Ankur Vishwakarma Optometrist

03/05/2024

Myopia control lenses, also known as orthokeratology (ortho-k) lenses or overnight contact lenses, are specialized lenses designed to slow down the progression of nearsightedness, or myopia, particularly in children and young adults. They work by gently reshaping the cornea overnight while sleeping, temporarily correcting vision during the day without the need for glasses or daytime contact lenses. The benefits of myopia control lenses are numerous. Firstly, they can potentially reduce the rate of myopia progression, which is crucial as high myopia increases the risk of eye diseases later in life, such as retinal detachment and glaucoma. Secondly, these lenses offer clear vision throughout the day without the hassle of glasses or traditional contact lenses, providing convenience and freedom for daily activities. Additionally, myopia control lenses can help improve self-esteem and confidence, especially in children and teenagers who may feel self-conscious about wearing glasses. Overall, myopia control lenses offer not only clearer vision but also the potential for healthier eyes and a better quality of life by addressing the underlying issue of myopia progression.

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01/04/2024

Oculomotor Synkinesis

Also known as aberrant regeneration of the third cranial nerve, this condition refers to the abnormal response to firing of the oculomotor nerve causing paradoxical co-contraction of muscles.

In this particular case, the patient presents a secondary synkinesis due to previous oculomotor nerve disfunction caused by an intracranial aneurysm that resulted in massive subarachnoid hemorrhage.

1? Can you see the palpebral elevation when she looks left and down?

31/03/2024

Molluscum Contagiosum

Any suggestion for this patient's treatment ?

30/03/2024

ORBITAL LIPODERMOIDS Lipodermoids are abnormal epibulbar growths of the adipose tissue. A conjunctival lesion, the lipodermoid (dermolipoma) is usually located near the temporal fornix and is composed of adipose tissue and dense connective tissue. Lipodermoids are congenital choristomas. Choristomas are histologically normal tissue found at an abnormal location, in contrast to hamartomas which are benign (not cancer) growths made up of an abnormal mixture of cells and tissues normally found in the body where the growth occurs. Lipodermoids are localized yellowish-white, soft, smooth masses firmly adherent to the overlying conjunctiva. They can be contiguous with orbital fat posteriorly and tend not to involve the cornea anteriorly. They are considered distinct but similar entities to epibulbar dermoids and complex choristomas. Choristomatous lesions make up 10-30% of childhood tumors of the conjunctiva.

30/03/2024

"Ligneous Conjunctivitis is a rare form of chronic conjunctivitis where thick, woody membranes develop on the conjunctiva. It can lead to vision impairment if not treated promptly. Spread awareness, stay informed! "

23/03/2024

👓 Happy Word Optometry Day! 👀 Today, we celebrate the incredible work of optometrists around the globe who help us see the world more clearly. Whether it's finding the perfect pair of glasses or ensuring our eyes are healthy, optometrists play a vital role in our lives. Let's show our appreciation for their dedication and expertise! 🌟🔍

08/12/2023

🔴how to remember and compare simply

◆You have to break up fixation by covering one eye to detect a phoria, whereas a tropia already exists but the patient is trying to fixate with both eyes (alternating fixation on covering)

◆Phorias in general are normal and whereas tropias are pathological

Phorias are generally comitant, whereas tropias can be both comitant and noncomitant

◆Phorias can be detected by the cover uncover test. When uncovering the covered eye observe for a phoria corrective refixation movement

A tropia can be detected by the cover test. The eye that was not covered is observed for a tropia corrective refixation movement.

◆Both Phoria and tropia are measured by the alternate cover test. With uncovering both eyes are observed for a correcting refixation movement

How to do Cover Test to Detect Tropias

The patient fixes a target with both eyes

Cover one eye

Watch the other eye for a tropia corrective refixation movement

If no movement occurs, repeat the process covering the other eye

How to do Cover/Uncover Test to Detect Phorias

The patient fixes a target while one eye is covered

Remove the occluder and watch for any corrective refixation movements in the just uncovered eye
repeat for the other eye to detect any corrective refixation movements

Simpler Way of Dealing with Phorias Versus Tropias

◆ Do a simple cover test to detect a tropia

Then do an alternate cover test in the various positions of gaze

If the initial cover test did not detect a tropia, then you have detected and measured a phoria

If the initial cover test detect a tropia, then you have detected and measured a tropia

other important tests

Prism cover test

* measures the angle of deviation.

* Repeat the alternate cover test, but with a prism bar placed in front of one eye

* adjusting the prism strength until neutralization and then reversal of the corrective movement occurs.

* The prism should be orientated infront of the eye with apex in the direction of deviation (base-out for an esotropia)

Maddox tests

* dissociative tests in which different images are presented to each eye

* assess symptomatic phorias

17/11/2023

All what u need to know about EOM 👁️

🔹 MR

• Origin: Annulus of Zinn

• Ms length: 40 mm

• Tendon length: 3.6 mm

• Insertion: 5.5 from


🔹 LR

• Origin: Annulus of Zinn

• Ms length: 40 mm

• Tendon length: 8.4 mm

• Insertion: 6.9 mm from limbus


🔹 SR

• Origin: Annulus of Zinn

• Ms length : 41 mm

• Tendon length: 5.4 mm

• Insertion: 7.7 mm from limbus

🔹 IR

• Origin: Annulus of Zinn

• Ms length: 40 mm

• Tendon length: 5.0 mm

• Insertion: 6.5 mm from limbus


🔹 SO

• Origin: Sphenoid

• Ms length: 32 mm

• Tendon length: From 10mm pre-trochlea

• Insertion : Posterior superotemporal


🔹 IO

• Origin: Orbital floor

• Ms Length: 34 mm

• Tendon length: Minimal

• Insertion : posterior temporal

🔹 3 rd nerve supply: IR , SR, MR ,IO

🔹 6th nerve supply: LR

🔹 4th nerve supply : SO

🔹 elevators : SR,IO

🔹depressors : IR, SO

🔹 abductors : LR ,SO, IO

🔹 Adductors : MR , SR, IR

🔹 intorters : SO, SR

🔹extorters : IO, IR

🔵 Regarding actions of EOMs

🔹Pure abductors ( LR)

🔹 Pure adductors (MR)

🔹 The two superiors ( SR,SO) are intorters

🔹 The two inferiors ( IR,IO) are extorters

🔹 The two obliques ( SO, IO) are abductors

🔹 The two vertical Recti ( SR,IR) are adductors

🔹 intorters

• Main intorter SO
• 2ry intorter SR

🔹 Extorters

• Main extorter IO
• 2ry extorter IR

🔹 abductors
• Main abductors LR
• 2ry abductors ( two obliques SO , IO)

🔹 adductors

• Main adductors MR
• 2ry adductors ( two vertical recti SR,IR)

🔹 elevators

• Main elevator SR
• 2ry elevator IO

🔹 depressors

• Main depressor IR
• 2ry depressor SO

04/11/2023

30M hospitalized last week after losing consciousness. Dx with Diabetic Ketoacidosis. Presents today with classic triad of ptosis, miosis, and anhidrosis. Full range of EOMs.

02/11/2023

02/11/2023

Diagnosis?

Ankur Vishwakarma OptometristAnkur Vishwakarma@