Computers in ophthalmology practice.

Computers are already in widespread use in medical practice throughout the world and their utility and popularity is increasing day by day. While future generations of medical professionals will be computer literate with a corresponding increase in use of computers in medical practice, the current generation finds itself in a dilemma of how best to adapt to the fast-evolving world of information technology. In addition to practice management, information technology has already had a substantial impact on diagnostic medicine, especially in imaging techniques and maintenance of medical records. This information technology is now poised to make a big impact on the way we deliver medical care in India. Ophthalmology is no exception to this, but at present very few practices are either fully or partially computerized. This article provides a practical account of the uses and advantages of computers in ophthalmic practice, as well as a step-by-step approach to the optimal utilization of available computer technology.

Molecular biologic techniques in ophthalmic pathology.

The polymerase chain reaction (PCR) and nucleic acid hybridization assays are recently introduced molecular techniques that allow for the identification of extremely small quantities of specific nucleic acids. These techniques have significant advantages over more conventional laboratory techniques, but also have some limitations. They are bound to have tremendous potential in diagnostic ophthalmic pathology and also in investigative pathology for deciphering the pathophysiology of ocular diseases. Despite their increased sensitivity and specificity, the results will still have to be co-related with clinical findings for maximum impact. For an ophthalmologist to derive maximum benefit, knowledge of these techniques, and their advantages, and limitations is essential. This article describes the basic concepts of molecular biology and the techniques of PCR, nucleic acid hybridization, and immunohistochemistry.

Postsurgical endophthalmitis: diagnosis and management.

Infectious endophthalmitis following intraocular surgery is a complication that could cause severe visual loss or loss of the eye. The categorisation of the event that led to intraocular infection will help the clinician to predict the infectious agent and begin appropriate therapy. Most of the cases of postsurgical endophthalmitis are seen following cataract surgery. It is important for all ophthalmologists, irrespective of specialisation and areas of interest, to be familiar with the management of endophthalmitis. This review briefly describes the facets of clinical and laboratory diagnosis, pathology, and management. While the different viewpoints in the management of endophthalmitis are mentioned in appropriate places, more attention is paid to present a rational approach to the management of endophthalmitis.

Botulinum toxin in the treatment of paralytic strabismus and essential blepharospasm.

As an alternative to conventional medical and surgical modalities that have met little success in the treatment of paralytic strabismus and essential blepharospasm, we explored the use of botulinum toxin as a treatment of choice in these two disorders. We used botulinum toxin in three patients with paralytic strabismus and in nine patients with essential blepharospasm. In three patients with paralytic strabismus, the botulinum toxin was injected into the ipsilateral antagonist of the paralysed muscle. The preinjection deviations ranged from 18 to 60 prism diopters. Two of these three patients achieved orthotropia around the thirtieth day and thereafter maintained it. The third patient became orthotropic on the eighteenth day, but deviation recurred and therefore required another injection of toxin. In nine patients with essential blepharospasm, botulinum toxin was injected into the orbicularis oculi muscles. Both objective and subjective improvement occurred in all nine patients within seven days and the effect lasted 12 to 15 weeks. Further injection of the toxin produced extremely beneficial results. However, the only significant complication that we encountered in both groups of strabismus and blepharospasm was ptosis, which was usually partial and temporary. From our experience, we advocate the use of botulinum toxin in the treatment of essential blepharospasm.

Treatment of uveitis with immunosuppressive agents.

The spectrum of uveitis constitutes one of the major causes of blindness. Advances in our understanding of the underlying mechanisms have altered the diagnostic and therapeutic approaches. The most notable development is the increasing usage of several immunosuppressive agents. A systematic approach in making accurate diagnosis is central to employment of specific, more effective treatment. One should be cognizant of the potential benefits and risks of each of these agents before exposing the patients to these very potent drugs.