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Conventionally, fundus camera is the only source for taking retinal images. With the advent of smartphones, fundus photography has become more portable, simpler, cheaper, and easier. Various techniques of fundus imaging with smartphones were put forth in the last decade. Senior ophthalmologists always prefer using a direct ophthalmoscope (DO) for viewing the fundus. DO has the advantage of viewing magnified images giving no scope in missing findings. We illustrate the use of a smartphone and a DO in recording patient's facial details, distant direct ophthalmoscopy apart from taking images of normal/pathological lesions of the optic disc, vessels, and retina in the form of a videograph or photograph. This technique is extremely useful for training purposes, bedside-imaging as in intensive care unit/wards, in remote areas such as camps, creating patient awareness, counseling, monitoring the progression, documentation, sharing, and cross consultation. These advantages are being utilized in our institute since 2014.

Background: Convergence insufficiency (CI) is a common condition characterized by patient's inability to maintain binocular alignment on objects as they approach from distance to near. One study has found association between low body mass index (BMI) and CI. The purpose of this study is to find the prevalence of CI and its association with BMI among patients aged 18–35 years. Subjects and Methods: In a prospective study, we recorded convergence among individuals aged 18–35 years. We defined CI as near point of convergence of >10 cm, exophoria greater for near than distance, and positive fusional vergence of

Background: Glaucoma is one of the leading causes of preventable blindness worldwide. It is estimated that by 2020, India will become the second largest population affected with glaucoma. Despite the various efforts by government and NGO agencies in conducting various out-reach and screening programmes the burden of glaucoma seems to be rising in India. Aims and Objectives: Our study was aimed to find the awareness about glaucoma and the level of knowledge and the various reasons for the lack of its knowledge. Materials and Methods: A questionnaire based study was done on 1311 participants above 40 years of age attending the OPD. Participants who were aware of the condition glaucoma were further asked about the basic knowledge of the condition pertaining to its symptoms, treatment options and its visual prognosis. Results: The awareness of glaucoma was found to be poor. Around 10% of the aware population had good to excellent knowledge about glaucoma. Relatives of people affected by glaucoma were the most aware and knowledgable. Conclusion: Our study showed that the awareness and knowledge about glaucoma and its risk factors and treatment were poor, especially in a population with lower economic status and literacy levels.

Background: Hypercholesterolemia is a risk factor for ischemic heart disease and cerebrovascular disease. Increased cholesterol in the meibomian gland secretion has been considered necessary for development of meibomian gland dysfunction (MGD). Aim: To study the association of MGD with hypercholesterolemia in adults aged 20-60 years age. Setting and Design: Observational case-control study. Methods and Materials: We studied one hundred and twenty individuals aged 20-60 years divided into two groups; sixty cases of MGD and no known hypercholesterolemia; sixty controls with neither MGD nor hypercholesterolemia. Examination included anterior segment examination, tear film break-up time (TBUT), Schirmer's test and assessment of meibomian gland function. MGD was graded based on quality of meibum secretion and meibomian gland function (expressibility). Other investigations included lipid profile, random blood sugar, serum creatinine and body mass index (BMI). Statistical Analysis: We calculated proportion, mean, standard deviation, 95% confidence interval (CI), Z- test, and paired t-test for comparison between groups. Results: Hypercholesterolemia (i.e. serum cholesterol ≥ 200 mg/dl) was found in 39 (65%) and 31 (51.67%) among cases and control respectively. Hypercholesterolemia was found in 17 (44.7%) cases with grade 2 meibomian gland function (i.e. expressibility) (p=0.038) and 26 (68.4%) cases with grade 2 meibomian gland secretion (p = 0.037), these associations were statistically significant. Conclusions: Moderate MGD (i.e. grade 2 expressibility and secretion) is associated with elevated level of total cholesterol (i.e. serum cholesterol level ≥ 200 mg/dl).

Chemical injury is one of the common ocular emergencies in ophthalmology practice. Ocular burns, especially with alkaline solution, can lead to hazardous effects on eye structures. Limbal ischemia resulting from such injury carries a grave prognosis. Lack of standard criterion results in difficult assessment of limbal ischemia. Diagnosis of limbal ischemia is purely dependent on subjective assessment. A 40-year-old female presented to our emergency department with alkali injury. Alkali injury was promptly diagnosed and treated. There was no sign of limbal ischemia during initial evaluation. On follow-up, the patient developed late-onset limbal ischemia.

Central retinal artery occlusion (CRAO) is an ophthalmologic emergency. Carotid artery atherosclerosis, cardiogenic emboli, hypertension, smoking, diabetes, and giant cell arteritis (GCA) are the contributing risk factors for CRAO. It is imperative to rule out GCA in patients aged above 50 years as it can cause severe visual loss involving both eyes, if not treated promptly, making diagnosis critical. Elevated C-reactive protein and erythrocyte sedimentation rate with a raised platelet count favor GCA as a probable diagnosis. Typical granulomatous inflammation on temporal artery biopsy confirms the diagnosis. The vision loss is permanent, but early steroid therapy is effective in preventing further visual loss.

Purpose: Pseudoexfoliation syndrome (PXS) is an age related microfibrillopathy characterized by deposition of whitish flaky material over various ocular tissues. PXS eyes are known to have thinner corneas and thus can lead to an underestimation in intraocular pressure measurement. The purpose of this study was to find if there is any variation in central corneal thickness and intraocular pressure in PXS eyes and if there was any relationship between them. Methods: A prospective observational study was done on 141 eyes of 85 patients with PXS without glaucoma between November 2015 to April 2017 in the department of Ophthalmology in a tertiary hospital. CCT and IOP were measured by a handheld ultrasonic pachymeter (DGH Technology INC. Pachette 2, USA) and Goldmann applanation tonometer respectively at 4 different times during office hours. Results: A significant reduction of about 10 μm in mean CCT and 1.4 mmHg in mean IOP was noted over the 4 sessions which was statistically significant (P < 0.001). A significant correlation exists between IOP and CCT in PXS eyes at all times during the day (P < 0.001). Conclusion: The CCT measurements show significant thinning throughout the day, similar drop in IOP was also noted. Our study shows that there is a significant correlation between diurnal variation of CCT and IOP. Hence, it is prudent to measure CCT along with IOP at all times.

Aim: The primary aim of the study is to determine the association between incidence, risk factors, and treatment outcomes in retinopathy of prematurity (ROP). Subjects and Methods: A longitudinal observational study was carried out on 65 babies who fulfilled the criteria for ROP screening at a tertiary center. Results: Of the 65 babies screened, 24 (36.9%) developed some stage of ROP with 12 developing Type 1 ROP. Mean birth weight, mean gestational age (GA), and duration of oxygen therapy were significantly associated with the development of ROP (P = 0.047, P < 0.001, and P < 0.001, respectively). One-third of the babies had maternal risk factors also. Of the 24 babies with ROP, zone 3 was involved in 13 (54.1%) babies and zone 2 was involved in 11 (45.8%) babies; 7 (29.1%) had stage 1, 9 (37.5%) had stage 2, and 8 (33.3%) had stage 3. Of 24 babies with ROP, 12 (50%) required treatment with laser photocoagulation and all these babies showed regression of ROP following treatment. Conclusion: Birth weight

Aim: The aim is to study the correlation of macular thickness and sensitivity in type 2 diabetes mellitus patients. Materials and Methods: A cross-sectional comparative study was done on 77 eyes with diabetic retinopathy. Patients were divided into three groups as follows: Group 1 – Diabetic retinopathy without maculopathy, Group 2 – Diabetic maculopathy without clinically significant macular edema (CSME), and Group 3 – CSME. Microperimetry was used to assess macular sensitivity, and optical coherence tomography (OCT) was used to measure retinal thickness. Comparison of retinal sensitivity and thickness was done between groups. Correlation of these parameters to duration of diabetes was also done. Results: The mean macular sensitivity (in dB) in Groups 1, 2, and 3 was 11.57, 11.51, and 8.03, respectively. The mean central macular thickness in Groups 1, 2, and 3 was 199.33, 208.62, and 334.25 μm, respectively. There was statistically significant difference in macular thickness and in macular sensitivity between Groups 1 and 3 (P < 0.001) and between Groups 2 and 3 (P < 0.001). This difference was not statistically significant between Groups 1 and 2 (P > 0.09). Macular sensitivity had a moderate correlation with macular thickness, which was statistically significant (P < 0.001). Conclusions: Macular sensitivity was found to decrease with increasing macular thickness.

Expulsive suprachoroidal hemorrhage can be surgical or spontaneous. Spontaneous expulsive suprachoroidal hemorrhage (SESCH) is a rare entity. Most of the reported cases of SESCH were caused by a combination of corneal pathology and glaucoma. We are reporting a rare presentation of SESCH with no pre-existing glaucoma or corneal pathology and caused by massive intra- and peri-ocular hemorrhage due to decompensated liver disease.