Indian Journal of Clinical and Experimental Ophthalmology

60-61

Authors: Rajendra P Maurya

Indian Journal of Clinical and Experimental Ophthalmology (IJCEO) is a refereed, peer-reviewed, indexed journal with academics and experts of repute as members of its Editorial Board. IJCEO publishes articles in the field of Ophthalmology and Vision science for a worldwide readership. It publishes original research papers, unusual case reportsand critical reviews dealing with all sub specialties of Ophthalmology like Pediatric ophthalmology, Neuro-ophthalmology, Ocular Oncology &Oculoplasty, CommunityOphthalmology, Oculartraumatology, Vitreo-retina and Cornea & refractive surgery etc. Special emphasis is given to issues that include new clinical trials, technical & surgical innovations and current ophthalmic updates, research activities and continuedmedical education in ophthalmic teaching. The role of Ophthalmologyin society and, new findings from the frontiers of current researchare always encouraged.

68-75

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

Background: Fungi can cause devastating ocular infections like keratitis and endophthalmitis; however, there are limited studies available on the epidemiology and risk factors of fungal ocular infections in Northern India. The aim of this study is to determine the epidemiology and factors affecting visual acuity in fungal keratitis, in population of Eastern Uttar Pradesh. Methods: All patients were reviewed for demographic features, predisposing factors, prior therapy, clinical features, microbiological findings, medical and surgical treatment, and outcome of therapy. For microbiological study corneal scrapings were taken by the Ophthalmologist using sterile blades. For the isolation of fungi, samples were inoculated on specific media and KOH mount were done .The identification of fungi was performed by microscopic evaluation and growth on specific media. Different epidemiological factors and risk factors were assed and compared to find association of risk factors to visual acuity in fungal keratitis. Results: Out of total 295 cases of culture-proven keratomycosis at our institute during the study period between June 2010 and March 2015, 254 cases were included in the analysis. In our study most of the patients (61.42%) were male, significant number of patients were from lower socio economic status (89.76%) and from rural background (91.34%). Illiteracy was one of the major factor was found in our patients (85.04%). 48.03% study subjects were having history of ocular trauma while 7.87% patients were Diabetics. Other factors responsible for poor visual outcome were patients age (age > 40 years in 66.15%), delayed Presentation ( > 7 days ,82.22% ), use of topical steroids (90.63% ) and TEM (80.00%), patients having infection caused by septate fungi (74.36%) , hypopyon (89.19%) and central corneal ulcer(78.74%) . Factors could not be assessed in 2 patients less than 1 year of age, so their visual acuity was not recorded. Conclusions: History of trauma, use of topical steroid, diabetes, lid margin disorders are major predisposing factors for fungal keratitis. Age > 40 years, steroid use, late presentation, central location of ulcer with hypopyon and use of traditional eye medication (TEM) were major risk factors for poor visual acuity with corneal opacity beung most common complication.

84-90

Authors: Manav Deep Singh, Chetna Sharma, Akhilandeswari Prasad

Background: Present definition of ‘Primary Open Angle Glaucoma’ considers raised intraocular pressure (IOP) as one of the risk factors for this disease. Association of alterations in ocular blood flow has been considered another risk factor, Moreover the eye being treated for glaucoma could be a part of wider systemic dysfunction of auto-regulation of ocular blood flow. This hypothesis is further backed up with the recognition of normal tension glaucoma as a clinical entity and observation of progressive glaucomatous damage despite IOP control. This study was, thus, undertaken to study retrobulbar blood flow using colour Doppler imaging (CDI) in patients of glaucoma and to see how the control of IOP affected these parameters. Methods: This is a prospective cohort study involving 43 freshly diagnosed patients of POAG and 30 controls. Peak systolic velocity (PSV) and mean end diastolic velocity (EDV) and resistivity index (RI) were studied in ophthalmic artery (OA), in central retinal artery (CRA) and short posterior ciliary arteries (SPCA). Values were compared with those of normal controls and also pre and post treatment among patients of POAG. Results: Mean PSV and EDV were found to be significantly low in OA and CRA only in patients of POAG compared to controls. Once target pressure was achieved, blood flow parameters were similar to non glaucomatous eyes. Conclusions: Blood flow in retrobulbar vessels is reduced among glaucomatous eyes as compared to the normal population. Once target pressure is achieved, blood flow parameters become similar to non glaucomatous eyes suggestive of improved blood flow as a function of reduced IOP. Colour Doppler imaging is not found to be reliable for measuring blood flow in SPCA. Role of RI as a true measure of resistance to blood flow is unclear.

95-99

Authors: Shreya Thatte, Anirudha D Gulanikar, Purvi Garg

Xeroderma Pigmentosa(XP) is an autosomal recessive disorder caused by defect in DNA repair mechanism which is induced by ultra violet rays . These patients have multisystem involvement (skin, eye, neurological and oral lesions with recurrent malignancy. Material and Method: It is a retrospective, observational study of 9 cases of xeroderma pigmentosa (XP) with ocular involvement. Presence of skin and ocular malignancy was the main feature. Skin malignancy diagnosed by histopathology showed squamous cell carcinoma of face, basal cell carcinoma of scalp and nose. Ocular malignancy diagnosed as squamous cell carcinoma and malignant melanoma. Cases with ocular malignancy presented with limbal nodule which was excised surgically along with application of intraoperative cyro and mitomycin C. Apart from ocular malignancy other ocular involvement was conjunctival melanosis and corneal scar. Impression cytology was done in all patients with ocular involvement. Observation: XP was seen more commonly in boys with age group of 5-25 years. Incidence of malignancy was the main feature in these patients. 5 patients had skin and ocular malignancies. Skin malignancy was observed in 2 patients in form of squamous cell carcinoma and basal cell carcinoma while ocular malignancy was seen in 3 patients in the form of squamous cell carcinoma in 2 patients and malignant melanoma in 1 patient. Other ocular feature like conjunctival melanosis was present in 2 cases and corneal scar was seen in 2 patients. Follow up was done up to 6 months to note recurrence of ocular malignancy. Conclusion: Early diagnosis of ocular malignancies is essential to plan treatment modality, which was done by impression cytology, accordingly mitomycin C and cryo was used to prevent recurrence.

104-106

Authors: Rohit Saxena, Digvijay Singh, Anuradha Chandra, Pradeep Sharma

Superior oblique palsy presents with a vertical and torsional deviation and diplopia which is often exacerbated by an ipsilateral inferior oblique over action. The usual surgical approach is defined by the extent of inferior oblique over action and/or vertical deviation and includes weakening of the ipsilateral inferior oblique muscle. If torsional diplopia outweighs the vertical component then, an antero-nasal transposition of the inferior oblique may be undertaken to correct both. We describe a novel surgical technique for adjustable antero-nasal transposition of the inferior oblique muscle for a residual torsional diplopia in one case of a superior oblique palsy.

110-117

Authors: Manav Deep Singh, Harshika Chawla

Centuries of research on Glaucoma have not been able to add any factor to ‘Intraocular Pressure (IOP)’ the modification of which can halt the progression of this blinding disease. Therefore, the need for accurate IOP measurement has always been the interest of researchers and industry. An array of instruments has, thus, been developed, each surpassing the errors of the previous modalities. Although all of them have certain advantages, they have their limitations too. The present article puts light on the various developments in the field of tonometry over two centuries starting digital tonometry to the latest developments. It has also briefly touched the factors affecting intraocular pressure and its measurement.