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2017| September-December | Volume 5 | Issue 3
Online since
October 11, 2017
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ORIGINAL ARTICLES
Effectiveness of scleral decompression procedures for preventing choroidal effusion in nanophthalmic eyes: A retrospective review
Parveen Rewri, Nirha Chetan Rao, Ronnie George, Shantha Balekdaru, Vijaya Lingam
September-December 2017, 5(3):111-114
DOI
:10.4103/jcor.jcor_43_15
Purpose:
The purpose of this study is to study role of prophylactic scleral decompression procedures in the prevention of choroidal effusion in nanophthalmos.
Materials and Methods:
Nanophthalmos was defined as eye with axial length (AL) (<20 mm), hyperopia (>+5.00 D) and scleral thickness (>1.7 mm). In a retrospective case series, we analyzed 21 eyes of 21 patients with nanophthalmos, who underwent cataract and/or glaucoma surgery with concurrent sclerotomy or sclerotomy with sclerectomy.
Results:
The mean age at the time of surgery was 51 ± 7 years. The mean AL was 17.18 ± 1.74 mm. Surgery-related complications were documented in 8 (38%) eyes. The prophylactic scleral decompression procedures did not offer protection against postoperative choroidal effusion (
P
= 0.6). On univariate logistic regression, preoperative intraocular pressure (
P
= 0.01) was significantly associated with postoperative complications.
Conclusion:
Prophylactic scleral decompression does not offer absolute protection against postoperative complications during cataract and/or glaucoma surgery in nanophthalmic eyes.
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Prevalence of ocular surface disorder and its effect on quality of life in patients with glaucoma using topical antiglaucoma medications
Mayuri Bakulesh Khamar, Parul Danayak, Ruchi Shah
September-December 2017, 5(3):121-126
DOI
:10.4103/2320-3897.216429
Purpose:
The objective of this study was to check for the presence of dry eye syndrome in patients using either a single or a combination of antiglaucoma medications and to analyze the symptoms of such patients versus controls with the help of Glaucoma Symptom Scale (GSS) and Ocular Surface Disease Index (OSDI) questionnaire.
Materials and Methods:
A cross-sectional prospective nonrandomized study was undertaken in 132 eyes of 66 patients (38 patients [G1] using a single drug and 28 patients [G2] using a combination of drugs) and a control group of 64 eyes of 32 participants (G0). Both the cases and the control group participants were evaluated for the presence of dry eye symptoms by statistically comparing the values obtained from tear break-up test (TBUT) and Schirmer's test. All the participants had to complete the self-administered versions of GSS questionnaire and also had to answer the OSDI questions.
Results:
The mean values of TBUT measured in seconds and of Schirmer's test measured in millimeters were lower while the mean values obtained by OSDI were higher in patients with glaucoma on more than a single drug and in those on treatment for more than 1 year.
Conclusion:
The rate of dry eye was higher in patients with glaucoma than in controls. Clinical features were directly proportional to the duration of therapy and amount of drugs prescribed.
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EDITORIAL
Understanding the various misconducts in the process of publication in biomedical journals
Barun K Nayak
September-December 2017, 5(3):109-110
DOI
:10.4103/jcor.jcor_104_17
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ORIGINAL ARTICLES
Pattern of uveitis in a tertiary eye care center in Western India
Aratee C Palsule, Vaidehi Jande, Aditi A Kulkarni, Nikhil N Beke
September-December 2017, 5(3):127-131
DOI
:10.4103/jcor.jcor_40_16
Context:
Uveitis is potentially sight-threatening disease. The age-sex adjusted prevalence of uveitis in India is 0.73%. Few studies from South and North India have reported the pattern of uveitis but none from Western India.
Aim:
The aim of the study was to report the pattern of uveitis in Western India and compare the findings with those seen in other studies from various parts of India and abroad.
Settings and Design:
This study was a retrospective study.
Subjects and Methods:
The diagnosis of uveitis and the associated systemic diseases was based on a detailed clinical history, ophthalmological, general physical examination, and laboratory tests. Anatomical location of the inflammation was assigned based on the Standardization of Uveitis Nomenclature criteria.
Results:
One hundred and ninety-eight patients were included in the study. Nearly 55.6% were female; mean age at presentation was 39.70 ± 14.06 years. Anterior uveitis was the most common variant (
n
= 82 [41.4%]), followed by panuveitis (
n
= 42 [21.2%]), posterior (
n
= 41 [20.7%]), and intermediate uveitis (
n
= 33 [16.7%]). Out of 198 patients, 98 (49.5%) were idiopathic and 100 (50.5%) patients with specific etiology. Fifty-five patients were diagnosed to have infectious etiology and 45 were noninfectious. Presumed ocular tuberculosis was leading cause for infectious etiology seen in 29 (52.73%) patients. Among the noninfectious patients, human leukocyte antigen B-27 (HLA B-27)-associated uveitis was the most common cause seen in 24 (53.33%) patients.
Conclusions:
Pattern of uveitis is not entirely same in different geographic areas. HLA B-27-associated uveitis was the most common noninfectious entity, and presumed ocular tuberculosis was leading cause for infectious entities in Western India.
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BRIEF COMMUNICATIONS
Conjunctival lymphangioma: A unique case report and review of literature
Anuradha Raj, Ramesh Chander Nagpal, Meena Harsh, Harsh Bahadur
September-December 2017, 5(3):142-144
DOI
:10.4103/jcor.jcor_35_16
Lymphangioma is a rare venolymphatic lesion or vascular hamartoma of lymphatic origin characterized by dilation of lymphatic vessels. It may present as an isolated lesion or often represent the surface component of a deep orbital lymphangioma. Conjunctival lymphangioma is a rare condition, in which patients can present with a red eye resistant to topical treatment. Recurrence of lesion can also be the concern of this entity. We report a case of conjunctival lymphangioma in a 60-year-old Indian female as no case has been reported from Indian origin till date to the best of our knowledge.
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ORIGINAL ARTICLES
Evaluation of quality and utility rate of donor corneal tissue received at tertiary eye care center
Shwetambari G Singh, Dipali R Satani, Amit P Patel, Dharmil C Doshi
September-December 2017, 5(3):133-136
DOI
:10.4103/jcor.jcor_60_16
Purpose:
This study was performed to evaluate quality and utility rate of donor corneal tissue received at tertiary eye care center.
Materials and Methods:
All tissues retrieved by our eye bank from January 2012 to December 2015 were evaluated. Donor age, lens status, utilization of the tissue for optical transplantation, therapeutic transplantation, or nonclinical purposes (e.g., research, training/discarded) and causes of using tissue for nonclinical purposes were noted. A careful chart review was performed to determine the precise cause of exclusion of each tissue from transplantation.
Results:
A total of 413, 454, 430, and 412 corneas were retrieved in the years 2012, 2013, 2014, and 2015, respectively. In study duration, 54% of tissues received were from donors aged more than 70 years, and 49.5% tissues were pseudophakic. The mean corneal utility rate of our study was 42%. In the year 2013, corneal utility rate was least (33.30%), when we received maximum number of pseudophakic and elderly (>70 years) donor eyes. Most common cause of clinical nonutility of the tissue was poor quality (37.3%) followed by medical history of the donor (15.4%) and safety reasons (2%).
Conclusion:
Retrieval of more number of pseudophakic and older donor eyes with poor quality lead to relatively lower tissue utility rate in our study. Eye donation awareness programs targeting multispecialty hospitals or trauma centers can be more rewarding to receive better quality younger donor eyes.
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BRIEF COMMUNICATIONS
Orbital myiasis presenting in a patient with fungating squamous cell carcinoma: Is there a role for ivermectin?
Sasha A Mansukhani, Anjali D Nicholson, Anamika H Agrawal, Faraaz S Hussain
September-December 2017, 5(3):139-142
DOI
:10.4103/2320-3897.216430
An 84-year-old female presented with multiple maggots crawling out of a large fungating left orbital mass. Computed tomography scan showed a heterogeneously enhancing mass arising from the left orbit surrounding the eyeball, displacing it laterally. Two days treatment with use of turpentine, betadine, hydrogen peroxide, and local removal was unsuccessful as the maggots would escape into depths of the orbit and crevices of the mass. A trial of 12 mg dose of ivermectin daily was given. After the first dose of the drug, the maggots were easier to remove manually. The orbit was maggot-free by the 2
nd
day. Ivermectin is of benefit in cases where conventional removal fails due to inaccessible worms. In view of its low cost and low side-effects profile, it can be explored as a first-line treatment along with manual removal.
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ORIGINAL ARTICLES
Impact of an educational module on the knowledge and attitude of nursing students toward eye donation
Nagarajan Swathi, S Venipriya, C Geetha
September-December 2017, 5(3):115-120
DOI
:10.4103/2320-3897.216428
Background:
The only source of cornea for corneal transplantation is from timely harvested safe eyes of deceased donors. Nurses attending on terminally ill patients can, if trained, motivate the relatives for eye donation.
Aims:
The aim of this study is to determine impact of an educational lecture on knowledge and attitude of nursing students toward eye donation.
Settings and Design:
This was an interventional study.
Subjects and Methods:
Nursing students in their 1
st
year and 4
th
year of training were administered a prestructured questionnaire. A 30-min interactive session was conducted for them regarding eye donation and transplantation. After 4 months, the questionnaire was readministered and their responses were analyzed with regard to number of correct responses for each question.
Statistical Analysis Used:
The statistical analysis used in this study was MedCalc for Windows, version 13.3.1 (MedCalc Software, Ostend, Belgium). Student's
t
-test was used to analyze change in knowledge and attitude.
P
<0.05 was considered significant.
Results:
The difference in the level of knowledge and attitude between first year and final year students before the exposure to educational awareness video was not statistically significant (
P
= 0.2 and
P
= 0.9, respectively). Four months following the interactive video, change in knowledge levels was significant for both groups (
P
= 0.01 - first year and
P
= 0.006 - final year), but there was no significant change in their attitude toward eye donation.
Conclusion:
Inclusion of eye donation in nursing curriculum is likely to be effective in imparting knowledge to nursing students who may be potential counselors for eye donation. “The proof of the pudding lies in the eating” and whether this translates to action by actual increase in registration as donors and corneal harvests remains to be seen.
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BRIEF COMMUNICATIONS
Attempted autoenucleation: Was not a Greek tragedy!
Gurudutt M Kamath, Rajesh R Nayak, Madhurima K Nayak, Lakshey Dudeja
September-December 2017, 5(3):137-139
DOI
:10.4103/jcor.jcor_106_16
Autoenucleation, also known as oedipism, is one of the most horrifying forms of self-mutilation frequently reported in literature. This is a case report of a 28-year-old schizophrenic man who autoenucleated his right eye. On examination, globe was luxated, his conjunctiva was lacerated superiorly with Tenon's prolapse, and he had a subconjunctival hemorrhage. Ocular movements were restricted in all positions of gaze. The eye could not be pushed back under general anesthesia. A lateral canthotomy was performed and the lids were sutured along the gray line after forcibly pushing the eye into the orbit. The patient was given intravenous antibiotics and steroids. Antipsychotic medications were restarted. After 1 month, the patient again tried to self-enucleate and was brought to the hospital. The globe was
in situ
with almost normal ocular movements. This report emphasizes the need to salvage the eye, even in worst of the cases.
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Early spontaneous reopening of traumatic macular hole
Ramesh Venkatesh, Manisha Agarwal, Prachi Gurav
September-December 2017, 5(3):145-147
DOI
:10.4103/jcor.jcor_65_16
Traumatic macular holes (MHs) are known to close spontaneously. Reopening of traumatic MHs is not reported frequently. The early spontaneous reopening of a traumatic MH is not known. We report a case of early onset spontaneous reopening of a traumatic MH. Ophthalmologists should be aware of this rare complication.
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