Purpose: With the advent of COVID-19 era, teaching activities have migrated from offline to online platform. In this study, we assess whether the increased exposure to visual display terminal (VDT) devices is affecting the health of school-age children with regard to computer vision syndrome (CVS). Methods: This cross-sectional study was carried out by means of an online questionnaire. Participants were students ranging from Class 1 to Class 12. Questions were posed to participants pertaining to screen exposure time, physical activity levels, dry eye symptoms, and asthenopia symptoms. The dry eye part was adapted from the 5 Item Dry Eye Questionnaire (DEQ5 questionnaire), and the asthenopia part was adapted from the questionnaire developed by Ames et al. A total of 554 students were included in the study. The data received were statistically analyzed. Results: An increase in screen exposure time during COVID era was reported by 237 (42.8%) students. The major contributors to screen usage were online classes and assignments (94% of students). The prevalence of headache was higher in students using tablet/iPad and smartphone as the VDT device. The headache, eyeache, DEQ5 scores, and asthenopia scores were significantly correlated with screen exposure time, and a significant increase was observed in parameters from pre-COVID to COVID era. Concentration span in online classes showed a positive correlation with amount of physical activity of the student. Conclusions: Dry eye, asthenopia, and musculoskeletal symptoms of CVS have increased significantly during COVID era. Screen exposure needs to be restricted and adequate attention needs to be given to physical activity.

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Purpose: To study the microbiological profile of clinically diagnosed infectious keratitis cases in tertiary care hospitals in Solan, HP (India). Design: The study design involves prospective cross-sectional study. Materials and Methods: It was a prospective cross-sectional study that included clinically diagnosed corneal ulcer patients from September 1, 2018 to September 1, 2019. The demographic data, predisposing risk factors, clinical details, previous treatment history, investigations, treatment, and visual outcomes were analyzed. Results: A total of 36 patients were included in the study, and no significant difference between the number of males and females was noted (P = 0.74). The most common etiology of ulcer was corneal trauma in 25 (69%) patients. Injury with vegetative material was the most common mode of injury (18 of 25, 72%), followed by injury during construction work (3 of 25, 12%). Twelve of 36 (33%) cases were fungal, 6 (16%) were found to be bacterial and 2 (5%) cases had mixed organisms. The most common organism isolated was Fusarium spp. in 8 (40%) cases. The most common bacterial isolate was Staphylococcus aureus in 4 (20%) cases, followed by one each of Streptococcus pneumonia (5%) and Pseudomonas spp. (5%). Thirteen patients (36%) reached outpatient department between 7 and 14 days and 15 (42%) patients 2 weeks after the start of symptoms with no significant difference in the two genders (P = 0.97). Conclusion: Majority of infectious corneal ulcers in our region are fungal due to injuries during predominantly agriculture-based lifestyles and need urgent management.

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Purpose: The purpose of this study was to study the patterns, prevalence, and risk factors which contribute to the development of retinopathy of prematurity (ROP) in a tertiary care multispecialty hospital. Materials and Methods: This was a retrospective study from April 2019 to March 2021. All the infants screened at our hospital for ROP as per the Government of India “Rashtriya Bal Swasthya Karyakram” guidelines were included. Baseline characteristics, systemic risk factors, and ocular findings including ROP stages and zones involved were noted in the designated pro forma. Statistical analysis was done using SPSS version 25 software. Results: Of the 604 eyes of 302 infants screened, 27.8% had ROP. The mean gestational age (GA) and birth weight were 32⁺⁵ ± 2⁺¹ weeks and 1.46 ± 0.39 kg, respectively. Among the 160 eyes with ROP, 44 eyes (27.5%) had Stage I ROP in Zone I, 57 eyes (35.6%) had Stage II ROP in Zone II, 17 eyes had Stage III (10.7%) ROP in Zone I and Zone II, and 42 eyes (26.25%) had aggressive posterior ROP (APROP). None had Stage IV or V ROP. GA <34 weeks, presence of blood transfusion, apnea, intraventricular hemorrhage (IVH), anemia, respiratory distress syndrome (RDS), and presence of two or more risk factors were positively associated with the development of ROP. Conclusion: The rate of ROP in our hospital is comparable to previously published data. A high rate of APROP was noted among the eyes developing ROP. Low GA and the presence of apnea, IVH, anemia, and RDS were associated with an increased chance of developing ROP.

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Background: Posterior capsule tear (PCT) during phacoemulsification affects the type, site, and timing of intraocular lens (IOL) implantation. Aim: The aim was to evaluate the visual outcomes and complications following sulcus implantation of single-piece foldable acrylic IOL after PCT during phacoemulsification. Setting and Design: The retrospective observational study was conducted at a tertiary care center in eastern India. Methods: Records of patients between July 2017 and March 2020 were reviewed. Thirty-six eyes of 36 patients, in whom PCT had occurred during phacoemulsification, were included. Statistical Analysis Used: Microsoft Excel 2007 and SPSS 108 software were used. Preoperative and postoperative visual acuity was compared using paired t-tests. Postoperative visual outcomes and complications were assessed in percentage. Results: Postoperative visual acuity was ≥6/12 in 22 (61.11%) patients on day 1 and 30 (83.33%) patients on day 30, with a statistically significant improvement compared to preoperative vision (P < 0.05). On the first postoperative day, corneal edema was seen in 8 (22.22%) patients, increased anterior chamber reaction in 5 (13.89%) patients, and raised IOP in 4 (11.11%) patients. After 3 months, 2 (5.56%) patients needed antiglaucoma medications for IOP control, 1 (2.78%) had iridocyclitis, and 1 (2.78%) had chronic cystoid macular edema. The mean follow-up duration was 17.44 ± 12.15 months (range: 3–46 months). Conclusion: To conclude, sulcus implantation of posterior chamber IOL during phacoemulsification surgery complicated with PCT may be considered if the adequate lens is not available, and sufficient capsular support exists. Our study revealed a good final visual acuity with minimal complications, though more research to ascertain our results is warranted.

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The 2017 Global Burden of Disease study ranked vision impairment, including blindness, as the third cause among all impairments for years lived with disability visual impairment has enormous social and economic consequences in terms of productivity losses and dependency. Seeing the rapidly increasing burden of low vision (LV) globally, and more specifically, in the developing world, there is a need to have the provision of good quality LV care as a key element of the comprehensive eye service. The assessment of a visually challenged client by an ophthalmologist or optometrist is substantially different from a standard or routine examination in an ophthalmology unit. Eye professionals should be prepared to spend twice or thrice the amount of time spent on routine eye examinations. An accurate assessment of visual, functional, and psychological needs leads to clarity in prescribing appropriate LV devices. LV rehabilitation is the only nonsurgical treatment modality for vision impairment and this review article throws light on this overlooked aspect of eye services.

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Aim: The aim of this study was to assess the relief from pain afforded by orally administered 20% dextrose as an analgesic for the purpose of retinopathy of prematurity (ROP) screening. Setting and Study Design: This was an observational case–control subject study design. Materials and Methods: This study was performed over a period of 19 months during the first ROP screening. The readings of clinical and behavioral parameters of preterm babies were taken at baseline and monitored continuously during the screening procedure. The right eye was examined before administration of oral dextrose (WOD) and the left eye was examined after administration of dextrose orally (WD). Babies were given 2 ml of 20% dextrose orally with syringe. ROP screening was performed under topical anesthesia with binocular indirect ophthalmoscope. Pain score was calculated by premature infant pain profile scoring system. Results: One hundred and two babies participated in this study, of which 33 (32.35%) babies had a gestational age ≤32 weeks. Statistical analysis done using Wilcoxon signed-rank test showed significant P values for pain score (P < 0.001), heart rate (P < 0.05), oxygen saturation (P < 0.05), and behavioral parameters (P < 0.001) for WOD and WD. Pain score, WOD, and WD in babies ≤32 and >32 weeks were also significant (P < 0.001) for pain score, heart rate (<0.05), and behavioral parameters except for oxygen saturation (P > 0.05) (Mann–Whitney U test). Conclusions: Oral dextrose has a significant role in reducing pain, during ROP screening, but does not alleviate pain completely. The within-subject study design ensured close to identical baseline parameters, thereby providing better internal reliability of the study.

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A 70-year-old male farmer underwent cataract surgery by the phacoemulsification technique 6 years ago. The patient has experienced diminished vision for the last 6 months. Slit-lamp biomicroscopy demonstrated significant opacification of the optic and haptic portion of the intraocular lens (IOL). The IOL was explanted followed by implantation of a polymethyl methacrylate IOL. The vision improved to 20/30 postoperatively. No IOL opacification was observed at follow-up visits. Histopathological evaluation of the explanted IOL exhibited calcium deposits in the optic and haptic portions of the IOL. We propose a new IOL opacification classification on the basis of etiology.

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Ophthalmomyiasis refers to an infestation of the eye, orbit, or periorbital tissue by larval stage of Diptera flies, classified as external or internal ophthalmomyiasis and orbital myiasis. Three patients having varied ocular conditions presented with ophthalmomyiasis to our outpatient department from November 2019 to February 2020. First case was histopathologically confirmed case of basal cell carcinoma of the lower lid, the second one being a case of herpes zoster ophthalmicus. Third one was a case of trauma to the upper lid. All of them presented with a history of maggots crawling from the involved area with local signs of inflammation. In all patients, manual removal of maggots with wound dressing was done daily, and they received systemic antibiotics, oral analgesics, and anti-inflammatory drugs for 10 days. Due to rarity of this condition and cluster of cases presenting within a short span of time, we bring forward a case series on ophthalmomyiasis.

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Retinal hemorrhage is common in Plasmodium falciparum and has been seldom reported with Plasmodium vivax. A 13-year-old girl presented with vision loss in both eyes after 1 week of intravenous artemisinin-based combination treatment for P. vivax. The patient had bilateral vision of 1/60 with retinal hemorrhage and internal limiting membrane (ILM) detachment. In view of heme-toxicity, the patient underwent an intravitreal tissue plasminogen activator along with 100% sulfur hexafluoride. Following this, hemorrhage resolved and vision improved to 6/9. Thus, although rare, retinal hemorrhage and ILM detachment can also be seen with P. vivax, albeit more common in P. falciparum.

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A 45-year-old male presented with a 3 mm × 3 mm painless, slow-growing, gelatinous, freely mobile, benign-looking mass on the temporal side of the limbus in the conjunctiva of the right eye for 1 year. Other ophthalmic findings were unremarkable. Orbital computed tomography showed no orbital involvement or localized lymphadenopathy. The mass was excised with a healthy collar of 3 mm, and the sample was sent for histopathological examination (HPE). The patient was followed up with usual signs of healing. The case took a surprising turn when HPE showed areas of keratin pearls of squamous origin along with lobules of malignant cells displaying nuclear palisading and basal cell nests, thereby diagnosing basaloid squamous cell carcinoma of the conjunctiva. Positive staining for 34βE12 and negative for BCL-2 on immunohistochemistry confirmed it. Identification is extremely important due to its aggressive course with frequent recurrences and distant metastasis. It has been reported only thrice before in the literature.

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