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   2013| January  | Volume 61 | Issue 1  
    Online since December 26, 2012

 
 
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ORIGINAL ARTICLES
Spectacle compliance amongst rural secondary school children in Pune district, India
Parikshit Gogate, Debapriya Mukhopadhyaya, Ashok Mahadik, Thomas J Naduvilath, Shrivallabh Sane, Amit Shinde, Brien Holden
January 2013, 61(1):8-12
DOI:10.4103/0301-4738.99996  PMID:23275214
Background: Refractive errors (RE) are the most common cause of avoidable visual impairment in children. But benefits of visual aids, which are means for correcting RE, depend on the compliance of visual aids by end users. Aim: To study the compliance of spectacle wear among rural school children in Pune district as part of the sarva siksha abhiyan (education for all scheme) after 6 - 12 months of providing free spectacles. Settings and Design: Cross-sectional follow-up study of rural secondary school children in western India. Materials and Methods: The students were examined by a team of optometrists who collected the demographic details, observed if the child was wearing the spectacles, and performed an ocular examination. The students were asked to give reasons for non-wear in a closed-ended questionnaire. Statistical Analysis: Chi-square test and multiple logistic regression used for data analysis. Results: Of the 2312 students who were dispensed spectacles in 2009, 1018 were re-examined in 2010. 523 students (51.4%) were female, the mean age was 12.1 years 300 (29.5%) were wearing their spectacles, 492 (68.5%) students claimed to have them at home while 211 (29.4%) reported not having them at all. Compliance of spectacle wear was positively associated to the magnitude of refractive error (P < 0.001), father's education (P = 0.016), female sex (P = 0.029) and negatively associated to the visual acuity of the better eye (P < 0.001) and area of residence (P < 0.0001). Of those that were examined and found to be myopic (N = 499), 220 (44%) wore their spectacles to examination. Factors associated with compliance to spectacle usage in the myopic population included increasing refractive error (P < 0.001), worsening visual acuity (P < 0.001), and higher academic performance (P < 0.001). The causes for not wearing spectacles were 'lost spectacles' 67(9.3%), 'broken spectacles' 125 (17.4%), 'forgot spectacles at home' 117 (16.3%), 'uses spectacles sometimes' 109 (15.2%), 'teased about spectacles' 142 (19.8%) and 'do not like the spectacles' 86 (12%). Conclusion: Spectacle compliance was poor amongst school children in rural Pune; many having significant vision loss as a result.
  5,925 516 3
Incidence of pupillary involvement, course of anisocoria and ophthalmoplegia in diabetic oculomotor nerve palsy
Kaushik U Dhume, Kiruba E Paul
January 2013, 61(1):13-17
DOI:10.4103/0301-4738.99999  PMID:23275215
Aims : To derive a reliable estimate of the frequency of pupillary involvement and to study the patterns and course of anisocoria in conjunction with ophthalmoplegia in diabetes-associated oculomotor nerve palsy. Materials and Methods: In this prospective analytical study, standardized enrolment criteria were employed to identify 35 consecutive patients with diabetes-associated oculomotor nerve palsy who were subjected to a comprehensive ocular examination. Standardized methods were used to evaluate pupil size, shape, and reflexes. The degree of anisocoria, if present and the degree of ophthalmoplegia was recorded at each visit. Results: Pupillary involvement was found to be present in 25.7% of the total number of subjects with diabetic oculomotor nerve palsy. The measure of anisocoria was < 2 mm, and pupil was variably reactive at least to some extent in all cases with pupillary involvement. Majority of patients in both the pupil-involved and pupil-spared group showed a regressive pattern of ophthalmoplegia. Ophthalmoplegia reversed much earlier and more significantly when compared to anisocoria. Conclusions: Pupillary involvement in diabetes-associated oculomotor nerve palsy occurs in about 1/4 th of all cases. Certain characteristics of the pupil help us to differentiate an ischemic insult from an aneurysmal injury to the 3 rd nerve. Ophthalmoplegia resolves much earlier than anisocoria in diabetic oculomotor nerve palsies.
  3,851 436 7
Our experience of fibrin sealant-assisted implantation of Ahmed glaucoma valve
Nikhil S Choudhari, Aditya Neog, Anuj Sharma, Geetha K Iyer, Bhaskar Srinivasan
January 2013, 61(1):23-27
DOI:10.4103/0301-4738.99976  PMID:23275217
Aim: To report our experience with the fibrin sealant as a suture substitute for securing the human scleral patch graft during implantation of Ahmed glaucoma valve (AGV). Materials and Methods: A retrospective, non-comparative study of 12 eyes of 12 patients who underwent an AGV implantation with fibrin sealant for part of the procedure during June 2009 to September 2010. Results: The mean patient age was 21.5 ± 20.6 years. Male: Female ratio was 2 : 1. Seven (58.3%) patients were monocular. The indications for AGV were varied. The mean number of intra-ocular surgeries prior to an implantation of AGV was 1.8. The mean follow-up duration was 24.5 ± 17.9 weeks. There was a statistically significant reduction in the mean IOP and in the mean number of anti-glaucoma medications at the final visit compared to the pre-operative values (P < 0.01, paired t test). Conjunctival retraction was seen in 1 (8.3%) case. The scleral patch graft was retracted posteriorly in another (8.3%) case. There was no case of AGV tube exposure, tube-cornea touch, or conjunctival erosion. Vision threatening complication viz. late post-operative rhegmatogenous retinal detachment, unlikely to be related to the use of the fibrin sealant, occurred in 2 (16.6%) eyes. Conclusion: The fibrin sealant offers the advantages of safety and convenience to the placement of a scleral patch graft during an AGV implantation.
  3,622 252 1
Retinal sensitivity improvement after intravitreal triamcinolone acetonide injection for macular edema secondary to branch retinal vein occlusion
Fevzi Senturk, Hakan Ozdemir, Murat Karacorlu, Serra Arf Karacorlu, Omer Uysal
January 2013, 61(1):3-7
DOI:10.4103/0301-4738.105048  PMID:23275213
Purpose: To evaluate the effect of intravitreal triamcinolone acetonide (IVTA) on retinal sensitivity in cases of macular edema(ME) secondary to branch retinal vein occlusion (BRVO). Materials and Methods: Total of 14 eyes of 14 cases of BRVO were included in this prospective study. In each eye, at baseline and 1, 3, and 6 months after IVTA injection, logMAR visual acuity, central 4° retinal sensitivity by MP-1 microperimetry, and optical coherence tomography foveal thickness were assessed. Results: Cases ages ranged from 60 to 79 years (mean 68 ± 8 years). At 1, 3, and 6 months, the logMAR visual acuity had increased from 0.71 ± 0.21 to 0.42 ± 0.21, 0.46 ± 0.30, and 0.46 ± 0.27; the mean foveal thickness had decreased from 540 ± 88 μm to 254 ± 51 μm, 288 ± 84 μm, and 280 ± 91 μm; and the mean retinal sensitivity had increased from 4.7 ± 2.5 dB to 7.9 ± 2.7 dB, 8.2 ± 3.6 dB, and 8.3 ± 4.6 dB, respectively. Conclusion: In eyes with ME secondary to BRVO, IVTA injections result in a significant increase in not only the visual acuity but also the central 4° retinal sensitivity in 6 months follow-up.
  2,963 459 -
BRIEF COMMUNICATIONS
Scheimpflug imaging in anterior megalophthalmos
Gabor Nemeth, Ziad Hassan, Andras Berta, Laszlo Modis
January 2013, 61(1):32-35
DOI:10.4103/0301-4738.105052  PMID:23275220
We report an anterior megalophthalmos case with decreased corneal thickness and show the findings using Scheimpflug imaging. A 25-year-old male was diagnosed with anterior megalophthalmos. In both eyes, enlarged corneal length was measured. Beside a comparatively good visual acuity, a thin but clear cornea, a fairly deep anterior chamber, and central lens opacity were found. Scheimpflug images were taken using Pentacam HR. Scheimpflug-based imaging can provide us new data at the examination of this syndrome affecting the whole anterior segment.
  3,163 196 -
Histopathologically proven siderotic cataract with disintegrated intralenticular foreign body
Rosalynn G Siantar, Rupesh Agrawal, Li W Heng, Bernard Chi Shern Ho
January 2013, 61(1):30-32
DOI:10.4103/0301-4738.105051  PMID:23275219
Cataract formation may be an indicator of early siderosis and has been associated with intralenticular foreign bodies. We report a unique case of histopathologically proven lens siderosis in a young man with a preceding history of trauma but no signs of retained intraocular foreign body. He presented with a total white cataract with brownish deposits on anterior capsule and underwent cataract surgery for same followed by histopathological staining of anterior capsule for iron deposits. This case illustrates the importance of close monitoring of patients with history of trauma or previous penetrating injury to the eye, albeit no intraocular foreign body, as they might develop ocular siderosis at a later stage.
  3,090 151 -
Hip-implant related chorio-retinal cobalt toxicity
Soo K Ng, Andreas Ebneter, Jagjit S Gilhotra
January 2013, 61(1):35-37
DOI:10.4103/0301-4738.105053  PMID:23275221
A 39-year-old female with elevated serum cobalt levels from her bilateral hip prostheses presented with a 3-week history of blurred vision in her left eye. Optical coherence tomography revealed patchy degeneration of the photoreceptor-retinal pigment epithelium (RPE) complex. The lesions were hypofluorescent on indocyanine green angiography. We postulate that this is a case of implant-related chorio-retinal cobalt toxicity.
  2,731 187 6
ORIGINAL ARTICLES
Anatomical and functional graft survival, 10 years after epikeratoplasty in keratoconus
Anita Panda, Anoop K Gupta, Namrata Sharma, Sasikala Nindrakrishna, Rasik Vajpayee
January 2013, 61(1):18-22
DOI:10.4103/0301-4738.105049  PMID:23275216
Purpose: To report outcomes of epikeratoplasty in keratoconus (KC), utilizing manually-prepared plano donor lenticules in terms of flattening of the cone, reduction in astigmatism and improvement in the visual acuity. Materials and Methods: Patients with KC, having visual acuity <20/200, astigmatism >12 diopters (D) but without corneal opacity underwent epikeratoplasty, using manually prepared plano donor lenticules from fresh or M.K preserved corneas, between 1990 - 2000 and followed for 10 years, were included in this report. Visual acuity slit-lamp-biomicroscopy, keratometry, and refraction were performed at 8 weeks, 12 weeks, and 6 months for all 59 patients. The same were carried out at 1 year, 5 years, and 10 years depending upon the availability of the patient for that period. Results: Of the 59 patients, only 26 were available for follow-up after 10 years. At 3 months, 1 year and 5 years, best corrected visual acuity of (BCVA) ≥20/60 were achieved in 84.7%, 84.4% and 80.3% of eyes, respectively. BCVA was 73% at 10-year follow- up, which was due to the presence of posterior subcapsular cataract (PSC). The average keratometric astigmatism and average flattening in diopters stabilized at the end of 3 months, which remained constant at 1, 5, and 10-year follow-up. The average diopter of myopia was stabilized by 1 year, which was almost same at 10 year. Graft was clear in all but 1 eye at 10 year follow-up. Conclusion: Epikeratoplasty is a useful technique for keratoconic eyes without apical scarring who fail or unable to use contact lenses.
  2,725 188 1
LETTERS TO THE EDITOR
Ultra-wide-field green (532 nm) and red (633 nm) reflectance imaging of the "sunset glow" fundus in chronic Vogt-Koyanagi-Harada disease
Soh-Eun Ahn, Seong-Woo Kim, Jaeryung Oh, Kuhl Huh
January 2013, 61(1):38-39
DOI:10.4103/0301-4738.105054  PMID:23275222
  2,677 180 -
EDITORIAL
Expounding newer vistas in VEGF
Sundaram Natarajan
January 2013, 61(1):1-2
DOI:10.4103/0301-4738.105047  PMID:23275212
  2,386 326 -
LETTERS TO THE EDITOR
Phacoemulsification with phakic intraocular lens
Stefano Zenoni, Piero Fontana, Mario R Romano
January 2013, 61(1):42-43
DOI:10.4103/0301-4738.105059  PMID:23275226
  2,410 173 -
BRIEF COMMUNICATIONS
Bilateral Descemet's membrane detachment after uneventful phacoemulsification in a case of diabetes mellitus
Prateek Gujar, Purendra Bhasin, Priyamvada Bhasin
January 2013, 61(1):28-29
DOI:10.4103/0301-4738.105050  PMID:23275218
We report a diabetic patient with bilateral Descemet's membrane (DM) detachment after successive phacoemulsification. The DM detachments were diagnosed and documented in early postoperative period using anterior segment optical coherence tomography (OCT) and managed successfully by descemetopexy using 14% C3F8. This case highlights that some patients may be anatomically predisposed to DM detachment. Careful preoperative examination including specular microscopy should be done preoperatively especially in diabetic patients.
  2,382 191 2
LETTERS TO THE EDITOR
Conventional dacryocystorhinostomy in a failed Trans-canalicular laser-assisted dacryocystorhinostomy
Yildiray Yildirim, Ertugrul Can
January 2013, 61(1):44-45
DOI:10.4103/0301-4738.97558  PMID:23275228
  2,320 164 -
Chondroid syringoma: A rare lid tumor
M Ashok Kumar, Krishnagopal Srikanth, Ramraj Vathsalya
January 2013, 61(1):43-44
DOI:10.4103/0301-4738.105060  PMID:23275227
  2,171 142 -
Assessing Framingham cardiovascular risk scores in subjects with diabetes and their correlation with diabetic retinopathy
Parthasarathi Roy
January 2013, 61(1):40-41
DOI:10.4103/0301-4738.105057  PMID:23275224
  2,018 154 -
Query to the author of 'comparison of different techniques of cataract surgery in bacterial contamination of the anterior chamber in diabetic and non-diabetic population'
Sanjiv Kumar Gupta, Swati Agarwal, Shilpa Goyal, Ajai Kumar
January 2013, 61(1):39-40
DOI:10.4103/0301-4738.105055  PMID:23275223
  2,064 100 -
Authors' reply
M Ashok Kumar, Sheen S Kurien, Stephen Selvaraj, Uma Devi, S Sevasundari
January 2013, 61(1):40-40
  1,692 87 -
Author's reply
Rajesh S Joshi
January 2013, 61(1):45-45
  1,421 109 -
Fibrin glue evaluation like an adjuvant in vitreo-retinal surgery
Edgard O Rodríguez-Torres, Daniel Moreno-Páramo, Olivia Baldivieso-Hurtado, María Ana Martínez-Castellanos, Abelardo Rodríguez-Reyes, Daniel Ochoa-Contreras
January 2013, 61(1):41-42
DOI:10.4103/0301-4738.105058  PMID:23275225
  528 105 -