Pseudoexfoliation syndrome is a multifactorial diffuse disease and is diagnosed clinically on slit lamp examination of the eye by the deposition of white, dandruff like material on different structures in anterior segment i:e corneal endothelium, iris, pupillary margin, anterior lens capsule, zonules and trabecular meshwork. The aim of study was to study demographic features, intraoperative and postoperative complications and the visual outcome of cataract surgery in pseudoexfoliation patients. 93 eyes of 93 patients with pseudoexfoliation posted for cataract surgery were included in the study. 79.56% patients were of more than 60 years of age group.43 patients were male and 50 patients were female. 44 patients had pseudoexfoliation syndrome in both eyes and 49 patients had either right eye or left eye involvement. Intraoperative problems encountered were poor pupillary dilatation, capsular bag prolapse, zonular dehiscence, posterior capsular rent, residual cortical matter and positive vitreous pressure. Postoperative complications reported were corneal edema, raised intraocular pressure, significant anterior chamber cell reaction, left cortical matter and exudative membrane. Best corrected visual acuity was more than 6/18 in 67 eyes, between 6/60-6/24 in 16 eyes, and less than 6/60 in 10 eyes. At 1 month, best corrected visual acuity was more than 6/18 in 92 eyes. Cataract surgery in pseudoexfoliation patients is associated with high risk of complications. Use of iris hooks and capsule tension rings where required during the surgery can decrease the intraoperative complications and thus will give better visual outcome.

Evaluation of success rate of manual DSEK in terms of central corneal thickness and BSCVA in patients of PBK. : Prospective, non-comparative, interventional study of 18 patients of PBK, who underwent manual DSEK between June 2021 to May 2022 with minimum six months to maximum 15 months post-operative follow up. DSEK lenticule was prepared by manual dissection. Push in technique with 26 G needle was used for graft insertion. Preoperative and post-operative CCT and BSCVA were measured and compared. : Preoperative central pachymetry in patients (n=18) was (832±162) μm which significantly reduced in the post operative period. The mean thickness of lenticule on day 1 post op was 203±93.5μm which became 156±76 μm (p =.0436) at 6 months and remained almost same till last follow up. Pre operative BSCVA ranged from HM to 2/60 in these 18 patients which was improved in 16/18 eyes post DSEK. Eighty eight percent (15/17) patients had regained BSCVA of 6/60 to 6/12. In early post operative period, complications noted were, partial detachment of lenticule and pupillary block glaucoma which were managed accordingly.: Manual DSEK is feasible, low-cost widely accessible alternative to DSAEK/DMEK for patients of PBK with good visual outcome in resource limited settings.: Manual DSEK has short learning curve and it’s training should be imparted to corneal surgeons for better outcome in PBK and other causes of endothelial decompensation.

To analyze different ophthalmic manifestations of rhino-orbital mucormycosis (ROM) infection in COVID-19 patients. Prospective interventional clinical study.20 microbiologically confirmed ROCM cases with ophthalmic involvement hospitalized between May 2021 and July 2021 in our center were included in this study. Among 20 cases there were 9 female and 11 male with a mean age of 57.5 years. All 20 patients had uncontrolled type 2 diabetes with a mean diagnosis duration of 3.67 years. All patients had COVID-19-associated acute respiratory distress syndrome and received corticosteroids. The mean time interval between COVID-19 diagnosis and ROM diagnosis was 3.46 days. 4 patients (20%) had orbital apex syndrome, and 16 patients (80%) presented with orbital cellulitis. CT scan/MRI revealed sino-orbital involvement in all patients, and 3 of these had cerebral involvement at initial presentation. All 20 patients received intravenous amphotericin B and 7 patients received TRAMB and all 20 patients had undergone radical debridement of involved sinuses. Despite all measures, 3 (7.5%) of 20 patients with cerebral dissemination expired. Severe COVID-19 is associated with a significant incidence of ROM with higher mortality rates due to immune dysregulation and the widespread use of steroids. An aggressive multidisciplinary approach can help to reduce mortality.

A 52-year-old male patient presented with a chief complaint of diminution of vision over the past two months. He is a known case of type -2 diabetes mellitus for 25 years but has not been taking his medication regularly. Ocular examination revealed visual acuity of 6/18 in both the eyes, xanthelasma, arcus senilis, posterior segment examination revealed creamy white discolouration of the retinal vessels. Routine blood investigation revealed high level of triglycerides (1550 mg/dl), cholesterol (615 mg/dl), LDL-C 10 mg/dl, HDL-C (187 mg/dl), and with HBA1C of 14.4%. Hence, diagnosed this case as lipaemia retinalis. The patient was referred to a physician for treatment, and after treating with statins, lipid-lowering therapy, and blood sugar control, the patient was reviewed every month; six months later, the patient had normal retinal vessels and improved visual acuity, in addition to normal triglyceride, cholesterol, and blood glucose levels.

An overview on Anti-Vegf and in search for an ideal anti VEGF agent - IJCEO- Print ISSN No: - 2395-1443 Online ISSN No:- 2395-1451 Article DOI No:- 10.18231/j.ijceo.2022.092, Indian Journal of Clinical and Experimental Ophthalmology-Indian J Clin Exp Ophthalmol

To describe the epidemiology, patterns of ocular trauma, clinical presentation, visual outcome and prognostic factors of blunt ocular trauma.A teaching hospital based prospective observational study was conducted over a period of 4 years from March 2012 to Feb 2016. 226 patients of all age group fulfilling the various inclusion and exclusion criteria were included in the study. All patients underwent detailed protocol based workup including a comprehensive ocular examination along with relevant radiological tests. Data regarding demographic profile, etiology, circumstances of the injury, traumatic agents, mode and mechanism of injury, extent and severity of injury, clinical features, management and visual outcome was analyzed and prognostic factors including ocular trauma score were evaluated.Out of 402 total cases of ocular trauma, 226 caused by blunt objects were included in this study. 181 (80.1%) were male rest 45(19.9%) were female. The mean age was 42.6 ± 18.8 years. Blunt trauma was more prevalent in age group 16-25yrs (24.3%) followed by 26-35 years (23.9%). Majority (68.6%) of victims belonged to rural background. Most of the patients sustained trauma at road /street (30.5%) and home (27.9%). The most common cause of blunt trauma was road traffic accident (26.5%) followed by sports related injury (22.6%) and physical assault (21.7%). The most frequent traumatic agent was wooden object (26.0%) followed by stone / brick (25.2%) and metallic object (23.1%). Only 32.3% of patients had isolated ocular injuries, rest had associated polytrauma. 93.3% victims had unilateral ocular injury. Left eye (52.3%) was predominantly involved. Majority of injured eyes had more than 3 ocular structure involvement. Out of 241 injured eye 14.0% eyes had only globe injury while 61.4% eyes had simultaneous globe and adnexal injuries. 55.6% eyes had closed globe injury while 19.9% eyes had globe rupture. 20.7% eyes had purely posterior segment injury, while 23.2% eyes had both anterior and posterior segment injury. Most common clinical finding was corneal abrasion (45.6% eyes) followed by hyphema (44.0% eyes), traumatic mydriasis (35.7%), vitreous hemorrhage (33.2%) retinal detachment (20.3%), lens dislocation (22.8%) and traumatic cataract (17.4%). At the time of initial presentation 33.2% eyes had visual impairment and 35.7% eyes had blindness. 14.5% eyes with closed globe injury and 5.0% eyes with open globe injury had zone III injury. Ocular trauma score was in Category I in 14.9% injured eyes and in category II in 7.1% eyes. After 6 months 14.5% of the right eye and 24.2% of the left eye showed blinding outcome.Blunt trauma is the commonest mode of ocular injury. Young adult males are more vulnerable. Intraocular hemorrhage, zone III injury, posterior segment involvement and low ocular trauma score are poor prognostic factors.

Oculomyiasis: An overview - IJCEO- Print ISSN No: - 2395-1443 Online ISSN No:- 2395-1451 Article DOI No:- 10.18231/j.ijceo.2022.089, Indian Journal of Clinical and Experimental Ophthalmology-Indian J Clin Exp Ophthalmol

Pseudoexfoliation (PXF) syndrome is an age-related process of unknown etiology characterized by the deposition of distinctive fibrillar material in the anterior segment of the eye. The material is commonly deposited in the anterior chamber, angle of the eye, iris, trabecular meshwork, anterior capsule of the lens, and also the cornea. It is associated with open and narrow angle glaucoma, the formation of cataracts and the corneal endothelial decompensation.PXF deposition in the lens zonules leads to disintegration of the lens zonules resulting in lens subluxation and dislocation. PXF deposition on the iris causes poor pupillary dilatation. Both zonular dehiscence and poor pupillary dilatation pose a great challenge to the cataract surgeon during surgery. Intra operatively, the chances of lens subluxation / dislocation, posterior capsular rupture, vitreous loss is high in the presence of pseudoexfoliation. In the immediate post-operative period, intra ocular pressure spikes, increased and prolonged iritis and corneal decompensation can affect the visual outcome of the surgery. This study will retrospectively analyze the clinical profile of the patients with pseudoexfoliation and to evaluate the occurrence of intra and immediate post-op complications of cataract surgery. In this way, the surgeon can plan his/her surgical technique to help avoid complications during cataract surgery and be prepared to manage the potential intraoperative and postoperative complications that can occur in pseudoexfoliation eyes.

: Purpose is to study the various typical and atypical manifestations of the retinoblastoma presented to our department.: Prospective study.: 2 years, January 2020 to December 2021.: All children presented with various signs and symptoms and cases with tumour suspicious manifestations were evaluated. Detailed birth history from parents, slit lamp examination, indirect ophthalmoscopy, B Scan, CT Scan Orbit (plain and contrast), MRI Orbit (plain and contrast) when tumour extension was suspected and documentation done in all cases.: Atypical manifestations requires proper evaluation to exclude Pseudo retinoblastomas. Many clinical conditions will masquerade the tumour and cause confusion in diagnosis. Pseudo retinoblastomas which reported in our study were commonly PHPV and Coats disease. One case of Retinoblastoma was also presented like Ocular cysticercosis with inflammatory signs in anterior and posterior segment, oral steroids were given, vitreous seeds which were present in anterior chamber disappeared after steroids and fundus showed creamish white lesion filling the entire vitreous cavity. Masquerades will cause delay in the diagnosis, which can lead to extension of tumour.: Diagnosis is not easy, most of the times in children particularly when media is not clear, delay in diagnosis may require enucleation where globe salvage may not be possible, sometimes intracranial extension of the tumour will increase the mortality.

The aim of this study was to identify the factors influencing the duration of spontaneous regression of Retinopathy of Prematurity. A prospective observational study was conducted over a duration of 1.5 years from December, 2019 to May, 2021. All the infants presenting with ROP or developed any stage later were considered for the study and were followed up as per International Classification of Retinopathy Guidelines (ICROP), 2005 guidelines till compete vascularisation. Data regarding the birth history and maternal factors were noted. In those neonates in whom the Retinopathy of Prematurity presented or progressed to type 1 ROP were treated and the rest were followed up till complete vascularisation and duration noted. Risk factors were compared in neonates undergoing spontaneous regression within 45 weeks PMA and those taking longer than 45 weeks. The Statistical analysis was performed by SPSS 23.0 version. Mean gestational age in neonates undergoing earlier spontaneous regression (<45 weeks) was 31.86±2.02 months, and that of delayed spontaneous regression group was 33±2.24 months. Mean birth weight in earlier spontaneous regression group was 1537.14±202.02 grams, and that delayed spontaneous regression group was 1406.19±229.88 grams. Mean duration of complete regression of ROP is 44.9 weeks postmenstrual age. Higher birth weight and Hyperbilirubinemia was found to significantly cause the regression of ROP within 45 weeks (P=0.021). Higher birth weight and Hyperbilirubinemia was found to cause earlier regression of ROP and hence could be a possible protective factor in the pathogenesis of ROP.

To evaluate and compare the efficacy of reduced-fluence photodynamic therapy (PDT) with standard-fluence photodynamic therapy in treating polypoidal choroidal vasculopathy. Twenty-eight eyes (27 patients) with polypoidal choroidal vasculopathy were retrospectively analysed; 14 eyes received Indocyanine green angiography-guided standard-fluence (SF) PDT (50 J/cm) and 14 eyes received Indocyanine green angiography-guided reduced-fluence (RF) PDT (25 J/cm). Primary outcome measured after 6 months of treatment were the changes in mean BCVA, polyp regression, polyp PED height, central choroidal thickness (CCT), post PDT intravitreal anti VEGF injection need and complications. Results of both the groups were comparable at 6 months follow up. Mean change in log mar visual acuity at 6 months for the SF PDT group was 0.12 compared to 0.13 for the RF PDT group (p = 0.919). Mean change in PED height at 6 months for the SF PDT group was 159 μm compared to 172 μm for the RF PDT group (p = 0.06). Mean change in CCT at 6 months for the SF PDT group was 45μm compared to 10μm for the RF PDT group (p = 0.96). While the SF PDT group needed a mean of 2 injections post PDT, the RF PDT group required a mean of 3 injections during the course of 6 months follow up. Neither of the group reported any adverse effects following the procedure. Our study demonstrated that reduced-fluence PDT is at least on par with standard-fluence PDT in management of PCV.

Oculo-cardiac and other oculo-visceral reflexes - IJCEO- Print ISSN No: - 2395-1443 Online ISSN No:- 2395-1451 Article DOI No:- 10.18231/j.ijceo.2022.090, Indian Journal of Clinical and Experimental Ophthalmology-Indian J Clin Exp Ophthalmol

To emphasize the importance of Posterior Reversible Encephalopathy syndrome (PRES) as the cause of sudden vision loss during pregnancy in patients with acute haemodynamic instability like preeclampsia, eclampsia, severe PIH.: In this prospective observational study pregnant women within age group of 25-40 years presenting with acute onset of visual, neurological symptoms to the emergency department were examined. Blood pressure recorded. Patients vision was recorded using snellens chart at the time of presentation and after the recovery. Slit lamp examination, fundus examination, pupillary reactions were noted to rule out other causes of vision impairment. MRI was done to detect PRES. Patients were stabilised and their blood pressure was monitored and treated with intravenous anti hypertensives.: 8 out of 10(80%) of the pregnant women presented with sudden vision impairment were preeclamptic and 2 out of 10(20%) were with features of eclampsia. Majority were in third trimester. All the patients were diagnosed early with PRES on MRI and regained vision within 2 days with immediate treatment with intravenous antihypertensives.Posterior Reversible Encephalopathy syndrome has to be kept in mind as one of the differential diagnosis while examining the pregnant women with eclampsia, preeclampsia, PIH coming with sudden visual impairment.

A 40-year-old male presented with a history of caterpillar fall in his right eye with subsequent foreign body feeling, discomfort, and redness to a tertiary care facility in southern India. His best corrected visual acuity in both eyes was 6/6. The IOP in both eyes were within normal range. Multiple caterpillar hairs were seen during a thorough examination of the right eye, in the palpebral conjunctiva, the superficial and deep corneal stroma, and the anterior chamber. There was no anterior chamber reaction. The fundus examination were within normal limits. Under topical anaesthesia, caterpillar hairs in the conjunctiva were removed with the help of forceps. The patient was started on topical steroids and antibiotics. The patient was carefully monitored. The patient's symptoms had improved. During the next visit, caterpillar hairs in the superficial cornea was removed. Despite having hairs in the anterior chamber, this patient had no anterior or posterior chamber reactivity. Two hairs on the iris were visible during the next follow-up, but there were none in the cornea or conjunctiva. The patient is still being followed up on regular basis (9 months). Caterpillar hairs have the capacity to move intraocularly through the cornea and are known to elicit an inflammatory response in the eye. Therefore, it is important to be aware of the potential for intraocular inflammation following the quiescent stage.

A 40-year old female came with complaints of headache for 5 days. Her general examination and vitals were within normal limits. On complete ophthalmic examination we found there are irregular streaks radiating from disc in the fundus of both the eyes suggesting of angioid streaks. We did a dermatological evaluation in view of increased stretchability of skin and papules over neck & thigh and diagnosed as pseudoxanthoma elasticum. So we diagnosed as angioid streaks with pseudoxanthoma elasticum also known as Groenblad-Strandberg syndrome.

Ligneous Conjunctivitis is an autosomal recessive, chronic form of conjunctivitis characterized by formation of pseudo-membrane particularly over tarsal conjunctiva attributed to plasminogen deficiency. Various forms of medical and surgical treatment modalities have been reported. We are reporting a case of ligneous conjunctivitis in a nine month old baby managed successfully with both topical and intravenous fresh frozen plasma, topical heparin and cyclosporine.

The retinal nerve fibre layer is a most crucial indicator of optic nerve damage in glaucoma as it advances visual field loss. Thickness of the RNFL can be measured using high resolution OCT. We conducted this study to evaluate the alterations in retinal nerve fibre layer thickness measured by SD- OCT in ametropes and to find various factors affecting RNFL thickness.: Study of retinal nerve fibre layer thickness (RNFL) by Optical Coherence Tomography (OCT) in ametropes in tertiary care hospital of central India.Hospital based prospective observational study included 300 eyes of 150 participants. Visiting ophthalmology outpatient department Gandhi medical college and fulfilling the inclusion and exclusion criteria.: Patients were divided into five groups of 60 eyes each on the basis of refractive status of eyes into emetropia, low hypermetropia, moderate hypermetropia, low mypopia and moderate mypopia. Subjects were subjected to OCT scan and RNFL thickness was measured. All groups were evaluated and observations were noted and results were analysed. To find the association between degree of ametropia and RNFL thickness one way ANOVA test was used. Correlation between axial length and RNFL was assesed by pearson correlation coefficient. p value <0.05 was considered as significant.: RNFL thickness in different groups followed ISNT rule with inferior quadrant showing the greatest thickness followed by the superior, nasal and temporal quadrants. The average RNFL thickness in emmetropics, Low hyperopic, Moderate hyperopic, Low myopic, Moderate myopic was 111.90μm, 110.58 μm, 114.59 μm, 103.33 μm, 93.33 μm respectively, wheras average axial length was 23.85mm, 22.36mm, 21.33mm, 24.72mm, 25.63mm.: With the help of OCT, we can differentiate the changes in RNFL thickness in various refractive errors. So, the refractive status of the eye should be kept in mind before making any ocular diagnosis in which the RNFL is a diagnostic criteria.

The study was conducted to observe the pattern of ocular morbidities in patients attending the ophthalmology department during the COVID-19 pandemic.: A prospective observational study was conducted in a tertiary eye care centre in Central India from 1 January 2020 to 31 December 2020, among a total of 982 patients with ocular manifestations who attended the outpatient department or emergency department. A detailed history was taken and a complete anterior and posterior segment examination was done. The standard investigation and treatment protocol of the institution was followed in all cases.: A total of 982 patients were enrolled in our study with a mean age of 36.42±18.05 years. Male preponderance was noted with an M: F ratio of 2.43. A wide spectrum of ocular manifestations during COVID-19 was observed. The anterior segment was involved in 85.1% and the posterior segment was involved in 14.9% and most common ocular manifestations affecting the anterior segment were noted as computer vision syndrome observed in 18.1% cases, followed by cataracts in 11.4% cases. : Various programs should be implemented to help in reducing the load of visual disability and blindness in the community which is increased after the COVID outbreak. With changing trends in geographical and socio-economical patterns of diseases, similar kinds of a pandemic may occur in the future. There should be formation of flexible government strategies for changing dynamics that can be timely implemented in the future for better management of curable/avoidable diseases.

Quantitative analysis of determinants of dry eye among patients undergoing phacoemulsification surgery. This was a single-centered hospital-based, prospective observational study. Sixty eyes of sixty patients suffering from senile cataract undergoing phacoemulsification surgery were evaluated after randomly selecting them and were followed up postoperatively on day 1 and week 4 to evaluate the dry eye parameters selected for the study.A total of 60 eyes of 60 patients were chosen with a mean age of 63.96 ± 6.95 (mean ± SD) years. The mean baseline Schirmer’s test I, tear break-up time, lissamine test, and OSDI values were 25.45 ± 4.68 mm, 14.15±2.79 s, 1.26 ± 0.44 s, and 7.28 ± 3.13 respectively, whereas post-operatively day 1 the values were 14.75 ± 4.32 mm, 8.91 ± 2.93 s, 3.11 ± 0.78, and 22.85 ± 6.80 respectively. On 4 week follow-up, the value were 22.60 ± 4.54 mm, 13.30 ± 2.79 s, 1.43 ± 0.67, and 12.13 ± 5.45 respectively.Dry eye after cataract surgery is mainly because of tear film stability.The study points to the fact that patients experience increase in dry eye symptoms postoperatively. We also observed a very predictable trend of dry eye in our study, wherein the incidence increases immediately in the early postoperative period, followed by a gradual decrease in dry eye parameters approaching their preoperative baseline value.

: To study the various tissue preparation and preservation which affect the quality of donor tissue along with the effect of recipient factors on short term graft survival. The ambi-spective study was carried out in order to know predictive value of factors like donor, tissue preservation and recipient factors and the extent of the effect on short term graft survival. A total of 26 eyes of 13 donors were studied, out of which 23 eyes had undergone penetrating keratoplasty. Out of 23 eyes, 3 eyes had undergone therapeutic penetrating keratoplasty, 16 eyes undergone optical penetrating keratoplasty and 4 eyes undergone triple procedures; penetrating keratoplasty with cataract extraction with posterior chamber intra ocular lens implantation. The results of penetrating keratoplasty were studied over a period of 3 months with follow ups at 1 week, 1 month and the final follow up at the 3rd month. The indication for penetrating keratoplasty in recipients in this study were essentially optical and therapeutic. The Statistical analysis was performed by SPSS 23.0 version. Categorical variables were described by taking percentages (analyzed using Chi Square test; Subgroup analysis was based on Adjusted Standardized Residuals). The variables with p value <0.05 was considered as statistically significant. Recipients with donor tissue from eyes retrieved within 4 hours of death and shorter preservation to utilization time have shown better graft survival. Practices including lid closure and eye drop instillation should be encouraged. Hospital cornea retrieval program should be promoted to ensure lesser death to enucleation time and preservation time for better graft outcome.

Application of cavitron ultrasonic surgical aspirator (CUSA) in orbital surgeries - IJCEO- Print ISSN No: - 2395-1443 Online ISSN No:- 2395-1451 Article DOI No:- 10.18231/j.ijceo.2022.091, Indian Journal of Clinical and Experimental Ophthalmology-Indian J Clin Exp Ophthalmol

To identify various causes of visual impairment in patients seeking visual disability certificate and study the demographic characteristics of visually disabled population. Cross-sectional study of patients seeking visual disability certificate from November 2014 to April 2015 was done. Cause of visual impairment was ascertained after detailed examination which included slit-lamp examination, direct ophthalmoscopy, indirect ophthalmoscopy, slit-lamp biomicroscopy with 90D lens, Optical Coherence Tomography (OCT) and/or ERG/VEP and MRI, CT scan, Ultrasonography (USG) in selected cases.Out of 250 cases in the study, most of them were in the age group of 21-40 years (44.80%). Mean age was 34.25 years. Male cases (192) were more compared to female (58) in this study. Male to female ratio was 3.31: 1. The cause for which most disability certificate issued was congenital anomalies (18.40%) followed by Other Retinal Pathology (15.20%) and retinitis pigmentosa (14.80%) and least were staphyloma (4%) and empty socket (4.80%). High number of eye were blind due to congenital diseases and retinitis pigmentosa explains the need of genetic counselling. Avoiding trauma, early diagnosis and treatment is necessary to prevent blindness from avoidable causes. Rehabilitation includes the provision of vocational and functional training as well as social and legislative service support. This is with a view to enhancing the chances of the affected individuals particularly children, who have their whole life ahead of them, to acquire a means of livelihood, improved social interaction and enhanc self-dignity.

Patients with preeclampsia or eclampsia may be associated with hypertension, seizures and other neurologic symptoms and deficits. A young female patient presented with a neurological and visual disturbance which included variable symptoms like visual disturbances, headache, seizures and altered consciousness or mental status with a history of postpartum eclampsia after an uneventful LUCS. She also gave a history of a two-bag blood transfusion one month ago. A neurological and ophthalmic evaluation was performed. Detailed history taking and clinical evaluation followed by an imaging study, potentially magnetic resonance imaging (MRI), helped to confirm the diagnosis of Posterior reversible encephalopathy syndrome (PRES). PRES is a clinico-neuroradiological disorder of neurotoxicity that typically involves headache, mental confusion, seizures, and occasionally loss of vision. The exact pathophysiology of PRES is still unclear and has not been thoroughly explained. Hypertension and endothelial cell injury may be pathognomic. Prompt management may help to recover early.

Episcleritis and scleritis are both inflammatory disorders of the eye and may have underlying systemic disorder precipitating them. Therefore a thorough clinical examination and laboratory investigations are needed to rule them out. Systemic conditions that have been associated include rheumatoid arthritis, Wegener’s granulomatosis, systemic vasculitis, systemic lupus erythematosis, sarcoidosis, spondyloarthropathies, tuberculosis, gout, syphilis, hepatitis B and many others.: To estimate the prevalence of systemic disorders in patients with episcleritis and scleritis visiting ophthalmology OPD. To identify the potential underlying systemic disorders requiring treatment.: This study was conducted in 105 patients who attended ophthalmology outpatient department of a tertiary care hospital over a period of one year and four months. Systemic association of a precipitating disease was noted in 20% of cases and the remaining 80% of cases had no association of an underlying precipitating systemic illness. Tuberculosis was a major precipitating disorder associated with scleritis and episcleritis. Rheumatoid arthritis, systemic lupus erythematosis, Wegener granulomatosis, syphilis, inflammatory bowel disease, sarcoidosis, ankylosing spondylitis and herpes zoster were some of the other systemic associations noted.: Scleritis and episcleritis are common conditions encountered in an ophthalmology out patient department. Their frequent association with an underlying systemic disorder prompts us to assess the systemic status of such patients. Early diagnosis and proper management of such disorders has helped to reduce both systemic and ocular morbidity.

Preoperative eye biometric measurements are critical for calculating IOL power, so it is essential to grasp how the various biometric parameters interact. The aim of this study is to determine the predictability and influence of biometric values on power calculation.To determine the relationship between IOL power and biometric values.It is an observational cross-sectional study done at a tertiary care center in Mysore, Karnataka. 110 eyes undergoing cataract surgeries were evaluated in the study over a period of four months. Preoperative biometry was performed and IOL power was calculated by SRK–II and A-scan. Pearson correlation coefficient matrix was tabulated. Model was obtained using multiple linear regression analysis. The comparison was made among all 6 models using the R square value and the standard error of the estimate.Ka had a positive correlation with the Kh (r=0.955) and Kv(r=0.963), which had a weak negative correlation with AL (r =-0.358). Model 2 (SRK II-IOLP= (-0.900)*Ka + (-2.500)*AL+118.200) had the highest R square with no error, indicating the highest predictability in estimating IOLP. Estimating IOLP using an A-scan was a significant predictor but had the highest error with an R Square value of 0.206.Model 1 (A-scan- IOLP=(-0.191) *Ka +(-1.002)*AL+52.445) was the second most successful model. Ka can provide better predictability with both the methods to calculate the IOLP and AL.There is a limited evidence in comparing both the formulas. The SRK-II IOLP measurement showed higher accuracy using Ka and AL with no error in refractive error. A scan provided precise biometry data and IOL power calculation within an average range of ALs. The SRK- II formula's predictability is higher than the A-scan formula.

To study the causes and risk factors for development of myopia and to see short term progression in children of 0 – 15 years. A prospective observational study was conducted among children attending the Ophthalmology department of a Tertiary care centre in Central India, from October 2019 to September 2021. In order to determine the refractive status of the eye, all subjects underwent visual acuity tests, anterior and posterior segment examinations, and various other investigations. Data was collected during the first year concerning their parents' use of spectacles, duration of indoor activity near work, and outdoor activity, and progression was tracked during the second year. Statistical software SPSS 23.0 version was used to tabulate and analyze the data.Amongst714 children between the age 0 – 15 years, myopia was seen in 19.9% subjects. Amongst those with myopia, 28% showed progression. In those showing progression, 50% belonged to 11 – 15-year age group, a female predilection of 64.3%, 50% with parental history of refractive error, 71.4% subjects were involved in > 2 hours/day of indoor active near work and 57.1% subjects were involved in < 2 hours/ day of outdoor activity. In subjects with progression of myopia, 71.4% had an increase in axial length of < 1 mm. While in subjects less than 10 years of age, steeper cornea was a more common factor for progression as compared to increase in axial length, seen in 57.1% cases. Myopia progression in the growing age group is inversely correlated with time spent engaging in outdoor activity, on the other hand, it shares a strong positive correlation with time spent on indoor active near work. Corneal curvature plays a more significant role in progression of myopia as compared to axial length in younger age group.

Rhino-orbital mucormycosis is a rare life threatening invasive fungal infection that has recently shown a very high mortality rate in India during COVID-19 pandemic. We have designed the present study to find out associations between COVID-19 induced rhino-orbital mucormycosis and concentrations of inflammatory markers, i.e. D-dimer, Ferritin, IL-6, CRP and PCT, in blood serum of Indian population.There were four groups in the study, viz. control group with healthy subjects, treatment group-1 with patients suffering from SARS-COV-2 infection, treatment group-2 with patients suffering from both SARS-COV-2 infection and rhino-orbital mucormycosis, and treatment group-3 with patients suffering from rhino-orbital mucormycosis after SARS-COV-2 infection recovery. Inflammatory markers were quantified with standard protocols, and recorded data were subjected to statistical analyses.We found that patients suffering from SARS-COV-2 infection were more susceptible to rhino-orbital mucormycosis, as they had higher concentrations of inflammatory markers in their blood than the other subjects. Diabetes mellitus, hypertension, cardiovascular diseases and renal disorders were the associated comorbidities with the patients. We also found higher concentrations of inflammatory markers in males than the females, indicating towards their higher susceptibility in developing rhino-orbital mucormycosis than females. Present study therefore suggests that the frequent occurrence of rhino-orbital mucormycosis in India during second wave of COVID-19 was possibly due to indiscriminate use of corticosteroids by COVID-19 patients. Subjects with previous history of comorbidities like diabetes mellitus, hypertension, cardiovascular disorders and renal diseases are the most susceptible population groups for developing infection. Moreover, males are at higher risk of developing mucormycosis than the females.

This study was carried out to evaluate the effect of corneal collagen cross-linking on visual acuity, astigmatism and topographic readings (K1, K2, Kapex). : A nonrandomized noncontrolled clinical study was conducted in two tertiary eye centres in Bangladesh from July 2017 to June 2019. All attending patients diagnosed with Keratoconus were included in this study according to selection criteria. Patients with a corneal thickness of fewer than 400 microns, previous viral infection, cornea scarring, corneal opacification, severe ocular surface disease, history of immune disorders, pregnancy, and breastfeeding were excluded from the study. All selected patients underwent collagen cross-linking with Riboflavin and Ultraviolet A, followed up five days, one and six months following the procedure. Visual acuity, topographic readings (K1, K2, Kapex) and cylindrical values were assessed on every visit. The mean value of visual acuity was compared statistically with the baseline value.: A total of 30 eyes of 30 patients were studied in this study. The male-to-female ratio was 2:1. The Mean age (± SD) of the study subjects was 22.7±7.10. Before CXL, the Mean uncorrected visual acuity (UCVA) ±SD was 0.86±.35. In post-CXL follow-up time, the mean UCVA±SD was 0.46±.23 after six months of CXL. Before CXL, the Mean BCVA±SD was 0.35±.22. In post CXL era, the Mean ± SD BCVA was 0.14±.13 after six months of CXL. The Mean K1±SD was 45.66±3.43 before CXL, and the result changed after CXL. The Mean K1±SD was 43.29±3.29 after six months of CXL. The Mean K2±SD was 50.22±5.93 before CXL, and the result differed after six months of CXL. The Mean Kapex ±SD was 54.50±7.38 before CXL, and that was 51.32±6.93 after six months of CXL. Keratoconus is a bilateral non-inflammatory disorder progressively leading to vision-threatening ocular morbidity. Collagen cross-linking improves visual and topographic findings– K1, K2, and Kapex and reduces astigmatism. Early diagnosis of Keratoconus and prompt treatment will help achieve better vision.

A rare case of 40 years old female, came with complaints of pain and blurring of vision in the left eye for the past week. The patient had a diminution of vision since birth in her left eye. On examination left eye vision was found to be 6/60 not improving with pinhole, also defective color vision 20/25. The right-eye vision was found to be normal. The left eye showed significant corneal edema, and moderate anterior chamber depth, with iris features of Corectopia, Pseudopolycoria, and iris atrophy. Pressures were found to be 30mm hg in the left eye, gonioscopy revealed high peripheral anterior synechiae extending anteriorly above Schwalbe’s line. Left eye fundoscopy was done and it showed increased CDR of 0.8 to 0.9 following which visual field analysis was done, it showed inferior field defect. The patient was started on e/d timolol and hypertonic saline for a week. The patient was reviewed after a week showing reduced pressures of 22mmg in the left eye with reduced corneal edema and pain. Diagnosis of iridocorneal endothelial syndrome-essential iris atrophy type with secondary glaucoma was made and now the patient is being followed up regularly. An iridocorneal endothelial syndrome is a group of disorders with three clinical variants as Chandler syndrome, Essential iris atrophy, and Cogan Reese syndrome. Pathology is the presence of abnormal endothelial cells, which behave as epithelial cells, able to proliferate and migrate. The iridocorneal endothelial syndrome is frequently associated with secondary glaucoma.

To study the epidemiological characteristics and predisposing factors of infective corneal ulcer.: 222 cases fulfilling the inclusion criteria were recruited for the study. A standardised proforma was used to record demographic data like, age, sex, occupation, rural/urban background and relevant history like associated ocular and systemic disorders, history of corneal injury, previous treatment and duration of symptoms. Statistical analysis was done using SPSS 22 software for chi square test.: 222 cases of infectious corneal ulcer was enrolled to the study out of which 138 (62.16%) were males and 84 (37.83%) were females. Out of the total, 132 (59.45%) were hailing from rural and 90 (40.54%) were hailing from urban background. Mean age of presentation was 52.009 years with standard deviation 12.26. 45.44% were farmers. 21.62% patients were diabetic. Ocular trauma was the most common predisposing factor, which was present in 24.32% (n=54). There was statistically significant association between trauma with vegetative matter and fungal corneal ulcer (p=0.004). These findings are in consensus with the epidemiological characterstics and predisposing factors in our geographic zone. Large number of fungal keratitis is associated with agriculture based economy, inadvertent use of steroid drops which implies lack of awareness.

VMT is a condition with an abnormal adhesion of vitreous to the macula. In classic form it is separated from the retina throughout the peripheral fundus but remains adherent posteriorly. We studied the efficacy of intravitreal expansile gas injection with proper patient positioning for relieving VMT, using OCT as main modality to image response. To study the efficacy of intravitreal injection of expansile gases (SF or CF) in releasing VMT and the improvement in the visual acuity. The study was conducted in a tertiary eye care centre during the period of October’14 to ‘16. 37 eyes of 30 patients were included. Those with HVMA of 750 µm had a 26.66% failure rate of non-resolution. The 33 eyes (P= 0.026) which were relieved of the traction provided a significant relevance of this treatment method in case of symptomatic VMT. Eyes treated with expansile gas injection and resolution of VMT showed non-significant improvement after one week of injection (P = 0.089), but did show significant improvement after one and three months (P<0.01). For patients unable to undergo long surgeries like PPV with ILM peeling, this modality of intravitreal expansile gas injection serves to relieve the traction easily and reduces any sort of visual distortion.

Retinal vein occlusions have a characteristic, although somewhat variable, appearance with intraretinal hemorrhage, cotton – wool spots, tortuous and dilated retinal veins, retinal edema and occasionally optic disc swelling. There are three distinct types of RVO: branch retinal vein occlusion (BRVO), central retinal vein occlusion (CRVO), and an anatomical variant of CRVO, namely, hemiretinal vein occlusion (HRVO). Intraocular steroid treatments and macular or scatter panretinal photocoagulation are also employed to manage vision loss from, and complications of, RVO.To study the various systemic & ocular risk factors of RVO and the prevalence of RVO (BRVO & CRVO).This hospital based study was conducted on all RVO patients attending the OPD of Department of Ophthalmology, RNT Medical College, Udaipur.The prevalence of RVO (0.77%), BRVO (0.52%) and CRVO (0.11%) which increased with increasing age. More common in 56-65 years males. The major risk factor associated with RVO was systemic hypertension. There is a significant link between diabetic mellitus, serum homocysteine levels, and hyperlipidemia. RVO is linked to smoking, coronary artery disease, use of OCP, and vascular occlusive disease. Macular edema was resolved and vision was significantly improved after intravitreal Anti-VEGF injections.To sum up, it is important to focus on modifiable risk factors like smoking, hyperlipidemia, systemic diseases like: hypertension and diabetes which are found to be associated with increased risk of developing RVO and also look into preventable aspect of the disease.

To compare the safety, efficacy and ease of administration of subtenon’s anaesthesia with peribulbar anaesthesia in manual small incision cataract surgery(MSICS) and assess the surgeon and patient comfort.A prospective longitudinal study was conducted among 200 patients undergoing MSICS at a rural tertiary care hospital wherein patients were randomly divided into the two groups of peribulbar (P) and subtenon’s (ST) block.After randomization, 200 patients were assessed for various factors including pain at the time of administration of anaesthetic, time to attain akinesia, patient’s comfort and satisfaction score.200 eyes of 200 patients who underwent MSCIS were divided into Peribulbar and Subtenon’s group by random number table; of which 122 were women (61%) and 78 were men (39%). There was a significant difference in the amount of anaesthetic used, with the group P (8.37+1.19 ml) usage being more than the group ST(4.02+0.91 ml) (p<0.001). Group P took significantly lesser time to attain akinesia compared to group ST. Group P achieved significantly higher degree of akinesia than group ST. (p<0.001) Significantly greater number of eyes in the group ST required additional anaesthetic injection compared to the group P (p<0.001). A significantly more number of patients experienced pain in the group P. (p=0.008)Significantly greater number of eyes in group ST had mild and moderate chemosis and subconjunctival haemorrhage compared to group P(p<0.001).We found that subtenon’s anaesthesia was an equally effective technique for achieving analgesia and akinesia when compared to peribulbar anaesthesia in patients undergoing MSICS.

Unique features of pediatric ocular trauma - IJCEO- Print ISSN No: - 2395-1443 Online ISSN No:- 2395-1451 Article DOI No:- 10.18231/j.ijceo.2022.064, Indian Journal of Clinical and Experimental Ophthalmology-Indian J Clin Exp Ophthalmol

The present study is aimed to assess the prevalence of steroid-induced glaucoma in vernal kerato-conjunctivitis patients treated with topical steroids and to determine the association between different types of topical steroids and the presence of steroid-induced glaucoma. This study was conducted as a hospital-based cross-sectional study on patients belonging to the age range of 8 years to18 years who were already diagnosed with vernal kerato-conjunctivitis and were using topical steroids as treatment. Detailed clinical history and ophthalmologic examination were done. Depending upon the potency of steroids and their intra-ocular pressure raising potential, patients were categorized into one of the 4 groups (A, B, C, D). Intra-ocular pressure levels were raised in 32.9% of the patients managed with topical corticosteroids. Steroid-induced glaucoma was observed in 15 (6.1%) of the patients with vernal kerato-conjunctivitis. Steroid-induced glaucoma was significantly associated with prolonged duration of corticosteroids and high potency corticosteroid use (p<0.05). Steroid-induced glaucoma is one of the common complications of injudicious and long-term use of topical corticosteroids particularly high potency steroids. Approximately one-third of the patients on treatment for vernal kerato-conjunctivitis are corticosteroid responders. High potency steroids and prolonged use of steroids are factors associated with steroid-induced glaucoma.

To analyze clinico-epidemiological trends in Retinitis Pigmentosa (RP) cases and syndromes associated with RP. : This is a prospective observational case series. All cases found to have clinical features suggestive of RP were studies. The period of study was for twelve months. Detailed history taking, General and ocular examinations were performed meticulously to look for various associations and findings related to RP.: Among 55 patients of Primary RP, 38 (69%) were males and 17 (31%) females. 69.9% had the onset in 1 decade, 14.5% in 2 decade and 16.36% beyond 2 decade. In 1 decade of life, pattern of inheritance showed a predominance of autosomal recessive pattern (34.5%) followed by sporadic (27.2%). 30 out of 55 cases (54%) had positive family history of night blindness while remaining 25(46%) were sporadic in nature. 40 (72.7%) had typical RP, 4 cases had atypical RP (7.2%) and 11 (20%) syndromic RP. Of 11 cases which had syndromic associations, most common was Usher syndrome being 5 (45%). Regarding treatment, myopia was corrected with best glasses in 25 cases and 5 required low vision aids. 35 cases (64%) maintained visual acuity and fields. Retinitis pigmentosa presents in an isolated or syndromic manner (20%). Periodic testing helps in timely detection of progression of disease. Correction of refractive error and use of low vision aids allows patients to pursue many activities of daily living better. Supportive genetic counselling and utility of ERG in detecting early loss of photoreceptor function.

A 65-year old male patient presented to our ophthalmology OPD for regular check up. On examination visual acuity of the right eye was 6/24 improving to 6/12p with pinhole and left eye was 6/18 improving with pinhole 6/9. On examination of anterior segment both eyes cornea showed multiple white round deposits at deep posterior stroma and Descemet membrane – endothelium complex scattered circumferentially in the peripheral cornea and the central cornea clear and lens showed Immature cataract. Fundus examination was within normal limits. A differential diagnosis of stromal corneal dystrophy or endothelial corneal dystrophy was made. By exclusion, we came to the diagnosis of macular corneal dystrophy.

The study was done to assess the pre and post awareness of eye health care and importance of regular eye test to detect ocular and systemic conditions which may be asymptomatic.This study done on 278 subjects, age group between 18-30years. 65% of the subjects are females and 35% of them are males are included. In this questionnaire study, pre and post data is collected among health care students on pre-eye examination, participants were asked questions on their demographic detail, Eye examination, visual symptoms, ocular symptoms, visual aids, safety eye wear, importance of eye examination and a pamphlet is shown to create knowledge, awareness after which post awareness data is collected.A total of 278 subjects were participated, our result showed a significant improvement in increasing awareness, knowledge level in post intervention of health care students regarding visual health awareness and eye care. Overall knowledge before intervention was low 55.43% and was increased to 87.1% after intervention.Awareness programs in eye care can have a positive effect on raising the profile of eye health services within health systems, thereby increasing the knowledge, confidence, and motivation in health care students.

Angioid streaks are irregular lines that radiate away from the optic disc to the retinal periphery, lying deep into the retina. They indicate the breaks in the calcified Bruch’s membrane. The most common complication of angioid streaks is choroidal neovascularization. They appear primarily bilaterally and are asymmetrical in nature.We report a 29-year-old man with choroidal neovascularization caused by angioid streaks. The study emphasizes seven years of follow-up of the disease treated with intravitreal bevacizumab and aflibercept injections. There were no injection related complications. Anti-VEGF treatment can help the clinician to stabilize the disease and achieve gradual progression. Nonetheless, it cannot help to prevent significant vision loss in long-term follow-up in all cases.

This study aims to compare accommodative functions between the dominant and non dominant eyes.A comparative study done in 50 healthy subjects include both males and females with age group ranging between (18 -25 years). It was a hospital-based study conducted in the outpatient department of Ophthalmology. The comparison of accommodative function between dominant and non-dominant eyes is measured to determine which eye shows a higher level of accommodative function. This study has been approved by IRB committee, before beginning this study informed consent has been given and the procedure has been explained clearly, 50 Young emmetropic adults were included. All participants were subjected to comprehensive ophthalmic examination including vision, refraction, Intraocular pressure measurements, slit-lamp examination, the dominance of eye is determined using the hole in the card method and Accommodative functions like the Monocular estimated method (MEM), Near the point of accommodation (NPA) and Accommodative facility (AF) done to find out the ocular dominance.This study shows a higher level of accommodative function in all aspects of accommodative factor such as Monocular estimated method (MEM), near the point of accommodation (NPA) and accommodative facility in the dominant eye. The Mean and Standard deviation value shows a significant difference in all parameters in the dominant eye with a t-value of 7.055(p=.000) when comparing with the Non dominant eye.Comparing the accommodative function between the Dominant and Non dominant eye we concluded that the Near Point of accommodation and accommodation facility were observed more in the dominant eye as compared with the non dominant eyes. The mean accommodative lead was found to be greater than the normal individual (dominant eye). Hence, it is concluded that the dominant eye has a better accommodative function than the non dominant eye.

To compare the outcome of revision external dacryocystorhinostomy (DCR) with or without mitomycin C. This Quasi prospective study was conducted over 30 diagnosed patients with failed external dacryocystorhinostomy came to the Oculoplasty clinic at Ispahani Islamia Eye Institute and Hospital from July 2019 to June 2020. Maximum of 40.0% of the patients were 41–50 age group in Group A (Mitomycin C) and 40.0% in 41-50 age group in Group B (without Mitomycin C). There were 7(46.7%) males, and 54-58 8(53.3%) females in Group A, 6(40.0%) male and 9(60.0%) female in Group B. 18(60%) patients underwent left-sided and 12(40%) patients underwent right-sided revision dacryocystorhinostomy respectively. Most patients had no complications in both groups of this study. Only one patient reported with corneal epithelial defect in the mitomycin C group. After six months follow up, 93.3% success rate was seen in revision external DCR with mitomycin C group and 66.7% in revision external DCR without mitomycin C group. Mitomycin C has a beneficial effect in preventing reclosure of the dacryocystorhinostomy stoma after revision external dacryocystorhinostomy and no significant complications resulting from its use.

Paediatric cataract is an important cause of treatable childhood blindness, provided it is recognized and managed early. Timely diagnosis, management, and visual rehabilitation of a child with a paediatric cataract are crucial determinants of a favourable prognosis. This particular topic, study of pattern of deviation of eye ball after traumatic cataract in children was selected because of the difference between the firm literature of Keith Lyle and the clinical observations. This study includes analysis of 25 patients. The key findings of this study were: Maximum incidence of traumatic cataract was seen in 6-10 years of age group, that too more commonly in boys and it was 2.5 times more than that of girls. lncidence of perforating injuries leading to cataract was 1.5 times more common than blunt trauma. In paediatrics cataract, the Diminution of vision in cases of traumatic cataract is usually at the level of mature or hypermature cataract. 40% of cases showed deviation in the range of 11-20° (irrespective to divergence or convergence). There was higher incidence of Exotropia than esotropia. Originally eye was divergent as per evolution of binocular vision in primates & our study also came out with a conclusion that when there is no force or compulsion of binocular Vision, most of the eyes tended to be Divergent in children after traumatic cataract.

Acute dacryocystitis is not uncommon in oculofacial and general ophthalmology clinics admissions. It happens with sudden inflammation of lacrimal sac that frequently occurs in the setting of pre-existing nasolacrimal duct obstruction. Long standing tear flow stasis results in change of bacterial flora and bacterial over-growth in the lacrimal sac as a reservoir of stagnant tear., However, acute dacryocystitis can be associated with dacryoliths or indefinite pre-existing anatomic nasolacrimal duct obstruction.

To assess the prevalence of various refractive errors in children attending ophthalmology out patient department of a tertiary hospital. 173 children with defective vision were assessed for refractive errors during June 2021- June 2022. Females accounted for the majority of children (61.6%). Most common type of refractive error was myopia (52%) followed by hyperopia (27.2%) and the least common was astigmatism(20.8%). Myopic astigmatism was the most common variety in cases of astigmatic cases(72.2%). The frequency of myopia increased with increasing age of children. This association was found to be statistically significant (p<0.01%). Mean refractive error was -1.047D. The SD was -2.57D. Low myopia was the most common (38.1%) with females being the majority of these cases (24.2%). Myopia had highest parental association among refractive errors (57.4%). Refractive errors when uncorrected can lead to amblyopia and strabismus and hence school based and community based screening is necessary to get a real estimate of the burden of uncorrected refractive errors.

The aim of this study was to identify the ophthalmologic clinical features manifestations of facial nerve palsy patients.: In this observational study we have analyzed 50 eyes from 50 facial nerve palsy patients who were referred to our ophthalmic clinic. Ophthalmic drops, ointment were prescribed according to symptoms, taping was conducted in all eyes. 60% of the Bell’s palsy patients treated with prednisolone alone acyclovir-prednisolone (depending on the pathology) recovered within 5 months. An invasive procedure like temporary tarsorrhaphy was carried out in 5 patients permanent tarsorrhaphy in 3 patients. 2 patients underwent temporal bone decompression surgery. 3 patients developed corneal opacity with severe visual impairment despite surgical intervention, ophthalmic ointment, taping. Signs had improved in 75% of patients (lagophthalmos), 90% (corneal epithelium defect), 60% (epiphora). The ophthalmic clinical features of facial nerve palsy were mainly corneal lesion and eyelid malposition, and their clinical course improved after invasive procedures. The prognosis and ophthalmic signs were worse than in cases of simple facial palsy. Understanding these differences will help the ophthalmologist take care of patients with facial nerve palsy.

The purpose of this study was to assess the causes of optic disc oedema and their systemic associations and to study the various clinical presentations of optic disc oedema.This is a retrospective observational study which was conducted at Department of Ophthalmology, JLN Medical College, Ajmer. All patients who reported to OPD with Optic disc oedema during the study period (February2020 to August 2021) were evaluated. Complete ophthalmic examination included visual acuity, anterior segment examination using slit lamp, fundus examination using direct and indirect Ophthalmoscope and 90 Dioptre lens, B-scan for optic nerve sheath diameter (ONSD) and OCT for retinal nerve fibre layer thickness (RNFL) measurement. fundus photography was also done. Investigations like complete blood test, Visual field testing using perimetry, computed tomography scan and magnetic resonance imaging were done as and when indicated. Total 80 optic disc oedema cases were included in our study. Out of 80 cases, 44(55%) and 36(45%) were males and females respectively. Different causes of optic disc oedema were found to be papilloedema 48 cases (60%), optic neuritis 13 cases (16.25%), NA-AION 9 cases (11.25%), CRVO 3 cases (3.75%), diabetic papillopathy 2 cases (2.5%), traumatic optic neuropathy 2 cases (2.5%) respectively. In 3 cases (3.75%) cause could not be detected (idiopathic). The most common cause was papilloedema, followed by optic neuritis and NA- AION

Use of digital devices like mobiles, tablets, laptops had increased with the advancement of time and technology as well as during COVID-19 pandemic. These digital devices have tendency to cause number of visual, ocular and systemic symptoms. The purpose of this study was to find the association between various ocular, visual and systemic symptoms with the duration of using digital devices. : An online Google questionnaire consisting of demographic information and pre tested questionnaires of symptoms related was distributed using social platforms. The responses were analysed using different statistical tests that included one way ANOVA, pearson Correlation and paired t-test. Statistical significance was considered if P < 0.05. : During lockdown, most of the participants were using the digital devices for more than 6 hours daily (68%). 88 (40%) of the respondents were using two digital devices and 24 respondents (10.9%) were using more than two digital devices during lockdown. Ocular symptoms including watering of eyes (P = 0.002), dry eyes (P = 0.006) and painful eyes (P = 0.011) showed positive correlation with hours of using digital devices during lockdown. Similarly, neck pain (P = 0.000) and shoulder pain (P = 0.009) were the major systemic symptoms associated with increasing hour of digital devices use.Increasing exposure to the multiple digital devices have negative impact on ocular and systemic symptoms.

: Visual deprivation is one of the most significant deficits recorded by humans. One can say ocular trauma is as old as human civilization. The ocular deformity is very evident in all facial injuries. Despite having a significant socio-economic impact, very little data is available on ocular trauma's magnitude & risk factors. To investigate the distribution of ocular injuries in and around the Vijayapura District. : From November 2019 to April 2021, the research was carried out at Tertiary care hospital in north karnataka. A total of 100 patients attending casualty and outpatient departments with a history of both mechanical and non-mechanical trauma were included. All cases were subjected to a thorough ocular examination of the anterior and posterior regions. Investigations were conducted wherever they were required. : Ocular trauma was more common in males (83%) and in the 20-30 year age group. In mechanical injury, close globe injuries included 18% contusion and 20% lamellar laceration. 16% were penetrating injuries, 6% were rupture, and 34% were adnexal injuries in open globe injury. 83% of cases were from a rural background, and 17% were from an urban background. Majority of patients presented within 6 hours of trauma to our center. The most commonly affected structures were the eyelid and adnexa in this study.: Road traffic accidents were the most common cause of ocular trauma. This necessitates the implementation of improved road safety measures in this region.

The study aims to compare the effect of long-term exposure to digital devices during covid-19 and before the lockdown. To assess the impact of the lockdown on digital device usage & consequently, the ocularsurface health implication related to digital eye strain. An open online survey was distributed to people via social media platforms (email, Facebook, Instagram, WhatsApp, Telegram, and so on). Females participated more than males, with 58.3%. With 30.76%, the >50 age group was found to participate, and at 13-31 years of age, participation was found to be more with 60%. Most individuals use digital devices for education with 44.2%. Before the lockdown, the duration of digital device usage is not there between 4 to 6 hours, but during the lockdown, it has been increased by 35% due to working from home. 76.3% of participants feel restless due to prolonged use of digital devices. It was discovered that before the lockdown the duration of digital device usage is not there between 4 to 6 hrs but during the lockdown, due to working from home it has increased and headache as an asymptomatic symptom is noticed more during prolonged use of digital devices in lockdown.

Corneal diseases are one of the leading causes of visual loss and blindness, after cataracts and glaucoma across the globe. Management of corneal blindness requires corneal transplantation which is dependent on voluntary corneal donations and needs tremendous post-operative care and follow-up. The success of the procedure depends upon various donor and recipient factors that need to be studied.A prospective study was conducted in the eye bank of the tertiary care eye center in central India after getting the approval of the institutional ethical committee. A total of 26 eyes of 13 donors were studied, out of which 23 eyes underwent penetrating keratoplasty, among these, 3 eyes underwent therapeutic penetrating keratoplasty, 16 eyes underwent optical penetrating keratoplasty and 4 eyes underwent triple procedures. Recipients were followed up at 1 week, 1 month, and 3rd months, and data were analyzed.Graft survival was significantly better in the recipients without pre-operative corneal vascularization (p=0.004). Corneas from a donor with open eyelids showed significantly poor graft survival. This was statistically significant (p= 0.047). On the other hand, based on donor lens status, we did not find any difference in the survival of the graft. Practices like lid closure and eye drop installation should be promoted from the time of death, for preserving donor tissue quality. HCRP should be promoted and practiced at the national level as it is effective in increasing the rate of eye donation and positively affects graft outcomes.