A questionnaire-based assessment of Safe Eye Examination (SEE) technique.

PURPOSE: This study aims to assess the novel and innovative method of Safe Eye Examination (SEE) technique using the model eye for the purpose of teaching, training, and resident examination. METHODS: A questionnaire-based study (Descriptive Data) with 53 participants, including ophthalmology residents, fellows in various subspecialties, and trainee optometrists was used. In our study, we used the Reti Eye model, but instead of the usual retina template sheet, we used prominent pathological fundus photographs loaded into the model eye. The study participants were asked to view prominent pathological fundus images printed on a matte finish paper. A circular image was cut and was placed in the Reti Eye model. The candidates were made to perform indirect ophthalmoscopy with a + 20D lens and to fill up a Google image assessment scale questionnaire with characteristics, including pixelation, sharpness, contrast, reflexes, blotchy appearance, and diagnostic confidence, which were then analyzed and depicted. Association between categorical variables was analyzed using Fisher exact test and Chi-square test. A P value of less than 0.05 was considered statistically significant. All data were analyzed with a statistical software package (SPSS, Version 16.0 for Windows). RESULTS: The number of positive responses (>90%) obtained for the pixelation, sharpness, contrast, reflexes, blotchy appearance, and diagnostic confidence of the image viewed were statistically more significant than the negative responses (P < 0.05). CONCLUSION: The SEE technique of using the model eye can be incorporated for teaching, training, and skill assessment in the examinations in these difficult times of COVID-19 (coronavirus disease 2019) pandemic.

Xanthomatous Hypophysitis Presenting in an Adolescent Girl: A Long-Term Follow-Up of a Rare Case and Review of the Literature.

OBJECTIVE: Primary hypophysitis refers to the isolated inflammation of the pituitary gland not associated with other secondary causes. Among its histopathologic subtypes, xanthomatous is the rarest. METHODS: We describe a 22-year-old woman with xanthomatous hypophysitis (XH), its clinical progression over 8 years as well as the treatment effects of prednisolone and azathioprine. Our patient was first referred for severe short stature and delayed puberty at the age of 14 years. RESULTS: Investigations revealed multiple pituitary deficiencies. Magnetic resonance imaging showed a pituitary mass whereby a partial resection was performed. A full resection was not feasible due to the location of the mass. The histopathologic analysis of the tissue was consistent with XH. The results of secondary workout for neoplasm, infection, autoimmune, and inflammatory disorders were negative. After surgery, a progressive enlargement of the mass was observed. Two courses of prednisolone were administered with a significant reduction in the mass size. Azathioprine was added due to the unsustained effects of prednisolone when tapered off and the concern of steroid toxicity with continued use. No further increase in the mass size was noted after 6 months on azathioprine. CONCLUSION: Glucocorticoid and immunotherapy are treatment options for XH; however, more cases are needed to better understand its pathogenesis and clinical progression.