Impact of moderate and severe primary open-angle glaucoma on quality of life due to activity limitation.

PURPOSE: To study the impact of moderate and severe primary open-angle glaucoma (POAG) on the quality of life (QoL) due to activity limitation using glaucoma-specific questionnaires. METHODS: This cross-sectional study enrolled 122 participants, 50% (n = 61) being controls and 50% were diagnosed cases of moderate/severe POAG. Three orally administered glaucoma-specific QoL instruments were used: Glaucoma Activity Limitation (GAL-9), Glaucoma Quality of Life (GQL-15), and Viswanathan questionnaires. The questions related to activity limitation were identified and analyzed for each questionnaire separately. RESULTS: The mean age of the participants was 61.04 ± 9.88 years and a majority were males (64.8%, n = 79). The mean scores in controls, moderate glaucoma, and severe POAG patients for GAL-9 questionnaire were 9.77 ± 1.36 (P = 0.44), 13.75 ± 4.76 (P < 0.001), and 23.45 ± 5.62 (P < 0.001), for GQL-15, these were 16.39 ± 2.18 (P = 0.5), 22.75 ± 7.89 (P < 0.001), and 39.34 ± 9.42 (P < 0.001), respectively, while for the Viswanathan questionnaire, they were 9.49 ± 0.94 (P = 0.38), 7.91 ± 1.59 (P < 0.001), and 4.41 ± 2.20 (P < 0.001), respectively. The GQL-15 and GAL-9 questionnaires concluded that activity limitation pertaining to dark adaptation-related tasks affected the QoL the most in moderate as well as severe POAG (P < 0.001). Using the Viswanathan questionnaire, it was observed that the peripheral vision-related activity limitation was most significant for the decrease in QoL in moderate POAG while near vision-related activity limitation affected the QoL the most in severe POAG (P < 0.001). CONCLUSION: All three questionnaires concluded that the activity limitation due to moderate and severe glaucoma has a negative impact on the QoL. The limitation of the tasks involving dark adaptation/glare and peripheral vision has the most significant impact on the QoL in moderate glaucoma. As the disease progresses to a severe category, the limitation of activities requiring central and near vision causes the most significant worsening in QoL.

Herpes Zoster Ophthalmicus After COVID-19 Vaccination: Chance Occurrence or More?

ABSTRACT: As the understanding of COVID-19 infection becomes better, it is being recognized as a complex multisystem pathology rather than just affecting the lungs. Several ocular findings have been documented by researchers in individuals infected with COVID-19, and ocular symptoms may even be the first presenting feature of COVID-19 infection in 2.26% individuals. Several countries have started vaccination with inactivated or live vaccines to combat this pandemic, and varied side effects have been reported after vaccination. Few cases of herpes zoster have previously been reported in elderly patients with comorbidities after receiving COVID-19 vaccines. In this article, the authors described 2 interesting cases of herpes zoster ophthalmicus (HZO) after receiving a live COVID-19 vaccine. The first case was a 35-year-old immunocompetent man who developed HZO 3 days postvaccine. The second case was a 40-year-old immunocompetent man who developed HZO 28 days postvaccine. To the best of our knowledge, no literature to date has described HZO after live vaccine.

COVID-19 pandemic and lockdown: Changing trends in Ophthalmology for in-patient and emergency services.

PURPOSE: The aim of this study was to evaluate the changing trends in terms of patient load, presenting complaints, surgical procedures and resource utilization in a multispeciality tertiary care hospital after lockdown due to COVID-19. METHODS: Retrospective.data were collected from Ophthalmology in-patient and emergency services of a government medical college and multispecialty tertiary care hospital in North India. Data pertaining to patient census, presenting complaints, surgical procedures and resource consumption were compared in the 6-month period (March 25 to September 30, 2020) following national lockdown and subsequent gradual unlock to data of same time period last year. RESULTS: A total of 1152 new patients visited Ophthalmology emergency service, whereas 324 sought tele-ophthalmology consultation.Majority were males (61.8%, n = 712), whereas average age of presentation was 34 ± 7.2 years. The number.of patients seeking emergency ophthalmic care reduced by 23.9% in the current year, in-patient record reduced by 96.53% and number of surgeries reduced by 98.13%. Tele-ophthalmology services comprised 21.95% of the total patient load. Use of triple layered surgical masks increased by 85.7%, use of disposable gloves increased by 89.5% but interestingly the availability of chlorhexidine hand rub fell by 15.9%, in the current year compared to last year. CONCLUSION: COVID-19 pandemic and lockdown have reduced the number of patients visiting tertiary health care facility for ophthalmic care. As manpower and resource consumption has increased, smart management is needed to tackle the current scenario efficiently. Tele-ophthalmology must be promoted and we must understand the changing trends to plan for the future accordingly.

Unusual case of intraocular medulloepithelioma in an adult male.

Medulloepithelioma is a rare tumor of the eye, arising from the posterior segment. This embryonic tumor is mostly seen in children and is very rare in adult population. This case report presents the case of a 39-year-old Indian male, who had gradual vision loss over 4 years in his left eye with new onset of pain. He was referred to our center in view of secondary cataract and intraocular mass. Vision in right eye was 20/ 20 while left eye had no light perception at presentation. Ocular examination of the left eye revealed shallow anterior chamber, florid iris neovascularization, raised intraocular pressure and cataractous lens. B-scan ultrasonography showed a heterogenous mass filling the entire globe. MRI scan confirmed the finding, showing a mass hyper-intense to vitreous. No invasion of optic nerve or sclera was observed. Left eye enucleation with PMMA implant placement was performed and histopathology confirmed the diagnosis of benign teratoid medulloepithelioma. At the time of submission of this report, the patient was still under follow-up and had no detectable metastases at 15 months follow-up. This report highlights a very rare case of embryonic tumor in adult male, which could be managed successfully with a high index of suspicion and timely intervention.