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   2010| May-August  | Volume 3 | Issue 2  
    Online since June 9, 2010

 
 
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ORIGINAL ARTICLES
Knowledge, attitude and practice regarding eye complications and care among Omani persons with diabetes - A cross sectional study
Rajiv Khandekar, Saleh Al Harby, Harith Al Harthy, Jawad Al Lawatti
May-August 2010, 3(2):60-65
DOI:10.4103/0974-620X.64228  PMID:21217897
Purpose : We present the level of Knowledge, Attitude and Practice (KAP) among diabetic patients regarding eye complications and their care. Materials and Methods : A cross sectional study was conducted in 2008 at seven regions of Oman. Arabic speaking nurses interviewed diabetics at clinics. They used a closed ended questionnaire with 15 questions. The responses were analyzed and the KAP were grouped into excellent (>80%), good (60 to 79%), average (40 to 59%), poor (20 to 39%) and very poor (<20%). They were also compared among epidemiologic variants. Result : Of the 750 participants, 'Excellent', grade of knowledge about diagnosis and eye care was present in 547 (72.9%) and 135 (18%) persons respectively. The 'excellent' grade of attitude about eye involvement and eye care was found in 135 (18%) and 224 (29.9%) participants. The practice for undergoing eye check up and accepting treatment was of 'excellent' grade in 390 (52%) and 594 (79.2%) respectively. Age (OR = 0.98), Sharqiya region (OR = 25) and '5 to 9' duration of DM (OR = 2.1) were associated with the knowledge. '<1 year' duration (OR = 0.3) and Dhakhiliya region (OR = 39) were associated with the attitude while '5 to 9 year' duration (OR = 3.4) was associated with better practices. Conclusions : Knowledge about eye complications and care is satisfactory among persons with diabetes. However, levels of attitude and practice were less than desired and should be improved. This could strengthen program approach for early detection and care of eye complications of diabetes in Oman.
  7,097 1,024 -
LETTERS TO THE EDITOR
Kajal (Kohl) - A dangerous cosmetic
Anup Mohta
May-August 2010, 3(2):100-101
DOI:10.4103/0974-620X.64242  PMID:21217909
  6,734 520 -
EDITORIAL
Do I have an ethical dilemma?
Alex V Levin
May-August 2010, 3(2):49-50
DOI:10.4103/0974-620X.64226  PMID:21217895
  5,859 784 -
REVIEW ARTICLE
Gene therapy in glaucoma-part 2: Genetic etiology and gene mapping
Mohamed Abdel-Monem Soliman Mahdy
May-August 2010, 3(2):51-59
DOI:10.4103/0974-620X.64227  PMID:21217896
Glaucoma diagnosis, identification of people at risk, initiation of treatment and timing of surgical intervention remains a problem. Despite new and improving diagnostic and therapeutic options for glaucoma, blindness from glaucoma is increasing and glaucoma remains a major public health problem. The role of heredity in ocular disease is attracting greater attention as the knowledge and recent advances of Human Genome Project and the HapMap Project have made genetic analysis of many human disorders possible. Glaucoma offers a variety of potential targets for gene therapy. All risk factors for glaucoma and their underlying causes are potentially susceptible to modulation by gene transfer. The discovery of genes responsible for glaucoma has led to the development of new methods of Deoxyribonucleic acid (DNA)-based diagnosis and treatment. As genetic defects responsible for glaucoma are identified and the biochemical mechanisms underlying the disease are recognized, new methods of therapy can be developed. It is of utmost importance for the ophthalmologists and glaucoma specialists to be familiar with and understand the basic molecular mechanisms, genes responsible for glaucoma and the ways of genetic treatment. Method of Literature Search The literature was searched on the Medline database, using the PubMed interface.
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ORIGINAL ARTICLES
Correlation of central corneal thickness and optic nerve head topography in patients with primary open-angle glaucoma
Tharwat H Mokbel, Asaad A Ghanem
May-August 2010, 3(2):75-80
DOI:10.4103/0974-620X.64231  PMID:21217900
Purpose : To evaluate whether changes in optic nerve head topography and visual field in patients with primary open-angle (POAG) are related to central corneal thickness (CCT). Materials and Methods : Eighty eyes of 50 patients with POAG underwent ophthalmic examination; optic nerve head imaging with the Heidelberg Retina Tomography II (HRT II), ultrasound corneal pachymetry, and visual field evaluation with the Humphrey visual field analyser (program 24-2). Correlation between CCT, age, gender, family history of glaucoma, visual acuity, intraocular pressure (IOP), optic disc surface area, vertical and horizontal cup: disc ratios, neuroretinal rim area, mean deviation of visual field, and number of glaucoma medications was analyzed. Patients were divided into a thin CCT group <540 μm or a thick CCT group >540 μm. Pearson correlation was used for correlation coefficient and a P value of <0.05 was considered statistically significant. Results : Thin CCT was significantly correlated with vertical and horizontal cup: disc ratios, neuroretinal rim area loss, and smaller optic disc surface area (r=0.043, r=0.021, r=0.036, and 0.031 respectively). Thin CCT was also significantly associated with worsened mean deviation of visual field, and increased number of glaucoma medications (r=0.065 and r=0.423). Patients with positive family history correlated with with greater vertical cup: disc ratio, and more glaucoma medications but this was not statistically significant. Conclusions : In patients with POAG those with thinner CCT are likely to develop greater glaucomatous optic nerve and visual field damages than those with a thicker CCT.
  4,717 592 1
Congenital fibrosis of the extraocular muscles
Pascale Cooymans, Sana Al-Zuhaibi, Rana Al-Senawi, Anuradha Ganesh
May-August 2010, 3(2):70-74
DOI:10.4103/0974-620X.64230  PMID:21217899
Background : Congenital fibrosis of the extraocular muscles (CFEOM) describes a group of rare congenital eye movement disorders that result from the dysfunction of all or part of the oculomotor (CN 3) and the trochlear (CN 4) nerves, and/or the muscles these nerves innervate. Aim : To describe the clinical and neuro-radiological findings in three patients with CFEOM and review literature with respect to clinical features, genetics and management of this condition. Materials and Methods : A retrospective chart review was performed of three Omani patients who had been diagnosed with CFEOM in our institution. All patients had undergone standardized orthoptic and ocular evaluations and magnetic resonance imaging (MRI) of the orbits and brain. Results : The three patients (age range nine months - 10 years) presented a history of congenital strabismus. All patients had severe bilateral ptosis and mild to moderate visual impairment secondary to the ptosis and astigmatism. Two of three patients demonstrated a positive jaw-winking phenomenon. A moderate to large angle exotropia with varying amount of hypotropia and limitations of almost all the extra ocular muscles was noted. Patient 3 was also developmentally delayed. MRI brain and orbit showed abnormalities of the extraocular muscles in two patients and brain malformation in one patient. Conclusions : CFEOM is a rare, congenital, and non-progressive disorder with multiple extra ocular muscle restrictions. CFEOM can be associated with neuro-radiological abnormalities; its diagnosis and classification is defined by clinical characteristics and genetics. Options for treatment are limited and difficult.
  4,508 649 -
CASE REPORTS
Bilateral anophthalmia with septo-optic dysplasia
Manisha Jana, Sanjay Sharma
May-August 2010, 3(2):86-88
DOI:10.4103/0974-620X.64233  PMID:21217902
Bilateral anophthalmia is a rare entity and association with septo-optic dysplasia is an even rare condition. The condition is characterized by absent eyeballs in the presence of eyelids, conjunctiva or lacrimal apparatus. Though anophthalmia can be diagnosed clinically, imaging plays a crucial role in delineating the associated anomalies. In addition, often clinical anophthalmia may prove to be severe microphthalmia on imaging. We describe the imaging findings in an infant with bilateral anophthalmia and septo-optic dysplasia.
  4,596 441 2
Retinal vasculitis in a patient with abdominal tuberculosis
Balaji Kannan, Kummararaj Govindarajan, Sherin Kummararaj, Vijayalakshmi Balaji, Venugopal Natarajapillai
May-August 2010, 3(2):81-85
DOI:10.4103/0974-620X.64232  PMID:21217901
Tuberculosis (TB) is one of the most common systemic diseases in India. Intraocular TB is however, rare. Retinal vasculitis is a relatively rare manifestion of intraocular TB. We report a case of bilateral retinal vasculitis in a 19-year-old girl with abdominal tuberculosis. The patient responded well to anti-TB treatment along with a short course of low dose oral steroids. Vision in her right eye however remained compromised due to residual maculopathy. This is the first report of bilateral retinal vasculitis due to colonic TB.
  3,558 461 1
An unusual case of penetrating ocular trauma with a pressure cooker
Soumya Swarup Chattopadhyay, Udayaditya Mukhopadhyay, Kumar Saurabh
May-August 2010, 3(2):89-90
DOI:10.4103/0974-620X.64234  PMID:21217903
Ocular trauma is a major cause of vision loss. The circumstances and agents implicated in such injuries are diverse. We present an unusual case of penetrating ocular trauma with the nozzle of a pressure cooker lid in a 32-year-old housewife causing deep laceration of the upper eye lid and sclera. The impacted metallic nozzle was removed on an emergency basis. Autoevisceration of ocular contents due the high velocity impact resulted in the final decision to surgically complete the evisceration and implant a glass ball implant. This case highlights the propensity of grievous ocular trauma in a domestic environment.
  3,628 387 1
ORIGINAL ARTICLES
Indirect evaluation of corneal apoptosis in contact lens wearers by estimation of nitric oxide and antioxidant enzymes in tears
RP Bhatia, Shikha Dhawan, HD Khanna, Amitabh Dash
May-August 2010, 3(2):66-69
DOI:10.4103/0974-620X.64229  PMID:21217898
Background : Contact lens induced trauma to the corneal epithelium results in increased release of inflammatory mediators. The keratocyte apoptosis is directly related to epithelial injury and has been correlated with increased production of nitric oxide. Potent antioxidant enzymes protect cells from oxidative damage by inactivating reactive oxygen species and thus inhibiting apoptosis. This study aims at determination of total nitric oxide and antioxidant enzymes in tears which will be an indirect criteria for assessing apoptosis. Materials and Methods : Nitric oxide and antioxidant enzymes were estimated in tears of 25 soft contact lens wearers and compared with 25 age and sex matched controls. Results : Statistically significant increase of nitric oxide (P<0.001), superoxide dismutase (P<0.001) and glutathione peroxidase (P<0.001) levels was seen in tears of contact lens wearers as compared to controls. There was also statistically significant increase in the levels of antioxidant enzymes, superoxide dismutase (P<0.05) and glutathione peroxidase (P<0.01), with increase in the total duration of contact lens wear in years. Conclusions : Increase in the level of nitric oxide and antioxidant enzymes in tears of contact lens wearers suggested that contact lens wear suppresses the process of apoptosis. However, it was also postulated that the increased levels of nitric oxide balances the anti-apoptotic activities of increased levels of antioxidant enzymes by its pro-apoptotic activity leading to protective outcomes in contact lens wearers.
  3,399 487 -
CASE REPORTS
Primary orbital rhabdomyosarcoma with skeletal muscle metastasis
Jayanta K Das, BK Tiwary, SB Paul, Harsha Bhattacharjee, Bhuyan Cida, Dipankar Das
May-August 2010, 3(2):91-93
DOI:10.4103/0974-620X.64235  PMID:21217904
We report a case of embryonal orbital rhabdomyosarcoma (RMS) in a five year old boy. Immuno-histochemistry of incisional specimen confirmed diagnosis. Eight cycles of chemotherapy along with radiotherapy resulted in over 50% reduction in size of the mass. However, increase in size was noted subsequent to completion of therapy and exenteration was deemed prudent. Margins of the excised specimen were free from tumor cells, but after five months, the patient developed multiple metastases, including skeletal muscle involvement, and died nine months after exenteration, despite repeat chemotherapy along with radiotherapy. Orbital RMS with metastasis to skeletal muscle is a rare entity.
  3,192 426 -
CLINICAL IMAGES
Anterior ischemic optic neuropathy in a case of Takayasu's arteritis
Suneetha Nithyanandam, Ajoy Mohan, Urmi Sheth
May-August 2010, 3(2):94-95
DOI:10.4103/0974-620X.64236  PMID:21217905
  2,930 400 -
Proliferative diabetic retinopathy in acromegaly
Chintan Malhotra
May-August 2010, 3(2):96-97
DOI:10.4103/0974-620X.64237  PMID:21217906
  2,785 403 1
CLINICAL QUIZ
Six-year-old girl with decreased vision
Agha Shahab Haider, Ahmed Al-Hinai, Anuradha Ganesh
May-August 2010, 3(2):98-98
DOI:10.4103/0974-620X.64239  PMID:21217907
  2,768 338 -
LETTERS TO THE EDITOR
Combined photodynamic therapy and intravitreal ranibizumab as treatment for extrafoveal choroidal neovascularization associated with age-related macular degeneration
Jay Kumar Chhablani
May-August 2010, 3(2):99-100
DOI:10.4103/0974-620X.64241  PMID:21217908
  2,480 381 1
Dealing of mass casualty in ophthalmology - A challenge
Kalpana Pandey, Parul Singh
May-August 2010, 3(2):101-101
DOI:10.4103/0974-620X.64243  PMID:21217910
  2,188 292 -
SELECTED ABSTRACTS
Selected Abstracts

May-August 2010, 3(2):103-103
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