Ophthalmology and Allied Sciences

We report a case of central retinal artery occlusion after Triamcinolone Acetonide suspension (TMA) injection into Temporomandibular joint (TMJ) and review of relevant literature. Case description: A 25-year old male presented with sudden painful vision loss in right eye immediately after TMA injection into right TMJ 24 hours prior to presentation. It was associated with transient dizziness and nausea. At presentation, his vision in the right eye was hand movement and projection of rays full. A complete ophthalmic examination was performed. Anterior segment examination was unremarkable, except for relative afferent pupillary defect in the right eye. Other than that, there was pale edematous retina with marked arteriolar thinning with intra-arterial TMA seen in few of the blocked arterioles and a cherry red spot at the macula. Treatment in form of ocular massage, hyperbaric oxygen therapy and oral Prednisolone (Omnacortil) 1.5mg/ kg as well as topical Difluprednate 0.05% (Diflucor), Bromfenac 0.09% (Unibrom) and Brimonidine 0.1% (Alphagan-P) was instituted, and patient was kept under observation for 1 week and followed up for one month, when the visual recovery was poor with final best corrected visual acuity at 6/60 on Snellen’s chart. Literature review: Several cases have been reported which show severe irreversible visual loss following intralesional corticosteroid injection in the head and neck area. Clinical relevance: Intra-articular injection into the TMJ should be given with caution

 Title: Letrozole induced central serous chorioretinopathy- a rare case report. Purpose: To report a case of letrozole induced central serous chorioretinopathy. Methods: This is a case report. Results: A 59 years old female presented with diminished vision in right eye. On examination she had central serous chorioretinopathy in right eye and was not responding to anti VEGF and treated with focal laser. Conclusion: Letrozole induced central serous chorioretinopathy has not been reported before. It may be prudent for oncologist to have an ophthalmology consultation for their patients on letrozole to

 Spectral domain-Optical coherence tomography (SD-OCT) provides information about the in-vivo histology of the retina. Diabetic retinopathy is associated with structural changes within the retina. Recently, disorganization of the inner retinal layers has also been shown to correlate with the final visual outcome.These changes can be observed by OCT, and correlate with the visual acuity. Accurate evaluation of the second hyper reflective band in the macular region, Ellipsoid Zone, on OCT is highly significant for providing valuable information regarding disease state and visual prognosis in diabetic

Aims: To study the prevalence and risk factors of diabetic retinopathy in diabetic patients attending a medical college hospital inTelangana. Methods: A total of 630 diabetic patients were evaluated for presence of diabetic retinopathy. Diabetic retinopathy is classified into non-proliferative diabetic retinopathy ( NPDR) and proliferative diabetic retinopathy (PDR). Various risk factors associated with

 Background: Pterygium is a wing shaped conjuctival encroachment onto the cornea generally situated on nasal side. Aim: To see the results of pterygium excision with sutureless glueless conjunctival autografting in urban and rural population of central India. Study Design: Prospective study. Place and Duration of Study: The Study was conducted in the Department of Ophthalmology, Chirayu Medical College and hospital for a period of two years from October 2014 to October 2016. Material and method:

 Aim of the study: To compare the clinical outcome of 8-0 vicryl suture versus fibrin glue in cases of pterygium excision with conjunctival autograft. Materials and Methods: A comparative prospective study was performed in forty eyes in forty patients in primary pterygium. The patient age ranged from thirty to sixty five years. They were randomly divided into two groups. Group A (20 eyes) who underwent pterygium excision with conjunctival autograft using 8-0 vicryl and Group B (20 eyes) with fibrin glue. Mean follow up period was for six months. Clinical assessment was done on first, seventh, thirtieth day and at the end of three months and six months. Results: The average surgical time for suture group was 30.56 minutes and in fibrin glue group it was 15.52 minutes. Postoperative symptoms like pain and foreign body sensation were significantly less in fibrin group compared to the suture group. Recurrence rates were not statistically different between the two groups. Conclusion: Use of fibrin glue in pterygium surgery gives postoperative comfort and also reduces surgical time.

Purpose: To study the role of B-scans ultrasound in detection of posterior segment pathology in cases of senile mature cataract. Material and method: This study was conducted in Department of Ophthalmology, Chirayu Medical College and Hospital, Bhopal from October 2012 to October 2017. The study included 1600 patients of mature cataract evaluated with B-Scan Ultrasonography for posterior segment lesions. Results: The cases were divided according to age ranging from 0-80 years. Male predominance was seen with sex ratio 1.37:1 (M:F). In this study Posterior staphyloma was seen in 62 (3.87%) cases, Vitreous hemorrhage in 28 (1.75%), Vitreous membrane in 30(1.87%), Chorioretinal Thickening in 25 (1.56%), and Retinal detachment 20 (1.12%) cases. Out of 1600 patients 320 (20.1%) were having ocular and systemic risk factors like hypertension, diabetes, increased IOP, uveitis. Conclusion: From, the present study it was noted that B-scan is very efficient tool in diagnosing various ocular abnormalities. Preoperative posterior segment evaluation with ultrasound in patients with hypermature cataract may influence the surgical results and postoperative visual prognosis.

 Objective: To study the diagnostic accuracy of Retinal nerve fibre layer (RNFL) thickness and perimetric field defects in early diagnosis of Primary open angle glaucoma(POAG). Materials and Methods: Eyes fulfilling inclusion criteria were selected for this study from ophthalmology glaucoma clinic outpatient department at R.L. Jalappa Hospital. Informed consent was take from all patients. They were divided

 Context: Awareness about diabetes mellitus and it’s ocular manifestations. Aim: To know the awareness about diabetes mellitus, it’s complications and ocular manifestations in Indian population. Settings and design: Survey done through Questionnaire in diabetic patients attending health camps and OPD in medical college. Methods & material: Total 1114 diabetic patients, 566 males and 548 females,

 Objective: To find the effectiveness of trabecular aspiration in reducing (IOP) Intraocular pressure in patients with pseudoexfoliation syndrome. Materials and Methods: The patients with pseudoexfoliation glaucoma visiting ophthalmology Outpatient department of R.L. Jalappa hospital were taken for this study. 44 patients out of 56 patients came for the followup. The patients were consecutively segregated

Background: Ocular injuries attain great socioeconomic importance in Ophthalmology due to industrialization in developing country like India. So, this study was planned to evaluate pattern of ocular manifestation of injuries, the modes of clinical presentation, their management and the visual outcome in Western Rajasthan. Material and Methods: This prospective study was conducted in all patients aged more than 18 years of industrial ocular injuries, who presented to Mathura Das Mathur Hospital, Jodhpur between September 2013 to September 2015. Detailed clinical history including type

Background: Patients who have PCO with significantly reduced visual acuity need posterior capsulotomy to improve vision. Nd:YAG laser for posterior capsulotomy is a widely used, safe, noninvasive, and effective procedure with minimal complications. The aim of this study is to estimate mean energy levels for Nd:YAG laser capsulotomy in various subtypes of PCO (membranous, fibrous,and fibro-membranous). Setting And Design: This is a prospective comparative study at a rural based, tertiary level hospital. Methods And Materials: This study has been performed at our institute between September 2013 and September 2015 after taking clearance from the ethics committee. 100 eyes of 100 patients with PCO were considered for Nd:YAG laser capsulotomy after minimum period of 6 months following uncomplicated extracapsular cataract extraction.Statistical analysis was done by the unpaired t-test using SPSS software. Results: In our study, the mean initial and mean summated laser energy levels were different for different subtypes of PCO. There was a significant difference in mean initial laser energy levels for different subtypes of PCO (p<0.001). Mean initial laser energy level was minimum for membranous PCO (1.4 mJ) followed by fibro-membranous PCO (2.2 mJ) and maximum for fibrous PCO (3.2 mJ), whereas the mean summated energy level for membranous was 25.22 mJ, for fibrous 51.48 mJ and for fibro-membranous was 70.08 mJ. The mean summated laser energy level was maximum

Context: Computer vision syndrome not only affects physical health but also affects the quality of life significantly. It also hampers productivity of work. Aims: To study the prevalence of symptoms of computer vision syndrome (CVS) among medical students. Settings and design: Institution based cross sectional study was carried out at MRIMS, Hyderabad. Methods and material: 164 Medical students fit as per inclusion and exclusion criteria were given self administered questionnaires. Only completely filled

 Context: There is paucity of data on the topic of color vision deficiency on a large scale. Studies on color vision deficiency in Hyderabad are not found. Aims: To study the prevalence and awareness of color blindness in school children of class V to X. Settings and design: School based cross sectional study conducted at schools located in Quthbullapur, Hyderabad. Methods and material: During the study period a total of 1000 school children belonging to classes V-X were screened for the presence of color vision

 Aim: To analyse the outcome of Pterygium excision with conjunctival auto graft with no glue, no sutures technique using autologous blood as tissue adhesive. Objective: To analyse a simple, cost effective, less painful and less time consuming technique of conjunctival autograft with autologous blood. Materials and methods: A total of 30 patients with primary pterygium in the age group of 30-60 years were included in the study. All patients underwent pterygium excision followed by conjunctival autografting. Autoblood fibrin clot was used as tissue adhesive to secure the conjunctival autograft.

Introduction: Refractive error is the inability of the optical system to bring an image to the sharp focus on the retina. Myopia is an optical aberration of the eye whereby objects at a distance are not focused onto the retina but brought to a focus in front of the retina, resulting in a blurred image. In India uncorrected refractive errors are second major cause of avoidable blindness. Materials and methods: This was a crosssectional, descriptive study over a period of 2 months to find the incidence of myopia and prevalence of peripheral retinal degenerations among medical students in ARMCH Kumbhari, Solapur. Sample size was calculated by using the formula n = z2 *p*q/d2, 400 students were included in the study. Results: The incidence of myopia among medical students was 278 (69.5%) and 122(30.5%) in non myopic, female

Pseudoexfoliation [PEX] syndrome is a common age – related disorder of the extracellular matrix that is frequently associated with severe chronic secondary open angle glaucoma and cataract. PEX syndrome may affect up to 30% of people older than 60 in a worldwide distribution and is biomicroscopically diagnosed by abnormal fibrillar deposits on ocular structures that line the aqueous bathed surfaces of the anterior segment. Often associated with the need for intraocular surgery, results of cataract and

 Introduction: Corneal ulcer is one of the most common causes of prolonged ocular morbidity and visual impairment in our country. While cataract remains the major cause of reversible visual loss, diseases of the cornea are emerging as an important cause of visual impairment. Corneal lesions were found to be responsible for 9% of all blindness in our country, in a recent national survey by government of India.1 The reported incidenceofcorneal ulceration in South India is 1130 per million population. Objectives: To know the etiology of corneal ulcers based on laboratory investigations done in our hospital regarding the type of pathogen and to determine the most common predisposing factor for corneal ulceration. Methods: This cross-sectional descriptive study included fifty patients attending Ophthalmology Outpatient Department in NRI medical College and Hospital with corneal ulcers during a period of one year i.e. July 2016 to June 2017. They were examined by slit-lamp and corneal scrapings were performed for cultures and smears by using standard protocols. Results: Corneal ulcers are more common inrural

Introduction: Cataract (opacification of the lens) affects vision in a significant way. Traumatic cataract caused by different modes of ocular trauma contributes adequately to the quantum of cataract blindness. The present study was conducted on patients with traumatic cataract to know the demographic status, mode of injury, type of traumatic cataract and associated ocular injuries in these patients. Methodology: Traumatic cataract cases (n=50) attending Ophthalmology OPD at Khaja Bande Nawaz Institute of Medical Sciences (KBNIMS), Kalaburagi were included in the study group, based on the inclusion & exclusion criteria. Results: Our study showed that maximum number of traumatic cases were found in the age group of 11-20 years. Majority of the patients were males. Total cataract was the most common form of cataract. 82% of them had visual acuity of < 3/60. Among the associated injuries the corneal injuries were most common. Conclusion: Traumatic cataract and its associated ocular injuries constitute one of the important causes of ocular morbidity and visual loss. It is absolutely necessary to take preventive steps to curtail incidence of these severe catastrophes to the minimum.

 Objective: To analyze the role of blood pressure in predicting progression of diabetic retinopathy. Materials and Methods: This prospective clinical study was done on patients with diabetic retinopathy attending the OPD of department of Ophthalmology & those willing to participate this study. Sample size: 50 patients based on inclusion criteria will be registered, evaluated & followed up subsequently for 12 months. Inclusion criteria Patients with type I OR Type II diabetes who have diabetic retinopathy

 Aim: The main objective of the current study is toinvestigate that the prevalence and type of glaucoma inthe rural area of Chhattisgarh. Material and methods: A retrospective study was conducted inthe department of ophthalmology at Lakhiram Agrawal Memorial Govt. Medical College and associated Kirodimal Govt. Hospital, Raigarh, (CG), total 513 patients were screened in the age group of 40 years to

 Aims and Objectives: To identify the specific pathogenic organisms risk factors responsible for infection in corneal ulcer patient. Materials and Method: The present study was undertaken on 200 patients of corneal ulcer attending the outpatient department, with special reference to the etiology and predisposing factors, examination in detail for morphological features, microbiological work up, management and follow up. Results: Out of 200 patients, Male:Female ratio was 1.8:1. Most common age group affected was between 31–50 years for all types of infectious keratitis, 45%, 35%, 6% and 14% for bacterial, mycotic, mixed and sterile keratitis respectively. Socio-economically poor classes had 88% of keratitis. Keratitis occurred more frequently in the residents of rural areas 82%. Trauma was found to be the most common predisposing factor accounting for 66.5% followed by chronic dacryocystitis 8.5%. Inferonasal cornea was involved with highest frequency in bacterial and central cornea in fungal keratitis. Staphylococcus epidermidis 37.04% was the most common bacterial isolate followed by staphylococcus aureus 24.07%. Fusarium sp. 33.3% and Aspergillus sp. 33.3% were most common of fungal isolates. Conclusion: Central

Background: Morbidity and mortality in HIV patients is supposed to be more due to the various opportunistic infections in them and hence management of these infections and their outcome is essential. Ocular infections may cause impairment of vision or blindness. Aim of the Study: To detect the outcome after management of HIV patients who presented to the department of ophthalmology with various opportunistic infections. Materials and Methods: A retrospective study was done on HIV patients who

Background: Pregnancy, being a genuine test to the human body, is connected with a gathering of physiologic and pathologic changes. A standout amongst the most essential pathologies going with pregnancy is the preeclampsia-eclampsia disorder. Preeclampsia-eclampsia influences all organs and frameworks including eyes. Aim: To study prevalence of ocular manifestations in new onset hypertension of pregnancy and normotensive pregnant women. Materials and Methods: This is a prospective case

 Vernal Keratoconjunctivitis (VKC) is an allergic disease that typically affects young individuals, of which males are predominant. The disease involves the lids, conjunctiva, limbus and the cornea. The corneal changes range  from punctate keratitis to shield ulcers. High incidences of keratoconus and abnormal corneal topographic patterns have been reported in these cases. The configuration of the corneal surface and the abnormal pattern of corneal surface can lead to vernal keratoconjunctivitis. Hence, an