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Introduction Ocular injury is the commonest ocular emergency and can vary across geographical and socioeconomic regions. This study was conducted to determine the pattern of ocular injuries presenting to our tertiary care hospital located in Puducherry, Southern India. Methods A retrospective hospital-based study was performed and analyzed the records of the patients who presented with ocular injuries to the emergency department between January 2016 and December 2017. Data were collected using a structured format and noted the demographic profile and clinical profile of ocular injury. Results Of the 392 ocular emergencies, 318 (81.1%) were caused by ocular trauma. Mechanical trauma was most common (306; 96.2%). Males were more frequently affected (ratio; 3.7:1). Most cases of trauma belonged to the 21–30 years age group (86, 28.1%) and were caused by road traffic accidents (RTAs) (197; 64.4%). Adnexal injuries were commonest (285; 93.1%). The ocular injury was close globe type in 93 (30.4%) and the open globe in three (1.0%). Serious lid injury was present in 71 cases (23.2%). Serious injuries such as globe rupture and traumatic optic neuropathy were present in three (1.0%) and eleven (3.6%) cases, respectively. Conclusion Ocular trauma is the most common cause of ocular emergencies and RTA is the commonest cause of ocular trauma. We need to explore strategies to minimize ocular trauma as a priority.

Purpose: The major drawback of an external dacryocystorhinostomy (ExDCR) is visible skin scar leading to poor patient satisfaction. In this study we have analyzed the skin scarring objectively after Curvilinear incision (CLI) and W shaped incision (WSI). Methods: This is prospective trial done at Department of Ophthalmology at tertiary level hospital. All the patients with primary acquired nasolacrimal duct obstruction were included in the study. Patients were assigned to group A(CLI) or Group B (WSI). Cosmetic outcome was assessed by scar visibility at 1st, 3rd and 6th month postoperatively by two ophthalmologists separately, who were unaware of incision type. Results: We studied 64 patients with median age 59.0 years (IQR [Interquartile range]: 50.0–66.8 years). Scar visibility was significantly (p = 0.001) more in WSI group at all follow-ups. None of the patients of CLI group showed visible scar at six months whereas ten patients (31.3%) of WSI group still had minimal scar (p 0.05) but extension of skin incision was more common in WSI group. Conclusions: We found that CLI is more aesthetic, simpler, requiring less operative time and less incision related complications when compared with WSI. Keywords: Dacryocystitis, Epiphora, Lacrimal, Lacrimation, Nasolacrimal duct

A 42-year-old male presented with complaints of pain in the left hypochondriac region and diffuse headache and gradual painless loss of vision in both eyes. Ocular examination revealed BCVA was 20/40 in the right eye and 20/60 in the left eye and Grade 5 Papilledema noticed in both eyes. Blood investigation revealed polycythemia and positive JAK2 mutation. Primary polycythemia was diagnosed. Immediate treatment with low molecular heparin was initiated, and regular phlebotomies were performed until the hematocrit dropped to 45%. This case reveals, papilledema as an important sign of polycythemia and as a guide to the diagnosis of cerebral venous sinus thrombosis (CVT).

Purpose To study the incidence, clinical features and outcome of primary canaliculitis with special reference to long-term epiphora after Snip–punctoplasty and curettage. Methods Single center, retrospective, telephonic questionnaire study. The medical records of patients who visited Orbit and Oculoplasty clinic, Tertiary Eye Hospital, India from 01 July 2011 to 31 June 2012 were analyzed. Records of the patients with primary canaliculitis were reviewed for clinical profile and management. Post-surgical patients thus identified were telephonically contacted in December 2012. Questionnaire was used to assess the postsurgical epiphora. Symptomatic patients were given clinic appointment, reassessed and managed. Results 2245 patients visited Orbit and Oculoplasty clinic during the study period. The incidence of primary canaliculitis was 1.4% (31 patients). The median age of the patients with canaliculitis was 65years (range, 14–80yrs). Sixteen patients were male. All cases were unilateral and four eyes showed both upper and lower canalicular involvement. The commonest clinical presentations were pus or concretion from punctum (28), mucous discharge (23), epiphora (18) and conjunctival injection (18). Three snip punctoplasty and canalicular curettage was performed in 30 of these patients. Twenty of the 25 available culture results were positive and streptococcus species was the most common isolated organism. Records revealed that five (22%) of these patients had persistence of symptoms. Twenty-three patients could be contacted telephonically. The median follow-up of these patients was 11months. On telephonic communication we found that two (8.7%) patients had epiphora. Munk epiphora score in these patients was three and one respectively. Conclusions Incidence of canaliculitis was 1.4%. Most common isolate was streptococcus species. Snip–punctoplasty and curettage is a safe and efficacious modality of treatment of canaliculitis. Post-operative epiphora occurred in 8.7% patients.

Melioidosis caused by Burkholderia pseudomallei (B. pseudomallei), is an emerging infection in India. Clinical manifestation of melioidosis is variable ranging from localized benign infection to fulminant septicemia. Ocular presentation of melioidosis is rare. However, cases of endophthalmitis, keratitis and orbital infections have been reported. We report the isolation of B. pseudomallei in a 40 year old male, presenting with fever and lid abscess. The patient was treated with meropenem during the acute phase and switched to trimethoprim/sulfamethoxazole for eradication phase