Fluorescein angiography
Fluorescein angiography is a diagnostic test that aids visualization of the blood circulation in the retina and choroid. Fluorescein is a water-soluble dye that is injected into a vein in the patient's arm. It travels through the blood vessels of the body thereby aiding multiple photographing of the retina. The images obtained help in detecting any swelling or leakage in the blood vessels. The patient's eyes are dilated with mydriatic eye drops so that photographs of the inside of the eye can be taken. Some patients may notice skin rash, itching or allergic reaction to the dye. Nausea or vomiting may be noticed. But this non-invasive test can usually be safely repeated. Abnormal results of fluorescein angiography test may indicate diabetic retinopathy, macular degeneration, or cancer. Ischaemia or oedema in the retina circulation can be detected with the help of fluorescein angiography
Neuro Ophthalmologist
All vision problems need not necessarily stem from the eye. Some vision problems involve the brain. Neuro ophthalmology is the sub specialty of both neurology and ophthalmology. A neuro ophthalmologist is a phycian who specializes in the diseases affecting vision that originates from the nervous system. Conditions such as optic nerve disorders, loss of vision from central nervous system disease, double vision diplopia and involuntary movement of the eyes nystagmus are some of the disorders under the purview of a neuro ophthalmologist. An ophthalmologsit attends to patients with disease or injury in the eye ball, cornea and the lens or into the eyeball at the retina inside the eye. If any problem occurs behind the eye in the optic nerve or in some distinct visual pathways connecting the brain, it requires the special skills of a neuro ophthalmologist.
A neuro ophthalmologist could be an ophthalmologist or a neurologist with additional special training. After completing a residency program in any one of the two specialty areas, they take a fellowship in neuro ophthalmology for a year or two before starting to practice as a neuro ophthalmologist. A neuro ophthalmologist attends to a full spectrum of neuro opthalmic conditions including evaluation, diagnostic and referral services of rare and complex disorders. A neuro ophthalmologist caters to:
Patients who suddenly lose part of their side vision.
Patients suffering from double vision.
Patients with unequal pupils.
A patient suffering form a stroke.
A patient with brain tumor
Patients who suddenly have their vision out of focus
Any and every patient with unusual vision problems.
In addition to the above, a neuro ophthalmologist provides emergency evaluation of a wide variety of disease that can cause visual loss. Unexplained visual loss can arise out of uncommon disease conditions like myasthenia gravis, multiple sclerosis, mitochondrial disease and other muscular diseases that affect the eye. The neuro ophthalmologist uses special testing techniques including visual fields, visual evoked response, imaging studies such as CT, MRI and angiography and ultrasound to diagnose the disease patterns. It becomes necessary for the neuro ophthalmologist to work closely with other medical specialists to offer multidisciplinary care and solution for complex cases.
Aortic Stenosis
Aortic Stenosis is a condition where the aortic valve of the heart becomes narrowed. This leads to obstructed blood flow to the aorta from the left ventricle. Aortic Stenosis is more common among men. Elderly persons are likely to face this heart valve disease. When the narrowing of the aortic valve is to a small extent, the patient does not feel any discomfort or other symptoms. But when there is significant reduction in the valve area, it leads to decrease in cardiac output and may result in heart failure. Aortic valve stenosis must not be ignored as it systematically weakens the heart. It forces the left ventricle to work harder.
Aortic Stenosis is often caused by rheumatic fever, calcification of the valve, coronary artery disease or heart murmur. Symptoms of aortic stenosis include chest pain (angina), shortness of breath and fainting spells. They occur due to the heart muscle's inablity to cope up with the extreme pressure load laid by Aortic stenosis. Patients suffering from aortic stenosis are likely to feel palpiatations, dizziness and chest pain on exertion.
Enlargement of the left ventricle or Aortic stenosis can be diagnosed with the aid of Doppler ultrasound, echocardiogram, chest x-ray and transesophageal echocardiogram. The physician will be able to notice arrhythmias and enlargement of left ventricle. Diuretics are prescribed to reduce high lung pressure. Blood thinners are used to prevent blood clots from being formed on the surface of the heart valves. Replacement of aortic valves is done in severe cases of valvular failure. Balloon valvuloplasty is a surgical procedure similar to balloon angiography where a balloon is placed in an artery and later inflated to relieve obstruction.
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