Available options for keratoconus managementAmr Mounir
This document discusses various treatment options for managing keratoconus, including glasses, hard contact lenses, corneal collagen cross-linking (CXL), intracorneal ring segments, and keratoplasty. It provides details on the types of intracorneal rings (e.g. kerarings and myoring) and guidelines for when each treatment option is most appropriate based on the severity and progression of the condition, the patient's age, and corneal parameters. Key points emphasized are that keratoconus is a progressive disease, treatment requires customization for each patient, and the goal is to delay or avoid keratoplasty through stabilization and regularization of the cornea.
Corneal ectasias are a group of diseases characterized by corneal thinning and changes in shape. The main types are keratoconus, keratoglobus, and pellucid marginal degeneration. Keratoconus causes a cone-shaped protrusion of the cornea typically in the inferior region. It has a variety of signs on exam including Fleischer rings, Vogt's striae, and corneal scarring. Treatment involves contact lenses, intracorneal ring segments, corneal cross-linking, or transplantation. Keratoglobus is a non-progressive ectasia causing generalized thinning. Pellucid marginal degeneration causes a band of thinning separated from the limbus.
This document provides information about keratoconus, a non-inflammatory thinning of the cornea that causes a cone-shaped bulge. It is most common in teenagers and young adults. The document discusses the definition, stages, etiology, associations, clinical features, investigations, and management of keratoconus. Keratoconus is typically managed initially with glasses or contact lenses, and more advanced cases may require collagen cross-linking, intracorneal ring segments, deep anterior lamellar keratoplasty, or penetrating keratoplasty to correct vision and stop further thinning. Differential diagnoses include keratoglobus and pellucid marginal degeneration.
Keratoconus is a non-inflammatory, progressive thinning and protrusion of the cornea that results in irregular astigmatism and decreased vision. It typically presents after puberty with no gender or racial predilection. Diagnosis is made based on corneal thinning, Fleischer ring, Vogt's striae, and irregular astigmatism seen on keratometry and topography. Mild cases are managed with spectacles while more severe cases require rigid gas permeable contact lenses, Intacs, or corneal transplantation.
This document summarizes a case of keratectasia that developed in a patient's right eye following LASIK surgery. Initially, the patient's vision was good in both eyes after bilateral LASIK, but over three years her vision deteriorated in the right eye. Examination revealed irregular corneal contour with inferior thinning and steepening in the right eye resembling keratoconus. This is a case of keratectasia, a serious complication where the cornea bulges out due to weakening from refractive surgery.
The document discusses Keratoconus, a degenerative eye disorder where the cornea becomes cone-shaped. It describes types and related diseases of Keratoconus and available treatment options including contact lenses, collagen cross-linking, and surgery. Specific contact lens options for Keratoconus are discussed in detail, including Rose K lenses, ClearKone lenses, and scleral lenses. Fitting approaches and considerations are provided for each lens type.
This case report discusses the management of keratoconus in a 24-year-old male. He was referred for contact lens fitting for keratoconus diagnosed 5 years prior in his right eye, which had previously undergone C3R procedure. Topography showed inferior thinning in the right eye. Rose K2 and soft toric lens trials produced good centration and vision. The lenses were ordered and the patient was asked to return for collection. The conclusion discusses recent advances in keratoconus treatment including collagen cross-linking, excimer laser, phakic IOLs, and intrastromal corneal ring segments.
This document discusses keratoconus, a degenerative condition characterized by thinning and steepening of the central cornea. It classifies keratoconus by severity from mild to severe based on diopter measurement. Symptoms include defective vision, photophobia, ghost images, and halos around lights. Diagnosis involves examination findings like scissor reflex on retinoscopy, irregular circles on Placido disc, and thinning/bulging of the central cornea on corneal topography. Management includes spectacle correction for mild cases, rigid contact lenses fitted with light central touch, and intracorneal ring segments or collagen cross-linking to halt progression. Surgery like lamellar or penetrating keratoplasty is indicated for
Management of Keratoconus
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Abnormalities of Shape of Cornea and Corneal Opacity.pptxKAJAYKIRAN41
The document discusses abnormalities of the cornea including ectatic conditions like keratoconus, keratoglobus, and pellucid marginal degeneration. It describes keratoconus in detail including its etiology, clinical features, morphological classification, complications, associations, and treatments. Corneal opacity is also discussed including causes, clinical features, and types of opacity. Keratoplasty is mentioned as a treatment for corneal abnormalities when other measures are not effective.
This document provides an overview of common eye conditions and disorders organized by anatomical structure of the eye. Key points covered include:
- Dry eye, conjunctivitis, keratoconus, refractive errors, uveitis, color blindness, retinal detachment, diabetic retinopathy, age-related macular degeneration, glaucoma, cataracts, and floaters.
- Causes, symptoms, and treatment options are described for each condition.
- Additional details are given on types of conjunctivitis, refractive errors, retinal detachments, diabetic retinopathy, age-related macular degeneration, glaucoma, and surgical procedures for cataracts and retinal detachment.
Keratoconus is a degenerative condition where the central cornea progressively thins and steepens, causing irregular astigmatism and vision changes. While the exact cause is unknown, risk factors include eye rubbing and genetic factors. Diagnosis is based on signs of corneal thinning, steepening, and irregularity seen on examination. Mild cases are managed with glasses or contact lenses, while more severe cases may require corneal collagen crosslinking or surgery.
This document summarizes various congenital corneal abnormalities including microcornea, megalocornea, and cornea plana. It then discusses corneal ectasias like keratoconus, keratoglobus, and pellucid marginal degeneration. Keratoconus is characterized by thinning and distortion of the cornea and can be detected using tools like retinoscopy, slit lamp examination, and corneal topography. It progresses slowly from puberty to middle age. Treatments include spectacles, rigid gas permeable contact lenses, and keratoplasty. Keratoglobus involves generalized corneal thinning from birth. Pellucid marginal degeneration causes inferior corneal thinning in a crescent shape.
This document summarizes various congenital corneal abnormalities including microcornea, megalocornea, and cornea plana. It then discusses corneal ectasias like keratoconus, keratoglobus, and pellucid marginal degeneration. Keratoconus is characterized by thinning and distortion of the cornea and can be detected using tools like retinoscopy, slit lamp examination, and corneal topography. It progresses slowly from puberty to middle age. Treatments include spectacles, rigid gas permeable contact lenses, and keratoplasty. Keratoglobus involves generalized corneal thinning from birth. Pellucid marginal degeneration causes inferior corneal thinning in a crescent shape.
This document provides information on keratoconus, a noninflammatory corneal ectasia characterized by progressive corneal thinning and protrusion. It discusses the etiology, pathophysiology, clinical features, diagnosis, and treatment modalities for keratoconus. Treatment options include spectacle correction, contact lenses, intrastromal corneal ring segments, collagen cross-linking, and corneal transplantation if visual correction is no longer possible due to excessive thinning or scarring.
This document discusses keratoconus, a progressive eye disorder causing corneal thinning and irregular astigmatism. Key signs include an irregular red reflex seen with an ophthalmoscope, Vogt striae seen on slit lamp exam, and a protruding cone shape of the cornea. Diagnosis involves examining the cornea and using tools like keratometry and OCT. Treatment focuses on rigid contact lenses to correct vision and corneal collagen cross-linking to slow progression. Surgical options like intrastromal corneal ring segments or keratoplasty may be considered for more advanced cases.
Keratoconus is a non-inflammatory bilateral ectatic condition of the cornea that causes progressive thinning and conical protrusion. It typically starts during puberty and progresses slowly. Symptoms include irregular astigmatism and myopia. Signs include Fleischer's ring, Munson's sign, and irregular astigmatism on retinoscopy. Treatment options include glasses, rigid gas permeable contact lenses, INTACS, collagen cross-linking, and keratoplasty for later stages. Keratoglobus is a rare noninflammatory diffuse corneal ectasia present from birth. Lenticonus is a rare congenital anomaly of the crystalline lens characterized by a conical protrusion on the lens capsule.
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Reimbursement Bootcamp- Coding, Coverage & Payment lecture by David Farber, K...Levi Shapiro
Presentation by David Farber, King & Spalding LLP, "Reimbursement Bootcamp- Coding, Coverage & Payment". Includes a comparison of FDA and CMS – The Important Differences. Setting Expectations and Understanding Timing. FDA Approval/Clearance vs. CMS (Medicare) Coverage. “Reasonable and Necessary”
CMS coverage determination
(formal or informal);
Focus on health benefits;
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External technology assessments;
Advisory committee recommendations;
Position statements by relevant groups; Expert opinions;
Public comments;
Economic and other cost-effectiveness data;
Other informal opinions. The Basics of Reimbursement
• Coverage
Is the item or service eligible for payment?
• Coding
How is the item or service identified?
• Payment
What are the payment methodologies and amounts?
Medicare Coverage:
Defined Benefit Category
Not Excluded
“Reasonable and necessary for
the diagnosis or treatment
of illness or injury or to improve
the functioning of a malformed
body member.”
— Social Security Act § 1862(a)(1)(A). CMS and Its Contractors Make
Medicare Coverage Decisions
• National Coverage
Determinations (NCDs)
• Local Coverage
Determinations (LCDs)
• Individual Consideration
National Coverage
Determinations (NCD):
National and binding decision by CMS
Coverage and Analysis Group (CAG).
May be requested by anyone
(CMS or external party.)
Public process that generally takes
9-12 months once initiated.
May include certain conditions for coverage (including Coverage with Evidence
Development (CED)). Coverage with Evidence Development (CED). Evidence-based coverage paradigm
that permits CMS to develop
coverage policies for treatments
that are likely to show health benefits
for Medicare beneficiaries but for
which the evidence base is not
sufficiently developed. Two kinds of CED: (1) clinical study
and (2) registry. Local Coverage
Determinations (LCD):
Issued by local Medicare
Administrative Contractors (MACs).
May be requested by anyone
(MAC or external party.)
New formal process in 2019 to
request LCDs.
Limited to particular MAC jurisdiction. Medicare Administrative Contractors. Coding is the “language of
reimbursement.”
Coding operationally links
coverage and payment.
Having a code does not
guarantee reimbursement! TYPE OF CODE, CODING SYSTEM, WHO SETS CODE? WHO USES CODE? Diagnosis, Procedure or Service, Products and Certain Services, Drugs. Current Procedural Terminology (CPT) Codes. Maintained by the AMA CPT Editorial Panel.
Identify medical services furnished by physicians.
5-digit numeric codes with generic descriptors.
Three types of CPT codes. Application process takes at least 15 months for Category I codes, with specific clinical data requirements.
Attitude and Readiness towards Artificial Intelligence and its Utilisation: A...ShravBanerjee
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Artificial Intelligence (AI): The theory and development of computer systems able to perform tasks normally requiring human intelligence, such as visual perception, speech recognition, decision-making, and translation between languages.
Our study showed that:
1. Nearly half of the study participants showed a favorable attitude towards role of AI in healthcare
2. Around three-fifth of the participants could define basic concepts of data sciences and AI and were ready to choose AI based applications for healthcare; they were willing to accept AI usage despite feeling a lack of cognitive skills
3. Most of them used AI-based applications for studying (ChatGPT), however, some of them faced difficulties in using them
Thank you!
"NeuroActiv6: Revitalize Your Mind with Youthful Energy and Clarity"Ajay Agnihotri
In today's fast-paced world, maintaining mental clarity and energy can be challenging. The constant demands of work, family, and social commitments often leave us feeling drained and foggy. Enter NeuroActiv6, a revolutionary supplement designed to rejuvenate your mind and restore youthful energy and clarity.
NeuroActiv6 is a brain-boosting supplement that combines a unique blend of natural ingredients known for their cognitive-enhancing properties. This powerful formula is designed to support brain health, improve mental performance, and boost energy levels. Whether you're a busy professional, a student, or someone looking to enhance your cognitive function, NeuroActiv6 offers a range of benefits to help you achieve your goals.
NeuroActiv6 works by providing your brain with the essential nutrients it needs to function at its best. The combination of these powerful ingredients helps reduce brain fog, improve focus and concentration, and increase energy levels. By supporting brain health and enhancing cognitive function, NeuroActiv6 allows you to tackle your day with renewed vigor and mental clarity.
50 Hr – Restorative Yoga Teacher Training Certificate Course
50 Hr – Restorative Yoga Teacher Training Course
Course Fee: INR 15,000 for Indian citizens only, for foreigners USD 350.
Yoga Manual (01)
Certificate
Excluded with accommodation and food
Upcoming Batches 50 Hr Non-Residential (Week-Days/Week-End)
Professional Yoga Teacher Training
Our 50 hours Restorative Yoga Teachers Training Course is beautifully programmed for those enthusiasts who desire to have a professional certificate in the future but can’t afford the time of two months in one slot.
If you have less time or you want to learn slowly, so 50-hour yoga teacher training course in Bangalore can be the perfect yoga course for you, karuna yoga offers a self-paced yoga teacher training course in Bangalore India, and you can join the other half in 1 year of time to complete 200/300 hours Teacher Training Course.
In order to obtain a professional certificate of 200/300 Hour, Teachers Training Course affiliated with the Yoga alliance one has to complete 200 Hours which is usually completed in one or two months of time, we designed this course in such a way that if any participant wants to first get introduced with the way and process of professional yoga teacher training course and have only short time then students can enroll for this yoga course.
Our 50 hours Yoga Teacher Training Course program runs along with our regular student of 200/300-hour Teacher Training Course students in the first phase, upon completion of the course if a student wants to finish remaining their balance of 150/250 hours of Teacher Training Course in the future, then students can continue the course of the second stage of Teacher Training Course to obtain 200/300-hour Teacher Training Course certificate affiliated with Yoga Alliance in order to have a professional certificate.
Our 50 hours can be accepted as continuing education from Yoga Alliance if in the future you want to continue the training from our center. Please make a note while completing 50 hour TTC you will be only provided with a certificate issued by our organization and the certificate will not be affiliated with Yoga Alliance, and only after completion of the second stage of balance 150/250 hours of TTC, which technically becomes 200/300 hours in total of training, we will issue the certificate of 200/300-hour Teacher Training Course.
Karuna Yoga Vidya Peetham is a Registered Yoga teacher training school in Bangalore, India with an affiliation of Yoga Alliance, USA which offers 50 Hour Yoga Teacher Training in Bangalore, India. If you look forward to the course then this is the best choice.
International Certification
Upon successful completion of the course, you will receive a certificate of completion of the 20 hour Hatha Yoga course, that you can count towards your continuing education. Our yoga teacher training courses are accredited by Yoga Alliance USA.
Pre-requisites:
This course is open to all students who wish to deepen their
CHAPTER THREE: MUDRA AND BANDHA
Chapter 3 Verse 1 Kundalini is the support of yoga practices
As the serpent (Sheshnaga) upholds the earth and its mountains and woods, so kundalini is the support of all the yoga practices.
Chapter 3 Verse 2 Guru’s grace and opening of the chakras
Indeed, by guru's grace this sleeping kundalini is awakened, then all the lotuses (chakras) and knots (granthis) are opened.
Chapter 3 Verse 3 Sushumna becomes the path of prana and deceives death
Then indeed, sushumna becomes the pathway of prana, mind is free of all connections and death is averted.
Chapter 3 Verse 4 Names of sushumna
Sushumna, shoonya padavi, brahmarandhra, maha patha, shmashan, shambhavi, madhya marga, are all said to be one and the same.
Chapter 3 Verse 5 Sleeping goddess is awakened by mudra
Therefore, the goddess sleeping at the entrance of Brahma’s door should be constantly aroused with all effort by performing mudra thoroughly.
Revolutionize Pain Management with Almagia’s PEMF Devices Shop Now.pptxALMAGIA INTERNATIONAL
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Etiologies of Bipolar disorders. Power Point Presentation ptxseri bangash
www.seribangash.com
Bipolar disorder, formerly known as manic-depressive illness, is a complex psychiatric condition characterized by extreme mood swings that include emotional highs (mania or hypomania) and lows (depression). The etiology of bipolar disorder involves a combination of genetic, biological, and environmental factors. Here's a breakdown of these etiologies:
Genetic Factors:
Family History: Bipolar disorder tends to run in families, suggesting a genetic component. Studies indicate that having a close relative with bipolar disorder increases the risk.
Genetic Studies: Research has identified specific genetic variations associated with bipolar disorder. These include genes involved in neurotransmitter signaling, ion channel function, and circadian rhythms.
Neurobiological Factors:
Neurotransmitter Imbalance: Imbalances in neurotransmitters such as dopamine, serotonin, and norepinephrine are implicated in bipolar disorder. For example, elevated dopamine levels during manic episodes and decreased levels during depressive episodes.
Neuroendocrine Factors: Dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis and abnormal cortisol levels have been observed in individuals with bipolar disorder.
Neuroanatomical Factors:
Brain Structure and Function: Structural and functional abnormalities in certain brain regions are linked to bipolar disorder. These include the prefrontal cortex, amygdala, and hippocampus, which are involved in emotional regulation and cognition.
Environmental Factors:
Stress: Stressful life events, such as trauma, loss, or significant life changes, can trigger or exacerbate episodes of bipolar disorder.
Substance Abuse: Substance use, particularly stimulants or drugs that affect neurotransmitter systems, can precipitate manic episodes or worsen the course of the disorder.
Developmental Factors:
Early Life Experiences: Adverse childhood experiences, including abuse, neglect, or chronic stress, may increase susceptibility to developing bipolar disorder later in life.
Trajectories: Some individuals may have a prodromal phase marked by subthreshold symptoms or other behavioral indicators before full-blown episodes manifest.
Yoga for Hypertension and Heart Diseases
Yoga Hypertension and Heart Diseases Certificate Course
Prevention and healing have been always the main purpose of yoga therapy practice. Yoga therapy is the process of empowering every individual to progress toward better health and optimal well-being through the application of the teachings and practices of Yoga therapy class. With the support of the Yoga trainer, implements a personalized and evolving Yoga therapy techniques that not only addresses the illness in a multi-dimensional manner, Pancha Kosa (Five Sheaths): Annamaya Kosha (Physical Body), Pranamaya Kosha (Energy Field), Manomaya Kosha (Mental Dimension), Vignanamaya Kosha (Psychic level of experience), Anandamaya Kosha (Bliss and Beatitude). It helps to reduce patient suffering in a progressive, non-invasive and complementary manner.
Why to study yoga Hypertension and Heart Diseases course?
Consequently, the demand for yoga therapist with specialized knowledge in yoga as a therapeutic tool, in different fields such as: health management organizations, hospitals and alcohol rehabilitation centers have grown rapidly. Studying yoga therapy as a tool to overcome and ease the symptoms of common illnesses has become extremely popular recently, due to the great therapeutic effects yoga practitioners experience in their body, mind and soul.
What you will learn from this course?
You may offer special seminars for people with similar diseases/conditions.
You will learn how to use yoga to assist in healing ailments and managing conditions?
You aim to be part of a positive change regarding health and lifestyle habits.
You want to teach people how to prevent diseases.
In group classes, you can teach your students how to become healthy.
You will feel more self-confident when approached by students that come to yoga seeking for support in their healing process.
Therapeutic applications of posture, movement and breathing.
Pre-Requisites:
This course is open to all students who wish to deepen their knowledge and application of some of the highest teachings of
Participants do not need to be yoga
Mastery of any yoga practice is not
Only yours sincere desire for knowledge and your commitment to personal
Love for Yoga is the most important eligibility factor for learning this course.
Students who want to know Yoga in totality and move beyond Asana and Pranayama, Mudra & Bandha.
Assessment and Certification
The students are continuously assessed throughout the course at all levels. There will be a written exam at the end of the course to evaluate the understanding of the philosophy of Yoga and skills of the students. Participants should pass all different aspects of the course to be eligible for the course diploma.
What do I need for the online course?
Yoga mat
Computer / Smartphone with camera
Internet connection
Yoga Blocks
Pillow or Bolster or Cushion
Strap
Notebook and Pen
Zoom
Recommended Texts
Asana Pranayama Mudra Bandha by Swami
2. Introduction
From Greek
Kerato= Cornea
Conus = Cone-shape
Definition - keratoconus is a degenerative non-inflammatory
disease of the cornea where the central or paracentral cornea
undergoes progressive thinning , changing it from dome-shaped to
cone shape , causing irregular astigmatism.
4. Onset of keratoconus
It can be anywhere between the ages of 8 and 45.
In the majority, it becomes apparent between the ages of 16 and 30
years .
It affects male and female equally .
KC is present in both eyes in over 90% of cases.
Onset is not always at the same time or to the same magnitude .
KC is has been associated with conditions such as-
• Hay fever
• Asthma
• Eczema
• Down’s syndrome
• Marfan’s syndrome etc.
5. Etiology
Still unknown.
The incidence of KC reported to be 1 in 2000 people
Heredity- there is less than one in ten chances that a blood relative
of keratoconic patient will have KC.
Eye rubbing- especially children due to some diseases as vernal
keratoconjunctivitis . So corneal curvature will be changed . Eye
rubbing among keratoconic patient has been reported 66% to 73% .
Hormonal change - that KC is often first develops around puberty.
Or advances during pregnancy.
Contact lens wearer- uncorrect fitting.
6. Classifications
Based on severity of curvature -
• Mild: <45.00D
• Moderate: 45.00D to 52.00D
• Advanced: 52.00D to 62.00D
• Severe: >62.00D
Based on shape -
• Nipple cones: cone small size 5mm
• Oval cones: larger ellipsoid 5-6mm
• Globus cones: largest>6mm, may involve over 75% of
cornea
7. Nipple cone Oval cone Globus cone
• Diameter: <5mm
• Cone: lies in centre towards
inferior nasal quadrant
• Easiest to fit with CL
• Diameter: >5mm
• Cone: displaced
inferiorly
• More difficult to fit
with CL
• Diameter: >6mm
• Cone: steepening
• 75% affected cornea
• Most difficult to fit with CL
9. The classic signs of KC
Corneal nerves:
• More prominent then in
normal eye.
Vogt’s striae:
• Fine vertical line in the
stroma and Descemet’s
membrane.
• disappear temporarily on
digital pressure.
Fleischer’s ring:
• Iron pigment ring forms
the base.
• May be partial or
complete.
10. The classic signs of KC
Corneal thinning:
• Represents an actual
reduction in the number
of stromal lamellae.
Munson’s sign:
• Ectasic protrusion of the
cornea on down gaze
produces a V-shaped
conformation of the lower
lid.
Rizzuti sign:
• Lateral illumination of the
cornea produces a steeply
focused beam of light near
the limbus.
11. Corneal scarring:
• Sub-epithelial corneal scarring.
• Not generally seen early.
• May occurs as keratoconus
progresses because of ruptures in
bowman’s membrane which is then
filled with connective tissue.
Corneal hydrops:
• Occurs generally in advanced cases,
when Descemet’s membrane
rupture, aqueous flows into the
cornea and reseals.
12. Diagnosis
Diagnosing keratoconus in its early
stages is more difficult . It requires a
through history and examination .
• Visual acuity – Reduced visual acuity
due to oblique astigmatism.
• Retinoscopy – scissor reflex
• Keratometer- distorted mires
• Ophthalmoscopy – oil droplet
• Reduced intraocular pressure- due to
corneal thinning or reduced scleral
rigidity.
13. • The topography of keratoconus – the photokeratoscope or placido
disc can provide an overview of the cornea and can show the
relative steepness of the corneal area.
Photokeratoscope with normal round curvature Distorted pattern of the rings.
14. Nipple-Shaped Topography
Small near central ectasia, less than
5.0 mm in cord diameter .
May manifest as a small central ectasia
with moderate to high with-the-rule
corneal astigmatism.
17. Management of kc
Spectacles-
• Mild keratoconus in early stage
can be corrected with spectacles.
• As the cornea steepens and
becomes more irregular , glasses
not capable of providing adequate
visual improvement.
18. Contact lenses -
• Soft contact lenses.
• Rigid gas permeable lenses.
• Combined lens system-
1. Piggy back system
2. Hybrid lens system
• Fully keratonic designed lenses-
1. Rose k
2. Scleral and mini scleral lens
19. soft contact Lenses -
• It is not better than spectacle lens but it works in piggy back system
.
• At very stage, this way work as equal to spectacle .
• But patient may not be satisfied with the level of vision he has even
though it is 6/6-
• Shadow effect of texts
• Ghosting of image
• Poor night vision
• Eye fatigue on prolong reading
20. Rigid Gas Permeable Lenses -
• Cost effective , easily available ,
suitable for mild to moderate
keratoconus .
• Fitting: three point conventional
fitting philosophy.
21. combined lens system -
Piggy back system-
Rigid lens fitted over a hydrogel lens
increases comfort resulting in
adequate wearing time with good
vision .
22. combined lens system -
hybrid lens system –
One way to overcome the problems with piggyback lenses, yet have
the optics of a rigid lens with the comfort of a hydrogel , it is to fuse a
soft rim onto a hard central portion .
24. Surgical intervention-
Collagen cross-
linking (CXL or C3-
R):
It may slow or halt the
progression of
keratoconus by using a
photo-oxidative treatment
to increase the rigidity of
the corneal stroma .
25. Keratoplasty
• For patients intolerant to contact lens and cases with scarring.
• Penetrating keratoplasty and Deep anterior lamellar keratoplasty can
be done .
Penetrating keratoplasty:
In this procedure , the central area
of the cornea is excised and a full-
thickness corneal button is sutured
into the recipient
26. Lamellar keratoplasty:
A partial thickness portion of the cornea is excised and a partial
thickness donor corneal button is sutured into the recipient
transplant .
27. Intacs: intrastromal corneal ring –
Two arc shaped segments of inert plastic are inserted into the
peripheral (outer) cornea.
These segments add volume to the thinned area .
This flattens the steep curvature and reduces the irregular shape.
28. STEPS IN KERATOCONUS TREATMENT
KERATOCONUS
PROGRESSIV
E
NON PROGRESSIVE
SPECTACLE
S
CONTACT
LENSES
CXL
CORNEAL SCLERAL
INTACT
S
CORNEAL
TRASPLANT
S
PHAKIC
IOLS
ACCELARAT
ED CXL
SURGICAL
OPTIONS
SCLERAL LENSES ARE THE BEST CHOICE FOR KERATOCONUS