Download Speciality clinics investigation

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,
ARMD, Eales disease.
CNVM
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)
b)
c)
d)
e)
Mature cataract
IOFB cases
Retinoblastoma
Orbit tumor
VIT. haemorrhage (PVD )
• LASER : ( Light Amplification by
Stimulated
Radiation)
Emission of
 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)
b)
c)
d)
Argon laser – Rate – 13,00,000
ND YAG Laser
DF YAG Laser
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.
CSCR
Vasculitis
ARMD
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 myopic
Lattice
Lattice with hole
One 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 glaucoma
PACG
POAG 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):
thickness and
changes.
- To measure the macular
cupping
Glaucoma - POAG, PACG, POAG Suspect.
CME,
Retina
- ARMD, Diabetic macular edema,
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.
in
- All glaucoma and cornea cases - Especially
Lasik case.
• 5. Fundus Photo:
Glaucoma - Comparisons of Optic Nerve
Head.
- Mainly use in Retina
cases if laser
need.
CORNEA CLINIC
Orbscan:
• 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 pathways
CSCR
RD
RP
Post PRP
Hereditary Fundus Dystrophy
Optic Neuritis
AION
Traumatic Optic Neuropathy
Diabetic Pappilopathy
Pappioedema
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