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Background: Ultrasound biomicroscopy (UBM) is a noninvasive imaging modality that enables in?vivo visualization of the structures of the anterior segment of the eye. Unlike routine ophthalmic diagnostic ultrasound which uses frequencies of 5–10 MHz, UBM utilizes ultrasound frequencies in the range of 50–100 MHz. The high?frequency probes in UBM allows for higher resolution and better visualization of subsurface ocular structures, even in the presence of anatomic or pathological obscuration. UBM has qualitative as well as quantitative applications in various disorders affecting the anterior segment of the eye. Despite its huge importance, many clinicians lack in knowledge about the technique and its clinical usefulness. The current educational video aims to address this gap in knowledge by highlighting the technique and various clinical indications of UBM. Purpose: The purpose of this video is to demonstrate the technique of UBM and showcase its quantitative and qualitative implications and importance through various clinical cases. Synopsis: UBM is an imaging technique that assesses the depth of tissue structures by measuring the time delay of the returning ultrasound signal. This modality is capable of measuring the size of various structures within the eye, such as the cornea, iris, ciliary body, sclera, and the depth of the anterior and posterior chamber. To perform a UBM, a transducer is inserted into a specially designed eye cup filled with distilled water, creating a water bath environment. Axial and longitudinal scans can be performed in a similar fashion as in routine diagnostic B?scan ultrasound. Quantitative indications for UBM depicted in this video include measurements of corneal thickness, depth of the anterior chamber, and the width of the angle. The video also showcases how UBM can aid in the diagnosis and management of various anterior segment disorders like angle?closure glaucoma, plateau iris configuration, secondary glaucoma, and anterior uveitis with complicated cataract. Qualitative indications for UBM highlighted in this video include its role in intermediate uveitis, ocular hypotony, ocular surface tumors, cystic lesions of iris, and identifying the location and type of intraocular foreign bodies in the anterior segment based on the type of artifact seen. Additionally, the video shows the applications of UBM in scleral and episcleral pathologies. Highlights: This video will educate clinicians about the technique of UBM and showcase a bouquet of UBM findings in various case scenarios, helping one to better understand the potential of this modality in clinical practice.
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During pandemic, eye banks worldwide faced drastic reduction of corneal retrieval. Since precut tissues are uncommon in India, the onus is on corneal surgeons to maximize the donor corneal usage. The stumbling block making the stromal part unusable in the graft preparation of the Descemet membrane endothelial Keratoplasty is the stromal window creation to place the orientation mark on the stromal side of the folded graft. To overcome this, we simply marked directly on the folded Descemet graft, after partly stripping it from the donor cornea. Then, we unfolded, punched, and created two grafts after completely stripping it, retaining the Descemet part for the endothelial Keratoplasty and the stromal part for lamellar Keratoplasty. Initially, we used a special F marker, and later we marked an L using just a spatula. This simple technique needing no extra donor tissue or instrumentation maximizes the tissue utility with proper patient selection.
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Purpose: The COVID?19 pandemic imposed challenges to access rehabilitation intervention to individuals with visual impairment, thereby increasing their disability effects. This study explored the viability maintaining the continuum of care through telerehabilitation. Methods: This study is a retrospective analysis of individuals with vision impairment who underwent telerehabilitation at the center of excellence in eye care at Hyderabad, Telangana, India, between April and September 2020. The International Classification of Functioning, Disability and Health framework was followed to provide services such as counseling for mental well?being, information and resources, educational interventions, Assistive Technology programs, therapeutic interventions for children with multiple disabilities, access to digital audio books and rehabilitation helpline. A team of professionals involved in the service care. Phone and what’s app calls were used to facilitate the training. The duration and the number of training sessions were individual need?based with an average of 45 minutes per session and 175 training sessions. Results: Three hundred and fifty individuals and their families benefited. The service include early intervention (n = 129), and low vision care (n = 176) inclusive of computer training (n = 53), soft skills (n = 53), digital books (n = 55). Nearly two?thirds of the participants were male (n = 205). Conclusion: Evidence from this study suggests telerehabilitation as a successful model of care. A well?planned telerehabilitation approach can expand the scope of reaching the visually impaired from geographically isolated areas where scarcity of service providers and service centers.