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1.
Int Ophthalmol ; 2021 Jan 04.
Artigo em Inglês | MEDLINE | ID: mdl-33392946

RESUMO

PURPOSE: To assess and compare the effectiveness of home-based pencil push-up therapy (PPT) and office-based orthoptic therapy (OBOT) in patients with convergence insufficiency. METHODS: In this randomized clinical trial, 176 symptomatic patients with convergence insufficiency, aged between 9 to 30 years, were randomly assigned to receive 6 weeks of home-based PPT (Group I) or OBOT (Group II) after determining refractive error, near point of convergence (NPC), convergence insufficiency symptom survey (CISS) score, near phoria and positive fusional vergences (PFV) at near. The participants of Group I underwent home-based PPT (pencil push-ups exercises15 minutes per day, daily for 6 weeks) and those of Group II OBOT (convergence fusional exercises on synoptophore for 20 min per day, 3 days a week, for 6 weeks) without home reinforcement. Patients were re-examined at 3 and 6 weeks after initiation of treatment. NPC and CISS score were the primary and secondary outcome measures, respectively. Statistical analysis was performed with the independent samples t-test, Friedman test and the analysis of variance (ANOVA). Statistical significance was indicated by p-value < 0.05. RESULTS: Participants of both the groups had statistically significant improvement in NPC, CISS score, PFV and near phoria (p < 0.001), but there was no statistically significant difference between the two groups (p > 0.05). However, patients of Group II had significantly better PFV after final visit than those of Group I (p < 0.001). CONCLUSION: Home-based PPT with good suppression control and with compliance ensured by log book entries, is a simple, cheap, less time consuming and comparably effective alternative to more expensive OBOT for patients suffering from CI. CTRI registration number: REF/2016/11/012,732, Date of registration 25/04/ 2016, Retrospectively Registered.

2.
BMJ Case Rep ; 14(1)2021 Jan 11.
Artigo em Inglês | MEDLINE | ID: mdl-33431469

RESUMO

Bilateral sight threatening macular and optic nerve inflammation may occur with dengue fever, necessitating the use of systemic steroids. We report a case of bilateral dengue maculopathy in an elderly woman managed with targeted intravitreal steroid therapy. A 63-year-old woman presented with acute-onset painless diminution of vision in both eyes following a dengue fever episode. She had bilateral foveal inflammatory lesions, macular oedema, small vessel occlusions at the macula and scattered retinal haemorrhages and cotton-wool spots. Following systemic evaluation, intravitreal triamcinolone acetonide injection was performed in both eyes at an interval of 3 days. The foveal lesion and macular oedema resolved quickly in both eyes with a normal foveal architecture at the end of 6-week follow-up. The visual acuity improved considerably in both eyes. Inflammatory retinopathy in dengue fever may be managed with a targeted intravitreal steroid injection approach.


Assuntos
Dengue/complicações , Glucocorticoides/administração & dosagem , Edema Macular/tratamento farmacológico , Edema Macular/virologia , Triancinolona Acetonida/administração & dosagem , Dengue/diagnóstico , Dengue/terapia , Feminino , Humanos , Injeções Intravítreas , Edema Macular/diagnóstico , Pessoa de Meia-Idade
4.
J Family Med Prim Care ; 9(9): 5010-5017, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-33209837

RESUMO

Aim: To study the intraocular pressure (IOP) and tear production changes in uncomplicated pregnant women at term pregnancy and immediate postpartum. Materials and methods: The patients admitted in the Department of Obstetrics and Gynaecology for delivery were included in the study. A total of 106 participants who were at term uncomplicated pregnancy were selected according to the inclusion and exclusion criteria. They were subjected to type 1 Schirmer's testing and intraocular pressure measurement by Perkin's tonometer before and after delivery. Result: There was no significant pre- and postdelivery IOP difference between the different age groups (<30 and ≥30 years), mode of delivery, and parity. There was a statistically significant (P < 0.001) increase in mean tear production (Schirmer's test) after delivery, irrespective of age group, mode of delivery, and gravida status. However, no significant intergroup difference was observed. Conclusion: There was no significant change in IOP before and after delivery in uncomplicated pregnancies. However, a statistically significant increase in tear production was observed in the immediate postpartum period.

5.
Eur J Ophthalmol ; : 1120672120971192, 2020 Nov 03.
Artigo em Inglês | MEDLINE | ID: mdl-33143475

RESUMO

INTRODUCTION: To study the accuracy of anterior segment optical coherence tomography (AS-OCT) function of Cirrus HD-OCT 500 (Carl Zeiss Meditec, Dublin, CA) in calculating the insertion of rectus muscles from the limbus in patients undergoing primary squint surgery. METHODOLOGY: A prospective, double-masked, observational study was conducted on 128 muscles of 46 patients with strabismus who were planned for strabismus surgery between January 2019 and December 2019. Insertion distance from limbus was measured using AS-OCT function of Cirrus HD-OCT 500 preoperatively. Intraoperative measurements were taken using Castroviejo caliper. A Bland-Altman analysis was performed to determine the agreement between the readings. RESULTS: A total of 128 muscles were successfully imaged and evaluated, including 13 superior recti (10.15%), 23 inferior recti (17.96%), 35 medial recti (27.34%) and 57 lateral recti (44.53%). 124 muscles (96.9%) were within 1mm difference, which was considered clinically acceptable. Bland-Altman plots showed the level of agreement between the two methods was good. CONCLUSION: Anterior segment scan function of Cirrus HD-OCT 500 is an accurate method to detect the insertion of extraocular recti muscles in patients of primary strabismus surgery.

7.
Am J Trop Med Hyg ; 2020 Oct 26.
Artigo em Inglês | MEDLINE | ID: mdl-33124538

RESUMO

We describe a case of dengue fever-associated foveolitis that presented initially to the ophthalmologists with complaints of unilateral diminution of vision. A 30-year-old Indian woman had presented with sudden onset diminution of vision in the left eye (LE) for the past 2 days. It was also associated with low-grade fever and myalgia, which started few days before visual deterioration. Fundus showed few retinal hemorrhages and tiny subretinal yellowish lesions at the fovea in the LE. Optical coherence tomography and fluorescein angiography were indicative of foveolitis. Amsler charting showed a central scotoma in the LE. She was treated with oral steroids along with supportive treatments. A near-complete anatomical and functional recovery was noted. Our case depicts the significance of awareness of the ophthalmic complications of dengue fever among both ophthalmologists and physicians, and also highlights the key clinical and multimodal imaging findings in a case of dengue foveolitis.

10.
Indian J Ophthalmol ; 68(11): 2577-2580, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-33120698

RESUMO

Blunt trauma to the eye can present with protean manifestations involving the anterior and posterior segments of the eye. Giant retinal tear (GRT) following trauma occurs most commonly at the equatorial region or anterior to the equator. GRT posterior to the equator is rare. Herein, we present a case of a 21-year-old male, who presented with sudden diminution of vision in the right eye following blunt-trauma with a cricket ball. Examination revealed a posterior-GRT, full-thickness macular hole, rhegmatogenous retinal detachment, and vitreous hemorrhage in the right eye. He was managed with vitrectomy, encircling scleral band, perfluorocarbon liquid-assisted flattening of GRT, internal limiting membrane peeling, and endotamponade. The probable etiopathogenesis of posterior-GRT and various surgical challenges encountered in this case were also described illustratively in this report.

12.
J Family Med Prim Care ; 9(8): 4456-4459, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-33110885

RESUMO

Morning glory disc anomaly (MGDA) is a rare congenital malformation that results from the incomplete formation of the optic nerve in utero. The majority of the patients have unilateral involvement and poor vision leading to sensory strabismus. Morning Glory Syndrome (MGS) may be a part of other syndromes and systemic abnormalities like transsphenoidal basal encephalocele, midfacial malformations, absent optic chiasma, MoyaMoya syndrome, and renal agenesis. In the present report, we describe a patient with a large disc with an excavated posterior scleral opening with a white glial tuft at the centre. The blood vessels were increased in number and arranged radially from the disc with peripapillary hyperpigmentation in clumps. Funnel-shaped excavation of the posterior globe was also noted on MRI. Associated ocular features were microcornea, nystagmus, esotropia, and systemic features included chronic myeloid leukemia- Philadelphia chromosome (CML-PC) and empty sella turcica. We report an unusual association of MGS with CML-PC.

13.
Strabismus ; : 1-7, 2020 Oct 16.
Artigo em Inglês | MEDLINE | ID: mdl-33063568

RESUMO

PURPOSE: To evaluate the surgical outcome of augmented BLR recession with conjunctival recession in cases of IXT. METHOD: A total of 15 patients of the basic type of IXT were included in this prospective study. The patients underwent augmented BLR recession with conjunctival recession and on the basis of postoperative deviation, the outcome was assessed in terms OF orthophoria/success (< or =10 PD exotropia and < or =5 PD esotropia), residual exotropia/undercorrection (>10 PD exotropia), and overcorrection (>5 PD esotropia). RESULTS: Preoperative primary horizontal deviation was 30.80 ± 9.56 PD (16-42 PD) for near (0.3 m) and was 33.93 ± 9.97PD (15-45 PD) for distance (6 m). The mean postoperative primary horizontal deviation was 5.6 ± 1.5 PD (4-8 PD) for distance and 6.73 ± 2.15 PD (4-10 PD) for near at 6 months follow-up. After 12 weeks of surgery, 12 (80%) of the patients were orthophoric, 2 (13.3%) of the patients were overcorrected and 1 (6.7%) of the patient was undercorrected for near and all 15 (100.0%) patients were orthophoric for distance. This alignment was maintained till 6 months of follow-up. CONCLUSIONS: Although fornix-based incisions for squint surgery are preferred these days augmented BLR recession with conjunctival recession by limbal-based incision leads to good surgical outcome and prevents undercorrection and recurrence.

16.
Indian J Ophthalmol ; 68(9): 1874-1875, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32823406
17.
Indian J Ophthalmol ; 68(9): 1999-2001, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32823457

RESUMO

Ocular manifestations due to cysticercosis may involve the vitreous cavity or subretinal space in the posterior segment of the eye. Management of subretinal cysticercosis is challenging, especially if it involves the submacular region. Removal of submacular cysticercosis (SMC) requires utmost care and competent expertise. In recent times, modern vitreo-retinal equipment has improved the outcome of SMC. On the contrary, untreated SMC run a high risk of spontaneous rupture, liberation of toxin from dying worm, and intense intraocular inflammation threatening vision eventually. In the present report, two cases of SMC were discussed who presented to us within a span of 1 week. We described the course of disease and final outcome in these two patients (one underwent surgical removal while other denied surgery) highlighting the urgent need of cyst removal in such scenarios.

20.
J Family Med Prim Care ; 9(1): 337-339, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-32110615

RESUMO

Background: Globally, ocular morbidities are one of the most underdiagnosed, underreported, and undertreated public health concern. Among estimated 39 billion blind in world, India shares major proportions, with majority of them living in rural population. In India, religious festivals like Kumbh Mela that involve mass gatherings are mainly attended by middle and elderly population who are usually susceptible to various ocular diseases. Therefore, we analyzed the data of our eye camp to document pattern and magnitude of ocular morbidities among pilgrims attending a mega religious festive event. Methods: In a cross-sectional, descriptive study, we included all those patients who participated in a mega eye camp "Netrakumbh" from January to March 2019 at Kumbh Mela, Prayagraj, India and were attended by voluntary ophthalmologist from All India Institute of Medical Sciences, Rishikesh. Presenting chief complaints and detailed history were collected from all participants. All patients underwent comprehensive eye examination including visual acuity, slit lamp biomicroscopic examination, tonometry, etc., Data were compiled and analyzed utilizing SPSS 22.0. Results: A total of 47142 eyes of 23571 persons of all age groups (range 5 years to 70 years) with approximate equal gender distribution attending the mega eye camp were examined. The most common ocular morbidity noticed after ocular examination was refractive error with underlying cause majorly as presbyopia, followed by cataract, after cataract, convergence insufficiency, lids, and adnexal disease, etc. Conclusions: This study highlights the changing pattern of common ocular morbidities presently among middle and elderly populations in developing countries like India.

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