Ophthalmology and Allied Sciences

Background: Advanced stages of retinal detachment may cause blindness, hence a need for early diagnosis and treatment is recommended. Aim of Study: To find out the incidence, risk factors and outcome of patients with bilateral rhegmatogenous retinal detachment reported at a tertiary referral hospital in Hyderabad, India. Material and Methods: We carried out a retrospective study by recording the data of patients from medical records of VitreoRetina Department, Sarojini Devi Eye Hospital, Hyderabad, India, operated between June 2015 to June 2016. Details of history and ophthalmological findings by slit lamp examination, indirect ophthalmoscopy, colour retina charting, B Scan were recorded and were compared with earlier similar studies. Results: The age of the patients ranged between 21 to 76 years, with a mean age of 27.5 years. Out of 250 patients, most of the patients (80%) were myopic and 20 (8%) presented with bilateral RD. Risk factor in most of the patients was myopia. We found that patients with fresh retinal detachment were managed with sclera buckling procedure. Patients with proliferative vitreoretinopathy changes were managed with pars plana vitrectomy with encircling band and silicone oil tamponade. When outcome after treatments were recorded, it was found that patients who reported without delay had good visual and anatomical outcome i.e. more than 80% of patients had good prognosis. Conclusion: We found less incidence of bilateral rhegmatogenous retinal detachment in our study when compared to the literature. Myopia, post cataract surgery were few risk factors observed in our study. hence regular follow-ups are suggested to prevent blindness in these patients.

Keywords: Horse Shoe Tear; Myopia; Proliferative Vitreoretinopathy; Pseudophakia; Rhegmatogenous Retinal Detachment. 

Purpose: To determine the “awareness of eye donation” and “willingness to donate eyes” in the rural population of North karnataka. Methods: A total of 300 subjects representative of the rural population of north Karnataka participated. Subjects in age group of 18yrs to 70yrs were interviewed by a standard questionnaire regarding awareness of eye donation and willingness to donate eyes Oral consent was taken before interviewing the subjects. Results: Out of 300 subjects, 19% were aware of eye donation, 81% were having no knowledge about eye donation. Out of those aware, 2% were females. Majority of those with knowledge about eye donation belonged to age group of 18 to 30 years (8%). Out of those with awareness 16% were literate and 3% were illiterate. The major source of awareness was media (11%) out of 300 subjects, 8% wanted to pledge their eyes, 12% were not interested, 64% needed more information about the procedure and 16% wanted to consult with relatives. 1% participants were aware that eye donation had to be done within 6 hours. Illiteracy and female sex were major predictors of ignorance. 16% were of opinion that there will be disfigurement after donating eyes. Conclusion: Eventhough multiple strategies are currently followed to increase awareness of eye donations, more creative strategies have to be applied, especially to target rural, illiterate population.

Keywords: Eye Donation; Awareness; Rural Population; North Karnataka. 

Aim: To determine the prevalence of ocular morbidity among orphanages and to manage ocular problems encountered among children. Materials and Methods: A Cross sectional study was carried out at two orphanages in Hubli, Karnataka. A total of 80 children aged less < 15 years were examined after informed consent from the owner of orphanages. History was taken and visual acuity, ocular examination, retinoscopy and fundoscopy was done on all children. Results: A total of 80 children were examined from two orphanages in Hubli. Percentage of ocular morbidity was found to be 38.75%. The two main causes of ocular morbidity among children were refractive errors (22.5%) and vitamin ‘A’ deficiency (7.5%). Blepharitis was found among 3 children (3.75%) and pthyriasis among 2 children (2.5%). Nebular grade corneal opacity and acute infective conjunctivitis each was found among one child. Conclusion: Percentage of ocular morbidity in this study is significant. This study strongly suggest that screening of orphanage children for ocular problems should be done at regular intervals.

Keywords: Prevalence; Ocular morbidity; Orphanages; Refractive errors. 

Context: The refractive power of the human eye depends on the power of the cornea and the lens, the position of the lens, and the length of the eye. Accurate assessment of these variables is essential in achieving optimal postoperative refractive results. Aims: To compare the accuracy of IOL power calculation by measuring the axial length with Optical (Partial Optical Coherence Interferometry ALScan) biometry and Ultrasound biometry. Settings and Design: It was a prospective observational study done at Medivision eye and Health Care centre. Methods and Material: The study group was 200 patients, who underwent Phacoemulsification. The SRKT formula was used to calculate the IOL power in all patients. Autokeratometry performed with the optical scan was used in all patients. Statistical Analysis: Mean (SD) and frequency (percentage) was used to describe summary data. Paired T test was performed to explore statistically significant difference between two measurements. Chisquare was used to assess the difference between categorical variables. Results: Out of 200 patients 83 (41.5%) were female and 117 (58.5%) were male. Mean Age of the study population was 62.30±7.66 years and the range 33 to 81. The mean difference between axial lengths measured by the 2 modalities was 0.1274±0.1733 mm with AL Scan measuring higher than US Biometry (Paired TTest p < 0.05). The residual error was Zero in 75 (37.5%) eyes in the ALscan group and 59 (29.5%) eyes in the Ascan group. When analyzed at 95% confidence for the difference at zero error in preoperative prediction versus postoperative acceptance of IOL power, the predictions did not differ between both the modalities. Conclusion: The ALscan is on average a closer predictor than Ascan of the final spherical equivalent. ALscan may offer a slight advantage because of the easier and quicker operation compared with the Ascan.

Keywords: Axial; AScan; Eye; Phacoemulsification.

Context: Corneal infection is a leading cause of ocular morbidity and blindness worldwide. Infective corneal ulcers form a major threat to vision and are an important cause of treatable corneal blindness. Settings and Design: Prospective Follow up Study. Aims: To study the Risk factors, etiology, clinical features and to analyse the treatment modalities, response and outcomes in 150 patients of infectious keratitis. Methods and Material: A Prospective study was done among 150 patients of infectious keratitis in a tertiary eye care hospital. History of predisposing factors and symptoms of infectious keratitis were documented. Morphology and characteristics of the ulcer were noted. Fluorescein staining was done in all cases. Patients were started on appropriate antimicrobial therapy based on clinical diagnosis, smear and culture reports. Statistical analysis used: Data entry and analysis were done by SPSS10.0 for windows software. Chi square test was done for risk factors of infectious keratitis. Results: Among the 150 patients, 54% were males and the mean age was 41.3 years. About 54% (81) gave history of trauma. About 44% were diagnosed as fungal keratitis, 40% bacterial keratitis, 12% viral and 4% had acanthamoeba keratitis. Overall 114 corneal ulcers healed well to medical management. Ulcers with trauma and smaller ulcers (< 3 mm) and reported within 7 days of onset of symptoms had better healing rate which was statistically significant (p< 0.013). Conclusions: Bacterial and fungal corneal ulcers are equally prevalent in our population. History of trauma is a significant risk factor. Patients who presented late and fungal etiology had poor prognosis.

Keywords: Infectious Keratitis; Prospective Study; Follow up Study; Hypopyon; Keratoplasty; Corneal Ulcer. 

Context: The origin of orbital lymphoma can be variable. It may arise from conjunctiva or likely to arise from eyelid or may happen to arise from orbit or lacrimar glands. Diagnosis is most likely to be delayed as the clinical features are not very specific. Aims: To study clinical presentation and outcome in orbital lymphoma cases. Settings and Design: It was a Prospective Interventional Study carried out at Sarojini Devi Eye, Hospital, Hyderabad for a period of two years. Methods and Material: A total of 26 cases were included in the study. Only lymphoma orbit cases were included. Appropriate intervention was done depending upon the need i.e. stage, histological type, patient age and any other patient characteristics. Outcome was studied specific to the intervention carried out. Statistical Analysis: The data was entered in Microsoft Excel Worksheet and analyzed using proportions. Results: Male predominance was observed in present study i.e. males were 69% and females were 31%. Majority of the study participants had proptosis (23.8%) as main clinical presentation. About 19.23% had orbital & lid mass. Small Lymphocytic lymphomas were observed in 50% of the study participant, Diffuse mix small & large cell was seen in 30.7%, Diffuse large cell in 11.5% and Burkitt’s lymphoma in 7.6% of cases. Conclusion: Small Lymphocytic lymphoma was the most common orbit lymphoma found in the present study almost in half of the cases. Next most common histologic type was Diffuse mix small & large cell in about one third of the cases. Incisional biopsy & radiotherapy was the most commonly adopted intervention by us.

Keywords: Orbit; Lymphoma; Proptosis; Lid. 

Introduction: Diabetes mellitus is one of the leading health problem all over the world. Dry eye syndrome (DES) is common in diabetes mellitus. The study was done to detect theprevalence of DES in type II diabetic patients and to determine the association of dry eyes with diabetic retinopathy. Methodology: Diabetic patients(n=200) attending Ophthalmology OPD at Khaja Bande Nawaz Institute of Medical Sciences (KBNIMS), Kalaburagi during the period fromApril to December 2017 were included in the study group, basedon the inclusion & exclusion criteria. Results: Our study showed that the prevalence of DES in diabetes was 51%, with higher rate in females and older age group. 33% of diabetic retinopathy patients had DES even though it was not statistically significant. Conclusion: Since there exists an association between diabetes and DES, all diabetic patients should be screened for DES to prevent ocular surface damage.

Keywords: Diabetes Mellitus; Diabetic Retinopathy; Dry Eye Syndrome (DES). 

Purpose: To evaluate intraoperative and post operative complications in Small incision cataract surgery in patients with poorly dilating pupil. Methods: An interventional study done between November 2016 to April 2017 which included patients with poorly dilating pupil (<6mm) after pharmacological dilatation, who underwent SICS under local anaesthesia by same surgeon. Intraoperative and post operative complications were studied. Patients were reviewed upto 6weeks postoperatively. Results: Total of 60 eyes with poorly dilating pupil underwent cataract surgery. Intra operative complications encountered were zonulardialysis (2 eyes), posterior capsular tear (1 eye), iris trauma (2 eyes). Post operative complications were corneal odema (12 eyes), anterior chamber reaction (6 eyes), irregular pupil (6 eyes), 80% patients had BCVA >6/18. Conclusion: Surgeons should be aware of the potential complications during cataract surgery in poorly dilating eyes. Caution should be taken at each stage to prevent complication.

Keywords: Intraoperative Complications; Post Operative Complications; Poorly Dilating Pupil.