Search

PURPOSE: Intracameral mydriatic agents (ICMAs) are replacing the conventional method of topical mydriasis for its fast action and no need for repeated instillation before cataract surgery. Its application for the management of intraoperative miosis needs to be studied with different doses of mydriatic agent. The objective of the study is to study cardiovascular effects of diluted intracameral combination of 0.02% tropicamide, 0.31% phenylephrine, and 1% lidocaine during phacoemulsification to manage intraoperative miosis. MATERIALS AND METHODS: The study was conducted at Mojiram Lions Eye Hospital Akbarpur Majra village, Palla Bakhtawarpur Road, Delhi, during the year 2021–2022 after taking approval from the Ethical Committee of the hospital. Patients undergoing cataract surgery who were not dilated adequately during the preoperative period or developed intraoperative miosis were managed by injecting diluted intracameral combination of 0.02% tropicamide, 0.31% phenylephrine, and 1% lidocaine (phenocaine plus). 0.5 ml of phenocaine plus was diluted with 1.5 ml of ringer lactate solution and 0.50 ml of this solution was injected intracameral and its effect on pulse rate, blood pressure (BP), and oxygen saturation were monitored continuously on pulse oximeter. RESULTS: There was no statistically significant effect of diluted ICMA (Phenocaine Plus) on diastolic BP and oxygen saturation. However, systolic BP showed a little change from mean of 133.78 (standard deviation [SD] =16.04) mmHg to 133.92 (SD = 15.33) mmHg which was statistically significant but clinically not significant. Pulse rate increased slightly from mean 76.46 per minutes (SD = 15.14) to 79.40 (SD = 14.95) at 10 s and 76.49 (SD = 15.15) at 60 s. The difference was again statistically significant but clinically insignificant. CONCLUSION: Low concentration of intracameral combination of 0.02% tropicamide, 0.31% phenylephrine, and 1% lidocaine is a very safe and effective method for the management of intraoperative miosis. [ABSTRACT FROM AUTHOR]

Purpose: To study the knowledge, attitude and practices (KAP) towards computer vision syndrome prevalent in Indian ophthalmologists and to assess whether ′computer use by practitioners′ had any bearing on the knowledge and practices in computer vision syndrome (CVS). Materials and Methods: A random KAP survey was carried out on 300 Indian ophthalmologists using a 34-point spot-questionnaire in January 2005. Results: All the doctors who responded were aware of CVS. The chief presenting symptoms were eyestrain (97.8%), headache (82.1%), tiredness and burning sensation (79.1%), watering (66.4%) and redness (61.2%). Ophthalmologists using computers reported that focusing from distance to near and vice versa ( P =0.006, χ2 test), blurred vision at a distance ( P =0.016, χ2 test) and blepharospasm ( P =0.026, χ2 test) formed part of the syndrome. The main mode of treatment used was tear substitutes. Half of ophthalmologists (50.7%) were not prescribing any spectacles. They did not have any preference for any special type of glasses (68.7%) or spectral filters. Computer-users were more likely to prescribe sedatives/ anxiolytics ( P = 0.04, χ2 test), spectacles ( P = 0.02, χ2 test) and conscious frequent blinking ( P = 0.003, χ2 test) than the non-computer-users. Conclusions: All respondents were aware of CVS. Confusion regarding treatment guidelines was observed in both groups. Computer-using ophthalmologists were more informed of symptoms and diagnostic signs but were misinformed about treatment modalities.

In our retinopathy of prematurity (ROP) screening program we found that babies tended to show poor, erratic and variable response to mydriatic drug instilled prior to ROP screening. We compared the adult Single-lid Retraction by Thumb Method (SRTM) with two-thumb-retraction-method (TTM) and the two-bud-instillation-method (TBM). Thirty instillations each for the three methods were studied using computerized randomization. Neonates with plus disease, Iris neovascularization and threshold ROP were excluded from study. Instillations were carried out by nurses and residents, who rated the ease of administration on a 5 point Likert Scale administered as a visual analog scale (5 = fully satisfied and 1 = fully dissatisfied). The instillation was rated as successful if the drop was instilled in the cul de sac and unsuccessful if delivered outside it in the first attempt. Second attempts and change of technique were considered unsuccessful. The percentage of successful instillations in the first attempt was 36.7% in SRTM, 70.0% in TTM and 83.3% in TBM (χ2 = 14.928, P = 0.001; Chi-square test). The mean ranks for the ease of administration were 43.02, 57.00, and 36.48 for the SRTM, TTM, and TBM methods respectively (H(2) =10.367, P = 0.006; Kruskal-Wallis test). SRTM failed in most cases on first attempt (67.3%). TBM was significantly more difficult than TTM or the SRTM. SRTM should not be recommended for infants and neonates in pediatric ophthalmology practices and ROP screenings in nurseries. However, larger studies are required to validate the findings of present study.

Purpose: Intracameral mydriatic agents (ICMAs) are replacing the conventional method of topical mydriasis for its fast action and no need for repeated instillation before cataract surgery. Its application for the management of intraoperative miosis needs to be studied with different doses of mydriatic agent. The objective of the study is to study cardiovascular effects of diluted intracameral combination of 0.02% tropicamide, 0.31% phenylephrine, and 1% lidocaine during phacoemulsification to manage intraoperative miosis., Materials and Methods: The study was conducted at Mojiram Lions Eye Hospital Akbarpur Majra village, Palla Bakhtawarpur Road, Delhi, during the year 2021-2022 after taking approval from the Ethical Committee of the hospital. Patients undergoing cataract surgery who were not dilated adequately during the preoperative period or developed intraoperative miosis were managed by injecting diluted intracameral combination of 0.02% tropicamide, 0.31% phenylephrine, and 1% lidocaine (phenocaine plus). 0.5 ml of phenocaine plus was diluted with 1.5 ml of ringer lactate solution and 0.50 ml of this solution was injected intracameral and its effect on pulse rate, blood pressure (BP), and oxygen saturation were monitored continuously on pulse oximeter., Results: There was no statistically significant effect of diluted ICMA (Phenocaine Plus) on diastolic BP and oxygen saturation. However, systolic BP showed a little change from mean of 133.78 (standard deviation [SD] =16.04) mmHg to 133.92 (SD = 15.33) mmHg which was statistically significant but clinically not significant. Pulse rate increased slightly from mean 76.46 per minutes (SD = 15.14) to 79.40 (SD = 14.95) at 10 s and 76.49 (SD = 15.15) at 60 s. The difference was again statistically significant but clinically insignificant., Conclusion: Low concentration of intracameral combination of 0.02% tropicamide, 0.31% phenylephrine, and 1% lidocaine is a very safe and effective method for the management of intraoperative miosis., Competing Interests: The author declares that there are no conflicts of interest in this paper., (Copyright: © 2023 Taiwan J Ophthalmol.)

The fourth industrial revolution refers to a fusion of technologies which blend the physical, digital and biological worlds. It can mitigate miseries of the teeming masses. However, India faces the unique challenge. It is both the creator of enormous amount of data required for this revolution as well as largest potential market for those innovations in the coming future. This article traces the challenges and draws parallels with the past experiences. The first transformation is expected to hit healthcare sector much sooner than projected earlier. It outlines the call to action required of our thought leaders today., (© Journal of the Association of Physicians of India 2011.)