cornea from a recently killed antelope and transplanted it into his pet's eye. The operation was a success, and the pet was able to see.
A sweet random fact.
Dr. A.
Adenoviral Conjunctivitis
Patients often complain of burning or gritty foreign body sensation. There is usually a watery, mucoid discharge—morning crusting is a common complaint. The lids may become red and edematous (swollen). Classically, preauricular lymphadenopathy (inflamed lymph node) can be palpated.
Symptoms usually begin and predominate in one eye, and within a few days, have spread to the contralateral eye. A history of antecedent upper respiratory tract infection or close contact with someone with a “red eye” is common.
When adenoviral eye infections further involve the cornea, the term “epidemic keratoconjunctivitis” (EKC) is used. Patients with EKC may have photophobia (intolerance to light) and reduced vision long after resolution of the acute infection.
Pharyngoconjunctival fever describes adenoviral conjunctivitis with the additional systemic symptoms of fever, sore throat, and headache. Corneal infiltrates are very rare.
Adenovirus infection is quite contagious, as the virus is transmitted readily in respiratory or ocular secretions, contaminated fomites (including eye droppers and mascara bottles), and even contaminated swimming pools. Frequent handwashing is recommended and care must be taken to avoid contamination to others through towels, make-up, instruments, or other fomites.
Please wash your hands frequently and sanitize your work station.
Notify immediately if you see a patient with the described signs.
occurs equally in men and women
no racial predilection highly contagious—outbreaks can sometimes be traced to infected individuals or locations
SYMPTOMS
“Red eye” noted by the patient
watery during the day and crusting noted in the mornings
swollen lids
patient noticed in one eye first, perhaps with later spread to the opposite eye in pharyngoconjunctival fever—sore throat, fever, and headache may be present
For Physicians: SIGNS
follicular conjunctivitis (especially on the inferior palpepral conjunctiva)
watery, mucoid discharge
crusting may be evident on the lashes
edematous lids
palpable preauricular lymphadenopathy
pinpoint suconjunctival hemorrhage in EKC, pseudomembranes and subepithelial (stromal) infiltrates can be seen.
For Physicians: TREATMENT : usually supportive
cool compress and artificial tears for comfort several times a day
prevent contagious spread (including washing sheets and pillowcases, handwashing, and cleaning of instrumentation in the physician’s office). Temporary leave of absence should be considered for patients who work with the public who have active infection.
NO antibiotic or antiviral drops are routinely used. In cases where bacterial co- or super- infection is suspect, antibiotic drops may be indicated. There are no antiviral drugs approved for adenoviral conjunctivitis in EKC only: pseudomembranes should be manually peeled every 2-3days. Topical corticosteroids may be needed (i.e. prednisolone acetate, 0.125%, q.i.d.) to prevent scarring.
Hoping no one gets infected...
Dr. A.
Patients often complain of burning or gritty foreign body sensation. There is usually a watery, mucoid discharge—morning crusting is a common complaint. The lids may become red and edematous (swollen). Classically, preauricular lymphadenopathy (inflamed lymph node) can be palpated.
Symptoms usually begin and predominate in one eye, and within a few days, have spread to the contralateral eye. A history of antecedent upper respiratory tract infection or close contact with someone with a “red eye” is common.
When adenoviral eye infections further involve the cornea, the term “epidemic keratoconjunctivitis” (EKC) is used. Patients with EKC may have photophobia (intolerance to light) and reduced vision long after resolution of the acute infection.
Pharyngoconjunctival fever describes adenoviral conjunctivitis with the additional systemic symptoms of fever, sore throat, and headache. Corneal infiltrates are very rare.
Adenovirus infection is quite contagious, as the virus is transmitted readily in respiratory or ocular secretions, contaminated fomites (including eye droppers and mascara bottles), and even contaminated swimming pools. Frequent handwashing is recommended and care must be taken to avoid contamination to others through towels, make-up, instruments, or other fomites.
Please wash your hands frequently and sanitize your work station.
Notify immediately if you see a patient with the described signs.
occurs equally in men and women
no racial predilection highly contagious—outbreaks can sometimes be traced to infected individuals or locations
SYMPTOMS
“Red eye” noted by the patient
watery during the day and crusting noted in the mornings
swollen lids
patient noticed in one eye first, perhaps with later spread to the opposite eye in pharyngoconjunctival fever—sore throat, fever, and headache may be present
For Physicians: SIGNS
follicular conjunctivitis (especially on the inferior palpepral conjunctiva)
watery, mucoid discharge
crusting may be evident on the lashes
edematous lids
palpable preauricular lymphadenopathy
pinpoint suconjunctival hemorrhage in EKC, pseudomembranes and subepithelial (stromal) infiltrates can be seen.
For Physicians: TREATMENT : usually supportive
cool compress and artificial tears for comfort several times a day
prevent contagious spread (including washing sheets and pillowcases, handwashing, and cleaning of instrumentation in the physician’s office). Temporary leave of absence should be considered for patients who work with the public who have active infection.
NO antibiotic or antiviral drops are routinely used. In cases where bacterial co- or super- infection is suspect, antibiotic drops may be indicated. There are no antiviral drugs approved for adenoviral conjunctivitis in EKC only: pseudomembranes should be manually peeled every 2-3days. Topical corticosteroids may be needed (i.e. prednisolone acetate, 0.125%, q.i.d.) to prevent scarring.
Hoping no one gets infected...
Dr. A.
Wednesday, September 15, 2010
Adenoviral conjunctivitis (Aashob e chasm)
Due to flood in Pakistan, I have seen patients of adenoviral conjunctivitis much more than usual. Its really a n epidemic right now in pakisatn and people have no awareness about it. Here are some facts:
1. Its one of the most contagious eye disease
2. It spreads by contact and its and air born infection
3. It does not spread by looking at the eyes of the infected person.
4. The infected person should be isolated from the community from 10 -14 days
5. People in a home should not share their common households like towels.
6. Its an occupational hazard for ophthalmologists too.
7. It is managed by prescribing the antibiotic eye drops to prevent the secondary bacterial infection
8. Topical decongestant like napahazoline are prescribed to ease the patient's discomfort.
9 It resolve usually within 1 -2 weeks.
Regards
Dr. Shahzad waseem
1. Its one of the most contagious eye disease
2. It spreads by contact and its and air born infection
3. It does not spread by looking at the eyes of the infected person.
4. The infected person should be isolated from the community from 10 -14 days
5. People in a home should not share their common households like towels.
6. Its an occupational hazard for ophthalmologists too.
7. It is managed by prescribing the antibiotic eye drops to prevent the secondary bacterial infection
8. Topical decongestant like napahazoline are prescribed to ease the patient's discomfort.
9 It resolve usually within 1 -2 weeks.
Regards
Dr. Shahzad waseem
Thank you Dr. Waseem :)
Thank you, Dr. Waseem, for allowing me to colaborate in such a wonderful crusade.
All questions are welcome, including General Ophthalmology, and topics related to it and General Medicine, Pediatrics and Genetics.
Cheers!
Dr. A.
All questions are welcome, including General Ophthalmology, and topics related to it and General Medicine, Pediatrics and Genetics.
Cheers!
Dr. A.
Tuesday, September 14, 2010
Eye problems
If anyone has any questions regarding eye diseases, he may ask freely. I will try to answer according to my capacity.
Regards
Dr. Shahzad Waseem
FCPS, Eye
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