Context: Ocular trauma is the cause of one-third of monocular blindness. The inherent risk factors for ocular injuries among the rural population, and lack of surveys conducted in the rural areas stresses the need for a descriptive study that identifies the cause and pattern of ocular injuries and visual outcome among the rural population. Aims: To analyze blunt ocular trauma with respect to (i) demographic profile, (ii) mode of injury, and (iii) the ocular structures involved. Settings and Design: Prospective study. Subjects and Methods: This study included 95 cases of blunt ocular trauma who attended the casualty and the outpatient Department of Ophthalmology of our institution. All patients underwent a comprehensive ocular examination along with relevant radiological tests. All the cases were appropriately treated and followed at regular intervals to assess the visual outcome and complications. Statistical Analysis Used: Not applicable. Results: The male to female ratio was 4.5:1; majority of the patients (42 patients, 44.2%) belonged to the 21–40 years age group. About fifty patients (52.6%) were from agricultural class. In 46 patients (48.4%) the injuries were agricultural in nature. Subconjunctival hemorrhage was the most common finding (36 patients, 37.89%) followed by traumatic uveitis (27 patients, 28.42%) and lid and adnexal injuries (21 patients, 22.10%). Conclusions: Ocular blunt trauma in the rural population is common in males and mostly agriculture-related with involvement of multiple ocular structures in the same eye. The spectrum of ocular complications can range from trivial to severe sight-threatening injuries. It is recommended that health education highlighting early diagnosis and prompt treatment of ocular injuries can help to reduce the ocular morbidity.

Background: There are very few previous studies regarding ocular screening done in term neonates. Retinal hemorrhages can occur in babies during delivery. Aims: To evaluate the correlation of retinal findings with the duration of second stage of labor in term neonates and mode of delivery. Settings and Design: This was a cross-sectional, observational study done on term newborns in a tertiary care centre. Convenience sampling was done. Subjects and Methods: Neonates were examined in the postnatal ward using handheld slit lamp and indirect ophthalmoscope. Fundus examination was done after dilating the pupils with 0.5% tropicamide and 2.5% phenylephrine eyedrops. Second stage of labor and mode of delivery were noted. Chi-square test and independent sample t-test were used to analyze the data. Results: One hundred and fifty infants were screened, of which 75 (50%) had retinal hemorrhages. Chi-square test showed statistical significance with duration of second stage of labor and occurrence of retinal hemorrhages (P < 0.001). Patients with second stage of labor shorter than 30 minutes of duration were found to have more chances of having retinal hemorrhages. Independent sample t-test used for association between mode of delivery and retinal hemorrhages showed patients born of normal vaginal delivery to have more chances of having hemorrhages (P = 0.006). Chi-square test showed statistical significant association with the presence of hemorrhages and day of evaluation (P < 0.001). Conclusion: Retinal hemorrhages were found to be common in full-term babies whose second stage of delivery was shorter than 30 minutes of duration.

Purpose: The purpose of this study is to compare the effective phaco time (EPT) and ultrasound time (UST) between phacoemulsification incisions of 2.8 mm and 2.2 mm among different grades of cataract and analysis of phacoenergy used. Materials and Methods: A prospective, interventional study was done on 300 eyes of 300 patients. Among them, 150 patients underwent 2.8 mm incision (Group-A), and 150 patients underwent 2.2 mm incision (Group-B) phacoemulsification. Cataract was graded into nuclear sclerosis (NS) 1–5 and white soft cataract. Phaco parameters were noted as EPT and UST in seconds. Statistical analysis was done using unpaired t-test using SPSS software. Results: Higher mean EPT and UST values were noted in 2.2 mm group than in 2.8 mm group in all grades of cataracts. On comparing the difference between two groups, higher mean values of EPT and UST in 2.2 mm incision were statistically significant in cataracts of NS Grade - 3, 4, and 5 (P < 0.001). However, the higher mean values in NS-2 and soft cataracts were statistically insignificant. Early postoperative striate keratopathy was noted in five patients in Group-A (2.8 mm) and ten patients in Group-B (2.2 mm). Conclusion: Dissipation of energy was higher in terms of EPT and UST in 2.2 mm group with statistically significant higher mean values in grades of NS-3, 4, and 5 concluding that 2.8 mm incision would be a safer option among higher grades of cataract.

Purpose: The aim of this study was to evaluate the distribution of wavefront aberrations in Indian children with refractive errors and to determine the correlation between the degree of refractive error and aberration. Materials and Methods: A prospective study was conducted on 216 eyes of 108 consecutive children attending the outpatient clinic. Based on refractive error, the children were allocated to five groups: “Emmetropic,” “hyperopic,” “simple astigmatism,” “compound astigmatism,” and “myopic” group. Lower order aberrations (LOAs) and higher order aberrations (HOAs) were analyzed within and between the groups. Results: Mean age of the children was 10.9 years. Of the total 216 eyes, 40 eyes had emmetropia, 52 had simple astigmatism, 54 had compound astigmatism, 43 had myopia, and 27 had hyperopia. In all the groups, increase in spherical equivalent was associated with increase in LOAs of defocus and astigmatism and the root mean square (RMS) of total HOAs. In comparison with the “emmetropic” group, all other groups showed a significant increase in LOAs (P < 0.001) and RMS of total HOAs (P < 0.001), with the “compound astigmatism” group showing higher values. Spherical aberrations were found to be associated with simple astigmatism, compound astigmatism (P = 0.008), and myopia (P = 0.041). Statistical analysis was done using analysis of variance applying Bonferroni correction factor and Pearson's correlation coefficient. Conclusions: Ametropic eyes are associated with HOAs. Indian children were found to have higher values of aberrations when compared to other races. Practitioners may need to factor this while treating children for refractive errors.

Background: Several studies have been carried out regarding the angiographic characteristics of acute Central serous chorioretinopathy (CSCR) in the Western population; however, fewer such studies have been done on the Asians and extremely few, if at all any, involving only the Indians. Aim: This study aimed to determine the angiographic characteristics of acute CSCR in a solely Indian population and its comparison with studies reported from the West as well as those involving the other Asian populations. Settings and Design: This retrospective study was carried out in a tertiary-level hospital from July 2012 to June 2015. Materials and Methods: All patients diagnosed as acute CSCR underwent a detailed fundus fluorescein angiography, and the number, location, shape, and topography of the leakage points were then recorded and subsequently analyzed. Results: Five hundred and forty-two eyes of 376 patients of acute CSCR were seen during this period. Majority were young (mean age: 36.2 years) and males 340 (90.43%). Bilateral involvement and multifocal leakage were common and seen in 44.15% and 55.72% of patients, respectively. The inkblot leakage pattern was most common and found in 410 (75.65%) eyes. Conclusion: CSCR is seen at much younger age with a higher male-to-female ratio in this subset of Indian population. The frequency of bilateral as well as multifocal involvement was similar to other Asian studies, and lesser than those reported from the West. The incidence of the inkblot type of leakage pattern was lower than what has been reported in Western literature.

Sympathetic ophthalmia (SO) is a rare, bilateral granulomatous panuveitis of unknown etiology that follows accidental or surgical trauma to the uveal tissue of one eye. We describe an unusual case of an 11-year-old male patient who developed SO following retinal detachment (RD) repair in conjunction with pars plana vitrectomy in the right eye (RE). Twenty days following surgery, the patient presented with a recurrent RD in RE and bilateral multifocal exudative RDs, inflamed optic nerve with characteristic changes of SO detected by fluorescein angiography, and ultrasound B-scan in the left eye (LE). Aggressive and effective management with topical and systemic immunosuppressive agents permitted control of the disease with good visual outcome in LE.

There are few methods for closing a full-thickness macular hole after primary vitrectomy and wide dye-assisted internal limiting membrane peel (ILM) fails. We report the anatomic and visual success rate of reoperation for large unclosed macular holes using macular fluid drainage and sulfur hexafluoride (SF6) tamponade. A retrospective study of patients with primary failure of vitrectomy with wide ILM peel for large macular holes was conducted. Further surgery consisted of vitrectomy, drainage of fluid within the macular hole, and SF6 tamponade. Anatomical closure was achieved in five out of seven cases with improvement in visual acuity. The two unclosed holes were originally >950 um in basal diameter. Intraoperative macular fluid drainage and SF6 tamponade may be used successfully in surgery for large, unclosed macular holes following primary failure of macular hole surgery with wide ILM peel.

With phacoemulsification with posterior chamber intraocular lens (PCIOL) implant being the standard of care for the past few decades, sufficient time and numbers have been crossed, revealing newer long-term complication related to the procedure. One of such complications being IOL opacification. The case discussed here is a 73-year-old female with no known ocular comorbidities who presented to our center with diminution of vision. The patient had undergone phacoemulsification cataract surgery with implantation of a foldable PCIOL at another center in the year 2006. Examination revealed glistening pearl-like crystalline opacities inside the IOL optic as well as haptic. The patient underwent an uneventful IOL explant with implantation of glued scleral-fixated IOL as a secondary procedure. The explanted lens was sent to another center for analysis who confirmed the presence of crystalline calcium deposits inside the IOL. Such opacities cause severe visual disability and are not amenable to YAG capsulotomy procedures. These cases warrant IOL explant for visual rehabilitation. Although similar cases were reported from Europe and the USA, no similar cases were previously reported from the Indian subcontinent. This is the first such reported case from the Indian subcontinent.

Diabetic ketoacidosis can present with a variety of infections. We present a case of rapidly progressive facial cellulitis complicated with superior ophthalmic vein thrombosis (SOVT) and diabetic ketoacidosis. She was managed in Intensive Care Unit with intravenous fluids, broad-spectrum antibiotics, anticoagulants and insulin therapy. The SOVT resolved completely without any sequelae. To the best of our knowledge, facial cellulitis resulting in SOVT without orbital cellulitis or cavernous sinus thrombosis has not been reported before. Such complication needs to be considered in the differential diagnosis in any patient presenting with facial cellulitis and proptosis.

This article aims to review the current literature to find the various current concepts in the diagnosis and management of anterior uveitis. It is important to go into the detailed history of the complaints. It will help in finding any systemic cause in most of the cases, if any. A thorough and detailed extraocular and ocular examination should be done. It will bring us closer as to which part of the uveal tissue is involved, i.e. anterior, intermediate, or posterior. It also highlights the various investigative and laboratory tests to be done, which will help in arriving at a diagnosis. Further aiding in diagnosis is radiological investigations such as computerized tomography of the chest which help in the diagnosis and management of systemic disorders such as tuberculosis or sarcoidosis. The primary modality of treatment in such cases is topical in the form of topical steroid and cycloplegics. The use of systemic steroids and immunosuppressants for treatment is reserved only for recalcitrant cases. The aim of the treatment is to preserve the vision of the patient and reduce the subsequent morbidity. To write this article, detailed search was carried out in the MEDLINE search. Published articles from various journals and national library of medicines MEDLINE were reviewed. Electronic database was also searched.