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   Table of Contents - Current issue
May-August 2020
Volume 8 | Issue 2
Page Nos. 49-86

Online since Thursday, July 2, 2020

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Ophthalmology during COVID-19 pandemic p. 49
Barun K Nayak
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The prevalence of refractive errors and spectacle uptake in truck drivers: A North Indian cross-sectional study p. 51
Shalinder Sabherwal, Ishaana Sood, Anand Chinnakaran, Atanu Majumdar, Shantanu Dasgupta
Aims: This study analyzes the prevalence and types of refractive errors among truck drivers, as well as their uptake of glasses. Subjects and Methods: Retrospective cross-sectional study of data collected between July 2017 and June 2018, through eye camps held across the national capital region. An optometrist conducted a comprehensive eye examination. Refractive error was defined as myopia (spherical equivalent of at least −0.5 diopter [D]), hyperopia (spherical equivalent of at least +0.5 D), or astigmatism (only cylinder of 0.5 D or more). Drivers requiring spectacles to read at a normal distance (35–40 cm) were categorized as having presbyopia. Those needing both distance and near vision correction were analyzed separately. Statistical Analysis: Data were analyzed for the prevalence of refractive errors and its types. Spectacles uptake and its association with age categories, number of affected eyes, type and severity of refractive errors were analyzed. Statistical analysis was carried out using R software version 3.1.1 and Excel 2013. Results: Refractive error (including presbyopia) was over 26% in the 4059 truck drivers screened. 8.8% needed distance correction, 24.3% needed near correction and 6.6% needed both, at least in one eye. Uptake was only 47% among those prescribed glasses and was higher among drivers requiring only near correction. Conclusions: Our study highlights the importance of eye examination among truckers. There is a need to increase the uptake of spectacles by increasing awareness and developing better models of spectacle delivery.
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Comparison of refractive error and related ocular morbidities between Saudi and Indian school children in Riyadh, Saudi Arabia p. 56
Ziaul Haq Yasir, Rajiv Khandekar, Hassan Al-Dhibi, Abdulrahman Salem Banaeem, Ahmad Khaled Al-Shangiti, Malek Abdulrahman Balous
Purpose: In children, refractive error (RE), especially myopia, is influenced by both genetic and environmental factors. We compared the magnitude and determinants of RE among Saudi and Indian students in Riyadh, Saudi Arabia. Methods: This study was conducted in 2017–2018 and evaluated students in preparatory and secondary grades. A “Spot Screener” was used to determine if the child passed or failed a refraction test. Data on vision, RE, anisometropia, and strabismus were compared between Indian and Saudi students. P < 0.05 was considered statistically significant. Results: The study sample was comprised of 770 Indian and 708 Saudi students. There were more Indian students (35.3%) with moderate visual impairment (<20/60–20/200) than Saudi students (6.1%) (odds ratio [OR] =8.4). The prevalence of RE in Indian and Saudi students was 50.1% and 43.6%, respectively. There were 45.6% Indian and 35.9% Saudi students with myopia (P < 0.001). The prevalence of hyperopia in Indian and Saudi students was 4.5% and 7.8%, respectively (P < 0.001). The prevalence of strabismus was significantly higher in Indian students (11%) compared to Saudi students (4.1%) (P < 0.001). The rate of anisometropia was higher in Indian than Saudi students (P = 0.001). A family history of RE was significantly lower in Indian students compared to Saudi students (OR = 0.7). Spectacle compliance was similar between Indian (78.9%) and Saudi (74.8%) students. Conclusions: Preparatory and secondary students of Indian and Saudi nationalities sharing the same environment had different rates and types of RE. Integrating RE services within the school healthcare system is required in both Indian and Saudi schools in Riyadh.
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A case of peripheral ulcerative keratitis associated with limited granulomatosis polyangiitis p. 62
Anushree Gupta, Shruti Anand
A 28-year-old Indian female presented with sudden onset reduced vision and pain in the left eye following blunt trauma. There was chronic history of redness, tearing, and irritation in both the eyes. She was diagnosed with peripheral ulcerative keratitis and corneal perforation in the left eye. Her corneal perforation was repaired with direct closure. Diagnostic workup revealed limited granulomatosis polyangiitis. The patient was treated with topical and systemic steroids and immunosuppressant drugs (rituximab).
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Herpes zoster ophthalmicus-related oculomotor palsy in a pediatric patient p. 65
Vimal Krishna Rajput, Chaithra D Aroor, Anupama Kiran Kumar, Prathana Bhandary
Herpes zoster ophthalmicus (HZO) is a rare form of shingles that typically presents with prodromal symptoms followed by rash along the V1 or V2 dermatomes. Associated ophthalmoplegia is even rarer. About 99% of adults with a history of chickenpox and up to 90% of those without have serology positive for varicella-zoster. Age and immune incompetence are the main risk factors. In the current report, we describe an immunocompetent 16-year-old girl who presented with pupil invoinvolving complete third nerve palsy associated with HZO. After an extensive literature search, we could not find any similar case reported before.
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Unilateral localized amyloidosis of levator palpebrae superioris muscle causing blepharoptosis p. 67
Avena Patel, Manju Kumari, Saptagirish Rambhatla
We report a rare case of unilateral localized amyloidosis of levator palpebrae superioris (LPS) muscle causing blepharoptosis. A 71-year-old male presented with a history of gradually progressing left upper eyelid ptosis. LPS resection was planned and the resected unusually thickened muscle was sent for histopathological examination which revealed amyloidosis. Investigations excluded systemic involvement. Amyloidosis should be considered in the differential diagnosis of aponeurotic ptosis.
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Unilateral phthiriasis palpebrarum infestation: An unusual case of pruritus p. 70
Sabin Sahu, Tshering Wangchuk Bhutia, Varun Shrestha, Vinit Kumar Kamble
Phthiriasis palpebrarum is a rare cause of eyelid infestation caused by phthiriasis pubis (crab louse) that mainly infests the hair of pubis and inguinal regions, but rarely eyelashes and eyelid. It is an uncommon condition of pruritus still seen in developing countries with poor personal hygiene. These conditions may have unusual presentations which may be misdiagnosed as conjunctivitis, blepharoconjunctivitis, dermatitis, or blepharitis due to similarities in the signs and symptoms. We report a case of a young male with unilateral pruritus and irritation which showed numerous nits adherent to the eyelashes and multiple lice at the base of eyelashes at the upper lid on examination. The patient was successfully treated with mechanical removal of lice and nits, and pilocarpine 2% drop were applied locally. A typical case of unilateral phthiriasis palpebrarum infestation, which is an unusual case of pruritus, is highlighted. Meticulous examination with suspicion is essential for the prompt diagnosis and treatment.
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A rare case of unilateral anterior megalophthalmos with developmental glaucoma: Sequelae of megalocornea or a separate entity? p. 72
Amit Mohan, Amit Kumar, Pradhnya Sen, Chintan Shah, Alok Sen, Elesh Jain
Megalocornea and megalophthalmos are bilateral developmental anomaly of the anterior segment of the eye. Either of these conditions has a high risk of developing glaucoma. We report the rare case in a 9-year-old child with simple megalocornea in one eye and megalophthalmos in other eye. He has increased corneal diameter in both the eyes and iris stromal hypotrophy exposing the radial vessels, raised intraocular pressure (IOP), and optic nerve head cupping in the left eye (LE). LE trabeculectomy with Ologen was performed. Postoperative IOP was well controlled at 1-year follow-up with favorable bleb morphology.
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Persistent fetal vasculature with colobomatous cystic optic disc in a microphthalmic eye: A clinicopathological case report p. 75
Palak Chirania, Dipankar Das, Kasturi Bhattacharjee, Manab Jyoti Barman, Gayatri Bharali, Panna Deka, Apurba Deka
Aim: To present a rare clinico-pathological case of persistent fetal vasculature with colobomatous cystic optic disc in a micro-ophthalmic eye. Method: A case report. Results: An 8 year boy presented to the tertiary eye care center was diagnosed as micro-ophthalmos, microcornea, inferior iris coloboma with suspected retinochoroidal coloboma in right eye (OD). Ultrasound B scan of OD was done which confirmed the above findings along with the presence of membranous echoes attached to the disc. On MRI of right orbit, retinal detachment with colobomatous cyst in the posterior aspect of the eyeball was present. OD was enucleated with parenteral consent and silicon ball and socket reconstruction was done. We thereafter examined the enucleated eyeball grossly as well as by histopathological examination. Herein, we present the pathological features of a case of persistent fetal vasculature (PFV) supported by gross and microscopic examination with a special emphasis on the presence of colobomatous cystic optic disc in a micro-ophthalmic eye. Conclusion: This is one of the rare associations of PFV making this original report a unique one.
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Craniofacial fibrous dysplasia with ipsilateral keratoconus p. 78
Rajat M Srivastava, Siddharth Agrawal
Fibrous dysplasia (FD) is a developmental dysplastic disorder of the bone, in which the normal matrix is replaced by fibroblastic proliferation. Keratoconus is usually an isolated sporadic disorder which may be associated with various ocular and systemic conditions. We report a case of ipsilateral keratoconus with craniofacial FD. Only a single such case has been reported in literature. An 18-year-old male patient presented to us with right eye (RE) proptosis and protrusion of the forehead and lateral skull associated with poor vision in the RE. He had earlier undergone conservative excision and recontouring for FD. Best-corrected visual acuity in the RE was counting fingers at 1 m and in the left eye was 20/20. Clinical signs of keratoconus were present in the RE. Corneal topography confirmed the diagnosis of keratoconus. The incidence of keratoconus in this case may be an independent finding or may be related to pressure on the globe due to expanding orbital walls.
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A unique form of blindness p. 82
Abhishek Juneja, Kuljeet Singh Anand
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Patient's response and tele-medicine applications under local coronavirus disease-2019 outbreak Highly accessed article p. 83
Sunny Chi Lik Au
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How to find the solution to epidemics of coronavirus induced acute respiratory syndromes? p. 84
Jatinder Bali, Ojasvini Bali
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