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   2010| September-December  | Volume 3 | Issue 3  
    Online since October 22, 2010

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Assessment of a modification of Brückner's test as a screening modality for anisometropia and strabismus
Abadan Khan Amitava, D Kewlani, Z Khan, A Razzak
September-December 2010, 3(3):131-135
DOI:10.4103/0974-620X.71890  PMID:21120049
Background : Current amblyopia screening methods are not cost effective. Aim : To evaluate the diagnostic capability of a modified Brückner test (MBT) for amblyopiogenic risk factors. Materials and Methods : We applied the MBT using the streak retinoscope to identify anisometropia and strabismus by noting an inter-ocular difference in movement and glow, from children who failed 6/9 Snellen on community vision screening, followed by comprehensive eye examination. Statisitics : Data were analyzed by 2 Χ 2 tables for diagnostic test parameters (95% CI). Results : From 7998 children vision-screened, 392 failed 6/9 VA and were referred. Since 34 failed to reach the centers, and 15 were excluded due to poor/ no glow, data from 343 was analyzed. The prevalence of anisometropia of 0.5D was 17%, of 1D was 11% and of strabismus 5%. For the MBT the accuracy was ≥ 90% (95%CI 89% to 97%) over the three outcomes. The sensitivity, specificity, NPV and +LR for anisometropia of 0.5D were: 0.57 (0.48, 0.64), 0.97 (0.95, 0.98), 0.92 (0.90, 0.93) and 18 (9.7, 35); for 1D: 0.74(0.60, 0.82), 0.95 (0.94, 0.97), 0.97 (0.95, 0.98) and 16 (9.3, 28); and for strabismus: 0.5 (0.32, 0.66), 0.98 (0.97, 0.98), 0.97 (0.96, 0.98) and 20 (9.1, 42). Conclusion : Our data suggests that the MBT is highly accurate and useful for ruling in anisometropia and strabismus in children who fail 6/9 Snellen. The MBT needs further validation, both by different care givers and on differing populations. It offers an affordable, portable, and clinically useful tool to detect anisometropia and strabismus. We suggest that performing an MBT prior to uniocular retinosocpy should be a routine practice.
  17,110 607 -
Accuracy of intraocular lens power calculation in high myopia
Asaad A Ghanem, Hosam M El-Sayed
September-December 2010, 3(3):126-130
DOI:10.4103/0974-620X.71888  PMID:21120048
Purpose : To study the accuracy of different recent intraocular lens (IOL) calculation formulas in predicting a target postoperative refraction ± 1.0D (Diopters) in patients with long eyes (axial length ≥ 26.0 mm) undergoing phacoemulsification. Materials and Methods : This study comprised 127 eyes of 87 patients who presented with cataract and axial eye length ≥ 26 mm. Before phacoemulsification and IOL implantation; axial length measurement using immersion ultrasound A-scan technique, and autokeratometry with or without computerized corneal topography for K readings were done. The IOL power was calculated using four formulas, namely the SRK-T, Hoffer-Q, Holladay-2, and Haigis formulas. Four months after surgery, refraction was done. Differences between actual postoperative refraction and assumed target refraction using the different formulas were analyzed. P < 0.05 was considered statistically significant. Results : In all 127 eyes, the mean axial length was 31.71 mm (range, 26.06-37.11 mm) and the mean K was 44.68 D (range, 40.05-55.14D). The mean preoperative spherical equivalent (SE) was -17.52D (range, -12.25 to -30.50D). After surgery, the mean spherical equivalent was -0.8 ± 0.83D (range, +1.25 to -3.75D). The mean postoperative refractive SE when implanting a plus power IOLs was -0.3 ± 0.51D (P < 0.001) while the mean postoperative refractive SE when implanting a minus power IOLs was +1.21 ± 0.11D denoting a highly significant tendency toward hyperopia (P < 0.001). Concerning the minus power group, most postoperative refractive error was within +1.0 to +2.0D in the actual implanted IOL and in all other formula calculated IOL power. However, Haigis formula showed the least deviation while SRK-T and other formulas showed a greater tendency toward hyperopia. Conclusions : In eyes with high axial myopia, the performance of SRK-T, Hoffer-Q, Holladay-2 and Haigis formulas are comparable in low plus-powered IOL implantation. Haigis formula is the best formula when minus power IOL is implanted.
  8,154 943 5
Sebaceous gland carcinoma of the eyelid
Upender K Wali, Abdullah Al-Mujaini
September-December 2010, 3(3):117-121
DOI:10.4103/0974-620X.71885  PMID:21120046
Sebaceous gland carcinoma, commonly arises in the periocular area, is an uncommon condition. It represents 1-5.5% of eyelid malignancies and is considered to be the third most common eyelid malignancy after basal cell and squamous cell carcinomas, although few reports placed this tumor as second most common after basal cell carcinoma. It usually affects elderly women and characterized by high rate of local recurrence, regional, and distant metastases. A delay in diagnosis, which can be attributed primarily to ability of this tumor to masquerade as more benign conditions, often leads to inappropriate management with increased morbidity and mortality rates. In this study, the authors discuss key elements of the primary disease and therapeutic options available to treat such devastating problem.
  7,725 610 3
Refractory reverse amblyopia with atropine penalization
Preeti Ajit Patil, S Meenakshi, TS Surendran
September-December 2010, 3(3):148-149
DOI:10.4103/0974-620X.71897  PMID:21120053
Pharmacological penalization with atropine has been shown to be equally effective as conventional occlusion therapy in the treatment of amblyopia in children. Reverse amblyopia of the sound eye with atropine penalization has been reported before, but is more common in cases where the effect is augmented with optical penalization and is mostly reversible. We report a case of reverse amblyopia with atropine penalization, in a 4-year-old girl, which was refractory to treatment. This report highlights the need for strict monitoring of the vision in the sound eye and regular follow-up in children undergoing amblyopia treatment.
  6,575 447 1
Total levator aponeurosis resection for primary congenital ptosis with very poor levator function
Abdullah Al-Mujaini, Upender K Wali
September-December 2010, 3(3):122-125
DOI:10.4103/0974-620X.71886  PMID:21120047
Aim : This study was designed to evaluate the effectiveness of total levator aponeurosis resection in patients with very poor levator function secondary to primary congenital ptosis. Design : A retrospective, noncomparative single-institutional study was designed. Participants : Seven patients with very poor levator function secondary to primary congenital ptosis operated between May 2008 and May 2010 by one surgeon (AM). Materials and Methods : A retrospective study of seven patients with congenital ptosis evaluating eyelid elevation following total levator aponeurosis resection. End result is improvement of the eyelid elevation. Conclusion : Total levator aponeurosis resection is easy and effective tool in elevating the eyelid in patients with very poor levator function secondary to primary congenital ptosis.
  5,960 617 2
Delayed capsular bag distension syndrome
Kalyan Das
September-December 2010, 3(3):155-156
DOI:10.4103/0974-620X.71905  PMID:21120056
  5,914 358 1
Cataract surgery under topical anesthesia: Gender-based study of pain experience
Sanjiv Kumar Gupta, Ajay Kumar, Swati Agarwal
September-December 2010, 3(3):140-144
DOI:10.4103/0974-620X.71893  PMID:21120051
Background : Pain perception, expression, tolerance, and the healthcare provider's evaluation and management of pain are affected by the gender of the patient. To the best of our knowledge, there is lack of gender-based evaluation of pain during cataract surgery under topical anesthesia. Aims : This study has been initiated to evaluate and determine pain experience during cataract surgery under topical anesthesia and to study the gender-based differences of the same. Settings and Design : Hospital-based study involving cataract surgery under topical anesthesia using standard cataract surgery. It was an interventional comparative case series. Materials and Methods : One hundred and sixty patients were included in four groups, according to the gender and choice of surgery. Patients underwent either phacoemulsification with foldable intra ocular lens (IOL) or manual small incision cataract surgery with rigid IOL under topical anesthesia. Patients ranked their pain experience on VAS scale after the surgery and the surgeon recorded the ease/difficulty accordingly using a questionnaire. Statistical Analysis Used : MedCalc version ( www.medcalc.be ) for windows was used to analyze the results. Analysis of variance (ANOVA) test and Kruskal-Walis test were used to analyze the data. Results : The overall visual analog scale (VAS) score was 0.8 (SD 1.3 range 0-8), with no statistical difference among the groups (P=0.5). The average surgeon's score was 3.3 (SD 0.71 range 3-7), with no statistical difference between the groups (P=0.37).There were no sight threatening complications during the surgery in any group. Conclusions : The outcome of the study demonstrates that the patients undergoing cataract surgery under topical anesthesia perceive comparable pain and discomfort irrespective of their gender.
  5,677 495 3
Anesthesia for cataract surgery: Recent trends
Rikin Shah
September-December 2010, 3(3):107-108
DOI:10.4103/0974-620X.71881  PMID:21120044
  5,004 759 -
Gene therapy in glaucoma-3: Therapeutic approaches
Mohamed Abdel-Monem Soliman Mahdy
September-December 2010, 3(3):109-116
DOI:10.4103/0974-620X.71883  PMID:21120045
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 including glaucoma 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. As genetic defects responsible for glaucoma are identified and the biochemical mechanisms underlying the disease are recognized, new methods of therapy can be developed. Genetic tests are indicated for treatment, diagnosis, prognosis, counseling, and research purposes; however, there is significant overlap among them. One of the important genetic tests for glaucoma is OcuGene. Therefore, it is of utmost importance for the glaucoma specialists to be familiar with and understand the basic molecular mechanisms, genes responsible for glaucoma, and the ways of genetic treatment. Recently, several promising genetic therapeutic approaches had been investigated. Some are either used to stop apoptosis and halt further glaucomatous damage, wound healing modulating effect or long lasting intraocular pressure lowering effects than the conventional commercially available antiglaucoma medications. Method of Literature Search The literature was searched on the Medline database using the PubMed interface. The key words for search were glaucoma, gene therapy, and genetic diagnosis of glaucoma.
  4,255 489 -
Unilateral optic nerve infiltration as an initial site of relapse of acute lymphoblastic leukemia in remission
Sabyasachi Bandyopadhyay, Debabrata Das, Gobinda Das, Sibnath Gayen
September-December 2010, 3(3):153-154
DOI:10.4103/0974-620X.71902  PMID:21120055
  4,277 353 1
Role of scheimpflug imaging in the diagnosis and management of keratitis caused by caterpillar seta
Ozgur Bulent Timucin, Mehmet Baykara
September-December 2010, 3(3):150-152
DOI:10.4103/0974-620X.71900  PMID:21120054
A 16-year-old boy presented with a history of an accidental hit to the left eye by a butterfly (Lepidoptera). One seta fragment was found to be embedded into the cornea and inflammation secondary to penetration of caterpillar seta was seen around the seta fragment. Scheimpflug imaging was performed in the area showing caterpillar seta. Corneal infiltration was imaged as a hyper-reflective area. Lesion dimensions were measured with calipers. Scheimpflug imaging is a potential tool for localization of corneal lesions, monitoring the progress of the injury and evaluating the treatment response objectively.
  3,940 248 -
Sequential occurrence of basal cell carcinoma in symmetrically identical positions of both lower eyelids: A rare finding of a common skin cancer
Shanti Pandey, Vimlesh Sharma, GS Titiyal, Vivekanand Satyawali
September-December 2010, 3(3):145-147
DOI:10.4103/0974-620X.71895  PMID:21120052
Basal cell carcinoma (BCC) is the most common type of skin cancer in white-skinned individuals but is rare in blacks and Indians. There are only few case reports about bilateral BCC of lower eyelids. Here we present a case of BCC appearing sequentially in symmetrically identical positions in both lower eyelids. The patient was a resident of high altitude and had worked out doors for seven to eight hours every day. Environmental and occupational parameters may have an important role to play in this context. There was no evidence of local invasion or distant metastasis.
  3,718 464 -
Topical anesthesia in phacoemulsification
Saad Waheeb
September-December 2010, 3(3):136-139
DOI:10.4103/0974-620X.71892  PMID:21120050
Purpose : To evaluate the efficacy of topical anesthesia; topical Benoxinate 0.4% (Oxybuprocaine) and Xylocaine (Lidocaine) gel, in selected cataract patients as an alternative to peribulbar or retrobulbar block anesthesia during cataract surgery. Materials and Methods : Prospective non-comparative evaluation of patients' and surgeon's satisfaction at the end of the procedure. Three hundred patients (300 eyes) were included in the study. The procedure was explained to patients with details regarding what will happen and what to expect during surgery. All patients received topical anesthesia with Benoxinate 0.4% eye drops and Xylocaine gel 2%. All surgeries were done by the same surgeon using the same machine (updated LEGACY phacoemulsifier, Alcon) and approach (clear corneal incision) and followed by a foldable intraocular lens (IOL) implantation. Results : None of the patients had severe pain during the procedure; only 2% (six of 300) required use of intravenous sedation (Propofol), both the surgeon's and the patients' satisfaction were high. Eye movements and blepharospasm were not significant problems, and no serious complications occurred. Rate of vitreous loss due to posterior capsule tear/rupture was within literature reported range and not different from our previous experience. Conclusion : Topical anesthesia is a satisfactory and safe alternative to retrobulbar and peribulbar anesthesia for clear corneal phacoemulsification and intraocular lens implantation in selected cataract patients in the hands of experienced cataract surgeon.
  3,699 470 1
Comparison of various techniques for cataract surgery, their efficacy, safety, and cost
Parikshit Gogate
September-December 2010, 3(3):105-106
DOI:10.4103/0974-620X.71880  PMID:21120043
  3,447 615 -
Is there a perioperative circulatory side effect of intracameral epinephrine in hypertensive patients undergoing phacoemulsification?
Salima Bhallil, Idriss Benatiya Andalloussi, Oualid El Abdouni, Ibrahim Mahjoubi, Hicham Tahri
September-December 2010, 3(3):161-162
DOI:10.4103/0974-620X.71914  PMID:21120061
  2,499 276 1
Side effects and prescription errors of ocular drugs
Saqib Ali Khan Utman, Astrid Specht, Hanna Masud Baig
September-December 2010, 3(3):162-163
DOI:10.4103/0974-620X.71915  PMID:21120062
  2,439 248 -
One-and-a-half year old child with leukocoria
Kishore Hanumanthappa
September-December 2010, 3(3):157-157
DOI:10.4103/0974-620X.71908  PMID:21120057
  2,413 238 -
Lower lid entropion correction with botulinum toxin injection
Amarendra Deka, SP Saikia
September-December 2010, 3(3):158-159
DOI:10.4103/0974-620X.71909  PMID:21120058
  2,310 313 1
Combined photodynamic therapy and intravitreal bevacizumab as treatment for nonresponsive myopic choroidal neovascularization
Jay Kumar Chhablani
September-December 2010, 3(3):159-160
DOI:10.4103/0974-620X.71911  PMID:21120059
  2,004 241 1
Congenital fibrosis of the extraocular muscles
Abdullah Al-Mujaini
September-December 2010, 3(3):160-161
DOI:10.4103/0974-620X.71912  PMID:21120060
  1,855 279 -

September-December 2010, 3(3):165-165
  1,437 164 -