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  Most popular articles (Since April 01, 2005)

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Ocular oncology practice guidelines during COVID-19 pandemic-An expert consensus
Fairooz P Manjandavida, Santosh G Honavar, Usha Kim, Usha Singh, Vikas Menon, Sima Das, Swathi Kaliki, Mahesh Shanmugam Palanivelu, Vikas Khetan, Parag K Shah, Pukhraj Rishi, Kaustubh Mulay, Arpan Gandhi, BM Vadhiraja, Vijay Anand Reddy, Sunil Bhat, Vasudha Rao
July 2020, 68(7):1281-1291
DOI:10.4103/ijo.IJO_1669_20  PMID:32587152
The outbreak of rapidly spreading COVID-19 pandemic in December 2019 has witnessed a major transformation in the health care system worldwide. This has led to the re-organization of the specialty services for the effective utilization of available resources and ensuring the safety of patients and healthcare workers. Suspension of oncology services will have major implications on cancer care due to delayed diagnosis and treatment leading to irreversible adverse consequences. Therefore various oncology organizations have called for a continuation of cancer care during this crisis with diligence. The COVID-19 pandemic has forced the clinicians to transform the components of care from screening to outpatient care and primary management. The purpose of this article is to establish guidelines and recommendations for ocular oncology in the management of ocular tumors set by a multidisciplinary team of experts including ocular, medical and radiation oncologists, and pathologists. As the pandemic is evolving fast, it will require constant updates and reformation of health strategies and guidelines for safe and quality health care.
  277,863 182 -
Potential ocular and systemic COVID-19 prophylaxis approaches for healthcare professionals
Rohit Shetty, Vaitheeswaran Ganesan Lalgudi, Pooja Khamar, Krati Gupta, Swaminathan Sethu, Archana Nair, Santosh G Honavar, Arkasubhra Ghosh, Sharon D'Souza
July 2020, 68(7):1349-1356
DOI:10.4103/ijo.IJO_1589_20  PMID:32587162
The COVID-19 pandemic has brought with it, innumerable challenges in healthcare, both through the direct burden of morbidity and mortality of the disease, and also by the curtailing of other essential albeit less emergency medical services to reduce the risk of community spread. Reports from around the world are showing mounting number of cases even in healthcare professionals spite of usage of adequate personal protective equipment. There are a number of factors which could account for this, be it the affinity of the virus to the respiratory and other mucosa or to patient risk factors for developing severe forms of the disease. In view of the growing need for resuming other medical services, it is essential to find newer ways to protect ourselves better, whether by systemic or topical mucosal prophylaxis with various medications or lifestyle changes promoting wellbeing and immunity. This article discusses additional prophylactic measures including drug repurposing or new indication paradigms to render protection. Certain medications such as chloroquine, trehalose, antihistaminics, and interferons used topically for various ocular conditions with reasonably good safety records are known to have anti-viral properties. Hence, can be harnessed in preventing SARS-CoV-2 attachment, entry, and/or replication in host cells. Similarly, use of hypertonic saline for nasal and oral mucosa and dietary changes are possible methods of improving our resistance. These additional prophylactic measures can be cautiously explored by healthcare professionals to protect themselves and their patients.
  241,705 479 -
Ophthalmological signet ring sign by a glaucoma implant
Sunny Chi Lik Au, Simon Tak Chuen Ko
September 2019, 67(9):1477-1477
DOI:10.4103/ijo.IJO_470_19  PMID:31436203
  87,610 85,635 -
Interpreting automated perimetry
Ravi Thomas, Ronnie George
April-June 2001, 49(2):125-140
Visual field testing is mandatory for many ophthalmic conditions including glaucoma. The current gold standard for visual field testing is automated perimetry. In this article we familiarize the reader with the components of an automated perimetry printout. We describe a systematic approach that leads to a thorough interpretation of the printout. With the help of examples the reader should be able to learn to identify a normal field, detect the presence of a field defect, determine whether it is due to glaucoma, and establish progression, if any.
  93,122 1 2
A tribute to frontline corona warriors––Doctors who sacrificed their life while saving patients during the ongoing COVID-19 pandemic
Suresh K Pandey, Vidushi Sharma
May 2020, 68(5):939-942
DOI:10.4103/ijo.IJO_754_20  PMID:32317499
  57,769 571 -
Management of vitreous haemorrhage.
S Saxena, S Jalali, L Verma, A Pathengay
April-June 2003, 51(2):189-196
Vitreous hemorrhage is one of the most common differential diagnoses for sudden painless decrease in vision. Often, it is caused by retinal vascular disorders secondary to common systemic ailments such as diabetes mellitus, systemic hypertension and haematological abnormalities. Sometimes it may be the beginning of a retinal tear and consequent retinal detachment that can be vision threatening if not operated early. This paper lays out practical guidelines for a tailored approach needed to arrive at the aetiology of vitreous haemorrhage so that appropriate, timely treatment can be planned.
  52,274 2,595 2
Susruta of ancient India
VK Raju
April-June 2003, 51(2):119-122
"It is interesting that while in Hindu medicine, cataract was defined by Susruta as opacity due to derangement of the intraocular fluid, subsequent history is full of fantasies and prejudices concerning its nature." Duke Elder[1] "All in all Susruta must be considered the greatest surgeon of the pre medieval period." A.O. Whipple[2]
  50,092 1,203 8
Amniotic membrane transplantation: A review of current indications in the management of ophthalmic disorders
Virender S Sangwan, Sanghamitra Burman, Sushma Tejwani, Sankaranarayana Pillai Mahesh, Ramesh Murthy
July-August 2007, 55(4):251-260
DOI:10.4103/0301-4738.33036  PMID:17595472
Amniotic membrane transplantation is currently being used for a continuously widening spectrum of ophthalmic indications. It has gained widespread attention as an effective method of reconstruction of the ocular surface. Amniotic membrane has a unique combination of properties, including the facilitation of migration of epithelial cells, the reinforcement of basal cellular adhesion and the encouragement of epithelial differentiation. Its ability to modulate stromal scarring and its anti-inflammatory activity has led to its use in the treatment of ocular surface pathology as well as an adjunct to limbal stem cell grafts. Amniotic membrane transplantation has been used for reconstruction of the corneal surface in the setting of persistent epithelial defects, partial limbal stem cell deficiency, bullous keratopathy and corneoscleral ulcers. It has also been used in conjunction with limbal stem cell transplantation for total limbal stem cell deficiency. Amniotic membrane grafts have been effectively used as a conjunctival substitute for reconstruction of conjunctival defects following removal of pterygia, conjunctival lesions and symblephara. More recently, amniotic membrane has been used as a substrate for ex vivo cultivation of limbal, corneal and conjunctival epithelial cells. This article reviews the current literature on the applications of amniotic membrane transplantation and its outcome in various ophthalmic conditions.
  45,297 4,971 37
A surge in eye clinic nonattendance under 2019 novel coronavirus outbreak
Sunny Chi Lik Au
May 2020, 68(5):948-948
DOI:10.4103/ijo.IJO_673_20  PMID:32317502
  27,998 20,200 -
White with pressure (WWP) and white without pressure (WWOP) lesions
Manoj Shukla, OP Anuja
May-June 1982, 30(3):129-132
  47,829 0 -
Bloody tears (haemolacria)
BK Ahluwalia, AK Khurana, S Sood
January-February 1987, 35(1):41-43
A case of bloody tears in a young hysterical female is described and rarity of the condition is stressed.
  47,329 0 3
Evaluation of periosteal fixation of lateral rectus and partial VRT for cases of exotropic Duane retraction syndrome
Pradeep Sharma, Ruchi Tomer, Vimla Menon, Rohit Saxena, Anudeepa Sharma
February 2014, 62(2):204-208
DOI:10.4103/0301-4738.121145  PMID:24618490
Purpose: The purpose of this study is to evaluate the lateral rectus periosteal fixation and partial vertical rectus transpositioning (VRT) as treatment modalities to correct exotropic Duane retraction syndrome (Exo-DRS). Materials and Methods: Prospective interventional case study of cases of Exo-DRS with limitation of adduction. A total of 13 patients were subdivided into two groups. Six patients underwent only lateral rectus periosteal fixation (group A) and seven patients also underwent partial VRT (group B). Assessment involved prism bar cover test, abduction and adduction range, extent of binocular single visual field and exophthalmometry. These tests were repeated at 1 week, 1 month and 3 months post-operatively and data analyzed. Results: The pre-operative mean values and ranges were 26.2 Δ (22-35) exotropia for group A and −21.3 Δ (14-30) exotropia for group B. The post-operative mean and range was +0.6 Δ esotropia (+20 to −8) for group A and 8 Δ (−2 to −20) exotropia for group B. Mean grade of limitation of abduction changed from −3.8 to −3.6 versus −3.6 to −2.8 and mean grade of limitation of adduction changed from −1.9 to −0.7 versus −1.5 to −0.5 in the groups A and B respectively. Mean binocular single visual field changed from 14.7° to 23.3° in group A and 11.8° to 26.4° in the group B respectively. Conclusion: Lateral rectus periosteal fixation is an effective surgery to correct the exodeviation, anomalous head posture and improving adduction in Exo-DRS and partial VRT in addition is effective in improving abduction and binocular single visual fields.
  46,771 281 3
COVID-19 pandemic: Lessons learned and future directions
Rohit C Khanna, Maria Vittoria Cicinelli, Suzanne S Gilbert, Santosh G Honavar, Gudlavalleti S V Murthy
May 2020, 68(5):703-710
DOI:10.4103/ijo.IJO_843_20  PMID:32317432
Emerging pandemics show that humans are not infallible and communities need to be prepared. Coronavirus outbreak was first reported towards the end of 2019 and has now been declared a pandemic by the World Health Organization. Worldwide countries are responding differently to the virus outbreak. A delay in detection and response has been recorded in China, as well as in other major countries, which led to an overburdening of the local health systems. On the other hand, some other nations have put in place effective strategies to contain the infection and have recorded a very low number of cases since the beginning of the pandemics. Restrictive measures like social distancing, lockdown, case detection, isolation, contact tracing, and quarantine of exposed had revealed the most efficient actions to control the disease spreading. This review will help the readers to understand the difference in response by different countries and their outcomes. Based on the experience of these countries, India responded to the pandemic accordingly. Only time will tell how well India has faced the outbreak. We also suggest the future directions that the global community should take to manage and mitigate the emergency.
  44,378 2,505 -
Ocular manifestations in the Hutchinson-Gilford progeria syndrome
Shivcharan L Chandravanshi, Ashok Kumar Rawat, Prem Chand Dwivedi, Pankaj Choudhary
November-December 2011, 59(6):509-512
DOI:10.4103/0301-4738.86327  PMID:22011502
The Hutchinson-Gilford progeria (HGP) syndrome is an extremely rare genetic condition characterized by an appearance of accelerated aging in children. The word progeria is derived from the Greek word progeros meaning 'prematurely old'. It is caused by de novo dominant mutation in the LMNA gene (gene map locus 1q21.2) and characterized by growth retardation and accelerated degenerative changes of the skin, musculoskeletal and cardiovascular systems. The most common ocular manifestations are prominent eyes, loss of eyebrows and eyelashes, and lagophthalmos. In the present case some additional ocular features such as horizontal narrowing of palpebral fissure, superior sulcus deformity, upper lid retraction, upper lid lag in down gaze, poor pupillary dilatation, were noted. In this case report, a 15-year-old Indian boy with some additional ocular manifestations of the HGP syndrome is described.
  41,105 2,162 -
Posterior Capsule Opacification : A Review of the Aetiopathogenesis, Experimental and Clinical Studies and Factors for Prevention
Suresh K Pandey, David J Apple, L Werner, Anthony J Maloof, E John Milverton
April-June 2004, 52(2):99-112
Posterior capsule opacification (PCO, secondary cataract, after cataract) is a nagging postsurgical complication following extracapsular cataract surgery (ECCE) and intraocular lens (IOL) implantation. PCO should be eliminated since it has deleterious sequelae and Neodynium: Yttrium Aluminium Garnet (Nd: YAG) laser treatment often is an unnecessary financial burden on the health care system. PCO following cataract surgery could be a major problem, since patient follow-up is difficult and the Nd:YAG laser is not always available. Advances in surgical techniques, IOL designs/biomaterials have been instrumental in bringing about a gradual and unnoticed decrease in the incidence of PCO. We strongly believe that the overall incidence of PCO and hence the incidence of Nd:YAG laser posterior capsulotomy is now rapidly decreasing - from 50% in the 1980s and early 1990s to less than 10% currently. Superior tools, surgical procedures, skills and appropriate IOL designs have all helped to significantly reduce this complication. In this article, we review the aetio pathogenesis, experimental and clinical studies and propose surgical and implant-related factors for PCO prevention. Careful application and utilisation of these factors by surgeons could lead to a significant reduction is secondary cataract, the second most common cause of visual loss worldwide
  37,013 4,952 34
Amplitude of accommodation in different age groups and age of on set of presbyopia in Bengalee population
DN Chattopadhyay, GN Seal
March-April 1984, 32(2):85-87
  38,669 0 -
Amplitude of Accommodation and its Relation to Refractive Errors
Lekha Mary Abraham, Thomas Kuriakose, Viswanathan Sivanandam, Nithya Venkatesan, Ravi Thomas, Jayaprakash Muliyil
April-June 2005, 53(2):105-108
DOI:10.4103/0301-4738.16173  PMID:15976465
Aims: To evaluate the relationship between amplitude of accommodation and refractive errors in the peri-presbyopic age group. Materials and Methods: Three hundred and sixteen right eyes of 316 consecutive patients in the age group 35-50 years who attended our outpatient clinic were studied. Emmetropes, hypermetropes and myopes with best-corrected visual acuity of 6/6 J1 in both eyes were included. The amplitude of accommodation (AA) was calculated by measuring the near point of accommodation (NPA). In patients with more than 2 diopter sphere correction for distance, the NPA was also measured using appropriate soft contact lenses. Results: There was a statistically significant difference in AA between myopes and hypermetropes ( P <0.005) and between myopes and emmetropes ( P <0.005) in the 35-39 year age group. In the 40- 44 year age group, there was a significant difference in AA between emmetropes and hypermetropes ( P <0.0001), emmetropes and myopes ( P <0.01) and hypermetropes and myopes ( P <0.0001). In patients above 45 years of age there was no significant difference ( P >0.5). Conclusion: Our study showed higher amplitude of accommodation among myopes between 35 and 44 years compared to emmetropes and hypermetropes
  35,927 1,920 17
Orbital regional anesthesia: Complications and their prevention
CM Kumar
April-June 2006, 54(2):77-84
DOI:10.4103/0301-4738.25826  PMID:16770022
Serious complications following orbital regional anesthesia are rare, but occur following both needle and blunt cannula (sub-Tenon's) techniques. Each technique of orbital regional anesthesia has its own risk/benefit profile. This article reviews the etiology, risk factors, treatment and prevention of complications of commonly used akinetic orbital blocks. Ophthalmologists and ophthalmic anesthesiologists must be prepared to deal with rare, but serious complications, that can occur with any technique of orbital regional anesthesia.
  32,973 2,346 26
Clinical and electrophysiological results of eye muscle surgery in 17 patients with downbeat nystagmus
Richard W Hertle, Ashraf Ahmad
January 2019, 67(1):109-115
DOI:10.4103/ijo.IJO_703_18  PMID:30574904
Purpose: To test the hypothesis that eye muscle surgery in treatment of patients with acquired downbeat nystagmus results in improvement measures of visual and ocular motor function. Methods: This is a prospective, interventional case series analysis of clinical and electrophyisological data before and after eye muscle surgery in 17 patients with acquired downbeat nystagmus who did not respond to medical treatments. Outcome measures included: 1) routine demography and clinical characteristics, 2) subjective oscillopsia (SO), 3) binocular best-corrected visual acuity in the null position (BVA), 3) primary position strabismic deviation (SD), 5) anomalous head posture (AHP), 6) contrast sensitivity function (CS), and 7) nystagmus slow phase velocity (SPV). All patients were followed at least 12 months. Parametric and non-parametric statistical analysis of outcome measure data above pre- and post-treatment were perfomed using standard software on grouped data using computerized software. Results: Patients' age ranged from 5 to 85 years (average 27 years). About 59% were male. Follow up ranged from 1–10 years (average 2.0 years). Around 70% had an associated central nervous systemic diagnosis, 100% had an AHP, oscillopsia and decreased CS, 53% had other eye disease, and 59% had strabismus. There were no complications from surgery. There were signficant post-treatment improvements in mean/median group BVA, SO, SD, AHP, CS, and SPV. Conclusion: This study supports the hypothesis that eye muscle surgery as treatments for patients with acquired downbeat nystagmus can result in improvements in multiple aspects of ocular motor and visual functions.
  33,828 166 -
Retinal vein occlusion
Sohan Singh Hayreh
July-September 1994, 42(3):109-132
In this review of the retinal vein occlusion (RVO), I have summarized recent advances on several controversial and clinically important topics: classification of RVO into six distinct clinical entities; pathogeneses and demographic characteristics of various types of RVO; differentiation of non-ischemic from ischemic central retinal vein occlusion (CRVO); differentiation of hemi-CRVO (HCRVO) from major branch RVO (BRVO); and the course, complications and management of various types of RVO
  33,608 4 38
Interpretation of computed tomography imaging of the eye and orbit. A systematic approach
Milind N Naik, Kishore L Tourani, G Chandra Sekhar, Santosh G Honavar
October-December 2002, 50(4):339-353
Computed tomography (CT) has revolutionised the diagnosis and management of ocular and orbital diseases. The use of thin sections with multiplanar scanning (axial, coronal and sagittal planes) and the possibility of three-dimensional reconstruction permits thorough evaluation. To make the most of this technique, users must familiarize themselves with the pertinent CT principles and terminology. The diagnostic yield is optimal when the ophthalmologist and radiologist collaborate in the radiodiagnostic workup. In this article we describe a systematic approach to the interpretation of ocular and orbital CT scans.
  30,260 3,229 4
The pathology of cornea (A histopathological study)
PK Agrawal
September-October 1983, 31(5):662-665
  33,233 0 -
Accommodative-convergence over accommodation (AC/A) ratio (in normal Indian subjects)
DK Sen, S.R.K Malik
December 1972, 20(4):153-157
  32,743 0 -
Mooren's ulcer : Current concepts in management
VS Sangwan, P Zafirakis, CS Foster
January-March 1997, 45(1):7-17
Mooren's ulcer is strictly a peripheral ulcerative keratitis (PUK) with no associated scleritis. It occurs completely in absence of any diagnosable systemic disorder that could be responsible for the progressive destruction of the cornea. The aetiology of Mooren's ulcer remains uncertain. However, recent studies indicate that it is an autoimmune disease directed against a specific target molecule in the corneal stroma, probably triggered in genetically susceptible individuals by one of several possible provocateurs. Advances have been made in the management of this disease. Immunosuppressive therapy has been shown increasingly successful in patients unresponsive to conventional treatment and in bilateral progressive destructive ocular disease.
  32,215 4 -
Limbal stem cell deficiency : Concept, aetiology, clinical presentation, diagnosis and management.
HS Dua, JS Saini, A Azuara-Blanco, P Gupta
April-June 2000, 48(2):83-92
Defects in renewal and repair of ocular surface as a result of limbal stem cell deficiency are now known to cause varying ocular surface morbidity including persistent photophobia, repeated and persistent surface breakdown and overt conjunctivalisation of the cornea. Ocular conditions with abnormalities of ocular surface repair include pterygium, limbal tumours, aniridia, severe scarring following burns, cicatricial pemphigoid and Stevens-Johnson Syndrome, sequelae of mustard gas exposure and Herpes simplex epithelial disease, radiation keratopathy, contact lens induced keratopathy, neuroparalytic keratitis and drug toxicity. Restoring ocular health in these eyes has traditionally been frustrating. An understanding of these intricate cell renewal and maintenance processes has spurred the evolution in recent years of new treatment methods for several blinding diseases of the anterior segment; many more exciting modalities are in the offing. However, there is inadequate awareness among ophthalmologists about the current principles of management of ocular surface disorders. The purpose of this article is to help elucidate the important principles and current treatment methods relevant to ocular surface disorders.
  31,967 17 42