Dr Gulzaman

04/11/2024

A black eye, or periorbital hematoma, occurs when blood collects in the tissue around the eye, usually due to trauma. It typically results from an injury, such as being hit in the face.

**Symptoms include:**
- Swelling and discoloration around the eye
- Pain and tenderness in the area
- Possible vision changes if the injury is severe

**Danger Levels:**
- Most black eyes are not serious and heal on their own within a week or two.
- However, if accompanied by severe pain, vision problems, or if there’s concern about a skull fracture, medical attention is necessary.

18/08/2024

Tube Shunt Surgery for Glaucoma
Tube shunt surgery, also known as glaucoma drainage device implantation or glaucoma tube surgery, is a surgical procedure used to lower intraocular pressure (IOP) in patients with glaucoma, particularly those in whom other treatments like medications, laser treatments, or trabeculectomy have failed or are not suitable. It involves the implantation of a small device that helps drain fluid from the eye, reducing the pressure that damages the optic nerve.

1. Purpose of the Surgery

Tube shunt surgery is typically performed when:

Medications and other surgical treatments (such as trabeculectomy) are insufficient to control intraocular pressure.
There is a high risk of failure with traditional surgeries due to scarring or other factors.
Complex types of glaucoma are present, such as:
Neovascular glaucoma (glaucoma with abnormal blood vessel growth).
Uveitic glaucoma (glaucoma associated with eye inflammation).
Congenital or pediatric glaucoma.
The goal is to preserve remaining vision by preventing further optic nerve damage caused by high eye pressure.

25/06/2024

A Sinking Stone

A 23 year old male patient presents with a history of sudden pain and FBS in the right eye for 1 day following trauma with a stone particle while working. Vision was 20/100 and improved to 20/60 with pinhole.

Exam findings include:
An inferior epithelial defect with probable limbal rupture, however Seidel testing was negative at that time. There were 3+ Cells in the anterior chamber with a mild hyphema, a stone particle is seen inferiorly (photo 2). The pupil was mid dilated and sluggish to react with a localized sub conjunctival hemorrhage nasally.

The patient was treated with topical moxifloxacin and steroids hourly, along with steady lubrication. A prompt referral was placed to the corneal surgeon for further surgical intervention and foreign body removal.

02/05/2024

https://docs.google.com/forms/d/e/1FAIpQLSe69C_geLQQvsZqJa-HdBVZMnnCiWaCUn0P6z3qg4bXE_7HDA/formResponse

Corneal Donation form. Plz Donate Corneas and help the needy blind patients.
One donor can give vision to two blind patients.

12/01/2024

Worrisome day 😳

Necrotizing stromal keratitis is an uncommon, but serious problem. While viral etiology is often suspected, one must be careful to rule out bacterial and fungal etiology first.

The combination of stromal inflammation with or without epithelial defect can quickly lead to perforation.

This young female recovered nearly back to baseline with treatment that originally started with antibiotics, followed shortly with oral antivirals and judicious topical steroids.

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02/12/2023

https://youtu.be/L0X5703WtlY?si=tmOC_VezvpaT14V2

08/11/2023

A 40yoM presented to the clinic with a large mass extending from his right eye. He estimates it had been growing for 2-3 years and had not sought medical care until now.

The mass which appeared multilobulated and multicolored seemed to originate from the temporal aspect of his globe had begun to encroach into his visual axis. The intraocular exam was otherwise unremarkable.

Detailed imaging revealed a heterogeneously enhancing mass that arose adjacent to or from the anterior margin of the right lacrimal gland measuring 3.9x0.8x1.9 cm. It appeared to involve the lateral re**us and had likely invaded surrounding lymph nodes. Conjunctival biopsy was performed to assist in identification. Pathology demonstrated a poorly differentiated malignant conjunctival neoplasm, likely round cell carcinoma.

The young man was referred to the local academic institution where orbital exenteration was recommended.

Have a great case and want to help your peers learn something about anterior segment? Direct message us your favorite photos and the case details for a chance to be featured on our page.

23/10/2023

Puri video dekhnyee ka layee link per click kryee👇

https://youtu.be/EfrGpwh5qhI?si=9xDESEFqi65omDYd

20/10/2023

10/10/2023

My article in X catagory has been published internationally . Alhumdullilah ❤️

23/08/2023

ris Arteriovenous Malformation:
▪️Iris arteriovenous malformations (AVM) are rare benign vascular lesions.
▪️This is not a true neoplasm, but rather an anomalous arteriovenous malformation with a tangle of vascular channels at the site of the communication.
▪️These vascular lesions are congenital. They are not associated with any systemic or ocular conditions.
▪️The basic underlying pathology is an artery connects directly to a vein bypassing the capillary network.
▪️This is thought to be due to a local failure of mesenchymal cell maturation.
▪️In normal early vascular development, primitive mesenchymal cells differentiate into solid cords, which then become canalize to form capillary networks.
▪️As blood enters the system, arteries, capillaries, and veins are formed.
▪️The intervening capillaries then retract and atrophy. In iris AVM, extensive atrophy occurs, leaving a single channel to shunt blood across the defective capillary zone.
▪️ While these lesions are benign in nature, they must be differentiated from other causes of abnormal iris vessels such as other iris hemangiomas, pathologic neovascularization of the iris, and dilated normal vessels resulting from chronic inflammation.
▪️Additionally, these lesions often present with a sclera sentinel vessel and thus concomitant malignancy such as uveal melanoma must be ruled out.

18/08/2023

3D view ♥️

15/08/2023

Pseudomonas Scare

This 70 yo AAF reported to clinic with a chief complaint of sudden, painless vision loss in the right eye when she woke up that morning. Vision was light perception. History revealed she had slept in the same contact lens for over a month. She was unsure about the type of CL on her eye and proceeded to pull out a “goodie bag” of different CL trials, most of which were daily disposable. She also receiving treatment for chronic pain.

There was marked edema of the upper eyelid with purulent discharge along the lashes. An impressive central corneal ulcer measuring over 5mmR was present along with a hypopyon. Fundus exam was attempted, but not possible due to the opacity.

A gram negative bacteria was suspected given the purulent discharge and CL wear gave concern for Pseudomonas. Corneal culture was performed followed by debridement of the necrotic tissue in an effort to remove as much of the microorganism as possible. A betadine wash was then performed, and the patient was started on fortified tobramycin and vancomycin in addition to ciprofloxacin, oral doxycycline, and vitamin C.

Culture results confirmed the organism was Pseudomonas aeruginosa and was susceptible to the chosen antibiotics, so on day 3 the patient was started on topical steroids. Image 4 was taken almost 3 months after her initial presentation. Best corrected vision with a scleral lens is 20/150 so the patient plans to have a corneal transplant.

Have a great case and want to help your peers learn something about anterior segment? Direct message us your favorite photos and the case details for a chance to be featured on our page.

12/07/2023

Coming soon👉🏻‼️

10/07/2023

Pediatric eye Examination

03/07/2023

Book online consultation By page instagram page And Whatsapp 👇