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   2009| September-December  | Volume 2 | Issue 3  
    Online since October 28, 2009

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Epidemiological profile of fungal keratitis in urban population of West Bengal, India
Suman Saha, Debdulal Banerjee, Archana Khetan, Jayangshu Sengupta
September-December 2009, 2(3):114-118
DOI:10.4103/0974-620X.57310  PMID:20927207
Background : Corneal diseases are one of the major causes of visual loss and blindness, second only to cataract. Amongst corneal diseases, microbial keratitis is a major blinding disease. In some countries, fungal keratitis accounts for almost 50% of patients with culture-proven microbial keratitis. Aim : This study was conducted to determine the epidemiological characteristics of fungal keratitis in an urban population of West Bengal and identify the specific pathogenic organisms. Methods : The charts of patients with microbial keratitis who attended the Cornea Services of Priyamvada Birla Aravind Eye Hospital from January to December 2008 were retrospectively reviewed. Records of patients with 10% KOH mount and culture positive fungal keratitis were analyzed for epidemiological features, laboratory findings and treatment outcomes. Results : Of the 289 patients of microbial keratitis included in the study, 110 patients (38.06%) were diagnosed with fungal keratitis (10% KOH mount positive). Of the 110 patients, 74 (67.27%) fitted the study inclusion criteria (10% KOH mount and culture positive). Forty five of 74 patients (60.81%) in the study group were in the older age group (>50 years). Ocular trauma in 35 cases (47.29%) was identified as a high risk factor and vegetative injuries in 17 cases (22.97%) were identified as a significant cause for fungal keratitis. Maximum organism source was from corneal scrapings in 41 cases (55%). The predominant fungal species isolated was Aspergillus sp (55.40%) followed by Candida albicans 14 cases (18.91%) and Fusarium sp. in 8 cases (10.81%). Agricultural activity related ocular trauma was the principal cause of mycotic keratitis and males were more commonly affected. Thirty of 74 cases (40.55%) of the culture positive patients healed with corneal scar formation with medical treatment whereas 44 cases (59.45%) required therapeutic keratoplasty. Conclusion : Fungal keratitis is an important cause of microbial keratitis with injury to the cornea being a leading predisposing factor. Although Aspergillus sp. was implicated in most of the patients in our study population, Candida sp. were found in higher numbers than previously reported. Keratitis caused by filamentous fungi responds adequately to medical management. Therapeutic keratoplasty continues to remain an important treatment modality in infections with Candida sp. Early diagnosis with prompt identification of the pathogenic organism is mandatory to initiate appropriate therapy and thereby reduce morbidity.
  7,592 846 8
Idiopathic choroidal neovascular membrane in a young female
Saad Abdullah Waheeb, Mahmood Jameel Showail
September-December 2009, 2(3):133-136
DOI:10.4103/0974-620X.57314  PMID:20927211
A case of idiopathic choroidal neovascular membrane (CNVM) is described in a 17-year-old female patient. On initial examination her vision was counting fingers at one meter in the left eye (OS) and Fluorescein angiography showed a well-defined hyperfluorescent area corresponding to the CNVM. Intravitreal bevacizumab was injected into OS, and at a five-week follow-up visit, visual acuity improved to 20/100 OS. This case is unusual, in that the CNVM developed in a young lady with no significant past medical history and with the absence of a choroidal or retinal pigment epithelial disease process that may be associated with a CNVM.
  5,761 571 2
Gene therapy in ophthalmology
Satagopan Uthra, Govindasamy Kumaramanickavel
September-December 2009, 2(3):108-110
DOI:10.4103/0974-620X.57308  PMID:20927205
It has been more than a year since ophthalmologists and scientists under Dr. Robin Ali's team at the Moorsfield Eye Hospital and the Institute of Ophthalmology, University College London, successfully treated patients with a severely blinding disease, Leber's congenital amaurosis (LCA) using gene therapy. This success does not look to be transient, and this achievement in gene replacement therapy clinical trial for LCA has instilled hope in numerous families with patients suffering from this and similar retinal degenerative diseases, for whom restoration of lost vision has remained a distant dream so far. The encouragement that this success has given is expected to also lead to start of clinical trials for other blinding ocular diseases for which gene therapy experiments at the laboratory and animal levels have been successful. This article reviews the various studies that have led to the understanding of gene therapy outcomes in human ocular diseases and attempts to provide a brief sketch of successful clinical trials.
  4,419 931 1
Changes in intraocular pressure after clear corneal phacoemulsification in normal patients
Salima Bhallil, Idriss Benatiya Andalloussi, Fouad Chraibi, Khadija Daoudi, Hicham Tahri
September-December 2009, 2(3):111-113
DOI:10.4103/0974-620X.57309  PMID:20927206
Purpose : To evaluate changes in intraocular pressure (IOP) after clear corneal phacoemulsification (CCP) in normal patients. Materials and Methods : A prospective study including 273 normal patients selected for cataract extraction by CCP. Intraocular pressure was recorded on the 15 th day, l st , 2 nd , 3 rd month and 6 months after surgery. Statistical Analysis : For statistical analysis, Epi Info was used to determine the statistical significance of changes in IOP. Results : The mean age of 96 women and 177 men was 71 ± 12 years. The mean IOP before surgery was 14.18 ± 3.4 mmHg. Our patients showed a mean decrease in IOP of 2.25 mmHg (16%) compared to preoperative values. Change in IOP was not related to lens thickness (P = 0.12), but significantly correlated with change in anterior chamber depth (ACD) (P = 0.002). The postoperative IOP was inversely related to preoperative ACD (P = 0.012). Age, sex and axial length were not significantly related to IOP reduction (P = 0.2-0.5) Conclusion : CCP was associated with a statistically significant reduction in IOP. The exact mechanism by which cataract surgery results in IOP reduction is unclear. CCP can be performed with the intent of achieving better IOP control.
  4,428 554 2
Vidi, vini, vinci: External ophthalmomyiasis infection that occurred, and was diagnosed and treated in a single day: A rare case report
Kamlesh Thakur, Gagandeep Singh, Smriti Chauhan, Anuradha Sood
September-December 2009, 2(3):130-132
DOI:10.4103/0974-620X.57313  PMID:20927210
Ophthalmomyiasis is an infestation of eye with larvae or maggots of certain flies. Oestrus ovis (sheep nasal botfly) belonging to family Oestridae is the most common cause of human myiasis. We describe here an acute presentation of a case of external ophthalmomyiasis, i.e., infestation of conjunctiva due to first instar larvae of Oestrus ovis. In this case report the occurrence, diagnosis and treatment all took place in the setting of a single day. Prompt treatment by removal of larvae mechanically followed by instillation of antibiotic and steroid eye drops helped to prevent serious complications. The taxonomic identification of fly is also important as some fly species are capable of penetrating deeper tissues of eyes, which is sight threatening.
  4,254 420 2
Orbital manifestations of Langerhans Cell Histiocytosis: A report of three cases
Jayanta K Das, Ronel Soibam, BK Tiwary, D Magdalene, SB Paul, Cida Bhuyan
September-December 2009, 2(3):137-140
DOI:10.4103/0974-620X.57315  PMID:20927212
Langerhans Cell Histiocytosis (LCH) is a spectrum of disorders characterized by accumulation of histiocytes in various tissues. It is rarely encountered in ophthalmic practice and has an affinity for the orbit. We report three patients with LCH involving the lateral orbital wall, each with a different form of the condition.
  3,968 473 3
Combined autologous and allograft limbal cell transplantation with penetrating keratoplasty in a case of chemical corneal burn patient
Sandip Mitra
September-December 2009, 2(3):126-129
DOI:10.4103/0974-620X.57312  PMID:20927209
A patient with chemical corneal burn presented two months after the acute episode of chemical injury to his right eye (OD) and was diagnosed with severe limbal stem cell deficiency and with vascularized corneal opacity OD. Limbal cell transplantation and penetrating keratoplasty (PKP) was performed. The autologous and allograft limbal tissue included peripheral cornea, limbus and conjunctiva obtained from contralateral eye and cadaveric eye bank cornea. Central corneal button was used for a PKP with 32 intermittent sutures. One year after the procedure, the corneal surface remains clear with a best corrected visual acuity of 6/12 (-2.00 DS / -2.75 DC-/ 150Ί. Eighteen sutures are still in place; no vascularization has extended beyond the host graft junction. Ocular surface is wetting well with no filamentary keratitis. Combined autologous and allograft limbal cell transplant can be performed for severe deficiency of corneal stem cells in a patient with chemical corneal burn.
  3,143 477 -
The determinants of trichiasis recurrence differ at one and two years following lid surgery in Vietnam: A community-based intervention study
Rajiv Khandekar, Ton Tin K Thanh, Vu Quoc Luong
September-December 2009, 2(3):119-125
DOI:10.4103/0974-620X.57311  PMID:20927208
Aim : To compare determinants for recurrence of trichiasis at one and two years following lid surgery in Vietnam. Study Design : Community-based intervention study. Methods : This study was carried out between 2000 and 2003 in four trachoma-endemic districts of Vietnam. Trained trichiasis surgeons performed modified Cuenod Nataf lid surgery on 648 eyes of 472 patients with Trachomatous trichiasis (TT). Trained investigators collected information on ocular and lid status before surgery and at one and two years following surgery. Trichiasis recurrence was calculated after adjusting for one or both eyes of each operated individual. Results : Fifty-six eyes developed recurrence at one year with adjusted prevalence of 8.8% (95% CI 6.60-11.01). One hundred and one eyes [15.9% (95% CI 13.04-18.72)] had recurrence two years following surgery. Female gender, older age group, study area, severe grade of trachomatous scarring (TS), past history of lid surgery, postoperative suture adjustment and surgeon were risk factors for recurrence at the end of one year. Study area and previous lid surgery were risk factors for recurrence in the second year. Recurrence at one year could be predicted if study area and severity of Trachomatous Scarring (TS) are known. Conclusions : One and two year recurrence rates with modified Cuenod Nataf lid surgeries for TT in Vietnam were acceptably low. Early recurrence could be reduced by proper case selection. However, late recurrence seems to be dependent on interaction of risk factors. Only age of the patient was the reliable predictor of recurrence.
  2,826 426 1
Subhyaloid hemorrhage as the presenting sign of pregnancy-induced hypertension
Sribhargava Natesh, K Harsha
September-December 2009, 2(3):149-150
DOI:10.4103/0974-620X.57320  PMID:20927217
  2,765 449 -
Orbital venous-lymphatic malformation: Role of imaging
Anuj Mishra, Khalifa Alsawidi, Ramadan Abuhajar, Ehtuish F Ehtuish
September-December 2009, 2(3):141-142
DOI:10.4103/0974-620X.57316  PMID:20927213
  2,610 403 -
Canaliculitis: Are we missing the diagnosis?
Abdullah Al-Mujaini, Upender Wali, Rana Al-Senawi
September-December 2009, 2(3):145-146
DOI:10.4103/0974-620X.57318  PMID:20927215
  2,512 351 -
Gene therapy within our vision: Illustrating the genetic paradigm
Sandy Raeburn
September-December 2009, 2(3):107-107
DOI:10.4103/0974-620X.57307  PMID:20927204
  2,240 601 -
VMD2 mutational analysis in a Japanese family with Best macular dystrophy
Satomi Shiose, Shigeo Yoshida, Keijiro Ishikawa, Tatsuro Ishibashi
September-December 2009, 2(3):143-144
DOI:10.4103/0974-620X.57317  PMID:20927214
  2,260 345 -
Twelve-year-old boy with decreased vision in his right eye
Ahmed Al-Hinai
September-December 2009, 2(3):147-148
DOI:10.4103/0974-620X.57319  PMID:20927216
  2,069 344 -
Selected Abstracts

September-December 2009, 2(3):151-153
  2,008 247 -