1
|
Fulminant keratomycosis caused by Cylindrocarpon lichenicola- A case report. Eur J Ophthalmol 2024; 34:NP8-NP12. [PMID: 38178787 DOI: 10.1177/11206721231223542] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2024]
Abstract
PURPOSE To report the clinical features, phylogenetic characteristics, microbiological characteristics, and the management of the rare emerging fungal species Cylindrocarpon lichenicola. METHODS A 55-year-old male farmer presented with a history of pain, redness, and defective vision. The corneal scrapings revealed septate hyphae macroconidia and multi-celled chlamydospores with lactophenol cotton blue mount. In addition, the culture revealed velvety to floccose, white growth with a pinkish-brown rim on the Sabouraud's dextrose agar. The growth was suggestive of the rare fungus Cylindrocarpon lichenicola. RESULTS The course of the infection was rapidly progressive, involving the entire cornea with descemetocele and impending perforation. Reinfection with the rapid spread of disease to the sclera was noted; finally, evisceration with scleral frill excision was done. CONCLUSION To our knowledge, this is the first case report of Fulminant Sclero Keratomycosis caused by Cylindrocarpon lichenicola.
Collapse
|
2
|
Immediate postoperative keratitis caused by Rhizopus species following standard CXL for keratoconus: A case report and literature review. Eur J Ophthalmol 2024:11206721241247589. [PMID: 38623696 DOI: 10.1177/11206721241247589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/17/2024]
Abstract
PURPOSE To report the first case of Rhizopus sp keratitis in a 15-year-old male patient who had undergone a conventional Epi-off CXL procedure for progressive keratoconus. METHODS A 15-year-old male studying at school presented with defective vision in both eyes recently. He was diagnosed with progressive keratoconus in the right eye more than left eye. After the conventional CXL procedure, the patient developed corneal ulcer on third postoperative day. RESULTS The microbiological diagnosis of both BCL and ulcer revealed Rhizopus sp. The patient responded to topical antifungals, and the ulcer entirely healed with a large central scar. CONCLUSION Rhizopus keratitis is rare in a healthy individual. Ours is the first case report of Rhizopus keratitis in patient undergone CXL.
Collapse
|
3
|
Management of symblepharon with Gore-tex as a novel treatment option for ocular chemical burns. Eur J Ophthalmol 2024:11206721241238302. [PMID: 38444229 DOI: 10.1177/11206721241238302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/07/2024]
Abstract
PURPOSE To assess the clinical outcomes of symblepharon release in patients with ocular surface chemical injury using Gore-Tex as a novel treatment option. METHODS This was a retrospective analysis of 23 eyes of 22 chemical injury patients done during a period of January 2014 to December 2021 at a tertiary eye care centre in South India. All patients underwent symblepharon lysis along with Gore-Tex application over the sclera with minimum 1 year follow up. The patients were assessed for demographic details, visual acuity, intraocular pressure, anterior and posterior segment details, photographic documentation, preoperative diagnosis, previous surgical details in recurrent cases, surgical procedures, final visual acuity, surgical outcomes, and complications. The clinical outcomes were assessed and outcomes were defined as success, partial success, or failure. RESULTS The median age was 17 years (IQR, 12-39 years). Among them 10 eyes with symblepharon had grade 3 length, 12 eyes grade 3 width and 12 eyes had grade 3 loss of palisades of Vogt. The success was achieved in 52.2% of the patients; partial success in 34.8% and 13.3% had failure. The mean duration of recurrence was 6.75 ± 3.6 months. Failure was noted in young patients with mean age 9.75years and with grade 3c symblepharon. There was no sight threatening complications noted. CONCLUSION The study showed very good results with Gore-Tex as a novel treatment option for chemical injury patient with symblepharon formation. It can be easily employed to prevent the symblepharon recurrence of various ocular surface disorders.
Collapse
|
4
|
Reasons for declining corneal refractive laser correction for refractive candidates in Southern India. Indian J Ophthalmol 2024; 72:118-122. [PMID: 38131581 PMCID: PMC10841811 DOI: 10.4103/ijo.ijo_1595_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2023] [Accepted: 07/10/2023] [Indexed: 12/23/2023] Open
Abstract
PURPOSE To analyze the reasons for declining corneal refractive laser correction procedures in patients presenting to tertiary eye care centers in Tamil Nadu, Southern India, and review the literature. METHODS Retrospective case records of subjects presenting from January 2019 to December 2021 for refractive surgery workup were analyzed. Demographic details and refractive parameters of patients rejected for corneal refractive laser corrections (CRLC) were documented and reviewed. RESULTS A total of 2358 patients presented for refractive surgery evaluation during the study period, and out of them, 395 patients (16.8%) were not considered ideal candidates for undergoing CRLC. The common reasons for rejecting the patients were unfit topography (n = 110, 27.8%), unstable refraction over a one-year duration (n = 9, 2.27%), low corneal thickness (n = 85, 21.5%), keratoconus (n = 5, 12.9%), and other ocular and systemic disorders (n = 48, 12.1%). CONCLUSION There was a marked change in magnitude and rationalization for not performing either laser-assisted in situ keratomileusis (LASIK) or photorefractive keratectomy in our study. The reasons are unfit topography, keratoconus, and systemic disorders, which were diagnosed during pre-LASIK screening workup, being the most common cause for rejecting patients for corneal refractive corrections.
Collapse
|
5
|
|
6
|
Corneal blindness and eye banking: Current strategies and best practices. Indian J Ophthalmol 2023; 71:3142-3148. [PMID: 37602600 PMCID: PMC10565931 DOI: 10.4103/ijo.ijo_1942_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2023] [Revised: 08/07/2023] [Accepted: 08/08/2023] [Indexed: 08/22/2023] Open
Abstract
Corneal blindness (CB) is one of the leading causes of blindness in India and globally, affecting around 8 million population worldwide. Many of these corneal blind patients may be visually rehabilitated by corneal transplantation (CT). Eye banking plays a crucial role in facilitating CT and ocular research. Many countries have adopted regulatory frameworks, quality assurance programs, and technological advancements to enhance the efficacy and safety of CT. Various infrastructural and organizational frameworks of eye banks (EBs) in India, according to the Eye Bank Association of India (EBAI), aid in establishing guidelines and standards for EB practices. Initiatives such as the National Programme for Control of Blindness (NPCB) have significantly contributed to eye donation rates and improved access to donor corneas. This review article discusses the established eye banking networks in countries such as India, the United States (USA), and Europe, where dedicated EB organizations work collaboratively to ensure efficient procurement, processing, and distribution of corneal tissue. It also highlights specific strategies employed in India and global countries to address EBs' challenges. These challenges include the shortage of donor corneas, improving donor screening and tissue processing techniques, ensuring timely distribution of corneal tissue, and maintaining high-quality standards. Interestingly, the comparative analysis between India and other developed countries highlights the similarities and differences in eye banking strategies. By understanding the strategies employed by different regions, EBs can learn from each other's experiences and work toward achieving optimal outcomes in CT and ocular research worldwide. It underscores the importance of knowledge sharing and collaborative efforts in addressing common challenges and implementing best practices in eye banking.
Collapse
|
7
|
Epithelial ingrowth under LASIK flaps: tips and tricks for preventing recurrence! Indian J Ophthalmol 2023; 71:3270. [PMID: 37602629 PMCID: PMC10565945 DOI: 10.4103/ijo.ijo_1029_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/22/2023] Open
Abstract
Background LASIK for refractive error correction has become a universal surgery. Despite its popularity, the estimated prevalence of traumatic flap dislocations in post-LASIK patients is 3.9%, and it is sometimes associated with epithelial ingrowth. The prognosis in such cases depends on the rapid surgical revision of the flap with the removal of the EI and perioperative steps to prevent Epithelial ingrowth (EI) recurrence in the future. Purpose The video aims to display the steps involved in revising the flap, removing EI, and tips to prevent its recurrence. Synopsis A 33-year-old post-LASIK patient presented with decreased vision, photophobia, and glare during the COVID pandemic in the right eye for 2 months. The best-corrected visual acuity was reduced to 6/60. The anterior segment revealed traumatic flap dislocation along with macro fold temporally and epithelial ingrowth. She underwent a successful flap revision surgery with no recurrence of epithelial ingrowth postoperatively. Highlights A successful revision of a 2-month-old traumatic folded flap was performed along with the complete removal of EI. It explains the step-by-step approach to avoid the recurrence of EI in each step of the surgical revision of the flap. The video is self-explanatory and guides novice surgeons too. Video link https://youtu.be/JuOSjhrfw0g.
Collapse
|
8
|
Clinical outcomes, time span for healing of various ocular surface disorders with amniotic membrane: A prospective, an Indian study. Indian J Ophthalmol 2023; 71:3186-3191. [PMID: 37602606 PMCID: PMC10565922 DOI: 10.4103/ijo.ijo_2904_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Revised: 04/17/2023] [Accepted: 06/08/2023] [Indexed: 08/22/2023] Open
Abstract
Purpose To study the clinical outcomes, time span of healing of various ocular surface disorders with amniotic membrane graft. Methods A total of 41 patients, presenting to cornea clinic were included in the study and divided into five groups depending on the type of diagnosis: Group 1, with either >2 weeks of Persistent epithelial defect following cataract/retinal/glaucoma surgeries or Shield ulcers, Group 2 with >4 weeks of Non healing corneal ulcers, Group 3 with chemical injuries, Group 4 with Epithelial defects following keratoplasty, and Group 5 is the miscellaneous group. Results The mean age of the study subjects was 50.0 years. Overall mean duration between clinical presentation and AMT was 23.59 (30.7) days, a median 16 days (IQR; 2-26 days). Failure rate was high in Group 5 (n = 3: 30.0%) and Group 2 (n = 3: 27.3%). Time taken for epithelial closure was slower in groups 1 and 5 patients. The average time taken for reabsorption of AMG was 14.98 days. The complications included repeat AMG was in four eyes (9.75%), and graft displacement was noted in four eyes (9.75%) required resuturing, three eyes required TPK (7.31%), and one eye underwent evisceration (2.43%) following severe corneal melt secondary to neurotropic ulcer. The mean log MAR visual acuity improved from 1.52 to 1.26 at the 3 months. Conclusion Understanding on timespan for healing of ocular surface disorders with AMG is needed to assess the prognosis of the disease, preoperative counselling for repeat procedures, and the compliance with regard to follow up.
Collapse
|
9
|
Commentary - Scleral lenses: The leading edge. Indian J Ophthalmol 2023; 71:2913-2914. [PMID: 37417147 PMCID: PMC10491042 DOI: 10.4103/ijo.ijo_528_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/08/2023] Open
|
10
|
The third eye: Retool to prevent back and neck pain! Indian J Ophthalmol 2023; 71:2917-2919. [PMID: 37417150 PMCID: PMC10491064 DOI: 10.4103/ijo.ijo_422_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/08/2023] Open
|
11
|
Commentary: Corneal biomechanics: Can it be overlooked or has to be perused? Indian J Ophthalmol 2023; 71:2428-2429. [PMID: 37322654 PMCID: PMC10417969 DOI: 10.4103/ijo.ijo_258_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/17/2023] Open
|
12
|
Assessment of parental awareness about pediatric visual problems by Knowledge-Attitude-Practice survey in South India. Indian J Ophthalmol 2023; 71:2175-2180. [PMID: 37202944 PMCID: PMC10391501 DOI: 10.4103/ijo.ijo_2717_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/20/2023] Open
Abstract
Purpose To find out parents' knowledge, attitude, and treatment practice (KAP) toward pediatric eye problems and to assess the effect of demographic factors such as gender, age, educational status, and number of children on KAP. Methods A cross-sectional descriptive study was conducted in a hospital setting. Two hundred parents were randomly selected for the questionnaire. All parents had children who were included in Systematic Pediatric Eye Care Through Sibling Screening Strategies (SPECSSS) study. A survey with 15 questions on KAP of pediatric eye diseases was prepared and administered to parents coming to a tertiary eye hospital with varied experience and education qualifications. Results The mean age of 200 patients was 9.6 (3.4) years, with the majority of them male (n = 110; 55.0%). The majority of the children (n = 91, 45.5%) were between the age group of 6-10 years. Knowledge of visual problems among parents was of a good grade in 9% only. The attitude of the parents toward the visual problem was positive at 17%, and the responses regarding the practice were of excellent grade at 46.5% and good at 26.5%. Analysis suggests that the level of knowledge and practice were not significantly associated with the demographic factors (p > 0.05). The positive attitude toward the visual problems of the children was associated with education of the parents (p < 0.05) and the father occupation (p < 0.05). Conclusion Knowledge about pediatric eye diseases was poor among parents and it was significantly affected by education and occupation of parents. The parents have positive attitude toward enhancing their attitude in treatment.
Collapse
|
13
|
A novel transconjunctival, intrascleral, ab-externo, knotless, and double-flanged technique with 6-0 Prolene for iridodialysis repair. Indian J Ophthalmol 2023; 71:2257-2259. [PMID: 37202964 PMCID: PMC10391415 DOI: 10.4103/ijo.ijo_2879_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/20/2023] Open
Abstract
Small traumatic iridodialysis (ID) may be asymptomatic, but large ones usually cause polycoria and corectopia, leading to symptoms like diplopia, glare, and photophobia. The management of ID, including medical and surgical methods, depends upon the patient's symptoms. Mild glare and diplopia can be treated either with atropine, antiglaucoma medications, tinted spectacles, colored contact lens, or corneal tattooing, but extensive IDs require surgical options. The surgical techniques are challenging due to the iris texture and the damage encountered during the primary surgery, the narrow anatomical workspace for repair, and the associated surgical complications. Numerous techniques have been described by several authors in the literature; each has its advantages and disadvantages. All the procedures described previously involve conjunctival peritomy, scleral incisions, and suture knots and are time consuming. Here, we report a novel transconjunctival, intrascleral, knotless, and ab-externo, double-flanged technique for repair of large ID with a 1-year follow-up.
Collapse
|
14
|
Non-compliance for wearing spectacles: Prevalence and determinants in school-going children in South India. Indian J Ophthalmol 2023; 71:608-613. [PMID: 36727371 DOI: 10.4103/ijo.ijo_1106_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
Purpose To study the prevalence and determinants of compliance with spectacle wear among school-age children in South India who were given spectacles free of charge under a school vision screening program. Methods A cross-sectional, descriptive study was performed. The participants were recruited from the school from Tirunelveli and Tuticorin districts of Tamil Nadu, where a school vision screening camp was conducted between January 2012 and October 2012. The school screening was performed under. “Lavelle Pediatric Eye Care Project” . Of the 129,720 children examined of 249 schools, 4253 of children had refractive error and 3333 were prescribed and dispensed spectacles. A total of 683 children were interviewed, who were not wearing glasses on follow-up. Results About 20% of the participants (683/3333) were not wearing their spectacles at examination. The most common reasons given for non-wear were lost (44.9%) or broken (35.3%) spectacles. There was no gender preference on compliance to spectacles. Conclusion Compliance with spectacle wear is less even when spectacles are provided free of cost, particularly in children among the age group of 5-15 years. Because factors such as type of school, area (urban or rural), parent's income, occupation, and their education were not significantly affecting the compliance of spectacle wear, proper encouragement and counseling of the parents and the child become extremely important.
Collapse
|
15
|
Eye banking and keratoplasty trend analysis during the COVID-19 pandemic: A South Indian observational study. Indian J Ophthalmol 2023; 71:498-502. [PMID: 36727346 PMCID: PMC10228964 DOI: 10.4103/ijo.ijo_1368_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Revised: 10/26/2022] [Accepted: 11/09/2022] [Indexed: 02/03/2023] Open
Abstract
Purpose To analyze the impact on eye donation and corneal transplantation during the COVID-19 pandemic in a tertiary eye hospital in south India. Methods A retrospective analysis of the donor and recipient records during the study period from January 2020 to May 2021 was conducted and tabulated in Microsoft Excel 2013. Demographic details of the donor, utility rate, cause of death, culture characteristics, storage methods, wet lab usage, and the surgical donor outcomes were evaluated. Additionally, the postoperative workup of the recipients, diagnosis, graft infection and rejection episodes, development of COVID-19 postoperatively, and outcome in terms of visual acuity at one, three, and six months were also noted. Results A total of 466 eyes from 249 donors were received during the study period. The mean age of the donor population was 62.43 years (20.9). The corneal transplantation utility rate was 36.4% (n = 170). Fifty-one percent of the total transplant surgeries were for therapeutic purposes. This was followed by penetrating optical keratoplasty (34%), Descemet's stripping endothelial keratoplasty (9%), and patch grafts (3%). Seventeen (10%) graft rejection episodes were noted and nine (53%) had complete resolution after medical treatment. Conclusion Proper preventive measures are key to carrying out safe and efficient eye banking activities even during a deadly pandemic, as COVID-19 transmission via transplantation is rare.
Collapse
|
16
|
Management of pediatric subluxated cataract and different methods to face the challenges. Indian J Ophthalmol 2023; 71:673. [PMID: 36727391 DOI: 10.4103/ijo.ijo_2057_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
Background Traumatic cataracts present in multiple and different forms. Based on the nature of injury, it necessitates a customized approach for individual case. Capsulorhexis and in the bag intraocular lens (IOL) placement are vital for long term centration of pediatric IOLs. Paediatric lenses having elastic capsule provide more challenges to perform optimum rhexis and the surgery becomes further complicated, when it is subluxated or fibrosed. Here is a pediatric case with such challenges managed using capsular tension ring (CTR) and capsular tension segment (CTS). Purpose To demonstrate the making of optimum rhexis in a fibrosed capsule in subluxated lens and placing the IOL along with fixation of bag using CTR and CTS. Synopsis A 13-year-old boy sustained an injury in the right eye from an air pistol, underwent lid tear repair in a local hospital, and presented to us one month post trauma with visual acuity of 6/60 in the right eye and 6/6 in the left eye. On examination, there was more than 180° temporal zonular dialysis with fibrosis of the anterior capsule. In this situation, creating an intact capsulorhexis was a challenge which was solved using micro-scissors and micro-vitreo-retinal forceps, in addition to routine instruments. After removing the lens material, CTS was placed initially in the bag to stabilize it while introducing CTR. The CTS was then fixated to the sclera. Foldable IOL was placed in the bag. Technique and tips to make intact rhexis and easy passage of suture are demonstrated. Highlights This video shows tips and different methods adopted in each step of the surgery for successful placement of IOL in bag along with fixation of bag using CTR and CTS in a case of traumatic subluxated cataract with shrunken anterior lens capsule. Video link https://youtu.be/Vwp1qUh1Mrc.
Collapse
|
17
|
Identification of potential barriers for timely access to pediatric sibling eye check-up in a tertiary eye care hospital. Indian J Ophthalmol 2023; 71:215-221. [PMID: 36588239 PMCID: PMC10155517 DOI: 10.4103/ijo.ijo_1739_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
Purpose To identify socio-economic, demographic, and clinical factors that may be associated with sibling access to ophthalmic check-up. Methods A cross-sectional, descriptive study investigated children in the age group of 0-15 years under a project on Systematic Pediatric Eye Care Through Sibling Screening Strategies (SPECSSS project). The siblings of pediatric patients (proband) with refractive errors, strabismus, cataract, glaucoma, and retinal pathologies were given a referral card for ophthalmic check-up. If parents do not bring siblings for check-up within 1 month of initial information and even after 2 SMS reminders, it was considered as failure to uptake of services. On follow-up later, they were provided a questionnaire. A questionnaire was given to the parent by interview through a project coordinator, and details were obtained from the parents or caretaker. Parents who were willing for telephonic interview were asked to respond to the questionnaire over phone on the scheduled date. The sibling details, parent-related details, and data from questionnaire forms were entered and analyzed. Results The mean age of 300 siblings was 9.3 ± 4.0 years with the majority of them being female (158). The most common reasons quoted by parents in the rural area compared with the urban area for not bringing siblings for eye exams were the travel distance from home to the hospital (n = 118, 83.7%), the travel time from home to the hospital (n = 109, 77.3%), more than one vehicle required to change (n = 111, 78.7%), and the transportation cost more than rupees 100 (INR) (n = 89, 63.1%) (p < 0.05). Unable to leave work responsibilities (n = 126, 79.3%) was stated more frequently by urban parents compared to rural (p = 0.039). Conclusion Our study suggests that the financial factor, the distance factor, and social belief play an important role in timely uptake of sibling eye check-up. Targeting siblings with treatable pediatric eye diseases could help in reducing the burden of refractive error, strabismus, and cataract in the pediatric population.
Collapse
|
18
|
The momentary deposits behind the phakic intraocular lens: The rationale! TNOA JOURNAL OF OPHTHALMIC SCIENCE AND RESEARCH 2023. [DOI: 10.4103/tjosr.tjosr_68_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/22/2023] Open
|
19
|
Colletotrichum asianum: A Novel Phytopathogen Causing Human Infection-A Case Report. Cornea 2022; 41:1458-1461. [PMID: 35439794 DOI: 10.1097/ico.0000000000003051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Accepted: 03/14/2022] [Indexed: 11/25/2022]
Abstract
PURPOSE The purpose of this study was to report the predisposing factors, clinical features, microbiological characteristics, and the management of the novel identified species, Colletotrichum asianum . METHODS Two patients, farmers by occupation, with a history of trauma with vegetative material, presented to us with redness and pain. The corneal scrapings revealed branched hyphae on potassium hydroxide mount, and woolly aerial fungal mycelia with gray colonies were seen on blood agar and potato dextrose agar. The findings were suggestive of a novel fungal organism C. asianum . RESULTS Both patients showed a remarkable response to commonly used antifungal agents. A healing response was obtained in 4 weeks. Molecular analysis by sequencing of the internal transcribed region of ribosomal DNA was performed to confirm the species C. asianum in both cases. CONCLUSIONS To the best of our knowledge, this is the first case report describing infective keratitis secondary to C. asianum .
Collapse
|
20
|
Side port incision in manual small-incision cataract surgery - A teaching video for postgraduates. Indian J Ophthalmol 2022; 70:4096. [PMID: 36308173 PMCID: PMC9907298 DOI: 10.4103/ijo.ijo_1559_22] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Background Manual Small Incision Cataract Surgery (MSICS) is the basic of cataract surgery with a short learning curve, less time-consuming, and can be performed in high-volume setups at low cost. Hence, it is imperative for every surgeon to know in detail the perfect way of wound construction and nucleus delivery methods. Purpose A teaching video prepared for the postgraduates to understand the importance of creating a proper side port wound construction in MSICS. Synopsis In MSICS, the side port is made for the intraocular manipulation, to fill the anterior chamber (AC) with viscoelastic and Balanced salt solutions, for easier rhexis in fluid tight maintained AC, for easy aspiration of cortex with deep AC, for cutting the extended rhexis margin with the vannas and for dialling the IOL into the bag complex (Video clip 1). In this video, a limbal stab incision for the side port is created with the 15 degree side port blade made of polycarbonate handle with maximum width of a 20G needle (1.5mm) made parallel to the iris plane of 1.5mm and the 90-110 degree distance from the superior main scleral incision to avoid astigmatic change in axis and power (Video clip 2). It is constructed with the pushing force applied along the cutting edge of the blade through the cornea to create an internal and external ostium, 0.5mm to 1mm thickness into the corneal stroma. The incision produced this way is considered astigmatically neutral (Video clip 3&4). Apart from the astigmatism, the side port is very important to avoid intra and postoperative wound leakage, iris prolapse, and DM detachment. The wound leakage favours bacterial contamination and endophthalmitis (Video clip 5). Ensure good quality of blade while entering the AC (Video clip 6). Hence, albeit small, the side port incision is as important as the main incision. Highlights The video explains the importance of creating a proper sideport, the benefits and the complications involved were clearly explained. Video link https://youtu.be/nljn8c6XaHY.
Collapse
|
21
|
Preferred practice of cataract surgery in brown cataract: A questionnaire-based survey among Indian ophthalmic surgeons. Indian J Ophthalmol 2022; 70:3893-3897. [PMID: 36308122 PMCID: PMC9907254 DOI: 10.4103/ijo.ijo_1555_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Purpose To determine the most preferred method of operating brown cataracts among ophthalmologists in India. Methods A cross-sectional, questionnaire-based study was conducted among ophthalmologists all over India through electronic and social media from May 1 to June 15, 2022. All single, voluntary entries within the stipulated time period were accepted for analysis. Results A total of 230 ophthalmologists participated in the study among which 198 (86%) preferred Manual small-incision cataract surgery (mSICS) as the first option. This was preferred due to the high risk of complications associated (40, 33.6%) as well as endothelial damage due to increased Phaco power (53, 47.9%). The majority of the surgeons (162, 70.4%) preferred a superior tunnel for SICS, and 51.7% (119) performed continuous curvilinear capsulorhexis in 100% of their cases. The most common complication encountered was posterior capsular rupture (PCR) (66%), followed by zonular dialysis (ZD) (18.7%), whole bag removal (8.3%), and Descemet's membrane detachment (7%). Conclusion Despite diverse recent new modalities of Femto Laser assisted cataract surgery (FLACS). Phakonit, and Smart Intraocular Lens (IOLs), the majority of ophthalmologists still find the manual small-incision cataract surgery (mSICS) procedure a safe surgery for mature brown cataracts.
Collapse
|
22
|
Gore-tex a magic sheet for symblepharon prevention! Indian J Ophthalmol 2022; 70:3745. [PMID: 36190104 PMCID: PMC9789825 DOI: 10.4103/ijo.ijo_515_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Background Symblepharon occurs as chronic sequelae of severe chemical injuries. The risk of recurrence is high due to unpredictable wound healing of conjunctiva and tenons following excision in young patients. Gore-tex aids in prevention of the recurrence of pterygium 1. Purpose To present a surgical video on role of Gore-tex in grade 4 Symblepharon lysis. Synopsis A 28-year-old male with a previous history of Grade 4 chemical injury presented with symblepharon and total obliteration of both upper and lower fornices after one year in the right eye. He underwent symblepharon lysis, Living related conjunctival allograft, Amniotic membrane graft and Gore-tex. The video explains the surgical steps in detail. A 360-degree complete peritomy was done, Symblepharon was released from the corneal surface, and the fibrotic tissue was extensively dissected away from the corneal surface and released into the fornix. Further, cryopreserved AMG was placed over the entire raw ocular surface and sutured to the episclera with glue. Prepared Gore-tex was placed on the superior and inferior fornix and sutured with 10-0 nylon suture. Again, AMG was placed over the Gore-tex in the fornices and covered with glue. A small 2x2mm biopsy of limbal stem cells from the superior limbus was already excised from the fellow eye (CLAG) and then Lr-CLAL was prepared from the patient's mother. These two grafts were placed on the nasal and temporal bulbar surface over the AMG and sutured to the underlying AMG and the episclera with glue. The entire surface was then covered with the AMG to promote epithelisation. At one month postoperative period, patient had stable ocular surface with intact Limbal conjunctival graft with mild conjunctival recurrence of fibrosis superiorly. Highlights The video clearly explains the surgical steps of Symblepharon and the benefits of using Gore-tex. Online Video Link https://youtu.be/aFfq2x9QBwA.
Collapse
|
23
|
Descemet Membrane Endothelial Transfer (DMET) in Pseudophakic Bullous Keratopathy After DSEK-A Case Report and Review of Literature. Cornea 2022; 41:1179-1181. [PMID: 34812783 DOI: 10.1097/ico.0000000000002942] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Accepted: 10/07/2021] [Indexed: 11/26/2022]
Abstract
PURPOSE The purpose of this study was to report a Descemet membrane endothelial transfer (DMET) in a patient with pseudophakic bullous keratopathy (PBK) who developed graft dislocation after manual Descemet stripping endothelial keratoplasty. METHODS A 60-year-old man presented with defective vision in the left eye; after Descemet stripping endothelial keratoplasty, graft dislocation was noted 1 month after surgery. RESULTS Corneal clarity was improving slowly over 3 months without any secondary surgical intervention. The mechanism of DMET and the review of literature were enunciated. CONCLUSIONS DMET occurs commonly in eyes with Fuch endothelial dystrophy and rarely in patients with PBK. The mechanism of DMET in PBK probably occurs because of migration of the donor endothelial cells from partially attached Descemet stripping endothelial keratoplasty grafts to the host stroma, in contrast to Fuch endothelial dystrophy, where the endothelial cells from the periphery migrate to the center. Hence, waiting for spontaneous corneal clarity is pivotal because of DMET even in patients with PBK for at least 3 months.
Collapse
|
24
|
Commentary: Bunsen-Roscoe reciprocity - Is it still valid? Indian J Ophthalmol 2022; 70:2936-2937. [PMID: 35918947 PMCID: PMC9672781 DOI: 10.4103/ijo.ijo_294_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
|
25
|
Tunnel infection: What next? Indian J Ophthalmol 2022; 70:2787. [PMID: 35918917 PMCID: PMC9672742 DOI: 10.4103/ijo.ijo_142_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
|
26
|
COVID-19 Lockdown: Not a Barrier for Retinopathy of Prematurity Screening. Indian J Community Med 2022; 47:459-460. [PMID: 36438533 PMCID: PMC9693961 DOI: 10.4103/ijcm.ijcm_882_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2021] [Accepted: 12/01/2021] [Indexed: 06/16/2023] Open
|
27
|
P.175 Anaesthesia for caesarean section in a parturient with systemic mastocytosis. Int J Obstet Anesth 2022. [DOI: 10.1016/j.ijoa.2022.103471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
|
28
|
Anisometropia and refractive status in children with congenital nasolacrimal duct obstruction-a prospective observational study. J AAPOS 2022; 26:76.e1-76.e4. [PMID: 35314316 DOI: 10.1016/j.jaapos.2021.11.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Revised: 10/25/2021] [Accepted: 11/08/2021] [Indexed: 10/18/2022]
Abstract
PURPOSE To assess the refractive status and anisometropia in children with unilateral and bilateral congenital nasolacrimal duct obstruction (CNLDO). METHODS Consecutive children newly diagnosed with CNLDO were prospectively enrolled from November 2017 to May 2019. A complete ophthalmic evaluation including cycloplegic refraction was performed followed by appropriate intervention. Patients were followed for 6 months, and cycloplegic refraction was performed at each visit. The final refractive error was defined as the refractive error obtained from the most recent visit. Amblyogenic risk factors were assessed based on 2013 referral criteria of the American Association for Pediatric Ophthalmology and Strabismus (AAPOS). RESULTS A total of 308 patients with CNLDO were enrolled: 205 (67%) unilateral cases and 103 (33%) bilateral cases. In unilateral cases, the affected eye and unaffected fellow eye showed statistically significant difference in terms of sphere (P < 0.001), cylinder (P = 0.019), and spherical equivalent (P < 0.001); there was no interocular difference in bilateral cases (P > 0.05). Anisometropia was more prevalent in unilateral cases than in bilateral cases (11.2% vs 1.9%; P = 0.005). Based on the 2013 AAPOS referral criteria, 3.9% of the unilateral and 3.9% of bilateral cases exhibited amblyogenic risk factors. Later age of presentation was associated with higher rate of anisometropia (53.8% in the age group >48 months). CONCLUSIONS In our study cohort, unilateral CNLDO was associated with a higher prevalence of anisometropia compared with bilateral CNLDO. The affected eye in unilateral CNLDO had higher prevalence of refractive error.
Collapse
|
29
|
Outpatient temporary tarsorrhaphy: An alternative, cost-effective, non-surgical model for ocular surface disorders. Indian J Ophthalmol 2022; 70:1434-1436. [PMID: 35326079 PMCID: PMC9240523 DOI: 10.4103/ijo.ijo_1961_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
|
30
|
"Outcomes of optical penetrating keratoplasty with the large sized donor for failed therapeutic grafts for infectious keratitis from the tertiary eye care center, South India". Eur J Ophthalmol 2022; 32:3411-3419. [PMID: 35275012 DOI: 10.1177/11206721221086143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
PURPOSE To evaluate the preoperative risk factors, complications, and postoperative outcomes following regraft with the large-sized donor for failed therapeutic grafts. METHODS In this retrospective interventional case series, patients who underwent optical penetrating keratoplasty for failed therapeutic keratoplasty (TPK) from 2010 till 2019 were studied at the Cornea clinic, Tertiary eye care center, with a maximum follow-up period of 3 years within the study period. Demographic patterns, preoperative risk factors, graft survival, visual outcomes, and complications were reviewed from the electronic medical records. RESULTS A total of 77 eyes of 77 patients underwent optical penetrating keratoplasty, with the mean age of 46.18 ± 12.56 years. The median interval between the two procedures was 10.29 months (IQR: 9.0-15.5) and a mean follow-up of 31.27 months. Non-healing fungal keratitis (n = 48) was the most common indication for TPK. The mean size of the donor used was 10 mm (IOR: 9.5-11 mm). The presence of Peripheral anterior synechiae (p < 0.001) and deep limbal vessels (p = 0.011) showed a significant association with the graft outcomes. Four eyes (5%) developed graft reinfection, one patient (1.2%) underwent evisceration, 28 eyes (39%) had graft rejection; among them, 11 eyes (14.28%) resolved with treatment, and in 17 eyes (22.07%), graft failed. Forty-seven eyes (61%) had secondary glaucoma, of which in 32 eyes (68.08%), intraocular pressure was controlled with anti-glaucoma medications; fifteen eyes (31.19%) needed surgery. The graft's cumulative success rate was 83.1% at six months, 58.4% at one year, and 35.1% at three years. CONCLUSION We conclude that despite the high complication rate following optical penetrating keratoplasty for failed therapeutic grafts, the visual and clinical outcomes are satisfactory for such high-risk grafts. Hence, it is imperative to venture surgical intervention to salvage these eyes.
Collapse
|
31
|
Gore-Tex- as an adjuvant to Tenon's patch graft for large perforated corneal ulcers during Covid times. Am J Ophthalmol Case Rep 2022; 25:101322. [PMID: 35097239 PMCID: PMC8785301 DOI: 10.1016/j.ajoc.2022.101322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Revised: 02/23/2021] [Accepted: 01/20/2022] [Indexed: 11/13/2022] Open
Abstract
Purpose Observations Conclusions and Importance
Collapse
|
32
|
Comparing the effectiveness of different postoperative counseling methods for post-keratoplasty patients. Indian J Ophthalmol 2022; 70:517-522. [PMID: 35086229 PMCID: PMC9023921 DOI: 10.4103/ijo.ijo_1285_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
PURPOSE To compare various counseling methods for improving patient education, compliance, and administration of eye drops prescribed for post-optical keratoplasty patients and assess the most efficient counseling method. METHODS A prospective, questionnaire-based pilot study was conducted among 60 post-optical keratoplasty patients who were randomly assigned into three groups for postoperative eye drop counseling, namely group 1 (video counseling), group 2 (chart counseling), and group 3 (verbal counseling at Cornea department). The questionnaire was answered by the patients/attendants applying the eye drops on the first 3 consecutive visits. McNemar-Bowker test was used to compare responses in each group and the Kruskal-Wallis test was used to compare responses among the three groups. The Institutional Ethics Committee of Aravind Eye Hospital, Tirunelveli (Registration number ECR 816/Inst/Tn/2016) approved this study. RESULTS Results demonstrated improvement in various categories assessed regarding drop administration in all three groups, which assessed patients' knowledge, attitude, and hygiene. Although all three groups showed improvements during subsequent follow-up visits, the video-counseling method was found to be an effective means of communication. CONCLUSION Our study emphasizes that the nonverbal and noncontact means of communication by video demonstration would be an effective way of counseling. It can be considered in the present scenario of the pandemic as well.
Collapse
|
33
|
A modified Tenons sling annular graft for advanced peripheral ulcerative keratitis with an hourglass cornea. Indian J Ophthalmol 2022; 70:655-657. [PMID: 35086257 PMCID: PMC9023998 DOI: 10.4103/ijo.ijo_2035_21] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Systemic tuberculosis mostly affects the lungs and ocular involvement is rare. The ocular manifestations are varied, and rarely peripheral ulcerative keratitis (PUK) occurs either due to direct invasion of the microorganism or due to immune reaction. We present a case of advanced PUK in a 28-year-old male patient diagnosed with pulmonary TB in the right eye with hourglass cornea. The ulcer was progressing circumferentially with necrosis of corneal stroma and undermined margins similar to Moorens ulcer, and was not responding to anti-tuberculosis treatment and topical steroids. We describe a modified novel surgical technique using tenons sling annular patch graft to manage the progressive advanced PUK with hourglass cornea to optimize visual and structural outcome in our patient.
Collapse
|
34
|
The aftermath of retained Descemet's membrane: A case report and review of literature. TNOA JOURNAL OF OPHTHALMIC SCIENCE AND RESEARCH 2022. [DOI: 10.4103/tjosr.tjosr_166_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
|
35
|
Comparison of ocular pathologies between children attending rural and urban schools in south india: A retrospective analysis. TNOA JOURNAL OF OPHTHALMIC SCIENCE AND RESEARCH 2022. [DOI: 10.4103/tjosr.tjosr_26_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
|
36
|
Optimal Time for Spectacle Prescription after Uneventful Clear Corneal Phacoemulsification. TNOA JOURNAL OF OPHTHALMIC SCIENCE AND RESEARCH 2022. [DOI: 10.4103/tjosr.tjosr_149_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
|
37
|
Abstract
We present the case of a 23-year-old young man with left-eye abducens nerve palsy following the COVID-19 vaccination. Given the temporal relationship between vaccination and the onset of symptoms, the lack of systemic history, and unremarkable magnetic resonance imaging, the patient’s abducens nerve palsy was related to his vaccination. The ophthalmologist should be aware of this neurotropic sequela of COVID-19 vaccination in young adults.
Collapse
|
38
|
|
39
|
A novel eyeball simulator for training postgraduate students during pandemic times. Indian J Ophthalmol 2021; 69:2879-2880. [PMID: 34571661 PMCID: PMC8597525 DOI: 10.4103/ijo.ijo_2013_21] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
|
40
|
Accommodative anomalies during COVID-19 in pediatric ophthalmology: Our experience. Indian J Ophthalmol 2021; 69:2549-2550. [PMID: 34427271 PMCID: PMC8544060 DOI: 10.4103/ijo.ijo_1673_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
|
41
|
A Survey of Visual Impairment in Children Attending a Blind School in South India. Indian J Community Med 2021; 46:327-328. [PMID: 34321755 PMCID: PMC8281874 DOI: 10.4103/ijcm.ijcm_209_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Accepted: 12/04/2020] [Indexed: 12/03/2022] Open
|
42
|
P.133 Spinal anaesthesia for caesarean section in a patient with undifferentiated intracranial lesion: importance of risk stratification in optimised management. Int J Obstet Anesth 2021. [DOI: 10.1016/j.ijoa.2021.103131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
|
43
|
Impact of teleophthalmology during COVID-19 lockdown in a tertiary care center in South India. Indian J Ophthalmol 2021; 69:714-718. [PMID: 33595507 PMCID: PMC7942072 DOI: 10.4103/ijo.ijo_2935_20] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Purpose: The aim of this study was to describe the experience of teleconsultations addressed at our hospital in India during the ongoing coronavirus (COVID-19) lockdown. Methods: This cross-sectional hospital-based study included 977 teleconsultations presenting between April 1st and May 31, 2020. A two-level protocol was implemented to triage the calls. Results: Overall, 977 teleconsultation were addressed. Of the 621 teleconsultation addressed the most common queries were related to redness/pain/ watering/blurred vision/itching/irritation (52.49%), followed by queries related to medications (28.01%), appointments (18.84%) & 0.64% cited an emergency need to visit the hospital due to sudden loss of vision. The majority of the queries were directed to the department of cornea (58.93%) followed by retina (16.26%), cataract (13.04%), glaucoma (10.14%) & pediatric ophthalmology (1.61%). The most common advice given to the patient was related to medications (47.66%) followed by appointment-related queries (31.72%) & fixing of surgical appointment (20.61%). Among the 356 preterm babies that were screened, 57 (16.01%) were diagnosed with retinopathy of prematurity (ROP). Of them 3 required laser and 3 were given injection. Conclusion: Teleconsultation is here to stay beyond the pandemic. WhatsApp was the preferred modality of communication for us. Teleophthalmology has given us insights to use this evolving technology to reach out to the population at large to provide eye care services. We believe that this mode of teleophthalmology has helped us in providing feasible eye care to the patients.
Collapse
|
44
|
Pediatric keratoconus - Current perspectives and clinical challenges. Indian J Ophthalmol 2021; 69:214-225. [PMID: 33463562 PMCID: PMC7933850 DOI: 10.4103/ijo.ijo_1263_20] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Revised: 06/18/2020] [Accepted: 07/16/2020] [Indexed: 01/09/2023] Open
Abstract
Keratoconus is an ectatic corneal disease characterized by progressive stromal thinning, irregular astigmatism, and defective vision. It can be unilateral or bilateral with asymmetric presentation. It starts at puberty and either progresses rapidly to an advanced stage of the disease or stops in case of delayed onset and slow progression. Pediatric keratoconus is more aggressive than in adults and the management protocols differ because of various rationales such as accelerated progression, advanced stage of disease at the time of diagnosis and co-morbidities. It poses a burden to the society as it affects the quality of life, social, and educational development in children. Hence early diagnosis, recognition of progression, and timely intervention with collagen crosslinking is imperative to arrest the worsening. Association with systemic syndromes and ocular comorbidities can be of concern in pediatric keratoconus. Severe ocular allergy when associated hastens progress and complicates timely intervention of crosslinking treatment and compliance to contact lens wear. Keratoplasty in pediatric keratoconus has good outcomes but can encounter frequent suture-related concerns. This article discusses the epidemiology, etiopathogenesis, clinical challenges, and current perspectives of management of pediatric keratoconus.
Collapse
|
45
|
A rare association of type 2 Duanes retraction syndrome with arthrogryposis multiplex congenita. Strabismus 2021; 29:34-36. [PMID: 33480805 DOI: 10.1080/09273972.2020.1871380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
A 10-year-old boy presented with complaints of abnormal eye movements and face turn since early There was a limitation of adduction in LE with narrowing of palpebral fissure and downshoot characteristic of type 2 Duane Syndrome. He was a known case of Arthrogryposis multiplex congenita (AMC) and had undergone multiple orthopedic surgeries. The literature on Duane Retraction Syndrome (DRS) in AMC is limited. Here, we report in brief the association of DRS type 2 in AMC.
Collapse
|
46
|
Malady of lattice. TNOA JOURNAL OF OPHTHALMIC SCIENCE AND RESEARCH 2021. [DOI: 10.4103/tjosr.tjosr_20_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
|
47
|
Isolated alacrimia associated with microblepharon. TNOA JOURNAL OF OPHTHALMIC SCIENCE AND RESEARCH 2021. [DOI: 10.4103/tjosr.tjosr_70_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
|
48
|
Hydrops as the presenting sign and “inverted bell sign” as a diagnostic sign of atypical pellucid marginal degeneration. TNOA JOURNAL OF OPHTHALMIC SCIENCE AND RESEARCH 2021. [DOI: 10.4103/tjosr.tjosr_5_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
|
49
|
Safety and efficacy of toric implantable collamer lens V4c model - A retrospective South Indian study. Indian J Ophthalmol 2020; 68:3006-3011. [PMID: 33229687 PMCID: PMC7856968 DOI: 10.4103/ijo.ijo_1492_20] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Purpose: The aim of this study was to evaluate the safety, efficacy, and complications of V4c Toric implantable collamer Lens (TICL) implantation for myopic astigmatism in the south Indian population. Methods: In this retrospective observational case series, a total of 109 eyes of 67 patients who underwent V4c TICL implantation (ICL, V4C Staar Surgical, Nidau, Switzerland) between January 2012 and August 2019 were studied with a minimum follow-up period of 6 months (mean 24 months). The main outcome measures were objective and subjective refraction, uncorrected distance visual acuity, corrected distance visual acuity (CDVA), safety, predictability, adverse events, and postoperative complications. Results: At 6 months, mean manifest refractive spherical equivalent (SE) decreased from - 10.90 ± 3.7D preoperatively to - 0.02 ± 0.13D postoperatively (P < 0.001) and mean cylinder decreased from - 2.3 ± 1.3 D preoperatively to - 0.04 ± 0.2 D postoperatively (P < 0.001). Postoperatively, SE within ± 0.5 D and ± 1.0 D of attempted correction were achieved in 96.3 (105 eyes) and 100% (109 eyes), respectively. Manifest refractive cylinder within ± 0.5 D and ± 1.0 D of attempted correction were achieved in 97.2 (106 eyes) and 100% (109 eyes), respectively. Sixty-two percent (68 eyes) showed no change in CDVA postoperatively, and no eye had lost lines of CDVA. The safety index was 1.12, and the efficacy index was 1.10. Complications were seen in two eyes (1.8%) due to high postoperative vault requiring secondary surgical interventions. Conclusion: V4c TICL is a highly effective, safe, and predictable option in treating myopic astigmatism with excellent improvement in vision and spectacle independence.
Collapse
|
50
|
Acute comitant esotropia in a very young child due to combined mechanism: A case report. Indian J Ophthalmol 2020; 68:2610-2612. [PMID: 33120711 PMCID: PMC7774155 DOI: 10.4103/ijo.ijo_344_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
We report a case of esotropia with high hyperopia in a 3-year-old female child. She was initially treated with hyperopic correction and noted to have residual esotropia, which was diagnosed as partial accommodative esotropia. Later when she presented with headache, she was diagnosed to have an intracranial tumour. To our surprise, after neurosurgical excision of tumour, her non-accommodative component of the esotropia resolved over 1 year implying that the intracranial lesion was an additional causative factor for this acute onset Accommodative esotropia. The child attained Orthophoria with the same hyperopic correction.
Collapse
|