Ophthalmology and Allied Sciences

 A 25 year old male reported to eye- opd with complaint of diminution of vision of left eye for 20 days following electric shock (11,000v) approximately three months back. On examination he had a unilateral star shaped anterior subcapsular cataract in his left eye. He was operated for cataract and achieved 6/6 and N6 visual acuity 3 weeks after surgery. This case highlights rare unilateral cataract following electric shock and excellent outcome following surgery provided fundus and optic nerve are unaffected. Need for awareness of this complication and screening of all cases of electric injury is emphasized.

Keywords: Anterior Subcapsular Cataract Electric Shock; Unilateral Star Shaped Cataract.

 We here present a cancer associated retinopathy with gradually progressive moderate diminution of vision in a patient of gall bladder carcinoma. There was bilaterally symmetrical cystoids macular oedema (CME) and was treated with intravitreal Bevacizumab injection with partial improvement in the vision and CME.

Keywords: Cancer Associated Retinopathy; Gall Bladder Carcinoma; Cystoids Macular Oedema; Intravitreal Injection; Bevacizumab; Anti-VEGF.

 Purpose: To report a case of atypical sympathetic ophthalmia following limbal corneal laceration. Methods and Results: An eleven year oldchild had a successful left eye (OS) corneal laceration repair at the temporal limbus with excision of exposed non necrotic iris tissue, resulting in good visual acuity of 20/ 80 and 20/25 postoperative day 1 and 7 respectively. The patient was prescribed 1mg/kg oral prednisolonein a tapering dose as prophylaxis. Post operative day 21, patient presented with acute onset decreased vision in both eyes. Visual acuity was counting fingers 3 feet in both eyes. On examination, anterior segment examination was quiet without any inflammation, anterior vitreous face showed 1+ cells and dilatedfundoscopy revealed bilateral symmetrical serous retinal detachmentsalongthe posterior pole. Optical coherence tomography (OCT)demonstrated separation and elevation of inner neurosensory layers from the outer segment marking presence of hyperreflective material along with subretinal fluid between detached surfaces. There was stippled hyperfluorescence along theposterior pole as seen in fluorescein angiography. With a diagnosis of sympathetic ophthalmia confirmed, oral prednisolne (2 mg/kg body weight) was instituted following which, there was gradual decrease in macular elevation with corresponding improvement in visual acuity with no recurrence for last 6 months. Conclusion: To our knowledge, this is the first reported instance of an atypical presentation of sympathetic ophthalmia and antecedant corticosteroid therapy would have mitigated robust anterior segment findings usually associated with the condition.

Keywords: Corneal Laceration; OCT; Open Globe Injury; Exudative Macular Elevation; Uveal Prolapse.

 Aims: To compare the efficacy and safety of Timolol maleate 0.5% and Brimonidine 0.2% in lowering IOP in cases of Primary Open Angle Glaucoma. Settings and Design: A single center randomized clinical trial was conducted in which the clinical outcome (efficacy) and safety profile of twice daily brimonidine tartarate 0.2% were compared with those of Timolol maleate 0.5% in patients with POAG for one year between November 2013 to October 2014. Materials and Method: Fifty patients were enrolled, twenty five in the Brimonidine group and twenty five in the Timolol group. Patients used drugs twice daily for five weeks, and were followed up at baseline visit and at weeks three and five. Clinical success meant reduction of intraocular pressure (IOP), Data about safety and adverse events were analyzed. Statistical Analysis Used: Student test. Results: Both drugs showed sustained ocular hypotensive efficacy in the study period of one year. At baseline the mean IOP was 24.34 ± 2.82 mm Hg in the timolol group and 24.16 ± 2.76 mm Hg in the brimonidine group. The IOP readings after treatment at 3rd and 5th week were significantly lower in both groups (P < 0.001) with no significant statistical difference between the two groups. 20% of the patients in Timolol group and 8% of patients in Brimonidine group, reported mild adverse events. Conclusions: Both the drugs have same efficacy and safety profile.

Keywords: Brimonidine; Glaucoma; Timolol.

 Aims: To study the effect of topical Diclofenac sodium 0.1% as an alternative to topical steroid, Dexamethasone phosphate 0.1% for post-operative control of inflammation after small incision cataract surgery. Settings and Design: Double blinded study done in a tertiary care hospital. Methods and Material: 100 patients with uncomplicated senile cataract who underwent uneventful small incision cataract surgery with posterior chamber intra ocular lens implantation were selected and divided into 2 groups of 50 each. One group was given dexamethasone phosphate 1%, other group diclofenac sodium 0.1% topically. They were examined on 7, 15, 30th day for congestion, corneal edema, anterior chamber flare, cells, intraocular pressure and grading was done as per severity and total score was assessed. The results were compared between the two groups. Statistical Analysis used: Chi square test with p value < 0.05 as significant. Results: Day 7 and 15 the response was good for dexamethsaone group for all the parameters. By day 30 there was no significant difference between the two groups in all the parameters. No significant difference in IOP at baseline and at 6 weeks post operatively between the two groups. Conclusions: The resolution of inflammation was quicker in the dexamethasone group than in the diclofenac group. But by the end of 30 days the effect on inflammation in both the groups are similar. So Diclofenac sodium 0.1% can be used as an alternative to Dexamethasone phosphate 0.1% in post operative patients following cataract surgery.

Keywords: Postoperative Inflammation; Dexamethasone Phosphate 0.1%; Diclofenac sodium 0.1%. 

 Purpose: In the present study we assessed the vertical effect of horizontal muscle transposition when performing a resection-recession procedure on a patients with moderate vertical deviation along with horizontal deviation with some additional displacement of horizontal recti i.e. 3/4th instead of 1/2 width displacement. Material and Method: Present study was carried out in a series of 20 cases in the age group 3-40 years of both sexes with complicated squint having both horizontal and vertical deviation of varying amount with special emphasis on sensory status. Cases were broadly divided into two groups- Group 1(12 cases): Patients with Exotropia (40-50PD) and Hypertropia of <12 PD. Group 2(8 cases): Patients with exotropia(40-50PD) and Hypertropia of 12-20 PD. Results: Postoperative vertical deviation corrections are graded as- Very Good :- < 2-4PD. Moderate: - 4-8PD, Fair: - 10-16 PD. In group 1-8 cases (66%) out of 12 results were very good; Rest 4 cases (34%) results were moderate. In group 2- 6 cases (75%) out of 8 results were very good; Rest 2 cases (25%) results were moderate. Conclusion: Vertical muscle displacement is a very good option for correction of moderate vertical deviation especially for ophthalmic surgeons not experienced in tackling oblique muscles. Present study suggests that 3/4th width muscle displacement was more effective than 1/2th width muscle displacement.

Keywords: Squint surgery; Strabismus Surgery;Hypertropia; Exotropia

 Objective: To evaluate the effect of intravitreal Ranibizumab in CSCR with ink blot type of leakage and NSD> 3 months duration. Study Design: Prospective Study. Place and Duration of Study: Base Hospital Delhi Cantt, New Delhi 110010 and Army College of Medical Sciences. Methodology: 20 eyes of 20 adult patients with CSCR were included in the prospective study of duration 08 weeks (02 months). Patients with bilateral CSCR, smoke stack and diffuse leakage of dye on FFA, choroidal neovascularization, treated cases of CSCR, history of thromboembolism, and intraocular inflammation were excluded from the study. After informed consent, all patients were given intravitreal injection of Ranibizumab. Best corrected visual acuity (BCVA) and central macular thickness (CMT) measurement with OCT and pattern of leaks were recorded on FFA at baseline and follow up at 02 and 08 weeks. The outcome measures were mainly BCVA status, CMT on OCT and changes in pattern of leaks on FFA pre and post Anti VEGF. Results: There were 15 (75%) males and 5 (25%) females. All cases were unilateral. Mean age was 39.09 ± 8.49 years. 11 (55%) eyes showed between 3to6 months involvement and 9 (45%) eyes showed more than 6 months involvement. All the cases were treated with single intravitreal dose of 0.5 mg Ranibizumab. After 08 weeks followup, It was observed that the CSCR with ink blot pattern showed moderate visual gain as well as 66.6% decrease in leak intensity on FFA (p <0.001). In addition, mean CMT on OCT showed 70% (p <0.001) decrease at 02 months follow up period. Conclusion: Intravitreal Ranibizumab injection was associated with improvement in BCVA, decrease in intensity as well as delay in onset of ink blot pattern of leaks on FFA and improvement in mean CMT as well as decreased NSD height on OCT in patients of CSCR.

Keywords: Central Serous Chorioretinopathy; Injection Ranibizumab; Optical Coherence Tomography, Intravitreal Injection.

 Not Provided.