Prevalence of the optic disc anomalies in the adult South Indian population.

PURPOSE: To determine the prevalence of congenitally abnormal disc (all anomalies) in an adult population in southern India. METHODS: Subjects aged ≥40 years (n=6013) underwent a complete ophthalmic examination. Optic disc anomalies were diagnosed according to the definitions given in the article. RESULTS: Optic disc anomalies were found in 81 eyes of 66 (1.1%, 95% CIs 0.00834 to 0.01361) patients. The prevalence of each anomaly in the descending order was peripapillary myelinated nerve fibre (0.28%), epipapillary glial tissue on the optic disc (0.28%), peripapillary vascular loops (0.16%), tilted disc (0.09%), optic disc coloboma (0.08%), optic nerve hypoplasia (0.04%), optic disc pit (0.04%), optic disc pigmentation (0.03%), optic nerve head drusen (0.03%), Bergmeister's papilla (0.03%), optic disc pit and coloboma (0.01%). CONCLUSIONS: The prevalence of optic disc anomalies is 1.1% in the adult South Indian population.

An unusual case of posttrabeculectomy conjunctival granuloma.

We report an unusual case of granulomatous inflammation that presented adjacent to bleb 3 weeks postoperatively after combined phacoemulsification and trabeculectomy surgery with mitomycin-C due to retained microfragments of methyl cellulose sponge. The commonly used antimetabolite delivery devices are made of cellulose. Methyl cellulose sponges are friable, and they are likely to leave behind microfragments in subconjunctival space. In our case, bleb integrity was maintained, unlike the earlier reported cases which presented with bleb leak. Hence, one should have high index of suspicion in unusual cases of postoperative inflammation not resolving conservatively. Although rare, retained sponge particles can be a cause of early bleb-related inflammation which can lead to bleb failure.

Comparative role of 20% cord blood serum and 20% autologous serum in dry eye associated with Hansen's disease: a tear proteomic study.

BACKGROUND: To compare the role of topically applied serum therapy with preservative-free artificial tear (AT) drops in patients with moderate to severe dry eye in Hansen's disease along with change in tear protein profile. METHODS: 144 consecutive patients were randomly divided into three groups. After a baseline examination of clinical parameters, each of the patients received designated modality of topical therapy six times a day for 6 weeks. Post-treatment documentation of clinical parameters was done at 6 weeks, and then at 12 weeks after discontinuation of topical therapy. Analysis of three tear proteins using gel electrophoresis (sodium dodecyl sulfate polyacrylamide gel electrophoresis) was done at baseline, at the first and second post-treatment visits. RESULTS: In the cord blood serum (CBS) group, except for McMonnies score and staining score, all other clinical parameters showed continued improvement in the first and second post-treatment analyses. In the autologous serum (ALS) group, all the clinical parameters except Schirmer's I showed significant improvement in the first post-treatment analysis .This was sustained at a significant level in the second analysis except for tear film break-up time (TBUT) and conjunctival impression cytology grading. In the AT group, all the parameters improved at a non-significant level except for TBUT in the first analysis. In the next analysis, apart from McMonnies score and TBUT, other clinical parameters did not improve. In the ALS and CBS groups, tear lysozyme, lactoferrin levels improved in both post-treatment measurements (statistically insignificant).Total tear protein continued to increase at statistically significant levels in the first and second post-treatment analyses in the CBS group and at a statistically insignificant level in the ALS group. In the AT group, the three tear proteins continued to decrease in both the analyses. CONCLUSIONS: In moderate to severe dry eye in Hansen's disease, serum therapy in comparison with AT drops, improves clinical parameters and causes betterment in tear protein profile. TRIAL REGISTRATION NUMBER: CTRI/2013/07/003802.

Boston keratoprosthesis restoring vision in an unusual case of end-stage limbal stem cell deficiency following exposure to Euphorbia latex.

We report the functional outcome of a patient who had undergone Boston keratoprosthesis type I for extensive ocular surface damage caused by latex of Euphorbia. The milky sap or latex of the Euphorbia plant is highly toxic and an irritant to the skin and eye. Damage to the eye ranges from mild to severe corneal edema, epithelial defects, anterior uveitis, secondary elevated intraocular pressure and, rarely, limbal stem cell deficiency with corneal neovascularization. A restrospective review was conducted of this patient for more than 1 year. During this period he was given subconjunctival bevacizumab injection to regress the corneal vascularization without much benefit, before finally performing Boston keratoprosthesis type I. The patient was evaluated periodically for both anatomical and visual outcome. At the end of 1-year follow-up the keratoprosthesis is well retained with a best-corrected visual acuity of 20/40 in the affected eye.