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BACKGROUND COVID-19, caused by a new strain of corona virus 2019-nCoV led to a global pandemic after first manifesting in humans in December 2019 in Wuhan, China. The government of India ordered a nationwide lockdown for 21 days, which was then extended. Hence, ophthalmology, being a branch which largely deals with elective surgeries, was majorly affected. We need to evaluate the impact of the COVID-19 crisis on ophthalmology trainees during pandemic in India. METHODS A prospective, observational study in which an online questionnaire (on Google forms) was circulated between 9 th September and 15th September 2020 among ophthalmologists in training. RESULTS 260 of the 550 training ophthalmologists who were approached responded. They were given 31 questions to answer. The average age of the respondents was 27.39 ± 1.92 years of which 72.69 % (189 / 260) were females. 68.08 % (177 / 260) of the respondents had been posted on COVID-19 related duties. 76.5 % (198 / 260) of the respondents agreed that the outpatient load had dropped to < 50 patients per day and 100 % (260 / 260) of the respondents stated that there had been a reduction in number of patients posted for elective surgery. As a result, 64.23 % (167 / 260) responded that it had led to a loss of interest in their daily activities. 74.23 % reported different levels of stress, 73.46 % reported anxiety and some 24.23 % even experienced sleep deprivation. CONCLUSIONS This study has demonstrated that majority of the training ophthalmologists were affected psychologically during the COVID-19 pandemic to varying degrees which included both groups of training ophthalmologists who did or did not perform any COVID related duties. The study therefore has highlighted the increased need for psychologists to identify and help these individuals who may suffer from severe depression, insomnia and high stress levels and provide the necessary help. KEYWORDS COVID-19, Pandemic, Psychological Impact, Ophthalmology Trainees

Introduction Cataract being one of the leading causes of avertible blindness has been found to be quite prevalent in developing countries like India. The National Programme for Control of Blindness (NPCB) aims at reducing blindness due to cataract via cataract control programs. The most commonly performed surgery is the manual small incision cataract surgery (MSICS). Aim The aim of this study was to determine the visual acuity and outcome in patients who underwent MSICS in a tertiary hospital in south India. Methodology A prospective longitudinal interventional study was conducted in a tertiary hospital in Karnataka, India, over a period of nine months. A total of 105 eyes underwent MSICS and were followed up for one month to assess their postoperative visual outcome and complications, if any. During this period, they were started on antibiotic + steroid combination eyedrops, which were tapered over four weeks. Results Results were assessed based on visual grading categorized by the World Health Organization (WHO). A total of 103 (98.1%) patients had good vision, i.e., visual acuity of 6/6 - 6/18, followed by two (1.9%) who had moderate vision i.e., visual acuity of

BACKGROUND Global developmental delay/intellectual disability are on a rise in children in the present time. Ocular and visual anomalies are frequently associated with it of which refractive errors are the most frequent. This if goes unnoticed leads to strabismus and amblyopia. MATERIALS AND METHODS This study aims to assess the prevalence of refractive error, strabismus and amblyopia among children with normal development or global developmental delay/intellectual disability attending ophthalmology OPD at KLES Hospital, Belagavi. Case records of all 200 new patients less than or equal to 12 years of age group who attended KLES, Dr. Prabhakar Kore Hospital between January 2015 and December 2015 were retrospectively reviewed. RESULTS The male:female ratio was 1.22:1. Out of the total evaluated 200 cases, 130 cases were with normal development and 70 with GDD/ID. Refractive errors were 85%, whereas the cases of amblyopia was 45.50% and strabismus 39.50%. Amblyopia with refractive error having GDD/ID was stastically significant as compared to amblyopia with refractive error having normal development (p=0.001). CONCLUSION Refractive error was the most common ocular disorder seen. Refractive error with amblyopia is more in children with GDD/ID as compared to normal children. Owing to the high percentage of visual anomalies, ophthalmological referral becomes essential in children with developmental anomalies.

The cornea, conjunctiva and the limbus comprise the tissues at the ocular surface. All of them are covered by stratified, squamous, non-keratinising epithelium and a stable tear film. The ocular surface health is ensured by intimate relationship between ocular surface epithelia and the preocular tear film. It is essential to establish accurate diagnosis for appropriate management of complex ocular surface disorders. Management has improved with introduction of the limbal stem cell concept and amniotic membrane transplantation.

Context: Surgically induced astigmatism (SIA) is the cause of poor postoperative vision even after uneventful cataract surgery. Aims: (1) To evaluate the effect of SIA after phacoemulsification clear corneal incision in the steepest meridian on the magnitude of preexisting astigmatism (PEA). (2) To map the magnitude of SIA by incisions in superior (S) and temporal (T) positions. Settings and Design: KLES Dr. Prabhakar Kore Hospital and Medical Research Centre (MRC), Belagavi, Karnataka. Longitudinal study. Subjects and Methods: The present 1-year study was conducted in the Department of Ophthalmology, KLES Dr. Prabhakar Kore Hospital and MRC, Belagavi, on patients undergoing cataract surgery during the period of January 1, 2014,-December 31, 2014. The patients undergoing phacoemulsification with PEA ranging from 0.5 D to 1.5 D were selected for the study to evaluate SIA after phacoemulsification clear corneal incision in the steepest meridian on the magnitude of the PEA. Statistical Analysis Used: Paired t-test was used to calculate mean SIA. Results: The result showed average SIA recorded was 0.54 ± 0.34 D with P < 0.001 (statistically significant). The SIA through temporal incision was 0.70 ± 0.35 D and through superior incision was 0.84 ± 0.49 D. This difference of SIA comparison between temporal and superior incision was not statistically significant (P = 0.145). On taking temporal incision, the mean keratometric difference was 1.03 ± 0.96, which was statistically significant. On taking superior incision, the mean keratometric difference was 0.92 ± 0.95, which was statistically significant. Conclusions: Choosing the clear corneal incision site based on the preoperative steepest meridian significantly decreased keratometric astigmatism at the temporal and superior locations. As well as, temporal incision is evidently better than superior incision in minimizing SIA.

AIM: To study the effect intracameral low molecular weight on postoperative inflammation after cataract surgery in diabetic patients. SETTING: Department of Ophtha lmology J. N. Medical College. Belgaum. DESIGN: Randomized control trial . MATERIAL AND METHODS: Forty patients with diabetes undergoing small incision cataract surgery with posterior chamber intraocular lens (IOL) implantation were randomly assigned to two groups, group A and group B. All patients in g roup A received low molecular weight heparin (enoxaparin) in the concentration of 40 IU in 500ml in the irrigating solution and patients in group B received irrigating solution without low molecular weight heparin. In all patients polymethyl methacrylate ( PMMA) IOLs were implanted. The patients were examined postoperatively on day 1, day 7, day 30 and day 60 for anterior chamber cells and flare and iris pigments on cell by slit lamp biomicroscopy. RESULTS: A statistically significant reduction in postoperat ive cells, flare and intraocular lens surface pigments was noted in group with addition of low molecular weight heparin (enoxaparin) at day 1(p0.001) and 1 week (p

We are reporting a case of the safe removal of the iron intraocular foreign body embedded on the iris with the use of forceps. Preoperative best-corrected visual acuity was 20/20. Cornea showed self-sealed entry site with no other ocular injury. With such good vision, there is a definite challenge to maintain vision and avoid subsequent serious complications. The foreign body was successfully removed via limbal route with use of forceps. Postoperative best corrected visual acuity was 20/20 with very minimal surgical damage.

PURPOSE: To evaluate ocular manifestations and visual field changes in patients with Sellar and Suprasellar Tumours. METHODS: Fifty patients with Sellar and Suprasellar tumours underwent a complete ophthalmic assessment and visual field analysis using the Humphrey Field Analyzer 30 - 2 program. Visual acuity, duration of symptoms, optic nerve head changes, pattern of visual field defects was noted. RESULTS: 50 patients including 15 male and 35 female subjects with mean age of 35.1±9.9 years and CT/MRI proven Suprasellar tumours 70% pituitary adenoma and 30% craniopharyngiomas were included. 70% cases presented with headache 80% with diminution of vision only 10% with hypothyroidism 50% with abnormal pupillary reaction including RAPD and anisocoria. Mean visual acuity at presentation was 0.46 log MAR . Of 100 eyes, 45 patients (90%) had visual field defects including temporal defects in 35 patients (70%), non - specific defects in 4 patients (20%) and 1patient (10%) without any defect. Optic nerve head changes note d and 5 patients (25%) presented with partial optic atrophy and 10 presented with established papilloedema. Visual field outcomes are correlated with duration of symptoms, optic nerve head changes at presentation and CT/ MRI findings. CONCLUSION: Visual fi eld defects were present in two thirds of patients at presentation. An overall deterioration in vision and visual fields was noted before surgical resection. A correlation was found between the duration of symptoms, MRI/ CT scan reports and visual field, s ignifying the importance in early diagnosis of neurological lesions on the basis of ophthalmic examination .

Background: The crystalline lens is part of the optical system of the eye that focuses rays of light on the retina. Apart from contributing to the optical power of the eye as a whole, the crystalline lens can dynamically change the optical power of the system by the process of accommodation for younger eyes. During life the ability of the crystalline lens to change in shape decreases, leading to presbyopia. For optimal visual performance, crystalline lens should be transparent. Cataract describes the pathological opacification of the crystalline lens. Removal of the crystalline lens followed by implantation of an artificial intraocular lens (IOL) in the capsular bag of the eye, as practiced in cataract surgery, offers an opportunity to address refractive anomalies in patients who are ametropic due to the removal of cataract. Implantation of an IOL with a fixed focal point (monofocal IOL) will render a patient at best emmetropic for a single fixed working distance only, leading to a postoperative result comparable to presbyopia in an emmetropic subject; pseudoaccommodation can play a role in increasing the depth of field but spectacle independence for a range of working distances is not be expected after implantation of a monofocal IOL. To restore the missing accommodation, we can implant multifocal IOLs. Multifocal IOLs, on the other hand, are designed to have two or more fixed focal points, thus, facilitating a sharp retinal image of objects at multiple working distances resulting in increased spectacle independence, but these lenses can cause a reduction in contrast sensitivity and higher incidence of photic phenomena such as halos, flare, and glare. Aim of The Study: The study was carried out with the aim of comparing the visual outcome after cataract surgery with multifocal IOLs and monofocal IOLs in respect to distant visual acuity, near visual acuity, contrast sensitivity, subjective symptoms, and to assess functional status and quality of life. Materials and Methods: A prospective observational study was conducted in the Department of Ophthalmology, KLES Dr. Prabhakar Kore Hospital and Medical Research Centre, Belagavi on patients undergoing cataract surgery during January 1, 2015–December 31, 2015. The study was approved by the Ethical and Research Committee of Jawaharlal Nehru Medical College, Belagavi. Forty eyes of forty patients who undergone phacoemulsification surgery with IOL implantation under LA. Choice of IOL inserted given according to their desire for spectacle independency. Monofocal group was taken as control. Both groups were evaluated postoperatively after 3 weeks and 6 weeks for distant vision, near vision, contrast sensitivity for distance, subjective satisfaction by standard questionnaire method and subjective symptoms such as glare and halos and difficulty in night driving. Data were analyzed by Chi-square test (P < 0.05%). Results: Distant visual acuity was 6/6–6/9 in 80% and 75% of the patients of multifocal and monofocal groups, respectively, remaining patients had 6/12–6/18 vision. 85% of multifocal group had N6–N8 vision (P < 0.0001). High contrast sensitivity for distance was almost similar in both groups, but low contrast was significantly reduced in multifocal group as compared to monofocal group (P = 0.0023). Fifteen percent of multifocal group had complained of glare and halos compared to monofocal group who never had these visual sensations. About 5% of patients in multifocal group had difficulty with nighttime driving. Nearly, 80% of patients in multifocal group and 40% of patients in monofocal group had become spectacles independent. Interpretation and Conclusion: Multifocal IOL group experienced reduced spectacle dependency for near vision and a high level of patient satisfaction despite some reports of halos, glare, and difficulty in night driving. Monofocal IOL group experienced spectacle dependency for near vision. Overall, multifocal IOLs offer best near vision acuity, good distance visual acuity, less limitation in visual function in selected and motivated individuals.

Orbital cavernous haemangiomas are most frequent intra-conal, intra-orbital primary tumor in adults. They represent 4% of all orbit tumors and 9-13% of all intracranial cavernous haemangiomas. Forty-two-year-old female came with complaints of protrusion of right eye (RE) since 3 months associated with diminution of vision, headache, and eye ache. Absolute proptometry was 28 mm OD and 20 mm OS. 2 mm of the inferior scleral show was seen in RE. Axial computed tomography (CT) showed unilaterally, moderately enhancing, homogeneous, smooth-contoured mass. The patient underwent right lateral orbitotomy with mass excision under general anesthesia. The histopathological evaluation proved it to be a cavernous haemangioma. We report a case of intra-orbital, intra-conal cavernous hemangioma occurring in a 42-year-old female presenting with proptosis. The tumor was diagnosed on CT and was removed using lateral orbitotomy approach. Patient had significant improvement in symptoms with the mild deterioration of vision.