PURPOSE: To report the prevalence and pattern of visual field loss in non-functioning pituitary adenomas and to study the relationship between the tumour size and severity of field defects. METHODS: Ninety-three patients with histologically confirmed pituitary adenomas, non-functional on hormonal assessment, underwent a complete ophthalmic assessment and automated perimetry using the HFA 30-2 programme. Defects with quadrantanopic or hemianopic characteristics, defined using criteria on the threshold/pattern deviation plots were considered typical. Typical defects were graded as mild, moderate and severe. All other defects were considered atypical. A neuroradiologist measured tumour size on a CT or MRI Scan. The Chi-square test for trend was used to test association of tumour volume with severity of typical defects. RESULTS: Eighty-eight (94.6%) of the 93 patients had a field defect. Typical field defects were seen in 69 (74.2%) patients and atypical in 19 (20.4%). A severe typical defect involving at least 3 quadrants in one or both eyes was the most common (24 patients or 25.80%). All 31 patients (33.3%) with a tumour size greater than 20 cc had field defects. Severity of field defect increased with tumour volume (Chi-square test for trends significant p = 0.0096). CONCLUSIONS: Field defects occurred in 95% of patients with non-functioning pituitary macroadenoma. A severe visual field loss involving at least 3 quadrants in one or both eyes was the most common. 20% of patients had atypical field defects. Severity of field defects increased with tumour volume

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Purpose:To study the visual outcome of cataract surgery in eyes with uveitis.Methods: A retrospective analysis of patients with uveitis operated for cataract. Results: 106 eyes of 89 patients with uveitis were operated for cataract. In 62.3% eyes (66/106), post -operative follow-up was at least 6 months. There was significant improvement (P<0.001) in visual acuity after cataract surgery. Provided the uveitis was well controlled for three months pre-operatively, additional pre-operative anti-inflammatory medications did not significantly affect (P=0.842) post -operative inflammation. Patients who received extracapsular cataract extraction (ECCE) or phacoemulsification with posterior chamber IOL (PCIOL) obtained better visual acuity at 6 weeks (P=0.009 and P=0.032 respectively ) than those with only ECCE without IOL. In 37 eyes vision did not improve due to persistent uveitis (23.9%, 16/67), cystoid macular oedeme (20.9%, 14/67), and posterior capsule opacification (14.9%, 10/67). Conclusion: Cataract extraction and PCIOL implantation is safe in eyes with uveitis. Additional preoperative medications may not alleviate post-operative inflammation if uveitis is well controlled for at least three months before surgery.

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Human immunovirus infection in India is rapidly increasing. Ocular lesions due to highly active antiretroviral therapy have been well recognized. Acquired immunodeficiency syndrome can affect all parts of the eye. However, posterior segment lesions are the most common and of these, Human immunodeficiency virus retinopathy and cytomegalovirus retinitis predominate. Often clinical examination can establish the diagnosis of many ocular lesions in acquired immunodeficiency syndrome; therefore, ophthalmologists need to be aware of the more common ones. Various drugs in different routes can used to treat cytomegalovirus retinitis. Highly active antiretroviral therapy has remarkably reduced systemic and ocular morbidity among acquired immunodeficiency syndrome patients. To facilitate care of these patients aseptic precautions for ophthalmic care personnel are now well established and therefore ophthalmologist should not hesitate to provide ophthalmic care to acquired immunodeficiency syndrome patients.

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Posterior capsular re-opacification can occur following Nd-YAG capsulotomy. This necessitates multiple capsulotomies with its potential complications. We report one such case and discuss possible predisposing factors and preventive measures for this condition

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Purpose: To demonstrate the usefulness of staining the internal limiting membrane (ILM) with a solution of indocyanine green (ICG) to facilitate the removal of ILM in eyes with idiopathic macular hole. Methods: Eighteen patients underwent vitrectomy with the removal of posterior cortical vitreous, induction of posterior vitreous detachment (PVD), ICG-enhanced removal of the macular ILM, and fluid-gas exchange, followed by facedown positioning. Results: Fifteen (83.33%) of the macular holes were closed at 3 months postoperatively. The visual outcome was relatively better in holes smaller than 400 microns in diameter, as compared to bigger macular holes (more than 400 microns in diameter). Of the 18 eyes, 9 (50%) recorded visual improvement of 2 or more lines over the preoperative level. Conclusion: Our results show the safety and usefulness of this technique in visualization of the ILM during macular hole surgery, thereby leading to successful removal of optimal amount of ILM, with minimum damage to the retina.

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PURPOSE: To evaluate the effect of 10 mm inferior oblique recession in horizontal strabismus with V pattern and primary inferior oblique overaction. METHODS: Ten patients of V esotropia and exotropia with primary inferior oblique overaction underwent 10 mm inferior oblique recession by the methods described by Park and Stallard. Pre- and postoperative V pattern, inferior oblique overaction and binocularity were assessed. Patients were followed up for 3 months. RESULTS: The mean preoperative V pattern was 38.3 PD and the mean inferior oblique overaction was 22 PD. After surgery the mean correction of the V pattern was 26.9 PD and the mean residual V pattern was 11.4 PD. None of the patients had inferior oblique overaction postoperatively. 70% of the patients showed improvement in binocularity. CONCLUSION: 10 mm Inferior oblique recession by the described technique is a simple, safe and effective method for the cosmetic and functional treatment of horizontal deviation and V pattern with primary inferior oblique overaction.

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Argon laser suture lysis using the Ritch lens provides a safe and effective means for correction of post - ECCE suture - induced astigmatism

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In the early stages of Wegener's granulomatosis, and in the atypical forms, the classic clinicopathologic features of the disease are often absent, delaying diagnosis. Recognition of the disease and its variant is aided by serological markers

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Inverse Marcus-Gunn phenomenon is very rare. It is usually acquired. We report a young male patient presenting with congenital ptosis and inverse Marcus-Gunn phenomenon

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PURPOSE: To analyse the in-vitro efficacy of commonly used antibacterials against bacterial pathogens from corneal ulcers. METHODS: We evaluated 596 patients seen over 18 months, period, September 1999 through March 2001. Corneal scrapings were subjected to microscopy and cultures using standard protocols. Antibacterial susceptibility of isolated bacteria were determined by the Kirby-Bauer disc-diffusion method. RESULTS: 626 bacterial pathogens were isolated from 596 corneal ulcer cases. 411(65.65%) were gram positive cocci Streptococcus pneumoniae (41.85%) was the predominant bacterial species. The antibacterial susceptibility was: 451(72.04%) to cefazolin, 471(75.24%) to chloramphenicol; 321(51.28%) to cephaloridine; 430(68.69%) to vancomycin; 564(90.09%) to ciprofloxacin; 429(68.53%) to norfloxacin; 464(74.12%) to gentamicin and 202(32.27%) to co.trimoxazole. CONCLUSION: This study provides information on the efficacy of ocular antibacterials commonly used against bacterial pathogens of keratitis. It is hoped that this information will help decision-making in empiric initial treatment of bacterial keratitis.

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This study assessed the use of spectacles and its demographic associations in a sample representative of the population of the Indian state of Andhra Pradesh. A total of 11,786 subjects of all ages were sampled from 94 clusters in one urban and three rural study areas of Andhra Pradesh using stratified, random, cluster, systematic sampling. The eligible subjects underwent detailed interview and eye examination including dilated examination of the posterior segment. The data on the use of spectacles were analysed for subjects >15 years of age. A total of 7,432 subjects >15 years of age participated in the study of whom 1,030 (13.8%) had a refractive error of spherical equivalent + 3.00 Diopter or worse. The prevalence of current use of spectacles in those with spherical equivalent + 3.00 Diopter or worse, who were likely to be visually impaired without refractive correction, was 34.2% (95% confidence interval 30.3-38%) and of previous use of spectacles was 12.3% (95% confidence interval 10.3-14.3%). The odds of using spectacles currently were significantly higher for those with any level of education, those living in the urban area, and for those with aphakia or psuedophakia as compared with natural refractive error. Among those who had used spectacles previously, 43.8% had discontinued because they felt that either the prescription was incorrect or that the spectacles were uncomfortable, suggesting poor quality of refractive services, and another 19.6% had lost the pair and could not afford to buy another pair. These data suggest that the use of spectacles in this population by those with refractive error was not optimal. Two-thirds of those with spherical equivalent + 3.00 Diopter or worse were not using spectacles. Of those who had discontinued the use of spectacles, a significant proportion did so for reasons related to poor quality of refractive services. Strategies such as vision screening programmes and eye health promotion need to be implemented, the quality of refractive services monitored and the cost of spectacles regulated, if the substantial burden of visual impairment due to refractive error in this population is to be reduced

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A rare case of medulloepithelioma of the ciliary body is described. The tumour necessitated enucleation of the eye; histopathological diagnosis was benign nonteratoid medulloepithelioma of the ciliary body

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We report a case of anterior chamber Cysticercus cellulosae that was removed by viscoexpression

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PURPOSE: Cytomegalovirus retinitis (CMV) is the most common ocular opportunistic infection in transplant recipients. This retrospective study attempts to report the differences in occurrence of cytomegalovirus retinetis in transplant recipients from those reported in patients with acquired immunodeficiency syndrome (AIDS). METHODS: 25 eyes of 15 transplant recipients (14 renal and one cardiac) with cytomegalovirus retinitis were retrospectively reviewed. Immunological profile included CD4+ and CD8+ T lymphocyte counts, CD4+/CD8+ cell ratio (5 cases) and serology for the viral antibodies (8 cases). RESULTS: A predominantly bilateral presentation (60%) was noted. Active cytomegalovirus retinitis (72%) in zone 2 (92%) of the inferotemporal quadrant (68%) was noted. The average cell counts were within normal limits (mean CD4 cell count-711/microliter), unlike in late stages of AIDS with cytomegalovirus retinitis (CD4 count < 50/microliter). Serology revealed an IgM positivity of 53%. Retinal detachment (52%) was the most common complication occurring after an average of 5.4 months. CONCLUSION: CMV retinitis in organ transplant recipients appears to differ from that in AIDS patients. CMV retinitis presents early and has different immunological profile, probably owing to differences in pathogenesis.

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