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Background. An important role in the structure of ophthalmic pathology is played by myopia, especially rapidly progressing in adolescence, and accommodation disorders, which are, in fact, the precursors and companions of myopia. The purpose was to prevent accommodation disorders and mild myopia in children of different age groups by using dietary supplements Doppelherz® Kinder Eye vitamins with lutein and Doppelherz® Kinder Glycine. Materials and methods. One hundred and three children of diffe-rent age groups underwent functional examination against the background of treatment: group I — primary school age, prepubertal period (6–11 years) — 24 children, group II — middle school age, pubertal period (12–18 years) — 79 children, 24 of them had problems of the neck and collar zone associated with computer load. Standard examination methods were used. Results. After the course of the proposed therapy, the Haidinger’s phenomenon decreased to 5.70 ± 0.01 conventional units (p < 0.05) in the first group; up to 4.60 ± 0.03 conventional units in 55 children of the second group without problems in the neck and collar zone and up to 5.40 ± 0.02 conventional units in 24 children who had such problems (p < 0.02). Conclusions. Using Doppelherz® Kinder Eye vitamins with lutein and Doppelherz® Kinder Glycine improves the functioning of the ciliary muscle. Under the influence of treatment, visual acuity and accommodation reserves increased, and the power of optical correction decreased. The positive influence of Doppelherz® Kinder Eye vitamins with lutein and Doppelherz® Kinder Glycine on the increase in the functional activity of the fovea-afferent system and the accommodative function of the visual analyzer in spasm of accommodation and mild myopia has been proven.

Purpose: To evaluate children in the Za'atari refugee camp in Jordan to better understand the prevalence of ocular pathology and to compare two photoscreening devices to evaluate their utility. Methods: Families at the Syrian American Medical Society Clinic were offered vision screening for children aged 1 to 18 years. Participants were offered visual acuity measurement and photoscreening with two devices approved for use in the United States. If visual acuity in either eye was worse than 20/40 or either photoscreening device indicated possible pathology, a complete eye examination was performed with cycloplegic refraction and dilated examination. Results: Ninety-one participants completed the screening protocol. The average age of participants who completed the study was 7.8 years (range: 1 to 16 years). Twenty-eight participants (30.8%) failed at least one screening component. In this population, the following pathology was identified: astigmatism (12.1%), esotropia (9.9%), amblyopia (9.9%), hyperopia (7.7%), exotropia (3.3%), and myopia (1.1%). The Plusoptix vision screener (Plusoptix) had a sensitivity of 100% for the identification of amblyopia and 85% specificity. The GoCheck Kids application (Gobiquity) had a sensitivity of 66.67% for the identification of amblyopia and 94% specificity. The positive predictive value for the Plusoptix vision screener and the GoCheck Kids application for the detection of amblyopia risk factors was 77% for both. Conclusions: The high rate of ophthalmic pathology identified in this study reinforces the urgent need for proper vision screening and intervention in this population. [ J Pediatr Ophthalmol Strabismus . 2021;58(6):396–400.]

The incidence of bariatric surgery is increasing due to obesity being one of our top public health challenges. As such, bariatric-related ophthalmic changes are a potentially new clinical area of knowledge, with increasing published evidence on post-bariatric complications experienced by patients and identified by clinicians. We reviewed the available literature and summarised the different complications and potential recommendations. A search strategy was conducted with PubMed, Cochrane, Medline, Embase, Allied and Complementary Medicine and DH-DATA databases to look for papers answering our research question: "What are the ophthalmological complications for patients after bariatric surgery?". Our search gave a total of 59 relevant papers. Bariatric surgery, particularly subtypes that cause direct bypass of nutrients from the stomach, lead to nutritional deficiencies. Vitamin A, crucial for proper functioning of body systems and specialised cells, manifests ophthalmologically as corneal ulceration, nyctalopia, conjunctival xerosis and more. Thiamine levels are also depleted, leading to Wernicke's Encephalopathy. Pre-existing diabetic retinopathy is also noted to worsen sub acutely, although evidence is conflicting. Patients undergoing surgery to treat idiopathic intracranial hypertension would have reduced IOP and resolving papilloedema. Other comorbidities of obesity like HB摘要: 肥胖是我们最大的公共卫生挑战之一, 减肥手术的实施率正在增加。随着关于减肥后并发症报道越来越多, 且这些都是由患者亲身经历或者经临床医生确认的, 因此与肥胖相关的眼部变化是一个潜在的新的临床知识领域。我们回顾了现有的文献, 总结了不同的并发症和潜在的建议。我们通过PubMed、Cochrane、Medline、Embase、联合和补充医学以及DH-DATA数据库进行了搜索, 以寻找能够回答我们关于““减肥手术后患者的眼科并发症是什么? ”问题的论文。我们共搜索到59篇相关论文。减肥手术, 特别是导致直接从胃中摄取营养的亚型手术, 会导致营养不足。维生素A对维持身体系统和特殊细胞的正常功能至关重要, 当维生素A缺乏时在眼部的表现为角膜溃疡、夜视、结膜干燥等。硫胺素水平也会下降, 并导致韦尼克脑病。术前存在的糖尿病视网膜病变也会亚急性恶化, 尽管目前的论文证据还存在相互矛盾。特发性颅内高压的患者在接受手术治疗后眼压会降低并缓解视乳头水肿。其它与肥胖的共患疾病如高糖化血红蛋白水平、阻塞性睡眠呼吸暂停综合症和代谢综合征也会在术后得到解决。病史记录仍然是医学实践的基石。根据证据, 我们建议考虑术前进行眼科病理筛查和术后的疾病进展监测。我们需要不断分析真实世界数据, 创建明确的管理途径, 帮助临床医生尽早识别眼部并发症, 改善患者预后。.

The prevalence of pterygium shows a substantial increase for increasing age and UV irradiation. There is paucity of available literature regarding the total area of pterygium, percentage of extension of pterygium on to the cornea and its effects on corneal astigmatism. Hence this study was undertaken to evaluate the pre and post-surgical effect of the size of the pterygium on corneal astigmatism. 100 out patients aged between 22 to 50 years diagnosed with pterygium were included in the study. Slit lamp bio microscope was used to measure the length and width of pterygium in millimetres. Slit beam was used to measure the diameter of cornea. Corneal astigmatism was measured pre and postoperatively on day 1 and 1 month follow up using keratometery. In this study 2.13±1.39 was the mean preoperative astigmatism, 1.36±1.03 was the mean post-operative astigmatism on day 1 and on 1 month follow up 0.86±0.91 was the mean post-operative astigmatism which was statistically significant(p As per our findings we draw a conclusion that surgical removal of pterygium significantly reduces pterygium induced astigmatism and also there is an improvement in visual acuity.

Purpose: To compare the efficacy of external dacryocystorhinostomy (DCR) and botulinum toxin-A in the management of functional epiphora. Materials and Methods: A prospective, comparative, interventional study included 45 patients with functional epiphora out of which 20 patients had undergone external dacryocystorhinostomy and 25 patients received 5 units of injection botulinum toxin in the palpebral lobe of lacrimal gland as per the patient’s preference. All patients underwent syringing and fluorescein dye disappearance testing before the procedure. Epiphora was graded subjectively with Munk scores obtained before and after intervention. Duration of side effects and severity were also noted. Results:This study showed functional epiphora common in elderly age group. Female constitued of 71.11% and male 28.89 % with female: male ratio of 2.4:1. Left eye (42.22%) predominantly involved. The overall success rate at 6 months after surgery for external DCR was 95% and that of injection botulinum was 91.17%. The overall success rate in both the group was not statistically significant(p>0.05%). Improvement in epiphora graded by Munk score was statistically significant after intervention in both the groups(p Conclusion: This study showed injection Botulinum toxin can be considered as an alternative management in case of functional epiphora for patient who do not want to undergo surgical intervention and for those with co-morbid conditions with high risk for surgical intervention like DCR. Keywords: Botulinum toxin A, External dacryocystorhinostomy, Fluorescein dye disappearance test, Functional epiphora

The article discusses the structure of ophthalmic pathology. These results are based on the analysis of statistical data of a large number of patients of the S. Fyodorov Eye Microsurgery Federal State Institution in 2019 (year before COVID-19 pandemic). In 2019 – 565988 patients were registered in medical database of our institution for the first time. The distribution of ophthalmic pathology among these patients was as follows. Cataract – 25.0%, including complicated cataract 15.9 %. Glaucoma – 3.1%; Vitreoretinal pathology – 8.2%; Diabetes – 2.9%; Oculoplastic pathology – 2.7%; Oncology – 1.1%; Eye diseases in children – 12.9%; Refractive errors – 17.2%; Diseases of the eye fundus – 12.6 %; Corneal pathology – 2.2%; Inflammatory diseases – 10.3%; Other diseases – 1.8 %. The article carefully describes the innovative technologies and the main trends that determine the overall development of such areas of ophthalmic surgery as: cataract surgery, glaucoma, corneal surgery, vitreoretinal surgery, laser refractive surgery, laser surgery of the retina and vitreous body, surgical manipulations in children, oculoplasty, ophthalmooncology. Key words: structure of ophthalmic pathology, innovative technologies of ophthalmic surgery, main trends of ophthalmic surgery.

Aim: Rhino orbital cerebral mucormycosis is an opportunistic fungal infection with high morbidity and mortality which has seen the rise during the second wave of covid 19 in our country. Aim of our study was to study the clinical course, diagnosis and management of patient of rhino orbital mucormycosis in post covid phase presenting at our tertiary care centre. Materila and Methods: 4 cases of rhino-orbital mucormycosis who presented to us in post covid phase was followed and details recorded and analyzed to study its clinical course, diagnosis and management. Observation: 4 patients presented to us in post covid phase with signs of orbital cellulitis like periorbital swelling with pain, drooping of eyelids, proptosis, restriction of extraocular movements, decrease and loss of vision and sluggish reacting pupil. MRI/CT of the patients showed intraconal and extraconal involvement suggestive of orbital cellulitis. Diagnostic Nasal Endoscopy (DNE) was done and tissue sent for KOH mounting, culture and histopathology. After KOH mount showed fungal hyphae, patients were started on IV liposomal amphotericin B and retrobulbar amphotericin B. Patients were then taken up for endoscopic debridement and significant improvement in proptosis, ptosis, peribulbar swelling and pain was seen in immediate post op period. Conclusion: significant improvement was seen in patients with IV amphotericin B, retrobulbar amphotericin B and endoscopic debridement. Key Message: Patients with rhino orbital mucormycosis can be managed with amphotericin and endoscopic debridement when exenteration is not possible. Keywords: Clinical course, Covid ­19, Fungal infection, Mucormycosis

Loa loa is a nematode that is highly endemic in the tropical rainforests of Western and Central Africa. It is also known as “African eye worm”. Occasionally the adult parasite is seen in the subcutaneous tissue space of humans and occasionally into the subconjunctival space. Our case is a 29-year-old male presented to the outpatient department with history of swelling, redness and foreign body sensation in the inferior bulbar conjunctiva of his right eye. Slit lamp examination shows, a nodular swelling in the inferior conjunctival space and diagnosed as subconjunctival granulomatous lesion. In the operation theater, the lesion was explored and a live worm was removed from the subconjunctival space. The worm was measured about 3.5 cm in length. The worm was confirmed to be a Loa loa adult specimen. The patient was treated with 400 mg oral albendazole for 3 weeks and 60 mg prednisone. Ophthalmologists should be aware of the typical manifestations and possible unusual presentations. An increasing number of subconjunctival Loa loa cases are reported from non-endemic areas are due to increased travel and migration. This report illustrates an unusual ocular disease, which is usually not found outside of Africa, but easily diagnosed and treated. Keywords: Loa loa, Subconjunctival, Amniotic membrane graft, Eosinophilia, Calabar swellings, Albendazole

The promotion of eye donation has always been a challenging task for any individual or institute, and hence there is more demand and less supply of corneal tissue. Legally corneal donations are usually cadaveric allograft. But living eye donation though rare is sometimes done. We report two rare cases in which the cornea of the first case was retrieved from living donor, who had traumatic expulsion of right eye in road traffic accident. So the cornea of this living donor after enucleation of globe was utilized to restore the vision of another corneal blind person. The second case was a patient with failed keratoplasty left eye who was managed by taking graft from his other eye having glaucomatous optic atrophy. Keywords: Eye donation, Keratoplasty, Corneal donation, Corneal graft

Background: Vernal keratoconjunctivitis (VKC) is a chronic form of ocular allergy that can potentially cause severe visual complications, affecting mainly children and young adults. The objective of this study is to evaluate the age group involved, sex predilection, occupation, seasonal variations, type of disease and prevalence of corneal involvement in cases presented to tertiary eye care centres of Eastern India. Materials and Methods: A total of 180 patients with signs and symptoms of VKC, who presented between April 2019 to March 2021 were studied. Patients who were not having any systemic or ocular illness and not received systemic or ocular medications during the four weeks, were included in the study. Results: Most of the patients were found to be between 6 to 15 years (67.22%) age group and 70% are male. 71.66% of the patients were school going children. Majority of the patients were presented in the month of April to September (71.11%) i.e. during warm weather. Bulbar variety (42.22%) are most common type of VKC and 68.51% cases had corneal involvement at presentation. Conclusion: Vernal Keratoconjunctivitis is the disease of childhood, mostly during school going age and more commonly affects males. It is usually bilateral and more prevalent during hot and humid climate. Keywords: Vernal keratoconjunctivitis, Allergic ocular disease, Papillae, Horner-Trantas spots

Purpose: Ocular trauma is an important cause of visual impairment worldwide. The reported annual incidence of severe ocular trauma is 9.75 per 1,000 adults. Ultrasonography (B scan) has emerged as a useful technique in ocular injury scenario. We aimed to evaluate role of B Scan ultrasonography in management of ocular injuries. Materials and Methods: All patients with ocular trauma attending the emergency department were enrolled for the study. Relevant history and demographic data was noted on the study proforma. Detailed ocular examination was done employing slit lamp biomicroscopy for anterior segment and direct and indirect ophthalmoscopy for posterior segment evaluation. All patients were necessarily subjected to B scan ultrasonography (USG) for additional clinical information. Results: A total of 50 cases were enrolled. The mean age of affection was 28 years. The most common mode of injury was agriculture related. The most common anterior segment finding was traumatic cataract as seen in 22(44%) cases while on USG posterior vitreous detachments seen in 36% cases, followed by retinal detachment in 24% cases and vitreous haemorrhage in 22% cases. Choroidal detachment was accurately localized in 2% cases. Conclusion: The study emphasizes the need for B-scan as a valuable tool in the diagnosis of posterior segment pathologies particularly when the media has become opaque as it can visualize and localize the position of the lesions which would not be possible by any other means. Keywords : Ocular trauma, B­scan, Traumatic cataract, Posterior vitreous detachment, Retinal detachment

To assess the efficacy of topical interferon alfa-2b as an adjunct therapy in the management of primary ocular surface squamous neoplasia (OSSN).: Clinically visible OSSN on slit lamp examination in 21 patients (21 tumors) was managed with topical interferon alfa-2b, 1 million IU/mL, 4times daily for a period of one month, before subjecting the patients to definitive surgery. The patients were periodically observed, over a period of 6 months. Tumor control and complications were evaluated according to American Joint Committee on Cancer classification. A significant reduction in size, was noted in smaller tumors. Final diagnosis and staging was done after histopathological examination of the surgically excised tumour, which had been excised with a 4mm margin. Bigger extensive lesion did not show appreciable response in terms of appearance or reduction of size. Tumor size was found to be reduced significantly in 19 out of 21 tumors (%) following topical interferon alfa-2b treatment for a period of 1 month, from the presentation. Of the 19 tumors, tumor surface area was reduced 44% (median). Two patients (8.3%) did not respond to the treatment.Based on American Joint Committee on Cancer classification, significant reduction was achieved in 2 of 3 Tis (67%), 17 of 20 T3 (85%), 19 of 23 N0 (83%), and 19 of 23 M0 (83%) category tumors. According to American Joint Committee on Cancer classification, significant reduction with topical interferon alfa-2b can be achieved in 67% of Tis, 85% of T3, and 83% of all OSSN.

To compare different techniques combined with excision in treatment of primary pterygium: Amniotic membrane transplant [AMG], Limbal-conjunctival autograft [CLAG], and mitomycin c with limbal-conjunctival autograft.[MMC+CLAG]: A prospective comparative study was performed in tertiary hospital on 105 patients satisfying the inclusion and exclusion criteria. Combined with excision, 35 eyes each were treated with AMG transplantation [Group 1] and CLAG [Group 2] for closure of defect. In 35 eyes low-dose mitomycin -C [0.02%] was applied on bare sclera for 1 minute and a CLAG was applied thereafter [Group 3]. Patients were followed up for 9 months.Study was conducted from June 2018 to April 2020 on patients of age 26 to 72 years with mean age of 46.3 ± 10 years with 42[40%] male and 63[60%] female. A statistically significant change [ paired t test, p Pterygium excision followed by CLAG and MMC+CLAG are an effective way of reducing recurrence. However close monitoring is required for use of adjuvant MMC.AMG can be reserved in patients with bilateral pterygium, severe limbal stem cell loss and in need of glaucoma surgery.

This study is aimed to assess the effect of retinal photocoagulation on contrast sensitivity and visual acuity.In this prospective observational study,patients with diabetic retinopathy in either one or both eyes requiring retinal photocoagulation were included in the study. Eyes which were subjected to treatment for diabetic retinopathy were divided into 3 groups. Group 1 included eye which were subjected to pan retinal photocoagulation (PRP) alone, Group 2 included eyes which were subjected to PRP and macular laser (ML) and Group 3 included eyes which were subjected to ML alone. Assessment of visual acuity and contrast sensitivity were done before and three months post retinal photocoagulation.Descriptive statistics were used and where required. paired t test, One- way, ANOVA, Post HOC tests, Tukey HSD tests were used. The sample size was calculated to be 64 eyes. Total of 64 eyes of 37 patients, underwent retinal photocoagulation for diabetic retinopathy. Out of the 37 patients, only 16 patients (29 eyes) came for follow up at the end of 3 months of laser photocoagulation. Number of eyes requiring PRP was more when compared to PRP with ML and ML alone. Pre-laser and post-laser visual acuity following PRP, remained unchanged. Improvement in visual acuity was seen in eyes that underwent ML alone. There was worsening of visual acuity in eyes that underwent combination of PRP and ML. However, p value was not significant. Pre-laser and post-laser contrast sensitivity, improved in eyes that underwent only PRP and macular laser alone. There was a reduction in CS when both forms of treatment were combined, though p value was not significant Eyes which underwent PRP alone, showed improvement in contrast sensitivity without any change in visual acuity. While reduction in visual acuity and contrast sensitivity was observed in eyes which underwent combination treatment (PRP and ML), there was improvement in visual acuity and contrast sensitivity in eyes which underwent macular laser alone. Contrast sensitivity is necessary component of visual function. Abnormal contrast sensitivity can affect day to day activities. Hence it is important to counsel patients about the possibility of contrast sensitivity being affected to some extent following laser treatment for diabetic retinopathy.

To study the etiology of ptosis among 20 - 50 years of age and analyse the management and surgical outcomes of various types of ptosis using different surgical modalities. This prospective study was conducted at Tertiary Eye Care centre in Chennai from July 2018 - June 2019.It included all patients with ptosis between the age of 20 - 50 years after excluding vascular malformations and malignant tumours of the lid. Here all variables are described with frequency distribution and displayed using percentage. Incidence of congenital ptosis was 11 cases (37%), aponeurotic ptosis 8 cases (26%), myogenic ptosis 4 cases (13%), neurogenic ptosis 3 cases (10%), mechanical ptosis. 2 cases (7%), post traumatic ptosis 2 cases (7%). 70% were males and the remaining 30% were females. Among 30 cases, 23 patients had unilateral and 7 patients had bilateral ptosis. Moderate ptosis (3-4mm) (46.7%) formed a major composition of our study shortly followed by severe ptosis (43.3%). Out of 30 cases, 9 cases were managed medically (30%) and surgical intervention was required in 21 cases (70%). Out of 7 bilateral ptosis, 2 cases were managed medically and 5 cases needed surgical intervention. Complications following frontalis sling were under correction (27.3%) in 3 cases followed by mild corneal exposure keratitis (9.1%) in one patient. Complications following levator advancement were under correction in one case (12.5%) and mild lid peaking in one case (12.5%). Among 2 cases of mechanical ptosis, one was squamous papilloma and other was a large chalazion. Out of 4 myogenic cases 3 cases were due to myasthenia and the other diagnosed to have CPEO. 2 cases of traumatic ptosis were due to traumatic 3rd nerve palsy and traumatic levator dehiscence. The most common acquired ptosis was aponeurotic followed by myogenic, neurogenic, traumatic and mechanical ptosis. Frontalis sling surgery is the most common surgery done for congenital ptosis. Use of polypropylene as a suspensory material gives a good functional outcome. Aponeurotic advancement surgery is the most common surgery performed for acquired ptosis.

Background. Currently, measures to prevent ophthalmic pathology in the coal mining industry are fragmentary, do not have systematic and organizational unity, which reduces the effectiveness of the preventive health care and increases the risks of professional-related, occupational morbidity, disability due to a low vision and blindness of the working population. The purpose of the work is to substantiate scientifically the system for the prevention of ophthalmic pathology in underground coal mining workers. Materials and methods. Using the results of previous researches and the fundamental principles of the modern theory of medical prevention, the organizational structure, content and the levels of prevention of ophthalmic pathology in underground coal mining workers were developed. Results. A qualitatively new differentiated organizational system for the prevention of ophthalmic pathology in underground coal mining workers has been created. The proposed system allows us: at the primary level of prevention — to improve sanitary and hygienic supervision of the working conditions of the staff, to optimize the lighting of the working area, to use more rationally personal protective equipment for the eyes, to introduce a system of preventive irrigation of the eye, to provide adequate conditions for the provision of first (pre-hospital) medical care at the mine; at the secondary level — to unify the program, to optimize volumes, to improve the organizational algorithm for conducting medical examinations of people working in underground conditions, to improve routing of patients in order to provide ophthalmological care and access to work in underground conditions; at the tertiary level — to justify the medical criteria for the detection of a professional origin of ophthalmic diseases among people working in underground conditions, to improve the organization of providing integrated medical and social rehabilitation care to patients. Conclusions. The widespread introduction of the proposed organizational system for the prevention of ophthalmic pathology in underground coal mining workers will improve the provision of medical and rehabilitation assistance to workers, reduce the risk of acute and chronic professional-related diseases and occupational ophthalmic pathology in them., Актуальность. В настоящее время мероприятия по профилактике офтальмологической патологии в угледобывающей отрасли являются фрагментарными, не имеют системности и организационного единства, что снижает эффективность профилактического звена здравоохранения и увеличивает риски возникновения производственно-­обусловленной, профессиональной заболеваемости, инвалидизации вследствие слабовидения и слепоты работающего населения. Цель работы: научно обосновать систему профилактики офтальмологической патологии у подземных работников угледобывающей отрасли. Материалы и методы. С использованием результатов проведенных ранее научных исследований и основополагающих принципов современной теории медицинской профилактики разрабатывались организационная структура, содержание и объемы профилактики офтальмологической патологии у подземных работников угледобывающей отрасли на разных уровнях. Результаты. Создана качественно новая дифференцированная организационная система профилактики офтальмологической патологии у подземных работников угледобывающей отрасли. Предложенная система позволяет: на первичном уровне профилактики — улучшить санитарно-гигиенический надзор за условиями труда работников, оптимизировать освещение рабочей зоны, более рационально использовать средства индивидуальной защиты органов зрения, внедрить систему профилактической ирригации глаза, обеспечить надлежащие условия оказания первой (доврачебной) медицинской помощи в условиях шахты; на вторичном уровне — унифицировать программу, оптимизировать объемы, усовершенствовать организационный алгоритм проведения медицинских осмотров работающих в подземных условиях, улучшить маршруты пациентов для обеспечения офтальмологической помощью и допуска к работе в подземных условиях; на третичном уровне — обосновать медицинские критерии для установления профессионального генеза офтальмологической патологии среди работающих в подземных условиях, улучшить организацию предоставления комплексной медико-социальной реабилитационной помощи больным. Выводы. Широкое внедрение предложенной организационной системы профилактики офтальмологической патологии у подземных работников угледобывающей отрасли позволит улучшить оказание медицинской и реабилитационной помощи работающим, снизит риск возникновения у них острой и хронической производственно-обусловленной и профессиональной офтальмологической патологии., Актуальність. У даний час заходи з профілактики офтальмологічної патології у вугледобувній галузі є фрагментарними, не мають системності й організаційної єдності, що знижує ефективність профілактичної ланки охорони здоров’я і збільшує ризики виникнення виробничо зумовленої, професійної захворюваності, інвалідизації внаслідок слабозорості й сліпоти працюючого населення. Мета роботи: наукове обґрунтування системи профілактики офтальмологічної патології в підземних працівників вугледобувної галузі. Матеріали та методи. З використанням результатів раніше проведених наукових досліджень і основоположних принципів сучасної теорії медичної профілактики розроблялися організаційна структура, зміст та обсяги профілактики офтальмологічної патології в підземних працівників вугледобувної галузі на різних рівнях. Результати. Створено якісно нову диференційовану організаційну систему профілактики офтальмологічної патології в підземних працівників вугледобувної галузі. Запропонована система дозволяє: на первинному рівні профілактики — покращити санітарно-гігієнічний нагляд за умовами праці працівників, оптимізувати освітлення робочої зони, більш раціонально використовувати засоби індивідуального захисту органа зору, упровадити систему профілактичної іригації ока, забезпечити належні умови надання першої (долікарської) медичної допомоги в умовах шахти; на вторинному рівні — уніфікувати програму, оптимізувати обсяги, удосконалити організаційний алгоритм проведення медичних оглядів працюючих у підземних умовах, покращити маршрути пацієнтів для встановлення офтальмологічної допомоги й допуску до роботи в підземних умовах; на третинному рівні — обґрунтувати медичні критерії щодо встановлення професійного генезу офтальмологічної патології серед працюючих у підземних умовах, покращити організацію надання комплексної медико-соціальної реабілітаційної допомоги хворим. Висновки. Широке впровадження запропонованої організаційної системи профілактики офтальмологічної патології в підземних працівників вугледобувної галузі дозволить покращити надання медичної та реабілітаційної допомоги працюючим, знизить ризик виникнення в них гострої і хронічної виробничо зумовленої і професійної офтальмологічної патології.

Amaç: Acil serviste oftalmoloji konsültasyonlarının aciliyetini ve oftalmik patolojinin varlığını değerlendirmek. Bu çalışma aynı zamanda hafta sonu fenomeninin, acil oftalmolojik konsültasyon taleplerini etkileyip etkilemediğini belirlemeyi amaçladı.Materyal ve Metot: Türkiye'de bir üçüncü basamak hastanenin akademik acil servisini Ocak-Aralık 2019 tarihleri arasında ziyaret eden hastalar için acil hekimi tarafından talep edilen oftalmoloji konsültasyonları geriye dönük olarak incelendi. Konsültasyon talepleri olası acil, acil olması muhtemel olmayan ve belirsiz olarak gruplandırıldı.Bulgular: Çalışmaya uygun toplam 256 hasta dahil edildi. Acil oftalmolojik konsültasyonların ilk üç nedeni künt travma (% 29,7), yabancı cisim (% 24,2) ve konjonktivit (% 13,3) idi. Hastaların % 70,3'ü olası acil, % 18,4'ü acil olması muhtemel olmayan ve % 11,3'ü belirsiz olarak kategorize edildi. Hafta sonları ve mesai saatleri dışında acil olması muhtemel olmayan olan tanılarla konsültasyon isteme sıklığı, hafta içi ve mesai saatlerine göre daha düşüktü (sırasıyla p=0.032, p=0.029). Olası acil konsültasyonların çoğunda oftalmik patoloji vardı (p =0.001).Sonuç: Travmatik yaralanmalar acil serviste oftalmoloji konsültasyonunun en sık nedenidir. Hastaların yaklaşık beşte biri acil olması muhtemel olmayanlardır. Olası acil kategorideki hastalarda erken oftalmoloji değerlendirmesi gereklidir. Hafta sonu etkisi, oftalmoloji konsültasyonlarını etkilememektedir. Göz acil servislerinin kurulması veya bir göz doktorunun bulunması özel uygulama becerisi gerektiren bu hastaların acil tanı ve tedavisinde büyük öneme sahiptir., Aim: To evaluate the urgency of ophthalmology consultations in the emergency department (ED) and the presence of ophthalmic pathology. This study also aimed to determine whether the weekend phenomenon affected emergency ophthalmologic consultation requests.Materials and Methods: Ophthalmology consultations requested by the emergency physician for patients who visited the academic ED of a tertiary care hospital in Turkey from January to December 2019 were retrospectively investigated. Consultation requests were grouped as possible emergent, unlikely to be emergent, and undetermined. Results: A total of 256 eligible patients were included in the study. The top three reasons for emergency ophthalmologic consultations were blunt trauma (29.7%), foreign body (24.2%), and conjunctivitis (13.3%). 70.3% of the patients were categorized as a possible emergent, 18.4% as unlikely to be emergent, and 11.3% undetermined. The frequency of consultation requests with diagnoses that are unlikely to be emergent at weekends and out of working hours was lower than during weekdays and working hours (p = 0.032, p = 0.029, respectively). Most of the possible emergent consultations had ophthalmic pathology (p = 0.001). Conclusion: Traumatic injuries are the most common cause of ophthalmology consultation in the ED. Approximately one-fifth of patients are unlikely to be emergent. Early ophthalmology evaluation is required in possible emergent category patients. The weekend effect does not influence ophthalmology consultations. Establishing eye emergency services or having an available ophthalmologist is crucial in the emergency diagnosis and treatment of patients who require special practice skills.

Introduction: Stevens-Johnson-Syndrome (SJS), and its severe variant, toxic epidermal necrolysis (TEN), are life-threatening diseases of skin and mucous membranes. Cases with pseudo-membrane formation and epithelial defects, have higher risk of ocular sequelae. Severe dry eye in SJS includes three mechanisms: (1) aqueous tear deficiency, (2) decreased wettability of corneal surface, and (3) increased evaporation. Observation: A 47-year-old male patient presented in OPD with chief complaint of severe discomfort and grittiness in both eyes since last 21 years. Proper history taking and examination was done. Patient was given conservative treatment and was explained about recent advancements of treatment that can help in improving his condition. Conclusion : In SJS patients, dryness causes eye pain, and unstable tear film causes diminution of vision. After acute stage reactions, visual impairment and severe dry eye are observed as ocular sequelae. Keywords : Case Report, Dry eye, Steven Johnson Syndrome, Toxic Epidermal Necrolysis

Purpose: To study the association of cystoid macular edema (CME) and Travoprost eye drops in a patient with diabetic retinopathy (DR). Materials and Methods: The study was carried out on a 65yr old patient on a regular follow up from 2009-2018. Results: A 65yr old patient of a DR of both eyes who had received 3 sittings of pan retinal photocoagulation (PRP) laser in both eyes and grid laser to his right eye. He was on regular follow up since 2009 with a stable proliferative diabetic retinopathy (PDR). Patient was also on topical antiglaucoma medication and had prophylactic YAG-PI done both eyes. He was on regular follow up since 2009 with a stable proliferative diabetic retinopathy (PDR). Right eye showed macular edema (ME) in 2014 and underwent OCT and FFA. Patient refused for intravitreal injection and preferred laser treatment, so patient underwent micropulse laser treatment in 2014. His edema persisted even after micropulse treatment. His systemic control was good and patient continued to use Travoprost eye drops. So in 2017 suspected CME secondary to topical prostaglandin (PG) analogue as he had strict glycemic control and was no fluctuation in ME. Hence topical PG analogue was withdrawn and stopped. On subsequent follow up after 2 months CME had completely disappeared and the foveal contour returned to normal on OCT. LE was status quo. Patient was followed up for more than 1 year and continuously followed up, 15 days back in June 2018 had no evidence of CME and vision was 6/9 in both eyes. Conclusions: Differentiation of DME and CME secondary to PG analogue should be made at the earliest. Keywords: CME, Diabetic Retinopathy, Travoprost

Aim: Road traffic accidents (RTAs) are the most common cause of polytrauma. This study aims to evaluate the various ocular manifestations in cases of RTAs. Materials and Methods: A retrospective review of patients who were treated for RTAs in a tertiary hospital in 6 months from December 2018 to May 2019. A total of 126 patients were reviewed. Age ranged from 2 to 85 years. The mean age was 32 years. Results: Ophthalmological examination was undertaken in all patients involved in RTA. Out of 126 patients, 112 were males and 14 were females. Young adult males (21-30 years) were most vulnerable to RTAs. Soft tissue injuries were the most common manifestations (57.93%) followed by neuro-ophthalmic manifestations (26.98%) and orbital fractures (15.07%). The presence of CT abnormalities especially intra cranial haemorrhage was associated with neuro-ophthalmic deficits. Conclusions: Soft tissue injuries were the most common ocular manifestations. It was found that head trauma causes many neuro-ophthalmic manifestations. Relative afferent pupillary defect (RAPD) was the most common neuro-ophthalmic manifestation. The most common cranial nerve involved was found to be oculomotor nerve. Retrobulbar neuritis was a rare finding. Keywords: Road traffic accidents, Head injury, Soft tissue injuries, Orbital fractures, Neuro Ophthalmic, manifestations.

Introduction: Glaucoma is the leading cause of irreversible blindness, one of the risk factor recognised being high myopia. Intra ocular pressure may be normal in myopic patients, with optic nerve head glaucoma characteristics. Eye ball elongation and optic nerve head tilting may be present in patients with high myopia that will represent field defects mimicking glaucoma. Treating patients with myopia having suspected aspects of glaucoma may be a challenge but even more challenging is the diagnosis of glaucoma in myopic patients. Aims: To evaluate the association of glaucoma features with myopia. To create the awareness regarding the long term follow up. Materials and Methods : Patients in the age group of 15 to 45 years who had attended our institution over a period of one year who fulfilled the inclusion and exclusion criteria were subjected for this study. Fifty four patients who were diagnosed to have moderate or high degree myopia were selected for this analytical study. They were subjected to vision, ocular examination, tonometry and results obtained were analysed. Results : In our study moderate myopes constituted 55.5% and high myopes were 44.5%. The mean Intra ocular pressure and the mean corrected Intra ocular pressure in high myopes were observed to be higher than in moderate myopia. It was observed that higher prevalence of glaucoma was observed in high myopes. Conclusion : There is a clinically as well as statistically significant difference between mean Intra ocular pressure and mean corrected Intra ocular pressure. So mean corrected Intra ocular pressure should be measured .From our study, there is a clear indication that there is increased prevalence of glaucoma in high myopes. Keywords: High myopia, Moderate myopia, Intraocular pressure, Glaucomatous optic disc changes, Visual field charts

Corneal foreign bodies are commonly seen in an ophthalmology emergency. The most common cause of this condition is a workplace-related injury. In these situations, the management differs from patient to patient and depends on a wide range of variables. In this article, we aim to review the literature on corneal foreign bodies in the past 50 years and classify them based on their level of impaction and elaborately discuss all the management options described for each. Keywords: Foreign bodies, cornea, surgical techniques, ocular trauma, corneal foreign body

Dry eye disease (DED) is a multifactorial disorder of the ocular surface that results in ocular discomfort, visual disturbance and damage to the ocular surface. It is one of the most common complaints in daily ophthalmic practice. The greater prevalence of dry eye in women compared to men suggests that sex hormones may have a role in this condition. Sex hormones; estrogen and androgens influence production of all components of the tear film including aqueous layer, lipid layer, and mucin layer. Various mechanisms such as decrease in hormonal levels, shift in feedback mechanisms, and changes in receptor receptivity interplay to alter the ocular surface homeostasis and subsequently result in DED. The purpose of this review is to briefly outline current scientific evidence on the influence of androgen and estrogen on the lacrimal and meibomian glands as well as on the ocular surface epithelia including conjunctival goblet cells during reproductive and menopausal periods. This article also outlines the updates regarding role of gonadal hormones in the treatment of dry eye. Keywords: Dry Eye, Sex hormones, Estrogen, Androgen, Testosterone, Progesterone, Tear film, Meibomian gland, Lacrimal gland, Ocular surface, Menopause, HRT, Schirmer’s test.

The purpose of this study is to evaluate prevalence risk factors, symptoms, signs, objective tests of dry eye diagnosis in patients attending to Out Patient Department of Mamata General Hospital, Khammam.All patients presenting with dry eye symptoms to ophthalmology outpatient department, Mamata Medical College over a period of one and half year. A prospective study was conducted for a period of 18 months from June 2018 to Jan 2021 among patients attending ophthalmology Out Patient Department unit with symptoms of dry eye. Among the 100 patients studied, prevalence of dry eye was found to be as high as 23%.The prevalence of dry eye increased with increase in age and was significantly higher among people more than 40 years of age. Prevalence was higher among females when compared to males. Conjunctival congestion was found to be reliable sign of dry eye with a strong positive association. Foreign body sensation was found to be the most common symptom associated with dry eye. People with refractive errors, with or without history of spectacle use, had a higher incidence of dry eye compared to emmetropes. OSDI was found to be reliable measure of dry eye symptoms. Higher, scores of OSDI, indicating severe dry eye, correlated well with diagnostic tests for dry eye. TBUT test showed a high sensitivity and specificity, followed by Schirmers test and impression cytology. Impression cytology was a reliable measure for detecting ocular surface changes. Many patients showed grade 2 or 3 changes. These changes were more among those with schirmer less than 5mm. Dry eye evaluation with an appropriate and standard questionnaire along with standard tests for dry eye helps in diagnosis and treatment. This will go a long way in the effective and successful management of patients with dry eye, specially so as the disease is chronic and needs long term treatment. Early and appropriate management will provideocular comfort and satisfaction with a better quality of life.

To analyze the visual outcome in patients with pseudoexfoliation and to know the surgical parameters to cogitate in patients with pseudoexfoliation syndrome. An Observational study which was conducted in the Ophthalmology department in a tertiary care hospital in a rural area from June 2019 to December 2019. A total of 52 eyes of 52 patients aged 40 years and above, of either sex, clinically diagnosed with senile cataract and associated with pseudoexfoliation were enrolled in the study. After assessing best corrected visual acuity (BCVA), a detailed anterior and posterior segment examination was performed along with lacrimal sac syringing, manual keratometry, contact A-scan biometry and intraocular lens (IOL) power was calculated. All patients underwent manual small incision cataract surgery under peribulbar anaesthesia and intraocular lens was implanted. Intraoperative complications were noted during the surgery and was reported .Best corrected visual acuity was recorded on day 1, at 1week and at 1 month of follow up. Out of 52eyes of 52 patients, 29 were females (55.76%) and 38 eyes (73.07%) exhibited bilateral involvement. Distribution of the PXF material in various ocular structures was observed and majority of them (36.53%) had PXF material equally in iris, pupillary margin and lens. Based on the morphology of cataract associated with psudoexfoliation, nuclear cataract was the most commonly observed in 16 eyes (30.76%) and 42 eyes (80.76%) had moderate pupillary dilatation. The intraoperative difficulties observed during cataract surgery was poor pupillary dilatation which was managed by controlled sphincterotomy during the surgery in 3 eyes (5.76%), Iridiodialysis, rhexis extension, zonular dialysis each in 1 eye and posterior capsular rent in 2 eyes. Around 92.30% of the total study population achieved post-operative BCVA of 6/12 or better at 1month of follow up. Decreased visual acuity was noted in 2 (3.84%) eyes due to persistent corneal edema, one eye (1.92%) had posterior capsular opacification and one eye (1.92%) had cystoid macular edema. This study concludes that with careful preoperative assessment and necessary intraoperative precautions, good visual outcome can be achieved in patients with cataract with pseudoexfoliation.