Friendly Doc

Treacher Collins Syndrome ( Mandibulo Facial Dysostosis )

noreply@blogger.com (Friendlydoc) — Sat, 16 Apr 2011 14:22:00 +0000

Classic clinical features that can be seen :

EYES

Downward slanting palpebral fissures
Lowerlid coloboma
Partial to total absence of lower eyelashes

EARS

Auricular malformations with or without tags and pre auricular blind fistulas
Stenosis or atresia of the external ear canals
Middle ear and ossicular abnormalities

FACE

Malar hypoplasia (hypoplastic zygomatic bones) and non fusion of the zygomatic arches
Flat frontal nasal angle
Hypoplastic supraorbital rims and ridges
Narrow nares and hypoplastic alar cartilages
tongues of hair onto cheeks

MANDIBLE AND ORAL CAVITY

Mandibular hypoplasia and severe hypoplasia of the mandibular condyle
Microstomia
High arched,narrow or cleft palate
Dental abnormalities

Clinical Findings Present In This Boy :

- downward slanting eyes

- sparse eyebrows

- supraorbital ridges less prominent

- flat frontonasal angle

- Malar eminence less prominent

- Zygomatic arches are non fused,infact on palpation in this patient a depression was felt

- External ear canals not present ( atresia )

- External ears - malformation

- small jaw -> micrognathia

- mandible underdeveloped

- this patient presented with history of decreased hearing...was finally diagnosed as Treacher Collins Syndrome..a rare entity ...

Reflections On Treacher Collins Syndrome.......
Check out this inspiring larger - than - life blog
http://www.treachercollins.org

How To Remove a Corneal Foreign Body

noreply@blogger.com (Friendlydoc) — Thu, 14 Apr 2011 06:18:00 +0000

Share Your Vision With the World : Eye Donation - Why You and Only You can make a difference !!

noreply@blogger.com (Friendlydoc) — Thu, 14 Apr 2011 05:39:00 +0000

If you think William Harvey discovered circulation...think again..!!

noreply@blogger.com (Friendlydoc) — Thu, 14 Apr 2011 05:38:00 +0000

How great a resource is Pubmed and how to use it ?

noreply@blogger.com (Friendlydoc) — Thu, 14 Apr 2011 05:38:00 +0000

Running Nose : Are you using Self-prescribed Nasal Drops - then here's what you must know..

noreply@blogger.com (Friendlydoc) — Thu, 14 Apr 2011 05:37:00 +0000

Ear Buds : How harmful can they be ?

noreply@blogger.com (Friendlydoc) — Thu, 14 Apr 2011 05:36:00 +0000

Ear Wax : How is it formed and Removed

noreply@blogger.com (Friendlydoc) — Thu, 14 Apr 2011 05:35:00 +0000

Great Tips To Counterstrike Computer Vision Syndrome

noreply@blogger.com (Friendlydoc) — Thu, 14 Apr 2011 05:33:00 +0000

Cataract

noreply@blogger.com (Friendlydoc) — Sat, 19 Mar 2011 14:45:00 +0000

cataract is the development of opacity in the lens

Subconjunctival Hemorrhage (Red Eye) : Causes,Diagnosis,Treatment,Management

noreply@blogger.com (Friendlydoc) — Sat, 19 Mar 2011 14:30:00 +0000

What is Subconjunctival Hemorrhage ?
The name says it all : simply put its bleeding ( or collection of blood ) below the conjunctiva.

What is "Conjunctiva" ?
Its the thin,transparent,moist membrane which is the outermost covering of the eye.Its blood vessels are very fragile and thus can easily rupture.

What does the patient complain of ? ( SYMPTOMS )

Red Eye ( blood collects between the conjunctiva and the white of the eye - sclera )
may be assosciated with itchy eyes
Usually asymptomatic

What the doctor should observe ? ( SIGNS )

Blood underneath the conjunctiva,often in one sector of the eye.

Sometimes the entire view of the white of the eye (sclera) can be obstructed by blood.

What Causes Subconjunctival hemmorhage ?

Trauma : most common cause
coughing,sneezing,constipation,epileptic fits,strangulation : these cause sudden venous congestion of the head leading to subconjunctival hemorhage
inflammation of the conjunctiva : which may be caused by bacterial or viral infections
Hypertension
Blood dyscrasias : like anemias , luekaemias
Bleeding disorders : like hemophilia
Antiplatelet or anticoagulant medications : like aspirin,clopidogrel,warfarin
in some cases,the cause is unknown

" But doc, my eye looks really scary " !!!

Yeah , sure it does...but rest assured..,its usually a harmless condition.

Subconjunctival hemorrhage in the process of healing ( being absorbed )

What is the treatment for subconjunctival hemorrhage ?

there is no specific treatment,the accumulated blood slowly gets reabsorbed in 7-21 days. ( so now u can guess how "scary" red eye really is )
Reassuring the patient forms the most important part of the treatment.

DONT's : - use medications like aspirin,clopidogrel as these may aggravate bleeding ( if you do use them for other medical ailments then do consult with your healthcare specialist )
- since the eyes may be itchy,artificial tears may be prescribed but some argue it may delay or interfere with the natural healing process.
Do's : - if a specific underlying cause is discovered then it must be treated.
- in case of assosciated infection of the conjunctiva , antibiotic eye drops are prescribed.

Notes for the Doc - Remember to :

Ask for history of eye rubbing,trauma,severe cough,medications used,bleeding or clotting disorders.
Ask whether this has frequently happened before.
And plz do check the Blood pressure !!

Have you suffered from Red Eye , what was your experience , what do you think you should or should not have done ,what queries would you have liked to ask..please feel free to share and comment

Lacrimal Syringing - How and why its done

noreply@blogger.com (Friendlydoc) — Fri, 18 Mar 2011 18:28:00 +0000

What Is Lacrimal Syringing ?

It is a common procedure performed by an ophthalmologist ( or an ENT surgeon ) wherein fluid (normal saline ) is passed from one end of the tear drainage system ( lacrimal apparatus ) to see whether it emerges from the other end. Thus we can easily asses whether the tear drainage system is patent or blocked.

Why Is Lacrimal Syringing Done ?
When a patient complains of excessive watering of the eyes , the doctor has to check whether his/her tears are draining properly..ie whether the watering eyes are due to a block in the tear drainage system.

To check the tear drainage system (naso lacrimal duct ) for any blockage ( the site and nature of the block ).
To flush out debris from the tear drainage system ( eg due to any infection ) .
In India it is done before cataract surgery to rule out chronic dacryocystitis ( infection of the nasolacrimal sac ) .
To instill antibiotics in the tear drainage system and also dye for X rays.

How Do The Tears Drain ?(the tear drainage system/lacrimal apparatus )

Easy Step-by-Step Guide To Lacrimal Syringing

Equipment you'll need :

Normal Saline

Syringe 2 ml

Topical Anesthetic Eye Drops

Nettleship's Punctum Dilator

Lacrimal Cannula

Also some sterile gauze pieces,cotton swabs,towels

Lacrimal Syringing Equipment Set