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Sreedhar SS, Rajalakshmi AR, Nagarajan S, Easow JM, Rajendran P. Comparison of preoperative prophylaxis with povidone-iodine (5%) and moxifloxacin (0.5%) versus povidone-iodine (5%) alone: a prospective study from India. Int Ophthalmol 2024; 44:48. [PMID: 38337066 DOI: 10.1007/s10792-024-03025-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2023] [Accepted: 01/11/2024] [Indexed: 02/12/2024]
Abstract
PURPOSE To compare the effect of povidone-iodine (PI) 5% and moxifloxacin 0.5% solutions versus PI 5% solution alone on the conjunctival bacterial flora. METHODOLOGY This is a comparative study in which the study population comprised adult patients scheduled for elective small incision cataract surgery. The eye to be operated (control eye) received topical moxifloxacin 0.5% drops 4 times, 1 day before surgery and 2 applications on the day of surgery. As placebo, the contralateral eye (study eye) received saline 0.90% drops as per the same schedule. Before surgery, on table, PI 5% was instilled in the conjunctival sac in both eyes. Conjunctival swabs were taken before initiation of therapy and 3 min after instillation of PI. RESULTS Of the 96 pairs of eyes included in the study, conjunctival cultures before prophylaxis were similar between the two groups (p = 0.31), with 54 samples (56%) of the study group and 49 (51%) of the control group showing growth. With positive cultures reducing to 7 (14%) in the study group and 8 (16%) in the control group, both the prophylaxis methods appeared equally efficacious (p = 0.79). Both the groups showed a significant reduction in positive cultures following prophylaxis (p < 0.0001). CONCLUSIONS PI 5% alone as preoperative prophylaxis was as effective as its combination therapy with moxifloxacin 0.5% in the reduction in conjunctival bacterial colonization.
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Affiliation(s)
- Sanjana S Sreedhar
- Department of Ophthalmology, Mahatma Gandhi Medical College and Research Institute, Sri Balaji Vidyapeeth, Puducherry, India
| | - A R Rajalakshmi
- Department of Ophthalmology, Mahatma Gandhi Medical College and Research Institute, Sri Balaji Vidyapeeth, Puducherry, India.
| | - Swathi Nagarajan
- Department of Ophthalmology, Mahatma Gandhi Medical College and Research Institute, Sri Balaji Vidyapeeth, Puducherry, India
| | - Joshy M Easow
- Department of Microbiology, Mahatma Gandhi Medical College and Research Institute, Sri Balaji Vidyapeeth, Puducherry, India
| | - Prabha Rajendran
- Department of Microbiology, Mahatma Gandhi Medical College and Research Institute, Sri Balaji Vidyapeeth, Puducherry, India
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Khurana DA, Swathi N, Rajalakshmi AR. Author Correction: Factors influencing the need and willingness for presbyopic correction: a cross sectional study from south India. Sci Rep 2024; 14:2481. [PMID: 38291190 PMCID: PMC10828483 DOI: 10.1038/s41598-024-52891-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2024] Open
Affiliation(s)
- Dhruval A Khurana
- Department of Ophthalmology, Mahatma Gandhi Medical College and Research Institute, Sri Balaji Vidyapeeth, Pondicherry, India
| | - N Swathi
- Department of Ophthalmology, Mahatma Gandhi Medical College and Research Institute, Sri Balaji Vidyapeeth, Pondicherry, India.
| | - A R Rajalakshmi
- Department of Ophthalmology, Mahatma Gandhi Medical College and Research Institute, Sri Balaji Vidyapeeth, Pondicherry, India
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Khurana DA, Swathi N, Rajalakshmi AR. Factors influencing the need and willingness for presbyopic correction: a cross sectional study from south India. Sci Rep 2023; 13:22906. [PMID: 38129652 PMCID: PMC10739945 DOI: 10.1038/s41598-023-50288-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Accepted: 12/18/2023] [Indexed: 12/23/2023] Open
Abstract
Presbyopia is an age-related physiological phenomenon in which eye gradually losses its ability to accommodate. It is one of the leading causes of visual impairment worldwide, especially in adults above the age of 40. If uncorrected, it can significantly impair a patient's quality of life. This study aims to evaluate the factors which affects patient's need and willingness to accept presbyopic correction. This cross-sectional analytical study was carried out in a semi urban tertiary care hospital from Jan 2021 to June 2022 among patients aged 40 and above who presented to Outpatient department (OPD). Demographic details, medical history, presenting ocular complaints pertaining to presbyopia, spectacle use and decision regarding using near vision correction were noted. Ocular examination included refraction and ocular biometry. Factors that may have influenced complaints of presbyopia or willingness to accept presbyopic correction were analysed. Three hundred and forty two patients with a mean age of 48.55 ± 6.68 years were included. Of these, 262 (76.61%) patients presented with chief complaints related to presbyopia. Those with higher educational qualification (p = 0.031), hypermetropia (p = 0.021), shallower AC depth (p = 0.028) and on medications for systemic ailments (p = 0.01), were more likely to present with chief complaints attributable to presbyopia. Among them, those with higher educational qualifications (p = 0.02) and skilled workers were more likely to accept near vision glasses (p = 0.02), while those with lower Hb (p = 0.01) and myopia (p = 0.01) were less likely to accept correction for presbyopia. Among the 80 patients without chief complaints related to presbyopia, 35 (43.75%) were not willing to accept near vision glasses. Those with higher BMI (p = 0.04) and hypermetropes (p = 0.05) were more willing to accept presbyopic correction. Presbyopia constitutes a significant reason for patients above the age of 40 visiting eye care facility. Multiple socio-economic, systemic and ocular factors influenced both the chief complaints related to presbyopia and willingness to accept presbyopic correction.
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Affiliation(s)
- Dhruval A Khurana
- Department of Ophthalmology, Mahatma Gandhi Medical College and Research Institute, Sri Balaji Vidyapeeth, Pondicherry, India
| | - N Swathi
- Department of Ophthalmology, Mahatma Gandhi Medical College and Research Institute, Sri Balaji Vidyapeeth, Pondicherry, India.
| | - A R Rajalakshmi
- Department of Ophthalmology, Mahatma Gandhi Medical College and Research Institute, Sri Balaji Vidyapeeth, Pondicherry, India
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Shaikh ZM, Rajalakshmi AR, Nagarajan S. Knowledge and awareness of COVID-19-associated mucormycosis among doctors in a tertiary care center. Indian J Ophthalmol 2023; 71:2309-2310. [PMID: 37202990 PMCID: PMC10391457 DOI: 10.4103/ijo.ijo_2740_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/20/2023] Open
Affiliation(s)
- Zeba Muzammil Shaikh
- Department of Ophthalmology, Mahatma Gandhi Medical College and Research Institute, Sri Balaji Vidyapeeth (SBV) Deemed to be University, Puducherry, India
| | - A R Rajalakshmi
- Department of Ophthalmology, Mahatma Gandhi Medical College and Research Institute, Sri Balaji Vidyapeeth (SBV) Deemed to be University, Puducherry, India
| | - Swathi Nagarajan
- Department of Ophthalmology, Mahatma Gandhi Medical College and Research Institute, Sri Balaji Vidyapeeth (SBV) Deemed to be University, Puducherry, India
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Alekhya C, Rajalakshmi AR, Nagarajan S. Ixodidae - A rare cause of blepharitis. Trop Parasitol 2023; 13:63-65. [PMID: 37415755 PMCID: PMC10321583 DOI: 10.4103/tp.tp_92_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Revised: 04/15/2022] [Accepted: 01/25/2023] [Indexed: 07/08/2023] Open
Abstract
Hard ticks are mainly responsible for more "tick-borne" diseases in humans when compared to soft ticks. Tick infestation of ocular and periocular tissues is rare. We report the case of a 61-year-old male with left upper eyelid edema with erythema and live parasite on the lid margin.
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Affiliation(s)
- C. Alekhya
- Department of Ophthalmology, Mahatma Gandhi Medical College and Research Institute, Sri Balaji Vidyapeeth, Puducherry, India
| | - A. R. Rajalakshmi
- Department of Ophthalmology, Mahatma Gandhi Medical College and Research Institute, Sri Balaji Vidyapeeth, Puducherry, India
| | - Swathi Nagarajan
- Department of Ophthalmology, Mahatma Gandhi Medical College and Research Institute, Sri Balaji Vidyapeeth, Puducherry, India
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Muthu Krishnan V, Rajalakshmi AR, Pokal U, Shivakumar K. Occipito-temporal infarction manifesting as isolated visual perceptual abnormalities: A rare case of posterior cerebral artery stroke. Eur J Ophthalmol 2023; 33:NP28-NP31. [PMID: 34615392 DOI: 10.1177/11206721211046146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Ischemic stroke in the Posterior Cerebral Artery (PCA) territory is an uncommon entity. Majority present with visual field defects while isolated visual perceptual abnormalities are an exceptional manifestation. About 60 year old hypertensive patient presented with vague symptoms of blurring of vision and palinopsia. Defective color vision was recorded in superior quadrants. Perimetry revealed bilateral congruous left superior quadrantanopia. Magnetic Resonance Imaging (MRI) disclosed right PCA infarct involving occipito-temporal region. This case highlights a rare presentation of PCA stroke with palinopsia and cerebral dyschromatopsia. Perimetric examination coupled with urgent neuroimaging helps the clinician in prompt diagnosis of neurological event causing unexplained visual phenomena.
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Affiliation(s)
- V Muthu Krishnan
- Department of Ophthalmology, Mahatma Gandhi Medical College & Research Institute, Pondicherry, Pondicherry, India
| | - A R Rajalakshmi
- Department of Ophthalmology, Mahatma Gandhi Medical College & Research Institute, Pondicherry, Pondicherry, India
| | - Upasana Pokal
- Department of Ophthalmology, Mahatma Gandhi Medical College & Research Institute, Pondicherry, Pondicherry, India
| | - Koushik Shivakumar
- Department of Ophthalmology, Mahatma Gandhi Medical College & Research Institute, Pondicherry, Pondicherry, India
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Pokal U, Swathi N, Rajalakshmi AR, Lokeshmaran A. Comparing retinal sensitivities on blue-on-yellow and green-on-yellow perimetry in glaucoma suspects. Indian J Ophthalmol 2022; 70:3550-3555. [PMID: 36190045 PMCID: PMC9789795 DOI: 10.4103/ijo.ijo_944_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Purpose To compare the retinal sensitivities between the blue-on-yellow perimetry (BYP)/short-wavelength automated perimetry (SWAP) and green-on-yellow perimetry (GYP) among patients with and without nuclear sclerosis among glaucoma suspects. Methods After ophthalmic examination, patients were subjected to two perimetric tests: BYP and GYP. The visual field (VF) parameters were compared between the two perimeters (p < 0.05 was considered significant). Results Fifty-five eyes of 39 patients with a mean age of 60.53 ± 9.70 years were included in the study. Twenty-one eyes had clear lens or pseudophakia. Twenty-six eyes had lower grades of nuclear sclerosis (NO2NC2, NO3NC3) and eight eyes had higher grades of cataract (NO4NC4, NO5NC5). The mean retinal sensitivity (RS) in BYP was 22.08 ± 5.02 (dB) and in GYP was 23.84 ± 5.50 (dB) (p = 0.08). The mean defect in BYP was -2.56 ± 4.40 (dB) and in GYP was -3.24 ± 5.05 (dB), pattern standard deviation (PSD) in BYP was 3.65 ± 1.91 (dB) and in GYP was 3.83 ± 1.99 (dB), and foveal threshold (FT) was 24.20 ± 4.32 (dB) in BYP and 28.10 ± 4.50 (dB) in GYP. The two perimeters showed good agreement by the Bland-Altman plot for all parameters. Fourteen eyes showed perimetric changes suggestive of glaucoma by BYP. In these, GYP had a sensitivity of 92.86% (95% CI of 66.13% to 99.82%) and specificity of 95.12% (95% CI of 83.47% to 99.40%). Conclusion BYP and GYP show good agreement. They are comparable in clear media as well as in different grades of nuclear sclerosis. GYP showed good sensitivity and specificity compared to BYP.
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Affiliation(s)
- Upasana Pokal
- Department of Ophthalmology, Mahatma Gandhi Medical College and Research Institute, Sri Balaji Vidyapeeth University, Puducherry, India
| | - N Swathi
- Department of Ophthalmology, Mahatma Gandhi Medical College and Research Institute, Sri Balaji Vidyapeeth University, Puducherry, India,Correspondence to: Dr. Swathi N, Mahatma Gandhi Medical College and Research Institute, Sri Balaji Vidyapeeth University, Puducherry, India. E-mail:
| | - A R Rajalakshmi
- Department of Ophthalmology, Mahatma Gandhi Medical College and Research Institute, Sri Balaji Vidyapeeth University, Puducherry, India
| | - A Lokeshmaran
- Department of Community Medicine, Mahatma Gandhi Medical College and Research Institute, Sri Balaji Vidyapeeth University, Puducherry, India
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Rajendran S, Rajalakshmi AR, Srikanth K, Ezhumalai G. Manual small incision cataract surgery: a viable option for cataract with pseudoexfoliation. Int Ophthalmol 2021; 42:1447-1455. [PMID: 34839453 DOI: 10.1007/s10792-021-02134-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Accepted: 11/12/2021] [Indexed: 10/19/2022]
Abstract
PURPOSE The aim of the study was to assess the spectrum of clinical presentation, intraoperative challenges and immediate surgical outcome of cataract patients with pseudoexfoliation syndrome (PXF) following manual small incision cataract surgery (MSICS). METHODS This prospective observational study which was conducted in a rural tertiary care hospital included adult patients with cataract and associated PXF. MSICS was performed for all after a complete ophthalmic and systemic examination. Clinical profile, intraoperative and post-operative complications were noted. Uncorrected visual acuity on first day post-surgery was used to assess the surgical outcome following MSICS. RESULTS MSICS was performed in 80 eyes with varying grades of cataract and PXF. The mean age of the patients was 62.5 ± 8.9 years. PXF material on pupillary margin in 77(96%) patients was the most common finding noted. Majority of the patients had advanced cataract (72, 90%) and inadequate mydriasis (62, 77.5%). Posterior capsular rent (8, 10%) and zonular dehiscence (8, 10%) were the intraoperative difficulties faced. Uncorrected visual outcome on first post-operative day was moderate to good in 71 (88.8%) patients, limited by post-operative corneal oedema (21, 26.3%), iritis (31, 38.8%) and aphakia (9, 11.3%). CONCLUSION Patients with pseudoexfoliation had poor pupillary dilatation, advanced cataracts and higher rate of posterior capsular rent. Our study showed good outcome of MSICS in PXF patients, even with advanced cataract suggesting that MSICS is a safe, effective and viable option for patients with PXF and cataract.
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Affiliation(s)
- Sruthi Rajendran
- Anand Eye Hospital Clear Vision Centre, Trivandrum, Kerala, India.,Department of Ophthalmology, Mahatma Gandhi Medical College & Research Institute, Sri Balaji Vidyapeeth (SBV) Deemed to be University, Pondicherry, 607402, India
| | - A R Rajalakshmi
- Department of Ophthalmology, Mahatma Gandhi Medical College & Research Institute, Sri Balaji Vidyapeeth (SBV) Deemed to be University, Pondicherry, 607402, India.
| | - K Srikanth
- Department of Ophthalmology, Mahatma Gandhi Medical College & Research Institute, Sri Balaji Vidyapeeth (SBV) Deemed to be University, Pondicherry, 607402, India
| | - G Ezhumalai
- Senior Statistician & Research consultant, Mahatma Gandhi Medical College & Research Institute, Sri Balaji Vidyapeeth (SBV) Deemed to be University, Pondicherry, 607402, India
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Paul A, Sainath D, Nagarajan S, Rajalakshmi AR. Practical problems and possible work-arounds for indirect ophthalmoscopy with personal protective equipment. Indian J Ophthalmol 2021; 69:3798. [PMID: 34827062 PMCID: PMC8837363 DOI: 10.4103/ijo.ijo_1473_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Affiliation(s)
- Anujeet Paul
- Department of Ophthalmology, Mahatma Gandhi Medical College and Research Institute, Pondicherry, India
| | - Dipika Sainath
- Department of Ophthalmology, Mahatma Gandhi Medical College and Research Institute, Pondicherry, India
| | - Swathi Nagarajan
- Department of Ophthalmology, Mahatma Gandhi Medical College and Research Institute, Pondicherry, India
| | - A R Rajalakshmi
- Department of Ophthalmology, Mahatma Gandhi Medical College and Research Institute, Pondicherry, India
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Paul A, Sainath D, Nagarajan S, Rajalakshmi AR. Two brutal waves of COVID-19: Where does ophthalmology residency training stand? Indian J Ophthalmol 2021; 69:2547. [PMID: 34427269 PMCID: PMC8544049 DOI: 10.4103/ijo.ijo_1832_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Affiliation(s)
- Anujeet Paul
- Department of Ophthalmology, Mahatma Gandhi Medical College and Research Institute, Pondicherry, India
| | - Dipika Sainath
- Department of Ophthalmology, Mahatma Gandhi Medical College and Research Institute, Pondicherry, India
| | - Swathi Nagarajan
- Department of Ophthalmology, Mahatma Gandhi Medical College and Research Institute, Pondicherry, India
| | - A R Rajalakshmi
- Department of Ophthalmology, Mahatma Gandhi Medical College and Research Institute, Pondicherry, India
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Sarkar S, Rajalakshmi AR, Avudaiappan S, Eswaran S. Exploring the role of macular thickness as a potential early biomarker of neurodegeneration in acute schizophrenia. Int Ophthalmol 2021; 41:2737-2746. [PMID: 33856596 DOI: 10.1007/s10792-021-01831-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2020] [Accepted: 03/29/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVE The retina has been investigated as a gateway to assess the neurodegenerative changes in the brain. Schizophrenia is also conceptualized as a neurodegenerative disorder like Alzheimer's and Parkinson's disease. The current literature suggests reduced retinal nerve fibre layer (RNFL) thickness and macular thickness (MT), as a marker of neurodegeneration, in patient suffering from chronic schizophrenia. This study aims to compare RNFL thickness and MT in acute schizophrenic patients with age and sex matched healthy controls. METHODS Twenty acutely ill schizophrenic patients and 20 normal controls were included in the study after proper informed consent. RNFL thickness and MT was measured using spectral domain Optical Coherence Tomography after clinical psychological assessment and ocular examination. RESULTS The two groups were comparable in terms of socio-demographic variables. The average RNFL thickness of patients and healthy controls was 102.11 ± 29.18 µm and 105.14 ± 27.35 µm, respectively. Central macular thickness was 181.12 ± 13.63 µm in patients and 234.58 ± 10.71 µm in controls. There was a statistically significant reduction in thickness of macula (p < 0.05) but not for RNFL (p = 0.339). CONCLUSION The study concludes that macular thinning rather than reduced RNFL is an early manifestation in acute schizophrenia patients and can be considered as a potential early biomarker of neurodegeneration in schizophrenia.
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Affiliation(s)
- Sukanto Sarkar
- Department of Psychiatry, Mahatma Gandhi Medical College and Research Institute, Sri Balaji Vidyapeeth (SBV) Deemed To Be University, Puducherry, India.,Department of Psychiatry, AIIMS, Kalyani, India
| | - A R Rajalakshmi
- Department of Ophthalmology, Mahatma Gandhi Medical College and Research Institute, Sri Balaji Vidyapeeth (SBV) Deemed To Be University, Puducherry, India.
| | - S Avudaiappan
- Department of Psychiatry, Mahatma Gandhi Medical College and Research Institute, Sri Balaji Vidyapeeth (SBV) Deemed To Be University, Puducherry, India
| | - S Eswaran
- Department of Psychiatry, Mahatma Gandhi Medical College and Research Institute, Sri Balaji Vidyapeeth (SBV) Deemed To Be University, Puducherry, India
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Rajalakshmi AR, Rajeshwari M. Efficacy of Brückner's Test for Screening of Refractive Errors by Non-ophthalmologist Versus Ophthalmologist: A Comparative Study. Middle East Afr J Ophthalmol 2020; 26:185-188. [PMID: 32153328 PMCID: PMC7034155 DOI: 10.4103/meajo.meajo_121_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2019] [Revised: 10/01/2019] [Accepted: 12/24/2019] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVE: The aim of this study is to assess the efficacy of Brückner's test as a screening tool for identifying refractive errors by a non-ophthalmologist and to assess the inter-observer variation. SUBJECTS AND METHODS: This was a quasi-experimental study conducted at a tertiary care medical college hospital. Brückner's test was performed by a non-ophthalmologist followed by an ophthalmologist. The results were confirmed by cycloplegic refraction. RESULTS: The study included 75 children (31 males and 44 females) with a mean age of 13.3 ± 1.2 years. The results of Brückner's test by both non-ophthalmologist and ophthalmologist showed good sensitivity and specificity when compared with cycloplegic refraction. There was a good strength of agreement between the observations of non-ophthalmologist and ophthalmologist. CONCLUSION: Brückner's test is simple, quick, reliable, and easy to administer on children of all age groups that can provide information about the presence of refractive errors by using a coaxial light source such as direct ophthalmoscope. The application of this test by training primary care providers would be of immense value in the early identification of refractive errors.
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Affiliation(s)
- A R Rajalakshmi
- Department of Ophthalmology, Mahatma Gandhi Medical College and Research Institute, Sri Balaji Vidyapeeth (Deemed to be University), Puducherry, India
| | - M Rajeshwari
- Department of Ophthalmology, Mahatma Gandhi Medical College and Research Institute, Sri Balaji Vidyapeeth (Deemed to be University), Puducherry, India
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Srikanth K, Ahmed Z, Rajalakshmi AR. Knowledge and awareness of glaucoma in South India. TNOA J Ophthalmic Sci Res 2019. [DOI: 10.4103/tjosr.tjosr_1_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Srikanth K, Senthil R, Jha K, Rajalakshmi AR. Functional and structural changes in the macula in diabetic retinopathy – A correlative study. TNOA J Ophthalmic Sci Res 2019. [DOI: 10.4103/tjosr.tjosr_9_19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Laishram M, Srikanth K, Rajalakshmi AR, Nagarajan S, Ezhumalai G. Microperimetry - A New Tool for Assessing Retinal Sensitivity in Macular Diseases. J Clin Diagn Res 2017; 11:NC08-NC11. [PMID: 28892948 DOI: 10.7860/jcdr/2017/25799.10213] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2016] [Accepted: 06/08/2017] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Macular disease is the leading cause of low vision in the Western world. Drusen and pigmentary irregularities are common among the rural Northern Indian population. The disease process leads to loss of central vision, metamorphopsia, macropsia or micropsia and colour vision defect. AIM To study the retinal sensitivity changes in macular diseases using microperimetry. MATERIALS AND METHODS It was an observational study, conducted in the Department of Ophthalmology at a rural tertiary care hospital. This study was started from December 2014 until June 2016, in all patients with macular disease above the age of 20 years attending the outpatient department. Microperimetry was done for 84 eyes of 52 patients with macular disease. Mean retinal Sensitivity (MS) and fixation stability was evaluated. The statistical analysis of mean retinal sensitivity, central 2° and 4° fixation was done by calculating the mean and standard deviation using 95% confidence interval. RESULTS The range of age was between 20-81 years. Majority were 32 males (62%) and 20 females (38%). Out of the 84 eyes studied, majority of the macular disease were Age-Related Macular Degeneration (AMD) (50%). Rest 50% were other macular diseases. The mean retinal sensitivity (dB) shown by microperimetry was 10.83 in AMD, 9.12 in Cystoid Macular Oedema (CME), 10.34 in Epiretinal Membrane (ERM), 10.74 in Pigment Epithelial Detachment (PED), 8.96 in Central Serous Chorioretinopathy (CSCR), 6.43 in macular dystrophy, 7.15 in Lamellar Hole (LMH), 9.8 in Pseudomacular Hole (PMH), 3 in geographic atrophy, 11.1 in macular telangiectasia, 5.6 in Berlin oedema, 12.3 in macular scar and 15.2 in haemorrhage in macula. The study showed 64% of the eyes had stable 2° central fixation, 35% had relatively unstable fixation and 1% had unstable fixation. No significant correlation between retinal sensitivity and retinal thickness in AMD was found. CONCLUSION This study shows that microperimetry can be a useful tool for objective evaluation of macular function and progression of the disease.
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Affiliation(s)
- Memota Laishram
- Resident, Department of Ophthalmology, Mahatma Gandhi Medical College and Research Institute, Puducherry, India
| | - Krishnagopal Srikanth
- Professor and Head, Department of Ophthalmology, Mahatma Gandhi Medical College and Research Institute, Puducherry, India
| | - A R Rajalakshmi
- Associate Professor, Department of Ophthalmology, Mahatma Gandhi Medical College and Research Institute, Puducherry, India
| | - Swathi Nagarajan
- Assistant Professor, Department of Ophthalmology, Mahatma Gandhi Medical College and Research Institute, Puducherry, India
| | - G Ezhumalai
- Senior Statistician, Department of Statistics, Mahatma Gandhi Medical College and Research Institute, Puducherry, India
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Abstract
Peribulbar block, though safe, can cause serious complications such as globe perforation and peribulbar hemorrhage. Hyaluronidase is an enzyme that is used as an adjuvant in peribulbar anesthesia, and it helps in rapid penetration of the anesthetic agent. Hypersensitivity to hyaluronidase is a rare but potentially sight-threatening complication. We report a case of hyaluronidase hypersensitivity following peribulbar injection for cataract surgery mimicking as peribulbar hematoma in the immediate postinjection phase and as orbital cellulitis 48 h later.
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Affiliation(s)
- A R Rajalakshmi
- Department of Ophthalmology, Mahatma Gandhi Medical College and Research Institute, Puducherry, India
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Elangovan S, Rajalakshmi AR, Velayutham V, Ranjit Prabhu D. An analysis of ocular firecracker injuries in five consecutive years during a festive season in a tertiary eye care hospital in South India. Expert Review of Ophthalmology 2016. [DOI: 10.1080/17469899.2016.1176913] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Kochupurakal RT, Srikanth K, Jha KN, Rajalakshmi AR, Nagarajan S, Ezhumalai G. Role of Optical Coherence Tomography in Assessing Anterior Chamber Angles. J Clin Diagn Res 2016; 10:NC18-20. [PMID: 27190851 DOI: 10.7860/jcdr/2016/17879.7701] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2015] [Accepted: 01/31/2016] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Gonioscopy is the gold standard in assessing anterior chamber angles. However, interobserver variations are common and there is a need for reliable objective method of assessment. AIM To compare the anterior chamber angle by gonioscopy and Spectral Domain Optical Coherence Tomography (SD-OCT) in individuals with shallow anterior chamber. MATERIALS AND METHODS This comparative observational study was conducted in a rural tertiary multi-speciality teaching hospital. A total of 101 eyes of 54 patients with shallow anterior chamber on slit lamp evaluation were included. Anterior chamber angle was graded by gonioscopy using the shaffer grading system. Angles were also assessed by SD-OCT with Trabecular Iris Angle (TIA) and Angle Opening Distance (AOD). Chi-square test, sensitivity, specificity, positive and negative predictive value to find correlation between OCT parameters and gonioscopy grading. RESULTS Females represented 72.7%. The mean age was 53.93 ±8.24 years and mean anterior chamber depth was 2.47 ± 0.152 mm. Shaffer grade ≤ 2 were identified in 95(94%) superior, 42(41.5%) inferior, 65(64.3%) nasal and 57(56.4%) temporal quadrants. Cut-off values of TIA ≤ 22° and AOD ≤ 290 μm were taken as narrow angles on SD-OCT. TIA of ≤ 22° were found in 88(92.6%) nasal and 87(87%) temporal angles. AOD of ≤ 290 μm was found in 73(76.8%) nasal and 83(83%) temporal quadrants. Sensitivity in detecting narrow angles was 90.7% and 82.2% for TIA and AOD, while specificity was 11.7% and 23.4%, respectively. CONCLUSION Individuals were found to have narrow angles more with SD-OCT. Sensitivity was high and specificity was low in detecting narrow angles compared to gonioscopy, making it an unreliable tool for screening.
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Affiliation(s)
- Reema Thomas Kochupurakal
- Resident, Department of Ophthalmology, Mahatma Gandhi Medical College and Research Institute, Sri Balaji Vidyapeeth University , Pondicherry, India
| | - Krishnagopal Srikanth
- Professor and Head, Department of Ophthalmology, Mahatma Gandhi Medical College and Research Institute, Sri Balaji Vidyapeeth University , Pondicherry, India
| | - Kirti Nath Jha
- Professor, Department of Ophthalmology, Mahatma Gandhi Medical College and Research Institute, Sri Balaji Vidyapeeth University , Pondicherry, India
| | - A R Rajalakshmi
- Associate Professor, Department of Ophthalmology, Mahatma Gandhi Medical College and Research Institute, Sri Balaji Vidyapeeth University , Pondicherry, India
| | - Swathi Nagarajan
- Associate Professor, Department of Ophthalmology, Mahatma Gandhi Medical College and Research Institute, Sri Balaji Vidyapeeth University , Pondicherry, India
| | - G Ezhumalai
- Senior Statistician and Research Consultant, Mahatma Gandhi Medical College and Research Institute, Sri Balaji Vidyapeeth University , Pondicherry, India
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Rajalakshmi AR, Suma E, Prabhu DR. Comparative Analysis of Visual Field Plotting by Octopus Interzeag 1-2-3, Humphrey Field Analyser II and Frequency Doubling Perimetry in Glaucoma Patients in South Indian Population. J Clin Diagn Res 2015; 9:NC01-3. [PMID: 26393152 DOI: 10.7860/jcdr/2015/13001.6204] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2015] [Accepted: 05/27/2015] [Indexed: 11/24/2022]
Abstract
PURPOSE Standard achromatic perimetry tests the differential light sensitivity whereas the frequency doubling technology tests the contrast sensitivity. The aim of this study was to compare and correlate the visual field indices with three different types of perimeters namely frequency doubling perimetry (FDP), Humphrey field analyser (HFA) and Octopus Interzeag 1-2-3 (OI) for detecting glaucomatous field defects. DESIGN Prospective cross-sectional observational study. MATERIALS AND METHODS Hundred eyes of 50 glaucoma patients were studied. All the patients underwent visual field examinations by Octopus Interzeag 1-2-3, Humphrey field Analyser II and Frequency Doubling perimetry (FDP). The correlations of the global indices were compared. The time taken to perform the test with the three perimeters was analysed. RESULTS The visual field plotting by the perimeters were comparable and significant positive correlation was observed. The time taken to perform visual field test by Octopus Interzeag 1-2-3 was shorter than the other two methods. CONCLUSION The visual field plotting by Octopus Interzeag 1-2-3, Humphrey field analyser and frequency doubling technology perimetry were comparable and Octopus field plotting takes lesser time than the rest two methods.
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Affiliation(s)
- A R Rajalakshmi
- Associate Professor, Department of Ophthalmology, Mahatma Gandhi medical college & research institute , Pondicherry, India
| | - Elangovan Suma
- Associate Professor, Department of ophthalmology, ESIC medical college and PGIMSR , K.K.Nagar, Chennai, India
| | - D Ranjit Prabhu
- Consultant, Nellai Eye Care Institute, 106 B2& B3 South Mount Road, Tirunelveli, India
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Kannan S, Wesley SD, Ruba A, Rajalakshmi AR, Kumaragurubaran K. Optimization of solvents for effective isolation of colchicines fromGloriosa superbaL. seeds. Nat Prod Res 2007; 21:469-72. [PMID: 17487621 DOI: 10.1080/14786410601129507] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
To meet the strong demand of colchicine an attempt is made to optimize the solvent system for isolation of colchicine. Gloriosa superba dried seed powder was extracted by using different solvents. Maximum yield of colchicine was obtained when extracted with water and alcohol in the ratio of 50 : 50.
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Affiliation(s)
- S Kannan
- SPIC Science Foundation, Chemical Technology Division, SPIC Nagar, Thoothukudi 628 005, Tamil Nadu, India
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