Indian Journal of Clinical and Experimental Ophthalmology

119-123

Authors: Shraddha Panday, Rajendra P. Maurya, Virendra P.Singh, Mahendra K Singh, Ishan Yadav, Sujit Deshmukh

Aim: To review the role of botulinum toxin in ophthalmology; its indications and side effects. Method: A literature search on pubmed was performed and articles explaining the role of botulinum toxin in ophthalmology were reviewed Result: Botulinum toxin is being widely used in ophthalmology for various indications like Essential Blepharospasm, Myokymia, Eyelid apraxia, Strabismus, Hyperlacrimation, Spastic entropion and Cosmetic uses. Complications of the injection include local effects like ecchymosis, pain or infection and spill over effects like ptosis, diplopia, lagophthalmos, mid facial weakness and dry eyes. Conclusion: There are various implications of botulinum toxin in ophthalmology. When considering its application in clinical practice, one should be careful of the indications, risks and benefits of the procedure. When properly delivered it is a potential, efficacious, minimally-invasive treatment modality.

130-136

Authors: Sameera Irfan

Purpose: To find out how effective and safe Trans-ciliary Filtration with a Fugo-Plasma Blade is in providing a long term IOP control in different varieties of Glaucoma. Material and Methods: A prospective interventional study was conducted at a tertiary care centre from Jan 2013 till July 2015. Trans-ciliary Filtration by Fugo Plasma Blade was performed by a single surgeon (SI) on 52 consecutive eyes from age 6 months to 55 years. All cases were referred because IOP was uncontrolled on triple anti-glaucoma medication .The mean follow-up after TCF was 1 year. Results: In 48 eyes, IOP remained below 15 mm without the addition of any anti-glaucoma medication up to 1 year follow-up. This was a success rate of 80.76%. In 2 eyes with neovascular glaucoma, the bleb failed due to neo-vascularization and Cycle-Cryotherapy had to be performed. In 2 eyes with Buphthalmos, the IOP gradually crept up to 22 mm and they needed the addition of topical beta blocker drug. Conclusion: TCF performed with the Fugo Plasma blade is a safe procedure with minimal complications, easy to learn and master and offers efficient long-term IOP control in various types of glaucoma except the neo-vascular.

143-148

Authors: Kamal Mohan Verma, K.J Singh

Background: The scale of the low vision problems is considerable. Most elderly people who experience visual impairment do so due to age-related macular degeneration, cataract, and glaucoma. A study in Devon concluded that an integrated approach to low vision rehabilitation can, as measured by patient’s satisfaction and low vision aids usage rate, result in a more successful service than traditional dispensing services. Aim: To assess vision –related quality of life (QOL) of patients with low vision. Objectives: To assess degree of difficulty with and importance of activities of daily living and to establish vision-related quality of life (QOL) scores. Material & Method: Each patients completed a ‘restrictions in activities of daily living questionnaire’(MLVQ) and vision specific QOL assessment (VCM1) to establish baseline measurements of vision related QOL in a group of low vision patients prior to their first clinic visit. Results & Interpretation: One hundred and ten patients who had low vision clinic appointments would be willing to participate in the study. Any patients who had been seen by other low vision services during the last six month were excluded &patients aged 16 years or less were excluded. A total of 80 patients (72.72% of those approached) agreed to take participate in the study. Conclusion: Most of the patients in the study were already in possession of low vision aids but many did not find them helpful for the various tasks of daily living that they were attempting to perform. Vision-related QOL issues causing patients most concern were: inability to carry out preferred activities due to their eyesight, frustration and annoyance due to their eyesight, fear of their vision deteriorating, safety outside the home and eyesight interfering with their life in general. Vision-related QOL issues causing patients less concern were: coping with everyday life, depression, embarrassment and loneliness due to their vision, and safety within the home. Ninety – nine percent of those patients in the study before their appointment at the Low Vision clinic were happy to be re-interviewed again six months later.

156--158

Authors: Sandhya R., Abhilasha Sinha, Niharika Shetty

Aim: A pilot study for evaluation of awareness and knowledge of potentially blinding ocular disease Glaucoma among people attending OPD of a medical college hospital in Tumkur district. Materials and Methods: A hospital-based study of 300 patients attending Ophthalmology as outpatients to Siddhartha Medical College, Tumkur, participants were given a questionnaire to probe into their knowhow levels on order to evaluate their awareness of Glaucoma. Questionnaire was properly explained to the subjects in their understandable language before assessing their awareness. Subjects less than 20 years or more than 75 years and the ones suffering from the disease were not included. Subjects "who had heard of a disease called Glaucoma” prior to their recruitment into the study were labelled as ‘aware’. The participants who has some understanding of Glaucoma were categorized as "knowledgeable" Results: Out of 300 subjects recruited for the study, only 5 subjects were aware of a disease called Glaucoma. Determinants of awareness about glaucoma were educational status & known (history of glaucoma) in the family. Conclusion: Awareness and knowledge of glaucoma in patients attending a medical college hospital was abysmally low.

164-167

Authors: Kavita Patil, Karishma Munoli, Nitish RM

Background: Manual small incision cataract surgery (MSICS) has emerged as a popular technique in the ophthalmic practice. Ophthalmic viscosurgical devices (OVDs) are an integral part of the modern ophthalmic practice their role came to prominence with the success of extra capsular cataract extraction (ECCE) and the use of intra ocular lens implants (IOLs).There are few published data about the effect of various OVDs following manual small incision cataract surgery. Aims and objective: To determine post operative intra ocular pressure(IOP) changes after MSICS technique upon using OVDs; hydroxy propyl methyl cellulose (HPMC) and sodium hyaluronate (NAH) and also to assess the post operative protective effect of these two OVDs on cornea. Methodology: Sample of 60 senile cataract patients selected from the outpatient department of Ophthalmology and divided into 2 equal groups of 2%HPMC(Group A) and 1%NAH(Group B).MSICS technique was adopted for cataract surgery .Pre and postoperative IOP was assessed using Goldmann applanation tonometer and the cornea was examined under slit lamp Biomicroscope. Data was statistically analyzed using SPSS (statistical package of social sciences) version 16.01. A value of p <0.05 was taken as statistically significant. Results: In both groups there was statistically significant rise in IOP in the 24 hours Postoperative period and insignificant drop in IOP in the 1 week postoperative period .In 1%NAH group few patients showed corneal complications. Conclusion: Our study showed significant increase in IOP in the 24 hours postoperative period upon using 2%HPMC and1%NAH and 2%HPMC proved better protection on the cornea.

175-180

Authors: Shruti P Hegde, Vijay Kautilya D, Ravi

Introduction: Signature is a visuo-motor skill which requires continuous processing of the visual perceptions to execute effectively the fine hand movements. Any defect in the visual inputs could affect a change in the signature. Understanding the variation in signature characters caused by visual acuity change can help better evaluate questioned documents. In our study we try to analyze and catalogue these changes in the signature of a person. Methodology: The study was conducted among 100 subjects above 18 yrs of age and having normal visual acuity. They were asked to provide three samples of their signature, after which the same tasks was repeated with serial increments of myopia. . Changes in the signature class characters were analyzed and compared in all grades of myopia. Results: In this study it was found that there was increase in signature size, signature space between letters and decrease in the Middle zone letter size in different grades of induced myopia. The signature slope and letter slant also changes in most subjects with change in the visual acuity. The changes were not linear and coudn’t be used to predict the grade of myopia. Conclusion: From the findings of the study it could be concluded that visual processes significantly influence the signature and myopia by effecting the visual acuity would induce corresponding changes in the signature class characters. These changes need to be kept in mind while evaluating question documents.

184-186

Authors: Syeed Mehbub Ul Kadir, Farhat Jahan, A.S.M.M Quadir, Md. Tauhidur Rahman

Purpose: We report a rare case of the eyelid subcutaneous filariasis in Bangladesh Methods: Through Ocular and systemic evaluation, CT scan of orbit and histopathological analysis plays an important role for diagnosis. Results: An11 yrs girl presented with right periocular swelling, moderate tenderness and the right eye could not be opened for the last 3 days. CT scan of orbit showed diffuse heterogeneous soft tissue swelling in both upper and lower eyelid which was suggestive of preseptal cellulitis. She was improved on conservative management. On clinical evaluation, we found a nodular swelling, firm in consistency and overlying skin was free, fixed to the tarsus in the most lateral part of right upper eyelid. Thyroid function test showed hypothyroidism. She was euthyroid after two months of treatment. Excision biopsy was done and the lesion was round, nodular, solid lesion. Histopathology report reviled filariasis of the eyelid. There were no features of filariasis on systemic evaluation. Conclusion: Filariasis may be found rarely in the eyelid. Painful eyelid swelling in patients should always raise the suspicion of filariasis.