Ophthalmology Department Of Hospital Research Articles

Evaluation of Amblyopia in School Children

Background: Amblyopia is a form of cortical visual impairment which can result from many condition which prevents normal visual stimulation in children in younger age group causing childhood visual impairment. The term “lazy eye” is often used for Amblyopia. It accounts to be the second common cause of blindness. Materials and Methods: A cross sectional study was conducted during the school health check up visits conducted by ophthalmology department of tertiary care teaching hospital for screening of eye disorders in school children who belongs to the age group of 5-15 years over a period of 1 year in which 813 children underwent screening ,among them 110 children with the reduced vision were referred to hospital for detailed ophthalmic evaluation which includes cycloplegic refraction and dilated fundus examination. Amblyopia was detected in children with reduced best corrected visual acuity. Results: A total of 813 study subjects were screened. Out of them 110 (13.5%) were found to have diminished vision. When the study subjects with diminished vision were subjected for further tests, 18 (2.2%), (p value is 0.494 )of them were found to have amblyopia. Amblyopia was present in 10 ( 18.9%) of females and 8( 14%) of males. Anisometropic amblyopia was the most common type of amblyopia found in 10 ( 55.6%) of the study subjects, followed by meridional and strabismus type of amblyopia in 4 cases each (22.2%). Among strabismus ,exotropia was seen in more study subjects 4(0.5%) than esotropia in 2 cases(0.2%). A higher number of moderate grade of amblyopia was seen than mild grade of amblyopia. Conclusion: The prevalence of amblyopia in our study is 2.2%. Anisometropic refractive errors are the most common underlying cause in our study subjects. We recommend implementation of visual screening programs for children of schoolgoing age group for early detection and proper management of Amblyopia.

Study of the efficiency and workflow of femtosecond laser-assisted cataract surgery in a Spanish public hospital

To assess the time-efficiency of a designated operating room (OR) workflow in the introduction of femtosecond laser-assisted cataract surgery (FLACS, LenSx, Alcon®). The study was carried out in a public hospital a with high-volume of procedures.We performed this prospective, controlled, surgical intervention study in the ophthalmology department of a Spanish tertiary referral public hospital. A total of 167 eyes were enrolled, including 62 eyes undergoing conventional phacoemulsification surgery. In phase I, patients were assigned either to FLACS-I (n=63) or conventional phacoemulsification surgery (n=62). One surgeon operated the femtosecond laser, and another completed the procedure, while a third performed conventional phacoemulsification. In the second phase (FLACS-II), all the surgeries were FLACS (n=42). One surgeon performed the FLACS procedure, and two different surgeons completed the surgeries in separate ORs. Surgical and turnover times of all the patients were recorded.Preparation time was statistically significantly lower in FLACS-I and FLACS-II (P<0.001), whereas the duration of the cataract procedure per se was higher in FLACS-II compared to conventional phacoemulsification (P=0.03). Phacoemulsification energy was higher in FLACS-II compared to FLACS-I (P=0.01), whereas laser-related surgical time was lower (P=0.001). Surgical complications and total surgical time showed no statistically significant differences between any of the three groups.This study suggests a time-efficient and suitable workflow model for FLACS, considering the specific requirements and restrictions of a fully booked public hospital. Even so, we have shown that the FLACS procedure does not take longer than conventional phacoemulsification when following a detailed plan for OR workflow. In addition, our data reflect an improvement in FLACS surgical times with ongoing experience.NCT03931629 (retrospectively registered).

Relationships between retinal structure and function and vision-related quality of life measures in advanced age-related macular degeneration.

To evaluate the association between ophthalmic structure/function measures and five standardized quality of life (QoL) instruments, in patients with advanced age-related macular degeneration (AMD). We examined 20 AMD patients (ages 66-93years) recruited from the Canberra Hospital Ophthalmology Department. Visual function measures included low and high contrast visual acuity (LCVA and HCVA) and measures from 10-2 Matrix visual fields (VF). Optical coherence tomography (OCT) quantified central retinal thickness (CRT), average macular thickness (AT), and retinal nerve fibre layer thickness (RNFL). The QoL instruments were the macular degeneration-related quality of life (MacDQoL), the National Eye Institute Visual Functioning Questionnaire (VFQ), its two face-recognition questions (A6 and 11), and the Geriatric Depression Scale (GDS). Pearson correlations, Canonical Correlation Analysis (CCA), and cross-validated stepwise-regression were used to examine the relationships between structure/function measures and the QoL instruments. The selected models for the five instruments had R2 ranging from 0.65 ± 0.12 to 0.90 ± 0.05 (mean ± SD) and median F-statistics > 188. HCVA was strongly associated with all QoL except the GDS, for which CRT, AT and RNFL figured highly. RNFL was most important for MacDQoL, and 2nd for VFQ question-A6. Centrally weighted VF measures were rarely selected but global VF measures were common, especially for the overall NEI-VFQ questionnaire. CCA revealed that the structure/function measures and QoL instruments contained 2 statistically independent mechanisms. In patients with advanced AMD, CRT and HCVA were strong determinants of QoL instruments in AMD patients.

Офтальмологические маски новой короновирусной инфекции

Goal. To present a clinical and statistical analysis of the somatic status and ophthalmological manifestations of the new coronavirus infection in patients treated in a round-the-clock ophthalmological hospital. Materials and methods. The clinical, laboratory and instrumental data of 12 patients with a new coronavirus infection treated in the ophthalmology department of the adult hospital of the Regional Clinical Hospital No. 2 from February 2020 to May 2021 were analyzed. Results. The structure of nosologies is represented by the following diseases: corneal ulcer – 33.3% (4/12), of which men – 25% (3/12), women – 8.3% (1/12); phlegmon of the orbit – 8.3% (1/12); combined corneal and vascular lesions (keratouveitis) – 16.6% (2/12); nerve tissue damage (optic neuritis, neuroretinovasculitis) – 16.6% (2/12); vascular lesions are represented by chronic iridocyclitis OD in the acute stage and panuveitis of fungal etiology – 16.6% (2/12); the lesion of the central retinal vein (CVC) is represented by partial thrombosis of its upper-temporal branch – 8.3% (1/12). The development of the disease is associated with the presence of systemic atherosclerosis and hypertension, or trauma to the visual organ. Conclusions. Ophthalmic masks of a new coronavirus infection are more common in men. The trigger factors include systemic atherosclerosis, arterial hypertension, or trauma to the eyeball, blood pathology, chronic diseases of the gastrointestinal tract, diabetes mellitus.

BACTERIOLOGICAL PROFILE AND ANTIMICROBIAL SUSCEPTIBILITY PATTERN OF ISOLATES FROM OCULAR INFECTIONS AMONG THE PATIENTS ATTENDING OPHTHALMOLOGY DEPARTMENT OF A TERTIARY CARE HOSPITAL.

Background: Ocular infections are one of the major causes of visual impairment around the world. Infections can either be due to single microbe or polymicrobial. it is essential to know the specic etiology of the infection for the effective management of ocular infections. This study aims to identify microbes responsible for common ocular infections and to determine its antibiotic susceptibility to commonly used antibiotics used in clinical practice. Clinical Methods: A hospital based cross sectional study included 290 patients attending the ophthalmology department of a tertiary care hospital. After a thorough clinical examination samples were taken and were subjected to Grams' stain, culture methods, biochemical tests for the identication of the microbe. Antibacterial susceptibility test was performed using Kirby Bauer disc diffusion method. Results: Among 290 patients, the common clinical conditions include conjunctivitis 108 (37.24%), keratitis 37 (12.76%), dacryocytitis 53 (18.28%), blepharitis 52 (17.93%), trauma 24 (8.28%), infective uveitis 10(3.45%) and endophthalmitis 6(2.07%). Among the total ocular infections 146(50.34%) were positive for culture. Among the total isolated, 110(75.34%) were Gram positive and 36(24. 66%) were Gram negative. The Gram positive bacteria isolated showed highest sensitivity to ciprooxacin (86.36%) followed by gentamycin (82.72%) and clindamycin (80%). The Gram negative bacteria showed high resistance to tetracycline 7(19.44%), followed by amoxicillin-clavulanic acid (30.56%). Conclusion: The most common ocular infection is conjunctivitis followed by dacryocystitis which is most commonly caused by Staphylococcus aureus, which showed high resistance to Amoxcillin, Tetracycline and Erythromycin. To prevent the emergence of antimicrobial resistance, it is necessary to perform antimicrobial susceptibility testing before initiating antibiotics in clinical practice.

The Application of Tissue Glue in Eyelid Laceration Repair in Children During the Coronavirus Disease 2019 Pandemic Lockdown in Wuhan.

ObjectiveTo discuss a rapid and effective treatment used for children with eyelid lacerations during the COVID-19 lockdown in Wuhan to limit the risk of cross-infection.MethodsA comparative study was conducted of forty-five patients with eyelid lacerations who attended the Ophthalmology Department of Wuhan Children’s Hospital between January 23, 2020 and March 6, 2020. The tissue glue Histoacryl was used to bond the wounds in 24 cases, while the traditional suture method was used for 21 cases. The wound healing time, complications, treatment satisfaction, and number of visits of the two groups were compared.ResultsThe two groups had similar baseline characteristics. The wound healing time (from wound disinfection to wound dressing) was shorter in the tissue glue group (4.35 ± 0.47min versus 11.71 ± 1.85 min, P< 0.01). There was 1 case of wound dehiscence in the tissue glue group. Twenty-two cases in the tissue glue group were satisfied, 2 cases were basically satisfied, and 0 were dissatisfied. Eleven cases in the traditional suture group were satisfied, 9 cases were basically satisfied, and 1 case was dissatisfied. The difference was statistically significant (P < 0.05). In terms of the number of visits, the tissue glue group visited (1.54 ± 0.88) times, while the traditional suture group visited (2.38 ± 0.59) times. The difference between the two groups was statistically significant (P < 0.01). The real-time reverse transcriptase polymerase chain tests for severe acute respiratory syndrome coronavirus 2 of all medical staff in the ophthalmology emergency room were negative.ConclusionCompared with the traditional suture method, tissue glue used in eyelid laceration in children has the advantages of painlessness, shorter operation duration, higher safety and satisfaction, greater ease of care, and fewer hospital visits. Tissue glue can be widely used to reduce the risk of cross-infection.

English

BACKGROUND Congenital ocular anomalies are one of the important causes of childhood blindness. Blindness is a serious public health issue, and also a social and economic problem worldwide. Majority of global blindness is avoidable and curable. Most of global blindness is in developing countries. The objectives of this study were to determine the prevalence of congenital ocular anomalies in the paediatric age group and its associated risk factors in a tertiary care hospital in Kancheepuram. METHODS This cross-sectional study was conducted among children of 0 – 14 years age group attending the ophthalmology department of SRM Medical College and Hospital, Kancheepuram from December 2018 to November 2020. Congenital ocular anomalies were detected by detailed ocular examination and the type of congenital ocular anomaly was assessed. Associated risk factors like family history of congenital ocular anomalies, family history of consanguinity and significant antenatal history of the mother of the children were collected. RESULTS Out of 9865 cases, we found that 61 cases had congenital ocular anomalies. There was a male preponderance. Majority of the cases were in the age group 0 - 5 years. A positive history of consanguinity was present in 10 % of cases. The most commonly found cases were congenital cataract and congenital dacryocystitis. CONCLUSIONS Children with congenital ocular anomalies and functional vision should be given glasses and low vision aid. There is a great need for early screening, detection and treatment by paediatric or trained ophthalmologists in referral hospitals. KEYWORDS Congenital Ocular Anomalies, Paediatric Age Group, Prevalence

Wies procedure for correcting involutional entropion of the lower lid in geriatrics

Objective: To evaluate the anatomic outcome and recurrence rate of the Wies procedure for treating involutional entropion of the lower lid in geriatrics.&#x0D; Materials and methods: This retrospective case series was conducted in the Ophthalmology department of a tertiary care hospital from January 1, 2016 to December 31, 2017. Geriatric patients (≥ 65 years) who had undergone the Wies procedure, i.e., transverse lid split and everting sutures for correction of involutional entropion of the lower lid were included. All the surgeries were done under local anaesthesia by a single ophthalmologist. The follow-up period was 12 months. A successful outcome was defined as restoration of lid margin to its position with no lash touching the cornea and no recurrence within 12 months.&#x0D; Results: Eighteen eyes of 13 patients with a mean age of 67.6 ± 2.2 SD years were included. There were 11 males (61%) and 7 females (39%). Bilateral entropion correction was done in five patients. Nine right eyes and nine left eyes were included. Anatomical success was 94.4% at 12 months. Recurrence was seen in one (5.6%) patient at 12 months.&#x0D; Conclusion: The Wies procedure for correction of involutional entropion with horizontal lid laxity in the geriatric population provided good anatomic results in our study. The recurrence rate was minimal within 1 year. The recurrence rate can be reduced by an accurate initial entropion assessment.

Drug utilization study in ophthalmology department at a tertiary care hospital

Background: Drug utilisation studies in present clinical practice have played significant role to promote rational drug use in the current health care system. The aim of present study was to analyse the prescribing pattern of drugs for various ocular conditions in Ophthalmology Department of Government Medical College and Hospital, Aurangabad, Maharashtra, India.Methods: Study was prospective, observational open label and descriptive clinical study which included 100 patients in OPD and IPD during November 2018 to February 2019 fulfilling inclusion criteria.Results: Out of the 100 study subjects, 56% were males and 46% were females, with the maximum number of patients falling in the age group 61-80 years. 38.26% patients received antibiotics as most prescribed drug while 69 % patients received analgesics and 47% anti-inflammatory. Among the antibiotics prescribed, fluoroquinolones were the most prescribed antimicrobial class. WHO prescribing indicators as analysed from the data collected were: average number of drugs per prescriptions was 3.79. Percentage of medicines prescribed by branded name- 33.79% and generic were 66.21%. 54% of the total drugs prescribed were from the National List of Essential Medicines 2017.Conclusions: Ocular ailments and conditions are frequently associated with high levels of utilization of drugs for their treatment. Thus, analysis of utilization of these drugs becomes very essential. In the present study, the drugs prescribed at our tertiary care hospital were found rational.

NEW GLAUCOMA CASE DETECTION IN A SCREENING CAMP AT A TERTIARY OPHTHALMOLOGY CENTRE: A CROSSSECTIONAL STUDY

AIM: To estimate the proportion of incidence of glaucoma cases in a screening camp conducted at a tertiary Ophthalmology centre. BACKGROUND: 1,2 Glaucoma is the second leading cause of blindness in the adult population in India .The diagnosis of glaucoma was based on the presence of at least two of the following criteria:IOP ≥ 21 mmHg,glaucomatous optic disc abnormalities,and glaucomatous visual field defects. MATERIALS AND METHODS: A prospective, cross sectional study was conducted on 100 consecutive individuals aged more than 40 years who came to our hospital Ophthalmology department from 08-March, 2020 to 14-March, 2020. All subjects underwent a comprehensive eye examination including brief history taking, slit lamp examination, applanation tonometry, gonioscopy, pachymetry, dilated fundus examination using slit lamp biomicroscopy with 90D lens and automated perimetry. RESULTS: One hundred individuals including 43 males and 57 females are screened.The screening result found to be positive in 9 (9%) subjects who underwent further diagnostic evaluation which concluded 3 cases of Normotension glaucoma,5 cases of Primary angle closure glaucoma and 1 individual with Secondary Glaucoma. CONCLUSION: Periodical glaucoma screening helps to detect more number of glaucoma cases thereby preventing blindness. Routine glaucoma screening for individuals more than 40 years should be strictly followed by Ophthalmologists in the society

Visual evoked potentials changes with surgery in primary congenital glaucoma: a pilot study.

To report the flash visual evoked potential (VEP) findings in children with primary congenital glaucoma (PCG) before and after successful surgical control of the intraocular pressure (IOP). The study enrolled children presenting with PCG to the Ophthalmology Department of Alexandria Main University Hospital in the period between June and December 2019. All study participants were subjected to a standard protocol of examination, to confirm the diagnosis of PCG. The child was then referred for flash VEP testing. Peaks were designated as negative and positive waves in a numerical sequence (N1, P1, N2, P2, N3 and P3). The child was then scheduled for surgery within 1week of presentation. Postoperative VEP testing was scheduled as soon as feasible and was conducted in the same way as the preoperative VEP testing. The study was conducted on 11 (four right) eyes of eight (five males) children. The mean ± standard deviation of the age of the study children at presentation and at postoperative VEP testing was 3.5 ± 1.6 and 5.1 ± 3.0months, respectively. The study eyes mean ± standard deviation IOP at presentation and at postoperative VEP testing was 23.0 ± 6.7 and 8.3 ± 2.4mmHg, respectively (p < 0.0001). There were a statistically insignificant reduction in P2 implicit time (p = 0.235) and a statistically insignificant increase in each of N1-P1 (p = 0.15) and N2-P2 (p = 0.67) amplitudes postoperatively than preoperatively. IOP elevation in PCG adversely affects the optic nerve function, but, at least in the short term, has no permanent detrimental effect on the optic nerve function as evidenced by the improvement in the VEP parameters.

Correlation of Central Versus Peripheral Macular Structure-Function With Acuity in Age-Related Macular Degeneration.

PurposePatients with advanced age-related macular degeneration (AMD) may have preserved visual function despite significant retinal structural changes. We aimed to evaluate the relationships among retinal thickness, macular sensitivity, and visual acuity (VA) in advanced AMD.MethodsWe examined 43 eyes of 22 patients with advanced AMD (ages 66–93 years), prospectively recruited from the Canberra Hospital Ophthalmology Department. Visual function was measured on participants with low and high contrast visual acuity (LCVA and HCVA) and 10-2 Matrix visual fields. Retinal structure was determined with spectral domain optical coherence tomography (OCT), and customized software mapped the 64 OCT macular thickness regions onto the 44 regions of the 10-2 test.ResultsMedian retinal thickness at each 10-2 region was near normal. Just 7 of 88 regions from the OCT analysis that were thicker than the median had sensitivity that declined significantly with increasing thickness (r = −0.698 ± 0.082, mean ± SD), whereas 17 of 88 thinner regions showed significantly decreasing sensitivity with decreasing thickness (r = 0.723 ± 0.078). The absolute value of deviations from median optical coherence tomography thickness (aOCT) outside the central eight degrees was significantly correlated with HCVA (r = −0.34, P = 0.047). Thickness in the central eight degrees was not. Similarly, matrix sensitivities inside the central eight degrees were significantly correlated with outer aOCT (r = −0.49, P = 0.002).ConclusionsRetinal thickness outside eight degrees were significantly associated with HCVA and macular sensitivity. These results suggest that outer macular thickness may be a useful prognostic indicator in AMD.Translational RelevanceRetinal structure at the borders of the macula may be a surrogate marker of vision and retinal thickness near fixation.

Treatment of Severe Recalcitrant Fungal Keratitis Using Subconjunctival Fluconazole as an Adjunctive Therapy

Purpose: To evaluate the safety and effectiveness of 2% subconjunctival injection of Fluconazole as an adjunctive treatment in severe recalcitrant fungal keratitis.&#x0D; Study Design: Interventional case series.&#x0D; Place and Duration of Study: Ophthalmology department of Holy family hospital, Rawalpindi medical university, from January 2019 to August 2019.&#x0D; Methods: The study included 18 eyes of 18 patients with severe resistant fungal corneal ulcer.We excluded those cases who had known hypersensitivities to Fluconazole. These ulcers were refractory toprimary conventional antifungal therapy with topical Natamycin, topical and systemic Fluconazole. Sample for culture was taken with sterile cotton bud and scraping was taken with kimura spatula. All resistant cases were given1.0 ml of 2% subconjunctival Fluconazole injection once a day for at least one week. After that depending upon the condition, the injections were givenonalternate days for 2 weeks.&#x0D; Results: Average age of the patients was 35.22 years (SD ± 10.42). Among total 18 patients, six (33.33%) were females and 12 (66.67%) were males. Thirteen (72.22%) cases showed absolute response after one week and 5 (27.77%) cases needed more injections. Four (22.22%) of these 5 cases partiallyimproved andone case failed to show improvement. Final vision varied in different cases according to the position of the residual scar. Five cases ended up in keratoplasty. Local or systemic toxicity was not seen in any case.&#x0D; Conclusion: Subconjunctival injection of 2% Fluconazole can be used as an adjunctive therapy for severe fungal keratitis without any toxic complications.&#x0D; Key Words: Keratomycosis, Evisceration, Keratoplasty.

Cycloaffaiblisement au laser diode micropulsé : une technique efficace, mais dont la stratégie reste à définir

We retrospectively included all MP-TSCP cases performed in the Bicêtre Hospital Ophthalmology department between January 2017 and September 2019. Intraocular pressure (IOP) and hypotensive medications were recorded preoperatively, at month 1, 3, 6 and at the conclusion of follow-up, as well as postoperative adverse events. Success was defined as an IOP between 6 and 21mmHg with a decrease of at least one medication or an IOP reduction>20%. Thirty eyes (28 patients) were included. Preoperative IOP was 27.2±10.6mmHg, with 3.5±0.6 hypotensive medications, the mean deviation on the Humphrey 24-2 visual field was -21.9±6.9dB, and 43% of eyes had a past history of filtering surgery. The mean follow-up was 13.5±8.1 months. Eleven patients (37%) had to be retreated with MP-TSCP during follow-up. At 3 and 6 months and at the conclusion of follow-up, the IOP was 18.3±7.3mmHg (-33%; P<0.0001), 22.5±11.8mmHg, (-17%; P=0.052), 22.7±12.0mmHg (-16,5%; P<0.050), respectively. The success rates were 57%, 50% et 53% at 3 months, 6 months and at the conclusion of follow-up, respectively. Severe adverse events included 3 cases of corneal ulcers and 2 cases of severe but transient ocular hypotony without visual impairment. MP-TSCP is an effective procedure for severe and/or refractory glaucoma, but retreatments are required in more than one-third of cases. Further studies are warranted to define factors predictive of success and indications for retreatment.

Development of Decision Support Software for Deep Learning-Based Automated Retinal Disease Screening Using Relatively Limited Fundus Photograph Data

Purpose—This study was conducted to develop an automated detection algorithm for screening fundus abnormalities, including age-related macular degeneration (AMD), diabetic retinopathy (DR), epiretinal membrane (ERM), retinal vascular occlusion (RVO), and suspected glaucoma among health screening program participants. Methods—The development dataset consisted of 43,221 retinal fundus photographs (from 25,564 participants, mean age 53.38 ± 10.97 years, female 39.0%) from a health screening program and patients of the Kangbuk Samsung Hospital Ophthalmology Department from 2006 to 2017. We evaluated our screening algorithm on independent validation datasets. Five separate one-versus-rest (OVR) classification algorithms based on deep convolutional neural networks (CNNs) were trained to detect AMD, ERM, DR, RVO, and suspected glaucoma. The ground truth for both development and validation datasets was graded at least two times by three ophthalmologists. The area under the receiver operating characteristic curve (AUC), sensitivity, and specificity were calculated for each disease, as well as their macro-averages. Results—For the internal validation dataset, the average sensitivity was 0.9098 (95% confidence interval (CI), 0.8660–0.9536), the average specificity was 0.9079 (95% CI, 0.8576–0.9582), and the overall accuracy was 0.9092 (95% CI, 0.8769–0.9415). For the external validation dataset consisting of 1698 images, the average of the AUCs was 0.9025 (95% CI, 0.8671–0.9379). Conclusions—Our algorithm had high sensitivity and specificity for detecting major fundus abnormalities. Our study will facilitate expansion of the applications of deep learning-based computer-aided diagnostic decision support tools in actual clinical settings. Further research is needed to improved generalization for this algorithm.

ROP Screening Tool Assessment and Validation in a Third-Level Hospital in Argentina: A Pilot Study.

To evaluate whether a mathematical tool that predicts severe retinopathy of prematurity (ROP) using clinical parameters at 6 weeks of life (ROPScore calculator smartphone application; PABEX Corporation) can be useful to predict severe ROP in a population of premature infants in Argentina. In this retrospective study, data from the clinical records of all premature infants examined between 2012 and 2018 in the ophthalmology department of a public third-level hospital in Córdoba, Argentina, were obtained. ROPScore screening was applied using a Microsoft Excel spreadsheet (Microsoft Corporation). The sensitivity, specificity, and positive (PPV) and negative (NPV) predictive values of the algorithm were analyzed. Between 2012 and 2018, a total of 2,894 pre-term infants were examined and 411 met the inclusion criteria, of whom 34% (n = 139) presented some form of ROP and 6% (n = 25) developed severe forms that required treatment. The sensitivity of the algorithm for any ROP and severe ROP was 100%. The PPV and NPV were 35.64% and 100%, respectively, for any ROP and 9.88% and 100% for severe ROP. One-time only calculation of the ROPScore algorithm could identify severe cases after validation, reducing the number of screened infants by 38% in infants with a birth weight of 1,500 g or less or a gestational age of 32 weeks or younger. [J Pediatr Ophthalmol Strabismus. 2021;58(1):55-61.].

Corneal endothelial morphology and central corneal thickness in type 2 diabetes mellitus patients.

Purpose:This study aimed to examine the corneal endothelial morphology and thickness in patients with Type 2 diabetes mellitus (T2DM) and compare them with age and sex-matched nondiabetic controls.Methods:This hospital-based cross-sectional observational study was conducted in the ophthalmology department of a tertiary hospital consisting of 262 patients (131 with T2DM as cases and 131 without diabetes who served as controls). All patients underwent a comprehensive ocular examination including visual acuity, slit-lamp biomicroscopy, intraocular pressure measurement. Central corneal thickness (CCT), endothelial cell density (ECD), coefficient of variance (CV), and percentage of hexagonal cells (HEX) were compared between the cases and controls. Predictors of corneal endothelial dysfunctions were analyzed. Data analysis was done by Statistical Package for the Social Sciences (SPSS) version 17.0. Chi-square test, Fisher’s exact test, and Spearman’s rho correlation analysis were used as appropriate.Results:Patients with T2DM showed poorer visual acuity and higher intraocular pressure. As compared to controls, patients with T2DM had thicker CCT, lesser ECD, decreased HEX, and higher CV but the differences were statistically nonsignificant. HbA1c levels showed a significant positive correlation with CCT and CV and a negative correlation with ECD. Macroalbuminuria and higher albumin creatinine ratio was associated with an increase in CV in patients with T2DM.Conclusion:Our study showed that poorly controlled patients with T2DM and those with macroalbuminuria have corneal endothelial abnormalities.

Study of dry eye parameters in diabetics in a tertiary care hospital

Aim: This study aims to study the frequency and severity of dry eye in diabetic patients and their correlation with duration of diabetes. Materials and Methods: This cross-sectional prospective study was conducted on all patients with diabetes mellitus presenting to ophthalmology department of a tertiary care hospital between November 1, 2019, and December 31, 2019. The study population included diabetic patients who were above the age of 40 years. Detailed ocular history including diabetic history was recorded and comprehensive ocular clinical examination to assess the dry eye status was done. Schirmer's I test and Tear film Break-Up Time (TBUT) tests were performed and results were recorded. Results: In this study, 100 eyes of 50 diabetic patients were subjected to dry eye tests. Varying degree of dryness was seen in 34 patients (68%). Schirmer's test was abnormal (

Cortical Blindness Following Neonatal Hypoxic Ischaemic Encephalopathy: Cases Series from Bamako

Purpose: Report of series of cases of cortical blindness that occurred after neonatal hypoxic-ischaemic by analysing its epidemiological frequency in black Africa. Methodology: This is the report of two clinical cases received in consultation on Monday 16th November 2020 and Thursday 7th January 2021 in the paediatric ophthalmology department of the IOTA-University Hospital. Results: They are two infants, aged 05 and 17 months respectively, who were brought in for consultation by their mother for lack of eye-tracking movement since birth. Both infants were born at term following a dystocic delivery. At birth, both infants had a very poor Apar score and were given a resuscitation treatment. The clinical examination coupled with the results of the paraclinical examinations allowed us to conclude at cortical blindness induced the neonatal hypoxic-ischaemic encephalopathy. Their therapeutic management, in collaboration with the neurologist, included the combination of piracetam suspension and Valproate sodium syrup. The evolution after three months of treatment is marked by the regression of epileptic seizures and the perception of light. Conclusion: In black Africa, neonatal hypoxic-ischaemic encephalopathy is the second leading cause of cortical blindness in children, after the neuromalaria sequels.

Standardized Classification of Mechanical Ocular Injuries: Efficacy and Shortfalls.

Objectives:The aim of this study was to examine the efficacy and the shortfalls of the Birmingham Eye Trauma Terminology classification system for ocular trauma in predicting the visual outcome.Methods:The records of 256 eyes of 246 patients with a diagnosis of mechanical ocular trauma admitted to the Osman Gazi University Hospital ophthalmology department between 1995 and 2000 were retrospectively reviewed. The zone, type, grade, and pupil status of the injuries were determined according to the Birmingham classification system. Injuries with a good prognosis were defined as injuries that resulted in vision of equal to or better than counting fingers at 1 meter. Fischer’s exact test was used to determine the statistical significance of relationships between the final visual acuity and the initial clinical findings.Results:Open eye injuries restricted to zone I, those with no afferent pupillary defect, and those graded as 3 or better or classed as type B were significantly associated with a better visual outcome (p<0.05). Open eye injuries that extended to zone III, had an afferent pupillary defect, or were graded as 4 or worse were significantly associated with a poorer visual outcome (p<0.05). Closed eye injuries classified as type B or grade 4 were significantly associated with a poor visual outcome (p<0.05).Conclusion:The Birmingham classification system for mechanical ocular trauma offers a standardized method for both open and closed eye injuries, however, adding subclasses to type C (injuries with foreign body involvement) could enhance the classification method and help to understand the influence of foreign body properties and sizes on the outcome.