A 49-year-old female presented with complaints of right-sided headache, right eye severe pain, and diminution of vision since 1 month. Examination revealed healed skin rashes over the right side of the forehead, right upper lid mechanical ptosis, unilateral restriction of movements, corneal edema, total hyphema, and thickening of retino-choroido-scleral (RCS) complex with subtenon fluid on ultrasonography. A diagnosis of herpes zoster uveitis with total hyphema with posterior scleritis was considered. She was started on topical steroids and intraocular pressure (IOP) lowering agents. But, she was lost to follow up and 6 months later, the eye was phthisical. Here, we present a relatively rare case of herpes zoster ophthalmicus (HZO) with hyphema and posterior scleritis.
{"title":"A conventional case of herpes zoster ophthalmicus with curious findings","authors":"Aravind Yaragani, Kamala Subramanian","doi":"10.4103/kjo.kjo_105_22","DOIUrl":"https://doi.org/10.4103/kjo.kjo_105_22","url":null,"abstract":"A 49-year-old female presented with complaints of right-sided headache, right eye severe pain, and diminution of vision since 1 month. Examination revealed healed skin rashes over the right side of the forehead, right upper lid mechanical ptosis, unilateral restriction of movements, corneal edema, total hyphema, and thickening of retino-choroido-scleral (RCS) complex with subtenon fluid on ultrasonography. A diagnosis of herpes zoster uveitis with total hyphema with posterior scleritis was considered. She was started on topical steroids and intraocular pressure (IOP) lowering agents. But, she was lost to follow up and 6 months later, the eye was phthisical. Here, we present a relatively rare case of herpes zoster ophthalmicus (HZO) with hyphema and posterior scleritis.","PeriodicalId":32483,"journal":{"name":"Kerala Journal of Ophthalmology","volume":"32 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70823627","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
To study the clinical profile and presence of perilimbal pigmentation in cases of vernal keratoconjunctivitis (VKC). This was an observational, cross-sectional study conducted at a tertiary eye care center in western-Maharashtra from March 2019 to February 2020. One hundred fifty-two cases of VKC were identified by history, characteristic symptomatology, and slit-lamp examination. The Statistical Package for the Social Sciences (SPSS) version 20.0 for Windows was used. The relationship of extent of pigmentation with severity and duration of the disease was analyzed using Chi-squared test. A P value of less than 0.05 was considered significant. Out of 152 cases, 79.61% were males. The mean age at presentation was 11.4 ± 5.62 years. A majority (38.82%) reported in the months of May–June. Most of them had mixed form followed closely by palpebral form. The most common symptom was itching. However, complications like focal-limbal stem-cell deficiency and shield-ulcer were seen in a few cases. Notably, the characteristic perilimbal-bulbar pigmentation was noted in 81 cases (53.29%; 95% CI 45.03%–61.42%; P < 0.0001), of which 15 had pigmentation in all the four quadrants (P = 0.0033). The extent of pigmentation corelated significantly with the severity of the disease (P < 0.0001). However, it did not correlate with the duration of the disease (P = 0.0794). Studies on VKC in India provide limited epidemiological data, and there has been no significant series that has explained its clinical pattern in the western part of the country. The presence of perilimbal pigmentation may be a diagnostic sign in mild VKC when signs and symptoms are subtle. This knowledge will help in early diagnosis and management and thus, help prevent sight-threatening complications of VKC.
目的:探讨春性角膜结膜炎(VKC)患者的临床特征及包膜周围色素沉着的存在。这是一项观察性横断面研究，于2019年3月至2020年2月在马哈拉施特拉邦西部的一家三级眼科护理中心进行。本文通过病史、症状特征及裂隙灯检查确定了152例VKC。使用SPSS 20.0 for Windows的社会科学统计软件包。采用卡方检验分析色素沉着程度与病情严重程度及病程的关系。A P值小于0.05被认为是显著的。152例中男性占79.61%。平均发病年龄11.4±5.62岁。大多数(38.82%)报告发生在5月至6月。多数为混合型，其次为眼睑型。最常见的症状是瘙痒。然而，局部角膜缘干细胞缺乏和屏障性溃疡等并发症也见于少数病例。值得注意的是，81例(53.29%)患者出现特征性的球周围色素沉着;95% ci 45.03%-61.42%;P < 0.0001)，其中四个象限均有15例色素沉着(P = 0.0033)。色素沉着程度与疾病严重程度显著相关(P < 0.0001)。然而，它与疾病持续时间无关(P = 0.0794)。印度对VKC的研究提供了有限的流行病学数据，并且没有重要的系列研究可以解释该国西部地区的临床模式。当体征和症状不明显时，阴囊周围色素沉着的存在可能是轻度VKC的诊断体征。这些知识将有助于早期诊断和治疗，从而有助于预防威胁视力的VKC并发症。
{"title":"An observational study on the clinical picture of vernal keratoconjunctivitis at a tertiary care center in Western India","authors":"M. Agrawal, Srujana Dubbaka, Sumedha Vats","doi":"10.4103/kjo.kjo_22_22","DOIUrl":"https://doi.org/10.4103/kjo.kjo_22_22","url":null,"abstract":"To study the clinical profile and presence of perilimbal pigmentation in cases of vernal keratoconjunctivitis (VKC). This was an observational, cross-sectional study conducted at a tertiary eye care center in western-Maharashtra from March 2019 to February 2020. One hundred fifty-two cases of VKC were identified by history, characteristic symptomatology, and slit-lamp examination. The Statistical Package for the Social Sciences (SPSS) version 20.0 for Windows was used. The relationship of extent of pigmentation with severity and duration of the disease was analyzed using Chi-squared test. A P value of less than 0.05 was considered significant. Out of 152 cases, 79.61% were males. The mean age at presentation was 11.4 ± 5.62 years. A majority (38.82%) reported in the months of May–June. Most of them had mixed form followed closely by palpebral form. The most common symptom was itching. However, complications like focal-limbal stem-cell deficiency and shield-ulcer were seen in a few cases. Notably, the characteristic perilimbal-bulbar pigmentation was noted in 81 cases (53.29%; 95% CI 45.03%–61.42%; P < 0.0001), of which 15 had pigmentation in all the four quadrants (P = 0.0033). The extent of pigmentation corelated significantly with the severity of the disease (P < 0.0001). However, it did not correlate with the duration of the disease (P = 0.0794). Studies on VKC in India provide limited epidemiological data, and there has been no significant series that has explained its clinical pattern in the western part of the country. The presence of perilimbal pigmentation may be a diagnostic sign in mild VKC when signs and symptoms are subtle. This knowledge will help in early diagnosis and management and thus, help prevent sight-threatening complications of VKC.","PeriodicalId":32483,"journal":{"name":"Kerala Journal of Ophthalmology","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70824063","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Comments on “Amblyopia: Effectiveness of visual screening for early detection in a comparative study between urban and rural children”","authors":"RB Radhika Krishnan","doi":"10.4103/kjo.kjo_64_23","DOIUrl":"https://doi.org/10.4103/kjo.kjo_64_23","url":null,"abstract":"","PeriodicalId":32483,"journal":{"name":"Kerala Journal of Ophthalmology","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70826355","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Ophthalmic conferences: Time for change?","authors":"Smita Narayanan","doi":"10.4103/kjo.kjo_82_23","DOIUrl":"https://doi.org/10.4103/kjo.kjo_82_23","url":null,"abstract":"","PeriodicalId":32483,"journal":{"name":"Kerala Journal of Ophthalmology","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70827037","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Myopia is becoming increasingly prevalent, posing a significant economic and social burden across the world. Myopia is one of the most common ocular disorders of the eye causing defective vision in young and adults, which is correctable by optical aids and surgical means. In addition to the disadvantages in terms of vision impairment, myopia increases the risk of myopic macular degeneration, retinal detachment, and cataract producing a significant effect on the quality of life as well. Progressive myopia can lead to potentially blinding complications. This article is aimed at discussing various interventions that can reduce the progression of myopia in childhood and include environmental considerations, pharmacological agents, and newer advances in spectacles and contact lenses.
{"title":"Myopia: Strategies to prevent progression","authors":"Geethu Sasidharan, B. Thampi","doi":"10.4103/kjo.kjo_53_22","DOIUrl":"https://doi.org/10.4103/kjo.kjo_53_22","url":null,"abstract":"Myopia is becoming increasingly prevalent, posing a significant economic and social burden across the world. Myopia is one of the most common ocular disorders of the eye causing defective vision in young and adults, which is correctable by optical aids and surgical means. In addition to the disadvantages in terms of vision impairment, myopia increases the risk of myopic macular degeneration, retinal detachment, and cataract producing a significant effect on the quality of life as well. Progressive myopia can lead to potentially blinding complications. This article is aimed at discussing various interventions that can reduce the progression of myopia in childhood and include environmental considerations, pharmacological agents, and newer advances in spectacles and contact lenses.","PeriodicalId":32483,"journal":{"name":"Kerala Journal of Ophthalmology","volume":"34 1","pages":"285 - 290"},"PeriodicalIF":0.0,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49320400","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pilomatrixoma is a rare periocular benign tumor involving hair follicle matrix cells. It presents as a hard, painless, and gradually enlarging mass. It is more common in Caucasians, has bimodal age distribution (5–15 years and 50–65 years) and with female preponderance. We present a rare case report of a 35-year-old Indian male presenting with progressively enlarging; noninflammatory mass in the left upper eyelid for which excision biopsy was performed and a diagnosis of pilomatrixoma was arrived at. The main differential diagnosis includes chalazion and it is vital to distinguish them prior to any surgical intervention as both have different lines of management. This article also deals with the clinical as well as histopathological features and syndromic association of pilomatrixoma along with a brief mention of its malignant variation. This case report also includes intraoperative photographs of the lesion which the authors could not find during literature search.
{"title":"A case report of eyelid pilomatrixoma: A rare presentation","authors":"P. Jain, Sapna Bhandari, A. Pattnaik, P. Shinde","doi":"10.4103/kjo.kjo_191_20","DOIUrl":"https://doi.org/10.4103/kjo.kjo_191_20","url":null,"abstract":"Pilomatrixoma is a rare periocular benign tumor involving hair follicle matrix cells. It presents as a hard, painless, and gradually enlarging mass. It is more common in Caucasians, has bimodal age distribution (5–15 years and 50–65 years) and with female preponderance. We present a rare case report of a 35-year-old Indian male presenting with progressively enlarging; noninflammatory mass in the left upper eyelid for which excision biopsy was performed and a diagnosis of pilomatrixoma was arrived at. The main differential diagnosis includes chalazion and it is vital to distinguish them prior to any surgical intervention as both have different lines of management. This article also deals with the clinical as well as histopathological features and syndromic association of pilomatrixoma along with a brief mention of its malignant variation. This case report also includes intraoperative photographs of the lesion which the authors could not find during literature search.","PeriodicalId":32483,"journal":{"name":"Kerala Journal of Ophthalmology","volume":"34 1","pages":"268 - 270"},"PeriodicalIF":0.0,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42293897","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"A mother's perspective on balancing family life, science, and ophthalmology","authors":"Rachel Chong","doi":"10.4103/kjo.kjo_104_22","DOIUrl":"https://doi.org/10.4103/kjo.kjo_104_22","url":null,"abstract":"","PeriodicalId":32483,"journal":{"name":"Kerala Journal of Ophthalmology","volume":"34 1","pages":"197 - 198"},"PeriodicalIF":0.0,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45335522","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Purpose: This study aimed to study and correlate fundus changes in patients with Type 2 diabetes mellitus with different stages of nephropathy. Materials and Methods: It is a prospective, observational study involving 100 patients at a tertiary health-care institute. Type 2 diabetic patients with diabetic nephropathy (DN) were enrolled. Those with uncontrolled hypertension, history of other ocular diseases, or surgeries were excluded. DN was defined as – microalbuminuria, macroproteinuria, and massive proteinuria based on 24-h urine protein analyser values. Participants underwent complete ophthalmic examination with fundus examination, fundus fluorescein angiography, and optical coherence tomography and were graded into various stages of diabetic retinopathy. The influence of nephropathy on retinal changes was assessed using Pearson's correlation analysis. Results: The study population included those with a median age of 56 years (range 38–79 years). In the group with microalbuminuria, 10 (62%) eyes did not have any retinopathy changes. In the macroproteinuria group, 61 (53%) showed mild-to-moderate nonproliferative diabetic retinopathy (PDR). In addition, 30 eyes of patients (48%) with massive proteinuria had PDR which were all statistically significant. Also in 32 eyes (16%) of DN patients, clinically significant macular edema was present, most of which, i.e., 24 (75%), were in the macroproteinuria group. Conclusions: These findings indicated that the severity of proteinuria was significantly associated with fundus changes in Type 2 diabetic patients. Thus, we conclude that DN is a marker of retinopathy and timely ophthalmic evaluation of patients should be done.
{"title":"Diabetic nephropathy may predict the retinal changes of patients with diabetes: An Indian population-based study","authors":"Saloni Gupta, Sahil Agrawal, Shailender Chaudhary, Mitali Jhamb","doi":"10.4103/kjo.kjo_208_21","DOIUrl":"https://doi.org/10.4103/kjo.kjo_208_21","url":null,"abstract":"Purpose: This study aimed to study and correlate fundus changes in patients with Type 2 diabetes mellitus with different stages of nephropathy. Materials and Methods: It is a prospective, observational study involving 100 patients at a tertiary health-care institute. Type 2 diabetic patients with diabetic nephropathy (DN) were enrolled. Those with uncontrolled hypertension, history of other ocular diseases, or surgeries were excluded. DN was defined as – microalbuminuria, macroproteinuria, and massive proteinuria based on 24-h urine protein analyser values. Participants underwent complete ophthalmic examination with fundus examination, fundus fluorescein angiography, and optical coherence tomography and were graded into various stages of diabetic retinopathy. The influence of nephropathy on retinal changes was assessed using Pearson's correlation analysis. Results: The study population included those with a median age of 56 years (range 38–79 years). In the group with microalbuminuria, 10 (62%) eyes did not have any retinopathy changes. In the macroproteinuria group, 61 (53%) showed mild-to-moderate nonproliferative diabetic retinopathy (PDR). In addition, 30 eyes of patients (48%) with massive proteinuria had PDR which were all statistically significant. Also in 32 eyes (16%) of DN patients, clinically significant macular edema was present, most of which, i.e., 24 (75%), were in the macroproteinuria group. Conclusions: These findings indicated that the severity of proteinuria was significantly associated with fundus changes in Type 2 diabetic patients. Thus, we conclude that DN is a marker of retinopathy and timely ophthalmic evaluation of patients should be done.","PeriodicalId":32483,"journal":{"name":"Kerala Journal of Ophthalmology","volume":"34 1","pages":"245 - 249"},"PeriodicalIF":0.0,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44808799","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Prevention of postoperative endophthalmitis – some random thoughts","authors":"S. Pillai","doi":"10.4103/kjo.kjo_103_22","DOIUrl":"https://doi.org/10.4103/kjo.kjo_103_22","url":null,"abstract":"","PeriodicalId":32483,"journal":{"name":"Kerala Journal of Ophthalmology","volume":"34 1","pages":"195 - 196"},"PeriodicalIF":0.0,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41477325","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Shailender Chaudhary, Saloni Gupta, Gangadhar Thellam, R. Tyagi, Sahil Agrawal
Introduction: Retinal vein obstruction is one of the leading causes of severe vision impairment and blindness with treatment options mainly including laser, vascular endothelial growth factors, and steroids. This study investigates an intravitreal dexamethasone implant (ozurdex), its efficacy, and complications in patients of retinal venous occlusion. Methods: A prospective, interventional study involving 30 patients with retinal venous occlusion. Patients diagnosed with RVO who had vision loss of at least two lines on Snellen's chart and increased central macular thickness (CMT) on OCT were included in the study. All the parameters such as best-corrected visual acuity (BCVA), CMT, and intraocular pressure (IOP) were noted at baseline for the affected eye. The patients were followed up at 1 month, 2 months, and 3 months following the implant. Result: Baseline parameters were comparable between the groups. Eyes receiving the implant had a statistically significant improvement (P < 0.001) in BCVA on the Snellen chart over the 3 months. There was also a constant decrease in macular edema and the mean difference value of CMT between baseline and 1 month, 2 months, and 3months were also found to be statistically significant. Also, a comparison of IOP between two-time points was done, between baseline and 1 month, 2 months, 3 months, and the mean difference value in IOP was also found to be significant but clinically well within the normal physiological range. Conclusion: The study concluded that an intravitreal dexamethasone implant is an effective treatment for retinal venous occlusion, and it has a statistically significant and clinically meaningful effect on BCVA and CMT. However, it may be associated with a significant rise in IOP but it is well within the physiological range.
{"title":"To study the effect of intravitreal ozurdex implant in cases of retinal vein occlusion","authors":"Shailender Chaudhary, Saloni Gupta, Gangadhar Thellam, R. Tyagi, Sahil Agrawal","doi":"10.4103/kjo.kjo_230_21","DOIUrl":"https://doi.org/10.4103/kjo.kjo_230_21","url":null,"abstract":"Introduction: Retinal vein obstruction is one of the leading causes of severe vision impairment and blindness with treatment options mainly including laser, vascular endothelial growth factors, and steroids. This study investigates an intravitreal dexamethasone implant (ozurdex), its efficacy, and complications in patients of retinal venous occlusion. Methods: A prospective, interventional study involving 30 patients with retinal venous occlusion. Patients diagnosed with RVO who had vision loss of at least two lines on Snellen's chart and increased central macular thickness (CMT) on OCT were included in the study. All the parameters such as best-corrected visual acuity (BCVA), CMT, and intraocular pressure (IOP) were noted at baseline for the affected eye. The patients were followed up at 1 month, 2 months, and 3 months following the implant. Result: Baseline parameters were comparable between the groups. Eyes receiving the implant had a statistically significant improvement (P < 0.001) in BCVA on the Snellen chart over the 3 months. There was also a constant decrease in macular edema and the mean difference value of CMT between baseline and 1 month, 2 months, and 3months were also found to be statistically significant. Also, a comparison of IOP between two-time points was done, between baseline and 1 month, 2 months, 3 months, and the mean difference value in IOP was also found to be significant but clinically well within the normal physiological range. Conclusion: The study concluded that an intravitreal dexamethasone implant is an effective treatment for retinal venous occlusion, and it has a statistically significant and clinically meaningful effect on BCVA and CMT. However, it may be associated with a significant rise in IOP but it is well within the physiological range.","PeriodicalId":32483,"journal":{"name":"Kerala Journal of Ophthalmology","volume":"34 1","pages":"234 - 239"},"PeriodicalIF":0.0,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49478685","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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