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   Table of Contents - Current issue
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July-December 2019
Volume 11 | Issue 2
Page Nos. 35-67

Online since Monday, March 9, 2020

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ORIGINAL ARTICLES  

Relationship between dry eye syndrome and occupational categories p. 35
Amina Tarig Mohamed Ahmed Sharief
DOI:10.4103/sjopthal.sjopthal_19_19  
Background: Dry eye syndrome is a broad clinical term that is used to describe a variety of ocular conditions that are characterized by ocular irritation and discomfort secondary to decreased tear production or increased tear evaporation. It is highly prevalent, with almost 1/3 of ophthalmic patients presenting with DES-related symptoms. Many risk factors were linked to the development of DES, including occupation-related risk factors. Aims and Objectives: This study was a cross-sectional study aimed at identifying the association between dry eye syndrome and various occupational categories to determine the occupation-specific risk factors in patients attending the corneal outpatient clinics of Khartoum Eye Teaching Hospital. Materials and Methods: Data were collected from all patients aging 25-50 years who presented with DES-related symptoms and had a positive Schirmer's test. A questionnaire was used in the data collection process. The data were analyzed using SPSS 20. Results: Among the 450 participants, 279 were females (62%). About 140 patients were white-collar workers (31.1%), 134 were blue-collar workers (67 skilled and 67 unskilled; constituting 29.8%), 112 were green-collar workers (24.9%) and the remaining 64 patients were unemployed. (14.2%) An increased risk (in comparison to the unemployed group) was observed for the white-collar (highest risk), blue-collar and green-collar (lowest risk) categories. (P-value < 0.05) Additionally, a highly significant association was noted between the female sex, computer use, and outdoor occupations. (P-value = 0.000) Conclusion: There is an increased risk of developing dry eye syndrome in the various occupational categories. Furthermore, females, computer users, and outdoor workers are also at high risk.
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Effect of mesopic pupil size on aberrometric outcomes after femtolaser-assisted intracorneal ring implantation in keratoconus p. 42
Amr Mounir, Engy Mohamed Mostafa
DOI:10.4103/sjopthal.sjopthal_29_19  
Purpose: This study aimed to evaluate the effect of mesopic pupil size on corneal high-order aberrations in keratoconic eyes implanted with femtosecond laser-assisted intracorneal ring segments (ICRS) implantation procedure. Design: The study design involves a retrospective, consecutive case series. Patients and Methods: A total of 160 consecutive eyes of 133 patients with the diagnosis of keratoconus (93 eyes with keratoconus Grade 2 and 67 with keratoconus Grade 3) were included in the study. Keraring (Mediphacos, Belo Horizonte, Brazil) implantations were performed using femtosecond-assisted laser in Sohag Refractive Center, Sohag, Egypt, between September 2015 and September 2017. Pupil size and anterior corneal aberrations were measured by Scheimpflug placido topography (Sirius, CSO, Italy). Results: There were statistically significant changes between corneal aberrations preoperatively and postoperatively in both groups. Mesopic pupil size had no significant correlation with all corneal aberrations. Conclusion: Mesopic pupil size did not prove to be affecting corneal aberrations after femtosecond laser-assisted ICRS implantation for keratoconus.
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Suture related astigmatism after penetrating keratoplasty p. 48
Anuradha Raj, Renu Dhasmana, Harsh Bahadur
DOI:10.4103/sjopthal.sjopthal_20_19  
Purpose: The purpose of the study was to evaluate the influence of various factors on the astigmatism before and after suture removal after penetrating keratoplasty. Methods: This observational study was conducted in which we reviewed retrospectively the records of 51 eyes of 50 patients who underwent PK for optical purposes in between March 2013 to February 2016. Various recipient parameters like age, sex, lens status , indications of PK, grading and size of recipient graft, pre and post suture removal (SR), best-corrected visual acuity (BCVA) refractive and keratometric astigmatism(KA) with axis, central corneal thickness(CCT), IOP, and graft clarity were noted. Results: Average age of the recipient was 51.16±18.53 years. Major indication of PK was corneal opacity in 47 (54.02%). B+ grade and graft size of ≥8 mm was used in maximum cases 79 (90.80%), 50 (57.47%) respectively. Pre SR refractive and KA were 4.85±1.04D and 5.24±1.08D respectively and post SR refractive and KA were 2.56±0.74D and 2.87±0.80D respectively. Pre SR in maximum cases 67 (77.01%) refractive astigmatism was seen with in 3-6 D and post SR maximum cases 53 (60.91%) were seen with refractive astigmatism <3 D. Indications of PK showed significant relationship with KA before SR with p value of 0.01. Size of graft showed significant relationship with pre SR refractive astigmatism, pre and post SR KA (P = 0.00,0.00,0.00) respectively. Conclusion: Indications of PK and size of the graft influence astigmatism both pre and post SR after PK.
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Patterns of uveitis at a tertiary care hospital in Kolkata, Eastern India p. 54
Sabyasachi Bandyopadhyay, Anil Kumar Ghanta, Aparna Mandal
DOI:10.4103/sjopthal.sjopthal_31_19  
Purpose: The purpose of this study is to study the pattern of uveitis at a tertiary care hospital in Eastern India. Materials and Methods: This is a prospective study of new cases of uveitis attending our tertiary care hospital in Kolkata, Eastern India, from July 1, 2016, to June 30, 2019. Data regarding patient demographic profile, clinical features, anatomical locations, and etiological diagnosis were evaluated. Results: Among 331 patients, 142 (42.9%) were male and 189 (57.1%) were female (P < 0.05). The mean age at uveitis onset was 32.4 ± 21.13 years (range: 5–61 years). Uveitis was mostly unilateral (77.64%) and nongranulomatous (85.2%). A specific etiology was identified in 187 patients (56.5%). Anterior uveitis was the most common form (183 patients; 55.29%), followed by posterior uveitis (79 patients; 23.87%), panuveitis (51 patients; 15.4%), and intermediate uveitis (18 patients; 5.44%). The most common cause of anterior uveitis was idiopathic (92 cases; 50.27%), followed by seronegative spondyloarthropathy (25 cases; 13.66%). In intermediate uveitis, a specific diagnosis was obtained in eight (44.45%) cases. Presumed tuberculosis, sarcoidosis, and seronegative spondyloarthropathy were among the specific etiological causes. In posterior uveitis, toxoplasmosis was the leading etiological cause (18 cases; 22.78%), followed by presumed tuberculosis and Behçet's disease. In panuveitis cases, a specific diagnosis was established in 33 cases (64.71%). The most common etiology was Behçet's disease (11 cases; 21.57%), followed by Vogt–Koyanagi–Harada disease and presumed tuberculosis. Conclusion: Anterior uveitis was the most common form of uveitis. A specific etiology was found in 56.5% of cases. Behçet's disease, seronegative spondyloarthropathy, presumed tuberculosis, and toxoplasmosis were the leading causes of uveitis.
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CASE REPORTS Top

A rare case of unilateral morning glory disc anomaly in a patient with turner syndrome p. 59
Abdi Rhizlane, Siham Chariba, Maadan Asmae, Sekhsoukh Rachid
DOI:10.4103/sjopthal.sjopthal_23_19  
Turner syndrome (TS) is caused by haploinsufficiency or structural anomaly of the X-chromosome in females. The chromosomal anomaly may affect all cells or some of them, as a form of mosaicism. The most common eye disorders detected in this syndrome include strabismus, ptosis, epicanthal folds, red–green color deficiency, nystagmus, keratoconus, anterior chamber dysgenesis, or bilateral eyelid edema related to lymphatic circulation disorders. Patients with TS may also experience the formation of drusen at the fundus of the eye, vascular lesions, or retinal detachment. We report the case of a girl with unilateral morning glory disc anomaly who had karyotype consistent with TS mosaicism.
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Reconstructing the socket p. 62
Santanu Das, Nayana Nagesh, Raghuraj Hegde
DOI:10.4103/sjopthal.sjopthal_26_19  
A 23-year-old male patient presented with a history of trauma to his right eye with a stick at the age of 1 year for which enucleation was done. No prosthesis was placed at that time. On examination, right eye fornices were contracted. Dermis fat grafting (DFG) with fornix formation sutures (FFS) was done. Postoperatively, there was shrinking of the inferior fornix. Buccal mucosal grafting with amniotic membrane grafting and inferior FFS was done. Postoperatively, the inferior fornix was well-formed. After 8 weeks, prosthesis was placed which fitted perfectly and gave good cosmetic results. Late presenting contracted anophthalmic sockets are difficult to manage. DFG takes care of both surface and volume deficit in an adult anophthalmic socket. When DFG is combined with FFS followed by a good ocular prosthesis, one can achieve excellent prosthesis even in such challenging cases.
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Rhizomelia: A rare cause of congenital cataract p. 65
Praveen Kumar Panwar, Champa Panwar, Tarun Sood
DOI:10.4103/sjopthal.sjopthal_27_19  
Rhizomelic chondrodysplasia punctata (RCDP) is an autosomal recessive disorder of peroxisomal metabolism characterized by skeletal deformities, cataract, growth retardation, and psychomotor retardation. We report a case of a 4½-year-old female child with complaints of limping and whitish discoloration of the right eye. On the basis of her clinical examination and radiological investigation, she was diagnosed with RCDP. We operated the child for congenital cataract, and posterior chamber intraocular lens (PCOL) was implanted. The rarity of this disorder has prompted us to report this case. Although there is no cure for this disorder, symptomatic and supportive treatment can improve the quality of life in these patients.
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