Inflicted neuro-trauma in infancy.

Two infants with non-accidental inflicted neuro-trauma are reported. One presented with sudden onset lethargy, respiratory difficulty and unexplained seizures. There were bilateral retinal bleeds and extradural hemmorage. Other was a well thriving child who had 2 seizures and was noted to lack visual fixation. Retinal hemorrhages and chronic subdural and intraparenchymal hemorrhages were subsequently discovered. We highlight the importance of suspecting child abuse in infants with sudden unexplained unresponsiveness, seizures or respiratory difficulty and the unusual occurrence of extradual hemorrhage.

Profile of Ocular Trauma at Tertiary Eye Centr

This prospective study reveals the epidemiological profile of ocular trauma referred to a tertiary eye centre over one year. All consecutive patients referred to Vitreo-retina service during 1 year period were examined.Out of total 523 eyes registered large proportion was <25years of age (67%), males (88%) and literate (77%). Forty-four percent belonged to rural area and 38% were students. Most of the open globe injuries were Zone 1(50.8%). 75% presented >1 week after injury. The incidence of intraocular foreign body and retinal detachment was 17.4, and 11.3% respectively. Diagnosis of post traumatic endophthalmitis was made in 20.5% of open globe injuries. Development of endophthalmitis correlated with younger age, rural setting, illiteracy, presence of foreign body and lens disruption. Ocular trauma requiring tertiary care commonly affects young students, labourers and factory workers. Younger, rural and illiterate patients are more likely to develop infection especially if they have lens injury or intraocular foreign body.

Suprachoroidal haemorrhage. Secondary management.

We report a case of successful management of expulsive suprachoroidal haemorrhage following cataract surgery. This case study highlights the strategy of adequate management.

Unusual retinal manifestation in a combination of Sturge-Weber and Klipplel-Trenaunay syndrome--a case report.

An unusual retinal manifestation of arteriovenous communications is reported in a case showing a combination of Sturge-Weber and Kippel-Trenaunay syndromes. The arteriovenous communications are thought to be similar to those seen in the limbs in Parkes-Weber syndrome. This retinal finding indicates that the three syndromes are intricately related to each other and may be an incomplete manifestation of a single pathophysiologic entity which may be named neurocutaneous angiomatosis.

Systemic aspirin and systemic vitamin E in senile cataracts: cataract V.

We undertook a prospective study in senile cataract patients using systemic aspirin and systemic vitamin E. Vitamin E treated eyes did show less progression of PSC opacities extent and less new nuclear opacities during the follow-up, but overall vitamin E treated eyes did no better than the control group eyes. More eyes in systemic aspirin treated group maintained the initial vision and loss of vision in the aspirin group was also less marked. Aspirin also caused a significant less mean increase in cortical opacity extent, nuclear/opacity and density and PSC opacity extent and density as well as in ophthalmoscopically graded opacity extent and density. We suggest that aspirin is a potential drug which should be further evaluated in large double blind photodocumentated studies. The present data does not justify the recommendation that aspirin be prescribed for slowing down cataract progression. This must await large studies and confirmation.

Topical glutathione therapy in senile cataracts. Cataract-III.

We undertook a prospective study in 66 cataract patients to study if topical glutathione has any effects on the progression of cataracts. The eye with more advanced cataract received topical glutathione drops q.i.d. and contralateral eye served as control. Only 32 patients completed the follow-up of three months or more. Data analysis revealed no beneficial effect of topical glutathione drops on any of the parameters studied. PSC opacity density in eyes treated with topical glutathione showed significant increase as compared to control eyes.

A simple accurate method of cataract classification. Cataract-I.

A simple and accurate system of cataract classification using slit lamp and direct ophthalmoscope is reported. Lens opacities are classified into cortical (anterior and posterior), nuclear and posterior sub-capsular and each sub-type of opacity is graded, extent and density wise, using both slit lamp and direct ophthalmoscope. A circle representing enface view of opacity divided into 100 equal parts is used in calculating the area of each opacity. This classification takes into account both the area and depth of opacity in arriving at the total extent of sub-type of each opacity. For density determination, we do not recommend the use of a resolution target projection ophthalmoscope. Intra-observer and inter-observer variability studies using this classification system indicated that the classification system is fairly reliable.

Methodology for studies on medical therapy of cataracts: cataract-II.

The methodology for testing any possible effect of potential anti-cataract agents is described. This is based on slit lamp and ophthalmoscopic cataract classification and on visual acuity. The difficulties encountered in such studies are highlighted. The presented methodology is suggested to be fairly adequate in assessing usefulness of any possible medical therapy of cataracts.

Topical sulindac therapy in diabetic senile cataracts: cataract-IV.

Sulindac, a non-steroidal anti-inflammatory drug has been found to be a potent inhibitor of enzyme aldose reductase. We used sulindac topically in diabetic senile cataract patients to note if it effects the progression of cataracts. More of sulindac treated eyes maintained initial vision and fewer eyes had visual loss of up to two lines or more as compared to control eyes. The extent and density of different opacities showed less progression in sulindac treated eyes but it was not statistically significant except that the ophthalmoscopically observed density of opacity showed statistically very significant lesser mean increase in sulindac treated eyes. We suggest that sulindac is a potential drug which should be further evaluated in large double blind photodocumented studies in diabetic senile cataracts.

Nerve fibre bundle defects and their perimetric correlation.

The importance of red-free fundus examination in revealing functional loss of the retinal nerve fibre layer is highlighted in some optic nerve diseases as corroborated by a good correlation observed between NFBDs and visual field defects. Red-free fundus examination could predict the site of a visual field defects, thus enabling the perimetrist to concentrate on that area and to detect field defects which were missed in a previous field examination. In cases of optic atrophy, the extent of nerve fibre layer loss correlated better with the functional loss in terms of visual acuity rather than the pallor of the disc, which was quite often misleading as an indicator of functional damage of the optic nerve. The technique of red-free fundus photography employed was fairly inexpensive and simple.