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   2016| September-December  | Volume 4 | Issue 3  
    Online since September 19, 2016

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Retinopathy of prematurity: Incidence, prevalence, risk factors, and outcomes at a tertiary care center in Telangana
Crystal Le, Laxman B Basani, David Zurakowski, Ramesh S Ayyala, Satish G Agraharam
September-December 2016, 4(3):119-122
Aims: To evaluate the incidence of retinopathy of prematurity (ROP), prevalence of pre-and postnatal risk factors for development of ROP, and treatment outcomes among preterm infants admitted to the Neonatal Intensive Care Unit (NICU) of a tertiary care hospital located in Hyderabad. Materials and Methods: Retrospective chart review of all infants admitted to the NICU between 2008 and 2013, who met the criteria for ROP screening: (a) ≤34 weeks of gestation, (b) ≤1750 g of birth weight, (c) infants with significant risk factors including sepsis, respiratory distress syndrome, or long-term oxygen use. Treatment was offered to infants with Stage III ROP disease or Stage II in Zone II with plus disease. Qualified infants were treated with argon laser photocoagulation within 48 h of diagnosis. They were followed until the disease was successfully treated. Results: A total of 2910 infants were admitted to the NICU. Incidence of ROP was found to be 2.3% (n = 66), the majority of whom (71%) had Stage I ROP. Seventeen percent of the infants weighed <1000 g. The most prevalent prenatal risk factor was multiple gestations (17%). Prevalent postnatal risk factors included oxygen treatment (71%) and respiratory distress syndrome (58%). Twelve percent (8/66) of infants met the treatment threshold. Following argon laser, regression was observed in 100% of infants, with no recurrence with follow-up between 1 and 4 years after treatment. Conclusions: This is the first study to evaluate the incidence of ROP in Telangana. Argon laser photocoagulation appears to be effective in the treatment of infants in this population. We recommend screening infants ≤32 weeks of gestation and infants born ≤1700 g birth weight.
  9,176 2,541 10
Pterygium excision with suture-free, glue-free conjunctival autograft (SFGF-CAG): Experience of a tertiary care hospital of the Northern India
Sushobhan Dasgupta, Vatsala Vats, Sanjeev Kumar Mittal
September-December 2016, 4(3):143-148
Aim: To evaluate and analyze the surgical outcome of suture-free, glue-free conjunctival autograft (SFGF-CAG) after pterygium excision. Design: Prospective, interventional, hospital-based study. Materials and Methods: Sixty eyes of sixty patients with primary pterygium were graded, and excision was performed by the single surgeon. To prevent recurrence, free CAG was taken from inferotemporal or inferior quadrant from the same eye and bare sclera was covered without the use of sutures or fibrin glue, allowing natural autologous coagulum of the recipient bed to act as a bioadhesive. The eye was patched for 24 h. Postoperatively, patients were put on topical eye drops (moxifloxacin 0.5%, loteprednol etabonate 0.5%, and carboxymethyl cellulose 1%) for 6 weeks. The outcomes were assessed in terms of any recurrence, complication(s), and operative time at each follow-up visit on day 1, 7, 15, 30, 120, and 180. Results: There were 44 females (73%) and 16 males (27%). The mean age of all the patients was 38.92 ± 11.2 years, range 18–60 years. Cosmetic blemish was the chief indication of surgery (42 eyes, 70%). Recurrence occurred in one eye (2%) and graft-related complication took place in one eye (2%; graft dehiscence). Resurgery was required in the latter (2%) as the former refused the same. No other complication was noted. An average surgical time was 16 ± 2 min. Conclusion: The recurrence, complication rate, and the operative time of SFGF CAG seem to be comparable with the current techniques in practice, without adding possible potential hazard of the surgical adjunct.
  5,433 709 2
High-risk penetrating keratoplasty
Shilpa Ajit Joshi, Madan Deshpande
September-December 2016, 4(3):163-170
Background: Loss of immune privilege has important connotations for graft survival, often in clinical scenarios where the other eye is irreversibly blind. This article looks at the state of the evidence-based treatment available for high-risk penetrating keratoplasty (P.K.). Materials and Methods: Review of pathophysiological and immunological mechanisms present was done. Conclusion: Pre-, intra-, and post-operative considerations in P.K. in high-risk situation along with the role of immune-suppression are discussed. Success in high-risk keratoplasty depends on an ongoing effort during as well as life-long after P.K. The role of nonimmunological factors such as glaucoma, reactivation of infection, and unstable ocular surface are important determinants in graft failure.
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A rare case of cerebrospinal fluid rhinorrhea post external dacryocystorhinostomy surgery
Chandana Chakraborti, Nabanita Barua, Kumaresh Chandra, Rosy Kahakashan Christi
September-December 2016, 4(3):157-159
Cerebrospinal fluid (CSF) leakage is an uncommon but significant complication of orbital and rarely lacrimal surgery. We report a rare case of CSF rhinorrhea following external dacryocystorhinostomy (DCR) surgery. A 38-year-old healthy lady was diagnosed to have chronic dacryocystitis for which right side external DCR was done. At the evening of first postoperative day, the patient noticed a discharge of clear fluid coming through the right nostril, in sitting posture. The fluid was sent for biochemical analysis. Based on clinical and biochemical tests of fluid, a diagnosis of iatrogenic CSF rhinorrhea was made. Contrast enhanced computed tomography and computed tomography cisternography failed to reveal any site of active leakage. However, the patient improved with conservative management only. CSF leakage occurs very rarely in external dacryocystorhinostomies with only a few case reports found in the literature. Knowledge of anatomy and thorough preoperative assessment may predict areas at high-risk for encountering this problem.
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Trivialization of procedures: A dangerous trend
Barun Kumar Nayak
September-December 2016, 4(3):117-118
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Magnetic resonance imaging (MRI) in Duane retraction syndrome
Siddharth Agrawal, Vinita Singh, Anit Parihar, Vishal Katiyar, Rajat M Srivastava, Vikas Chahal
September-December 2016, 4(3):137-141
Purpose: To study the magnetic resonance imaging (MRI) findings in Duane retraction syndrome (DRS). Materials and Methods: In this case–control study, 16 consecutive cases of Duane syndrome underwent MRI of the brain and orbit, after informed consent. MRI (fast imaging enhancing state acquisition) was done with special focus on pontomedullary junction to look for the status of abducens nerve and associated abnormalities along with quasi-coronal sections of orbit to estimate thickness and cross sectional area of horizontal extra-ocular muscles (EOMs). Thickness and cross-sectional area of EOMs were compared to the contralateral side and to age-matched controls. Results: Of 16 cases, 14 had DRS Type I, and 2 had DRS Type II. MRI revealed absent abducens nerve on the ipsilesional side in 12 out of 14 in DRS I, whereas two DRS II patients revealed intact abducens nerve on the affected side. Thickness and cross-sectional area of the horizontal recti was statistically comparable to the contralateral side and age-matched controls. Conclusions: All the DRS patients in study had structurally normal horizontal recti muscles, whereas 12 out of 14 of DRS-I patients had an absent abducens nerve on MRI.
  2,553 317 2
Adequacy and relevance of Indian optometry curricula to practicing optometrists
Nilesh D Thite, Parikshit Gogate, Jyoti Jaggernath, Gauri K Kunjeer
September-December 2016, 4(3):127-136
Context: To ensure that future optometry graduates receive appropriate knowledge and skills to provide comprehensive primary eye care, it is important to evaluate the current optometry curricula. Aim: To evaluate the relevance of optometry curriculum in India by assessing the perceptions on the curriculum strengths and lacunae by practicing optometrists. Setting and Design: Questionnaire-based survey in India. Materials and Methods: A questionnaire was used to elicit the opinions of purposively selected, 4-year trained optometrists, on the adequacy, and relevance of the optometric curriculum subjects offered in the optometric institutions. Statistical Analysis Used: Descriptive analysis was used to show reported frequencies of single responses to questions. The Cronbach's alpha test was used to measure consistency of responses to questions. Results: One hundred and three valid complete responses were received. Fifty eight (56%) participating optometrists were females. The most adequately covered optometry subjects as reported by the participating optometrists were contact lenses (n = 87, 85%), refraction (n = 86, 84%), ocular investigation (n = 75, 73%), and ocular disease (n = 75, 73%). Ocular diseases, low vision, and dispensing optics were, reportedly, covered sufficiently in theory, but the participants lacked adequate practical exposure. Basic optics had a maximum score regarding practical exposure, among support subjects while communication skills, computer skills, and community optometry were rated very low. Business aspect and legal aspect were inadequately taught. The optometry curricula in India are considered as being adequate and relevant, some subjects need more practical demonstrations and teaching of support subjects needs amendments.
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A prospective study of incidence and risk factors for secondary glaucoma after penetrating keratoplasty
Aruna Kumari R Gupta, Roopam Kumar R Gupta
September-December 2016, 4(3):123-126
Aim: To carry out a prospective study to analyze the incidence and risk factors for secondary glaucoma after penetrating keratoplasty (PK). Materials and Methods: Three hundred and eleven consecutive penetrating keratoplasties that were performed between January 1, 2006, and December 31, 2008, with a follow-up of 12 months were prospectively analyzed to determine the factors associated with postoperative glaucoma. Results: Of 311 eyes, secondary glaucoma developed in 57 cases. This yields an incidence of 18.3%. In conditions, such as aphakic bullous keratopathy, the incidence of post-PK glaucoma was 3.0%; in pseudophakic bullous keratopathy 14.0%, and in cases of failed graft 16.0%, while in cases of corneal ulcer and corneal opacity it was 49.0% and 18.0%, respectively. Conclusion: We conclude in our study that the incidence of glaucoma developing post-PK was highest in phakic eyes, which may be due to the formation of posterior synechiae and development of intumescent cataract. Higher incidence of glaucoma developing in infective cases could be due to recipient hot eye and the high incidence in cases of large graft could be attributed to the formation of peripheral anterior synechiae.
  2,205 382 1
Postoperative corneal deposits the following polypharmacy
Valiyaveettil Babitha, Chellappan Prasannakumary, Zuhara Fathima, Kuzhippally Vallon Raju
September-December 2016, 4(3):155-157
Corneal deposits can rarely develop in patients using fluoroquinolones and dexamethasone eye drops. A 68-year-old female patient presented with postoperative corneal drug deposits following small incision cataract surgery. Corneal scraping was done, and histopathological examination shows an amorphous material.
  2,357 191 3
Scrape cytology in ophthalmology: Our experience with three cases
Sheetal Bakshi, Vidyashankar Balasubramaniam, Shubhda V Kane, Nikita S Oza, Swati B Dighe
September-December 2016, 4(3):151-155
The aim was to describe the use of scrape cytology as a procedure for the preliminary diagnosis of suspicious lesions in case of three patients. The first patient was diagnosed with sebaceous gland carcinoma of the upper lid, second patient had squamous cell carcinoma (SCC) of the bulbar conjunctiva, and the third patient had SCC of the skin of medial canthus of eye. In this article, we have discussed the history of evolution of cytology briefly. Different types of cytology procedures as well as advantages and disadvantages of each procedure have also been discussed. We have described the procedure of taking scrape specimen and further processing in brief. The article emphasizes the role of scrape cytology in initial diagnosis, treatment plan, prognosis, and subsequent follow-ups in patients of ocular surface tumor.
  2,268 185 1
A rare case of polymethylmethacrylate intraocular lens opacity
Somen Misra, Kunal Patil, Neeta Misra
September-December 2016, 4(3):149-150
Optical transparency of the intraocular lens (IOLs) is paramount in maintaining visual improvement after cataract extraction. There have been reports of the IOL developing opacity after years of cataract surgery. IOL opacities have been reported in silicone, acrylic lens, and very rarely in polymethylmethacrylate (PMMA) IOLs. Though the exact cause is not known, long-term exposure to ultraviolet light can be one of the most probably causes, leading to disruption of PMMA and release of gaseous (nitrogen) within the PMMA substance. We report one such rare case of PMMA IOL opacity in a 75-year-old female.
  1,523 179 -
Comments on: Coexistence of optic disc drusen and idiopathic intracranial hypertension in a nonobese female
Anubhav Chauhan, Shashi Datt Sharma
September-December 2016, 4(3):161-161
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