Ophthalmology and Allied Sciences

 Charles Bonnet syndrome is among one of the clinical conditions which are not very commonly encountered. Visual hallucinations generally found along with it are complex but interesting. Elderly persons with visual impairment are more prone to develop this syndrome. But pieces of literature have shown that impairment of visual function might not be always accompanying with it. Here we are reporting a case of Charles Bonnet syndrome that had no gross visual abnormality.

Keywords: Charles Bonnet Syndrome; Hallucination; Occipital Cortex; Olanzapine.

 The discovery of Vascular Endothelial Growth Factors (VEGF) and its role in retinal diseases has provided insight in the retinal diseases and as an example of translational medicine, invention of antiVEGF molecules has provided new modality of therapy for retinal diseases. This review article comments on the utility and the changes in the therapy of retinal diseases brought up by the availability and use of these Anti-VEGF molecules.

Keywords: Anti-VEGF, VEGF, Diabetic retinopathy, Eale’s Disease, Retinoblastoma, Retinopathy of Prematurity.

 Background: Glaucoma is the leading cause of untreatable blindness throughout the world. Being a multi factorial optic neuropathy, early diagnosis and prompt treatment is the only vision saving strategy. This requires referral for glaucoma screening by a family physician or any doctor with a high index of suspicion, based on basic knowledge of Glaucoma, a prerequisite for all the medical practitioners. Glaucoma is routinely taught as a part of Ophthalmology curriculum during first phase of Clinical curriculum in the final year of MBBS. The aim of this study is to determine the knowledge of the future primary health care givers. A questionnaire about glaucoma in administered to final year MBBS students of Sri Siddhartha Medical College of Tumkur, Karnataka: the students who have completed Ophthalmology curriculum. The students are expected to be aware of the basic facts of this potentially blinding disease Glaucoma. Material and Methods: A total of 50 student volunteers studying in final year MBBS took the survey questionnaire, without revealing their identity. Results: The students were found to be aware with a fair knowledge about the disease entity.

Keywords: Awareness; Knowledge; Glaucoma; Medical College.

 Background: Study was conducted to compare efficacy in pupil dilatation between 2% Homatropine(2H) alone and alternate application of 2% Homatropine with 4% Xylocaine(2H/4X) eye drops for easy estimation of refractive error and posterior segment examination. Methods: Over 6 months, after obtaining waiver of consent in 100 eyes of 50 patients age between 5-20years (14.26±3.06), one drop of Xylocaine 4% was applied to left eye ( study eye). After 60 seconds 1 drop of 2% Homatropine was applied in both right (control eye) and left (study eye). Pupil diameter was measured via transparent scale before instillation of first drop. At every 15 minutes interval, pupillary size was measured and subsequent instillations were done, upto one hour. Results: There was a statistical significant difference in pupil diameter between eyes dilated with 2H/4X and 2H alone at 30-60minutes (p<0.001). 31 patients (62%) developed maximum pupillary dilatation of (7.42±0.84) in left eye by 45minutes, while only 4 patients (8%) in right eye. Mean dilatation at 60 minutes in study eye was 7.94±0.24 but in control eye was 7.00±0.83 with p<0.001. Conclusion: Combination of 2H/4X potentiates mydriatic effect produced by Homatropine alone causing quicker onset of action, increases patient comfort level by reducing stinging effect of Homatropine and reducing the chances of side effects of Homatropine like delirium, hallucination, dry mouth by reducing the number of drop instillations. So, combination of 2H/4X can reduce patient’s waiting time in OPD and quicker examination of interior of eye and refractive error with ease.

Keywords: Homatropine; Mydriasis; Xylocaine.

 Clinical evaluation of management of amblyopia in adolescent age group (10-19 years) with addition of citicoline to the conventional occlusion therapy. Abstract Aim - To evaluate efficacy of citicoline as an adjuvant to occlusion and near activity exercise in management of amblyopia in adolescent age group. Material and Methods- We included 79 eligible patients of age group 10-19 years for study. Consent was taken from each of patients. All patients undergone full ophthalmological examination to establish diagnosis of amblyopia and were prescribed their best corrected spectacles. They were divided in three groups using randomization chart, Group A-received full time occlusion, Group B - received full time occlusion and near activity exercises and Group C - received full time occlusion and oral citicoline 500 mg BD for three months. They were followed up four weekly up to 24 weeks. Result- During follow up 9 patients lost to follow up. Out of 70 patients who completed study, 36 (51.43%) showed improvement in their vision for distance. We recorded this improvement in lines on snellenýÿs chart. No improvement was present in 14 patients (58%) in group A, 15 patients (60%) in group B and 5 patients (23.81%) in group C. Among groups, responders were 41.67%, 40% and 76.2% in group A, B and C respectively. The difference among three groups was statistically significant (p value-0.024 chi-square test). ConclusionOral citicoline added to occlusion therapy is a new, safe and effective modality for amblyopia management and chances of improvement in visual acuity is better than other treatment options.

Keywords: Strabismus; Amblyopia; Occlusion; Citicoline.