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   2017| July-September  | Volume 55 | Issue 3  
    Online since March 9, 2018

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Update on optical biometry and intraocular lens power calculation
Nazneen Nazm, Arup Chakrabarti
July-September 2017, 55(3):196-210
Intraocular lens (IOL) power calculation is the single most important determinant of functionally improved result of a technically precise cataract surgery. We have discussed recent advances in the field of optical biometry and IOL power calculation formulae as a means to achieve better postoperative visual outcome. The use of automated optical biometry device, the current 'gold standard' of IOL power calculation, dates back to 1999. We have highlighted the evolution of newer optical biometry devices and the technology they are based on, and their advantages and limitations. We have done technical comparison of contemporary biometers and have included contextual current review of literature. We have described newer generation IOL power formulae, IOL power calculation in high to extreme myopia, toric calculators and intraoperative aberrometry, and concluded our discussion with a note on future prospects of IOL power calculation.
  7,003 939 2
Orbital cellulitis- A review
Raghuraj Hegde, Gangadhara Sundar
July-September 2017, 55(3):211-219
Orbital cellulitis is an infection of the orbital soft tissues posterior to the orbital septum. It has the potential to be affect sight and function of the eye and extraocular tissues. Although it is commonly seen in the pediatric age group, adult orbital cellulitis is not uncommon. Infection usually originates from sinuses but sometimes the nidus of infection is in the eyelids, from retained vegetative foreign bodies, or very rarely from distant infection spreading to the orbit spread from blood. It is characterized by pain, proptosis, chemosis, diminution of vision, fever, periorbital erythema, and limitation of ocular motility. Historically orbital cellulitis was a sight and life-threatening condition. However, with the advent of high quality imaging, antibiotics and early surgical intervention to drain the orbital abscess when indicated, the chances of visual loss have reduced significantly. The purpose of this review is to describe current investigative and management paradigms in the treatment of orbital cellulitis and current recommendation in the management of complications resulting from it.
  6,574 639 1
Clinical profile of nonstrabismic binocular vision anomalies in patients with asthenopia in North-East India
Damaris Magdalene, Pritam Dutta, Mitalee Choudhury, Saurabh Deshmukh, Krati Gupta
July-September 2017, 55(3):182-186
Aim: To report the clinical profile of non-strabismic binocular vision anomalies (NSBVA) in patients with asthenopia in North-East India. Materials and methods: A hospital based study was conducted on 131 patients from age group 10-40 years attending the vision therapy clinic. Patients were divided into the age groups 10-20 years, 21-30 years and 31-40 years. A detailed orthoptic evaluation was carried out including sensory and motor testing and a diagnosis was made comparing various orthoptic parameters of the particular patients. Results: Of the 131 patients, 81 were female and 50 were male. The number of patients was 62 in the 10-20 years age group, 49 in 21-30 years age group and 20 in 31-40 years age group. The prevalence of NSBVA in age group 10-20 years was 69.35%, 21-30 years was 67.35% and 31-40 years was 50.00%. It was observed that the most common NSBVA was convergence insufficiency across all age groups followed by accommodative insufficiency and convergence excess. Conclusion: Early detection of NSBVA is important because these deviations may decompensate without treatment and become strabismic resulting in loss of stereopsis and development of suppression. Early detection and treatment provides best opportunity for academic success in school going age groups.
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Generic drugs in ophthalmic practice: Boon or bane?
Murali Ariga, M Rajalakshmi, C Praveena
July-September 2017, 55(3):220-222
Generic pharma products are inexpensive as compared to the original innovator branded drugs. True generics are not freely available in India. There have been concerns about efficacy and quality of generics that are available. This review outlines these issues and the legislation regarding the availability and use of generics in our practice.
  3,007 188 -
Quality healthcare and clinical processes: An amalgamation needed to achieve clinical excellence
Suneeta Dubey, Deepika Verma, AK Arora
July-September 2017, 55(3):187-191
Quality improvement is an essential component of 21st-century medicine. Dr. Shroff's Charity Eye Hospital is National Accreditation Board for Hospitals and Healthcare Providers-accredited organization which firmly believes in amalgamating quality measures with clinical processes and bringing out the most effective clinical environment for best patient care, one of the values of the organization. Clinical excellence is achieved through a stepwise approach.
  2,639 171 -
Wavefront analysis: An additional tool for detection of keratoconus
Sujatha Mohan, Mohan Rajan, Siddhartha Singh, Atul Bhirud, Sriram Annavajjhala
July-September 2017, 55(3):177-181
Aims: The aim of this study is to analyze the role of wavefront analysis as an additional tool for the detection of keratoconus in three groups of patients (i.e., simple refractive errors, high astigmatism, and keratoconus). Design: This study was a prospective comparative study. Patients and Methods: In this prospective comparative study, a total of 115 eyes of 62 patients were examined. All the patients had a complete examination done, which included best spectacle-corrected visual acuity, slit-lamp and fundus examination, and corneal topography for diagnosis of keratoconus. Higher-order aberrations (HOAs) (coma, spherical aberration, and trefoil) were examined using Tscherning aberrometer, based on WaveLight® analyzer II. Statistical Analysis: The one-way analysis of variance test was used. Results: Spherical aberrations were reported highest in the patients with high astigmatism (mean value: 0.149), which was statistically significant when compared to simple refractive errors (P = 0.046). Trefoil aberrations were reported highest in patients with high astigmatism group (mean value: 5.579) in comparison to the other two groups (i.e., simple refractive errors and keratoconus) but were not statistically significant (P > 0.05). Coma and total aberrations were reported highest in keratoconus group (mean value: 0.314 and 2.058, respectively) in comparison to other groups (i.e., simple refractive error and high astigmatism), which was found to be highly significant (P = 0.000). Root-mean-square values of Zernike coefficient polynomials up to the third order were analyzed. Conclusions: This study highlights that assessment of HOAs using wavefront analysis can be used as an additional tool in the early diagnosis of keratoconus in addition to other standard methods.
  1,582 141 -
Papilledema and cerebral venous sinus thrombosis due to polycythemia vera
Tamilarasy Vasanthakumaran, Rachula Daniel
July-September 2017, 55(3):233-237
The following case reports of a young male, a chronic alcoholic and smoker, who presented with an episode of severe headache and was admitted to emergency department in a tertiary care hospital. Clinical examination showed patient to have bilateral papilledema. Further investigations showed cerebral venous sinus thrombosis and polycythemia vera. This case report emphasizes the importance of a thorough ophthalmic and neurological evaluation along with relevant biochemical investigations in patients presenting with a history of acute or persistent headache.
  1,476 104 -
Iridocorneal endothelial syndrome: A case report
V Sharmila Devi, Prasanna Venkatraman, Anand Babu
July-September 2017, 55(3):238-242
Iridocorneal endothelial (ICE) syndrome includes a group of rare ocular pathologies with unilateral involvement, frequently affecting young women. The disease complex includes essential iris atrophy, Chandler's syndrome, and Cogan–Reese syndrome. We present a case of ICE, in which there was a combination of features of essential iris atrophy and Cogan–Reese syndrome.
  1,409 115 -
Role of anemia in incidence and progression of retinopathy of prematurity in premature infants
KR Vijayabharathi
July-September 2017, 55(3):192-195
Aim of the study: This study aims to correlate the relationship of retinopathy of prematurity (ROP) with anemia in premature infants with regard to incidence and progression of ROP. Materials and Methods: All high-risk infants from our institution and neighboring districts as selected by neonatologist were screened at Special newborn care unit every Thursday on regular basis, and this study includes infants screened at ROP clinic during January 2017–March 2017. Conclusion: In our study at ROP clinic, high-risk premature infants who were screened showed a significant prevalence of ROP in babies weighing <2.000 kg and with female preponderance. The role of anemia and other neonatal risk factors needs to be evaluated further in our ongoing study.
  1,315 115 -
Air bubble-induced intraocular lens opacification in hydrophobic intraocular lens following posttraumatic cataract surgery: A first-ever case report
GV Prabhakar, JK Reddy, Shadab Khan
July-September 2017, 55(3):225-226
A 19 year old male presented with complaints of diminution of vision in right eye. He had undergone cataract surgery in right eye elsewhere 6 years ago for firecracker injury. On examination, eccentric pupil is noticed with intraocular lens (IOL) opacity. on dilatation, rest of the intraocular lens is clear. As the rest of the IOL, which was protected by iris, was noted to be clear, the opacification at pupillary area suggests it to be secondary to air bubble contact .IOL exchange was done and explanted was tested and got confirmed as hydrophobic material. There are cases reports of IOL opacification post intra cameral air injection in hydrophilic lenses, to our knowledge this is the first case report of IOL opacification in hydrophobic lenses. with this case report we want to highlight the fact that one should be careful before intracameral air injection in eyes with both types of IOL.
  1,331 94 -
Heavy eye syndrome with cataract
Sandra Ganesh, Sasikala A Elizabeth, Amrutha Sindhu, Kalpana Narendran
July-September 2017, 55(3):247-249
A 58-year-old female with high myopia, progressive esotropia, hypotropia, abduction limitation diagnosed with heavy eye syndrome and defective vision due to age-related cataract underwent loop myopexy and phacoemulsification with intraocular lens implantation. Postoperatively, the patient had improved ocular motility, better cosmesis, and considerable visual outcome.
  1,268 75 -
Orbital implantation of submandibular salivary gland for dry eye syndrome
G Baskararajan, B Bhuvanasundari
July-September 2017, 55(3):243-246
Dry eye syndrome or keratoconjunctivitis sicca is a disorder with reduction of tear secretion. In recent times, tear supplements form a major product by several pharmaceutical companies. In earlier days, parotid gland duct transfer into lower fornix through subcutaneous route had been performed. Among the three pairs of salivary glands, submandibular salivary gland secretion has the consistency more watery and akin to tears. Since the transfer of it is autologous, no rejection occurs and tissue acceptance with the resumption of secretary property is immediate and permanent.
  1,219 66 -
A case of frosted branch angiitis
Abhay Gupta, VK Anuradha
July-September 2017, 55(3):223-224
Frosted branch angiitis (FBA) is typically a bilateral diffuse retinal periphlebitis that may occur in a number of varying conditions. Here, we report a case of a young female who presented with bilateral sudden diminution of vision with a fundus picture of FBA. A series of investigations were carried to rule out the possible underlying diseases, and significant recovery of vision was seen on treatment with oral steroids.
  1,174 94 -
From the editor's desk
Nirmal T Fredrick
July-September 2017, 55(3):173-174
  1,147 117 -
Uniocular thyroid orbitopathy
G Baskararajan, B Bhuvanasundari
July-September 2017, 55(3):227-230
Thyroid associated orbitopathy is used to describe the ocular manifestations of thyroid eye disease. The pathogenesis of the disorder is poorly understood. Considered to be an ophthalmic auto immune disease, it is usually associated with hyperthyroidism, and may occur in euthyroid as well as in hypothyroid individuals. It also can occur with Hashimoto Thyroiditis .The manifestations are usually bilateral or may start as unilateral and later progress to bilateral. These can present as exophthalmos or lid retraction or a combination of both or inflammatory reaction with conjunctival congestion. Decreased vision can occur either due to optic nerve compression, by crowding of the apex of orbit by enlarged extra ocular muscles and increase in volume of fibro fatty tissue or exposure keratitis. Enlargement of extra ocular muscles with restriction of movements can also lead to diplopia. Among patients with Thyroid Associated Orbitopathy, approximately 90% have Graves' hyperthyroidism, 1% have primary hypothyroidism, 3% have Hashimoto thyroiditis and 6% are Euthyroid. This is a report of cases either with uniocular exophthalmos alone or isolated lid retraction only. Surgical correction was performed in these patients due to cosmetic disfigurement and psycho-social problems.
  1,049 97 -
Exudative retinal detachment and retinal pigment epithelial rip due to central serous retinopathy in eye with diabetic retinopathy
Kumar Saurabh, Rupak Roy, M Nivean
July-September 2017, 55(3):231-232
This is a case report of a 47-year-old male patient , a diabetic who presented with gradual loss of vision in both eyes. He had a combination of central serous retinopathy with diabetic retinopathy. Retinal laser was not possible due to exudative retinal detachment posing a therapeutic dilemma.
  1,054 78 -
Practice, business and life
V Siddharthan
July-September 2017, 55(3):175-176
  1,013 90 -
Photo quiz/image
Devi Radhakrishnan, Padmaja Jagadeesan
July-September 2017, 55(3):253-255
  799 59 -
Journal scan
Shruti Nishanth, Murali Ariga
July-September 2017, 55(3):250-252
  802 55 -
Answers to previous issue photo quiz
Devi Radhakrishnan, Padmaja Jagadeesan
July-September 2017, 55(3):256-258
  784 64 -