Ophthalmology and Allied Sciences

Aims: 1. =o present a case report of a case of Neurocysticercosis presented with severe episodes of headache and bilateral papilloedema as a relatively silent manifestation of Neurocysticercosis. 2. =o evaluate the bilateral papilloedema as to whether it is true papilloedema or a pseudo papilloedema as an ocular manifestation of ocular cysticercosis involving optic discs of both eyes or due to combination of both. &ntrodution: Neurocysticercosisis (N88), a parasitic infestation caused by the =apeworm,=aenia solium. It is the leading cause of epilepsy in developing countries including India, Africa, Latin America and 8hina. Alternately patients may present with generali>ed headache secondary to raised intra cranial pressure and meningitis. In addition, in many cases of N88, the number, si>e, location and intensity of cysts lead to varied symptomatic presentations. =hese clinical manifestations vary from completely asymptomatic infestation to severe disease and death. Casereort: In this paper we discuss a case of 17 year old female who presented with severe episodes of headache in March 2021. She was found to have disseminated N88 on MRI and 8= and bilateral papilloedema as an ocular manifestation of ocular cysticercosis involving optic discs of both eyes. We also discuss about the cause of papilloedema and how this patient was non surgically managed. 'isussion: =he present case is a rare case of disseminated N88 presenting only as severe episodes of headache with out any evidence of focal or generali>ed neurological signs or symptoms (ie)relatively a silent case. =here was evidence of bilateral papilloedema which can be due to infectious generali>ed subtle brain parenchymal edema or due to meningitis. =he presence of calcified foci on both optic discs give an appearance simulating pseudopapilloedema, as seen in 7rusen of the optic disc. Goth factors might have played a role in producing the bilateral papilloedema. MRI and 8= scan of brain and high resolution ultrasound of orbits confirmed disseminated N88 and ocular cysticercosis and symptoms improved after medical management with anti epileptics, cysticidal antihelmenthic drugs and steroids. Conlusions 1. =his case highlights how N88 may present as a case of severe episodes of headache without focal or generali>ed neurological signs as a relatively silent case. 2. Gilateral papilloedema seen needed to be evaluated whether it was true edema or pseudo papilloedema as an ocular manifestation of ocular cysticercosis involving both optic discs. A. =he nonsurgical medical management in the form of antihelmenthic cysticidal drugs though contraversial, along with steroids will try to delay or prevent the occurrence of focal or generali>ed neurological signs and symptoms.

Key words: Neuro cysticercosis; <pilepsy; Sei>ures and pseudopapilloedema.

)a$/groundand!im: 8orneal ulcer is a major public health problem in the developing world causing prolonged ocular morbidity and visual impairment. In a vast agricultural country like India, minor eye injuries sustained in agricultural farms often lead to corneal ulceration of fungal etiology and loss of vision.  Fence, this study was undertaken to study the risk factors, clinical presentation and to know the statistical significance regarding the common type of fungi and prognosis with regard to the available mode of therapy. %aterialsand%ethods7 All patients with suspected corneal ulcer presenting to NM8FHR8, Raichur, 7epartment of ophthalmology from September 2017 to March 2019 were evaluated. 7etailed history was taken and thorough ocular and systemic examination with Microbiological work up was done in all patients. =hey were given necessary medications. Outcome was recorded in terms of regression of symptoms and development of complications. Resultsand(on$lusion: Out of 120 patients with suppurative keratitis, 7: (;2.:0I) were clinically suspected of mycotic keratitis and positive for fungal elements. 89.AI were in the working population. :0.;7I were farmers. =rauma with vegetative matter was a predisposing factor in 40I of the cases. All patients were OOF positive and among them 70.;;I were culture positive. In our study Aspergillus(4;.7I) was the most commonly isolated fungus.In all 7: patients ulcer debridement was done.

Key words: Fungal corneal ulcer; OOF sensitivity; Aspergillus. Sp; Antifungal treatment; Surgical debridement.

Aim: =o know the influence of small incision cataract surgery on tearfilm by measuring dryness symptoms using ocular surface disease index (OS7I) score and Euantify changes in tear film using tear meniscus height,schirmers test 1, =GD=, Fluorescein staining , impression cytology. Materialandmethod: A prospective descriptive study was conducted among 180 patient undergoing small incision cataract surgery in department of ophthalmology, NM8F Raichur. .esults: Out of 180 patient, =he mean age group was :;.87R9.:0 years.Mean value of pre- operative vspost operative 1st,Ard,;th week for OS7I was11.274,21.9A2, 18.880,1:.A7; respectively. schirmers 1 test showed mean21.7::,12.A22, 1:.7A8,17.01;. =GD= values were 12.;89,7.922,8.400,9.9;1 respectively . =ear meniscus height mean score were 0.A01, 0.21:, 0.1;1,0.212 respectively.mean value of impression cytology showed 7A2.0:R2A2.4; and A:;.A;R107.1; cells / mm2.. . Oxford scheme grading showed grade 1 in pre operative period and grade 1 ,2 ,1 in post operative followup for 1st, Ard, ;th week respectively. Conclusion: A significant number of patient with no dryness symptom before cataract surgery developed tear film abnormalities in immediatepost operative periodstudies with longer time period are recommended to assess time taken for tear film to recover to pre operative state. In addition to this patient also needed to be started on lubricating drops intensively prior to surgery for patient comfort post operatively.

key words: Small incision cataract surgery; =ear film; OS7I score; Schirmers test; =GD=.