KERATOPLASTY

Keratoplasty, also called corneal grafting or corneal transplantation, is an operation in which the patient's diseased cornea is replaced by the donor's healthy

STROMAL CORNEAL DYSTROPHIES

Granular dystrophy
Also known as 'Groenouw type I, is an autosomal
dominant dystrophy characterised by milky-granular
hyaline deposits in anterior stroma. Intervening
stroma is

HERPES ZOSTER OPHTHALMICUS Treatment

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Therapeutic approach to herpes zoster ophthalmicus should be vigorous and aimed at preventing severe devastating ocular complications and promoting rapid healing of the skin lesions without the formation of massive crusts which result in scarring of the nerves and postherpetic

Pterygium Treatment.

Treatment. Surgical excision is the only satisfactory
treatment, which may be indicated for: (1) cosmetic
reasons, (2) continued progression threatening to
encroach onto the pupillary area (once the pterygium
has encroached pupillary area, wait till it crosses on
the other side), (3) diplopia due to

Phlyctenular keratitis.

Corneal involvement may occur secondarily from extension of conjunctival
phlycten; or rarely as a primary disease. It may present in two forms: the 'ulcerative phlyctenular keratitis' or 'diffuse infiltrative keratitis'.

A. Ulcerative phlyctenular keratitis may occur in the following three forms:
1. Sacrofulous ulcer is a shallow marginal ulcer formed due to breakdown of small limbal phlycten. It differs from the catarrhal ulcer in that there is no clear space between the ulcer and the limbus and its

TRACHOMA Complications & Diagnosis

Complications
The only complication of trachoma is corneal ulcer
which may occur due to rubbing by concretions, or
trichiasis with superimposed bacterial infection.

Diagnosis
A. The clinical diagnosis of trachoma is made from
its typical signs; at least two sets of signs should be
present out of the following:

INFLAMMATIONS OF CONJUNCTIVA

Inflammation of the conjunctiva (conjunctivitis) is
classically defined as conjunctival hyperaemia
associated with a discharge which may be watery,
mucoid, mucopurulent or purulent.

Etiological classification
1. Infective conjunctivitis: bacterial, chlamydial, viral, fungal, rickettsial, spirochaetal, protozoal, parasitic etc.
2. Allergic conjunctivitis.

3. Irritative conjunctivitis.
4. Keratoconjunctivitis associated with

Refractive surgery for presbyopia

Refractive surgery for presbyopia, still under trial,
includes :

• Monovision LASIK, i.e., one eye is corrected for distance and other is made slightly near sighted.
• Monovision conductive keratoplasty (CK) is being considered increasingly to correct presbyopia in one eye. Principle is same as for correction of hypermetropia.
• Scleral expansion procedures are being tried, but results are controversial.
• LASIK-PARM i.e., LASIK by Presbyopia Avalos Rozakis Method is a technique undertrial in which the shape of the

Refractive surgery for astigmatism

Refractive surgical techniques employed for myopia
can be adapted to correct astigmatism alone or
simultaneously with myopia as follows:
1. Astigmatic keratotomy (AK) refers to making
transverse cuts in the mid periphery of the steep
corneal meridian (Fig. 1).

Fig. 1. Astigmatic keratotomy. (A) showing flat and deep meridians of cornea; (B) paired transverse incisions to flattern
the steep meridian; (C) showing correction of astigmatism after astigmatic keratotomy.

AK can be performed
alone (for astigmatism only) or along with RK (for
associated myopia).
2. Photo-astigmatic refractive keratotomy (PARK)
is performed using