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  Most popular articles (Since August 25, 2016)

 
 
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CASE REPORTS
Blue sclera and osteogenesis imperfecta - A rare association
Sujit Das, Kavita Bhatnagar
September-December 2017, 29(3):240-243
DOI:10.4103/kjo.kjo_75_17  
The sclera is a dense poorly vascularized connective tissue structure composed of Types I, III, IV, V, VI, and VIII collagen. The characteristic blue sclera is caused by thinness and transparency of the collagen fibers of the sclera that allow visualization of the underlying uvea. The sclera may be thinned in congenital diseases such as osteogenesis imperfecta or in acquired diseases such as iron deficiency anemia.
  13,692 179 -
PG CORNER
Preparation of fortified antimicrobial eye drops
Hilda K Nixon
May-August 2018, 30(2):152-154
DOI:10.4103/kjo.kjo_63_18  
Fortification means to intensify or strengthen the medication, to achieve adequate drug concentration. Fortified antimicrobials are not commercially available, thus should be, prepared of optimal constitution in a sterile pharmaceutical dispensary. This article provides guidelines on topical fortified therapy dosage concentration and methodology of preparation of drugs for patients with infectious keratitis. Acquaintance on fortified antimicrobial medication, its appropriate usage and timely intervention will help us to treat most of the resistant microbial keratitis and prevent the need for surgical intervention.
  7,110 549 -
MAJOR REVIEW
Prisms in clinical practice
J Antony
May-August 2017, 29(2):79-85
DOI:10.4103/kjo.kjo_84_17  
Prisms are used in diagnosis and Therapy of Ophthalmic disorders. Prismotherapy provides symptomatic relief not only in many kinds of squints, but also in non strabismic conditions like convergence insufficiency, nystagmus, heminopia etc. One of the most important therapeutic skill we have acquire in this direction, is the localisation of such clinical needs and the timely use of the wonderful therapeutic functions of prisms for the relief of such conditions. Thin Fresnel prisms are now more used in clinical practice.
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ORIGINAL ARTICLES
Safety and efficacy of Razumab – The new biosimilar in India: Our experience
VV Sameera, AG Apoorva, Shrinivas Joshi, AS Guruprasad
September-December 2016, 28(3):180-185
DOI:10.4103/kjo.kjo_18_17  
Aim: The aim of this study was to evaluate the safety and efficacy of biosimilar intravitreal ranibizumab (Razumab) for the treatment of chorioretinal vascular diseases such as diabetic macular edema (DME), neovascular age-related macular degeneration (nAMD), and macular edema secondary to retinal vein occlusions (RVOs). Methods: A prospective analysis was performed on consented patients with DME (Group 1), nAMD (Group 2), and macular edema secondary to RVO (Group 3). All patients received Razumab at baseline. Snellen visual acuity assessment, anterior segment and fundus evaluation, fundus photo, and optical coherence tomography imaging were done at days 0, 1, 7, and 30, respectively. The International Society for Clinical Electrophysiology of Vision standard electroretinography (ERG) was performed at baseline and day 30 (23 eyes who could afford the investigation). Primary and secondary outcome measures were safety parameters that included signs of clinical and ERG toxicity and changes in best-corrected visual acuity (BCVA) and central macular thickness (CMT), respectively. Results: One hundred and twenty-three eyes of 95 patients received biosimilar intravitreal ranibizumab injection between November 2015 and April 2016. No serious drug-related ocular or systemic adverse events were identified. Mean pretreatment BCVA was 0.67 ± 0.41 logMAR with CMT 345.90 ± 128.84 μm and postinjection BCVA at day 30 was 0.57 ± 0.37 logMAR with CMT reducing to 287.66 ± 90.28 μm, indicating statistical significance (P = 0.001 and P< 0.0001, respectively) for all groups. Conclusion: The biosimilar intravitreal ranibizumab for DME, nAMD, and macular edema secondary to RVO was tolerated over a month with improvements in BCVA and CMT without detectable ocular and systemic toxicity. While the long-term safety and efficacy remain unknown, these short-term results suggest that biosimilar ranibizumab could become a safe, low-cost therapy for macular diseases.
  4,900 304 1
INNOVATION
Innovative smartphone apps for ophthalmologists
John Davis Akkara, Anju Kuriakose
May-August 2018, 30(2):138-144
DOI:10.4103/kjo.kjo_68_18  
The first iPhone was released in 2007 and the first Android phone in 2008. Ten years later, smartphones are becoming ubiquitous. They now have more advanced sensors, cameras and more processing power, which have allowed several innovative apps to be made, which were not possible a few years ago. These apps will change the way we interact with patients and with clinical data, provide affordable and advanced testing, enhance the way we learn, and hopefully improve doctor–patient interactions. However, most of these apps are made without professional input and needvalidation before use. We try to review the current landscape of Smartphone Apps in Ophthalmology.
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CASE REPORTS
Shield ulcer: A very rare presentation
Sujit Das
September-December 2017, 29(3):244-246
DOI:10.4103/kjo.kjo_73_17  
Shield ulcer is a severe form of vernal keratoconjunctivitis (VKC). Shield ulcer is an uncommon, incapacitating corneal manifestation that occurs in 3%–11% of patients suffering from VKC. Patients might present with intense itching, sensitivity to light, and “ropy” discharge from the eyes. Shield ulcer, as a rare complication of VKC, should always be kept in mind for patients suffering from vernal conjunctivitis.
  3,059 110 -
MAJOR REVIEW
Inflammatory macular diseases: A review
Dheeresh K Velly, Haard Shah, Ranju Kharel, Jyotirmay Biswas
May-August 2016, 28(2):96-102
DOI:10.4103/kjo.kjo_31_16  
Inflammatory macular diseases, a group of disorders, are a major cause of severe visual impairment. They may be caused by primary ocular disease or secondary to systemic or infectious disease. All of them present with almost similar symptoms. The key to successful management is early detection and aggressive treatment with steroids, antimicrobials, and if needed, immunosuppressives. Risk of recurrences and complications, such as choroidal neovascularization, are taken in to account in the management.
  2,280 149 -
DIAGNOSTIC AND THERAPEUTIC CHALLENGES
Vision screening at schools: Strategies and challenges
Sanitha Sathyan
May-August 2017, 29(2):121-130
DOI:10.4103/kjo.kjo_86_17  
  2,175 203 -
MAJOR REVIEW
Retinal vein occlusion
Rodney Morris
January-April 2016, 28(1):4-13
DOI:10.4103/0976-6677.193868  
Retinal vein occlusion is commonly seen in the elderly.This article aims to comprehensively discuss the etiology,classification,risk factors and latest modalities of management of this condition.
  1,920 264 -
INNOVATION
Aurolab aqueous drainage implant: My surgical technique
S Archana, C Premanand, Ganesh V Raman
January-April 2017, 29(1):41-45
DOI:10.4103/kjo.kjo_56_17  
Aurolab aqueous drainage implant is a nonvalved tube implant used to treat refractory glaucoma. Although implanting the device could be surgically more demanding than certain other drainage devices, the author aims to describe the techniques which enable him to perform the surgery safely and efficiently.
  1,906 162 -
MAJOR REVIEW
Convergence insufficiency
Sanitha Sathyan, NF Beena, Dhanyasree Nair, Angel M Varughese
May-August 2016, 28(2):88-95
DOI:10.4103/kjo.kjo_3_17  
Convergence insufficiency is a common disorder of binocular vision in children and young adults. Common symptoms include eyestrain, headache, blurred vision, double vision, etc., Diagnosis of the condition involves a battery of tests for assessment of refraction, convergence, and accommodative functions. Management involves proper refractive correction, prism, and vision therapy. This review stresses on the systematic evaluation of this condition and the common treatment strategies employed.
  1,803 216 -
MAJOR REVIEWS
Eyelid malpositions: An overview
Marian Pauly, TJ Maya
September-December 2017, 29(3):160-167
DOI:10.4103/kjo.kjo_112_17  
Eyelid malpositions are the result of forces acting upon the eyelid margin. A normal eyelid should have a quick return snap to the eyeball. Frequently, tendon laxity at the medial and lateral canthi will render the eyelid margin unstable making it susceptible to contractile forces. Based on the contractile forces either entropion, ectropion, retraction or lagophthalmos can occur. The goal in treating a given eyelid malposition is to reposition the eyelid so that the new healing forces will overcome the pathologic forces. The common approaches include eyelid and canthal tendon tightening, eyelid retractor advancement or recession and skin grafting or transposition flaps. This review article briefly describes the various aspects of lid malpositions in detail.
  1,786 206 -
CASE REPORTS
A case of cavernous sinus thrombosis complicating orbital cellulitis
JK Ann, Ani Sreedhar, Meenu C Jacob
January-April 2016, 28(1):61-64
DOI:10.4103/0976-6677.193869  
A 47-year-old patient with a swelling of the left upper eyelid, redness, proptosis, and defective vision of few days duration was seen in our clinic. The history, examination, and investigations were suggestive of cavernous sinus thrombosis complicating orbital cellulitis. The patient was admitted and treated by a team of specialists including ophthalmology, neurosurgery, and hematology. Patient recovered fully after 3 weeks of treatment. This case report is being presented to highlight the importance of careful clinical examination and high index of suspicion in recognizing such a serious complication.
  1,800 132 -
ORIGINAL ARTICLES
Effectiveness of prisms in relieving diplopia in superior oblique palsies
R Neena, A Giridhar
January-April 2016, 28(1):38-42
DOI:10.4103/0976-6677.193885  
Aim: To study the effectiveness of prisms in relieving diplopia in patients with superior oblique palsies. Materials and Methods: This was a retrospective study of all patients with superior oblique palsies who were prescribed prisms for relief of symptomatic diplopia in our institute from September 2013 to March 2015. A detailed analysis was performed of demographic features of the patients; nature, onset, duration, and course of diplopia; measurement of deviation in all gazes; diplopia charting; assessment of torsion; systemic risk factors; and amount and type of prism given. The effectiveness of prisms was measured by an objective score by the examiner as well as a subjective score reported by the patient. Results: Among the total 25 patients, 21 patients had acquired superior oblique palsies and 4 patients had congenital causes. Males outnumbered females. Majority had unilateral involvement. Deviation in primary position ranged from 3 Prism Dioptre to 25 PD with 80% having less than 10 PD. Seventy-six percent had less than 10° torsion in primary gaze. Eighty-eight percent were given less than 10 PD prisms, 12% were given more than 10 PD, of which two were Fresnel Prisms. Seventy-six percent were satisfied with the prisms. Fifty-two percent had spontaneous improvement whereas 16% needed surgery. Conclusion: Prisms were effective in relieving diplopia in most of the acquired unilateral superior oblique palsies where the primary deviation was less than 10 PD and torsion was less than 10°.
  1,685 122 -
MAJOR REVIEWS
Retinopathy of prematurity-An overview
Natasha Radhakrishnan, Gopal S Pillai, KR Kiran, A Lekshmypriya
September-December 2017, 29(3):154-159
DOI:10.4103/kjo.kjo_111_17  
Retinopathy of prematurity (ROP) is a vasoproliferative disease that affects premature infants. ROP is on a rise in India as a result of the improved neonatal care and better neonatal survival rate. Identifying and screening of at-risk premature infants performed by an experienced ophthalmologist remains the most important strategy in the management of ROP. In developing countries, the introduction of Retcam-assisted screening enables screening and follow-up of the rural population where an experienced ophthalmologist may not be available. Currently, laser photocoagulation of avascular retina has replaced cryotherapy as the gold standard treatment for ROP depending on the severity of disease. Among the various ongoing treatment approaches currently under trial to suppress the neovascularization, anti-vascular endothelial growth factor drugs provide valuable and encouraging information, especially in Zone 1 disease. Although many ongoing animal trials aimed at finding an ideal treatment have come out with newer treatment options, their safety and efficacy in humans are yet to be established.
  1,574 201 -
MAJOR REVIEW
Update on hydroxychloroquine retinopathy
Remya Mareen Paulose, Jay Chhablani, Mahima Jhingan
January-April 2017, 29(1):9-13
DOI:10.4103/kjo.kjo_29_17  
Hydroxychloroquine (HCQ) in recent times has been used in treatment for a variety of autoimmune diseases and dermatological and rheumatological conditions. Retinal toxicity from HCQ and its analog chloroquine has been recognized for many years. Retinal toxicity secondary to HCQ is irreversible and can continue to progress even after cessation of therapy. Prompt screening and serial monitoring, with the utilization of imaging modalities, is of paramount importance to early detection.
  1,529 193 -
CASE REPORTS
Oral eplerenone for treatment of bullous retinal detachment secondary to chronic central serous retinopathy
Prachi Abhishek Dave, Jay Chhablani
January-April 2017, 29(1):54-56
DOI:10.4103/kjo.kjo_39_17  
The bullous variant is a rare manifestation of central serous retinopathy (CSR). Multiple therapeutic approaches have been described to treat these bullous detachments which mainly involve laser photocoagulation or surgical drainage. Here, we demonstrate the efficacy of oral eplerenone in the treatment of the bullous variant of CSR. A 44-year-old female presented to us with diminution of vision in the left eye (OS) for 1 month. On clinical examination, she was diagnosed to have a chronic CSR in both eyes along with a bullous retinal detachment in the OS which was confirmed on multimodal imaging. She underwent focal laser, which failed to resolve the bullous variant in the OS, then the patient was started on oral eplerenone for 3 months. At 3-month follow-up, the ultrasound scan of the OS confirmed resolution of the bullous detachment, and some residual subretinal fluid could be noted at the posterior pole. This was maintained till 6-month follow-up. Oral eplerenone can be an effective, cheap, and safer alternative in treating patients with nonresolving bullous detachments secondary to chronic CSR.
  1,607 107 -
A case of myopic strabismus fixus “Fixed” with loop myopexy
Sanitha Sathyan, R Jyothi
January-April 2016, 28(1):65-67
DOI:10.4103/0976-6677.193865  
Myopic strabismus fixus is a rare condition seen in high myopes and presents with sudden onset of strabismus. This case report describes a high myopic patient who presented with acute onset strabismus and was successfully treated with loop myopexy of superior rectus and lateral rectus muscles.
  1,461 120 -
MAJOR REVIEWS
Rosacea and eye
Lalit Gupta, Anubhav Chauhan
September-December 2017, 29(3):168-172
DOI:10.4103/kjo.kjo_105_17  
Rosacea is a multisystem disorder and to the general practitioner, involvement of the skin is what comes to the mind first of all. A broad array of ocular manifestations encompasses this condition and ocular examination is as essential as examination of other part of body when rosacea is talked about. Here, we present an in depth review of ocular rosacea so that adequate knowledge is shared among all the doctors regarding thglalit7@gmail.come subject.
  1,414 130 -
ORIGINAL ARTICLES
Study of factors influencing central corneal thickness among patients attending ophthalmology outpatient department at a tertiary care center in North Kerala
Vivek Oommen Varghese, Latha N Vadakkemadam, Shamin Jacob, KK Praveena, Ratheesh Raj, Jipina Kizhakkepatt
September-December 2016, 28(3):193-198
DOI:10.4103/kjo.kjo_9_17  
Context: Central corneal thickness (CCT) was assumed to be a constant when Goldmann designed his applanation tonometer. Knowledge of the CCT is of importance in the assessment of intraocular pressures (IOPs). Aim: The aim of the study was to examine the association of CCT with ocular, demographic, and metabolic factors such as age, race, gender, smoking, alcoholism, diabetes mellitus, hypertension, obesity, metabolic syndrome, corneal curvature, and axial length. Settings and Design: A cross-sectional study was conducted in 166 patients aged between 30 and 70 years who had presented for routine eye checkup from January 1, 2014, to July 1, 2015, in our Ophthalmology Department. Subjects and Methods: Patient parameters were recorded using an interview schedule, and complete ocular examination, including visual acuity and IOPs, were recorded. CCT was measured using PacScan Plus A-Scan/Pachymeter. Statistical Analysis Used: Mean CCT across different variables were compared using ANOVA and t-test. Further analysis was done using univariate and multivariate analysis. Results: On univariate analysis, it was found that age, presence, and duration of diabetes, elevated fasting blood sugar levels, alcohol consumption, corneal curvature (in diopters), and IOP were associated with CCT. Multivariate analysis showed significant association of CCT with age, duration of diabetes, corneal curvature, and IOP (P < 0.05). Conclusions: From our study, we concluded that CCT was significantly associated with age, duration of diabetes, corneal curvature, and IOP. Duration of diabetes and IOP showed a positive correlation with CCT whereas age and corneal curvature showed a negative correlation.
  1,425 84 -
Knowledge, attitude and practice about eye donation among medical and paramedical students in tertiary eye care hospital
Hosamani Sushma, VG Warad, Mansi Kshetrapal
May-August 2016, 28(2):112-115
DOI:10.4103/kjo.kjo_30_16  
Background: Eye sight is very important for human life. The World Health Organization (WHO) estimates that every 5 seconds someone goes blind. Globally, 37 million people are blind, and of these nearly 10 lakh blind people are willing for corneal transplantation. Aims: The aim of the study was to assess the knowledge, attitude, and practice regarding eye donation among the students. Materials and Methods: The data were collected by the questionnaire method from medical and paramedical students at Al Ameen Medical College, Bijapur. Data collected from the participants were analyzed using percentage and descriptive statistics. Results: Out of the 250 students, 60.4% were Muslim by religion. The participants were wellaware of eye donation (99.2%) quoting media as a major source of information for their knowledge. Attitude regarding eye donation in few (45.6%) was different as it was against their religious belief, although they said it was a service to the mankind (92%). Out of the 250 students, 48% were willing to pledge and 52% students did not believe in pledging their eyes. Conclusion: The findings of the study showed that overall knowledge about eye donation among students was good, however the attitude and practice showed mixed responses.
  1,260 140 -
MAJOR REVIEW
Genetics in diabetic retinopathy - A brief review
Gopal S Pillai, Rebecca Varky
January-April 2016, 28(1):14-19
DOI:10.4103/0976-6677.193880  
Genetic factors are assumed to contribute to determining an individual's risk for the development of DR and for progression to proliferative diabetic retinopathy (PDR). This article aims to review the developments concerned with the genetics of DR.
  1,171 180 -
INNOVATION
Initial experience with DIYretCAM – A do it yourself retinal camera
Biju Raju, NSD Raju
January-April 2016, 28(1):53-55
DOI:10.4103/0976-6677.193876  
Smartphone based fundus photography may have a role in teleophthalmology. In this article, we discuss our initial experience with DIYretCAM, a do it yourself smartphone retinal camera attachment, that is a cost-effective alternative to conventional fundus camera.
  1,219 110 -
MAJOR REVIEWS
The art of retinoblastoma management - Curable yet challenging
Fairooz P Manjandavida, Shaifali Chahar
January-April 2018, 30(1):17-27
DOI:10.4103/kjo.kjo_26_18  
Retinoblastoma (RB) is the most common intraocular childhood malignancy, and it is considered potentially fatal if untreated. The management of RB has undergone a tremendous leap in the past four decades, with a global effort to save life along with eye and vision. Despite the on-going genetic and clinical research, there is a lack of clinical expertise and understanding of optimal management as it is customized and has to be tailored individually depending on various factors. In this review, we explore the management of RB and various chemotherapeutic alternatives using intravenous chemotherapy and the newer modalities such as intra-arterial and intravitreal chemotherapy in combating this deadly but curable disease. The strategy of management is challenging and mainly depends on the stage of the disease and tumor laterality.
  1,147 145 -
EDITORIAL
The final cut
Ashok Nataraj
September-December 2017, 29(3):151-151
DOI:10.4103/kjo.kjo_110_17  
  1,129 136 -