Group⟨D⟩~[4th Year]^(39)

د.توفيق الخطيب Case 8 A 65 years old man came to eye clinic with his daughter , he is diabetic for 10 years ,he complained of diminution of vision in both eyes with lacrimation,but right eye is more than left , he came on mobile chair because he can not walk successfully, he has a history of stroke 4 months ago , but the eye vision problem is from before that , he has also a history of asthma , BP and HbA1c last measure is good . Right eye V/A CF 2 Senile cataract Normal pupil Conjunctival injection Ocular motility is somewhat restricted in right gaze " may be 2ry to cataract " no 3rd nerve affection Left eye V/A CF 2 m Senile cataract

د.توفيق الخطيب Case 7 A 55 years old women came to eye clinic complaining of decrease vision in the left eye and she has a history of eye surgery to the right eye 2 years ago. Right eye V/A 6/18 Pseudophakia Iris atrophy RAPD Jen Black pupil posterior capsular opacity Left eye V/A CF 3 m Mature senile cataract RAPD " more than right"

د.توفيق الخطيب Case 6 A teen girl came with her father to eye clinic to ophthalmologist to see a colored mass on the eye white , she said that it is stationary in growth and she has it since 18 years from now , but it is bothering her cosmetically , especially she well be on wedding time soon . Right eye Brown , vascularized 3 to 6 mm , mass in eye white near to the limbus Left eye Normal Spot diagnosis is nevus ( focus on history)

د.توفيق الخطيب Case 5 A 38 years old man came to eye clinic complaining of eye strain and headache due to excessive using of eyelid closure during driving to avoid his diplopia, the diplopia is due to his known outward eye deviation recently, the patient has a history of intracranial tumor surgical removal in India one year ago , and followed by Gamma knife radiotherapy, now he is referred by a neurologist to assess his eye function. Right eye V/A 6/36 Round , semi reactive and regular pupil Lazy right eye " 2ry amblyopia " Slight partial 3rd nerve palsy Slight ptosis ( post surgically) Slight proptosis Left eye V/A 6/6 Relatively normal findings MRI should be always monitored, the only way to help him now is correction of refractive error by glasses with neurosurgeon and ophthalmologist follow-up .

د.توفيق الخطيب Case 4 A 35 years old women came to eye clinic complaining of foreign body sensation and decrease in vision with lacrimation . Right eye Pterygium " moderate " B- Pterygium Ciliary injection Conjunctival injection Left eye Normal

د.توفيق الخطيب Case 2 A 50 years old man came to eye clinic , has a history of exenteration before 20 years and now surgical closure is opened. He is complaining of itchy painful eye with sometimes bleeding since 8 moths ago . Right eye empty orbit with extensive offensive  pus like material all over the empty orbit , with some awful serangiounous cheesy like material , there is a signs of erosion and tissue molting. Left eye Normal "but is in risk" The patient had an extensive BCC " basal cell carcinoma " from skin over the lateral orbital wall and undergo exenteration with plastic surgery ( now the most suspected diagnosis is recurrence rather than 2ry infection) so ENT consultation is needed before any surgical intervention to clean the orbit. Recurrence after 20 years old is the diagnosis and surgical intervention is needed

د.توفيق الخطيب Case 1 50 years old man came to eye clinic for ophthalmologist oncologist report friedership , the man complained from painless lower eye lid nodule since 2 years ago and then it ulcerate with time since one year . Right eye Disfiguring extensive lower eyelid ulcer , with somewhat nodular remnant lesion , there is also conjunctival and ciliary injection. Palpable mass Hard " very firm "background No pain No tenderness   Left eye Immature senile cataract BCC  "basal cell carcinoma " is diagnosed and is confirmed by biopsy.

د.حورية Case 8 A 27 to 29 years old girl , the girl is mobility disabled came to the eye clinic by mobile chair with her mother , the girl was referred from a neurosurgeon to do ophthalmologic consultation about the retina and eye function. Right eye V/A counting finger Some degree of squint Fundoscopy shows attenuated BVs , optic disc oedema with some retinal changes . Left eye V/A counting finger Fundoscopy also shows attenuated BVs , optic disc oedema with some retinal changes . We couldn't do Pupillary light reflex , because the patient is not co-operative and cannot do fixation at all . The patient has papilloedema, with some retinal changes in both eyes. Urgent decompression early as soon as possible ( life saving ) there is an alarming sign of severe increase in ICP.

د.حورية Case 7 A 38 years old man came to the clinic for seeing the ophthalmologist who did to him the DCR operation one month ago , he is complaining of dryness with burning sensation in his right eye . Right eye Silicon tube is seen clearly . It Show some dryness and slight Hyperemia , with no inflammation signs . The doctor reassure the patient about the dryness is a good sign of successful operation and she teached him How to do lacrimal sinus massage Left eye Normal

د.حورية Case 6 An 6 years old child came to eye clinic with his grandfather, for seeing that it is the time for surgery or not , because the child was having upper and lower RTI and still on treatment for  today , the surgery is Bilateral . Bilateral congenital cataract Our doctor refuse to do cataract extraction surgery until the child came over from his infection first

د.حورية Case 5 A 45 years old women came to the OPD to visit the doctor , she request to do DCR surgery, because no improvement of her situation by doing conservative traditional therapy for the past 8 months , now complain of some pain and psychological unfamiliarity with this situation (cosmetic sense ) and discomfort from it day and night. Right eye Lacrimation + ve regurgitation test V/A 6/12 suggest 2ry astigmatism Left eye Normal V/A 6/6

د.حورية Case 3 6 years old child came to OPD by his mother , complaining of red eye and oedema . Eye trauma Fluorescence test is requested

د.حورية Case 1 A 60 years old man came to OPD complaining of diminution of vision in right eye since 2 weeks ago Right eye V/A 6/36 Senile immature to mature cataract " spiky like mature " at the clock number 7 with browny color in immature background.  Left eye V/A 6/6 Senile Immature cloudy cataract Fundoscopy for right eye shows that , normal optic cup , pinkish well defined optic disc ,without any retinal changes.

د.توفيق الخطيب Case 10 A 28 years old man came to the eye clinic for seeing ophthalmologist to check about his right eye , he is complaining of painful eye with discharge since one week ago , the patient exposed to car accident 4 years ago and undergo eye trauma and plastic surgeries with eyelid grafting , and came here because of his complain . Right eye Disfiguring after graft eyelids , pus , positive discharge palpation sign the eye is clearly show proptosis (2ry to trauma and surgery) Very tender in palpation Left eye Normal MRI is requested

د.حورية Case 4 An 18 years old teen girl came to eye clinic by her father , she complain of inability to see far at all , even in school she asks the help from her classmates to give her board written lectures , this problem unfortunately was from childhood , but now becomes more terrible. Right eye Malignant "high" Myopia , with direct Ophthalmoscope , the retina is seen clearly with ( 17 power ). Left eye Simple Myopia , with direct Ophthalmoscope , the retina is seen clear with ( 6 to 7 power ) Amblyopia is noted for right eye. Anisometropia is high. V/A is requested

د.حورية Case 2 An evisceration request for 90 years healthy man , has been exposed to recent penetrating eye trauma ,but within 24 hours he has been lost vision at all .

د.عدنان ثابت Case 5 A 45 years old man comes with history of penetratting left eye trauma by steel with red eye and scleral sketching . Right eye Left eye Red eye Sketching and suturing Tractional penetratting eye trauma Treatment was surgical suturing without removal of steel FB . Give him Liodex tab for symptoms Systemic antibiotics .

د.عدنان ثابت Case 4 A 5 years old child presented by his mother after 28 days from stone left eye trauma and corneal sketching in OPD and now cannot see well . Right eye Left eye Corneal sketching Post traumatic cataract Portable tonometry is requested Treatment is surgery Diamox is given before operation Sketching removal at least after 3 months

د.عدنان ثابت Case 3 A 36 years old women complaining of something covering her cornea with foreign body sensation and headache on reading without any chronic illness and no contraceptive drug using. Right eye Pterygium " Encroachment of cornea by conjunctival tissue " V/A 6/12 Mild astigmatism is suspected Left eye No pterygium seen V/A 6/12 Autorefractometry is requested because the complain is Bilateral while nothing abnormal I left eye

د.عدنان ثابت Case 2 73 years old women complaining of diminishing of vision in left eye with no DM or HTN history. Right eye Pseudophakia After cataract " posterior capsular " "Jen Black pupil " Left eye Mature cataract