001-028.ps, page 1-28 @ normalize ( sc preliminary.indd )aios.org/posters.pdf · study of 30 eyes...

377

SCIENTIFIC

POSTERS

YOUR POSTER IN AIOS PROCEEDINGS…

Please send your Poster material in Corel Draw format in a CD to the Editor, Proceedings — AIOS for inclusion

in his next Proceedings CD.

Please do not forget to mention your

Poster Panel/Board No. & FP Code No. on the CD.

SCIENTIFICSCIENTIFICPOSTERS

The Best Poster selected from those displayed will be eligible for the

E.T. SELVAM AWARD(Subject to the conditions of the Award)

Non-ratified members will not be eligible for any AIOS Award

378

Information InSight

SCIENTIFIC POSTER SCHEDULING INFORMATIONPoster Panel/Board Number 1-100 has to be set up from 7:00 AM to 9:00 AM on January 31, 2008, displayed on January 31, 2008 and February 1, 2008 and removed at 6:00 PM on February 1, 2008. (FIRST 2 DAYS ONLY)

Poster Panel/Board Number 101-200 has to be set up from 7:00 AM to 9:00 AM on February 2, 2008, displayed on February 2, 2008 and February 3, 2008 and removed at 2:00 PM on February 3, 2008 (LAST 2 DAYS ONLY)

Set-up time:, 7:00 AM to 9:00 AM

Display time: 9:00 AM to 6.00 PM

Display venue: Poster Area at Videhi Institute of Medical Sciences, White Field, Bangalore.

Maximum poster dimensions: 150 cm (60 inches) horizontally and 90 cm (36 inches) vertically. The poster board will be oriented horizontally. LOC will provide the poster board, a sign noting your poster number and push pins.

Dismantling time: 6:00 PM (Posters left on the display board beyond the allowed dismantling time will be discarded)

Discussion time: Authors are required to be present at their posters for a specified 1-hour period for discussion with the interested delegates and to facilitate judging for the Best Poster Award.

Please collect your Scientific Poster Presentation Certificate from the Coordinator at the Poster area [UNCOLLECTED CERTIFICATES WILL NOT BE SENT BY POST] and also have to sign a register at the time of Set-up & Dismantling. The Best Poster selected will be eligible for the E.T. SELVAM AWARD. You will be considered for the same, if you haven’t already won the award and if you are a ratified member of AIOS. Non-ratified members poster will NOT be evaluated/marked.

Submissions accepted as Scientific Poster may be read in the HYDE PARK session (5 Minutes only) on 3.2.2008 Hall N from 11 am-1, if registered with the Chairman, Scientific Committee. Only first 20 requests will be accepted. In case of large no. of requests are received, selection will be made on marks scored. The Poster will also have to be displayed in the allotted Board no. Hyde Park entries will be given a Certificate of presentation as a PAPER but will NOT be eligible for any Award for the paper other than the eligibility for the poster. For each presenting author, only one paper will be allowed to present at Hyde Park.

JUDGES FOR THE BEST POSTER:Judges visiting time: Posters 1-100 on 1st February 2008 from 3:00 PM to 4:00 PM & Posters 101-200 on 2nd February 2008 from 3:00 PM to 4:00 PM.

Dr. AJIT BABU MAJJI

Dr. (Col) R. P. GUPTA

Dr. RAVI SHANKAR K.

Dr. SAXENA ANAND

Dr. SHREEKANT KELKAR B.

379

SCIENTIFIC

POSTERS

WINNER OF E.T. SELVAM AWARD*

FOR THE BEST POSTER ATAIOC 2007, HYDERABAD

Poster Panel No. 1 [FP1081/2007]*

COMPARATIVE RESULTS OF VARIOUS TREATMENT MODALITIES FOR RECALCITRANT DIABETIC MACULAR OEDEMA (DME)

Dr. MEENA CHAKRABARTI [Dr. MEENA CHAKRABARTI], Dr. VALSA STEPHEN, Dr. SONIA RANI JOHN, Dr. ARUP CHAKRABARTI — TRIVANDRUM

Aim: To compare the efficacy of various treatment modalities for recalcitrant DME. Methods: Prospective randomized study was carried out on 40 eyes of 20 patients. Group I (PPV group) underwent vitrectomy and focal laser where Triamcinolone Acetonide (TA) was used to induce posterior vitreous detach-ment (PVD) while Group II (IVT Group) received only Intravitreal TA followed by laser PHC. Data analyzed included resolution of DME, visual improve-ment, recurrences and complications. Results: Analysis of results showed resolution in 84.6% of Group I Vs 30% of Group II eyes; visuals improvement (50% Group I Vs 43% Group II), recurrence (6% Vs 40%) and glaucoma (2% Vs 30%). Conclusion: PPV with TA assisted PVD induction and focal laser appears to provide greater benefits in the control of recalcitrant DME.

Poster Panel/Board number 1-100 has to be set up from 7:00 AM to 9:00 AM on January 31, 2008, displayed on January 31, 2008 and February 1, 2008 and

removed at 6:00 PM on February 1, 2008 (FIRST 2 DAYS ONLY)

Poster Panel No. 2 [FP0627] CATARACT

OUTCOME OF MANUAL SMALL INCISION CATARACT SURGERY BY PHACO-SANDWICH TECHNIQUE – A COHORT STUDY

Dr. ASHWINI MEHERDA [Presenting Author: Dr. ASHWINI MEHERDA], Dr. PATTANAYAK SABYASACHI — JAGATSINGHPUR

The study was conducted to evaluate the surgical and postoperative outcome of 100 consecutive cases of age related cataract of all grades without any risk factor for cataract surgery undergoing manual small incision cataract surgery by phaco sandwich technique. Evaluations are made at 2nd, 4th and 6th post operative week on the basis of pre and post operative keratometry results, intra-operative complications encountered, post operative corneal clarity and time period of visual rehabilitation to prove the advantages of phaco-sandwich technique as a safe and simple procedure associated with least complications.

SCIENTIFIC POSTERS

380

Information InSight


ASTIGMATISM, VISUAL RECOVERY, AND STABLE REFRACTION IN CONVENTIONAL ECCE, SUTURED SICS, AND SUTURELESS SICS

Dr. RAJWINDER KAUR [Presenting Author: Dr. RAJWINDER KAUR], Dr. HARJEET KAUR SIDHU, Dr. BHATNAGAR RAVINDRA NATH, Dr. AMIT GROVER, Dr. TRIVENI GROVER, Dr. RAJESH GARG — PATIALA

Aim: To evaluate surgically induced astigmatism, visual recovery and stable refraction in conventional ECCE, sutured SICS, and sutureless SICS. Methods: 30 patients each of ECCE, sutured SICS, and sutureless SICS were examined for BCVA, refraction, and astigmatism 1, 4, 6, and 12 weeks postop. Results: (1) All groups had BCVA 6/18 or better at 12 weeks (2) Group 1 showed stable refraction at 12 weeks, group 2 at 6 weeks and group 3 at 4 weeks (3) Astigmatism was 2.41 D, 1.60 D, 0.88 D respectively.


MICROPHAKO-PRIMARY POSTERIOR CAPSULORHEXIS : A PROSPECTIVE STUDY OF 30 EYES WITH CONGENITAL CATARACT

Dr. CHANDRAKANTHA K.S. [Presenting Author: Dr. CHANDRAKANTHA K.S.], Dr. NIRUPAMA R., Dr. SHEEJA VISWANATH — CALICUT

30 eyes between the age group of 4 years to 7 years were involved in this study. 10 children had bilateral and other 10 had unilateral cataracts. Visual Acuity ranged between 3/60 and 6/36 (S G charts were used). Systemic diseases were excluded. All the surgeries were performed by a single surgeon. All the eyes underwent Phakoemulsification, wherein only the irrigation and aspiration probe was used to remove the soft cataract after performing anterior Capsulorhexis. A primarly posterior capsulorhexiswas performed about 4 mm in diameter under viseolastics. In all eyes a large haptic (6 mm) Rigid IOL was placed between the leaves of Anterior and posterior Capsules.There was no intra or post operative complications. 3 eyes developed thick inflammatory membrane. 22 eyes had a best corrected visual acuity of 6/12.


PHACOEMULSIFICATION OF LENS COLOBOMAS WITH CAPSULAR TENSION RING INSERTION AND FOLDABLE LENS IMPLANTATION-GOOD SURGICAL AND VISUAL OUTCOME

Dr. (Prof.) MEENAKSHI YADAV DHAR [Presenting Author: Dr. (Prof.) MEENAKSHI YADAV DHAR], Dr. LAKSHMI NISHA MENON, Dr. NIRANJAN PHERE — COCHIN

We describe the management of five eyes with lenticular colobomas with absence of zonules. The surgical precautions and capsular tension ring insertion [CTR] ensured a good visual outcome. Strategies included – small, central capsulorhexis with careful, slow hydrodissection at multiple sites; using copious amounts of viscoelastices — ‘soft-shell technique’ i.e. both dispersive and cohesive — with no stress on the zonules, to prevent vitreous herniation and also not to over

381

SCIENTIFIC

POSTERS

pressurise anterior chamber; phaco with low flow and aspiration settings with appropriate power; and implantation of single piece foldable IOL. CTR ensures the capsular support, enhances safety of phaco and long term stable IOL placement.


CLINICAL PEARLS OF THE SAFETY OF PROPHYLACTIC INTRACAMERAL TOPICAL MOXIFLOXACIN IN CATARACT SURGERY

Dr. ASHOK GARG [Presenting Author: Dr. ASHOK GARG] — HISAR

This study was designed to determine the safety of Intracameral Moxifloxacin (0.5%) solution in 60 patients under going cataract surgery. All patients received an Intracameral injection of 0.1 ml Moxifloxacin Solution (0.5%) through a 27 guage cannula at the end of the surgery. The average patient age was 68.5%. Intracameral Moxifloxacin solution is non-toxic in terms of visual rehabilitation, anterior cahmber cell/flare and endothelial cell density. Intracameral Moxifloxacin seemed to provide a benefit in preventing endophalmitis and decreases the risk of developing TASS (Toxic Anterior Segement Syndrome).


CATARACT SURGERY IN SUBLUXATED CATARACTUOUS LENS — MY EXPERIENCES

Dr. SINGH S.P. [Presenting Author: Dr. SINGH S.P.] — ALLAHABAD

Aim: To discuss cataract surgery in various grades of subluxated lens. Method: Eight patients with subluxated lens were taken. Out of eight three were of MARFANS syndrome, two of pseudoexfoliation, and three were of traumatic subluxation. Grade of subluxation was 3-9 clock hours. We divided the patients into three groups. In one with mild subluxation simple phacoemulsification with out iris hooks and CTR was done. In second group iris hooks were used to stabalize the capsule and after that phaco was done. In third group with severe subluxation iris hooks and CTR were used, and after that phaco was done. In severe subluxation vitrectomy was done. Results: In seven patients IOL was stableand no immediate post operative complications like inflammation, corneal oedema, raised IOT etc. was present. In one patient IOL was dropped and patient was referred to vitreoretinal surgeon. Conclusion: In subluxated lens we can perform phacoemulsification with CTR and iris hooks. This gives good result seven in severe subluxation.


CLINICAL STUDY OF POST CATARACT SURGERY ENDOPHTHALMITIS

Dr. SRINIVAS VEGESNA [Presenting Author: DR. SHIVKUMAR CHANDRASHEKHARAN], Dr. RAMAKRISHNAN R. — TIRUNELVELI

Retrospective analysis of 18 case records of patients with acute [<6weeks] postcataract surgery endophthalmitis showed an incidence of 0.1%

382

Information InSight

[18 of 17,783], the time of onset ranging from 1st to 40th postoperative day. Pathogenic organisms could be identified in 66.6% [12] of cases. The organisms isolated were nocardia in 22.2% [4], streptococcus sps in 22.2% [4], staphyloccus sps 22.2% [4] of cases. Parsplanavitrectomy was done in 66.6% [12] cases. Final visual acuity was > = 6/24 in 27.7% [5] and < = 3/60 in 55.5% [10].


COMPARATIVE QUANTIFICATION OF INGRESS OF TRYPAN BLUE INTO ANTERIOR CHAMBER FOLLOWING BIMANUAL OR MICRO COAXIAL PHACOEMULSIFICATION

Dr. VASAVADA ABHAYKUMAR RAGHUKANT [Presenting Author: Dr. VAISHALI ABHAYKUMAR VASAVADA], Dr. MAMIDIPUDI RAMAKRISHNA PRAVEEN, Dr. DEEPAK PANDITA, Dr. DEVARSHI GAJJAR, Dr. VIRAJ ABHAYAKUMAR VASAVADA — AHMEDABAD

Purpose: Comparison of ocular surface fluid ingress in anterior chamber after micro coaxial (MCP) or bimanual phacoemulsification using trypan blue tracer. Methods: Prospective study 30 eyes each randomized group 1 MCP through 2.2 mm incision group 2 bimanual phacoemulsification through 1.2 & 1.4 mm incision for phaco tip & irrigating chopper. 0.0125% sterile trypan blue 0.5 ml instilled on ocular surface & 0.1 ml aqueous fluid aspirated from anterior chamber. Optical density measured with UV spectrophotometer. Logs of dilutions used. Results: Statistically significant decrease in logs of mean dilution and penetration of trypan blue in group 1 over group 2P<0.001 & P<0.001. Conclusion: Trypan blue ingress significantly less with MCP than bimanual phacoemulsification


CONFIRMATION OF LENS EPITHELIAL CELLS IN THE ANTERIOR CHAMBER POST PHACOEMULSIFICAITON

Dr. VASAVADA ABHAYKUMAR RAGHUKANT [Presenting Author: Dr. MAMIDIPUDI RAMAKRISHNA PRAVEEN], Dr. KAID JOHAR, Dr. SHYAMAL R. RAVAL, Dr. OKIHIRO NISHI — AHMEDABAD

Aim: To detect presence of live lens epithelial cells in the anterior chamber of eye at the end of phacoemulsification, Material and Methods: Fluid of anterior chamber was collected. Calcein AM & propidium iodide for viability & ? A-crystallin and vimentin for LEC. Results: Out of 30 samples, 27 showed presence of cells. Average number of cells was 64.70 out of which 22.97 were viable. 87.75% (n=10) cells were positive for presence of ? A-crystallin and 90.49% (n=10) cells were positive for presence of vimentin implying that the cells observed were lens epithelial cells. Conclusion: LECs are left in anterior chamber at the end of phacoemulsification.

383

SCIENTIFIC

POSTERS


TACKLING A THICKENED POSTERIOR CAPSULE DURING PHACOEMULSIFICATION BY POSTERIOR CAPUSULORHEXIS

Dr. (Col.) NEERAJ BHARGAVA [Presenting Author: Dr. (Col.) NEERAJ BHARGAVA] — LUCKNOW

100 eyes of 150 patients were found to be having thickened posterior capsule. We performed 2 mm posterior capsulorhexis and then implanted a foldable posterior chamber three piece hydrophobic IOL. The anterior vitreous was contained behind the optic of the IOL. CME and Cyclitis was observed in 5% cases which resolved in four weeks time. Corrected vision was 6/9 or better in all the cases after six weeks. To conclude Posterior Capsulorhexis was found to be the best choice in tackling the posterior capsule while performing phacoemulsification.


SCLERAL FIXATED LENS IMPLANTATION MADE SIMPLE

Dr. REDDY RAVI KUMAR [Presenting Author: Dr. REDDY RAVI KUMAR], Dr. VANGALA CHANDRA SEKARA REDDY, Dr. TANDAVA KRISHNAN P. — HYDERABAD

Aim: To demonstrate the efficacy of a modified technique of implanting Scleral Fixated IOL (SFIOL) Methods: During last 3 years 114 eyes of 79 patients underwent SFIOL surgery through scleral tunnels both for the IOL insertion and prolene suture anchoring instead of trap doors. Whenever needed vitrectomy was performed after IOL insertion to prevent intraoperative hypotony and associated complications. No sutures were applied either to the tunnels or conjunctiva. Results: 45% achieved BCVA of 6/12 or better. Raised IOP (10.5%) was the most common complication. Only 1.7% had Retinal detachment. Conclusions: This technique is simple and safe.


SUB IMM CATARACT SURGERY

Dr. NEERA NILESH [Presenting Author: Dr. NEERA NILESH], Dr. AGARWAL AMAR, Dr. SOOSAN JACOB, Dr. AGARWAL ATHIYA, Dr. DHIVYA A. — CHENNAI

Aims at reporting for the first time, the smallest technique reported worldwide for cataract surgery – the use of a 700 micron phaco needle for cataract removal. 25 patients underwent 700 micron surgery without any major pre- or post-operative complications. These microincisions additionally decrease the incidence of postoperative wound leak, induced astigmatism etc. It especially assumes great significance in the light of recent reports of greater incidence of endophthalmitis with clear corneal incisions. This microincision will set the scene for future technology in the form of rollable and injectable IOLs.

384

Information InSight


CATARACT WOUND ARCHITECTURE ANALYSIS WITH THE ANTERIOR SEGMENT OCT

Dr. DHIVYA A. [Presenting Author: Dr. DHIVYA A.], Dr. AGARWAL AMAR, Dr. SOOSAN JACOB, Dr. AGARWAL ATHIYA — CHENNAI

Anterior segment OCT has revolutionalised the imaging modalities in the anterior segment. We aim to explain the various applications of the OCT in post operative cataract surgical wound and present our study on 50 patients who have undergone phacoemulsification for cataract with various machines by the same surgeons over a period of one month. Post operative parameters like incision plane, wound hydration, presence or absence of fish mouthing at the corneal entry wound, presence or absence of descemet’s fold, descemet’s tear and wound healing recorded on day 1, day 3 and week 1 are analyzed and the data exhibited.

Poster Panel No. 15 [FP0676] COMMUNITY SOCIAL

CREATING BASIC HUMAN RESOURCE FOR EYE CARE DELIVERY IN THE COMMUNITY – LVPEI’S EXPERIENCE WITH “VISION GUARDIANS”

Mr. SHUBHRAKANTI BHATTACHARYA [Presenting Author: Dr. ROHIT CHANDRAMOHAN KHANNA], Mr. SRINIVAS MARMAMULA, Mr. VILAS KOVAI, Dr. GULLAPALLI N. RAO — HYDERABAD

Purpose: To create a community based eye care human resource. Methods: Volunteers with interest and having reading and writing skills are trained for identifying common eye conditions and cataract, screening for near and distance vision and dispensing readymade near vision glasses. Each one receives a tool kit. They also refer people the nearest facility and follow up patients who undergo surgery. Target population is 5000. Results: Over two and half years 22637 screened, 2619 referred and 521 glasses sold. Conclusions: Vision guardians can be useful eye care human resource in the community to increase awareness and service uptake.


LEPROSY — THREAT TO THE EYE

Dr. HETAL KUMAR YAGNIK [Presenting Author: Dr. KAMLA ADNANI], Dr. HETAL S. NAIK, Dr. SUMITA DAS, Dr. SHAILESH AGRAWAL — BARODA

Incidence and ophthalmic manifestations, alongwith sight threatening conditions, were studied in 150 patients of leprosy. Complete ocular and systemic examination with investigational profile was recorded. 20% cases had ocular involvement, major being lepromatous (76.6%) type. Incidence of untreatable blindness was 9.3%. Common involvement was: eyebrows (83%) in lepromatous while cornea (70%) in tubercular type. Anterior uveitis(36.6%) was observed only in lepromatous type. Potentially sight threatening lesions (corneal vascularisation, ulcer, pthisical eye etc.): 50% (15 patients) and BCVA<6/60 (legal blindness): 50% (15 patients). So this preventable blindness should be looked with high index of suspicion in patients of Leprosy and therapy advocated at its earliest.

385

SCIENTIFIC

POSTERS


CHILD-TO-CHILD AND CHILD-TO-FAMILY COMMUNICATION AS A STRATEGY TO IMPROVE AWARENESS AND UPTAKE OF EYE CARE SERVICES IN URBAN AREA OF SOUTH INDIA

Dr. ROHIT CHANDRAMOHAN KHANNA [Presenting Author: Dr. ROHIT CHANDRAMOHAN KHANNA], Mr. KIRAN D., Dr. USHA RAMAN, Dr. SHAMANNA B.R. — DIST. CHANDRAPUR

A pilot study was done to look at the feasibility and effectiveness of utilizing children to promote relevant eye health messages in community and to improve uptake of eye care services. Children of middle school were trained for this. Results: 145 trained children disseminated eye health messages to their family members and screened 2210 subjects. 617 (28%) were identified with vision problems who were referred. Pre and post training evaluation of children showed an increase in level of knowledge and uptake of services. Conclusions: Children can promote relevant health messages in community and improve uptake of eye care services.


AN OVERVIEW OF OCULAR PROBLEMS AT HIGH ALTITUDE

Dr. (Col.) RAJENDRA PRASAD GUPTA [Presenting Author: Dr. (Col.) RAJENDRA PRASAD GUPTA], Dr. (Lt. Col.) BARANWAL V.K., Dr. (Col.) PARIHAR J.K.S., Dr. (Col) GURUNADH V.S. — INDORE

Our vast northern borders in high altitude area are guarded by soldiers. We have confronted with various ocular problems at these heights. We have studied 650 healthy soldiers and 325 cases of High Altitude Pulmonary Oedema (HAPO) for ocular aliments. We found retinal haemorrhage, increased incidence of pterygium & cataract, destabilisation of glaucoma patients and muscular imbalance. In addition to retinal haemorrhage, retinal changes included papilloedema, neovascularisation, intraretinal microvascular abnormalities (IRMVA). Venous engorgement & optic disc hyperaemia was encountered in many cases. In HAPO cases incidence of retinal changes was high.

“Epporul yaar yaar vaay keetpinum apporul meypporul kaaNpa thaRivu”.

(Thirukkural, 423 “Possession of Wisdom”)

Means: Whatever said, whomsoever says, pursue the ultimae truth in it (or pursuit of truth is intelligence) or To grasp the truth from everywhere, from everyone is wisdom fair!!

386

Information InSight


SCHOOL – BASED SCREENING IN CENTRAL INDIA FOR EARLY DETECTION & TREATMENT OF PREVENTABLE CAUSES OF BLINDNESS IN SCHOOL CHILDREN

Dr. RUPESH VIJAY AGRAWAL [Presenting Author: Dr. GANESH YUVRAJ BHAMARE] — JALNA

Purpose: To determine the prevalence of ocular disorders in school children for prompt treatment. Method: Prospective study in 4 phases i.e., Teacher’s training, Screening by teachers followed by Optometrist and Ophthalmologist. Results: Out of 33,912 children screened from urban and taluka schools, 11.13% had visual and ocular disorders. Of these, Refractive error = 5.74%, Amblyopia and Strabismus = 2.99%, Corneal and Conjunctival disease = 1.05%, Cataract = 0.15%, Retinal pathology = 0.37%, Disc and Neurophthal = 0.15%, Adnexal pathology = 0.17%. Conclusion: There was a high prevalence of ocular and visual disorder in school children. Early detection helps in preventing potential visual loss.


REHABILITATION OF BLIND – A COMPREHENSIVE APPROACH

Dr. PUSHPA VARMA [Presenting Author: Dr. ULKA SRIVASTAVA], Dr. VIJAY BHAISARE, Dr. NEETI GUPTA, Dr. AMOD NAYAK, Dr. MAHESH BIRLA, Dr. JIDNAYA SHAH — INDORE

Rehabilitation provides services to the people so that they can achieve maximum potential in home and community in educational setting and employment. Rehabilitation services available for blind are adjustment to the environment, Rehabilitation counseling, Braile instructions, job placement, travel training, low vision services and vocational training. Our study conducted in 9 blind schools pertains to various rehabilitation modalities available and their implementation.


A SURVEY OF SCHOOL BUS DRIVERS IN A DISTRICT OF CENTRAL INDIA REGARDING VISUAL STATUS AND OCULAR HEALTH

Dr. PUSHPA VARMA [Presenting Author: Dr. PREETI RAWAT], Dr. ULKA SRIVASTAVA, Dr. AMOD NAYAK, Dr. MAHAVIR DATTANI, Dr. VINEET GUPTA, Dr. SANJAY PANDEY — INDORE

21 schools and colleges were visited, 158 school bus drivers were examined.Maximum drivers were in age group 20-30 years. Eye strain and watering were the most common complaint. Presbyopia was present in 11 cases, hypermetropia in 3 cases while 1 driver had myopia. BCVA was 6/6 in all except 1. No color blindness was seen. To conclude good visual status and ocular health of school bus drivers is necessary for safety of school children.

387

SCIENTIFIC

POSTERS


REFRACTIVE ERRORS IN CHILDREN – A POPULATION BASED STUDY

Dr. MAHESH S. [Presenting Author: Dr. MAHESH S.], Dr. KAMALA SUBRAMANIAN, Dr. RAVI SHANKAR H.N., Dr. ANUPAM SAHU, Dr. MANIMALA, Dr. SRILAKSHMI, — DAKSHIN KANNADA

Aim: To study the distribution and types of refractive errors, and the visual defect associated. Materials and Methods: 18479 children were screened in a predominantly rural area. The screening was done in schools and anganwadis to include all the children in the village. Results: Myopia was the most common error among all children. Hypermetropia was most common in the 0–5 age group. Conclusion: Different spectrum of refractive errors in school children and non school going children were observed.


THE PRAKASAM DISTRICT DIABETES PREVENTION PROGRAM – TARGETING THE FUTURE THROUGH CHILD-TO- FAMILY COMMUNICATION FOR LIFESTYLE CHANGE AND HEALTH PROMOTION

Miss SHEELADEVI [Presenting Author: Dr. GULLAPALLI N. RAO], Miss JAYANTHI SAGAR, Dr. PRAVEEN K. NIRMALAN — HYDERABAD

Aim: Developing a sustainable district level model to promote lifestyle changes to prevent complications due to diabetes Methodology: Teachers, school children, NGOs, physicians and self-help groups (SHG) are trained about diabetes and prevention. They perform urine glucose estimations on persons through Indian Diabetic risk score. Service delivery is linked to the nearest facility. Counselling for risk factors and life style modifications offered. Results: Trained 8 physicians, 16,795 children and 974 teachers. Screened 279,363 persons. Sugar tested for 23,606 persons, 3546 suspected diabetics were referred. Conclusion: Integrating health promotion within the school curriculum can ensure behavioral changes towards preventing chronic ailments.


AWARENESS OF EYE BANKING AMONGST HEALTH CARE WORKERS

Dr. BAGESHRI GOGATE [Presenting Author: Dr. (Col.) MADAN DESHPANDE], Dr. SAYAN BASU, Dr. PARIKSHIT GOGATE, Dr. RAJIV KHANDEKAR, Mr. SATISH KURPAD — PUNE

We conducted a study to determine level of knowledge and attitude of health staff in health institutions of Pune in 2005. Close-ended questionnaire comprised of 13 questions was used to collect this information. Frequencies and percentage proportions were calculated. The responses related to knowledge were grouped into excellent, good and poor grade of knowledge. 206 health staff participated in this study. 104 of them had <2 years of medical experience. Excellent grade of knowledge was found in 25 (12.1%) of the participants. Poor grade of knowledge

388

Information InSight

was noted in 59 (28.6%) participants. The trends suggested that the knowledge was associated to type of health staff. Excellent knowledge of eye donation was in 11 (44%) medical students followed by 9 (36%) of the post-graduate doctors. ‘Poor’ grade of knowledge was noted in 33 (56%) of nurses. Increasing awareness of health staff regarding eye donation is needed.


COSTING OF PEDIATRIC CATARACT SURGERY

Dr. (Col) MADAN DESHPANDE [Presenting Author: Dr. (Col.) MADAN DESHPANDE], Dr. PARIKSHIT GOGATE, Dr. KULDEEP DOLE, Dr. SATISH S. RANADE — PUNE

Pediatric cataract is an important treatable cause of childhood blindness. Specialist pediatric ophthalmology clinics have came up to tackle pediatric cataract. A costing study done of a pediatric ophthalmology clinic found the fixed facility cost to be Rs. 1024 per patient. This included the child friendly OPD, child friendly operation theater, specialized pediatric vision testing equipment and trained manpower (Pediatric ophthalmologist, optometrist, pediatrician, counselor, pediatric nurse, outreach workers, pediatric anesthetist etc). The consumable cost for each surgery varied between a minimum of Rs.1320 to a maximum of Rs. 13367 depending on the type of intra-ocular viscoelastic, disposable blades and vitrector used. Final cost varied between Rs. 2344 to Rs. 16024 to the service provider.


EYE DONATION AWARENESS AMONG MEDICAL PROFESSIONALS

Dr. VARSHA SINGH [Presenting Author: Dr. AMBASTA ANITA], Dr. SUDHIR KUMAR, Dr. SUNIL KUMAR SINGH — PATNA

Purpose: to evaluate awareness amongst non-ophthalmic medical professionals towards eye donation. Methods: 150 non-ophthalmic medical professionals and 150 college teachers (controls) were evaluated with a self administered questionnaire about awareness regarding eye donation. Results: About 60% of medical professionals and 82% of college teachers were unaware about the time limit about eye retrieval. 60% of college teachers and 15% of medical professionals thought that related donors were required. 98% of college teachers and 90% of medical professionals did not know where to contact for eye donation. Conclusion: There is need for more community based programmes and eye banks in Bihar.

The habitudes of patients and disease, the cries of the illThese must the learned leech think over well, then use his skill.

— Thirukkural, 949

Means: The learned (physician)should ascertain the condition of his patient; the nature of his disease, and the season (of the year) and (then) proceed (with his treatment).

389

SCIENTIFIC

POSTERS


PREVALENCE OF DIABETIC RETINOPATHY IN URBAN SLUM IN WESTERN INDIA

Dr. DHARMESH KAR [Presenting Author: Dr. DHARMESH KAR], Dr. MIHIR KOTHARI, Dr. NATARAJAN S. — MUMBAI

This cross sectional study included 5000 randomly selected subjects from an urban slum aged 40-90 years (Mean age (SD) yrs: 51.95 ± 9.86). 65.5% were males. The prevalence of Diabetes was 9.7% (95% CI: 8.88-10.52), DR was 4.2% (95% CI: 3.64 – 4.76). The prevalence of non-proliferative retinopathy was 82.7%, proliferative retinopathy was 12.4% and maculopathy was 25.5 %. Multiple logistic regression analysis showed duration of diabetes to be the strongest risk factor for the retinopathy (Pearson Correlation Coefficient (r) 0.63, S, P<0.001). High prevalence of sight threatening retinopathy in this population justifies the need of a screening program for the DR.

Poster Panel No. 28 [FP0990] CORNEA

OCULAR LESIONS ARISING AFTER STINGS BY HYMENOPTERAN INSECTS

Dr. SIDDHARTHAN K.S. [Presenting Author: Dr. SIDDHARTHAN K.S.], Dr. ANITA RAGHAVAN, Dr. REVATHI R. — CHENNAI

Purpose: To describe the ocular lesions and their management after stings from hymenopteran insects. Methods: We examined and treated the ocular alterations in four patients who suffered ocular trauma from bee stings. Results: In all the 4 cases the insect was identified as bee. The cases presented with significant corneal edema, which resolved dramatically in 3 cases after removal of stingers. One case needed a lamellar graft and another developed Intumuscent cataract with increased I.O.P. Conclusion: Although a rare occurrence, ocular trauma caused by hymenopteran insects have a potential to cause severe ocular damage in humans.


A COMPARATIVE STUDY OF CORNEAL SMEARS FROM SCRAPPINGS WITH CULTURE REPORTS IN INFECTIOUS KERATITS.

Dr. NISHANT VIJAY RADKE [Presenting Author: Dr. NISHANT VIJAY RADKE], Dr. CHANDRAKER A.K., Dr. NIDHI PANDEY, Dr. MANGILAL GARG, Dr. SNEHAL RADKE, Dr. EESH NIGAM, Dr. VINAY JAISWAL — NASHIK

80 cases of microbial keratitis were studied from 2005 December to April 2007. Scrapping done with 26 g needles or No. 15 Blade. Smears stained with gram stain and KOH preparation made. Samples collected for culture and sensitivity. Results and Conclusions: Corneal Scrapings: Sensitivity = 93.22% (95% CI 83.82-97.33%). Specificity = 60% (95% CI: 31.27-83.18). PPV = 93.22%, NPV = 60%. Culture: Sensitivity = 75.81% (95% CI: 63.85% - 84.76%). Specificty = 61.11% (95% CI: 38.62% – 79.69%). PPV = 87.04%, PV = 42.31%. Corneal Scrapping: Reliable and more Sensitive than culture but equally specific. (Specificity 60% and 61.11%). Culture is better to refute the diagnosis.

390

Information InSight


MANAGEMENT OF MYCOTIC KERATITIS : OUR EXPERIENCE

Dr. SUDESH KUMAR ARYA [Presenting Author: Dr. SUDESH KUMAR ARYA], Dr. SONIKA GUPTA, Dr. NAVNEET KAUR TULI, Dr. JAGDISH CHANDER, Dr. SUNANDAN SOOD — CHANDIGARH

Retrospective analysis of 127 patients with clinical diagnosis of mycotic keratitis was done. 86 (68%) patients were males. Majority of patients (35%) were young adults (21-40 years). 48% patients belonged to rural background. Commonest predisposing factors was trauma with vegetative matter (31% patients). KOH was positive in 34% smears while culture for fungus was positive in 24% patients. Therapeutic penetrating keratoplasty was needed in 19% patients. Other interventions done were AMT 4%, BCL and Glue 3%, intracameral antifungal 4%, plaque removal 2%. Early clinical suspicion with prompt medical therapy with timely surgical intervention can save the eye with mycotic keratitis.


CLINICAL PROFILE OF PATIENTS WITH MICROBIAL KERATITIS

Dr. REENA ANAND [Presenting Author: Dr. REENA ANAND], Dr. KUMAR K., Dr. SHARMA B., Dr. POOJA SINGAL — BHOPAL

A clinical study of 60 patients of microbial keratitis was done. It was found that, commonest age group to be affected was 40 to 50 years (38.3%) followed by under 10 yrs. Males were more affected in ratio of 2:16 Rural population was affected more 83.33%. It was predominant more in poor socioeconomic class 91.6%, Farmers were most commonly affected 33.33%. It is seen maximum in March and April 36.66%. Trauma was the most common predisposing factor 58.33%. Most common presentation was central corneal ulcer 81.67% and Most common causative organism was Bacteria 61%, & Fungal 29.73%, 76.67% person responded to broad spectrum initial treatment, & only 18.92% patients required a change in therapy.


CORNEAL COLLAGEN CROSS LINKING WITH RIBOFLAVIN IN KERATOCONUS – INITIAL RESULTS

Dr. NOEL MONIZ [Presenting Author: Dr. FREDDY T. SIMON], Dr. KALAMATHI — ERNAKULAM

We conducted a prospective study on 16 eyes of keratoconus who had corneal collagen cross linking with riboflavin. It is a new treatment to prevent progression of keratoconus. Out of 16 treated patients unaided vision improved in 8 patients (50%), stable in 7 patients (43.7%) and reduced in 1 patient (6.2%). In the last patient aided vision improved. Post operatively all patients had corneal haze which cleared at 1 month follow up. All patients had

391

SCIENTIFIC

POSTERS

mild improvement in topography. We conclude that the initial study of corneal collagen cross linking with riboflavin is encouraging but long term follow up is necessary.


BINDI KERATO CONJUNCTIVITIS: A FREQUENTLY UNRECOGNIZED ENTITY

Dr. KALAVATHY C.M. [Presenting Author: Dr. KALAVATHY C.M.], Dr. PRAGYA PARMAR, Dr. PHILIP A. THOMAS, Dr. KALIAMURTHY, Dr. AMJAD SALMAN, Dr. NELSON JESUDASAN — TRICHY

Methods: A retrospective analysis of ocular presentations of 9 patients of Keratoconjunctivitis with retained ocular foreign body (bindi) in upper conjunctival fornix. Results: Age of the patients ranged from 2 months to 3 years. Ocular presentation included 3 cases of mucopurulent conjunctivitis, 4 cases of suppurative keratitis and 2 cases with epithelial defects. Response was good to topical antibiotics after removal of foreign body in all cases except one case which required therapeutic keratoplasty. Conclusion: Young children presenting with unilateral keratitis or conjunctivitis should alert the clinician to the possibility of retained foreign body in the eye.


AUTOLOGOUS LIMBAL STEM CELL TRANSPLANT (ALSCT): CONVENIENT APPROACH FOR RESTORATION OF OCULAR SURFACE DAMAGED BY CHEMICAL AND THERMAL BURNS

Dr. INDU ARORA [Presenting Author: Dr. INDU ARORA], Dr. VINEET SINGH, Dr. VINAY KUMAR BOHRA — JAIPUR

Aim: Restoration of optically smooth ocular surface and visual improvement after chemical and thermal burns. Methods: Prospective study of 25 cases; (76% alkali, 20% acid, 4% thermal burn) with ALSCT. Time between injury and ALSCT was 7.7 months. Follow up was done for 3 years. Results: VA improved by 1 or 2 Snellen’s line in 21 (84%), remained same in 4 (16%). Regression of superficial vascularization occurred in 21 (84%).16% had recurrence of symblepharon and pseudopterygium. Conclusion: ALSCT helps in restoring an ocular surface damaged by chemical and thermal burns; success was limited by level of cicatrisation.

Disease, its cause, what may abate the ill the illLet leech examine these, then use his skill.


Means: Let the physician enquire into the (nature of the) disease, it cause and its method of cure and treat it faithfully according to (medical rule).

392

Information InSight


MANAGEMENT OF ACUTE HYDROPS WITH INTRACAMERAL PERFLUOROPROPANE (C3F8)

Dr. RAMENDRA BAKSHI [Presenting Author: Dr. RAMENDRA BAKSHI], Dr. SITALAKSHMI G., Dr. BHASKAR SRINIVASAN — CHENNAI

Aim: To report 2 cases of acute hydrops managed with intracameral Perfluoropropane (C3F8) gas injection. Methods: Intracameral C3F8 0.2 ml at a nonexpansile concentration of 10% was administered in 2 patients who presented with acute hydrops. The etiology of acute hydrops was Keratoconus and Pellucid Marginal Degeneration, in the first and second patient respectively. Results: There was a rapid and complete resolution of the corneal edema with residual scarring within 3 weeks of gas injection in both the cases. Conclusion: Intracameral C3F8 is a useful technique for faster resolution of corneal edema following acute hydrops.


CHEMICAL INJURIES — A 6 YEAR ANALYSIS (2000-2006) IN A TERTIARY CARE HOSPITAL.

Dr. SUBASHINI V. [Presenting Author: Dr. BHASKAR SRINIVASAN], Dr. SITALAKSHMI G., Dr. PALLAVI SUGANDHI, Dr. VINAY, Dr. GEETHA KRISHNAN IYER — CHENNAI

This study aims to analyze the demographic profile, the offending agent, severity of injury, and the treatment outcome (medical and surgical) of all cases of chemical injury reporting to a tertiary referral centre in south India. Outcome measures analyzed were the achievement of a stable ocular surface (surface epithelialisation), results of surgical and medical interventions and the final visual acuity. Records of 418 eyes (221 pts) were reviewed. Alkali was the commonest offending agent. 208 eyes had grade 3 or worse injuries. 104 eyes underwent surgical interventions. Eyes with grade 3 and 4 injuries required multiple surgeries and had worse prognosis.


SURGICAL MANAGEMENT OF MOORENS ULCER USING FIBRIN GLUE.

Dr. SITALAKSHMI G., [Presenting Author: Dr. BHASKAR SRINIVASAN], Dr. RENU R. ATHANIKAR, Dr. GEETHA KRISHNAN IYER, Dr. VINAY — CHENNAI

To report 5 cases of corneal melt in Moorens ulcer managed surgically using fibrin glue. 4 eyes underwent lamellar keratoplasty and 1 eye underwent amniotic membrane transplantation with fibrin glue as an adjuvant with or without sutures. Except for 1 eye which had a slight displacement of graft all other eyes achieved tectonic stability and at 2 months follow up there was no recurrence. Fibrin glue is a useful adjuvant in the treatment of corneal melts and it reduces the intra operative time and reduces the need for sutures and suture related problems.

393

SCIENTIFIC

POSTERS


INDICATIONS AND OUTCOME OF PENETRATING KERATOPLASTY AT A TERTIARY EYE CARE CENTRE

Dr. ANIL TARA [Presenting Author: Dr. JAYA GUPTA], Dr. PARUL SONY — NEW DELHI

Purpose: To evaluate indications and outcome of Penetrating Keratoplasty (PKP) at tertiary eye centre. Methods: Retrospective review of hospital records of 278 patients who underwent PKP (1999-2005) was performed. Information reviewed included age, gender, socioeconomic status, diagnosis, surgical details, postoperative complications, visual and anatomical outcome at last follow-up. Results: Main indications of PKP were post-infectious keratitis corneal scarring (26.8%), active infectious keratitis (25.5%), PBK (18.4%), regraft (14.2%) & ABK (5.6%). 61.2% eyes maintained clear grafts and visual acuity of 20/200 = at follow-up. Conclusion: Infectious keratits (healed & active) is main indication of PKP at our centre. Two-third patients had clear grafts at last follow-up.


CORNEA OR WHOLE EYE TRANSPLANTATION: A MYTH ON EYE DONATION AMONG ENGINEERING AND SCIENCE GRADUATES FROM SAMBALPUR UNIVERSITY, WESTERN ORISSA

Dr. ANUP DAS [Presenting Author: Dr. DAS GUNASAGAR], Dr. SHARMISTHA BEHERA, Dr. MARUTHI H., Dr. SAMIR MAHAPATRA, Dr. JITENDRA K.R. PANDA — SAMBALPUR

Aim: To study awareness of eye donation and eye banking among graduating students. Methods: A pilot study with formatted questionnaire about eye donation was performed on 236 consecutive participants and data evaluated for response and appropriate analysis. Results: Various response were obtained from 96 Engineering Students and 140 science graduates. 183 (77.5%) responded for whole eye transplantation. Only 22.45% knew about corneal transplantation. 110 students (46.6%) were willing to donate eye. 86% had acquired knowledge from media. Only 23 (9.7%) participants knew about contact details of eye bank. Science graduates had better knowledge about corneal transplantation 36 cases (15.25%). Conclusion: The missing link among educated people about Eye banking needs to be sensitized.


CONFIRMATION OF THE CLINICAL DIAGNOSIS OF KERATOMYCOSIS IN PATIENTS PRETREATRED WITH ANTIFUNGAL EYEDROPS: ROLE OF A POLYMERASE CHAIN REACTION (PCR) BASED MOLECULAR TECHNIQUE.

Dr. HIMADRI DATTA [Presenting Author: Dr. SOMNATH MUKHOPADHYAY],Dr. SAYAN BASU, Dr. (Prof) DHRUBAJYOTI CHATTOPADHYAY, Mr. ABHRAJYOTI GHOSH — KOLKATA

394

Information InSight

Purpose: To evaluate the effectiveness of PCR and ribosomal DNA typing in the diagnosis of keratomycosis in pretreated patients. Methods: Corneal scraping samples were obtained from the affected eye and conjunctival swabs were obtained from the fellow eye of 25 patients presenting with clinically suggestive keratomycosis and a history of pretreatment. Smear, culture, and PCR was performed on each sample. Results: PCR showed a sensitivity of 95% and specificity of 84%. Culture was significantly less sensitive (P=0.001) and also took more time (P<0.0001). Conclusion: PCR is a fast, sensitive and specific method of detecting fungal pathogens in pretreated corneas.


LIMBAL STEM CELL TRANSPLANTATION IN CHEMICAL BURN AND RECURRENT PTERYGIUM

Dr. KAMALJEET SINGH [Presenting Author: Dr. KAMALJEET SINGH] — ALLAHABAD

Aim: To study the surgical outcome of autologus limbal transplantation in stem cell deficiency. Method: Asmall study of six patients who underwent limbal stem cell transplantation. Primary diagnosis included chemical burn (n=2) and recurrent pterygium (n=4). Duration of disease ranged from 1-2 years. Superior limbus was utilised as a source of graft. Results: Follwup ranged from 3-7 months Outcome was satisfactory: corneal surface was stable and improvement in vision and symptoms. Complete epithelialisation in all casesin 5-14 days. BCVA, vascularization and corneal oedema was decreased. No complications were seen except conjunctival growth in one patient. Conclusions: Autologus limbal stem cell transplantation is an adequate procedure for stablizing ocular surface in limbal stem cell deficient eye.


A COMPARATIVE STUDY OF ARTIFICIAL TEAR EYE DROPS VS COMBINATION OF 0.05% CYCLOSPORIN OPHTHALMIC EMULSION AND ARTIFICIAL TEAR EYE DROPS IN DRY EYE DISORDERS

Dr. NEEBHA ANAND [Presenting Author: Dr. CHAWLA URMIL], Dr. ASHOK KUMAR KHURANA, Dr. PRERNA AGGARWAL — ROHTAK

A prospective clinical traial was carried on 40 patients of dry eye disease. Gp. I (20 pts) were subjected to artifical tear eye drops (polyvinyl alcohol 1.4% + polyvinyl pyrollidone 0.6%) QID and Gp. II (20 pts) were subjected to cyclosporin ophthalmic emulsion (.05%) BD along with artificial tear eye drops QID. Different ocular symptoms and tear film profile tests (Schirmer test tear film breakup time (TBUT), Rose Bengal staining, marginal tear strip test, fluoroscein staining) were scored from 0 to 3 in order of increasing severity of the condition and were evaluted in both groups on follow up at 2 weeks, 1 month, 3 months and 6 months. Net score (difference between total score at 0 day and at 6 month) was calculated. The mean net score in Gp. I was 13.75 and in Gp. II was 15.7 the difference being statistically significant. Thus a combination therapy of cyclosporin & artificial tear drops proves to be a better alternative than only artificial tear drops in dry eye disease.

395

SCIENTIFIC

POSTERS

Poster Panel No. 43 [FP0029] EXTERNAL DISEASE

PEARLS IN PTERYGIUM SURGERY

Dr. SANTOSH KUMAR NAIR [Presenting Author: DR. SANTOSH KUMAR NAIR], Dr. HALDIPURKAR S.S. — PANVEL

Pterygium surgery has undergone many refinements over the past many years, especially involving conjunctival autografts and pharmacological modification. These refinements have resulted in minimum recurrences and each step in modern pterygium surgery has reached a certain state of standardization. This paper also emphasizes the type of post-operative care needed to get these results.


EPIDEMIOLOGICAL AND MICROBIOLOGICAL PROFILE OF FUNGAL KERATITIS IN CENTRAL INDIA

Dr. SEJAL SANGHVI MAHESHWARI [Presenting Author: Dr. SEJAL SANGHVI MAHESHWARI], Dr. JAIN P.P., Dr. SHEKDE S., Dr. HINGORANI P.N., Dr. SHAH P. — JALNA

The purpose of the study was to know the epidemiological profile and risk factors in cases of fungal keratitis in Central India. Retrospective analysis of 638 cases of microbial keratitis presenting between April 2001 to January 2007 to authors 1, 2 was done out of which 425 (66.61%) were caused by fungi. Commonest predisposing factor was ocular trauma: 40% cases; 42.9% due to vegetative matter. Direct microscopy was positive in 90.6%; cultures in 67.3%. Commonest pathogens were Fusarium spp 150 (50.2%) and Aspergillus spp: 56 (18.7%). In rural and semirural areas, fungus is the commonest causative organism of suppurative keratitis.


A CLINICAL PROFILE OF OCULAR SURFACE DISORDERS (OSD)

Dr. TIWARI UMA SHARAN [Presenting Author: Dr. TIWARI UMA SHARAN], Dr. NEHA CHAUHAN, Dr. VAIBHAV MITTAL, Dr. SAMIKSHA CHOUDHARY, Dr. DIPTI GUPTA — GWALIOR

Ocular Surface disorder (OSD) can cause Ocular morbidity hence present study was undertaken to find out prevalence, risk factors and pattern of OSD. Two hundred consecutive patients attending Eye OPD were screened for OSD using Hikichi’s questionnaire, Schirmer’s test, Lissamine green staining, TFBUT and presence of Mucus strands. Twenty six (13%) patients had OSD. Ten cases (38.5%) had exposure to air pollution with high temperature as contributory factor. Two (7.69%) case were smokers. Foreign body sensations was commonest complaint (69.23%) followed by burning (65.38%) and itching (57.69%).To conclude, OSD is a common cause of morbidity that deserves proper workup.

396

Information InSight


CICARTICIAL ECTROPION IN LAMELLAR ICTHYOSIS

Dr. JITENDRA JETHANI [Presenting Author: Dr. SWATI V. RAWANI], Dr. URVASHI SOLANKI, Dr. ABHISHEK SHARMA — AHMEDABAD

Lamellar ichthyosis affected infants present as “colloidion babies” at birth. Main ocular manifestation is bilateral ectropion. A biopsy confirmed case of a 6 years old child of lamellar ichthyosis was referred from skin OPD for management of ocular complains. Patient had bilateral severe lower lid ectropion (grade-3), conjunctival congestion & forniceal contracture secondary to long standing ectropion. He had bilateral visual acuity of 6/6 without correction. Rest of the anterior & posterior segment was within normal limits. At birth, baby was covered with shiny membrane all over the body, which desquamated leading to peeling with the scale. Ectropion was noticed few weeks after the birth. We report a case of bilateral severe lower lid ectropion & its management.


LIMBAL CONJUNCTIVAL AUTOGRAFT TRANSPLANTATION IN ADVANCED AND RECURRENT PTERYGIUM

Dr. SHASHI JAIN (AGARWAL) [Presenting Author: Dr. SHASHI JAIN (AGARWAL)], Dr. RATHORE M.K., Dr. DWIVEDI P.C., Dr. EVA TIRKEY, Dr. CHOUDHARY PANKAJ, Dr. SUJATA LAKHTAKIA, Dr. SUPREET JUNEJA — REWA

Advanced and recurrent pterygium is a challenging entity often resistant to conventional treatment. Ultraviolet rays induced stem cell deficiency is it’s most accepted etiology. In this study 39 cases of advanced and recurrent pterygium are treated with conjunctival autograft transplantation and followed for one year. Two cases showed recurrence of pterygium but there was no vision threatening complication. The complications were conjunctivitis in 2 cases, granuloma formation in 2 cases, subconjunctival hemorrhage in two cases, graft rejection in 2 cases and early graft edema in 90% (35) of cases.


TOPICAL FRESH FROZEN PLASMA AS A CHEAP AND EFFECTIVE ALTERNATIVE TO PLASMINOGEN IN THE TREATMENT OF LIGNEOUS CONJUNCTIVITIS.

Dr. ASHWIN SAINANI [Presenting Author: Dr. ASHWIN SAINANI], Dr. RAJSHREE SANGITRAO — MUMBAI

Ligneous conjunctivitis is a chronic pseudomembranous conjunctivitis associated with deficiency of type I plasminogen in the blood. Topical plasminogen has been reported to show recovery and prevent recurrence. We present a case of chronic (3 years) ligneous conjunctivitis in a child, not responding to excision of membrane and topical corticosteroid, cyclosporine or heparin. Preparing plasminogen from fresh frozen plasma is a complex and expensive process. We successfully treated

397

SCIENTIFIC

POSTERS

the child with topical fresh frozen plasma with no recurrence on a follow-up of 3 months. Fresh frozen plasma is an effective and cheap alternative to plasminogen in cases of ligneous conjunctivitis.


CLINICAL PRESENTATION AND MANAGEMENT OF EYELID MEIBOMIAN GLAND CARCINOMA IN SOUTHERN ORISSA

Dr. SARITA PANDA [Presenting Author: Dr. PRANGYA PANDA], Dr. SUCHITRA DAS, Dr. JOGENDRA PRASAD BEHERA — BERHAMPUR

Aims and Objective: To study the clinical presentation and Management of meibomian gland carcinoma of the eyelid. Material and Methods: Details of the data of the patients diagnosed to have meibomian Carcinoma of the lid were studied for 3 years i.e. from April 2002-April 2005. Results: Out of 8 patients 5 were males and 3 females. Age range, 45-70 years. 7 growths were in upper lid, one in lower lid. 2 had undergone surgical procedures for benign legions, 2 for malignant. 3 had metastasis to regional lymph nodes. Patients underwent surgical excision of the growth (8) and lid reconstruction (6), radiotherapy (5). In follow-up, one developed local recurrence after 2 years. Conclusion: Meibomian gland carcinoma is more common in elderly patients, more in upper lid. Misdiagnosed clinically in early stages. Wide surgical excision is best.


DEMOGRAPHIC PROFILE OF EPIBULBAR DERMOIDS IN A TERTIARY CARE CENTRE

Dr. PANDA ANITA [Presenting Author: Dr. PANDA ANITA], Dr. MOHAN SHALINI, Dr. ANAND AGGARWAL, Dr. VANATHI M., Dr. SHIBAL BHARTIYA – NEW DELHI

Purpose: The study was done to evaluate demographic profile and management options for epibulbar dermoids. Methods: 238 patients with epibulbar dermoid were examined retrospectively. Results: Bilateral involvement was observed in 27 patients and single lesions in 220 eyes. Temporal involvement was observed in 233 eyes. Pre auricular tag was present in 109 and familialinvolvement in 5 cases. Simple excision was done in 88 lesions while 162 eyes required lamellar keratoplasty. Conclusion: Epibulbar dermoid is a potentially serious corneal problem from visual point of view. Therefore, early referral to tertiary hospitals where meticulous surgical facilities are available is mandatory.

For patient, leech, and remedies, and him who waits by patient’s side.The art of medicine must fourfold code of laws provide.


Means: Medical science consists of four parts, viz., patient, physician, medicine and compounder; and each of these (again) contains four sub-divisions.

398

Information InSight


IMPRESSION CYTOLOGY STUDY OF CONJUNCTIVAL EPITHELIAL PHENOTYPES ON THE HEALING OCULAR SURFACE AFTER PTERYGIUM EXCISION.

Dr. (Mrs.) KAVITA RAJAN BHATNAGAR [Presenting Author: Dr. (Mrs.) KAVITA RAJAN BHATNAGAR], Dr. (Prof) KARANDIKAR M.N., Dr. (Col.) DESHPANDE M., Dr. (Lt. Col.) RAMCHANDRAN N., Dr. MUJUMDAR D. — PUNE

Purpose: To compare conjunctival epithelial regeneration after different types of pterygium excision procedures. Methods: Forty five eyes with primary pterygium were randomly assigned to three groups. Group 1 had pterygium excision with bare sclera, Group II with intraoperative mitomycin-C (MMC) and Group III with conjunctival autografting. Controls were age and sex matched subjects. Impression cytology was performed on day 10, 1, 3, 6, and 12 months postoperatively. Nucleus-cytoplasm ratio of epithelial cells and goblet cell density in pterygial area were calculated and compared. Results & Conclusions: Healing of conjunctiva is delayed by MMC and is promoted by auto grafting.

Poster Panel No. 52 [FP0946] GLAUCOMA

OCULAR PULSE AMPLITUDE MEASUREMENT BY APLANATION TONOMETRY

Dr. PRADNYA MESHRAM [Presenting Author: Dr. MOREKER SUNIL RATILAL], Dr. AHTESHAM MOMIN, Dr. RAJESHREE SANGITRAO, Dr. MAYUR MOREKER, Dr. RENU SHUKLA — BOMBAY

Ocular pulse amplitude (OPA), an emerging parameter for predicting visual field loss in glaucoma is measured by the Pascal’s Dynamic contour tonometer. Applanation tonometry can be used to record OPA as well. Aim: To correlate OPA measured by applanation tonometry with that measured by Pascal’s Tonometer Methods: In a prospective study of 100 eyes without glaucoma, intraocular pressure was measured using dynamic contour tonometry and Goldmann applanation tonometry. Results: A good correlation between OPA measured by dynamic contour tonometry and Goldmann applanation tonometry was found (r = 0.639; P < 0.001). Conclusion: OPA can be fairly accurately measured by the age old gold standard-applanation tonometer.


RNFL DATA BASE OF 250 JUVENILE OPEN ANGLE GLAUCOMA PATIENTS VERSUS NORMALS IN INDIAN EYES

Dr. CHARU KHURANA [Presenting Author: Dr. RUCHI GOEL], Dr. USHA YADAVA, Dr. MANJU MEENA, Dr. SHIKHA JAIN, Dr. LANALYN, Dr. SAHANA G.V. — NEW DELHI

250 eyes of patients with JOAG were compared with 245 eyes of age and sex matched controls. The Stratus IV OCT was used to image the RNFL thickness

399

SCIENTIFIC

POSTERS

using the 3.2mm parapapillary fast optic disc scan. Average RNFL thickness in superior, nasal, inferior and temporal quadrants was 74.27, 48.63, 70.91 and 48.64μ respectively while corresponding value in controls was 112.34, 78.91, 118.31 and 70.64μ respectively. The difference was statistically significant (p=0.001). These values may be used to diagnose and quantify the severity of the disease and serve as a useful parameter for follow up and monitoring of disease progression


M-FLAP MODIFICATION OF SINGLE-INCISION COMBINED TRABECULECTOMY WITH SICS AND IOL.

Dr. MOKADAM PRAFULLA J. [Presenting Author: Dr. MOKADAM SHAUNAK PRAFULL], Dr. SHAMIK PRAFULL MOKADAM, Dr. SHWETA SHAMIK MOKADAM — NAGPUR

Method: Central partial thickness triangular flap added to standard Blumenthal frown shaped flap (with vertical extensions at either end), taken during combined SICS+IOL+Trabeculectomy, gives the flap an “M” shaped appearance. Study of 50 cases with modified ‘M’-flap, operated by same surgeon is presented.Postoperatively: • No shallowing of anterior-chamber. • Satisfactory intra-ocular pressure on 7th, 30th, & 90th day in 45 cases. • Initial rise of IOT in 3 cases, normalised after discontinuing topical steroids. • Anti-glaucoma drugs controlled IOT in 2 cases. • No case required repeat glaucoma surgery. Conclusion: M-flap modification gives satisfactory results in single-incision Combined Trabeculectomy+SICS+IOL.


NON-RESPONDERS TO BRIMONIDINE, TIMOLOL COMBINATION IN GLAUCOMA CASES

Dr. VERMA NITESHWAR PRASAD [Presenting Author: Dr. VERMA NITESHWAR PRASAD], Dr. AKHAURY RANJAN KUMAR — PATNA

Aim: To evaluate failure of Brimonodine Timolol combination in glaucoma cases.Material & Methods: Over a span of 12 months, Glaucoma cases failing to respond to Brimonidine Timolol combination as a first line treatment regimen were studied and the causes of failure assessed. Result: Out of 86 cases on combination treatment, 3 cases didn’t respond at all. All of them responded to Bimatoprost alone or added with systemic ocular hypotensives. Conclusion: About 3.5% of cases don’t respond to Brimonidine Timolol combination, especially those with IOP > 35 mm of Hg.

You have to dream before your dreams can come true.

— Dr. A.P.J. Abdul Kalam

400

Information InSight


ROLE OF HRT-II IN CURRENT GLAUCOMA MANAGEMENT

Dr. (Col.) MADAN DESHPANDE [Presenting Author: Dr. VIDYA CHELERKAR], Dr. SANJANA SHIGGON — PUNE

50 normals, 50 early-POAG patients underwent complete ophthalmic examination including BCVA, SLE, Gonioscopy, Disc-examination, VF testing, HRT-II. Objectives: Correlate clinical diagnosis and HRT-II in early POAG. Study role of HRT-II in identifying early glaucomatous damage. Mean-Age – Normals: 50.76 + or – 7.0, POAG: 51.78 + or – 8.7 years. Mean-IOP: Normals: 14.75 +or – 1.9, POAG: 22.64 + or – 2.2 mm Hg. Mean of mean-deviation (VF) in POAG: – 6.4 dB Results: HRT-Sensitivity: 90%, Specificity: 94%, PP Value: 93.7%, NP Value: 90.4% Rim-volume, Cup Shape Measure, RNFL-thickness – significant(P<0.05) Measure-of-Kappa value – 0.618 (P=0.00) Conclusion: HRT-II can be adjuvant to clinical evaluation in diagnosis of early POAG.


EFFICACY OF LATANOPROST IN MANAGEMENT OF CHRONIC ANGLE CLOSURE GLAUCOMA

Dr. SURESH KUMAR [Presenting Author: Dr. SURESH KUMAR] — CHANDIGARH

Objective: To study the effect of latanoprost 0.05% on intraocular pressure (IOP) in subjects diagnosed as having chronic angle closure glaucoma (cacg). Design: Open label study. Participants: 44 patients participated in the study, out of whom 20 were males and 24 were females. Methods: 44 patients with bilateral cacg were treated with latanoprost 0.05% Once daily at bedtime. IOP was recorded at baseline, 2 weeks, 4 weeks, 8 weeks and 12 weeks after starting the treatment. Main outcome measure: the major parameter studied was the change in iop after administration of latanoprost. Results: the mean age of the study sample was 50.35 years (40-65 years). There were 20 males and 24 females in the study. Mean IOP at baseline was 23.25 ± 3.01. Mean iop decreased to 16.32 ± 2.8 at 2 weeks, 16.03 ± 4.10 at 4 weeks, 16.01 ± 2.9 at 8 weeks and 16.00 ± 3.12 at 12 weeks. There was a statistically significant reduction in mean IOP at 2 weeks as compared to baseline IOP (p<0.000). Mean reduction in IOP at 2 weeks was 6.28 ± 4.73. Conclusion: Latanoprost, a prostaglandin analogue is effective in reducing IOP in chronic angle closure glaucoma patients. The significant reduction in IOP is evident by 2 weeks, and there is no further reduction, however the initial significant improvement was maintained till the endpoint of the study.


EVALUATION OF ANGLE CHAMBER PARAMETERS AFTER CATARACT EXTRACTION IN CHRONIC PRIMARY ANGLE CLOSURE GLAUCOMA

401

SCIENTIFIC

POSTERS

Dr. DADA TANUJ [Presenting Author: Dr. MOHAN SHALINI], Dr. ANAND AGGARWAL, Dr. SHIBAL BHARTIYA, Dr. RAMANJIT SIHOTA — NEW DELHI

Purpose: To evaluate angle parameters after phacoemulsification in eyes with chronic primary angle-closure glaucoma (PACG). Materials and Methods: Chronic PACG patients underwent phacoemulsification and anterior chamber parameters were assessed on Ultrasound biomicroscopy. Results: Fifty six eyes included had baseline intraocular pressure (IOP) of 52.25 ± 17.01 that decreased to 14.3 ± 5.1 mm Hg at 6 weeks (p = 0.0001). Superior and inferior trabecular iris angle increased from 3.85 ± 6.54 and 4.13 ± 7.6 to 18.1 ±12.9 and 21.6 ± 14.9 respectively (p=0.002 & 0.001). Conclusions: Phacoemulsification leads to opening up of iridocorneal angle and lowering of IOP in chronic PACG patients. Therefore, lens extraction may be considered as primary procedure in these eyes.


TO EVALUATE ANTERIOR SEGMENT CHANGES IN OPAQUE GRAFTS WITH POST PENETRATING KERATOPLASTY GLAUCOMA (PPKG) USING ULTRASOUND BIOMICROSCOPY (UBM)

Dr. ANAND AGGARWAL [Presenting Author: Dr. ANAND AGGARWAL], Dr. DADA TANUJ, Dr. MOHAN SHALINI, Dr. VANATHI M., Dr. SUJITH VENGAYIL, Dr. PANDA ANITA — NEW DELHI

Materials & Methods: 31 eyes of 31 PPKG patients were evaluated. UBM was undertaken. Associated procedures performed during keratoplasty were noted. Results: The mean age was 48.58 ± 15.8 years. The mean IOP was 35.54 ± 5.88 mm Hg. The mean CCT was 932.12 ± 259.83 μm. Optical keratoplasty was performed in 18 of 31 eyes (58.06%) and therapeutic keratoplasty in 13 of 31 eyes (41.93%). 30 eyes (96.77%) had peripheral anterior synechiae (PAS). Conclusion: PAS is the major cause for PPKG in opaque grafts. UBM serves as a useful tool for anterior segment evaluation in such eyes.


POSTURAL INTRAOCULAR PRESSURE (IOP) — ITS IMPORTANCE IN GLAUCOMA CONTROL

Dr. NOOPUR PARAKH [Presenting Author: Dr. NOOPUR PARAKH], Dr. ANURADHA, Dr. RAJIV GARG, Dr. PAMELA D’SOUZA, Dr. RAJESH JAIN — KANPUR

Purpose: Circadian variation of IOP with change of posture in glaucomatous eyes. Methods: 100 eyes of 50 subjects [50 each of controls & Primary Open Angle Glaucoma (POAG)] were subjected to 4 hourly measurements of sitting & supine IOP (Perkin’s tonometer). Results: Significant Postural variation of IOP was found in POAG as compared to controls (p<.001). Mean fluctuation of Habitual IOP (minimum sitting IOP and maximum supine IOP) in POAG (7.11 ± 2.87mm) was significantly more than fluctuation recorded in either sitting or supine IOP (p<0.01). Conclusion: Control of Postural IOP response is important for early diagnosis and adequate therapeutic control in POAG patients.

402

Information InSight


GLAUCOMA IN UVEITIS — IDENTIFICATION OF FACTORS INFLUENCING OUTCOME

Dr. SURINDER SINGH PANDAV [Presenting Author: Dr. REEMA BANSAL], Dr. SUSHMITA KAUSHIK, Dr. AMOD GUPTA, Dr. VISHALI GUPTA — CHANDIGARH

Purpose: To report outcome of uveitic glaucoma and identify risk factors influencing it. Methods: Retrospective analysis of 1600 uveitis patients, 87 (5.43%) patients (132 eyes) met criteria for uveitic glaucoma. Main outcome measure was success, defined as IOP< 22 mm Hg with/without maximum antiglaucoma drugs, and > 5mm Hg. Results: 74.6% eyes were medically controlled. 16.8% of secondary open angles,75% of angle-closures and 80% of neovascular glaucoma (NVG) required surgery. 118 eyes (90.1%) showed success. Conclusion: Majority of patients were controlled with medical treatment. NVG required more aggressive treatment and had least favourable outcome. Patients with posterior/panuveitis, or with IOP elevations >50 mm Hg were difficult to manage (p< 0.05).


STUDY OF BIODEGRADABLE COLLAGEN IMPLANT IN TRABECULECTOMY

Dr. JANSARI PIYUSH HIMATLAL [Presenting Author: Dr. JANSARI PIYUSH HIMATLAL], Dr. PORWAL MUKESH, Dr. CHETAN R. HINDOCHA — RAJKOT

Aim: To study the effect of biodegradable Subconjunctival collagen implant in trabeculectomy. Study Design: Surgical case series. Methods: Five patients with chronic angle closure glaucoma underwent trabeculectomy with or without cataract extraction, and subconjunctival implantation of biodegradable collagen matrix. Postoperative IOP and bleb morphology were the main outcome measures. Results: In all five patients IOP was controlled below 18mm Hg at the end of 3 months. One patient required postoperative 5FU injections. Conclusion: Biodegradable Collagen Matrix implant in trabeculectomy keeps bleb formed and IOP Controlled without post op hypotony.


A METHOD FOR STANDARDISING DRUG DELIVERY OF MITOMYCIN-C USING WHATMAN FILTER PAPER

Dr. NANGIA VINAY KUMAR B. [Presenting Author: Dr. RAJESH KUMAR S. JAWADE], Dr. RAJESH KUMAR S. JAWADE, Dr. ARSHIA MATIN, Dr. KRISHNA BHOJWANI, Dr. JOST JONAS — NAGPUR

Mitomycin-C used intraoperatively inhibits fibrosis and enhances the success of glaucoma surgery. Drug delivery varies significantly depending on the method. Subconjunctival or intrascleral use of single or multiple weck cell pieces or cotton pledgets soaked in mitomycin-C is described. Uneven surface, irregular shape, size and contact area to sclera and conjunctiva causes variable drug delivery.

403

SCIENTIFIC

POSTERS

We describe the use of Whatman filter paper No. 1, 7 X 3 mm size, soaked with 2 drops of mitomycin-C. 0.4 mg/ml. This is placed on the sclera. This standardises drug delivery and may potentially safeguard against excessive filteration, bleb leak and hypotony.


EFFICACY OF SELECTIVE LASER TRABECULOPLASTY (SLT) IN PRIMARY OPEN ANGLE GLAUCOMA (POAG)

Dr. SATHI DEVI A.V. [Presenting Author: Dr. SATHI DEVI A.V.], Dr. RAMGOPAL B., Dr. ANITHA S., Dr. BHUJANG SHETTY — BANGALORE

Purpose: To evaluate the safety and efficacy of Selective Laser Trabeculoplasty in POAG. Materials and Methods: 29 eyes of 19 patients with POAG who underwent SLT between June 2006 and Dec. 2006 were included in this prospective study. 18 eyes had a followup of 6 to 9 months (minimum – 3 months) Results: Mean pretreatment IOP was 23.2 mm Hg which dropped to 18.9 mm Hg post treatment (mean IOP decrease of 4.3mm Hg). 59.1% of eyes had IOP decrease of more than 3 mm Hg. Transient spike in IOP was seen in 3 patients. Conclusion: SLT appears to be safe and effective in reducing IOP in POAG.


EFFICACY OF ARGON LASER SUTUROLYSIS IN PATIENTS UNDERGOING COMBINED CATARACT AND GLAUCOMA SURGERY

Dr. NANGIA VINAY KUMAR B. [Presenting Author: Dr. DEEPAK AGARWAL], Dr. KRISHNA BHOJWANI, Dr. ARSHIA MATIN, Dr. MAITHILI KULKARNI — NAGPUR

Aim: To assess the efficacy of laser suturelysis in reducing intraocular pressure following combined phacoemulsification, lens implantation and trabeculectomy. Methods: 11 patients (POAG – 6 and PACG – 5) underwent laser suturolysis at a mean duration of 12 days. The Argon laser with Ritch suturolysis lens was used. Results: The mean pre laser IOP was 25.55 + 7.3 mm. Hg. The mean post laser IOP 13.73 + 3.90 mm. Hg. The reduction was significant at P=0.001. Conclusion: Argon laser suturolysis is an effective method of lowering IOP following combined cataract and glaucoma surgery. It should be performed within 2 weeks post-op.

Poster Panel No. 66 [FP0848] INFLAMMATION

MYCOPHENOLATE MOFETIL – AN ALTERNATIVE IMMUNOSUPPRESSANT FOR BILATERAL SEVERE NECROTIZING SCLERITIS WITH ULCERATIVE KERATITIS AND ANTERIOR NONGRANULOMATOUS UVEITIS IN C-ANCAPOSITIVE WEGNER’S GRANULOMATOSIS

Dr. SUJITHRA HARIDAS [Presenting Author: Dr. SUJITHRA HARIDAS], Dr. MEENAKSHI YADAV DHAR, Dr. LAKSHMI NISHA MENON — COCHIN

This describes the management of severe vision threatening necrotizing scleritis [NS] with peripheral ulcerative keratitis bilaterally in a 40-year-old lady. She

404

Information InSight

complained of recurrent episodes of redness, photophobia, watering from eyes, joint pains for 3 months with bilateral gradual visual loss. In spite of systemic steroids scleritis worsened with marked thinning and ciliary staphyloma. Both Fundi were normal. After thorough systemic workup she was started on mycophenolate mofetil [MM] for 3 months, along with systemic and topical steroids. Her vision improved dramatically and scleritis became quiscent. Thus Mycophenolate Mofetil is safe and an effective immunosuppressant, in refractory inflammatory eye disease.


OCULAR INFLAMMATION: SUSPECT TUBERCULOSIS IN INDIAN SCENARIO

Dr. HETAL KUMAR YAGNIK [Presenting Author: Dr. VANSADIA BHARAT RAGHUNATHSINH], Dr. OM PRAKASH BILLORE, Dr. SHARAD SIVASANE, Dr. SUMITA DAS, Dr. DISHANT SHAH, Dr. FALGUNI S. MEHTA— BARODA

A prospective investigational study of 51 patients of anterior/posterior uveitis and phlyctenuler conjunctivitis/episcleritis was conducted. 21 patients (34%) with episcleritis, 15 (30.5%) anterior uveitis, 15 (30.5%) posterior segment involvement (vitritis/choroiditis/eales’/csr). BCVA varied from PR4 + to 6/12. 18 (35.3%) had recurrent history of same lesion. High ESR in 38 (74.5%), positive MT, IgG, IgM in 36 (70.6%), 7 (13.7%), 42 (42.4%) respectively. 42 patients were put on AKT and visual improvement in mean duration of 3 months to atleast upto 6/18 or more, while resolution of uveitis in 26 (62%); conjunctival lesion and episcleritis healed completely. In Indian scenario, always suspect tuberculosis even in case of only tertiary organ involvement, unless proved otherwise.


PSEUDOENDOPHTHALMITIS — A CASE REPORT

Dr. SHAKUN GUPTA [Presenting Author: Dr. SHAKUN GUPTA], Dr. BHUDHENDRA KUMAR JAIN — CHITRAKOOT

This poster will show a case report of patient, operated topical phaco with acryofoldable for cataract, discharge with 1st POD VA (unaided) – 6/12 & anterior segment – NAD, return back in 3-4 days with VA – PL & marked hypopyon & reaction in AC. On first look, we consider it as a case of endophthalmitis & as patient don’t want to go higher centre, we admitted patient. Aqueous tap report was – sterile & B-scan show – post segment – WNL & we manage case with AC wash & eyedrops only & patient regain his full VA-6/6, N6. So, as pseudoendophthalmitis simulate endophthalmitis, careful examination & proper management is required for postoperative case with severe AC reaction.

405

SCIENTIFIC

POSTERS


WEGENER’S GRANULOMATOSIS — A RARE CASE REPORT

Dr. SHILPA BALCHANDRA KODKANY [Presenting Author: Dr. SANJEV KUMAR], Dr. PATIL SHIVANAND B., Dr. MANJUNATH K., Dr. CHAITRA K. L., Dr. SHIVAKUMAR HIREMATH, Dr. KAPA RAMAKRISHNA — BELGAUM

A 29 Year old male, presented with bilateral mechanical ptosis secondary to dacryoadenitis, persistent headache, epistaxis, nasal block and skin rashes. He then progressively developed diminution of vision in both eyes secondary to peripheral corneal ulceration, breathlessnes and pedal edema over one year. A diagnosis of Wegener’s granulomatosis was made on the basis of elevated renal parameters, hematuria, positive c-ANCA and elevatd anti-PR3 antibodies, Chest X-ray revealed bilateral alveolar infiltrates with cavitations. Cyclosporine eye drops and lubricating eye drops were given for the ocular manifestations, and recovery was noted in one month.


A DOUBLE MASKED PHARMACOKINETIC STUDY OF TOPICAL NEPAFENAC AND KETOROLAC FOR PAIN & EPITHELIAL HEALING FOLLOWING PRK

Dr. ASHOK GARG [Presenting Author: Dr. ASHOK GARG] — HISAR

This study was designed to compare the epithelial wound healing effects of topical Nepafenac (0.1%) Suspension and Topical Ketorolac (0.4%) on 30 patients (60 eyes) who underwent Photorefractive Keratectomy (PRK). Each patient received one drop 3 times a day on the top of contact lens for 3 days. Patients were graded for pain, burning, irritation, comfort and photophobia at day 1, 3, 4, 5, & 7. Final results showed a statistically significant difference in epithelial healing and advantage of Topical Nepafenac suspension in terms of pain control. Nepafenac also showed greater tolerability with more comfort, less irritation and less burning and stinging. The difference in healing time was also significant in Nepafenac group.


PRESUMED TUBERCULAR CHOROIDITIS WITH RETINAL VASCULITIS

Dr. RAHIM H. MULJIANI [Presenting Author: Dr. RAHIM H. MULJIANI], Dr. DIMPLE SHAH, Dr. KAMAL SARIYA, Dr. PRIYANKA DOCTOR, Dr. RAHUL DOCTOR — MUMBAI

Aim: Systemic tuberculosis is known to be associated with choroiditis, choroidal tubercles and tuberculomas as well as inflammation of retinal vessels. We describe a case to highlight the presentation, course and management of this form of vasculitis. Methods: Retrospective, non-comparative case study. Results:The patient responded to Anti-tubercular treatment and corticosteroids and has retained queiscence for the past 6 months. Conclusion: Systemic tuberculosis may present with retinal vasculitis in addition to choroiditis and these patients may respond to Anti Tubercular treatment.

406

Information InSight

Poster Panel No. 72 [FP0317] LACRIMAL

CENTRAL RETINAL ARTERY OCCLUSION (CRAO) FOLLOWING DACRYOCYSTORHINOSTOMY (DCR) — A CASE REPORT

Dr. MITTAL RAMAN [Presenting Author: Dr. MITTAL RAMAN] — RAIPUR

Aim: To report a case who developed Central Retinal Artery Occlusion following Dacryocystorhinostomy. Methods: A 25 year female with 20/20 visual acuity, was operated for Repeat DCR + Nasal Intubation + Fistulectomy. Five days post-operatively she presented with inaccurate projection of rays due to right orbital abscess with ethmoidal and middle meatal empyema. She was surgically and medically managed. Results: After management final visual acuity was 20/32 but with markedly constricted visual field. Conclusion: Extraocular surgery like DCR can also have sight threatening complications.


PLEOMORPHIC ADENOMA OF THE LACRIMAL GLAND CLINICO RADIOLOGICAL DIAGNOSIS AND APPROPRIATE MANAGEMENT — A CASE REPORT

Dr. RAJASHEKHAR DANDUR KOTRAPPA [Presenting Author: Dr. SHARANABASAMMA], Dr. REKHA B.K. — BELGAUM

Lacrimal gland tumours are rare. Because of the clinical rarity of lacrimal gland masses, many ophthalmologists have difficulty in accurately diagnosing them preoperatively. Pleomorphic adenomas of the lacrimal gland have a high rate of recurrence if tumour cells are dispersed into the adjacent tissue during excision or biopsy. The tumours should be diagnosed on radiological and cilincal evidence and biopsy avoided. Here we present a case of a 25 year old female with 5 year history of proptosis. The case was diagnosed on clinical and radiological basis and appropriate management was done.


GIANT PLEOMORPHIC ADENOMA — A RARE LACRIMAL GLAND TUMOUR

Dr. REENA ABDUL RASHEED [Presenting Author: Dr. REENA ABDUL RASHEED], Dr. GIRIJA DEVI P.S., Dr. ANJANA KRISHNAN — THIRUVANANTHAPURAM

We report a case of massive eccentric proptosis in a 75 year old female patient. She presented with no light perception in her affected eye. Clinically and radiologically the possibility of a malignant neoplasm was high while hercytology suggested a pleomorphic adenoma. We proceeded with lid sparing exenteration of her left orbit. Histopathology examination confirmed the diagnosis of Giant Pleomorphic Adenoma of Lacrimal Gland (4th case being reported) — making this case unique for its rarity, delayed presentation and giant tumour size.

407

SCIENTIFIC

POSTERS


MICROBIOLOGICAL EVALUATION OF DACRYOCYSTITIS

Dr. JAYASHREE DORA [Presenting Author: Dr. JAYASHREE DORA], Dr. BEHERA J.P., Dr. MAHAPATRA R.C., Dr. BEHERA R.K., Dr. PANIGRAHI S. — BERHAMPUR

A prospective study undertaken with the patients diagnosed as dacryocystitis from January 2006 to January 2007. Sample was collected with a sterile swab from the regurgitated material expressed on pressure over lacrimal sac area, and processed microbiologically. Results: About (63.4%) sample, +ve culture were obtained out of which in 30% strep. Pneumoniae was isolated, in (12.8%) staph. aurious was found, In (4%) of cases fungus (Candida albicans) was isolated. Conclusion: In our study the commonest organism isolated was streptococcus pneumoniae. Though rare in (4%) of cases fungus was isolated.


STUDY OF ENDOCANALICULAR LASER DCR — ANALYSIS OF 50 CONSECUTIVE SURGERIES

Dr. RAMGOPAL [Presenting Author: Dr. RAMGOPAL], Dr. GUPTA ROSHMI, Dr. SHETTY BHUJANG K. — BANGALORE

Purpose: To describe preliminary outcomes of endocanalicular laser DCR (ECLDCR) for patients with nasolacrimal duct obstruction. Design: Prospective, non comparative, interventional case series. Materials and Methods: 50 patients who underwent ECLDCR between February - April 2007 were evaluated for success of surgery at 1 month postoperatively; success defined as resolution of symptoms/patent lacrimal syringing. Results: Six surgeries were considered failures on basis of recurrent epiphora/discharge/reflux on lacrimal syringing. One failure needed nasal adhesion release; other two needed repeat ECLDCR. Success rate at one month postoperatively was 89.1%. Conclusion: ECLDCR offers a minimally invasive alternative procedure for treatment of NLDO with good success.


MODIFIED SIMPLIFIED DCR VS CONVENTIONAL EXTERNAL DCR — A SIMPLER AND MORE EFFECTIVE SURGERY

Dr. CYNTHIA ARUNACHALAM [Presenting Author: Dr. CYNTHIA ARUNACHALAM], Dr. VIDYA HEGDE, Dr. ANUPAMA BAPPAL, Dr. NEELAM PUTHRAN — MANGALORE

Conventional external DCR is a tedious and often messy surgery even in the best of hands. Modified simplified DCR is an ideal alternative especially in cases of revision DCR where it is not possible to get any nasal mucosa or where there is only some remanant of the lacrimal sac. A comparative study was undertaken in our hospital on 60 cases over the past 2 years. It has shown that the long term success is statistically more significant in the modified simplified DCR as compared to conventional external DCR.

408

Information InSight


ADULT PROBING – THE FIRST LINE OF TREATMENT TO CHRONIC DACROCYSTITIS

Dr. GHOSH R.K. [Presenting Author: Dr. GHOSH R.K.], Dr. SOMEN GHOSH, Dr. ABHIJIT GHOSH — HOWRAH

Chronic dacryocytitis has been a major problem in adults, which requires different surgical interventions like dacryocystorhinostomy, lacrymal implants etc, with variable success results. Our study will try to prove the efficacy of adult probing in treatment for chronic dacryocystitis. Adult probing is cost effective, quicker and effective procedure than the conventional DCR, which also gives other options of treatment if it fails. So ideally adult probing should be the first line of treatment.


BACTERIOLOGICAL STUDY OF MICROBIAL FLORA CAUSING DACYROCYSTITIS

Dr. DEVENDRA KUMAR SHAKYA [Presenting Author: Dr. DEVENDRA KUMAR SHAKYA], Dr. VAIBHAV MITTAL, Dr. DIPTI GUPTA, Dr. SAMIKSHA CHOUDHARY, Dr. NEHA CHOUHAN, Dr. ABHILASH RAJPUT — GWALIOR

Dacyrocystitis is a constant menace to the eye and is being commonly treated by Broad Spectrum Antibiotics prior to sac surgery. Hence, present study was undertaken to find out pathogenic organisms responsible for dacyrocystitis. Swabs of discharge (either by regurgitation test, syringing or peroperative from sac) were taken from 60 consecutive cases and were subjected to Culture Sensitivity test. The commonest organism grown was Staphylococcus aureus (45%), followed by gram’s negative bacilli (28%) and pseudomonas (20%), whereas 07% specimens were sterile. It is concluded that patients of Dacryocystitis should have a Culture sensitivity test done to choose appropriate antibiotic therapy.


A RARE CASE OF CONGENITAL LACRIMAL GLAND FISTULA

Dr. PRIYANKA SODANI [Presenting Author: Dr. PRIYANKA SODANI], Dr. NIYATI ABROL — JAMMU

A 4 year old girl presented with complaints of constant watering since birth from an opening 1.5 cm from lateral canthus of LE. Clear transparent fluid could be seen constantly discharging from orifice, more so when there was excessive lacrimation. There was no evidence of excoriation, inflammation or tenderness. RE, including lacrimal apparatus was WNL. No other congenital abnormality found. A fine probe could be passed in the fistula for about 7mm upwards & medially in the direction of lacrimal gland. Biochemical assay of transparent fluid from fistula was consistent with that of tears.

409

SCIENTIFIC

POSTERS


PROFILE AND MANAGEMENT OF INJURIES TO LACRIMAL DRAINAGE SYSTEM IN A TERTIARY CARE HOSPITAL IN NORTHERN INDIA

Dr. MRIDULA MALHOTRA MEHTA [Presenting Author: Dr. NEELAM PUSHKER], Dr. NEELAM PUSHKER, Dr. MANDEEP SINGH BAJAJ, Dr. NOORNIKA KHURIAJAM, Dr. PAWAN LOHIA, Dr. MAHESH CHANDRA, Dr. GHOSE SUPRIYO — DELHI

Purpose: To describe the profile and management of lacrimal apparatus injuries in a large hospital. Methods: Two years analysis of clinical and surgical records. Results: Among our 20 patients ( Age 1 m - 55 yrs, M:F = 3:1), road-traffic accidents 11/20 (55%) and animal attacks 7/20 (35%) were main causes. Telecanthus, avulsion of eye-lids, dystopia canthorum, ptosis were associated abnormalities. Lid with canalicular surgery primarily, DCR/ DCT with modified incision (Y/Z-shaped for simultaneous canthus repair) and lid reconstruction were done secondarily (4, 9 & 7 cases respectively). Conclusion: Lacrimal drainage system injuries are commoner in young males. Modification of DCR incision corrects associated canthal abnormalities.

Poster Panel No. 82 [FP1056] MISCELLANEOUS

ACUTE VISUAL LOSS IN SINUSITIS

Dr. SAROJ GUPTA [Presenting Author: Dr. SAROJ GUPTA], Dr. RAJENDRA KUMAR GUPTA, Dr. RASHMI GOYAL, Dr. HARPAL SINGH — BHOPAL

Acute visual loss may occur in association with sinusitis, either as complication of orbital cellulites or due to retro bulbar optic neuritis. Here we describe two cases of temporary monocular visual loss caused by acute ethamoid sinusitis. Comprehensive clinical examination and radiographic studies were done to conform the diagnosis. Surgical intervention was required in one case. Vision improved to 6/12 and 6/6 in both cases. We present our findings in detail and give guidelines for management of such patients. The relationship between sinusitis and blindness is discussed.


A RARE CASE OF OCULAR PROGERIA

Dr. ABHIJEET KHAKE [Presenting Author: Dr. ABHIJEET KHAKE], Dr. ANURADHA S. RAO — KOCHI

A 23 year old boy who turned man early and grew older prematurely presented with defective vision both eyes. On examination he was diagnosed to have Posterior subcapsular cataract and Primary open angle glaucoma. Further tests revealed biarcuate field defect, superior & inferior RNFL thinning in left eye on OCT, and thin cornea on pachymetry. He had graying of hair & balding, bird like face, excessive wrinkling of facial skin, short stature, feminine voice, and gynaecomastia. Investigations revealed type II diabetes and hypercholestrolemia. DNA analysis was suggestive of Werners Syndrome with classical features of ocular progeria.

410

Information InSight


DIABETIC RETINOPATHY SCREENING USING AN INTEGRATED TELEMEDICINE APPROACH IN SOUTH INDIA

Dr. KIM RAMASAMY [Presenting Author: Dr. KIM RAMASAMY] — MADURAI

Purpose: To screen for diabetic retinopathy (DR) among the community using a novel mobile van with satellite connectivity. Methods: A mobile van equipped to capture digital 5 field retinal images and transmit them via satellite to a reading center. From here, reports are transmitted within one hour to the van, where the paramedic counsels the patient for further management as indicated. Results: 3365 persons were examined. 1181 (35.1%) were diabetic and of this 237 (20.06%) had DR. Of these 105 (44.3%) were diagnosed for the first time. Conclusion: This unique concept of screening the unreached at their doorstep improves access to specialty care.


EFFICACY OF CRYOTHERAPY IN MANAGEMENT OF RESISTANT PALPEBRAL VERNAL CATARRH

Dr. SANTOSH SINGH PATEL [Presenting Author: Dr. SANTOSH SINGH PATEL], Dr. CHANDRAKER A.K., Dr. MANGILAL GARG, Dr. NIDHI PANDEY, Dr. VIJAYA SAHU — DURG, BALOD

Purpose: The objective of this study was to evaluate the effectiveness of cryosurgery in resistant palpebral vernal catarrh. Materials and Methods: 14 eyes of 7 cases with resistant palpebral vernal catarrh were treated with cryosurgery by round-ended probe. Tip temperature of –70 degrees C was used for tarsal application after excision of large cobblestones. Result: During mean follow up of 6 months this resulted in complete relief of symptoms and flattening of papillae in 85% cases. Conclusion: Cryosurgery has been shown to be effective, simple, and inexpensive treatment of resistant palpebral vernal catarrh and avoids the long-term use of topical corticosteroids.


VISUALISING THE INVISIBLE

Dr. SANTOSH KUMAR NAIR [Presenting Author: DR. SANTOSH KUMAR NAIR], Dr. SUHAS HALDIPURKAR — PANVEL

The light spectrum in the infrared and ultraviolet regions have been utilized enormously in Ophthalmolgy for various diagnostic and therapeutic uses. The auto refractometer, The Hiedelberg retina tomograph, the OCT, diode laser, YAG laser, ICG angiography, IOL master, etc. all use invisible light and light sensors for various ocular uses. The present posters potray all these uses schematically.

411

SCIENTIFIC

POSTERS


SPINDLE CELL CONJUNCTIVAL CARCINOMA

Dr. VIMALA T. [Presenting Author: Dr. JAYA SUGANTHI B.], Dr. BALAJI G., Dr. GANADIN, Dr. PARVATHAM K., Dr. JAYASHREE, Dr. VINAYAGAMOORTHY, — CHENNAI

A case of highly aggresive form of spindle cell variant of conjunctival carcinoma in a young male with visual acuity 6/9. It was treated with wide local excision following which recurrence of carcinoma was seen. Tumour recurrence regressed following topical mitomycin application.


I-125 (IODINE) PLAQUE BRACHYTHERAPY FOR CHOROIDAL METASTASIS – OUR INITIAL EXPERIENCE

Dr. PREETAM SAMANT [Presenting Author: Dr. PREETAM SAMANT], Dr. VIVEKANAND, Mr. SURESH CHAUDHARI, Mr. SUDESH DESHPANDE, Dr. NAYAK B.K. — MUMBAI

A 75 years male patient was diagnosed to have right eye choroidal metastasis secondary to pulmonary adenocarcinoma. His vision was 6/9, N8; macula and optic nerve was spared. A 15 mm custom made gold-plated eye plaque containing 12 Iodine – 125 seeds was sutured externally to the sclera corresponding to the tumor location. Dose prescribed was 60 Gray to the apex of the tumor over 10 days after which the plaque was surgically removed. A week later there were signs of resolution of the mass lesion documented by ultrasonography and serial fundus photos; with preservation of visual acuity.


NANOTECHNOLOGY ITS FUTURE IN OPHTHALMOLOGY

Dr. DIPANKAR DAS [Presenting Author: Dr. DIPANKAR DAS], Dr. LOKESH JAIN, Mr. AKSHAY K. DEKA, Dr. PANNA DEKA, Dr. KRISHNA GOGOI, Dr. KASTURI BHATTACHARJEE, Dr. HARSHA BHATTACHARJEE — GUWAHATI

Nanotechnology is an idea of emerging technologies in which structure of matter is controlled at nanometer scale developed to produce sophisticated creation in which configuration of matter is precisely controlled. This theoretical concept involves exploratory work in number of areas in ophthalmology like glaucoma, occlusive vascular disease, retinal diseases, drug delivery, tumour, ophthalmic diagnostics, molecular biology, protein engineering, receptor based transport and mapping, micromanipulation techniques, genetic engineering, customized therapy etc. This poster will give insight of possible disease spectrum where and how the ideas of Nanotechnology will be beneficial to the Ophthalmologist & basic science researchers.

412

Information InSight


COMPUTER VISION SYNDROME: DO NOT OVERLOOK THE REFRACTION

Dr. JATINDER BALI [Presenting Author: Dr. JATINDER BALI], Dr. NEERAJ NAVIN, — DELHI

We studied the refractive status and presenting complaints of symptomatic-computer-users (n = 32) and compared them with the non-visual-display-unit (VDU) near-workers/zari-workers (n = 32). The refractive state at presentation was compared with that after a 2-week-rest. A cycloplegic examination was carried out at presentation. Most common symptoms in computer-users were headaches (n = 15), blurred and double vision (n = 24) while in zari-workers these were watery-eyes (n = 17) and pain-in-back (n = 22). Dry-error-at-start was more in computer-users (Mean = – 1.325D; SD = -0.442D) than near-workers (Mean = – 0.357D; SD = -0.197D) [F = 29.098; p = 0.00. ANOVA]. Pseudomyopia was more frequent and more severe in computer-users [15.6%] (Mean = 0.125D; SD = 0.333 D) than in non-computer-users [6.25%] (Mean = 0.017D; SD = 0.064D) [F = 5.862; p = 0.017, ANOVA]. A greater role for refractive interventions is hence advocated in computer-users.


OPHTHALMOMYIASIS EXTERNA : A CASE REPORT

Dr. PUSHPA VARMA [Presenting Author: Dr. VIJAY BHAISARE], Dr. ULKA SRIVASTAVA, Dr. AMOD NAYAK, Dr. VINEET GUPTA, Dr. MAHAVIR DATTANI, Dr. SAURABH SONI — INDORE

Purpose: We report a case of Ophthalmomyiasis externa observed by us in a dental student. Methods: A 26 year male presented with foreign body sensation, irritation and mucoid discharge RE since 1 week. SLE revealed rapidly moving worms over conjunctiva. Nine live worms were removed from the right eye under operating microscope and sent to microbiology. Results: Microbiology examination revealed the presence of the Larvae of Oestrus ovis. Follow up was uneventful with no recurrence Conclusions: Although ophthalmomyiasis externa is an uncommon condition in upper socioeconomic strata, early diagnosis and management is important in preventing further complications.


RACIAL DIFFERENCE IN MULTIFOCAL ERG RESPONSE

Dr. ANIRUDDHA MAITI [Presenting Author: Dr. ANIRUDDHA MAITI], Dr. MAHESH UPARKAR, Dr. NATARAJAN S., Dr. SHEOREY U., Dr. BORSE N., Dr. TOSNIWAL S., Dr. MAHINDREKAR A. — MUMBAI

In a prospective, single-visit, non–randomized study of Indian cases of typical retinitis pigmentosa and healthy volunteers, latencies and amplitudes of the waveforms of kernel 1 responses (Rings 1, 2 and 3) were analyzed. From March

413

SCIENTIFIC

POSTERS

2006 to March 2007, among 43 patients of RP, 24 (55.81% – 47 eyes) were selected. Comparison of waveform parameters of current study with a similar study by Seeliger et al (European Caucasian) showed notable differences in the cases as well as controls when considering latencies and amplitudes. Racial differences in the mfERG responses need to be explored further for its etiology and clinical implications.


PHACOMATOSIS-UNILATERAL NEVUS OF OTA WITH OPEN ANGLE GLAUCOMA

Dr. THIRUMALACHAR C.R. [Presenting Author: Dr. THIRUMALACHAR C.R.], Dr. TANUJA ABHILASH, Dr. PADMAJA T., Dr. VIDYA DEVI MAHADEVAPPA, Dr. SANDEEP PATIL, Dr. BHAVIN SHANKARLAL SHAH, Dr. KOTESHWAR RAO — KOLAR

A 50 year old male presented with black pigmentation of left side of face and left eye since childhood. On examination-patient had nevus of left side of forehead and cheek. Left eye showed- conjunctival melanosis, black pigmentation of sclera, heterochromia iris. Gonioscopy-LE revealed hyperpigmentation of trabecular meshwork in all 4 quadrants. Vision RE- 6/12, LE-6/24. IOT recorded in RE-17.3 mmHg, LE- 23.0 mm Hg. Fields and retinal nerve fibre analysis were within normal limits. Patient was treated with topical beta blockers.


SUDDEN OUTBREAK OF PHOTOPHTHALMIA FOLLOWING EXPOSURE TO NAKED ARC LIGHT — A REPORT

Dr. ANUP DAS [Presenting Author: Dr. BHOI SACHALA], Dr. SHARMISTHA BEHERA, Dr. MARUTHI H., Dr. SAMIR MAHAPATRA, Dr. JITENDRA KUMAR PANDA, Dr. SASMITA AGASTY — SAMBALPUR

Purpose: To analyse the Factors related to photophthalmia and correlating it with signs & symptoms. Materials & Methods: 316 eyes of 158 patient with history of mass exposure to naked arc mercury vapour light during an opera show were evaluated. Detail examination done. All patients received topic lubricants, diclofenac sodium and pad bandage. Patients followed up for 1 month. Results: Watering, blepharospasm and lid edema were seen in 293 eyes (93%). Patients nearer to light 169 eyes (53.4%) were severely affected. Florescent stain was positive in 300 eyes (95%). Sign & symptoms were severe in children & women (110 eyes). Maculopathy observed in 38 eyes (12.02%). All patients recovered after one month. Visual acquity was variable and could not be correlated with photophthalmia. Conclusion: Exposure to naked arc mercury vapour light can endanger vision. Distance from source light and duration of exposure were factors evaluated.

414

Information InSight

Poster Panel No. 95 [FP0375] NEURO OPHTHALMOLOGY

NEUROFIBROMATOSIS TYPE 2 PRESENTING AS ACUTE ONSET COMITANT ESOTROPIA

Dr. HEMALINI SAMANT [Presenting Author: Dr. HEMALINI SAMANT], Dr. LAHANE T.P., Dr. RAGINI PARIKH, Dr. PREETAM SAMANT, Dr. SAYALEE LAHANE — MUMBAI

Acute Onset Comitant Esotropia type 2 has been earlier described by Franceschetti to be associated with posterior fossa lesions. This paper discusses a rare and interesting case of a 13 year old child with Neurofibromatosis Type 2 who presented as Acute Onset Comitant Esotropia for a considerable time before the cerebellar signs secondary to bilateral schwanommas at the cerebello pontine angle were obvious. This paper also describes the other clinical features of NF-2 a rare type of phacomatoses, which our patient was found to have.


EMPTY SELLA SYNDROME — A RARE CASE PRESENTING WITH VISUAL FIELD DEFECTS

Dr. MADHAVI MADHU [Presenting Author: Dr. MADHAVI MADHU], Dr. RAJU V.K., — RAJAHMUNDRY

19 year old girl presented with temporal side vision loss since last one year. She was seen by several ophthalmologists before. On examination she has right temporal hemianopia and left temporal upper quadrantopia. CT Scan was normal. But we persisted suspecting intracranial space occupying lesion and got the MRI done which showed Empty sella syndrome. We present this rare case and how an ophthalmologist plays an important role in diagnosing such rare cases.


PEDIATRIC MYESTHENIA GRAVIS – A DIAGNOSTIC DILEMMA FOR THE OPHTHALMOLOGIST!

Dr. HEMALINI SAMANT [Presenting Author: Dr. HEMALINI SAMANT], Dr. PREETAM SAMANT, Dr. DIMPLE SHAH, Dr. KAMAL — MUMBAI

Myesthenia Gravis is a disorder of the neuromuscular transmission. It assumes a more varied clinical and pathogenetic features in pediatric population as compared to adults and which along with its rarity, contributes to diagnostic difficulty for the ophthalmologist.! This paper describes two interesting cases of pediatric myesthenia gravis and elaborates on the clinical features, diagnostic tests and its management.

415

SCIENTIFIC

POSTERS


SEVERE BILATERAL VISUAL LOSS AS A PRESENTING SIGN OF CEREBRAL VENOUS SINUS THROMBOSIS: CASE REPORT

Dr. (Miss) PUJA GOYAL [Presenting Author: Dr. (Miss) PUJA GOYAL], Dr. RAHUL SHAH — PUNE

A 52 year old man presented with severe bilateral visual loss, headache, bilateral papilloedema and constricted visual fields. CT shows thrombosis in the superior sagittal and transverse venous sinuses. The patient was treated with oral acetazolamine and anticoagulation. Patient showed reduction in papilloedema but vision loss remained. Severe visual loss can be a presenting sign of cranial venous sinus thrombosis. Treatment should aim at decreasing intracranial pressure in order to avoid optic nerve atrophy and visual loss.


OPTIC NEUROPATHY DUE TO RADIOTHERAPY

Dr. SRIVASTAVA LALIT [Presenting Author: Dr. SRIVASTAVA LALIT], Dr. KHURRUM M.A., Dr. KHARE B.D. — BHOPAL

Optic neuropathy is an ISCHAEMIA of optic nerve causing irriversible vision loss and is a retrobulbar process. I observed in eight cases who underwent radiation with cobalt 60 particularly in patients with brain, skull base, paranasal and in orbital malignancies. There is gradual loss of vision after 3 to 6 weeks duration with more than 4000 cGy dose. O/E gradual diminision of vision, palor of disc after 3 to 6 weeks. In one patient Ptosis with optic atropthy was noted. Field changes on humphery are central scotoma and alitudinal defects. disc edema, haemorrhage, exudates were presents. CT was normal. Treatment with Corticosteroids, and Methyl Prednisolone tried but no relief.


A CASE OF BILATERAL OPTIC NEURITIS IN A CHILD DIAGNOSED AS MULTIPLE SCLEROSIS

Dr. BHANUMATHI M. [Presenting Author: Dr. BHANUMATHI M.], Dr. RAGHAVENDRA S., Dr. SHETTY BHUJANG K. — BANGALORE

Aim: To study the cause of bilateral optic neuritis in a child. Materials and Methods: A female child of 12 years presented to the OPD with history of inability to see clearly and unable to write the exam. vision was 6/6parts both eyes and N6 and N8. Color vision was normal. Disc showed mild temporal pallor in the LE. It was suspected to be a case of malingering. On repeated examination and following VEP, LP and MRI, diagnosis of bilateral optic neuritis due to multiple sclerosis was made. Conclusion: This is a rare cause of bilateral optic neuritis in a child. She responded well to IV steroids. Malingering should be thought of after ruling out organic causes.

416

Information InSight


NEURO CYSTECERCOSIS – VISUAL LOSS THE ONLY SYMPTOM

Dr. NUPUR CHAKRAVARTHY [Presenting Author: Dr. NUPUR CHAKRAVARTHY] — MUMBAI

Aim: To impress upon that visual loss may be the only presenting symptom for neuro cystecercosis. Materials and Methods: 5 young 20-25 year old male patients presented with repeated attacks of unilateral peripheral dimunition of vision. There was no history of trauma or any systemic illness. On examination central vision was normal but peripheral vision was restricted. Perimetry was done and showed unilateral hemianopia. Routine investigations were within normal limits. CT scan was done and showed scolii of cystecercosis in the occipital lobe. Patients were put on full dose of Albendazole. Conclusion: Whenever there is sudden visual loss neurocystecercosis should be a differential diagnosis.


A CASE OF SINO-ORBITAL FUNGAL DISEASE

Dr. (Col) ASHOK KUMAR SOOD [Presenting Author: Dr. (Col) ASHOK KUMAR SOOD], Dr. (Col) V. P. SINGH CLASSIFIED SPECIALIST (ENT), Dr. (Col.) D.C. GUPTA SENIOR ADVISER (MEDICINE) — GARHI CANTT., DEHRADUN

A 42 yrs old soldier, an old case of IDDM admitted with poor diabetic control, headache, nausea & vomiting developed sudden gross diminition of vision left eye. Diagnosed as Optic Neuritis he developed CRAO (Lt) in a rapid sequence of events. ENT referral, surgical debridement of nasal growth and histopathology clinched the diagnosis of Mucormycosis. Comprehensively managed alongwith physician & ENT surgeon with use of intravenous Amphoterecin-B and periodic debulking/debridement of nasal/sinus cavities patient responded initially but eventually succumbed to orbiticranial spread and/or septicaemia. The case is presented for its rarity.


CAROTICOCAVERNOUS FISTULA

Dr. PRIYA RANGARAJAN [Presenting Author: Dr. PRIYA RANGARAJAN], Dr. PADMAMALINI MAHENDRA DAS, Dr. KANNAN MYSORE NARAYANA, Dr. BHUJANG K. SHETTY — BANGALORE

Aim: To present three cases of caroticocavernous fistula. Materials and Methods: Retrospective interventional case series. Six eyes of three patients were

Poster Panel/Board number 101-200 has to be set up from 7:00 AM to 9:00 AM on February 2, 2008 displayed on February 2, 2008

and February 3, 2008 and removed at 2:00 PM on February 3, 2008.

(LAST 2 DAYS ONLY)

417

SCIENTIFIC

POSTERS

studied from July 2003 to May 2007. Results: Three male patients age range 32 years - 54 years presented with unilateral axial proptosis, dilated vessels and secondary glaucoma. These patients underwent MRA which revealed caroticocavernous fistula. One patient underwent embolisation of the fistula and had regression of proptosis. Two patients were kept on observation. Conclusion: A high index of suspicion is essential in diagnosing CCF which is a treatable cause of blindness.


ORBITAL MIGRAINE

Dr. FRANCIS M.V. [Presenting Author: Dr. FRANCIS M.V.] — ALLEPPEY

Aim: To document migraine pain manifesting in the orbital region. Methods: 24 patients aged 20 to 40 years without any inflammatory or pressure eye signs were studied over a period of 4 years. ICHD 2 diagnostic criteria for migraine without aura fulfilled by all. Results: 13 reported pain in the whole of the orbital region, 4 retrobulbar, 3 medial orbital area and 2 just below the eye brow. In 21 of them, common migraine triggers in this region precipitated the episodes of pain.Conclusion: orbital migraine is a diagnostic possibility in patients with eye pain without any associated ocular or neuroocular signs.

Poster Panel No. 105 [FP0826] OPTICS/REFRACTION/CL

CONTACT LENS – DRY-EYE

Dr. MONA R. DESHMUKH [Presenting Author: Dr. NANDKISHOR GUNWANTRAO RAUT], Dr. RAVI R. DEKATE, Dr. OM PRAKASH GUPTA — NAGPUR

It has been traditionally reported that long-term use of contact lenses is associated with dry-eye. We present with cross-sectional study of 25 medical-students using soft contact lenses. Method: 20 cases of soft contact lens & 5 cases of RGP’s were studied for contact-lens related dry-eye problems who presented with symptoms of burning sensation, gritty sensation, discomfort. They were evaluated using tear film break-up time (TFBUT) & Schirmer test. They were given tear-film. Substitute (preservative free carboxymethyl cellulose) & observed for 1 yr. Effectiveness of treatment was taken as relief from symptoms of dry-eye, improvement in TFBUT, Schirmer test. Result: Patients on tear substitute were much more comfortable. There was improvement in above mentioned parameters in all the cases & compliance was good.

“Great dreams of great dreamers are ALWAYS transcended.”


418

Information InSight


TREATMENT OF MILD TO MODERATE KERATOCONUS WITH THE HELP OF SEMI-SOFT AND PIGGYBACK CONTACT LENSES

Dr. DEEPAK C. MEHTA [Presenting Author: Dr. DEEPAK C. MEHTA], Dr. LAVINGIA B.C., Dr. GARIMA AGGARWAL, Dr. RUCHIKA NAGORI — AHMEDABAD

Aim: To study the results of semi-soft contact lenses on mild to moderate cases of keratoconus. Materials & Methods: A prospective study of 50 cases was done at M&J institute of ophthalmology, Ahmedabad over 1 year. Complete assessment of every case was done with keratometry and corneal topography. Advanced cases of keratoconus & the cases where no satisfactory improvement was found with either type were excluded. Results: 41(82%) cases of mild keratoconus improved with semi-soft contact lenses, with a few complicated by persistent corneal edema. 9 (18%) cases of moderate type did well with piggyback lenses. A few had damage at the interface between semi-soft & soft lenses. Conclusion: Contact lenses prove quite beneficial in relieving the burden of surgical intervention, sparing it for advanced and refractory cases.


AXIAL LENGTH IN A POPULATION BASED STUDY – THE CENTRAL INDIA EYE AND MEDICAL STUDY. (CIEMS)

Dr. KRISHNA BHOJWANI [Presenting Author: Dr. KRISHNA BHOJWANI], Dr. MONICA YADAV, Dr. NIKHIL KHANORKAR, Dr. NANGIA VINAY KUMAR B., Dr. MAITHILI KULKARNI, Dr. VINAY NANGIA, Dr. JOST JONAS — NAGPUR

Introduction: To determine the normative values of axial length (AL) and its correlations in a population based study the CIEMS. Methods: One eye of 2341 subjects of the CIEMS were included. Subjects underwent ophthalmic evaluation including ocular biometry. Mean age was 47.3 + 13.4 yrs. Mean refractive error was – 0.23 ± 1.53D and mean axial length was 22.69 ± 0.85 mm. Results: Multivariate analysis revealed mean axial length significantly correlating with lens thickness (p = 0.001; 95% CI:0.03, 0.13), anterior chamber depth (p<0.001; 95% CI:0.62, 0.76) and spherical equivalent (p<0.001; CI:95% – 0.2, –0.17) Conclusions: The study determined the axial length in Central India. Axial length significantly correlated to anterior chamber depth, lens thickness, and refractive error.


LEARNING DISORDERS AND ASTIGMATISM

Dr. NUPUR CHAKRAVARTHY [Presenting Author: Dr. NUPUR CHAKRAVARTHY], — MUMBAI

Aim: To impress that in dyslexic children astigmatism is the commonest refractive error. Materials and Methods: 25 dyslexic certified children were screened for refractive errors under cycloplegics. These children were prescribed glasses

419

SCIENTIFIC

POSTERS

according to retinoscopy. All these children had astigmatism more than 1D along with myopia or hypermeteropia. The myopic or hypermeteropic component was not significant as compared to their asigmatism Very few children had only simple myopia or hypermetropia. Conclusion: Dyslexic children can be helped in their school by correcting their astigmatism.


PUPIL SIZE IN THE ADULT SOUTH INDIAN POPULATION

Dr. RAMESH DORAIRAJAN [Presenting Author: Dr. RAMESH DORAIRAJAN], Dr. GEETHA, Dr. KAVITHA — CHENNAI

Data on the size of the pupil in the south indian population is sparse. 40 eyes of patients in the age group 40-49, 50-59, 60-69 and 70 yrs. and above were measured in photopic, mesopic and scotopic conditions. Mean mesopic pupil size was 4.4mm in the fourth decade and 3.37 in the fifth decade. There was a minimal 0.2mm decrease from the fifth to the seventh decade.


SHAPE OF THE OPTIC DISC IN MYOPIA

Dr. MAITHILI KULKARNI [Presenting Author: Dr. MAITHILI KULKARNI], Dr. KRISHNA BHOJWANI, Dr. NANGIA VINAY KUMAR B., Dr. MONICA YADAV, Dr. ARSHIA MATIN, Dr. JOST JONAS — NAGPUR

Purpose: To assess the shape of the optic disc in myopia. Methods: 141 eyes of 74 myopic subjects underwent an ophthalmic evaluation and optic disc photography. Optic disc diameters were measured at 00, 300, 600, 900, 1200 and 1500. The mean refractive error was – 6.3+2.8. Results: No significant difference was seen on T test between any of the above diameters. However the superonasal – inferotemporal diameters (at 30 and 60 degrees from horizontal) were found to be greater than the vertical diameter in a majority of eyes. (54%) Conclusions: Myopic subjects may have a greater frequency of obliquely oval discs with the greatest diameter showing a superonasal – inferotemporal orientation in both eyes.


COMPARISON OF CONTRAST SENSITIVITY IN NORMAL VOLUNTEERS WHEN MEASURED USING THE FUNCTIONAL ACUITY CONTRAST TESTING AND THE VECTOR VISION CS 1000

Dr. MATHEW KURIAN [Presenting Author: Dr. MATHEW KURIAN], Dr. ROHIT SHETTY, Dr. AJOY VINCENT, Dr. SHETTY BHUJANG K. — BANGALORE

50 normal volunteers were screened to ensure that the best corrected Snellens vision was 6/6, color vision was normal; media was clear and fundus examination normal. Contrast sensitivity was tested using the Functional Acuity Contrast Testing and the Vector Vision CS 1000 instruments in photopic and mesopic conditions and with and without glare. The intraclass correlation of the results

420

Information InSight

for each spatial frequency was estimated using SPSS software. It was found that the Vector Vision CS 1000 recordings are consistently lower than the Functional Acuity Contrast Testing.


MEASURMENT OF PUPIL SIZE WITH ANY AUTO-REFRACTOMETER

Dr. RAMESH DORAIRAJAN [Presenting Author: Dr. RAMESH DORAIRAJAN], Dr. GEETHA, Dr. KAVITHA — CHENNAI

Pupil size is important for refractive and multifocal surgery. The video monitor of the autorefractometer magnifies pupil size by 7 times. Accurate pupil size can be measured with a ruler placed on the monitor. This can be done in photopic, mesopic and scotopic conditions.


THE AGE RELATED EYE DISEASES STUDY (AREDS) GRADING OF THE LENS AND ITS CORRELATIONS IN THE CENTRAL INDIA EYE AND MEDICAL STUDY (CIEMS)

Dr. NANGIA VINAY KUMAR B. [Presenting Author: Dr. MAITHILI KULKARNI], Dr. ARSHIA MATIN, Dr. KRISHNA BHOJWANI, Dr. JOST JONAS — NAGPUR

Purpose: To grade the lens according to AREDS and determine its correlations in the CIEMS. Methods: One randomized eye of 964 subjects were included. Subjects underwent an ophthalmic examination with slit lamp photography of the lens. The photos were graded on the AREDS scale of 1-7. Mean age was 47.84 + 13.06. Results: The mean grading was 4.39 + 1.07. Multivariate analysis showed a correlation with age (p < 0.001), and negative correlation with spherical equivalent (p = 0.001) and best corrected visual acuity (p < 0.001), but not with lens thickness. P = 0.12). Conclusions: AREDS grading and its correlations were established for the CIEMS, a population based study.

Poster Panel No. 114 [FP0572] ORBIT/PLASTIC

PRIMARY ORBITAL PLASMOCYTOMA MIMICKING LACRIMAL GLAND TUMOR: VALUE OF FNAC

Dr. (Col.) MADHU BHADAURIA [Presenting Author: Dr. (Col.) MADHU BHADURIA], Dr. (Col.) REENA BHARDWAJ, Dr. (Col.) THAKUR P.K., Dr. BARANWAL V.K. — PUNE

59 years old lady reported with painless proptosis for past 6 months with diminished vision and watering. She had more supero lateral fullness with exposure of cornea and conjunctiva. Vision was reduced to 6/36 with disc edema. MRI showed tumor involving supero lateral orbit including lateral rectus. She was diagnosed as lacrimal gland tumor but FNAC showed plasmocytoma which was confirmed

421

SCIENTIFIC

POSTERS

by immunohistochemistry. Systemic workup showed no evidence of multiple myeloma. She was treated with radiotherapy which led to complete resolution of tumor, regression of proptosis with visual improvement. No recurrence has been seen in last 3 years.


RADIOTHERAPY IN HEMOPHILIC PSEUDOTUMOUR OF ORBIT

Dr. BENJAMIN NONGRUM [Presenting Author: Dr. BENJAMIN NONGRUM], Dr. RENUKA SRINIVASAN, Dr. ARVIND GUPTA, Dr. DUTTA GULNAR PANDIAN — PONDICHERRY

We report a case of hemophilic pseudotumor in a 8 yr. old boy with hemophilia. He presented with rapidly progressive expansile right orbital mass following blunt trauma and had no perception of light. CT scan and MRI showed features consistent with pseudotumour. He was treated conservatively and observed for a month. The swelling progressively increased. Radiation therapy was considered and a Low dose radiation of 900 cGy, in 5 fractions over 5 consecutive days was given. The effect of radiation was noticed only after 4 weeks, and the swelling regressed to 1/3rd of the original size by 6 weeks.


EPIDEMIOLOGY OF OCULAR PSEUDOTUMOR: A RETROSPECTIVE STUDY OF 115 CASES AT A TERTIARY HEALTH CARE CENTRE, WESTERN ORISSA

Dr. SHARMISTHA BEHERA [Presenting Author: Dr. GOPESWARI HOTA], Dr. ANUP DAS, Dr. MARUTHI H., Dr. MANJULATA DAS, Dr. PANDA B.B., Dr. GEETA MOHANTY — SAMBALPUR

Aim: To study the epidemiology, clinical presentation and management of Ocular pseudotumor over 3 years. Methods: 115 eyes with Ocular pseudotumor were retrospectively analysed for incidence, clinical manifestation and management. All patients had undergone Computerized tomographic examination and intravenous methyl prednisolone was given as first line of therapy. Data was subjected to apparent Statistical analysis. Results: M:F – (1:1.2), 30 to 40 years age group was most affected (41.7%), 81 cases (70%) responded very well to Methyl prednisolone. 22.6% had reccurences, who again responded to a course of steroids.15.7% had associated lateral rectus palsy with Diplopia. Conclusion: Ocular pseudotumor is a diagnosis of exclusion after proper evaluation. IV Methyl prednisolone tapered slowly to oral preparations, give good results.

“To succeed in your mission, you must have single-minded devotion

to your goal”


422

Information InSight


DIAGNOSTIC SIGNIFICANCE OF ENLARGED EXTRA OCULAR MUSCLE IN CT ORBIT

Dr. MODINI PANDHARPURAR [Presenting Author: Dr. MODINI PANDHARPURAR], Dr. MALLAJOSYULA SUBRAHMANYAM, Dr. ATHER MOHAMMED — HYDERABAD

Aim: To study the incidence, and etiology of enlarged extra ocular muscle (EOM) in CT orbit. Methods: Prospective study of 223 cases with enlarged EOMs in CT orbit among 418 cases of proptosis at a tertiary care center during January 2006 to April 2007. Results: Enlarged EOM is the most common CT finding in proptosis (53.4%). Thyroid orbital disease (32%), NSOIS (24), myocysticercosis (22%) are the common causes, followed by CCF, lymphoma, orbital infections. Rhabdomyosarcoma and Secondary metastatic tumors are rare causes. Conclusions: Enlarged EOM is the most common CT finding in proptosis. Most cases are managed medically.


ORBITAL LYMPHOMA — A RARE CASE REPORT

Dr. SHILPA KODKANY [Presenting Author: Dr. KAUSHIK HEGDE], Dr. PATIL SHIVANAND B., Dr. MACGA R.S., Dr. SMITHA K.S., Dr. MANJUNATH K. — BELGAUM

A 25 year old man presented with history progressive protrusion of left eye since one year. He did not give history of any diminution vision. On examination his BCVA was 6/6, he had 4 mm of proptosis, axial in direction, the posterior segment showed swollen congested optic nerve hed. CT showed a homogenous mass with moderate contrast enhancement in the retrobulbar space. A medial trans conjunctival orbitotomy with total excision of the mass was carried out. Histopathology was inconclusive with the report of ‘lymphoid hyperplasia’ on further immunohistochemistry studies it was confirmed as malignant lymphoma of the orbit.


RECURRENT ADENOID CYSTIC CARCINOMA PRESENTING AS PAINFUL PROPTOSIS

Dr. SYED ASGHAR HUSSAIN [Presenting Author: Dr. SYED ASGHAR HUSSAIN], Dr. VENKATESH SUGANTHARAJ, Dr. LILY DANIEL, Dr. VISWANATHAN S., Dr. PRIYANKA DOCTOR, Dr. RAHUL DOCTOR, Dr. GAGAN BHATIA — CHENNAI

Aim: To describe a rare case of Recurrent Adenoid Cystic Carcinoma of the lacrimal gland Methods: Case report: A 50 year old male presented with unilateral painful proptosis. He had similar complains two years prior, which was diagnosed as Adenoid cystic carcinoma of the lacrimal gland. A CT Scan was performed which revealed a 3 cm x 2 cm x 1 cm lesion within the lacrimal gland. A lateral orbitotomy was performed with excision of the lesion. Conclusion: This is a rare case of recurrent adenoid cystic carcinoma of the lacrimal gland.

423

SCIENTIFIC

POSTERS


IV METHYLPREDNISOLONE (IVMP) AS AN ALTERNATIVE TO DECOMPRESSION SURGERY IN SEVERE THYROID ASSOCIATED ORBITOPATHY (TAO) NOT RESPONDING TO ORAL STEROIDS

Dr. REJI KOSHY THOMAS [Presenting Author: Dr. REJI KOSHY THOMAS], Dr. SUNEETHA NITHYANANDAM, Dr. GANAPATHY, Dr. AJOY MOHAN V.K., Dr. DAVID PUDUKADAN, Dr. FEBSON FRANCIS — BANGALORE

Aim: Safety and efficacy of IVMP in severe TAO not responding to oral steroids Method: 6 patients with severe TAO not responding to oral steroids were treated with pulsed IVMP followed by oral steroids for 6 months. All had an activity score of 3 or more, with dry eye, motility restriction, proptosis, nocturnal exposure, restricted retropulsion. Visual loss 3, raised IOP 3, and papilledema 1. Results: 3 patients responded to 1 cycle, while 3 required 2 cycles. No patient required decompression. Conclusion: Pulsed IVMP is a safe and efficacious option in severe TAO not responding to oral steroids, specifically before contemplating major decompression.


RARE PRESENTATION OF EWINGS SARCOMA OF SPHENOID

Dr. MARAGATHAM K. [Presenting Author: Dr. MARAGATHAM K.], Dr. VELAYUTHAM VEERABAHU, Dr. JAYANTHI N., Dr. PRADEEP A.V., Dr. SWATHI N., Dr. UMA MAHESHWARI — CHENNAI

16 year old male presented with acute onset defective vision (CFCF) and proptosis (OD). On imaging, biopsy and immunohistochemistry (positive for vimentin and CD 99) it was confirmed to be Ewing’s sarcoma of right pterigoid plate, sphenoid and lateral ramus of mandible (stage Ila/T2bNoMo). Following chemotherapy, patient’s vision improved to 6/24 and proptosis in the right eye regressed. Ewing’s sarcoma is a primitive neuroectodermal tumour arising from medullary cavity of affected bones in children within second decade.


SIGNET RING CELL TUMOR – A PRIMARY ORBITAL LIPOSARCOMA

Dr. BHADURI ANIRBAN [Presenting Author: Dr. BHADURI ANIRBAN], Dr. RAMESH MURTHY, Dr. GEETA K. VEMUGANTI, Dr. VIJAYANAND P. REDDY, Dr. SANTOSH G. HONAVAR — KOLKATA

Purpose: To describe a unique signet-ring cell tumour in the orbit. Methods: A 61-year-old male, presented with lower lid swelling and mild restriction of abduction. Biopsy revealed a signet-ring cell tumor suggestive of metastatic gastrointestinal adenocarcinoma. Systemic workup was unrevealing. Tumor was excised and fresh frozen sections stained for fat. Results: Oil red O staining of fresh tissues was suggestive of Liposarcoma. Presence of

424

Information InSight

lipoblasts confirmed the diagnosis. Patient was treated with radiotherapy with excellent outcome at 1 year. Conclusion: Liposarcoma is a rare mimic of signet-ring cell adenocarcinomas. Staining of fresh tissue is essential for the diagnosis.


FUNGAL CONJUNCTIVITIS WITH ORBITAL APEX SYNDROME

Dr. LILY DANIEL [Presenting Author: Dr. VENKATESH SUGANTHARAJ], Dr. VISWANATHAN S., Dr. ANUPAMA KINDO, Dr. GAGAN BHATIA, Dr. RADHA ANNAMALAI, Dr. SYED ASGHAR HUSSAIN — CHENNAI

Case report of a rare fungus Engyodontium Album. 56 yr. old female, diabetic for 15 yrs., diagnosed with orbital apex syndrome with involvment of 2nd, 3rd, 4th, 6th, & 1st div. of 5th cranial nerve, with panuveitis. Histopathology of Orbital apex tissue revealed mucormycosis, conjunctival swab revealed Engyodontium Album. E Album, rare fungus, has been reported to be isolated from jute, paper, linen, painted walls and stratosphere at 41 km above sea level. Not a conjunctival commensal, rarely a human pathogen.


PROPTOSIS A CLINICAL PROFILE, AND MANAGEMENT IN DIFFERENT AGE GROUPS

Dr. KALYANI VIJAYA KUMARI [Presenting Author: Dr. KALYANI VIJAYA KUMARI], Dr. CHINNAYYA K.N. RAO, Dr. (Col.) MADAN DESHPANDE, Dr. RAHUL DESHPANDE — PUNE

Twenty two patients, 11 males, 11 females between 2-70 yrs. reported in 3 years studied with thorough history, detailed clinical and radiological, histopathological investigations with pre and post operative photographs. Medical and surgical treatment was carried out. It is observed that unilateral is more common (77%) than bilateral porptosis (23%). Neoplasms found to be more common etiological factor (50%) followed by orbital inflammations (31%), Endocrinal exaophthalmos (9%), trauma (5%) and cavernous sinus thrombosis (5%). 59% of patients are of age group 2-15 yrs.


ANTERIOR LAMELLAR REPOSITIONING, GREY LINE SPLITTING AND BLEPHAROPLASTY IN TRACHOMATOUS UPPER LID CICATRICIAL ENTROPION – A RETROSPECTIVE ANALYSIS

Dr. SAMEER VERMA [Presenting Author: Dr. SAMEER VERMA], Dr. BHUDHENDRA KUMAR JAIN, Dr. RAJESH JOSHI — CHITRAKOOT

Objective: To determine the efficacy of anterior lamellar repositioning, grey line splitting and blepharoplasty in giving long term anatomical

425

SCIENTIFIC

POSTERS

correction and cosmesis in cases of trachomatous cicatricial entropion. Method: Clinical profile, pre and post-op. data was analyzed retrospectively of 133 patients of whom 11% were previously operated for entropion. Result: symptomatic improvement – 92%, anatomical success – 84%, lid margin defect – 25%, failure and recurrence – 16% cases. Conclusion: This is an excellent procedure for anatomical correction and cosmesis in cases of upper lid cicatricial entropion and gives good result in previously operated cases.


ORBITAL ALVEOLAR SOFT PART SARCOMA – MANAGEMENT AND OUTCOME

Dr. BHADURI ANIRBAN [Presenting Author: Dr. BHADURI ANIRBAN], Dr. RAMESH MURTHY, Dr. MILIND NAIK, Dr. GEETA K. VEMUGANTI, Dr. VIJAYANAND P. REDDY, Dr. SANTOSH G. HONAVAR — KOLKATA

Purpose: To study the clinical, radiological features and treatment outcome of orbital alveolar soft part sarcoma. Methods: Retrospective interventional case series Results: Of 670 orbital tumours, 4 patients had a histological diagnosis of alveolar soft part sarcoma. There were three children and one adult, who presented with proptosis. Imaging showed a homogenous, well-circumscribed, contrast enhancing soft tissue mass involving an extraocular muscle in 3 cases. Patients underwent exenteration or excision biopsy followed by radiotherapy. At a mean follow-up of 21.25 months, all patients were disease free. Conclusions: Alveolar soft part sarcoma can be successfully managed by combined surgery and radiotherapy.


CHEMICAL INJURY IN PERIOCULAR AREA: MANAGEMENT AND OUTCOME

Dr. NOORNIKA KHURAIJAM [Presenting Author: Dr. PAVAN VIJAYKUMAR LOHIA], Dr. MRIDULA MEHTA, Dr. NEELAM PUSHKAR, Dr. MANDEEP BAJAJ, Dr. MAHESH CHANDRA — NEW DELHI

Aim: To review the different modalities for reconstruction of periocular area following chemical injury. Methods: retrospective & photographic review of cases. Results: Periocular reconstruction was performed in 30 eyes (7 children, 21 adults) with chemical injury. The main cause was acid burn followed by alkali. Others were molten aluminium, household detergent. Skin grafting, Z-plasty, flap advancement were the procedures that were done. The follow-up period was 3-6 months. The main complications were residual ectropion and infection. Conclusions: Functional and cosmetic outcome is achievable in varied cases of periocular chemical injury.

426

Information InSight


NEUROFIBROMATOSIS-1 WITH OCULAR INVOLVEMENT — REVIEW OF LITERATURE AND CASE REPORTS

Dr. CHANDRAKER A.K. [Presenting Author: Dr. CHANDRAKER A.K.], Dr. MANGILAL GARG, Dr. NIDHI PANDEY, Dr. SANTOSH SINGH PATEL, Dr. VIJAYA SAHU — RAIPUR

Objectives: The ocular and systemic manifestations of von Recklinghausen’s neurofibromatosis-1 are reviewed with role of oculoplastic surgery. Material Method: We have reported two cases of Neurofibromatosis-1 diagnosed clinically with HPE confirmation, mechanical ptosis were managed surgically with serial photographic review. Result: Oculopalpebral neurofibromatosis may cause severe soft tissue deformity. Conclusion: The periorbital appearance and comfort of patients with NF type 1 who have orbitotemporal NF can be significantly improved through oculoplastic surgery. The ophthalmologist should be aware of broad scope of this disorder so that a complete evaluation of the patient can be made.

Poster Panel No. 130 [FP0087] PEDIATRIC

RATE OF GROWTH OF HEAD CIRCUMFERENCE (HC) AS A MARKER OF OCULAR GROWTH. AT BIRTH, 6 AND 10 WEEKS AFTER BIRTH

Dr. (Prof) SARITA BERI [Presenting Author: Dr. (Prof) SARITA BERI], Dr. PRACHIR AGGARWAL, Dr. RAJIV GARG, Dr. RAJESH JAIN, Dr. PAMELA D’SOUZA, Dr. ARAVIND SAILI, Dr. ANURADHA DHAWAN — DELHI

Aim: To study the correlation of rate of growth of HC with ocular growth in preterms. Materials & Methods: 50 term neonates, 50 preterms (AGA) and 50 preterms (IUGR) were included as Group A, B and C respectively. Ocular examination with biometry and measurement of HC was done at birth, 6 and 10 weeks after birth. Results: Mean HC (cm) in Group A, B & C: 342.88, 371.96 & 305.18 at birth. Mean axial length (mm) in Group A, B & C: 16.45, 15.49, 15.33 at birth. Rate of growth of HC was significantly correlated with increase in axial length (p<0.01). Conclusions: Rate of growth of head circumference is a reliable and easily recordable marker for ocular growth.


PRIMARY INTRAOCULAR LENS IMPLANTATION (SINGLE PIECE HYDROPHOBIC) IN INFANTS UNDER 1 YEAR OF AGE

Dr. (Col) MADHU BHADURIA [Presenting Author: Dr. (Col) MADHU BHADURIA], Dr. (Brig) VATS D.P., Dr. (Col) BAIJAL V., Dr. GURUNADH V.S. — PUNE

Purpose: To assess safety and efficacy of primary PCIOL implants in infants.Material and Methods: Primary PCIOL implant (Single piece hydrophobic IOL) was done in 26 eyes of infants after posterior CCC and anterior vitrectomy over a period of four years. Follow up 9 to 42 months. Results:

427

SCIENTIFIC

POSTERS

Etiology was CRS in 8 eyes, recurrent hypoglycemia in 6 eyes, galactossemia in 4 eyes and 8 eyes idiopathic. Significant inflammation was in 8 eyes, pupillary anomalies in 6 eyes, opacification of visual axis in 5 eyes. 96% infants followed objects, 27% infants could read up to 6/24. Conclusion: Primary PCIOL implants in infants are safe and effective in experience hands in tertiary care centers.


SURGICAL RE-DO’S IN STAGE V ROP

Dr. KAROBI RANI LAHIRI [Presenting Author: Dr. KAROBI RANI LAHIRI] — NAVI MUMBAI

This is a study of 10 patients of Stage V ROP who had initial surgery for ROP in the form of Lensectomy + Vitrectomy + belt buckle + membrane segmentation/ Delamination with or without drainage with Haelon Injection. Of these, 4 patients (40%) had closed funnel detachment and 6 (60%) had open funnel detachment. Then initial surgery was uneventful with no break formation without SRF drainage. The surgery done was to reopen the funnel. Membrane clearance + SRF drainage. In 2 patient silicone oil was injected. Of the 4 pateints (40%) that did well, one of closed funnel (10%) and 3 of open funnel (30%). The outcome of these surgeries, the surgical benefits and difficulties will be discussed.


ORBITAL GRANULOCYTIC SARCOMA AND ACUTE MYELOID LEUKAEMIAS IN CHILDREN

Dr. GHOSE SUPRIYO [Presenting Author: Dr. SEEMA KASHYAP], Dr. MRIDULA MEHTA, Dr. NEELAM PUSHKER, Dr. SEEMA SEN, Dr. SEEMA KASHYAP, Dr. MANDEEP SINGH BAJAJ, Dr. SAMEER BAKSHI — NEW DELHI

Purpose: To describe a case series, emphasizing clinical features and investigations in cases of orbital granulocytic sarcomas, a localized malignant tumor of myeloid origin. Methods: Retrospective 3 yr. clinical and pathological record analysis. Results: Sudden bilateral proptosis was presenting feature in all 6-cases (3-11 y Mean = 7.2 y, SD = 2.99), with decreased vision and retinal hemorrhages. CT-scan demonstrated bilateral orbital deposits in all. Peripheral smear, bone-marrow aspiration, orbital FNAC and biopsy helped diagnose AML, with immunohistochemistry (MPO, CD-68, RAEB) in doubtful cases. Conclusions: AML should be ruled out in bilateral proptosis in children with retinal hemorrhages. The all-important peripheral smear is simple, cheap and advantageous.

You are never too old to set another goal

or to dream a new dream

— C. S. Lewis

428

Information InSight


ELECTROPHYSIOLOGY IN CONGENITAL MOTOR NYSTAGMUS

Dr. JITENDRA JETHANI [Presenting Author: Dr. JITENDRA NENUMAL JETHANI], Dr. ANURAG MISHRA, Dr. SHASHIKANT SHETTY, Dr. VIJAYALAKSHMI P. — AHMEDABAD

To study role of electroretinogram in confirming the diagnosis of congenital motor nystagmus (CMN). 62 eyes of 31 consecutive children having CMN with visual acuity of 6/60 or better underwent electroretinogram (ERG) examination. All children underwent complete ophthalmological examination if required under anesthesia. Mean age was 10.19 +/– 2.26 years. Fourteen (22.6%) eyes had a visual acuity 6/12 or better, 21 (33.6%) had a visual acuity of 6/36 or worse and 27 had visual acuity better than 6/36 but worse than 6/12. Mean scotopic and photopic responses (amplitude and implicit time) were compared for a given visual acuity. Eyes with visual acuity better than 6/36 showed normal or near normal responses for both scotopic and photopic responses. Electroretinogram can be used to compare the visual acuity in children with CMN. ERG correlates well with visual acuity in children with CMN.


VISUAL ACUITY ASSESMENT AND CO-RELATION WITH VISUAL EVOKED POTENTIAL AND FUNDUS FINDINGS IN THE MENTALLY CHALLENGED

Dr. KAROBI RANI LAHIRI [Presenting Author: Dr. KAROBI RANI LAHIRI], — NAVI MUMBAI

A study of 124 patients of diminished visual maturation of CP, PDD, Autism, Downs syndrome, subjected to a complete visual examination including cycloplegic refraction, retinoscopy, fundus examination, VEP test and assesment of visual function by visual function battery and ethological signs in the preschool children, Allens and Snellens. The fundus findings of total/partial, secondary/primary optic atrophy were co-related with the VEP and VA. This study was aimed at rehabilitation and providing a better quality of life to the mentally challenged as their examination do not follow normal norms.


PROSPECTIVE STUDY OF CENTRAL RETINAL SENSITIVITY IN ANISOMETROPIC AND STRABISMIC AMBLYOPIAS

Dr. VANGALA CHANDRA SEKARA REDDY [Presenting Author: Dr. VANGALA CHANDRA SEKARA REDDY] — HYDERABAD

Aim: To study the changes in central retinal sensitivity in anisometropic and strabismic amblyopias. Materials & Methods: 100 amblyopia patients between the ages of 8-15 years were selected. With Humphrey visual field anlyser central retinal sensitivity was plotted with full optical correction of both eyes seperately.Results were studied and analysed for the changes in retinal sensitivity in both types amblyopia patients. Results: All patients showed reduced retinal sensitivity

429

SCIENTIFIC

POSTERS

more in latter age. If properly done this investigation will help to confirm suspected cases of amblyopias and also can be used for follow up as prognostic indicator in amblyopia treatment.


VISUAL OUTCOME AFTER UNILATERAL Vs BILATERAL PEDIATRIC CATARACT SURGERY

Dr. MEHUL ASHVINKUMAR SHAH [Presenting Author: Dr. MEHUL ASHVIN KUMAR SHAH], Dr. MEHUL SHAH, Dr. SHREYA SHAH, Dr. SANDIP VORA, Dr. PRASHANT VASAIYA — DAHOD

Purpose: Comparison of visual outcome in unilateral and bilateral cataract after surgery in pediatric age group and to evaluate factors responsible. Method: Retrospective analysis included 178 eyes, operated for pediatric cataract comprising of 36 bilateral & 106 unilateral cataracts. IOL implant was done after removal of cataracts using Aspiration or Lensectomy. IOL implantation was avoided in patients under 1.5 years of age. Patching was used to treat amblyopia. Conclusion: Laterality was not the sole factor determining visual outcome. Density of cataract and presence of sensory nystagmus in bilateral cataract and delayed treatment in unilateral cataract were associated with poor visual recovery.


TWO-STAGE SURGICAL CORRECTION OF THE BLEPHAROPHIMOSIS SYNDROMES: OBJECTIVE ANALYSIS OF SURGICAL OUTCOME

Dr. KULDEEP KUMAR SRIVASTAVA [Presenting Author: Dr. KULDEEP KUMAR SRIVASTAVA], Dr. BHUDHENDRA KUMAR JAIN — CHITRAKOOT

Purpose: To study the surgical outcome in Blepharophimosis Syndrome. Methods: Eight patients (8 months-6 years) with Blepharophimosis Syndrome undergoing Mustarde double Z plasty and 5-0 Prolene Crawford brow suspension (4-6 weeks later) were studied prospectively. Results: Following surgery, epicanthal folds were completely abolished in all and mean reduction in intercanthal distance was 30%. Mean change in vertical palpebral aperture was 90% and mean MRD1 after correction was 2.5 mm. All had formed eyelid creases with improved upper lid position. Conclusion: Mustarde double Z plasty and Crawford brow suspension are an effective surgical combination in the treatment of Blepharophimosis Syndrome.


ROTATIONAL AUTOKERATOPLASTY WITH PUPILLOPLASTY FOR PEDIATRIC CORNEO-IRIDIC SCARS

Dr. VANATHI M. [Presenting Author: Dr. VANATHI M.], Dr. SUJITH VENGAYIL, Dr. SANJAY KAI, Dr. GEETA BEHERA, Dr. ANITA PANDA, Dr. SUDARSHAN KHOKHAR — NEW DELHI

Purpose: To report the outcome of rotational autokeratoplasty for pediatric post-traumatic corneo-iridic scars. Methods: A retrospective analysis of five consecutive

430

Information InSight

patients with post-traumatic corneo-iridic scars who underwent ipsilateral rotational keratoplasty with pupilloplasty. The pre-operative visual acuity, size of the trephines used, intra-operative procedures, postoperative complications, visual outcome and astigmatism at final follow-up were noted. Results: Four male and one female patient of mean age 9.1 + 5.22 (3 to 15 years) had undergone ipsilateral rotational keratoplasty with pupilloplasty with a mean follow-up of 11.8 + 4.14 (5-16 months). The graft size was 7 mm (2 cases) and 7.5 mm (3 cases). Postoperative best corrected visual acuity improved by 3-6 lines. Postoperative problems included suture replacement (1) and early suture loosening with mucus aggregations (2) Postoperative astigmatism ranged from –1.5 D to –6.0 D. Conclusion: Rotational autokeratoplasty with pupilloplasty has a role to play in pediatric cases of central corneo-iridic scars, when the central scarring can be rotated to the periphery provided sufficient undamaged peripheral cornea remains and interference with angle structures is minimal.

Poster Panel No. 140 [FP0216] REFRACTIVE SURGERY

ABERROPIA : A NEW REFRACTIVE ENTITY

Dr. SOOSAN JACOB [Presenting Author: Dr. SOOSAN JACOB], Dr. AMAR AGARWAL, Dr. ATHIYA AGARWAL, Dr. DHIVYA A. — CHENNAI

Aims at describing a previously unidentified new refractive entity -aberropia wherein patients with best corrected visual acuity of </=6/12 improved by >/= two Snellen lines after wavefront guided LASIK. There was no known cause for decreased pre-operative BCVA including abnormal topography/ amblyopia. In this retrospective study, eyes with pre-operative BCVA < 6/9 whose BCVA improved = two lines post-operatively were included. Root Mean Square values pre and post laser showed a reduction in the HOA. Similar to the conventional refractive errors, it is only logical that this HOA induced loss of vision– aberropia could be correctable by removing these aberrations.


COMPARISON OF TOPICAL NSAIDS FOR MANAGEMENT OF POST-OPERATIVE PAIN FOLLOWING PRK

Dr. PRAGYA PARMAR [Presenting Author: Dr. AMJAD SALMAN], Dr. KALAVATHY C.M., Dr. KALIA MURTHY J., Dr. PHILIP A. THOMAS, Dr. YASFIR BASHIR, Dr. NELSON JESUDASAN C.A. — TRICHY

Aim: To compare the efficacy and safety of topical NSAIDs in the management of post-operative pain and inflammation following PRK. Methods: 60 eyes of 30 patients undergoing PRK for myopia randomly received either topical diclofenac or ketorolac in one eye and placebo in the other eye. Outcome measures studied were post-operative pain scores, inflammatory signs, epithelial healing and visual acuity. Results: Diclofenac was more effective than ketorolac (p=0.04) and placebo (p=0.03) in post-operative pain relief. There was no significant difference in terms of inflammatory signs, epithelial healing and visual outcome. Conclusion: Topical diclofenac provides superior pain relief following PRK as compared to ketorolac.

431

SCIENTIFIC

POSTERS


COMPUTER VISION SYNDROME AND LASIK

Dr. RADHIKA N. [Presenting Author: Dr. RADHIKA N.], Dr. PREMA PADMANABHAN — CHENNAI

Purpose: To analyse computer vision syndrome (CVS) before and after LASIK.Methods: LASIK patients who work on visual display units were enrolled from July 2006. They answered a validated CVS questionnaire before LASIK and at one month. Tear and orthoptic evaluation were also done in these visits. Analysis of 24 patients was done to compare computer vision parameters before and after LASIK. Results: Symptomwise, excessive blinking (p=0.046) had reduced and glare (p=0.046) had increased after LASIK. Among tests, vergence facility (p=0.041) increased while Schirmer’s test (p=0.027) reduced marginally after LASIK. Conclusion: Tear function and extraocular muscle balance show change after LASIK in computer users.


DEEP ANTERIOR LAMELLAR KERATOPLASTY FOR POST-LASIK ECTASIA

Dr. KAUSHIK MURALI [Presenting Author: Dr. KAUSHIK MURALI], Dr. MALLIKARJUN M. HERALGI, Dr. UMESH Y., Dr. JAGADEESH KUMAR REDDY K. — COIMBATORE

Purpose: To describe 3 eyes of post LASIK ectasia managed with deep anterior lamellar keratoplasty (DALK). Methods: Clinical findings including pre and post operative topography, surgical technique, and outcomes are reported. Results: Two patients reported with progressive loss of vision after LASIK. The Sim k was 9.5 D. Both patients underwent uneventful DALK surgery with the air injection technique. The postoperative recovery was uneventful. The spherical equivalent improved from –19.67 D to –3.75 D. The grafts and lamellar interfaces were clear and topography compared. Conclusions: DALK is an alternative to penetrating keratoplasty for pathology with healthy endothelium including post-LASIK ectasia.


EPILASIK, SURFACEABLATION AND LASEK, PERSPECTIVES OF NEW TECHNICS

Dr. SAMBASIVA RAO V. [Presenting Author: Dr. SAMBASIVA RAO V.], Dr. NARENDRA G.V., Dr. RAVINDRA M.S., Dr. SUJATHA MOHAN, Dr. BABU RAJENDRAN, Dr. VANDANA JAIN — VIJAYAWADA

This poster show various types of (ASA) advances surface ablation like Epilasik. Advanced surface ablation (ASA) include any laser surface ablation technique that does not invade the corneal stromal tissue with a mechanical or laser microkeratome forming a lamellar corneal stromal flap. Lasek is based on the detachment of an epithelial flap after the application of a dilute alcohol

432

Information InSight

solution. Wavefront — guided ablation become more common and the possibility of supervision become reality.


A STUDY TO EVALUATE WHETHER CTR INCREASES REFRACTIVE UNPREDICTABILITY BETWEEN PREDICTED AND ACTUAL IOL POSITION

Dr. (Lt.Col.) VINOD KUMAR BARANWAL [Presenting Author: Dr. (Lt.Col.) VINOD KUMAR BARANWAL], Dr. (Col.) MADHU BHADURIA, Dr. (Col.) NEERAJ BHARGAVA, Dr. (Lt.Col.) SHYAM SUNDER K., Dr. (Lt.Col.) SANTOSH KUMAR, Dr. (Col.) PARIHAR J.K.S., Dr. (Col.) SAGARIKA PATYAL — NEW DELHI

We did a prospective study to evaluate the position of IOL in 20 cases with CTR and compared it with IOL position in 20 cases with out CTR. Preoperatively UBM examination & IOL power calculation by IOL master was done in all cases.Postoperatively refraction and UBM examination was done in all cases for finding out the exact location of IOL. We found out that IOL is located posteriorly in cases in which CTR ring was put as compared to cases in which CTR ring was not put. This leads to refractive unpredictability. Presentation will be supported by UBM pictures & video presentation.


LIMBAL RELAXING INCISION — CURE FOR VISUAL DISTORTION

Dr. PRAVIN JAIN [Presenting Author: Dr. PRAVIN JAIN], Dr. RUPAM DESAI, Dr. BILLORE O.P., Dr. FALGUNI MEHTA, Dr. JIGISHA RANDERI — NAVSARI

A prospective study of efficacy of LRI on postsurgical astigmatism in 53 eyes of 43 patients was done. The length, depth and number of incision was determine according to Gills normogram. The manifest corneal astigmatism, UCVA, BCVA was measured pre and postoperatively at different intervals. The mean astigmatism corrected was 2.724 ± 0.710,2.713 ± 0.931,1.144 ± 0.237,0.567 ± 0.601,0.179 ±0.422 respectively in Group I (>4.0D), Group II (3.0-4.0D), Group III(2.0-3.0D), Group IV (1.0-2.0D), Group V (= 1.0D). The mean correction in UCVA was 0.200 ± 0.230 (LogMAR). There was no serious post operative complications. So, to conclude LRI is simple, safe and effective method to correct astigmatism after cataract surgery.


ADULTS WITH MYOPIC ANISOMETROPIC AMBLYOPIA: THINK LASIK

Dr. SUMITA DAS [Presenting Author: Dr. SUMITA DAS], Dr. OM PRAKASH BILLORE, Dr. SHARAD SIVASANE, Dr. HETAL KUMAR YAGNIK, Dr. DISHANT SHAH, Dr. FALGUNI S. MEHTA, Dr. RUPAM JANAK DESAI — JAMNAGAR

A retrospective study was conducted to evaluate visual outcome in 13 adults with myopia (-4.5D to -10.0D) having anisometropic amblyopia who underwent LASIK.

433

SCIENTIFIC

POSTERS

12 months after surgery, no eye lost lines of BCVA, 42.8% remained unvaried, 35.8% gained one line and 21.4% gained two lines improvement. Mean improved decimal BCVA was 0.194 which was statistically significant (paired t test, p :< 0.01). LASIK, by correcting refractive error in these patients alleviate anisometropia and improves visual acuity. These patients may require further amblyopia treatment for better visual recovery.

Poster Panel No. 148 [FP0642] RETINA/VITREOUS

CORRELATION OF OCT FEATURES AND VISUAL OUTCOME IN ANATOMICALY SUCESSFUL SCLERAL BUCKLING PROCEDURE

Dr. PRATHIBA M. [Presenting Author: Dr. VANILA C.G.], Dr. AMJAD SALMAN, Dr. RAJAMOHAN M., Dr. NELSON JESUDASAN C. A., Dr. SAMARTH AGGARWAL — TRICHY

Aim: To correlate structural alterations of the macula to visual outcome after successful scleral buckling for rhegmatogenous retinal detachment. Methods: Twenty three eyes of 23 patients post operative macula “on” after scleral buckling were scanned at monthly intervals. Results: Normal foveal architecture was associated with visual improvement of 2 or more lines in 13 eyes. Visual acuity continued to improve as the fovea regained normal architecture. Altered foveal architecture was observed in ten patients with sub-normal visual outcome. Conlcusion: OCT helps in detecting cause of poor vision and chances of late visual gain after RD surgery.


INTRAVITREAL MACUGEN IN THE MANAGEMENT OF MACULAR EDEMA IN CENTRAL RETINAL VEIN OCCLUSION

Dr. SUPRIYA DABIR [Presenting Author: DR. SUPRIYA DABIR], Dr. ANIRUDDHA MAHINDRAKAR, Dr. MAHESH UPARKAR, Dr. ASHISH ATHALE, Dr. ANIRUDDHA MAITI, Dr. NATARAJAN S., Dr. KRUTI MODI — MUMBAI

Single-center, one year, restrospective, interventional study. Participants: Ischemic and non-ischemic CRVO cases with macular edema of >3 months duration. Results: From June 2006 to May 2007, 4 cases (4 eyes) with CRVO (1 ischemic, 3 non-ischemic) were injected intravitreal macugen (0.3 mg) with a mean of 1.75 injection per eye. Pre-treatment mean visual acuity (VA) and macular thickness were 1.14 + 1.26 and 578 + 266 microns respectively. At six months, there was no change in mean VA while mean macular thickness increased to740 + 305 microns (p=0.107). Conclusion: Intravitreal Macugen showed no visual or structural benefit in treating CRVO related macular edema.

“Be more dedicated to making solid achievements than in running after swift but synthetic happiness”


434

Information InSight


ABNORMAL PRESENTATION OF HIGH ALTITUDE RETINOPATHY

Dr. (Col.) PAVAN KUMAR [Presenting Author: Dr. (Col.) PAVAN KUMAR], Dr. (Lt. Col.) MANN S.S., Dr. (Col.) KALRA D. — PUNCHKULA

High altitude retinopathy as a health hazard occurs on exposure to high altitude in response to compression of retinal veins, increased blood viscosity and hypoxia. The fundus picture studied in six individuals showed findings comparable to published literature as grades 1-4 with dilated veins, retinal hemorrhages and papilloedma. However one acclimatised case showed gross diminition of vision with retinal hemorrhages, macular edema and yellowish submacular precipitates not yet described inliterature which responded well to conservative managemeht at plains. In conclusion such retinopathy can occur even in an acclimatised person but still recovers well.


BIMANUAL VITRECTOMY FOR ADVANCED PROLIFERATIVE DIABETIC RETINOPATHY USING ILLUMINATED INFUSION CANNULA – THE 4-LESS-1 TECHNIQUE

Dr. SAYALEE LAHANE [Presenting Author: Dr. LAHANE TATYARAO PUNDLIKRAO], Dr. PREETAM SAMANT, Dr. RAGINI PAREKH, Dr. HEMALINI SAMANT, Dr. BRAHMI, Dr. GURUNAREN — MUMBAI

13 eyes with Advanced Proliferative Diabetic Retinopathy with RD underwent bimanual Vitrectomy using illuminated infusion cannula. 11 eyes had successful retinal reattachment. Besides all the advantages of doing a bimanual Vitrectomy, this technique avoids the need for a 4th sclerotomy for the endoilluminator. It therefore eliminates adverse surgical factors such as globe instability and assistant fatigue arising from continuously holding the endoillumination probe through the 4th sclerotomy. It gives a diffuse illumination comparable to the Chandelier light systems thus improving visualization during membrane dissection. The illuminated infusion cannula gives us the surgical privilege of performing a 3 port bimanual Vitrectomy.


REVERSAL OF NEOVASCULARISATION FOLLOWING METABOLIC CONTROL IN PROLIFERATIVE DIABETIC RETINOPATHY

Dr. DEEPENDRA VIKRAM SINGH [Presenting Author: Dr. DEEPENDRA VIKRAM SINGH], Dr. YOG RAJ SHARMA, Dr. SOMAN SUKUMARAN NAIR, Dr. AJAY PAL JHINJA, Dr. BIPUL BAISHYA, Dr. RAJEEV SHARMA — NEW DELHI

A 54 years old female with type II NIDDM with neovascularisation of the disc (NVD), elsewhere (NVE) and tractional retinal detachment (TRD) involving the macula underwent strict glycemic control prior to surgery. Following strict metabolic control for 3 weeks, significant regression of the NVE and NVD was noted. Subsequently the patient underwent surgery for the TRD which

435

SCIENTIFIC

POSTERS

involved membrane removal with focal laser. Complete regression of the NVE and NVD at the final follow-up was noted without the need for pan retinal photocoagulation. This case demonstrates the importance of strict metabolic control in reversing neovascularisation in diabetic retinopathy in the absence of laser therapy.


SUTURELESS VITREORETINAL SURGERY — THE MIDDLE PATH

Dr. SATYEN DEKA [Presenting Author: Dr. SATYEN DEKA], Dr. HARSHA BHATTACHARJEE, Dr. MANABJYOTI BARMAN, Dr. HEMALATA DEKA, Dr. PAREENETA KAUR, Dr. LOKESH JAIN — GUWAHATI

Aim: To establish the best sutureless approach for vitreoretinal surgery. Methods: 60 eyes underwent sutureless vitrectomy by 3 different approaches. Surgical techniques involved (1) 20-gauge reverse self sealing, (2) 23-gauge transconjunctival, and (3) 25-gauge transconjunctival system. Surgical outcome compared using statistical tests. Results: Mean surgical time and postoperative recovery time were significantly less in 23 and 25-gauge system. Intraoperative maneuver is difficult in 25-gauge system, whereas 20-gauge reverse self-sealing sclerotomy is technically difficult and limited to upper 2 sclerotomies. 23-gauge system offers all advantages of sutureless vitrectomy. Conclusion: We recommend 23-gauge system for sutureless vitreoretinal surgery.


RETINAL ASTROCYTOMA IN A CASE OF TUBEROUS SCLEROSIS – A RARE CASE REPORT

Dr. SUJATHA RATHOD B.L. [Presenting Author: Dr. MADHU KUMAR R.], Dr. SRIPRAKASH K.S., Dr. KALPANA S., Dr. BALAJI M.S., Dr. SASHIDHAR, Dr. VISHWANATH — BANGALORE

Male pt aged 25 years presented with h/o swellings over the face & the lids. No other ocular complaints. History of convulsions since childhood. Fundus examination revealed a grayish white elevated lesion superior to the disc measuring 2 DD. One more lesion was seen just above the fovea which was correlating with the appearance of ash leaf spot which is very rarely mentioned in the literature concerned to eye. FFA revealed an exudative detachment picture which is supposed to be one of the rarest presentation of a retinal astrocytoma. OCT showed hyper reflective lesion along with an underlying exudative detachment.

There is no better way to thank God for your SIGHT than by giving a helping hand to someone in the DARK.

— Helen Keller

436

Information InSight


METABOLIC SYNDROME AND THE EYE

Dr. PRIYANKA DOCTOR [Presenting Author: Dr. PRIYANKA DOCTOR], Dr. VISWANATHAN S., Dr. NATARAJAN K., Dr. RAHUL DOCTOR, Dr. SHYAMAL RAVAL, Dr. ANISH — MUMBAI

Background: Microvascular complications of diabetes contribute significantly to the disease morbidity. The metabolic syndrome is common among subjects with diabetes and is a very important risk factor for macrovascular complications. However, its contribution to the microvascular complication has not been assessed in Indian subjects. Objectives: To assess the risk of microvascular complications associated with the metabolic syndrome in diabetes subjects. Methods: The study group comprised 150 diabetic subjects attending a Diabetic clinic. The prevalence of microvascular complications was compared between 75 diabetic subjects with metabolic syndrome (NCEP-III criteria) and 75 diabetic patients without. Results: We found that as a group, diabetic subjects with metabolic syndrome had a significantly higher frequency of microvascular-related complications (Retinopathy) than diabetic subjects without the syndrome. Conclusions: In addition to hyperglycemia and disease duration, the metabolic syndrome is a significant risk factor for the development of microvascular complications in diabetic subjects.


HALF-FLUENCE PHOTODYNAMIC THERAPY COMBINED WITH INTRAVITREAL LUCENTIS AND SUBTENON TRIAMCINOLONE ACETONIDE FOR CHOROIDAL NEOVASCULARIZATION: ETDRS VISION AND OCT FINDINGS

Dr. RENU SUSHIL KUMAR [Presenting Author: Dr. RENU SUSHIL KUMAR], Dr. BANKER ALAY S. — AHMEDABAD

Purpose: To determine results of triple therapy for choroidal neovascularization (CNV). Methods: Prospective study of 10 eyes treated with half-fluence PDT + Intravitreal Lucentis (IL) + subtenon-triamcinolone-acetonide. ETDRS visual acuity (VA), fluorescein angiography and central retinal thickness (CRT) were evaluated. Results: At final follow-up (2-6 months, mean: 5) all eyes showed resolution of CNV. The mean final VA was 0.387+ 0.188 (LogMar ETDRS) as compared to 0.725 + 0.175 (p<0.001) at baseline. The mean final CRT was 201.36 as compared to 294.18 at baseline (p<0.005). Only 2 eyes required one additional IL. Conclusions: Combination Half-fluence PDT with intravitreal Lucentis results in significant and sustained visual acuity improvement after only one treatment.

“My imperfections & failures are as much a blessing from God as my successes and my talents and I lay them both at his feet”

— Mahatma Gandhi

437

SCIENTIFIC

POSTERS


ARMD & SMOKING — ARE THEY RELATED?

Dr. AMIT GROVER [Presenting Author: DR. AMIT GROVER], Dr. HARJEET KAUR SIDHU, Dr. BHATNAGAR RAVINDRA NATH, Dr. TRIVENI GROVER, Dr. RAJWINDER KAUR, Dr. GURPREET GARCHA — PATIALA

In Indian society where we have the largest number of smokers in the world, the effects of smoking on ocular health have escaped our notice. Aim: To study the correlation between smoking and ARMD. Methods: 100 patients with documented features of age related maculopathy or age related macular degeneration on fundus examination were asked for history of smoking in terms of pack years (1 pack year = 1 pack of cigarettes every day for 1 year). Results: (a) Overwhelming 38% of patients had history of smoking, (b) No. of pack years directly correlated with severity of ARMD.


A WORM’S DAY OUT – LIVE SCOLEX IN A CASE OF OCULAR CYSTECERCOSIS (RARE CASE PRESENTATION)

Dr. SUJATHA RATHOD B.L. [Presenting Author: Dr. MADHU KUMAR R.], Dr. SRIPRAKASH K.S., Dr. VISHWANATH, Dr. KALPANA S., Dr. GLADYS, Dr. SASHIDHAR — BANGALORE

A female patient aged 27 years presented with the history of pain, redness and rapid loss of vision in the left eye. On examination, anterior segment was within normal limits. Fundus examination revealed multiple vitreous cysts with two bright yellowish lesions. While taking fundus photography, accidentally we were able to capture live scolex coming out of the cyst and again going back into the cyst. The live scolex is captured in the fundus photos clearly showing its parts, which has not been published in any of the previous literature in Ophthalmology.


ROLE OF TRIAMCINOLONE ACETONIDE FOR DIFFUSE DIABETIC MACULAR EDEMA

Dr. SUJATHA RATHOD B.L. [Presenting Author: Dr. SANJAY KUMAR MANDAL], Dr. SRIPRAKASH K.S., Dr. KALPANA S., Dr. MADHU KUMAR R., Dr. SASHIDHAR, Dr. VISHWANATH — BANGALORE

Aim: To study the efficacy of Intravitreal injection of Triamcinolone Acetonide for diffuse diabetic macular edema. Materials and Methods: Interventional Case Series. 40 eyes of 40 patients with Diabetic macular edema. Duration: One year. Detailed history and examination was done. FFA, OCT and systemic evaluation was done. Results: Mean follow up time was 6 months. Before treatment the mean central foveal thickness was 480 ± 120 microns & after 3 months of treatment thickness was 260 ± 78 microns. While after 6 months of treatment it was 319 ± 90 microns. Conclusion: Intravitreal triamcinolone acetonide is an effective treatment for diffuse diabetic macular edema.

438

Information InSight


A CLINICAL STUDY OF VISUAL FIELD LOSS WITH CAPILLARY NON-PERFUSION IN NON-PROLIFERATIVE AND PROLIFERATIVE DIABETIC RETINOPATHY

Dr. ASHISH MITRA [Presenting Author: Dr. RATHORE M.K.], Dr. DWIVEDI P.C., Dr. SHASHI AGARWAL, Dr. CHOUDHARY PANKAJ, Dr. EVA TIRKEY, Dr. SUJATA LAKHTAKIA — REWA

Eighty eight eyes of 51 patients with capillary non-perfusion from NPDR and PDR underwent visual field testing on the 30-2 program of HFA. Staging of diabetes was done as per the ETDRS classification. The mean defect (MD) p value was < 5% in 82 eyes (93.18%) & CPSD was < 10% in 85 eyes (96.5%). Areas of capillary non-perfusion demonstrated by FFA were closely associated with areas of reduced retinal sensitivity in these 85 eyes. More severe visual field defects were present in non-insulin dependent diabetics and in older patients. MD & CPSD p value less than 0.5% and 1% respectively were found to be associated NIDDM (p<0.05 and p<0.01 respectively) and with the older age group (p<0.05).


A NEW CLINICAL GRADING OF THE CLINICAL EFFECTS OF BEVACIZUMAB IN RETINAL VASCULAR DISORDERS

Dr. NANGIA VINAY KUMAR B. [Presenting Author: Dr. AJIT KUMAR SINHA], Dr. KRISHNA BHOJWANI, Dr. ANIL PREMCHAND HARWANI — NAGPUR

Introduction: Bevacizumab is an anti VEGF monoclonal antibody, used in retinal disorders. We devised a clinical grading to assess its efficacy on retinal parameters, using colour and fluorescein images. Methods: Patients underwent imaging prior to and after bevacizumab. The parameters graded were retinal haemorrhage, vascular tortuosity, dilatation, disc blurring, parapapillary oedema, disc oedema macular oedema and vascular staining. Results: Grade 1, reduction from 0-25% in above parameters, Grade 2, 25 – 50%, Grade 3, 50 – 75% and Grade 4, 75 – 100%. Conclusions: This method enables us to assess the efficacy of intravitreal bevacuzimab, and may be applied in follow-up and clinical research.


SIGHT THREATENING DIABETIC RETINOPATHY (STDR), SYSTEMIC COMPLICATIONS AND MORTALITY

Dr. SOMDUTT PRASAD [Presenting Author: Dr. VINEETH KUMAR], Dr. GOEL SIDDARTHA, Dr. MODI S., Dr. KOSHY Z.R. — OXFORD

Purpose: To evaluate STDR (defined as maculopathy, proliferative retinopathy, laser treated) as a predictor of systemic complications and mortality. Methods: Retrospective review of the diabetic register database during the period 1997-2005. 469 patients with STDR were identified. Results: 183 of the 469 patients developed systemic complications. More than 50% had onset of systemic complications within 2 years. 134 died with identifiable cause during the

439

SCIENTIFIC

POSTERS

seven year period. More than half died from IHD, renal problems etc. within a few years of onset of STDR. Conclusion: STDR is a predictor for the development of systemic complications and mortality.


COMPARISON OF 23G AND 25G TRANSCONJUNCTIVAL SUTURELESS VITRECTOMY SYSTEMS

Dr. ANIRUDDHA MAITI [Presenting Author: Dr. ASHISH ATHALE], Dr. ANIRUDDHA MAHINDRAKAR, Dr. ASHAD SIVARAMAN, Dr. MAHESH UPARKAR, Dr. ANKUR AGARWAL, Dr. NATARAJAN S., Dr. JAYDEEP WALINJKAR — MUMBAI

21 patients for 25G and 12 patients for 23G, including diabetic vitreous haemorrhage; BRVO with vitreous haemorrhage; Eales disease and ERM patients, follow-up of 6 weeks. Results: Average operative time was 49 min with 25G, 42 min. with 23 G. Mean pre-op visual acuity was 1.1 log MAR in 25G and 1.3 log MAR in the 23G group. Mean post-op visual acuity was 0.64 and 0.72 respectively. Improvement in VA greater than 3 lines occurred in 9 (52.6%) and 6 (50%) patients respectively. Hypotony and recurrent vit hemorrhage was slightly more in 23G group but was stastically not significant.


TOXOPLASMIC OPTIC NEUROPATHY

Dr. MEENA CHAKRABARTI [Presenting Author: Dr. MEENA CHAKRABARTI], Dr. ARUP CHAKRABARTI, Dr. VALSA STEPHEN, Dr. SONIA RANI JOHN — TRIVANDRUM

Aim: This poster presentation aims to picturise the course of florid disc oedema in 5 young patients who were seropositive for antibodies to Toxoplasma Gondii. Method: The remarkable resolution of disc oedema and recovery of vision with anti toxoplasmic antimicrobials is followed up with serial fundus photography, fluorescein angiography and field analysis. Results: Toxoplasmic papillitis is an important differential diagnosis in young patients presenting with acute disc oedema. Good recovery of visual function with persistence of field defect was observed on recovery. Conclusion: Toxoplasmic Optic Neuropathy should be considered in the differential diagnosis of Papillitis and Neuroretinitis. Prompt diagnosis and early initiation of therapy ensures good functional recovery.

The only thing that will stop you from fulfilling your

dreams is YOU!!— Tom Bradley

440

Information InSight


ANALYSIS OF PROGNOSTIC FACTORS IN EPIMACULAR MEMBRANE (EMM) SURGERY

Dr. MEENA CHAKRABARTI [Presenting Author: Dr. MEENA CHAKRABARTI], Dr. ARUP CHAKRABARTI, Dr. VALSA STEPHEN, Dr. SONIA RANI JOHN — TRIVANDRUM

Aim: To analyze factors determining vision following EMM surgery and to define impact of combined internal limiting membrane (ILM) and EMM peeling on final outcome. Methods: 20 patients underwent vitrectomy for EMM. Analysis of age, aetiology, duration, severity, it’s co-relation to visual prognosis and to recurrence was undertaken. 45% (9 eyes) underwent ERM peeling only (ILM Preserved: Group 1) and in 11 eyes (55%) combined EMM and ILM peeling was performed (ILM Peeled: Group 2) intraoperatively. Results: Visual outcome = 6/60 was associated with younger age (80%), idiopathic Grade III membranes (76%) and in ILM Peeled Group (78%). Recurrence occurred in 10% of ILM Peeled group and in 56% of ILM preserved group. Conclusion: ILM peeling combined with EMM peeling gave better functional results and less recurrence.


COMPARISON OF OPTIC NERVE HEAD (ONH) MORPHOMETRY IN CASES WITH CENTRAL RETINAL VEIN OCCLUSION AND PRIMARY OPEN ANGLE GLAUCOMA

Dr. MAHESH UPARKAR [Presenting Author: Dr. SVETLANA TOSHNIWAL], Dr. NATARAJAN S., Dr. SIVARAMAN ASHAD, Dr. MUKHERJEE A., Dr. SHARMA S., Dr. ATHALE A., Dr. ANIRUDDHA MAITI — MUMBAI

In a prospective non-randomized, one year study, consecutive cases of Central Retinal vein occlusion (CRVO)-24 and Primary open angle glaucoma (POAG)-21, from a single tertiary center were studied for ONH parameters using Stratus and Image J softwares. The mean central cup-depth of the CRVO (affected and fellow eyes) and POAG cases was 413.92 +/- 167.89 and 566.48 +/- 220.83 respectively (p = 0.014). There was no significant difference in mean age at assessment (p = 0.239), cup diameter (p = 0.129) or disc diameter (p = 0.462) between the two groups. A shallow cup was seen to be associated with CRVO cases. ONH morphometry may play a role in CRVO.


TO EXAMINE THE INCIDENCE AND RISK FACTORS FOR FLAT OR SHALLOW ANTERIOR CHAMBER FOLLOWING VITREO RETINAL SURGERY WITH FLUID AIR EXCHANGE IN APHAKIC EYES WITH OR WITHOUT GAS TAMPONADE

Dr. ANKUR AGARWAL [Presenting Author: Dr. ANKUR AGARWAL], Dr. SATISH CHANDRA GUPTA, Dr. ARINDAM CHAKRAVARTI, Dr. VINAY GARG, Dr. SHIRISH BATRA — DELHI

441

SCIENTIFIC

POSTERS

Thirty nine eyes of 39 patients underwent vitreo retinal surgery for varied pathologies. Nineteen eyes were aphakic preoperatively and 20 were rendered aphakic during surgery. Fluid air exchange was performed in all patients and gas tamponade given in 20 eyes. Flat or shallow anterior chamber was noted in 7 eyes (18%). Anterior chamber reformed spontaneously in 1 eye while it was reformed in six. Risk factors found associated with shallow AC post operatively were post traumatic eyes, pre-existing aphakia with floppy iris, shallow anterior chamber pre operatively, intra operative long acting gas injection and non compliance with post-operative prone position.

Poster Panel No. 168 [FP0076] SQUINT

INTERMITTENT DIVERGENT SQUINT : OUR EXPERIENCE

Dr. SONIKA GUPTA [Presenting Author: Dr. SONIKA GUPTA], Dr. RACHNA KUMAR, Dr. SUDESH KUMAR ARYA, Dr. NAVNEET TULI, Dr. SUNANDAN SOOD — MOHALI

78 patients of intermittent divergent squint were evaluated retrospectively. Age of onset ranged from 6 months to 34 years. 44% were males and 56% females. 49% patients were asymptomatic, 28% had asthenopia, 20% diplophotophobia and 3% transient diplopia. Type of squint was basic (75%), convergence insufficiency (12%), divergence excess (13%). 64% patients were managed surgically while 36% received medical therapy comprising refractive error correction, prisms and orthoptics. Following treatment, anatomical alignment within 10 prisms diopters of orthotropia and improvement in binocular status was achieved in more than 90% cases.


SURGICAL MANAGEMENT OF CONGENITAL SUPERIOR OBLIQUE PALSY:A STUDY OF 15 CASES

Dr. (Mrs.) SEEMA. A.V. [Presenting Author: Dr. (Mrs.) SEEMA. A.V.], Dr. KALPANA NARENDRAN, Dr. THOMAS MATHEW, Dr. KAUSHIK ARVIND SHAH, Dr. INDRANIL DEB, Dr. SANDRA GANESH — BANGALORE

Purpose: To study the clinical presentation and surgical outcome of congenital SO palsy. Methods: retrospective analysis of 15 cases of congenital SO palsy in the age group of 7-20 years between 2004-2006 was done. Preoperative and postoperative vertical deviation was measured in 9 diagnostic positions of gaze and compared. One muscle or two muscles were tackled depending upon the amount of vertical deviation in primary position. Results: All cases had resolution of head posture postoperatively with reduction of vertical deviation to <5 PD.

“Kind words can be short and easy to speak, but their echoes are truly endless.”

— Mother Teresa

442

Information InSight


COMPARATIVE EVALUATION OF ATROPINE VERSUS OCCLUSION IN TREATMENT OF AMBLYOPIA

Dr. SUBHASH DADEYA [Presenting Author: Dr. SUBHASH DADEYA], Dr. PANKAJ VATS, Dr. DEPTI — NEW DELHI

Aim: To compare the atropine penalization in treatment of amblyopia with conventional occlusion therapy. Material and methods: 85 patients, who were having amblyopia as per philips criteria were taken for this study. The patients were randomly divided into two groups. The patients in group 1 were treated with conventional occlusion therapy, while patients in group 2 were penalized by atropine. The age group of patients varied from 2-6 years. Results: The improvement in visual acuity of more than two lines was seen in 80% patients in group 1 compared to 50% patients in group 2. Compliance was better in group 2. Conclusion: Our results indicates that full time occlusion remains gold standard therapy in treatment of amblyopia.


A CLASSICAL CASE OF MOBIUS SYNDROME WITH TALIPES EQUINOVARUS DEFORMITY

Dr. PRIYANK MAHESHWARI [Presenting Author: Dr. VIJAYA PAIH], Dr. YOGESH KAMATH, Dr. SHIJI GANGADHARAN, Dr. RAJESH KUMAR — MANIPAL

A 2 year old female child with both eyes squint and limb abnormality since birth. On examination child showed cross fixation with 30 degree esotropia with limited abduction both eyes suggestive of lateral rectus palsy. Child also showed bilateral lower motor neuron facial palsy. Orthopaedic evaluation revealed bilateral congenital talipes equinovarus with syndactyly. All the above features are component of classical mobius syndrome.


STUDY OF STRABISMUS IN PAEDIATRIC AGE GROUP

Dr. REENA ANAND [Presenting Author: Dr. REENA ANAND], Dr. BHAVANA SHARMA, Dr. RAHUL AGARWAL, Dr. KAVITA KUMAR — BHOPAL

This study was conducted to determine the incidence of squint in random pediatric population. Details regarding age of onset, role of heredity, visual impairment and amblyopia was studied in these cases. Cases were evaluated in a simplified manner and necessary management was done. 34% cases were of less than 5 years. 56% cases were from urban & 43% cases were from rural locality. 88.88% were esodeviated out of which 61.44% were hypermetropes. 12.22% were exodeviated. In this study 16.66% cases of esodeviation and 10.52% cases of exodeviation had eccentric fixation. Nystagmus was present in 7.27% of cases. A or V pattern deviation in 7.27% cases and 1.31% cases had Duane Syndrome type I Optical correction was done in 69.09%, optical + orthoptic was advised in 10.90% & surgery was advised in 20% cases.

443

SCIENTIFIC

POSTERS


MANAGEMENT OF ESOTROPIA : OUR EXPERIENCE

Dr. (Prof) SUDESH KUMAR ARYA [Presenting Author: Dr. (Prof) SUDESH KUMAR ARYA], Dr. SONIKA GUPTA, Dr. NIDHI RELHAN, Dr. (Prof) SUNANDAN SOOD, Dr. NAVNEET KAUR TULI — CHANDIGARH

Retrospective analysis of 156 patients with esotropia was done to know the clinical features and final outcome. There were 94 (60%) males and 62 (40%) females.129 (83%) children were below 7 years of age. The type of deviations were accommodative 37 (24%), nonaccomodative with alternate type 33 (21%) and unilateral type 86 (55%) patients. 61 (39%) patients had amblyopia out of which 39 (64%) could achieve normal visual acuity with occlusion. 42 (35%) patients underwent surgery for nonaccommodative esotropia. Overall 82 (52%) patients had parallel visual axis with normal binocular single vision. Early diagnosis with prompt rehabilitation and timely surgical intervention in esotropia can give best results.


A CLINICAL STUDY OF ACCOMMODATIVE ESOTROPIA IN CHILDREN

Dr. BHANUMATHI M. [Presenting Author: Dr. BHANUMATHI M.], Dr. ARUN SAMPRATHI B.S., Dr. SHETTY BHUJANG K. — BANGALORE

Aim: The effect of anisometropia of >+1.5D with regard to prevalence of amblyopia and successful ocular alignment in children with accommodative esotropia. Methods: Retrospective observational case series of 32 children studied between January 2004 to January 2007. Results: 32 children aged between 8 months to 10 years were studied. 25% had satisfactory ocular alignment with full hyperopic correction. 12.5% needed bifocals for ocular alignment. All the children had amblyopia which was managed with occlusion and penalization. Conclusion: Anisometropia >+1.5D is a risk factor for deviation not controlled satisfactorily with spectacles and needs more close follow up with vigorous management of amblyopia.


ROLE OF HESS CHARTING IN THE EVALUATION AND MANAGEMENT OF INCOMITANT STRABISMUS

Dr. SUMA GANESH [Presenting Author: Dr. SUMA GANESH], Dr. ARCHANA GUPTA, Dr. ANKIT BHAVSAR, Dr. MANISH SHARMA, Dr. PREM KUMAR SINGH — NEW DELHI

Aim: To evaluate the role of Hess Charting in assessing the progress, planning treatment and evaluating the results of Incomitant strabismus. Seven cases of Incomitant strabismus. Studied: 3 cases of third nerve palsy, 2 sixth nerve palsy, and 2 incomitant strabismus due to pseudotumor. Clinical findings were correlated with Hess Screen for the above 3 factors. Test results were compared and data analyzed. Case reports are discussed with photographs and Hess charts. Conclusion: Hess charting is a

444

Information InSight

useful motility test in planning treatment and evaluation of postoperative results in incomitant strabismus; it also helps in documentation of the progress.


TO REPORT THE USE OF ASYMMETRICAL BILATERAL LATERAL RECTUS RECESSIONS COMBINED WITH A RETROEQUATORIAL MYOSCLEROPEXY, IN THE TREATMENT OF A CASE OF ASYMMETRICAL DISSOCIATED HORIZONTAL DEVIATION WITH COMITANT ALTERNATING EXOTROPIA

Dr. ABHISHEK DAGAR [Presenting Author: Dr. ABHISHEK DAGAR], Dr. GAURAV KAKKAR — NEW DELHI

Methods: The term Dissociated Strabismus Complex (DSC) has been proposed to include the horizontal and torsional components, usually accompanying a case of dissociated vertical deviation. We present a case of DSC, which was managed surgically with an asymmetrical bilateral Lateral Rectus Recession with Faden Operation. Conclusion: When approaching patients with comitant tropias with a component of dissociated strabismus, each component of the complex should be separately assessed, in addition to documenting coexisting horizontal tropia, for a proper surgical management of the patient’s ocular motility pattern.


A CASE OF A PATTERN ESOTROPIA WITH DVD WITH BILATERAL CONGENITAL PTOSIS

Dr. ARCHANA GUPTA [Presenting Author: Dr. ARCHANA GUPTA], Dr. SUMA GANESH, Dr. SAMAN ADIL — NEW DELHI

Dissociated Vertical Deviation is an intermittent anomaly of the non-fixing eye consisting of an upward excursion, excyclotorsion and outward deviation frequently associated with infantile esotropia. Theories for the causation of DVD include the supra nuclear theory and the theory of hypo function of the superior oblique. The triad of A pattern esotropia or exotropia, bilateral superior oblique over action and DVD has been reported earlier. However, there have been no case reports of an associated bilateral congenital ptosis. We present a case of A pattern esotropia with bilateral Superior oblique over action and incomitant DVD and bilateral congenital ptosis.

Poster Panel No. 178 [FP0682] TRAUMA

RETROSPECTIVE ANALYSIS OF 77 CASES OF PENETRATING CORNEAL TRAUMA

Dr. SHARAD SIVASANE [Presenting Author: Dr. LAVINGIA B.C.], Dr. OM PRAKASH BILLORE, Dr. SUMITA DAS, Dr. DISHANT SHAH, Dr. KAVITA PATIL, Dr. FALGUNI S. MEHTA — BARODA

445

SCIENTIFIC

POSTERS

77 Cases of penetrating corneal trauma were retrospectively analyzed to correlate improvement in postoperative vision with duration between injury and repair, site & size of tear and repair with/without cataract extraction. 85.7% patients were males; common age group 11-30 years (45.5%). Vision was = 6\60 in 28.6% on presentation which improved to 81.8% after repair. Post-operative BCVA was better in those operated within 6 hours of trauma (p<0.01), tears <6mm (p<0.05) and located peripherally (p<0.05); no difference between those undergone tear repair with/without cataract extraction (p>0.05). Early presentation, smaller tear size and peripheral location are good prognostic signs in the absence of posterior segment involvement.


INTRAOCULAR FOREIGN BODY – A CHALLEGE FOR MANAGEMENT

Dr. ABHIJIT GHOSH [Presenting Author: Dr. ABHIJIT GHOSH], Dr. SOMEN GHOSH — KOLKATA

Intra ocular foreign body is mostly seen in young male individuals from lower socio-economic group of persons. Proper and energetic management is required, which gives a very good prognosis. The management of such cases has undergone a dramatic change in the last decade. This paper will highlight the experience and analyze the result of 15 years of intraocular foreign body management.


ULTRASOUNDBIOMICROSCOPY (UBM) FOR DETECTION OF INTRAOCULAR FOREIGN BODIES (IOFB)

Dr. THAKKAR HANSA HARSHADBHAI [Presenting Author: Dr. THAKKAR HANSA HARSHADBHAI] — AHMEDABAD

Aim: To detect IOFB that escapes detection by slit lamp biomicroscopy or ultrasonography (USG) B-scan. Methods: Five patients with strong positive history but no demonstrable IOFB on slit lamp examination or USG were subjected to UBM examination. Results: IOFB detection and localisation was possible in all the patient with successful further management. Conclusion: UBM is an excellent tool for detection and localisation of anteriorly placed IOFBs that are difficult to demonstrate by routine investigations.


EFFICACY AND SAFETY OF MANUAL SMALL INCISION CATARACT SURGERY FOR PEDIATRIC TRAUMATIC CATARACT

Dr. RUPESH VIJAY AGRAWAL [Presenting Author: Dr. MOHINI S. SAHASRABUDDHEY] — JALNA

Purpose: To evaluate outcome and PCO rate after surgery for pediatric traumatic cataract. Design: Retrospective review of 31 cases. Methods: Records of 31

446

Information InSight

patients operated by a single surgeon were retrospectively reviewed. Results: Patients age =16 years. Males>Females. 38.70% also had primary wound repair. Corneal wound (70.96%) and PC rent (19.35%) were associated. 60% developed PCO when primary posterior capsulotomy was not done. Higher PCO rate in younger patients (66.67%). Post-operatively vision of = 6/9 as achieved in 61.29%. Conclusion: Good clinical outcome was obtained in pediatric traumatic cataract with primary cataract surgery with IOL implantation. Corneal scar and PCO led to poorer vision.


EFFICACY OF CONCURRENT AHMED GLAUCOMA VALVE AND PHACOEMULSIFICATION WITH CTR IN CASES OF ANGLE RECESSION GLAUCOMA WITH TRAUMATIC SUBLUXATED LENS

Dr. (Col.) PARIHAR J.K.S. [Presenting Author: Dr. (Col.) PARIHAR J.K.S.], Dr. (Lt.Col.) RAKESH MAGGON, Dr. (Lt.Col.) VIJAY MATHUR, Dr. (Lt.Col.) (Maj.) ANIRUDH SINGH, Dr. (Lt.Col.) SANTOSH KUMAR, Dr. (Lt.Col.) SHANTANU MUKHERJEE — DELHI CANTT

This poster presents clinical presentation, surgical technique and final outcome of Combined Glaucoma Valve implant surgery and Phacoemulsification with CTR and foldable IOL implantation in cases of Angle Recession Glaucoma with Traumatic Subluxated Cataract. Followup was upto one year. Intra and post operative constraints, complications and their management will be highlighted. Over all outcome based on critical evaluation of postoperative IOP, Visual field status, OCT changes as well as on corneal topography and pachymetry analysis will also be presented.


CASE PRESENTATION: HOLISTIC MANAGEMENT OF TRAUMATISED EYE

Dr. RAJIV MOHAN [Presenting Author: Dr. NEHA RATHI], Dr. SANJIV MOHAN, Dr. (Brig) VIKAS SINHA, Dr. PARUL LOKWANI — NEW DELHI

24/M presented with multiple lacerations of face & DOV LE following RTA. O/E multiple lacerations on face with foreign bodies. V/A RE 6/6 (-3 Ds), LE PL + PR inaccurate full thickness laceration of lids involving margins with loss of tissue, full thickness corneoscleral tear with vitreos prolapse, other details not clear. 3D CT face #nasal bone. Floor orbit, primary repair of globe and lids was done along with plastic surgeon. At 1 month-LE V/A PR accurate, left lower lid ectropion, EOM full, subluxated cataractous lens, USG-RD underwent VR surgery with lensectomy with silicon oil at 2 months-BCVA LE 6/60, cornea clear with scar, retina flat at 6 months-LLL ectropion corrected at 8 months-BCVA 6/60, retina flat.

“Hands that help are holier then the lips that pray”

447

SCIENTIFIC

POSTERS


STUDY OF ETIOLOGY OF OCULAR TRAUMA IN A RURAL HOSPITAL BASED IN INDUSTRIAL ZONE OF CENTRAL INDIA

Dr. REKHA RAJU KHANDELWAL [Presenting Author: Dr. (Mrs.) REKHA RAJU KHANDELWAL], Dr. (Mrs.) SHIVANI BIDAYE (SULE), Dr. (Mrs.) MOHANA MAJUMDAR, Dr. AMOL TAMHANE, Dr. JINNI PATEL — NAGPUR

Purpose: To identify the preventable causes of ocular trauma. Methods: This is a cross sectional study of 536 patients of ocular trauma who were interviewed to assess the etiology, from June 2005–June 2006. Results: Of the 536 patients, 67% had industrial ocular trauma, 12% had farm injuries, 9% had sports injuries, 5% had injuries in school, 5% were injured on roads and 2% at home. Conclusion: Of the total patients, three quarters had preventable causes of trauma. Simple safety measures are neglected due to ignorance and illiteracy. Educating masses through celebrities and media is the need of the hour.


PROFILE OF TRAUMATIC CATARACT IN CHILDREN IN A RURAL HOSPITAL

Dr. INDRANIL DEB [Presenting Author: Dr. INDRANIL DEB], Dr. SANJIB BANDYOPADHYAY, Dr. PRONOB KALITA — MIDNAPORE

Traumatic cataract is very common in rural area. In our hospital 141 cataract surgeries were performed in children in 2006. About 40% of them were traumatic. 84% of them were boys. Mean age was 7.65 years. Time of presentation was quite late in most of the cases. Commonest mode of injury was stick (30%), followed by bird beak (16%). 81% cases were associated with corneal injury. IOL could be implanted in 81% cases. Wide variation in visual outcome was seen depending on the extent of injury and the time of presentation. Prevention of ocular injury is certainly the best solution.


COMPARISON OF OCULAR INJURIES TO INDIAN TROOPS IN VARIOUS WARS

Dr. (Lt.Col.) SATISH KUMAR SRIVASTAVA [Presenting Author: Dr. (Col.) SATISH KUMAR SRIVASTAVA], Dr. (Lt.Col.) VINOD KUMAR BARANWAL — C/O 56APO

With successive wars after independence, there has been a relative increase in injuries to eyes as compared to other parts of body amongst Indian troops.The main causes of injuries have changed with advances in techniques and weapons of warfare. Better understanding of pathophysiology of ocular trauma, improved surgical techniques and sepsis control by antibiotics has changed the management protocol. It was observed that artillery shell injuries are the major cause of ocular damage compared to bullets, as was the case earlier. Open globe and orbital injuries are now more common compared to closed globe injuries earlier. Enucleation commonly performed earlier has

448

Information InSight

declined. Sympathetic ophthalmia is rare. We report our experience in Sri Lanka (OP Pawan) 1987-89 & Kargil war (OP VIJAY) 1999 and compare it with other Indian wars.


MANAGEMENT OF CRANIO-MAXILLO-FACIO-ORBITAL TRAUMA: TEAM APPROACH

Dr. (Maj) VINOD KUMAR BARANWAL [Presenting Author: Dr. (Lt.Col.) VINOD KUMAR BARANWAL], Dr. (Lt.Col.) SUDHIR SAXENA, Dr. (Col.) MADHU BHADURIA, Dr. (Col.) SAGARIKA PATYAL, Dr. (Col.) PARIHAR J.K.S., Dr. (Lt.Col.) SHYAM SUNDER K., Dr. (Lt.Col.) SANTOSH KUMAR — LUCKNOW

Cranio-maxillo-facio-orbital trauma is very common now a days due to advacements in field of mechanical transport. Its scientific management is a team work. Our team comprising of neurosurgeon, ophthalmologist, maxillofacial surgeon, ENT surgeon, reconstructive surgeon, radiologist & anasthesiologist managed 136 such cases in last 24 months. Team decided an integrated treatment plan after comprehensive initial assessment in each case & managed cases accordingly.This led to defining of protocol for panfacial injuries. We report our experience. Presentation will be supported by excellent pictures & CT films.


MANAGEMENT OF A CASE OF TRAUMATIC FACIAL PALSY WITH LAGOPHTHALMOS, EXPOSURE KERATITIS & TRAUMATIC CATARACT

Dr. VISHNU PRABHU [Presenting Author: Dr. NAMEETH D.A. D’SOUZA], Dr. NEELAM PUTHRAN, Dr. UMA KULKARNI, Dr. RASHMI JAIN, Dr. NAMEETH D.A. D’SOUZA, Dr. SANJEER MOHAMED — MANGALORE

Adult male aged 28 yrs, while working for a construction company had trauma with iron rod to his left eye. He came to this hospital one week after the incident. He presented with severe pain, photophobia & loss of vision in the left eye with inability to close the left eye completely. On examination of left eye he had lid oedema, lagophthalmos, exposure keratitis & traumatic cataract. The management was tricky as, if we do tarsoraphy the management of cataract will be difficult at a later date as palpebral fissure will be narrowed. If we do cataract surgery first then post operative wound healing will be hampered & topical steroids can cause danger.This paper explains the line of treatment.


ETIOLOGY AND OUTCOME OF OPEN GLOBE INJURY

Dr. RAVI SHANKAR H.N. [Presenting Author: Dr. RAVI SHANKAR H.N.], Dr. MAHESH S., Dr. KAMALA SUBRAMANIAN, Dr. ANUPAM SAHU, Dr. SRILAKSHMI, Dr. MANIMALA — SHIMOGA

449

SCIENTIFIC

POSTERS

Aim: To analyze the causes, extent and outcome of open globe injury in a predominantly rural area. Materials and Methods: It is a retrospective study of cases of open globe injury attending the emergency clinic during the period January 2005 to December 2006. The hospital records of these patients were analyzed. Results: Records of 75 patients were examined. The most common etiology was injury with stick followed by sport related injuries. The most important factor associated with better outcome was extent of injury.

Poster Panel No. 190 [FP0106] UVEA

PHACOEMULSIFICATION — IS IT SAFE FOR COMPLICATED CATARACT?

Dr. (Lt. Col.) SHRIKANT WAIKAR [Presenting Author: Dr. (Lt. Col.) SHRIKANT WAIKAR], — JAMMU

Phacoemulsification requires special skill and expertise. It becomes even more challenging if it has to be performed in a complicated cataract. This study evaluates the safety and efficacy of phacoemulsification in 34 cases of complicated cataract due to uveitis. The various factors evaluated were peroperative difficulties, postoperative reactivation of uveitis, IOL deposits, PCO, anterior capsular fibrosis, IOL decentration, cystoid macular oedema and post operative visual recovery over a followup period of one year. Analysis of these complicating factors and their managment and the final postoperative visual outcome would be presented.


OCULAR TUBERCULOSIS

Dr. AMARJEET KADAM [Presenting Author: Dr. AMARJEET KADAM]— BARODA

Purpose: To highlight the diversity of clinical presentations of ocular tuberculosis and discuss the diagnostic approach and an effective treatment. Method:Descriptive case series Results: A total of 7 cases of varied presentations of ocular tuberculosis diagnosed over a period of 1 year. Presentations included Scleritis (anterior/posterior), Interstitial keratitis, Recurrent granulomatous uveitis, Serpiginous choroiditis. All cases had a chronic or recurrent course and responded very well to antitubercular treatment with steroids. Diagnosis was assisted by positive tuberculin testing. Conclusion: A high index of suspicion helps diagnose ocular tuberculosis and antitubercular treatment seems highly effective.

That you are the master of your thought, the molder of your character and the maker and shaper of condition, environment and destiny.

— James Allen

450

Information InSight


EFFICACY OF SINGLE DRUG CHEMOTHERAPY IN CHOROIDAL MELANOMA

Dr. SANTOSH SINGH PATEL [Presenting Author: Dr. SANTOSH SINGH PATEL], Dr. CHANDRAKER A.K., Dr. MANGILAL GARG, Dr. NIDHI PANDEY, Dr. VIJAYA SAHU — DURG, BALOD

Objective: Role of single drug chemotherapy in Choroidal melanoma. Material and Method: Treatment of Choroidal melanoma by chemotherapy is usually unsuccessful with response rate of less than 1%. We have reported two cases of Choroidal melanoma confirmed by biopsy taken from lesion which showed impression of Choroidal melanoma. They were started chemotherapy inj. Decarbazine. Result: During follow up patients were normal & compliance was good without any evidence of local or systemic relapse. Conclusion: Decarbazine with Thalidomide is an effective therapy as an alternative to the multi drug toxic chemotherapy in the management of choroidal melanoma.


SECONDARY GLAUCOMA IN UVEITIS — A CLINICAL STUDY

Dr. MALA B. [Presenting Author: Dr. MALA B.], Dr. PADMAMALINI MAHENDRA DAS, Dr. SATHI DEVI A.V., Dr. SHETTY BHUJANG K. — BANGALORE

Aim: Study of prevalence, pathophysiology and management outcome of uveitic glaucoma. Methods: Prospective study of uveitic glaucoma patients over a period of one year. Results: Of 325 uveitic patients 59 (20.7%) developed secondary glaucoma. Chronic presentation was common (74.5%). Steroid induced glaucoma was seen in 32%, open angle mechanism in 64%, angle closure mechanism in 17% and combined mechanism in 10%. All cases were treated medically. Ten cases underwent laser iridotomy and 8 cases underwent trabeculectomy with anti metabolites. Conclusion: Secondary glaucoma is common and therapeutically challenging in chronic than in acute uveitis.


QUANTITATIVE AND QUALITATIVE ASSESSMENT OF UVEITIC MACULAR OEDEMA USING STRATUS OCT 3 Vs SLO OCT

Dr. PADMAMALINI MAHENDRA DAS [Presenting Author: Dr. PADMAMALINI MAHENDRA DAS], Dr. SHETTY BHUJANG K. — BANGALORE

Aim: To study the morphological characteristics of Uveitic macular edema using StratusOCT Vs SLO OCT and correlation with visual acuity. Methods: 21 eyes of 18 patients with Uveitic macular oedema were studied Results: Visual acuity was 0.05 to 0.63 (median 0.3) Morphologically 6 eyes had DME, 12 eyes CME one had vitreomacular traction. Central retinal thickness was comparable between both the machines with a difference of 10 microns. Vitreomacular traction in one eye is picked up by SLO OCT. Conclusion: StratusOCT and SLO OCT correlated well in the detection of DME and CME. Visual acuity inversely correlated with macular edema.

451

SCIENTIFIC

POSTERS


ANALYSIS OF PATIENTS WITH HLA-B27 REALTED UVEITIS

Dr. JYOTIRMAY BISWAS [Presenting Author: Dr. HARSHA G.] — CHENNAI

Aim: Study HLA-B27 positive Uveitis. Method: Retrospective analysis of 16 HLA-B27 positive uveitis patients (2003-2007). Results: Mean age 38.75 years, 8 (50%) patients in 30-40 age group. 10 (62.5%) were men. H/o previous uveitis in 12 (75%), prior steroid therapy 16 (100%), rheumatologic involvement 9 (56.25%), hypopyon 2 (12.75%), fibrin 2 (12.75%). Vision — maintained in 12 (75%) deteriorated in 4 (25%). Posterior subcapsular cataract in 7 (43.75%), increased IOP in 2 (12.75%). Anterior non granuolomatous uveitis 16 (100%); active -5, chronic 1, healed 11 & recurrent in 10 eyes. Conclusion: HLA-B27 positive uveitis had a characteristic pattern with good visual outcome.


CYTOMEGALOVIRUS RETINITIS IN HUMANIMMUNO DEFICIENCY VIRUS INFECTION

Dr. USHA LAKSHMI H.M. [Presenting Author: Dr. USHA LAKSHMI H.M.], Dr. PADMAMALINI, Dr. SIVAKAMI PAI, Dr. NARESH KUMAR YADAV, Dr. RAJESH BABU — BANGALORE

Aim: To study Cytomegalovirus retinitis in HIV infected individuals Materials and Methods: Retrospective interventional case series of 56 eyes of 28 patients from Jan 2005 to Feb 2007 Results: 24 males and 4 females, age range of 11-47 years, with baseline and six months median CD4 counts of 38 cells/mm3 & 70 cells mm/3 respectively. 22.7% had bilateral CMV retinitis. 81.81% responded well to intravitreal Gancyclovir. 10.7 % responded to intravitreal and intravenous Gancyclovir. Conclusion: Antiretroviral therapy not only decreases the incidence of death due to HIV but also facilitates cessation of anti CMV therapy with immune reconstitution.


OCULAR LESIONS IN HOSPITALIZED AIDS PATIENTS – CORRELATION WITH SYSTEMIC AND IMMUNE STATUS AND EFFECT OF ANTIRETROVIRAL THERAPY

Dr. BISWAS JYOTIRMAY [Presenting Author: Dr. SUDHARSHAN S.], Dr. RAJESH BABU — CHENNAI

Ocular lesions in 130 hospitalized AIDS patients seen between 2005-2006 at an AIDS care centre was analysed in correlation with their systemic status prospectively. Follow-up till March 2007. 54% of the patients had ocular lesions attributable to HIV. CMV retinitis was the commonest opportunistic infection. Commonest cause of hospitalization was mainly due to exacerbation of Pneumocystis carinii pneumonia (PCP) and tuberculosis (TB). Major causes of mortality were due to PCP and cryptococcus meningitis. Early improvement in the systemic status helped prevent irreversible vision loss though immune reconstitution syndrome was a major cause of ocular morbidity in such patients with improved immune status.

452

Information InSight


ANTI TUBERCULAR THERAPY ELIMINATES RECURRENCES AND IMPROVES OUTCOME IN PATIENTS OF SERPIGINOUSLIKE CHOROIDITIS

Dr. GUPTA AMOD KUMAR [Presenting Author: Dr. NISHANT SACHDEV], Dr. VISHALI GUPTA, Dr. RAMANDEEP SINGH, Dr. GUPTA AMOD KUMAR — PANCHKULA

Introduction: To study the efficacy of ATT in patients with serpiginous like choroiditis. Methods: Prospective case series of 42 patients, divided into two groups. Groups 1 included patients with no evidence of tuberculous infection, and were treated with oral corticosteroids alone while group 2, which included patients with evidence of tubercular etiology, were treated with 4 drug ATT therapy in addition to oral corticosteroids. Results: A significant decrease in number of recurrences and a better visual outcome (p<0.01) was seen in group 2 patients. Conclusion: ATT is beneficial in treatment of patients with serpiginous like choroiditis.


UVEITIS IN ARMY PERSONNEL

Dr. (Col.) VIJAY KUMAR SRIVASTAVA [Presenting Author: Dr. (Col.) VIJAY KUMAR SRIVASTAVA] — JABALPUR

64 consecutive cases of uveitis affecting army personnel were studied. All the cases were new and were being seen by an Ophthalmologist for the first time. This study particularly involves a relatively healthy community and throws light on the aetiology, various features of clinical presentation and the outcome of treatment in such a population. Aetiological diagnosis could be established only in 27% cases. The anatomical classification was: anterior uveitis 78%, intermediate uveitis 3%, mixed anterior and intermediate 11%, posterior uveitis 5% and pan uveitis 3%.


UVEITIS IN HERPES ZOSTER OPHTHALMICUS PATIENTS RECEIVING INTENSIVE ANTIVIRAL THERAPY

Dr. SUNEETHA N. LOBO [Presenting Author: Dr. SUPRIYA DABIR], — BANGALORE

Aim: Uveitis is a common ocular complication in herpes zoster ophthalmicus, which is often not recognized and treated appropriately. Incidence, onset and severity of uveitis and its effects on visual outcome in HZO was evaluated. Method: 43 consecutive HZO patients who received systemic and topical acyclovir were included. Results: Uveitis occurred in 19/43 (44.1%) patients; mild to moderate uveitis in 16/43 (37.2%) and severe in 3/43 (7%). Onset was 10-15 days after rash onset. Uveitis was a significant risk factor for visual loss. Severe uncontrolled uveitis caused irreversible severe visual loss in 2 patients. Conclusion: Early detection and treatment of uveitis reduces visual loss.

* * * * *

453

SCIENTIFIC

POSTERS

DATE: 3.2.2008 HALL: N TIME: 11.00-1.00

[EACH 5 MINUTES ONLY]

Judges: Dr. ARNAB BISWASDr. SWARNA GUPTADr. KAROBI RANI LAHIRIDr. MEENA CHAKRABARTIDr. NARANG SUNIL KUMAR

1. [FP0066] SQUINT - Poster Panel No. 176

TO REPORT THE USE OF ASYMMETRICAL BILATERAL LATERAL RECTUS RECESSIONS COMBINED WITH A RETROEQUATORIAL MYOSCLEROPEXY, IN THE TREATMENT OF A CASE OF ASYMMETRICAL DISSOCIATED HORIZONTAL DEVIATION WITH COMITANT ALTERNATING EXOTROPIA.

Dr. ABHISHEK DAGAR [Presenting Author: Dr. ABHISHEK DAGAR], Dr. GAURAV KAKKAR — NEW DELHI

2. [FP0471] MISCELLANEOUS - Poster Panel No. 92

RACIAL DIFFERENCE IN MULTIFOCAL ERG RESPONSE

Dr. ANIRUDDHA MAITI [Presenting Author: Dr. ANIRUDDHA MAITI], Dr. MAHESH UPARKAR, Dr. NATARAJAN S., Dr. SHEOREY U., Dr. BORSE N., Dr. TOSNIWAL S., Dr. MAHINDREKAR A. — MUMBAI

3. [FP0418] RETINA/VITREOUS - Poster Panel No. 167

TO EXAMINE THE INCIDENCE AND RISK FACTORS FOR FLAT OR SHALLOW ANTERIOR CHAMBER FOLLOWING VITREO RETINAL SURGERY WITH FLUID AIR EXCHANGE IN APHAKIC EYES WITH OR WITHOUT GAS TAMPONADE

Dr. ANKUR AGARWAL [Presenting Author: Dr. ANKUR AGARWAL], Dr. SATISH CHANDRA GUPTA, Dr. ARINDAM CHAKRAVARTI, Dr. VINAY GARG, Dr. SHIRISH BATRA — DELHI

4. [FP0898] NEURO OPHTHALMOLOGY - Poster Panel No. 104

ORBITAL MIGRAINE

Dr. FRANCIS M.V. [Presenting Author: Dr. FRANCIS M.V.] — ALLEPPEY

5. [FP0659] ORBIT/PLASTIC - Poster Panel No. 116

EPIDEMIOLOGY OF OCULAR PSEUDOTUMOR: A RETROSPECTIVE STUDY OF 115 CASES AT A TERTIARY HEALTH CARE CENTRE, WESTERN ORISSA

Dr. SHARMISTHA BEHERA [Presenting Author: Dr. GOPESWARI HOTA], Dr. ANUP DAS, Dr. MARUTHI H., Dr. MANJULATA DAS, Dr. PANDA B.B., Dr. GEETA MOHANTY — SAMBALPUR

H Y D E P A R K

454

Information InSight

6. [FP0748] CORNEA - Poster Panel No. 34 AUTOLOGOUS LIMBAL STEM CELL TRANSPLANT (ALSCT):

CONVENIENT APPROACH FOR RESTORATION OF OCULAR SURFACE DAMAGED BY CHEMICAL AND THERMAL BURNS

Dr. INDU ARORA [Presenting Author: Dr. (Prof.) INDU ARORA], Dr. VINEET SINGH, Dr. VINAY KUMAR BOHRA — JAIPUR

7. [FP0377] GLAUCOMA - Poster Panel No. 62 STUDY OF BIODEGRADABLE COLLAGEN IMPLANT IN

TRABECULECTOMY Dr. JANSARI PIYUSH HIMATLAL [Presenting Author: Dr. JANSARI PIYUSH

HIMATLAL], Dr. PORWAL MUKESH, Dr. CHETAN R. HINDOCHA — RAJKOT

8. [FP0454] ORBIT/PLASTIC - Poster Panel No. 117 DIAGNOSTIC SIGNIFICANCE OF ENLARGED EXTRA OCULAR MUSCLE

IN CT ORBIT Dr. MODINI PANDHARPURAR [Presenting Author: Dr. MODINI

PANDHARPURAR], Dr. MALLAJOSYULA SUBRAHMANYAM, Dr. ATHER MOHAMMED — HYDERABAD

9. [FP0913] GLAUCOMA - Poster Panel No. 54 M-FLAP MODIFICATION OF SINGLE-INCISION COMBINED

TRABECULECTOMY WITH SICS AND IOL Dr. MOKADAM PRAFULLA J. [Presenting Author: Dr. MOKADAM SHAUNAK

PRAFULL], Dr. SHAMIK PRAFULL MOKADAM, Dr. SHWETA SHAMIK MOKADAM — NAGPUR

10. [FP0835] RETINA/VITREOUS - Poster Panel No. 155 METABLIC SYNDROME AND THE EYE Dr. PRIYANKA DOCTOR [Presenting Author: Dr. PRIYANKA DOCTOR],

Dr. VISWANATHAN S. , Dr. NATARAJAN K., Dr. RAHUL DOCTOR, Dr. SHYAMAL RAVAL, Dr. ANISH — MUMBAI

11. [FP0243] INFLAMMATION - Poster Panel No. 71 PRESUMED TUBERCULAR CHOROIDITIS WITH RETINAL VASCULITIS Dr. RAHIM H. MULJIANI [Presenting Author: Dr. RAHIM H. MULJIANI],

Dr. DIMPLE SHAH, Dr. KAMAL SARIYA, Dr. PRIYANKA DOCTOR, Dr. RAHUL DOCTOR — MUMBAI

12. [FP1088] INFLAMMATION - Poster Panel No. 69 WEGENER’S GRANULOMATOSIS - A RARE CASE REPORT Dr. SHILPA BALCHANDRA KODKANY [Presenting Author: Dr. SANJEV

KUMAR], Dr. PATIL SHIVANAND B., Dr. MANJUNATH K., Dr. CHAITRA K.L., Dr. SHIVAKUMAR HIREMATH, Dr. KAPA RAMAKRISHNA — BELGAUM

13. [FP1117] LACRIMAL - Poster Panel No. 73 PLEOMORPHIC ADENOMA OF THE LACRIMAL GLAND CLINICO

RADIOLOGICAL DIAGNOSIS AND APPROPRIATE MANAGEMENT - A CASE REPORT

Dr. RAJASHEKHAR DANDUR KOTRAPPA [Presenting Author: Dr. SHARANABASAMMA], Dr. REKHA B.K. — BELGAUM

455

SCIENTIFIC

POSTERS

14. [FP0081] TRAUMA - Poster Panel No. 187

MANAGEMENT OF CRANIO-MAXILLO-FACIO-ORBITAL TRAUMA: TEAM APPROACH

Dr. (Maj.) VINOD KUMAR BARANWAL [Presenting Author: Dr. (Lt.Col.) VINOD KUMAR BARANWAL], Dr. (Lt.Col.) SUDHIR SAXENA, Dr. (Col.) MADHU BHADURIA, Dr. (Col.) SAGARIKA PATYAL, Dr. (Col.) PARIHAR J.K.S., Dr. (Lt.Col.) SHYAM SUNDER K., Dr. (Lt.Col.) SANTOSH KUMAR —LUCKNOW

15. [FP0481] RETINA/VITREOUS - Poster Panel No. 149

INTRAVITREAL MACUGEN IN THE MANAGEMENT OF MACULAR EDEMA IN CENTRAL RETINAL VEIN OCCLUSION

Dr. SUPRIYA DABIR [Presenting Author: Dr. SUPRIYA DABIR], Dr. ANIRUDDHA MAHINDRAKAR, Dr. MAHESH UPARKAR, Dr. ASHISH ATHALE, Dr. ANIRUDDHA MAITI, Dr. NATARAJAN S., Dr. KRUTI MODI — MUMBAI

16. [FP0191] TRAUMA - Poster Panel No. 180

ULTRASOUNDBIOMICROSCOPY (UBM) FOR DETECTION OF INTRAOCULAR FOREIGN BODIES (IOFB)

Dr. THAKKAR HANSA HARSHADBHAI [Presenting Author: Dr. THAKKAR HANSA HARSHADBHAI] — AHMEDABAD

17. [FP0672] GLAUCOMA - Poster Panel No. 56

ROLE OF HRT-II IN CURRENT GLAUCOMA MANAGEMENT

Dr. (Col) MADAN DESHPANDE [Presenting Author: Dr. VIDYA CHELERKAR], Dr. SANJANA SHIGGON — PUNE

18. [FP0214] UVEA - Poster Panel No. 200

UVEITIS IN HERPES ZOSTER OPHTHALMICUS PATIENTS RECEIVING INTENSIVE ANTIVIRAL THERAPY

Dr. SUNEETHA N. LOBO SRIVASTAVA [Presenting Author: Dr. SUPRIYA DABIR] — BANGALORE

19. [FP0458] Poster Panel No. 163

COMPARISON OF 23G AND 25G TRANSCONJUNCTIVAL SUTURELESS VITRECTOMY SYSTEMS

Dr. ANIRUDDHA MAITI [Presenting Author: Dr. ASHISH ATHALE], Dr. ANIRUDDHA MAHINDRAKAR, Dr. ASHAD SIVARAMAN, Dr. MAHESH UPARKAR, Dr. ANKUR AGARWAL, Dr. NATARAJAN S., Dr. JAYDEEP WALINJKAR — MUMBAI

001-028.ps, page 1-28 @ normalize ( sc preliminary.indd )aios.org/posters.pdf · study of 30 eyes...

Documents