International Journal of Medical Ophthalmology

Journal Information
ISSN / EISSN : 2663-8266 / 2663-8274
Published by: Comprehensive Publications (10.33545)
Total articles ≅ 86
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Vikas Aili
International Journal of Medical Ophthalmology, Volume 3, pp 27-29; https://doi.org/10.33545/26638266.2021.v3.i2a.84

Abstract:
PKP can visually rehabilitate many of those who suffer from visual impairment due to corneal diseases so the primary objective of this study was to report treatment results of patients, who received a total penetrating Keratoplasty for various corneal diseases. Purpose: Review the surgical treatment, anatomical and functional results, and complications of treatment in this group of patients at our institution in terms of graft survival and visual acuity.Methods: This was a hospital based prospective study done in 70 patients admitted in ophthalmology ward, department of Ophthalmology, Basaveshwar teaching general hospital, M.R. Medical college, Kalaburagi over a period of two years. Patients diagnosed with non-healing corneal ulcer, corneal perforation, bullous keratopathy, infectious keratitis, autoimmune disease, injury of the eyeball (mainly chemical burns), and other combined disorders were indicated for total penetrating Keratoplasty After a complete ocular examination, total penetrating Keratoplasty (diameter ≥ 10.0 mm) was performed. The surgical technique involved dissection of affected tissues with a margin of minimum 1.0 mm of non-affected tissue. The size of the corneal graft ranged from 10.0 to 14.0 mm,Results: This group consisted of 36 females, whose mean age was 66.13 ± 9.94 (range 39 to 80 years), and 34 males, whose mean age was 63.69 ± 14.48 (range 32 to 92 years). There was no statistically significant difference with respect to gender and age between both groups. The main cause of surgical treatment failure was persistent epithelial defect, observed in 28 (40%) operated eyes, resulting from decreased corneal sensitivity and impaired tear production. Conclusion: Our study confirms that Full Thickness Penetrating Keratoplasty: Surgical boon and effective tool in management of chronic non-healing microbial corneal ulcer refractory to medical therapy, corneal dystrophy and degenerations and various other corneal diseases at my geographical area. It not only eliminates infection but also maintain globe integrity and improve visual acuity and thus improving social life
Anusha N Sangapur, Varsha Huralikoppi, Renuka
International Journal of Medical Ophthalmology, Volume 3, pp 34-38; https://doi.org/10.33545/26638266.2021.v3.i2a.87

Abstract:
Background: Amblyopia is the most common cause of monocular vision loss in children and as amblyopia is a major preventable and treatable cause of pediatric low vision, early detection and treatment of amblyopia is very important to reduce the prevalence of amblyopia. Materials and Methods: A cross sectional study was conducted during the school health check up visits conducted by ophthalmology department in tertiary care teaching hospital for screening of eye disorders in school children who belongs to the age group of 5-15 years over a period of 1 year in which 813 children underwent screening, among them 110 children with the reduced vision were referred to hospital for detailed ophthalmic evaluation which includes cycloplegic refraction and dilated fundus examination. Amblyopia was detected in children with reduced best corrected visual acuity. Results: A total of 813 study subjects were screened. Out of them 110 (13.5%) were found to have diminished vision. When the study subjects with diminished vision were subjected for further tests, 18 (2.2%), (p value is 0.494) of them were found to have amblyopia. Amblyopia was present in 10 (18.9%) females and 8 (14%) males. Anisometropic amblyopia was the most common type of amblyopia found in 10 (55.6%) study subjects, followed by meridional and strabismus type of amblyopia in 4 cases each (22.2%). Among strabismus, exotropia was seen in more study subjects 4(0.5%) than esotropia in 2 cases (0.2%). A higher number of moderate grade of amblyopia was seen than mild grade of amblyopia.Conclusion: The results indicate the importance of screening school going children for amblyopia and the importance of early detection and treatment.
Shikha Uday Prabhu Lawande, Rohit Shirodkar, Ambika Juwarkar
International Journal of Medical Ophthalmology, Volume 3, pp 86-88; https://doi.org/10.33545/26638266.2021.v3.i2b.93

Abstract:
Fat embolism syndrome (FES) is a multiple organ disorder that can appear after long bone fractures. The clinical picture includes hypoxia predominantly, accompanied by diffuse petechiae, alveolar infiltrates, altered mental status, fever, tachypnea, and tachycardia. We present a case of FES in a 35-year-old man with no prior medical history, following fracture of neck of right femur. Fifteen hours post-admission, patient developed respiratory failure with altered mental status and needed admission in the intensive care unit. The chest radiography and later chest tomography raised the suspicion of a COVID-19 disease, even if our first suspicion was FES. After being carefully investigated for COVID-19 with two negative RT-PCR SARS-CoV-2 tests, patient received treatment for FES. In the context of the SARS CoV-2 pandemic, differential diagnosis has become an increasingly challenging process.
A Pradeep Kumar, Pandurangaiah Elluru
International Journal of Medical Ophthalmology, Volume 3, pp 14-16; https://doi.org/10.33545/26638266.2021.v3.i2a.78

Abstract:
Background: A blurred image caused by the shape of the eye which does not bend light correctly. It is a major health problem globally affecting a large number of people with many ocular morbidities. Aim: The aim of the study was to compare the noncycloplegic refractive error with cycloplegic refractive error using autorefractometer. Materials and methods: This study was conducted in Department of ophthalmology, Nizam Medical College, Hyderabad between August 2018 to August 2019. Total number of patients selected were 70. Results: Autorefractometer values were comparable between pre and post cycloplegic values which were 23 and 24 right and left eyes of hypermetropia patients. From dioptric range, number of patients increased significantly (+0.25 to +1.25) to (+2.75 to +3.75) which was 11 to 26 and 21 to 32 right and left eyes respectively. P value in right eye and left eye was
Pandurangaiah Elluru, A Pradeep Kumar
International Journal of Medical Ophthalmology, Volume 3, pp 10-13; https://doi.org/10.33545/26638266.2021.v3.i2a.77

Abstract:
Background: Low vision is problem in which it makes hard for the people to do everyday activities and this problem can’t be fixed with glasses, contact lenses, medicines or surgery. Aim: This study was conducted to assess the quality of life in patients with low vision. Materials & Methods: In present study, there were 2 categories of 90 patients each who were joined in the outpatient department of Ophthalmology, Gandhi Medical College, Hyderabad, Telangana State. Category 1 consisted of 90 patients of low vision (Moderate visual impairment). Category 2 consisted of 90 patients of low vision (Severe visual impairment). Results: The mean age was 60.22±10.52 and 60.66±8.96 years respectively. 36% were males and 64% were females in category 1 and 57% were males and 43% were females in category 2. Mean comparision of various questionnaires were found to be statistically significant between two categories. Category 2 people have more difficulty in reading ordinary newspaper, small print on telephone book, medicine bottle while wearing glasses and they need help from others due to their poor eye sight. Category 2 people recognise people with more difficulty even though they know the people across the room. Conclusion: In patients of both categories, low vision affects quality of life. This study concluded that Category 2 people have poor quality of life in comparison to Category 1.
Lakum Archana
International Journal of Medical Ophthalmology, Volume 3, pp 47-53; https://doi.org/10.33545/26638266.2021.v3.i2a.90

Abstract:
Background and Objectives: Dry eye is a common multifactorial disorder of tear film resulting in ocular discomfort and tear-film instability with potential damage to ocular surface, due to decreased tear production or increased tear evaporation. It progressively increases in severity and if not detected may lead to sight threatening complications. This study was undertaken to study the prevalence, risk factors and diagnostic tests for dry eye. Methods: This study was conducted in Ophthalmology OPD at Regional Eye Hospital and attached to kakatiya Medical College, Warangal from September 2017 to August 2019. 300 patients were enrolled in this study. Occupation, smoking history and other systemic co-morbidities were documented. They were given OSDI questionnaire and subjected to four tests (Schirmer’s test, TBUT, Rose Bengal test, Fluorescein staining). If ≥2 tests were positive, the patients were diagnosed as dry eye. All dry eye patients were treated with tear substitutes and those with MGD were treated with tablet Doxycycline 100mg BD. Results and Conclusion: Dry eye prevalence was found to be 46.7%. It was more prevalent in females >40 years of age (60.4%). The prevalence increased with increasing age more among patients >50 years of age (49.3%) followed by age group 30-39 years (35%). Patients with outdoor jobs such as farmers, labourers had higher percentage of dry eye (50%) followed by office workers (22.1%). 70% of the dry eye patients had refractive error with or without history of spectacle use (p
Apurva H Suthar
International Journal of Medical Ophthalmology, Volume 3, pp 98-102; https://doi.org/10.33545/26638266.2021.v3.i2b.96

Abstract:
Background and Aim: Dry eye disease has a significant impact including physical, social, psychological, negatively affecting daily activities and workplace productivity. This study is conducted to find the prevalence of dry disease in patients of type 2 diabetes mellitus and to find the correlation between glycemic control and prevalence of dry eye. Material and Methods: A total of 130 patients fulfilled the criteria and total 200 eyes are included in the study. Type II diabetic patients diagnosed by the American Diabetes Associations criteria. The duration of diabetes, fasting and post-prandial blood sugar and Hb1Ac values were recorded. A complete ocular examination of the lid margins, conjunctiva, cornea and tear film was done. Examination of fundus was done to access the grade of diabetic retinopathy in the patients. Relevant examination of other important ocular structures was done. Following this, tests to diagnose dry eye were performed. These are tear break up time (TBUT), ocular surface staining by Rose Bengal and fluorescein staining, Schirmer’s tests and conjunctival impression cytology. Diagnosis of dry eye was made if OSDI Score was more than 12 with one of the positive specific tests for dry eye. Results: Prevalence of dry eye in diabetes in males and females were comparable to each other that are 44.99% and 54.01%. A statistically significant co-relation was found on comparing between Schirmer score of that eye and HbA1c level of that individual. All the patient with severe NPDR and PDR had Schirmer score of below 5 mm. Our study found that with increased duration of diabetes, the chance of developing dry eye increases, and poor glycemic control increases the severity of dry eye. The severity of diabetes has a positive correlation with goblet cell loss and morphological changes in conjunctival impression cytology. Conclusion: Significant correlation between the prevalence of dry eye in the diabetic patient which shows poor glycemic control is directly related to dry eye. This study reveals that attention should also be paid on dry eye, particularly among patients suffering from DM when they are concerned about diabetic retinopathy.
Rahul Ramchandrarao Dagwar, Aakanksha Patel, Ravi Chauhan
International Journal of Medical Ophthalmology, Volume 3, pp 21-26; https://doi.org/10.33545/26638266.2021.v3.i2a.83

Abstract:
Context: Unaddressed refractive errors account for a large proportion of ocular morbidities among adolescents and can hamper their overall development. Hence, compliance with the use of visual aids should be ensured. Aim: To evaluate the degree of spectacle compliance and to assess the principle determinants for non-compliance among adolescents in a tertiary care hospital. Settings and Design: Hospital based, prospective observational study. Methods and Material: A prospective observational study was conducted over 2 years. 365 adolescents (10-19 years) attending ophthalmology OPD were observed and interviewed using questionnaire and possible causes associated with non-compliance identified. Results: Out of 365 adolescents, 190 (52.05 %) were females and 175 (47.95 %) males. Overall compliance rate was 47.12 %. Compliance was more with urban residence (p value 0.014), father’s education (p value 0.022), myopia (p value 0.001) and poor uncorrected visual acuity in better eye (p value 0.0015). The common causes for not wearing spectacles were peer pressure (17.62 %), parental disapproval (15.03 %), broken spectacles (13.47 %), dislike spectacles (11.92%), social stigma/misconceptions (10.87%), occasional use (8.81 %), forgetfulness (7.25 %), lost spectacles (6.22%), headache due to spectacles (5.18 %) and discomfort due to spectacles (3.63 %). Conclusion: Proper counselling of adolescents and their parents regarding importance of using spectacles is essential at the time of prescribing spectacles and it can improve spectacle compliance and visual outcome.
Rohit M Shirodkar, Ugam Ps Usgaonkar
International Journal of Medical Ophthalmology, Volume 3, pp 30-33; https://doi.org/10.33545/26638266.2021.v3.i2a.85

Abstract:
Background: Myopia is considered a risk factor for open-angle glaucoma. This study aimed to assess the association of axial length and degree of myopia on RNFL thickness.Material and Method: This cross-sectional study is conducted among 50 myopic patients aged between 18 to 60yrs attending ophthalmology OPD at a tertiary care hospital. The study was conducted after getting approval from institutional ethics committee and patients recruited after obtaining informed consent. The ocular examination of all the included patients was done using an auto refractometer, retinoscopy, ONH OCT for RNFL thickness measurement, fundus with IDO and 90D. The average RNFL thickness was recorded globally and separately for the superior, inferior, nasal, and temporal quadrants.Results: A total of 100 eyes were evaluated, mean age of the study population was 35.02±9.07 years with range of 21-54years. The mean of refraction errors in all the patients was -3.41±2.04D with a range of -1 to -20D and mean axial length was 24.11±1.10 with a range of 22.18 to 26.8mm. There is a significant decrease in the RNFL thickness in patients with increase in refractive error and the axial length. (p
Mittal Kuchhadiya, Shilpa Bhatt, Bhargavi Parth, Chirag Odedara, Marium Mansuri, Jineel Bhatt
International Journal of Medical Ophthalmology, Volume 3, pp 17-20; https://doi.org/10.33545/26638266.2021.v3.i2a.79

Abstract:
Objective: To evaluate the spectrum and frequency of patients presenting with vitreo-retinal diseases at a tertiary care hospital in Gujarat.Material and Methods: A total of 92922 patients were seen on OPD basis at the Department of Ophthalmology, GMERS Medical College, Gandhi Nagar, from 01 January 2018 to 31 December 2020. Their data was obtained from the OPD register. Demographic details, evaluation of vision with refraction, anterior segment slit lamp examination, dilated posterior segment slit lamp examination with 90 D lens, indirect ophthalmoscopy with 20 D lens were done. When needed ultrasound (B Scan), Fundus Fluorescein angiography and OCT examination were also done. Data was analysed for simple frequency and inter group differences were performed using the Chi-Square test.Results: Out of the total OPD patients, 4952 patients had vitreo-retinal diseases. Diabetic retinopathy was the most common vitreo-retinal disease. Vision threatening DR was found in 884 patients having DR. Age related macular degeneration (ARMD) and Retinal Vascular occlusive diseases were the next common vitreo retinal diseases causing vision impairment. Co-existent DM and Hypertension were the most common associated systemic diseases. Hematological tests, OCT were the most commonly done investigations.Conclusion: Diabetes is major factor contributing to blindness due to vitreo retinal diseases in the form of Diabetic Retinopathy and its association with retinal vessel occlusive disease. With the changing demographic in the coming years, this problem is going to increase. The time has now come to rise up to the situation and plan the establishment of human resources, early screening, timely management and awareness of the disease and to make it affordable and easily accessible to the community.
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