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   1997| July-September  | Volume 45 | Issue 3  
 
 
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OPHTHALMOLOGY PRACTICE
Ophthalmology on the information superhighway : An introduction to the internet
S Prasad, M Nagpal, PN Nagpal
July-September 1997, 45(3):181-187
PMID:9475022
Internet, e-mail, world wide web and the information superhighway have fast become part of the modern human vocabulary. How are we as ophthalmologists affected by this revolution and how can we utilise the enormous potential of this revolution? This article provides an overview of the practicalities and possibilities of this new medium.
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COMMUNITY EYE CARE
Survey of visual impairment in an Indian tertiary eye hospital
P Herse, VK Gothwal
July-September 1997, 45(3):189-193
PMID:9475023
A retrospective survey of 4, 122 consecutive patient records was performed in a tertiary care eye hospital in Hyderabad, India. Data collected included age, gender, visual acuity after completion of treatment and diagnosis. 62.8% of the patients were male. After completion of treatment, 10.8% had low vision (best corrected visual acuity <6/18 to 3/60 in the better eye) and 2.6% were blind (best correct visual acuity <3/60 in the better eye). Most cases of low vision were found in the 50 to 70 year age group (42.9%). The most common visual acuity range after treatment amongst patients with vision loss was <6/18 to 6/60 (71%). The 4 main causes of low vision were cataract (21.4% of low vision group), glaucoma (14.0%), diabetic retinopathy (13.0%), and retinitis pigmentosa (10.7%). The 4 main causes of blindness were glaucoma (16.3% of blind group), diabetic retinopathy (13.2%), corneal opacities (11.6%) and retinitis pigmentosa (11.6%). It is suggested that patients with low vision at the conclusion of treatment be referred to a vision rehabilitation centre. Referral should be made in cases with a best corrected visual acuity <6/18 to 3/60 or with visual field loss to within 15 of fixation. Patients aged under 50 years of age are expected to achieve maximal rehabilitation success. Motivation and vocational requirements should be assessed in older or more complex cases before referral. The data of this study show that about 10% of patients seen at a tertiary care eye hospital in India could benefit from low vision rehabilitation.
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CURRENT OPHTHALMOLOGY
Current concepts in the management of adult intraocular tumours
MP Shanmugam, P De Potter, L Gopal, J Biswas, MP Bhende
July-September 1997, 45(3):143-161
PMID:9475017
The management of intraocular tumours has come a long way since the days when enucleation was the only modality of treatment available to the ophthalmologist. Despite the fact that enucleation is still necessary in certain situations, the emphasis is currently on conservative management, thereby saving the eye and some amount of useful vision wherever possible. This review highlights the current trends in the management of adult intraocular tumours with emphasis on newer diagnostic modalities such as computed tomography, magnetic resonance imaging, and fine needle aspiration biopsy. Only those tumours that are most likely to be seen in clinical practice are included.
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ORIGINAL ARTICLE
Indications for penetrating keratoplasty in India
L Dandona, K Ragu, M Janarthanan, TJ Naduvilath, R Shenoy, GN Rao
July-September 1997, 45(3):163-168
PMID:9475018
Indications for penetrating keratoplasty (PK) in the developing world from a large series are not well documented. This study was done to evaluate the indications for PK in a major eye care institution in India. The records for a consecutive series of 1,964 PKs were analysed and multiple logistic regression was used to study the effect of age, socioeconomic status and sex on the indications for PK. The indications for PK were corneal scarring in 551 (28.1%) including adherent leukoma in 147 (7.5%), regrafts in 336 (17.1%), active infectious keratitis in 239 (12.2%), aphakic bullous keratopathy in 231 (11.8%), pseudophakic bullous keratopathy in 209 (10.6%), corneal dystrophies in 165 (8.4%) including Fuchs' dystrophy in 23 (1.2%), keratoconus in 118 (6%), and miscellaneous in 115 (5.9%). The odds that the patient belonged to lower socioeconomic status were significantly higher if the PK was done for active infectious keratitis (odds ratio 2.73, p<0.0001), corneal scarring (odds ratio 1.72, p=0.0009) or regraft (odds ratio 1.44, p=0.047). Corneal scarring, including adherent leukoma, and active infectious keratitis are relatively more common indications whereas keratoconus, pseudophakic bullous keratopathy and Fuchs' dystrophy are less common indications for PK in India than reported from the developed world. Indications for PK which carry a poorer prognosis for graft survival are relatively more common in India than in the developed world.
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Randot stereoacuity at various binocular combinations of snellen acuity
V Menon, A Bansal, P Prakash
July-September 1997, 45(3):169-171
PMID:9475019
Binocular combinations of Snellen acuity were varied from 6/60 to 6/6 in standard steps in twenty normal adults and Randot stereoacuity was measured at each level. Using the 560 unique stereoacuity scores thus obtained, a nomogram was constructed which provides expected stereoacuity scores at all unique binocular combinations of Snellen acuity. It was seen that there is a linear correlation between binocular isoacuity (at level 6/36 or better) and Randot stereoacuity.
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Topical ketorolac 0.5% solution for the treatment of vernal keratoconjunctivitis
A Sharma, R Gupta, J Ram, A Gupta
July-September 1997, 45(3):177-180
PMID:9475021
The efficacy of topical ketorolac 0.5% in treatment of vernal keratoconjunctivitis (VKC) was evaluated in a randomised double-blind prospective trial in 21 patients. Ketorolac treated eyes showed 50.7% reduction in main symptoms of itching compared to 33.3% relief in placebo treated eyes after 2 weeks of treatment (p<0.01). Photophobia, ropy discharge, and conjunctival injection also lessened by 39.9%, 31.6%, and 39.1%, respectively, in ketorolac treated eyes compared to 23.8%, 17.3%, and 20.3% in placebo group. Transient stinging sensation was observed in 3 (14.3%) patients on ketorolac therapy. This study shows efficacy of ketorolac 0.5% solution in controlling symptoms in VKC.
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EDITORIAL
Realistic targets and strategies in eye banking
JS Saini
July-September 1997, 45(3):141-142
PMID:9475016
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ORIGINAL ARTICLE
Short-term results of initial trabeculectomy with intraoperative or postoperative 5-fluorouracil for primary glaucomas
PA Lamba, PK Pandey, UK Raina, V Krishna
July-September 1997, 45(3):173-176
PMID:9475020
Thirty-three eyes of 33 patients were prospectively evaluated to study the short term efficacy, safety, and overall surgical outcome of initial trabeculectomy for primary glaucomas with adjunctive intraoperative or postoperative 5-Fluorouracil (5-FU) use. Twelve eyes serving as controls underwent trabeculectomy without adjunctive antimetabolites. Eleven eyes received intraoperative 5-FU, while 10 eyes received subconjunctival 5-FU postoperatively. Intraocular pressure (IOP) was maintained below 22 mmHg at 3 months of follow up in 90.9% and 80% of patients in the intraoperative and postoperative 5-FU groups, respectively, without use of additional antiglaucoma medications, whereas 66.7% of the patients in the control group achieved similar IOP levels. Hypotony (IOP < 6 mmHg) was seen more commonly after intraoperative 5-FU (27.3%). Corneal epithelial defects were seen exclusively in the postoperative 5-FU group (40%). The use of intraoperative 5-FU exclusively as a mode of antimetabolites delivery seems an acceptable alternative to enhance success rates of trabeculectomy for the primary glaucomas.
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