Aji K Devadas

Mahathma Eye Hospital, Trichy, Tamil Nadu, India · Optometry

Purpose The purpose is to find out changes in endothelial cell density (ECD) in eyes undergoing phacoemulsification (Phaco) versus manual small-incision cataract surgery (MSICS) or small-incision cataract surgery (SICS) with 6-month postoperative follow-up. Methods An observational prospective study of 200 eyes of 200 patients was conducted over 1...

Keratoprosthesis - Grafting the Curve The slit lamp biomicroscopy photograph reveals a Boston 1 Keratoprosthesis in situ, in diffuse illumination in the postoperative period. The Boston Keratoprosthesis (KPro) is the most widely used artificial cornea or Keratoprosthesis. It is a treatment option for corneal disease not amenable to standard penetra...

Retinochoroidal colobomas are rare congenital anomalies of the eye. It has varying clinical presentations depending on the extent and involvement of ocular tissue, which can either be unilateral or bilateral. Choroidal colobomas are the most common type of ocular colobomas, and it is important to learn its various types. It can present with other a...

The foetal vasculature gives nourishment to the developing lens and retina during embryonic development and then regresses after the formation of the retinal vessels. The failure of the foetal ocular vasculature to go through the usually planned involution results in persistent foetal vasculature (PFV), which causes blindness or severe vision loss....

Glaucoma, a prevalent and debilitating eye disease, has long been associated with vision impairment and blindness. However, recent research has shed light on the often-underestimated psychological dimensions of this condition. Anxiety and depression, two pervasive psychiatric comorbidities, have been increasingly recognized among glaucoma patients....

This comprehensive review embarks on a captivating journey into the complex relationship between cardiology and normal-tension glaucoma (NTG), a condition that continues to baffle clinicians and researchers alike. NTG, characterized by optic nerve damage and visual field loss despite normal intraocular pressure, has long puzzled clinicians. One eme...

Standard automated perimetry (SAP) is the gold standard and an internationally accepted device for evaluating the presence of visual field defects (VFDs) in the glaucoma patients. Nevertheless, it needs some unavoidable conditions, such as prolonged attention, stable fixation, and space restriction. Moreover, it was nearly impossible to assess the...

Secondary open-angle glaucoma (SOAG) is a rare yet consequential complication following implantable collamer lens (ICL), also known as a phakic intraocular lens insertion, particularly in high myopia patients. This case report emphasizes the importance of recognizing SOAG and details the diagnostic complexities, reevaluation procedures, and success...

The landscape of glaucoma treatment has undergone a profound shift with the introduction of minimally invasive glaucoma surgery (MIGS), and within this paradigm, the emergence of mixed and compound MIGS has signaled a transformative departure from traditional approaches. Mixed MIGS intricately blends various MIGS techniques from the same anatomical...

Ophthalmic imaging has shown tremendous progress in the past century in terms of numerous advancements in the way we image and interpret the human eye, with all its intricacies. Recent times have emphasized imaging as a diagnostic tool, a modality to document patient progress, and a useful learning medium for budding clinicians. Imaging in ophthalm...

Glaucoma is a chronic, progressive eye disease that causes irreversible damage to the optic nerve head. Visual field loss, the functional change seen in glaucoma correlates well with structural loss in the neurosensory part of the eye involving the retinal ganglion cell layer (GCL) and retinal nerve fibre layer (RNFL). Early assessment and preventi...

Photo Essay A 75-year-old male patient came for a regular ophthalmic examination with a best corrected visual acuity of 20/20 in both eyes. Examination revealed involuntary closure of his right eyelid on opening his mouth [Figure 1]. On questioning, the patient revealed that he had developed facial paralysis 40 years ago, after which he had involun...

In this manuscript, we have reported an augmented reality (AR) application named, 'Eye MG AR' innovated by us, to show different anatomical/pathological parts of the eyeball pertaining to glaucoma, from multiple customized angles of the user's choice to simplify glaucoma learning and clinical counseling. It is available free of cost from the Google...

Purpose: A novel convolutional neural network approach in detecting diabetic retinopathy (DR) was employed to overcome the black box dilemma in artificial intelligence (AI). In addition to identification and classification, this tool is intended to identify signs such as microaneurysms, hard exudates, dot-blot haemorrhages and flame-shaped haemorrh...

Vascular brain damage can manifest as various ophthalmic pathologies. It is important to understand cerebral circulation to understand the aetiopathogenesis of the disease. It can manifest as various ocular pathologies with visual field defects, cranial nerve palsies, orbital diseases, etc. In this review, with the help of three-dimensional (3D) im...

Glaucoma in its early stages is left undiagnosed as it starts affecting the vision from the periphery and gradually move towards the centre. In general, 24‐2 and 30‐2 threshold VF testing strategies, are done routinely to pick up early glaucomatous changes. 10-2 VF testing is reserved for advanced glaucoma and those who have tunnel vision in 24-2 o...

Vogt-Koyanagi-Harada (VKH) syndrome is a rare bilateral granulomatous panuveitis typically affecting the more pigmented races, and women more than men. VKH syndrome is theorized due to a T-cell-mediated autoimmune reaction against antigens related to melanin and melanocytes, that may happen due to cutaneous or viral triggers. Along with the clinica...

A Striking Imaging Canvas in a Patient With Ischemic Central Retinal Vein Occlusion With Minimal Haemorrhages

A 8-year-old female presented to the emergency department with sudden pain and diminution of vision in the right eye (OD). Slit lamp evaluation revealed an anteriorly luxated phakic crystalline lens with 360° visibility of the lens equator OD (Figure 1); the left eye (OS) revealed a small spherical lens with a visible equator on dilatation. Anterio...

The healthcare sector has had a relatively late implementation of environmental thinking in its setup. “Green electronic technologies and go green healthcare system” has recently evolved to address the biodegradability and biocompatibility issues faced by inorganic electronics and non-biodegradable materials. Green healthcare has the capability to...

Aims: This study aims to evaluate the non-mydriatic fundus image quality obtained with a confocal fundus device. Also, to evaluate the influence of non-mydriatic pupil size on image quality. Settings and Design: A cross-sectional study was conducted in the outpatient department of a high-volume tertiary eye care centre in South India during the thi...

Innovations in Ophthalmology Holographic elysium of a 4D ophthalmic anatomical and pathological metaverse with extended reality/mixed reality Extended reality is one of the leading cutting-edge technologies, which has not yet fully set foot into the field of ophthalmology. The use of extended reality technology especially in ophthalmic education an...

Traditional methods for neuroretinal rim width measurement in spectral domain optical coherence tomography (SD-OCT) employs the Bruch's membrane opening (BMO) as the anatomical border of the rim, referenced to a BMO horizontal reference plane, termed as "Bruch's Membrane Opening-Horizontal Rim Width" (BMO-HRW). BMO-HRW is defined as the distance be...

Big data has been a game changer of machine learning. But, big data is a form of centralized version of data only available and accessible to the technology giants. A way to decentralize this data and make machine learning accessible to the smaller organizations is via the blockchain technology. This peer-to-peer network creates a common database a...

The coronicle (corona + cubicle) provides state-of-the-art features required for comprehensive ocular evaluation. Assembling this cubicle requires acrylic sheets, aluminum beading, fevicol, araldite paste, and a jigsaw cutting blade, which can be done in a do-it-yourself template. Dimensions of the cubicle are 16 × 16 × 8 feet with only a total are...

Practical sessions facilitate teaching, critical thinking, and coping skills, especially among medical students and professionals. Currently, in ophthalmology, virtual and augmented reality are employed for surgical training by using three-dimensional (3D) eyeball models. These 3D models when printed can be used not only for surgical training but a...

A 10-year-old male child presented with blunt force injury to his right eye (OD), with best-corrected visual acuity of 20/200. Posterior segment evaluation showed vitreous hemorrhage, Berlin's edema, and choroidal rupture anterior to the equator, parallel to the ora serrata, associated with subretinal hemorrhages. In this manuscript, we have report...

Concepts pertaining to ophthalmology have lots of theoretical frameworks. Neophyte residents and novice surgeons may have to mentally visualize these concepts during the initial days of training. Only a powerful cognitive tool such as a three-dimensional (3D) eyeball model, with real-time TrueColor confocal images (and not animated images or models...

Purpose: For diagnosing glaucomatous damage, we have employed a novel convolutional neural network (CNN) from TrueColor confocal fundus images to conquer the black box dilemma in artificial intelligence (AI). This neural network with CNN architecture with human-in-the-loop (HITL) data annotation helps not only in diagnosing glaucoma but also in pr...

Thromboembolic manifestations of the eye can vary from a trivial tributary retinal vein occlusion to a catastrophic cerebral venous sinus thrombosis. These conditions can be classified as pathologies directly affecting the eye or those causing secondary lesions due to systemic issues and can be managed accordingly. Also, recently the incidence of t...

Cerebral circulation is the flow of blood through a group of arteries and veins which supply the brain. There are various diseases related to ophthalmology, due to pathologies in the cerebral arterial system. Arteries inside the skull can be blocked by plaque or disease, which in turn triggers a series of events leading to various cranial nerve pal...

The field of augmented reality (AR) and three-dimensional (3D) printing are rapidly growing with many new potential applications in medical education and pedagogy. In this chapter, we have used 3D AR and 3D printed models of the cerebral arterial circulatory system, created by us to simplify concept learning. Various cerebral circulation diseases p...

Augmented reality (AR) has come a long way from a science‑fiction concept to a science‑based reality. AR is a view of the real, physical world in which the elements are enhanced by computer‑generated inputs. AR is available on mobile handsets, which constitutes an essential e‑learning platform. Today, AR is a real technology and not a science‑ficti...

In this manuscript, occurrence of an aborted superior-nasal RCC has been reported, which has never been reported in the literature before.

To our knowledge, assessment of striate keratopathy (SK) is subjectively done with slit-lamp bio-microscopic examination, which is the most common practice. In this manuscript, we have reported the role of objective scheimpflug imaging modality, in decoding the healing and repair process of SK, post prolonged cataract surgery. The quantitative and...

In this manuscript, two striking images of spectacle and goggle are reported in the OCT macula image of two advanced diabetic eye disease patients.

The right eye (OD) fundus shows scattered subretinal pigmentary clumping of post retinal detachment (RD) flattened retina; in the structural form of a butterfly, which is usually seen in post exudative RDs. It is also known as leopard’s spots, which is an uncommon but clinically distinct manifestation of various disorders. The causes need to be ass...

Scleral flap tears during trabeculectomy are difficult to repair in a predictable fashion. Donor scleral flap reinforcements are commonly preferred for managing trabeculectomy flap-related over-filtration, leading to shallow anterior chamber (AC). Due to the advent of COVID-19 lockdown, especially in the initial phases, eye banking activities almos...

This manusript highlights the usage of Green Mat technology, as a new-age innovative pedagogical tool for virtual ophthalmic webinars, for continuing medical education in e-ophthalmology during the COVID-19 pandemic.

The coronavirus disease 2019 (COVID-19) pandemic is still not over, and is continuously showing a wide spectrum of thrombotic ophthalmic manifestations in an unpredictable magnitude, with pathologies creeping from trivial vision sparing entities to conditions having irreversible visual losses. The ophthalmic features can develop at any point in the...

Anti-glaucoma medications (AGM) become an integral part of every person’s life, from the day he or she is diagnosed with glaucoma. It is well documented that non-compliance towards glaucoma eye drop medications could result in unnecessary changes to medications or listing for more invasive procedures, thus increasing risk to the patient and costs t...

In this manuscript, we report a rapid intra-operative detection test for visualisation of mucor, with the use of the Smartphone-based intraocular lens microscope (IOLSCOPE). IOLSCOPE helps not only in detecting tissue affected by mucor, but also makes sure that the surgeon does not leave any fungus behind; similar to the principles employed by a ‘F...

In this manuscript, the role of human‑in-the‑loop machine learning for augmenting and supporting glaucoma detection artifical intelligence models are highlighted.

We report a case series of three patients, presenting with the ciliopathic disorder of Bardet–Biedl syndrome, highlighting the need for fundus auto-fluorescence (FAF) and infrared reflectance (IRR) imaging in them, with additional gonadal photographs which are poorly reported in literature.

General Ophthalmology Photo Quiz With Answers

A 35-year-old female presented with severe headache and left-sided hemifacial spasm to the ophthalmic outpatient department. Ocular examination revealed normal visual acuity and color vision, with a presumably normal posterior pole in OU, except for parafoveal central serous chorioretinopathy (CSCR) in OD. Infrared imaging of both fundi revealed g...

Polypoidal choroidal vasculopathy (subtype of exudative age-related macular degeneration)

How patient's face mask position can interfere with performances and safety of bowl-type perimetry versus enclosed chamber perimetry are discussed in this Letter to Editor.

Posterior amorphous corneal dystrophy (PACD) is classically characterised by bilaterally thin and flat central corneas with a deep, stromal sheet-like opacity. The epithelium, Bowman's layer, and anterior stroma are usually normal in PACD. Here, we report a case that had bilaterally anterior oval amorphous corneal opacities, which is different from...