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Purpose: The purpose of this article is to study the factors affecting postoperative alignment in patients of infantile esotropia with deviation more than or equal to 30 prism diopter (PD) after 12 weeks of follow-up. Materials and Methods: A total of 23 patients with infantile esotropia were included in this study over a period of 18 months. All the patients were assessed preoperatively and postoperatively at day 1, 3rd week, 6th week, and 12th week. The patients underwent horizontal muscle surgery alone or vertical combined with horizontal muscle surgery wherever required. All surgeries were planned and performed according to W.E. Scott table by a limbus-based approach. Results: Mean age of our study population was 13.36 ± 8.0 years (1.5–30 years). Fifteen (65.2%) patients were hypermetropic, 5 (21.7%) patients were emmetropic and 3 (13.1%) were myopic. Among the study participants, amblyopia was present in 13 patients (56.6%). The mean preoperative horizontal deviation was 48.04 PD ± 13.3 PD (range = 30–70 PD). Eleven patients had preoperative esotropia of >50 PD and 12 had <50 PD. The mean postoperative horizontal deviation was 5.1 ± 3.1 PD (range = 2–14 PD). Twenty-one (91.30%) patients had orthophoria, 2 (8.70%) patients had residual esotropia and none had overcorrection. Conclusion: The postoperative alignment was not influenced by age at the time of surgery (P = 0.67) and magnitude of preoperative deviation (P = 0.67) Further, the postoperative outcome was independent of the laterality of surgery (unilateral vs. bilateral, P = 0.6) and extraocular muscles operated (horizontal vs. combined horizontal and vertical, P = 0.537).

Purpose: To evaluate the correlation of Meiboscale with symptom score (Ocular Surface Disease Index [OSDI]) and meibomian gland dysfunction (MGD) sign score. Methods: We performed a cross-sectional hospital-based study of 53 patients of primary MGD who filled the OSDI questionnaire form and underwent complete ocular examination. The MGD sign score was calculated in both eyes using the sum of six grading systems proposed by Arita et al . in 2016. The participants underwent imaging of the upper and lower eyelids of both eyes (212 eyelids) by specular microscope. The area of meibomian gland loss (MGL) was visually assessed and scored using the Meiboscale photographic card. Correlation between these three values – OSDI score, sign score, and MGL score based on Meiboscale - was calculated using Spearman’s correlation analysis and Jonckheere–Terpstra (J–T) test. Correlation coefficient r s > 0.5 was considered clinically significant. Results: Associations between MGL score and OSDI score, as well as between OSDI and sign score were statistically significant, but not clinically significant ( r s = 0.3684, P < 0.001 and r s = 0.41179, P < 0.001, respectively). The association between MGL score and MGD sign score was statistically as well as clinically significant ( r s = 0.8392, P < 0.001). J–T test revealed large effect size ( P < 0.001, r -effect = 0.93). Conclusion: The Meiboscale card had not been tested for utility in the Indian outpatient setting yet. Meiboscale can be used for reliable assessment and grading of MGD, and has clinical utility similar to the sum of six MGD sign scores. Additionally, assessment of symptoms using OSDI or a similar questionnaire is also recommended.