• DIFFERENT INVESTIGATION IN SPECIALTY CLINIC

DIFFERENT INVESTIGATION IN SPECIALTY CLINIC

Refraction

Auto Refractor Machine -Rate -2, 00,000

Topcon uses : Check correct power, Correct Axis, Auto K –reading, Correct IPD

Fields : 1. Bjerums screen method 2. Confrontation method 3. HFA method

• A-Scan :• To measuring eye ball length • Distance between cornea and retina• To find out IOL power calculation

• K – Reading: • To find out corneal curvature • To find out the correct cylinder axis

verified to measure the calculation

OPD:• NCT: Non Contact Tonometry

Rate – 3, 00, 000• To measuring the Tension.

Slitlamp Uses : Anterior segment examination (Ex.

Trauma, mangnification of Conjunctiva, Tra.Cat, IMC,MC)

• Vitreous (with lens) (Ex: Cells, Vit. Opacity)

• Retina pathology (with lens)

Slitlamp with Applanation : • To measuring intra ocular pressure

Direct Ophthalmoscope :

• High magnification (around 15 times)• Less field of view • Central parts only seen • Cost is less

Indirect Ophthalmoscope:

• Less magnification (around 5 times)• More field of view • Inverted image • All cases seen periphery• Cost is more• Need good practice • Myopic cased need periphery

examination

RETINA CLINIC  FFA : (Fundus Fluorescein

Angiography) -

USES : To detect leakage, bleeding,NVD, NVE in retina and macular area.

INJ. Used : Inj. Fluorescien -20% - 3ml.

  Patient eligible are : Diabetic Hypertensive

Retinopathy, CSCR, CNVM, ARMD, Eales disease.

 

RETINA CLINIC  FFA : (Fundus Fluorescein

Angiography) -

USES : To detect leakage, bleeding,NVD, NVE in retina and macular area.

  USG : (Ultra Sono Grapy) –USG Uses :

It is used for detected examination of inner coats of retina which are not detected by I/O.

It is also used for detecting vitreous abnormalities.

Procedure: All age group Bellow 5yrs if need GA Painless test

Immediate result given.

Patient eligible are:

a)   Mature cataractb)   IOFB casesc)   Retinoblastomad)   Orbit tumore)   VIT. haemorrhage (PVD ) 

• LASER : ( Light Amplification by Stimulated Emission of Radiation)

USES:

It is used in peripheral Iridotomy to open PCO as YAG capsulotomy.

In posterior segment it is used to do barrage in sealing holes and to create adhesion. Between retina and choroid.

It is also used to photocoagulate tissue in NVD and NVE.

Laser machine types:

a)  Argon laser – Rate – 13,00,000b)  ND YAG Laser c)  DF YAG Laserd) Diode Laser

Laser Procedure:

Laser out patient procedure

Need pupil full dilate

S/L method using mainster & three mirror lens with viscomet.

L/O method using 20 D lens

Laser delivery :• S/L (contact lens method)• L/O (non contact method)

Cases :Diabetic & Hypertensive retinopathy.Myopic cases.Vein occlusion.CSCRVasculitisARMD SRNVM

Types of laser

Focal laser : (CSME, CSCR, CNVM, ARMD) It is used to seal focal leak in

macula.  Grid laser : (Diabetic Retinopathy case)

This is applied all over macular area expect fovea.

Peripheral PRP : (PRP 1 SITTING)

In vacuities case when there is NVD, NVE Peripheral PRP is done.

In diabetic Retinopathy cases additional laser is done.

Sector PRP :

BRVO case to seal small NVE, NVD and new vessels.

Scatter PRP : (PRP I SITTTING) This is done for small NVD, NVE.

Full scatter PRP : (PRP 2nd SITTTING) PRP 2nd is done for

Large NVD NVE Pre Retinal Hemorrhage Sub Hyloid Hamaarge Fibrous Vascular Proliferation Old CRVO.

• Barrage laser: PAY-750/-, FREE -375/-

• Done for:High myopicLattice Lattice with holeOne eye RD surgery done other eye having lattice case Post operative RD surgery with any fluid leakage.

• Xenon laser:

Retinal Tumor (small) Retinoblastoma case

In case with cataract changes, media haziness, VIT-haemorrhage.

Immediate post operative cases slit lamp is not used. In such cases laser delivered via I/O.

• YAG PI :

In this procedure a free thickness hole is made in iris.

Done in cases : Angel closure glaucomaPACGPOAG Non opthalomas, SOAG (PXF),Pupillary black

YAG Capsulotomy :

This laser is used to clear posterior capsular opacity.Cases:

Cataract + PCIOL + PCO Done: After 3 months.

• ALS :( Argon laser suturoysis):

• Hoskins lens

• Post operative IOP high, Bleb not forming, and high astigmatism cases.

• No charges

• ALT: (Argon laser Trabeculoplasty):

• Glaucoma last stage.

• When patient us non compliant to drugs,

• ALT is done. It reduces to the IOP but there is no improvement in vision.

• Cryopexy:

• Cryopexy is used when the hole is in peripheral retina.

• The hole is sealed used N2O Gas.

• ARC : ( Anterior Retinal Cryopexy) :

• Cases:• Pain full• blind eye,• NOPL, • Absolute glaucoma cases. (3600 angel)

It is done to relieve pain and not for improvement of vision.

• ERG :( Electro Retino Gram) :

• It is not theraptic but only diagnostic use.

• It is used to diagnose all retinal diseases especially RP case.

• TTT : ( Trans pupillary Thermo Theraohy) :

• This is done in cases of SRNVM in macular area.

• PDT :( Photo Dynamic Therapy):

• It leaves no scar. It is done in dark room.

• Should not be exposed to sun light for 3 days.

GLACOMA CLIIC

HFA : ( Humphrey Field Analyzer):

To check for Field of vision.

Glaucoma - All cases

Neuro - AION.

• OCT :( Optical Coherent Tomography):

- To measure the macular thickness

and cupping changes.

Glaucoma - POAG, PACG, POAG Suspect.

Retina - ARMD, Diabetic macular edema, CME,

CSR, Macular Hole. -

- Pay with out print (BE)

• GDX:

Rate- 18, 00,000

• Same OCT

Only glaucoma cases.

Can be done undilate eyes.

• CCT :( Central Corneal Thickness):

- RATE:2O,OO,OOO

- To measure central corneal thickness.

- All glaucoma and cornea cases - Especially in Lasik case.

• 5. Fundus Photo:

Glaucoma - Comparisons of Optic Nerve Head. - Mainly use in Retina cases

if laser need.

CORNEA CLINICOrbscan:

• Cases: High myopia

Kerato conus,

Hypermetropia, Pterygium (Study purpose) cases.

It is used to diagnose corneal thickness and K-reading.

ORBIT CLINIC

• Exophthalmometry: Proptois case.

• Diplopia charting: TRO Case.

• X-ray Orbit : Proptosis, Sinusitis, IOFB, Ocular Tumors

• B-SCAN : TRO, Inflammation of orbit (Proptosis).

• CT-SCAN Orbit :-RATE-2,000

• Orbital Tumors

• Injures of Orbit

• IOFB.

NEURO OPHTHAL CLINIC Fields :

Drivers

Medical Fitness Optic atrophy Temporal pallor, Cortical blindness Lesions in visual pathwaysCSCRRD

RPPost PRP Hereditary Fundus DystrophyOptic Neuritis AIONTraumatic Optic Neuropathy Diabetic PappilopathyPappioedema Cranial Nerve Palsies

Colour vision:

Drivers, Medical fitness, Optic atrophy, Temporal Pallor, Optic Neuritis, AION, Traumatic Optic Neuropathy, Congenital colour blindness, Diabetic Papillopathy, Papilloedema, Cranial Nerve Palsies.

Hess Chacting & Diplopia Charting:

Cranial Nerve Palsies (2nd, 3rd, 4th)

Myastheniagrnins, Ocularmyopathy.

CT-Scan & CT-Angiography:

Chronic Head ache, Optic Neuritis Papilloedema Bergin ICT high (BIH) Field defect Traumatic Optic Neuropathy Tumors of brain Head Injury Nerve Palsies Aneurysms Intra Cranial Bleedings CVA

 MRI:

Unexplained Neurological defects,

Cartico - Cavernonsfistula.

MRI & MRA:

Optic Neuritis (Demyelization)

Aneurysms and Vascular abnormalities