Panscleritis masquerading as an attack of primary acute angle closure glaucoma.

Purpose: To report a female who presented with acute angle closure glaucoma and was found to have panscleritis on further evaluation. Method: Case report. Case description: A 50-year-old female was referred to us as a case of primary acute angle closure attack in the right eye and for laser peripheral iridotomy. She had severe pain, redness, a very shallow anterior chamber, and an intraocular pressure of 38 mmHg in the right eye. However, the fellow eye had a deep anterior chamber and the right eye also had severe chemosis, lid edema, scleral tenderness, choroidal folds, and pain during ocular movements which was limited. Ultrasound biomicroscopy showed a ciliochoroidal effusion with anterior rotation of the ciliary body. The ultrasound of the eye revealed an increased thickness of the ocular coats and subtenon fluid. A diagnosis of panscleritis causing secondary angle closure glaucoma was made. She responded well to topical atropine, and topical with systemic steroids. Conclusions: Secondary angle closure glaucoma due to panscleritis may mimic primary acute angle closure attack in a clinical setting. It is important to differentiate the two as treatment is opposite and may worsen the condition if misdiagnosed.

Exploring geospatial techniques for spatiotemporal change detection in land cover dynamics along Soan River, Pakistan.

Classification of land cover dynamics via satellite imagery has played indispensible services in developing effective management strategies for evaluation and management of water resources. The present study employed geospatial techniques, i.e., integrated GIS and remote sensing for effectual land change study. Hybrid classification approach was applied using ERDAS Imagine 11 to detect changes in land cover dynamics using satellite imagery of Landsat 4, 5 TM, Landsat 7 ETM, and Landsat 8 OLI for the years of 1992, 2002, and 2015, respectively. The study area was classified into four categories, i.e., vegetation, water body, barren, and urban area. Resultant maps, overlay maps, and post classification comparison maps were produced using ArcGIS 10.2 indicated remarkable shrinkage of water body up to 58.81%, reduction in vegetation area 53.24%, and increase in urban and barren area to 49.04 and 137.32%, respectively. The significant changes in land cover dynamics of Soan River are posing threats to its survival. Therefore, proper management, policies, and development of land use inventory are needs of the hour for saving Soan River.

Manual suture less small incision cataract surgery in patients with uveitic cataract.

PURPOSE: The purpose of this study is to evaluate the outcome of manual small incision cataract surgery (SICS) in eyes with uveitic cataract. SETTING: Medical college hospital of the subcontinent. DESIGN: Retrospective case series. MATERIALS AND METHODS: In this retrospective study, patients who underwent SICS with posterior chamber intraocular lens implantation for uveitic cataract from 2006 to 2009 were evaluated. Patients with less than 3 months follow-up were excluded. Post-operative vision and complications were analyzed. RESULTS: A total of 54 patients completed the study. The mean age was 52.3 ± 9.3 years. The mean follow-up was 11.53 ± 5.05 months. The mean surgical time was (10.2 ± 3.8 min). Etiological diagnosis was possible in 31.41% (17/54) of patients. There was a statistically significant improvement in vision after surgery (P < 0.001). When uveitis was well-controlled, pre-operative corticosteroids did not change post-operative inflammation (P = 0.796). However, pre-operative corticosteroids were statistically significantly associated to final best corrected visual acuity (BCVA) (P = 0.010). CONCLUSION: SICS with posterior chamber intraocular lens implantation is safe in most cataracts due to uveitis and improves BCVA at 6 months. Inflammation should be well-controlled pre-operatively for at least 3 months. Posterior capsule opacification, macular edema and persistent uveitis were the main factors affecting visual outcome. SICS requires minimal instrumentation, surgical time is short and can also be performed in rural clinics and eye-camps, where phacoemulsification machines are unavailable. SICS may be a more practical and cost-effective technique for uveitic cataract, in such circumstances.