Assessment of prevalence of dry eye among medical students using ocular surface disease index questionnaire - Is COVID-19 to be really blamed?

Purpose: An undergraduate research conducted during the pre-covid times, to highlight the importance of screen time and its association with dry eye in medical students. The aim was to study the prevalence of dry eye among medical students using the ocular surface index (OSDI) questionnaire. Methods: This was a cross-sectional study. This study was conducted among medical students using an OSDI questionnaire in the pre-covid times. Based on the pilot study, the minimum sample size calculated was 245. A total of 310 medical students participated in the study. These medical students answered the OSDI questionnaire. The OSDI score was used to categorize students with dry eye as mild (13-22 points), moderate (23-32 points), and severe (33-100 points). In addition, the associations between the OSDI score and possible risk factors such as gender, contact lens/spectacle wear, laptop/mobile usage, and duration of exposure to air conditioners were also studied. Results: The analysis of the study revealed that out of 310 students, dry eye was seen in 143 (46.1%) and severe dry eyes were seen in 50 (16.1%). A high OSDI score (>13 points) was associated with the usage of a laptop/mobile for more than 6 h in 40 (52.6%) (P < 0.001). Conclusion: The prevalence of dry eye among medical students was 46.1% in the present study. Longer duration of usage of visual display units (laptop/mobile) was the only factor that showed a statistically significant association with dry eye in our study.

Diabetic retinopathy in patients with diabetic foot syndrome in South India.

Purpose: The purpose was to study the retinopathy status in diabetic patients with a risk of diabetic foot (DF) syndrome visiting a tertiary care hospital in South India. Methods: In this cross sectional study all patients with diabetes mellitus (DM) with a risk of DF syndrome, visiting a tertiary care hospital during the study period, underwent an ophthalmological evaluation for documentation of their retinopathy status. Results: One hundred and eighty-two patients diagnosed to have a risk profile for DF syndrome were included in the study. Their mean age was 59.28 years and 75.27% were males. The mean duration of Type 1 and Type 2 variants of DM was 14.9 years and 10.9 years, respectively. Of the 182 patients, 67.58% had retinopathy changes. Proliferative diabetic retinopathy (DR) constituted 17.88% of the total patients with retinopathy. An increased presence of retinopathy in patients with an increased risk grade of DF was found significant by the Chi-square test (P < 0.001). Conclusion: Our study found an increased presence of DR in a South Indian cohort with DF syndrome. The severity of retinopathy was greater in patients with higher grades of risk for DF. The establishment of an association between DR and DF syndrome will help in developing an integrated management strategy for these two debilitating consequences of diabetes.

Morphometric Analysis of Peripapillary Thickness in Hypertensives and Normotensives using Optical Coherence Tomography (OCT).

INTRODUCTION: Hypotension following antihypertensive treatment is associated with retinal nerve fibre loss. There are studies that have reported the changes in RNFL in hypertensives. AIM: To compare the Retinal Nerve Fibre Layer (RNFL) thickness using Optical Coherence Tomography (OCT) in hypertensive and normotensive individuals. MATERIALS AND METHODS: The cross-sectional study was conducted from October 2012 to September 2014 to compare the RNFL thickness using SD OCT in hypertensive {no other ocular or systemic co-morbidity, vision better or equal to 6/9 (n=30)} and normotensive (n=30) individuals. RESULTS: Statistically significant RNFL loss was detected in hypertensives (98.31 ± 7.01) when compared to the normotensives (102.51 ± 8.72) p=0.001. CONCLUSION: Significant loss of RNFL in hypertensives point towards the altered autoregulation and warrants larger studies to assess the clinical relevance.

Orbital cellulitis with periorbital abscess secondary to methicillin-resistant Staphylococcus aureus (MRSA) sepsis in an immunocompetent neonate.

This article advocates the need for early incision and drainage of periorbital abscesses. We report a case of a 1.5-month-old neonate with orbital cellulitis and periorbital abscess, which had rapidly developed over a period of 3 days. Treatment history revealed methicillin-resistant Staphylococcus aureus sepsis treated with intravenous vancomycin, and incision and drainage of abscesses at multiple sites (left parotid region, upper and lower limbs). A small swelling noted on the left temporal region on discharge from the hospital was treated with oral cotrimoxazole. However, it spread rapidly to involve the periorbital tissue and the bones of the orbital walls to form a periorbital abscess and orbital cellulitis.

Primary orbital chronic granulomatous reaction to deep staphylococcal infection due to trauma in immunocompetent.

A 53-year-old man presented with a slow-growing mass in the right orbit and temporal area of 1 year duration following a road traffic accident. Examination revealed a nodular fungating mass involving the orbit, right temporal area with multiple discharging sinuses causing proptosis and restricted ocular motility. The patient denied light perception in the right eye. There was exposure keratopathy and optic atrophy. Imaging showed mass lesion of the orbit extending intracranially. Tissue biopsy and culture revealed a chronic granulomatous reaction due to deep infection with coagulase-positive staphylococci. The patient showed remarkable improvement to systemic antibiotics and anticonvulsants. Mortality is high in such cases due to intracranial extension if there is a delay in treatment. This case report summarises a rare aetiology and successful treatment of a case of chronic granulomatous reaction due to deep bacterial infection following trauma and is deemed rare as cases of primary orbital infection in immunocompetent have not been reported so far.

Assessment of awareness of diabetic retinopathy among the diabetics attending the peripheral diabetic clinics in melaka, malaysia.

In view of the alarming increase in the incidence of diabetes mellitus in Malaysia, we conducted a study to assess the awareness of complications of diabetes among the diabetics attending the peripheral clinics in Melaka. The study period was from January 2007 to December 2007. 351 patients were included in the study. 79.8% were aware of the complications of diabetes mellitus and 87.2% were aware that diabetes can affect the eyes. However, only 50% of the patients underwent an ophthalmological evaluation. Although awareness was good, the motivation to undergo the assessment was poor.

Eye donation - awareness and willingness among attendants of patients at various clinics in Melaka, Malaysia.

AIM: Corneal blindness accounts for 3.42% of blindness in Malaysia; the rate of eye donation is low. The aim of the study was to assess the awareness about eye donation and willingness to donate eyes among attendants of patients at various clinics in Melaka, Malaysia. MATERIALS AND METHODS: This observational study was conducted on attendants who accompanied patients (n = 400) visiting various outpatient departments of the General Hospital and two peripheral clinics in Melaka between August and October 2007. The participants answered a questionnaire (Malay and English versions) which included demographic profile, awareness of eye donation, knowledge regarding facts of eye donation, and willingness to donate eyes. Univariate and multivariate logistic regression was performed at 5% level of significance. RESULTS: Awareness of eye donation was observed in 276 (69%) participants. Multivariate analysis showed that awareness was more among females when compared to males (P = 0.009). Of the 276 participants who were aware of eye donation, only 34.42% were willing to donate eyes. Willingness was more among the Indian race (P = 0.02) and males (P = 0.02). Educational status did not influence the willingness to donate eyes. CONCLUSIONS: Although majority of participants were aware of eye donation, willingness to donate eyes was poor.

Descriptive study on ocular survival, visual outcome and prognostic factors in open globe injuries.

A prospective observational study was done to assess ocular survival, visual outcome and prognostic factors of open globe injury. Eighty eyes of penetrating trauma between 2004 and 2006 were categorized according to the ocular trauma classification system. Primary repair was done and outcomes were assessed at one, three and six months. The final vision was categorized as per World Health Organization classification of visual impairment. Factors at presentation were evaluated for prognostic value towards visual outcome. Sixty-nine eyes with minimum one month follow-up were included for analysis. Statistical analysis was done using Univariate and Multivariate analysis. We found Grade IV visual acuity (< 5/200) at presentation (64%) as the most important factor contributing to poor visual outcome. Statistically insignificant factors were time since injury, cataract, and presence of intraocular foreign body. Ocular survival was 97%. We concluded that initial visual acuity, hyphema, zone and length of injury, retinal detachment and vitreous hemorrhage are statistically significant factors affecting outcome in open globe injuries.

Bilateral macular hole secondary to remote lightning strike.

We report a case of a 16-year-old girl, who was struck by lightning, and experienced blurred vision in the right eye (RE) immediately following the episode. She reported for ophthalmic evaluation two months later. Examination revealed relative afferent pupillary defect in the RE. Posterior subcapsular cataract was noted in both eyes. Fundus examination revealed macular holes and multiple areas of RPE hyperpigmentation in the periphery in both eyes. Fundus fluorescein angiography showed increased choroidal transmission with early fluorescence and late fading in the foveal region and retinal pigment epithelium (RPE) stippling in the periphery in both eyes. This is the first case report of such nature in India to the best of our knowledge.