ABSTRACT
To report an unusual variant of Goldenhar syndrome We reviewed a 7 year old boy attending our OPD with left upper eyelid coloboma and multiple congenital deformities including auricular, facial and vertebral abnormalities like microtia, hemifacialmicrosomia, cleft palate, dental abnormalities, kyphoscoliosis and tilted optic disc. He underwent radiological imaging and thorough ocular & systemic examination which were suggestive of Goldenhar syndrome. The most common ocular finding of Goldenhar syndrome, also known as oculo-auriculo-vertebral spectrum, is epibulbar dermoid, which was absent in our case, instead there was upper-eyelid coloboma and tilted optic disc. However other facial, auricular and skeletal deformities were in concordance with the spectrum of Goldenhar Syndrome. Goldenhar syndrome consists of a large spectrum of congenital abnormalities and patients might not present with the most diagnostic ocular features. Hence, its diagnosis and treatment requires a multidisciplinary approach.
ABSTRACT
Diabetic Retinopathy is an important cause of blindness with diabetic macular edema(DME) affecting 15% of patients 15yrs after diagnosis. The prevalence of diabetes mellitus(DM) is expected to approximately double globally between 2000 and 2030. The burden of DME is likely to increase as prevalence of DM is expected to rise by 50% globally, from 2000 to 2030. Therefore, is a major cause of concern. To study diabetic macular edema prevalence and pattern in association with severity of diabetic retinopathy in patients of type 2 diabetes mellitus. 300 patients with type 2 diabetes mellitus were included in anobservational cross sectional study. Clinical assessment was done by recording Visual acuity by Snellen's drum test, slit lamp examination, direct and indirect ophthalmoscope, fundus examination with +90 D lens, Goldman applanation tonometry, gonioscopy, Cirrus SD-OCT macula and fundus photography. Among 600 eyes, prevalence of DME was 14.0% and 24.3% in NPDR and PDR eyes respectively. Statistically, this difference was not significant (p=0.226).Among the categories of diabetic retinopathy, a significant increase in prevalence of DME was observed with increasing severity of NPDR (p<0.001). Among 87 eyes with DME, the pattern of DME was 59.8% with diffuse retinal thickening, 21.8% with cystoids macular edema and 18.4% with serous retinal detachment. Prevalence of DME was more in NPDR group increasing with severity of NPDR. The prevalence of DME pattern of diffused retinal thickening was most followed by cystoid macular edema and serous retinal detachment among those with diabetic retinopathy.
ABSTRACT
Cataract is the chief cause of avoidable blindness in the developing countries of the world including India. These patients can regain normal sight with the help of cataract surgery, which has undergone many advances and Small Incision Cataract Surgery (SICS) has gained wide acceptance world over as the surgical method requires minimal infrastructure. The present study compares it’s safety profile for the patients as well as acceptability amongst the doctors performing conventional Extra Capsular Cataract Extraction (ECCE) surgery in peripheral resource poor settings. Methods: All patients having cataract were examined prior to surgery and were randomized in two groups: group I - small incision cataract surgery and group II - conventional extra capsular cataract extraction surgery with posterior capsular intra ocular lens implantation. The various intra and post-operative complications were evaluated. Results: 252 eyes of 252 patients were enrolled with 121 patients in group I and 131 patients in group II and intra-operative and post-operative complications compared. Intra-operatively difficulty in nucleus delivery was higher in group I (12.3%) whereas repeated iris protrusion (12.5%) and posterior capsular rent (8.3%) was higher in group II. Postoperatively, on day 1 striate keratopathy was commoner in group I (20.6%) whereas uveitis was seen more commonly (26.7%) in group II. At 6 weeks, surgically induced astigmatism was higher (61%) in group II as compared to group I (35%). Conclusion: SICS is a safe and acceptable alternative to conventional ECCE in a peripheral teaching setup.