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Cysticercosis is caused by the larvae ofTaenia soliumand is a significant health problem. Disseminated cysticercosis is an infrequent manifestation of the same. A woman in her 30s presented to us with a history of seizures, outward protrusion of both eyes and multiple soft-tissue swellings over the face and tongue for 3 years. Imaging studies revealed multiple cystic lesions in the brain parenchyma, extraocular muscles, subcutaneous tissue, muscles of mastication and tongue. A high index of suspicion and a planned therapeutic approach is required in such cases.

The most recent challenge being faced by the healthcare system during the worldwide COVID-19 pandemic is increase in the incidence rate of coinfection or superinfection; one of the most fatal being mucormycosis. This study aimed to estimate the risk factors, symptoms and signs, treatment outcome and prognosis of COVID-19-associated mucormycosis (CAM) patients.This is an interventional study of 35 patients diagnosed and managed as CAM at a tertiary care centre in New Delhi, India.The mean age of patients was 40.45 ± 6 years with a male preponderance. CAM did not affect healthy individuals; the major risk factors included diabetes in 65.7% and injudicious steroid use in 51.4% patients. Orbital/facial edema was the most common presenting symptom (25.7%) as well as sign (28.57%). 68.5% patients were stage 3 (involvement of orbit) at presentation; 33.3% showed medial wall involvement. Treatment included intravenous Amphotericin and oral Posaconazole in all patients, paranasal sinus (PNS) debridement in 94.2%, orbital exenteration was done in 8 patients. Adjuvant retrobulbar Amphotericin B injection was administered in 12 patients with radiological resolution seen in 50% after 1 cycle. In patients with Stage 4 disease who underwent exenteration along with PNS debridement, survival rate was 100% at 30 days, and disease reduction occurred in 87.5% patients (P 0.01). Overall, 68.5% responded to therapy, 8.5% showed progression and mortality rate was 22.85%, at a mean follow up period of 59.5 days.A multidisciplinary and aggressive approach is essential in the management of CAM patients.

Purpose: The most recent challenge being faced by the healthcare system during the worldwide COVID-19 pandemic is increase in the incidence rate of coinfection or superinfection; one of the most fatal being mucormycosis. This study aimed to estimate the risk factors, symptoms and signs, treatment outcome and prognosis of COVID-19-associated mucormycosis (CAM) patients. Methods: This is a prospective, interventional study of 35 patients diagnosed and managed as CAM at a tertiary care centre in New Delhi, India. Results: The mean age of patients was 40.45± 6 years with a male preponderance. CAM did not affect healthy individuals; the major risk factors included diabetes in 65.7% and injudicious steroid use in 51.4% patients. Orbital/facial edema was the most common presenting symptom (25.7%) as well as sign (28.57%). 68.5% patients were stage 3 (involvement of orbit) at presentation; 33.3% showed medial wall involvement. Treatment included intravenous amphotericin and oral posaconazole in all patients, paranasal sinus (PNS) debridement in 94.2%, orbital exenteration was done in 8 patients. Adjuvant retrobulbar amphotericin B injection was administered in 12 patients with radiological resolution seen in 50% after 1 cycle. In patients with Stage 4 disease who underwent exenteration along with PNS debridement, survival rate was 100% at 30 days, and disease reduction occurred in 87.5% patients (P

Background: Diabetic retinopathy is a common microvascular complication of diabetes leading to DiabeticMacular Edema (DME)and visual impairment in the working age population1About one third of diabeticindividuals had some degree of Diabetic retinopathy and less than 10% develop DME.Intravitreal dexamethasone implant in cases unresponsive to anti VEGF therapy has a beneficial role inimproving visual acuity and macular morphology. The possible mechanism of action could be resolution ofedema that was resistant to anti VEGF agentsAims and Objectives: To determine the efficacy of intravitreal dexamethasone implant for DMEunresponsive to anti Vascular Endothelial Growth factor(VEGF)treatmentMethodology: A retrospective analysis of refractory 21 cases, 30 eyes of DME to primary anti VEGFtreatment was performed to analyze the profile of presentation and treatment outcome to Intravitrealdexamethsone implants. Ranibizumab (0.5 mg) administered monthly and if, were unresponsive after 5-6injection were switched to Intravitreal Dexamethasone implants (0.7 mg).Failure to therapeutic response was characterized by increase in central macular thickness from baselinefinding or no response to treatment. Intravitreal dexamethasone implant was administered every two monthsBest corrected visual acuity,Intraocular pressure and central macular thickness was evaluated at baselinesand following intravitreal dexamethasone impant.Result: The mean age was 56.3± 5.9 years. The mean Intra ocular pressure was 17.3±2.7 mmHg.The mean anti VEGF treatment sessions was 5.8±1.2. The mean BCVA improved significantly from LogMar0.76 ±0.16 to 0.67 ±0.19 (p value=0.029) and CMT improved significantly from 431.6 ±100.9µm to 379.1±80.72µm (p value =0.0005).Conclusion: Intravitreal dexamethasone is effective in refractory cases of DME unresponsive to anti VEGFtherapy. Optimal evaluation and tailoring therapy with the therapeutic response will be beneficial.

Dear Sir, Coronavirus disease 2019 (COVID-19), declared a pandemic by the WHO on March 11, 2020, is caused by the highly transmissible Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). The key to combating this disease besides prevention is rapid and early diagnoses of cases, which include identification of atypical presentations of this respiratory illness as well as possible routes of transmissibility. Recently, concerns regarding the eyes as both a portal of entry and a carrier of the virus have been raised, owing to the conjunctival signs and symptoms observed in a subset of patients with COVID-19 and the detection of SARS-CoV-2 in tears, thus presenting an additional risk potential for person-to-person transmission of this virus. ### Supplementary data [postgradmedj-2020-138069supp001.pdf] There have been several reports suggesting that SARS-CoV-2 can cause conjunctivitis, either as an early sign of infection or during hospitalisation for severe COVID-19 disease. In a meta-analysis by Loffredo et al 1, they stated that the overall rate …

Stargardt disease (STGD) or fundus flavimaculatus is a progressive form of juvenile macular degeneration with considerableclinical and genetic heterogeneity. It may be considered a syndromal cone-rod dystrophy due to overlapping clinical features suchas loss of color vision and photophobia in some patients. Here, we report a case of fundus flavimaculatus in a 32-year-old femaleand discuss the literature pertaining to it. Clinical data including medical history, findings on physical examination and localexamination were suggestive of fundus flavimaculatus. Best-corrected visual acuity of the patient remained constant at 6/12 for1 year with the patient being on 3-month follow-up. No particular or specific treatment is available for this fundus dystrophy andfrequent follow-ups may help diagnose and manage associated choroidal neovascular membrane at the earliest. The only modalityis available in the form of low vision aids for advanced disease.

Most patients who suffer from epiphora usually have a blockage located near the end of the system within the nasolacrimal duct.

Aim: The purpose of this study was to study the epidemiology of glaucoma in a semi urban population of delhi. Methods: 24651 patients attending the eye OPD of Attar Sain Jain Eye and General Hospital, Govt of NCT of Delhi were screened and treated for glaucoma over a period of 6 months-from 1st July to 31st December, 2013. Results: Total of 261 cases of all types of glaucoma was identified. Out of these 43 were angle closure glaucoma and 218 were open angle glaucoma. Newer cases diagnosed were 118(78 of open angle glaucoma and 30 of angle closure glaucoma). Thus the overall incidence was 4.79 cases per 1000 population. Overall prevalence of glaucoma was 10.59 cases per 1000 population. The overall male to female distribution was 121 male cases to 140 female cases but this figure was skewed towards 30 females to 13 males in case of angle closure. Family history for glaucoma was positive in 73 percent of all cases (191 cases). Two cases required surgery and 32 cases required laser iridotomy (new and augumentation). 62 percent of the overall patients were diabetics and 32 percent were smokers. Conclusion: Glaucoma is one of the leading causes of blindness in the world and India and is a silent killer of the eye. There is a lack of glaucoma epidemiological and risk factor studies and more such studies are required with larger population base and longer duration to have an assessment of the burden of glaucoma. Initiatives to increase public awareness and comprehensive eye examinations by ophthalmologists are the key to reducing or eliminating undiagnosed glaucoma. If all ophthalmologists perform comprehensive eye examinations (that includes basic slitlamp examination, intraocular pressure (IOP) measurement, pachymetry, gonioscopy and dilated fundus examination), we can definitely minimize under-diagnosis.

BACKGROUND: The purpose of this study was to study the correlation between severities of Diabetic Retinopathy with control and duration of diabetes. Methods: 1200 diabetic patients attending the eye OPD of Safdarjung Hospital between 2008 to 2010 were screened for diabetic retinopathy. The control of diabetes was monitored using glycosylated hemoglobin level. Their duration of diabetes was noted. RESULTS: Patients with uncontrolled diabetes developed Diabetic Retinopathy 23.32 times more compared with controlled groups. 82.18% of controlled diabetics had no retinopathy compared to 16.51% of uncontrolled diabetics. Occurrence of moderate and severe Retinopathy was significantly higher in uncontrolled diabetics, 43.12% and 20.64%, respectively as compared with 5.29% and 2.14% in controlled diabetics. All 10 cases of proliferative retinopathy were found in uncontrolled diabetics. Only 21.69% of patients having diabetes for 05years developed retinopathy compared with 58.82% of patients having the diabetes for 20 years or more. It was shown that for every 5years increase in the duration of diabetes, the risk for retinopathy increased 1.57fold. Also the retinopathy severity increased with increasing duration. CONCLUSION: Statistical methods concluded that Retinopathy was more likely to occur and with more severity in uncontrolled than controlled diabetics. Also Retinopathy was more likely to occur as the duration of diabetes increased.

Methods: Clinical data including medical history, findings on physical examination, local examination, Fundus Fluorescein Angiography, USG B-Scan, MR Angiography of head and orbit was done for a 31 year old male, case of retinal juxtapapillary hemangioblastoma. Patient was given 2 injections of intravitreal Anti-VEGF at 4 weeks interval to reduce tumor vascularity, size and associated exudation, oedema and SRF to improve visual acuity. PDT was done following this for the residual tumor mass.

PURPOSE: To report a case of Central Macular Areolar Dystrophy and to discuss the literature pertaining to it. METHODS: Clinical data including medical history, findings on physical examination and local examination were recorded for a 35years old male, case of Central Macular Areolar Dystrophy. No treatment was advised and patient was called for regular follow up to cater for low vision aids if required in the future. RESULTS: Best corrected Visual acuity of the patient remained constant at 6/36 for a period of one year with the patient being on 3monthly follow up. CONCLUSION: No particular or specific treatment is available for this rare macular dystrophy. The only modality available in the form of low vision aids for progressive disease.

*Address for correspondence To report a case of Axenfeld-Rieger syndrome which is a rare developmental disorder and to discuss the literature pertaining to it.Clinical data was recorded for a 22 year old male, case of AxenfeldRieger syndrome. Patient was put on multiple topical anti-glaucoma medicines and was called for regular followup.Visual acuity of the patient improved from finger counting at 1.5mts both eyes to 3mt both eyes and intraocular pressure was reduced from 28 mm Hg in both eyes to 10 and 12 mmHg in right and left eye respectively. Thus multiple topical glaucoma medicines along with frequent follow-ups can help achieve useful vision in cases of Axenfeld-Rieger syndrome.