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Purpose: To analyze the correlation between the mean retinal nerve fiber layer (RNFL) and ganglion cell layer (GCL) thickness with axial length and refractive errors among children aged 5–15 years. Methods: This cross?sectional, observational study was done on 130 eyes of 65 consecutive subjects with refractive errors. The patients were evaluated for RNFL thickness and macular GCL thickness using spectral domain? optical coherence tomography. Results: One hundred and thirty eyes of 65 subjects aged between 5 and 15 years were divided into three groups based on their spherical equivalent in diopters (D). The children with a spherical equivalent of ??0.50 D were considered myopic, ??0.5 to ?+0.5 D were considered emmetropic, and ?+0.50 D were considered hypermetropic. RNFL thickness and GCL thickness were correlated with age, gender, spherical equivalent, and axial length. The mean global RNFL thickness was 104.58 ?m ± 7.567. Conclusion: There exists a negative correlation between RNFL thickness and macular GCL thickness with increasing severity of myopia and increase in axial length, and the possible reason could be stretching of the sclera, which further leads to stretching of the retina, resulting in thinner RNFL and macular GCL thickness
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Background: In acute chemical injury, damage can range from ocular surface epithelial defects to limbal and scleral ischemia. This may subsequently progress to corneal or scleral melting and perforation and finally result in phthisis bulbi. Thus, acute chemical injury is a potentially blinding condition and warrants attention. The accurate technique to assess the damage incurred should be practiced to avoid undertreatment and subsequent complications. Surgical intervention wherever needed should be appropriately timed and should be performed. The primary aim of medical or surgical intervention in acute chemical injury is to attain a stable and epithelized ocular surface. Even a conjunctival phenotype over the cornea is a desirable outcome. Purpose: This video discusses the nuances involved in the assessment and planning of Tenon advancement with amniotic membrane grafting for treating limbal ischemia in acute chemical injury. Synopsis: The video demonstrates the technique of restoration of limbal vascularization by performing Tenon advancement with amniotic membrane grafting and its outcome. Highlights: Ocular surface painting with fluorescein dye is essential to assess the areas of surface involvement. Merely instilling the fluorescein dye in the cul?de?sac will underestimate the extent of the damage. Tenon advancement should ideally be planned between 7 and 10 days following an injury when actual limbal blanching is obvious. A stable and epithelized ocular surface is the desirable outcome irrespective of the epithelial phenotype.
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Purpose: To report the clinico?demographic profile of rhino?orbito?cerebral mucormycosis (ROCM) in patients during the “second wave” of the COVID?19 pandemic in eastern India, and their ophthalmic manifestations at presentation to our tertiary institute. Methods: Cross?sectional study amongst patients presenting to our center based on their hospital records. Demographic information, history related to COVID?19, records of detailed ocular examination, and microbiological, radiological, and histopathological investigation were entered into an online worksheet and analyzed using SPSS 26.0. Results: A total of 219 patients with ROCM were treated from May to September 2021, and 110 of these had ocular manifestations at presentation (50.2%). The age of patients ranged from 22 to 83 years and the mean ± standard deviation (SD) age was 49.9 ± 12.9 years. Ninety (81.8%) patients had been diagnosed with diabetes mellitus, 31 (34%) had hypertension, and 10 had other comorbidities. The duration between the onset of COVID?19 and mucormycosis symptoms was 0 to 60 days with a mean ± SD interval of 20.9 ± 12.6 days. Fifty?six (50.9%) patients had a history of steroid use. Unrelenting ocular or facial pain was the most common presenting symptom, ptosis was the most common anterior segment manifestation, and ophthalmic artery occlusion was the most common posterior segment manifestation. Conclusion: Our data from eastern India reinforces the relationship between COVID?19, diabetes, corticosteroid use, and ROCM. Knowledge of various presenting anterior and posterior segment manifestations of the disease as described in the present study will guide clinicians to recognize the disease early and make every effort to prevent complications.
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Background: Steven–Johnson syndrome (SJS) is a serious disorder affecting the skin and mucous membrane, causing multiple flaccid bullae and purpuric rashes with sheet?likeepithelial detachment including the ocular surface. The long?term outcomes following SJS are dismal and manifest as corneal vascularization, lid?wiper keratopathy, and severe dry eyes. The disease course can be modified if amniotic membrane graft is performed at the first week of disease, and the above?said complications can be avoided. This procedure thus not only decreases the morbidity but also improves the quality of life. Purpose: This video discusses the long?term sequelae of SJS which can be modified with timely intervention during the acute stage and thus significantly decreases morbidity. Synopsis: The video demonstrates the simple technique of amniotic membrane transplantation in the acute stage in SJS and its impact in long run. Highlights: There should be a low threshold for doing early amniotic membrane transplantation in patients with SJS with ocular surface involvement. Early intervention can change the disease course and decrease disease morbidity significantly.
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A rare case of adult-onset bilateral optic neuritis without associated autoimmune or infectious disorders has been reported in this study. A 19-year-old male described sudden bilateral diminution of vision (sequential) with headache with no other remarkable history. Ophthalmological findings revealed asymmetrically reduced visual acuity on the initial visit. Fundus examination showed nerve fibre layer oedema (more in right eye). Radiological examination was suggestive of bilateral, asymmetrical optic neuritis. Visual evoked potential tests suggested asymmetrical and sequential P100 delay. No auto-immune/infectious aetiology was found. The condition was diagnosed as an atypical presentation of optic neuritis with sequential bilateral involvement. Patient was treated with intravenous methyl prednisolone followed by tapering oral doses owing to the bilaterality of the involvement. A careful follow-up is being performed. The condition involving bilateral inflammation of the optic nerves can have hazardous outcome and hence prompt, careful and comprehensive diagnostic and treatment approach is necessitated.
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Introduction: With the increase in the life span of humanbeings and added to that the culture of processed food thereare increase in life style disorders in humans. The commonestorthopedic problem which we see due sedentary life style,lack of healthy wholesome diet are bone related disordersmainly osteoarthritis.Ropivacaine, an alternative to bupivacaine is structurallyclosely related to bupivacaine and supplied as the pureS-enantiomer. We therefore decided to compare the efficacy ofcontinuous infusion of levo bupivacaine against ropivacaine toidentify the differences or superiority of one drug over other.Material and methods: After obtaining the Ethics Committeeapproval, we recruited 110 patients undergoing Total KneeReplacement (TKR) surgery under Combined Spinal Epidural(CSE) Anaesthesia. Sample size of study which was calculatedas 110. All patients underwent a routine pre anaesthetic checkup including the spine examination. Pre-anaesthetic check- upwas done a day prior to surgery. All routine investigationswere advised. The details of our study were explained to thepatients, in the language understood by them. Consent wasobtained for post-operative use of Elastomeric infusion pump.They were explained about the use of VAS.Results: Both groups were comparable with respect todemographic profile. The patients in ropivacaine group showedsignificantly lower pulse rate as compared to levobupivacainegroup. Patients in ropivacaine group recorded significantlylower systolic blood pressure throughout the infusion periodas compared to those in the levobupivacaine group. Thedifference in diastolic blood pressure was not significant. Thetime taken for the sensory block to regress to L1 was longerin ropivacaine group as compared to levobupivacaine group.Conclusion: Patients in both the group had comparable VASpost operatively. Although Patients in the ropivacaine grouphad better VAS score as compared to levobupivacaine, thedifference was not statistically significant. There were noside effects like motor weakness, hypotension, bradycardia orPNOV in any group. Our present study thus concludes thatas far as analgesic properties are concerned Ropivacaine withits more suitable toxicity profile and less motor block is morefavourable for continuous infusion for patients undergoingTKR when used in equipotent doses.