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Embryology of the eye is a complex topic to master - due to the obscure understanding of general principles and lack of application of the learned concepts in our routine practice.
This handwritten manual aims to bridge the knowledge gaps & missing links - thereby presenting itself as a Complete Course on Ocular Embryology from Genes to Clinics.
Highlights :
1) Profusely illustrated with colourful diagrams and clinical photographs
2) Flowcharts to aid understanding of complex derivatives
3) Relevant applied aspects accompany every detail of individual structure
4) Must read for residents, practising ophthalmologists and paediatricians

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Published by Dr Pranesh Balasubramaniam, 2023-06-20 15:07:21

Clinical Embryology of the Eye

Embryology of the eye is a complex topic to master - due to the obscure understanding of general principles and lack of application of the learned concepts in our routine practice.
This handwritten manual aims to bridge the knowledge gaps & missing links - thereby presenting itself as a Complete Course on Ocular Embryology from Genes to Clinics.
Highlights :
1) Profusely illustrated with colourful diagrams and clinical photographs
2) Flowcharts to aid understanding of complex derivatives
3) Relevant applied aspects accompany every detail of individual structure
4) Must read for residents, practising ophthalmologists and paediatricians

Assoc E l t t Metabolic Intrauterine Syndromes disorders Infections Galactosemia GPUT enzymedeficiency Galactose 1 Phosphate oil droplet cataract Luridyltransferase Lowe syndrome Oculocerebrorenal syndrome XLR Fabry disease Mannosidosis deficiency a mannosidase


Assoc E l Moffatb EitEfinne syndromes TORCH es syphilis Herpes Toxoplasma RIbeyatcytomg.gg


Congenital RubellaSyndrome Gregg's syndrome H Classic Triad Dense Nu ear cataract Rubell Retinopathy


Congenital syphilis saddle shaped Note Clutton's Joints SabreTibia notched smallteeth Hutchison's Teeth Interstitial keratitis 1 Sensorineural Hearing Loss HUTCHISON'sTRIAD


Congenital Toxoplasmosis SABIN'sTETRAD Cartwheel Madison Intracranial calcification Mental Retardation Hydrocephalus microcephaly


Syndromes t t t Downs Edwards Patan Trisomy21 Trisomy18 Trisomy 13


Down's syndrome congenital cataract flat nasal bridge Brushfield spots Y1 focalareas of stromal Tissue Hyperplasia Upslanting palpebral fissure epicanthalfolds Got M c Refractory error Hypermetropia M c Typeof Astigmatism Oblique M c Typeof strabismus Esotropia NLD obstruction common


Defect information of Lenscapsule H Lenticonus Anterior Posterior 1 t Assoc c ALPORT's Assoc E Lowe's SYNDROME SYNDROME


t t microspherophahia microphatia He smaller diameter shatter diameter f spherical in Lowe's A syndrome Risk of PupillaryBlock Angle closure Weil Marchasani Marfan's Hyperlysinemia Peter's Anomaly


Ectopia Lentis EL J t t congenital Acquired t t Marfan's PostTraumatic Weil Marchasani Homocystinuria EhlerDanlos syndrome manifest2 Retinal Sticklersynd Mostcommon oath Detach Inferonasal EL Superoptemporeaf micyspherophahia Homotustinuria Inmate.IT uipYanfmidsi'sIIIan eg


Homocystinuria Marfan's Weitmarchasani Syndrome BIL Inferonasal Superolemporal Inferior EL EL EL t Zonulav Intactanules Microspherophab Disintegration t t 40 Accomodation IntactAccomod 2 pupillaryblouk glaucoma Matanoid Tall.thin Opposite K features Arachnodactyly marfans I t GothiclHighanhed shortfingers Thrombo palate embolism Tnt'Laxity shortstature MentalRetard


Stickler syndrome Hereditary Arthro Ophthalmopathy 3main features High myopia Vitreous Retinal 4 degeneration RD Cataract


3 waves of NCC 3 waves of NCC migration bln Lens surface 1 ectoderm L v 1 1st wave 2nd wave 3rd wave t t t Endothelium stoma of Iris Shoma of cornea of cornea Descend'smemb pupillary membrane Ref AAO 2019 woo somebooks say 2 YnaeaYs mmas l 3rd wave in's


cornea t t 1 Epithelium otherlayers t t from surface Ectoderm from NCC corneal Transparency 1 due to maturationof corneal Lamellae but failure of heratocytes to produce collagen fibres in Lamellar Array t Scleralisation of cornea Sotero cornea


moderate Sdewcome a severe Sdew cornea Differentialsfor Congenital Corneal Clouding clewcornea Tears in Des cemets post Trauma Iker Mucopolysaccharidosis Metabolic disorders Peder's Anomaly Posterioraxialstromal defect Edema CongenitalHereditary EndothelialDystrophy Dermoid


Microcornea us Megalocornea t t Horizontal corneal Horizontal corneal diameter Elomm diameter 213mm in adults in adults Cor f 9mm in newborn Nole cornealdiameter Assoc Pigment pension 10mm 12mm Syndrome 1 Neonates 2yrs till Adult


Isa


Anterior Chamber Posterior Chamber pig me see Primo men E ftp.eo.i.mesenchsylimteihbln developing in's Hens posterior chamber Pc


Trabecular Meshwork Dgeveloping corneal endothelium elopingcornea Ncc Mesenchyme t.fi e iieiine a Ac CollectionFest of undifferentiated Ncc mesenchyme t Trabecular Anlage Cinema mu b mean eYit t


Trabecular Anlage 13Wh 0 capillaries y Ant chamber to Trabecular Pupillary membrane cells Schlemm's Sc canal 22Wh giant Vacuoles in SC Enlarged InterTrabecular Connective spaces Tissue LTrabewfaveys


Schemm's Canal me.sentiemme Fm from Ncc mesenchyme Deep ATM collectionof small capillaries fuse to form single elongated slit likevessel CANAL of Sc LE nm from Mesodermaf vessel w Mesenchyme vacuoles Endothelialcells


Trabecular Anlage t Develops into Trabeculen Meshwork x 3pqHs I l 1 Innermost Middle Outermost H H Hi Unreal Meshwork Comeosderal Juxta Meshwork canalicular I f Cribriform cord like Zone Lamellar f Loosely arranged Schlemm Tuxtacanaticular Meshwork fffcandoc corneosderal Meshwork j savedmeshwork 99


Tn Er Microscopic Anatomy of Tnt in Adults


GONIO DYSGENESIS Maldevelopment of Iridocorneal Angle t t Trabeculedysgenesis Fido corner only dysgenesis Isolated TM maldevelop t a Impaired Aqueous outflow 1 Axenield W o other major ocular Riegersyndrome abnormalities 2 Peter'sAnomaly I 3 Aniridia PRIMARY CONGENITAL SECONDARY CONGENITAL GLAUCOMA GLAUCOMA Mostimportantgene CYPIBI


Primary Congenital Glaucoma riad 1 T Epiphora 2 Photophobia DBlephawspasm I HAAB's STRIAE cut'rvilinear healedbreaks in Descend'smembrane


Axenfeld Riegersyndrome to 4 Axenfeld Anomaly Riteger Rieger f Anomaly syndrome Reiger Anomaly Extraocular 1 manifestations prominenteanteriorlydisplaced Schwalbe's line _posterior f Embryotoxon peripheral iris strands extending into cornea


Rieger's Anomaly mimics IndocornealEndothelial ICE syndrome


Rieger's syndrome Telecanthus BroadNasalBridge MaxillaryHypoplasia DentalAnomalies microdontia Hypodontia small teeth fewteeth Peter's Anomaly 1 2 Corneal involvement Corneatlens only Type 2 Type I Hallmark Central defectin Descemets's Endothelin Thinning opacified corresponding Shona


Central corneal opacity Ii docorneal Adhesions Lenticulo corneal Adhesions


Eye Lids fusion of Lids complete 10wksof GA


yureof mesoderm 1 Tarsal plate lqwksremainfusedtill28thwhlSacendosedbyfusedlidsft.y Conjunct sac Corneal Epithelium I linedby ectoderm


r cornea Note failureof T I Lidformation Lidfusion Lidseparation t CRYPTOPHTHALMOS CotoBomA Away BLEPHARON t Assoc c Fraser I Syndrome


LID COLOBOMAS 2 syndromes Treacher Collins Goldenhar H H Lower Lid coloboma Upperlid coloboma details givenlater 1 Triad Peribulbar dermoid Pre auricularappendages Pre tragal fistulas


Goldenhav syndrome limbaldermoid Preauriculattags


Epicanthus inversus foldof skin extending from lowerlid to medial 1 canthus 1 Assoc I BPES Blepharophimosis Ptosis Epicanthus inversus syndrome


Telecanthus us Hypertelorism f Bendohyperklorism 4 Abnormally ton wide bonyseparation medial canthallIndons of orbits I f orbital Hyperklorism feddistance bln I medialcanthi manifestationof a f TInnercanthal craniofacial deformity distance OCD IPD TICD OCD IPD OCD Outer Canthal Distance IPD Inter pupil Dist ICD Inner canthd pistons


edetainthus Hyterlelorism


Orbit contents Bones Striated Tendons ExtraocularMuscles Intermusadarseplae ConnectiveTissue AdiposeTissue Mesoderm Neural CrestCells Note All bones are membranous except sphenoid cartilaginous 3rdmonth 2 Ossification of GA f 7thmonth 7 fusion


Congenital Craniofacial Abnormalities f t craniosynostosis Nonsynostosis t t Premature fusion of Branchial ArchSyndrome 4 Cranialsutures failure of Development of f 151 2 Branchial Arches 3 syndromes I 2syndromes L I Aperisterouson Pfeiffer Treacher Goldenhar coins i nYdD t Mandibulofacial Dysostosis


Apeitsyndrome most severe craniosynostosis mid facial Hypoplasia Parrotbeaknose syndactyl oxycephaly CConicalskull Lowsetears


Gougon Syndrome MidfacialHypoplasia shallow orbits Proptosis Hypertelorism Shot anlocoposteriorDiameter ofShul


Pfeiffer syndrome a cloverleaf shaped skull 1 Exorbilism spontaneous profusion of eyes due toshallow orbit


Treacher Collins Synd Downward slantingeyes Bk Hypoplasia of mandible Zygoma Lower Lid colobomas Punctal Atresia


Lacrimal Gland surface NasoLacrimalDrainage Ectoderm LacrimalGland go.sepittdialbudsfwmfoyyngngn.nl Nonfunctioning till Newborndon'ttearup bwnsglik when they cry Congenital ALacrimia ltypoplastiahbsI.tljyeeye.inyoung


Lacrimal Drainage Vaso lacrimal solidepithelial Groove cord blnfwntonasal 5 swhsot GA Maxillaryprocess Isolated complete cavities canalisation 4h7 9thmon


NasoLacrimal Ductpatency 1 completes by7thmonthof life H Incomplete canalisation of NLD 1 Congenital NLD obstruction th M C c Imperforate Hasner's Membrane Valueof Hasner lowerendof NLD Last part to canalised


Epiphora in Newborn l t t Congenital Acquired Is EffITgenimeDaoyogstowe L NLD Punto IngenitalNLDObslmoti Agenesis H Atresia Most common cause Fistula Eanalicular of Agenesis Epiphora in Atresia Newborn H


Non Patent NLD CompetentValve of Hasner Collection of Amnioticfluid Mucus in Lacrimal sac Amniontocede Congenital Dacryocele perinatal bluish cystic swelling or below medial canthus DD Encephalocele above medial canthat k tendon


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