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   2017| April-June  | Volume 55 | Issue 2  
    Online since December 26, 2017

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Newer drugs in glaucoma management
Sujatha V Kadambi, Ronnie George
April-June 2017, 55(2):134-139
Glaucoma, a chronic progressive neurodegenerative disease, has both intraocular pressure dependent and independent pathogenetic mechanisms. Medical therapy is the first line of treatment in glaucoma management. Patient adherence and persistence to pharmacotherapy is a great barrier to its success. This review highlights the recent advances in medical management and discusses newer pharmacotherapy including new molecules with novel mechanisms of action, novel target molecules/genes/tissues, and newer drug delivery systems, many of which are still in clinical trial phase.
  4,831 734 -
Traumatic luxation of the globe: A novel simple treatment
Viji Rangarajan, Yazhini Tamilmani
April-June 2017, 55(2):145-147
Luxation of the eyeball is a rare clinical entity that may present spontaneously or more commonly following trauma, but it carries a risk of threat to permanent vision loss. Appropriate intervention should be undertaken instantly. Prompt reduction results in restoration of full anatomical, functional, and visual recovery in otherwise healthy eyes. We report a case of globe luxation following trauma by the brake handle of a two-wheeler in a 12-year-old female, who recovered completely after reposition of the globe using Desmarres Lid Retractors.
  1,971 154 -
Botulinum toxins and fillers for treatment of the aging face
Bhupendra C. K. Patel
April-June 2017, 55(2):113-119
We present a comprehensive review of how to best use neuro-toxins and fillers to rejuvenate the aging face. With modern neuro-toxins and fillers, it is now possible to achieve an improvement in the aging changes of young, middle-aged, and older patients. Furthermore, with the appropriate application of these materials, surgical results can be kept looking good without the need for repeated surgical intervention. As it is important to understand the relationship of the different parts of the face when assessing the aging face, we review the best practices as applied to the whole face.
  1,895 199 -
Optical coherence tomography angiography: A general view
Arulmozhi Varman, Ramya Muralidharan, Dinesh Balakumar
April-June 2017, 55(2):107-112
Optical coherence tomography angiography (OCTA) is a new, non-invasive imaging technique that generates angiography images in a matter of seconds. Since it detects vascular compromise even before clinical picture sets in , it is a very useful tool in the diagnosis of retinal vascular pathology.In this review we introduce the technology and compare it with the current angiographic gold standards, fluorescein angiography (FA) and indocyanine green angiography (ICGA). Finally we summarize its potential application to retinal vascular diseases..Its current limitations include a relatively small field of view, inability to show leakage & motion artefacts.Published studies hint at OCTA's potential efficacy in the evaluation of common ophthalmologic diseases such as age related macular degeneration (AMD), diabetic retinopathy, artery and vein occlusions, and glaucoma.
  1,732 206 -
Encysted bleb following ahmed glaucoma valve surgery: A histopathological case report
Maithri B Arunkumar, Murali Ariga, Malarchelvi Palani, Nivean Madhivanan
April-June 2017, 55(2):150-153
A 27-year-old male patient, with family history of glaucoma was diagnosed to have iridocorneal endothelial syndrome in the left eye. He was treated initially with topical medications and subsequently underwent trabeculectomy with the express implant. Postoperatively, the bleb was found to be well functioning for few months and later became flat and he was given subconjunctival (SC) 0.1 ml 5-Flourouracil (FU) injection with bleb needling. As the bleb did not form despite these measures, he underwent a second surgery with an Ahmed glaucoma valve (FP7) implantation. On review after 4 weeks, the patient had developed a large encysted bleb. Needling was done again and another dose of SC 5-FU 0.1 ml was given. The bleb became encysted again after 6 weeks, hence bleb wall excision was done, and the cyst wall was sent for histopathological analysis which revealed presence of loculated cysts and goblet cells but no inflammation. To the best of our knowledge, there have been very few histopathological case reports of encysted bleb published in peer-reviewed literature.
  1,578 129 -
Teleophthalmology: A successful model to tackle diabetic retinopathy
Tamilarasan Senthil, Malathi Nainappan
April-June 2017, 55(2):131-133
The aim of this study is to describe the application of teleophthalmology in screening for diabetic retinopathy in association with diabetes centers. Our model of diabetic retinopathy screening uses, technology innovation to reach out to patients who would otherwise not visit eye hospitals regularly. With more than 70 million diabetic population and only 20,000 ophthalmologists, a regular model of patients visiting eye care practitioners in person is not a feasible option in India. Technology can be used to address this gap, wherein Welcare sets up a telemedicine facility in existing diabetes centers, which includes a fundus camera, telemedicine platform and also more importantly provides a network of reporting ophthalmologists who see the images from these centers and report back within ½ h. Teleophthalmology can be a very effective model for screening of diabetic retinopathy and can help in greater detection of retinopathy and can help prevent a large number of patients from irreversible vision loss.
  1,562 142 -
Retina spotlight: Diabetic retinopathy - Preferred practice patterns
Syed Asghar Hussain, S Natarajan, N Kasinathan, Amjad Salman, Nazimul Hussain
April-June 2017, 55(2):123-130
The management of diabetic retinopathy (DR) has always been a right combination of medical and surgical interventions, influenced by various landmark international clinical trials and treatment guidelines as proposed by various bodies such as the American Academy of Ophthalmology, the Royal College of Ophthalmologists, the International Council of Ophthalmology, and the All India Ophthalmological Society to name a few. This article aims to share the various best practices, presently being followed by senior vitreoretinal surgeons, both nationally and internationally, in managing DR, as we are experiencing a paradigm shift in the investigative modalities and treatment regimens, as compared to those which were followed, just a decade ago. A literature search was conducted using the various keywords, for the years 1980–2017 that included pertinent information from the review of more than 3537 citations collectively, using PubMed, Medline, and Hinari databases, which included comprehensive and systematic literature review and meta-analysis reports. Articles were included, only if they contributed new information about the treatment of DR, techniques in widespread clinical use and excluded those related to techniques that are considered experimental and redundant. Studies with follow-up of <18 months were excluded from this review. The relevant articles were thoroughly analyzed, with each being rated, based on the strength of the study design and weight of evidence.
  1,516 161 -
No suture no glue conjunctival autografting with pterygium surgery: A retrospective study of 35 cases
M Umamaheshwari, P Ramesh, R Vasumathi
April-June 2017, 55(2):104-106
Background: Conjunctival autografting in pterygium surgery without the use of sutures and fibrin glue is being practiced by some surgeons recently. The present study was undertaken to evaluate the outcome of the procedure. Methods: This retrospective study was conducted by reviewing the records of thirty-five consecutive cases of pterygium surgery with sutureless and glue-free conjunctival autografting done by a single surgeon from February 1, 2017, to April 30, 2017. One patient had nasal and temporal pterygium, and all other patients had primary nasal pterygium. Under peribulbar block, pterygium was excised and autologous conjunctival grafting was performed without sutures or fibrin glue. Grafts were taken from superior bulbar conjunctiva. Postoperative follow-up was done on the 1st and 7th postoperative day and then after 1 month and 2 months. Results: Patients who had graft recession, graft edema, subconjunctival hemorrhage, and dellen during immediate postoperative period eventually settled down, and the cosmetic outcome was good in all patients. Except one, in all other cases, grafts were in situ. None of them had recurrence till the last follow-up. Conclusion: Sutureless glue-free conjunctival autografting in pterygium surgery takes short surgical time, is economic, and has good cosmetic outcome.
  1,285 134 -
Transient smartphone blindness
V Adhiyaman
April-June 2017, 55(2):154-155
Transient smartphone blindness is a temporary phenomenon where a person develops visual loss in one eye following prolonged exposure to a bright smartphone screen in the dark. It is caused by differential bleaching of the retinal pigment. Awareness of this condition and a careful history is important to make the correct diagnosis.
  1,172 109 -
Migrainous infarction: A case report
P Geetha, PR Prabash
April-June 2017, 55(2):148-149
40 year old male who had h/o migraine presented with migraine followed by defective vision.On examination he had left homonymous hemianopia with normal fundus.MRI showed infarct in right PCA territory. Neurologist opinion obtained and a diagnosed to be migrainous infarction.Since ophthalmologist may be the first person to see such patients high index of suspicion and prompt treatment is essential.
  1,164 97 -
From the editor's desk
T Nirmal Fredrick
April-June 2017, 55(2):101-102
  1,127 122 -
How to design a research study at your clinic?
Rachula Daniel
April-June 2017, 55(2):120-122
It remains a goal of TNOA JOSR to encourage members to share their medical research with the community of ophthalmologists by publishing the results of their work in TNOA JOSR. The TNOA Journal of Ophthalmic Science and Research is a peer-reviewed, quarterly, online before print that is published in English. TNOA JOSR publishes multiple types of medical education-related contributions that include original research manuscripts, review articles, editorials, case reports, case series, practice-related articles, drug review, brief communication, spotlight on a current topic of interest, journal scan, and photo quiz. The objective of this paper is to simplify steps in selecting an appropriate topic and how to go about doing a research study amidst a busy clinic or hospital schedule.
  1,113 114 -
Publish and flourish
K Vasantha
April-June 2017, 55(2):103-103
  1,094 79 -
Orbital lymphoma
Baskararajan Gopalakrishnan, B Bhuvanasundari
April-June 2017, 55(2):140-144
Lymphoma of the orbit are painless, soft, palpable masses occurring around the eyeball , that occur commonly in elderly individuals and responds well to chemotherapy and radiotherapy. Prognosis depends on the histological type, grade and stage and treatment modality employed. In this case series, all the treated patients responded well with radiotherapy as well as chemotherapy.
  1,041 81 -
Photo quiz answers
R Vasumathi
April-June 2017, 55(2):164-166
  893 78 -
Journal Scan: Compiled by R. Vasumathi
R Vasumathi
April-June 2017, 55(2):156-160
  890 68 -
Photo quiz
Devi Radhakrishnan, Padmaja Jagadeesan
April-June 2017, 55(2):161-163
  810 73 -