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BACKGROUND: Infectious conjunctivitis is common in Nepal. MATERIALS AND METHODS: This prospective study recruited 60 patients with presumed acute infectious conjunctivitis from the B.P. Koirala Lions Center for Ophthalmic Studies in Kathmandu, Nepal. Swabs from the conjunctiva and anterior nares were processed for metagenomic RNA deep sequencing (RNA-seq). RESULTS: Pathogens were identified in 55% of cases. RNA viruses were the most common pathogen class identified. Severe acute respiratory syndrome coronavirus 2 was the most common RNA virus identified. CONCLUSIONS: Acute infectious conjunctivitis varies by location. Contrary to expectations, RNA viruses predominated. Repeat surveillance may be useful and RNA-seq allows for detection of the unexpected pathogen including RNA viruses.

BackgroundSeasonal outbreaks of infectious conjunctivitis remain a public health issue. Determination of outbreak etiologies in the context of a worldwide pandemic may provide useful information to guide public health strategies. The aim of this study was to identify pathogens associated with outpatient infectious conjunctivitis during the COVID-19 Delta surge.MethodsThis prospective study was conducted from April 2021 to September 2021. All outpatients presenting to the Aravind Eye Center (Madurai, India) with signs and symptoms consistent with acute infectious conjunctivitis were eligible. Three swabs were obtained from each participant: one from each conjunctiva and one from the anterior nares. Samples were processed for metagenomic RNA deep sequencing (RNA-seq).ResultsSamples from 106 study participants were sequenced. The most common presenting symptoms were tearing (86%) and itching (71%). Preauricular lymphadenopathy was present in 38% of participants. 20% of participants had close contacts with similar symptoms. Systemic symptoms such as coughing, runny nose, vomiting or diarrhea were uncommonly reported. 60% of all participants used some medicated eye drops upon enrollment. 75% of study participants demonstrated infection with human adenovirus D (HAdV-D). 11% of conjunctivitis was associated with SARS-CoV-2. 15% had no definitive pathogen detected. 8% of all participants had codetection of more than one pathogen on RNA-seq.ConclusionsDuring the COVID-19 Delta surge in India, HAdV-D was the most common pathogen associated with infectious conjunctivitis. SARS-CoV-2 was the second most common associated pathogen. Seasonal surveillance may be necessary for the determination of emerging and reemerging pathogens responsible for infectious conjunctivitis.

Dengue fever is a tropical disease which is endemic in tropical/subtropical nations like Nepal. Bilateral optic neuritis with unilateral foveolitis is an unusual dengue-related ophthalmic complication. We here present to you a case of bilateral optic neuritis with right eye foveolitis who initially presented with complaints of sudden diminution of vision in one eye following dengue fever. This report deals with prolonged treatment of rare ocular presentation of dengue infection. Patient had persistent myodesopsia and scotoma in the right eye even after 5 months of treatment with oral steroids. Dengue-related ophthalmic findings although rare, can have significant and long-lasting visual impairment if not treated timely and appropriately. [ABSTRACT FROM AUTHOR]

This study highlights the role of cycloplegic refraction in the detection of accommodative spasm and the use of tropicamide 1% as cycloplegic and single vision plus lens for its management. This was a case study carried at tertiary eye hospital in Kathmandu, Nepal. In this study, 2 subjects presenting with complain of sudden onset of diminution of vision for near and distance along with asthenopic symptoms having history of prolonged near work were recruited. Pre-cycloplegic refraction showed fluctuating myopic refractive error which after cycloplegia showed a significant hyperopic shift. Single vision plus lens (base on post-mydriatic treatment) giving optimal vision for near and distance along with tropicamide 1% twice a day basis and abstinence of triggering factor was started as initial treatment modality. Subjects were kept under close surveillance and followed up fortnightly over 2 months. During this period, the dosages of tropicamide were gradually tapered based on symptomatic relief of patient and no recurrence of the condition was observed in both subjects for next 2 month. [ABSTRACT FROM AUTHOR]

This study aims to report the clinical features and role of different treatment modalities in final visual outcome in traumatic optic neuropathy (TON). The authors retrospectively reviewed the records of patients with TON over 4 years. There were 37 patients of unilateral TON. Mean age was 28.70 ± 15.20 years (range: 8–90) and 89% (n= 33) were males. Road traffic accident was the common cause (43.2%), followed by fall injury (35.1%). There was improvement of visual acuity in 51.4% (n= 19) cases. Out of different treatment modalities, high-dose intravenous methylprednisolone (1 g/day) led to significant improvement in final visual acuity (p= 0.013). There was no significant improvement in final visual outcome in patients with poor initial visual acuity and those with intracranial injuries. [ABSTRACT FROM PUBLISHER]

Introduction: Optic neuritis (ON) is the involvement of the optic nerve as a result of inflammation, demyelination or infection., Objective: To study the correlation between peripapillary retinal nerve fibre layer thickness (pRNFL) and visual evoked potential (VEP) in ON cases., Materials and Method: A non-interventional, descriptive, cross sectional study enrolling 66 eyes of 49 patients with ON was done. pRNFL thickness was measured by Optical Coherence Tomography (OCT) and VEP was also done. OCT and VEP findings were compared with the control group. In addition correlation between pRNFL thickness and VEP was done., Results: The mean pRNFL in affected eyes were significantly higher than the control superiorly (p-value<0.001), inferiorly (p-value <0.001), temporally (p-value 0.005) and nasally (p-value <0.001). The mean P100 latency in the affected eyes were significantly prolonged than the control eyes both at 1º (p-value<0.001) and at 15' (p-value=0.05). The mean N75-P100 amplitude in the affected eyes were significantly reduced than the control eyes both at 1º (p-value<0.001) and at 15' (p-value<0.001). The mean pRNFL thickness in all four quadrants and VEP findings of the affected eyes showed no significant correlation., Conclusion: The increased thickness in non-myelinated pRNFL has no correlation with the increased latency or decreased amplitude in cases of ON. However, OCT is seen as a useful tool in detecting and quantifying even subtle pRNFL changes in cases of optic neuritis., (© NEPjOPH.)