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Knowledge and practice of eye drops instillation technique in India: A survey of 396 optometrists 印度滴眼液技术的知识和实践:对396名验光师的调查
Pub Date : 2023-01-01 DOI: 10.4103/hjo.hjo_19_22
R. Chaurasiya, Akansha Gupta, Sarbojeet Goswami
Aim: The aim of this article is to evaluate the knowledge about perfect eye drops instillation technique among optometrists in India. Materials and Methods: An online questionnaire-based, cross-sectional study was conducted. A self-administered, electronic questionnaire with a cover letter explaining the aim of the study was distributed among optometrists practicing in India. Demographic characteristics were summarized using descriptive statistics. Categorical variables were summarized using frequencies and percentages. Results: Among 396 respondents, 237 (59.84%) were females and 159 (40.16%) were males with a mean age of 24.5 ± 2.81 years. Two-fifths of the optometrists opted for washing hands before eye drop instillation. Similarly, almost nine-tenths of the participants preferred to instill eye drops asking patients to sit and about one-tenth of the optometrist preferred patients in supine position during administering drops. Most common errors during drop instillation among optometrists were drop instillation without nasolacrimal occlusion (19.95%) and hand hygiene (69.94%). Conclusion: Proper education and awareness about eye drop instillation process should be given to all eye care practitioners so that non-compliance and incorrect methods of drop instillation can either be minimized or nullified from patients’ end.
目的:本文的目的是评估印度验光师对完美滴眼液滴注技术的了解。材料与方法:以在线问卷为基础进行横断面研究。在印度执业的验光师中分发了一份自我管理的电子问卷,并附有解释研究目的的求职信。用描述性统计方法总结人口统计学特征。分类变量用频率和百分比进行总结。结果:396例被调查者中,女性237例(59.84%),男性159例(40.16%),平均年龄24.5±2.81岁。五分之二的验光师选择在滴眼液前洗手。同样,几乎十分之九的参与者更喜欢让患者坐着滴眼液,大约十分之一的验光师更喜欢让患者在滴眼液时仰卧。验光师滴注过程中最常见的错误是无鼻泪阻塞滴注(19.95%)和手卫生(69.94%)。结论:应对所有眼科医护人员进行适当的滴眼液滴注过程教育和认识,从患者的角度减少或消除滴眼液滴注不合规和不正确的方法。
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引用次数: 0
Dissociated vertical deviation: Simplified 解离垂直偏差:简化
Pub Date : 2022-07-01 DOI: 10.4103/hjo.hjo_18_22
Neha Preet, Mittali Khurana, Srishti Sharma, Anupama Singh
Dissociated vertical deviation (DVD) is not a well-understood ocular motility disorder. It is defined as an intermittent anomaly of a non-fixing eye consisting of upward excursion, ex-cyclotorsion, and lateral deviation. It can present as latent or manifest deviation. It is usually bilateral, asymmetrical, and often associated with latent nystagmus and infantile esotropia. In unilateral cases, it can be associated with amblyopia. Binocular vision is usually absent in these patients. There are huge variations in the measurements of DVD, as it becomes visible only with one eye covered, hence making quantification of its magnitude difficult. Therefore, choosing an adequate management option is difficult. Management options include both conservative as well as surgical treatment. Conservative management is done with spectacles correction to encourage fusion. Surgical management is indicated in large, frequent DVD or with anomalous head posture. Surgical options commonly adopted are superior rectus recession with or without posterior fixation sutures. Different surgical approaches to DVD are currently being used but no recommended guidelines are available, hence is based on the amount of deviation and experience of a surgeon.
游离性垂直偏差(DVD)是一种尚未被充分理解的眼运动障碍。它被定义为非固定眼的间歇性异常,包括向上偏移、前旋扭和侧向偏移。它可以表现为潜在的或明显的偏差。它通常是双侧的,不对称的,常伴有潜伏性眼球震颤和婴儿内斜视。在单侧病例中,它可能与弱视有关。这些患者通常没有双眼视力。DVD的测量有很大的差异,因为它只有一只眼睛被遮住才能看到,因此很难量化它的大小。因此,选择一个适当的管理方案是困难的。治疗方案包括保守和手术治疗。保守治疗是通过眼镜矫正来促进融合。手术治疗适用于大,频繁的DVD或头部姿势异常。通常采用的手术选择是上直肌后退,有或没有后路固定缝合线。目前正在使用不同的DVD手术方法,但没有推荐的指导方针,因此是基于偏差的数量和外科医生的经验。
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引用次数: 0
Recent advances and innovations in ophthalmology 眼科的最新进展和创新
Pub Date : 2022-07-01 DOI: 10.4103/hjo.hjo_15_22
S. Mittal
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引用次数: 0
Refractive alternatives for prevention of myopia progression 预防近视进展的屈光替代物
Pub Date : 2022-07-01 DOI: 10.4103/hjo.hjo_16_22
Anupam Singh
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引用次数: 0
A cross-sectional comparative analysis of corneal endothelial parameters by specular microscopy in post covid versus normal population in Western India 在印度西部,通过镜面显微镜对covid后和正常人群角膜内皮参数的横断面比较分析
Pub Date : 2022-07-01 DOI: 10.4103/hjo.hjo_10_22
J. Kaushik, Ankita Singh, V. Anargh, Eram Riyaz, Srikanth Sathagopam, A. Arun kumar, Renu Nair, Ishan Aggarwal
Objective: To observe the changes in corneal endothelium post COVID-19 infection in different age groups using specular microscopy and compare it with the normal population in western India during the pandemic. Materials and Method: 129 patients COVID-19 recovered, and 123 age-matched healthy controls were included in this cross sectional, comparative, monocentric study. Corneal endothelial parameters like Cell Density (CD) (cell/mm2), Coefficient of Variation (CV) (polymegathism, %), Cell hexagonality (polymorphism, %), Average cell area (MCA) (μm2/cell), and mean value of Central Corneal Thickness (CCT) (μm) were evaluated with a non-contact specular microscope (TOMEY EM-4000, CBD.TOMEY USA) Results: The mean (SD) time since COVID diagnosis (months) in the study group was 6.67 (1.94). The mean (SD) time since RT-PCR negative (months) in the study group was 6.34 (1.74). The mean (SD) of CV (%) in the study group was (RE) 37.75 (6.03), (LE) 36.25 (4.66) and in control group was (RE) 35.23 (3.75), (LE) 34.77 (3.64). The mean (SD) of hexagonality (%) in the study group was (RE) 47.33 (6.84), 48.45 (7.33) and in control group was (RE):56.73 (4.13), (LE) 56.21 (5.34). Conclusion: The specular microscopic examination on the COVID-19 recovered patients revealed a decrease in the hexagonality of the endothelial cells (pleomorphism) and an increase in the cell size (polymegathism). Specular microscopic examination can be done to assess such earliest changes in corneal endothelium to evaluate the effects of the infection following recovery on ocular tissue to avoid long term sequalae.
目的:应用高倍显微镜观察印度西部不同年龄段人群COVID-19感染后角膜内皮的变化,并与正常人群进行比较。材料与方法:本研究采用横断面、比较性、单中心研究,纳入129例COVID-19康复患者和123例年龄匹配的健康对照。采用非接触式镜面显微镜(TOMEY EM-4000, CBD)评价角膜内皮细胞密度(CD) (Cell /mm2)、变异系数(CV)(多态,%)、细胞六边形(多态性,%)、平均细胞面积(MCA) (μm2/ Cell)和角膜中央厚度(CCT)平均值(μm)等参数。结果:研究组自COVID诊断以来的平均(SD)时间(月)为6.67(1.94)。研究组距RT-PCR阴性的平均(SD)时间(月)为6.34(1.74)。研究组CV(%)的均值(SD)为(RE) 37.75 (6.03), (LE) 36.25(4.66);对照组的均值(RE) 35.23 (3.75), (LE) 34.77(3.64)。研究组六边形(%)均值(SD)分别为(RE) 47.33(6.84)、48.45(7.33),对照组(RE) 56.73(4.13)、(LE) 56.21(5.34)。结论:新冠肺炎恢复期患者的镜下镜检显示内皮细胞六边形减少(多形性),细胞大小增加(多巨性)。镜下显微镜检查可以评估角膜内皮的早期变化,以评估恢复后感染对眼组织的影响,以避免长期后遗症。
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引用次数: 0
Post-ROCM restrictive strabismus: A challenge for strabismus surgeon rocm后限制性斜视:斜视外科医生面临的挑战
Pub Date : 2022-07-01 DOI: 10.4103/hjo.hjo_17_22
Ashutosh Kumar Singh, S. Verma, Mittali Khurana, Srishti Sharma, P. Kumari, A. Tyagi
Restrictive strabismus is characterized by extraocular motility restriction, which is confirmed by performing forced duction test. It can be congenital because of various syndromes or acquired after thyroid eye disease, after long-standing strabismus, after sinus surgery, or after trauma. Recently, we have faced a devastating epidemic of rhino-orbito-cerebral mucormycosis (ROCM) during the second wave of COVID-19 pandemic, which was treated by both surgical (sinus surgery) and medical (antifungal agents) modalities. Diabetes mellitus and the inadvertent use of systemic steroid were the leading risk factors for ROCM outbreak. India being the diabetic capital of the world favored this condition. We are reporting a challenging case of ROCM with diabetes mellitus, who presented to us with troublesome diplopia with extraocular motility restriction. He had a history of right-sided ROCM treated by sinus surgery and systemic antifungal agents 1 year back, followed by a good residual vision and restrictive strabismus leading to the symptoms. A previous history of sinus surgery and post-ROCM scarring and narrow surgical field posed a great challenge for strabismus surgery. In spite of all odds, a good postoperative alignment was achieved by a single-stage strabismus surgery, and the patient was asymptomatic after 3 months of follow-up.
限制性斜视以眼外运动受限为主要特征,可通过强迫屈光度试验证实。它可以是由于各种综合征而先天性的,也可以是甲状腺眼病、长期斜视、鼻窦手术或外伤后获得的。最近,在第二波COVID-19大流行期间,我们面临着一场毁灭性的鼻-眶-脑毛霉菌病(ROCM)流行,该疾病通过手术(鼻窦手术)和药物(抗真菌药物)两种方式治疗。糖尿病和不小心使用全身性类固醇是ROCM爆发的主要危险因素。印度是世界糖尿病之都,这有利于这种情况。我们报告一个具有挑战性的病例ROCM合并糖尿病,谁向我们提出了麻烦的复视与眼外运动限制。患者有右侧ROCM病史,1年前接受鼻窦手术和全身抗真菌药物治疗,随后视力良好,限制性斜视导致症状。既往的鼻窦手术史和术后瘢痕及狭窄的手术视野对斜视手术提出了很大的挑战。尽管困难重重,通过单期斜视手术获得了良好的术后对齐,患者在随访3个月后无症状。
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引用次数: 0
An overview of microbiological profile in chronic microbial keratitis at a tertiary care center 在三级保健中心的慢性微生物性角膜炎的微生物概况概述
Pub Date : 2022-07-01 DOI: 10.4103/hjo.hjo_11_22
Manisha Gupta, Priyanka Gupta, Juhi Panwar
Aims: Clinical feature and microbiological investigation help in reaching the diagnosis in cases of microbial keratitis. But in cases where a patient is already on polytopical therapy, clinical features are altered so dependency on microbiological investigation is more by the time cases reached to the referred hospital. The present study aimed to overview the profile of microbial investigation in microbial corneal ulcer cases that were already on polytherapy referred to the ophthalmic department of tertiary care center. Materials and Methods: This is a retrospective hospital record-based study where microbiological reports of 58 infective keratitis cases of moderate-to-severe nature were analyzed. Statistical analysis was calculated with confidence intervals (CIs) using “Medcalc” statistical software online. Results: Following are the results of the study: 52% patients were males; 18.97% cases were positive for Gram stain. Aerobic culture was positive in 10.34%; potassium hydroxide (KOH) mount was positive in 9.62% cases; sabouraud dextrose agar culture was positive in 7.69% cases. Sensitivity of Gram stain was 33.3% (95% CI: 4.33%–77.72%), whereas specificity was 82.7% (95% CI: 69.67%–91.77%); positive predictive value (PPV) was 18.18% (95% CI: 2.28%–51.78%) and negative predictive value (NPV) was 91.49% (95% CI: 79.62%–97.63%). Sensitivity of KOH mount was 25% (95% CI: 0.63%–80.59%), whereas specificity was 91.67% (95% CI: 80.02%–97.68%); PPV was 20.20% (95% CI: 0.51%–71.64%) and NPV was 93.62% (95% CI: 82.46%–98.66%). Pseudomonas aeruginosa and Staphylococcus aureus were the most common bacterial isolates. Conclusions: Basic microbiological investigations have a low yield in chronic infectious keratitis cases that are on prior cocktail long-term therapy. Therefore, advanced tests such as polymerase chain reaction, confocal microscopy, and corneal biopsy may be helpful in managing such challenging cases.
目的:对细菌性角膜炎的临床特点和微生物学检查有助于诊断。但是,如果患者已经接受了多局部治疗,则临床特征会发生改变,因此当患者到达转诊医院时,对微生物调查的依赖程度更高。摘要本研究旨在回顾在三级保健中心眼科接受综合治疗的微生物性角膜溃疡病例的微生物调查概况。材料和方法:这是一项基于医院记录的回顾性研究,分析了58例中重度感染性角膜炎病例的微生物学报告。统计分析采用“Medcalc”在线统计软件计算置信区间(ci)。结果:研究结果如下:52%的患者为男性;革兰氏染色阳性18.97%。好氧培养阳性占10.34%;9.62%的病例氢氧化钾(KOH) mount阳性;Sabouraud葡萄糖琼脂培养阳性率为7.69%。革兰氏染色的敏感性为33.3% (95% CI: 4.33% ~ 77.72%),特异性为82.7% (95% CI: 69.67% ~ 91.77%);阳性预测值(PPV)为18.18% (95% CI: 2.28% ~ 51.78%),阴性预测值(NPV)为91.49% (95% CI: 79.62% ~ 97.63%)。KOH mount的敏感性为25% (95% CI: 0.63% ~ 80.59%),特异性为91.67% (95% CI: 80.02% ~ 97.68%);PPV为20.20% (95% CI: 0.51% ~ 71.64%), NPV为93.62% (95% CI: 82.46% ~ 98.66%)。铜绿假单胞菌和金黄色葡萄球菌是最常见的分离菌。结论:基础微生物学检查在长期接受鸡尾酒治疗的慢性感染性角膜炎患者中效果较差。因此,先进的测试,如聚合酶链反应,共聚焦显微镜和角膜活检可能有助于管理这类具有挑战性的病例。
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引用次数: 0
Pediatric penetrating keratoplasty and its unique challenges 儿童穿透性角膜移植术及其独特的挑战
Pub Date : 2022-07-01 DOI: 10.4103/hjo.hjo_12_22
A. Raj
Pediatric penetrating keratoplasty (PK) or full-thickness cornea transplant is defined as PK in a patient younger than 16 years old. This procedure is different from the adult due to anatomical differences of the globe, excessive inflammation postoperatively, the higher expectation of the parents, and less visual outcome due to amblyopia. It is often convenient to look at these issues at various stages such as preoperative, intraoperative, and postoperative phases. All these phases pose their own unique challenges that can be managed with various strategies. Proper indication of the PK, proper evaluation, timing of the surgery, surgical planning and technique, intraoperative considerations, postoperative management, follow-ups, and outcome measurement matters a lot for the success of this surgery. Everything eventually affects the outcome and prognosis of PK in the pediatric age group.
儿童穿透性角膜移植术(PK)或全层角膜移植定义为16岁以下患者的PK。由于眼球的解剖差异、术后过度炎症、父母的期望较高以及弱视导致的视力效果较差,该手术与成人手术不同。在术前、术中和术后等不同阶段观察这些问题通常是方便的。所有这些阶段都有自己独特的挑战,可以通过各种策略进行管理。正确的PK指征、正确的评估、手术时机、手术计划和技术、术中注意事项、术后管理、随访和结果测量对手术的成功至关重要。所有因素最终都会影响到儿童年龄组PK的结局和预后。
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引用次数: 0
Vitreopapillary traction a missed or underdiagnosed entity: Case report 玻璃体乳头牵引遗漏或诊断不足:1例报告
Pub Date : 2022-07-01 DOI: 10.4103/hjo.hjo_14_22
G. Sood, S. Mahajan, Aditi Parashar, S. Sood
We report two cases of pseudo disc edema due to vitreopapillary traction. The first is 50-year- old female who had been evaluated for disc edema, with normal neurological examination and imaging study. On presentation we noted the presence of glial tissue at disc bilaterally and optical coherence tomography (OCT) revealed vitreopapillary traction (VPT). Second case is a 63-year old female who presented with history of unilateral blurring of vision in right eye. On examination she had cataract in right eye with blurring of bilateral disc margins. There was no colour vision or field defect and OCT was supportive of VPT.
我们报告两例假椎间盘水肿由于玻璃体乳头牵引。第一位患者为50岁女性,经诊断为椎间盘水肿,神经系统检查和影像学检查正常。在就诊时,我们注意到双侧椎间盘存在神经胶质组织,光学相干断层扫描(OCT)显示玻璃体乳头牵引(VPT)。第二例为63岁女性,有右眼单侧视力模糊病史。检查发现右眼白内障伴双侧椎间盘边缘模糊。无色觉或视野缺损,OCT支持VPT。
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引用次数: 0
Frequency-double Nd-YAG laser hyaloidotomy for treatment of small subhyaloid hemorrhage at the fovea
Pub Date : 1900-01-01 DOI: 10.4103/hjo.hjo_4_22
G. Sood, S. Mahajan, S. Sood, Aditi Parashar
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引用次数: 0
期刊
Himalayan Journal of Ophthalmology
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