Pattern of Recurrent Inflammation following Anti-tubercular Therapy for Ocular Tuberculosis.

PURPOSE: To investigate recurrence patterns following anti-tubercular therapy (ATT) in different anatomical presentations of ocular tuberculosis (OTB). METHODS: Retrospective analysis of clinically diagnosed OTB patients divided anatomically into groups A (anterior + intermediate uveitis) and B (posterior + panuveitis). Recurrence was defined as reappearance of intraocular inflammation in a quiescent eye following completion of at least 6-months ATT. Anatomical sites of recurrence were compared to that of presentation. RESULTS: No significant difference in post-ATT recurrent inflammation was noted between groups A (14.29%, 4/28) and B (8.59%,11/128) (p = .57). Mean follow up was 13.13 ± 14.67 months. All group A recurrences were in the same anatomical segment, whereas in group B, 41.7% (5/11) recurrences were in group A sites. Overall, the group A:B ratio was significantly higher during recurrent inflammation (8:7) than at presentation (28:128) (p < .0001, z-score). CONCLUSION: Anterior and intermediate uveitis, though uncommon at presentation, are relatively more common during post-ATT recurrences in OTB.

Assessment of quality of life, mental health and ocular morbidity in children from schools for the blind in North-East India.

Purpose: The aim of this study was to describe causes of severe visual impairment and blindness (SVI/BL), and assess the mental health and quality of life of children in schools for the blind in North-East India in two phases. Methods: A total of 515 children were examined in 17 schools for the blind in the first phase of study across eight states in North-East India, 6 in Assam, 2 each in Meghalaya, Manipur, Mizoram, and Tripura, 1 each in Arunachal Pradesh, Nagaland, and Sikkim. WHO/PBL eye examination record was used to document findings. In the second phase of study, mental health and quality of life were objectively measured using depression anxiety stress scales (DASS) and low-vision quality of life (LVQOL) questionnaires in 442 children. Results: Approximately 3.1% of children had SVI and 71.84% of children were blind. Anatomical sites of SVI/BL were the whole globe in 44.85%, cornea in 17.66%, and retina in 11.65% of children. The underlying cause of visual loss was undetermined in 55% of children. Hereditary pattern was observed in 1.35% of cases. Approximately 74.94% of children were either blind or severely visually impaired since birth. DASS score revealed that 56.56% of children manifested some levels of anxiety and stress while 85.52% had some reduction in quality of life. Conclusion: A large significant number of these children suffered from potentially preventable and/or treatable cause of SVI/BL. Though nonvisual factors such as physical and mental health were strong predictors of quality of life, this study proves that visual impairment also plays a considerable role in one's quality of life in a population with low vision.

Community outreach: An indicator for assessment of prevalence of amblyopia.

Purpose: To study the prevalence, determine the magnitude, and cause of amblyopia among the children aged 6 months to 16 years in Kamrup district, Assam, India. Methods: Among a total of 39,651 children between 6 months and 16 years of age, door-to-door screening was conducted by trained workers. For children above 5 years of age who failed to read the 6/9 line, camps were conducted in the nearby schools. Children below 5 years of age were directly referred to the tertiary eye care institute. After visual acuity assessment at the institute, cycloplegic refraction and complete ophthalmic examination were done to rule out other causes of diminution of vision. Axial length measurement and corneal topography were performed in children with high refractive errors. Results: Of the total 39,651 children screened, 469 were diagnosed to have amblyopia at the camp and 223 were diagnosed at the institute. The prevalence of amblyopia was 1.75%. Amblyopia was more common among the males (52.50%) as compared to females. Maximum number of patients were found in the age group of 11-16 (63.58%). Refractive amblyopia was found to be the most common cause of amblyopia (45.29%). In children below 5 years, deprivation amblyopia and strabismic amblyopia were more common. Conclusion: Awareness of amblyopia among the parents is essential for early detection and treatment of the disease, which will, in turn, reduce the burden of childhood visual impairment.