Aim: The aim of this study is to evaluate, assess and grade the severity of dry eye disease following manual small incision cataract surgery (MSICS). Background: Any phenomenon which disturbs the ocular surface directly or indirectly leads to the beginning of ocular surface disease and dry eye syndrome. Ophthalmic surgeries, especially cataract surgery is one of the factors which causes dysfunction of the Lacrimal Functional Unit and may lead to dry eye disease. MSICS is the surgery of choice in the majority of the rural and suburban sector of India. Many patients undergoing MSICS complains of dry eye symptoms in their postoperative follow-up period. Materials and Methods: This was a prospective, hospital-based, longitudinal study consisting of 100 patients, conducted in a tertiary health care hospital over a period of 18 months, from November 2017 to May 2019, after obtaining ethical committee approval. Patients undergoing MSICS were evaluated for dry eyes using ocular surface disease index questionnaire, schirmer's-1 test (without anesthesia), tear film break-up time test, and oxford system of ocular surface staining, preoperatively and postoperatively on three follow up visits on days 7, 21 and 45 respectively. Results: Overall incidence of dry eye disease was 69%. The severity of dry eye disease was mild in 13%, moderate in 33% and severe in 23% of patients. The incidence of dry eye disease was more in higher in the elderly age group following surgery (mean age 61 ± 11 years, P < 0.05). Conclusion: The study found a higher incidence of dry eye disease following MSICS. The sign and symptoms were most profound around first week postoperatively and then regressed overtime, suggesting its self-limiting course. Majority of patients had moderate dry eye disease and also elderly patients being affected more frequently.

Background: Brunescent cataracts are associated with higher incidence of ocular comorbidities which predispose to intraoperative and postoperative complications. Objectives: To compare the surgical outcomes of Phacoemulsification (PE) and Manual Small Incision Cataract Surgery (MSICS) in Brunescent cataracts. Patients and Methods: Retrospective observational study of patients who underwent either MSICS or phacoemulsification for brunescent cataracts over a 1-year period were reviewed for complication rates and visual outcomes. Multiple logistic regression analysis using Stata software (version 11.0, Stata Corp LP) performed to find factors associated with surgical complications. P < 0.05 considered statistically significant. Results: A total of 959 eyes of 950 cases with brunescent cataract were reviewed of which 654 underwent MSICS and 305 underwent PE. A total of 53 intraoperative complications were encountered in both groups. PE group had 14 (2.95%) with the commonest being PCR in 9 cases. In the SICS group, 39 complications (5.96%) were noted with PCR in 16 followed by ZD in 12. Postoperative complications were noted in both groups with higher incidence of corneal edema in the PE group. Statistically significant difference in visual outcome was seen after 1 month with PE group (0.21±0.21) having better uncorrected visual acuity (P <0.001) compared to MSICS (0.44±0.26). Conclusions: For developing nations, where cost and training are the rate limiting factors and patients tend to present late with harder and complicated cataracts, MSICS is comparable to PE in terms of complication rates and visual outcomes.

Context: Orbital trauma occurs in a variety of settings, with road traffic accidents (RTAs) being the most common. Injuries vary in severity and have the potential for visual impairment and disfigurement. Aims: The aim of the study is to evaluate the clinical pattern of orbital injuries and its effect on visual acuity (VA). Settings and Design: This is a descriptive, cross-sectional study. Subjects and Methods: This is a descriptive, cross-sectional study of thirty patients who had attended Regional Institute of Ophthalmology and Government Ophthalmic Hospital, Chennai, with a history of orbital trauma. Patients were examined and information was gathered. The data were then computerized, and statistical analysis was done using SPSS. Statistical Analysis Used: SPSS software was used for statistical analysis. Results: RTA was the leading cause of orbital trauma (50%), with a female-to-male ratio of 7:23, left eye was the most commonly injured eye (57%), and the age group affected was from 21 to 40 years (60%). The most common fracture was involving the floor (47%), with direct force constituting 54% as the cause of trauma. VA remained 6/6 for a majority of cases (58%) and grossly reduced to perception of light in 6.67% of cases. The most commonly presented clinical feature was periorbital edema with ecchymosis (43%) followed by ocular movement restriction (40%). Out of the thirty cases, surgical intervention was done for 63% and medical management for 37%. Conclusion:The study concluded that each mode of injury of the orbit leads to varying clinical presentation with varying frequency of involvement of VA. Therefore, early recognition of trauma and timely intervention can result in better visual outcomes.

Severe acute respiratory syndrome- coronavirus-2 is an enveloped, single-stranded RNA virus that causes novel coronavirus disease 2019 (COVID-19). It is highly transmissible and has a significant fatality rate, especially in the elderly and those with comorbidities such as immunosuppression, respiratory disease, and diabetes mellitus. The purpose of this brief review is to summarize those published studies as of early May 2020 on COVID in ophthalmology and to present a review of various national and international ophthalmological society guidelines, hoping to make a contribution for protecting ophthalmologists and patients.

Epigenetics is the regulation of gene expression through alterations in DNA or associated factors other than the DNA sequence. These regulatory processes control the transcription of information encoded in the DNA sequence into RNA before their translation into proteins. Unlike DNA sequence, which is largely fixed throughout the lifecourse, epigenetic patterns not only vary from tissue to tissue but alter with advancing age and are sensitive to environmental exposures. It is this propensity for change that makes epigenetic processes the focus of such interest, as they lie at the interface of the environment and co-ordinated transcriptional control. These factors control the diverse manifestations of diseases. Insights into epigenetic modification may lead to new therapies for common diseases. This article gives a brief overview of the epigenetic mechanisms and their role in some of the common eye diseases.

Intraocular pressure (IOP) is currently the only modifiable risk factor in glaucoma. Since all our efforts are directed towards maintaining a stable IOP to halt glaucoma progression, proper understanding about the science behind IOP measurement and biomechanics of cornea becomes paramount. In this paper, we address the basics of corneal biomechanics, recent developments and its impact on glaucoma diagnosis and management. An extensive literature search was done using PubMed and Google Scholar with the search terms such as biomechanics, hysteresis, and glaucoma. Relevant articles published in English language were reviewed.

Low vision service has been least prioritised for decades in eye care. Vision 2020[1] the Global initiative for avoidable blindness has identified Refractive errors and low vision as a priority. In spite of low vision has been a focus area in vision 2020, the service has not been widely accepted in eye care for the benefit of patients, except for a few tertiary eye care institutions. This article discusses in detail, about clinical low vision, basic optics, types of low vision aids, and inventory, required at an eye care practitioners' level to integrate lowvision as a part of refraction service in their eye care services.

An asymptomatic 3-year-old child presented with megalocornea, mild corneal haze, high intraocular pressure, and advanced optic disc damage in both eyes. The child was taken up for trabeculectomy and trabeculotomy in the right eye and trabeculectomy alone in the left eye. Due to the failure of the procedure in the right eye, Aurolab aqueous drainage implant was placed. The asymptomatic nature of the child led to the late presentation with advanced disc damage. Therefore, awareness of subtle signs of congenital glaucoma is crucial among the pediatricians for proper screening and referral.

An 11-year-old boy presented with port-wine stain on the right side of the face and pigmentation of the sclera and iris in the left eye (LE). Fundus examination revealed inferior rim excavation of disc with orangish red tomato ketchup appearance of background retina suggestive of diffuse choroidal hemangioma in the right eye (RE) and normal retina in the LE. Ultrasonography showed increased thickness of retinochoroidal scleral complex, and swept-source optical coherence tomography showed choroidal thickening in the RE. He was diagnosed to have phakomatosis pigmentovascularis (PPV) with Sturge–Weber syndrome and glaucoma. PPV is a rare congenital disorder characterized by the presence of capillary malformation and pigmentary nevi. PPV can present with or without systemic involvement. Those without systemic involvement need to be followed up closely as they can manifest later in life.

Phacoemulsification with foldable intraocular lens (IOL) implantation is the standard of care offered for a cataract. Single-piece acrylic (SPA) IOL is designed to be placed in the bag and not suitable for sulcus implantation. If implanted in sulcus, it can lead to pigmentary glaucoma, due to constant friction with the iris, leading to pigment release, which blocks trabecular meshwork. We report the case of pigment dispersion glaucoma due to sulcus-implanted SPA presented 3 years after cataract surgery. It was managed successfully by an IOL exchange where we could implant a foldable three piece IOL into the intact capsular bag.

Alveolar soft-part sarcoma (ASPS) is a very rare, highly vascular, soft-tissue sarcoma predominantly seen in adolescents and young adults. Orbital involvement is rare, and only few case reports have been published. We report the case of a 12-year-old girl who presented with proptosis of the right eye of 2 months' duration. Magnetic resonance imaging showed a well-defined lesion in the superolateral right orbit, with the possibility of a hemangioma. Right-eye lateral orbitotomy with excision biopsy of the mass was done. Histopathology revealed ASPS, and the patient was referred for metastatic workup.

Positioning of patient and adjusting the microscope to achieve adequate field of view is crucial for a comfortable cataract surgery. When there are hindrances to such an ideal positioning, several strategies have to be adopted to facilitate the surgery. Kyphosis, characterized by excessive curvature of the thoracic spine is one such condition. This case report illustrates an elderly male presenting with severe visual impairment and circumstances making surgery inevitable. The emphasis is to understand the ingenuine measures to be taken to tackle the challenges faced in such a scenario.

Glioblastoma multiforme, also referred to as grade IV astrocytoma, is the most aggressive form of glioma and incredibly a fast-growing tumor. The typical presentation of the frontal lobe tumors includes difficulty in attention and concentration, urinary incontinence, problems in memory and learning, and difficulties in impulse control, reasoning, planning, decision-making, control, and coordination of movement. Frontal lobe tumors can become very large before they manifest clinically, and their symptoms may be trivial. We report here a case of Foster–Kennedy syndrome presenting as depression as the first symptom along with the rare finding of “Transient Oculomotor Nerve palsy” during the seizure episode.