Acanthi amoeba keratitis presents as diagnostic dilemma as it mimics herpes simpex viral keratiti... more Acanthi amoeba keratitis presents as diagnostic dilemma as it mimics herpes simpex viral keratitis. It is also a diagnostic challenge due to lack of awareness, difficulty in diagnosis which requires strong clinical suspicion and lack of effective treatment further complicates its management. We report a case of 47years old female with pain, redness and watering having deep stoma ring infiltrates. The strong suspicion based on clinical findings and failure to respond to antiviral therapy prompted us to investigate her further and the diagnosis of acanthi amoeba keratitis was made although there was no history of contact lens wear. Inspite of full diagnostic work up for bacterial, fungal and viral corneal pathogen, the diagnosis of Acanthi amoeba can be easily missed, therefore one must keep the possibility of this rare entity.
Journal of Clinical & Experimental Ophthalmology, 2021
We all have become slaves to our mobile phones for most of our daily activities which directly or... more We all have become slaves to our mobile phones for most of our daily activities which directly or indirectly has hazardous impact on our health and lives especially for vision. Although blast injuries are common with war, cooking gas and firecracker, but in last couple of years, mobile phone blast cases also popularly known as “BOMBILE” (Blast of Mobile Battery in Living Eye) are coming up which are time to time reported on internet and in scientific journals. We present a case series of 3 patients presented with phone battery explosion which highlights how this technology driven device created to make our lives easier can be a menace and why there is an urgent need to create awareness in society for their safe and proper handling.
Purpose: To study intraocular pressure of natives of high altitude versus low altitude at Indira ... more Purpose: To study intraocular pressure of natives of high altitude versus low altitude at Indira Gandhi Medical College Shimla in the hilly terrain of Himachal Pradesh. Methods: A hospital based prospective observational study was conducted from July2017 to June2018 in the ophthalmology department at Indira Gandhi Medical College Shimla. Total of 200 healthy subjects underwent IOP measurement using Huvitz non contact tonometer. Of the 200 subjects, 100 subjects residing at a height, greater than 2000m above the sea level were included in the study group (cases), 100 subjects residing at a height of less than 2000m above the sea level were included in the control group. Results: The study population consisted of 200 healthy subjects from 30 to 69 years of age. There were 49 males and 51 females were in the both the groups. IOP measurements was done in all cases and controls. IOP of both eyes of all subjects were taken. The mean IOP of cases for right and left eye was 12.51±1.60 and 1...
Purpose: To study the incidence and risk factors of retinopathy of prematurity at Indira Gandhi M... more Purpose: To study the incidence and risk factors of retinopathy of prematurity at Indira Gandhi Medical College Shimla and Kamla Nehru State Hospital For Mother & Child Shimla in the hilly terrain of Himachal Pradesh. Methods: A hospital based prospective observational study was conducted from July2014 to June2015at neonatal intensive care unit and ophthalmology unit at Indira Gandhi Medical College Shimla and Kamla Nehru State Hospital For Mother & Child Shimla. 92 babies admitted to the neonatal unit who were ≤ 1750gms or whose gestation was ≤ 34 weeks were examined by an ophthalmologist by indirect ophthalmoscope at 4 weeks postnatal age. Results: Out of 92 babies screened 22 babies developed ROP. The incidence of ROP was 23.92%.Out of 22 babies who developed ROP 8 (36.36%) had stage 1, 6 (27.27%) had stage 2, 7 (31.81%) had stage 3, 1 (4.54%) had APROP, 1 (4.54%) had preplus disease and 2 (9.09%) had plus disease. On univariate analysis birth weight, gestational age, oxygen admi...
1 M..B.B.S,M.S.Ophthalmology, medical officer DDUZH Shimla 2 M..B.B.S,M.S.General Surgery, Medica... more 1 M..B.B.S,M.S.Ophthalmology, medical officer DDUZH Shimla 2 M..B.B.S,M.S.General Surgery, Medical Officer, C.H.Theog 3 M.B.B.S,M.S.Ophthalmology, Associate Professor, Department of Ophthalmology, Indira Gandhi Medical College Shimla 4 M.B.B.S, M.D. Community Medicine Assistant Professor Dr Radhakrishnan Government Medical College, Hamirpur 5 M.B.B.S, M.S General Surgery, Medical Officer, C.H.Theog *Corresponding author: Dr.Seema
Rhizomelic chondrodysplasia punctata (RCDP) is an autosomal recessive disorder of peroxisomal met... more 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.
Background: Dry eye is a multifactorial, heterogeneous disorder of the preocular tear film becaus... more Background: Dry eye is a multifactorial, heterogeneous disorder of the preocular tear film because of tear deficiency or excessive tear evaporation. Many patients who have undergone cataract surgery have complained of dry eyes postoperatively. The aim of this study was to evaluate the incidence and severity pattern of dry eye after clear corneal phacoemulsification. Design: Cohort Follow up study. Materials and Methods: 140 uncomplicated cataract patients coming to Indira Gandhi Medical College and Hospital, Shimla were selected for study. Dry eye incidence and pattern were analyzed preoperatively and at days 1, 7, 30 and 60 after phacoemulsification using Results: The incidence and severity of dry eye peaked at seven days post-phacoemulsification and was measured by OSDI questionnaire and all four clinical tests. Within 30 days and 2 months post-surgery, both the symptoms and signs showed rapid and gradual improvements respectively. Conclusion: The incidence of dry eye after phacoe...
As possession of a mobile phone becomes ubiquitous in the general population, its hazards, especi... more As possession of a mobile phone becomes ubiquitous in the general population, its hazards, especially for vision, should be better known and understood. Although blast injuries are common in war, gas cooking and with firecrackers, mobile phone blasts, popularly known as BOMBILE (Blast of Mobile Battery in the Living Eye), are becoming more and more frequent. We present three cases phone battery explosion diagnosed with ocular surface burn. Although none had severe injuries and vision was salvageable and no visual or cosmetic impairment resulted, this may not always be so. Public education, producer liability, and better technological solutions are urgently required to lessen the risks.
Ocular trauma accounts for a significant proportion of cases in any emergency eye outpatient depa... more Ocular trauma accounts for a significant proportion of cases in any emergency eye outpatient department. There are very few cases reporting ocular injuries after leech exposure. Leeches are annelids belonging to the subclass Hirudinea; they dwell in fresh water and the sea and can be terrestrial. An oral sucker present anteriorly helps to attach to the host by releasing an anesthetic that prevents its recognition as a foreign body. Although many methods of leech removal have been proposed, its removal with forceps after instillation of local anesthetic remains a safe and effective method.
Intermittent distance exotropia is a deviation characterized by an exophoria at near fixation and... more Intermittent distance exotropia is a deviation characterized by an exophoria at near fixation and manifest exotropia at distance fixation. There is normal binocular fusional vergence and stereoacuity at near fixation, but the eyes tend to diverge in bright sunlight, tiredness, day dreaming and the patient may close one eye in such circumstances. Prematurity is associated with numerous eye pathology, besides retinopathy of prematurity, amblyopia, refractive errors, it is also associated with a higher risk esotropia and exotropia. We report a case of a 5-year-old girl (preterm and very low birth weight) with an intermittent deviation of both eyes since three years. On her detailed ocular examination diagnosis of divergence excess intermittent exotropia with normal accommodative convergence to accommodation ratio was made. Bilateral lateral rectus recession was done using hang back technique. Postoperatively, the eyes were aligned normally thereby achieving orthotropia. This article reviews various neurophysiological aspects of intermittent divergent squint delineating the etiopathogenesis, classification system, and management options in intermittent exotropia.
Acanthi amoeba keratitis presents as diagnostic dilemma as it mimics herpes simpex viral keratiti... more Acanthi amoeba keratitis presents as diagnostic dilemma as it mimics herpes simpex viral keratitis. It is also a diagnostic challenge due to lack of awareness, difficulty in diagnosis which requires strong clinical suspicion and lack of effective treatment further complicates its management. We report a case of 47years old female with pain, redness and watering having deep stoma ring infiltrates. The strong suspicion based on clinical findings and failure to respond to antiviral therapy prompted us to investigate her further and the diagnosis of acanthi amoeba keratitis was made although there was no history of contact lens wear. Inspite of full diagnostic work up for bacterial, fungal and viral corneal pathogen, the diagnosis of Acanthi amoeba can be easily missed, therefore one must keep the possibility of this rare entity.
Journal of Clinical & Experimental Ophthalmology, 2021
We all have become slaves to our mobile phones for most of our daily activities which directly or... more We all have become slaves to our mobile phones for most of our daily activities which directly or indirectly has hazardous impact on our health and lives especially for vision. Although blast injuries are common with war, cooking gas and firecracker, but in last couple of years, mobile phone blast cases also popularly known as “BOMBILE” (Blast of Mobile Battery in Living Eye) are coming up which are time to time reported on internet and in scientific journals. We present a case series of 3 patients presented with phone battery explosion which highlights how this technology driven device created to make our lives easier can be a menace and why there is an urgent need to create awareness in society for their safe and proper handling.
Purpose: To study intraocular pressure of natives of high altitude versus low altitude at Indira ... more Purpose: To study intraocular pressure of natives of high altitude versus low altitude at Indira Gandhi Medical College Shimla in the hilly terrain of Himachal Pradesh. Methods: A hospital based prospective observational study was conducted from July2017 to June2018 in the ophthalmology department at Indira Gandhi Medical College Shimla. Total of 200 healthy subjects underwent IOP measurement using Huvitz non contact tonometer. Of the 200 subjects, 100 subjects residing at a height, greater than 2000m above the sea level were included in the study group (cases), 100 subjects residing at a height of less than 2000m above the sea level were included in the control group. Results: The study population consisted of 200 healthy subjects from 30 to 69 years of age. There were 49 males and 51 females were in the both the groups. IOP measurements was done in all cases and controls. IOP of both eyes of all subjects were taken. The mean IOP of cases for right and left eye was 12.51±1.60 and 1...
Purpose: To study the incidence and risk factors of retinopathy of prematurity at Indira Gandhi M... more Purpose: To study the incidence and risk factors of retinopathy of prematurity at Indira Gandhi Medical College Shimla and Kamla Nehru State Hospital For Mother & Child Shimla in the hilly terrain of Himachal Pradesh. Methods: A hospital based prospective observational study was conducted from July2014 to June2015at neonatal intensive care unit and ophthalmology unit at Indira Gandhi Medical College Shimla and Kamla Nehru State Hospital For Mother & Child Shimla. 92 babies admitted to the neonatal unit who were ≤ 1750gms or whose gestation was ≤ 34 weeks were examined by an ophthalmologist by indirect ophthalmoscope at 4 weeks postnatal age. Results: Out of 92 babies screened 22 babies developed ROP. The incidence of ROP was 23.92%.Out of 22 babies who developed ROP 8 (36.36%) had stage 1, 6 (27.27%) had stage 2, 7 (31.81%) had stage 3, 1 (4.54%) had APROP, 1 (4.54%) had preplus disease and 2 (9.09%) had plus disease. On univariate analysis birth weight, gestational age, oxygen admi...
1 M..B.B.S,M.S.Ophthalmology, medical officer DDUZH Shimla 2 M..B.B.S,M.S.General Surgery, Medica... more 1 M..B.B.S,M.S.Ophthalmology, medical officer DDUZH Shimla 2 M..B.B.S,M.S.General Surgery, Medical Officer, C.H.Theog 3 M.B.B.S,M.S.Ophthalmology, Associate Professor, Department of Ophthalmology, Indira Gandhi Medical College Shimla 4 M.B.B.S, M.D. Community Medicine Assistant Professor Dr Radhakrishnan Government Medical College, Hamirpur 5 M.B.B.S, M.S General Surgery, Medical Officer, C.H.Theog *Corresponding author: Dr.Seema
Rhizomelic chondrodysplasia punctata (RCDP) is an autosomal recessive disorder of peroxisomal met... more 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.
Background: Dry eye is a multifactorial, heterogeneous disorder of the preocular tear film becaus... more Background: Dry eye is a multifactorial, heterogeneous disorder of the preocular tear film because of tear deficiency or excessive tear evaporation. Many patients who have undergone cataract surgery have complained of dry eyes postoperatively. The aim of this study was to evaluate the incidence and severity pattern of dry eye after clear corneal phacoemulsification. Design: Cohort Follow up study. Materials and Methods: 140 uncomplicated cataract patients coming to Indira Gandhi Medical College and Hospital, Shimla were selected for study. Dry eye incidence and pattern were analyzed preoperatively and at days 1, 7, 30 and 60 after phacoemulsification using Results: The incidence and severity of dry eye peaked at seven days post-phacoemulsification and was measured by OSDI questionnaire and all four clinical tests. Within 30 days and 2 months post-surgery, both the symptoms and signs showed rapid and gradual improvements respectively. Conclusion: The incidence of dry eye after phacoe...
As possession of a mobile phone becomes ubiquitous in the general population, its hazards, especi... more As possession of a mobile phone becomes ubiquitous in the general population, its hazards, especially for vision, should be better known and understood. Although blast injuries are common in war, gas cooking and with firecrackers, mobile phone blasts, popularly known as BOMBILE (Blast of Mobile Battery in the Living Eye), are becoming more and more frequent. We present three cases phone battery explosion diagnosed with ocular surface burn. Although none had severe injuries and vision was salvageable and no visual or cosmetic impairment resulted, this may not always be so. Public education, producer liability, and better technological solutions are urgently required to lessen the risks.
Ocular trauma accounts for a significant proportion of cases in any emergency eye outpatient depa... more Ocular trauma accounts for a significant proportion of cases in any emergency eye outpatient department. There are very few cases reporting ocular injuries after leech exposure. Leeches are annelids belonging to the subclass Hirudinea; they dwell in fresh water and the sea and can be terrestrial. An oral sucker present anteriorly helps to attach to the host by releasing an anesthetic that prevents its recognition as a foreign body. Although many methods of leech removal have been proposed, its removal with forceps after instillation of local anesthetic remains a safe and effective method.
Intermittent distance exotropia is a deviation characterized by an exophoria at near fixation and... more Intermittent distance exotropia is a deviation characterized by an exophoria at near fixation and manifest exotropia at distance fixation. There is normal binocular fusional vergence and stereoacuity at near fixation, but the eyes tend to diverge in bright sunlight, tiredness, day dreaming and the patient may close one eye in such circumstances. Prematurity is associated with numerous eye pathology, besides retinopathy of prematurity, amblyopia, refractive errors, it is also associated with a higher risk esotropia and exotropia. We report a case of a 5-year-old girl (preterm and very low birth weight) with an intermittent deviation of both eyes since three years. On her detailed ocular examination diagnosis of divergence excess intermittent exotropia with normal accommodative convergence to accommodation ratio was made. Bilateral lateral rectus recession was done using hang back technique. Postoperatively, the eyes were aligned normally thereby achieving orthotropia. This article reviews various neurophysiological aspects of intermittent divergent squint delineating the etiopathogenesis, classification system, and management options in intermittent exotropia.
Uploads
Papers by praveen panwar