Eye Care Center In South India Research Articles

Clinical profile and challenges faced in the management of optic neuritis: the Indian scenario.

Optic neuritis (ON) is a relatively common ophthalmic disease that has recently received renewed attention owing to immunological breakthroughs. We studied the profile of patients with ON with special reference to antibody-mediated ON and the challenges faced in its management. Caserecords of patients with ON presenting to a tertiary eye-care center in South India were analyzed. Data on demographics, presenting visual acuity (VA), clinical features, seropositivity for aquaporin-4 immunoglobulin G (AQP4-IgG) and myelin oligodendrocyte glycoprotein immunoglobulin G (MOG-IgG), details of magnetic resonance imaging (MRI) of orbits and brain, and treatment were collected. Among138cases with acute ON, male: female ratio was 1:2. Isolated ON was present in 41.3% of cases. Antibody testing of sera was performed in 68 patients only due to financial limitations. Among these, 48.5% were MOG-IgG-seropositive, 11.76% were AQP4-IgG-seropositive, and 30.88% samples were double seronegative. Other causes included multiple sclerosis (n = 4), lactational ON (n = 4), tuberculosis (n = 2), invasive perineuritis (n = 2), COVID-19 vaccination (n = 2), and COVID-19 (n = 1). The mean presenting best corrected visual acuity (BCVA) was 1.31 ± 1.16 logMAR (logarithm of the minimum angle of resolution). The mean BCVA at 3months was 0.167 ± 0.46 logMAR. Only initial VA ≤ 'Counting fingers' (CF) had a significant association with the visual outcome for final VA worse than CF. The steep cost of investigations and treatment posed challenges for many patients in the management of ON. MOG-IgG-associated ON is common in India. Unfortunately, financial constraints delay the diagnosis and timely management of ON, adversely affecting the outcome.

Knowledge, attitude and practice assessment in glaucoma patients at a tertiary eye-care centre in South India: A questionnaire-based study

To assess knowledge, attitude and practice of glaucoma patients and to analyse the quality of life using GQL-15 questionnaire.: 70 patients with glaucoma who attended our tertiary eye care centre from November 2022 to April 2023 were included in the study. The patients were counselled regarding the nature of the disease, anti-glaucoma medications, their dose and frequency of instillation in their first visit. The patients were assessed using KAP and GQL-15 questionnaire in the next visit. Trained optometrists of our hospital administered the questions in the local language. Out of 70 patients who were enrolled in the study, 52 (74.28%) of patients were found to have adequate knowledge related to nature of the disease, drug, dose, frequency and method of instillation of anti-glaucoma medications and the remaining eighteen (25.71%) were found to have inadequate knowledge. A positive attitude towards usage of eye drops was noticed in 46 (65.71%) of patients and the remaining 24 (34.28%) showed negative attitude. 49 (70%) of patients were found to follow safe practice and remaining 21 (30%) followed negative practice. 45 (64.28%) of patients showed low GQL score based on GQL-15 questionnaire in their second visit, while 25(35.71%) of them showed high HQL score.This study intends to highlight that awareness and adequate knowledge regarding glaucoma can help patients in adhering to the treatment and may help in reducing the disease and eventually blindness burden due to this sight threatening disease.

Incidence of re-surgery after manual small-incision cataract surgery at a tertiary eye-care center in South India.

To study the incidence of re-surgery after manual small-incision cataract surgery (MSICS) at a tertiary eye-care center in South India and to compare the re-surgery rate between trainees and experts. A retrospective study was conducted at a tertiary eye-care center in Andhra Pradesh state of South India, which included 19,515 patients who underwent MSICS between 2012 and 2022 with 369 eyes of 369 patients who underwent re-surgery within 1 week of primary surgery. Factors included demographic data, type of re-surgery, that is, wound re-suturing, IOL repositioning, cortical wash, as well as anterior chamber (AC) wash. 19,515 eyes from the year 2012-2022 were analyzed. Most of the patients undergoing re-surgery belonged to the age group of 61-70 years (40.3%). Wound re-suturing was the more frequently performed re-surgery (47.6%). Wound re-suturing rates were comparable between the trainees and experts, whereas IOL repositioning, cortical wash, and AC wash were higher in the cases performed by trainees though statistically not significant. Careful pre-operative assessment, training under supervision, and other measures can be taken to reduce the re-surgery rates. Timely diagnosis and early treatment can give better outcomes and prevent devastating complications like endophthalmitis.

A clinical study of patients with optic neuritis in a tertiary eyecare centre

To evaluate the clinical profile and visual outcome of optic neuritis patients presenting to a tertiary eyecare centre.It is a retrospective hospital-based study carried out over a period 5 years between 2013 to 2018 in a tertiary eyecare centre in South India. Case records of 20 patients diagnosed and treated for optic neuritis were evaluated based on clinical profile, type of presentation and visual outcome.Patients had a mean age was 34.7±13.5 years. 60% presented in age group of 20-40years. Male preponderance was seen (65% of cases). Papillitis (65% of eyes) was more common than retrobulbar neuritis (35% of eyes). Unilateral involvement was seen in 85% of cases with Bilateral presentation seen in only 15% cases. Baseline visual acuity in 10(43%) patients was in the range of Counting fingers to <6/60, 3(13%) patients had vision>= 6/60, 5(22%) patients had Hand movements positive and 5(22%) had Perception of light positive. Periocular pain was seen in 8(40%) of the cases. 13(56%) patients had defective colour vision. 16(70%) patients had Grade 3-4 RAPD while the remaining had grade 1-2 RAPD. One patient was diagnosed with multiple sclerosis (MS). Recurrence was seen in 1 patient (5%). After treatment with 3 doses of 1gm IV Methylprednisolone 15 patients (74% of eyes) showed improvement in vision, 7 eyes (35%) had improvement in colour vision, 4 eyes (20%) had improvement in pupillary reaction after 3 doses of IV Methylprednisolone.Optic neuritis is idiopathic in nature. Papillitis is the commonest presentation when compared to Retrobulbar neuritis.

Keratoconus - a Review from a Tertiary Eye-Care Center

Purpose To understand the clinical pattern of keratoconus in patients visiting a tertiary eye-care center. This may improve the knowledge of the disease and treatment options. Methods The records from a tertiary eye-care hospital-based center were reviewed retrospectively to collect the required data. Medical records from 187 patients who had visited the contact lens clinic in the course of a three-month period were reviewed. The data available on demographics, year of diagnosis of keratoconus, topographic measurements, slit-lamp biomicroscopic findings, previously used or currently advised refractive correction, visual acuity and contact lens parameters were reviewed and recorded. Results Of the 187 patients, 365 eyes were included in the study. Six eyes that had previous corneal grafting and 3 eyes that were fellow normal eyes of unilateral keratoconus were excluded. The patients’ mean age was 21.3±6.96 years. There were 172 (47.12%) eyes previously diagnosed as keratoconus and 193 (52.87%) eyes that had been newly diagnosed as keratoconus. In the newly diagnosed group, 188 eyes were fitted with different types of contact lenses and 5 eyes were advised surgery. In the previously diagnosed group, 138 eyes and 6 eyes continued wearing conventional and multicurve custom rigid gas permeable (RGP) contact lenses, respectively. Of the remaining 28 eyes, 3 eyes were fitted with RGP lenses, 16 were refitted with piggyback, 2 with multicurve custom RGP and 7 were advised for scleral lenses or surgery. Conclusion This study brings out the clinical profile of keratoconus patients in a tertiary eye-care center in south India. The findings in this study stresses out the importance of defining the treatment options in keratoconus with the appropriate contact lenses.

Clinical and microbiological profile of Bacillus keratitis.

To examine the clinical and microbiological profile of Bacillus keratitis. A retrospective review was done of all medical and laboratory records of patients with infectious keratitis in an urban tertiary level eye-care center in South India between January 1991 and June 1997. Nineteen eyes of 17 patients having microbiologically proven Bacillus keratitis were reviewed. The mean age of the patients was 32.64 years (range, 3-70). The duration of symptoms ranged from 1 day to 3 months, with 11 eyes seen within a week of onset of symptoms. Trauma (five eyes), lagophthalmos (two eyes), topical corticosteroid therapy (one eye), bullous keratopathy (two eyes), previous corneal scars (two eyes), and diabetes (one eye) were identified as predisposing factors. Severe corneal features, disproportionate to the duration of symptoms, were present in most of the eyes. Gram stain of corneal scrapings showed variably stained bacilli in eight (42.1%) cases. Polymicrobial infection was present in six eyes (two fungal, four bacterial). Of the 16 isolates tested for in vitro antibiotic susceptibility, 100% were sensitive to gentamicin, 15 (93.75%) were sensitive to ciprofloxacin and norfloxacin, 14 (87.5%) were sensitive to chloramphenicol, and 10 (62.5%) were sensitive to cefazolin. Whereas 12 (63.1%) eyes required only medical therapy, adjunctive procedures were required in seven (36.8%) eyes. The ulcers healed (mean time to healing, 37.4+/-28.6 days) in 16 eyes (lost to follow-up, three). Visual acuity had improved after treatment in 10 (71.4%) of 14 eyes in whom vision could be recorded. Bacillus is an unusual pathogen in the clinical setting of infectious keratitis. The infection is mostly amenable to treatment with commonly used antibiotics, and the final outcome is often satisfactory.