Discover and read the best of Twitter Threads about #Ophthalmology

Most recents (24)

Interesting case, what is the most likely diagnosis in this 25 y/o F w/ 1 year history of migraine headaches, left hand numbness, and b/l retinal artery occlusions? 🧠 👁️
#Ophthalmology #neurology #neurosurgery #neurotwitter #MedEd @TheASNR #MedTwitter ImageImageImageImage
Answer: Susac syndrome 🧠

▶️Susac syndrome is a microangiopathy (likely autoimmune affecting the precapillary arterioles) with a strong female predilection, typically occurring in women age 20-40
Clinical presentation:

Classic triad
1️⃣Encephalopathy
2️⃣Branch retinal artery occlusions
3️⃣Hearing loss

💡Though most patients do not present with the complete triad (it may develop over years)
Read 7 tweets
A 31-YO♂️, #sexually active with 2♂️partners in the previous month: 8 days before redness of the R eye, an itchy perianal rash & rectal pain; scattered, tender, shallow ulcers & pustules on chest (A), abdomen (B), back (C) & perianal (D)
1/9

nej.md/44ILgLy
#proctology Image
PCR from the perianal vesicel:➕for nonvariola orthopoxvirus DNA.
Species-specific PCR: ➕for #mpox virus, clade II.

The patient reported a new rash with numerous ulcer on his chest, abdomen, and back

MPOX (formerly known as #monkeypox)
2/9

#MolBiol #virology
During the next 2 days, the patient took tecovirimat & reported redness & discomfort of the right eye and become painful

He had learned that mpox had been diagnosed in one of his #sexual partners from the previous month.

Likely MPOX CONJUNTIVITIS
3/9

#ophthalmology #IDtwitter On examination of the right...
Read 9 tweets
Do you have an undiagnosed patient despite exome sequencing? 🤔

It could be a repeat expansion disorder.

Here are 5 scenarios that should make you think of a repeat expansion disorder in adults. 🧵

#GeneChat #MedTwitter
1/5
A 21 y man with slurred speech who is experiencing difficulty with coordination and balance over the last several years. He fatigues easily.

Diagnosis: Friedreich's ataxia
Genetics: GAA repeat expansion in the 1st intron of FXN
Inheritance: Autosomal recessive

#Neurology
2/5
A 25 y woman with hot flashes and irregular menses over the last several months (early menopause).

Diagnosis: Fragile X-associated primary ovarian insufficiency (FXPOI)
Genetics: CGG repeat expansion in the 5' UTR of FMR1
Inheritance: X-linked

#OBGYN
Read 7 tweets
Dacryocystitis in this patient with painful swelling in the region of the right medial canthus

Etiology: obstruction of the nasolacrimal duct leads to proximal dilatation and superimposed infection of the nasolacrimal duct sac

#ophthalmology #ent #radres @ASHNRSociety ImageImage
May be congenital or acquired

Congenital: imperforate membrane, incomplete canalization, or atresia leads to tears and mucus accumulation causing a dacryocystocele, if infected/inflamed, use the term dacryocystitis

Adults: acquired from any cause of obstruction
Imaging: often obtained to evaluate for orbital cellulitis

Look for a well defined cystic lesion at the medial canthus with continuity with the nasolacrimal duct

When reporting, discuss the extent of the lesion, laterality, and if there are signs of infection 🧠
Read 3 tweets
1/ A $PVCT THREAD: (3) Potential 2023 read outs of preclinical data from sponsored research programs (#SRAs) in different diseases. #research. #oncology #hematology #dermatology #InfectiousDiseases #ophthalmology #WoundHealing #TissueRegeneration. #rosebengal #rosebengalsodium.
2/ $PVCT 2023 Stockholder Letter (released January 9th). . #rosebengal #rosebengalsodium.
3/ In 2023, $PVCT expects research collaborators at different academic medical institutions to read out data from their preclinical research work under newly established and existing #SRAs. #research. #rosebengal #rosebengalsodium.
Read 60 tweets
A 24-YO♀️: a 10-year of episodes of redness & photophobia in eyes, &⬇️visual acuity
SLE: conjunctival hyperemia & peripheral corneal opacification, inflammation & crystalline deposits on the corneal
⬇️
INTERSTITIAL KERATITIS
1/5

DOI: 10.1056/NEJMicm1709103
#eye #internalmedicine
Etiologies:
✔️Bacterial: SYPHILIS, Lyme borreliosis, tuberculosis, etc.
✔️Viral: Herpesviridae (HERPES SIMPLEX, H. zoster, E-B)...
✔️Parasitic: Onchocerciasis, Acanthamoeba...
✔️Immune: Cogan's syndrome, contact lens-associated keratitis, autoimmune disease…
2/5

#microbiology
ESR:⬆️& evaluation for infectious causes: unremarkable.
6 months after the diagnosis of interstitial keratitis: vertigo, tinnitus, & hearing loss.
Audiometry: sensorineural hearing loss in both ears.
Clinical findings consistent with COGAN´S SYNDROME
3/5

#Ophthalmology #MedEd
Read 5 tweets
1/ A THREAD on what $PVCT achieved in 2022. #event #discovery #milestone #milepost. #rosebengal #rosebengalsodium.
2/ $PVCT 2023 Stockholder Letter (released January 9th). . #rosebengal #rosebengalsodium.
3/ $PVCT #clinical and #research collaborators made 6 presentations at 5 medical conferences about PV-10 for different cancers. #ENETS22 #AACR22 #ASCO22 #ISOO2022 #melanomabridge. #presentations. #rosebengal #rosebengalsodium.
Read 50 tweets
45F presents with painless progressive left eye vision loss. MR shows homogenous enhancement encasing the left optic nerve with an associated lesion at the entrance of the optic canal (yellow arrow)
#radres #futureradres #NeuroRad #MedTwitter @AlbanyMedRadRes ImageImageImage
Differential Diagnosis:

Optic Neuritis
Optic nerve sheath meningioma
Optic nerve glioma
Orbital sarcoidosis
Orbital lymphoma
Orbital pseudotumor

#Ophthalmology #radtwitter
Diagnosis: Optic nerve sheath meningioma

Remember the optic nerve is an extension of the CNS and therefore, is surrounded by meninges and arachnoid cap cells from which meningiomas arise. Look for the “tram-track” sign of enhancement surrounding the optic nerve
#Ophthalmology
Read 4 tweets
A 25-YO♂️ in Nigeria 2 years earlier: recurrent itchy swellings on his hands and forearms, appearing every week or so for the past few months.

What's in the #eye (A) & in the blood (B)?
1/4

doi.org/10.1016/S0140-…
#Ophthalmology #parasitology #microbiology ImageImage
Identification of:
📌an adult worm in the eye
📌the microfilariae on a blood smear

LOA LOA FILARIASIS is a skin and eye disease caused by the nematode worm Loa loa.
2/4

#parasites #MedEd #MedTwitter ImageImage
Loa loa is one of three parasitic filarial nematodes that cause subcutaneous filariasis in humans.
The other two are Mansonella streptocerca and Onchocerca volvulus (causes river blindness).
3/4

#Doctor #MedStudentTwitter #oftalmologia
Read 4 tweets
🌓🤪 Pac-Man ate my visual fields!

50 year old person presents with sudden onset headache and seeing "pieces of things" on the R.
Visual fields look like this👇👇

➡️What's happening?

#MedTwitter #MedStudentTwitter #neurotwitter #MedEd #Neurology #EndNeurophobia #stroke Image
🗺️🧠 Where across the visual system is likely the lesion?
#Ophthalmology
⭕️ Which artery has to be implicated, if this presentation is due to an ischemic #stroke and the rest of the neuro exam is normal?
Read 7 tweets
A👨, HIV + (CD4 = 25 cells/mm3): rash on arms, hands, chest, & buttocks compatible with #monkeypox
Ocular: redness, pain, itching, swelling, discharge, photosensitivity, & vision changes

Unilateral conjunctivitis, ulcer, & keratitis (fig.)
1/8

#ophthalmology #IDtwitter
A PCR swab of the conjunctival lesion:➕for Orthopoxvirus

OCULAR #MONKEYPOX
2/8

DOI: dx.doi.org/10.15585/mmwr.…
#eye #ojo #oftalmologia
Patients with #monkeypox can experience serious ocular complications:
5 consecutive patients with ocular monkeypox, have experienced delays in treatment, prolonged illness, hospitalization, & vision impairment.
3/8

DOI: dx.doi.org/10.15585/mmwr.… #MedEd #MedTwitter
Read 8 tweets
A 49-YO man “looking through branches in a tree.”: decreased vision in his L eye.

Fundus: linear and arcuate disturbances in the retina (A).

What´s in the vitreous?!! (B)
1/4

DOI: 10.1056/NEJMicm075735
#parasitology #OJO #Ophthalmology Image
A fly larva was initially observed in the macula and after 4 days of treatment with thiabendazole, a segmented fly larva in the vitreous (B).

OCULAR MYIASIS
2/4

#oftalmologia #parasites #eye Image
The patient elected to undergo vitrectomy.
Eight weeks after the vitrectomy, the lesions in the retina were attenuated and the visual acuity had improved to 20/40.
3/4

#MedEd #IDtwitter #MedTwitter
Read 4 tweets
1/n) ICMR released Standard Treatment Workflows (STWs) volume 3 which contains 11 specialties with 52 diseases. It is accessible at stw.icmr.org.in/stws and on the Mobile App.
@MoHFW_INDIA @DeptHealthRes #STW
2/n) Standard Treatment Workflows (STWs) on #𝐃𝐞𝐫𝐦𝐚𝐭𝐨𝐥𝐨𝐠𝐲 containing 14 major diseases. It is accessible at stw.icmr.org.in/stws and on the Mobile App. @MoHFW_INDIA @DeptHealthRes
3/n) Standard Treatment Workflows (STWs) on #Endocrinology containing 06 major diseases. It is accessible at stw.icmr.org.in/stws and on the Mobile App. @MoHFW_INDIA @AyushmanNHA @WHOSEARO #diabetes
Read 12 tweets
👧22 meses, finca familiar con muchas moscas: secreción conjuntival y ojo derecho rojo de 2-3 semanas con algo que se mueve. No refieren viajes al extranjero
En canto externo de ojo D, nematodos en movimiento (vídeo)
1/3
continuum.aeped.es/screens/play/1…
#pediatria #ophthalmology
TELAZIOSIS OCULAR
Thelazia callipaeda es un nematodo y la causa más frecuente de telaziosis en humanos, perros y gatos.
Produce sensación de cuerpo extraño, epífora, conjuntivitis y úlceras corneales.
Tratamiento: extracción manual de los parásitos
2/3

#pediatric #parasitology
Los cánidos salvajes y domésticos son los principales hospedadores definitivos.
La mosca de la fruta Phortica variegata: vector y hospedador intermedio.
3/3

🖋️Martín Valbuena J
#MedEd #IDtwitter #MedTwitter
Read 3 tweets
The spectrum of Marfan syndrome and related connective tissue disorders is intriguing and mind-bending 💫✨

Here is a🧵exploring it

@CPSolvers @rabihmgeha @DxRxEdu @Sharminzi @AnnKumfer @rav7ks @sargsyanz @DrCindyCooper @jackpenner @MatthewHoMD @ASanchez_PS

#MedTwitter
#2 Skeletal manifestations

-Tall stature
-Long slender arms & legs
-Arachnodactyly
-Pectus excavatum
- Pectus carinatum
-Joint hypermobility
-Pes planus
-Camptodactyly (bent fingers)
-Kyphoscoliosis
-Micrognathia & Retrognathia
-Dolichocephaly
-Malar hypoplasia

#MedTwitter
#3 Cardiovascular

-Mitral valve prolapse (can lead to CHF & arrhythmias)
-Aortic aneurysms
-Aortic root dilation
-Aortic dissection
-Aortic regurgitation
-Pulmonary artery dilation (often asymptomatic)

#MedTwitter #CardioTwitter @Gurleen_Kaur96 @KannuBansalMD @this_is_svenka
Read 19 tweets
It is that time of year when i'll start getting questions from graduating #ophthalmology residents about the best ways to prepare for #retina fellowship...here are some of my favorite resources
🧵
Going through the @aao_ophth BCSC Retina book is a great way to start. All the important topics are covered here to some degree. A good grasp of the information in this book will help build a foundation.
There are plenty of retina textbooks out there. Truthfully you likely won't have time to go cover to cover but you can pick out topics for a deep dive. Ryan's Retina is a classic AND may be available online for free through your medical center library
Read 10 tweets
Estornudos 🤧

Todo el mundo sabe que se puede estornudar por gripe, alergia o cualquier irritación nasal momentánea pero…

…si tú o alguien que conoces ESTORNUDA CON LA LUZ☀️, DESPUÉS DE COMER🍇 O POR EXCITACIÓN SEXUAL🔥, este hilo es para ti

🧵👇🏼

1/13
Estornudar es un reflejo protectivo🛡 y en ocasiones puede ser signo de alguna condición médica. Ocurre debido a la estimulación del tracto respiratorio alto (o superior), particularmente de la cavidad nasal👃🏼

2/13

#Sneeze #Nose #RespiratoryTract
A lo largo de la historia se le ha dado diferentes explicaciones a estornudar, incluyendo #mitos y #supersticiones, ej: grieg@s y roman@s creían q era un signo de #bienestar y expresaban buenos deseos a la persona q lo hacía diciendo “Larga vida” o “Que Júpiter te bendiga”

3/13
Read 14 tweets
I'll be adding short important points which would hopefully help in remembering certain concepts during #PLAB preparation, to this thread🧵every now and then as I take them out from my scattered notes. Feel free to comment your tips and tricks which would help others, as well 👇
Please don't take any of these as medical advice 😂🙏. Real life stuff is much more nuanced. These are just clinchers for the sake of the exam.
#PLAB
1. Drug contraindications...
-Avoid BAN drugs in Asthma (Beta blockers, aspirin, NSAIDS) &
-DAMN drugs in diarrhoea (Diuretics, ACEIs, Metformin, NSAIDs)
#PLAB
Read 60 tweets
Every speciality who is on (or wants to be) the ‘Mucor’ team- how many are willing to admit a patient with Mucor under their care and manage (even after surgical debridement). How many were admitting before and will admit after the pandemic? (1/n)#Mucormycosis #COVID19India
Some hypothetical consultations in the emergency before and after the pandemic:

#ENT : We will operate and transfer back

#Ophthalmology : Call us during the Surgey, we will coordinate with ENT in the OT, if needed

#Neurology : Continue Amphotericin (2/n)
#Endocrinology : Send us a consultation after admission under primary, we will control sugars

#Neurosurgery :No active neurosurgical intervention required

#Nephrology :We will do renal modification of Amphotericin

#Medicine/ #Infectiousdisease Admit under any of the above
Read 4 tweets
Accountability

Flowers, I will go see she said.

Headed to Esplanade (cuz this photo alone would check a box but would actually be cheating - the power of “optics” or manufactured data whose lives & careers are Twitter).

Question everything you see
See like a #pediatrician Image
I shall see from a new perspective she said - I will cross on the other side.

(Actually, I wanted to be on the other side but would have to walk a block to cross so, fine, I’ll cross on this side. Bah humbug). Image
I shall admire the barely born green hope unfurling into the crisp Spring air, fragile yet #resilient, she said

(Yay #Science and @museumofscience #BostonStrong #Boston ... and yes, and requisite monuments to male anatomy and war as well) Image
Read 25 tweets
I can't speak to the details of all the pardons and commutations handed out by Trump, but there is one especially heinous one I'm moved to address. It involves #ophthalmology and #RacialEquity in health care.

Come along... 1/21
First, you have to know a little about age-related macular degeneration (ARMD). We have a smart wallpaper (retina) that lines the back of our eyes (the center of which is called the macula), and it turns light into electrical signal to send to the brain. 2/21
Melanin-derived pigment is an important photochemical buffer for absorbing this light over the course of an eye's life.

Macular degeneration, therefore, is a breakdown of this pigment layer of the retina. 3/21
Read 21 tweets
Kitten physical exam: (A thread)
Lymph node exam
#IDtwitter #Peds
Kitten physical exam:
Dysmetria testing
#Neuro
Kitten physical exam:
"Road test"
#Ortho #Geri
Read 12 tweets
#Tweetorial time! A little late this week as I’ve been busy on inpatient. Transitioning to #CommonNeuroConsults and this week will start with a #stroke and #ophthalmology topic @DGlaucomflecken @MedTweetorials #meded #medstudenttwitter

“Transient Monocular Vision Loss”
1/
You may also hear this called “amaurosis fugax” and can be due to an ocular cause, a vascular cause, or an optic nerve head problem!
2/
Let’s start with a brief review of ocular and oculovascular anatomy!

Your optic nerve is cranial nerve 2. This is the nerve that transmits visual information from the retina to the visual cortex.
3/ Image
Read 18 tweets
"Ever get the feeling you've been cheated?" (John Lydon)

The publication of this letter & the nature of its correction raises questions about the reliability of the academic record.

@llantwit @FFLMUK @RCPath @AAPTTweets @mike4path @Richard56 @JJPJ #autopsy

THREAD

1/14
When the letter by Won Sriwijitalai & Viroj Wiwanitkit was published in #JFLM, fact-checking journalists @SureAndShare in Thailand shared their concerns about it on @Twitter & @Facebook.

2/14
@SureAndShare were concerned that they were unable to verify who the 1st author was (or where they worked), or the death of a #forensic #medical professional from #COVID19. They cautioned against sharing the story.

3/14
Read 15 tweets

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