ABSTRACT
Infectious keratitis is an important problem in the Indian context, and epidemiological studies suggest a higher prevalence of disease as compared to the developed world. Various aspects of the problem, including the host defence, ocular and systemic risk factors and microbial mechanisms that enhance pathogenesis have been discussed. The clinical and microbiological approach to the infected eye and patient and the relevant tests have been outlined. The major classes of medications that are used the methods of delivery are specified. Finally, the approach to patients with non-responsive keratitis that requires surgical manoeuvres is also highlighted. Clinical experience is important in distinguishing an infective from an inflammatory corneal pathology. The role of an experienced microbiologist is inevitable, for good clinical outcome. Therapeutic keratoplasty has to be done at the right time for better clinical outcomes.
ABSTRACT
Intermediate Uveitis (IU) is an inflammatory disease, primarily involving the vitreous and peripheral retina. It accounts for around 8% of cases of uveitis and affects primarily children and young adults. The etiology is unknown but, found as an isolated and idiopathic condition or in association with systemic disorders such as multiple sclerosis and sarcoidosis and infectious diseases. Symptoms include painless blurring of vision, floaters and deterioration of vision. Clinical features seen are anterior segment affection with keratic precipitates and anterior chamber cells, vitritis, vasculitis in the peripheral retina, vitreal snow banks and cystoid macular edema (CME). CME was the major threat for deterioration of vision; other complications include vitreous haemorrhage, periphlebitis, cataract and glaucoma. Treatment of intermediate uveitis is based on periocular and oral corticosteroids. Cryotherapy or laser photocoagulations of the peripheral retina are options in patients when there is an insufficient response to periocular or systemic corticosteroids. Immunomodulatory therapy is used when other therapies fail. Pars plana vitrectomy (PPV) is indicated in patients with chronic significant inflammation, non-responsive cystoid macular edema, non-clearing vitreous haemorrhage, tractional retinal detachment and epiretinal membranes. IU is an intraocular inflammation involving the anterior vitreous, peripheral retina and pars plana. It usually affects patients from 5 to 30 years old, without gender or racial preferences. The etiology is unknown but there are several associated diseases. The long-term prognosis of intermediate uveitis is usually good, particularly with strict control of inflammation and with proper management of complications.
ABSTRACT
Of the myriad reasons for visits to an ophthalmologist, one of the most common maladies afflicting patients is Dry Eye Disease (DED), which can cause mild discomfort in the early stages and endstage ocular surface damage in its more severe forms. Dry eye is a problem of utmost importance, more in the developed rather than developing nations. Various aspects of the manifestation, including the tear osmolarity, ocular surface homeostasis and the role of ocular surface epithelial stem cells in maintaining the ocular surface homeostasis have been discussed. The objective tests to assess and grade dry eye have been noted. A systematic approach to the affected eye and the patient has also been outlined. The major categories of medications used along with the methods of delivery are specified in this review. A systematic approach in understanding the type and grade of Dry Eye Disease is mandatory for good clinical response. Along with clinical management the doctor should also stress on environmental changes that exaggerates dryness.
ABSTRACT
Introduction- Patients undergoing cataract surgery develop astigmatism based on location of incision. This retrospective study investigated the “Pre & post operative astigmatism after cataract surgery based on incision”. Purpose of this study was to compare astigmatismobtained in temporal & superior incision. Material and Methods- Out of 50 cataract patients collected, 25 patients were in the temporal incision PHACO group and 25 were in the superior incision PHACO group. Corneal astigmatism and corrected visual acuity were assessed 30 and 90 days after cataract surgery. Results- against the rule astigmatism is more common after superior incision cataract surgery and with the rule astigmatism is more common after temporal incision cataract surgery. Conclusion: The study reveals temporal incision, increase with the rule & superior incision increase against the rule and also concluded astigmatism is least in temporal incision.
ABSTRACT
Introduction: Thickness of RNFL around the different quadrants of the optic disc margin progressively increases. Macular fibers occupying the lateral quadrant are the most resistant to glaucomatous damage and explain the retention of the central vision till end. This study was undertaken to determine the age related changes in the optic nerve head (ONH) and retinal nerve fiber layer (RNFL) in a group of normal subjects. Material and Methods: This prospective cross sectional hospital based study consisted of 150 healthy eyes of 75 subjects whom underwent ONH measurement using the Optovue optical coherence tomography (OCT) and examined the result of optic nerve head parameters and RNFL. Results- Mean cup disc ratio was found to be higher with increasing age. And the average RNFL thickness was found to decrease with increasing age. Conclusion: There are changes in optic disc parameters and RNFL with increasing age and the changes were measurable and significant.
ABSTRACT
Introduction: Recurrent Corneal Erosion Syndrome is a resistant condition to treat .Many modalities of treatment is available. Alcohol assisted epithelial delamination is relatively a new procedure and not widely practiced. This study evaluates the efficacy and safety of the procedure. Material & Methods: This is a retrospective study conducted in our hospital .We have enrolled 30 patients who underwent the procedure within last two years. Patients with RCE who remained symptomatic despite topical lubrication was included .Patients were followed up at 1 day, 4 days, 1 week, and 1 month. Success was defined as resolution of symptoms after 1 month of treatment. The preoperative and postoperative data were collected from EMR and analyzed. Results: Twenty nine patients were stable after the procedure. One patient required repeated treatment. There were no post operative complications. No patients lost any line of visual acuity. Conclusion: Alcohol assisted epithelial delamination is a safe and effective procedure for treating patients with recurrent corneal erosion syndrome.