Impact of learning effect on reliability factors and global indices in visual field testing by standard automated perimetry in normal healthy subjects and primary open-angle glaucoma patients to obtain an accurate baseline perimetry chart

Purpose: To record and evaluate the reliability parameters (fixation loss (FL) %, false positive (FP) %) and global indices (mean sensitivity (MS), mean deviation (MD), pattern standard deviation in dB) in three visual field test sessions within two weeks to assess the learning effect in normal healthy subjects and POAG patients and comparison of learning effect gender wise and age wise in primary open?angle glaucoma (POAG) patients. Methods: This study was a prospective observational study. An oculus visual field testing was done and analyzed in 30 eyes of POAG patients and 30 eyes of normal healthy subjects in three visits. Results: There were 16 (53.3%) males and 14 (46.6%) females in the POAG group and 16 (53.33%) males and 14 (46.66%) females in the normal healthy subject group. A significant difference in data change between each visit in FL, FP, MD, MS was found though the difference was more pronounced in the second visit than in the third visit. The pattern standard deviation does not change significantly in subsequent visits in both groups. Gender wise and age wise no significant difference was found in the POAG group. Conclusion: Significant improvement in reliability parameters and global indices with each subsequent visit in both the POAG group and normal patients signifies the importance of learning effect on these parameters and the need to perform at least three tests to get the baseline perimetry chart, especially in POAG patients, while in normal subjects, second perimetric result can be accepted. It was also concluded that the learning effect is not influenced by age and gender.

Prevalence of dry eye, its categorization (Dry Eye Workshop II), and pathological correlation: A tertiary care study

Purpose: To study the prevalence of dry eye disease (DED), further categorize using DEWS II protocol, grade squamous metaplasia in each group, and determine associated risk factors in a tertiary care hospital. Methods: This cross?sectional hospital?based study screened 897 patients ?30 years via systematic random sampling. Patients with both symptoms and signs as defined by the Dry Eye Workshop II protocol were considered as DED, further categorized, and subjected to impression cytology. Categorical data were assessed using the Chi?square test. P value < 0.05 was considered statistically significant. Results: In total, 265 (of 897) patients were defined as DED based on the presence of symptoms (DEQ?5 ?6) and at least one positive sign (fluorescein breakup time [FBUT] <10 s or OSS ?4). DED prevalence was thus 29.5% with aqueous deficient dry eye (ADDE), evaporative dry eye (EDE), and mixed type seen in 92 (34.71%), 105 (39.62%), and 68 (25.7%) patients, respectively. The risk of developing dry eye was higher in the age above 60 years (33.74%) and in the third decade. Females, urban dwellers, diabetics, smokers, history of previous cataract surgery, and usage of visual display terminal devices were found to be significantly associated with risk factors of DED. Squamous metaplasia and goblet cell loss were more severe in mixed compared to EDE and ADDE. Conclusion: Hospital?based prevalence of DED is 29.5% with a preponderance of EDE (EDE 39.62%, ADDE 34.71%, and mixed 25.71%). A higher grade of squamous metaplasia was seen in the mixed type compared to other sub?types.

Isolated abscess in superior rectus muscle in a child.

Pyomyositis is a primary bacterial infection of striated muscles nearly always caused by Staphylococcus aureus. Development of the intramuscular abscess involving the extra‑ocular muscles (EOMs) remains an extremely rare process. We herein present a case of isolated EOM pyomyositis involving superior rectus muscle in a 2‑year male child who was referred with complaints of swelling in left eye (LE) and inability to open LE since last 1‑month. Orbital computed tomography (CT) scan showed a well‑defined, hypo‑dense, peripheral rim‑enhancing lesion in relation to left superior rectus muscle suggestive of left superior rectus abscess. The abscess was drained through skin approach. We concluded that pyomyositis of EOM should be considered in any patient presenting with acute onset of orbital inflammation and characteristic CT or magnetic resonance imaging features. Management consists of incision and drainage coupled with antibiotic therapy.

Primary carcinoid tumor of the kidney: Case report and brief review of literature.

Primary carcinoid tumor of the kidney is an extremely uncommon tumor. As a consequence, very little is known about its histogenesis, clinicopathologic features and prognosis. We herein describe a case of renal carcinoid with atypical features.