Comparison of cosmesis, mydriasis, fundus visibility, and anterior chamber depth following single-pass four-throw pupilloplasty in congenital and traumatic iris defects.

PURPOSE: To compare postoperative cosmesis, mydriasis, fundus visibility, and anterior chamber depth (ACD) in congenital and traumatic iris defects after single-pass four-throw pupilloplasty (SFTP). SETTINGS AND DESIGN: Hospital-based non-randomized interventional study. METHODS: SFTP was done along with phacoemulsification in six patients each with congenital and traumatic iris defects, and the patients were followed for a minimum period of 3 months. The postoperative pupil shape, size, mydriasis, and ACD were compared between the two groups. RESULTS: Tissue approximation was successful in 11 out of 12 patients (91.7%), whereas it failed to do so in one patient with traumatic iris tear (8.3%). A central round pupil was attained in all six patients with congenital defects (group 1), whereas in the traumatic group (group 2), a central round pupil was attained in four cases. Group 1 did not show a significant reduction in horizontal pupil diameter, but group 2 had a significant reduction in pupil diameter postoperatively. Mydriasis and fundus visibility were satisfactory in all cases. There was a significant deepening of ACD in both groups. CONCLUSION: Traumatic mydriasis usually requires SFTP at two opposite poles to achieve a central pupil with a significant reduction in pupil size, whereas congenital coloboma requires SFTP to be done at the site of coloboma with occasional enlargement at the opposite pole if the pupil is eccentric.

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.

Clinical and diagnostic color-coding in ophthalmology - An indispensable educational tool for ophthalmologists.

Schematic diagrams have been important tools in Ophthalmology for ages. These are vital tools to document ocular pathologies, assist in the comparison of clinical records on follow-up visits, serve as standardized means of communication between ophthalmologists, educating trainees and postgraduates, and helping in the easy follow-up of disease course over a period. There are standardized color codes for depicting different pathologies in the anterior and posterior segments. The understanding of these guidelines allows proper documentation of findings and helps in standardizing ophthalmic care. This method of documentation is beneficial as this is a less expensive tool, provides immediate records at a glance, allows distinctive marking of clinical findings not possible to document with clinical photographs, and can help in medico-legal cases as well. This article focuses on highlighting the standard guidelines that will be useful for training ophthalmologists. This article primarily focuses on various color-codings for anterior and posterior segment schematic representations, along with a brief touch on the importance of color-coding in glaucoma and standardized eye drop (vials) color codes as per the American Academy of Ophthalmology guidelines. We believe this can be taken as a template for future reference by all trainees, postgraduates, fellows, and clinician ophthalmologists in their day-to-day clinical practice.

Photo-activated chromophore for infectious keratitis cross-linking and its efficacy as a treatment modality in managing microbial keratitis.

Purpose: To assess Photo Activated Chromophore for Infective Keratitis-Cross Linking (PACK-CXL) and its efficacy as a treatment modality in managing microbial keratitis. Methods: Single Centre prospective interventional study in infectious keratitis. A total of eleven patients were taken who had corneal thickness (CT) more than 400µm. PACK-CXL was performed according to Dresden's protocol. The response was assessed by slit lamp examination, BCVA and AS-OCT at the time of complete healing. Results: The mean visual acuity at presentation was 1.207logMAR (0.3-3) which improved to mean value of 0.53logMAR (0.3-1). Mean time taken for complete epithelization was 17.45 days (14- 30 days) and that for complete healing was 33.72 days (21- 60 days). Mean CT at the baseline was 650.5± 108µm which reduced on consecutive follow up visits. There was reduction in the symptoms in nine patients except in two. One case reported increase in symptoms with worsening increase in endoexudates and hypopyon, and the other developed drug toxicity due to topical medications. Conclusion: Patients who underwent PACK-CXL showed good and early healing, good remodelling of cornea and improved visual acuity. The recalcitrant cases became responders to the same medications after PACK-CXL. Thus, PACK-CXL works well for both fungal and bacterial keratitis.

Outcome of UV-B exposure and induction of some chlorophyll phenodeviants in two important hepatoprotective ethnomedicinal wild plants.

Present piece of work has been performed with an aim to engender genetic variations in Andrographis paniculata (Burm f.) Nees and Phyllanthus niruri L. since both plants own low or very poor genetic variations due to wild nature. A. paniculata and P. niruri both are magnificent hepatoprotective wild medicinal plants which have been used since ancient times as an ethnomedicine to cure several common and chronic ailments with the high competence and less side effects. UV-B radiations induce mutations because they are absorbed by major biomolecule predominantly by proteins and nucleic acids chiefly DNA. Owing to enormous potential as herbal medicines, both plants i.e. Andrographis and Phyllanthus have been selected for mutation breeding experiments using Ultraviolet-B radiations (UV-B) as a mutagen. When germinating seedlings of A. paniculata and P. niruri were reached up to 1-3 cm, they were treated with UV-B radiations for 0 min, 10 min, 20 min and 30 min with a recovery period of one hour at room temperature and were planted in earthen pots in triplicates. During observations, significant variations in growth and pigment content have been observed in both plants (A. paniculata and P. niruri) in a dose based manner. A wide spectrum of chlorophyll phenodeviants (chlorophyll deficient mutants) in M2 generation such as xantha, xanthoviridis, alboviridis, virscent and chlorina mutants in A. paniculata and variegated plant, xanthoviridis, xantha and albino mutants in P. niruri have also been observed. Out of all the chlorophyll mutants obtained, few were lethal hence not survived later, while rest were survived till different stages of development. On the basis of occurrence of chlorophyll phenodeviants in Andrographis and Phyllanthus, mutagenic effectiveness and efficiency of different doses of UV-B rays have been indexed. The practice of indexing of effectiveness and efficiency of any mutagen is being used for the successful execution of mutation breeding programs to find the optimum dose that may facilitate induction of a multitude of other lucrative mutations.

Genetic damage induced by a food coloring dye (sunset yellow) on meristematic cells of Brassica campestris L.

We have performed the present piece of work to evaluate the effect of synthetic food coloring azo dye (sunset yellow) on actively dividing root tip cells of Brassica campestris L. Three doses of azo dye were administered for the treatment of actively dividing root tip cells, namely, 1%, 3%, and 5%, for 6-hour duration along with control. Mitotic analysis clearly revealed the azo dye induced endpoint deviation like reduction in the frequency of normal divisions in a dose dependent manner. Mitotic divisions in the control sets were found to be perfectly normal while dose based reduction in MI was registered in the treated sets. Azo dye has induced several chromosomal aberrations (genotoxic effect) at various stages of cell cycle such as stickiness of chromosomes, micronuclei formation, precocious migration of chromosome, unorientation, forward movement of chromosome, laggards, and chromatin bridge. Among all, stickiness of chromosomes was present in the highest frequency followed by partial genome elimination as micronuclei. The present study suggests that extensive use of synthetic dye should be forbidden due to genotoxic and cytotoxic impacts on living cells. Thus, there is an urgent need to assess potential hazardous effects of these dyes on other test systems like human and nonhuman biota for better scrutiny.