Parallelism between hypovitaminosis D3 and recently detected myopia in children with amplified screen use in the COVID-19 era—A preliminary study

Purpose: This introductory study aims to analyze the association of serum vitamin D3 levels with recently detected myopia in Indian children following home confinement post?COVID?19 pandemic. Methods: Children aged 5–15 years who had not attended physical school in the past 1 year and visited the ophthalmology department with various ocular symptoms were divided into two groups: the myopic group with recently detected myopia and the non?myopic group with ocular ailments other than myopia. All children underwent basic ophthalmic evaluation and a general physical examination. Blood samples were collected for serum vitamin D3 levels. A pretested questionnaire inquiring about the duration of exposure to a digital screen, outdoor activities, and socioeconomic status was filled out for all children. Results: The mean serum vitamin D3 level in the myopic group was 28.17 ± 15.02 ng/dl in comparison to 45.36 ± 17.56 ng/dl in the non?myopic group (P value < 0.05). Linear regression of the data establishes that myopia is associated with hypovitaminosis D3 (OR? 13.12, 95% CI 2.90–50.32, a P value of 0.001). The correlation between spherical equivalent and vitamin D3 levels was significant (Pearson correlation value: 0.661). In the myopic group, 63.3% of children had screen use >6 hours against 43.3% of children in the non?myopic group. In the myopic group, 33.3% of the children had an outdoor activity duration of <2 hours against 6.6% of children in the non?myopic group. Conclusion: This study proposes hypovitaminosis D3 as a strong factor associated with the development of myopia in children. Although it is a preliminary study, it suggests that the trial for vitamin D3 supplementation in young children to delay or cease the development of myopia is warranted.

An inadvertent usage of the deep stromal lenticule in anterior lamellar keratoplasty – An emancipator technique

Anterior lamellar keratoplasty (ALK), of late, has gained popularity because of its prolonged graft survivability as a result of reduced endothelial cell loss. A 56-year-old female with bilateral granular corneal dystrophy was taken up for ALK in the left eye. Because of unforeseen errors during the procedure, the surgeon was obliged to customize a novel technique by using a deep stromal lenticule after removal of Descemet’s membrane. Post-op visual recovery was equivalent to conventional ALK with complete epithelization of the graft. This new or adapted technique has an added advantage for surgeons to prevent forfeiture of the valuable donor tissue. In the developing world, manual dissection is still the primary technique of lamellar keratoplasty and many precious corneas get wasted because of intra-operative unintended errors of dissection and trephination. Therefore, this novel technique holds its importance in saving the precious corneal tissue, especially in developing countries, and opens a new area for exploration.