Advances in the surgical instrumentation and vitreoretinal techniques have allowed intraoperative reapproximation of retina to a more normal position. The use of intravitreally injected liquid materials (viscoelastic liquids, liquid perfluorocarbons and silicone oil), as adjunctive agents to vitreo-retinal surgery play an important role in facilitating retinal reattachment. These materials are used as intraoperative instruments to re-establish intraocular volume, assist in separating membranes adherent to the retina, manipulate retinal detachments and mechanically flatten detached retina. Over the longer term, silicone oil maintains intraocular tamponade. One should be cognizant of the potential uses, benefits and risks of each of these vitreous substitutes.

The problem of senile cataract blindness (SCB) is very acute in India, contributing to 80 per cent of total blindness. The national objective of reducing the prevalence of blindness from 1.49 per cent, during 1986-89 to 0.3 per cent by AD 2000 has necessitated the surgical correction of SCB to be the major activity. With the introduction of District Blindness Control Society (DBCS), there has been a substantial increase in the number of operations of SCB in those districts. However, in the absence of standard, feasible, simple and cost effective methods to estimate the prevalence and incidence of SCB, the DBCS may find it difficult to plan and execute its major activity in a realistic way. The paper suggests two such methods for the use by DBCS. Only five seemingly rational assumptions have been adopted for the purpose. The authors feel that proper field testing is required to be sure about the reliability and validity of these methods.

A case-control study (244 cases and 264 controls) was done during 1986-89 on a hospital based population to evaluate the risk factors associated with the etiology of senile cataract. Patentis with age between 40-60 years, visual acuity of 6/9 or less, and presence of lenticular opacity of senile origin were included as cases. Age matched individuals with absence of lenticular opacity made up the controls. Multivariate logistic regression analysis revealed that higher systolic BP and number of meals were significantly (P < 0.05) associated with presence of senile cataract; whereas higher weight, education and income, and utilization of cooking water had a significant protective effect against senile cataract. The present study helps the clinician to understand the possible risk factors associated with the development of senile cataract and could be helpful in designing a intervention strategy in future.

Several alternative approaches to screen diabetics followed by referral of patients with retinopathy changes, are being investigated. The intent is to demonstrate usefulness of a cost effective, easy and valid screening test. We investigated in this report the efficacy of graded corneal sensitivity for screening presence of diabetic retinopathy. In 105 randomly chosen subjects with (70 subjects) and without (35 subjects) diabetes mellitus, corneal aesthesiometry and status of retinopathy was determined independently. Corneal sensitivity in subjects of diabetes mellitus without retinopathy (1.17±0.29 gm/mm[2]) was significantly different when compared to healthy controls (0.99±0.04 gm/mm[2]) (p<0.01). Also corneal sensitivity in eyes with any type of retinopathy was significantly worse (1.94±1.33 gm/mm[2]) when compared to eyes without retinopathy. At a cut off value of 1.20 gm/mm[2] the sensitivity and specificity of corneal hypoesthesia as a test to detect diabetic retinopathy was 86% and 74%, respectively. For detecting presence of proliferative diabetic retinopathy at a cut off value of 1.49 gm/mm[2] the sensitivity and specificity were 89% and 80% respectively. These observations indicate that corneal hypoesthesia may be a reasonable indication of the presence of diabetic retinopathy and could be used to screen diabetic populations for retinopathy, after its validity is confirmed in larger studies.

Preseptal cellulitis has a typically benign course when treated with antibiotics, the clinical course depending on age of the patient, aetiology and the causative organism. In this study, 14 cases of preseptal cellulitis are documented with the age ranging from 2 to 55 years. The organisms isolated were Staphylococcus aureus (7 cases), Streptococcus pyogenes (2 cases) and Pseudomonas aeruginosa (1 case). In the remaining four patients no organism could be identified. All except four patients were cured within 6 weeks. Complications seen included lagophthalmos, lid abscess, cicatricial ectropion and lid necrosis in one patient each. The prognosis for preseptal cellulitis is good with appropriate antibiotics and surgical therapy.

A Census survey in Mohadi block, Bhandara district of Maharashtra, indicated that the prevalence of blindness and cataract blindness has increased, compared with the 1986 survey. Around one third of the persons blind from cataract have been covered by surgical services. To increase coverage, more emphasis on information, educational and communication is essential.