ABSTRACT
Background: Dry eye condition has multi-factorial origin and most of the times missed or left untreated leading to resistance in its treatment modalities. Various studies had been conducted with conflicting outcomes. Dry eyes condition being more prevalent in Odisha, there is very limited published data on its management. Hence this study was conducted to evaluate the efficacy and outcome of medical and surgical management of dry eye cases due to different aetiologies.Methods: Patients were selected from those who attended ophthalmology, Skinand VD, O and G and Paediatrics OPD. Their tear film parameters like Tear film breakup time, tear meniscus height, Schirmer test, Rose Bengal stain were assessed at baseline level. Thereafter they were put on medical therapy for 6 weeks followed by appropriate surgical intervention like amniotic membrane graft, punctual occlusion, use of Symblepharon shell in resistant cases -which again was reviewed by analysis of tear film parameters.Results: Majority of patients (75% approx.) responded well to medical therapy. non responders were due to Steven Johnson syndrome, Vitamin A deficiency, KCS and systemic association. These patients underwent surgical management with follow up after 6 weeks. After 6 weeks of surgical therapy 80% cases showed improvement, while few cases due to SJS showed poor response.Conclusions: The medical modality of treatment was found to be the primary approach with better efficacy in majority of dry eye cases predominantly in mild to moderate severity. Surgical interventions proved more efficacious in severe degree of presentation.
ABSTRACT
Diabetes being considered as an epidemic, long term untreated complicated diabetes resulting in retinopathy will be a leading cause of blindness worldwide. Many cross-sectional studies reported a strong relationship between chronic hyperglycaemia and development, progression of retinopathy, however the underlying mechanism that cause retinal microvascular damage following prolonged hyperglycaemia, yet to be revealed. Continued research worldwide focuses on understanding the molecular basis with the ultimate goal to prevent diabetic retinopathy by developing newer therapeutic targets. This article reviews multiple biochemical pathways that are implicated in diabetic retinopathy. Recent advancement in the molecular basis of the disease as well as clinical trials undertaken to target these molecules in order to block the signalling cascade prevailing in diabetic retinopathy is also discussed. This review highlights the recent therapeutic targets to prevent the onset as well as the progress of retinopathy in diabetes.