Ophthalmology and Allied Sciences

Introduction: Colour vision tests that were originally intended for the study of congenital dyschromatopsias
produce confusing results when applied to patients with acquired diseases. Ishihara test plates primarily designed
for detecting congenital dyschromatopsias, are widely used to detect acquired colour vision defects because of
their convenience, apparent simplicity of administration and availability. This study was done to compare the
results of Ishihara’s test and Roth 28 hue test in identifying and quantification of colour vision abnormalities in
Optic Nerve disorders and to establish patterns of colour vision defects in acquired optic Nerve disorders. Materials
and methods: This was prospective, cross sectional, comparative study done on patients with various optic nerve
disorders attending the OPD from January 2016 to December 2018 were included. 71 patients of various optic
neuropathies were included. All patients underwent comprehensive ophthalmic examination including visual
acuity assessment, slit lamp examination, fundus examination, and IOP measurement. Colour vision was tested
mono-ocularly with Ishihara’s test and Roth 28 Hue test. All the data was tabulated and statistically analysed.
Results: The study included 139 eyes of 71 patients with various optic neuropathies. The mean age was 36 years.
The causes of optic neuropathies included were papilledema, optic neuritis, optic atrophy, glaucomatous optic
neuropathy, and tobacco-alcohol amblyopia. Two patients had Traumatic optic neuropathy and one patient had
non-arteritic ischaemic optic neuropathy. On comparing Ishihara and Roth test, there was statistically significant
correlation between two tests (p<0.001). On comparing BCVA with both the test results, statistically significant
correlation was found. (Ishihara: p=0.001, Roth: p<0.001). Conclusion: Even though Ishihara’s test was designed to
screen congenital colour vision defects, our study shows that it can be still used to detect colour vision abnormalities
in acquired colour vision defects such as optic neuropathies because the results are comparable to arrangement test
such as Roth test.

Keywords: Colour Vision, Ishihara and Roth Test, Optic Nerve Disorders.
 

Limbal stem cell maintains the homeostasis around the cornea. Limbal stem cell deficiency (LSCD) occurs either by congenital or acquired causes due to the destruction of niche in the complex microenvironment. The diagnosis of LSCD is made on clinical findings and newer methods such as imaging modality, molecular markers and impression cytology which has led to more effective grading of the severity of LSCD and its strategic management planning. This article reviews the clinical presentation, newer techniques for diagnosis and management of LSCD.

Keywords: Limbal stem cell deficiency (LSCD); Diagnosis; Imaging modality; Molecular markers; Cytology.   

 Aim: To determine safety and efficacy of pars plana vitrectomy (PPV) for dropped nucleus after complicated cataract surgery and evaluate the correlation of final visual acuity with time interval lapsed till active intervention done. Material and methods : We did a retrospective analysis of patients who underwent PPV for dropped nucleus in cataract surgery from july 2014 to August 2018 at SGRRIM & HS, Dehradun, India. The data was recorded in terms of details of complicated cataract surgery , point of occurrence of dropped nucleus, time elapsed till PPV done, the intraoperative and postoperative complications. Final outcome measures were the best corrected visual acuity (BCVA) at three months follow up and its correlation with time at which PPV was done. Results: Out of 14 cases of dropped nucleus during this four year period of study 3 (21.4%) patients were referred from outside , while 11 patients (78.5%) had the complication in our hospital itself of total 5760 cataract surgeries done contributing to an incidence of 0.191%. PPV was done in the same sitting in majority of cases (57.1%) with BCVA, 6/18 or better at the last follow up. One eye had retinal detachment two months postoperatively for which fluid/gas exchange was performed. All patients (92.9%) had IOL implantation except one (7.1%) who had corneal decompensation. The correlation between BCVA at three months follow up and time interval between complicated cartaract surgery and PPV was statistically significant (χ2 = 14.000, p = 0.003) , all those patients (21.4%) who were referred late and operated after one week had vision less than 6/60. Conclusion: Though dropped nucleus is a sight threatening complication of cataract surgery, PPV if done on time is safe and effective and the final visual outcome is definitely better in patients who get intervened early. However future studies with larger sample size and longer follow up are required to confirm our results.

Keywords: Dropped Nucleus; Vitrectomy; Visual Acuity.

 Objective: To make a comparative analysis of clear corneal phacoemulsification (PHACO) with rigid intraocular lens (IOL) and small incision cataract surgery (SICS) in camp patients reporting from hilly areas of Uttrakhand in terms of safety, efficacy and final visual outcome. Design: Retrospective study Material and Methods: A total of 214 patients of senile cataract were enrolled in this study conducted in ophthalmology department SGRRIM & HS, Dehradun, India over a period of twelve months. The participants were divided into PHACO and SICS as group A and group B respectively. The final outcome measures were the uncorrected visual acuity (UCVA) on day one, best corrected visual acuity (BCVA) at six weeks, the surgical induced astigmatism (SIA) at six weeks, the intraoperative and postoperative complications. Results: Post-operative UCVA at day one was 6/18 or better in group A (72 of 104 eyes - 69.2%) as compared to group B (20 of 112 eyes -18.2%) and statistically significant (p < 0.001). The post operative BCVA at 6 weeks follow up revealed overall good visual outcome between 6/6 - 6/9 with PHACO group (76 of 104eyes -73.1%) showing better results than SICS (55 of 110 eyes -50.0%) group. (p < 0.001) The mean SIA at the end of six weeks in Group A (PHACO) was 1.10 ± 0.51, and in Group B (SICS) was 1.22 ± 0.42. (p =0.065). Overall incidence of intra operative complications was 8.7% in group A and 13.6% in group B. (p<0.619). Conclusions: Although both surgical techniques are sutureless, safe and effective for visual rehabilitation of cataract patients in camps, our study shows PHACO group demonstrating better final visual outcome as compared to SICS group. However, there was no significant difference in terms of surgically induced astigmatism and the complication profile.

Keywords: Camp; Visual Acuity; Astigmatism; Phacoemulsification.

 Objective: To find the relationship between the amount of energy used and significant rise in IOP (>5mmHg) after Nd:YAG laser posterior capsulotomy. Materials and Methods: 100 pseudophakic eyes of adults age 30-70 yrs of either sex having PCO are included. Amount of laser energy (milli joules) used in each case noted, IOP was measured just before the procedure and at 1,4,24 hours after procedure in each case. Total energy used is grouped into low (<20mJ), intermediate (20-40mJ), high (>40mJ). Change of IOP at 3 post laser recording times categorized into 1) No change 2) Rise of 1-5mmHg 3) >5 mm Hg. Results: 100 pseudophakic eyes, 61 males and 39 females. Number of patients in low, intermediate, high energy group were 43,45,12 respectively and significant rise in IOP (>5mm Hg) noted are 6/43 (13.9%), 12/45 (26.6%), 8/12 (66%) respectively. Significant rise in IOP noted at 1,4,24 hours post laser application are 7/26 (26.9%), 15/26 (57.6%), 4/26 (15.3%) respectively. Conclusion: There is a directly proportionate relationship between the amount of laser energy used and IOP rise.

Keywords: Neodymium; Yttrium-Aluminum-Garnet Laser; Intraocular Pressure; Cataract.

 Background: Majority (80%) of all visual impairment globally is considered to be avoidable or reversible if identified early in life. Children are the most venerable group as they do not identify / notify the early signs of visual impairment. Aims and Objective: To estimate prevalence of ocular morbidity in School going children in Solapur district of Maharashtra. Methods: This cross-sectional study was conducted in 10 selected schools, 4 urban and 6 rural schools. Detailed ophthalmic examination was done by an ophthalmologist. A total of 3212 school going children, 1664 boys and 1578 girls, were examined between August 2017 and February 2018. Results: A total of 436 children with different ocular morbidities were detected in the study, revealing the prevalence of ocular morbidity equal to 13.57%. The overall prevalence of ocular morbidity in boys and girls was 14.18 % and 12.92%. The overall prevalence of ocular morbidity was not significantly different in boys and girls (Z = 1.05, p=0.30). The most common ocular morbidity was refractive errors (8.75%), followed by miscellaneous conditions which included infectious or allergic conditions like conjunctivitis, blepharities etc. Conclusion: The study has concluded that the overall prevalence of ocular morbidity was 13.57%. The prevalence of refractive errors was significantly more in urban children than in rural children. Similarly refractive errors were significantly more in older children (> 11) years than in children below the age of 11 years.

Keywords: Ocular Morbidity; Prevalence; School Going Children; Refractive Errors.

 Purpose: To evaluate the best corrected visual acuity (BCVA) outcomes and surgical complications in a consecutive series of functionally monocular patients who had small incision cataract surgery with IOL implantation. Method: An interventional study done between December 2017 to May 2018 which included monocular patients who underwent SICS under local anaesthesia by same surgeon. Intraoperative and post operative complications were studied. Patients were reviewed upto 6weeks postoperatively. Results: A total of 50 eyes of 50 monocular patients with cataract underwent SICS. Out of 50, 30 were male and 20 were females. 38 eyes had BCVA between 6/6-6/18, 10 had BCVA between 6/18-6/60, 2 had BCVA between <6/60 due to aphakia. Conclusion: The common causes for poor vision in unoperated eye were Leucomatous corneal opacity, post traumatic pthisisbulbi,post traumatic iridocyclitis, glaucomatous optic atrophy, pseudophakic bullous keratopathy, and retinal detachment, traumatic optic neuropathy. A thorough eye examination is must before operating such cases for surgery and surgeon should be cautious while operating monocular cases.

Keywords: Intra Operative Complications; Monocular Patients; Post Operative Complications; SICS.

 Aim: To study the age, sex, causal distribution, incidence and various modes of presentation of Thyroid Orbitopathy. Methods: 40 patients with a diagnosis of Thyroid Orbitopathy seen between October 2016 - October 2018 were included in this study. A complete ophthalmic examination including visual acuity, ocular motility, exophthalmometry, intraocular pressure, slit lamp examination and fundoscopy was done. Results: Among 40 patients with Thyroid Orbitopathy, 28 (70%) were females and 12 (30%) were males. Mean age of the patients was years 41.82 years (range 18-67). The female: male ratio was 2.3:1. 28 patients (70%) had Grave’s hyperthyroidism, 8 patients (20%) had euthyroidism and 4 patients (10%) were hypothyroid. 80% of the patients had bilateral involvement. The most common ocular signs were eyelid retraction (80%), periorbital oedema (62.5), proptosis (60%) and chemosis (60%). Involvement of extraocular muscles in the descending order of frequency was inferior rectus (70%), medial rectus (50%), superior rectus (27.5%) and lateral rectus (15%). Coclusion: Eyelid retraction was the most common clinical sign of Thyroid Orbitopathy in our patients. On orbital computed tomography (CT) scanning inferior rectus was the most commonly involved muscle. Lower eyelid retraction should be included in the diagnostic criteria in Asian patients.

Keywords: Thyroid Orbitopathy; Hyperthyroidis; Eyelid retraction; Periorbital oedema; computed tomography (CT) scanning

 Introduction: Advances in neonatology and ventilator systems, results in exposure of preterm and low birth weight babies to high oxygen concentration there by leading to initiating ROP. This study was done to identify the incidence, risk factors, for the ROP formation in Neonatology ICU at a tertiary care hospital in South India. Methods: Pre term babies with gestational age less than 32 weeks and wright less than 1750 gm were included in the study. Babies were followed up till complete vascularization of retina. Risk factors and details of ROP were recorded in the proforma. Results: Seventy two babies were thus examined. The incidence of ROP is 8.33% in the study group and it peaks at 38.46% in babies ≤ 30 weeks gestation and/or ≤ 1250 gm birth weight. RDS, Apnea, Sepsis, oxygen administration, ventilation, hyperoxia and hypoxia are independent risk factors significantly associated with ROP (p<0.05). Conclusion: Ongoing ROP screening programme is recommended to all babies ≤ 32 weeks gestation age and/or ≤ 1750 gm birth weight at 4 weeks after birth by indirect ophthalmoscopy. Screening of babies ≤ 30 weeks gestation and /or ≤ 1250 gm birth weight would be more cost effective. It would detect the more severe stages of ROP easily enough to permit treatment, reduce unnecessary examinations and avoid wastage of time and manpower. Screening should be intensified in the presence of riskfactors.

Keywords: ROP; Pre-Mature Baby; Hyperbaric Oxygen; Cryotherapy.

 Introduction: Type 2 Diabetes Mellitus (DM) is a very common chronic condition which has affected almost 382 million people worldwide. Currently, about 62 million people in India are diagnosed with DM, and has the highest number of diabetics in the world.The prevalence of diabetes is predicted to double globally from 171 million in 2000 to 366 million in 2030 with a maximum increase in India. This number is predicted to reach 79.4 million by the year 2030. Development of diabetes related complications are not uncommon and are insidious in onset. These complications are responsible for various co-morbidities which affect the quality of life. Diabetic retinopathy is the main cause of visual impairment and blindness among the people suffering from diabetics. The prevalence of diabetic retinopathy is estimated to be around 33.9% in patients suffering from DM. Visual impairment due to diabetic retinopathy is observed in more than 86% of Type 1 Diabetic patients and 33% of Type 2 Diabetic patients. Over the last 2 decades, diabetic retinopathy has emerged as a common cause of ocular morbidity and blindness in India, moving up from number 17 (1986-1989 WHO-NPCB Survey, Government of India) to number 6 (2001–2002 NPCB national survey) in the list of causes of blindness. In this study we tried to assess the awareness about the various common aspects of Diabetes Mellitus, knowledge about the visual loss in Diabetic retinopathy and the different modalities of treatment available for Diabetic retinopathy among the general practitioners practicing modern medicine (MBBS doctors) and indigenous medicine (BAMS doctors) working in rural areas of North Karnataka . Materials and Methods: Study design: The study was a descriptive cross-sectional survey conducted between October 1, 2016 and December 14, 2017 in rural areas of north karnataka. Institutional approval was obtained from the hospital research and ethics committee before commencement of the study. Study Population:The study respondents were general practitioners (GPs), practicing modern medicine (MBBS doctors) and indigenous medicine (BAMS and BHMS doctors) and working in rural areas of north karnataka. Study Protocol: A total of 179 general practitioners (GPs) participated in the study out of which 49 were BAMS, 72 BHMS and58 MBBS doctors. Informed consent was taken and confidentiality of subjects was maintained. All the participants were given a pre-tested structured questionnaire. The questionnaire consisted of two sections A and B. Section A had questions pertaining to the general awareness of DM and section B regarding the knowledge and various treatment modalities available for diabetic retinopathy. Each correct answer was allotted one mark each. The extracted data was analyzed using Microsoft Excel. Results: Over all 179 doctors of various discipline participated in the study, out of which 49 (27%) were practicing Ayurveda, 72 (41%) were practicing Homeopathy and 58 (32%) were practicing Allopathy. Majority i.e., 128 (72%) of the respondents were male and 51 (28%) were female. There were 58 (32%), 44 (25%), 39 (22%) and 38 (21%) respondents in the 31–40 years, 41–50 years, 51 years or older and 21 – 30 years age categories, respectively. Majority 167 (93.29%) were aware that Diabetes Mellitus effects the eye. Conclusion: Diabetic retinopathy remains the main cause of visual impairment and blindness among the people suffering from diabetics. Hence, early detection and intervention helps to reduce the loss of vision due to diabetic retinopathy. Our study found that there is a lot of scope for improvement in knowledge and awareness related to diabetes and diabetic retinopathy among general practitioners. Workshops/CMEs/Guest lectures/Seminars will help them to update their knowledge and is the need of the hour to improve the ocular health outcomes especially in diabetic patients.

Keywords: Diabetes; Diabetic Retinopathy; Blindness.

 Glaucoma is the second most common cause of blindness and the leading cause of irreversible type of blindness worldwide. Objective: To correlate the angles assessed and categorized by gonioscopy, with the quantified value of angles by the UBM. Method: Participants: Patients having open and closed angles coming to the glaucoma clinic were selected for this study. Grade 0 to Grade 4 were assigned to temporal quadrants of the angles of participants using Shaffer’s classification. Quantification of angles was done by ultrasound biomicroscopy (UBM) using following biometric parameters namely- Angle opening distance at 500µ (AOD 500) from the scleral spur and trabecular meshwork-ciliary process distance (TCPD). Schaffer’s Grade 0,1 and 2 were classified as “narrow angles” and Schaffer’s Grade 3 and 4 as “open angles”. Outcome Measures: Measurements of UBM were calculated and analyzed in relation to measurements of Gonioscopy. Results: Two hundred eyes of 100 patients were analyzed. 96 eyes had “narrow angles” and 104 eyes had “open angles” on gonioscopy. The difference of means calculated by UBM and angle grade estimated by Gonioscopy was significant (p<0.001). The Pearson correlation coefficient was calculated using all UBM parameters and gonioscopy grades which came out significant at the 0.01. Conclusions: The estimated of angle width done by gonioscopy significantly correlated with the angle dimensions those measured by the UBM. Gonioscopy, is thus a reliable method for estimation of the angle width, although it is a subjective test.

Keywords: Glaucoma; Ultrasound Bio-Microscopy; Gonioscopy; Aod; Tcpd.

 Aims & Objectives: To evaluate the postoperative visual acuity and complications in diabetics and non-diabetics with cataract surgery Method: A prospective case study of 100 eyes group A 50 eyes of diabetic and group B 50 eyes of non–diabetic all cases were operated by single surgeon. Patients underwent minimal incision cataract surgery SICS with PCIOL. Age group was taken 30 to 60years and above with good glycaemic control, surgical technique, and preoperatively and postoperative follow up day 1, POD 1week , 6weeks respectively, complication and ocular evaluation done with visual acuity (BCVA). Results: Total 100 eyes 50 diabetic and 50 non-diabetics 41 males and 59 females. The mean age group in diabetic was 57.66 ± 8.29 years and 57 ± 7.27 years in non-diabetic group. All cases underwent SICS with PCIOL. Mean preoperative visual acuity in the diabetic patients group A was 1.28 + 0.42 and non-diabetic patients group B was 1.37 +0.59. Mean post-operative best corrected visual acuity in log MAR units in the diabetic group A was 0.30 + 0.4 and in the group, B was 0.28 +0.5. The difference in pre and post op visual outcome was statistically not significant (p=0.01). Post-operative visual acuity of 6/9 or better was achieved in 36 (72%) eyes in diabetics and 40 (80%) among non-diabetics. Post-operative complications like Wound malposition, corneal oedema, striate keratopathy, anterior chamber reaction, pigment dispersion, cystoids macular edema and posterior capsular opacification. This incidence was higher in the diabetics (p<0.01). Conclusion: Patients with no diabetic retinopathy or maculopathy do not require any special management if cataract surgery was uncomplicated. Visual acuity is similar in both groups. Post-operative complications like corneal oedema and anterior chamber reaction are more common in diabetics.

Keywords: Diabetic; Non-Diabetic; Cataract Surgery; Diabetic Cataract; Diabetes Mellitus.

 Introduction: A cataract is opacity of the lens that interferes with vision, and is the most frequent cause of visual impairment. It is always important it identify the risk factors that affect the development and progression of cataract. We have attempted in our study to identify the risk factors and grade of cataract associated with diabetes. Materials and Methods: Demographic details, physical and clinical evaluation was done for 245 patients. Blood pressure was taken and HdA1c levels was measured for all patients with elevated blood sugar levels. The nature of the cataract was categorized such as immature senile cataracts–partially opaque lens and the disc view hazy (IMSC), mature senile cataracts–completely opaque lens with no disc view (MSC) and hyper mature senile cataracts-liquefied cortical matter (HMSC). Results: 72.7% of these patients had diabetes while 66.9% of them had hypertension. The prevalence of cataract was more in patients with diabetes and hypertension rather than those with these risk factors alone. In the patients who had diabetes for less than 5 years, 86.4% of the patients had Immature senile cataracts with partially opaque lens and hazy disc view (IMSC) and 8.8% patients had hyper mature senile cataract with liquefied cortical matter (HMSC). In patients who had diabetes for more than 15 years, 98.1% had IMSC and there were no patients with HMSC. Conclusion: Although diabetes has no influence on the age and the grade of the cataract, there was a considerable association between diabetes and cataract.

Keywords: Cataract; Diabetes; Visual Impairment.

 Introduction: A cataract is opacity of the lens that interferes with vision, and is the most frequent cause of visual impairment. It is always important it identify the risk factors that affect the development and progression of cataract. We have attempted in our study to identify the risk factors and grade of cataract associated with diabetes. Materials and Methods: Demographic details, physical and clinical evaluation was done for 245 patients. Blood pressure was taken and HdA1c levels was measured for all patients with elevated blood sugar levels. The nature of the cataract was categorized such as immature senile cataracts–partially opaque lens and the disc view hazy (IMSC), mature senile cataracts–completely opaque lens with no disc view (MSC) and hyper mature senile cataracts-liquefied cortical matter (HMSC). Results: 72.7% of these patients had diabetes while 66.9% of them had hypertension. The prevalence of cataract was more in patients with diabetes and hypertension rather than those with these risk factors alone. In the patients who had diabetes for less than 5 years, 86.4% of the patients had Immature senile cataracts with partially opaque lens and hazy disc view (IMSC) and 8.8% patients had hyper mature senile cataract with liquefied cortical matter (HMSC). In patients who had diabetes for more than 15 years, 98.1% had IMSC and there were no patients with HMSC. Conclusion: Although diabetes has no influence on the age and the grade of the cataract, there was a considerable association between diabetes and cataract.

Keywords: Cataract; Diabetes; Visual Impairment.

 Background: In majority of cases of glaucoma the disease progresses in such a slow symptomfree course, that by the time patient, seeks help from the ophthalmologist, a great deal of permanent damage has occurred already. Thus, delay on the part of patient in many cases is due to his ignorance about glaucoma. The present study was undertaken to assess the efficacy & safety of intraoperative 5 – Fluorouracil in Trabeculectomy. Methods: The present study was undertaken in the Department of Ophthalmology, ARMCH & RC, Kumbhari and cases which were diagnosed clinically as having primary glaucoma with raised intraocular tension were randomly selected to receive or not to receive intraoperative 5 – Fluorouracil application between conjunctival flap and sclera for 1 minute duration. Results: There was 67% reduction in baseline intraocular tension with intraoperative use of 5 – Fluorouracil while 58% reduction in baseline intraocular tension was observed without use of 5 – Fluorouracil. Intraocular tension was controlled below 15 mmHg in 92% cases with intraoperative use of 5 – Fluorouracil and 64% cases without use of 5 – Fluorouracil. In high risk glaucoma, adequate control of intraocular tension was observed with intraoperative use of 5 – Fluorouracil. Conclusion: It is a safe and effective alternative to subconjunctival injections of 5 – Fluorouracil. It is also useful in controlling the intraocular tension in high risk eyes.

Keywords: Glaucoma; Trabeculectomy; 5-Fluorouracil; Visual Acuity; Bleb.

 Aim: To clinically evaluate cases of ocular motor nerve palsy and to diagnose their possible aetiological causes as they are often perceived as a sign of serious underlying pathology such as intracranial aneurysms. Purpose: To clinically evaluate cases of ocular motor nerve palsy so as to make anatomical localization and also to make possible aetiological and pathological diagnosis of the neurological lesion. Anatomical localization and aetiopathological diagnosis of the neurological lesion will help the attending neurologist in better management of the case. Introduction: Ocular motor nerve palsies may be congenital or acquired, complete or partial, pupil sparing or pupil involving, and isolated or multiple accompanied by signs of more extensive neurological involvement. Precise knowledge of its origin and course from nuclear level to terminal muscles along with associated clinical features helps in localization and management of neurological lesions. Materials And Methods: 50 consecutive cases of ocular motor nerve palsy attending the outpatient clinic of the department of ophthalmology Malla Reddy Hospital, Malla Reddy Institute of Medical Sciences or referred from other specialties are evaluated and investigated thoroughly as a Prospective, observational, non – interventional and Hospital study study from 1st January 2018 to 31st December 2018. All underwent complete ophthalmological, medical, neurological, otorhinolaryngological and general examination along with complimentary investigations and neuroradiological imaging where ever possible. Inclusion Criteria: Acquired ocular motor nerve palsy with a recent onset (within two weeks), all age groups and both sexes included, ocular motor nerve palsies associated with other neurological signs and symptoms other than the palsy itself and acceptance of the patients to undergo investigations wherever needed. Exclusion Criteria: Congenital ocular motor nerve palsy, patients with incomitant squint due to myogenic, myasthenic and restrictive causes, patients who were terminally ill and those palsies secondary to neurosurgical causes were excluded from the study. Results: Paralyses of the sixth and third cranial nerve were the most common. Complete ptosis and full mydriasis were mostly seen in isolated cases of third carnial nerve palsy. Majority of them are pupil sparing. Common causes were vascular, otorhinolaryngological and trauma. Micro vascular ischemia group as an aetiological factor has good recovery rate and so is the case with pupil sparing oculomotor nerve palsy. Conclusion: Proper evaluation of cases of ocular motor nerve palsy in close collaboration with other specialists will go a long way not only in localizing the serious neurological lesion and also help in reducing the mortality, morbidity and better management of ocular motility disorder.

Keywords: Isolated Ocular Motor Nerve Palsy; Pupillary Sparing Microvascular Ischemia.

 Background: Diabetes mellitus is one of the most common non communicable disease and one of the most important public health problems in India. There are many known ocular complications of diabetes, ranging from conjunctivitis to more severe one like diabetic retinopathy, retinal vein occlusion and optic nerve atrophy. Aim: The present study was conducted to find out the prevalence of ocular morbidities in type 2 diabetes mellitus of more than 10 years duration. Material and Methods: A hospital based cross sectional study was conducted on patients suffering from diabetes mellitus, type 2, for more than 10 years. After initial laboratory investigations, a detailed ocular examination was conducted using auto-refractometer, Snellen’s chart, Slit lamp, Schiotz’s tonometer. Retinoscopy and fundus examination was also carried out to determine the relevant pathologies. If required, further examinations such as B scan, Gonioscopy were done. Results: The most common ocular morbidity noted was cataract (47.61%). More severe complications like, chorio retinal complications were seen in 198 (32.62%) subjects. Other ocular morbidities were refractive errors (25.70%), glaucoma (8.24%), Episcleritis (0.66%), Uveitis (0.49%), Mono neuropathy; 3, 4 or 6th nerve palsy (0.49%). The study has revealed that the duration of diabetes was statistically associated with the diabetic retinopathy (p<0.001). Conclusions: Diabetes mellitus affects all parts of the visual system.

Keywords: Diabetes Mellitus; Ocular Morbidity; Cataract; Duration of Diabetes.

 Aim: The main objective of the current study is toinvestigate that the prevalence of maculopathy in rural area of Chhattisgarh. Material and methods: A retrospective study was conducted inthe department of ophthalmology at Lakhiram Agrawal Memorial Govt. Medical College and associated Kirodimal Govt. Hospital, Raigarh, (CG), total 415 patients were screening in the aged group of 40 years to above. Essential ophthalmic examination was done before the oparation. Result: Out of 415 patients, fifty-four (10.52%) were diagnosed tomaculopathy suspect. out of 54 (27) patients were POAG, 18 (3.5%) had PACG, 5 (0.97%) had lens induced glaucoma and 4 (0.77%) wereglaucomasuspected. Conclusion : Finding of the current study concluded that the Performing of a comprehensive eye evaluation for cataract surgery was great importance in the detection of undiagnosed maculopathy (retinal disease blindness). It is the most important causes of the rural area of Chhattisgarh in central India population.

Keywords: Glaucoma; Maculopathy; Cataract Surgery; Prevalence.

 Background: Dacryocystitis is infection of the lacrimal sac. It results from stasis of lacrimal secretions due to blockage of the nasolacrimal duct. The present study was done to determine the common casuative bacteria and histopathological examination of lacrimal sac in chronic dacryocystitis. Methods: About 50 patients of chronic dacryocystitis are selected. Samples from the contents of the lacrimal sac are collected from these patients and sent to microbiology department for culture for aerobic and anaerobic bacteria and fungi .Samples were collected from 13 patients who underwent dacryocystectomy. Results: Fifty patients with an average age of 52.5 years (range, 6mths –70 years) of chronic dacryocystitis were identified. Female subjects (68%) predominated in the present study. As per the cultures from the nasolacrimal sac about 42 (84%) were positive for bacteria, mostly gram positive bacteria predominated by pneumococcus (40%). Non-granulomatous inflammation of the sac is observed in histo pathological reports of all the 13 specimens. Conclusions: Gram positive bacteria mainly pneumococci was the commonest pathogen isolated. In lacrimal sac biopsy, non-granulomatous inflammation consistent with chronic dacryocystitis is the most common finding.

Keywords: Dacryocystitis; Gram Positive Bacteria; Lacrimal Sac.

 Aim: To find out the proportion of Dry eye among patients affected with Pterygium. Materials And Methods: It was a cross-sectional study. The patients with clinical diagnosis of Pterygium were selected. Ocular examination with special emphasis on Schirmer test, Tear film Break–up Time, Tear Meniscus Height, size of Pterygium was conducted. Data was entered into Microsoft Excel. Statistical analysis was made using Chi-Square test and Correlation test. Results: Dry eye condition was assessed on the basis of the tests. 20.5% of eye on Schirmer test, 33.5% of eyes on Tear film Break–up Time, and 59.5% of eyes on Tear Meniscus Height were found to be affected with Dry eye. Mean value of Schirmer test was 16.94 mm on right eye and 17.85 mm on left eye. Mean value of Tear film Break–up Time was 10.14 sec on right eye and 10.72 sec on left eye.Mean value of Tear Meniscus Height was 0.39 mm on right eye and 0.38 mm on left eye. The association between Dry eye tests and presence of Pterygium not showed any positive association, expect in the case of Tear film Break–up Time and Pterygium on right eye. The Dry eye tests between right and left eyes showed strong association, irrespective of unilateral or bilateral Pterygium. Conclusion: Dry eye condition is seen at least in 26% of eyes, but significant association between Dry eye and presence of Pterygium is not seen. Irrespective of the eye affected with Pterygium, Dry eye tests of both eyes showed strong association. Further case control studies can be done.

Keywords: Pterygium; Dry Eye; Schirmer’s Test; Tear Film Break–Up Time; Tear Meniscus Height.

 Introduction: Diabetic retinopathy plays a main role in adult blindness. Early identification of diabetes mellitus and its risk factors will result in decreasing complications .The aim of this study is to identify the association between the lipid profile with the diabetic retinopathy severity. Methods: This study comprises cases of 200 number type II diabetes mellitus (100 cases of diabetic retinopathy and 100 cases of normal fundus) and control with 100 number with age/sex matched were examined ophthalmologically. Fundus were dilated and examined with ophthalmoscopy and slit lamp biomicroscopy. Grading of severity of retinopathy calculated by ETDRS classification. Lipid profile analyzed using biochemical method. Results: There was significant association between serum cholesterol level and diabetic retinopathy. Visual acuity was not affected. Conclusions: Hypercholesterolemia may acts as one of the risk factor in diabetic retinopathy and also CSME.

Keywords: Hypercholesterolemia; Diabetic Retinopathy; Ophthalmoscopy

 Introduction: One of the most common complications of a cataract surgery is the Posterior Capsular Opacification. In the past, the treatment of PCOs was done surgically by making a small opening in the posterior capsule. Nd. YAG laser treatment causes photo disruption at a very high energy levels thereby disintegrating tissues. Materials and Methods: 140 patients ranging from 31 to 90 years of age with significant PCO, and complaining of gradual diminution of vision after a period of appreciably good vision following successful cataract extraction surgery were included in the study. After regular physical and clinical examination and visual acuity exam by Snellen’s test, confirmation was done by slit lamp method. With the help of the slit lamp, the optical beam was focuses on the posterior capsule and the laser shots were given. Lowest energy of 1.0 mJ was used initially and was increased as and when required. Results: The predominant age group affected was between 51 to 70 years of age. It took 6-12 months in most of the cases for the PCO to form after the cataract surgery (31.43%). For mild opacification, laser power setting was between 1-2mJ for most of the patients, For moderate opacifcation, >2 – 3mJ was required and for severe, requirement was >3-5 mJ. the visual acuity of the patients improved to a large extent. 6/6 -6/12 improvement was seen in 82 (58.57%) of the patients, while 46 patients (32.85%) had an improvement to 6/18-6/24. Out of the complications observer among the patients, the most common one was a rise in intraocular pressure by more than 5 mmHg which was seen in 22.14% patients. Conclusion: Nd:YAG laser capsulotomy as a good and successful treatment of PCO. It is one of the recent, non invasive and effective mode of treatment for PCO with least amount of complications and no hospitalization.

Keywords: Cataract surgery; Posterior Capsular Opacification; Neodymium Yttrium Aluminium-Garnet.