Ocular Causes Research Articles

Ocular Lesions in Birds of Prey in Portugal: A Retrospective Study

In wildlife rehabilitation centers, thousands of animals are treated annually, with a substantial proportion being birds of prey. Since vision is essential for the survival of these species, this study focused on investigating the causes of ocular injuries in raptors admitted to four rehabilitation centers across mainland Portugal from 2017 to 2021. Of the 2207 birds admitted during this period, 156 (7%) presented ocular injuries. Hyphema (28.2%) and corneal ulcers (20.5%) were the most prevalent injuries, often occurring together or alongside lens luxation. Nocturnal raptors showed a higher prevalence of these injuries (76.9%) compared to diurnal raptors (23.1%). A significant association was found between ocular injuries and causes of admission, particularly with ocular hemorrhages and multiple injuries in the eye. Despite the severity of the ocular injuries, the release rate remained relatively high at 51%, underscoring the critical role of comprehensive ocular examinations and vision assessments in guiding treatment decisions and discharge decisions. This study highlights the need for further research with larger samples to better understand the impact of ocular injuries on the rehabilitation success of wild birds in Portugal.

Review of Ocular and Non-Ocular causes of Headache in Adult and Pediatric Patients; A multicenter study

Purpose: To determine ocular and non-ocular causes of headache in adult and pediatric patients in three tertiary care hospital of Multan, Pakistan Study Design: Cross-sectional study. Place and Duration of Study: This multi-centre study was conducted in Combined Military Hospital, Multan, Pakistan and The Children’s Hospital and The Institute of Child Health, Multan, Pakistan from February 2023 to September 2023. Methods: The non-probability convenience sampling technique was used. The data collection and diagnosis were done by a consultant ophthalmologist. The statistical analysis of this study was conducted using SPSS version 23. Results: The study comprised of a total of 600 patients. The mean age of the adult patients was 27.16±14.39 years ranging between 16to 80 years and the mean age of pediatric patients was 10.1±2.40 years. The patients were divided into four groups based on the etiology of headache that were ocular, non-ocular, combined ocular causes and ocular and non-ocular causes combined. The most common ocular cause was myopia in 43(14.3%) adults and 47 (15.8%) pediatric patients. However, the most common non-ocular cause was migraine in 72(24.0%) adult patients and frontal sinusitis in 43 (14.3%) pediatric patients. Conclusion: Refractive errors were the most common ocular etiology of headache in ophthalmology patients predominately myopia in the adult and pediatric population. Migraine was the most common non-ocular etiology in adult population whereas frontal sinusitis was most common in the pediatric age group.

Phacoemulsification Combined with Pars Plana Vitrectomy: Outcome in Horses with Acquired Cataracts Associated with Uveitis.

Cataracts resulting from equine recurrent uveitis (ERU) or other forms of uveitis are usually associated with rapid progression. ERU is the most common ocular disease cause of blindness and cause of cataracts in horses. The necessity for the posterior capsulorhexis (PC) during phacoemulsification (PE) is controversial. This study aimed to evaluate vision and complications after PE combined with pars plana vitrectomy (PPV) in horses with uveitis-associated cataracts and compare the PE technique with and without posterior capsulorhexis. Thirty-two eyes of 28 horses with uveitis-associated cataracts aged 14 months to 19.6 years were treated with PE-PPV under identical conditions. Twenty-three eyes of 21 horses were affected by an ERU-associated (ERU group), and nine eyes of 7 horses were affected by cataracts related to uveitis with pathogenesis different to ERU (non-ERU group). PE-PPV was performed in 12 eyes of 10 horses (PC group) and 20 eyes of 18 horses without posterior capsulorhexis (NPC group). Follow-up examination was performed at a mean of 1.7 ± 1.8 years postoperatively (range: 1 month-6.4 years). In the period up to 1 month postoperatively, 17/20 (85%) NPC-eyes and 8/12 (67%) PC-eyes (total: 25/32 [78%]) were visual. From 1-6 months postoperatively, 16/20 (80%) NPC-eyes and 7/12 (58.3%) PC-eyes (total: 23/32 [72%]), and from 6-12 months, 7/11 (63.6%) NPC-eyes and 3/8 (37.5%) PC-eyes (total: 10/19 [52.6%]) were visual. From 12-18 months postoperatively, 3/7 (42.9%) NPC-eyes and 2/9 (22.2%) PC-eyes (total: 5/16 [31.3%]), and from 18-24 months, 3/8 (37.5%) NPC-eyes and 1/8 (12.5%) PC-eyes (total: 4/16 [25%]) were visual. After 24 months postoperatively, 2/7 (28.6%) NPC-eyes and 1/8 (12.5%) PC-eyes (total: 3/15 [20%]) were visual. Despite the higher number of visual eyes in the NPC group at each time point, differences were not significant. No obvious differences regarding postsurgical vision were observed between the ERU- and non-ERU groups at each time point. In the overall population, a significant decrease in the number of eyes with postoperative active uveitis was observed during the follow-up examinations (p < 0.001). A significant increase in the number of eyes that were blind due to retinal detachment was observed in the overall patient population as the examination period progressed (p < 0.001). Retinal detachment was the sole long-term cause of blindness. In horses diagnosed with uveitis-associated cataracts and treated with PE-PPV, no persistent active uveitis was observed in the present study during follow-up examinations. However, the proportion of eyes that were blind due to retinal detachment increased. Whilst PE-PPV may prevent postsurgical persistent active uveitis and remove lens opacity, the prognosis for a visual outcome is guarded. A superior outcome in postsurgical vision was observed in the NPC group. However, caution is required when interpreting these results due to several factors that affect the independent comparison of the surgical groups.

Profile of Ophthalmic Causes of Headache – A Prospective Study

Headache is the most common cause encountered in ophthalmological practice. It is mistaken that all headaches are associated with refractive errors and other ocular diseases. However, it can be an alarming sign in many cerebral disorders and be a key indication for intervention. The study emphasizes determining the causes of headaches and quantifying the ocular causes. Purposive sampling of the subjects above five years presenting with a headache was included in the study. Data was collected with the help of proforma. Cross references from other specialties like ENT, medicine, dentistry, and neurology were taken. Out of 500 subjects in our study, 391 patients (78.2%) directly attended the ophthalmology OPD with headache. In contrast, 109 (21.8%) were referred from other (ENT, Medicine, Dental, Neurology, Surgery) specialties to ophthalmology OPD because of evaluation of headache. A wide range of differential diagnoses must be considered when evaluating patients with headaches with ocular pain or visual disturbances. Hence, the ophthalmologist is the first physician to triage these patients. Keywords: Headache, Ophthalmic, Benign, Refractive errors, Causes

The Frequency and Manifestations of Ocular Causes of Abnormal Head Posture

ABSTRACT Purpose To determine the frequency and manifestations of different ocular causes of abnormal head posture (AHP). Method This prospective, consecutive case series study was performed on 149 patients with ocular AHP at Farabi hospital, Iran, from February 2020 to June 2021. All patients underwent routine ophthalmic examinations. The manifestation of AHP was determined by direct observation from three viewing angles, while the patient read the smallest line on the vision chart that they could see. In front, above, and lateral gazes, observations were performed to find head tilt, head turn, and chin abnormal position, respectively. A picture with habitual AHP was taken from all patients. The amount of head tilt was measured by calculating the angle between the line that connects the lips center to the center of the eyebrows and the vertical line using the Corel Draw X7 computer software. Results The mean age of 149 patients with ocular AHP [101 (67.8%) males and 48 (32.2%) females] was 16.2 ± 12.2 (range, 2–57) years. The most common ocular sources of AHP were found to be superior oblique palsy (SOP) in 66 (44.3%) patients, 54 (36.2%) cases with Duane’s retraction syndrome (DRS), and 12 (8.1%) patients with nystagmus. Other frequent causes of ocular AHP were dissociated vertical deviation (DVD) in 5 (3.4%), A and V pattern strabismus in 3 (2.0%), and 2 cases (1.3%) in each of Brown syndrome, inferior rectus (IR) palsy, and congenital fibrosis of the extraocular muscles (CFEOM). The most common manifestations of AHP in all cases were “pure head turn” (48.3%), followed by “pure head tilt” (24.8%), “simultaneous head tilt and head turn” (20.8%), and “chin up” (6.0%). The mean head tilt among all patients with head tilt was 10.4° ± 8.9° (range, 5.0°−31.7°). Conclusion The most frequent ocular sources of AHP were SOP, DRS, and nystagmus, followed by DVD, A and V pattern strabismus, IR palsy, CFEOM, and Brown syndrome. In addition, pure head turn and pure head tilt were the most common manifestations of ocular AHP but were not always seen in the same direction or combination as previously reported with these etiologies.

Torticollis in Non-Syndromic Unicoronal Craniosynostosis Is Predominantly Ocular Related.

(1) Background: Patients with unicoronal craniosynostosis (UCS) often show torticollis which can result from either an ocular cause or contraction of the sternocleidomastoid muscle. For clinicians, it is crucial to know the prevalence of ocular torticollis (OT) to ensure appropriate referral for treatment. Furthermore, associated ophthalmic features with OT in these patients are scarcely described. The aim of this study was to determine the prevalence of OT in non-syndromic UCS patients and investigate its associated ophthalmic features. (2) Methods: In this descriptive cross-sectional study medical records of non-syndromic UCS patients treated between 1994-2022 in one tertiary care hospital in The Netherlands were retrospectively reviewed. Collected data included: diagnosis and type of torticollis, binocular single vision (BSV), strabismus, ocular motility, alphabetical patterns, refractive error, and amblyopia. Patients were classified as OT, based on their ophthalmic and/or orthoptic diagnosis. Prevalence was determined with the 95% CI using the Clopper-Pearson exact test. Associations between OT and the ophthalmic features were determined using Chi-square or Fishers' exact test and its effect size was calculated using Cramer's V. (3) Results: In total, 146 patients were included, of whom 57 had torticollis. An ocular cause for the torticollis was found in 54 patients. The prevalence of OT was 37% (n = 146; 95% CI [0.292-0.454]). Significant associations were found between OT and strabismus (p < 0.001), ocular motility abnormalities (p < 0.001), alphabetical patterns (p < 0.001), and amblyopia (p = 0.002). BSV (p = 0.277) and refractive error (p = 1.0) were not significantly associated with OT. However, in OT the BSV was relatively poor (42.1%) and more frequently absent (26.3%) compared to the non-torticollis group (7% poor and 16.3% absent). In both groups, excyclotorsion was predominantly present (62.3%). (4) Conclusions: In 95% of cases, torticollis in UCS patients is ocular-related. Overall, one in three patients with UCS have OT. This study emphasizes the importance of a timely referral of all patients with UCS with torticollis to an orthoptist and/or ophthalmologist, specialized in diagnosing and treatment of OT, before considering physiotherapy.

Computer Vision Syndrome: An Ophthalmic Pathology of the Modern Era.

Digital device usage has increased significantly in last decade among all age groups, both for educational and recreational purposes. Computer vision syndrome (CVS), also known as digital eye strain (DES), represents a range of ocular, musculoskeletal, and behavioral conditions caused by prolonged use of devices with digital screens. This paper reviews the principal environmental, ocular, and musculoskeletal causes for this condition. Due to the high prevalence of DES and frequent usage of digital devices, it is important that eye care practitioners be able to provide advice and management options based on quality research evidence.

A CLINICAL STUDY OF OCULAR CAUSES OF HEADACHE

Aims :To enumerate the Ocular causes of headache. Objectives: 1. To assess the various Ocular manifestations in patients with headache. 2. To study the various causes of headache and early diagnosis of various causes of headache 3. To assess the severity of Ocular manifestations in patient who present with headache Materials and Methods: This was a Hospital based cross sectional study done on patients who attended to OPD with a cheif complaint of headache, Dr. R.S.P.R Government Regional Eye Hospital, Andhra Medical College, Visakhapatnam from August 2021 to August 2022. Relevant detailed history and Ocular examination was done. Results: Outof 100,35(53.9%)has Refractive errors,10(12.8%)has Convergence insufficiency,14(17.95%)hasAccomadativeinsufficiency,7(9%)hasHeterophorias,1(1.3%)has Heterotropias,5(5%)has Systemic diseases. Majority were in the age group between 21-30yrs(31%)in which 13% males,17%females and least are under 0-10 and 61-70 years(3%). 52(52%)had Eye strain,10(10%)had Photophobia,12(12%)had Raised IOP, 10(10%)had Nausea,5(5%)had Frequent blinking, 5(5% )had Vertigo,3(3%)had diseases of External eye and adnexia2(2%) had Scalp tenderness 1(1%) had Photopsia and 1(1%)Iatrogenic. Conclusion: Early detection and management of Refractive errors and Accomodative squint and distinguishing the other causes of headache like migraine, sinusitis, and systemic diseases like hypertension and benign tumours.

A study of the ocular pathology of headache in patients presenting to ophthalmic OPD in a tertiary care center

Aims: Headache is a common presenting complaint of ophthalmic patients, but it is also a symptom of a wide range of systemic problems some of which are life threatening while others benign. This study aimed to detect the common ocular causes of headache in patients visiting the eye outpatient department (OPD). Settings and Design: This was a cross-sectional, observational study of one year duration conducted in a tertiary care center. Materials and Methods: Demographic data and a detailed history was collected from 395 patients complaining of headache and attending the eye OPD, followed by a detailed ocular examination including visual acuity, refraction, intraocular pressure, slit-lamp examination, and fundus. Statistical Analysis: The data was analyzed using the Statistical Package for the Social Sciences (SPSS) software version 21. Frequencies and percentages were calculated. A P value of &lt;0.05 was considered significant. Results: There were 298 females (75.4%) and 97 males (24.5%) with headache. Fifty-six point four percent of the headaches occurred in the 21–40-year age group. Forty-seven percent of headaches were ocular, the most common ocular cause being uncorrected refractive errors (21.3%) followed by computer vision syndrome (19%). Fifty-three percent of headaches had non-ocular pathology, of which 33.5% were primary headaches: overall, the most common type of headache in the study. Red flag signs were noted in 21 cases. Conclusion: This study helped to identify and estimate the frequency of ocular and non-ocular causes of headaches. Also, we identified red flag signs which should be looked out for to avoid missing a life-threatening secondary pathology behind the headache.

Exudative Retinal Detachment in Nigerians: Demographics and Causes.

Exudative retinal detachment (ERD) is a rare type of retinal detachment (RD), and information on its causes and presentation in Nigerians and Black Africans is scarce. To report the prevalence, vision at presentation, and causes of ERD in a cohort of RD patients. A prospective, multicentre, hospital-based study. We examined consecutive eyes diagnosed with ERD in ophthalmic patients seen within 1 year in four ophthalmic hospitals in Nigeria. The patients had a complete eye examination, including visual acuity, intraocular pressure measurement, slit lamp examination of the anterior segment, dilated fundus examination, and other ancillary investigations. Statistical analysis was done using SPSS version 22.0. Nine out of 237 patients were diagnosed with ERD, giving a hospital-based prevalence of 3.8% of RDs. The mean age of patients was 45.8 ± 21.6 years (6 months-80 years), male:female = 2:1. ERD was bilateral in one patient and unilateral in eight patients. There was no gender association (P = 0.84), but systemic disease was associated with a risk of ERD (P = 0.001). Five out of 9 (55.6%) patients had an associated systemic disease. The systemic diseases include two patients (40%) who had chronic renal failure, two patients (40%) who had systemic hypertension, and one patient (10%) who had lung cancer. Other ocular causes of ERD include post endophthalmitis, coats disease, and age-related macular degeneration in one eye each. 80 % of eyes were blind at presentation. ERD is a rare form of RD in Nigerians and is associated with systemic diseases. There are inflammatory, neoplastic, vascular, and degenerative causes of ERD. At presentation, most eyes are blind. Early presentation will be beneficial in salvaging vision. Also, awareness of the occurrence and causes of ERD should be created amongst eye care practitioners.

"Power" ful eye causing postoperative blurring of vision after non-ocular surgery under general anesthesia.

Dear Editor, Ocular complications can occur in patients following non-ocular surgeries under general anesthesia which range from transient blurring of vision to irreversible blindness.[1] We report a case where preexisting hypermetropia was the cause of postoperative blurring of vision. A 38-year-old man with no comorbidities was posted for laparoscopic orchidectomy for right undescended testis. Preoperative evaluation revealed no abnormalities. General anesthesia was induced with fentanyl 100 mg, propofol 120 mg, atracurium 30 mg, and intubated with 8 mm endotracheal tube. Anesthesia was maintained with oxygen, air, sevoflurane and atracurium 5 mg, and fentanyl 50 mg. Opticlude eye patch (3M India) was used to gently close the eyes during surgery. Surgery in supine position lasted for 1 h and was uneventful. After reversal with neostigmine 2.5 mg and glycopyrrolate 0.5 mg, the patient was extubated. Postoperative recovery was uneventful. 24 h later in the ward, the patient complained of blurring of vision in both eyes while viewing a mobile phone. Ophthalmologist’s opinion was taken. Anterior segment examination including cornea was normal in both eyes. Fundus examination and extraocular movements were normal in both eyes. Uncorrected Snellen’s visual acuity for distance was 6/12 right eye and 6/6 left eye and uncorrected near visual acuity was N6 in both eyes. On refraction testing, the patient had simple hypermetropia of + 1.5 diopters in the right eye and no refractive error in the left eye. On questioning, the patient accepted that he had some difficulty while reading small print even before the surgery but never visited an ophthalmologist. The patient was reassured and glasses were prescribed for hypermetropia following which the blurring of vision resolved. The causes of postoperative blurring of vision after non-ocular surgeries can range from simple corneal abrasion to serious retinal vascular occlusions and ischemic optic neuropathy.[2,3] Our patient complained of blurring of vision postoperatively. We ruled out corneal abrasion and other serious ocular causes. To our surprise, he had hypermetropia which was corrected with spectacles. In a study by Warner et al.[4] on 671 patients undergoing non-ocular surgery under anesthesia, 4.2% of patients experienced new-onset blurred vision of at least 3 days duration postoperatively. In most of them, it resolved spontaneously over weeks. 25% of patients with blurred vision required new corrective lens or changes to existing lens over the next 18 months. The authors found no significant risk factors. Our patient had hypermetropia preoperatively itself which got unmasked after surgery. Preexisting refractive errors can get exaggerated following surgical stress due to transient accommodative weakness and can cause blurring of vision postoperatively. Due to limited mobility in the postoperative period, patients commonly watch mobile and read books for a prolonged time. This constant focus on simple visual tasks may cause patients to notice any small change in their vision. Further studies are required to know the incidence and risk factors for the transient postoperative blurring of vision from refractive errors. It is also important to enquire about the difficulty in vision for both near and far during preanesthetic checkup in all patients coming for surgery as medicolegal documentation. Declaration of patient consent The authors certify that they have obtained all appropriate patient consent forms. In the form the patient(s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed. Financial support and sponsorship Nil. Conflicts of interest There are no conflicts of interest.

Assessing the Performance of a Novel Bayesian Algorithm at Point of Care for Red Eye Complaints.

The current diagnostic aids for red eye are static flowcharts that do not provide dynamic, stepwise workups. The diagnostic accuracy of a novel dynamic Bayesian algorithm for red eye was tested. Fifty-seven patients with red eye were evaluated by an emergency medicine physician who completed a questionnaire about symptoms/findings (without requiring extensive slit lamp findings). An ophthalmologist then attributed an independent "gold-standard diagnosis". The algorithm used questionnaire data to suggest a differential diagnosis. The referrer's diagnostic accuracy was 70.2%, while the algorithm's accuracy was 68.4%, increasing to 75.4% with the algorithm's top two diagnoses included and 80.7% with the top three included. In urgent cases of red eye (n = 26), the referrer diagnostic accuracy was 76.9%, while the algorithm's top diagnosis was 73.1% accurate, increasing to 84.6% (top two included) and 88.5% (top three included). The algorithm's sensitivity for urgent cases was 76.9% (95% CI: 56-91%) using its top diagnosis, with a specificity of 93.6% (95% CI: 79-99%). This novel algorithm provides dynamic workups using clinical symptoms, and may be used as an adjunct to clinical judgement for triaging the urgency of ocular causes of red eye.

Аномальное положение головы: новая парадигма

Purpose. To determine the most common ocular causes and types of anomalous head position and give details of their functional features. Material and methods. The research included 105 patients with an anomalous head position. Depending on the oculomotor pathology, patients were divided into 6 groups. 1st group – 10 patients with Brown syndrome, 2nd group – 20 patients with Duane syndrome of types 1 and 2, 3rd group – 30 patients with nystagmus, 4th group – 30 patients with n. abducensparalysis, 5th group – 15 patients with n. trochlearisparalysis, and control 6th group – 20 patients with one of the above pathology, but without anomalous head posture (AHP). Results. Out of 105 patients with AHP, 83.8% had both fusion and stereopsis. There was no statistical difference in the rate of fusion or stereopsis among the different AHP types (p=0.580). The control group showed accurately low scores of stereopsis and fusion loss (5.3%) (p=0.001). The overall incidence of amblyopia in all groups of patients with AHP (with Brown, Duyane syndrome, with nystagmus by 3.7 times, with paralysis and paresis of n. abducensand n. trochlearis) is statistically significantly lower (p&lt;0.001) than in the control group. Conclusion. The most common ocular causes of anomalous head position are nystagmus and paralysis of the abducens nerve, as well as Duane syndrome and paralysis of the trochlear nerve. Head rotation is most commonly associated with congenital nystagmus, Duane syndrome, and n. abducens paralysis and paresis. Head tilt or various combinations of head tilt with a raised chin is most characteristic of n. trochlearis paralysis and paresis and Brown syndrome. AHP formation is a «protective» mechanism in terms of developing amblyopia and loss of binocular single vision. Key words: abnormal head position, binocular vision, stereopsis, amblyopia.

Validity and reliability of CVI Range assessment for Clinical Research (CVI Range-CR): a longitudinal cohort study

IntroductionCortical visual impairment (CVI) is the leading cause of paediatric visual impairment in developed countries. Children with CVI exhibit visual behaviours that differ from those with ocular causes of visual...

Ocular Findings in Children with Headache

ABSTRACT Purpose To determine the prevalence of ophthalmological findings suggesting an ocular cause for headache or occult neurological disease, among children with headache. Methods Retrospective cross-sectional study on children with headache at a tertiary outpatient ophthalmology clinic. All children underwent sensorimotor, anterior segment, and dilated fundoscopic examinations, with or without cycloplegic refraction. Prevalence of one or more new findings of ocular or occult neurological cause of headache, including glaucoma, uveitis, optic nerve elevation, or possible asthenopia from strabismus or refractive issues. Headache characteristics and associated symptoms were evaluated as risk factors for ocular findings. Results Among 1,878 children with headache (mean age 10 yrs, range 2–18), 492 (26.1%, 95% CI 24.3–28.2%) children had one or more new ocular findings that could cause headache or indicate intracranial disease: refractive issues (342, 18.2%), strabismus (83, 4.4%), optic nerve elevation (51, 2.7%; 26 with papilledema, 25 with pseudopapilledema), uveitis (6, 0.3%), and glaucoma (2, 0.1%). Shorter headache duration was associated with ocular findings (p = .047), but headache frequency, photophobia, nausea/vomiting, and visual changes were not. In univariable analysis, visual changes (p ≤ .001), nausea/vomiting (p ≤ .002), and morning headache (p = .02) were associated with optic nerve elevation. Conclusion An ophthalmologic examination including cycloplegic refraction is indicated in children with headache, as one-quarter have a treatable ocular condition, which may be related to the headache, or sign of intracranial pathology. While nausea, visual changes, or morning headache should raise concern, coincident visual, ocular, or systemic symptoms are not reliable predictors of discovering ocular pathology in a child with headache.

Causes of poor eye contact in infants: a population-based study

BackgroundEstablishing eye contact between infants and parents is important for early parent-child bonding and lack of eye contact may be a sign of severe underlying disease. The aim of the study was to evaluate the causes of poor or lacking eye contact in infants.MethodsCross-sectional study reviewing all referrals of infants ≤1 year of age from January 1rst, 2016 to December 31rst, 2018. Medical information was retrieved from patient files covering pregnancy, birth, diagnostic work-up and ocular parameters such as refraction, visual acuity and structural findings.ResultsWe identified 99 infants with poor or lacking eye contact. The relative frequency of causes was neurologic disease 36.4% (36/99), delayed visual maturation 24.2% (24/99), ocular disease 21.2% (21/99) and idiopathic infantile nystagmus 4.0% (4/99). Fourteen infants had a visual function within age-related norms at first examination despite poor eye contact at the time of referral. Of the infants with available data, 18/27 (33.3%) with neurologic cause, 15/23 (65.2%) with delayed visual maturation and 9/21 (42.9%) with ocular cause had visual acuity within the age-related norm at latest follow-up (0-41 months). In 23 infants, a genetic cause was found.ConclusionPoor eye contact in infants may be a sign of severe underlying disease, such as neurological or ocular disease. Close collaboration between pediatric ophthalmologists and neuro-pediatricians are warranted in the management of these infants.

Prevalence of Smartphone Addiction and Associated Ocular Problem in Young Population Of U.P, India

Abstract: Through the technological development mobile phone entered in our lives which becoming the most commonly used technical device. The telecom technology (smart phones mainly) development has profound impact on lives of the students. It has more advantages, it enhance or improvise our knowledge , increase more activity in less time but sometimes it act as a harmful device by the excessive usage , on our young generation . It becomes adductor device in young population. Purpose- the main purpose of this study is used to find the impact on users -academic performance, daily activities, physical and mental health, social relationships, ocular problems, and withdrawal tendency. Design- This study is based on the young age group. A complete descriptive questionnaire based study. Method - Total 100 students were included in this study, mainly young age group between 18 to 25 years. 20 questions was structured in Google form and then sent to the student through their mobile phone. Their working hour on the smart phones, component of applications which were they most used. Result - This study proved the level of mobile phone addiction scale, their physical, mental and behavioral changes. Ocular problems found such as Dry eye, headache, blurred vision, eyestrain, neck and shoulder pain, fatigue and red eye also general health problem like pain in wrist, index finger, phalanges etc. Conclusion - the data collected from 100 students shows mobile addiction was determined to relate to withdrawal, tolerance and salience. The most common ocular causes was dry eye, blurred vision, eye strain, headache are recorded in this study. Keywords: Smartphone’s addiction, human machine interaction, mobile phones functions, increase impatience, daily life routine disturbance, behavioral changes.

Cisd2 plays an essential role in corneal epithelial regeneration.

BackgroundAge-related changes affecting the ocular surface cause vision loss in the elderly. Cisd2 deficiency drives premature aging in mice as well as resulting in various ocular surface abnormalities. Here we investigate the role of CISD2 in corneal health and disease.MethodsWe studied the molecular mechanism underlying the ocular phenotypes brought about by Cisd2 deficiency using both Cisd2 knockout (KO) mice and a human corneal epithelial cell (HCEC) cell line carrying a CRISPR-mediated CISD2KO background. We also develop a potential therapeutic strategy that targets the Ca2+ signaling pathway, which has been found to be dysregulated in the corneal epithelium of subjects with ocular surface disease in order to extend the mechanistic findings into a translational application.FindingsFirstly, in patients with corneal epithelial disease, CISD2 is down-regulated in their corneal epithelial cells. Secondly, using mouse cornea, Cisd2 deficiency causes a cycle of chronic injury and persistent repair resulting in exhaustion of the limbal progenitor cells. Thirdly, in human corneal epithelial cells, CISD2 deficiency disrupts intracellular Ca2+ homeostasis, impairing mitochondrial function, thereby retarding corneal repair. Fourthly, cyclosporine A and EDTA facilitate corneal epithelial wound healing in Cisd2 knockout mice. Finally, cyclosporine A treatment restores corneal epithelial erosion in patients with dry eye disease, which affects the ocular surface.InterpretationThese findings reveal that Cisd2 plays an essential role in the cornea and that Ca2+ signaling pathways are potential targets for developing therapeutics of corneal epithelial diseases.FundingThis study was supported by the Ministry of Science and Technology (MOST) and Chang Gung Medical Research Foundation, Taiwan.

Ophthalmic Causes of Headache among Patients Attending Tertiary Care Center in Kathmandu, Nepal

The purpose of this study was to evaluate the ophthalmic causes of headache among patients attending tertiary care hospital. This was a descriptive, cross sectional hospital-based study. One hundred and thirty-two patients with ocular cause of headache excluding primary headache and pediatrics patients during one year were included. Detail ocular examination was done including visual acuity, refraction, binocular vision assessment like convergence insufficiency and fusional insufficiency, anterior and posterior segment examination. Among headache patients, female was 106 (80.3%) and male was 26 (19.7%). The prevalence of headache in female was 6.9% and in male was 2%. Headache was more common in age group 18-29 (59.8%). The mean age of presentation was 29.9 ± 10.2 years (range 18-61 years). Out of 132 patients with headache, 104 (78.8%) had refractive error, 15 (11.4%) had fusional insufficiency, 6 (4.5%) had convergence insufficiency, 10 (7.6%) had anterior segment diseases and 5 (3.8%) had posterior segment diseases. Among refractive errors, both eyes astigmatism was the commonest 48 (36.5%) followed by both eyes simple myopia 44 (33.4 %) which was statistically significant with ocular headache (p=0.000). Ocular anomalies other than refractive error may coexist with headache complaints. Therefore, thorough ocular examination should be done in all patients suffering from headache.

Ocular Abnormal Head Posture: A Literature Review.

Purpose:To provide a comprehensive review on different characteristics of abnormal head postures (AHPs) due to different ocular causes, its measurement, and its effect on facial appearance.Methods:In this review article, PubMed, Scopus, and Google Scholar search engines were searched for the scientific articles and books published between 1975 and September 2020 based on the keywords of this article. The selected articles were collected, summarized, classified, evaluated, and finally concluded.Results:AHP can be caused by various ocular or nonocular diseases. The prevalence of ocular causes of AHP was reported to be 18%–25%. 1.1% of patients presenting to ophthalmology clinics has AHP. The first step in evaluating a patient with AHP is a correct differential diagnosis between nonocular and ocular sources by performing comprehensive eye examinations and ruling out other causes of orthopedic and neurological AHP. Ocular AHP occurs for a variety of reasons, the most important of which include nystagmus, superior oblique palsy, and Duane's retraction syndrome. AHP may be an essential clinical sign for an underlying disease, which can only be appropriately treated by the accurate determination of the cause. Long-standing AHP may lead to facial asymmetry and secondary muscular and skeletal changes.Conclusion:In conclusion, a proper differential diagnosis between nonocular and ocular causes, knowledge of the different forms of AHP and their measurement methods, accurate diagnosis of the cause, and proper and timely treatment of ocular AHP can prevent facial asymmetry and secondary muscular and skeletal changes in the patients.