International Journal of Medical Ophthalmology

Journal Information
ISSN / EISSN : 2663-8266 / 2663-8274
Published by: Comprehensive Publications (10.33545)
Total articles ≅ 112
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Sayed Aejaz Hussein, Pritish Gupta, Manoj Gupta
International Journal of Medical Ophthalmology, Volume 4, pp 10-13; https://doi.org/10.33545/26638266.2022.v4.i1a.105

Abstract:
Pterygium surgery has evolved a lot with newer technigues to help create better postoperative outcomes, to make the surgery time less consuming, to have fewer complications and to provide more better postoperative comfort to the patient. Our study is based on one of this new techniques of Conjuctivo Limbal Autograft with autologous serum which is comparatively less time consuming compared to its is precedessors and is a sutureless and glueless technique. The aim of the study is to find the safety, efficacy and relation of stability of intraoperative grafts (graft fixation)with their postoperative outcomes. We found that intra operative stable grafts to provide good results postoperatively having major displacement of only 1.15%.thus making this technique a faster, stable and economical technique for the patients and the doctors.
Zeba Ahmed, Sm Ahmed, Alhaj Farhath Tasneem, Faiza Syed Jafar, B Shraavya
International Journal of Medical Ophthalmology, Volume 4, pp 23-29; https://doi.org/10.33545/26638266.2022.v4.i1a.109

Abstract:
Cornea of diabetic patients is exposed to increased glucose concentration which contributes to the accumulation of advanced glycation end products, on the basement membrane lamina. Reduced corneal endothelial cell density and swelling of the cornea are indicators of corneal dysfunction and there is evidence that patients with diabetes mellitus have some functional corneal abnormalities. There is a paucity of data from India on the effects of small incision cataract surgery on the corneal endothelium, therefore this study will give us an insight and better understanding of the methods to adapt while operating to prevent the endothelial cell loss.Objectives: To assess the endothelial cell changes and central cornel thickness pre operatively and post operatively in patients with type II diabetes mellitus and age matched individuals after Manual Small Incision Cataract Surgery.Methods: It is a hospital based prospective cohort study done on 60 eyes of sixty diabetic patients and 60 eyes of age matched individuals who underwent small incision cataract surgery. The endothelial cell density, coefficient of variation, hexagonality and the central corneal thickness was measured at regular intervals on post operative day 1, week 1, week 4 and week 8.Results: Statistical significance in reduced ECD, increase in the coefficient of variation and central corneal thickness post operatively in diabetics when compared to age matched controls. Endothelial cell loss was independent of the duration and severity of diabetes.Conclusion: The decrease in the endothelial cell density, reflects that surgical trauma is more in diabetic patients than normal individuals.
Namita Bhore, Sunil G Biradar
International Journal of Medical Ophthalmology, Volume 4, pp 42-48; https://doi.org/10.33545/26638266.2022.v4.i1a.113

Abstract:
Introduction: Pterygium is a common degenerative disease of the anterior segment of the eye characterized by a wedge-shaped fibrovascular dysplasia of the bulbar conjunctiva with a prevalence of 12%. Exact etiology is unknown; risk factors include, long term exposure of ultraviolet B rays, dust, wind, chemicals and air pollution. To minimize recurrence after the traditional bare sclera surgical technique, adjuvant therapies and modifications to the surgical technique are being adopted. Geographically, Vijayapura is located close to the equator with inherent risk of higher ultraviolet radiation exposures. Of late there is an upsurge in the number of patients with diagnosed with pterygium opting for surgical correction. Conjunctival autograft transplant is promising modification of bare sclera technique is associated with significant reduction in pterygium-induced astigmatism thereby improved visual acuity, decreased postoperative complications and decreased recurrence rates. Objective: To evaluate the visual outcome and complications following conjunctival autograft transplant in management of primary pterygium. Methods: The present study was conducted in the department of Ophthalmology, B.L.D.E. deemed to be university Shri B.M. Patil Medical College, Hospital and Research Centre, Vijayapura between October 2019 to April 2021. A total of 52 patients above 18 years with a diagnosis of primary pterygium were included in the study. Age, gender, occupation, side and severity of pterygium was recorded. Preoperative visual acuity and corresponding decimal pin whole equivalent was calculated for each patient. Upon surgery with conjunctival autograft under local anaesthesia, postoperatively, visual acuity, corresponding decimal pin hole equivalent and complications were evaluated at day 1, day 7 and day 30. Comparison of pre and postoperative data was done using appropriate statistical tests. Results: Mean age of patients was 54.38±10.70 years and 69.3% belonged to the age group of 50-70 years. Slight female predominance was noted with female to male ratio of 1.17:1. Most of the patients were farmers (48.5%) followed by housewives (23.1%). All patients had nasal pterygium prominently on the left side than right (61.5% vs 38.5%). 76.9% patients had grade 2 pterygia. Preoperatively, most patients had a visual acuity of 6/24 (25%), followed by 6/36 (19.2%) and 6/60 (17.3%). The mean decimal equivalent value was 0.35±0.21. Compared to preoperative visual acuity, significant improvement was seen at postoperative day 1 (p=0.000), postoperative day 7 (p=0.001) and at postoperative day 30 (p=0.001). Similarly significant increase in the decimal equivalent postoperatively (0.001) than preoperative values. Factors including age, gender, occupation, side and severity had significant association on the visual outcome based on visual acuity at all follow ups. Most common postoperative complication at day1 was subconjunctival haemorrhage (36%) is the common one followed by graft edema (36%) and graft retraction (13.5%). Resolution of complications was seen by day 30.Conclusion: Conjunctival autograft is a feasible and safe option in patients with primary pterygium with severe grading.
Ganeshkumar Jayakrishnan, Nallamuthu P, Giridhar Ps
International Journal of Medical Ophthalmology, Volume 4, pp 14-16; https://doi.org/10.33545/26638266.2022.v4.i1a.107

Abstract:
Introduction: Albinism comes from ‘albus’, the Latin word meaning white, and refers to a group of hereditary disorders wherein the biosynthesis of the pigment melanin is absent or reduced. Oculocutaneous albinism (OCA) is a heterogeneous and autosomal recessive disorder that involves a lack of pigment in the skin, hair, and eyes, and is associated with ocular and visual defects such as photophobia, strabismus, nystagmus and low vision. Materials and Methods: This was a cross sectional descriptive community based study conducted at a tertiary care medical college hospital. The Department of Ophthalmology enrolled 39 subjects satisfying the inclusion criteria. The diagnostic criteria for OCA patients included in the study, were those having ocular features of iris transillumination and retinal hypopigmentation in addition to depigmentation of the skin, hair and nails. Results: 39 patients with OCA were included, mean age 20 years. The largest proportion of participants (40%) included those between 16 and 25yrs. Using World Health Organization classification based on best corrected distance visual acuity, 8%, 70%, 15% and 7% of 78 eyes had normal vision, moderate VI, severe VI and blindness respectively. Conclusion: There is high prevalence of refractive, non-refractive and mixed ophthalmic disorders among albinos. There was significant improvement in visual acuity and function following optical correction and alignment in people with albinism, despite overall subnormal acuity. Refractive correction should be encouraged for people with albinism.
Matta Namrata Kamal, Vijay Bhanudas Barge, Basanagouda K Patil
International Journal of Medical Ophthalmology, Volume 4, pp 05-09; https://doi.org/10.33545/26638266.2022.v4.i1a.104

Abstract:
Introduction: Phacotrabeculectomy is a combined procedure in which both cataract extraction and glaucoma filtering surgery are performed in the same operative session. The one-site approach consists of both cataract extraction and trabeculectomy occurring through a single scleral incision. The two-site approach begins with cataract surgery, typically through a clear cornea incision, followed by a completely separate trabeculectomy performed superiorly upon completing the cataract procedure. This study looks at IOP changes, vision, loss of endothelial cells and BCVA between single-site and twin-site phacoemulsification -trabeculectomy surgeries, Methods: This prospective, randomized study was conducted between September 2014 to August 2015 with sample size of 80 subjects at National institute of Ophthalmology, Pune. Results: The endothelial cell loss was significantly more in single site surgery when compared to twin site surgery, in both at 1 month and 3 months follow-up time points (P-value
Sagarika Aggarwal, Wazid Ali, Parveen Rewri
International Journal of Medical Ophthalmology, Volume 4, pp 01-04; https://doi.org/10.33545/26638266.2022.v4.i1a.103

Abstract:
Tonometry has evolved over centuries to find an ideal instrument to correctly measure IOP. Goldmann applanation tonometer (GAT) remains the gold standard for tonometry. The newer tonometers have been developed which operate without anaesthesia, fluorescein dye and with no or minimal contact. This non-interventional, cross-sectional study was done to know the agreement between three types of tonometers –Goldmann applanation tonometer, rebound tonometer (RT) and non-contact tonometry (NCT), in Indian eyes of healthy individuals. When compared to GAT, the measured IOP difference was found to be within ±3 mm Hg in two seventy-six eyes (84.6%; 95% CI: 80.6-88.5%) with RT, and in two eighty-one eyes (86.1%; 95% CI: 82.3-89.8%) with NCT. Both RT and NCT can be used as screening tools for IOP measurement in clinical practice within a relative range of IOP and CCT.
Manjula Mangane, Kundurthi Susmitha
International Journal of Medical Ophthalmology, Volume 4, pp 30-37; https://doi.org/10.33545/26638266.2022.v4.i1a.110

Abstract:
Introduction: Epiphora is an imperfect drainage of tears through the lacrimal passage. This is an annoying symptom, embarrassing both socially and functionally. The most common cause being chronic Dacryocystitis. The two widely accepted treatments are external and endonasal endoscopic dacryocystorhinostomy.Objective: To compare the primary success rate of external DCR and endonasal endoscopic DCR.Methods: In a prospective randomized controlled study, 50 cases of lower lacrimal passage obstruction were divided into two groups of 25 each. These two groups were surgically treated as Group I- underwent External DCR and Group II –underwent endonasal endoscopic DCR after investigating and evaluation as per the predesigned proforma.Results: 50 cases (7 males, 43 females) of lower nasolacrimal passage obstruction admitted in Mahadevappa Rampure Medical College, Kalaburagi, were operated, 25 cases underwent external DCR and 25 cases underwent Endonasal Endoscopic DCR. The mean age of the patients was 41.98 years. The success was defined by anatomical patency by sac syringing. At the end of follow up of 3 months, the success rate in group I was 88% (23 cases) and in group II was 76% (19 cases). The average surgical duration required was 59.4 minutes in Group I and 41.8 minutes in group II.Conclusion: Both the procedures represent good alternative for the treatment of lower lacrimal passage obstruction.
Madhuri Patil, M Gitanjali
International Journal of Medical Ophthalmology, Volume 4, pp 49-55; https://doi.org/10.33545/26638266.2022.v4.i1a.115

Abstract:
Background: Pseudoexfoliation is the common identifiable cause of secondary glaucoma. It is noted to be more aggressive with a high mean progression rate leading to full field blindness within 10 years. Aim of study: The aim of this study is to assess the demographic aspects, magnitude, clinical spectrum and response to treatment of glaucoma in pseudoexfoliation syndrome. Materials and Methods: All patients with pseudoexfoliation syndrome who attended Ophthalmology department, Trichy SRM medical college hospital and research centre, Trichy were selected for this study. This is a cross sectional study done over a period from july2018 to September 2020 in patients who fulfilled the inclusion criteria. All patients have undergone complete ocular examination includingvisual acuity, slit lamp examination, ophthalmoscopic examination, IOP measurement, gonioscopy, pachymetry and visual field examination and these patients were advised to followup at regular intervals. Observation and Results: In this study of 96 patients, males with age group of 61-70 years are commonly affected. Pseudoexfoliation syndrome is unilateral on presentation but eventually becomes bilateral. The IOP is fluctuating and produce severe optic nerve damage. The course is aggressive and recalcitrant to treatment needs definitive surgical therapy. Conclusion: Pseudoexfoliation is an common identifiable cause of secondary glaucoma producing ocular morbidity. Due to its fluctuating IOP, aggressive course and difficulty in managing with medical treatment it stands as a distinct enigmatic clinical entity. Pseudoexfoliation needs early detection, regular follow up and definitive therapy.
Devika Parameshwar, Akarshitha B, Rajani Kadri, Sudhir Hegde, Ajay Kudva, Akansha Shetty, Jayaram Shetty
International Journal of Medical Ophthalmology, Volume 4, pp 17-20; https://doi.org/10.33545/26638266.2022.v4.i1a.108

Abstract:
Importance:Pediatric inpatient referral for Ophthalmology consultations are often requested to evaluate a variety of conditions at a teaching institute hospital. The on-going coronavirus disease (COVID-19) pandemic has affected every aspect of health care in general, including inpatient referrals that could result in long term adverse effect due to the delay in screening, management and providing of required care. Objective: To know the change in paediatric inpatient referral pattern for ophthalmic consultation from pre COVID to COVID times and the effect of the same on visual morbidity. Design, Setting, and Participants: This retrospective record review study included paediatric inpatient references for ophthalmology consultation in a teaching institute hospital from Dec 2019 to May 2020. Result: Of the total 67 inpatient referrals requested, 45 were during preCOVID-19 times (group 1) and 22 during COVID-19 pandemic (group 2). Mean age was 4.85 ±4.47 and 4.55 ± 4.35 years in group 1 and 2 respectively. Refractive error was the cause for referral in 10 patients in group 1 and none in group 2(P=0.019). Referral for optic disc oedema assessment was seen in 6 and 15 in group 1 and 2 respectively (P=0.000). 2 and 4 patients were referred in group 1 and 2 respectively to screen for cataract (P=0.069) of which a group 1 patient was diagnosed and treated for the same. While 10 and 2 patients were referred for ophthalmic screening (P=0.193), it was 3 and 1 for strabismus (P=0.732) respectively in group 1 and 2. Conclusion: COVID times adversely affected the inpatient refractive error screening, a cause of amblyopia in older patients. In patient referral for papilledema screening increased despite the pandemic as the condition is considered an emergency.
Viswanathan Sivaraman, Shakthi Priya Sampath Kumar, Mayuri Sukumaran, Janarthanam Jothi Balaji
International Journal of Medical Ophthalmology, Volume 4, pp 38-41; https://doi.org/10.33545/26638266.2022.v4.i1a.111

Abstract:
Purpose: Interpupillary distance (IPD) measurement is important in various sub-fields in ophthalmology and vision sciences. Social distancing is one of the protocols which is being followed since COVID -19 pandemic across the globe. This protocol was a major limitation while measuring the IPD during spectacle dispensing. Hence, we need an alternate method which allows to measure IPD at 1-meter distance. This study aims to report the agreement between contact and non-contact IPD measurements.Methods: Monocular and binocular distance and near IPD were measured using contact (Essilor pupillometer; Pupillon, Essilor, France) and non-contact (OptikamPad; Optikam Tech Inc., Canada) measuring device. Gender effects were assessed using Wilcoxon and Mann-Whitney tests respectively. Agreement was assessed using Spearman correlation and Bland-Altman plots.Results: A total of fifty subjects IPD data were analysed (male 62.0%). The mean age ± standard deviation (SD) for the study subjects were 53.35 ± 11.91 (range 32 - 81) years. The IPD measurements by Contact digital pupillometer and Non-Contact digital IPD measuring devices showed an insignificant difference both for monocular and binocular IPDs and also had a good agreement between the methods.Conclusions: The IPD measurements by the Non-Contact digital IPD measuring device was comparable with the Contact digital pupillometer. In order to maintain social distance during COVID 19, the non-contact digital measuring device can be considered as an alternate tool for IPD measurement.
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