Dr Parth Shah | Medical and health

Dr Parth Shah

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25.01.2022 Eye muscle surgery can be performed in patients with strabismus (squint) for either functional or reconstructive purposes. This young patient came to see me recently. She had undergone four previous operations and now had a large angle right divergent squint (exotropia) for two years. This was worst when she tried to look to the left, because the right eye could not look past the midline. As the eye misalignment had started in childhood, she had learnt to use one eye or the ...other (suppression), but never both together. This means she did not suffer from double vision. However, the strabismus was significantly impacting on her quality of life due to the negative effect on social and professional interactions. I found the previously recessed right medial rectus muscle well past the equator of the globe, and advanced it forwards. As you can see in the post-operative images, the right eye is now re-aligned with the left, and can now look to the left. Happy patient and happy surgeon!! Reconstructive eye muscle surgery can have a huge impact on a patient’s life. These are some of my happiest and most grateful patients. #strabismus #eyemusclesurgery #ophthalmologist #ophthalmology #franzco

22.01.2022 Happy World Sight Day 2020! Today is an important day on the eye health calendar for advocacy and communications. This year’s theme is #HopeInSight I was delighted to be a part of this video campaign by the World Society of Paediatric Ophthalmology and Strabismus, where we shared our hopes in sight. A big shout out to my international colleagues and most importantly, my patients who also contributed! ... Let’s work together to eliminate avoidable blindness. #HopeInSight #WSD2020 #WorldSightDay #WSPOS #ophthalmology #strabismus #paediatricophthalmology @WSPOS

22.01.2022 I feel honoured to be an invited speaker at the upcoming WSPOS (World Society of Paediatric Ophthalmology & Strabismus) World Wide Connect Meeting on Saturday 26th September. Very excited and have been looking forward to this virtual international conference, with several interesting topics up for discussion. The line-up is amazing, with speakers and moderators from leading institutes around the world. Session 2 - The Child with a White Spot on the Cornea. I’ll be talking o...n Blepharokeratoconjunctivitis (yes, a mouthful - but call it BKC for short!). This is a common yet under-recognised and under-treated eye condition in children. It is associated with recurrent eye redness, styes, light sensitivity, corneal scarring and reduced vision. Early detection and aggressive long term treatment is important to optimise visual outcomes for these children. Check out the entire program here - https://www.wspos.org/world-wide-connect-2020/ Register early, and look forward to seeing you there! @wspos @kenknischal #ophthalmologist #ophthalmology #franzco #conference #WSPOS #paediatricophthalmology #paediatrics

21.01.2022 Anyone who has had a scratch on their eye will know that it is extremely painful! This is because the cornea has an exquisite nerve supply and is 300 times more sensitive than skin - this is a protective mechanism for vision. The corneal nerves also stimulate blinking and tear production. These are photos of a middle-aged male who presented with a red eye and blurred vision, getting worse over many weeks. There is a large central corneal ulcer - more than half of the cornea... is affected as seen on the image with the fluorescein staining. Despite this large ulcer, the patient had no pain whatsoever! This is a very bad sign... The absence of pain in this case is due to the patient having no corneal sensation in this eye - this is known as neurotrophic keratitis. It is a vision threatening condition, and may also herald a potentially life threatening problem. Common causes for neurotrophic keratitis are viral infection (herpetic eye disease) and a palsy of the nerve supplying the cornea (trigeminal nerve) due to problems such as a brain tumour, stroke, or trauma. In this case, the patient had a brain tumour compressing the trigeminal nerve. The tumour has been removed. Without a nerve supply, the ocular surface breaks down easily and the cornea may not heal without appropriate and aggressive treatment. This includes eye drops, ointment and temporary closure of the eyelids to allow the ulcer to heal. It is in fact possible to restore corneal sensation through a complex surgical procedure known as corneal neurotisation, where healthy nerve is transplanted to the affected cornea. I was fortunate to be part of the team at the Children's Hospital of Pittsburgh that performed this sight-saving surgery for young infants who had been born without corneal sensation. #keratitis #cornealulcer #ophthalmologist #ophthalmology #franzco #eyesurgery

19.01.2022 I am regularly reminded of the importance of basic clinical examination skills that I learned in first year medical school. One of these is the red eye reflex. The red comes from light reflecting off the choroidal tissue (rich in blood vessels) at the back of the eye. The #redreflex can help in the early diagnosis of sight and life-threatening conditions in infants. This includes cataract and the eye cancer retinoblastoma. With the advent of modern camera technology and "red ...eye reduction", these clues can be lost. Examination of the red reflex is a part of the newborn baby check. This is because a congenital cataract needs to be surgically removed in a timely fashion, otherwise the child will never see well. This 2-year-old girl was referred to me with an intermittent squint (strabismus). She was otherwise completely well and had never complained about any issues with vision. Testing visual acuity using age-appropriate techniques showed that her vision in the right eye was very poor, while the left eye was normal. You can see that there is an obvious asymmetry in the red reflex between the two eyes. The right red reflex has an irregular appearance. The colour asymmetry is due to both the presence of cataract, as well as a difference in the focusing power (anisometropia) due to the eye being slightly smaller. Closer examination shows an irregular cataract in the right eye with disruption of the posterior capsule. This is due to a condition called persistent foetal vasculature, the most common cause of unilateral paediatric cataract. It is usually present from birth, but can progress over time. The fundus photograph shows the effect of the cataract in casting a shadow on the retina. Her left eye is normal with no cataract. A review of the family's digital photo album showed that the cataract was present when the girl was only a few months old, consistent with the impression that this cataract had likely been present at birth. #redeyereflex #paediatriccataract #cataract #amblyopia #cataractsurgery #franzco #ophthalmologist #ophthalmology #ophthalmicphotography

14.01.2022 WSPOS WORLD WIDE CONNECT 2020 meeting is on its way! Just had an amazing live virtual session with expert colleagues from around the world, discussing corneal diseases in children. And this was only the second session of this 24-hour worldwide meeting!! So many exciting talks yet to come... I have my coffee and snacks ready! ... Check out the free papers and video competition as well. https://www.wspos.org/world-wide-connect-2020/ @wspos @kenknischal #wspos #connect #ophthalmology #franzco #conference #paediatricophthalmology

11.01.2022 Happy World Sight Day 2020! Today is an important day on the eye health calendar for advocacy and communications. This year’s theme is #HopeInSight I was delighted to be a part of this video campaign by the World Society of Paediatric Ophthalmology and Strabismus, where we shared our hopes in sight. A big shout out to my international colleagues and most importantly, my patients who also contributed! ... Let’s work together to eliminate avoidable blindness. #HopeInSight #WSD2020 #WorldSightDay #WSPOS #ophthalmology #strabismus #paediatricophthalmology @WSPOS

02.01.2022 Pseudoexfoliation (PXF) is a systemic basement membrane disorder that is usually diagnosed after an eye examination. It is more common with increasing age, and in Scandinavian populations. The hallmark is a ring of dandruff-like white flaky deposits on the anterior lens capsule.This is an obvious case, but the findings can be subtle in the early stages. The deposition occurs as the posterior surface of the iris rubs against the lens as the pupil naturally constricts and dila...tes. The fibrillar material may also be seen at the pupil border. PXF is associated with early cataract, glaucoma and poor pupil dilation. There is weakness of the zonules (the suspensory ligaments of the lens), which means the lens can become unstable (subluxation). As a result of all of these factors, cataract surgery in PXF eyes is more challenging and can be complicated. It is called pseudo because true exfoliation is a splitting or delamination of the lens capsule, originally described in glassblowers due to prolonged exposure to heat and infrared radiation. #cataractsurgery #cataract #franzco #ophthalmologist #ophthalmology #ophthalmicphotography

02.01.2022 Excited to be a panelist and discussant in the 3rd WSPOS Global Grand Rounds Webinar TOMORROW! Saturday at 2 PM London time (1am Sunday Sydney / AEST). Strabismus Case: Up Gaze Diplopia - To Treat or Not to Treat?... Non-Strabismus Case: Aniridia - Management Issues Panel Discussion followed by Q&A Watch on YouTube or Facebook live streams, links at: https://www.wspos.org/world-wide-webinar/ Join us as we discuss things that are not normally discussed such asrefracting with children in nystagmus and how to avoid anti-elevation syndrome.All of this & more will be discussed on the Global Grand Rounds. Be there!!!! Three Reasons Why You Should Tune In: 1. Hear first-hand from Paediatric Ophthalmologists on key management issues in Aniridia and Anti-Elevation Syndrome. 2. Enjoy a unique opportunity to listen in as our discussants share their experiences and advice. 3. Voice your questions and thoughts with our speakers and expert panel. WSPOS Global Grand Rounds continue to be interactive; we will have questions for you to answer via Mentimeter. Please rest assured, all our Mentimeter surveys are anonymous; neither your name, nor your identity / any other details will be visible to anyone before, during the webinar or even later. We will announce the Mentimeter code at the beginning of the webinar. @wspos @kenknischal @alki7584 @cguiraonavarro @draclaudiapolo #ophthalmologist #ophthalmology #WSPOS#paediatricophthalmology #paediatrics#aniridia #strabismus #franzco

01.01.2022 This patient has a left periocular port-wine stain. The fundus photos show that the colour of the retina on the affected left side appears more red-orange than the right, which is due to the presence of a diffuse choroidal haemangioma. There is also an asymmetry in the optic discs with the left side being more cupped", meaning a higher risk of glaucoma. A port-wine stain (naevus flammeus) is in the family of disorders known as vascular malformations. It is a true birthmar...k, presenting as a flat pink-red patch in newborn babies, and may progress over time to a darker purple colour (the colour of port wine). It is generally unilateral or segmental in distribution, and respecting the vertical midline. Two-thirds of affected cases are female, and two-thirds are found on the head and neck region. They can be treated by #dermatologist using specialised laser. Note: an infantile haemangioma (strawberry naevus) is a different lesion that is not present at birth and grows in the first few weeks to months of life. When a vascular malformation is present around the eye, especially the upper eyelid, a thorough eye examination is essential because there is a risk of glaucoma and reduced vision. Sturge-Weber syndrome (SWS) is a spectrum of abnormalities including facial port-wine stain, haemangioma of the meninges and brain, and eye abnormalities. SWS is thought to be caused by a somatic (not inherited) mutation in the gene GNAQ1. The skin, brain and eyes may be involved to different degrees. Some symptoms such as glaucoma may not develop until adulthood. Regular monitoring is therefore essential. @dr.deshan #portwinestain #sturgewebersyndrome #ophthalmologist #ophthalmology #franzco #glaucoma #dermatology #dermatologist