Rose-K versus Soper contact lens in keratoconus: a randomized comparative trial

To perform a comparative evaluation of the efficacy and acceptability of Rose-K and Soper contact lenses in Keratoconus. Dr. Rajendra Prasad Center for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi. A randomized comparative clinical trial was performed in keratoconic eyes fitted with Rose-K [Rose-K group] and Soper [Soper group] contact lenses. Patients data were evaluated for best spectacle corrected visual acuity, best contact lens corrected visual acuity [BCLCVA], corneal topography, glare acuity, contrast sensitivity, tear function tests and specular microscopy. Patients were also asked to complete a self-reported comfort questionnaire at each visit. Sixty eyes were randomized to the Rose-K and Soper groups. The two groups were comparable in all the baseline parameters. There was a statistically significant improvement in BCLCVA in both groups at 3 months [P < 0.01, both groups]. The difference between in BCLCVA in both groups was not statistically significant. In both groups, there was a significant improvement in the comfort score at 3 months compared to baseline [P< 0.05, both group]. The Rose-K group had statistically significantly better scores at 1 and 3 months compared with the Soper group [P- 0.006 and P< 0.001 respectively]. Both groups were associated with a significant [P< 0.0l], but comparable improvement in glare acuity at 3 months. There was a significant improvement in contrast sensitivity at 3 months in both groups [P< 0.0l]? the Rose-K group was significantly better than the Soper group at 1 and 3 months [P= 0.001 and 0.002 respectively]. The mean number of trial lenses required for fitting Rose-K lens [2.00 +/- 0.59] was significantly lower than the Soper lens [3.43 +/- 0.82; P< 0.00l]. Both the contact lens designs provide an equal improvement in visual acuity in patients with Keratoconus. However, Rose-K contact lens provides greater comfort, better quality of vision and requires less chair time compared with the Soper lens and hence may possibly have a greater acceptability

Herpes zoster ophthalmicus: disease spectrum in young adults

To establish the clinical profile of herpes zoster ophthalmicus [HZO] in adults younger than 40 years and correlate the clinical manifestation with their immune status. A retrospective chart review was performed of patients younger than 40 years who presented with HZO. Data were collected on demographics, medical history, clinical presentation, results of serological investigations, and visual outcome. The study cohort comprised 18 subjects with a mean age of 29.7 +/- 6.2 years. Ophthalmic features included lid edema, ptosis, cicatricial lid deformities, sclerokeratitis, peripheral ulcerative keratitis, neuroparalytic keratitis, keratouveitis with concomitant glaucoma, secondary bacterial keratitis and superficial punctate keratitis with dry eye, optic neuritis, and trochlear nerve palsy. Eight of 18 [44.4%] subjects were found to be positive for Human Immunodeficiency Virus [HIV]. Disseminated herpetic lesions were seen present in 5 [63%] of these 8 subjects. Postherpetic neuralgia was noted in 6 [75%] of 8 HIV-positive subjects and in 1 HIV-negative patient. Final visual acuity was 20/40 or better in 90% of the immunocompetent subjects and 20/200 or worse in 100% of the HIV-positive subjects. Immunocompetent young adults do present with features of HZO. However, the disease spectrum in HIV-negative patients is localized, less severe, and more amenable to therapy as compared with young adults with HIV