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   2016| May-August  | Volume 28 | Issue 2  
    Online since March 20, 2017

 
 
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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.
  11,142 858 1
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.
  8,300 520 -
ORIGINAL ARTICLES
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.
  6,024 457 3
MAJOR REVIEW
Guidelines for imaging in Neuro-ophthalmic and Orbital disease
Thomas A Varghese, Anusha Varghese
May-August 2016, 28(2):103-111
DOI:10.4103/kjo.kjo_5_17  
Neuroimaging has progressed from plain X-ray to magnetic resonance imaging, noninvasive angiography, and special sequences. Utilization of the appropriate investigation can save the sight and sometimes life of the patient. This article attempts to guide the ophthalmologist in choosing the most suitable modality in the different clinical scenarios.
  4,566 515 1
ORIGINAL ARTICLES
Myopic choroidal neovascular membrane: A retrospective study
S Sindhu, G Mahesh, Bindu Rajesh, A Giridhar
May-August 2016, 28(2):116-119
DOI:10.4103/kjo.kjo_25_16  
Purpose: The purpose of the study was to analyse the fundus fluorescein angiographic (FFA) and Spectral domain Optical coherence tomographic (SD- OCT) patterns of myopic CNVM and to evaluate their response to anti-VEGF. Materials and Methods: This is a retrospective analysis of 24 treatment naïve eyes diagnosed with myopic CNVM. Eyes with age related macular degeneration, coexisting diabetes mellitus, inflammatory CNVM, idiopathic CNVM and Pseudophakia were excluded.Analysis of degree of myopia, the best corrected visual acuity (BCVA) at presentation and one year after treatment, FFA features, SD-OCT images and the response to intravitreal anti VEGF injections were carried out. Results: 24 eyes of 21patients ( 6 males, 15 females) were included in the study Mean age of the patients was 44.78 ± 17.40 years.Degree of myopia ranged from -2.5D to -22 D. Fundus fluorescein angiography showed classic CNVM in all eyes with subfoveal location in 19 eyes and juxtafoveal in 5 eyes. SD-OCT imaging showed subretinal hyperreflective material with intraretinal oedema in all eyes. Intravitreal bevacizumab (1.25mg in 0.5ml) was given in 18 eyes and ranibizumab (0.5 mg in 0.5ml) in 6 eyes. Mean number of injections taken was 1.83 (range 1 to 5). At 1 year follow up,13 eyes showed improvement in BCVA (54.16%), 6 worsened (25%), 5 remained stable (20.83%). Conclusion: Myopic CNVM responds to finite number of anti-VEGF injections anatomically and visually with no associated complications. The worsening is due to degenerative changes rather than recurrence of CNVM.
  3,820 182 -
CASE REPORTS
Choroidal osteoma: An atypical case
Anu Paul, Liz S Mani, Revati Ramesh, A Anabi Shahi
May-August 2016, 28(2):145-147
DOI:10.4103/kjo.kjo_4_17  
A case of choroidal osteoma in a 20-year-old male diagnosed incidentally following dilated fundus examination is reported. The lesion was yellowish-orange in color with well-defined scalloped margins, present in the macular region above the inferior arcade, involving the fovea. Visual acuity was not affected, and there was complete absence of subjective symptoms in the eye. B-scan ultrasonography revealed findings consistent with a choroidal osteoma. Optical coherence tomography showed no retinal edema, retinal thinning or choroidal neovascular membrane. We report this case of choroidal osteoma with atypical presentation in a male and no visual involvement in spite of its location in the posterior pole involving the fovea.
  3,655 194 -
ORIGINAL ARTICLES
Half-fluence photodynamic therapy in chronic central serous chorioretinopathy
Anubhav Goyal, Ananthraman Giridhar, Mahesh Gopalakrishnan
May-August 2016, 28(2):125-130
DOI:10.4103/kjo.kjo_6_17  
Purpose: The aim of this study is to investigate the effect of half-fluence photodynamic therapy (PDT) in chronic central serous chorioretinopathy (CSC). Materials and Methods: Forty-two eyes of 34 patients with chronic CSC and symptoms for at least 6 months were retrospectively reviewed. All eyes were treated with indocyanine green (ICG)-guided half-fluence PDT. The primary outcome measure was the proportion of eyes with complete resolution of subretinal fluid (SRF) on spectral domain-optical coherence tomography (SD-OCT). The secondary outcome measure was change in best corrected visual acuity (BCVA). SPSS v. 16 software was used for statistical analysis. Results: The mean follow-up period was 12.5 ± 4.3 months. Twenty six (78.78%) eyes showed complete resolution of SRF (P < 0.01). BCVA increased by a mean of 0.43 to 0.42 log MAR (P < 0.31) at 12-month follow-up. Serous macular detachment height reduced from a mean of 166 μ to 40 μ (P < 0.01), and BCVA improvement of ≥ 1 line was seen in 16 eyes at 12 month follow-up visit. Ellipsoid line improvement was seen in 12 (36.36%) eyes compared to 5 (15.15%) eyes at the baseline visit (P = 0.01). Eyes with SD-OCT features of idiopathic serous-pigment epithelial detachment showed improvement of 0.12 logMAR in BCVA, as compared to irregular retinal pigment epithelium (0.01 logMAR) in 12 months duration. Conclusion: Half-fluence PDT is an effective and safe method in the treatment of chronic CSC with stabilization or improvement of anatomical and functional outcomes.
  3,074 204 -
CASE REPORTS
A rare case of large bilateral optic nerve glioma in a child without neurofibromatosis type 1
Virna M Shah, Sukumar Sharanya
May-August 2016, 28(2):137-138
DOI:10.4103/kjo.kjo_2_17  
We report a rare case of atypical large bilateral malignant optic nerve glioma in a child with no clinical evidence of neurofibromatosis.
  2,855 169 -
Trabeculectomy with scleral patch graft for advanced glaucoma in ehler–danlos syndrome
Dhanya Cheriyath, Shabana Bharathi, Ganesh V Raman
May-August 2016, 28(2):142-144
DOI:10.4103/kjo.kjo_32_16  
We report a case of secondary glaucoma in Ehler–Danlos syndrome (EDS) Type VI, which was uncontrolled with maximal medical therapy, and was subsequently managed surgically. EDS comprises a subgroup of heritable connective tissue disorders characterized by generalized joint hypermobility, skin hyperextensibility, and tissue fragility. The surgical challenges in these patients are presence of scleral thinning, vascular fragility, and poor wound healing. Surgical intervention such as trabeculectomy in EDS has not been reported in the literature. With this case report, we share our trials and tribulations in managing this patient with trabeculectomy without antimetabolites, with unexpected modification in the surgery and success.
  2,777 192 1
GUEST EDITORIAL
Infectious uveitis – A challenge to ophthalmologists
Ranju Kharel, Jyotirmay Biswas
May-August 2016, 28(2):86-87
DOI:10.4103/kjo.kjo_27_16  
  2,387 241 -
ORIGINAL ARTICLES
Ocular open globe injuries at workplace among domestic migrant laborers in the Angamaly–Perumbavoor belt of Kerala
Sanitha Sathyan, Dona Davis
May-August 2016, 28(2):120-124
DOI:10.4103/kjo.kjo_1_17  
Aim: To analyze the pattern of workplace ocular open globe injuries affecting domestic migrant laborers (DML) in the Angamaly–Perumbavoor belt of Ernakulam district. Materials and Methods: Retrospective analysis of medical records of migrant laborers who suffered from ocular open globe injuries sustained at workplace and treated at a tertiary care ophthalmic hospital during the period June 2011 to June 2016 was performed. Results: Fifty eyes of 48 DML in the Angamaly–Perumbavoor belt, with ocular open globe injuries sustained at workplace were included in the study. Mean age of the participants was 27.18 ± 8.5 years. Fifteen (30%) patients belonged to the 18–22 age group; 13 (26%) belonged to the 22–26 age group. Most common mode of open globe injury was injury with flying metal piece (46%) followed by injury with stone (36%). Thirty-eight (74%) had rupture of globe, 10 (20%) had penetrating injury, 2 (4%) patients had intraocular foreign body, and 1 (2%) had perforating injury. According to the Ocular Trauma Score Classification, 30 (61%) had Zone 1 injuries, 14 (29%) had Zone 2 injuries, and 5 (10%) had Zone 3 injuries. Grade 3 injuries accounted for 23 (46%) cases, followed by Grade 4 injuries in 16 (32%). The follow-up data and long-term visual outcomes of ocular globe injury in DML could not be analyzed as there was a high percentage of patients who were lost to follow up. Twenty-nine (58%) were of patients who were lost to follow-up after 1 month post surgery, 16 (32%) patients were lost to follow-up after 3 months, and follow up records beyond 6 months were available only for 5 (10%) patients. Conclusion: The prevalence of open globe injuries among migrant labourers in Kerala is high. The clinical findings indicate that most of them are serious sight threatening injuries. Socioeconomic and legal factors involved in these cases need to be addressed.
  2,404 174 -
CASE REPORTS
Vertebrobasilar dolichoectasia
V Babitha, C Prasannakumari, KV Raju
May-August 2016, 28(2):139-141
DOI:10.4103/kjo.kjo_33_16  
Dolichoectasia is the increase in the length and diameter of vessels. It is a rare disease effectin g major vessels. For an ophthalmologist awareness of this entity is important to avoid unwanted investigation since this disease present as external ophthalmoplegia.
  2,399 157 -
PHOTO ESSAY
Imaging features of orbital hemangioma
Reddy Ravikanth
May-August 2016, 28(2):148-149
DOI:10.4103/kjo.kjo_28_16  
  2,373 181 -
INNOVATION
Innovations in management of optic nerve head pit associated maculopathy
Smita S Karandikar, Parag K Shah
May-August 2016, 28(2):131-132
DOI:10.4103/kjo.kjo_20_16  
Management of chronic macular edema following optic nerve head pit has always been challenging. There are many treatment options available but none are universally accepted. In this article we present the newer techniques available for management of this disease.
  2,318 197 -
DIAGNOSTIC AND THERAPEUTIC CHALLENGES
Optic disc maculopathy
Awaneesh Upadhyay, Ashok Nataraj
May-August 2016, 28(2):133-136
DOI:10.4103/kjo.kjo_14_17  
  2,297 182 -
EDITORIAL
Setting new goals
Ashok Nataraj
May-August 2016, 28(2):85-85
DOI:10.4103/kjo.kjo_7_17  
  2,248 190 -
JOURNAL REVIEW
Journal Review
R Jyothi
May-August 2016, 28(2):150-152
DOI:10.4103/kjo.kjo_34_16  
  1,961 152 -
SPOT DIAGNOSIS
Autofluorescence of optic disc
Amit Mohan
May-August 2016, 28(2):153-153
DOI:10.4103/kjo.kjo_29_16  
  1,728 157 -