Authors:Bruce E Spivey Pages: 746 - 751 Abstract: Bruce E Spivey Indian Journal of Ophthalmology 2018 66(6):746-751 This paper summarizes the personal experience of an ophthalmologist who has been involved in medical education for over 60 years. With clinical experience and leadership positions within ophthalmology and in broad medical organizations, this paper chronicles the evolution of educational practice and approaches for over a half-century. Citation: Indian Journal of Ophthalmology 2018 66(6):746-751 PubDate: Tue,22 May 2018 DOI: 10.4103/ijo.IJO_738_18 Issue No:Vol. 66, No. 6 (2018)
Authors:Ashok Kumar Grover, Santosh G Honavar, Rajvardhan Azad, Lalit Verma Pages: 752 - 783 Abstract: Ashok Kumar Grover, Santosh G Honavar, Rajvardhan Azad, Lalit Verma Indian Journal of Ophthalmology 2018 66(6):752-783 We present a residency curriculum for Ophthalmology in India. The document derives from a workshop by the All India Ophthalmological Society (AlOS) which adapted the International Council of Ophthalmology residency curriculum and refined and customized it based on inputs by the residency program directors who participated in the work shop. The curriculum describes the course content, lays down the minimum requirements of infrastructure and mandates diagnostic and therapeutic procedures required for optimal training. It emphasises professionalism, management, research methodology, community ophthalmology as integral to the curriculum. The proposed national ophthalmology residency curriculum for India incorporates the required knowledge and skills for effective and safe practice of ophthalmology and takes into account the specific needs of the country. Citation: Indian Journal of Ophthalmology 2018 66(6):752-783 PubDate: Tue,22 May 2018 DOI: 10.4103/ijo.IJO_327_18 Issue No:Vol. 66, No. 6 (2018)
Authors:Partha Biswas, Parikshit Madhav Gogate, Quresh Badr Maskati, Sundaram Natarajan, Lalit Verma, Payal K Bansal Pages: 785 - 792 Abstract: Partha Biswas, Parikshit Madhav Gogate, Quresh Badr Maskati, Sundaram Natarajan, Lalit Verma, Payal K Bansal Indian Journal of Ophthalmology 2018 66(6):785-792 Purpose: To gauge the differences in ophthalmology residency training, academic, clinical and surgical, in the last three decades of the 20th century and the first decade of the 21st century. Methods: A survey was conducted by the Academic and Research Committee of the All India Ophthalmological Society, in 2014–2016, using a prevalidated questionnaire, which was circulated to ophthalmologists to gauge the practicality of the teaching protocols of clinical and surgical skills during postgraduate residency program. Results: Of the 1005 respondents, 320 ophthalmologists who completed residency between 1967 and 2002 (20th century trained) and 531 who completed a residency in 2003–2012 (21st century trained) fulfilled the inclusion criteria. The average age was 49.2 years (standard deviation [SD] 4) and 32.6 years (SD 4), respectively. Twenty-first century trained ophthalmologists rated their training significantly better than the 20th century trained ophthalmologists for slit lamp examination (P = 0.001), indirect ophthalmoscopy, gonioscopy, automated perimetry, optical coherence tomography, and fundus photography (all having P < 0.001), while the 20th century trained rated their teaching of refraction, synoptophore, diplopia charting better (all P < 0.001). The range of grading was 0–10 in all categories. The median number of surgeries performed independently by 20th century and 21st century trained (during their training period) were: intracapsular cataract extraction (ICCE) 10, 0; extracapsular cataract extraction (ECCE) 43, 18; small incision cataract surgery (SICS) 5, 55; phacoemulsification (Phaco) 0, 1; pterygium excision 20, 15; dacryocystectomy 11, 4; dacryocystorhinostomy 11, 2; chalazion 35, 30; trabeculectomies 5, 0; strabismus correction 0, 0; vitrectomy 0, 0; keratoplasty 0, 0; eyelid surgery 6, 2; and ocular emergencies 18, 20. Conclusion: Teaching of many clinical skills had improved over decades. Cataract surgery training has shifted from ICCE and ECCE to SICS and Phaco, but other surgeries were still taught sparingly. There was an enormous variation across the country in residency training which needs immediate attention. Citation: Indian Journal of Ophthalmology 2018 66(6):785-792 PubDate: Tue,22 May 2018 DOI: 10.4103/ijo.IJO_108_17 Issue No:Vol. 66, No. 6 (2018)
Authors:Soumya Ramani, Thanuja Gopal Pradeep, Divya D Sundaresh Pages: 793 - 797 Abstract: Soumya Ramani, Thanuja Gopal Pradeep, Divya D Sundaresh Indian Journal of Ophthalmology 2018 66(6):793-797 Purpose: The aim of this study was to study the effect of wet-laboratory training on the surgical outcome of resident performed manual small-incision cataract surgery (MSICS). Methods: We conducted a retrospective, comparative observational study on resident performed MSICS in our institute. We collected data of 464 patients of which Group A had 232 cases performed by residents without prior wet-laboratory training and Group B had 232 resident performed cases after adequate skill training in the wet laboratory. The demographics, type of cataract, intraoperative, postoperative complications, and immediate visual outcome were compared between the two groups. Results: The age, sex, and type of cataract were similar in both groups of residents. The frequency of intraoperative complications was higher in Group A (23.7%) than in Group B (15.08%) (P = 0.019). The occurrence of posterior capsule (PC) rupture and vitreous loss showed a statistically significant difference, with Group A showing a high rate of 14.3% PC rent and vitreous loss while only 6.9% (P = 0.01) had this complication in Group B. The postoperative visual outcome also was better in Group B than in Group A, with 62.06% of patients in Group B, having a postoperative day 1 vision of better than 6/18 as compared to only 38.36% in Group A. Conclusion: The wet-laboratory training is an effective method of improving the skills of the ophthalmology residents in MSICS. The reduction of complications will improve the quality of surgery and improve the postoperative visual outcome. Citation: Indian Journal of Ophthalmology 2018 66(6):793-797 PubDate: Tue,22 May 2018 DOI: 10.4103/ijo.IJO_1041_17 Issue No:Vol. 66, No. 6 (2018)
Authors:Jameel Rizwana Hussaindeen, Mithra Anand, Viswanathan Sivaraman, Krishna Kumar Ramani, Peter M Allen Pages: 799 - 805 Abstract: Jameel Rizwana Hussaindeen, Mithra Anand, Viswanathan Sivaraman, Krishna Kumar Ramani, Peter M Allen Indian Journal of Ophthalmology 2018 66(6):799-805 Purpose: Variant myopia (VM) presents as a discrepancy of >1 diopter (D) between subjective and objective refraction, without the presence of any accommodative dysfunction. The purpose of this study is to create a clinical profile of VM. Methods: Fourteen eyes of 12 VM patients who had a discrepancy of >1D between retinoscopy and subjective acceptance under both cycloplegic and noncycloplegic conditions were included in the study. Fourteen eyes of 14 age- and refractive error-matched participants served as controls. Potential participants underwent a comprehensive orthoptic examination followed by retinoscopy (Ret), closed-field autorefractor (CA), subjective acceptance (SA), choroidal and retinal thickness, ocular biometry, and higher order spherical aberrations measurements. Results: In the VM eyes, a statistically and clinically significant difference was noted between the Ret and CA and Ret and SA under both cycloplegic and noncycloplegic conditions (multivariate repeated measures analysis of variance, P < 0.0001). A statistically significant difference was observed between the VM eyes, non-VM eyes, and controls for choroidal thickness in all the quadrants (Univariate ANOVA P < 0.05). The VM eyes had thinner choroids (197.21 ± 13.04 μ) compared to the non-VM eyes (249.25 ± 53.70 μ) and refractive error-matched controls (264.62 ± 12.53 μ). No statistically significant differences between groups in root mean square of total higher order aberrations and spherical aberration were observed. Conclusion: Accommodative etiology does not play a role in the refractive discrepancy seen in individuals with the variant myopic presentation. These individuals have thinner choroids in the eye with variant myopic presentation compared to the fellow eyes and controls. Hypotheses and clinical implications of variant myopia are discussed. Citation: Indian Journal of Ophthalmology 2018 66(6):799-805 PubDate: Tue,22 May 2018 DOI: 10.4103/ijo.IJO_1115_17 Issue No:Vol. 66, No. 6 (2018)
Authors:Rolli Khurana, Shailja Tibrewal, Suma Ganesh, Rajoo Tarkar, Phuong Thi Thanh Nguyen, Zeeshan Siddiqui, Shantanu Dasgupta Pages: 806 - 811 Abstract: Rolli Khurana, Shailja Tibrewal, Suma Ganesh, Rajoo Tarkar, Phuong Thi Thanh Nguyen, Zeeshan Siddiqui, Shantanu Dasgupta Indian Journal of Ophthalmology 2018 66(6):806-811 Purpose: The aim of this study was to compare noncycloplegic refraction performed in school camp with that performed in eye clinic in children aged 6–16 years. Methods: A prospective study of children with unaided vision <0.2 LogMAR who underwent noncycloplegic retinoscopy (NCR) and subjective refraction (SR) in camp and subsequently in eye clinic between February and March 2017 was performed. A masked optometrist performed refractions in both settings. The agreement between refraction values obtained at both settings was compared using the Bland–Altman analysis. Results: A total of 217 eyes were included in this study. Between the school camp and eye clinic, the mean absolute error ± standard deviation in spherical equivalent (SE) of NCR was 0.33 ± 0.4D and that of SR was 0.26 ± 0.5D. The limits of agreement for NCR were +0.91D to − 1.09D and for SR was +1.15D to -1.06D. The mean absolute error in SE was ≤0.5D in 92.62% eyes (95% confidence interval 88%–95%). Conclusion: A certain degree of variability exists between noncycloplegic refraction done in school camps and eye clinic. It was found to be accurate within 0.5D of SE in 92.62% eyes for refractive errors up to 4.5D of myopia, 3D of cylinder, and 1.5D of hyperopia. Citation: Indian Journal of Ophthalmology 2018 66(6):806-811 PubDate: Tue,22 May 2018 DOI: 10.4103/ijo.IJO_982_17 Issue No:Vol. 66, No. 6 (2018)
Authors:Niranjan Pehere, Pratik Chougule, Gordon N Dutton Pages: 812 - 815 Abstract: Niranjan Pehere, Pratik Chougule, Gordon N Dutton Indian Journal of Ophthalmology 2018 66(6):812-815 Purpose: The aim of this study is to identify common causes, associated ophthalmological abnormalities, and systemic comorbidities in children in Andhra Pradesh, India, with cerebral visual impairment (CVI). Methods: A retrospective review of case records of all children aged <16 years with diagnosis of CVI seen between January 2016 and December 2016 was carried out. Data were collected for their age, gender, cause of CVI, refraction, accommodation, anterior and posterior segment examination findings, and systemic problems. Results: A total of 124 patients were identified and studied (80 boys and 44 girls, mean age 5.23 years, 44.8% aged <2 years). The most common causes of CVI were hypoxic–ischemic encephalopathy (HIE) (34.4%), undetermined etiology (32.8%), neonatal seizures, and infantile spasms (16% each). The most common presenting complaints were poor vision (76%) and squint (11.2%). Profound visual impairment was seen in 88.8%, and 11.2% had high functioning CVI. Fifty-eight (46.4%) patients had significant refractive errors, 40 (32.25%) had strabismus, 4 (3.2%) had visually significant cataract, and 40 (32%) had optic atrophy. Motor delay was observed in 39.5%, speech delay was evident in 22.4%, and cognitive delay in 16%. Conclusion: HIE is the most common cause (one-third) of CVI in our population, and the majority of them presented at age <2 years (44.8%) with profound visual impairment (88.8%). A significant number of them have treatable ophthalmic conditions such as refractive errors (46.4%), accommodative insufficiency (12.1%), and cataract (3.2%), and more than one-third of them also have delay in other areas of development. Citation: Indian Journal of Ophthalmology 2018 66(6):812-815 PubDate: Tue,22 May 2018 DOI: 10.4103/ijo.IJO_1274_17 Issue No:Vol. 66, No. 6 (2018)
Authors:Namrata Sharma, Deepali Singhal, Prafulla Kumar Maharana, Rahul Jain, Pranita Sahay, Jeewan S Titiyal Pages: 816 - 819 Abstract: Namrata Sharma, Deepali Singhal, Prafulla Kumar Maharana, Rahul Jain, Pranita Sahay, Jeewan S Titiyal Indian Journal of Ophthalmology 2018 66(6):816-819 Purpose: The aim of this study is to describe a modified surgical technique of continuous intraoperative optical coherence tomography (iOCT)-guided shield ulcer debridement with tuck-in multilayered Amniotic membrane transplantation (ML AMT) in vernal keratoconjunctivitis (VKC) with shield ulcer with plaque. Methods: Seven eyes of seven patients presenting with VKC with shield ulcer with plaque were enrolled in this prospective case series and planned for shield ulcer debridement with ML AMT. Debridement of the ulcer base with double-layered AMT was done under the continuous guidance of iOCT. The main outcome measure was the time for complete reepithelialization. Statistical analysis was performed using the Stata-14.0 program for Windows. Data were presented as mean ± standard deviation/median (minimum-maximum) and frequency percentage as applicable. Results: The surgery could be completed successfully in all cases and iOCT could provide real-time assessment of the depth of dissection during the entire procedure. The duration of complete healing and disintegration of amniotic membrane varied from 7 to 12 days. Recurrence was not seen in any case till 2 months follow-up. Conclusion: iOCT provides continuous monitoring of the depth of dissection and allows for a safe and complete debridement of the shield ulcer with plaque. Citation: Indian Journal of Ophthalmology 2018 66(6):816-819 PubDate: Tue,22 May 2018 DOI: 10.4103/ijo.IJO_929_17 Issue No:Vol. 66, No. 6 (2018)
Authors:Prafulla Kumar Maharana, Jay K Chhablani, Tara Prasad Das, Atul Kumar, Namrata Sharma Pages: 820 - 824 Abstract: Prafulla Kumar Maharana, Jay K Chhablani, Tara Prasad Das, Atul Kumar, Namrata Sharma Indian Journal of Ophthalmology 2018 66(6):820-824 Purpose: The purpose of this article is to document the current practice pattern of Indian ophthalmologists for antibiotic prophylaxis in cataract surgery to prevent endophthalmitis. Methods: Fifteen structured questions were sent online to all ophthalmologists registered with the All India Ophthalmological Society. The questionnaire was divided into three main categories of prophylaxis – preoperative, intraoperative, and postoperative. A web-based anonymous survey was conducted, and a unique response link allowed completing the survey only once. We compared the results with a similar 2014 survey among the members of the American Society of Cataract and Refractive Surgeons (ASCRS). Results: The response was received from 30.2% (n = 4292/14,170) ophthalmologists. The results were as follows: all respondents do not prepare the eye with 5% povidone-iodine (83% of them use povidone iodine), majority (90%) use topical antibiotic both pre- and post-operatively, 46% use subconjunctival antibiotic at the end of surgery, and 40% use intracameral antibiotic (46% of them in high-risk patients only). Moxifloxacin was the preferred antibiotic for topical and intracameral use. Comparison with the 2014 ASCRS survey results showed a similarity in decision for pre- and post-operative antibiotics and intracameral antibiotic but dissimilarity in the choice of intracameral antibiotic and decision for subconjunctival antibiotic. Conclusion: The antibiotic prophylaxis practice by the Indian ophthalmologists is not too dissimilar from the practice in North American Ophthalmologists (ASCRS) though all ophthalmologists in India must be nudged to preoperative preparation of the eye with povidone-iodine and discontinue the practice of postoperative subconjunctival and systemic antibiotic. Citation: Indian Journal of Ophthalmology 2018 66(6):820-824 PubDate: Tue,22 May 2018 DOI: 10.4103/ijo.IJO_1336_17 Issue No:Vol. 66, No. 6 (2018)
Authors:Sabyasachi Sengupta, Dhaivat Vasavada, Utsab Pan, Manavi Sindal Pages: 827 - 830 Abstract: Sabyasachi Sengupta, Dhaivat Vasavada, Utsab Pan, Manavi Sindal Indian Journal of Ophthalmology 2018 66(6):827-830 Purpose: The purpose of this study is to determine factors predicting resolution of acute pseudophakic cystoid macular edema (PCME) after 6 weeks of topical prednisolone and nepafenac application. Methods: Case records of patients with a clinical and optical coherence tomography (OCT)-based diagnosis of acute PCME were retrospectively reviewed for best-corrected visual acuity and OCT-based parameters at the time of presentation with PCME. In addition, demographic variables, intraoperative and early postoperative factors, and type of treatment prescribed (tapering vs. nontapering prednisolone, generic vs. branded prednisolone and nepafenac) were recorded from case records for analysis. Complete and any successes were defined and baseline factors predicting complete success at 6 weeks were analyzed. Results: We analyzed 69 eyes of 69 patients out of which complete success with topical medications was seen in 37 eyes (54%) and any success was seen in 55 eyes (80%) at 6 weeks. Multivariable logistic regression showed that eyes with lower vision at presentation had a significantly lower likelihood of experiencing both, complete (odds ratio [OR] = 0.83 with one-line decrement in baseline vision, 95% confidence interval [CI] = 0.61–0.89, P = 0.003) and any success (OR = 0.61, 95% CI = 0.4–0.9, P = 0.007). Baseline OCT thickness did not influence success rates. Conclusion: Topical prednisolone and nepafenac lead to resolution in PCME in half of the eyes at 6 weeks. Baseline vision is the only factor predicting rates of success and PCME resolution with topical medications. Citation: Indian Journal of Ophthalmology 2018 66(6):827-830 PubDate: Tue,22 May 2018 DOI: 10.4103/ijo.IJO_735_17 Issue No:Vol. 66, No. 6 (2018)
Authors:Mert Simsek, Mehmet Citirik, Serdar Ozates, Dilara Ozkoyuncu Pages: 831 - 836 Abstract: Mert Simsek, Mehmet Citirik, Serdar Ozates, Dilara Ozkoyuncu Indian Journal of Ophthalmology 2018 66(6):831-836 Purpose: This study evaluated the effect of intravitreal dexamethasone implant (IDI; Ozurdex) injection for treating macular edema in patients with branch retinal vein occlusion (BRVO) or central retinal vein occlusion (CRVO). Methods: This prospective study included 40 eyes of 40 patients with nonischemic BRVO and 31 eyes of 31 patients with nonischemic CRVO who received IDI injection as the first-line treatment for macular edema. The best-corrected visual acuity (BCVA) value before and after the treatment; intraocular pressure; optic coherence tomography findings; and all ocular examination findings, including central foveal thickness (CFT) measurement and fluorescein angiography findings, were evaluated for each patient. Results: After the IDI injection, BCVA value increased (P < 0.001) and CFT value decreased (P < 0.001) in both groups. The recurrence rates of CFT elevation after the first and the second Ozurdex injections were 65.0% and 65.3%, respectively, in patients with BRVO and 70.9% and 68.1%, respectively, in patients with CRVO. A statistically significant correlation was observed between preinjection CFT value and postinjection recurrence of CFT elevation (P = 0.017). Conclusion: Treatment with the IDI injections resulted in significant short-term improvement in CFT and BCVA values in patients with clinically significant RVO-related macular edema. Moreover, we observed that high preinjection CFT value was associated with a risk of postinjection recurrence of CFT elevation. Citation: Indian Journal of Ophthalmology 2018 66(6):831-836 PubDate: Tue,22 May 2018 DOI: 10.4103/ijo.IJO_1259_17 Issue No:Vol. 66, No. 6 (2018)
Authors:Amar Pujari, Atul Kumar, Rohan Chawla, Sudarshan Khokhar, Divya Agarwal, Meghal Gagrani, Namrata Sharma, Pradeep Sharma Pages: 837 - 840 Abstract: Amar Pujari, Atul Kumar, Rohan Chawla, Sudarshan Khokhar, Divya Agarwal, Meghal Gagrani, Namrata Sharma, Pradeep Sharma Indian Journal of Ophthalmology 2018 66(6):837-840 Purpose: To review the nature of firecracker-related ocular injuries at a tertiary eye hospital in northern India following the firecracker ban and also to review the level of awareness among the victims. Methods: A cross-sectional observational study involving the patients presenting with firecracker-related ocular injuries from October 18 to 27, 2017 were assessed for demographic distribution, detailed ocular evaluation, and a questionnaire related to the awareness about the injuries. Results: A total of 68 patients were observed. Fifty patients (74.5%) were males. This year, a majority of patients were from outside Delhi. Uttar Pradesh constituted the most 38.23% of the patients followed by Haryana 30.88%, Delhi 23.5%, and Bihar 7.35%. Visual acuity varied from 6/6 to no perception of light. Open globe injury was observed in 56 patients (82.35%) who commonly had zone I injury. A significant number of patients (88.23%) were aware of firecracker-related injuries, and a large number of such injuries (58.8%) occurred in those who were not actively involved in the ignition of firecrackers but were in the vicinity. Conclusion: This year, following a ban, the number of firecracker-related ocular injuries reported from areas outside Delhi outnumbered as compared to within Delhi. However, firecracker-related ocular injuries are still a major cause of significant visual loss, especially involving the bystanders. Thus, firecracker-related celebrations should be monitored with a stringent protocol. Citation: Indian Journal of Ophthalmology 2018 66(6):837-840 PubDate: Tue,22 May 2018 DOI: 10.4103/ijo.IJO_1290_17 Issue No:Vol. 66, No. 6 (2018)
Authors:Priya Narang, Keiki Mehta, Amar Agarwal Pages: 841 - 844 Abstract: Priya Narang, Keiki Mehta, Amar Agarwal Indian Journal of Ophthalmology 2018 66(6):841-844 Placement of an anterior chamber iris implant for cosmetic reasons has been associated with development of various complications. Even after the implant has been explanted from the eye, it leaves a trail of after effects that necessitate surgical management. We describe a technique that comprises of performing phacoemulsification with single-pass four-throw pupilloplasty and a pre-Descemet's endothelial keratoplasty procedure for this eye with cosmetic iris implant complication. Citation: Indian Journal of Ophthalmology 2018 66(6):841-844 PubDate: Tue,22 May 2018 DOI: 10.4103/ijo.IJO_1279_17 Issue No:Vol. 66, No. 6 (2018)
Authors:Pradeep Venkatesh, Seema Kashyap, Shreyas Temkar, Varun Gogia, Gaurav Garg, Rahul Kumar Bafna Pages: 845 - 847 Abstract: Pradeep Venkatesh, Seema Kashyap, Shreyas Temkar, Varun Gogia, Gaurav Garg, Rahul Kumar Bafna Indian Journal of Ophthalmology 2018 66(6):845-847 Fine-needle aspiration biopsy (FNAB) of intraocular mass lesions is an important intervention in the presence of diagnostic difficulty. FNAB of intraocular mass lesions is also likely to become more commonly recommended for prognostication of tumors such as choroidal melanoma. The most commonly described approach for tumor localization and visualization during FNAB is transillumination and indirect ophthalmoscopic viewing. Herein, we report endoillumination (chandelier) and wide-angle viewing assisted, microscope-based approach for FNAB in two patients using two port minimally invasive vitreoretinal surgical approach. The submission is supported by a video demonstration. The entire procedure was completed under the microscope. Adequate sample was obtained. In the first patient, the inflammatory nature of the lesion was confirmed though magnetic resonance imaging had been reported as melanoma. In the second patient, a clinical diagnosis of amelanotic melanoma was confirmed. Endoillumination-assisted FNAB of intraocular mass lesions is easier to learn and more precise and hence carries lesser risks. Citation: Indian Journal of Ophthalmology 2018 66(6):845-847 PubDate: Tue,22 May 2018 DOI: 10.4103/ijo.IJO_1306_17 Issue No:Vol. 66, No. 6 (2018)
Authors:Constantine D Georgakopoulos, Olga E Makri Pages: 852 - 852 Abstract: Constantine D Georgakopoulos, Olga E Makri Indian Journal of Ophthalmology 2018 66(6):852-852
Citation: Indian Journal of Ophthalmology 2018 66(6):852-852 PubDate: Tue,22 May 2018 DOI: 10.4103/ijo.IJO_227_18 Issue No:Vol. 66, No. 6 (2018)
Authors:Jose Manuel Abalo-Lojo, Ihab Abdulkader-Nallib, Laura Martínez Pérez, Francisco Gonzalez Pages: 854 - 855 Abstract: Jose Manuel Abalo-Lojo, Ihab Abdulkader-Nallib, Laura Martínez Pérez, Francisco Gonzalez Indian Journal of Ophthalmology 2018 66(6):854-855 Kaposi sarcoma (KS) is a low-grade, multicentric vascular neoplasm. Most commonly, it involves the skin, but it can occur at any site on the body. The cutaneous lesions are often located on the lower legs, genitalia, oral mucosa, and face. KS is categorized in four different types: classic, endemic, epidemic or AIDS associated, and transplantation associated. We report a case of HIV-negative, classic KS located on the eyelid. The eyelid lesion was completely excised, and after a 1-year follow-up, no recurrences were observed. Ocular involvement by KS in a patient who is serologically negative for HIV is extremely rare. Citation: Indian Journal of Ophthalmology 2018 66(6):854-855 PubDate: Tue,22 May 2018 DOI: 10.4103/ijo.IJO_1073_17 Issue No:Vol. 66, No. 6 (2018)
Authors:Shivanand C Bubanale, Linda Maria Genoveva De Piedade Sequeira, Bhagyajyothi B Kurbet Pages: 856 - 858 Abstract: Shivanand C Bubanale, Linda Maria Genoveva De Piedade Sequeira, Bhagyajyothi B Kurbet Indian Journal of Ophthalmology 2018 66(6):856-858 Congenital lamellar ichthyosis is an autosomal recessive, heterogeneous disorder presenting at birth with generalized skin involvement. The most common ophthalmic manifestation noted is bilateral ectropion of the lower eyelids. A 1-month-old female neonate, the second born of a nonconsanguineous marriage, presented with 4 days' history of redness, discharge, and swelling in the right eye. There was severe right upper eyelid ectropion, conjunctival injection, chemosis, a subconjunctival mass on the temporal bulbar conjunctiva spontaneously draining pus and corneal haze. The anterior chamber, iris, lens and fundus appeared normal. Congenital lamellar ichthyosis was suspected because of scaling and excessive dryness of the entire body. The occurrence of a spontaneous subconjunctival abscess is not known in lamellar ichthyosis. We thus report the management of a rare case of unilateral upper eyelid ectropion, subconjunctival abscess with orbital cellulitis in congenital lamellar ichthyosis. Citation: Indian Journal of Ophthalmology 2018 66(6):856-858 PubDate: Tue,22 May 2018 DOI: 10.4103/ijo.IJO_1171_17 Issue No:Vol. 66, No. 6 (2018)
Authors:Saurabh Choudhry, Neha Goel, Aanchal Mehta, Nidhi Mahajan Pages: 858 - 860 Abstract: Saurabh Choudhry, Neha Goel, Aanchal Mehta, Nidhi Mahajan Indian Journal of Ophthalmology 2018 66(6):858-860 Postoperative opacification of a hydrophilic acrylic intraocular lens (IOL) is an uncommon complication. A 57-year-old diabetic female who had undergone phacoemulsification with IOL implantation in her right eye 16 years back presented with diminution of vision in the same eye for 3 years. Significant IOL opacification was observed clinically and anterior segment optical coherence tomography clearly delineated the intraoptic deposits, sparing the haptics, and edges of the optic. IOL explant and exchange was performed leading to restoration of visual acuity to 6/9. Histochemical evaluation of the IOL confirmed that the hydrophilic acrylic IOL optic had calcium deposits. Citation: Indian Journal of Ophthalmology 2018 66(6):858-860 PubDate: Tue,22 May 2018 DOI: 10.4103/ijo.IJO_1172_17 Issue No:Vol. 66, No. 6 (2018)
Authors:Harsh Kumar, Avnindra Gupta, Viney Gupta Pages: 861 - 862 Abstract: Harsh Kumar, Avnindra Gupta, Viney Gupta Indian Journal of Ophthalmology 2018 66(6):861-862 We present a case of tube endothelial touch where a suture technique for repositioning of the Ahmed glaucoma valve was performed. Advantage of this technique is that it is minimally invasive and anterior chamber stability is maintained during the procedure. Citation: Indian Journal of Ophthalmology 2018 66(6):861-862 PubDate: Tue,22 May 2018 DOI: 10.4103/ijo.IJO_987_17 Issue No:Vol. 66, No. 6 (2018)
Authors:Richa Ranjan, Manisha Agarwal Pages: 863 - 865 Abstract: Richa Ranjan, Manisha Agarwal Indian Journal of Ophthalmology 2018 66(6):863-865 A 43-year-old male with chronic Vogt–Koyanagi–Harada syndrome (VKH) presented with subfoveal choroidal neovascular membrane (CNVM) in the right eye with no evidence of active inflammation. He underwent intravitreal bevacizumab and dexamethasone injections. Postinjection he developed fresh keratic precipitates and exudative retinal detachment (RD). He received two more bevacizumab injections with oral corticosteroids and immunosuppressants causing resolution of exudative RD with scarred CNVM. We report this case to highlight that intravitreal injection may act as a trigger for rebound inflammation in VKH patients and may require anti-inflammatory drugs to be started even in the absence of an active inflammation. Citation: Indian Journal of Ophthalmology 2018 66(6):863-865 PubDate: Tue,22 May 2018 DOI: 10.4103/ijo.IJO_1145_17 Issue No:Vol. 66, No. 6 (2018)
Authors:S Bala Murugan, Girish Bharat Velis, Manavi D Sindal Pages: 866 - 868 Abstract: S Bala Murugan, Girish Bharat Velis, Manavi D Sindal Indian Journal of Ophthalmology 2018 66(6):866-868 Bilateral uveal effusion syndrome associated with bilateral acute retinal necrosis is a diagnostic and therapeutic challenge. A 52 year old man presented with bilateral angle closure with choroidal detachment. With restricted fundus view, parenteral steroid was started. During close follow up bilateral discrete areas of peripheral retinitis were noted. Parenteral steroids were promptly stopped and parenteral antivirals with oral steroids were continued. It showed healing response with nil recurrences till last follow up. Aggressive treatment of bilateral uveal effusion with parenteral steroids can cause progression of bilateral acute retinal necrosis leading to phthisis bulbi. However early diagnosis, prompt intervention and close follow up are the key elements to therapeutic success even during diagnostic surprises and avoid costly mistakes. Citation: Indian Journal of Ophthalmology 2018 66(6):866-868 PubDate: Tue,22 May 2018 DOI: 10.4103/ijo.IJO_954_17 Issue No:Vol. 66, No. 6 (2018)
Authors:Cigdem Altan, Berna Basarir, Cem Kesim Pages: 869 - 871 Abstract: Cigdem Altan, Berna Basarir, Cem Kesim Indian Journal of Ophthalmology 2018 66(6):869-871 A 47-year-old male presented with bilateral 4 + circulating pigment in the anterior chamber, diffuse iris transillumination, dilated pupils unresponsive to light, and high intraocular pressure (IOP) levels in both eyes. Visual acuity and IOP improved bilaterally with topical steroid and antiglaucomatous therapy. In the 10th month, bilateral cystoid macular edema (CME) was developed and resolved after subtenon triamcinolone injections. CME recurred after cataract surgery in the right eye which was treated with intravitreal dexamethasone implant injection. CME was recurred in the left eye and treated with intravitreal dexamethasone implant at the same setting with cataract surgery. CME can be seen in the course of bilateral acute iris transillumination (BAIT). This is the first BAIT case presenting with bilateral CME. Citation: Indian Journal of Ophthalmology 2018 66(6):869-871 PubDate: Tue,22 May 2018 DOI: 10.4103/ijo.IJO_1134_17 Issue No:Vol. 66, No. 6 (2018)
Authors:Pradeep Sagar, R Rajesh, Mahesh Shanmugam, Vinaya Kumar Konana, Divyansh Mishra Pages: 872 - 876 Abstract: Pradeep Sagar, R Rajesh, Mahesh Shanmugam, Vinaya Kumar Konana, Divyansh Mishra Indian Journal of Ophthalmology 2018 66(6):872-876 The aim of this study is to compare the optical coherence tomography angiography (OCTA) and fundus fluorescein angiography (FFA) features of retinal capillary hemangioblastoma (RCH). This is an observational case series of three patients with von Hippel–Lindau (VHL) disease and one patient with juxtapapillary RCH. All patients underwent FFA with a mydriatic fundus camera and OCTA with swept-source angio OCT. The FFA and OCTA characteristics of tumors were compared. In our series, FFA could identify tumors as small as the width of a third-order retinal artery, which was missed on clinical examination. OCTA identified these tiny tumors, but only those closer to the posterior pole. Both FFA and OCTA could identify the intrinsic vasculature and feeder vessel in juxtapapillary RCH. On OCTA, the tumors were better defined than in FFA. The depth of the lesion can be identified on OCTA. Feeder and the draining vessels could be identified precisely in OCTA than FFA, particularly in small tumors. OCTA can identify tumors in VHL missed on clinical examination. It can identify the feeder vessel and intrinsic vasculature of sessile juxtapapillary RCH and aids in its diagnosis. Tumors are better defined in OCTA than FFA due to the absence of leakage. However, FFA can identify nearly all the early tumors, but OCTA fails to image the peripheral tumors due to its smaller field and prolonged acquisition time. Technological advances and the development of wide-field OCTA in the future can be helpful in identifying all the unsuspected tumors in VHL disease. Citation: Indian Journal of Ophthalmology 2018 66(6):872-876 PubDate: Tue,22 May 2018 DOI: 10.4103/ijo.IJO_1199_17 Issue No:Vol. 66, No. 6 (2018)
Authors:Swaranjali S Gore, Neha Rathi, Amol Y Ganvir, Nayana A Potdar, Monisha K Apte, Trupti R Marathe, Akshay Gopinathan Nair, Chhaya A Shinde Pages: 877 - 879 Abstract: Swaranjali S Gore, Neha Rathi, Amol Y Ganvir, Nayana A Potdar, Monisha K Apte, Trupti R Marathe, Akshay Gopinathan Nair, Chhaya A Shinde Indian Journal of Ophthalmology 2018 66(6):877-879 Subperiosteal hemorrhages are typically the result of blunt orbital or facial trauma. Nontraumatic subperiosteal hemorrhages are uncommon and are usually attributed to increase in central venous pressure and bleeding disorders. Here, we report the case of a 38-year-old female who underwent an upper gastrointestinal (GI) endoscopy and developed bilateral nontraumatic subperiosteal hemorrhages that resolved with conservative treatment. Here, we discuss the source of bleeding and the mechanisms for the occurrence of orbital subperiosteal bleeds. GI surgeons and ophthalmologists should be sensitive to the possibility that orbital hemorrhage that can occur following endoscopy, especially when retching or gagging occurs during the procedure. Citation: Indian Journal of Ophthalmology 2018 66(6):877-879 PubDate: Tue,22 May 2018 DOI: 10.4103/ijo.IJO_123_18 Issue No:Vol. 66, No. 6 (2018)
Authors:Kasturi Bhattacharjee, Samir Serasiya, Deepika Kapoor, Harsha Bhattacharjee Pages: 879 - 882 Abstract: Kasturi Bhattacharjee, Samir Serasiya, Deepika Kapoor, Harsha Bhattacharjee Indian Journal of Ophthalmology 2018 66(6):879-882 Two cases of traumatic optic neuropathy presented with profound loss of vision. Both cases received a course of intravenous corticosteroids elsewhere but did not improve. They underwent Navigation guided optic canal decompression via external transcaruncular approach, following which both cases showed visual improvement. Postoperative Visual Evoked Potential and optical coherence technology of Retinal nerve fibre layer showed improvement. These case reports emphasize on the role of stereotactic navigation technology for optic canal decompression in cases of traumatic optic neuropathy. Citation: Indian Journal of Ophthalmology 2018 66(6):879-882 PubDate: Tue,22 May 2018 DOI: 10.4103/ijo.IJO_1167_17 Issue No:Vol. 66, No. 6 (2018)
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