Clinicobacteriological study of chronic dacryocystitis in adults.

Chronic dacryocystitis is the inflammation of lacrimal sac, frequently caused by bacteria. Obstruction of nasolacrimal duct converts the lacrimal sac a reservoir of infection. It is a constant threat to cornea and orbital soft tissue. Moreover, it causes social embarrassment due to chronic watering from the eye. This study was conducted to find out the current clinicobacteriological profile of chronic dacryocystitis in adults. A total of 56 adult patients were selected from ophthalmology OPD. Detail history and clinical examinations were carried out. All patients underwent either dacryocystorhinostomy or dacryocystectomy. A part of the sac was collected for culture and sensitivity. This study revealed that chronic dacryocystitis is more common in females and left eye is more frequently involved than right eye. It is common among lower socioeconomic strata with habit of pond-bathing. Some form of nasal pathology like hypertrophied inferior turbinate, deviated nasal septum, nasal polyp and allergic rhinitis werefound in 19.6% of the patients. Complications of chronic dacryocystitis like conjunctivitis, corneal ulcer, acute on chronic dacryocystitis, lacrimal abscess and fistula were seen in 25.0% of these patients; 53.6% of the culture samples were positive for bacterial growth. Gram-positive organisms were most common isolate. Unlike other studies, Staphylococcus aureus (40.0%) was found to be most common Gram-positive organism, followed by Staphylococcus epidermidis (10.0%) and Steptococcus pneumoniae (10.0%). Among the Gram-negative organisms, Pseudomonas aeruginosa (16.6%) was the most common, followed by Klebsiella pneumoniae (6.6%) and Haemophilus influenzae (6.6%). Antibiotic sensitivity tests were done. Most of the organisms were resistant to penicillin. Chloramphenicol was effective against most of the Gram-positive organisms. Aminoglycosides, tobramycin in particular, was effective against Staphylococcus epidermidis. Fluoroquinolones, namely ciprofloxacin and ofloxacin were effective against Pseudomonas aeruginosa and Klebsiella pneumoniae.

Evaluation of visual outcome following cataract surgery in a tertiary eye care hospital.

A retrospective study was conducted at the Regional Institute of Ophthalmology (RIO), Kolkata to assess the visual outcome in senile cataract after surgery in the age group of 45-65 years. A total number of 1837 operated eyes (1826 patients) were included in the study during the period of January, 2000 to December, 2000. Patients with low vision unrelated to cataract surgery were excluded. The mean age at cataract extraction was 56 +/- 9 years. Patients were followed for 6 months. Of 1837 operated eyes, 26 (1.4%) were blind (visual acuity < 3/60), 122 (6.6%) had low visual acuity (3/60-6/18) and 1689 eyes (92.2%) gained good vision (visual acuity > 6/18). Of 148 visually compromised eyes posterior capsular opacity (41.2%) was the commonest complication followed by corneal oedema (36.5%) and glaucoma (12.8%). Other posterior segment causes accounted for the remaining cases. The study emphasises the need for proper selection, good pre-operative check-up, skilled surgery and regular follow-up to improve the qualitative aspect of cataract surgery.

Availability of donor corneal tissue for transplantation.

The utilization rate of available donor corneas is very low almost everywhere. The present work was undertaken to study the rate of acceptability of donor corneas in a city eye bank in India. Donor eyes were evaluated under slit lamp examination and tissue quality was categorized as: very good; good; fair; and poor following the guidelines laid down by the Eye Bank Association of America in 1992. One hundred and eight eyes (from 54 donors) were studied. The mean age of the donors was 75.9 years (range 30-97 years). Thirty-nine (36%) eyes were of very good to good quality and of these 37 (34.3%) were acceptable for grafting either for optical or therapeutic purposes. Sixty-one (56.4%) eyes were not acceptable owing to fair to poor tissue quality. Four (3.7%) eyes were discarded on medical grounds and six (5.6%) were discarded both because of fair to poor tissue quality and on medical grounds. Twenty-three of 50 tissues (46%) available from donors aged 75 years or younger were acceptable while 14 of 58 (24.1%) tissues from donors over 75 years were acceptable.

Malignant melanoma of conjunctiva--a case report.

A 65-year-old male patient presented with a rapidly increasing mass in his left eye. It did not show any intra-ocular extension as examined by slit lamp, gonioscopy, indirect ophthalmoscopy and ultrasonography, nor there was any sign of systemic metastasis. The mass was excised completely. Buccal mucous membrane grafting was done to cover up the lower forniceal area and conjunctival autograft taken from right eye and placed over upper fornix and bulbar area. Postoperative radiotherapy was suggested. Histopathological examination of the mass revealed the diagnosis of malignant melanoma of conjunctiva.

Late spontaneous extrusion of a wooden intraorbital foreign body.

Wooden intraorbital foreign body is characteristic for delayed manifestation, silent progression and unpredictable outcome. A silent wooden intraorbital foreign body is difficult to diagnose clinically. Spontaneous expulsion of entire foreign body is rare.