Optometry Club - A.K.D

Optometry Club - A.K.D Dr.A.K.Dwivedi
(Doctor of optometry)
Best Eye Care Advice / Eye diseases & Vision Care / Best Glasses & Contact Lenses /Low Vision Rehabilitation.

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Founder : Arun Kumar Dwivedi 🙏

Describe the fundus pathology 👁️ ?
27/04/2026

Describe the fundus pathology 👁️ ?









26/04/2026

Describe about the Lacrimal apparatus 👁️ ?

The lacrimal apparatus is the physiological system containing the orbital structures for tear production and drainage.
It consists of The lacrimal gland, which secretes the tears, and its excretory ducts, which convey the fluid to the surface of the eye; it is a j-shaped serous gland located in lacrimal fossa.

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C/O - Diminess of Vision in RE since 2 years back RE) VA - 1/60 Dilate with tropicamide Comment your diagnosis ? Follow ...
11/04/2026

C/O - Diminess of Vision in RE since 2 years back

RE) VA - 1/60

Dilate with tropicamide

Comment your diagnosis ?
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09/04/2026

What is Chorioretinal Atrophy 👁️ ?

Chorioretinal Atrophy
Chorioretinal atrophy (CR) is the result of loss of the choriocapillaris, Retinal Pigment Epithelium (RPE), and the outer layers of the sensory retina. This may be due to loss of circulation from the choriocapillaris or from an inflammatory event. The result is a “window view” of the choroid and sometimes the sclera. There is often pigment clumping in and around the lesion due to migration of the degenerated RPE cells into the inner retinal layers and sometimes, there may be pigment cuffing of a vein crossing the lesion. If the fundus lesion allows a clearer view of the choroid, it is likely to be CR atrophy. In the posterior pole, the view is of choroid but in the periphery where there is usually much less choroidal vessels and melanocytes, the sclera is often seen. At times, this may have a light yellow color to the lesion. If it occurs in the macula, it is called geographic atrophy.
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07/04/2026

C/O- Diminess of Vision in RE since 3 year

RE) VA : PL+PR+

Comment your diagnosis ?
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06/04/2026

C/O. Diminess of vision in Left Eye since at 10 year back.

VA. RE) 6/9
LE) 3/60
With PGP - RE) 6/6
LE) 6/60
Comment your diagnosis guys ?
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31/03/2026

C/O- mild itching & Irritation in the eye...

Comment your diagnosis 🤔?
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28/03/2026

Photodynamic Therapy (PDT) in the Eye is a specialized treatment used to manage certain retinal diseases—especially those involving abnormal blood vessels.

🔬 What is Photodynamic Therapy ?

Photodynamic Therapy is a two-step treatment that uses:
A light-sensitive drug (photosensitizer)
A low-energy laser light
These work together to selectively destroy abnormal blood vessels in the eye without damaging most of the surrounding healthy tissue.

💉 Drug Used
The most commonly used drug is:

👉 Verteporfin
⚙️ Mechanism of Action
Verteporfin is injected into a vein (usually in the arm).
It circulates and accumulates in abnormal retinal blood vessels.
A cold laser (non-thermal) is directed onto the retina.
The drug gets activated by light → produces reactive oxygen species.
This leads to closure of abnormal vessels.

👁️ Indications (Uses in Eye Diseases)

* PDT is mainly used for:
Age-related Macular Degeneration (especially classic CNV)
* Central Serous Chorioretinopathy
* Polypoidal Choroidal Vasculopathy
* Choroidal hemangioma

🏥 Procedure (Step-by-Step) :-

Patient is prepared and IV line is started
Verteporfin is injected over ~10 minutes
After 5 minutes, laser is applied to the retina
Laser exposure lasts about 83 seconds
Patient can go home the same day

⚠️ Precautions After PDT :-
👉 Avoid direct sunlight or bright indoor light for 48 hours
👉 Wear protective sunglasses
👉 Avoid skin exposure (risk of burns due to photosensitivity)

✅ Advantages :-

👉 Selective targeting of abnormal vessels
👉 Minimally invasive
Less damage to surrounding retina

❌ Limitations / Side Effects :-

* Temporary vision decrease
* Need for repeat treatments
* Photosensitivity reactions (skin/eye)
* Not as commonly used now due to anti-VEGF therapy dominance

🔄 PDT vs Anti-VEGF :-

Anti-VEGF injections are now first-line treatment

✨ PDT is still useful in:
👉 Chronic CSCR
👉 PCV (often combined with injections)
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26/03/2026

Blood Supply & Nerve supply of the human eye 👁️😳✅
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✅ Nerve Supply of the Human Eye 👁️The nerve supply of the eye is divided into Sensory, Motor, Parasympathetic, and Sympa...
26/03/2026

✅ Nerve Supply of the Human Eye 👁️
The nerve supply of the eye is divided into Sensory, Motor, Parasympathetic, and Sympathetic supply.

🔶 1. Sensory Supply (General Sensation)

Supplied by Trigeminal nerve
Mainly through Ophthalmic division (V1) → Nasociliary nerve.

🔹 Long Ciliary Nerves supply:

• Cornea (very sensitive)
• Iris
• Ciliary body

👉 Responsible for pain, touch, and corneal reflex (afferent limb)

🔶 2. Motor Supply (Extraocular Muscles)

🔹 Supplied by Oculomotor nerve
* Superior re**us
* Inferior re**us
* Medial re**us
* Inferior oblique
* Levator palpebrae superioris

🔹 Supplied by Trochlear nerve
• Superior oblique
🔹 Supplied by Abducens nerve
• Lateral re**us

👉 Mnemonic: ⭐ LR6 SO4 — Rest by 3

🔶 3. Parasympathetic Supply (Pupil Constriction & Accommodation)

Origin: Edinger-Westphal nucleus

Pathway:
Via Oculomotor nerve → Ciliary ganglion → Short ciliary nerves

🔹 Functions:
👉 Sphincter pupillae → Miosis (pupil constriction)
👉 Ciliary muscle → Accommodation (near vision)

🔶 4. Sympathetic Supply (Pupil Dilatation)
Origin: Hypothalamus → Spinal cord (T1–T2)
Synapse in Superior cervical ganglion
Travel via carotid plexus → Long ciliary nerves

🔹 Functions:
👉 Dilator pupillae → Mydriasis (pupil dilatation)
👉 Supply to Müller’s muscle (helps eyelid elevation)
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✅ Blood Supply of the Human Eye 👁️The blood supply of the eye is mainly derived from the Ophthalmic artery, which is a b...
25/03/2026

✅ Blood Supply of the Human Eye 👁️
The blood supply of the eye is mainly derived from the Ophthalmic artery, which is a branch of the Internal carotid artery.
It is divided into arterial supply and venous drainage.

🔴 Arterial Supply of the Eye

1. Central Retinal Artery (CRA) :-
• Branch of ophthalmic artery
• Enters the eye through the optic nerve
• Supplies:
* Inner retinal layers

• Clinical importance:

° Blockage causes Central Retinal Artery Occlusion (CRAO) → sudden painless vision loss

2. Posterior Ciliary Arteries :-

These are very important for choroid and optic nerve head.

a) Short Posterior Ciliary Arteries :-
* Usually 6–12 in number

• Supply :

° Choroid
° Outer retina (photoreceptors)
° Optic nerve head

Form Circle of Zinn–Haller

• b) Long Posterior Ciliary Arteries (2)

Nasal and temporal
Supply:

° Ciliary body
° Iris
Good

• Form Major arterial circle of iris

3. Anterior Ciliary Arteries
Branches from muscular arteries of recti muscles

• Supply:

° Conjunctiva
° Episclera & sclera
° Iris and ciliary body (partly)

4. Lacrimal Artery :-

• Supplies:
* Lacrimal gland
* Eyelids and conjunctiva

🔵 Venous Drainage of the Eye

1. Central Retinal Vein (CRV) :-

• Drains inner retina
• Empties into:
° Superior ophthalmic vein or directly into cavernous sinus

• Blockage causes Central
Retinal Vein Occlusion (CRVO)

2. Vorticose (Vortex) Veins :-

• Usually 4–6 veins
• Drain:
° Choroid
•Open into ophthalmic veins

3. Anterior Ciliary Veins
° Drain anterior segment structures.

⭐ Quick Exam Summary :-

👉 Inner retina → Central retinal artery
👉 Outer retina & choroid → Short posterior ciliary arteries
👉 Iris & ciliary body → Long posterior + anterior ciliary arteries
👉 Venous drainage → Central retinal vein + vortex veins
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23/03/2026

✅ What is Refraction?
Refraction is the bending (change in direction) of light rays when they pass from one transparent medium to another medium of different density.
In the human eye, refraction occurs mainly at:
Cornea (major refraction ~ 2/3rd)
Crystalline lens (fine focusing)
This bending of light helps to focus the image exactly on the retina, so that we can see clearly.

✅ Definition (Clinical)

Refraction is the process of determining the refractive power of the eye and prescribing suitable lenses to obtain clear vision.

✅ Physics Concept (Important)
Refraction follows Snell's Law, which explains how light bends when it moves between different media (like air → cornea).

✅ Types of Refraction (In Optometry)

1️⃣ Objective Refraction
* Done without patient response
* Examples:
* Retinoscopy
* Auto-refractometer

2️⃣ Subjective Refraction
Done with patient response
Example:
* Trial frame & trial lenses
Phoropter test.

✅ Types of Refractive Errors (Found During Refraction)
* Myopia (near sightedness) 🔎
* Hypermetropia (far sightedness) 🌄
* Astigmatism 🎯
* Presbyopia 👓

✅ Purpose of Refraction :-

⭐ To determine glasses power
⭐ To improve visual acuity
⭐ To diagnose refractive errors
⭐ Important before contact lens fitting / cataract surgery

✅ Simple Example
When light enters from air → water, it bends.
Similarly, when light enters air → cornea → lens → retina, refraction helps to form a clear image.
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