OSP Journal of Ophthalmology and Ocular Care

Thelazia callipaeda, which is the main causative organism in thelaziasis, commonly infects orbital cavities and associated tissues. Thelazia callipaeda infectin is rarely reported in humans, especially in infants. Here we reported a case about a 3-month-old male infant infected thelazia callipaeda. Mother found something squirmed in the right eye when breastfeeding the baby without secretions and redness. On examination under the slit lamp, we found the creamy thread-like mobile worm in the conjunctival sac in the right eye. During surgical opration, 2 worms were extracted from the right eye. No recurrence during 3-month follow-up. Here presented the life of Thelazia callipaeda, the detailed clinical and morphological information. The case indicates us to identify differential diagnosis of ocular surface diseases, especially in infant patients.

Purpose: To study the contribution of quarantine with online work and education to exacerbating digital eye strain and causing possible refractive changes. To illustrate the prevalence of mask associated dry eyes and potential increase use of contact lenses.

Methods: This is a questionnaire-based cohort study from Lebanon during the period between July 1 and October 1, 2021. The questionnaire consisted of 10 multiple choice questions in. The included age group was between 5 and 50 years old.

Results: The total number of questionnaires was 100. The mean age was 25.8 years. 73% of patients were involved in online work or education during COVID pandemic and these were divided into subcategories. 83% of the patients reported an increase in screen time during quarantine. Furthermore, 59% declared worsening of their dry eye symptoms, developing dry eyes, had ocular fatigue and/or headache secondary to increased screen time (70% of the participants had an existing chronic dry eyes).

Crosstabulation analysis showed that out of the patients who reported increased in digital eye strain symptoms, 83.1% had online work or education (28.8% had online school classes, 18.6% had online university classes and 35.6% were involved in online work) while 16.9% weren’t involved in any online activity (P=0.011).

Conclusion: Patients who switched to online work and education during COVID-19 pandemic had significantly higher incidence of digital eye strain. No significant change in refraction was noted as compared to patients without online work and education. Mask associated dry eyes was noted in a large number of patients.

Purpose: Review the incidence, spread, resistance patterns, and management of bacterial keratitis inthe South of Seville in the last 4 years.

Methods: Clinical record results of the microbiological isolates of patients with a clinical diagnosis of bacterial keratitis were retrospectively reviewed.

Results: A total of 159 patients were treated, with 129 cultures. We obtained positive cultures in 76 of 129 cultures (47,2%) and 102 microorganisms (20 cultures had a polymicrobial result). The distribution was 23,7% gram positive, 60,8% gram negative, and 15,5% fungal. The most common were Pseudomona aeruginosa (16,6%), Serratia marcescens (11,7%), and Staphylococcus aureus (9,8%). When analyzing susceptibilities to gram-positive’s bacteria, greater resistance rate was demonstrated for fluoroquinolones (13,6%) and aminoglycosides (18,2%). We observed 10% aminoglycoside resistance in the gram-negative group and 5% resistance to ceftazidime. No resistance to vancomycin was observed.

Conclusions: The higher resistance rate to aminoglycosides and fluoroquinolones in gram-positive’s bacteria in our area differed from the literature, especially inside the Streptococcus group. We propose not using fluoroquinolone, aminoglycoside, or cephalosporin as initial monotherapy management of severe bacterial keratitis in our area.

Purpose: To elucidate optical coherence tomography features that may be predictive of visual outcomes after phacoemulsification in eyes with a primary and secondary Epiretinal Membrane (ERM).

Patients and methods: Retrospective consecutive case series. Visual Acuity (VA) and Spectral-Domain Optical Coherence Tomography (SD-OCT) characteristics at pre-operative and post-operative visits in eyes with pre- existing ERM that underwent uncomplicated phacoemulsification were analyzed.

Results: In the 57 eyes, median VA improved significantly from 20/50 at baseline to 20/30 at 1, 3, 6, and 12 months (all p <0.001). VA improved by at least 3 lines in 45% to 58% of eyes at each time point. Mean OCT Central Foveal Thickness (CFT) was 335 μm at baseline and increased by 33 μm (p<0.001), 17 μm (p=0.005), 36 μm (p=0.018), and 11 μm (p=0.18) at 1, 3, 6, and 12 months, respectively. Cystoid macula edema was typically treated with topical steroidal and nonsteroidal medications. Intact Inner-Outer Segment (IS/OS) junction at the preoperative visit was a statistically significant positive predictor of higher visual improvements, while intact foveal pit and preoperative CFT were not. There was no difference between the primary and secondary ERMs in terms of visual improvements or CFT at any time point.

Conclusions: Given significant visual improvements and mild, transient retinal thickening increase without significant membrane progression through 1 year, phacoemulsification alone may be recommended in eyes with preexisting ERMs. No OCT characteristic, other than intact IS/OS junction, was a significant predictor of better long-term visual improvements.

Context: Ophthalmic morbidities pose a huge burden to society as well as individuals. In India the projected prevalence of blindness as per (2015-2018) survey from NPCB is 0.45 %, of which corneal blindness constitute 0.9% causes. Microbial keratitis is an important cause attributing to avoidable cause of corneal blindness.

Aims: To determine the aetiopathogenesis and antimicrobial susceptibility pattern among   the isolates causing microbial keratitis.

Settings and design: It were a prospective study carried out from June 2014 to April 2019.

Methods and Material: Corneal scrap, vitreous, anterior chamber tap, conjunctival swab and corneal button samples of all the patients suspected of microbial keratitis were subjected to direct microscopy (gram’s stain and 10% KOH mount) and culture on blood agar and sabouraud’s dextrose agar. The isolates were identified and drug susceptibility testing was performed as per CLSI M51-A for four drugs Voriconazole, Amphotericin B, Fluconazole and Itraconazole.

Results: Out of 267 cases of corneal ulcers 50 (18.7%) were bacterial causes, 147(55) % were fungal isolates among which 93.8% revealed fungal hyphae in 10% KOH wet mount and rest showed no hyphae on direct examination but were culture positive,4 cases of Acanthamoeba spp and 3 cases of Microsporidium spp were identified. In 40 cases no growth either bacterial or fungal was observed. Aspergillus spp (72%) and Fusarium spp (29%) were the predominant isolates among fungal corneal ulcers and Staphylococcus aureus (36%), Pseudomonas aeruginosa (24%) and Streptococcus species (18%) were the predominant isolates among bacterial corneal ulcers.

Conclusion: Microbial keratitis is an important cause of corneal blindness. Fungal etiology is more common to cause keratitis specially in agriculture dominated region like ours because of trauma due to vegetative matter.

Aims: To compare the visual, anatomic and refractive outcomes in eyes treated with combined phacovitrectomy versus sequential phacoemulsification and vitrectomy.

Methods: A retrospective chart review was performed of eyes with cataract and idiopathic Epiretinal Membrane (ERM) that underwent either combined or sequential phacoemulsification and Pars Plana Vitrectomy (PPV). Data were collected at preoperative (baseline) and Postoperative Month (POM) 1, 3-6, and 12, and the most recent exam beyond POM12 (last exam). Changes from baseline in visual acuity (mean approximate ETDRS letter score), mean Optical Coherence Tomography (OCT) parameters, and mean Refractive Target Error (RTE) calculated as the difference between predicted and actual Spherical Equivalent (SE) were compared between the combined and sequential groups.

Results: Of 100 eyes assessed, 65 had combined phacovitrectomy, 28 had phaco 1st, and 7 had PPV 1st. No significant differences in RTE were observed between groups. No significant differences in mean approximate ETDRS letter score improvement, Central Foveal Thickness (CFT) or Macular Cube Volume (MCV) changes were observed between the combined and either sequential group, or between sequential groups, at any postoperative time point.

Conclusion: Combined and sequential phacoemulsification and vitrectomy procedures produced similar results with respect to visual, anatomic, and refractive outcomes in the population assessed. Surgeons may choose either approach while targeting specific circumstances of each individual patient.

Background: Proliferative Diabetic Retinopathy (PDR) can be treated with intra-vitreal injection of anti-VEGF compounds. It can be expected that the study of the effects of this treatment on the diameter and oxygen saturation of larger retinal vessels may contribute to our knowledge about the pathophysiology of PDR.

Methods: Seventeen patients referred with PDR and neovascularizations at the optic disk were subjected to retinal oximetry before and (mean ± SD) 6.9 ± 3.8 days after intra-vitreal injection with anti-VEGF compound. Changes in diameter and oxygen saturation in the larger retinal vessels before and after treatment were assessed.

Results: At the follow-up examinations the diameter of retinal arterioles had decreased significantly from (mean ± SD) 118.7 ± 13.9 µm to 109.5 ± 18.7 µm (p<0.01), whereas there was no significant change in the diameter of retinal venules (p=0.24). There was no significant changes in the oxygen saturation in retinal arterioles (from 97.3 ± 6.1 % to 98.0 ± 6.3 %, p=0.44) or in retinal venules (from 63.2 ± 12.1 % to 62.3 ± 10.4 %, p=0.66).

Conclusions: Regression of retinal neovascularizations after treatment of proliferative diabetic retinopathy is related to constriction of retinal arterioles but not to changes in oxygen saturation in the larger retinal vessels.

Purpose: To estimate prevalence and causes of visual impairment (VI) among people ≥40 years and barriers for uptake of services among visually impaired using Rapid Assessment of Visual Impairment (RAVI) survey methodology in Surat district of Gujarat state, India.

Method: A cross sectional population based survey was conducted using 26 random clusters selected by probability proportional to size of sampling. VI was defined as presenting visual acuity (PVA) <6/18 in better eye. A validated RAVI questionnaire on barriers was introduced to those whose VA did not improve to ≥6/18 with pinhole.

Results: A total of 1560 people were enumerated and out of them 1487 people were examined (response rate 95.3%). The age and sex adjusted prevalence of VI was 27.31% (95% CI 24.6-30.0) which included 30 people with blindness (Prevalence 2.03% (95% CI 1.31-2.76).  Refractive error (63%) was found to be major cause of all VI and Cataract was the leading cause of blindness (70%, 21/30). Affordability (36.9%) was found to be main cause of barriers to uptake eye care services.

Conclusion: Cataract and Refractive Errors were found to be major causes. The findings suggest there should be an effective cataract and refractive services provided to the community at free/subsidized rates. This is the first of its kind baseline data which will definitely be useful in planning eye care services in the district.

The author used his own medical data to investigate the impact on his diabetic retinopathy condition and its risk probability percentage or hazard ratio (HR) over a period of 7-years.