Primary angle closure is an acute medical emergency. There are various predisposing factors in primary angle closure glaucoma such as age > 60 years, female gender, Eastern and Indian Asian race, positive family history, hypermetropia, eyes with short axial length and thicker lens. We report a case of 50 year old female presenting with sudden painful loss of vision in right eye. After control of increased intraocular pressure slit lamp examination was done which showed bilateral phacodonesis. Indirect gonioscopy revealed grade 1 narrow angle in all quadrants in right eye and open angle in left eye. Features suggestive of retinitis pigmentosa in both eyes were found on dilated fundus examination. Laser peripheral iridotomy and cataract extraction was performed in right eye and laser peripheral iridotomy alone was done in left eye. Zonular instabilty with thick anteriorly displaced lens due to retinitis pigmentosa has been found as the main causative factor resulting in angle closure in this case.
Background: Several investigators tried to modify the technique of 20-gauge vitrectomy to preserve the conjunctiva aiming to decrease surgical trauma and time.
Aim: To evaluate the efficacy and safety of 20-gauge trans-conjunctival vitrectomy for various surgical indications.
Setting and Design: A retrospective review of an interventional case series.
Methods: This study included 59 eyes of 58 patients who underwent 20-gauge transconjunctival vitrectomy for variable surgical indications using trocar system with suturing of the sclerotomies at the end of surgery. Postoperative follow up records were reviewed and data collected included best corrected visual acuity (BCVA), intraocular pressure, intraoperative and postoperative complications for 6 months of follow up.
Results: The most common intraoperative complication was slippage of the cannula, occurred in 8 cases (14%); followed by trauma to the lens 4 cases (7%) and lastly retina incarcerated in the cannula 2 cases (3.5%). The post-operative intraocular pressure (IOP) was high in 6 cases (10%). The most common postoperative complication was inferior retinal detachment (RD) 12 (21%) cases, followed by vitreous hemorrhage 4 (7%) cases and lastly epiretinal membrane (ERM) 2 (3%) cases.
Conclusion: The 20-gauge transconjunctival vitrectomy technique is an effective procedure with acceptable results. It allows the use of conventional 20-G instruments with less cost.
Aims: To investigate visuoperceptive abnormalities in adult dyslexics with the TETRA Analyzer™, and to compare the results with those obtained with normal adult readers.
Study Design: Epidemiological study.
Place and Duration of Study: Service of Neuro-Ophthalmology, University of Turin, Italy, between April 2016 and October 2017.
Methodology: Ocular dominance, spatial relationship perception, and interocular visual input have been tested in 25 adolescent and adult dyslexic readers (age 11-34 years) with the TETRA Analyzer™. The TETRA Analyzer™ is a set of 4 exams devised to evaluate ocular dominance (Domitest M), spatial relationship perception (Eidomorphometry), interocular sensory pattern (Domitest S), and their effect of the reading performance (Reading Performance Test, REPORT). Results have been compared with the normative data of a sample of adult subjects (“mature readers”) gathered in a previous investigation.
Results: Compared to mature readers, a higher proportion of adult dyslexics showed dominance instability (20% vs 4%). Average spatial relationship anisotropy was up to threefold higher in adult dyslexics (3.54% vs 1.32% in mature readers). The distribution of the interocular inhibition was bimodal, resembling that of immature readers (children). The reading rate of non words was strongly affected by the inter-letter spacing (R2=0.50, P=.01), in support of an involvement of these alterations in affecting the lexical function.
Conclusion: Defective visuoperceptive functions can play a role not only in children but even in adult dyslexic. The resemblance of dominance, spatial relationship perception and especially interocular inhibitory pattern of adult dyslexics and immature readers may be the sign that a stunt or delay of the normal development of these visuoperceptive functions takes place in a subpopulation of dyslexic subjects.
Aim: To analyse different parameters responsible for occurrence of retinopathy of prematurity (ROP) in neonatal care unit of a tertiary care hospital and to study the associated risk factors.
Materials and Methods: A prospective analytical study was carried out at NICU of KIMS Hospital Hubli, Karnataka. A total of 140 babies with gestational age at birth less than 34 weeks and birth weight less than 1750 grams were examined. Associated prenatal, intranatal and postnatal history was noted down.
Results: Incidence of ROP was found to be 27.14%. Among 140 babies screened. ROP was found in 38 babies among which 20 were males and 18 were females. Stage 1 ROP was in 11 babies (7.85%), stage 2 ROP in 24 babies (17.14%), stage 3 ROP in 2 babies (1.42%) and Aggressive Posterior Retinopathy of Prematurity (APROP) was found in 1 baby (0.71%). Factors which were having association with ROP by univariate analysis are gestational age at birth (p=0.005), birth weight (p=0.005), respiratory distress syndrome (RDS) (p=0.017), oxygen therapy (p=0.020), sepsis (p=0.001) and blood transfusion (p=0.002). Among them factors which were having independent association by multivariate analysis are birth weight (p=0.007, Odds ratio 12.581), sepsis (p=0.022, Odds ratio 5.427), blood transfusion (p=0.009, Odds ratio 23.054).
Conclusion: Incidence of ROP among screened babies is significant. All high risk babies should be screened for ROP and all eligible babies should be advised treatment. Risk factors which were having independent association with ROP are birth weight, sepsis and blood transfusion.
Purpose: To evaluate the impact that the pupil size and the crystalline lens opacification have on optical coherence tomography (OCT) accuracy and the necessity of pupil dilation for the examination of the nerve retinal fibber layer and the macula.
Methods: One hundred fifty six eyes of 156 patients separated in two distinct groups, were examined with OCT (Stratus 3000), before and after pharmacological mydriasis. The first group consists of 78 patients with clear optical media while the second consists of 78 patients with lens opacification according the Lens Opacities Classification System III (LOCS III). The fast RNFL thickness protocol was used to evaluate RNFL thickness and the fast macular scan pattern thickness for the macula thickness and volume.
Results: No significant statistically differences were found between the pupil size, the quality of the signal (P>10%) and also between the pupil size and all of the parameters examined, of both groups (P>10%). Instead the signal quality was found significant different before and after mydriasis (P<0,001) without influence on the measurements accuracy.
Conclusion: Pupil dilatation increases the signal strength of the examination but has no impact on the accuracy of the OCT scan. OCT for the RNFL and the macular thickness parameters can be performed with physiological pupil size and in cases in which mydriasis is difficult, incomplete or is contraindicated.
Purpose: To compare the short term effects of preserved prednisolone acetate to preserved nepafenac eye drops on punctum size.
Methods: The punctum size (inner diameter, outer diameter and height) as well as tear meniscus (height & area) were evaluated using AS-OCT in 50 eyes of 48 patients who were scheduled for phacoemulsification. Post operatively, eyes were randomized to receive either prednisolone acetate (group A) or nepafenac eye drops (group B) for 3 weeks. Punctal size and tear meniscus were re-measured at 2 weeks, 1 month and 3 months post-operatively.
Results: Punctum size measurements showed no statistically significant differences between the 3rd month post-operative visit and the pre-operative evaluation in either group (p-values: >0.05). There was no statistically significant difference between both groups (p-value: >0.05 for all the parameters). Tear meniscus height and area showed statistically significant increase in both groups compared to preoperative values at the 2nd postoperative visit (p-value = 0.046 and 0.019 in group A compared to 0.001 for both in group B).
Conclusions: Short term preserved prednisolone acetate and nepafenac eye drops have no effect on the lacrimal punctal size. Benzalkonium chloride has a short term effect on tear film stability observed as increased tear meniscus parameters on AS-OCT.
Cornea is a transparent structure present at the center of eye, which acts as a protective barrier against harmful objects and plays an important role in vision. Corneal disorders are major cause of concern as they have fatal ocular consequences. These disorders may be due to any degenerative disorders like keratoconus or have infectious origin or dystrophies due to hereditary causes. They can lead to visual impairment or sometimes vision loss, if not treated ontime. Visual disability of cornea due to infectious etiology is preventable if identified and treated earlier. Infective corneal ulcers or microbial keratitis is more common among all corneal diseases. Other corneal diseases due to infectious origin are herpes zoster ophthalmicus, peripheral ulcerative keratitis and phlyctenular keratoconjunctivitis. There is availability of advance diagnostic techniques to identify these diseases in earlier stage, which can guide appropriate therapeutic options. There is a need of knowledge and awareness about these diseases for identification, proper management and prevention of ocular morbidity.