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Purpose: Keratoconjunctivitis sicca (KCS) or dry eye disease (DED) is a multifactorial disease that results in discomfort, visual disturbance, and tear film instability with potential damage to the ocular surface. A pilot study was undertaken to determine if there were any major substantial differences in the ocular microbiome in DED patients versus healthy controls. Methods: The bacterial communities residing in the conjunctiva of patients with DED (n = 4) and healthy controls (n = 4) were assessed by 16S ribosomal RNA (rRNA) gene sequencing of the V4–V5 region. Results: The phyla Proteobacteria, Actinobacteria, Bacteroidetes, and Firmicutes were most dominant and accounted for 97% and 94.5% of all bacterial sequences in patients and controls, respectively. At the genus level, 27 bacterial genera were found with more than two?fold difference between patients and controls. Four of these – Acinetobacter, Corynebacterium, Lactobacillus, and Pseudomonas spp. – dominated the ocular microbiome of all subjects, but were proportionately lower in DED (16.5%) compared to controls (37.7%). Several bacterial genera were found to be unique in DED (34) and controls (24). Conclusion: This pilot study is an attempt to profile the ocular microbiome in patients with DED that demonstrated a higher concentration of microbial DNA compared to controls, with Firmicutes phyla dominating the bacterial population in patients with DED.
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Purpose: The study sought to describe the clinical presentation pattern of pediatric cataracts and factors leading to delay in surgery at a tertiary care center in North India. Methods: A cross?sectional, interview?based study was conducted from January 2020 to October 2020, that included pediatric patients <12 years, with unilateral or bilateral congenital or developmental cataract. A pre?validated questionnaire was used to record data. The parameters recorded were age at first symptoms, age at diagnosis of cataract, age at surgery, laterality of cataract, first symptom, first family member noticing the abnormality, the morphology of cataract, association of perinatal complications, family history, systemic diseases, and cause (s) of delay in surgery. Results: A total of 89 patients were included. The mean age of subjects was 4.75(±3.51) years. A white pupil was the most common symptom (64.04%) and appeared in infancy in 30.3% of cases. Parents first detected the problem in 60.67%, and the pediatrician was the first medical contact in 11.23% of cases. The median (IQR) delay period between diagnosis of cataract and cataract surgery was 4 (3–6) months, the major causes were long GA waiting (30.33%), and delay due to systemic ill health (14.61%). Conclusion: Parental education on cataract detection is recommended to help in the timely detection and hence, improved outcomes of pediatric cataract surgery. Pediatricians, consulted for any systemic illness, have the role of the second most important contact in the detection of pediatric cataract.
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Purpose: To determine the seasonality, clinical profile, and treatment outcome of Fusarium keratitis. Methods: A retrospective medical chart review of 97 patients with culture?proven Fusarium keratitis at a tertiary eye care institution from January 2018 to December 2019. Results: The median (SD) age at enrollment was 44.6 (16) years; 75 (79.8%) of them were male. Presence of infiltrate less than 4 mm2 at baseline indicated 4.4 times the odds of achieving final BCVA more than 20/60 (95% CI: 1.4–13.3; P = 0.008). The absence of surgical management indicated 8.1 times the odds of achieving final BCVA of more than 20/60 (95% CI: 0.9–71.5; P = 0.06). The visual acuity at presentation, duration between symptoms and presentation, history of ocular trauma, previous use of topical medications, and presence of hypopyon were not identified as significant predictors of final BCVA in the multivariable regression analysis. Conclusion: Smaller infiltrate size and absence of surgical management are the significant predictors of good visual outcome. Visual outcome of Fusarium keratitis is poor, and a significant number of patients did not respond to anti?fungal therapy and had to undergo surgeries. To the best of our knowledge, this is the largest case series on Fusarium keratitis to date