BACKGROUND The success rate of endonasal dacryocystorhinostomy with the modified flap technique is almost equivalent to that of external dacryocystorhinostomy. In the initial period, the nasal mucosal flap was excised in endoscopic endonasal dacryocystorhinostomy and the ridge of the bony ostium is left uncovered. This leads to outgrowth of the bony ostium which is the commonest cause for failure in endonasal dacryocystorhinostomy. In our modified technique, we have covered the bony ridge with nasal mucosal flap to prevent bony outgrowth and closure of the ostium. The study was performed to evaluate the improvement in success rate following modified mucosal flap technique in endoscopic endonasal dacryocystorhinostomy (DCR).

BACKGROUND Eye disorders in children with different presentations come to Ophthalmology OPD. Early detection and treatment of ocular morbidity is important. This study aimed to detect the prevalence and pattern of common ophthalmic problems in paediatric age group, in a rural based tertiary care hospital. MATERIALS AND METHODS Study design was observational, retrospective review of all children less than 12 yrs. old, who came to the rural based Chengalpattu Government medical college Ophthalmology OPD, between September 2015 and May 2016. Data collection and analysis was based on the age of presentation of both sexes (newborn (0-28 days), infants (1 year), preschool (1-5 years), school going (above 5 years)) from rural and semi-rural areas and diagnosis were analysed using graph pad prism 5.0. 'P value' less than 0.05 was considered statistically significant. RESULTS During the study period, out of total 2520 OP cases (100%), 230 children (10.95%) were evaluated. The male: Female ratio was 1.1:1. The children from school going age constituted the largest group, male (48 .4%) & Female (51.5%) (p<0.001). Children from semi-rural area constituted (55%) and rural area constituted (45%). Defective vision (26%) was the common complaint, eye discharge accounts for (20%), and lid swelling accounts for (11.3 %). Common conditions were refractive error (26%), Conjunctivitis (20%), Lid Inflammations (11.3%), and Injuries for (10.3%). Refractive Error was common in females (53.3%) and in school going children (60 %). Myopia (85%) was the common refractive error. Conjunctivitis was seen more in males (52.17%) and less in females (47.8%). In preschool age group conjunctivitis was common. CONCLUSION The common childhood eye diseases observed in our study is refractive error. This has led to poor scholastic performance in school and absenteeism. Health Education & Environmental Hygiene will help in managing most of these eye disorders.

BACKGROUNDThe epidemiological study of diabetic maculopathy in Indian population for the period of three years duration and study the treatment outcome following laser photocoagulation for various type of diabetic maculopathy. MATERIALS AND METHODSThe study was conducted from July 2000 to November 2002 in 96 eyes of 50 patients. Diabetic patients either referred or detected at GOH are taken into study. History regarding onset, duration, family history, drug schedule and dietary habits. Associated systemic factors HT, IHD, renal diseases are recorded. Patients are tested for BCVA using Snellen's chart, IOP using Goldmann applanation tonometer, slit lamp examination, fundus examination using direct and indirect ophthalmoscope and 90D biomicroscopy. Fundus photography taken using fundus camera. FFA done in all cases. RESULTS32 patients were above 50 years of age and 18 patients are below 50 years of age. The ratio of male-to-female is 2.85:1 and 92% of patients have bilateral involvement. 28% of patients with maculopathy had diabetes mellitus of 6-10 years duration and 24% of patients had 11-15 years duration. 18.7% cases had clinically significant macular oedema. In FFA study showed 44.8% had focal lesions, 34.4% had diffuse lesions and 28.8% had ischaemic lesions. 76.9% of focal lesions improved with focal photocoagulation and 50% of diffuse lesions improved with grid photocoagulation.

BACKGROUNDChildhood blindness constitutes a burden on the economy of the country and produces psychosocial and emotional disturbance to the child and family at large. Similar to the visual impairment produced by vitamin deficiency state in children, ocular injuries form another group which if identified early and treated promptly can reduce irreversible damage. Eye injuries are responsible for the large scale ocular morbidity worldwide. At extremes of age, the incidence of eye injuries are common because of the negligence in their care.The aim of the study is to determine the prevalence, various mechanisms, agents of injury and environmental influence causing eye injuries in children brought to Ophthalmic Outpatient Department of Chengalpattu Medical College in Kanchipuram District, Tamilnadu. MATERIALS AND METHODSA retrospective review of medical records of 230 children who attended Ophthalmic Outpatient in Chengalpattu Medical College Hospital between 01.09.2015 to 30.09.2016. Records of children of both genders between the age group of (0 to 12) years who attended the Ophthalmic Outpatient Department with history of ocular injury coming from both rural and urban areas of the district. Their data was collected and analysed and tabulated based on demography, mechanism and place of injury. RESULTSSchool going age groups (5-12 years), 84% sustained injuries more commonly. Children from rural areas sustained 54.7% injuries. Blunt trauma accounted for 65% injuries. 52.6% injuries occurred at home. 41.7% were due to stick and wood. Children were admitted to hospital for a mean of 4 days, range (1-25 days), 96% >6/12 v/a, 3% children had v/a (6/18-6/60), 1% blind 6/60 vision. Bilateral blindness was not reported. 1% visual impairment registered. CONCLUSIONThis study showed that rural children suffered more ocular injuries;commonest were injuries due to sticks followed by cracker injuries. Home-based injuries were more common. Visual prognosis was good because of prompt treatment. Facilities for treatment of ocular emergencies have significantly improved in tertiary hospitals located in mofussil areas.

BACKGROUND Macula is an important portion of retina that occupies the posterior pole of retina. Any disease that affects macula results in significant loss of central vision, form vision and colour vision to an extent. Macular lesions can be hereditary as well as acquired. Macular lesions occur in both younger and older individuals. Anatomically, a macular lesions can vary from a simple lesion like an RPF defect to a vision-threatening lesions like choroidal neovascular membrane. Many screening tests that are sensitive and specific are available to assess the functioning of macula called as 'macular function test'. But, the greater understanding of the retinal vascular led to the usage of fluorescein angiogram in the detection and screening of macular, retinovascular and optic disc lesions. Through fundus fluorescein angiogram is a thirty-year-old procedure; it is still in vogue in almost all parts of the world. It has its own merits. The aim of the study is to study the role of fluorescein angiography in the evaluation of macular lesions. MATERIALS AND METHODS A hospital-based prospective randomised study was done, which included 50 patients. Detailed patient history was taken and thorough ocular and systemic examination was done. All patients were examined by ophthalmoscopy (direct and indirect) and slit-lamp examination with 90D followed by fluorescein angiography. Ophthalmoscopic and fluorescein angiography findings were analysed and categorised. Patients were advised proper ocular and systemic treatment and follow up. RESULTS 50 cases with macular lesions were analysed and categorised into conditions like ARMD, CSR, macular oedema, CME, degenerations and dystrophies and miscellaneous conditions. FFA altered the diagnosis in 8% cases and categorised the cases in all cases. 16% patients developed adverse reactions like allergy, vomiting and nausea. On statistical analysis, FFA proved to be cheap and superior diagnostic tool in confirming the lesions detected by ophthalmoscopy clinically. CONCLUSION FFA is a superior diagnostic tool even after four decades of its use in ophthalmology for evaluating, localising, confirming lesions involving macula, retinal vasculature and choroid.