Chapters authored
Retinopathy of Prematurity: A NICU Based Approach
Retinopathy of prematurity is a fibrovascular proliferative disorder affecting the peripheral retinal vasculature in premature infants. It is one of the leading causes of preventable childhood blindness across the globe. The world is currently experiencing ROP as third epidemic, where majority of the cases are from middle-income countries. With intensive use of in-vitro fertilisation (IVF) and multiple births, ROP emerging as a significant problem globally. High quality neonatal services, better equipment, improved training, evidence-based screening protocols and access to ROP specialists preventing blindness due to ROP in most of the countries. For more than three decades, improvement in treatment strategy for severe ROP markedly decrease the incidence of ROP related blindness. Current international screening guidelines recommend ROP screening for all premature infants based on birth weight of less than 1501 g or a gestational age of 30 weeks or less, while latest Indian screening guidelines includes all premature infants with birth weight of <2000 grams or gestational age of <34 weeks. Current strategies include adoption of newer screening guidelines, telemedicine and vision rehabilitation.
Part of the book: Topics on Critical Issues in Neonatal Care
Vogt-Koyanagi-Harada Disease: Current Diagnosis and Management
Vogt-Koyanagi-Harada (VKH) disease is a rare granulomatous inflammatory disease that affects pigmented structures, such as eye, inner ear, meninges, skin, and hair. This disease is mainly a T1 lymphocyte-mediated aggression to melanocytes. The availability of new investigational methods has improved our knowledge of the pathogenesis, clinical approach, diagnosis, and management of VKH disease. The disease has an acute onset of bilateral blurred vision with hyperemia in the absence of prior ocular trauma or any previous intraocular surgery. The chronic phase comprises of ocular and integumentary system pigmentary changes. Ocular findings may be accompanied by meningismus, hearing impairment, and skin lesions in a variable proportion of patients. Prompt diagnosis with early, aggressive, and long-term treatment of high-dose corticosteroids ensures good visual outcomes. The aim of this chapter is to present the clinicopathology, classification, recent imaging, investigations, and management of VKH disease.
Part of the book: Uveitis