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  Citation statistics : Table of Contents
   2005| January-March  | Volume 53 | Issue 1  
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Epidemiological and Microbiological Diagnosis of Suppurative Keratitis in Gangetic West Bengal, Eastern India
Samar K Basak, Sukumar Basak, Ayan Mohanta, Arup Bhowmick
January-March 2005, 53(1):17-22
DOI:10.4103/0301-4738.15280  PMID:15829742
PURPOSE: To determine the epidemiologcial pattern and risk factors involved in suppurative corneal ulceration in Gangetic West Bengal, eastern India, and to identify the specific microbial agents responsible for corneal infections. METHODS: All patients with suspected microbial keratitis presenting to the corneal clinic at Disha Eye Hospital, Barrackpore, West Bengal, India, from January 2001 to December 2003 were evaluated. Sociodemographic data and information pertaining to the risk factors were recorded. After diagnosing infective corneal ulcer clinically, corneal scraping and cultures were performed. RESULTS: Over a three-year period, 1198 patients with suppurative keratitis were evaluated. Ocular trauma was the most common predisposing factor in 994 (82.9%) patients (P< 0.0001), followed by use of topical corticosteroids in 231 (19.28%) patients. Cultures were positive in 811 (67.7%) patients. Among these culture positive cases, 509 (62.7%) patients had pure fungal infections (P< 0.001), 184 (22.7%) patients had pure bacterial infections and 114 (14.1%) had mixed fungal with bacterial infections. Acanthamoeba was detected in 4 (0.49%) patients. The most common fungal pathogen was Aspergillus spp representing 373 (59.8%) of all positive fungal cultures (P< 0.0001), followed by Fusarium spp in 132 (21.2%) instances. Most common bacterial isolate was Staphylococcus aureus, representing 127 (42.6%) of all the bacterial culture (P< 0.0001) followed by Pseudomonas spp 63 (21.1%). CONCLUSION: Suppurative keratitis in Gangetic West Bengal, most often occurs after a superficial corneal trauma with vegetative or organic materials. Fungal ulcers are more common than bacterial ulcers. Aspergillus spp and Staphylococcus aureus were the most common fungus and bacteria respectively. These ′regional′ findings have important public health implications for the treatment and prevention of suppurative corneal ulceration in this region of India.
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Relationship between clinical presentation and visual outcome in postoperative and posttraumatic endophthalmitis in South Central India
Taraprasad Das, Derek Y Kunimoto, Savitri Sharma, Subhadra Jalali, Ajit B Majji, T Nagaraja Rao, Usha Gopinathan, Sreedharan Athmanathan
January-March 2005, 53(1):5-16
DOI:10.4103/0301-4738.15298  PMID:15829741
PURPOSE: To determine risk factors for poor visual outcome in postoperative and posttraumatic endophthalmitis in a large referral center in south central India. METHODS: In this prospective observational series the authors examined 388 patients of postoperative (n= 206) and posttraumatic (n= 182) endophthalmitis at the L V Prasad Eye Institute in Hyderabad, India between 1991 and 1997.The analysis was confined to 236 patients-128 (62.1%) postoperative and 108 (59.3%) posttraumatic patients who were followed for a minimum period of 3 months. A detailed protocol was followed. Chi-square and logistic regression analysis were used to determine risk factors for visual outcome worse than 6/18 and worse than 6/120. RESULTS: Postoperative endophthalmitis: In univariate analysis the features associated with poor visual acuity (grouped as < 6/18 and < 6/120) included intracapsular cataract surgery, poor presenting visual acuity, presence of vitreous cells, inability to visualise the optic disc on indirect ophthalmoscopy, presence of vitreous membranes on ultrasonography, and a culture-positive vitreous biopsy. In the multivariate analysis, visual acuity of < light perception (LP) at presentation was associated with a 3-month postoperative visual acuity of < 6/18, with an odds ratio of 5.85 [ 1.25 - 27.42, 95% CI], and vitreous membranes seen on ultrasonography was associated with a final visual acuity of < 6/120, with an odds ratio of 2.47 [1.05 - 5.83, 95% CI]. Posttraumatic endophthalmitis: In univariate analysis the features associated with poor visual acuity (grouped as < 6/18 and < 6/120) included a retained intraocular foreign body (IOFB), trauma by needle (hypodermic or sewing), poor presenting visual acuity, inability to visualise the optic disc on indirect ophthalmoscopy, presence of vitreous membranes on ultrasonography, and a culture-positive vitreous biopsy. In multivariate analysis, IOFB was associated with a 3-month follow-up visual acuity of < 6/18, with an odds ratio of 5.90 [1.85 - 18.78, 95% CI], and trauma by a needle (hypodermic or sewing) and retained IOFB was associated with a final visual acuity of < 6/120, with an odds ratio of 4.47 [1.22 - 16.38, 95%CI] and 3.76 [1.36 - 10.37, 95% CI] respectively. CONCLUSION: This is the largest, single-centre, prospective study on risk factors for poor visual outcome in postoperative and posttraumatic endophthalmitis. The independent risk factor for 3-month follow-up visual acuity of < 6/18 was the presenting visual acuity of ≤LP in postoperative endophthalmitis and a retained IOFB in posttraumatic endophthalmitis. The independent risk factor for 3-month visual acuity of <6/120 was the presence of vitreous membranes on ultrasonography in postoperative endophthalmitis, and trauma by a needle (hypodermic/ sewing) and retained IOFB in posttrauamtic endophthalmitis.
  26 8,765 630
Results of Probing for Congenital Nasolacrimal Duct Obstruction in Children Older than 13 Months of Age
Rajat Maheshwari
January-March 2005, 53(1):49-51
DOI:10.4103/0301-4738.15285  PMID:15829747
PURPOSE: To determine the success rate of probing for congenital nasolacrimal duct obstruction in children older than 13 months of age. METHODS: In a retrospective study of 84 children, 13 months and older who underwent probing for congenital nasolacrimal duct obstruction, the age at probing was correlated with success of probing. The children were divided into two groups, Group 1(13 - 24 months) and Group 2 (>24 months). Success was defined as complete resolution of signs and symptoms. The chi-square test was used to analyse the result. RESULTS: The success rate was 88.1% in-group 1 and 80.1% in-group 2 (P = 0.84). There was no significant difference in the cure rate with increasing age (P = 0.6). CONCLUSION: Probing is highly successful in the older age group and should remain the first line of treatment in older children.
  19 8,086 453
RPE Atrophy following Photodynamic Therapy in Type 2A Idiopathic Parafoveal Telangiectasis
Mahesh P Shanmugam, Manisha Agarwal
January-March 2005, 53(1):61-63
DOI:10.4103/0301-4738.15289  PMID:15829751
We report a case of Type 2A idiopathic parafoveal telangiectasis treated by Photodynamic Therapy (PDT), resulting in retinal pigment epithelial (RPE) atrophy corresponding to the size of the laser spot used. This raises a doubt regarding the safety of photodynamic therapy in CNVM secondary to type 2A parafoveal telangiectasis.
  16 8,163 300
Intravitreal Triamcinolone Acetonide in Serpiginous Choroidopathy
Avinash Pathengay
January-March 2005, 53(1):77-79
DOI:10.4103/0301-4738.15295  PMID:15829756
  13 5,110 295
Early Results of Penetrating Keratoplasty following Limbal Stem Cell Transplantation
Virender S Sangwan, Merle Fernandes, Aashish K Bansal, Geeta KK Vemuganti, Gullapalli N Rao
January-March 2005, 53(1):31-35
DOI:10.4103/0301-4738.15282  PMID:15829744
PURPOSE: To describe the early results of penetrating keratoplasty (PKP) in patients who had earlier received limbal transplantation (LT). METHODS: Prospective, non-comparative interventional case series comprising of four patients with limbal stem cell deficiency (LSCD) due to chemical injury (Cases 1, 2, 4) and xeroderma pigmentosum (Case 3). Cadaveric kerato-limbal allografts or living-related conjunctival-limbal allografts were done in four eyes followed by PKP for visual rehabilitation 3 - 4.5 months later. The following details were noted: demographics, primary aetiology, type of limbal transplant (cadaveric or living-related), immunosuppression, vision and ocular surface stability before and after LT and PKP, surgical complications and outcome of PKP. RESULTS: Three eyes received living-related conjunctival-limbal allotransplantation and one received cadaveric kerato-limbal allograft. Duration of follow up after PKP ranged from 4 to 11 months. Visual acuity improved in the early postoperative period in all patients but reduced in 2 due to endothelial rejection and after trans-scleral cyclophotocoagulation for medically uncontrolled glaucoma. The ocular surface remained stable in all patients. All patients were started on immunosuppression on the first postoperative day. This was continued till the last follow-up visit. Post-PKP complications were punctate epithelial keratopathy, corneal allograft rejection and secondary glaucoma (one patient each). CONCLUSION: Satisfactory visual rehabilitation is possible after PKP following LT without compromising ocular surface stability. However, a prolonged and close follow-up is warranted to avert complications.
  12 12,630 601
Perceived Barriers to the Provision of Low Vision Services among Ophthalmologists in India
Sarfaraz A Khan, BR Shamanna, Rishita Nuthethi
January-March 2005, 53(1):69-75
DOI:10.4103/0301-4738.15293  PMID:15829755
PURPOSE: To identify and report the perceived barriers to the provision of low vision services among ophthalmologists in India. METHODS: Seventy nine ophthalmologists responded to a structured self-administered questionnaire. Information was collected to understand the level of awareness and barriers/constraints to provision of low vision services. Significant factors associated with each barrier/constraint and perceptions on providing low vision care were investigated. RESULTS: Lack of training/knowledge [65 (82.3%)], lack of awareness [59 (74.7%)] and non-availability of low vision devices [57 (72.2%)] were perceived as the major constraints / barriers to providing low vision care. At least one significant factor was found for each of the above constraints/barriers in providing low vision care. The perception of lack of awareness as being one of the constraints/barriers was significantly higher [OR 3.97 (95% CI, 1.02 - 7.8)] among ophthalmologists from organisations providing low vision services. The perception of lack of motivation as constraintd/barrier was significantly higher [OR 3.62 (95% CI, 1.3 - 10.3)] among ophthalmologists from organisations providing low vision services and/or those involved in VISION 2020: The Right to Sight programmes [OR 3.83 (95% CI, 1.4 - 10.4)]. The likelihood of responding that low vision care is time consuming was greater for those belonging to a teaching institute [OR 7.19 (95% CI, 2.0 - 26.1)], those involved in low vision services [OR 5.45 (95% CI, 1.8 - 16.5)] and those who knew that low vision is a priority in VISION 2020 [OR 15.1, 95% CI, 1.5 -155.4]. CONCLUSION: Ophthalmologists need more education about the benefits of low vision care in order to increase their level of awareness and knowledge.
  11 7,017 507
A Cluster of Cases of Mycobacterium chelonei Keratitis following Penetrating Keratoplasty
M Srinivasan, Lalitha Prajna, N Venkatesh Prajna
January-March 2005, 53(1):67-68
DOI:10.4103/0301-4738.15292  PMID:15829754
Cluster infection with Mycobacterium chelonei following penetrating keratoplasty is described. All the donor eyes were harvested from the same collection centre. This underscores the importance of adherence to sterile protocols.
  10 4,919 228
Efficacy and Safety of Latanoprost for Glaucoma Treatment: A Three-Month Multicentric Study in India
Ravi Thomas, Rajul Parikh, Devendra Sood, L Vijaya, G Chandra Sekhar, Narendra N Sood, M Baskaran, K Kalyani Prasad
January-March 2005, 53(1):23-30
DOI:10.4103/0301-4738.15281  PMID:15829743
PURPOSE: To evaluate the short-term efficacy and safety of 0.005% topical latanoprost in Indian eyes. DESIGN: Prospective non-randomised open-label multicentric trial. METHODS: One hundred and fifty patients with ocular hypertension (OHT), primary open-angle, pseudoexfoliation or pigmentary glaucoma were enrolled at four centers. Each center contributed at least 20 patients. Following baseline measurements, 0.005% latanoprost was applied topically once daily in the evening for three months. Patients were examined at 2, 6 and 12 weeks. The primary outcome measure was mean intraocular pressure (IOP) reduction. The mean diurnal variation of IOP (difference between highest and lowest IOP) at baseline and at 12-weeks was compared. RESULTS: One hundred and thirty of 150 enrolled patients completed the study. One randomly selected eye of each patient was included for analysis. At three months, latanoprost reduced the mean IOP from 24.9 (± 3.16) mmHg at baseline to 16.10 (± 2.7) mmHg, a reduction of 35.25%. 83% had a reduction in IOP of > 25%. The IOP reduction was maintained throughout the study period, and was not affected by gender or age of the patient. One eye did not show any response to the drug. Daytime diurnal variation of IOP was reduced from 4.5 to 2.9 mmHg. 20 patients had conjunctival hyperemia. Six patients had side effects requiring withdrawal from the study. CONCLUSIONS: In this short-term multicentric study, latanoprost effectively reduced IOP and stabilised the diurnal curve in Indian eyes. There were no clinically significant ocular or systemic adverse effects.
  10 11,958 666
Speciation of Coagulase Negative Staphylococcus causing Bacterial Keratitis
P Manikandan, M Bhaskar, R Revathy, Rajesh K John, Kalpana Narendran, V Narendran
January-March 2005, 53(1):59-60
DOI:10.4103/0301-4738.15288  PMID:15829750
Thirty-five coagulase negative Staphylococcus (CoNS) cultured from corneal ulcer were speciated and antibiotic sensitvity tested. S epidermidis was the commonest isolate and it was sensitive to ampicilin and vanconycin.
  9 20,745 644
Can Ocular Torsion be Measured Using the Slitlamp Biomicroscope?
Mihir T Kothari, G Venkatesan, Jugal P Shah, Kulin Kothari, Praveen K Nirmalan
January-March 2005, 53(1):43-47
DOI:10.4103/0301-4738.15284  PMID:15829746
PURPOSE: To evaluate and compare a stereo-biomicroscopic technique of ocular torsion measurement with fundus photographic technique. METHODS: This prospective masked observational study included 72 eyes of 36 consecutive subjects with normal ocular motility. The disc-foveal angle was measured by two masked investigators using a slitlamp stereo-biomicroscopic and fundus photographic technique. RESULTS: The mean age was 13.7 years (6 - 44 years), and 15 (41.6%) were males. The average torsion using the slitlamp technique was 5.5 3.3o and 6.1 4.3o with fundus photographic technique. Clinical agreement between the two techniques for 5o and 6o torsion was 81% and 90% respectively. The average difference between the two techniques was 3.0 2.6o. The mean inter-ocular difference was 3.3 2.7o (SD, 2.77) and 5.5 4.6o using the slitlamp and fundus photographic technique respectively. The Pearson correlation coefficient (r2) was 0.5 CONCLUSION: The fundus photographic technique remains the gold standard test for the measurement of ocular torsion. The slitlamp biomicroscopic method can be useful where a fundus camera is unavailable. Further studies are required to test the repeatability of these tests.
  8 7,806 314
Split-Conjunctival Grafts for Double - head Pterygium
Sejal Maheshwari
January-March 2005, 53(1):53-55
DOI:10.4103/0301-4738.15286  PMID:15829748
PURPOSE: To describe the technique of split-conjunctival grafts (SCG) for double-head pterygia and to evaluate its postoperative outcome. METHOD: A retrospective analysis of seven eyes with primary double-head pterygium was done. All eyes received pterygium excision with split-conjunctival grafts harvested from the superior quadrant. All patients were followed up for recurrence of the lesion and incidence of complications. RESULTS: No recurrence was noted with a mean follow-up of 17.7 6 months. CONCLUSION: Split-conjunctival graft is a useful procedure for double-head pterygium.
  6 7,675 427
A Case of Periocular Dirofilariasis Masquerading as a Lid Tumour
G Mahesh, A Giridhar, Jyotirmay Biswas, SJ Saikumar, Ananthakrishna Bhat
January-March 2005, 53(1):63-64
DOI:10.4103/0301-4738.15290  PMID:15829752
We describe an unusual case of periocular Dirofilariasis masquerading as a slow growing lid tumour in an elderly female patient.
  5 5,273 247
Persistent Depot of Triamcinolone Acetonide after a Single Intravitreal Injection
Vasumathy Vedantham, Chandramohan Kolluru, Kim Ramasamy
January-March 2005, 53(1):65-66
DOI:10.4103/0301-4738.15291  PMID:15829753
The persistence of depot of triamcinolone at four months following a single intravitreal injection is described.
  2 8,010 246
Disseminated Metastasis following Periampullary Cancer Resection Masquerading as Uveitis
Sushmita Kaushik, Vishali Gupta, Ramandeep Singh, Rakesh K Vasishta, Arvind Rajwanshi, Amod Gupta
January-March 2005, 53(1):57-59
DOI:10.4103/0301-4738.15287  PMID:15829749
The Uveitis Masquerade Syndromes (UMS) are a group of ocular diseases that mimic intraocular inflammation, but are in fact neoplastic in nature. We report a patient with disseminated malignancy who presented with uveitis 5 years after an apparently successful resection of periampullary adenocarcinoma. The Masquerade Syndrome was detected by cytological examination of the vitreous.
  2 5,649 265
Changing Times, Evolving Responses
Barun K Nayak
January-March 2005, 53(1):1-3
DOI:10.4103/0301-4738.15278  PMID:15829740
  2 4,837 186
Bilateral Epithelial Defects after Laser in situ Keratomileusis. Clinical Features, Management and Outcome
Srinivas K Rao, Debraj Shome, Geetha K Iyer, Rajesh Fogla, Prema Padmanabhan
January-March 2005, 53(1):37-42
DOI:10.4103/0301-4738.15283  PMID:15829745
PURPOSE: To describe the preoperative characteristics, intraoperative details, management, and postoperative in patients with bilateral epithelial defects after laser in situ keratomileusis (LASIK). METHODS: Retrospective non-comparative case series. RESULTS: Six patients with bilateral epithelial defects after LAISK were part of a cohort of 605 patients undergoing bilateral LASIK at our center from December 2001 to April 2003. The mean age of the patients (5M:1F) was 28.5 7.9 years, and the average pretreatment myopic spherical equivalent (SE) refraction was 7.3 0.7 D (-4, -12.25D). An epithelial flap was present in 6 eyes and an epithelial defect with a mean diameter of 3 mm (2mm, 6mm) was seen in 6 eyes. In four patients the epithelial disturbance was bilaterally similar. All defects occurred in the inferior cornea and the epithelial flaps had the hinge positioned superiorly. None of the patients had ocular or systemic risk factors that could have resulted in this complication. A bandage contact lens was used in 6 eyes. At last follow-up of 5.5 9.5 months (0.25, 21 months), unaided visual acuity was 6/9 or better in 10 eyes. Best spectacle-corrected visual acuity (BSCVA) was maintained in 8 eyes, while 4 eyes lost one line of BSCVA. Recurrent corneal erosions were not reported in the follow-up period. CONCLUSIONS: These patients represent a hitherto unrecognised group of individuals who appear to have a subclinical weakness of adhesion of the corneal epithelium to the underlying structures, which is not evident on clinical examination. This results in bilateral epithelial disturbances after LASIK. Appropriate management results in satisfactory clinical outcomes. Other options for treatment of the fellow eye of such patients include the use of a different microkeratome, release of suction during the reverse pass of the Hansatome microkeratome, and photorefractive keratectomy if the refractive error is low.
  2 8,161 289
Myoconjunctival Enucleation for Enhanced Implant Motility. Result of a Randomised Prospective Study
Raj Anand, Harish Pathak, Vijay P Wagh, Milind N Naik
January-March 2005, 53(1):79-80
DOI:10.4103/0301-4738.15296  PMID:15829758
  1 2,967 191
Myoconjunctival Enucleation for Enhanced Implant Motility. Result of a Randomised Prospective Study
Mandeep S Bajaj, Neelam Pushker, Ramamurthy Balasubramanya, Vijay B Wagh, Sanjiv Gupta
January-March 2005, 53(1):80-80
DOI:10.4103/0301-4738.15297  PMID:15829759
  - 2,743 217
Phacolytic Glaucoma in Fuch's Heterochromic Uveitis
Anita Peddi, G Chandra Sekhar
January-March 2005, 53(1):77-77
DOI:10.4103/0301-4738.15294  PMID:15829757
  - 4,267 233